Diabetes Mellitus

Cardiovascular Diseases

Hamad Medical Coorporation

Qatar Cardiometabolic Registry

Hamad Medical Corporation

Group A - smoking cessation with no assistance

Group B - smoking cessation with the addition of a smoking cessation patch

Focus: Smoking Cessation as it Relates to Fracture Healing

To compare the smoking cessation outcome in patients with fractures with or without the help of smoking cessation patches.

Smoking cessation patch

The Ottawa Hospital

The Ottawa Hospital- Civic campus

Smoking Cessation Intervention Within the Fracture Clinic

Spontaneous smoking cessation rates within the orthopaedic trauma population (first cohort) are presently unknown within the literature, however hypothesized to be low. The investigators anticipate a greater than 30% long term cessation rate upon implementation of this model, as compared to its previous implementation in different patient settings. A significant decrease in orthopaedic trauma complications, and long term decreased smoking related morbidity and mortality is expected. The primary outcome of this study will be a comparison of long-term smoking cessation rates between the two cohorts of patients.

Dr. J. Werier

Surgeon

Ottawa Hospital Research Institute

Osteomyelitis

UT Southwestern Medical Center

Osteomyelitis: Procalcitonin to Diagnose and Monitor Osteomyelitis (PCT)

Osteomyelitis: Procalcitonin to Diagnose and Monitor Osteomyelitis

Serial measurements of procalcitonin at Baseline, Week 3 and Week 6.

University of Texas Southwestern Medical Center

after the diagnosis of the poststernotomy wound infection is established the clinical procedure is obtained as follows: firstly the empiric antibiotic therapy with vancomycin is induced. The lab samples including bacteriology test are obtained. Surgical debridement is made until occurrence of tissue bleeding. Finally VAC sponge is implanted wit the negative suction pressure of 75 mmHg.
The patients are obtained 5 to 7 times to the surgical procedures in time intervals of 48/72 hours. Subsequently when the last three bacteriology samples are negative a delayed primary closure or rectus abdominal muscle flap may be done.

In the first step, after the diagnosis of the infection was done, and the empiric antibiotic therapy is induced with vancomycin in the first surgical intervention the sternal wires will be removed, the mediastinum is explored and extensive surgical debridement is performed until occurrence of tissue bleeding.The patients will receive treatment delivered through the VAC system in the first 48 hours following the first surgical intervention, subsequently the wound is closed.

Mediastinitis

Arm A) Secondary closure with the vacuum-assisted system (VAC); The initial surgical revision is done within 24 hours. The first revision with second look and debridement is usually made in 72 hours Subsequently in the following days the wound is stepwise revised during VAC changes.The patients are obtained 5 to 7 times to the surgical procedures in time intervals of 72 hours. Subsequently when the last three bacteriology samples are negative a delayed primary closure or rectus abdominal muscle flap may be done.
Arm B) Surgical procedure by delayed primary closure; The patients will receive treatment delivered through the VAC system in the first 48 hours following the first surgical intervention, subsequently the wound is closed. after the sternum is closed by using metallic wires, pectoral muscle on both chest parts is mobilized and closed directly over the bone.

osteomyelitis/nicitín

Qatar Cardiometabolic Registry

Smoking Cessation Intervention Within the Fracture Clinic

Osteomyelitis: Procalcitonin to Diagnose and Monitor Osteomyelitis (PCT)

Delayed Primary Versus Late Secondary Wound Closure in Sternum Infections

An bunachar luibheanna míochaine is iomláine le tacaíocht ón eolaíocht