Timing of prophylactic antibiotics administration and suspected systemic infection after percutaneous biliary intervention.

BACKGROUND/PURPOSE: Prophylactic antibiotics administration before percutaneous biliary intervention (PBI) is currently recommended, but the underlying evidence is mostly extrapolated from prophylactic antibiotics before surgery. The aim of this study was to evaluate the impact of prophylactic antibiotics administration timing on the incidence of suspected systemic infection after PBI. METHODS: The incidence of suspected systemic infection after PBI was compared in patients who received prophylactic antibiotics at four different time intervals between antibiotics administration and skin puncture for PBI. Suspected post-intervention systemic infection was assessed according to predetermined clinical criteria. RESULTS: There were 98 (21.6%) suspected systemic infections after 454 PBIs in 404 patients. There were significant differences among the four groups in the incidence of suspected systemic infection after the intervention (p = .020). Fever was the most common sign of suspected systemic infection. Administration of prophylactic antibiotics more than an hour before PBI was identified as an independent risk factor of suspected systemic infection after adjusting for other relevant factors (adjusted odds ratio = 10.54; 95% confidence interval, 1.40-78.86). CONCLUSIONS: The incidence of suspected systemic infection after the PBI was significantly lower when prophylactic antibiotics were administered within an hour before the intervention.

Retrospective analysis of the incidence and predictors of postoperative nausea and vomiting after orthopedic surgery under spinal anesthesia.

BACKGROUND: Postoperative nausea and vomiting (PONV) commonly occurs after spinal anesthesia; however, its incidence rate and predictors have been scarcely studied. Therefore, we aimed to investigate its incidence rate and potential predictors. METHODS: The electronic medical records of 6,610 consecutive patients undergoing orthopedic surgery under spinal anesthesia were reviewed between January 2016 and December 2020. The primary outcome was PONV incidence within 24 h after spinal anesthesia. Along with its incidence rate, we investigated its predictors using multivariable logistic regression analysis. RESULTS: Among the 5,691 patients included in the analysis, 1,298 (22.8%) experienced PONV within 24 h after spinal anesthesia. Female sex (odds ratio [OR]: 3.23, 95% CI [2.72, 3.83], P < 0.001), nonsmoker (OR: 2.12, 95% CI [1.46, 3.07], P < 0.001), history of PONV (OR: 1.52, 95% CI [1.26, 1.82], P < 0.001), prophylactic 5-hydroxytryptamine receptor antagonist use (OR: 0.35, 95% CI [0.24, 0.50], P < 0.001), prophylactic steroid use (OR: 0.53, 95% CI [0.44, 0.62], P < 0.001), baseline heart rate ≥ 60 beats/min (OR: 1.38, 95% CI [1.10, 1.72], P = 0.005), and postoperative opioid use (OR: 2.57, 95% CI [1.80, 3.67], P < 0.001), were significant predictors of the primary outcome. CONCLUSIONS: Our study showed the common incidence of PONV after spinal anesthesia and its significant predictors. A better understanding of its predictors may provide important information for its management.

Multiplexed imaging of therapeutic cells with multispectrally encoded magnetofluorescent nanocomposite emulsions.

Here, we describe the fabrication of multispectrally encoded nanoprobes, perfluorocarbon (PFC)/quantum dots (QDs) nanocomposite emulsions, which could provide both multispectral MR and multicolor optical imaging modalities. Our strategy exploited the combination of the multispectral MR properties of four different PFC materials and the multicolor emission properties of three different colored CdSe/ZnS QDs. The PFC/QDs nanocomposite emulsions were fabricated by exchanging hydrophobic ligands coated onto CdSe/ZnS QDs using 1H,1H,2H,2H-perfluorooctanethiol, which renders the QDs to be dispersible in the PFC liquids. To provide biocompatibility, the PFC liquids containing QDs were emulsified into aqueous solutions with the aid of phospholipids. The distinct (19)F-based MR images of PFC/QDs nanocomposite emulsions were obtained by selective excitation of the nanocomposite emulsions with magnetic resonance frequency of each PFC, while a specific fluorescence image of them could be selected using appropriate optical filters. The uptake of PFC/QDs nanocomposite emulsions was high in phagocytic cells such as macrophages (90.55%) and dendritic cells (85.34%), while it was low in nonphagocytic T cells (33%). We have also shown that the nanocomposite emulsions were successfully applied to differentially visualize immunotherapeutic cells (macrophages, dendritic cells, and T cells) in vivo. The PFC/QDs nanocomposite emulsions are expected to be a promising multimodality nanoprobe for the multiplexed detection and imaging of therapeutic cells both in vitro and in vivo.

Multifunctional perfluorocarbon nanoemulsions for (19)F-based magnetic resonance and near-infrared optical imaging of dendritic cells.

A novel type of bimodal imaging nanoprobe based on (19)F-based magnetic resonance imaging and near-infrared optical imaging has been synthesized and applied for the labeling and imaging of dendritic cells both in vitro and in vivo.