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26 results on '"Bohnen, John M.A."'

9. Soft tissue infections and the diabetic foot

Author

Smith, Andrew J., Daniels, Timothy, and Bohnen, John M.A.

Subjects
Foot -- Ulcers, Diabetic neuropathies -- Complications, Antibiotics -- Health aspects, Health
Abstract

Soft tissue infections are classified as local or spreading. Spreading soft tissue infections are potentially life-threatening conditions, requiring prompt diagnosis and treatment. The information presented is based on a literature review and the authors' clinical experience. Diagnosis of soft tissue infections is aimed at determining the level of infection (skin, fascia, muscle) and whether necrosis is present. The bacteriology of these infections is varied and is of secondary importance. Treatment of skin infections that have no dead tissue is with antibiotics alone. Infections at the fascial or muscle level and those with necrosis at any level require surgical debridement and adjuvant antibiotics. The feet of diabetic patients are prone to planter forefoot ulcers associated with tissue destruction and infection. The vast majority are caused by mechanical factors. If local immune defenses are adequate, bacterial colonization occurs without infection. Most diabetic foot ulcers will respond to relief of pressure, which may require total contact casting. Antibiotics and debridement are required in infected or deep ulcers, or when the ulcer does not respond to total contact casting.

Published
1996

10. Pharmacodynamics of antimicrobial therapy in surgery

Author

DiPiro, Joseph T., Edmiston, Charles E., Jr., and Bohnen, John M.A.

Subjects
Anti-infective agents -- Health aspects, Pharmacokinetics -- Health aspects, Microorganisms -- Effect of antibiotics on, Aminoglycosides -- Evaluation, Health
Abstract

INTRODUCTION: 'Pharmacodynamics' refers to the relationship of drug concentrations in serum or tissues to effects on biologic systems. Concepts used to describe antimicrobial pharmacodynamics include the minimal inhibitory concentration (MIC), the minimal bactericidal concentration (MBC), and serum bactericidal titers (SBT), as well as post-antibiotic effect. METHODS: Pertinent published literature was identified through a MEDLINE search. RESULTS: Aminoglycosides have a concentration-dependent effect on bacteria killing and possess a relatively long postantibiotic effect. Given these characteristics, single-daily dosing, where the total daily dose with a traditional aminoglycoside regimen is given as one dose, may be more efficacious compared with more frequent dosing. For beta-lactam antimicrobials, bacterial killing is related to the duration of time that the free drug concentration exceeds the bacterial MIC. Beta-lactam antimicrobials have been shown to have no, or a short postantibiotic effect. Beta-lactam antimicrobials may be more effective when administered as continuous intravenous infusions. CONCLUSIONS: Pharmacodynamic variation may result from differences in drug sensitivity among individuals and the nature of the interaction between antimicrobials and microorganisms. Proper use of pharmacokinetic and pharmacodynamic principles can result in more effective and less toxic antimicrobial regimens. Am J Surg. 1996;171:615--622.

Published
1996

12. Pneumonia complicating abdominal sepsis: an independent risk factor for mortality

Author

Mustard, Robert A., Bohnen, John M.A., Rosati, Carl, and Schouten, B. Diana

Subjects
Nosocomial infections -- Risk factors, Pneumonia -- Causes of, Septicemia -- Patient outcomes, Health
Abstract

Pneumonia acquired during hospitalization (nosocomial) is the leading cause of death from hospital-acquired infection. This condition is usually caused by aspiration of gram-negative bacilli, often in patients with decreased immune defenses. A prospective study was undertaken of 300 patients with intra-abdominal abscess to compare the outcomes of patients with nosocomial pneumonia with the outcomes of patients without pneumonia but with recurrence of intra-abdominal abscess. There were 34 patients who were admitted to the hospital with pneumonia; these had a mortality of 44 percent and were excluded from the study. The mortality of 171 patients with no nosocomial pneumonia and no recurrent intra-abdominal abscess was 20 percent (34 patients). The 36 patients with recurrent abdominal abscess had a 17 percent mortality; 47 patients with nosocomial pneumonia had a 53 percent mortality. There were and additional 12 patients who had both nosocomial pneumonia and recurrent intra-abdominal abscess; mortality in this group was 75 percent. Several risk factors were identified: APACHE II score (Acute Physiology and Chronic Health Evaluation), the need for assistance with respiration, steroids, generalized peritonitis, and need for surgery. It is concluded that nosocomial pneumonia is an independent risk factor associated with significant mortality, compared with recurrence of intra-abdominal abscess. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1991

14. The author responds

Author

Bohnen, John M.A.

Abstract

The argument that minimally symptomatic hernias may be left unoperated upon is well supported by data described by Preshaw (1) and cited in my article, (2) that show irreducibility rates [...]

Published
2015

15. Complications on a general surgery service: incidence and reporting

Author

Wanzel, Kyle R., Jamieson, Christopher G., and Bohnen, John M.A.

Subjects
Male, Ontario, Medical Audit, Medical Errors, Data Collection, Incidence, Iatrogenic Disease, Documentation, Severity of Illness Index, Medical Records, Hospitals, University, Quill on Scalpel, Humans, Original Article, Female, Prospective Studies, Morbidity, Intraoperative Complications, Surgery Department, Hospital, Total Quality Management
Abstract

To determine the incidence and nature of complications on a general surgery service and to compare these results with pre-existing institutional recording and reporting methods.A single observer prospectively monitored the presence and documentation of complications for all patients admitted to the general surgery service at the Wellesley Central Hospital over a 2-month period, through daily chart reviews, attendance at rounds and surgical operating rooms, frequent patient visits on the ward and interviews with the health care team.The general surgery service of an urban, university-affiliated teaching hospital.One hundred and ninety-two general surgery inpatients over 1277 patient-days from June 16, 1996, until Aug. 15, 1996. Same-day surgery patients were not included.Seventy-five (39%) of the 192 patients suffered a total of 144 complications. Two complications (1%) were fatal, 10 (7%) were life threatening, 90 (63%) were of moderate severity and 42 (29%) were trivial. Of these 144 complications, 26 (18%) were deemed potentially attributable to error. One hundred and twelve (78%) of the complications occurred during or after a surgical operation and were related directly or indirectly to it. Only 9 (6%) complications were not documented in the progress notes of the patients' charts. However, 115 (80%) were not presented at weekly morbidity and mortality rounds, and 95 (66%) were not documented on the face sheet of the patients' final medical records.Complications are common and are underreported by traditional methods. Since hospital funding and quality improvement efforts depend on accurate identification and recording of adverse events, strategies to improve the recording and reporting of complications must be developed.

Published
2000

16. Clinical and scientific importance of source control in abdominal infections: summary of a symposium

Author

Bohnen, John M.A., Marshall, John C., Fry, Donald E., Johnson, Steven B., and Solomkin, Joseph S.

Subjects
Male, Clinical Trials as Topic, Anti-Infective Agents, Abdomen, Humans, Original Article, Middle Aged, Infections, Aged
Abstract

In May 1997, a panel of surgeon-investigators met to discuss the clinical importance and research implications of controlling the source of abdominal infections. It was concluded that source control is critical to therapeutic success and that antimicrobial therapy and other adjunctive interventions will fail if the source of infection is not controlled by resection, exteriorization or other means. The panelists presented different definitions of source control, depending on the scientific purpose of the definition. All participants agreed that failure to consider the adequacy of source control of infection has limited the value of most clinical trials of therapeutic anti-infective agents. Besides recognizing source control as an essential goal of patient care, the panelists emphasized the need for further investigative work to define, record and stratify the adequacy of source control in clinical trials of therapeutic agents for abdominal infections.

Published
1999

22. LIPOSOMAL CEFOXITIN IN A PORCINE MODEL OF INTRAABDOMINAL SEPSIS

Author

Soltes, Sandor, Shek, Pang N., Mustard, Robert A., Soric, Ivana, Bohnen, John M.A., and Mittelman, Marc W.

Abstract

The effects of free versus liposomal cefoxitin on various physiological parameters in a porcine model of Gram-negative intra-abdominal sepsis were evaluated. Four different doses of Escherichia coliinoculum mixed with sterile pig feces were used (108, 109, 1010, and 1011cfu/animal), and the most consistent hemodynamic changes were observed with an inoculum of approximately 1011bacteria/20 kg animal. Two treatment groups were established as follows: free cefoxitin (n = 9) and liposomal cefoxitin (n = 9). All animals were maintained under anesthesia for the duration of the study, and then euthanized 24 h following intra-abdominal inoculation. The inoculated and nontreated animals showed increases in heart rate, mean pulmonary arterial pressure, systemic and pulmonary vascular resistance, and decreases in mean systemic arterial pressure and cardiac index. These changes were significant (p< .05) compared with a control group injected with normal saline. Liposomal cefoxitin-treated animals showed significantly lower decreases in mean systemic arterial pressure and increases in heart rate (p< .05) compared with both the inoculated nontreated and free cefoxitin-treated groups. Both liposomal and free cefoxitin significantly modulated the mean pulmonary arterial pressure compared with the inoculated nontreated animals (p< .05). Acidosis that developed during intra-abdominal infection diminished 6 h following the first dose of liposomal cefoxitin (p< .05). The results of these experiments demonstrate that liposomal cefoxitin exerts a beneficial modulation of some of the hemodynamic disturbances during intra-abdominal Gram-negative sepsis.

Published
1996

24. Privacy of patients' information in hospital lifts: observational study.

Author

Vigod, Simone N, Bell, Chaim M, and Bohnen, John M.A.

Subjects
RIGHT of privacy, CONFIDENTIAL communications, PATIENT-professional relations, PHYSICIAN-patient relations, HOSPITAL patients, MEDICAL ethics, PROFESSIONAL ethics, ELEVATORS
Abstract

Presents the results of an observational study of breaches of patients' confidentiality by healthcare professionals in hospital lifts. Participants; Methodology; Results; Commentary; Conclusion that confidentiality was breached in 3%-7% of lift rides in hospitals, and that these breaches compromise ethical health care and undermine patients' confidence in caregivers.

Published
2003
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25. MANAGEMENT OF ABDOMINAL HERNIAS (Book Review).

Author

Bohnen, John M.A.

Subjects
MANAGEMENT of Abdominal Hernias (Book)
Abstract

Reviews the book `Management of Abdominal Hernias,' 2nd ed., by H. Brennan Devlin and Andrew Kingsnorth with Patrick J. O'Dwyer and Karen Bloor.

Published
2000

26. Contributors

Author

Abcarian, Herand, Aboutanos, Michel B., AbuRahma, Ali F., Adams, David B., Adams, Reid B., Ahn, Samuel S., Ahrendt, Steven A., Ahuja, Nita, Alef, Matthew J., Angel, Luz P., Arepally, Aravind, Arnold, Meghan A., Ashley, Stanley W., Ayscue, Jennifer M., Baker, Marshall S., Balsam, Leora B., Bandyk, Dennis F., Barbul, Adrian, Barie, Philip S., Bartlett, John G., Bartlett, Robert, Bauer, Todd W., Beart, Robert W., Jr., Becquemin, Jean Pierre, Behrns, Kevin E., Belizon, Avraham, Berenholtz, Sean, Bernstein, Douglas, Bhanot, Parag, Bilchik, Anton J., Black, James H., III, Bland, Kirby I., Bohnen, John M.A., Boller, Anne-Marie, Boykin, Kevin N., Brandes, Steven B., Bremner, Cedric G., Brennan, Murray F., Britt, L.D., Brock, Malcolm V., Brunicardi, F. Charles, Brunt, L. Michael, Buckman, Robert F., Jr., Burton, John R., Busuttil, Ronald W., Byrne, John, Caliendo, Frank J., Cameron, Andrew M., Campbell, Kurtis A., Canter, Robert J., Caparrelli, David J., Carson, John G., T. Castaldo, Eric, Cataldo, Peter A., Chaer, Rabih A., Chahwan, Santiago, Chaikof, Elliot L., Chapman, William C., Chen, Herbert, Chin, Edward H., Cho, Clifford S., Choti, Michael A., Christmas, Colleen, Church, James M., Cima, Robert R., Clagett, G. Patrick, Clark, Orlo H., Cohen, James I., Colombani, Paul M., Colquhoun, Steven, Comerota, Anthony J., Como, John J., Conte, Michael S., Cooper, Zara, Cornwell, Edward E., III, Costanza, Michael J., Costedio, Meagan M., Cowgill, Sarah M., Crisostomo, Paul R., Croce, Martin A., Cryer, H. Gill, III, Cunningham, Steven C., Curi, Michael A., Curley, Steven A., Cushing, Melissa M., Czuczman, Gregory, Dackiw, Alan P.B., Darling, R. Clement, III, Fuente, Sebastian G. de la, Dellon, A. Lee, DeMatteo, Ronald P., DeMeester, Steven R., DeMeester, Tom R., Dempsey, Daniel T., Dente, Christopher J., DeRubertis, Brian G., DeSimone, Joseph, Deune, E. Gene, Deveney, Karen E., Dietz, David W., Dixon, Matthew R., Dorman, Todd, Duane, Therèse M., Duncan, Mark D., Dunn, Geoffrey P., Dunst, Christy, Eachempati, Soumitra R., Echenique, Ignacio A., Eckhauser, Aaron, Eckhauser, Frederic E., Edmonds, Rebecca D., Efron, David T., Eldred, Jennifer, Ellis, C. Neal, Ellison, E. Christopher, Esnaola, Nestor F., Esquivel, Jesus, Evans, Douglas B., Evers, B. Mark, Evers, Kathryn, Fabian, Timothy C., Facklis, Katherine, Fang, Robert, Faries, Mark B., Faries, Peter L., Feingold, Daniel L., Feliciano, David V., Ferguson, Charles M., Fink, Aaron S., Fischer, Anne C., Fischer, Josef E., Fischer, William E., Fishman, Elliot K., Fleming, Jason B., Fleshner, Phillip, Fong, Yuman, Fotoohi, Mehran, Freeswick, Paul, Freischlag, Julie A., Friel, Charles M., Fry, Donald E., Fry, Robert D., Fullerton, James K., Gahtan, Vivian, Galandiuk, Susan, Gamelli, Richard L., Garvin, Robert, Garwood, Robert A., Gaughan, Colleen B., Gearhart, Susan L., Georgiades, Christos S., Gerke, Henning, Geschwind, Jean-Francois, Gewertz, Bruce L., Gibson, B. Robert, Gibson, Michael K., Giuliano, Armando E., Glasgow, Sean C., Goldstone, Jerry, Grant, Clive S., Gray, Keith D., Gregorcyk, Sharon G., Gruen, Russell L., Guillem, José G., Gupta, Vinay K., Haft, Jonathan, Hagen, Jeffrey A., Haider, Adil H., Hall, Jason F., Halverson, Amy L., Han, David C., Hanks, John B., Harbison, Sean P., Harken, Alden H., Harmon, John W., Hassoun, Heitham T., Haut, Elliott R., Hazzan, David, Heitmiller, Richard F., Henderson, J. Michael, Henderson, Peter W., Heniford, B. Todd, Herlong, H. Franklin, Herndon, David N., Hiatt, Jonathan R., Hines, O. Joe, Hojman, Horacio, Holzman, Michael, Hong, Kelvin, Horton, Karen M., Howard, Thomas J., Huber, Philip J., Jr., Hunter, John G., Huston, Jared M., Hutcheon, David F., Iannettoni, Mark D., Inaba, Kenji, Infante, Jeff, Iqbal, Corey W., Ivatury, Rao R., Jackson, Lindsey N., Jacobs, Lisa K., Jan, Badar U., Jimenez, Juan Carlos, Jobe, Blair A., Johansen, Kaj H., Jurkovich, Gregory J., Kaiser, Andreas M., Kaiser, Larry R., Kalloo, Anthony N., Kasparek, Michael S., Kassis, Edmund S., Kavic, Stephen M., Kazin, Rebecca, Keating, Kevin P., Kebebew, Electron, Kelley, E. Lynne, Kellicut, Dwight C., Kent, K. Craig, Kenyon, Christopher, Kern, Kenneth A., Kesler, Kenneth A., Khaitan, Leena, Kirk, H. Alden, Klein, Andrew S., Klimberg, V. Suzanne, Koch, Wayne M., Kozarek, Richard A., Krontiras, Helen, Krupski, William C., Kuwayama, David P., Labropoulos, Nicos, Ladner, Daniela P., Lai, Edward C.S., Lamont, Jeffrey, Lange, Julie R., Lawrence, Peter F., Ledgerwood, Anna M., Lee, James A., Leibold, Tobias, Li, Mark, Liapi, Eleni, Liau, Siong-Seng, Liaw, Jane M., Lidor, Anne, Lillemoe, Keith D., Lipsett, Pamela A., Lipsitz, Evan C., Locke, Jayme E., Lowry, Ann C., Lowry, Stephen F., Lucas, Charles E., Luketich, James D., Lumsden, Alan B., Lynch, William R., Mabry, Helen, Maccabee, David, MacFadyen, Bruce V., Mackersie, Robert C., MacLean, Anthony R., Magno, Priscilla, Magnuson, Thomas, Mahmoud, Najjia N., Maier, Ronald V., Makary, Martin A., Malas, Mahmoud B., Malayeri, Ashkan A., Malhotra, Ajai K., Manahan, Michele A., Mancini, Gregory J., Manis, George, Manson, Paul N., Margolin, David A., Marohn, Michael R., Marshall, John C., Marshall, William, Martinez, Elizabeth A., Mathisen, Douglas J., Matthews, Brent D., McCarty, Todd M., McClusky, David A., III, McFadden, David W., McHenry, Christopher R., McIntyre, Thomas, McKernan, J. Barry, McSwain, Norman E., Jr., Melancon, Joseph Keith, Meldrum, Daniel R., Mellinger, John D., Melton, Genevieve B., Melvin, W. Scott, Menaker, Jay, Mendez-Tellez, Pedro Alejandro, Merritt, Robert E., Messersmith, Wells, Meyer, Anthony, Milner, Stephen M., Mintz, Yoav, Mitchell, John D., Mitchell, Mack C., Jr., Mittendorf, Elizabeth A., Moesinger, Robert C., Molena, Daniela, Moley, Jeffrey F., Moore, Frederick A., Moreman, Kevin A., Morgan, Katherine A., Morrow, Monica, Morton, Donald L., Mullins, Richard J., Muscarella, Peter, II, Nagle, Deborah, Nair, Deepak, Nakeeb, Attila, Napolitano, Lena M., Narula, Vimal K., Nenshi, Rahima, Ness, Paul M., Newell, Mark A., Newman, Lisa A., Nguyen, Louis L., Norbury, William B., Norton, Jeffrey A., O'Mara, Charles S., Onders, Raymond P., Ong, Adrian W., O'Rourke, Robert W., Pachter, H. Leon, Pak, Jimmy, Pappas, Peter J., Pappas, Sam G., Pappas, Theodore N., Parikh, Sanjiv, Park, Adrian, Park, Julie E., Pasquale, Michael D., Pawlik, Timothy M., Pearl, Jonathan, Peden, Eric, Peitzman, Andrew B., Pemberton, John H., Perler, Bruce A., Perrier, Nancy D., Peters, Jeffrey H., Peyré, Christian G., Phillips, Kacy, Philp, Allan S., Picozzi, Vincent J., Pinson, C. Wright, Pitt, Henry A., Poirier, Madeleine, Ponsky, Todd A., Poulose, Benjamin K., Poylin, Vitaliy Y., Procaccino, John A., Rabinovici, Reuven, Rafferty, Janice F., Rakinic, Jan, Ramshaw, Bruce, Rauth, Thomas, Read, Thomas E., Reber, Howard A., Redett, Richard J., Reifsnyder, Thomas, Reilly, Patrick M., Rhee, Peter, Riall, Taylor S., Ribero, Dario, Rice-Townsend, Samuel E., Richards, William O., Richardson, J. David, Rikkers, Layton F., Roddy, Sean P., Rodriguez, Aurelio, Roman, Sanziana A., Roseborough, Glen S., Rosemeier, Frank, Rosemurgy, Alexander S., II, Rosen, Michael, Rosenthal, David, Rosenwasser, Robert H., Rosson, Gedge D., Rotondo, Michael F., Rozycki, Grace S., Rubin, Brian G., Rudloff, Udo, Rushing, G.D., Salky, Barry A., Sarr, Michael G., Scalea, Thomas M., Schermer, Carol R., Schuchert, Matthew J., Schulick, Richard D., Schweitzer, Michael, Sebastian, Molly L., Senagore, Anthony J., Serur, Anna, Sharp, Kenneth W., Shepard, Alexander D., Sheppard, Brett C., Shermak, Michele A., Sherwood, J. Timothy, Sicard, Gregorio A., Siddiqui, Adnan H., Sihler, Kristen C., Silver, Geoffrey M., Simmons, Rache M., Simon, Brett A., Simpfendorfer, Conrad H., Sims, Carrie A., Singer, Samuel, Singh, Navin, Singh, Vijay A., Singhal, Sunil, Singletary, S. Eva, Situ, Esther, Slater, Robert R., Smith, C. Daniel, Smith, Dane E., Smith, Lee E., Smith, Stephen T., Solomkin, Joseph S., Sonnenday, Christopher J., Soper, Nathaniel J., Sosa, Julie Ann, Spence, Robert J., Stamos, Michael J., Steele, Kimberly, Stefater, James A., St-Hilaire, Hugo, Stone, Patrick A., Strasberg, Steven M., Streiff, Michael B., Sugarbaker, Paul H., Sugawa, Choichi, Sundaram, Magesh, Swanstrom, Lee L., Talamini, Mark A., Tamm, Eric P., Tan, Miguel, Tang, Julin F., Tarpley, John, Taubman, Kevin E., Taylor, Rebecca, Taylor, Spence M., Teh, Swee H., Thompson, Geoffrey B., Thompson, Jon S., Thomsen, Robert W., Thorson, Alan G., Todd, S. Rob, Tran, N. Anh, Traverso, L. William, Trudel, Judith L., Tsangaris, Theodore N., Tufaro, Anthony P., Tunkel, David E., Udelsman, Robert, Urist, Marshall M., Usatii, Anatolie, Vargish, Thomas, Vauthey, Jean-Nicolas, Veeraswamy, Ravi, Vercruysse, Gary A., Vitale, Gary C., Wahlgren, Carl-Magnus, Waibel, Brett, Warshaw, Andrew L., Watson, William C., Weinberg, Jordan A., Weingart, Jon David, Whang, Edward E., Whelan, Richard L., Whitlow, Charles B., Whyte, Richard I., Williams, G. Melville, Williams, Valerie A., Winkleman, Brian J., Winters, Brad, Wolff, Bruce G., Wong, Virginia L., Woodside, Kenneth J., Wren, Sherry M., Wright, Cameron D., Yang, Stephen C., Youkey, Jerry R., Yowler, Charles J., Zarins, Christopher K., Zarnegar, Rasa, Zarzaur, Ben L., Zeiger, Martha A., Zemon, Harry, Zenilman, Michael E., Zierler, R. Eugene, and Zyromski, Nicholas J.

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