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10.1097/TA.0000000000000438 http://scihub22266oqcxt.onion/10.1097/TA.0000000000000438 C4266139!4266139!25494431     free     free     free Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 267.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 267.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       J+Trauma+Acute+Care+Surg 2014 ; 77 (5): 769-73 Nephropedia Template TP {{tp|p=25494431|t=2014. Clinical Relevance of Mold Culture Positivity With and Without Recurrent Wound Necrosis Following Combat-Related Injuries |pdf=|usr=}}{{25494431}} gab.com Text Clinical Relevance of Mold Culture Positivity With and Without Recurrent Wound Necrosis Following Combat-Related Injuries JO: J Trauma Acute Care Surg http://www.kidney.de/pget.php?&tw=1&pmid=25494431 #FOAvip Background: Invasive fungal wound infections (IFI) are a recognized threat for personnel who sustain combat-related blast trauma in Afghanistan. Blast trauma, particularly when dismounted, has wounds contaminated with organic debris and potential for mold infection. Trauma-associated IFI is characterized by recurrent wound necrosis on serial debridement with histologic evidence of invasive molds and/or fungal culture growth. Wounds with mold growth, but lacking corresponding recurrent necrosis present a clinical dilemma of whether to initiate antifungal treatment. Our objective was to assess the clinical significance of fungal culture growth without recurrent wound necrosis. Methods: United States military personnel wounded during combat in Afghanistan (June 2009 - August 2011) were assessed for growth of mold from wound cultures and/or histopathological evidence of IFI. Identified patients were stratified based upon clinical wound appearance (with/without recurrent necrosis) and the resultant groups were compared for injury characteristics, clinical management, and outcomes. Results: A total of 96 patients were identified: 77 with fungal elements on histopathology and/or fungal growth plus recurrent wound necrosis and 19 with fungal growth on culture but no wound necrosis after initial debridements. Injury patterns and severity were similar between the groups. Patients with recurrent necrosis had more frequent fevers and leukocytosis during the first two weeks post-injury, and the majority received antifungal therapy compared to only three (16%) patients without recurrently necrotic wounds. Overall, patients without recurrent wound necrosis had significantly less operative procedures (p=0.02), shorter length of stay in the intensive care unit (p<0.01), and lower rates of high-level amputations (5% versus 20%) and deaths (none versus 8%) despite no or infrequent antifungal use. Conclusions: The finding of molds on wound culture among patients with blast trauma in the absence of recurrently necrotic wounds on serial debridement does not require systemic antifungal chemotherapy. Twit Text FOAVip Clinical Relevance of Mold Culture Positivity With and Without Recurrent Wound Necrosis Following Combat-Related Injuries ????J Trauma Acute Care Surg http://www.kidney.de/pget.php?&tw=1&pmid=25494431 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=25494431 #FOAvip English Wikipedia <ref>{{Cite pmid|25494431}}</ref> Clinical Relevance of Mold Culture Positivity With and Without Recurrent Wound Necrosis Following Combat-Related Injuries #MMPMID25494431 Rodriguez C; Weintrob AC; Dunne JR; Weisbrod AB; Lloyd B; Warkentien T; Malone D; Wells J; Murray CK; Bradley W; Shaikh F; Shah J; Carson ML; Aggarwal D; Tribble DR J Trauma Acute Care Surg 2014[Nov]; 77 (5): 769-73 PMID25494431show ga Background: Invasive fungal wound infections (IFI) are a recognized threat for personnel who sustain combat-related blast trauma in Afghanistan. Blast trauma, particularly when dismounted, has wounds contaminated with organic debris and potential for mold infection. Trauma-associated IFI is characterized by recurrent wound necrosis on serial debridement with histologic evidence of invasive molds and/or fungal culture growth. Wounds with mold growth, but lacking corresponding recurrent necrosis present a clinical dilemma of whether to initiate antifungal treatment. Our objective was to assess the clinical significance of fungal culture growth without recurrent wound necrosis. Methods: United States military personnel wounded during combat in Afghanistan (June 2009 - August 2011) were assessed for growth of mold from wound cultures and/or histopathological evidence of IFI. Identified patients were stratified based upon clinical wound appearance (with/without recurrent necrosis) and the resultant groups were compared for injury characteristics, clinical management, and outcomes. Results: A total of 96 patients were identified: 77 with fungal elements on histopathology and/or fungal growth plus recurrent wound necrosis and 19 with fungal growth on culture but no wound necrosis after initial debridements. Injury patterns and severity were similar between the groups. Patients with recurrent necrosis had more frequent fevers and leukocytosis during the first two weeks post-injury, and the majority received antifungal therapy compared to only three (16%) patients without recurrently necrotic wounds. Overall, patients without recurrent wound necrosis had significantly less operative procedures (p=0.02), shorter length of stay in the intensive care unit (p<0.01), and lower rates of high-level amputations (5% versus 20%) and deaths (none versus 8%) despite no or infrequent antifungal use. Conclusions: The finding of molds on wound culture among patients with blast trauma in the absence of recurrently necrotic wounds on serial debridement does not require systemic antifungal chemotherapy. äClinical Relevance of Mold Culture Positivity With and Without Recurre(epmc).pdf DeepDyve Pubget Overpricing