BACKGROUND: Patients who are born without spleen or who have impaired splenic function due to disease or splenectomy become vulnerable to sepsis caused by bacteria. Overwhelming post-splenectomy infection (OPSI) occurs at an estimated incidence of 0.23-0.42% per year with a lifetime risk of 5%. The risk of OPSI with encapsulated bacteria is generally considered greatest in the first 2 years after splenectomy but the increased risk remains lifelong. Because vaccination doesn't completely protect against infection with encapsulated bacteria that prevent OPSI, use of prophylactic antibiotics are recommended for prevention of infection after splenectomy.METHODS: A retrospective review of 41 patients who underwent splenectomy from January 1990 to December 2012 in Inje University Busan Paik Hospital were identified through the medical records.RESULTS: Of 41 patients, 100% (41/41) were vaccinated in pneumococcal vaccines, 27% (11/41) were vaccinated in HIB vaccines. Prophylactic antibiotics (penicillin G benzathine IM every 4 weeks) were prescribed in 73% (30/41) of patients. We could not find any septic events.CONCLUSION: Because of the high mortality, the fulminant course, and the refractoriness to common treatment of overwhelming infections caused by encapsulated bacteria, prevention through vaccination and antibiotic prophylaxis is the basis of the management of patients who have had splenectomy or have hyposplenism. Prophylactic antibiotics using Penicillin G benzathine every 4 weeks is effective for preventing septic events in splenectomized patients. But further improvement in coverage of recommended vaccines and continuous prophylactic antibiotics after splenectomy is needed to reduce the risk of serious infection.
Anti-Bacterial Agents ; Antibiotic Prophylaxis ; Bacteria ; Ethylenediamines ; Haemophilus influenzae type b ; Humans ; Incidence ; Medical Records ; Mortality ; Penicillin G Benzathine ; Pneumococcal Vaccines ; Retrospective Studies ; Sepsis ; Spleen ; Splenectomy ; Vaccination ; Vaccines

Sleep deprivation or insomnia is one of the most common but neglected health conditions, with serious long-term consequences. In addition, insomnia is linked to poor work performance, impaired memory, and lack of concentration. Improving sleep quality is a crucial aspect of health care. Hypnotic agents, such as benzodiazepines, antidepressants, and antihistamines, are often used to enhance sleep quality; however, these medications often result in tolerance and dependence, resulting in withdrawal syndrome upon discontinuation. In recent years, studies have focused on natural and herbal therapies as alternative sleep aids to overcome the adverse effects of available sleep medications. Plant extracts contain phytochemicals that exert anxiolytic and sedative properties. This includes Passiflora incarnata (FSD-PI) and Lactuca sativa L. (FSD-LS) which can induce sleep. Herein, we assessed the effects of natural products, FSD-PI and FSD-LS, as well as their synergistic effects on pentobarbital sleep-induced ICR mice. We observed that natural extracts did not cause any behavioral changes capable of negative effects in mice. Furthermore, sleep duration was prolonged in pentobarbital-treated mice administered with FSD-LS (100 mg/kg). Our data suggest that FSD-LS may be a safe and effective sleep promoter.