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Hip hemiarthroplasty after displaced femoral neck fracture: a survivorship analysis

• Femoral neck fracture – broken knee joint • Total Hip Arthroplasty – Yes….better results for patients than internal fixation and hemiarthroplasty.• Some Results for age group 60 + differ from this: “0-35 % dislocation cases” – quite highREASON ? Major one is comorbidities!

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Biomarkers as a Tool for Management of Immunosuppression in Transplant Patients

•Immuno-suppressive drugs•Without immunosuppression therapy, transplatation surgery could be fatal.•Therapeutic drug monitoring – DOES NOT reflect adverse effects to immune cells.•Pharmacodynamic monitoring (biomarkers)

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Problem of infection in the ICU

•Infections possible - ventilator-associated pneumonia, catheter-associated urinary tract infection, catheter-related bloodstream infection•Need to be attentive to horizontal infection

and use proper antibiotics for multi-resistant bacteria like MRSA.

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Managing infection in the critical care unit: how can infection control make the ICU safe?

Infection Control in the ICU

Device Related Nosocomial Infection In ICU

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Ventilator Associated Pneumonia

Antibiotic Resistance Pathogens

Catheter-related Infections

Modifiable◦ Frequency of ventilator

circuit changes◦ Antibiotic usage

Nonmodifiable◦ Patient age and gender◦ Severity of illness◦ Coma

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Bronchoscopic techniques

Nonbronchoscopic techniques

Balance between initial antibiotic and overuse

Risk Factors Prevention

Decrease Infection in Neonatal Intensive Care Unit

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Long-Term Acute Care Hospital

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  VAP rate per 1,000 device days

CR-BSI rate per 1,000 device days

Year 1997 2004 2002 2004

Medical ICU 29 18 8.2 3.4

Surgical ICU Similar declines  10.5 4.5

Burn Center Similar declines  9.5 1.85

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Bundle Methodology

VAP: Ventilator-Associated PneumoniaCR-BSIs: Catheter-Related Bloodstream Infections

Pursuing perfection in fighting with VAP and CR-BSIs in ICU

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