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Sample records for chronic aseptic sternal

  1. Chronic aseptic meningitis in a patient with systemic lupus erythematosus.

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    Lancman, M E; Mesropian, H; Granillo, R J

    1989-08-01

    Chronic aseptic meningitis is a rare manifestation of systemic lupus erythematosus. It may occur early in the course of the disease and sometimes may be the initial symptom. We report a patient with chronic aseptic meningitis associated with systemic lupus erythematosus. Magnetic resonance imaging showed several ischemic lesions and an appearance which was compatible with chronic inflammation of the ependyma of the lateral ventricles.

  2. Chronic sternal osteomyelitis complicating primary manubriosternal septic arthritis.

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    Sinha, S; Sinha, A; Nagarajah, K; Oei, E L; Critchley, P; McNally, M A

    2006-11-01

    We present a 40-year-old woman complaining of worsening chest pain. She was previously treated with a prolonged course of antibiotics for suspected sternal osteomyelitis. Radiological investigations were suggestive of ongoing inflammation within the manubriosternal joint. Formal surgical debridement yielded evidence corroborating the diagnosis although microbiological samples were negative. Prolonged empirical treatment with intravenous antibiotics leads to a complete resolution of symptoms. Primary culture-negative manubriosternal septic arthritis is rare, and suboptimal treatment, particularly if confused with other conditions such as synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome, compounds its considerable morbidity.

  3. Comparative experimental evaluation of the efficacy of Prostamol Uno and Samprost on rat model of chronic aseptic prostate inflammation.

    Science.gov (United States)

    Pahomova, A V; Borovskaja, T G; Fomina, T I; Ermolaeva, L A; Vychuzhanina, A V; Rumpel, O A; Granstrem, O K; Baranova, O V

    2011-11-01

    Comparative experimental evaluation of the efficiency of prostatotropic drugs Prostamol Uno and Samprost on the model of the chronic aseptic prostate inflammation in rats was performed. It was established that peptide drug Samprost decelerates sclerotic processes in the prostate gland to a greater extent than herbal preparation Prostamol Uno. Both products equally stimulate secretory activity of the gland. Prostamol Uno, unlike Samprost, prevents the development of reduced sexual motivation, one of the complications of chronic prostatitis.

  4. Chronic Granulomatous Disease Presenting as Aseptic Ascites in a 2-Year-Old Child

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    J. F. Moreau

    2013-01-01

    Full Text Available Chronic granulomatous disease (CGD is a rare inherited immunodeficiency syndrome that results from abnormal nicotinamide adenine dinucleotide phosphate (NADPH oxidase function. This defect leads to recurrent catalase-positive bacterial and fungal infections as well as associated granuloma formation. We review the case of a 2-year-old boy who presented with ascites and fever of an unknown origin as manifestations of CGD. Cultures were negative for infection throughout his course, and CGD was suspected after identification of granulomas on peritoneal biopsy. Genetic testing revealed a novel mutation in the CYBB gene underlying his condition. This paper highlights the importance of considering CGD in the differential diagnosis of fever of unknown origin and ascites in children.

  5. Tuberculous sternal osteomyelitis.

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    Cataño, Juan Carlos; Galeano, Daniela; Botero, Juan Camilo

    2014-10-01

    A 32-year-old female patient with systemic lupus erythematosus presented with 1 month of nocturnal subjective fevers, night sweats, poor appetite, malaise, 8-kg weight loss, and a 6-cm painful sternal mass. She had normal vital signs with a physical examination notable only for the presence of a fluctuating sternal mass. A computed tomographic scan of the thorax showed a 67 × 32 × 27-mm sternal mass associated with severe sternal osteomyelitis (Fig. 1); then a surgical drainage was performed, and abundant caseous material was removed, leaving a penrose drain (Fig. 2). Histologic examination of the bone tissue revealed extensive necrosis and granulomas with multinucleated giant cells. The bone, secretion, and soft tissue were negative for acid-fast bacillae on Ziehl-Neelsen stain; but culture grew Mycobacterioum tuberculosis, and she was started on 4 first-line antituberculosis medications, showing rapid symptomatic improvement, and was discharged 4 weeks after admission (Fig. 3).

  6. Investigation of Sternal Photoplethysmography – Design of a Vital Sign Patch

    DEFF Research Database (Denmark)

    Chreiteh, Shadi

    %). In the second study, sternal PPG recording was conducted from 30 admitted patients with either asthma or Chronic Obstructive Pulmonary Disease (COPD). We compared the SpO2 levels simultaneously obtained from the sternal PPG recording and a conventional finger pulse oximeter. The Pearson correlation between...... to 36 breaths/min the Pearson correlation was 0.93 (p

  7. Imaging findings of sternal abnormalities

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    Franquet, T. [Dept. of Radiology, Hospital de Sant Pau, Universidad Autonoma de Barcelona (Spain); Gimenez, A. [Dept. of Radiology, Hospital de Sant Pau, Universidad Autonoma de Barcelona (Spain); Alegret, X. [Dept. of Radiology, Hospital de Sant Pau, Universidad Autonoma de Barcelona (Spain); Sanchis, E. [Dept. of Radiology, Hospital de Sant Pau, Universidad Autonoma de Barcelona (Spain); Rivas, A. [Dept. of Radiology, Hospital Vall d`Hebron, Universidad Autonoma de Barcelona (Spain)

    1997-05-01

    Radiographic findings in the sternal abnormalities are often nonspecific, showing appearances from a localized benign lesion to an aggressive lesion as seen with infections and malignant neoplasms. A specific diagnosis of sternal abnormalities can be suggested on the basis of CT and MR characteristics. Familiarity with the presentation and variable appearance of sternal abnormalities may aid the radiologist is suggesting a specific diagnosis. We present among others characteristic radiographic findings of hemangioma, chondrosarcoma, hydatid disease, and SAPHO syndrome. In those cases in which findings are not specific, cross-sectional imaging modalities may help the clinician in their management. (orig.)

  8. Salmonella typhi sternal wound infection.

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    Sfeir, Maroun; Youssef, Pierre; Mokhbat, Jacques E

    2013-12-01

    Samonella typhi usually causes gastrointestinal infections. Few reports in the literature described skin and soft tissue infections related to Salmonella species, especially in immunocompetent patients. Our case exhibited sternal abscess growing Salmonella typhi.

  9. STERNAL FORAMEN: A CASE REPORT

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    Taqdees

    2015-05-01

    Full Text Available Sternal foramen is a congenital oval defect at the lower third of the sternum that is usually asymptomatic & occurs due to incomplete fusion of multiple ossification centres . During our routine osteology classes, a sternum with a foramen in the lower part of its body measuring about 11mmx10mm was found. Knowledge about such variation is important as it has risk of life threate ning complications like pneumothorax or even pericardial or cardiac puncture during sternal biopsy or acupuncture.

  10. Pathogenicity of aseptic Bursaphelenchus xylophilus.

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    Li-hua Zhu

    Full Text Available Pine wilt is a disease of pine (Pinus spp. caused by the pine wood nematode (PWN, Bursaphelenchus xylophilus. However, the pathogenic mechanism of pine wilt disease (PWD remains unclear. Although the PWN was thought to be the only pathogenic agent associated with this disease, a potential role for bacterial symbionts in the disease process was recently proposed. Studies have indicated that aseptic PWNs do not cause PWD in aseptic pine trees, while PWNs associated with bacteria cause wilting symptoms. To investigate the pathogenicity of the PWN and its associated bacteria, 3-month-old microcuttings derived from certain clones of Pinus densiflora Siebold & Zucc. produced in vitro were inoculated under aseptic conditions with aseptic PWNs, non-aseptic PWNs and bacteria isolated from the nematodes. Six-month-old aseptic P. densiflora microcuttings and 7-month-old P. massoniana seedlings were also inoculated under aseptic conditions with aseptic PWNs and non-aseptic PWNs. The results showed that the aseptic microcuttings and seedlings inoculated with aseptic PWNs or non-aseptic PWNs wilted, while those inoculated with bacterial isolates did not wilt. Nematodes were recovered from wilted microcuttings and seedlings inoculated with aseptic PWNs and non-aseptic PWNs, and the asepsis of nematodes recovered from aseptic PWN-inoculated microcuttings and seedlings was reconfirmed by culturing them in NB liquid medium at 30°C for more than 7 days. Taken together, the results indicate that the asepsis of PWN did not cause the loss of pathogenicity.

  11. Pathogenicity of aseptic Bursaphelenchus xylophilus.

    Science.gov (United States)

    Zhu, Li-hua; Ye, Jianren; Negi, Sapna; Xu, Xu-ling; Wang, Zhang-li; Ji, Jin-yi

    2012-01-01

    Pine wilt is a disease of pine (Pinus spp.) caused by the pine wood nematode (PWN), Bursaphelenchus xylophilus. However, the pathogenic mechanism of pine wilt disease (PWD) remains unclear. Although the PWN was thought to be the only pathogenic agent associated with this disease, a potential role for bacterial symbionts in the disease process was recently proposed. Studies have indicated that aseptic PWNs do not cause PWD in aseptic pine trees, while PWNs associated with bacteria cause wilting symptoms. To investigate the pathogenicity of the PWN and its associated bacteria, 3-month-old microcuttings derived from certain clones of Pinus densiflora Siebold & Zucc. produced in vitro were inoculated under aseptic conditions with aseptic PWNs, non-aseptic PWNs and bacteria isolated from the nematodes. Six-month-old aseptic P. densiflora microcuttings and 7-month-old P. massoniana seedlings were also inoculated under aseptic conditions with aseptic PWNs and non-aseptic PWNs. The results showed that the aseptic microcuttings and seedlings inoculated with aseptic PWNs or non-aseptic PWNs wilted, while those inoculated with bacterial isolates did not wilt. Nematodes were recovered from wilted microcuttings and seedlings inoculated with aseptic PWNs and non-aseptic PWNs, and the asepsis of nematodes recovered from aseptic PWN-inoculated microcuttings and seedlings was reconfirmed by culturing them in NB liquid medium at 30°C for more than 7 days. Taken together, the results indicate that the asepsis of PWN did not cause the loss of pathogenicity.

  12. Reconstruction of sternal defect - a literature review

    DEFF Research Database (Denmark)

    Juhl, Alexander Andersen; Koudahl, Vibeke; Damsgaard, Tine Engberg

    2012-01-01

    OBJECTIVES: The management of sternal defects arisen after deep sternal wound infection is challenging and often requires extensive interdisciplinary teamwork between plastic and thoracic surgeons. In this study, the published literature on methods used to reconstruct sternal defects arisen...... as a result of deep sternal wound infection after open-heart surgery will be reviewed. DESIGN: The Cochrane, Embase, PubMed, and SveMed+ databases were searched in December 2011. Only papers regarding treatment of deep sternal wound infection after open-heart surgery in adults were included. RESULTS......: The literature search identified 224 original papers that met the inclusion criteria. The majority dealt with surgical techniques. None of the studies regarding reconstructive options were designed as randomized controlled trials, and the levels of evidence are generally low. CONCLUSION: The treatment of deep...

  13. A clinical study of short-term sternal photoplethysmography: recordings from patients with obstructive airways diseases

    DEFF Research Database (Denmark)

    Chreiteh, Shadi; Saadi, Dorthe Bodholt; Belhage, Bo

    2016-01-01

    and commercially accepted range. We then compared the SpO2 levels simultaneously obtained from the sternal PPGs and a commercially available finger pulse oximeter on 28 admitted patients with either asthma or Chronic Obstructive Pulmonary Disease (COPD). The Pearson correlation between the SpO2 levels estimated...

  14. Repair of Inferior Sternal Cleft Using Bilateral Sternal Bar Turnover Flaps in a Patient with Pentalogy of Cantrell

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    Yeow, Vincent Kok-Leng

    2014-01-01

    We report a case of sternal reconstruction using bilateral sternal bar turnover flaps in a 4-year-old boy with an inferior sternal cleft, as part of Cantrell's pentad. When the patient was 10 months old, he underwent sternal reconstruction using a resorbable poly-L-lactic-polyglycolic acid plate in the first stage when there was insufficient autogenous tissue to provide a reliable reconstruction. Bilateral sternal bar turnover was performed in the second stage at 4 years of age. This operative technique is described in this report. This novel technique provides a robust, dynamic, and reliable reconstruction for inferior sternal defects. PMID:24511499

  15. Pectoralis Muscle Flap Repair Reduces Paradoxical Motion of the Chest Wall in Complex Sternal Wound Dehiscence

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    Zeitani, Jacob; Russo, Marco; Pompeo, Eugenio; Sergiacomi, Gian Luigi; Chiariello, Luigi

    2016-01-01

    Background The aim of the study was to test the hypothesis that in patients with chronic complex sternum dehiscence, the use of muscle flap repair minimizes the occurrence of paradoxical motion of the chest wall (CWPM) when compared to sternal rewiring, eventually leading to better respiratory function and clinical outcomes during follow-up. Methods In a propensity score matching analysis, out of 94 patients who underwent sternal reconstruction, 20 patients were selected: 10 patients underwent sternal reconstruction with bilateral pectoralis muscle flaps (group 1) and 10 underwent sternal rewiring (group 2). Eligibility criteria included the presence of hemisternum diastases associated with multiple (≥3) bone fractures and radiologic evidence of synchronous chest wall motion (CWSM). We compared radiologically assessed (volumetric computed tomography) ventilatory mechanic indices such as single lung and global vital capacity (VC), diaphragm excursion, synchronous and paradoxical chest wall motion. Results Follow-up was 100% complete (mean 85±24 months). CWPM was inversely correlated with single lung VC (Spearman R=−0.72, p=0.0003), global VC (R=−0.51, p=0.02) and diaphragm excursion (R=−0.80, p=0.0003), whereas it proved directly correlated with dyspnea grade (Spearman R=0.51, p=0.02) and pain (R=0.59, p=0.005). Mean CWPM and single lung VC were both better in group 1, whereas there was no difference in CWSM, diaphragm excursion and global VC. Conclusion Our study suggests that in patients with complex chronic sternal dehiscence, pectoralis muscle flap reconstruction guarantees lower CWPM and greater single-lung VC when compared with sternal rewiring and it is associated with better clinical outcomes with less pain and dyspnea. PMID:27733997

  16. Autoimmune Myasthenia Gravis after Sternal Fracture

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    Jens A. Petersen

    2012-01-01

    Full Text Available We report a 54-year-old woman who suffered a commotio cerebri, whiplash injury and a chest trauma with sternal fracture due to a high-velocity car accident. Two months later, she developed unilateral ptosis and blurred vision, which worsened during the day. Multiple diagnoses were suggested, ranging from thoracic outlet syndrome towards depression. Symptoms persisted and five years later, the patient consulted a neurologist. Laboratory analysis revealed significantly elevated levels of antibodies to acetylcholine receptors, and the diagnosis of myasthenia gravis was made. Speculatively, the damage of retrosternal thymic remnants due to a sternal fracture might have precipitated the condition or exacerbated subclinical disease.

  17. Aseptic meningitis and viral myelitis.

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    Irani, David N

    2008-08-01

    Meningitis and myelitis represent common and very infrequent viral infections of the central nervous system, respectively. The number of cases of viral meningitis that occurs annually exceeds the total number of meningitis cases caused by all other etiologies combined. Focal central nervous system infections, such as occur in the spinal cord with viral myelitis, are much less common and may be confused with noninfectious disorders that cause acute flaccid paralysis. This article reviews some of the important clinical features, epidemiology, diagnostic approaches, and management strategies for patients with aseptic meningitis and viral myelitis. Particular focus is placed on the diseases caused by enteroviruses, which as a group account for most aseptic meningitis cases and many focal infections of the spinal cord.

  18. Traumatic sternal fracture: Incidence, causes and CT features

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    Kim, Hyo Weon; Kim, Young Tong; Jou, Sung Shick; Han, Jong Kyu; Bae, Won Kyung [Dept. of Radiology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan (Korea, Republic of)

    2015-05-15

    To evaluate the incidence of sternal fracture due to trauma, the CT features of sternal fractures, and the hospitalization period. The medical records and CT images of 755 patients who suffered trauma from January 2012 to August 2013 were analyzed retrospectively. We compared the incidence of sternal fracture due to various traumatic causes. We evaluated the location and shape of the sternal fracture on CT scans and the relationship between a sternal fracture and the hospitalization period. The incidence of sternal fracture was 9.27% (70/755) in all patients; 11.7% (53/453) due to a traffic accident (TA), and 5.63% (17/302) due to other causes. TA was the most frequent cause (75.71%) of a sternal fracture, fracture incidences after a TA differed by traumatic cause (p < 0.05). Among sternal fractures, the body was the most commonly involved (68.57%), one wall was limited (32.85%), and anteroposterior length increased (7.14%). Body fractures involving two or more segments included 33.33% of the cases. The hospitalization period was not related with sternal fracture (p = 0.30). Fracture was more frequent after a TA than due to other causes. Fracture incidences after a TA depended on the traumatic causes. Involvement of two or more segments and one wall-limitation were common among sternal fractures. Sternal fractures occurred even in slightly injured patients.

  19. Amoxicillin-induced aseptic meningoencephalitis

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    Radi Shahien

    2010-06-01

    Full Text Available Radi Shahien1, Vetaly Vieksler1, Abdalla Bowirrat11Department of Neurology and Neurophysiology, Ziv Medical Center, Safed, IsraelAbstract: Meningitis is usually produced by an infectious agent, but there are multiple noninfectious causes. Drug-induced aseptic meningitis (DIAM is an important entity and has been reported as an uncommon adverse reaction with numerous agents. Thus, DIAM constitutes a diagnostic and patient management challenge. We present a patient with three episodes of aseptic meningitis due to amoxicillin, and then review the literature on this rare idiosyncratic event which may occur after local or systemic drug administration. A 77-year-old man was admitted to our hospital with fever, headache, and neck stiffness. Seven days before admission he had a dental and gingival inflammation. He was treated with two oral doses of 500 mg daily of amoxicillin for one week. The seventh day he awoke with the complaints that prompted hospital admittance. Amoxicillin was stopped 1 day before his admission. From his history we knew of two similar episodes: The first episode was after a dental procedure 3 months before this incident. He had received a 1-week course of postprocedure amoxicillin of 500 mg daily and had similar headache, fever, and chills during the entire course of treatment. He wasn’t admitted to the hospital, because he stopped taking amoxicillin and he felt spontaneous pain relief after taking symptomatic pain treatment. The second episodes was 6 months after his first admission, he had been admitted to our hospital with the same symptoms. Amoxicillin was stopped and changed with intravenous (IV ceftriaxone (CTRX for 10 days due to suspected partial untreated meningitis. The patient improved rapidly within 2 days and was discharged from the hospital. On the basis of these three confirmed episodes of meningitis after recurrent exposure to amoxicillin, with repetitive negative testing for viral, bacterial, and mycobacterial

  20. The safe zone for blinded sternal interventions based on CT evaluation of midline congenital sternal foramina

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    Boruah, Deb K.; Dhingani, Dhaval D.; Achar, Shashidhar; Augustine, Antony; Mahanta, Kangkana [Assam Medical College and Hospital, Department of Radio-diagnosis, Dibrugarh, Assam (India); Prakash, Arjun [NIMHANS, Department of Radio-diagnosis, Bangalore, Karnataka (India); Yadav, Rajnikant R. [Sanjay Gandhi Post Graduate Institute and Medical Sciences, Department of Radio-diagnosis, Lucknow (India)

    2016-12-15

    The aim of this study was to evaluate the safe zone for performing blind sternal procedures based on computed tomography (CT) evaluation of congenital midline sternal foramina using multidetector computed tomography (MDCT). This retrospective study was carried out on 1,180 patients who underwent MDCT of the thorax from March 2015 to February 2016. The MDCT images were evaluated in axial and reformatted planes. Morphometry and prevalence of midline congenital sternal foramina (SF) and manubrio-foraminal distance (MFD) were evaluated. The safe zone was defined for a blinded intervention, based on palpable anatomical landmarks. Data were presented in terms of percentage, mean ± standard deviation and calculations were carried out using Microsoft Excel. The prevalence of SF in our study sample was 11.6 %. The majority of SF were located in a typical position in the lower sternal body at the level of fifth costo-chondral junction (CCJ) in 108 patients (78.8 %). The structure directly beneath the SF was mediastinal fat in 73 patients (53.3 %), followed by anterior pericardium in 44 patients (32.1 %) and lung parenchyma in 20 patients (14.6 %). The mean MFD in our study population was 11.90 ± 1.31 cm. Sternal interventions should be avoided at the level of fourth to sixth CCJ, which is considered the danger zone. An intervention at the fourth to sixth CCJ may lead to disastrous consequences in patients who have SF. (orig.)

  1. Isolated Sternal Fracture. A Case Report

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    Yovanny Ferrer Lozano

    2014-12-01

    Full Text Available Isolated sternal fractures are rare; there are few reports in the medical literature. This article discusses the diagnosis and treatment of a patient who attended the emergency department because of a direct trauma to the anterior chest caused by a car accident. After the diagnosis of isolated sternal fracture, a conservative treatment was adopted. The clinical course was satisfactory until hospital discharge and during the following nine months, the patient remained asymptomatic. The literature on the subject was located and reviewed to support and comment on the case. It is concluded that conservative treatment can lead to consolidation and no sequelae such as pain or different degrees of disability related to the fracture.

  2. Magnetic resonance imaging in the evaluation of patients with aseptic meningoencephalitis and connective tissue disorders

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    Appenzeller, Simone; Kobayashi, Eliane; Costallat, Lilian T.L.; Zanardi, Veronica de Araujo; Ribeiro Neto, Jose Menezes; Damasceno, Benito Pereira; Cendes, Fernando [Universidade Estadual de Campinas, SP (Brazil). Faculdade de Ciencias Medicas

    2000-03-01

    To describe the role of magnetic resonance imaging (MRI) in the evaluation of patients with chronic and recurrent aseptic meningitis. Method: A retrospective study of five patients with aseptic meningoencefalitis diagnosed by clinical and CSF findings. CT scans showed without no relevant findings. Results: MRI showed small multifocal lesions hyperintense on T2 weight images and FLAIR, with mild or no gadolinium enhancement, mainly in periventricular and subcortical regions. Meningoencephalitis preceded the diagnosis of the underlying disease in four patients (Behcet's disease or systemic lupus erythematosus). After the introduction of adequate treatment for the rheumatic disease, they did not present further symptoms of aseptic meningoencephalitis. Conclusion: Aseptic meningoencephalitis can be an early presentation of an autoimmune disease. It is important to emphasize the role of MRI in the diagnosis and follow-up of these patients. (author)

  3. Magnetic resonance imaging in the evaluation of patients with aseptic meningoencephalitis and connective tissue disorders

    Directory of Open Access Journals (Sweden)

    APPENZELLER SIMONE

    2000-01-01

    Full Text Available OBJECTIVE: To describe the role of magnetic resonance imaging (MRI in the evaluation of patients with chronic and recurrent aseptic meningitis.METHOD: A retrospective study of five patients with aseptic meningoencefalitis diagnosed by clinical and CSF findings. CT scans showed without no relevant findings. RESULTS: MRI showed small multifocal lesions hyperintense on T2 weighted images and FLAIR, with mild or no gadolinium enhancement, mainly in periventricular and subcortical regions. Meningoencephalitis preceded the diagnosis of the underlying disease in four patients (Behçet´s disease or systemic lupus erythematosus. After the introduction of adequate treatment for the rheumatic disease, they did not present further symptoms of aseptic meningoencephalitis. CONCLUSION: Aseptic meningoencephalitis can be an early presentation of an autoimmune disease. It is important to emphasize the role of MRI in the diagnosis and follow-up of these patients.

  4. Computed Tomographic Evaluation of Presumptively Normal Canine Sternal Lymph Nodes.

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    Iwasaki, Ryota; Mori, Takashi; Ito, Yusuke; Kawabe, Mifumi; Murakmi, Mami; Maruo, Kohji

    The sternal lymph nodes receive drainage from a wide variety of structures in the thoraco-abdominal region. Evaluation of these lymph nodes is essential, especially in cancer patients. Computed tomography (CT) can detect sternal lymph nodes more accurately than radiography or ultrasonography, and the criteria of the sternal lymphadenopathy are unknown. The purpose of this retrospective study was to describe the CT characteristics of the sternal lymph nodes in dogs considered unlikely to have lymphadenopathy. The ratio of the short axis dimension of the sternal lymph nodes to the thickness of the second sternebra was also investigated. At least one sternal lymph node was identified in each of the 152 dogs included in the study. The mean long axis and short axis dimensions were 0.700 cm and 0.368 cm, respectively. The mean ratio of the sternal lymph nodes to the second sternebrae was 0.457, and the 95% prediction interval ranged from 0.317 to 0.596 (almost a fixed value independent of body weight). These findings will be useful when evaluating sternal lymphadenopathy using CT.

  5. Embryology, sternal clefts, ectopia cordis, and Cantrell's pentalogy.

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    Engum, Scott A

    2008-08-01

    Sternal clefts, ectopia cordis, and Cantrell's pentalogy continue to be very rare congenital anomalies in pediatric surgery. Unfortunately, these conditions present as neonatal emergencies and demand early surgical intervention. This article reviews the embryological development of the chest wall, specific sternal defect anomalies, along with available methods of treatment.

  6. Congenital medium sternal cleft with partial ectopia cordis repair.

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    Sousa, Paulo Rego; Antunes, Sónia; Couto, Alexandra; Santos, Gonçalo Cassiano; Leal, Luis Gagp; Magalhães, Manuel Pedro

    2009-01-01

    Congenital sternal malformation is a rare anomaly often diagnosed as an asymptomatic condition at birth. The authors report a clinical case of a full-term female neonate with congenital sternal cleft and partial ectopia cordis. Successful surgical repair was accomplished at 6 days of age. When surgery is performed shortly after birth, the procedure is easier and better results are achieved.

  7. A Case of Bilateral Aseptic Necrosis of the Femoral Head

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    KAMAL, DIANA; TRĂISTARU, RODICA; KAMAL, C.K.; ALEXANDRU, D.O.; MOGOANTĂ, L.; GRECU, D.C.

    2014-01-01

    Aseptic necrosis of the femoral head is a disease whose etiology is not completely elucidated and generally affects young adults aged between 30 and 50 years. In a significant number of patients bilateral disease occurs, which makes detection in its early stages constitute an important objective. We present the case of a male patient, aged 23 years, with the following risk factors: smoking and chronic alcohol consumption, who is diagnosed with aseptic necrosis of the left femoral head, ARCO stage IV, and in just six months after the diagnosis and hip arthroplasty, he suffers an injury which leads to the same diagnosis in the contralateral hip. We want to emphasize that for all patients with a high index of suspicion there should be an MRI examination, because the plane radiographs or CT are most often not relevant in detecting early signs of this condition. Diagnosis of aseptic necrosis of the femoral head in the early stages is a necessity in order to obtain an optimal result of conservative treatment. PMID:26788359

  8. A Case of Bilateral Aseptic Necrosis of the Femoral Head.

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    Kamal, Diana; Trăistaru, Rodica; Kamal, C K; Alexandru, D O; Mogoantă, L; Grecu, D C

    2014-01-01

    Aseptic necrosis of the femoral head is a disease whose etiology is not completely elucidated and generally affects young adults aged between 30 and 50 years. In a significant number of patients bilateral disease occurs, which makes detection in its early stages constitute an important objective. We present the case of a male patient, aged 23 years, with the following risk factors: smoking and chronic alcohol consumption, who is diagnosed with aseptic necrosis of the left femoral head, ARCO stage IV, and in just six months after the diagnosis and hip arthroplasty, he suffers an injury which leads to the same diagnosis in the contralateral hip. We want to emphasize that for all patients with a high index of suspicion there should be an MRI examination, because the plane radiographs or CT are most often not relevant in detecting early signs of this condition. Diagnosis of aseptic necrosis of the femoral head in the early stages is a necessity in order to obtain an optimal result of conservative treatment.

  9. Aseptic Plant Culture System (APCS) Project

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    National Aeronautics and Space Administration — Aseptic plant culture plays a significant role in biotechnology and plant physiology research, and in vegetative propagation of many plant species. The development...

  10. Aseptic Plant Culture System (APCS) Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Aseptic plant culture plays a significant role in biotechnology and plant physiology research and in vegetative propagation of many plant species. The development of...

  11. Premature sternal fusion in gonadal dysgenesis with coarctation

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    Herman, T.E.; Kushner, D.C.; Cleveland, R.H.

    1985-07-01

    In reviewing lateral chest roentgenograms in three infants with Turner's syndrome and aortic coarctation, and in infant with mixed gonadal dysgenesis and aortic coarctation, we have found obvious sternal fusion abnormalities which are reported here.

  12. Modified Transverse Thoracosternotomy and Cost-Effective Reinforced Sternal Closure.

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    Costa, Joseph; Sonett, Joshua R; D'Ovidio, Frank

    2015-12-01

    The bilateral transverse thoracosternotomy clamshell incision provides excellent exposure to the mediastinal structures in double lung transplantation. The use of a modified transverse sternotomy and a figure of 8 configuration with one monofilament metal wire, along with two longitudinal wires across the sternal division, results in greater stability and equally distributed oblique tension. Our described technique was more cost effective and resulted in no incidence of dehiscence. We present our experience using a modified transverse sternotomy and reinforced sternal closure method.

  13. Scintigraphic imaging with technetium-99M-labelled ceftizoxime is a reliable technique for the diagnosis of deep sternal wound infection in rats

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    Costa, Paulo Henrique Nogueira; Diniz, Simone Odilia Fernandes; Cardoso, Valbert Nascimento; Tarabal, Bernardo; Takenaka, Isabella; Braga, Otavio; Vidigal, Paula Vieira Teixeira; Gelape, Claudio Leo; Araujo, Ivana Duval, E-mail: phnc@uol.com.br [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil)

    2015-07-01

    Purpose: to evaluate whether scintigraphy with technetium-99m-labeled ceftizoxime ({sup 99m}Tc-CFT) can differentiate mediastinitis from aseptic inflammation associated with sternotomy. Methods: twenty female Wistar rats were randomly distributed into four groups: S (control) -partial upper median sternotomy with no treatment; SW (control) - sternotomy and treatment of sternal wounds with bone wax; SB - sternotomy and infection with Staphylococcus aureus; SWB - sternotomy with bone wax treatment and bacterial infection. Scintigraphy with {sup 99m}Tc-CFT was performed eight days after surgery and images were collected 210 and 360 min after infusion of the radiopharmaceutical. Results: no animals exhibited clinical signs of wound infection at the end of the experiment, although histological data verified acute inflammatory response in those experimentally infected with bacteria. Scintigraphic images revealed that tropism of {sup 99m}Tc-CFT to infected sternums was greater than to their non-infected counterparts. Mean counts of radioactivity in bacteria-infected sternal regions (SB and SWB) were significantly higher (p = 0.0007) than those of the respective controls (S and SW).Conclusion: scintigraphy with technetium-99m-labeled ceftizoxime is a method that can potentially detect infection post sternotomy and differentiate from aseptic inflammation in animals experimentally inoculated with S. aureus (author)

  14. Evaluation of Sternal Closure with Absorbable Polydioxanone Sutures in Children

    Directory of Open Access Journals (Sweden)

    Hamid Bigdelian

    2014-03-01

    Full Text Available Introduction: Sternal dehiscence, sternal wound infection and mediastinitis are troublesome complications following median sternotomy which are major causes of morbidity and mortality of patients. Synthetic polydioxanone absorbable suture seems effective in prevention of these complications in children undergoing open heart surgery.Methods: During 2 years period, 620 patients who underwent median sternotomy were studied. The efficacy of absorbable polydioxanone suture was tested on patients using figure-of-eight suture technique. The patients’ age ranged from newborn to 15 years old. All surgical interventions were performed according to a standard protocol.Results: No sternal sutures were broken during the sternal closure and no case of mediastinitis was seen. Two patients experienced sternal dehiscence (0.32%. Follow-up period of patients were established between 1 to 132 months after open heart surgery.Conclusion: Sternal closure with the polydioxanone suture in combination with figure-of-eight technique is a safe and suitable method in children with good clinical results.

  15. CT scan of bacterial and aseptic meningitis

    Energy Technology Data Exchange (ETDEWEB)

    Takemoto, Kazumasa; Saiwai, Shigeo; Tamaoka, Koichi (Kobe Central Municipal Hospital (Japan))

    1983-01-01

    CT scans of the patients with aseptic and bacterial meningitis were reviewed and compared to previous reports. In aseptic meningitis, no abnormal CT findings were observed. In bacterial meningitis, CT findings were ventricular dilatation, subdural fluid collection, parenchymal low density, intracerebral hematoma and meningeal enhancement after contrast injection. Three patients among 48 suffered from status epileptics during the course of the illness. All of the 3 patients developed parenchymal inhomogeneous low density and progressive ventricular dilatation which did not improve after ventricular peritoneal shunt surgery. We believe that these changes are most likely due to hypoxic hypoxemia during epileptic seizure and meningitis itself seems to play a little role.

  16. Complete sternal cleft associated with right clavicular, manubrial, and thyroid hypoplasia, pectus deformity, and spinal anomalies.

    Science.gov (United States)

    Golden, Eleza T; Alazraki, Adina; Loewen, Jonathan; Braithwaite, Kiery

    2016-01-01

    Sternal cleft anomalies are rare. Associated anomalies include pentalogy of Cantrell and posterior fossa abnormalities, hemangiomas, arteriopathy, cardiac anomalies, eye abnormalities, and sternal defects syndrome. There is only a single report of complete sternal cleft, pectus excavatum, and right clavicular hypoplasia in an adult. Thyroid hemiagenesis is also very rare. To our knowledge, this is the first case of complete sternal cleft, pectus deformity, and right clavicular hypoplasia in a child and the first case with right thyroid hemiagenesis.

  17. Pulmonary agenesis associated with dextrocardia, sternal defects, and ectopic kidney.

    Science.gov (United States)

    Eroglu, Atilla; Alper, Fatih; Turkyilmaz, Atila; Karaoglanoglu, Nurettin; Okur, Adnan

    2005-12-01

    Pulmonary agenesis is a rare embryological defect, usually unilateral, and is associated with skeletal, cardiovascular, and other anomalies. A 22-month-old girl was admitted to our clinic with recurrent pulmonary infections. A chest X-ray and multidetector computed tomography (MDCT) revealed pulmonary agenesis with dextrocardia, sternal defects, and a right pelvic ectopic kidney. We report on the first known case of right-sided pulmonary agenesis combined with isolated dextrocardia, sternal defects, and an ectopic kidney. The importance of MDCT for the diagnosis of pulmonary agenesis and associated other anomalies is demonstrated.

  18. Congenital sternal foramen in a stillborn Holstein calf

    Institute of Scientific and Technical Information of China (English)

    Shahrzad Azizi; Mohsen Khosravi Bakhtiary; Mehdi Goodarzi

    2012-01-01

    Congenital sternal foramen is an anomaly whose occurrence is rare in human but is especially unusual in animals. This defect was formed when fusion of multiple ossification centers was incomplete. It may be associated with other lesions in body organs especially cardiac anomalies. In the present study, we report a very rare case of congenital sternal foramen in a Holstein calf. The oval defect was like a gunshot wound and located at the lower third of the sternum. Apparently, the rest of skeleton system seems normal. The awareness of the anomaly is important for better diagnosis and treatment of diseases.

  19. Sternal osteomyelitis after bacillus Calmette-Guérin vaccination

    Directory of Open Access Journals (Sweden)

    Rolandas Selvestravičius

    2016-09-01

    Full Text Available Presented here is the case of a nine-month-old boy with the osteomyelitis of the upper area sternum caused by bacillus Calmette-Guerin (BCG, the Danish 1331 strain vaccine against tuberculosis. Upon examination, a swelling of approximately 2×3 cm diameter was observed in the upper sternal area. The mass was hard, fixed and sensitive to palpation with no local skin hyperaemia. Chest X-rays revealed a round mass anterior to the sternum, suggesting a diagnosis of osteomyelitis. A consequent sternal biopsy was performed and Mycobacterium bovis BCG was identified by a positive growth culture.

  20. Sternal Osteomyelitis after Bacillus Calmette-Guérin Vaccination

    Science.gov (United States)

    Selvestravičius, Rolandas; Sučilienė, Elena; Saniukas, Kęstutis; Bobelytė, Odeta; Usonis, Vytautas

    2016-01-01

    Presented here is the case of a nine-month-old boy with the osteomyelitis of the upper area sternum caused by bacillus Calmette-Guerin (BCG), the Danish 1331 strain vaccine against tuberculosis. Upon examination, a swelling of approximately 2×3 cm diameter was observed in the upper sternal area. The mass was hard, fixed and sensitive to palpation with no local skin hyperaemia. Chest X-rays revealed a round mass anterior to the sternum, suggesting a diagnosis of osteomyelitis. A consequent sternal biopsy was performed and Mycobacterium bovis BCG was identified by a positive growth culture. PMID:27777704

  1. Early acute aseptic iritis after cataract extraction.

    Science.gov (United States)

    Allen, H F; Grove, A S

    1976-01-01

    Severe iritis which occurs within the first five days after cataract extraction may be categorized as (1) bacterial endophthalmitis, (2) toxic iritis, or (3) aseptic iritis. These entities can sometimes be distinguished because of their clinical features. If bacterial endophthalmitis is suspected, anterior chamber paracentesis should be considered and appropriate antibiotic treatment should be initiated. Acute iritis may result from the introduction of toxic agents into the eye, and may follow the use of products sterilized with ethylene oxide. Early acute aseptic iritis probably occurs more often than has previously been recognized. Response to intensive anti-inflammatory treatment is usually prompt and dramatic. The judicious use of cryoextraction and the careful manipulation of intraocular tissues may minimize the incidence and the severity of postoperative inflammation.

  2. Management of sternal osteomyelitis and mediastinal infection following median sternotomy

    Institute of Scientific and Technical Information of China (English)

    GAO Ju; WANG Wen-zhang; WANG You-li; LU Shu-qiang; CAI Ai-bing; YANG Zhi-fu; HAN Zhi-yi; LI Jiu-jiang; WEN Yu-ming; GENG Feng-yong

    2010-01-01

    Background Median sternotomy is considered the most usually performed procedure in cardiac operations. This study aimed to assess clinical effectiveness of bilateral pectoralis major muscle flaps (BPMMF) for management of sternal osteomyelitis and mediastinal infection following median sternotomy.Methods Clinical data were collected and retrospectively analyzed from twelve patients who underwent the BPMMF transposition for management of sternal osteomyelitis and mediastinal infection following median sternotomy from January 2006 to June 2009. Procedure consisted of rigorous debridement of necrotic tissues, dead space obliteration using the BPMMF, and placement of drainage tubes connected to a negative pressures generator for adequate drainage.Results No patients died of drainage, and all 12 patients had viable BPMMF when discharged from hospital. At 1 week post discharge, 2 patients presented with sternal infection but recovered following local debridement and medication. No patients showed infection recurrence during the follow-up period over 10 months.Conclusions Sternal osteomyelitis and mediastinal infection following median sternotomy may be effectively managed through rigorous debridement of infected soft tissues, resection of the damaged stermal segment, transposition of the BPMMF to fill the damaged sternum resulting from debridement, and adequate postoperative drainage.

  3. A Case of Lymphoma Simulating Primary Sternal Tumour

    Directory of Open Access Journals (Sweden)

    Atalay Sahin

    2014-02-01

    Full Text Available Any mass on the chest wall may not always be the primary local pathology. A case of lymphoma with an aggressive course may involve the sternum through local invasion and can mimic a chest wall tumour. A 15-year-old boy with mediastinal lymphoma presented with a sternal mass. Partial sternectomy with replacement by methyl methacrylate prosthesis was performed.

  4. Control of the aseptic processing environment.

    Science.gov (United States)

    Frieben, W R

    1983-11-01

    Methods used by industry with applications to hospital pharmacy for maintaining an aseptic environment in production of sterile pharmaceutical products are discussed. A major source of product contamination is airborne microorganisms. The laminar-airflow workbench with a high-efficiency particulate air filter provides an ultraclean environment for preparation of sterile products. However, the workbench does not guarantee sterility of products and is not effective if not properly installed and maintained or if the operator uses poor aseptic technique. The laminar-airflow workbench should be tested for leaks, airflow velocity, and airflow patterns when installed, and the workbench should be checked periodically thereafter. The workbench should be placed in a cleanroom where traffic and air disturbances that might affect the laminar airflow are eliminated. A major source of airborne microbial contamination in cleanrooms is people. Personnel movement through an area and presence of personnel without lint-free, nonshedding protective garments increase the levels of microbial contaminants in an area. The transport of nonsterile products (bottles, boxes, paper products) into a cleanroom should be minimized. The cleanroom itself should be sanitized and should be immaculate. Microbial or particulate monitoring should be conducted in the cleanroom using a quantitative method, and corrective-action limits should be set. Hospital pharmacists should examine industrial sterile-processing techniques and apply them to the preparation of sterile products.

  5. Possible Tick-Borne Human Enterovirus Resulting in Aseptic Meningitis

    OpenAIRE

    Freundt, Eric C.; Beatty, Douglas C.; Stegall-Faulk, Teresa; Wright, Stephen M.

    2005-01-01

    Enterovirus-specific genetic sequences were isolated from two Amblyomma americanum tick pools. Identical genetic sequences were later obtained from cerebrospinal fluid of a patient with aseptic meningitis and a recent history of tick attachment. These observations suggest the possibility of an emerging tick-borne human enterovirus associated with aseptic meningitis.

  6. Semester-Long Assessment of Aseptic Technique in Microbiology Labs

    Directory of Open Access Journals (Sweden)

    Daniel Aruscavage

    2013-08-01

    Full Text Available Biology educators emphasize aseptic technique when teaching lab courses. Aseptic technique is very important in microbiology to ensure safety and prevent cross-contamination. Although it can be assessed throughout the semester by examining the students’ technique and observation of contamination, this tool offers a simple semester-long graded assessment of each student’s technique. The procedures allow the students to perform a quick exercise that can determine if cross-contamination occurs, thus determining if aseptic technique was observed. Instructors can quickly check for the presence of cross-contamination. After implementing this procedure, a quantifiable improvement in my students’ aseptic technique throughout the semester was observed. It was noted that between the middle and end of the semester there was a slight increase in the amount of cross-contamination but still well below the contamination observed at the beginning of the semester. This procedure was a valuable way to assess aseptic technique during the course of a semester. A search for “aseptic technique” on the American Society of Microbiology website reveals that several lab experiments and job opportunities mention the importance of aseptic technique. It is a skill that must be used for all laboratory procedures when working with microorganisms. It is important for both the safety of the students and for the proper handling of microorganisms. There are several good explanations of aseptic technique on the Internet, and the Nuffield Foundation provides a very good description of techniques (1. The goal of this project is to provide instructors with a tool to assess the aseptic technique of their students by using simple transfers of bacteria to fresh media to identify cross-contamination. When class experiments do not work students may not understand how poor aseptic technique impacted the project. This tool would work best for undergraduate students in an

  7. Sex estimation from sternal measurements using multidetector computed tomography.

    Science.gov (United States)

    Ekizoglu, Oguzhan; Hocaoglu, Elif; Inci, Ercan; Bilgili, Mustafa Gokhan; Solmaz, Dilek; Erdil, Irem; Can, Ismail Ozgur

    2014-12-01

    We aimed to show the utility and reliability of sternal morphometric analysis for sex estimation.Sex estimation is a very important step in forensic identification. Skeletal surveys are main methods for sex estimation studies. Morphometric analysis of sternum may provide high accuracy rated data in sex discrimination. In this study, morphometric analysis of sternum was evaluated in 1 mm chest computed tomography scans for sex estimation. Four hundred forty 3 subjects (202 female, 241 male, mean age: 44 ± 8.1 [distribution: 30-60 year old]) were included the study. Manubrium length (ML), mesosternum length (2L), Sternebra 1 (S1W), and Sternebra 3 (S3W) width were measured and also sternal index (SI) was calculated. Differences between genders were evaluated by student t-test. Predictive factors of sex were determined by discrimination analysis and receiver operating characteristic (ROC) analysis. Male sternal measurement values are significantly higher than females (P < 0.001) while SI is significantly low in males (P < 0.001). In discrimination analysis, MSL has high accuracy rate with 80.2% in females and 80.9% in males. MSL also has the best sensitivity (75.9%) and specificity (87.6%) values. Accuracy rates were above 80% in 3 stepwise discrimination analysis for both sexes. Stepwise 1 (ML, MSL, S1W, S3W) has the highest accuracy rate in stepwise discrimination analysis with 86.1% in females and 83.8% in males. Our study showed that morphometric computed tomography analysis of sternum might provide important information for sex estimation.

  8. Invasive Scedosporium sternal osteomyelitis following lung transplant: Cured

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    E.J. Denton

    2016-06-01

    Full Text Available Scedosporium is an important pathogen in cystic fibrosis (CF and post-transplant but rarely causes invasive infection. Treatment remains challenging, particularly due to inherent resistance to multiple antifungal agents. We present a young man with CF who developed invasive sternal and rib infection 10-months following lung transplant. The infection has been clinically and radiologically cured with extensive surgery and triazole therapy. This case highlights the importance of adjunctive surgery in addition to prolonged triazole treatment to manage invasive Scedosporium infections in immunosuppressed patients.

  9. Pseudomass of the sternal manubrium in osteogenesis imperfecta

    Energy Technology Data Exchange (ETDEWEB)

    Yekeler, Ensar; Kumbasar, Basak; Dursun, Memduh; Tunaci, Mehtap [Department of Radiology, Istanbul University, Istanbul Faculty of Medicine, 34390, Capa, Istanbul (Turkey); Cantez, Serdar; Emiroglu, Halil Haldun [Department of Pediatrics, Istanbul University, Istanbul Faculty of Medicine, 34390, Capa, Istanbul (Turkey)

    2003-06-01

    Skeletal abnormalities such as hypertrophic callus formation and ''popcorn'' calcifications are rare radiological findings of osteogenesis imperfecta, causing tumor-like appearances on imaging. We report on a 7-year-old girl with osteogenesis imperfecta presenting with hepatomegaly and palpable lymphadenopathy in the left inguinal region on physical examination. Computed tomography examination revealed a high-density mass-like lesion of the manubrium sterni. Ultrasonography and a lateral roentgenogram of the chest verified that this was a pseudomass caused by a bowed sternal manubrium. (orig.)

  10. Staphylococcus aureus sternal osteomyelitis: a rare cause of chest pain

    Directory of Open Access Journals (Sweden)

    Kaur M

    2015-10-01

    Full Text Available Chest pain is a common presenting symptom with a broad differential. Life-threatening cardiac and pulmonary etiologies of chest pain should be evaluated first. However, it is critical to perform a thorough assessment for other sources of chest pain in order to limit morbidity and mortality from less common causes. We present a rare case of a previously healthy 45 year old man who presented with focal, substernal, reproducible chest pain and Staphylococcus aureus bacteremia who was later found to have primary Staphylococcus aureus sternal osteomyelitis.

  11. Giant Leaking Colloid Cyst Presenting with Aseptic Meningitis

    DEFF Research Database (Denmark)

    Bakhtevari, Mehrdad Hosseinzadeh; Sharifi, Guive; Jabbari, Reza

    2015-01-01

    status, and meningismus. Microbiological examination of the cerebrospinal fluid revealed aseptic meningitis. Brain imaging revealed a third ventricular colloid cyst with hydrocephalus. RESULTS: The tumor was resected via endoscopic intervention. There were no persistent operative complications related...

  12. [Benign recurring aseptic meningitis. What requires our attention?].

    Science.gov (United States)

    Kruis, T; Kredel, L; Nassir, M; Godbersen, M; Schneider, T

    2016-02-01

    Benign recurrent aseptic meningitis (BRAM) or Mollaret's meningitis is a rare disease characterized by recurrent episodes of aseptic meningitis followed by spontaneous recovery. Disease courses over several years have been reported. In most cases, BRAM is caused by HSV-2, less frequently by other viruses or autoimmune diseases. In up to 10 %, the aetiology remains unclear. We present a case of idiopathic BRAM and discuss clinical findings, diagnosis and therapeutic options of this rare illness.

  13. Aseptic Meningitis with Craniopharyngioma Resection: Consideration after Endoscopic Surgery

    Science.gov (United States)

    Chen, Jenny X.; Alkire, Blake C.; Lam, Allen C.; Curry, William T.; Holbrook, Eric H.

    2016-01-01

    Objectives While bacterial meningitis is a concerning complication after endoscopic skull base surgery, the diagnosis can be made without consideration for aseptic meningitis. This article aims to (1) present a patient with recurrent craniopharyngioma and multiple postoperative episodes of aseptic meningitis and (2) discuss the diagnosis and management of aseptic meningitis. Design Case report and literature review. Results A 65-year-old female patient with a symptomatic craniopharyngioma underwent transsphenoidal resection. She returned postoperatively with symptoms concerning for cerebrospinal fluid (CSF) leak and bacterial meningitis. Lumbar puncture demonstrated mildly elevated leukocytes with normal glucose levels. Cultures were sterile and she was discharged on antibiotics. She returned 18 days postoperatively with altered mental status and fever. Again, negative CSF cultures suggested aseptic meningitis. Radiological and intraoperative findings were now concerning for widespread cerebrovascular vasospasm due to leaked craniopharyngioma fluids. In the following months, her craniopharyngioma recurred and required multiple surgical resections. Days after her last operation, she returned with mental status changes and a sterile CSF culture. She was diagnosed with recurrent aseptic meningitis and antibiotics were discontinued. The patient experienced near complete resolution of symptoms. Conclusions Consideration of aseptic meningitis following craniopharyngioma resection is critical to avoid unnecessary surgical re-exploration and prolonged courses of antibiotics. PMID:27722072

  14. Aseptic Meningitis with Craniopharyngioma Resection: Consideration after Endoscopic Surgery.

    Science.gov (United States)

    Chen, Jenny X; Alkire, Blake C; Lam, Allen C; Curry, William T; Holbrook, Eric H

    2016-10-01

    Objectives While bacterial meningitis is a concerning complication after endoscopic skull base surgery, the diagnosis can be made without consideration for aseptic meningitis. This article aims to (1) present a patient with recurrent craniopharyngioma and multiple postoperative episodes of aseptic meningitis and (2) discuss the diagnosis and management of aseptic meningitis. Design Case report and literature review. Results A 65-year-old female patient with a symptomatic craniopharyngioma underwent transsphenoidal resection. She returned postoperatively with symptoms concerning for cerebrospinal fluid (CSF) leak and bacterial meningitis. Lumbar puncture demonstrated mildly elevated leukocytes with normal glucose levels. Cultures were sterile and she was discharged on antibiotics. She returned 18 days postoperatively with altered mental status and fever. Again, negative CSF cultures suggested aseptic meningitis. Radiological and intraoperative findings were now concerning for widespread cerebrovascular vasospasm due to leaked craniopharyngioma fluids. In the following months, her craniopharyngioma recurred and required multiple surgical resections. Days after her last operation, she returned with mental status changes and a sterile CSF culture. She was diagnosed with recurrent aseptic meningitis and antibiotics were discontinued. The patient experienced near complete resolution of symptoms. Conclusions Consideration of aseptic meningitis following craniopharyngioma resection is critical to avoid unnecessary surgical re-exploration and prolonged courses of antibiotics.

  15. Management of isolated sternal fractures using a practical algorithm

    Directory of Open Access Journals (Sweden)

    Dimos Karangelis

    2014-01-01

    Full Text Available Background: The implementation of seat belt legislation has led to an increase in the frequency of isolated sternal fractures (ISFs in motor vehicle crash. Aims: We reviewed retrospectively the medical records of our tertiary center in order to find out the frequency of ISFs, review our experience in their management, and define the mean length of hospitalization. Materials and Methods: From January 2008 to April 2012, 64 patients were admitted to the accident and emergency department of the University Hospital of Larissa, Greece, suffering from sternal fractures (SFs. Of these 64 patients, 45 had sustained ISF, while the remaining 19 had SF and additional injuries (intrathoracic and extrathoracic. The files of these 45 patients were further investigating as concerning the mechanism of injury, hospitalization days, morbidity, and mortality. Results: All the patients had been involved in motor vehicle crashes and most of them were wearing seat belts during the accident (91%. The hospital length of stay (LOS was 1.85 ± 1.67. All the patients had upon admission chest radiograms, serial electrocardiographs (ECGs, echocardiograms, and cardiac enzyme levels. Two patients had abnormal ECG and abnormal cardiac enzymes which contributed in prolonged hospitalization. However, there was no incidence of cardiac complications or deaths. Conclusions: ISFs, with normal electrocardiogram, cardiac enzymes, and chest X-ray in the absence of complications, require no further investigation.

  16. The Association between Blunt Cardiac Injury and Isolated Sternal Fracture

    Science.gov (United States)

    McMaster, Jason; Desai, Pathik J.; Desai, Sapan S.; Kuy, SreyRam; Mata, Maggy; Cooper, Jamie

    2014-01-01

    The treatment of isolated sternal fractures (ISF) throughout the world is heterogeneous. This study aimed to identify the incidence, morbidity, and mortality associated with isolated fractures of the sternum and describe current practice for diagnosis and management of ISF and cardiac injury at a level I trauma center in the UK. A retrospective cohort study of adult patients (>16 years) with ISF presenting from 2006 to 2010 was conducted. Eighty-eight patients with ISF were identified. Most patients (88%, 77) were admitted to hospital with 66% (58) of them discharged within 48 hours. Two (2%) patients had an ER EKG with abnormality but both resolved to normal sinus rhythm within 6 hours of follow-up. Serum CEs were drawn from 55 (63%) patients with only 2 (2%) having a rise in serum troponin >0.04; however, in both of these patients troponin quickly normalized. Six (7%) patients underwent echocardiograms without significant findings. In all 88 patients with ISF, no cases of clinically significant cardiac injury were identified. Patients presenting with an isolated sternal fracture with no changes on EKG or chest X-ray do not warrant an admission to hospital and may be discharged from the ER. PMID:24653859

  17. The Association between Blunt Cardiac Injury and Isolated Sternal Fracture

    Directory of Open Access Journals (Sweden)

    Anahita Dua

    2014-01-01

    Full Text Available The treatment of isolated sternal fractures (ISF throughout the world is heterogeneous. This study aimed to identify the incidence, morbidity, and mortality associated with isolated fractures of the sternum and describe current practice for diagnosis and management of ISF and cardiac injury at a level I trauma center in the UK. A retrospective cohort study of adult patients (>16 years with ISF presenting from 2006 to 2010 was conducted. Eighty-eight patients with ISF were identified. Most patients (88%, 77 were admitted to hospital with 66% (58 of them discharged within 48 hours. Two (2% patients had an ER EKG with abnormality but both resolved to normal sinus rhythm within 6 hours of follow-up. Serum CEs were drawn from 55 (63% patients with only 2 (2% having a rise in serum troponin >0.04; however, in both of these patients troponin quickly normalized. Six (7% patients underwent echocardiograms without significant findings. In all 88 patients with ISF, no cases of clinically significant cardiac injury were identified. Patients presenting with an isolated sternal fracture with no changes on EKG or chest X-ray do not warrant an admission to hospital and may be discharged from the ER.

  18. Complicated sternal dehiscence treated with the strasbourg thoracic osteosyntheses system (STRATOS and the transposition of greater omentum: a case report

    Directory of Open Access Journals (Sweden)

    Casablanca Giuseppe

    2010-06-01

    Full Text Available Abstract Sternal dehiscence is a serious complication after cardiac surgery. Sternal refixation, performed by simple rewiring or techniqual modification of rewiring as described by Robicsek, can fail, overall when the bone quality is poor or the sternum is completely destroyed. The sternal closure systems, consisting of plates, screws or rib clips and titanium bars, have been recently introduced to treat the complicated sternal dehiscence. We describe for the first time the use of the Strasbourg Thoracic Osteosyntheses System (STRATOS and the greater omentum, to treat a complicated sternal dehiscence, causing chest pain and respiratory failure.

  19. Sternal Insufficiency Fractures of Post-menopausal Women:Retrospective Analysis of 17 Cases

    Institute of Scientific and Technical Information of China (English)

    Zhe-yuan Huang; Bi-long Yi; Hao-yuan Liu

    2012-01-01

    Objective To retrospectively investigate the clinical characteristics of sternal insufficiency fractures (SIFs) of post-menopausal women.Methods Findings on the clinical presentation,associated diseases,and imaging of SIFs in 17 postmenopausal women admitted to our hospital between February 1999 and January 2009 were reported.Results Twelve patients complained of severe pain in their anterior chest.Other symptoms included cough (5 cases),dyspnoea (3 cases),breathlessness (3 cases),and wheeze (2 cases).Four patients had no discomfort.The sternums of 11 cases were tender to palpation.Seventeen patients had osteoporosis.Other associated diseases were chronic obstructive pulmonary disease (7 cases),rheumatoid arthritis (3 cases),systemic lupus erythematosus (1 case),asthma (1 case),and thoracic vertebral fracture (13 cases).Nine patients had received glucocorticoid treatment.The fractures were located in the body of the sternum in 15 patients,in the manubrium in 1 patient,and in the manubriosternal junction in 1 patient.Displaced fracture was present in 13 cases.Lateral radiography of the sternum showed a fracture line in 14 patients.In the remaining 3 cases,other imaging examinations such as bone scan,computed tomography or magnetic resonance imaging demonstrated the presence of a fracture.Conclusions Osteoporosis,glucocorticoid therapy,chronic obstructive pulmonary disease,and rheumatoid arthritis might be risk factors for SIFs.SIFs should be considered in the differential diagnosis of chest pain.

  20. Frequency of sternal foramen evaluated by MDCT: a minor variation of great relevance.

    Science.gov (United States)

    Babinski, Marcio A; de Lemos, Leandro; Babinski, Monique S D; Gonçalves, Marianna V T; De Paula, Rafael C; Fernandes, Rodrigo M P

    2015-04-01

    Due to inadvertent cardiac or great vessel injury, sternal foramina may pose as a great hazard during sternal puncture. They can also be misinterpreted as osteolytic lesions in cross-sectional imaging of the sternum. The distribution of these variations differs between populations, but data from Brazilians are scarcely reported. Therefore, this study aimed to verify the frequency of midline sternal foramen and double-ended xiphoid process, as developmental variations, in order to avoid fatal complications following sternal puncture of sternal acupuncture treatment. A total of 114 chest computed tomograms were evaluated. The frequency of midline sternal foramen in a complication risk bearing feature is of approximately 10.5%. The double-ended xiphoid process was present in 17.5%. We conclude that sternal acupuncture should be planned in the region of corpus-previous CT should be done to rule out this variation. Furthermore, we strongly recommend the acupuncture technique which prescribes a safe superficial-oblique approach to the sternum.

  1. MR features in patients with residual paralysis following aseptic meningitis

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Dae Chul; Park, Young Seo [College of Medicine, Asan Meidcal Center, University of Ulsan, Seoul (Korea, Republic of)

    1991-01-15

    MR studies were performed in three patients with paralysis in the lower extremities. Poliomyelitis-like paralysis can be caused by neurovirulent strains of nonpolioenteroviruses. Entervirus 71 (EV 71) is documented as one of the potentially neurovirulent strains and a causative agent of some epidemics (1-7). The clinical manifestations associated with the EV 71 infection include aseptic meningitis, hand-food-mouth disease (HFMD), acute respiratory illness and gastrointestinal disease(6). Although rarely fatal, flaccidparalysis can be followed by EV 71 induced aseptic meningitis. Anterior horn cell necrosis was suggested on MR in two patients with residual paralysis (7). MR features, however, have not yet been described in detail. In this report we present three cases of patients with clinical evidence of EV 71 induced aseptic meningitis whose MR studies showed residual changes in spinal cord.

  2. Cat scratch disease complicated with aseptic meningitis and neuroretinitis

    Directory of Open Access Journals (Sweden)

    Vitor Laerte Pinto Jr.

    2008-04-01

    Full Text Available Cat scratch disease (CSD is a self limited condition characterized by fever, lymph node enlargement and less often eye involvement. Central nervous system involvement by Bartonella henselae infection is possibly an important cause of morbidity; its role as an agent of aseptic meningitis is unknown. We report a case of a 40 years-old man with CSD accompanied by aseptic meningitis and neuroretinitis. Serum indirect immmunofluorescence (IFI assays for B. henselae were positive and the cerebrospinal fluid (CSF analysis showed mononuclear pleocytosis and increased level of protein. Serological tests for other etiologies were negative. The patient responded well to antibiotic therapy with oral doxycicline plus rifampin and in the 12th day of hospitalization evolved to total regression of the headache and partial regression of the visual loss. Clinicians should consider CSD as a differential diagnosis when assessing previously healthy patients with aseptic meningitis associated with regional lymphadenopathy and epidemiological history of feline contact.

  3. Aseptic meningitis in children: analysis of 506 cases.

    Directory of Open Access Journals (Sweden)

    Athanasios G Michos

    Full Text Available BACKGROUND: Non-polio human enteroviruses are the leading cause of aseptic meningitis in children. The role of enterovirus PCR for diagnosis and management of aseptic meningitis has not been fully explored. METHODOLOGY/PRINCIPAL FINDINGS: A retrospective study was conducted to determine the epidemiological, clinical, and laboratory characteristics of aseptic meningitis and to evaluate the role of enterovirus PCR for the diagnosis and management of this clinical entity. The medical records of children who had as discharge diagnosis aseptic or viral meningitis were reviewed. A total of 506 children, median age 5 years, were identified. The annual incidence rate was estimated to be 17/100,000 children less than 14 years of age. Most of the cases occurred during summer (38% and autumn (24%. The dominant clinical symptoms were fever (98%, headache (94% and vomiting (67%. Neck stiffness was noted in 60%, and irritation in 46% of the patients. The median number of CSF cell count was 201/mm(3 with polymorphonuclear predominance (>50% in 58.3% of the cases. Enterovirus RNA was detected in CSF in 47 of 96 (48.9% children tested. Children with positive enterovirus PCR had shorter hospitalization stay as compared to children who had negative PCR or to children who were not tested (P = 0.01. There were no serious complications or deaths. CONCLUSIONS: Enteroviruses accounted for approximately one half of cases of aseptic meningitis. PCR may reduce the length of hospitalization and plays important role in the diagnosis and management of children with aseptic meningitis.

  4. Congenital superior sternal cleft repair using our modified Sally technique: A case report

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    Tomoyuki Kuwata

    2014-12-01

    Full Text Available We report the case of an 8-month-old male neonate who underwent reconstructive surgery for a congenital superior sternal cleft to decrease the risk of commotio cordis. With regard to use of the Sally technique for the repair of a relatively wide cleft (4 × 4 cm, we were concerned about respiratory problems caused by compression following closure of the sternal halves. By closing the sternal halves imperfectly, elevation of intrapleural pressure can be avoided to some extent. By bridging the surplus resected cartilage from the lower sternum over the gap of the upper sternum, the heart is protected by more rigid material. We recommend our modified Sally technique because it is both flexible and effective for sternal cleft repair.

  5. Sternal fractures and delayed cardiac tamponade due to a severe blunt chest trauma.

    Science.gov (United States)

    Liang, Huai-min; Chen, Qiu-lin; Zhang, Er-yong; Hu, Jia

    2016-04-01

    Sternal fractures caused by blunt chest trauma are associated with an increased incidence of cardiac injury. Reports of the incidence of cardiac injury associated with sternal fracture range from 18% to 62%. Delayed cardiac tamponade is a rare phenomenon that appears days or weeks after injury. Moreover, after nonpenetrating chest trauma, cardiac tamponade is very rare and occurs in less than 1 of 1000. This case describes a patient who had delayed cardiac tamponade 17 days after a severe blunt chest trauma.

  6. Sternal Reconstruction of Deep Sternal Wound Infections Following Median Sternotomy by Single-stage Muscle Flaps Transposition

    Institute of Scientific and Technical Information of China (English)

    Ji-yan Xie

    2014-01-01

    Objective To assess clinical effectiveness of using bilateral pectoralis major or plus rectus abdominis muscle flaps in treating deep sternal wound infection (DSWI) following median sternotomy. Methods Between January 2009 and December 2013, 19 patients with DSWI after median sternotomy for cardiac surgery were admitted to our hospital, including 14 males (73.7%) and 5 females (26.3%), aged 55±13 (18-78) years. According to the Pairolero classification of infected median sternotomies, 3 (15.8%) patients were type II, and the other 16 (84.2%) were type III. Surgical procedure consisted of adequate debridement of infected sternum, costal cartilage, granulation, steel wires, suture residues and other foreign substances. Sternal reconstruction used the bilateral pectoralis major or plus rectus abdominis muscle flaps to obliterate dead space. The drainage tubes were placed and connected to a negative pressure generator for adequate drainage. Results There were no intraoperative deaths. In 15 patients (78.9%), bilateral pectoral muscle flaps were mobilized sufficiently to cover and stabilize the defect created by wound debridement. 4 patients (21.0%) needed bilateral pectoral muscle flaps plus rectus abdominis muscle flaps because their pectoralis major muscle flaps could not reach the lowest portion of the wound. 2 patients (10.5%) presented with subcutaneous infection, and 3 patients (15.8%) had hematoma. They recovered following local debridement and medication. 17 patients (89.5%) were examined at follow-up 12 months later, all healed and having stable sternum. No patients showed infection recurrence during the follow-up period over 12 months. Conclusion DSWI following median sternotomy may be effectively managed with adequate debridement of infected tissues and reconstruction with bilateral pectoralis major muscle or plus rectus abdominis muscle flap transposition.

  7. An Alternative Technique for Surgical Management of Poststernotomy Osteomyelitis and Reconstruction of the Sternal Defect

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    Petros Konofaos

    2013-01-01

    Full Text Available Introduction. Sternal osteomyelitis with or without mediastinal infection is a severe and rare complication of median sternotomy. In this paper, an alternative technique for the reconstruction of sternal defects with the use of bilateral pectoralis major pedicled muscle flaps is presented. Case presentation. A 70-year-old man with the diagnosis of poststernotomy osteomyelitis underwent reconstruction of his sternal defect with the use of bilateral pectoralis major muscle flaps. The patient had an uneventful recovery, and the physical examination revealed a normal range of motion for both upper limbs and sternal stability. Conclusion. The proposed technique incorporates a simple mobilization of the two pectoralis major muscles to be used as flaps to fill the sternal defect without the need for humeral detachment or a second cutaneous incision. Using this technique, a muscular implant is made that seals the dead space, which has no tension due to the presence of a second layer. Postoperative results are excellent, not only regarding infection and functionality but also from an aesthetic point of view.

  8. Viral etiology of aseptic meningitis among children in southern Iran.

    Science.gov (United States)

    Hosseininasab, Ali; Alborzi, Abdolvahab; Ziyaeyan, Mazyar; Jamalidoust, Marzieh; Moeini, Mahsa; Pouladfar, Gholamreza; Abbasian, Amin; Kadivar, Mohamad Rahim

    2011-05-01

    Aseptic meningitis refers to a clinical syndrome of meningeal inflammation in which bacteria cannot be identified in the cerebrospinal fluid (CSF). The viral etiology and the epidemiological, clinical, and laboratory characteristics of aseptic meningitis among children aged 2 months to 15 years in Shiraz, southern Iran were determined. From May 2007 to April 2008, 65 patients were admitted to the hospital with aseptic meningitis. Seven viruses, non-polio human enteroviruses, mumps virus, herpes simplex virus (HSV), varicella-zoster virus (VZV), human cytomegalovirus (HCMV), human herpes virus type 6 (HHV-6), and Epstein-Barr virus (EBV) were investigated by polymerase chain reaction (PCR) method. Viruses were detected in 30 (46.2%) patients in whom non-polio human enterovirus and mumps virus were detected in 13 (43.3%) and 11 (36.7%), respectively. The remaining 6 (20%) of the cases were caused by HSV, VZV, HCMV, and HHV-6. Haemophilus influenzae and non-polio human enterovirus were detected in one patient simultaneously. Viral meningitis was found to be more frequent during spring and summer. The majority (66.6%) of the patients were treated in the hospital for 10 days and had received antibiotics in the case of bacterial meningitis. Rapid diagnosis of viral meningitis using PCR testing of CSF can help shorten hospitalization, and avoid the unnecessary use of antibiotics.

  9. Coronary artery bypass surgery in diabetic patients – risk factors for sternal wound infections

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    Lenz, Kristina

    2016-07-01

    Full Text Available The incidence of sternal wound infections (SWI after coronary artery bypass surgery (CABG as reported worldwide is low. However, it is associated with significant increase of postoperative mortality and treatment costs. The major risk factors discussed are diabetes mellitus and bilateral IMA harvesting of the internal mammary artery. This study analyses data of 590 patients receiving CABG concerning the risk factors for SWI. Sternal wound infections occur significantly more often in diabetic patients, one crucial and significant additional risk factor is obesity.

  10. Reconstruction of Chest Wall by Cryopreserved Sternal Allograft after Resection of Aneurysmal Bone Cyst of Sternum

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    Kambiz Sheikhy

    2017-01-01

    Full Text Available A 20-year-old female was referred to our hospital due to deformity and bulging in anterior aspect of chest wall in sternal area. Chest X-ray and CT scan confirmed a large mass with destruction of sternum. Pathologic diagnosis after incisional biopsy was compatible with aneurysmal bone cyst. We resected sternum completely and reconstructed large anterior defect by a cryopreserved sternal allograft. In follow-up of patient there was no unstability of chest wall with good cosmetic result.

  11. Reconstruction of Chest Wall by Cryopreserved Sternal Allograft after Resection of Aneurysmal Bone Cyst of Sternum

    Science.gov (United States)

    Sheikhy, Kambiz; Abbasi Dezfouli, Azizollah

    2017-01-01

    A 20-year-old female was referred to our hospital due to deformity and bulging in anterior aspect of chest wall in sternal area. Chest X-ray and CT scan confirmed a large mass with destruction of sternum. Pathologic diagnosis after incisional biopsy was compatible with aneurysmal bone cyst. We resected sternum completely and reconstructed large anterior defect by a cryopreserved sternal allograft. In follow-up of patient there was no unstability of chest wall with good cosmetic result. PMID:28299230

  12. Aseptic Meningitis Caused by Lassa Virus: Case Series Report.

    Science.gov (United States)

    Okokhere, Peter O; Bankole, Idowu A; Iruolagbe, Christopher O; Muoebonam, Benard E; Okonofua, Martha O; Dawodu, Simeon O; Akpede, George O

    2016-01-01

    The Lassa virus is known to cause disease in different organ systems of the human body, with varying clinical manifestations. The features of severe clinical disease may include bleeding and/or central nervous system manifestations. Whereas Lassa fever encephalopathy and encephalitis are well described in the literature, there is paucity of data on Lassa virus meningitis. We present the clinical description, laboratory diagnosis, and management of 4 consecutive cases of aseptic meningitis associated with Lassa virus infection without bleeding seen in a region of Nigeria known to be endemic for both the reservoir rodent and Lassa fever. The 4 patients recovered fully following intravenous ribavirin treatment and suffered no neurologic complications.

  13. Associated injuries in traumatic sternal fractures: a review of the National Trauma Data Bank.

    Science.gov (United States)

    Oyetunji, Tolulope A; Jackson, Hope T; Obirieze, Augustine C; Moore, Danier; Branche, Marc J; Greene, Wendy R; Cornwell, Edward E; Siram, Suryanarayana M

    2013-07-01

    Sternal fractures occur infrequently with blunt force trauma. The demographics and epidemiology of associated injuries have not been well characterized from a national trauma database. The National Trauma Data Bank was queried for patients with closed sternal fractures. The demographics were analyzed by age, gender, mechanism and indicators of anatomic and physiologic injuries. Types of commonly associated injuries were also determined. A total of 23,985 records were analyzed. Males accounted for 68.3 per cent and whites 70.9 per cent. Motor vehicle crash was the leading mechanism. More than 56 per cent had severe injuries based on Injury Severity Score (greater than 15) and 17 per cent with Glasgow Coma Score 8 or less. Crude mortality was 7.9 per cent. The majority (57.8%) and approximately one-third (33.7%) of the patients had rib fractures and lung contusions, respectively, 22.0 per cent with closed pneumothorax, 21.6 per cent had a closed thoracic vertebra fracture, 16.9 per cent with lumbar spine fracture, 3.9 per cent with concussion, and blunt cardiac injury in 3.6 per cent. Sternal fractures are usually associated with severe blunt trauma. Lung contusion remains the leading associated injury followed by vertebral spine fractures. Cardiac injuries are less frequent and vascular injuries less so. Mechanism of injury and presence of sternal fractures should alert providers to these potential associated injuries.

  14. Intrapericardial migration of dislodged sternal struts as late complication of open pectus excavatum repairs

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    Haverich Axel

    2011-03-01

    Full Text Available Abstract We present a case of sternal steel strut dislodgement and migration in a patient undergoing Ravitch repair for pectus excavatum (PE 37 years ago. Broken struts perforated the right ventricle and right ventricular outflow tract (RVOT and additionally migrated into the left upper lobar bronchus. Dislodged sternal struts represent rare complications after surgical repair of patients suffering from pectus excavatum. Reviewing the literature, only five cases of intrapericardial migration of dislodged sternal struts or wires have been reported so far. In our case, the first strut was removed from the airways through a left antero-lateral thoracotomy. Using cardiopulmonary bypass, a second strut was removed via ventriculotomy. These life-threatening sequelae underscore the importance of postoperative follow-up and early removal of osteosynthetic materials used in open PE repair. Accurate preoperative localization of migrated materials and availability of CPB support are crucial for successful surgical removal. Introduction The migration of dislodged sternal steel struts or wires into the pericardium and cardiac cavities is a rare but life-threatening complication of open pectus excavatum (PE repair 1. Removal of these materials poses a challenge for cardiothoracic surgeons. Herein, the authors report a case of migration of dislodged steel struts through the right ventricle and right ventricular outflow tract (RVOT into the left upper lobar bronchus in a patient who underwent Ravitch repair 37 years ago.

  15. Mesenchymal Stem/Stromal Cells from Discarded Neonatal Sternal Tissue: In Vitro Characterization and Angiogenic Properties

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    Shuyun Wang

    2016-01-01

    Full Text Available Autologous and nonautologous bone marrow mesenchymal stem/stromal cells (MSCs are being evaluated as proangiogenic agents for ischemic and vascular disease in adults but not in children. A significant number of newborns and infants with critical congenital heart disease who undergo cardiac surgery already have or are at risk of developing conditions related to inadequate tissue perfusion. During neonatal cardiac surgery, a small amount of sternal tissue is usually discarded. Here we demonstrate that MSCs can be isolated from human neonatal sternal tissue using a nonenzymatic explant culture method. Neonatal sternal bone MSCs (sbMSCs were clonogenic, had a surface marker expression profile that was characteristic of bone marrow MSCs, were multipotent, and expressed pluripotency-related genes at low levels. Neonatal sbMSCs also demonstrated in vitro proangiogenic properties. Sternal bone MSCs cooperated with human umbilical vein endothelial cells (HUVECs to form 3D networks and tubes in vitro. Conditioned media from sbMSCs cultured in hypoxia also promoted HUVEC survival and migration. Given the neonatal source, ease of isolation, and proangiogenic properties, sbMSCs may have relevance to therapeutic applications.

  16. Role of Negative-Pressure Wound Therapy in Deep Sternal Wound Infection After Open Heart Surgery

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    Cemalettin Aydın

    2013-08-01

    Full Text Available Introduction: Mediastinitis is a devastating complication in open heart surgery. The most common treatments after debridement are rewiring with antibiotic irrigation. Vacuum assisted closure therapy is a recently introduced technique that promotes the healing of difficult wounds, including post-sternotomy mediastinitis.Patients and Methods: Forty one patients with deep sternal wound infection were divided into two groups based on the treatment method used. Twenty two patients with post-cardio to my deep sternal wound infection were treated primarily by vacuum assisted closure method (group A and 19 patients with deep sternal wound infection who received closed mediastinal irrigation were treated with antibiotics (group B between January 2006 and January 2010.Results: The two groups were compared. Three patients died during treatment in group B. The median healing time was significantly shorter in group A (mean, 13.5 ± 3.2 days compared to 18 days (mean, 21.2 ± 16.4 days in group B (p< 0.001. Deep sternal wound infection showed no recurrences after the vacuum treatment, while 7 (24% patients in group B suffered recurrences. Hospital stay was significantly shorter in group A (median, 30.5 days; mean, 32.2 ± 11.3 days vs. median, 45 days; mean, 49.2 ± 19.3 days (p= 0.001.Conclusion: A significantly shorter healing time was confirmed with vacuum assisted closure. Hospital stay remained significantly shorter in group A (35 vs. 46 days.

  17. Triclosan-coated sutures and sternal wound infections: a prospective randomized clinical trial.

    Science.gov (United States)

    Steingrimsson, S; Thimour-Bergström, L; Roman-Emanuel, C; Scherstén, H; Friberg, Ö; Gudbjartsson, T; Jeppsson, A

    2015-12-01

    Surgical site infection is a common complication following cardiac surgery. Triclosan-coated sutures have been shown to reduce the rate of infections in various surgical wounds, including wounds after vein harvesting in coronary artery bypass grafting patients. Our purpose was to compare the rate of infections in sternotomy wounds closed with triclosan-coated or conventional sutures. A total of 357 patients that underwent coronary artery bypass grafting were included in a prospective randomized double-blind single-center study. The patients were randomized to closure of the sternal wound with either triclosan-coated sutures (Vicryl Plus and Monocryl Plus, Ethicon, Inc., Somerville, NJ, USA) (n = 179) or identical sutures without triclosan (n = 178). Patients were followed up after 30 days (clinical visit) and 60 days (telephone interview). The primary endpoint was the prevalence of sternal wound infection according to the Centers for Disease Control and Prevention (CDC) criteria. The demographics in both groups were comparable, including age, gender, body mass index, and rate of diabetes and smoking. Sternal wound infection was diagnosed in 43 patients; 23 (12.8%) sutured with triclosan-coated sutures compared to 20 (11.2%) sutured without triclosan (p = 0.640). Most infections were superficial (n = 36, 10.1%), while 7 (2.0%) were deep sternal wound infections. There were 16 positive cultures in the triclosan group and 17 in the non-coated suture group (p = 0.842). The most commonly identified main pathogens were Staphylococcus aureus (45.4%) and coagulase-negative staphylococci (36.4%). Skin closure with triclosan-coated sutures did not reduce the rate of sternal wound infection after coronary artery bypass grafting. (clinicaltrials.gov: NCT01212315).

  18. Arteriovenous Loop-Independent Free Flap Reconstruction of Sternal Defects after Cardiac Surgery.

    Science.gov (United States)

    Dornseifer, Ulf; Kleeberger, Charlotte; Ehrl, Denis; Herter, Frank; Ninkovic, Milomir; Iesalnieks, Igors

    2016-09-01

    Background Sternal defects following deep wound infections are predominantly reconstructed using local and regional flaps. The lack of appropriate recipient vessels after cardiac surgery may explain the minor role of free flaps. To date, arteriovenous loops have been the leading solution to enable microsurgical closure of these defects. However, the related surgical effort and the risk of flap failure are increased. We reviewed our experiences with the right gastroepiploic vessels as alternative recipient vessels for free flap reconstructions. Methods Between September 2010 and July 2015, 12 patients suffering deep wound infection after cardiac surgery underwent sternal reconstruction with free flaps anastomosed to the right gastroepiploic vessels. Gracilis flaps (n = 8) and anterolateral thigh perforator flaps (n = 4) were used for sternal reconstruction. Recipient vessels were harvested by laparoscopic dissection in five patients. Half of the free flaps were variably combined with omental flow-through flaps. Results Healing of all flaps was uneventful with no partial or total flap loss. Simultaneous interdisciplinary harvesting of recipient vessels by laparoscopy significantly shortened mean operative time from 313 to 216 minutes (p = 0.018). One incisional hernia was observed in the laparotomy group. Revision of a gracilis donor site was necessary in another patient due to postoperative bleeding. No recurrent sternal infection occurred during a mean follow-up of 20 months (range, 3-59 months). Conclusions The concept of gastroepiploic recipient vessels allows reliable free flap reconstructions of sternal defects in such high-risk patients without the need for arteriovenous loops.

  19. Clinical application of mesenchymal stem cells for aseptic bone necrosis

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    Tomoki Aoyama

    2008-11-01

    Full Text Available Since 2007, we had started clinical trial using mesenchymal stem cell (MSCs for the treatment of aseptic bone necrosis as a first clinical trial permitted by Japanese Health, Labour and Welfare Ministry.Aseptic bone necrosis of the femoral head commonly occurs in patients with two to four decades, causing severe musculoskeletal disability. Although its diagnosis is easy with X-ray and MRI, there has been no gold standard invented for treatment of this disease. MSCs represent a stem cell population in adult tissues that can be isolated and expanded in culture, and differentiate into cells with different nature. Combination with β-tri-calcium phosphate and vascularized bone graft, we succeeded to treat bone necrosis of the femoral head.Regenerative medicine using stem cells is hopeful and shed a light on intractable disease. To become widespread, Basic, Translational, Application, and Developmental study is needed.? From an experience of cell therapy using MSCs, we started to research induced pluripotent stem cell (iPS for clinical application.

  20. Performance analysis of exam gloves used for aseptic rodent surgery.

    Science.gov (United States)

    LeMoine, Dana M; Bergdall, Valerie K; Freed, Carrie

    2015-05-01

    Aseptic technique includes the use of sterile surgical gloves for survival surgeries in rodents to minimize the incidence of infections. Exam gloves are much less expensive than are surgical gloves and may represent a cost-effective, readily available option for use in rodent surgery. This study examined the effectiveness of surface disinfection of exam gloves with 70% isopropyl alcohol or a solution of hydrogen peroxide and peracetic acid (HP-PA) in reducing bacterial contamination. Performance levels for asepsis were met when gloves were negative for bacterial contamination after surface disinfection and sham 'exertion' activity. According to these criteria, 94% of HP-PA-disinfected gloves passed, compared with 47% of alcohol-disinfected gloves. In addition, the effect of autoclaving on the integrity of exam gloves was examined, given that autoclaving is another readily available option for aseptic preparation. Performance criteria for glove integrity after autoclaving consisted of: the ability to don the gloves followed by successful simulation of wound closure and completion of stretch tests without tearing or observable defects. Using this criteria, 98% of autoclaved nitrile exam gloves and 76% of autoclaved latex exam gloves met performance expectations compared with the performance of standard surgical gloves (88% nitrile, 100% latex). The results of this study support the use of HP-PA-disinfected latex and nitrile exam gloves or autoclaved nitrile exam gloves as viable cost-effective alternatives to sterile surgical gloves for rodent surgeries.

  1. Usefulness of the evaluation of preoperative sternal shape for reconstruction of pectus excavatum using three-dimensional computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Noguchi, Masahiko; Kondoh, Shohji; Kondoh, Yoshiaki; Akabane, Genichiroh [Nagano Children`s Hospital (Japan); Matsuo, Kiyoshi

    1997-04-01

    In the reconstruction of the pectus excavatum deformity, when sternal growth must be considered, it is desirable that osteotomy of the sternum be performed if necessary. From this standpoint, we evaluate the preoperative sternal shape using three-dimensional computed tomography. The sternum is outlined on the mid-sagittal plane, and the curved portions are examined. Preoperatively, the sternums are classified into 3 groups based on the number of curved portions. On the basis of these observations, we determine the position and degree of the sternal osteotomy and, if necessary, combined sternal osteotomy and augmentation using resected cartilage. We think that this method is useful not only for reconstruction of pectus excavatum but also in evaluating the postoperative shape of the thorax. (author)

  2. Recurrent aseptic encephalitis in periodic fever, aphthous stomatitis, pharyngitis and adenopathy (PFAPA) syndrome.

    Science.gov (United States)

    Frye, Richard E

    2006-05-01

    An 11-year-old boy with episodes of periodic fever, aphthous stomatitis, pharyngitis and adenitis (PFAPA) is reported. Two PFAPA episodes were associated with aseptic encephalitis and seizures. Recurrent acute aseptic encephalitis or seizures have never been reported during the febrile episodes of PFAPA. This possible association is discussed within the context of the etiology of PFAPA.

  3. RECURRENT ASEPTIC ENCEPHALITIS IN PERIODIC FEVER, APHTHOUS STOMATITIS, PHARYNGITISAND ADENOPATHY (PFAPA) SYNDROME

    OpenAIRE

    Frye, Richard E.

    2006-01-01

    An 11-year-old boy with episodes of periodic fever, aphthous stomatitis, pharyngitis and adenopathy (PFAPA) is reported. Two PFAPA episodes were associated with aseptic encephalitis and seizures. Recurrent acute aseptic encephalitis or seizures have never been reported during the febrile episodes of PFAPA. This possible association is discussed within the context of the etiology of PFAPA.

  4. Paediatric Investigators Collaborative Network on Infections in Canada (PICNIC study of aseptic meningitis

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    Robinson Joan L

    2006-04-01

    Full Text Available Abstract Background The seasonality, clinical and radiographic features and outcome of aseptic meningitis have been described for regional outbreaks but data from a wider geographic area is necessary to delineate the epidemiology of this condition. Methods A retrospective chart review was completed of children presenting with aseptic meningitis to eight Canadian pediatric hospitals over a two-year period. Results There were 233 cases of proven enteroviral (EV meningitis, 495 cases of clinical aseptic meningitis and 74 cases of possible aseptic meningitis with most cases occurring July to October. Headache, vomiting, meningismus and photophobia were more common in children ≥ 5 years of age, while rash, diarrhea and cough were more common in children Conclusion The clinical presentation of aseptic meningitis varies with the age of the child. Absence of CSF pleocytosis is common in infants

  5. Aseptic multiplication of banana from excised floral apices.

    Science.gov (United States)

    Cronauer, S S; Krikorian, A D

    1985-08-01

    Most economically important bananas and plantains are large triploid seedless herbs that must be propagated vegetatively by removing small side shoots or "suckers" from the parent plant or by planting seed pieces of larger corms. Consequently, multiplication of stock material is time consuming, Recently, the rapid production of young banana plantlets suitable for use as "seed" material has been described. Vegetative shoot apices were isolated and multiplied using aseptic tissue culture techniques. Although these multiplication systems, once established, can produce thousands of plants in a relatively short period of time, their establishment necessitates the initial sacrifice of an individual specimen, which may not always be desirable or prudent should a limited parent stock be available. We describe here the production and multiplication of rooted banana plantlets from the isolation and culture of terminal floral apices.

  6. Cloning higher plants from aseptically cultured tissues and cells

    Science.gov (United States)

    Krikorian, A. D.

    1982-01-01

    A review of aseptic culture methods for higher plants is presented, which focuses on the existing problems that limit or prevent the full realization of cloning plants from free cells. It is shown that substantial progress in clonal multiplication has been made with explanted stem tips or lateral buds which can be stimulated to produce numerous precocious axillary branches. These branches can then be separated or subdivided and induced to root in order to yield populations of genetically and phenotypically uniorm plantlets. Similarly, undifferentiated calluses can sometimes be induced to form shoots and/or roots adventitiously. Although the cell culture techniques required to produce somatic embryos are presently rudimentary, steady advances are being made in learning how to stimulate formation of somatic or adventive embryos from totipotent cells grown in suspension cultures. It is concluded that many problems exist in the producing and growing of totipotent or morphogenetically competent cell suspensions, but the potential benefits are great.

  7. Aseptic Meningitis Caused by Lassa Virus: Case Series Report

    Directory of Open Access Journals (Sweden)

    Peter O. Okokhere

    2016-01-01

    Full Text Available The Lassa virus is known to cause disease in different organ systems of the human body, with varying clinical manifestations. The features of severe clinical disease may include bleeding and/or central nervous system manifestations. Whereas Lassa fever encephalopathy and encephalitis are well described in the literature, there is paucity of data on Lassa virus meningitis. We present the clinical description, laboratory diagnosis, and management of 4 consecutive cases of aseptic meningitis associated with Lassa virus infection without bleeding seen in a region of Nigeria known to be endemic for both the reservoir rodent and Lassa fever. The 4 patients recovered fully following intravenous ribavirin treatment and suffered no neurologic complications.

  8. Early morbidity after aseptic revision hip arthroplasty in Denmark

    DEFF Research Database (Denmark)

    Lindberg-Larsen, M.; Hansen, Torben Bæk

    2014-01-01

    aseptic revision THRs from 1st October 2009 to 30th September 2011 using the Danish National Patient Registry, with additional information from the Danish Hip Arthroplasty Registry. There were 1553 procedures (1490 patients) performed in 40 centres and we divided them into total revisions, acetabular...... component revisions, femoral stem revisions and partial revisions. The mean age of the patients was 70.4 years (25 to 98) and the median hospital stay was five days (interquartile range 3 to 7). Within 90 days of surgery, the readmission rate was 18.3%, mortality rate 1.4%, re-operation rate 6.......1%, dislocation rate 7.0% and infection rate 3.0%. There were no differences in these outcomes between high- and low-volume centres. Of all readmissions, 255 (63.9%) were due to 'surgical' complications versus 144 (36.1%) 'medical' complications. Importantly, we found no differences in early morbidity across...

  9. Hand hygiene and aseptic technique in the emergency department.

    Science.gov (United States)

    Al-Damouk, M; Pudney, E; Bleetman, A

    2004-02-01

    Hand hygiene and simple aseptic measures before invasive procedures are effective in reducing rates of healthcare-associated infection. The perceived urgency of a clinical situation in the emergency department, however, may influence medical staff's compliance with good practice in infection control. The aims of this prospective, single-blinded, observational study were twofold. First, to assess doctors' compliance with good practice in hand hygiene between patient episodes and asepsis during invasive procedures in the emergency department. Second, to assess the effect of clinical urgency on compliance with good practice in hand hygiene and asepsis during invasive procedures. Good practice standards for asepsis in invasive procedures and hand hygiene between patient episodes were compiled from a literature search. Doctors' compliance with these standards was observed in two emergency departments (UK and New Zealand). Observed clinical cases were classified as immediate, urgent and non-urgent based on the triage system. There was poor compliance with good practice guidelines for asepsis in invasive procedures in both centres. Staff achieved high compliance with the guidelines in only 27% of cases in the UK and 58% of cases in New Zealand. Clinical urgency did not appear to adversely affect compliance with aseptic good practice. Hand hygiene between patient consultations was very low at 14% in the UK and 12% in New Zealand. Asepsis and hand hygiene was poor in both the UK and New Zealand emergency departments. There may be a need for some compromise in standards of asepsis in very sick patients due to the urgency of the clinical situation. Compliance in all situations especially non-urgent procedures needs to be improved.

  10. Midline raphé, sternal cleft, and other midline abnormalities: a new dominant syndrome?

    Science.gov (United States)

    Forzano, Francesca; Daubeney, Piers E F; White, Susan M

    2005-05-15

    Sternal fusion defects are malformations that often present as an isolated finding. An association with multiple malformations has been reported, in particular with midline raphe and craniofacial hemangiomas and as part of the pentalogy of Cantrell. Most syndromic cases were sporadic with a few families reported with recurrence in sibs. We describe a mother and two daughters with midline raphe and sternal defects. Affected members also had double central incisors, congenital heart defect, neck webbing, bicornuate uterus and minor anomalies including long face with hypotelorism. None of the three affected relatives had hemangiomas. The manifestations of these patients do not fit any previously described condition, and we propose they represent a new syndrome. This family is also important as it points to a possible genetic cause for at least some cases of this disorder of the ventral midline.

  11. Sternal Osteomyelitis and Abscess Caused by Elbowing during a Basketball Game

    Directory of Open Access Journals (Sweden)

    Hideo Ichimura

    2012-01-01

    Full Text Available A 15-year-old boy was referred to our hospital for further investigation and treatment of sternal osteomyelitis due to blunt chest trauma, more specifically elbowing during a basketball game 19 days earlier. On an initial presentation, his chest was markedly swollen and chest computed tomography demonstrated a sternal fracture and massive fluid collection in the chest wall. Since his general condition remained fairly good, we initially selected minimal drainage concomitant with antibiotics; if it was unsuccessful, we planned to switch to a more radical debridement procedure. The patient recovered without further invasive intervention and was discharged on postoperative day 26. There is no sign of recurrence six months after operation. This case report indicates that minimal drainage would be a good option for treatment in a phased strategy.

  12. Degradation of 316L stainless steel sternal wire by steam sterilization.

    Science.gov (United States)

    Shih, Chun-Che; Su, Yea-Yang; Chen, Lung-Ching; Shih, Chun-Ming; Lin, Shing-Jong

    2010-06-01

    Sterilization is an important step prior to the implantation of medical devices inside the human body. In this work we studied the influence of steam sterilization cycles on the oxide film properties of stainless steel sternal wire. Characterization techniques such as open- circuit potential, potentiodynamic measurement, electrochemical impedance spectroscopy, cathodic stripping, transmission electron microscopy, atomic force microscopy and scanning electron microscopy were employed to investigate the cycles of steam sterilization on the corrosion behavior of sternal wire. The results showed that the oxide properties are a function of the number of steam sterilization cycles and deteriorate as the number of cycles increases. Steam sterilization might damage the implant integrity and heavy metals could be released to the surrounding tissues due to deterioration of the oxide film.

  13. Corrosion of stainless steel sternal wire after long-term implantation.

    Science.gov (United States)

    Tomizawa, Yasuko; Hanawa, Takao; Kuroda, Daisuke; Nishida, Hiroshi; Endo, Masahiro

    2006-01-01

    A variety of metallic components have been used in medical devices where lifelong durability and physical strength are demanded. To investigate the in vivo changes of implanted metallic medical devices in humans, stainless steel sternal wires removed from patients were evaluated. Stainless steel (316L) sternal wires removed from four patients after 10, 13, 22, and 30 years of implantation were evaluated using scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS). Macroscopically, the removed specimens maintained their metallic luster and color. Under SEM, small holes were observed sporadically at 10 years and they tended to connect in the drawing direction. The longer the implanted duration, the more numerous and deeper were the crevices observed. By EDS, sulfur, phosphorus, and calcium were identified in all areas at 10 years, in addition to the component elements of stainless steel, comprising iron, chromium, nickel, and manganese. Corrosion products observed at 30 years were identified as calcium phosphate. In conclusion, stainless steel sternal wires develop corroded pores that grow larger and deeper with time after implantation; however, the pores remain shallow even after decades of implantation and they may not be a cause of mechanical failure. An amount of metal ions equivalent to the corroded volume must have been released into the human body, but the effect of these metal ions on the body is not apparent.

  14. MR analysis of sternal bone marrow using STIR in hematologic diseases

    Energy Technology Data Exchange (ETDEWEB)

    Kozawa, Eito [Saitama Medical School, Moroyama (Japan)

    1998-12-01

    The magnetic resonance (MR) signal intensity pattern of sternal bone marrow was examined in 21 normal volunteers and 10 patients with aplastic anemia (n=4), multiple myeloma (2), AML (2), gammaglobulinemia (1) and MDS (1) using a sagittal STIR sequence. Double Echo STIR images (TR/TI/TE/NEX=2000/180/20, 100/1) were obtained with a CP body array coil. Craniocaudal phase-encoding with a handmade positioning device effectively avoided overlapping artifacts due to cardiac pulsation. In the normal volunteers, age showed a significant inverse correlation with the calculated SIR (signal intensity ratio of bone marrow relative to subcutaneous fat) using STIR with short TE. The SIR in the sternal body was significantly higher than that in the manubrium (p<0.05). Knowledge of the sternal bone marrow distribution according to age is useful for evaluating hematologic diseases. The proposed method provided high spatial resolution and an excellent bone marrow signal, and may be useful for determining site for aspiration. (author)

  15. Location of Sternal Fractures as a Possible Marker for Associated Injuries

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    Max J. Scheyerer

    2013-01-01

    Full Text Available Introduction. Sternal fractures often occur together with serious and life-threatening additional injuries. This retrospective study was designed to assess concomitant injuries and develop a correlation between fracture location and the severity of injury. Methods. All patients ( diagnosed with a fracture of the sternum by means of a CT scan were analysed with respect to accident circumstances, fracture morphology and topography, associated injuries, and outcome. Results. Isolated sternal fractures occurred in 9%. In all other admissions, concomitant injuries were diagnosed: mainly rip fractures (64%, injury to the head (48%, the thoracic spine (38%, lumbar spine (27%, and cervical spine (22%. Predominant fracture location was the manubrium sterni. In these locations, the observed mean ISS was the highest. They were strongly associated with thoracic spine and other chest injuries. Furthermore, the incidence of head injuries was significantly higher. ICU admission was significantly higher in patients with manubrium sterni fractures. Conclusion. Sternal fractures are frequently associated with other injuries. It appears that the fracture location can provide important information regarding concomitant injuries. In particular, in fractures of manubrium sterni, the need for further detailed clinical and radiologic workup is necessary to detect the frequently associated injuries and reduce the increased mortality.

  16. Application and evaluation of improved surgical aseptic technique curriculum in specialty nurse training in Henan Province

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    Bing Bai

    2016-09-01

    Conclusion: Novel surgical aseptic technique and application in the curriculum design of training for OR nurses should be developed to enhance their mastery of theoretical and practical skills and to modify their behaviors.

  17. Aseptic Splenic Abscess as Precursory Extraintestinal Manifestation of Inflammatory Bowel Disease

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    Joel Brooks

    2014-01-01

    Full Text Available Splenic abscesses are most often secondary to aerobic bacterial infections due to Streptococcus, Staphylococcus, and Enterococcus species of organisms. Sterile splenic abscesses rarely occur and diagnosis and treatment of those are challenging. We report a case of a previously healthy young female presenting with aseptic splenic abscesses as the initial manifestation of Crohn’s disease along with a review of the literature on aseptic splenic abscess as an extraintestinal manifestation of Crohn’s disease.

  18. The changing epidemiology of pediatric aseptic meningitis in Daejeon, Korea from 1987 to 2003

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    Lee Mi-Hee

    2005-11-01

    Full Text Available Abstract Background Aseptic meningitis is a relatively frequent childhood disease and virologic data suggest that enteroviruses are the commonest etiologic agents. We evaluated the epidemiologic characteristics of aseptic meningitis in Daejeon, South Korea from 1987 to 2003. Methods 2201 medical records of children with aseptic meningitis admitted to The Catholic University of Korea, Daejeon St Mary's Hospital were retrospectively analyzed. Results Outbreaks of aseptic meningitis were observed in 1990, 1993, 1996, 1997, 2001 and 2002. The age distribution of cases was relatively uniform, with a higher incidence in those aged P = 0.001. Neurologic sequelae were observed in 0.7% of the patients. Conclusion Aseptic meningitis, rare before the 1980s in Korea, has since become a common clinical entity. Since 1990, outbreaks of aseptic meningitis have occurred every 1 to 3 years in Daejeon in keeping with Korea-wide epidemics. The frequency of disease affecting children less than one year of age may reflect herd immunity to the epidemic strain.

  19. Sternal "retraction": a novel application of a mandibular distractor in treating ectopia cordis with complete cleft sternum.

    Science.gov (United States)

    Gart, Michael S; Vicari, Frank A

    2015-05-01

    Complete thoracic ectopia cordis is associated with a uniformly dismal prognosis. The primary challenges of this disorder are (1) returning the heart to the thoracic cavity, (2) stabilizing the chest wall, and (3) repairing the sternal defect. Previously published techniques for achieving these goals have demonstrated very limited success and/or significant morbidity.We present a novel application of a mandibular distraction device as part of staged repair of this historically challenging problem. This method uses immediate stabilization and gradual "retraction" of the sternal remnants, thereby allowing physiologic compensation and avoiding the cardiorespiratory embarrassment associated with returning the heart to the thoracic cavity. Moreover, this technique allows stabilization of the associated sternal cleft and chest wall without the commonly associated morbidity of the currently available techniques.

  20. Transapical Mitral Valve-in-Valve Replacement in Patient With Previous Complex Sternal Reconstruction.

    Science.gov (United States)

    Hynes, Conor F; Fatemi, Omid; Sharma, Aditya C; Nagy, Christian D; Trachiotis, Gregory D

    2016-01-01

    We present a complex case of a transapical redo mitral valve-in-valve replacement. Repeat mitral valve replacement was indicated for severe symptomatic bioprosthetic stenosis. In addition to the patient's numerous comorbidities that included diabetes, hepatic cirrhosis, ischemic cardiomyopathy, and atrial flutter, he had undergone a previous open mitral valve replacement that was complicated by sternal dehiscence requiring extensive chest wall reconstruction. Transapical approach was performed through left minithoracotomy incision with balloon-expandable valve. Transapical valve-in-valve replacement of a stenotic mitral bioprosthesis is a viable solution in a patient with previous complex chest wall reconstruction and multiple comorbidities.

  1. Cerebrospinal fluid lactate dehydrogenase isoenzymes in children with bacterial and aseptic meningitis.

    Science.gov (United States)

    Nussinovitch, Moshe; Finkelstein, Yaron; Elishkevitz, Keren Politi; Volovitz, Benjamin; Harel, Daniella; Klinger, Gil; Razon, Yaron; Nussinovitch, Udi; Nussinovitch, Naomi

    2009-10-01

    Differentiation of bacterial from aseptic meningitis may be difficult. Our aim was to determine the pattern of distribution of lactate dehydrogenase (LDH) isoenzymes in the cerebrospinal fluid (CSF) of patients with bacterial and aseptic meningitis. One hundred and fifty-seven patients with suspected meningitis were enrolled in the study. They were divided into 3 groups according to the culture- or bacterial antigen assay-proven diagnosis and CSF findings: bacterial meningitis (n = 31), aseptic meningitis (n = 65), and non-meningitis (n = 61). Total LDH level and percentages of LDH isoenzymes in the CSF were measured in each patient. Each group showed a distinct LDH isoenzyme distribution pattern, with a statistically significant difference among the groups in the percentages of the various isoenzymes. Compared with the non-meningitis group, total LDH activity in the CSF was high in the aseptic meningitis group (49.82+/-35.59 U/L, P < 0.001) and exaggerated in the bacterial meningitis group (944.53+/-112.3 U/L, P < 0.001). Low LDH-2 levels were unique to bacterial meningitis (P < 0.01), whereas high LDH-3 levels were characteristic of aseptic meningitis (P < 0.05). Both groups had low levels of LDH-1 and high levels of LDH-4 and LDH-5. In conclusion, the LDH isoenzyme pattern may be of clinical diagnostic value in meningitis, particularly when culture results are pending.

  2. Unusually severe varicella zoster (VZV) virus viral (aseptic) meningitis in an unimmunized, immunocompetent host with chickenpox.

    Science.gov (United States)

    Cunha, Burke A; Warren-Favorito, Heather; Mickail, Nardeen

    2011-01-01

    Chickenpox is caused by the varicella zoster virus (VZV) and may be more severe in adults than in children. Central nervous system (CNS) manifestations of chickenpox and VZV are uncommon, for example, encephalitis and cerebellar ataxis. Viral (aseptic) meningitis is a rare CNS complication of VZV. The cerebrospinal fluid (CSF) profile in VZV viral (aseptic) meningitis is indistinguishable from other causes of viral meningitis. The clue to most of the diagnoses of VZV aseptic meningitis is based on the temporal relationship between antecedent or concomitant chickenpox. Chickenpox is a clinical diagnosis based on the appearance and distribution of the rash. The rash of chickenpox is vesicular/pruritic and typically appears in crops over 3 successive days. VZV vesicles are fragile, superficial, and surrounded by a erythematous halo. Common nonspecific laboratory findings in chickenpox include leukopenia, thrombocytopenia, and elevated serum transaminases (serum glutamate-oxaloacetate transaminase/serum glutamate-pyruvate transaminase). The erythrocyte sedimentation rate (ESR) is not highly elevated in chickenpox. In VZV aseptic meningitis, the CSF shows a lymphocytic pleocytosis with normal protein, glucose, and lactic acid levels. CSF red blood cells are not a feature of VZV meningitis. We present the case of a healthy unimmunized adult who was hospitalized with chickenpox complicated by VZV aseptic meningitis with an unusually severe headache and nuchal rigidity that occurred during hospitalization.

  3. Supportive treatment using a compression garment vest of painful sternal instability following deep surgical wound infection: a case report

    Directory of Open Access Journals (Sweden)

    Klement Andreas

    2010-08-01

    Full Text Available Abstract Introduction Sternal dehiscence and instability poses a significant cause of persistent pain and limited quality of life following hospital discharge for 0.2% to 5% of patients who have undergone median sternotomy for open heart surgery. We report a successful, conservative, supportive long-term therapy of painful sternal non-union using a customized compression garment vest. Case presentation We report a case of painful sternal instability following open heart surgery in a 74-year-old Caucasian man. The complicating factors of obesity (body mass index of 40, renal failure, insulin-dependent diabetes mellitus and absolute arrhythmia with atrial fibrillation were present. Conclusion A number of studies have demonstrated the efficacy of surgical interventions for secondary sternal stabilization, but individual patients may reject this option or may be, for other reasons, no longer operable. The task of primary care physicians and other health care providers is to offer this group of patients an alternative option for pragmatic, inexpensive and effective supportive therapy, of which compression garments are an example.

  4. Recurrent aseptic meningitis in association with Kikuchi-Fujimoto disease: case report and literature review

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    Komagamine Tomoko

    2012-09-01

    Full Text Available Abstract Background Kikuchi Fujimoto disease (KFD, or histiocytic necrotising lymphadenitis, is a benign and self-limiting condition characterised by primarily affecting the cervical lymph nodes. Recurrent aseptic meningitis in association with KFD is extremely rare and remains a diagnostic challenge. Case presentation We report a 28-year-old man who presented 7 episodes of aseptic meningitis associated with KFD over the course of 7 years. Histopathological findings of enlarged lymph nodes led to the diagnosis of KFD. The patient’s headache and lymphadenopathy spontaneously resolved without any sequelae. Conclusions A diagnosis of KFD should be considered when enlarged cervical lymph nodes are observed in patients with recurrent aseptic meningitis. A long-term prognosis remains uncertain, and careful follow-up is preferred.

  5. District nurses' and aseptic technique: where did it all go wrong?

    Science.gov (United States)

    Unsworth, John

    2011-01-01

    Concerns have been raised about whether it is possible to perform aseptic procedures within a community setting. Hallett (2000) has described how community nurses often have a fatalistic view about whether such procedures can really be performed at home. At the same time there has been an increase in the number of patients being cared for at home who need interventions which must adhere to the principles of asepsis. While it has been acknowledged for some time that community nurses must be resourceful and adapt the procedure, the view that community nurses cannot really perform aseptic procedures is a fairly new phenomenon. This article explores the reasons why concerns about the performance of aseptic procedures in the community may have arisen and what steps can be taken to address these concerns to ensure that care at home is both safe and effective.

  6. Etiology of aseptic meningitis and clinical characteristics in immune-competent adults.

    Science.gov (United States)

    Han, Su-Hyun; Choi, Hye-Yeon; Kim, Jeong-Min; Park, Kwang-Ryul; Youn, Young Chul; Shin, Hae-Won

    2016-01-01

    Viral meningitis is the most common cause of aseptic meningitis. Use of the polymerase chain reaction (PCR) has increased the ability to determine the etiology of viral meningitis. This study used PCR analysis to evaluate the etiology of aseptic meningitis in 177 previously healthy adults over a 5-year period, as well as analyzing the clinical characteristics, cerebrospinal fluid (CSF) findings, and prognosis according to each etiology. The most frequent cause of aseptic meningitis was enterovirus (EV), followed by varicella zoster virus (VZV). Patients with EV meningitis were significantly younger than those with VZV meningitis. The percentage of lymphocytes in white blood cell counts and protein concentrations in the CSF differed significantly among patients with EV, VZV and meningitis of undetermined etiology. Younger age and lower percentage of lymphocyte and protein level in CSF analysis may be suggestive of EV meningitis. Further prospective studies are warranted to identify the correlations between the clinical characteristics and the etiologies of meningitis.

  7. An investigation of the aseptic loosening of an AISI 316L stainless steel hip prosthesis.

    Science.gov (United States)

    Godec, Matjaz; Kocijan, Aleksandra; Dolinar, Drago; Mandrino, Djordje; Jenko, Monika; Antolic, Vane

    2010-08-01

    The total replacement of joints by the implantation of permanently indwelling prosthetic components has been one of the major successes of modern surgery in terms of relieving pain and correcting deformity. However, the aseptic loosening of a prosthetic-joint component is the most common reason for joint-revision surgery. Furthermore, it is thought that wear particles are one of the major contributors to the development and perpetuation of aseptic loosening. The aim of the present study was to identify the factors related to the aseptic loosening of an AISI 316L stainless steel total hip prosthesis. The stem was evaluated by x-ray photoelectron spectroscopy, with polished and rough regions being analyzed in order to establish the differences in the chemical compositions of both regions. Specific areas were examined using scanning electron microscopy with energy dispersive x-ray spectroscopy and light microscopy.

  8. MOLECULAR-EPIDEMIOLOGICAL INVESTIGATION OF THE OUTBREAK OF ASEPTIC MENINGITIS IN NOVOSIBIRSK REGION

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    A. V. Demina

    2016-01-01

    Full Text Available The aim of this study was to investigate the outbreak of aseptic meningitis in theNovosibirskregion in 2008–2009. We studied genetic diversity and molecular-epidemiological characteristics of human enteroviruses that caused aseptic meningitis. Materials and metods. In the present study we investigated samples of cerebrospinal fluid from 199 patients with a diagnosis “aseptic meningitis”, based on the clinical characteristics of the disease (headache, stiff neck, fever, nausea, vomiting, and confirmed by laboratory tests of spinal fluid (lymphocyte cell count > 10 cells/ml.All samples were tested by PCR for RNA of Enterovirus and Flavivirus and DNA Myc. tuberculosis, Borrelia spp., Neisseria spp. In the samples there were not found RNA Flavivirus, DNA Myc. tuberculosis, Borrelia spp., Neisseria spp., but in 73 samples (37% was identified RNA enterovirus (EV. Determination of nucleotide sequences of 5’UTR and VP1-region of EV revealed that they belong to the following genotypes: the highest percentage was presented by genotype ECHO 30 (62%; another genotypes were Cox A2 (8%, Cox A4 (5%, Cox A14 (3%, Cox A16 (5%, Cox B5 (8%, ECHO 6 (3%, ECHO 9 (3% and ECHO 25 (3%. In 2008 most of the EV that caused the symptoms of aseptic meningitis belonged to genotype ECHO 30 (76%. In 2009 the clinical specimens containing genotype ECHO 30 were not found, but the largest percentage of EV belonged to genotypes Cox A2 (33% and Cox A4 (22%. Thus, in 2008 we recorded outbreak of aseptic meningitis, the major etiological factor was enterovirus ECHO 30. And the rise of the incidence of aseptic meningitis in 2009 is related to the circulation of new genotypes of EV. The investigated strains were deposited in an international database GenBank under accession numbers KP258231-KP258235, HM559584.

  9. Dual infection with hepatitis A and E virus presenting with aseptic meningitis:A case report

    Institute of Scientific and Technical Information of China (English)

    Kushal Naha; Suman Karanth; Mukhyaprana Prabhu; Manpreet Singh Sidhu

    2012-01-01

    ABSTRACT We report the case of a young male who presented with features of aseptic meningitis and elevated serum liver enzymes, but no symptoms or signs suggestive of an acute hepatitis. Subsequently, he was diagnosed with dual infection with hepatitisA andE viruses, and recovered completely with symptomatic therapy.Isolated aseptic meningitis, unaccompanied by hepatitic features is an unusual presentation of a hepatotrophic viral infection, and is yet to be reported with hepatitisA andE virus co-infection.

  10. Nuss procedure in adult pectus excavatum: a simple artifice to reduce sternal tension.

    Science.gov (United States)

    Ravenni, Giacomo; Actis Dato, Guglielmo Mario; Zingarelli, Edoardo; Flocco, Roberto; Casabona, Riccardo

    2013-07-01

    Nowadays the Nuss operation represents the standard surgical choice for pectus excavatum repair in children and teenagers. Some concerns have been raised regarding its applicability in adults, as compared with younger patients, in view of the higher rate of complications after surgery. We describe an easy trick that has been performed on a 36-year old man with a moderate pectus excavatum after an unsatisfactory Nuss procedure. It consisted of a T-shaped partial anterior sternotomy, performed after positioning of the stainless steel bar, in order to promote a hinge mechanism of the sternum to reduce the tension over the reinforcement. This procedure was successful with well-controlled postoperative pain and great patient satisfaction. No complications were recorded at 1-year follow-up. In our opinion, this simple trick could represent a valid surgical option for pectus excavatum repair in late adolescents and adults to obviate the occurrence of major sternal tension.

  11. The history of the management of sternal osteomyelitis and mediastinitis - from Hippocrates until today.

    Science.gov (United States)

    Ennker, Ina Carolin; Ennker, Jürgen C

    2014-01-01

    Even during the time of Hippocrates, Galen and their colleagues recognized mediastinal affections. However, they were not considered with the surgical treatment. First progress in the treatment options of this severe disease, still denoted as 'terra incognita', over to today's gold standard are pictured. The mediastinitis-registry which was founded by the German Society for Thoracic and Cardiovascular Surgery (DGTHG) in 2011 and the recent establishment of the study group to adopt a guideline 'diagnosis and therapy of postoperative mediastinitis/sternal osteomyelitis following cardiac surgery' are attempts to a standardization of the treatment. Substantial advancement in the treatment of postoperative mediastinitis could be achieved in the past. The mortality dropped as low as less than 10%. With these implementations more benefit for the patients' outcome can be expected.

  12. The history of the management of sternal osteomyelitis and mediastinitis – from Hippocrates until today

    Directory of Open Access Journals (Sweden)

    Ennker, Ina Carolin

    2014-06-01

    Full Text Available Even during the time of Hippocrates, Galen and their colleagues recognized mediastinal affections. However, they were not considered with the surgical treatment. First progress in the treatment options of this severe disease, still denoted as ‘terra incognita’, over to today’s gold standard are pictured.The mediastinitis-registry which was founded by the German Society for Thoracic and Cardiovascular Surgery (DGTHG in 2011 and the recent establishment of the study group to adopt a guideline ‘diagnosis and therapy of postoperative mediastinitis/sternal osteomyelitis following cardiac surgery’ are attempts to a standardization of the treatment. Substantial advancement in the treatment of postoperative mediastinitis could be achieved in the past. The mortality dropped as low as less than 10%. With these implementations more benefit for the patients’ outcome can be expected.

  13. Re-admissions, re-operations and length of stay in hospital after aseptic revision knee replacement in Denmark

    DEFF Research Database (Denmark)

    Lindberg-Larsen, M; Jørgensen, C C; Bæk Hansen, T;

    2014-01-01

    We present detailed information about early morbidity after aseptic revision knee replacement from a nationwide study. All aseptic revision knee replacements undertaken between 1st October 2009 and 30th September 2011 were analysed using the Danish National Patient Registry with additional inform...

  14. Infraareolar pectoralis major myocutaneous island flap as treatment of first choice for deep sternal wound infection.

    Science.gov (United States)

    Simunovic, Filip; Koulaxouzidis, Georgios; Stark, G Bjoern; Torio-Padron, Nestor

    2013-02-01

    Deep sternal wound infection (DSWI) is a grave complication of median sternotomy, associated with high morbidity, mortality and escalating treatment costs. There is general consensus that optimal treatment comprises radical debridement followed by coverage with a vascularised flap. However, there is ongoing debate regarding the ideal operative procedure. We present our experience with the infraareolar pectoralis major island myocutaneous flap (PEC-MI flap) as treatment of first choice in DSWI. Following a retrospective chart review, data pertaining to patient demographics, type of cardiac surgery performed, prevalence of known DSWI risk factors, identified pathogens, duration of surgery, flap-related complications, duration of hospital stay and antibiotic therapy, as well as mortality were noted. Additionally, we describe the operative technique and review the relevant literature. Twenty-five patients underwent coverage with the PEC-MI flap in our department. The average age was 69.2 years. Nineteen patients underwent coronary artery bypass surgery, 10 valve replacement, two aortic replacement surgery and one pericardiectomy. In six cases, no internal mammary artery was used in cardiac surgery, in 11 cases one and in seven cases both internal mammary arteries were used. The average duration of surgery was 154.2 min and the average hospital stay was 28.4 days. Complications which required revision surgery were haematoma in three cases, one wound dehiscence and one recurrent infection. Two cases required coverage with an additional regional flap. The PEC-MI flap has been used as flap of first choice in our clinic for treatment of DSWI. It is sufficient to raise the flap unilaterally, and it does not require skin grafting. The combination of immunocompetent bulky muscle tissue used to obliterate the sternal cavity and the large skin paddle enabling a low-tension skin closure allows reliable and efficient treatment of this severe complication.

  15. [Sternal re-entry using the retractor for harvesting internal thoracic artery].

    Science.gov (United States)

    Niinami, H; Takeuchi, Y

    2002-06-01

    The number of redo cardiac operations, especially coronary artery bypass grafting (CABG), has recently been increasing mainly due to the failure of saphenous vein grafts. Re-opening a median sternotomy is troublesome, because of possible adhesion of the heart to the sternum. Preoperative computed tomography is quite useful and helpful in determining the degree of the adhesion of the heart and ascending aorta to the back of the sternum. We report here a safe and useful technique for sternal re-entry using a retractor for harvesting the internal thoracic artery (ITA). When re-opening a median sternotomy the incision is made to the sternal wires; the wires are then cut and removed. Small rake retractors, which are connected to the ITA retractor, are hooked to both ends of the left side of the sternum. The ITA retractor is gently wound up to lift up the sternum. An oscillating saw is then applied to divide the anterior table of the sternum. When the posterior table of the sternum is carefully divided, the left side of the sternum is automatically elevated slightly. Complete division of the sternum can be confirmed by this slight elevation. If the left side of the sternum is elevated a little bit more by the ITA retractor, the dissection of the adhesion between the sternum and the heart can be performed without assistance. This technique is most beneficial for a case of redo CABG with the use of the left ITA, but it can be applied in any patients who previously underwent median sternotomy.

  16. Improving Quality of Refrigerated Potato Strips by Near-Aseptic Packaging

    Science.gov (United States)

    The effect of hot water blanching and near-aseptic packaging on the shelf-life of refrigerated potato strips was investigated based on quality; microbial, textural and color. Potato strips were first blanched at low temperature (60 °C) for 10- or 20-min, and then second blanched at high temperature ...

  17. Magnetic thermometry in the aseptic processing of foods containing particulates (abstract)

    Science.gov (United States)

    Ghiron, Kenneth; Litchfield, Bruce

    1997-04-01

    Aseptic processing of foods has many advantages over canning, including higher efficiency, lighter packaging, better taste, and higher nutritional value. Aseptic processing is different from canning where the food and container are sterilized together. Instead, a thin stream of food is heated and the packaging is independently sterilized before the food is placed in the package. However, no aseptic processes have been successfully filed with the FDA for foods containing sizable solid particles because of uncertainties in the thermal sterilization of the particles (e.g., soup). We have demonstrated that by inserting small paramagnetic particles in the interior of the simulated and real food particles, the local temperature can be measured. With this information, any questions about the adequate sterilization of the particles can be resolved. The measurements were done by directing the food stream through a magnetic field and sensing the voltages induced in a pickup coil by the motion of the magnetized particles. Details of the equipment design and data analysis will be discussed along with an introduction to the aseptic processing of foods.

  18. Excacerbation of systemic lupus erythematodes, aseptic meningitis and acute mental symptoms, following metrizamide lumbar myelography

    Energy Technology Data Exchange (ETDEWEB)

    Gelmers, H.J.

    1984-01-01

    A clinical constellation of excacerbation of systemic lupus erythematodes (SLE), together with aseptic meningitis, and acutre mental symptoms occurred following lumbar myelography with metrizamide. Excacerbation of SLE has not been previously described following myelography with any contrast agent. Meningeal reactions and acute mental symptoms have been reported earlier, but this clinical constellation is new.

  19. Nuss procedure for surgical stabilization of flail chest with horizontal sternal body fracture and multiple bilateral rib fractures.

    Science.gov (United States)

    Lee, Sung Kwang; Kang, Do Kyun

    2016-06-01

    Flail chest is a life-threatening situation that paradoxical movement of the thoracic cage was caused by multiply fractured ribs in two different planes, or a sternal fracture, or a combination of the two. The methods to achieve stability of the chest wall are controversy between surgical fixation and mechanical ventilation. We report a case of a 33-year-old man who fell from a high place with fail chest due to multiple rib fractures bilaterally and horizontal sternal fracture. The conventional surgical stabilization using metal plates by access to the front of the sternum could not provide stability of the flail segment because the fracture surface was obliquely upward and there were multiple bilateral rib fractures adjacent the sternum. The Nuss procedure was performed for supporting the flail segment from the back. Flail chest was resolved immediately after the surgery. The patient was weaned from the mechanical ventilation on third postoperative day successfully and was ultimately discharged without any complications.

  20. Management plan for deep sternal wound infection targeting to survival free of recurrence: A prospective evaluation study

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    Ibrahim Kasb

    2016-10-01

    Conclusion: Management of DSWI is tedious, has prolonged hospital stay and is associated with high morbidity and mortality rates. Management of DSWI must be personalized according to findings on exploration of the sternal wound and flap coverage must be initiated only when the patient is bacteriologically free. Both PMF and/or VOF provided high acceptable success rate defined as survival free of DSWI recurrence.

  1. Chronic meningitis in systemic lupus erythematosus: An unusual etiology

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    Anu Gupta

    2014-01-01

    Full Text Available Chronic aseptic meningitis is a rare manifestation of systemic lupus erythematosus (SLE. Apart from immunological causes and drugs, the aseptic meningitis group can include some unidentified viral infections that cannot be detected by routine microbiological testing. It is imperative to do complete cerebrospinal fluid (CSF workup before implicating the symptoms to disease activity or drugs, as untreated infections cause significant mortality in SLE. We present a case of young female with SLE who presented with chronic meningitis of an uncommon etiology.

  2. Semiochemicals from the predatory stink bug Eocanthecona furcellata (Wolff): components of metathoracic gland, dorsal abdominal gland, and sternal gland secretions.

    Science.gov (United States)

    Ho, Hsaio-Yung; Kou, Rong; Tseng, Hsin-Kuang

    2003-09-01

    Volatile compounds from the metathoracic glands (MTG), dorsal abdominal glands (DAG), and sternal setae of the generalist predatory stink bug Eocanthecona furcellata (Wolff) were studied by gas chromatography-mass spectrometry. MTGs of both male and female bugs contained (E)-2-decenal as the major component, with lesser amounts of (E, E)-2,4-decadienal, (E, Z)-2,4-decadienal, and (E)-2,9-decadienal. The relative amount of (E)-2,9-decadienal in the MTGs of female bugs was higher than in male bugs. There was no dimorphism in the morphology of the DAGs of adults. However, the DAG contents of adult bugs were different between the sexes. Geraniol was found only in the DAGs of males, and limonene and alpha-terpineol were found only in the DAGs of females, whereas linalool oxide isomers, linalool, neral, and geranial were found in DAGs of both sexes. The DAG contents of nymphs were also analyzed, with 4-oxo-(E)-2-hexenal, 4-oxo-(E)-2-octenal, tridecane, and tetradecanal being major components. Male bugs but not females possess sternal setae, and 6,10,13-trimethyltetradecyl isovalerate was detected from extracts of the sternal setae of males. The possible biological significance of dimorphism in the contents of the glands in adults is discussed.

  3. Etiologies and Management of Aseptic Meningitis in Patients Admitted to an Internal Medicine Department.

    Science.gov (United States)

    Jarrin, Irène; Sellier, Pierre; Lopes, Amanda; Morgand, Marjolaine; Makovec, Tamara; Delcey, Veronique; Champion, Karine; Simoneau, Guy; Green, Andrew; Mouly, Stéphane; Bergmann, Jean-François; Lloret-Linares, Célia

    2016-01-01

    Several studies have focused on the clinical and biological characteristics of meningitis in order to distinguish between bacterial and viral meningitis in the emergency setting. However, little is known about the etiologies and outcomes of aseptic meningitis in patients admitted to Internal Medicine.The aim of the study is to describe the etiologies, characteristics, and outcomes of aseptic meningitis with or without encephalitis in adults admitted to an Internal Medicine Department.A retrospective cohort study was conducted in the Internal Medicine Department of the Lariboisière Hospital in Paris, France, from January 2009 to December 2011. Clinical and biological characteristics of aseptic meningitis were recorded. These included cerebrospinal fluid analysis, results of polymerase chain reaction testing, final diagnoses, and therapeutic management.The cohort included 180 patients fulfilling the criteria for aseptic meningitis with (n = 56) or without (n = 124) encephalitis. A definitive etiological diagnosis was established in 83 of the 180 cases. Of the cases with a definitive diagnosis, 73 were due to infectious agents, mainly enteroviruses, Herpes Simplex Virus 2, and Varicella Zoster Virus (43.4%, 16.8%, and 14.5% respectively). Inflammatory diseases were diagnosed in 7 cases. Among the 97 cases without definitive diagnoses, 26 (26.8%) remained free of treatment throughout their management whereas antiviral or antibiotic therapy was initiated in the emergency department for the remaining 71 patients. The treatment was discontinued in only 10 patients deemed to have viral meningitis upon admission to Internal Medicine.The prevalence of inflammatory diseases among patients admitted to internal medicine for aseptic meningitis is not rare (4% of overall aseptic meningitis). The PCR upon admission to the emergency department is obviously of major importance for the prompt optimization of therapy and management. However, meningitis due to viral agents or

  4. A Rare Case of Crowned Dens Syndrome Mimicking Aseptic Meningitis

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    Teruyuki Takahashi

    2013-03-01

    Full Text Available Background: Crowned dens syndrome (CDS, related to microcrystalline deposition in the periodontoid process, is the main cause of acute or chronic cervical pain. Microcrystal-line deposition most often consists of calcium pyrophosphate dehydrate crystals and/or hydroxyapatite crystals. Case Presentation: This report describes the case of an 89-year-old woman who presented with sudden onset, high fever, severe occipital headache, and neck stiffness. A laboratory examination revealed a markedly elevated white blood cell count (11,100/µl and C-reactive protein level (23.8 mg/dl. These clinical findings suggested severe infection such as meningitis with sepsis. However, the results of blood culture, serum endotoxin, and procalcitonin were all negative, and cerebrospinal fluid studies revealed only a slight abnormality. The patient was first diagnosed with meningitis and treated with antiviral and antibiotic agents as well as non-steroidal anti-inflammatory drugs, but they only had limited effects. A cervical plain computed tomography (CT scan and its three-dimensional (3D reconstruction detected a remarkable crown-like calcification surrounding the odontoid process. On the basis of the CT findings, the patient was diagnosed as a severe case of CDS and was immediately treated with corticosteroids. The patient's condition drastically improved within a week after one course of corticosteroid therapy. Conclusion: Some atypical symptoms of CDS are misleading and may be misdiagnosed as meningitis, as happened in our case. A CT scan, especially a 3D-CT scan, is necessary and useful for a definitive diagnosis of CDS. CDS should be considered as a differential diagnosis of a possible etiology for fever, headache, and cervical pain of unknown origin.

  5. Transorbital superior ophthalmic vein sacrifice to preserve vision in ocular hypertension from aseptic cavernous sinus thrombosis.

    Science.gov (United States)

    Ladner, Travis R; Davis, Brandon J; He, Lucy; Mawn, Louise A; Mocco, J

    2015-12-01

    Aseptic cavernous sinus thrombosis (CST) is rare and may clinically masquerade as a carotid cavernous fistula. Conventional management includes oral anticoagulation, but cases of ocular hypertension affecting vision may require more aggressive intervention. We report a case of a woman with spontaneous bilaterally occluded cavernous sinuses with elevated intraocular pressure (IOP), which resolved immediately following unilateral superior ophthalmic vein (SOV) sacrifice. She was subsequently placed on oral anticoagulants. By 4 months postoperatively her IOP was normalized and her vision had improved. Repeat angiography demonstrated stable venous filling, with some mild improvement of flow through the cavernous sinus. Coil-mediated sacrifice of the SOV might be an effective means to relieve ocular hypertension and preserve vision in the setting of aseptic CST.

  6. Radiopharmaceutical uptake as a marker of sternal blood supply following internal mammary artery harvesting.

    Science.gov (United States)

    Rivas, L F; Hawkins, T; Morritt, G N; Behl, R P; Griffin, S C; Brown, A H

    1994-04-01

    To evaluate the impact of internal mammary artery harvesting on sternal blood supply after open heart surgery, a conventional bone scan was performed 7 days after operation in 30 patients. After administration of 370 MBq of technetium 99 m-medronic acid complex, imaging was carried out at the level of the sternum and including the humerus as a reference. A quantitative analysis of uptake (sternum/humerus uptake index) was performed and compared in three different groups of patients: group A, ten patients who had only vein grafts or valve surgery; group B, ten patients with single internal mammary artery harvesting; and group C, ten patients with bilateral internal mammary artery harvesting. These results were compared with 24 non-surgical subjects as a control (group D). Although intervention had a significant influence in raising the uptake index of the surgical groups (A = 3.34; B = 3.09 and C = 3.48) when compared with normal subjects (D = 2.45) (P 0.05). It was concluded that the vascular supply of the sternum is not entirely dependent upon the internal mammary arteries and that mobilization of both vessels does not cause per se additional serious impact to the bone vascularization after midline sternotomy, at least beyond day 7 after operation.

  7. Our experience with pectoralis major flap for management of sternal dehiscence: A review of 25 cases

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    Parag Sahasrabudhe

    2011-01-01

    Full Text Available Objective: To report our experience of the pectoralis major flap as the treatment modality for post coronary artery bypass sternal wound dehiscence. Materials and Methods: A retrospective study of 25 open heart surgery cases, performed between January 2006 and December 2010 at Deenanath Mangeshkar Hospital, Pune, was carried out. Unilateral or bilateral pectoralis major muscle flap by the double breasting technique using rectus extension was used in the management of these patients. The outcome was assessed on the basis of efficacy of flap surgery in achieving wound healing and post-surgery shoulder joint movements to evaluate donor site morbidity. The follow-up ranged from 5 months to 3.5 years. Results: Twenty-three (92% patients were discharged with complete wound closure. One patient (4% had wound dehiscence after flap surgery. One patient (4% died in the hospital in the immediate postoperative period due to mediastinitis. No recurrent sternum infection has occurred till date in 24 patients (96%. For one patient (4% who had wound dehiscence, daily dressing was done and wound healing was achieved with secondary intension. At follow-up, shoulder joint movements were normal in all the patients. Conclusions: The double breasting technique of the pectoralis major muscle flaps with rectus sheath extension is efficient in covering the entire length of the defect and can reduce the morbidity, without affecting the function of the shoulder joint.

  8. Osteomielite esternal por Mycobacterium tuberculosis Sternal osteomyelitis caused by infection with Mycobacterium tuberculosis

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    Diego Michelon De Carli

    2009-07-01

    Full Text Available Descrevemos o caso de um paciente de 74 anos, masculino, com dor torácica na porção superior do esterno com um ano de evolução associada a eritema, edema e fístula com drenagem de material purulento. Paciente HIV negativo e sem história prévia de contato com TB. A TC de tórax evidenciou lesão osteolítica esternal, e o material de biópsia revelou granuloma caseoso negativo para fungos e bacilos álcool-ácido resistentes no exame microbiológico direto. O diagnóstico de osteomielite esternal por Mycobacterium tuberculosis foi realizado por PCR.We report the case of a 74-year-old male patient with a one-year history of chest pain in the suprasternal notch associated with erythema, edema and drainage of purulent material from a fistulous lesion. The patient was HIV-negative with no history of TB. A CT scan of the chest showed an osteolytic lesion in the sternum, and a biopsy revealed caseous granuloma, which, in the microbiological evaluation, was negative for fungi and acid-fast bacilli. The diagnosis of sternal osteomyelitis caused by Mycobacterium tuberculosis was confirmed using PCR.

  9. Molecular epidemiology of human enterovirus associated with aseptic meningitis in Shandong Province, China, 2006-2012.

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    Zexin Tao

    Full Text Available BACKGROUND: Human enteroviruses (HEVs are common causes of acute meningitis. However, there is limited information about HEV associated with aseptic meningitis in mainland China because it has not been classified as a notifiable disease. OBJECTIVES: To characterize the HEVs associated with sporadic aseptic meningitis in China and to analyze their genetic features. STUDY DESIGN: Cerebrospinal fluid, throat swab and feces specimens were collected from patients with aseptic meningitis in 5 sentinel hospitals in Shandong Province, China between 2006 and 2012. Virological investigation (viral isolation and molecular identification and phylogenetic analysis were performed. RESULTS: A total of 437 hospitalized patients were reported, and enteroviruses were detected in the specimens from 84 patients (19.2% and were identified into 17 serotypes. The nine main serotypes were echovirus (E 30 (27.4%, EV71 (13.1%, coxsackievirus (CV B1 (9.5%, CVB3 (7.1%, CVB5 (7.1%, E6 (7.1%, E9 (7.1%, CVA9 (6.0%, and CVA10 (3.6%. Monthly distribution of isolated enteroviruses revealed a major peak in summer-fall season and a small second peak in winter constituted totally by EV71. Sequence analysis on VP1 coding region suggested Shandong strains had great genetic divergence with isolates from other countries. CONCLUSIONS: Multiple serotypes were responsible for enterovirus meningitis in mainland China. Aseptic meningitis caused by EV71 and coxsackie A viruses-the predominant pathogens for the hand, foot, and mouth disease-is currently an important concern in mainland China.

  10. Densitometric evaluation might prevent failure of knee artroplasty for aseptic loosening

    OpenAIRE

    2016-01-01

    Objectives: To study the correlation between quantitative ultrasound (QUS) expressed as stiffness index (SI) and the risk of aseptic loosening of knee arthroplasty. Methods: An observational retrospective controlled study was performed on 85 female patients (mean age: 73.3 years) divided into 2 groups from January 2007 to March 2015 and carried out at the Orthopedic Rehabilitation Unit, Casa di Cura Eremo, Arco, Trento, Italy. Group A included 42 patients who had undergone a revision of knee ...

  11. Storage stability of cashew apple juice preserved by hot fill and aseptic processes

    OpenAIRE

    Costa,Maria Cecília Oliveira; MAIA Geraldo Arraes; Figueiredo,Raimundo Wilane de; Souza Filho,Men de Sá Moreira de; Brasil, Isabella Montenegro

    2003-01-01

    Cashew (Anacardium occidentale L.) apples from Pacajus, Ceará State, Brazil, were processed into high pulp content juice. The juice was packed either by hot fill or an aseptic process and evaluated for physical, physical-chemical, and sensorial changes during a 12-month storage period at room temperature. The results indicated that pH, soluble solids, total acidity, total sugar content and color did not change significantly during storage nor were affected by the type of filling. The sensoria...

  12. Behçet's disease complicated by multiple aseptic abscesses of the liver and spleen.

    Science.gov (United States)

    Maeshima, Keisuke; Ishii, Koji; Inoue, Megumi; Himeno, Katsuro; Seike, Masataka

    2013-05-28

    Aseptic abscesses are an emergent entity and have been described in inflammatory bowel disease, especially in Crohn's disease, and in other diseases. However, aseptic abscesses associated with Behçet's disease are extremely rare. We report a Japanese male diagnosed with an incomplete type of Behçet's disease who developed multiple aseptic abscesses of the spleen and liver. In 2002, the spleen abscesses were accompanied by paroxysmal oral aphthous ulcers and erythema nodosum. As the patient's response to antibiotic treatment was inadequate, a splenectomy was performed. Severe inflammatory cell infiltration, largely of polymorphonuclear neutrophils, was observed without evidence of bacterial or fungal growth. Although the patient had no history of ocular symptoms or genital ulcers, a diagnosis of incomplete Behçet's disease was made according to the Japanese diagnostic criteria because of the presence of paroxysmal arthritis and epididymitis since 2002. In 2005, multiple liver abscesses developed with right hypochondrial pain and seemed to be attributed to Behçet's disease because the abscesses yielded negative results during a microbiologic investigation and failed to go into remission under antibiotic therapy. Oral prednisone (15 mg/d) was started in May 2006, and the abscesses dramatically disappeared 4 wk after treatment. Although the patient had a relapse of the liver abscesses in association with the tapering of prednisone, the augmentation of prednisone dosage yielded a response. The abscesses of the liver and spleen were strongly suggested to be attributed to Behçet's disease. Clinician should be aware of the existence of aseptic abscesses as uncommon manifestations of Behçet's disease.

  13. Mesenteric Lymphadenopathy in Childhood Epidemic Aseptic Meningitis: Sonographic Features and Clinical Significance

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    Mun, Sung Hee; Park, Young Chan; Lee, Young Hwan [Catholic University of Daegu, College of Medicine, Daegu (Korea, Republic of)

    2006-09-15

    To evaluate the sonographic features of mesenteric lymphadenopathy in childhood epidemic aseptic meningitis and to assess their clinical significance. Thirty-three patients (25 male, 8 female: mean age, 8.6 years) with a diagnosis of aseptic meningitis were prospectively evaluated with abdominal ultrasonography for the presence of enlarged mesenteric nodes. The size and number of enlarged mesenteric lymph nodes were analyzed in relationship with the patient's age, between the patients with abdominal pain or diarrhea (16 cases, 48%) and asymptomatic patients (17 cases, 52%). Mesenteric lymphadenopathy was seen in 31 patients (94%), all 16 symptomatic and 15 of the 17 asymptomatic patients. The number of enlarged nodes was most prevalent between 6-10, seen in 16 patients (52%) and the largest node ranged in size from 4 to 8 mm. Among the 31 patients with mesenteric lymphadenopathy, the mean size of the largest node was statistically different between the symptomatic (6.0 mm) and asymptomatic (5.0 mm) groups (p = 0.021). The number of enlarged nodes and the patient's age were not statistically different between the two groups. Mesenteric lymphadenopathy was seen in almost all cases of childhood epidemic aseptic meningitis, and may be related to the mesenteric lymphadenitis caused by enterovirus

  14. The BCL2 -938C>A Promoter Polymorphism Is Associated with Risk for and Time to Aseptic Loosening of Total Hip Arthroplasty.

    Science.gov (United States)

    Stelmach, Patrick; Wedemeyer, Christian; Fuest, Lena; Kurscheid, Gina; Gehrke, Thorsten; Klenke, Stefanie; Jäger, Marcus; Kauther, Max D; Bachmann, Hagen S

    2016-01-01

    Aseptic loosening is a major cause of revision surgery of total hip arthroplasty (THA). Only few host factors affecting aseptic loosening have been identified until now, although they are urgently needed to identify and possibly treat those patients at higher risk for aseptic loosening. To determine whether the functional single nucleotide polymorphism (SNP) c.-938C>A (rs2279115), located in the promoter region of the BCL2 gene has an impact on aseptic loosening of THA we genotyped and analyzed 234 patients suffering from aseptic loosening and 231 patients after primary THA. The polymorphism is associated with risk for aseptic loosening with the CC genotype at highest risk for aseptic loosening, Odds Ratio CC vs. AA 1.93, 95%CI 1.15-3.25, p = 0.013. In contrast, low risk AA genotype carriers that still developed aseptic loosening showed a significantly shorter time to aseptic loosening than patients carrying the C allele (p = 0.004). These results indicate that the BCL2 -938C>A polymorphism influences the occurrence and course of aseptic loosening and suggests this polymorphism as an interesting candidate for prospective studies and analyses in THA registers.

  15. The BCL2 -938C>A Promoter Polymorphism Is Associated with Risk for and Time to Aseptic Loosening of Total Hip Arthroplasty.

    Directory of Open Access Journals (Sweden)

    Patrick Stelmach

    Full Text Available Aseptic loosening is a major cause of revision surgery of total hip arthroplasty (THA. Only few host factors affecting aseptic loosening have been identified until now, although they are urgently needed to identify and possibly treat those patients at higher risk for aseptic loosening. To determine whether the functional single nucleotide polymorphism (SNP c.-938C>A (rs2279115, located in the promoter region of the BCL2 gene has an impact on aseptic loosening of THA we genotyped and analyzed 234 patients suffering from aseptic loosening and 231 patients after primary THA. The polymorphism is associated with risk for aseptic loosening with the CC genotype at highest risk for aseptic loosening, Odds Ratio CC vs. AA 1.93, 95%CI 1.15-3.25, p = 0.013. In contrast, low risk AA genotype carriers that still developed aseptic loosening showed a significantly shorter time to aseptic loosening than patients carrying the C allele (p = 0.004. These results indicate that the BCL2 -938C>A polymorphism influences the occurrence and course of aseptic loosening and suggests this polymorphism as an interesting candidate for prospective studies and analyses in THA registers.

  16. Computed tomographic assessment of sternal lymph node dimensions and attenuation in healthy dogs.

    Science.gov (United States)

    Milovancev, Milan; Nemanic, Sarah; Bobe, Gerd

    2017-03-01

    OBJECTIVE To assess dimensions and attenuation of sternal lymph nodes (SLNs) observed by means of CT in healthy dogs. ANIMALS 12 healthy adult research dogs. PROCEDURES Precontrast and postcontrast enhanced CT of the thorax was performed on each dog. Objective and subjective contrast-enhanced CT measurements were obtained. RESULTS By use of CT, 2 SLNs were identified in 10 of the 12 dogs and 1 SLN was identified in 2. Median SLN length, height, and width were 8.5 mm (range, 4 to 22 mm), 6.0 mm (range, 3 to 10 mm), and 5.0 mm (range, 3 to 10 mm), respectively. Median SLN length-to-T4 ratio, height-to-T4 ratio, and width-to-T4 ratio were 0.64 (range, 0.24 to 1.22), 0.37 (range, 0.25 to 0.53), and 0.29 (range, 0.19 to 0.67), respectively. Median SLN volume was 123 mm(3) (range, 38 to 484 mm(3)). Median height-to-length ratio, width-to-length ratio, and height-to-width ratio were 0.57 (range, 0.27 to 1.75), 0.51 (range, 0.31 to 1.25), and 1.27 (range, 0.50 to 2.50), respectively. All SLNs had homogenous contrast enhancement with median precontrast and postcontrast attenuation values of 18.3 Hounsfield units (HU; range, 4.4 to 36.9 HU) and 41.3 HU (range, 24.0 to 77.4 HU), respectively. All SLNs had a visible hilus, which was fat attenuating in 8 dogs and hypoattenuating in 4 dogs. CONCLUSIONS AND CLINICAL RELEVANCE CT imaging characteristics described in this study may provide a reference for dimensions and appearance of SLNs of healthy dogs and serve as a basis for comparison with results for diseased dogs.

  17. Sternal pulse rate variability compared with heart rate variability on healthy subjects.

    Science.gov (United States)

    Chreiteh, Shadi S; Belhage, Bo; Hoppe, Karsten; Branebjerg, Jens; Thomsen, Erik V

    2014-01-01

    The heart rate variability (HRV) is a commonly used method to quantify the sympathetic and the parasympathetic modulation of the heart rate. HRV is mainly conducted on electrocardiograms (ECG). However, the use of photo-plethysmography (PPG) as a marker of the autonomic tone is emerging. In this study we investigated the feasibility of deriving pulse rate variability (PRV) using PPG signals recorded by a reflectance PPG sensor attached to the chest bone (sternum) and comparing it to HRV. The recordings were conducted on 9 healthy subjects being in a relaxed supine position and under forced respiration, where the subjects were asked to breathe following a visual scale with a rate of 27 breaths/min. HRV parameters such as the mean intervals (meanNN), the standard deviation of intervals (SDNN), the root mean square of difference of successive intervals (RMSSD), and the proportion of intervals differing more than 50 ms (pNN50) were calculated from the R peak-to-R peak (R-R) and pulse-to-pulse (P-P) intervals. In the frequency domain the low and high frequency ratio of the power spectral density (LF/HF) was also computed. The Pearson correlation coefficient showed significant correlation for all the parameters (r > 0.95 with p < 0.001) and the Bland-Altmann analysis showed close agreement between the two methods for all the parameters during resting and forced respiration condition. Thus, PRV analysis using sternal PPG can be an alternative to HRV analysis on healthy subjects at.

  18. Use of a sternal elevator to reverse complete airway obstruction secondary to anterior mediastinal mass in an anesthetized child

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    Maria E. Linnaus

    2016-05-01

    Full Text Available Patients with an anterior mediastinal mass pose significant risk for cardiorespiratory compromise during surgical procedures and general anesthesia. Several techniques have been described to reverse airway obstruction in these patients. In extreme circumstances, patients may require cardiac bypass or extracorporeal membrane oxygenation (ECMO until definitive treatment of the mass and patient stabilization is achieved. We present a case in which the RulTract® system was used for emergency sternal elevation as a bridge to ECMO in acute respiratory collapse in an 11-year-old female with a minimally symptomatic anterior mediastinal mass.

  19. Legal, ethical, and procedural bases for the use of aseptic techniques to implant electronic devices

    Science.gov (United States)

    Mulcahy, Daniel M.

    2013-01-01

    animals often mask the signs of infection to avoid attracting predators (Wobeser 2006). Guidance specific to sterilization of electronic devices for implantation is limited in the wildlife record (Burger et al. 1994; Mulcahy 2003). Few biologists have been formally trained in aseptic technique, but most biologists know that electronic devices should be treated in some way to reduce the chance for infection of the host animal by bacteria, viruses, parasites, and fungi. Most biologists (73%) who implant devices into fishes believe aseptic techniques are important (Wagner and Cooke 2005). However, I maintain that many biologists find it difficult to place the concept of asepsis into practice in their work because of confusion about what constitutes aseptic technique, a lack of surgical knowledge and training, the perception of increased costs, or the belief that aseptic surgeries are impractical or unnecessary for their application. Some have even argued that, while compromising surgical techniques in the field might result in complications or mortalities, the money saved would allow for a compensatory increase in sample size (Anderson and Talcott 2006). In this paper I define aseptic surgical techniques, document the legal and professional guidance for performing aseptic surgeries on wild animals, and present options for sterilizing electronic devices and surgical instruments for field use.

  20. An echovirus 18-associated outbreak of aseptic meningitis in Taiwan: epidemiology and diagnostic and genetic aspects.

    Science.gov (United States)

    Tsai, Huey-Pin; Huang, Sheng-Wen; Wu, Feng-Ling; Kuo, Pin-Hwa; Wang, Shih-Min; Liu, Ching-Chuan; Su, Ih-Jen; Wang, Jen-Ren

    2011-09-01

    In 2006, an outbreak of aseptic meningitis was noted in Taiwan. From January to October 2006, a total of 3283 specimens collected from patients with viral infection, including 173 cerebrospinal fluid (CSF) samples, were examined for virus isolation and identification. Overall, 339 enterovirus (EV)-positive cases were identified by virus culture: echovirus 18 (E18) formed the majority (27.4 %, 93 cases), followed by coxsackievirus B2 (13.8 %, 47 cases) and coxsackievirus A2 (10.8 %, 37 cases). The manifestations of the 93 E18 cases were aseptic meningitis (44.1 %), viral exanthema (23.6 %), acute tonsillitis (15.1 %), acute pharyngitis (14.0 %), acute gastritis (11.8 %), herpangina (7.5 %) and bronchopneumonia (5.3 %). Of 107 E18 isolates identified, 100, 62.5 and 19 % were obtained following culture in RD, MRC-5 and A549 cells, respectively. E18 was identified most frequently from throat swabs (67.2 %) and less frequently from stool samples (15.9 %) and CSF (16.8 %). The detection rate of E18 was 78.2 % from CSF, 50 % from stool samples and 22.9 % from throat swabs. Phylogenetic relationships among the E18 strains were examined. Analysis of the partial VP1 gene showed 3.7-23.8 % variation in sequence compared with sequences from GenBank and, notably, the amino acid change V152S was detected in a protruding loop within the VP1 protein. These results indicate that a genetic variant of E18 was circulating and caused an outbreak of aseptic meningitis in Taiwan in 2006.

  1. A case of aseptic vertebral necrosis in the context of metastatic lumbar disease

    Energy Technology Data Exchange (ETDEWEB)

    Panow, C. [Radiologie Florissant, Geneva (Switzerland); Valavanis, A. [Institut fuer Neuroradiologie, Universitaetsspital Zuerich (Switzerland)

    2002-03-01

    Aseptic bone necrosis has many well recognized etiologies: caisson disease, corticosteroids, alcohol, Gaucher's disease and sickle cell anemia being a few of a long list. Little attention has been paid to metastatic disease as a possible cause and we were unable to find reference in the literature to this association. We present imaging features of metastatic Ewing's sarcoma involving the vertebral spine, which, in certain aspects, mimics other well-known entities of this region, such as Kuemmell's and Scheuermann's diseases. (orig.)

  2. Somatic embryogenesis ofCyclamen persicum Mill. 'Anneke' from aseptic seedlings.

    Science.gov (United States)

    Takamura, T; Miyajima, I; Matsuo, E

    1995-01-01

    InCyclamen persicum 'Anneke', explants from the various vegetative organs of aseptic seedling formed embryoids. The optimal responses were recorded in Murashige and Skoog (MS) medium enriched with 5.0µM 2,4-dichlorophenoxyacetic acid (2,4-D), 0.5µM kinetin and 3-6% sucrose. Embryogenesis was enhanced at higher temperature of 25-30°C. On the other hand, light inhibited embryogenesis. Histological and morphological studies confirmed that the embryoids were indeed somatic embryos.

  3. Combined exposure to big endothelin-1 and mechanical loading in bovine sternal cores promotes osteogenesis.

    Science.gov (United States)

    Meyer, Luisa A; Johnson, Michael G; Cullen, Diane M; Vivanco, Juan F; Blank, Robert D; Ploeg, Heidi-Lynn; Smith, Everett L

    2016-04-01

    Increased bone formation resulting from mechanical loading is well documented; however, the interactions of the mechanotransduction pathways are less well understood. Endothelin-1, a ubiquitous autocrine/paracrine signaling molecule promotes osteogenesis in metastatic disease. In the present study, it was hypothesized that exposure to big endothelin-1 (big ET1) and/or mechanical loading would promote osteogenesis in ex vivo trabecular bone cores. In a 2×2 factorial trial of daily mechanical loading (-2000με, 120cycles daily, "jump" waveform) and big ET1 (25ng/mL), 48 bovine sternal trabecular bone cores were maintained in bioreactor chambers for 23days. The bone cores' response to the treatment stimuli was assessed with percent change in core apparent elastic modulus (ΔEapp), static and dynamic histomorphometry, and prostaglandin E2 (PGE2) secretion. Two-way ANOVA with a post hoc Fisher's LSD test found no significant treatment effects on ΔEapp (p=0.25 and 0.51 for load and big ET1, respectively). The ΔEapp in the "no load + big ET1" (CE, 13±12.2%, p=0.56), "load + no big ET1" (LC, 17±3.9%, p=0.14) and "load + big ET1" (LE, 19±4.2%, p=0.13) treatment groups were not statistically different than the control group (CC, 3.3%±8.6%). Mineralizing surface (MS/BS), mineral apposition (MAR) and bone formation rates (BFR/BS) were significantly greater in LE than CC (p=0.037, 0.0040 and 0.019, respectively). While the histological bone formation markers in LC trended to be greater than CC (p=0.055, 0.11 and 0.074, respectively) there was no difference between CE and CC (p=0.61, 0.50 and 0.72, respectively). Cores in LE and LC had more than 50% greater MS/BS (p=0.037, p=0.055 respectively) and MAR (p=0.0040, p=0.11 respectively) than CC. The BFR/BS was more than two times greater in LE (p=0.019) and LC (p=0.074) than CC. The PGE2 levels were elevated at 8days post-osteotomy in all groups and the treatment groups remained elevated compared to the CC group on days 15

  4. Neuro-Behçet disease: Coexistence of transverse myelitis and aseptic meningitis

    Directory of Open Access Journals (Sweden)

    Volkan Solmaz

    2013-09-01

    Full Text Available Behçet’s disease is a disorder that the etiology and pathogenesisis not well known and this episodic disease ischaracterized with recurrent oral and genital ulcers, panuveitis.The incidence of Behçet’s disease increased inMediterranean region, Middle East region, East Asian region,some part of Japan. The prevalence of this diseasewas 110/100000 in Turkey. If a neurological symptom isadded to Behçet’s disease it is called Neuro-Behçet syndrome.The most seen neurological complication of Neuro-Behçet syndrome is headache. In Behçet’s syndromeif the neurological symptoms are not completely occur,to diagnose neuro-Behçet may be very difficult. However,sometimes neurological complications can be progressvery fast. Especially the formation of transverse myelitisis very rare neurologic condition for this syndrome. Herewe presented a 17-year-old girl with Behçet’s disease;she admitted for her headache and confusion, in lumbarpuncture findings we considered aseptic meningitis. 1day later she complained paraparesis and hypoesthesiaunder thoracal 5 level, MRI scanning showed transversemyelitis in almost all thoracic levels. We presented thiscase because coexistence of transverse myelitis andaseptic meningitis is very rare.Key words: Behçet’s disease, neuro-Behçet, transversemyelitis, aseptic meningitis

  5. Genotyping of human parechoviruses in Iranian young children with aseptic meningitis and sepsis-like illness.

    Science.gov (United States)

    Rahimi, Pooneh; Naser, Hakimeh Mahdian; Siadat, Seyed Davar; Sohrabi, Amir; Mostafavi, Ehsan; Motamedirad, Mahdieh; Bahramali, Golnaz; Sadat, Seyed Mehdi; Ardestani, Mehdi Shafiee

    2013-12-01

    Human parechoviruses (HPeV) are classified into 14 genotypes. HPeV1 and HPeV2 are the most prevalent genotypes in young children, which have been associated with mild to severe diseases. This study was conducted to investigate the involvement of HPeVs in aseptic meningitis and sepsis-like illness in Iran. Viral RNA was extracted from 148 cerebrospinal fluid samples from children meningitis and/or sepsis-like illness. Specific HPeV, HEV real-time PCR and HPeV typing were done to identify the infection rate of these viruses. HPeV and HEV were detected in 64 (43.24 %), 31 (20.94 %) of 148 patients with 10 (6.75 %) coinfection. VP1/VP3 junction region was successfully sequenced from 12 of the HPeV-positive specimens, and all of them were identified as HPeV1. HPeV was more prevalent than HEV in both aseptic meningitis and sepsis-like illness, so further studies are needed to understand the disease burden of HPeV infections, and clinical manifestations especially in specific illnesses of possible viral etiology. Direct detection of these viruses leads to reduce hospitalization and use of antibiotic, which are often followed by other complications in neonates and young children.

  6. Intravenous Immunoglobulin with Enhanced Polyspecificity Improves Survival in Experimental Sepsis and Aseptic Systemic Inflammatory Response Syndromes

    Science.gov (United States)

    Djoumerska-Alexieva, Iglika; Roumenina, Lubka; Pashov, Anastas; Dimitrov, Jordan; Hadzhieva, Maya; Lindig, Sandro; Voynova, Elisaveta; Dimitrova, Petya; Ivanovska, Nina; Bockmeyer, Clemens; Stefanova, Zvetanka; Fitting, Catherine; Bläss, Markus; Claus, Ralf; von Gunten, Stephan; Kaveri, Srini; Cavaillon, Jean-Marc; Bauer, Michael; Vassilev, Tchavdar

    2015-01-01

    Sepsis is a major cause for death worldwide. Numerous interventional trials with agents neutralizing single proinflammatory mediators have failed to improve survival in sepsis and aseptic systemic inflammatory response syndromes. This failure could be explained by the widespread gene expression dysregulation known as “genomic storm” in these patients. A multifunctional polyspecific therapeutic agent might be needed to thwart the effects of this storm. Licensed pooled intravenous immunoglobulin preparations seemed to be a promising candidate, but they have also failed in their present form to prevent sepsis-related death. We report here the protective effect of a single dose of intravenous immunoglobulin preparations with additionally enhanced polyspecificity in three models of sepsis and aseptic systemic inflammation. The modification of the pooled immunoglobulin G molecules by exposure to ferrous ions resulted in their newly acquired ability to bind some proinflammatory molecules, complement components and endogenous “danger” signals. The improved survival in endotoxemia was associated with serum levels of proinflammatory cytokines, diminished complement consumption and normalization of the coagulation time. We suggest that intravenous immunoglobulin preparations with additionally enhanced polyspecificity have a clinical potential in sepsis and related systemic inflammatory syndromes. PMID:26701312

  7. A Fuzzy Expert System for Distinguishing between Bacterial and Aseptic Meningitis

    Directory of Open Access Journals (Sweden)

    Mostafa Langarizadeh

    2015-05-01

    Full Text Available Introduction Bacterial meningitis is a known infectious disease which occurs at early ages and should be promptly diagnosed and treated. Bacterial and aseptic meningitis are hard to be distinguished. Therefore, physicians should be highly informed and experienced in this area. The main aim of this study was to suggest a system for distinguishing between bacterial and aseptic meningitis, using fuzzy logic.    Materials and Methods In the first step, proper attributes were selected using Weka 3.6.7 software. Six attributes were selected using Attribute Evaluator, InfoGainAttributeEval, and Ranker search method items. Then, a fuzzy inference engine was designed using MATLAB software, based on Mamdani’s fuzzy logic method with max-min composition, prod-probor, and centroid defuzzification. The rule base consisted of eight rules, based on the experience of three specialists and information extracted from textbooks. Results Data were extracted from 106 records of patients with meningitis (42 cases with bacterial meningitis in order to evaluate the proposed system. The system accuracy, specificity, and sensitivity were 89%, 92 %, and 97%, respectively. The area under the ROC curve was 0.93, and Kappa test revealed a good level of agreement (k=0.84, P

  8. Immunocytochemical localization of Na+,K(+)-ATPase in the calcium-transporting sternal epithelium of the terrestrial isopod Porcellio scaber L. (Crustacea).

    Science.gov (United States)

    Ziegler, A

    1997-03-01

    Terrestrial isopods store large amounts of calcium carbonate between the epithelium and the old cuticle of the first four anterior sternites before molt. During the formation of these sternal CaCO3 deposits, large amounts of calcium are transported across the anterior sternal epithelium from the base to the apical side of the integument, and in the reverse direction during resorption of the deposit. A monoclonal antibody against the avian alpha-subunit of Na+,K(+)-ATPase was used to localize Na+,K(+)-ATPase in the anterior and the posterior sternal epithelium of Porcellio scaber. Semithin cryosections 0.5 micron thick were used for immunofluorescence microscopy and ultrathin cryosections for immunogold electron microscopy. The Na+,K(+)-ATPase was localized in the basolateral plasma membrane of the posterior and anterior sternal epithelium. The apical plasma membrane, including cytoplasmic extensions into the newly secreted cuticle, was virtually devoid of the enzyme. This pattern of immunolocalization was not affected by the direction of transepithelial calcium transport associated with the deposition and resorption phases of the molt cycle.

  9. Ultrastructural evidence for transepithelial calcium transport in the anterior sternal epithelium of the terrestrial isopod Porcellio scaber (Crustacea) during the formation and resorption of CaCO3 deposits

    Science.gov (United States)

    Ziegler

    1996-05-20

    Before the molt, terrestrial isopods store large amounts of calcium carbonate between the epithelium and the old cuticle of the first four anterior sternites. In order to test whether the anterior sternal epithelium has specific structural differentiations indicative of transepithelial ion transport, the anterior sternal epithelium and, as a control, the posterior sternal epithelium were studied using electron-microscopical techniques. During the formation of calcium carbonate deposits, the basolateral plasma membrane of the anterior sternal epithelium forms an elaborate interconnected network of interstitial dilations and channels. Numerous osmiophilic granules occur within this basolateral intercellular network during resorption of the calcium carbonate deposits. Electron energy-loss spectroscopy of the osmiophilic granules indicates that they contain calcium. During the resorption of the calcium carbonate deposits, the apical plasma membrane of the anterior sternal epithelium has many subcuticular folds. An interstitial network, osmiophilic granules, and apical, subcuticular folds do not occur in the posterior sternal epithelium. Taken together, these structural features are indicative of transepithelial ion transport and are probably necessary for the formation and resorption of the anterior sternal calcium carbonate deposits.

  10. Membrane particle distribution in the sternal epithelia of the terrestrial isopod Porcellio scaber latr. (Crustacea, oniscidea) during CaCO(3) deposit formation and resorption, a freeze-etch analysis.

    Science.gov (United States)

    Ziegler, A; Merz, E

    1999-10-01

    The anterior sternal epithelium of terrestrial isopods transports cuticular Ca(2+) to and from large sternal CaCO(3) deposits. We analyzed the anterior and posterior sternal epithelium by the means of the freeze-etch technique and measured the size distribution and density of intramembrane particles (IMPs) during three different molting stages. At least three IMP size classes around 4.5, 7.7, and 9.4 nm can be distinguished on the P-face of the apical and basolateral plasma membrane. An additional size class of around 12.8 nm is restricted to the apical compartment. In the anterior sternal epithelium, the density of these large particles changes by a factor of 1.9 during the molt cycle, suggesting a role in CaCO(3) formation and/or resorption. The density of the smaller IMPs rises transiently by a factor of 1.3 in the posterior sternal epithelium only. The IMP density of the basolateral plasma membrane increases significantly by a factor of 1.4 and 1.3 in the anterior and posterior sternal epithelia, respectively. The results indicate that increases in the IMP density contribute to the differentiation to an increased transport activity during the cyclic enlargements of the plasma membrane surface area in the anterior sternal epithelium.

  11. A diagnostic dilemma: drug-induced aseptic meningitis in a 45-year-old HIV-positive man.

    LENUS (Irish Health Repository)

    Rowley, D

    2014-03-01

    We describe a case of aseptic meningitis following the administration of moxifloxacin in a 45-year-old man with human immunodeficiency virus (HIV). At presentation he was receiving tuberculosis treatment on a modified regimen following severe hepatotoxicity; this included moxifloxacin, started 8 days previously. Initial cerebrospinal fluid (CSF) analysis was grossly abnormal. Anti-viral and -bacterial treatments were started. All microbiological tests proved negative and his moxifloxacin was withheld resulting in a complete normalisation of CSF. Drug-induced aseptic meningitis is a diagnosis of exclusion and presents a serious diagnostic dilemma. The decision to withhold medication cannot be taken lightly.

  12. Potential application of quantitative microbiological risk assessment techniques to an aseptic-UHT process in the food industry.

    Science.gov (United States)

    Pujol, Laure; Albert, Isabelle; Johnson, Nicholas Brian; Membré, Jeanne-Marie

    2013-04-01

    Aseptic ultra-high-temperature (UHT)-type processed food products (e.g., milk or soup) are ready to eat products which are consumed extensively globally due to a combination of their comparative high quality and long shelf life, with no cold chain or other preservation requirements. Due to the inherent microbial vulnerability of aseptic-UHT product formulations, the safety and stability-related performance objectives (POs) required at the end of the manufacturing process are the most demanding found in the food industry. The key determinants to achieving sterility, and which also differentiates aseptic-UHT from in-pack sterilised products, are the challenges associated with the processes of aseptic filling and sealing. This is a complex process that has traditionally been run using deterministic or empirical process settings. Quantifying the risk of microbial contamination and recontamination along the aseptic-UHT process, using the scientifically based process quantitative microbial risk assessment (QMRA), offers the possibility to improve on the currently tolerable sterility failure rate (i.e., 1 defect per 10,000 units). In addition, benefits of applying QMRA are (i) to implement process settings in a transparent and scientific manner; (ii) to develop a uniform common structure whatever the production line, leading to a harmonisation of these process settings, and; (iii) to bring elements of a cost-benefit analysis of the management measures. The objective of this article is to explore how QMRA techniques and risk management metrics may be applied to aseptic-UHT-type processed food products. In particular, the aseptic-UHT process should benefit from a number of novel mathematical and statistical concepts that have been developed in the field of QMRA. Probabilistic techniques such as Monte Carlo simulation, Bayesian inference and sensitivity analysis, should help in assessing the compliance with safety and stability-related POs set at the end of the manufacturing

  13. Are chest compressions safe for the patient reconstructed with sternal plates? Evaluating the safety of cardiopulmonary resuscitation using a human cadaveric model

    Directory of Open Access Journals (Sweden)

    McKay Douglas R

    2010-08-01

    Full Text Available Abstract Background Plate and screw fixation is a recent addition to the sternal wound treatment armamentarium. Patients undergoing cardiac and major vascular surgery have a higher risk of postoperative arrest than other elective patients. Those who undergo sternotomy for either cardiac or major vascular procedures are at a higher risk of postoperative arrest. Sternal plate design allows quick access to the mediastinum facilitating open cardiac massage, but chest compressions are the mainstay of re-establishing cardiac output in the event of arrest. The response of sternal plates and the chest wall to compressions when plated has not been studied. The safety of performing this maneuver is unknown. This study intends to demonstrate compressions are safe after sternal plating. Methods We investigated the effect of chest compressions on the plated sternum using a human cadaveric model. Cadavers were plated, an arrest was simulated, and an experienced physician performed a simulated resuscitation. Intrathoracic pressure was monitored throughout to ensure the plates encountered an appropriate degree of force. The hardware and viscera were evaluated for failure and trauma respectively. Results No hardware failure or obvious visceral trauma was observed. Rib fractures beyond the boundaries of the plates were noted but the incidence was comparable to control and to the fracture incidence after resuscitation previously cited in the literature. Conclusions From this work we believe chest compressions are safe for the patient with sternal plates when proper plating technique is used. We advocate the use of this life-saving maneuver as part of an ACLS resuscitation in the event of an arrest for rapidly re-establishing circulation.

  14. Clavicles, interclavicles, gastralia, and sternal ribs in sauropod dinosaurs: new reports from diplodocidae and their morphological, functional and evolutionary implications.

    Science.gov (United States)

    Tschopp, Emanuel; Mateus, Octávio

    2013-03-01

    Ossified gastralia, clavicles and sternal ribs are known in a variety of reptilians, including dinosaurs. In sauropods, however, the identity of these bones is controversial. The peculiar shapes of these bones complicate their identification, which led to various differing interpretations in the past. Here we describe different elements from the chest region of diplodocids, found near Shell, Wyoming, USA. Five morphotypes are easily distinguishable: (A) elongated, relatively stout, curved elements with a spatulate and a bifurcate end resemble much the previously reported sauropod clavicles, but might actually represent interclavicles; (B) short, L-shaped elements, mostly preserved as a symmetrical pair, probably are the real clavicles, as indicated by new findings in diplodocids; (C) slender, rod-like bones with rugose ends are highly similar to elements identified as sauropod sternal ribs; (D) curved bones with wide, probably medial ends constitute the fourth morphotype, herein interpreted as gastralia; and (E) irregularly shaped elements, often with extended rugosities, are included into the fifth morphotype, tentatively identified as sternal ribs and/or intercostal elements. To our knowledge, the bones previously interpreted as sauropod clavicles were always found as single bones, which sheds doubt on the validity of their identification. Various lines of evidence presented herein suggest they might actually be interclavicles - which are single elements. This would be the first definitive evidence of interclavicles in dinosauromorphs. Previously supposed interclavicles in the early sauropodomorph Massospondylus or the theropods Oviraptor and Velociraptor were later reinterpreted as clavicles or furculae. Independent from their identification, the existence of the reported bones has both phylogenetic and functional significance. Their presence in non-neosauropod Eusauropoda and Flagellicaudata and probable absence in rebbachisaurs and Titanosauriformes shows a

  15. Prospective study on the chemokine CXCL13 in neuroborreliosis and other aseptic neuroinfections.

    Science.gov (United States)

    Pícha, D; Moravcová, L; Smíšková, D

    2016-09-15

    The study evaluates the clinical significance of CXCL13 (leukocyte chemoattractant synthesized in CSF ) in Lyme neuroborreliosis (LNB) and other aseptic CNS infections. 244 patients with symptoms of neuroinfection and/or LNB were divided into groups: A - patients with LNB-positive antibodies in serum and CSF (96) or CSF only (14); B - patients with aseptic non-borrelial neuroinfections (82); C - negative controls (52). Group A was divided into A1-A4 according to pleocytosis in CSF and AIIgG positivity. The highest CSF CXCL13 concentrations (max. 81,287.60pg/ml; median 1766.90pg/ml) were in A1 (positive AI, pleocytosis) and A3 (negative AIIgG, pleocytosis; max. 7201,60pg/ml, median 56.22pg/ml). A2 (positive AI without pleocytosis) and A4 (negative AI without pleocytosis) had low CXCL13 levels - A2 max. 650.50pg/ml (median<7.80pg/ml); A4 max. 118.56pg/ml (median<7.8pg/ml). In B the median was 28.10pg/ml (max. 595.87pg/ml). In C the CXCL13 concentrations were the lowest (max. 83.83pg/ml; median<7.80pg/ml). The lowest cut-off was 29pg/ml (sensitivity 90.0%, specificity 72.2%), the highest one 400pg/ml (sensitivity 59.6%, specificity 94.0%). The group differences of serum CXCL13 were insignificant. The highest concentrations were at the beginning of the disease. In LNB CXCL13 correlates better with the CSF pleocytosis than AI positivity.

  16. Establishing and monitoring an aseptic workspace for building the MOMA mass spectrometer

    Science.gov (United States)

    Lalime, Erin N.; Berlin, David

    2016-09-01

    Mars Organic Molecule Analyzer (MOMA) is an instrument suite on the European Space Agency (ESA) ExoMars 2020 Rover, and the Mass Spectrometer (MOMA-MS) is being built at Goddard Space Flight Center (GSFC). MOMA-MS is a life-detection instrument and thus falls in the most stringent category of Planetary Protection (PP) biological cleanliness requirements. Less than 0.03 spore/m2 are allowed in the instrument sample path. In order to meet these PP requirements, MOMA-MS must be built and maintained in a low bioburden environment. The MOMA-MS project at GSFC maintains three clean rooms with varying levels of bioburden control. The Aseptic Assembly Clean room has the highest level of control, applying three different bioburden reducing methods: 70% Isopropyl Alcohol (IPA), 7.5% Hydrogen Peroxide, and Ultra-Violet C (UVC) light. The three methods are used in rotation and each kills microorganisms by a different mechanism, reducing the likelihood of microorganisms developing resistance to all three. The Integration and Mars Chamber Clean rooms use less biocidal cleaning, with the option to deploy extra techniques as necessary. To support the monitoring of clean rooms and verification that MOMA-MS hardware meets PP requirements, a new Planetary Protection lab was established that currently has the capabilities of standard growth assays for spore or vegetative bacteria, rapid bioburden analysis that detects Adenosine Triphosphate (ATP), plus autoclave and Dry Heat microbial Reduction (DHMR) verification. The clean rooms are monitored for vegetative microorganisms and by rapid ATP assay, and a clear difference in bioburden is observed between the aseptic and other clean room.

  17. Imaging and histopathological aspects in aseptic osteonecrosis of the femoral head.

    Science.gov (United States)

    Trăistaru, Magdalena Rodica; Kamal, Diana; Kamal, Kamal Constantin; Rogoveanu, Otilia Constantina; Popescu, Mihai; Bondari, Simona; Alexandru, Dragoş Ovidiu; Ionovici, Nina; Grecu, Dan Cristian

    2015-01-01

    Aseptic osteonecrosis causes various clinical manifestations, depending on its location, but has in common a histopathological and radiological substrate. Aseptic osteonecrosis of the femoral head is a condition whose pathogenesis remains unclear despite many theories developed so far, and the discovery of numerous risk factors. The objective of this study is to emphasize the role of imaging techniques and correlating histology and immunohistochemistry methods in order to more accurately stage the disease. This retrospective study was performed on a total of 103 patients with clinical and radiological suspicion of unilateral or bilateral osteonecrosis. For the diagnosis criteria, we used clinical information, pelvic X-ray images, magnetic resonance imaging (MRI) or computed tomography (CT). For the inclusion of patients in a disease stage, we used the Association Research Circulation Osseous (ARCO) classification system. For patients diagnosed at an advanced stage, who underwent hip arthroplasty, we harvested biological material necessary for the histopathological study. There were differences in the appearance and extent of the lesion on the histological samples compared to macroscopic examination and even those obtained through imaging means, particularly for patients in evolutionary stage III. Aspects such as the extension of the area of fibrosis, bone tissue remodeling, the density of the newly formed vascular network and degree of impairment of the cartilage, are determined more accurately using histology and immunohistochemistry techniques. Before classifying patients in a certain stage, after correlating clinical and imaging data, histopathological aspects have to be considered, particularly in patients in stages III and IV, in which total hip arthroplasty could be delayed.

  18. Macrophage response in patients diagnosed with aseptic necrosis of the femoral head presenting different risk factors.

    Science.gov (United States)

    Kamal, Diana; Trăistaru, Rodica; Kamal, Constantin Kamal; Alexandru, Dragoş Ovidiu; Ion, Daniela Adriana; Grecu, Dan Cristian

    2015-01-01

    Aseptic necrosis of the femoral head is a condition caused by partial or total interruption of blood supply to the femoral head. The diminished blood supply causes necrosis of the cellular elements and of the bone marrow, followed by the collapse of the bone structure, events that ultimately lead to the destruction of the bone tissue, the appearance of local pain and loss of function in the affected coxofemoral joint. The importance of this condition is that it mainly affects young adults aged 30-50 years, active from a socio-professional standpoint, and increased life expectancy. The material studied to achieve CD68 immunostaining was represented by bone fragments from the area of necrosis and from the adjacent areas of the femoral heads, harvested from 39 patients when performing hip arthroplasty surgery. The patients were diagnosed with aseptic necrosis of the femoral head and hospitalized in the Clinic of Orthopedics and Traumatology, Emergency County Hospital of Craiova, Romania, from June 2014 to January 2015. The 39 patients included in the study were divided into four categories according to presented risk factors (alcohol, alcohol and smoking, trauma, corticosteroids). All the 39 cases had positive immunostaining for CD68, macrophage being highlighted both in the area of necrosis and in the adjacent areas. We noted significant differences in the number and arrangement of macrophages in patients presenting different risk factors. The highest number of macrophages was present in patients presenting a risk factor corticosteroids, and the lowest number of macrophages was found in patients who had trauma as the main risk factor.

  19. Establishing and Monitoring an Aseptic Workspace for Building the MOMA Mass Spectrometer

    Science.gov (United States)

    Lalime, Erin

    2016-01-01

    Mars Organic Molecule Analyzer (MOMA) is an instrument suite on the ESA ExoMars 2018 Rover, and the Mass Spectrometer (MOMA-MS) is being built at Goddard Space Flight Center (GSFC). As MOMA-MS is a life-detection instrument and it thus falls in the most stringent category of Planetary Protection (PP) biological cleanliness requirements. Less than 0.03 sporem2 is allowed in the instrument sample path. In order to meet these PP requirements, MOMA-MS must be built and maintained in a low bioburden environment. The MOMA-MS project at GSFC maintains three cleanrooms with varying levels of bioburden control. The Aseptic Assembly Cleanroom has the highest level of control, applying three different bioburden reducing methods: 70 IPA, 7.5 Hydrogen Peroxide, and Ultra-Violet C light. The three methods are used in rotation and each kills microbes by a different mechanism, reducing the likelihood of microorganisms developing resistance to all three. The Integration and Mars Chamber Cleanrooms use less biocidal cleaning, with the option to deploy extra techniques as necessary. To support the monitoring of cleanrooms and verification that MOMA-MS hardware meets PP requirements, a new Planetary Protection lab was established that currently has the capabilities of standard growth assays for spore or vegetative bacteria, rapid bioburden analysis that detects Adenosine Triphosphate (ATP), plus autoclave and DHMR verification. The cleanrooms are monitored both for vegetative microorganisms and by rapid ATP assay, and a clear difference in bioburden is observed between the aseptic the other cleanroom.

  20. Major bleeding during negative pressure wound/V.A.C.® - therapy for postsurgical deep sternal wound infection - a critical appraisal

    Directory of Open Access Journals (Sweden)

    Segers Patrique

    2011-09-01

    Full Text Available Abstract Negative-pressure wound therapy, commercially known as vacuum-assisted closure (V.A.C.® therapy, has become one of the most popular (and efficacious interim (prior to flap reconstruction or definite methods of managing deep sternal wound infection. Complications such as profuse bleeding, which may occur during negative-pressure therapy but not necessarily due to it, are often attributed to a single factor and reported as such. However, despite the wealth of clinical experience internationally available, information regarding certain simple considerations is still lacking. Garnering information on all the factors that could possibly influence the outcome has become more difficult due to a (fortunate decrease in the incidence of deep sternal wound infection. If more insight is to be gained from fewer clinical cases, then various potentially confounding factors should be fully disclosed before complications can be attributed to the technique itself or improvements to negative-pressure wound therapy for deep sternal wound infection can be accepted as evidence-based and the guidelines for its use adapted. The authors propose the adoption of a simple checklist in such cases.

  1. Ultrastructural changes of the anterior and posterior sternal integument of the terrestrial isopod Porcellio scaber Latr. (Crustacea) during the moult cycle.

    Science.gov (United States)

    Ziegler, A

    1997-02-01

    The ultrastructure of the anterior (ASE) and posterior sternal epithelium (PSE) was investigated during the biphasic moult cycle. During early premoult the sternal epithelial cells increase in size, accumulate huge amounts of glycogen, and increase the abundance of cellular organelles. CaCO(3) deposit formation begins before the secretion of the epicuticle in the anterior sternal integument and continues through the secretion of the first exocuticular layers. The deposition of cuticle is delayed in the ASE until the CaCO(3) deposit is fully resorbed between the anterior and posterior moult. The development of the interstitial network (IN), which enormously increases the basolateral compartment of the plasma membrane, starts at the beginning of the exocuticle deposition. During CaCO(3) deposit formation and resorption the volume fraction of the mitochondria is much larger in the ASE than in the PSE, although the cuticle is secreted faster in the posterior integument. The results suggest that the exocuticular and epicuticular layers are permeable to calcium and probably also carbonate ions; that the IN is required during late premoult, when CaCO(3) deposition is accelerated, but not during early CaCO(3) deposition; and that active mechanisms contribute to transepithelial ion transport during CaCO(3) deposit formation and resorption.

  2. Morphometric analysis of the calcium-transporting sternal epithelial cells of the terrestrial isopods Ligia oceanica, Ligidium hypnorum, and Porcellio scaber during molt.

    Science.gov (United States)

    Glötzner, J; Ziegler, A

    2000-07-01

    Isopods shed first the posterior and then the anterior half of the body. Before molt, most terrestrial species resorb CaCO3 from the posterior mineralized cuticle. The mineral is stored in anterior sternal deposits, which are used to calcify the new posterior cuticle after molt. For Porcellio scaber it is known that the anterior sternal epithelium has specific structural differentiations for epithelial transport. These differentiations include the plasma membrane surface areas, and the volume fraction of the mitochondria. We analyzed the ultrastructure of the sternal epithelium and used a morphometric approach to study the variations of these parameters between species living in different terrestrial environments. In Ligidium hypnorum, which lives in moist environments, the plasma membrane surface area and volume fraction of mitochondria are much larger than in the semiterrestrial Ligia oceanica. This is in accordance with the relatively larger CaCO3 deposits and shorter time intervals for their formation and resorption in L. hypnorum. For P. scaber, which is adapted to mesic habitats, most values are between those of L. oceanica and L. hypnorum. However, P. scaber has even larger CaCO3 deposits which are formed and degraded within similar time intervals as in L. hypnorum. This unexpected result is considered from the standpoint of more effective mechanisms being present for epithelial ion transport.

  3. Molecular characterisation of the smooth endoplasmic reticulum Ca(2+)-ATPase of Porcellio scaber and its expression in sternal epithelia during the moult cycle.

    Science.gov (United States)

    Hagedorn, Monica; Weihrauch, Dirk; Towle, David W; Ziegler, Andreas

    2003-07-01

    The anterior sternal epithelial cells of the terrestrial isopod Porcellio scaber transport large amounts of calcium during the formation and resorption of intermittent calcium carbonate deposits. Recent investigations on epithelia involved in mineralisation processes suggest a role of the smooth endoplasmic reticulum Ca(2+)-ATPase (SERCA) in transcellular calcium transport. We present the first molecular characterisation of a SERCA within a crustacean mineralising epithelium. We cloned the SERCA from a cDNA library of the anterior sternal epithelium and used in situ hybridisation to compare the expression of the SERCA mRNA between three different moulting stages. The full-length SERCA cDNA has an open reading frame of 3006 nucleotides. The deduced 1002 amino-acid polypeptide has a predicted molecular mass of 109.7 kDa and 87% identity to the SERCA of Procambarus clarkii axial muscle isoform. In situ hybridisation confirmed expression within the anterior sternal epithelium and revealed an increase in SERCA mRNA abundance from the non-transporting, early premoult stage to the calcium transporting, late premoult and intramoult stage. The results support previous indications of a contribution by the smooth endoplasmic reticulum to transcellular calcium transport and suggest a transcriptional regulation of SERCA activity.

  4. A case of cerebral salt-wasting syndrome associated with aseptic meningitis in an 8-year-old boy.

    Science.gov (United States)

    Inatomi, Jun; Yokoyama, Yoshiki; Sekine, Takashi; Igarashi, Takashi

    2008-04-01

    Cerebral salt-wasting syndrome is a disorder in which excessive natriuresis and subsequent hyponatremic dehydration occur in patients with intracranial diseases. Cerebral salt-wasting syndrome often develops in patients with severe neurosurgical disorders, such as hydrocephalus, cerebral infarction, and tuberculous meningitis. Here, we report on the case of an 8-year-old boy with cerebral salt-wasting syndrome associated with aseptic meningitis. He showed mild developmental retardation and had a history of convulsion. Four days after his admission, cerebral salt-wasting syndrome abruptly started: natriuresis and hyponatremia gradually improved over 10 days. To the best of our knowledge, this is the first report on cerebral salt-wasting syndrome associated with clinically benign aseptic meningitis.

  5. Aseptic Abscesses and Inflammatory Bowel Disease: Two Cases and Review of Literature

    Science.gov (United States)

    Scaffidi, Michael A.; Al-Mazroui, Ahmed; Tessolini, Jenna; Showler, Adrienne; Colak, Errol

    2017-01-01

    Background. Aseptic abscesses (AA) are sterile lesions that represent an extraintestinal manifestation (EIM) of inflammatory bowel disease (IBD). Though Canada has the highest prevalence of IBD in the world, reports of IBD-associated AA are absent in Canada. This may represent a different IBD phenotype or underrecognition and underreporting. Purpose. To explore AA as a possible EIM of IBD and evaluate clinical and investigative findings among patients with IBD-associated AA. Methods. Retrospective chart and literature reviews were performed to find cases of IBD-associated AA at our institution and in the literature. Results. We identified 2 cases of IBD-associated AA in our institution. Both patients had ulcerative colitis and presented with fever, abdominal pain, and weight loss. Radiological workup and aspiration showed sterile splenic abscesses. The AA were unresponsive to antibiotics. One patient improved on corticosteroids and one underwent splenectomy. We retrieved 37 cases of IBD-associated AA from the literature. All patients showed no evidence of infection, failed to resolve with antibiotics, and, if attempted, improved on corticosteroids. Conclusions. Our cases are the first reported in Canada. They support literature which suggests AA as an EIM of IBD and may help increase recognition and reporting of this phenomenon.

  6. MRI evaluation of aseptic osteonecrosis in children over the course of hyperbaric oxygen therapy

    Energy Technology Data Exchange (ETDEWEB)

    Scherer, A.; Engelbrecht, V.; May, P.; Moedder, U. [Duesseldorf Univ. (Germany). Inst. fuer Diagnostische Radiologie; Bernbeck, B.; Goebel, U. [Duesseldorf Univ. (Germany). Dept. of Pediatric Hematology and Oncology; Willers, R. [Duesseldorf Univ. (Germany). Inst. of Statistics

    2000-10-01

    Purpose: The study aimed at MRI evaluation of aseptic osteonecrosis (AON) in children over the course of hyperbaric oxygen (HBO) therapy. Material and methods: Retrospective analysis of 72 MRI studies in 20 children presenting with AON during chemotherapy. Two groups were differentiated: Gr. I (n=8) was treated exclusively with relief of weightbearing structures, Gr. II (n=12) was additionally treated with HBO therapy. The MRI examinations were evaluated by a point-score system (1-6 points) by two radiologists. Results: Gr. II initially showed more severe findings (average score: 3.4) in comparison to Gr. I (average score: 2.65). During the follow-up time period the average scores rose to 3.2 score-points in Gr. I and 4.1 points in Gr. II. No statistically significant difference was evident between the two groups in the course of AON. Conclusion: The majority of chemotherapy associated AON which initially present with advanced findings show a progression in MRI over their further course. HBO therapy in addition to the relief of affected weightbearing structures statistically shows no significant improvement in MRI morphology during the course of the treatment. (orig.)

  7. Herpes simplex virus type 2-associated recurrent aseptic (Mollaret's meningitis in genitourinary medicine clinic: a case report

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    Abou-Foul AK

    2014-03-01

    Full Text Available Ahmad K Abou-Foul, Thajunisha M Buhary, Sedki L Gayed Department of Genitourinary Medicine, Royal Blackburn Hospital, East Lancashire Hospitals NHS Trust, Blackburn, UK Introduction: Cases of idiopathic recurrent benign aseptic meningitis were first described by Mollaret. Today, herpes simplex virus (HSV is considered the cause of most cases of Mollaret's meningitis. Case report: A 40-year-old male was referred to our genitourinary medicine clinic with recurrent genital herpetic lesions. He had HSV-2-positive genital ulcers 8 years earlier. One year after the first infection, he developed severe recurrent attacks of headache associated with meningitis symptoms. The results of all radiological and biochemical tests were normal, but the patient reported a correlation between his attacks and genital herpes flare-ups. We diagnosed the patient with Mollaret's meningitis and started him on continuous suppressive acyclovir therapy, which resulted in marked clinical improvement. Discussion: Mollaret's meningitis is a rare form of idiopathic recurrent aseptic meningitis that has a sudden onset, short duration, and spontaneous remission with unpredictable recurrence. We believe that the presence of concurrent or recurrent mucocutaneous herpetic lesions can aid its diagnosis, prior to which, affected patients usually have many unnecessary investigations and treatments. Therefore, detailed sexual history should be sought in all patients with aseptic meningitis, and clinicians should also ask about history of recurrent headaches in all patients with recurrent herpetic anogenital lesions. Continuous suppressive acyclovir therapy may reduce the frequency and severity of attacks and can dramatically improve lifestyle. Keywords: HSV-2 virus, acyclovir, Mollaret's meningitis, recurrent aseptic meningitis, HSV-2 virus, viral meningitis, acyclovir

  8. Epidemiological and clinical studies on aseptic meningitis in 377 cases, 3. A study on brain CT scan in acute phase

    Energy Technology Data Exchange (ETDEWEB)

    Nishimura, Masaaki; Kondo, Tomio; Takashima, Akira; Kono, Shinya; Yamashina, Manabu (Ogaki Shimin Hospital, Gifu (Japan))

    1984-02-01

    Brain CT scan performed in the acute phase of aseptic meningitis in 88 cases revealed abnormal findings in 5 consisting of 2 of cerebral edema, 2 of subdural hygroma and one of cerebral atrophy. Clinical findings showed no particular relation to the age, but cerebral edema was observed in the cases of possible cephalomeningitis diagnosed on the basis of accompanying convulsion and disturbance of consciousness. Abnormal findings were associated with 25% of symptoms diagnosed more than 4 days after onset.

  9. COMPARISON OF THE FREQUENCY AND COMPLICATIONS OF INAPPROPRIATE ANTIDIURETIC HORMONE SECRETION IN PATIENTS WITH SEPTIC AND ASEPTIC MENINGITIS

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    Ali HONARPISHEH MD

    2010-04-01

    Full Text Available ObjectiveDue to the high prevalence of syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH. This study was carried out to evaluate the prevalence and relevant parameters of SIADH in children with septic and aseptic memingitis hospitalized at Kashan Shahid Beheshti Hospital between 1996 and 2006.Materials & MethodsThis descriptive study was conducted on 230 patients with meningitis hospitalized in the pediatric wards of Kashan Shahid Beheshti Hospital between 1996 and 2006. Relevant information (age, gender, type of meningitis, serum sodium and potassium, urine specific gravity (USG, blood sugar, blood urea nitrogen, serum creatinin, hydration condition was collected from patients' records. Data was analyzed using Mann-Whitney and K2 tests.ResultsOut of 230 patients with meningitis, 33 had incomplete records and only 197 patients were recruited for this study. Sixty eight cases (34.5% suffered from SIADH. It was more frequent among 1-2 year old  children.According to this research, SIADH was diagnosed in 57% of the 121 patients with hyponatremia, 58.7% of the 167 patients with USG > 1.004, 74% of the 93 patients with serum osmolity ConclusionDue to the high prevalence of SIADH in septic and aseptic meningitis and its complication, it is recommended to restrict fluid therapy and monitor serum sodium, urine specific gravity and other diagnostic tests for SIADH.Keywords: Hyponatremia; Meningitis; SIADH, Septic, Aseptic

  10. Establishment of an operating room committee and a training program to improve aseptic techniques for rodent and large animal surgery.

    Science.gov (United States)

    Héon, Hélène; Rousseau, Nathalie; Montgomery, Jane; Beauregard, Gilles; Choiniére, Manon

    2006-11-01

    Investigators of our research facility generally accept the concept of asepsis as an important component of adequate surgical care for animals. However, they experience difficulties putting it into practice, especially in the case of rodents. The reasons for this are inconvenience, cost, and lack of training. To better assist investigators in the implementation of aseptic surgical techniques in their laboratories, we have created an Operating Room (OR) Committee modeled after OR committees found in human hospitals. A reconstructive surgeon, a veterinarian, a research scientist, a nurse involved in the training of OR personnel, interns, graduate students, and an animal health technician were chosen as committee members in light of their OR and animal care expertise. The first task of the OR Committee was to establish institutional guidelines for aseptic surgery, taking into account the costs imposed on research budgets by these procedures. The OR Committee also supports a complete training program in aseptic surgery techniques, which consists of lectures, a training manual, videos, and a practical course. Furthermore, when experimental procedures require specialized equipment, the OR Committee collaborates with researchers to develop strategies to achieve asepsis. This OR Committee and the training program proved to be important tools to promote and improve the quality of animal care during surgery.

  11. Chemistry of the sternal gland secretion of the Mediterranean centipede Himantarium gabrielis (Linnaeus, 1767) (Chilopoda: Geophilomorpha: Himantariidae)

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    Vujisić, Ljubodrag V.; Vučković, Ivan M.; Makarov, Slobodan E.; Ilić, Bojan S.; Antić, Dragan Ž.; Jadranin, Milka B.; Todorović, Nina M.; Mrkić, Ivan V.; Vajs, Vlatka E.; Lučić, Luka R.; Ćurčić, Božidar P. M.; Mitić, Bojan M.

    2013-09-01

    The geophilomorph centipede, Himantarium gabrielis, when disturbed, discharges a viscous and proteinaceous secretion from the sternal glands. This exudate was found by gas chromatography-mass spectrometry, liquid chromatography-high resolution mass spectrometry, liquid chromatography-mass spectrometry-mass spectrometry and NMR analyses to be composed of hydrogen cyanide, benzaldehyde, benzoyl nitrile, benzyl nitrile, mandelonitrile, mandelonitrile benzoate, 3,7,6 O-trimethylguanine (himantarine), farnesyl 2,3-dihydrofarnesoate and farnesyl farnesoate. This is the first report on the presence of benzyl nitrile and mandelonitrile benzoate in secreted substances from centipedes. Farnesyl 2,3-dihydrofarnesoate is a new compound, while himantarine and farnesyl farnesoate were not known as natural products. A post-secretion release of hydrogen cyanide by reaction of mandelonitrile and benzoyl nitrile was observed by NMR, and hydrogen cyanide signals were completely assigned. In addition, a protein component of the secretion was analysed by electrophoresis which revealed the presence of a major 55 kDa protein. Analyses of the defensive exudates of other geophilomorph families should produce further chemical surprises.

  12. Successful human infection with P. falciparum using three aseptic Anopheles stephensi mosquitoes: a new model for controlled human malaria infection.

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    Matthew B Laurens

    Full Text Available Controlled human malaria infection (CHMI is a powerful method for assessing the efficacy of anti-malaria vaccines and drugs targeting pre-erythrocytic and erythrocytic stages of the parasite. CHMI has heretofore required the bites of 5 Plasmodium falciparum (Pf sporozoite (SPZ-infected mosquitoes to reliably induce Pf malaria. We reported that CHMI using the bites of 3 PfSPZ-infected mosquitoes reared aseptically in compliance with current good manufacturing practices (cGMP was successful in 6 participants. Here, we report results from a subsequent CHMI study using 3 PfSPZ-infected mosquitoes reared aseptically to validate the initial clinical trial. We also compare results of safety, tolerability, and transmission dynamics in participants undergoing CHMI using 3 PfSPZ-infected mosquitoes reared aseptically to published studies of CHMI using 5 mosquitoes. Nineteen adults aged 18-40 years were bitten by 3 Anopheles stephensi mosquitoes infected with the chloroquine-sensitive NF54 strain of Pf. All 19 participants developed malaria (100%; 12 of 19 (63% on Day 11. The mean pre-patent period was 258.3 hours (range 210.5-333.8. The geometric mean parasitemia at first diagnosis by microscopy was 9.5 parasites/µL (range 2-44. Quantitative polymerase chain reaction (qPCR detected parasites an average of 79.8 hours (range 43.8-116.7 before microscopy. The mosquitoes had a geometric mean of 37,894 PfSPZ/mosquito (range 3,500-152,200. Exposure to the bites of 3 aseptically-raised, PfSPZ-infected mosquitoes is a safe, effective procedure for CHMI in malaria-naïve adults. The aseptic model should be considered as a new standard for CHMI trials in non-endemic areas. Microscopy is the gold standard used for the diagnosis of Pf malaria after CHMI, but qPCR identifies parasites earlier. If qPCR continues to be shown to be highly specific, and can be made to be practical, rapid, and standardized, it should be considered as an alternative for diagnosis

  13. Tissue engineering chamber promotes adipose tissue regeneration in adipose tissue engineering models through induced aseptic inflammation.

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    Peng, Zhangsong; Dong, Ziqing; Chang, Qiang; Zhan, Weiqing; Zeng, Zhaowei; Zhang, Shengchang; Lu, Feng

    2014-11-01

    Tissue engineering chamber (TEC) makes it possible to generate significant amounts of mature, vascularized, stable, and transferable adipose tissue. However, little is known about the role of the chamber in tissue engineering. Therefore, to investigate the role of inflammatory response and the change in mechanotransduction started by TEC after implantation, we placed a unique TEC model on the surface of the groin fat pads in rats to study the expression of cytokines and tissue development in the TEC. The number of infiltrating cells was counted, and vascular endothelial growth factor (VEGF) and monocyte chemotactic protein-1 (MCP-1) expression levels in the chamber at multiple time points postimplantation were analyzed by enzyme-linked immunosorbent assay. Tissue samples were collected at various time points and labeled for specific cell populations. The result showed that new adipose tissue formed in the chamber at day 60. Also, the expression of MCP-1 and VEGF in the chamber decreased slightly from an early stage as well as the number of the infiltrating cells. A large number of CD34+/perilipin- perivascular cells could be detected at day 30. Also, the CD34+/perilipin+ adipose precursor cell numbers increased sharply by day 45 and then decreased by day 60. CD34-/perilipin+ mature adipocytes were hard to detect in the chamber content at day 30, but their number increased and then peaked at day 60. Ki67-positive cells could be found near blood vessels and their number decreased sharply over time. Masson's trichrome showed that collagen was the dominant component of the chamber content at early stage and was replaced by newly formed small adipocytes over time. Our findings suggested that the TEC implantation could promote the proliferation of adipose precursor cells derived from local adipose tissue, increase angiogenesis, and finally lead to spontaneous adipogenesis by inducing aseptic inflammation and changing local mechanotransduction.

  14. Colgajo de omento para tratamiento de dehiscencia de herida esternal Omental flap for management of sternal wound dehiscence

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    A. Pérez García

    2013-03-01

    Full Text Available La mediastinitis es una de las complicaciones más graves de la cirugía cardíaca. Aparece en el 0,5-5 % de las esternotomías y esta incidencia es mucho mayor en pacientes diabéticos, obesos, inmunodeprimidos, con enfermedad pulmonar obstructiva crónica (EPOC, etc. Presentamos el caso de una paciente diabética, obesa mórbida, que sufre mediastinitis tras doble by-pass coronario. Para la cobertura del defecto se empleó un colgajo de epiplon tunelizado transdiafragmático. El colgajo omental permite cubrir grandes defectos además de que posee capacidad antimicrobiana y favorece la revascularización tisular. Las características de este colgajo hacen que actualmente deba considerarse como primera elección en pacientes con grandes defectos esternales y trastornos de la inmunidad y la cicatrización.Mediastinitis is one of the most serious complications from cardiac surgery. It is reported to occur in 0'5-5 % of sternotomy incisions, and this incidence is much higher in diabetic patients, obese, immunocompromised, COPD, etc. We report a case of a diabetic and morbid obese woman suffering mediastinitis after double coronary bypass surgery. For the reconstruction a transdiaphragmatic tunnelled omental flap was used. The omentum is useful to cover large defects. It has antiinfective properties and promotes revascularization of neighbouring tissues. Omental flap can be a highly effective treatment for patients with large sternal wounds and immune disorders and wound healing disorders.

  15. Superficial and deep sternal wound infection after more than 9000 coronary artery bypass graft (CABG: incidence, risk factors and mortality

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    Abbasi Kyomars

    2007-09-01

    Full Text Available Abstract Background Sternal wound infection (SWI is an uncommon but potentially life-threatening complication of cardiac surgery. Predisposing factors for SWI are multiple with varied frequencies in different studies. The purpose of this study was to assess the incidence, risk factors, and mortality of SWI after coronary artery bypass grafting (CABG at Tehran Heart Center. Methods This study prospectively evaluated multiple risk factors for SWI in 9201 patients who underwent CABG at Tehran Heart Center between January 2002 and February 2006. Cases of SWI were confirmed based on the criteria of the Centers for Disease Control and Prevention. Deep SWI (bone and mediastinitis was categorized according to the Oakley classification. Results In the study period, 9201 CABGs were performed with a total SWI rate of 0.47 percent (44 cases and deep SWI of 0.22 percent (21 cases. Perioperative (in-hospital mortality was 9.1% for total SWI and about 14% for deep SWI versus 1.1% for non-SWI CABG patients. Female gender, preoperative hypertension, high functional class, diabetes mellitus, obesity, prolonged intubation time (more than 48 h, and re-exploration for bleeding were significant risk factors for developing SWI (p = 0.05 in univariate analysis. In multivariate analysis, hypertension (OR = 10.7, re-exploration (OR = 13.4, and female gender (OR = 2.7 were identified as significant predictors of SWI (p Conclusion Rarely reported previously, the two risk factors of hypertension and the female gender were significant risk factors in our study. Conversely, some other risk factors such as cigarette smoking and age mentioned as significant in other reports were not significant in our study. Further studies are needed for better documentation.

  16. Expression and polarity reversal of V-type H+-ATPase during the mineralization-demineralization cycle in Porcellio scaber sternal epithelial cells.

    Science.gov (United States)

    Ziegler, Andreas; Weihrauch, Dirk; Hagedorn, Monica; Towle, David W; Bleher, Reiner

    2004-04-01

    The formation and resorption of CaCO(3) by epithelial cell layers require epithelial transport of protons. We used the anterior sternal epithelium of the terrestrial isopod Porcellio scaber as a model to study the expression pattern and immunolocalization of a V-type H(+)-ATPase during the mineralization and demineralization of intermittent CaCO(3) deposits. Semiquantitative RT-PCR revealed that the expression of the V-type H(+)-ATPase increases from non Ca(2+)-transporting control stages to the stages of CaCO(3) deposit formation and resorption. In the Ca(2+)-transporting stages the expression was larger in the anterior than in the posterior sternal epithelium, which is not involved in deposit formation and transports just moderate amounts of CaCO(3). Immunocytochemistry of the B-subunit of the V-type H(+)-ATPase in the anterior sternal epithelium reveals an increase in the abundance of the protein within the basolateral membrane, from undetectable to strong signals in the control stage to the stages of CaCO(3) deposit formation, respectively. From the stage of CaCO(3) deposit formation to that of CaCO(3) resorption the signal decreased within the basolateral plasma membrane and increased within the apical plasma membrane. For the first time the results indicate a contribution of a V-type H(+)-ATPase to CaCO(3) deposition and a reversal of its polarity from the basolateral to the apical plasma membrane compartment within the same cells.

  17. Aseptic loosening rate of megaprostheses and related factors%肿瘤型人工关节假体无菌性松动率及相关因素

    Institute of Scientific and Technical Information of China (English)

    肖何; 牛晓辉

    2014-01-01

    With the development of chemotherapy, imaging, surgical techniques and material science, limb-salvage has become a widely accepted concept in the treatment of bone and soft tissue tumors. Prosthetic reconstruction after tumor segment resection has become a common operation method. In the history, there appeared many kinds of materials for the reconstruction after the resection of tumors. The megaprosthesis has a history of more than 60 years, and has become the mainstream now, with many advantages over the other reconstruction materials. The aseptic loosening of megaprotheses is a common postoperative complication and also a prominent cause of prosthesis failure. How high is the aseptic loosening rate? Will the rate be affected by such factors as the patient’s age, gender, disease category, implantation site, reconstruction length, chemotherapy and so on? Will the rate be obviously reduced due to the improvement of megaprotheses? These questions are worth researching. The aseptic loosening rate of megaprostheses and related factors are reviewed in this article based on previous studies. According to previous reports, many factors concerning the patient and the prosthesis have an impact on the aseptic loosening rate. The clear and deifnite related factors included the implantation site, porous coating in the collar, type of articulation, age at the time of surgery and reconstruction length, and the gender and disease category are irrelevant factors. As to the size of intramedullary stem, ifxation mode, modular/custom and chemotherapy, their correlation with the aseptic loosening rate is still unclear.

  18. Vitrified sperm banks: the new aseptic technique for human spermatozoa allows cryopreservation at -86 °C.

    Science.gov (United States)

    Sánchez, R; Risopatrón, J; Schulz, M; Villegas, J V; Isachenko, V; Isachenko, E

    2012-12-01

    The vitrification technique is simple, quick, cost-effective and has showed a significantly stronger cryoprotective effect in contrast to conventional freezing. The method is based on the rapid cooling of the cell by direct immersion in liquid nitrogen (LN (2) ), thereby avoiding the formation of ice crystals, due to the lower risk of water thawing, which impairs cell function. The aim of this study was to evaluate the effect of storage at -86 °C compared to the conventional -196 °C (under LN (2) ) on essential parameters of the functioning of aseptically vitrified human sperm. Sperm motility, integrity of mitochondrial membrane potential and the rate of DNA fragmentation were determined. The comparison of -86 °C and -196 °C demonstrated no statistical difference in sperm progressive motility (73% vs. 77%), integrity of mitochondrial membrane potential (71% vs. 74%) or DNA fragmentation (3.1% vs. 2.9%). In conclusion, aseptically vitrified sperm can be preserved at -86 °C; eliminating the use of LN (2) simplifies and significantly reduces the costs associated with storage in sperm banks by decreasing the time and space needed for storage, the effort in finding stored samples, and by improving safety for the operator. However, for prolonged storage further studies are needed.

  19. Description of a widespread outbreak of aseptic meningitis due to echovirus 30 in Rio de Janeiro state, Brazil

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    Vitor Laerte Pinto Junior

    2009-10-01

    Full Text Available Echovirus 30 belongs to the genus Enterovirus and is widely associated with aseptic meningitis (AM outbreaks. In Brazil epidemics due to this serotype were reported in several states but in Rio de Janeiro, before this study, it was only involved in sporadic episodes. We retrospectively collected data from AM notifications charts and enterovirus isolation database from Rio de Janeiro State Health Department (RJSHD and Enterovirus Reference Laboratory in the year of 2005. An outbreak of AM was detected during March, April and May associated with a high cell culture isolation rate for echovirus 30 (17.4%. Male children with ages varying from 1 to 9 years were more affected. Of the 22 patients with confirmed echovirus 30 disease, clinical information was available in eight; fever, headache and vomiting were the most common manifestations. CSF analysis showed a typical pattern of viral infection with median of cellularity of 100 cells/mm³ and mononuclear cell predominance in 64.7% of the cases. The median of protein and glucose levels of 49 mg/dL and 56.5 mg/dL. The fatality rate was null. Despite its benign course and the lack of treatment options, aseptic meningitis surveillance is crucial for early identification of causative agents of outbreaks, which helps to avoid additional testing and inappropriate use of antimicrobials.

  20. An outbreak of aseptic meningitis caused by coxsackievirus A9 in Gansu, the People's Republic of China

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    Mao Naiying

    2010-04-01

    Full Text Available Abstract Background An outbreak of aseptic meningitis occurred in Tianshui city of Gansu Province, the People's Republic of China, from March to June 2005. A total of 85 patients were clinical confirmed as aseptic meningitis in this outbreak. Results CVA9 was mainly responsible for this outbreak supported by the clinical manifestations of the patients, epidemiological data of the outbreak, the results of RT-PCR and complete VP1 sequence determination, conventional neutralization assays, IgM serological assays, viral isolation and phylogenetics analysis. Through phylogenetic analysis and homogeneity analysis for partial VP1 gene, the nucleotide and amino acid homologies between Gansu isolates and former Chinese CVA9 strains were 88.2%-96.1% and 97.2%-99.2%, respectively. Multiple transmission chains of CVA9 occurred in different provinces or years in China. Moreover, in order to clarify the genotype of CVA9, Gansu CVA9 strains isolated in this outbreak were compared with other CVA9 isolates based on VP1/2A junction regions (genotyping region and they might belong to a new genotype of CVA9, which could be assigned for genotype XIII, Conclusions CVA9 was confirmed as the pathogen responsible for this outbreak. The phylogenetic analysis indicated that the CVA9 strains isolated in this outbreak might belong to a new genotype.

  1. Percutaneous bone cement refixation of aseptically loose hip prostheses: the effect of interface tissue removal on injected cement volumes

    Energy Technology Data Exchange (ETDEWEB)

    Malan, Daniel F. [Leiden University Medical Center, Department of Orthopaedics, Leiden (Netherlands); Delft University of Technology, Department of Intelligent Systems, Delft (Netherlands); Valstar, Edward R. [Leiden University Medical Center, Department of Orthopaedics, Leiden (Netherlands); Delft University of Technology, Department of Biomechanical Engineering, Delft (Netherlands); Nelissen, Rob G.H.H. [Leiden University Medical Center, Department of Orthopaedics, Leiden (Netherlands)

    2014-11-15

    To quantify whether injected cement volumes differed between two groups of patients who underwent experimental minimally invasive percutaneous cement injection procedures to stabilize aseptically loose hip prostheses. One patient group was preoperatively treated using gene-directed enzyme prodrug therapy to remove fibrous interface tissue, while the other group received no preoperative treatment. It was hypothesized that cement penetration may have been inhibited by the presence of fibrous interface tissue in periprosthetic lesions. We analyzed 17 patients (14 female, 3 male, ages 72-91, ASA categories 2-4) who were treated at our institution. Osteolytic lesions and injected cement were manually delineated using 3D CT image segmentation, and the deposition of injected cement was quantified. Patients who underwent preoperative gene-directed enzyme therapy to remove fibrous tissue exhibited larger injected cement volumes than those who did not. The observed median increase in injected cement volume was 6.8 ml. Higher cement leakage volumes were also observed for this group. We conclude that prior removal of periprosthetic fibrous interface tissue may enable better cement flow and penetration. This might lead to better refixation of aseptically loosened prostheses. (orig.)

  2. Chronic pancreatitis

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    Chronic pancreatitis - chronic; Pancreatitis - chronic - discharge; Pancreatic insufficiency - chronic; Acute pancreatitis - chronic ... alcohol abuse over many years. Repeated episodes of acute ... chronic pancreatitis. Genetics may be a factor in some cases. ...

  3. Analysis of Ca(2+) uptake into the smooth endoplasmic reticulum of permeabilised sternal epithelial cells during the moulting cycle of the terrestrial isopod Porcellio scaber.

    Science.gov (United States)

    Hagedorn, Monica; Ziegler, Andreas

    2002-07-01

    In terrestrial isopods, large amounts of Ca(2+) are transported across anterior sternal epithelial cells during moult-related deposition and resorption of CaCO(3) deposits. Because of its toxicity and function as a second messenger, resting cytosolic Ca(2+) levels must be maintained below critical concentrations during epithelial Ca(2+) transport, raising the possibility that organelles play a role during Ca(2+) transit. We therefore studied the uptake of Ca(2+) into Ca(2+)-sequestering organelles by monitoring the formation of birefringent calcium oxalate crystals in permeabilised anterior and posterior sternal epithelium cells of Porcellio scaber during Ca(2+)-transporting and non-transporting stages of the moulting cycle using polarised-light microscopy. The results indicate ATP-dependent uptake of Ca(2+) into organelles. Half-maximal crystal growth at a Ca(2+) activity, a(Ca), of 0.4 micromol l(-1) and blockade by cyclopiazonic acid suggest Ca(2+) uptake into the smooth endoplasmic reticulum by the smooth endoplasmic reticulum Ca(2+)-ATPase. Analytical electron microscopical techniques support this interpretation by revealing the accumulation of Ca(2+)-containing crystals in smooth membranous intracellular compartments. A comparison of different moulting stages demonstrated a virtual lack of crystal formation in the early premoult stage and a significant fivefold increase between mid premoult and the Ca(2+)-transporting stages of late premoult and intramoult. These results suggest a contribution of the smooth endoplasmic reticulum as a transient Ca(2+) store during intracellular Ca(2+) transit.

  4. The Protective Effect of Bafilomycin A1 Against Cobalt Nanoparticle-Induced Cytotoxicity and Aseptic Inflammation in Macrophages In Vitro.

    Science.gov (United States)

    Wang, Songhua; Liu, Fan; Zeng, Zhaoxun; Yang, Huilin; Jiang, Haitao

    2016-01-01

    Co ions released due to corrosion of Co nanoparticles (CoNPs) in the lysosomes of macrophages may be a factor in the particle-induced cytotoxicity and aseptic inflammation accompanying metal-on-metal (MOM) hip prosthesis failure. Here, we show that CoNPs are easily dissolved under a low pH, simulating the acidic lysosomal environment. We then used bafilomycin A1 to change the pH inside the lysosome to inhibit intracellular corrosion of CoNPs and then investigated its protective effects against CoNP-induced cytotoxicity and aseptic inflammation on murine macrophage RAW264.7 cells. XTT {2,3-bis (2-methoxy-4-nitro-5-sulfophenyl)-5-[(phenylamino) carbonyl]-2H-tetrazolium hydroxide} assays revealed that bafilomycin A1 can significantly decrease CoNP-induced cytotoxicity in RAW264.7 cells. Enzyme-linked immunosorbent assays showed that bafilomycin A1 can significantly decrease the subtoxic concentration of CoNP-induced levels of pro-inflammatory cytokines (tumor necrosis factor-α, interleukin-1β, and interleukin-6), but has no effect on anti-inflammatory cytokines (transforming growth factor-β and interleukin-10) in RAW264.7 cells. We studied the protective mechanism of bafilomycin A1 against CoNP-induced effects in RAW264.7 cells by measuring glutathione/oxidized glutathione (GSH/GSSG), superoxide dismutase, catalase, and glutathione peroxidase levels and employed scanning electron microscopy, transmission electron microscopy, and energy dispersive spectrometer assays to observe the ultrastructural cellular changes. The changes associated with apoptosis were assessed by examining the pAKT and cleaved caspase-3 levels using Western blotting. These data strongly suggested that bafilomycin A1 can potentially suppress CoNP-induced cytotoxicity and aseptic inflammation by inhibiting intracellular corrosion of CoNPs and that the reduction in Co ions released from CoNPs may play an important role in downregulating oxidative stress in RAW264.7 cells.

  5. Data on the cost effective surface sterilization method for C.carandas (L.) seeds and callus induction from aseptic seedling.

    Science.gov (United States)

    Bhadane, Bhushan S; Patil, Ravindra H

    2016-06-01

    Surface sterilization of explant is an important and most sensitive step in plant tissue culture. Inappropriate concentrations of sterilants have lethal effect in cell division and it restricts growth and development of explant. Therefore, suitable concentration, combinations and duration of exposure of sterilant is essential to raise in vitro cultures successfully. This data demonstrates use of various sterilizing agents for aseptic plantlet germination from seed of Carissa carandas (Apocynaceae). The present dataset provides information in support of cost-effective explant sterilization potential of benzalkonium chloride containing commercial bleach (Lizol) and its comparison with traditionally used surface sterilants in plant tissue culture i.e. 0.1% HgCl2 alone and in combination with 70% alcohol. The data on callogenic response using MS medium supplemented with plant growth regulators is also shared.

  6. Data on the cost effective surface sterilization method for C.carandas (L. seeds and callus induction from aseptic seedling

    Directory of Open Access Journals (Sweden)

    Bhushan S. Bhadane

    2016-06-01

    Full Text Available Surface sterilization of explant is an important and most sensitive step in plant tissue culture. Inappropriate concentrations of sterilants have lethal effect in cell division and it restricts growth and development of explant. Therefore, suitable concentration, combinations and duration of exposure of sterilant is essential to raise in vitro cultures successfully. This data demonstrates use of various sterilizing agents for aseptic plantlet germination from seed of Carissa carandas (Apocynaceae. The present dataset provides information in support of cost-effective explant sterilization potential of benzalkonium chloride containing commercial bleach (Lizol and its comparison with traditionally used surface sterilants in plant tissue culture i.e. 0.1% HgCl2 alone and in combination with 70% alcohol. The data on callogenic response using MS medium supplemented with plant growth regulators is also shared.

  7. Metal is not inert: role of metal ions released by biocorrosion in aseptic loosening--current concepts.

    Science.gov (United States)

    Cadosch, Dieter; Chan, Erwin; Gautschi, Oliver P; Filgueira, Luis

    2009-12-15

    Metal implants are essential therapeutic tools for the treatment of bone fractures and joint replacements. The metals and metal alloys used in contemporary orthopedic and trauma surgery are well tolerated by the majority of patients. However, complications resulting from inflammatory and immune reactions to metal implants have been well documented. This review briefly discusses the different mechanisms of metal implant corrosion in the human body, which lead to the release of significant levels of metal ions into the peri-implant tissues and the systemic blood circulation. Additionally, this article reviews the effects of the released ions on bone metabolism and the immune system and discusses their involvement in the pathophysiological mechanisms of aseptic loosening and metal hypersensitivity in patients with metal implants.

  8. Ultrasound of Sternal Fracture

    Directory of Open Access Journals (Sweden)

    Shadi Lahham

    2015-12-01

    Full Text Available A 61-year-old female was brought in by ambulance after being the restrained driver of a head-on motor vehicle collision at 40MPH. There was positive airbag deployment and intrusion from the other vehicle. During workup, the patient complained of midline chest pain, and left chest wall pain. The patient was not in acute respiratory distress, and had the following vital signs: temperature 37°C, heart rate 84, blood pressure of 150/64, respiratory rate 18, and oxygen saturation of 97% on two liters of oxygen. On physical exam, breath sounds were heard bilaterally, with no acute cardiopulmonary issues identified. A bruise was identified on the lower abdomen, which was thought to be a potential seatbelt sign. A focused assessment with sonography for trauma was negative, and an ultrasound of additional chest and mediastinal structures was performed for the chest tenderness.

  9. Aseptic meningitis in a large MMR vaccine campaign (590,609 people in Curitiba, Paraná, Brazil, 1998

    Directory of Open Access Journals (Sweden)

    ARRUDA Walter Oleschko

    2001-01-01

    Full Text Available The aseptic meningitis after Measles-Mumps-Rubella vaccine (MMR is a well recognized complication, and different incidences have been observed in several studies. We retrospectively analyzed forty cases of aseptic meningitis, during a large public immunization campaign (1998 in Curitiba, Southern Brazil (590,609 people, admitted in our Service. The vaccine utilized was Leningrad-3-Zagreb mumps strain, Edmonston-Zagreb measles strain, and RA 27#3 rubella strain. In all county, a total number of 87 cases were reported, resulting in a incidence of 1.7 cases per 10,000 given doses . The mean age was 23.7 ± 12.8 years. The female:male ratio was 1.35:1. Severe headache with meningismus (92.5%, fever (87.5%, nausea/vomiting (82.5% were the most common clinical findings. Three cases (7.5% developed mild mumps. All patients underwent cerebrospinal fluid (CSF tap with the following findings: mononuclear pleocytosis from 100 to 500 cells/mm³ in 17 cases (42.5%; 257.5 ± 260.6 cells/mm³; increased protein 28 cases (67.5%; 92.1 ± 76.9 mg/dL; glucose was normal in all cases (56.8 ± 11.2 mg/dL except in 4 (10% cases, which presented less than 44 mg/dL. All serological tests (latex to bacterial meningitis, Cryptococcus, cysticercosis, VDRL and bacteriological cultures were negative. Virus identification were also negative in 8 samples. None of the patients had neurological deficits or related symptoms after one year of onset. We believe the benefit of vaccination clearly outweights the incidence of benign vaccine-associated meningitis.

  10. Plasmodium falciparum malaria challenge by the bite of aseptic Anopheles stephensi mosquitoes: results of a randomized infectivity trial.

    Directory of Open Access Journals (Sweden)

    Kirsten E Lyke

    Full Text Available BACKGROUND: Experimental infection of malaria-naïve volunteers by the bite of Plasmodium falciparum-infected mosquitoes is a preferred means to test the protective effect of malaria vaccines and drugs. The standard model relies on the bite of five infected mosquitoes to induce malaria. We examined the efficacy of malaria transmission using mosquitoes raised aseptically in compliance with current Good Manufacturing Practices (cGMPs. METHODS AND FINDINGS: Eighteen adults aged 18-40 years were randomized to receive 1, 3 or 5 bites of Anopheles stephensi mosquitoes infected with the chloroquine-sensitive NF54 strain of P. falciparum. Seventeen participants developed malaria; fourteen occurring on Day 11. The mean prepatent period was 10.9 days (9-12 days. The geometric mean parasitemia was 15.7 parasites/µL (range: 4-70 by microscopy. Polymerase chain reaction (PCR detected parasites 3.1 (range: 0-4 days prior to microscopy. The geometric mean sporozoite load was 16,753 sporozoites per infected mosquito (range: 1,000-57,500. A 1-bite participant withdrew from the study on Day 13 post-challenge and was PCR and smear negative. CONCLUSIONS: The use of aseptic, cGMP-compliant P. falciparum-infected mosquitoes is safe, is associated with a precise prepatent period compared to the standard model and appears more efficient than the standard approach, as it led to infection in 100% (6/6 of volunteers exposed to three mosquito bites and 83% (5/6 of volunteers exposed to one mosquito bite. TRIAL REGISTRATION: ClinicalTrials.gov NCT00744133.

  11. Strontium-doped calcium polyphosphate/ultrahigh molecular weight polyethylene composites: A new class of artificial joint components with enhanced biological efficacy to aseptic loosening

    Energy Technology Data Exchange (ETDEWEB)

    Gu, Zhipeng [College of Polymer Science and Engineering, Sichuan University, Chengdu 610065 (China); Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu 610041 (China); Huang, Bingxue; Li, Yiwen [College of Polymer Science and Engineering, Sichuan University, Chengdu 610065 (China); Tian, Meng [Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu 610041 (China); Li, Li [Department of Oncology, the 452 Hospital of Chinese PLA, Chengdu 610021 (China); Yu, Xixun, E-mail: yuxixun@163.com [College of Polymer Science and Engineering, Sichuan University, Chengdu 610065 (China)

    2016-04-01

    To enhance implant stability and prolong the service life of artificial joint component, a new approach was proposed to improve the wear resistance of artificial joint component and endow artificial joint component with the biological efficacy of resistance to aseptic loosening. Strontium calcium polyphosphate (SCPP) were interfused in ultrahigh molecular weight polyethylene (UHMWPE) by a combination of liquid nitrogen ball-milling and flat-panel curing process to prepare the SCPP/UHMWPE composites. The micro-structure, mechanical characterization, tribological characterization and bioactivities of various SCPP/UHMWPE composites were investigated. The results suggested that this method could statistically improve the wear resistance of UHMWPE resulting from a good SCPP particle dispersion. Moreover, it is also observed that the SCPP/UHMWPE composites-wear particles could promote the production of OPG by osteoblasts and decrease the production of RANKL by osteoblasts, and then increase the OPG/RANKL ratio. This indicated that the SCPP/UHMWPE composites had potential efficacy to prevent and treat aseptic loosening. Above all, the SCPP/UHMWPE composites with a suitable SCPP content would be the promising materials for fabricating artificial joint component with ability to resist aseptic loosening. - Highlights: • SCPP/UHMWPE composites could enhance biological efficacy of resistance to aseptic loosening. • SCPP would improve biological efficacy with a few sacrifice of wear resistance. • The results might provide a promising wear-resistant material for fabricating acetabular cup.

  12. Why does it take so long? ‘Lean processing’ in the aseptic compounding unit at the Midland Regional Hospital Tullamore

    LENUS (Irish Health Repository)

    Greene, C

    2011-06-01

    Increasing numbers of oncology\\/haematology patients attending Midland Regional Hospital Tullamore (MRHT) has increased the workload of the Regional Oncology Haematology Pharmacy (ROHP) compounding unit. Staff restrictions require optimisation of current workflow practices. This audit (November 2010 and June 2011) focused on workflow in the aseptic compounding unit.\\r\

  13. Characteristic of endocrine cells of rat small intestine after administration of cryopreserved placenta on the background of acute aseptic peritoneal inflammation

    Directory of Open Access Journals (Sweden)

    Shepitko K.V.

    2015-06-01

    Full Text Available Background. Modern conceptions about mechanisms of inflammation of the small intestine could not be formed without an understanding of intercellular relationships that are realized by biologically active signaling molecules produced by endocrine cells. Methods. The experimental study has been carried out on the small intestine extracted from 140 adult male rats. Electron and light microscopy methods were used. Acute aseptic inflammation was modeled by intraperitoneal carrageenan injection; influence of subcutaneously cryopreserved placenta injection was analyzed. Results. After modeling of the acute aseptic peritoneal inflammation the maximal increase of ECL-cells was noted on the 21st day. The slowest restoration of endocrine cells number occurred on all measured parameters and was observed on day 30th of the observation. In case of administration of cryopreserved placenta at the early stages (days 3rd – 7th the increase of average number of EC- and ECL-cells promoted the enhanced permeability of vessels in the lamina propria. The decrease in number of P-cells prevented the development of hyperacid gastritis. Reduction in the average number of D1- cells prevented the excessive vasodilatation and facilitated the excretion of excess fluid from the foci of inflammation. In simultaneous subcutaneous administration of cryopreserved placenta and modeling of acute aseptic peritoneal inflammation the number of ЕС- and ЕСL-cells increased, accelerating the vascular response to inflammation. Conclusion. Active appearance of low-differentiated cells including those with “shapes of mitosis” on the day 14th indicates restoration of structural components of the small intestine mucosa and processes of absorption and parietal digestion after placenta administration during acute aseptic inflammation. Citation: Shepitko KV. [Characteristic of endocrine cells of rat small intestine after administration of cryopreserved placenta on the background of

  14. [EVALUATION OF THE BACTERIOSTATIC EFFECT OF IMMOBILIZED ON COLLAGEN CARRIER ANTIBIOTICS AND SILVER IONS IN PROVISION OF THE ASEPTIC STATE OF THE TISSUE WOUNDS].

    Science.gov (United States)

    Storublevtsev, S A; Popov, V I; Antipova, L V; Stukalo, O G; Bolgova, S B

    2015-01-01

    In the treatment of tissue wounds practically all the time there is necessary the establishment of aseptic conditions in the area of the damaged tissue. In modern medical practice quite a while the use of materials on the basis of collagen aroused widespread. The aim of the study was an assessment the bacteriostatic properties both of collagenic substance with the antibiotics immobilized on it, and ions of silver also. The presence on a surface of collagen of a large number of active functional groups allow to use it as a matrix for an immobilization of various biologically active and medicinal agents. Authors performed an assessment of possibility of an immobilization of antibiotics on the collagenic carrier. The purpose of an immobilization was in the prolongation of the impact of an active component--Polymyxin-M or Gentamycin. Besides aseptic effect, availability of specific amino acids of collagen will promote the acceleration of the reparative processes in a wound. There were performed investigations on determination of bacteriostatic effect of immobilized on the protein carrier (collagen of hydrobionts) antibiotics, and silver ions also. Bacteriostatic effect was estimated by the disco--a diffusive method with use of E. coli as test culture. Results of the studies showed that the delivered preparation had bacteriostatic effect on the test culture. At that the area of a zone of a growth inhibition in case of the of use--Polymyxin was 1.3 time more than, than in case of the use of a preparation of Gentamycin. The obtained collagenic substances of an origin with the immobilized bacteriostatic components and ions of silver have considerable prospects and real opportunity in the delivery of aseptic preparations of a domestic production. Taking into account the available data in further there is planned the development of aseptic preparations with the occluded biologically active agents and nanoparticles of metals for providing an aseptics and acceleration the

  15. [Chronic recurrent multifocal osteomyelitis].

    Science.gov (United States)

    Schilling, F; Eckardt, A; Kessler, S

    2000-01-01

    The aim of this paper is to give a detailed description of the so-called "chronic recurrent multifocal osteomyelitis" (CRMO). The clinical, radiological and histopathological results of an analysis of 29 cases (15 children/adolescents and 14 adults) are presented and correlated to current data from the literature. We could delinate the following points: 1. CRMO is a systemic aseptic inflammation of the bone marrow (Osteitis), it can occur polytopically and association with pustulous dermatologic symptoms is possible. 2. It is not a rare disease 3. Osteomyelitis is probably "reactive" and a plasma-cell sclerotic process with ist own characteristic histologic three-phase course. 4. We could observe 5 specific types of localization which can be documented by X-ray or bone scan. 5. Accompanying arthritis os often present, especially "sympathetic coxitis". 6. The use of drugs in treatment of CRMO (i.e. azithromycin, calcitonin, and bisphosphonates) is discussed. In conclusion we want to point out, that 1. 99mTC bone scan should always be performed when there is suspicion for CRMO to reveal the pattern of affection, 2. the rheumatologist and dermatologist should be contacted, 3. operation is normally not necessary for treatment of the mostly self-limitin disease, and 4. the term "SAPHO syndrome" should be avoided, further differentiation of the diagnosis is necessary.

  16. Interleukin-6 in serum and in synovial fluid enhances the differentiation between periprosthetic joint infection and aseptic loosening.

    Directory of Open Access Journals (Sweden)

    Thomas M Randau

    Full Text Available The preoperative differentiation between septic and aseptic loosening after total hip or knee arthroplasty is essential for successful therapy and relies in part on biomarkers. The objective of this study was to assess synovial and serum levels of inflammatory proteins as diagnostic tool for periprosthetic joint infection and compare their accuracy with standard tests. 120 patients presenting with a painful knee or hip endoprosthesis for surgical revision were included in this prospective trial. Blood samples and samples of intraoperatively acquired joint fluid aspirate were collected. White blood cell count, C-reactive protein, procalcitonin and interleukin-6 were determined. The joint aspirate was analyzed for total leukocyte count and IL-6. The definite diagnosis of PJI was determined on the basis of purulent synovial fluid, histopathology and microbiology. IL-6 in serum showed significantly higher values in the PJI group as compared to aseptic loosening and control, with specificity at 58.3% and a sensitivity of 79.5% at a cut-off value of 2.6 pg/ml. With a cut-off >6.6 pg/ml, the specificity increased to 88.3%. IL-6 in joint aspirate had, at a cut-off of >2100 pg/ml, a specificity of 85.7% and sensitivity of 59.4%. At levels >9000 pg/ml, specificity was almost at 100% with sensitivity just below 50%, so PJI could be considered proven with IL-6 levels above this threshold. Our data supports the published results on IL-6 as a biomarker in PJI. In our large prospective cohort of revision arthroplasty patients, the use of IL-6 in synovial fluid appears to be a more accurate marker than either the white blood cell count or the C-reactive protein level in serum for the detection of periprosthetic joint infection. On the basis of the results we recommend the use of the synovial fluid biomarker IL-6 for the diagnosis of periprosthetic joint infection following total hip and knee arthroplasty.

  17. 人工关节假体植入后无菌性松动的发病机制%Pathogenesis of aseptic prosthesis loosening after artificial prosthesis implantation

    Institute of Scientific and Technical Information of China (English)

    马玉超; 田京

    2012-01-01

    BACKGROUND: There are many clinical researches on aseptic loosening of artificial prosthesis, but the exact pathogenesis is still unclear.OBJECTIVE: To review the pathogenesis of prosthesis aseptic loosening after artificial prosthesis implantation.METHODS: A computer-based online search of PubMed and CNKI was performed to search related articles published between 2006 and 2011 with the key words of “artificial prosthesis, aseptic loosening” both in English and Chinese. A total of 77 articles were obtained, and finally 38 articles were included.RESULTS AND CONCLUSION: Aseptic loosening after long-term total hip replacement is one of the main failure reasons. In the recent years, analysis of revision total hip replacement for failed hip arthroplasty showed that aseptic loosening is the chief reason. The mechanism of aseptic loosening mainly includes mechanical mechanisms, biological and other mechanisms. With further research and the improvement of implantation method and prosthetic materials, aseptic loosening will eventually be minimized, so that the service life of prosthesis will be longer.%背景:对于人工关节无菌性松动的基础和临床研究很多,但其确切机制仍不甚明确.目的:综述人工关节假体植入后无菌性松动的发病机制.方法:由第一作者应用计算机检索PubMed和中国期刊全文数据库2006/2011相关文献.在标题、摘要、关键词中以"artificial prosthesis,aseptic loosening"或"人工关节、无菌性松动"为检索词进行检索.共检索到77篇文献,最终纳入符合标准的文献38篇.结果与结论:无菌性松动已成为人工关节置换后远期失败的主要原因之一.近年来对人工全髋关节置换后翻修病例回顾性分析的统计显示,无菌性松动位于翻修原因第1位.关于人工关节无菌性松动的机制主要分为机械机制、生物机制及其他机制,它们的共同结果是造成骨吸收、骨溶解,最终导致假体松动.随着研究

  18. Pyrolysis of aseptic packages (tetrapak) in a laboratory screw type reactor and secondary thermal/catalytic tar decomposition.

    Science.gov (United States)

    Haydary, J; Susa, D; Dudáš, J

    2013-05-01

    Pyrolysis of aseptic packages (tetrapak cartons) in a laboratory apparatus using a flow screw type reactor and a secondary catalytic reactor for tar cracking was studied. The pyrolysis experiments were realized at temperatures ranging from 650 °C to 850 °C aimed at maximizing of the amount of the gas product and reducing its tar content. Distribution of tetrapak into the product yields at different conditions was obtained. The presence of H2, CO, CH4, CO2 and light hydrocarbons, HCx, in the gas product was observed. The Aluminum foil was easily separated from the solid product. The rest part of char was characterized by proximate and elemental analysis and calorimetric measurements. The total organic carbon in the tar product was estimated by elemental analysis of tars. Two types of catalysts (dolomite and red clay marked AFRC) were used for catalytic thermal tar decomposition. Three series of experiments (without catalyst in a secondary cracking reactor, with dolomite and with AFRC) at temperatures of 650, 700, 750, 800 and 850 °C were carried out. Both types of catalysts have significantly affected the content of tars and other components in pyrolytic gases. The effect of catalyst on the tetrapack distribution into the product yield on the composition of gas and on the total organic carbon in the tar product is presented in this work.

  19. [Bacteriological control of blood preservation, production of infusion solutions and dry human plasma under conditions of aseptic work and possible sources of their contamination].

    Science.gov (United States)

    Bosković, S; Lucić, N; Aganović, N; Grbić, E

    1975-01-01

    In premises for blood conservation, production of dry human plasma and infusion solutions "notwithstanding the permanent measures for desinfection, new bacterial contamination occurs from time to time and whose source are the casings and material originating from non-sterile environment. Bacteriological control, which has primarily a preventive character, enables a due forecast for measures to be undertaken by the appropriate desinfection of the working surfaces and air, satisfactory conditions of aseptic work can be maintained. General hygiene should be paid attention to as well as mechanical cleansing of premises, avoidance of groups for lunch-time etc., since the treatment by desinfectors would not be sufficient for maintenance of aseptic working conditions. In order to prevent the transmission of bacterial contamination, premises for blood conservation should be strictly separated from other operations and also prevent the unnecessary movements of personnel through corridors. The results of the bacteriological control of the personnel show that greater attention should be paid to their health care since the workers there work in closed aseptic systems and thus avoid them as a bacteria transmittors in respect to danger of blood and dry human plasma contamination. It is also necessary to efficiently educate the personnel for work in aseptic conditions and also increase their elementary knowledge from bacteriology and hygiene. The bacterial skin-flora on the spot of donor's venepuncture also presents a certain danger for blood contamination. Therefore, it is necessary to establish the most optimal manner of skin desinfecate together with the most appropriate means having a fast bactericidal and fungicidal action. It would also be useful, on the basis of further test, to suggest certain standard for an allowed number of conditionally pathogenic and saprophytic microorganisms which would be used by the instutions performing the blood transfusion and production of

  20. Strontium-doped calcium polyphosphate/ultrahigh molecular weight polyethylene composites: A new class of artificial joint components with enhanced biological efficacy to aseptic loosening.

    Science.gov (United States)

    Gu, Zhipeng; Huang, Bingxue; Li, Yiwen; Tian, Meng; Li, Li; Yu, Xixun

    2016-04-01

    To enhance implant stability and prolong the service life of artificial joint component, a new approach was proposed to improve the wear resistance of artificial joint component and endow artificial joint component with the biological efficacy of resistance to aseptic loosening. Strontium calcium polyphosphate (SCPP) were interfused in ultrahigh molecular weight polyethylene (UHMWPE) by a combination of liquid nitrogen ball-milling and flat-panel curing process to prepare the SCPP/UHMWPE composites. The micro-structure, mechanical characterization, tribological characterization and bioactivities of various SCPP/UHMWPE composites were investigated. The results suggested that this method could statistically improve the wear resistance of UHMWPE resulting from a good SCPP particle dispersion. Moreover, it is also observed that the SCPP/UHMWPE composites-wear particles could promote the production of OPG by osteoblasts and decrease the production of RANKL by osteoblasts, and then increase the OPG/RANKL ratio. This indicated that the SCPP/UHMWPE composites had potential efficacy to prevent and treat aseptic loosening. Above all, the SCPP/UHMWPE composites with a suitable SCPP content would be the promising materials for fabricating artificial joint component with ability to resist aseptic loosening.

  1. The role of Card9 overexpression in peripheral blood mononuclear cells from patients with aseptic acute pancreatitis.

    Science.gov (United States)

    Yang, Zhi-wen; Weng, Cheng-zhao; Wang, Jing; Xu, Ping

    2016-03-01

    Activated mononuclear cells are an early event in the course of severe acute pancreatitis (SAP). To date, the molecular mechanism triggering peripheral blood mononuclear cells (PBMCs) is poorly understood. The aim of this paper was to determine the potential role of Card9 in SAP. We collected data from 72 subjects between January 2013 and June 2014. Subsequently, PBMCs were isolated on day 1, 3 and 5 of pancreatitis. Immunofluorescence staining, quantitative real-time PCR, Western blotting, immunoprecipitation and ELISA were used to determine the role of Card9 in SAP. Microbial culture showed that SAP patients at the early period did not develop any bacteria and fungi infection. Card9 expression in SAP patients was higher than that in mild acute pancreatitis and volunteer healthy controls, up to the peak on day 1. The monocyte-derived cytokines interleukin (IL)-17, IL-1β, IL-6 and tumour necrosis factor-α mediated by the induction of Card9 markedly increased in SAP patients compared with the control group. Furthermore, the inducible formation of Card9-Bcl10 complex was found in PBMCs, which may be involved in nuclear factor kappa B (NF-κB) and p38 activation in SAP. Receiver operating characteristic curve indicated that Card9 levels had a high sensitivity of 87.5% and specificity of 67.7%, showing the close correlation with SAP patients. Card9 overexpression was firstly found in aseptic SAP, which may be played an important role in NF-κB and p38 activation in PBMCs. It also provided the new insights into therapeutic interventions by targeting monocytes activation in SAP patients.

  2. Progress of Aseptic Purification Technique of Cyanobacteria%蓝藻无菌化方法研究进展

    Institute of Scientific and Technical Information of China (English)

    李天丽; 郑凌凌; 张琪; 宋立荣

    2015-01-01

    随着微藻产业的蓬勃发展,蓝藻作为具有重要经济价值的资源受到人们越来越多的关注,其多糖和蛋白的开发已被应用于多个领域。为了更深入清晰地挖掘蓝藻的特性和功能,研究者首先需获得无菌的纯种藻株,这是深入开展蓝藻生理生化、遗传和毒性等研究的基础。重点综述了如何根据蓝藻的结构及生理特性选择合适的无菌化方法,介绍了基于蓝藻与污染菌之间差异性的无菌化方法,以期为蓝藻的无菌化工作提供参考。%With the vigorous development of the microalgae industry, people are paying much more attention to cyanobacteria according to its important economic value, as its polysaccharide and protein are applied in many fields.In order to excavate the characteristics and function of cyanobacteria more in-depth and clearly, it is necessary to obtain axenic cultures of cyanobacteria, which is also regarded as the foundation for the further research on physiological, biochemical, genetic and taxonomic characteristics of cyanobacteria.This paper mainly reviewed the chosen of appropriate aseptic purification methods based on their structures and physiological characteristics.Furthermore, the methods based on the differences between cyanobacteria and contaminated bacteria were introduced.The paper was expected to provide useful information for the works on purification of cyanobacteria.

  3. On the absence of sternal elements in Anchiornis (Paraves) and Sapeornis (Aves) and the complex early evolution of the avian sternum.

    Science.gov (United States)

    Zheng, Xiaoting; O'Connor, Jingmai; Wang, Xiaoli; Wang, Min; Zhang, Xiaomei; Zhou, Zhonghe

    2014-09-23

    Anchiornis (Deinonychosauria: Troodontidae), the earliest known feathered dinosaur, and Sapeornis (Aves: Pygostylia), one of the basalmost Cretaceous birds, are both known from hundreds of specimens, although remarkably not one specimen preserves any sternal ossifications. We use histological analysis to confirm the absence of this element in adult specimens. Furthermore, the excellent preservation of soft-tissue structures in some specimens suggests that no chondrified sternum was present. Archaeopteryx, the oldest and most basal known bird, is known from only 10 specimens and the presence of a sternum is controversial; a chondrified sternum is widely considered to have been present. However, data from Anchiornis and Sapeornis suggest that a sternum may also have been completely absent in this important taxon, suggesting that the absence of a sternum could represent the plesiomorphic avian condition. Our discovery reveals an unexpected level of complexity in the early evolution of the avian sternum; the large amount of observable homoplasy is probably a direct result of the high degree of inherent developmental plasticity of the sternum compared with observations in other skeletal elements.

  4. Classification of acute stress using linear and non-linear heart rate variability analysis derived from sternal ECG.

    Science.gov (United States)

    Tanev, George; Saadi, Dorthe B; Hoppe, Karsten; Sorensen, Helge B D

    2014-01-01

    Chronic stress detection is an important factor in predicting and reducing the risk of cardiovascular disease. This work is a pilot study with a focus on developing a method for detecting short-term psychophysiological changes through heart rate variability (HRV) features. The purpose of this pilot study is to establish and to gain insight on a set of features that could be used to detect psychophysiological changes that occur during chronic stress. This study elicited four different types of arousal by images, sounds, mental tasks and rest, and classified them using linear and non-linear HRV features from electrocardiograms (ECG) acquired by the wireless wearable ePatch® recorder. The highest recognition rates were acquired for the neutral stage (90%), the acute stress stage (80%) and the baseline stage (80%) by sample entropy, detrended fluctuation analysis and normalized high frequency features. Standardizing non-linear HRV features for each subject was found to be an important factor for the improvement of the classification results.

  5. Chronic myelogenous leukemia (CML)

    Science.gov (United States)

    CML; Chronic myeloid leukemia; Chronic granulocytic leukemia; Leukemia - chronic granulocytic ... Chronic myelogenous leukemia is grouped into phases: Chronic Accelerated Blast crisis The chronic phase can last for ...

  6. Syphilitic aseptic meningitis

    Science.gov (United States)

    Meningitis - syphilitic; Neurosyphilis - syphilitic meningitis ... Syphilitic meningitis is a form of neurosyphilis . This condition is a life-threatening complication of syphilis infection. Syphilis is ...

  7. Added value of experts' knowledge to improve a quantitative microbial exposure assessment model--Application to aseptic-UHT food products.

    Science.gov (United States)

    Pujol, Laure; Johnson, Nicholas Brian; Magras, Catherine; Albert, Isabelle; Membré, Jeanne-Marie

    2015-10-15

    In a previous study, a quantitative microbial exposure assessment (QMEA) model applied to an aseptic-UHT food process was developed [Pujol, L., Albert, I., Magras, C., Johnson, N. B., Membré, J. M. Probabilistic exposure assessment model to estimate aseptic UHT product failure rate. 2015 International Journal of Food Microbiology. 192, 124-141]. It quantified Sterility Failure Rate (SFR) associated with Bacillus cereus and Geobacillus stearothermophilus per process module (nine modules in total from raw material reception to end-product storage). Previously, the probabilistic model inputs were set by experts (using knowledge and in-house data). However, only the variability dimension was taken into account. The model was then improved using expert elicitation knowledge in two ways. First, the model was refined by adding the uncertainty dimension to the probabilistic inputs, enabling to set a second order Monte Carlo analysis. The eight following inputs, and their impact on SFR, are presented in detail in this present study: D-value for each bacteria of interest (B. cereus and G. stearothermophilus) associated with the inactivation model for the UHT treatment step, i.e., two inputs; log reduction (decimal reduction) number associated with the inactivation model for the packaging sterilization step for each bacterium and each part of the packaging (product container and sealing component), i.e., four inputs; and bacterial spore air load of the aseptic tank and the filler cabinet rooms, i.e., two inputs. Second, the model was improved by leveraging expert knowledge to develop further the existing model. The proportion of bacteria in the product which settled on surface of pipes (between the UHT treatment and the aseptic tank on one hand, and between the aseptic tank and the filler cabinet on the other hand) leading to a possible biofilm formation for each bacterium, was better characterized. It was modeled as a function of the hygienic design level of the aseptic

  8. BIOTECHNOLOGICAL APPROACHES FOR CONSERVATION OF THE ENDANGERED SPECIES Crambe koktebelica (JUNGE N. BUSCH AND EFFECT OF ASEPTIC IN VITRO CULTIVATION ON ITS BIOCHEMICAL PROPERTIES

    Directory of Open Access Journals (Sweden)

    Pushkarova

    2016-08-01

    Full Text Available The aim of the study was to establish efficient protocols of seed surface sterilization with further multiplication in vitro for threatened species Crambe koktebelica (Junge N. Busch and to show the effect of biotechnological approach (in vitro cultivation of biodiversity conservation on plants biochemical properties. Seed surface sterilization was carried out according to the original method with further microclonal multiplication of aseptic sprouts from lateral buds on the Murashige and Skoog (MS medium supplemented with different concentrations of growth regulators. Fatty acid content was determined using Gas chromatography-mass spectrophotometry of fatty acid ethers. Antioxidant activity was determined using 2.2-diphenyl-1-picrylhydrazyl radical scavenging method. Total soluble protein content was measured using Bradford method and polyfructan content determination was based upon ketosugars ability to color in the acidic environment with resorcinol. Plants that were grown under in vitro and in vivo conditions and seeds were used in this research. Efficient protocol of surface sterilization that resulted in 45% of aseptic seed material 50% of which has sprouted was elaborated for C. koktebelica as well as fast microclonal multiplication methods that provided with up to 5.25 ± 0.50 new formed plantlets from 1 lateral bud (on the MS medium that contained 1 mg/L of 6-benzylaminopurine. It was also shown that aseptic cultivation benefits to saturated fatty acid accumulation and increases protein content but on the other hand it reduces unsaturated fatty acid amount and polyfructan content as well as antioxidant activity of plant material. Obtained data confirms the prospect of biotechnology approach to biodiversity conservation and suggest the necessity of father in vitro cultivation effect on biochemical composition of plant study.

  9. An experimental animal model of aseptic loosening of hip prostheses in sheep to study early biochemical changes at the interface membrane

    Directory of Open Access Journals (Sweden)

    Akens Margarete K

    2004-03-01

    Full Text Available Abstract Background Aseptic loosening of hip prosthesis as it occurs in clinical cases in human patients was attributed to wear particles of the implants, the response of the tissue dominated by macrophages and the production of inflammatory mediators and matrix degrading enzymes; however, the cascade of events initiating the process and their interaction regarding the time course is still open and discussed controversially. Therefore, the goal of this study was to establish an experimental animal model in sheep allowing to follow the cascade of early mechanical and biochemical events within the interface membrane and study the sequence of how they contribute to the pathological bone resorption necessary for aseptic loosening of the implant. Methods A cemented modular system (Biomedtrix was used as a hip replacement in 24 adult Swiss Alpine sheep, with one group receiving a complete cement mantle as controls (n = 12, and the other group a cement mantle with a standardized, lateral, primary defect in the cement mantle (n = 12. Animals were followed over time for 2 and 8.5 months (n = 6 each. After sacrifice, samples from the interface membranes were harvested from five different regions of the femur and joint capsule. Explant cell cultures were performed and supernatant of cultures were tested and assayed for nitric oxide, prostaglandin E2, caseinolytic and collagenolytic activity. RNA extraction and quantification were performed for inducible nitric oxide synthase, cyclooxygenase-2, interleukin 1, and interleukin 6. Overall differences between groups and time periods and interactions thereof were calculated using a factorial analysis of variance (ANOVA. Results The development of an interface membrane was noticed in both groups at both time points. However, in the controls the interface membrane regressed in thickness and biological activity, while both variables increased in the experimental group with the primary cement mantle defect over time

  10. Idiopathic Facial Aseptic Granuloma in a 13-Year-Old Boy Dramatically Improved with Oral Doxycycline and Topical Metronidazole: Evidence for a Link with Childhood Rosacea

    Directory of Open Access Journals (Sweden)

    Camille Orion

    2016-07-01

    Full Text Available Idiopathic facial aseptic granuloma (IFAG is a rare, benign pediatric dermatological lesion that occurs in children between 8 months and 13 years of age. The pathogenesis of IFAG is still unclear but it is likely to be associated with granulomatous rosacea in childhood. Here we describe a case of IFAG in a 13-year-old boy who showed a dramatic response to oral doxycycline and topical metronidazole, which supports the hypothesis that IFAG may belong to the spectrum of rosacea.

  11. Molecular detection and genotyping of enteroviruses from CSF samples of patients with suspected sepsis-like illness and/or aseptic meningitis from 2012 to 2015 in West Bank, Palestine

    Science.gov (United States)

    Dumaidi, Kamal; Al-Jawabreh, Amer

    2017-01-01

    Background Human enteroviruses (HEVs) are the most frequently reported cause of aseptic meningitis with or without CSF pleocytosis in childhood. Rapid detection and genotype of HEVs is essential to determine the causative agent and variant causing sepsis-like illness and/or aseptic meningitis. Aim To investigate the molecular epidemiology of enteroviruses (EVs) among patients with sepsis-like illness and/or aseptic meningitis admitted to three major hospitals in West Bank, Palestine from 2012 to 2015. Methods During the study period, 356 CSF samples were collected from patients with sepsis-like illness and/or aseptic meningitis. Two RT-nested PCR assays targeting a partial part of 5'UTR for direct diagnosis and the VP1 region for genotyping by sequence analysis of the viral genome were used. Results HEV RNA was detected in 66 of 356 (18.5%) of CSF samples. Age distribution showed that 64% (42/66) were infants (sepsis-like illness and/or aseptic meningitis. In addition, the molecular method utilized for direct diagnosis and genotyping of HEV from CSF revealed that more than one HEV type circulated in the West Bank, Palestine during the study period. PMID:28225788

  12. Comparison of nuring of thoracoscopic and median sternal incision cononary artery bypass graft operation%胸腔镜与正中开胸冠状动脉搭桥术后的护理比较

    Institute of Scientific and Technical Information of China (English)

    汤红莲; 苏冰莲; 徐建婷

    2010-01-01

    Objective To compare nuring of thoracoscopic and median sternal incision cononary artery bypass graft (CABG) .To investigate the peculiarity of nuring after thoracoscopic CABG.Methods From April 2005 to November 2008 , 57 cases of thoracoscopic CABG and 65 cases of median sternal incision CABG were performed in our hospital.The nuring after both type of operations, including monitoring of hemodynamics, ward of circulatory and respiratory system, using of vasoactive drugs, drainage blood volume and pain were analyzed and campared.Results The patients underwent thoracoscopic CABG had more stable circulatory and respiratory system, less using of vasoactive drugs, earlier time of extubation, eating, movement and recovery, a little more pulmonary complications than the patients underwent median sternal incision CABG.Conclusions The nuring of thoracoscopic CABG is easier, less amount of work and more efficient than those of median sternal incision CABG.The patients of thoracoscopic CABG have less trauma and pain, recover more quickly and cound leave ICU earilier.%目的 比较胸腔镜冠状动脉搭桥与正中开胸冠状动脉搭桥的术后护理方法,探讨术后护理的特点和措施.方法 分析胸腔镜下冠状动脉搭桥患者57例与常规正中开胸冠状动脉搭桥缺损65例患者术后血流动力学监测、循环与呼吸系统的监护、血管活药物的应用、引流血量及术后疼痛护理等方面情况.结果 胸腔镜下冠状动脉搭桥较正中开胸手术患者呼吸系统、循环系统相对稳定,而且术后用药少、拔管早、进食早、活动早、恢复快、但肺部并发症稍多.结论 胸腔镜下冠状动脉搭桥较正中开胸护理相对简单,减少了工作量少,提高了护理工作效率,且患者术后创伤小,疼痛轻,恢复快,住IcU时间明显缩短.

  13. 无菌药品生产车间灭菌系统设计探讨%A Discussion of Sterilization Systems in Production Plants for Aseptic Pharmaceuticals

    Institute of Scientific and Technical Information of China (English)

    李颖

    2012-01-01

    灭菌是无菌药品生产的关键环节,根据《药品生产质量管理规范》(2010年修订)的要求,结合本人的设计实例,对无菌药品生产车间灭菌系统的设计做简单的探讨和归纳。阐述了干热灭菌、湿热灭菌、过滤除菌三种方法的工作原理及影响灭菌效果的主要因素,并对灭菌设备的选用情况作简要说明。%Sterilization was a critical unit operation in production of aseptic pharmaceuticals. Complying with the re- quirements by cGMP (2010 Version) and integrating design examples, a brief discussion and induction on the design of the sterilization systems in production plants for aseptic pharmaceuticals were presented. The operating principle and fac- tors reducing sterilization efficiency of 3 methods including dry -heat sterilization, moist -heat sterilization, and filtration sterilization were summed up, and the sterilization equipment selection was discribed briefly.

  14. Effects of low dosage Co-60 irradiation in the course of aseptic arthritis of the knee joint of rabbits; Effekte einer niedrig dosierten Co-60-Bestrahlung auf den Verlauf einer aseptischen Arthritis am Kniegelenk des Kaninchens

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, U.; Koch, F.; Ludewig, E. [Univ. Leipzig (Germany). Veterinaermedizinische Fakultaet; Kamprad, F.; Melzer, R.; Hildebrandt, G. [Leipzig Univ. (Germany). Klinik fuer Strahlentherapie und Radioonkologie

    1998-12-01

    Purpose: Numerous clinical observations demonstrate the efficacy of low radiation doses in the treatment of painful osteoarthritis. Experimental investigations remain scarce. We investigated the effects of locally daily 5 times 1.0 Gy 60-Co irradiation on an artificially induced aseptic gonarthritis in rabbits. Material and methods: Three separate experiments (EV) were performed (10 rabbits per experiment, 5 treated/5 controls; duration: EV1: 18 days; EV2: 6 days; EV3: 29 days). An aseptic arthritis in the right knee joint of rabbits was induced by intraarticular injection of 0.5 ml papain solution (3%, 30,000 USP/mg) on day 0. The arthritic knee joint of the anesthesized animals was irradiated daily from day 1 to 5 with 5 times 1.0 Gy. The controls were sham-irradiated under the same conditions. The time course of arthritis in treated animals and sham-treated controls was evaluated by clinical, laboratory-chemical and histological criteria. The clinical investigation was performed daily, the puncture of the knee-joints was carried out several times in EV1, and at the end of experiments in EV2 and EV3. At the end of the observation period, animals were killed and the knee joints excised for histological analysis. Results: The intraarticular injection of papain caused a peracute inflammatory response in all animals. After 1 week the chronical stage was reached, and the experimental arthritis resolved slowly within several weeks. Local irradiation accelerated the decrease of inflammatory joint swelling, being significant by day 4. On day 6 the volume of synovial fluid in irradiated knee-joints was significantly smaller. The morphometric data indicated a reduction in thickness of synovial membrane, a decrease in number of synovial cell layers, and a decrease in distance between capillaries and the synovial membrane surface following irradiation of arthritic joints. Due to considerable individual variability, the morphometric data partially did not reach statistically

  15. Chronic cholecystitis

    Science.gov (United States)

    Cholecystitis - chronic ... Most of the time, chronic cholecystitis is caused by repeated attacks of acute (sudden) cholecystitis. Most of these attacks are caused by gallstones in the gallbladder. These ...

  16. Chronic Pain

    Science.gov (United States)

    ... pain. Psychotherapy, relaxation and medication therapies, biofeedback, and behavior modification may also be employed to treat chronic pain. × ... pain. Psychotherapy, relaxation and medication therapies, biofeedback, and behavior modification may also be employed to treat chronic pain. ...

  17. Chronic Pain

    Science.gov (United States)

    ... a problem you need to take care of. Chronic pain is different. The pain signals go on ... there is no clear cause. Problems that cause chronic pain include Headache Low back strain Cancer Arthritis ...

  18. Chronic prostatitis

    OpenAIRE

    Le, Brian; Schaeffer, Anthony J.

    2011-01-01

    Chronic prostatitis can cause pain and urinary symptoms, and usually occurs without positive bacterial cultures from prostatic secretions (known as chronic abacterial prostatitis or chronic pelvic pain syndrome [CP/CPPS]). Bacterial infection can result from urinary tract instrumentation, but the cause and natural history of CP/CPPS are unknown.

  19. Chronic prostatitis

    OpenAIRE

    Erickson, Bradley A.; Schaeffer, Anthony J.; Le, Brian

    2008-01-01

    Chronic prostatitis can cause pain and urinary symptoms, and usually occurs without positive bacterial cultures from prostatic secretions (known as chronic abacterial prostatitis or chronic pelvic pain syndrome, CP/CPPS). Bacterial infection can result from urinary tract instrumentation, but the cause and natural history of CP/CPPS are unknown.

  20. The rehabilitation treatment of children after operation of aseptic necrosis of head of femur%小儿股骨头无菌性坏死术后康复治疗

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@Background: Aseptic necrosis of head of femur of children is a kind of ischemic necrosis of the center of epiphysis of femoral head. Currently we treat it with synovectomy, transplantation of vessel tract, intertrochanteric osteotomy and every kinds of pelvic truncation to improve head-mortar relation, but the effect is not satisfying. After head of femur conversion and self-ilium transplantation operation, the follow-up effect is satisfying. Objective: Discussing the treatment effect of operation on children aseptic necrosis of head of femur. Unit:Second People's Hospital of Ningxia Municipality.

  1. Cell lineage analysis of the mandibular segment of the amphipod Orchestia cavimana reveals that the crustacean paragnaths are sternal outgrowths and not limbs

    Directory of Open Access Journals (Sweden)

    Scholtz Gerhard

    2006-12-01

    Full Text Available Abstract The question of arthropod head segmentation has become one of the central issues in Evolutionary Developmental Biology. The number of theories pertaining to head segments progressively enlarges, old concepts have been revitalized, and nearly every conceivable composition of the arthropod head has at some point received discussion. One contentious issue involves a characteristic mouthpart in crustaceans – the lower lips or the so-called paragnaths. The paragnaths build the posterior border of the mouth region antagonistic to the upper lip – the labrum. We show here the development of the appendage-like structures in the mandibular region of the amphipod crustacean Orchestia cavimana at a high level of cellular resolution. The embryos are examined during development of the mouthparts using in vivo labeling. An invariant cell division pattern of the mandibular segment was detected by 4D-microscopy and a preliminary model for pattern of the first cleavages in the mandibular region created. With this indispensable precondition single ectodermal cells of the grid-like pattern were labeled with DiI – a lipophilic fluorescent dye – to trace cell lineages and determine the clonal composition of the developing mouthparts, especially the mandibular segment. From our data it is evident that the paragnaths are sternal outgrowths of the mandible segment. The assumption of the limb nature of paragnaths and the presence of an additional head segment between the mandibular and the second antennal segments are clearly refuted by our data. Our results show the power of cell lineage and clonal analyses for inferences on the nature, origin and thus homology of morphological structures. With this kind of investigation morphological and gene expression data can be complemented. We discuss notable similarities of paragnath anlagen to those of the hypopharynx complex in myriapods and hexapods. The fact that both structures grow out as two lateral buds

  2. 心脏外科术后纵膈感染的临床特点%The Clinical Chaar cteristic of Mediastinitis Relve ant to Cardiac Surgery Prco edures via Median Sternal Incisoi n

    Institute of Scientific and Technical Information of China (English)

    卫向阳; 宋志斌; 孙英民

    2014-01-01

    目的:总结经胸骨正中切口行心脏手术后发生纵隔感染的诊治经验。方法:对2005年9月~2012年10月,我科47例胸骨正中切口心脏术后纵隔感染病人的临床表现,诊断方法,鉴别诊断,治疗手段,及预后进行回顾分析,10例行胸骨固定,纵膈冲洗,其中2例行胸大肌肌瓣填充修补,37例局部切开引流换药,47例患者发热6例,无发热41例,患者中毒症状6例,无中毒症状者41例,47例患者均有切口渗出和胸骨不稳定,切口分泌物培养18例阳性,其中MRSA 2例,根据药物敏感试验结果调整抗生素。结果:死亡6例,死亡率12%,见于中毒症状者和MRSA感染者。余患者均存活。随访1~5年,无远期死亡,感染复发3例。结论:胸骨正中切口行心脏手术后,纵膈感染是一种危及生命的严重并发症,早期清创、开放引流冲洗是有效的治疗方法。严重感染者预后极差。%Objective:To summarize the experience of diagnosis and treatment of mediastinitis relevant to cardiac surgery procedures via median sternal incision .Method s:From September 2005 to October 2012, mediastinitis developed in 47 ( 2.8%) of 1645 consecu-tive cardiac surgery procedures via median sternal incision .We reviewed the variation of clinical characteristics、diagnostic approach 、dif-ferential diagnosis、treatment approch and the prognosis in these patients .10 patients underwent extensive sternal and soft tissue debride-ment and dosed mediastinal irrigation with antiseptic solution and drainage through tubes .Two of them were given plastics procedures using rectus abdominus flaps or pectoralis major muscle flaps ,Only local drainage and irrigation with antiseptic solution were given in 37 be-cause of the mild infection .6 patients of 47 patients had a fever , the others had no fever , All of 47 patients had incision exudation and sternum unstability ,Samples of sternal drainage and

  3. Optimization of Culture Conditions for Aseptic Sweet Pepper Seedling%甜椒无菌苗培养条件的优化

    Institute of Scientific and Technical Information of China (English)

    李妹芳; 苗纪忠; 卜祥勇; 刘学芳; 夏江华; 郭尚敬

    2014-01-01

    以茄门甜椒种子为试材,对无菌苗培养前的种子消毒剂种类及不同消毒时间、浓度等的消毒效果进行了比较研究;对影响无菌苗生长的培养基配方、pH值及生长时间等因素进行了探讨。结果表明,甜椒无菌苗的最佳消毒流程和生长条件为:55℃无菌水浸种15 min,室温静置4~5 h,用10%NaClO消毒30 min,无菌水冲洗3次,接种至1/2MS培养基+15 g/L蔗糖+7.5 g/L琼脂,pH值为5.8,(25±1)℃,子叶长出6~10 d左右,即可作为转基因用无菌苗。%Using Qiemen sweet pepper as materials , the disinfection effects of different disinfectant a-gents, disinfection times and contents on seeds before culture were compared , and the effects of medium for-mula, pH value and growth time on growth of aseptic seedling were investigated .The results showed that the optimum disinfection method and culture conditions for aseptic sweet pepper seedling were soaking seeds in a -septic water of 55℃for 15 minutes, then staying at room temperature for 4~5 hours, disinfecting with 10%NaClO for 30 minutes, washing 3 times with aseptic water and then culturing in medium of 1/2MS+15 g/L sugar+7.5 g/L agar with pH value of 5.8 under (25 ±1)℃.When the cotyledon sprouted for 6~10 days, the seedlings could be used for genetic transformation .

  4. Correlation between the findings of magnetic resonance imaging and prognosis of patients with predisposing factors of aseptic necrosis of the femoral head

    Energy Technology Data Exchange (ETDEWEB)

    Takatori, Yoshio; Nakamura, Shigeru; Nakamura, Toshitaka; Ninomiya, Setsuo; Kokubo, Takashi (Tokyo Univ. (Japan). Faculty of Medicine); Sugimoto, Hisayuki

    1991-08-01

    Eighteen patients with the predisposing factors for aseptic necrosis of the femoral head were followed up for more than two years after the initial magnetic resonance (MR) imaging. At the time of the initial examination, 24 femoral heads showed abnormal low-intensity areas on MR images without abnormal findings on plain radiographs. Among them, six femoral heads collapsed in the follow-up period. The initial mid-coronal T{sub 1}-weighted MR images of these femoral heads had shown characteristic findings, that is, band-shaped low-intensity areas with the lateral end not covered by the acetabulum. Subchondral fracture of the femoral head occurred in the vicinity of the lateral end of the band. The findings of initial MR imaging seem to predict subsequent collapse of the femoral head. (author).

  5. Efficacy and safety of the use of platelet-rich plasma for sternal wound infections: a meta-analysis%富血小板血浆预防胸骨感染效果的Meta分析

    Institute of Scientific and Technical Information of China (English)

    孙斌; 冯子阳; 徐芳芳; 臧艳; 花美仙; 钱宝华

    2015-01-01

    目的 评估富血小板血浆(platelet-rich plasma,PRP)预防胸骨感染(sternal wound infection,SWI)的安全性与有效性.方法 计算机检索PubMed,EMbase,The Cochrane Library以及中国生物医学文献数据库(CBM)中胸心外科手术患者局部应用PRP预防感染的相关研究,并辅以文献追溯法查找相关文献.检索时限均从建库至2014年8月.由2名评价者按纳入与排除标准独立选择文献、提取资料并评价质量后,采用Stata12.0软件进行Meta分析.结果 最终纳入5个研究,共5 613名患者.Meta分析结果显示:与对照组相比,PRP组发生SWI和胸骨浅表切口感染(superficial sternal wound infection,SSWI)的风险分别下降了74%(RR =0.26;95%CI,0.08-0.88;P<0.05)和76%(RR=0.24;95% CI,0.10-0.61;P<0.05),差别有统计学意义;而PRP组胸骨深部切口感染(deep sternal wound infection,DSWI),二次手术以及死亡的风险与对照组的差别无统计学意义.结论 局部应用自体PRP可以降低胸心外科手术患者SWI和SSWI的风险,其确切机制以及其他临床应用有待进一步研究.

  6. [Chronicity, chronicization, systematization of delusions].

    Science.gov (United States)

    Trapet, P; Fernandez, C; Galtier, M C; Gisselmann, A

    1984-05-01

    Chronicity in psychopathology is indicative of a term, a decay. Chronicization only leads the way to this term. Here, chronicization is taken literally as an inscription in the time course of delusions. The mechanism of systematization seems to be a central mark in the approach to chronic delusions. It is not an alienation or an irreversible closing but an attempted accommodation with reality in the life of psychotic subjects, irrespective of the delusional structure. The role of therapy and drug treatment as a follow-up may in that case assume another meaning.

  7. Chronic pancreatitis

    OpenAIRE

    Kocher, Hemant M.; Froeling, Fieke EM

    2008-01-01

    Chronic pancreatitis is characterised by long-standing inflammation of the pancreas owing to a wide variety of causes, including recurrent acute attacks of pancreatitis. Chronic pancreatitis affects 3–9 people in 100,000; 70% of cases are alcohol-induced.

  8. Chronic pancreatitis

    OpenAIRE

    Kocher, Hemant M.; Kadaba, Raghu

    2011-01-01

    Chronic pancreatitis is characterised by long-standing inflammation of the pancreas due to a wide variety of causes, including recurrent acute attacks of pancreatitis. Chronic pancreatitis affects between 3 and 9 people in 100,000; 70% of cases are alcohol-induced.

  9. APPLICATION OF TITANIUM PLATE AND Teflon PATCH IN CHEST WALL RECONSTRUCTION AFTER STERNAL TUMOR RESECTION%钛板联合Teflon补片重建胸骨肿瘤切除后胸廓

    Institute of Scientific and Technical Information of China (English)

    吴显宁; 陈名久; 喻风雷

    2011-01-01

    Objective To study the reconstruction method and effectiveness of titanium plate and Teflon patch for the chest wall after resection of sternal tumors. Methods Between October 2006 and November 2009, 4 patients with sternal tumors were treated and the thoracic cages were reconstructed. There were 2 males and 2 females, aged 30-55 years. The patients were admitted because of chest lump or pain. The sizes of palpable lump ranged from 4 cm×3 cm to 10 cm×8 cm. CT examination showed bone destruction. After sternal tumor resection, defect size ranged from 10 cm x 8 cm to 18 cm×4 cm, and titanium plate and Teflon patch were used to repair and reconstruct the chest wall defect. Results The operations of the tumor resection and reconstruction of chest wall defect were successfully performed in 4 cases. Incisions healed by first intention with no abnormal breath, subcutaneous emphysema, pneumothorax, and infection. One case failed to be followed up after 6 months; 1 case died of intracranial hemorrhage; and 2 cases were followed up 1 and 4 years respectively without tumor recurrence. The chest wall had good remodeling. No loosening and exposure of titanium plate, difficulty in breathing, chest distress, and chest pain were observed during follow-up. Conclusion Surgical resection of sternal tumors will cause large chest wall defect which can be repaired by titanium plate and Teflon patch because it had the advantages of easy operation, satisfactory remodeling, and less complication.%目的 探讨胸骨肿瘤切除术后采用钛板联合Teflon补片重建胸廓的方法及疗效.方法 2006年10月-2009年11月,收治4例胸骨肿瘤患者.男2例,女2例;年龄30~55岁.以胸部肿块、疼痛1~6个月后入院.检查见胸前区范围为4cm×3em~10cm×8cm的肿块,质硬.CT检查见骨质破坏.采用胸骨肿瘤扩大切除术,切除范围为10cm×8cm~18em×14cm,采用钛板联合Teflon补片重建胸廓.结果 患者手术均顺利完成.术后切口Ⅰ期

  10. A survival case of painless chronic type A aortic dissection with a history of stroke and anticoagulant use.

    Science.gov (United States)

    Tugcu, Aylin; Yildirimturk, Ozlem; Demiroglu, I C Cemsid; Aytekin, Saide

    2010-10-01

    We report the case of a patient with completely painless chronic aortic dissection, who presented to another hospital with a left hemiparesia 3 months ago and received anticoagulation therapy with a diagnosis of ischemic stroke. Most of her symptoms had resolved when she presented to our outpatient clinic except for numbness of her left hand and dysphasia. Physical examination found a diastolic murmur at the left sternal border and a bruit over the right carotid artery. Transthoracic echocardiography and carotid sonography demonstrated aortic dissection with extension into the internal right carotid artery and severe aortic regurgitation. Surgery was performed successfully and the patient was discharged. This case emphasizes that the diagnosis of a completely painless aortic dissection with only neurologic symptoms at presentation can be extremely difficult and should always be considered as a cause of ischemic stroke to avoid catastrophic antithrombolytic or anticoagulation therapy.

  11. The preparation of aseptic rabbit tissue cage infection model%兔组织笼无菌感染模型的制备

    Institute of Scientific and Technical Information of China (English)

    刘树玲; 丁丽; 邢昆

    2015-01-01

    目的:制备兔组织笼无菌感染模型,为药物药动学-药效学结合模型(pharmacokinetic‐pharmaco‐dynamic modeling ,PK‐PD)研究提供在体动物实验载体。方法选取健康家兔28只,耳缘静脉注射盐酸赛拉嗪注射液0.15ml/kg麻醉,每只分别背部备皮、切开皮肤,然后在皮下植入长约5cm的无菌中空胸腔引流管1个,继而在无菌操作下手术缝合。术后应用青霉素肌肉注射3d以预防感染。结果5只家兔先后因不同原因死亡,23只家兔均获得清亮的无菌组织液,成功建立兔组织模型,成功率为82.14%。结论通过严格控制无菌操作,选择合适的麻醉剂,手术刀口选择在兔背部,术后及时预防感染,可以成功制备兔组织笼无菌感染模型,并获得清亮的无菌组织液。%Objective To prepare a rabbit tissue cage model so as to provide drug animal carrier in vivo for drug PK‐PD modeling study .Methods 28 healthy rabbits were selected and injected with the anesthesia xylazine iv respectively .The back hair was cut in each rabbit ,and then the skin was cut open .A 5cm of sterile hollow chest tube drainage was implanted subcutaneously .In the end the wound was sewed up with aseptic technique .After op‐eration penicillin im was injected for 3 days to prevent infection .Results Among the 28 rabbits ,5 rabbits were dead due to different causes .Clear and sterile tissue fluid were gotten from other 23 rabbits .A rabbit tissue model was established successfully ,and the success rate was 82 .14% .Conclusion By stricted controlling aseptic opera‐tion ,selecting the appropriate anesthesia and surgical incision in the back of the rabbit ,timely postoperative anti‐infection ,a rabbit tissue cage model can be successfully established ,so does clear tissue fluid .

  12. Aseptic meningitis by echovirus 30 in São Paulo state, Brazil Meningite asseptica por echovírus 30 no estado de São Paulo, Brasil

    Directory of Open Access Journals (Sweden)

    Bráulio Caetano Machado

    2007-03-01

    Full Text Available The objective of this study was to identify and characterize the immunological and molecular aspects of Human Enterovirus (HEV associated with aseptic meningitis cases in São Paulo State, Brazil. Clinical samples (cerebrospinal fluid CSF, stool and sera were analyzed from 21 viral meningitis suspected cases collected in the period from 1998 to 1999. The isolated virus were identified as belonging to Enterovirus genus and specifically to echovirus serotype 30 (EV-30, using immunological techniques as Indirect Immunofluorescense Assay (IFA and Neutralization (Nt and by molecular technique of Reverse Transcription Polymerase Chain Reaction (RT-PCR directed to the 5' NTR and VP1 regions of viral genome. The results obtained contributed with to the surveillance system of São Paulo State and they are important due to a shortage of epidemiological data about the circulation of EV-30 associated to aseptic meningitis in this region of the world.O objetivo deste estudo foi identificar e caracterizar quanto aos aspectos imunológicos e moleculares os Enterovirus humanos associados a casos de meningite asséptica. Amostras clínicas (líquido cefaloraquidiano, fezes e soro originárias de 21 casos suspeitos de meningite viral, provenientes do estado de São Paulo no período de 1998 a 1999 foram analisadas. Os vírus isolados foram identificados como pertencentes ao gênero Enterovirus e mais especificamente ao sorotipo echovírus 30 (EV-30, utilizando-se técnicas imunológicas como Imunofluorescência Indireta e Neutralização e técnica molecular da transcrição reversa - reação em cadeia da polimerase (RT-PCR direcionada para as regiões 5' não traduzida (5'NTR e Proteína Viral 1(VP1 do genoma viral. Os resultados obtidos contribuíram com o sistema de vigilância epidemiológica do estado de São Paulo na geração de informações sobre a circulação de EV-30 associado à meningite asséptica nessa região do mundo.

  13. Ear infection - chronic

    Science.gov (United States)

    Middle ear infection - chronic; Otitis media - chronic; Chronic otitis media; Chronic ear infection ... up. When this happens, infection can occur. A chronic ear infection develops when fluid or an infection ...

  14. The clinical features of 101 cases of children with aseptic encephalitis%101例儿童无菌性脑炎的临床特点分析

    Institute of Scientific and Technical Information of China (English)

    王贤柱; 李玖军

    2015-01-01

    目的:探讨无菌性脑炎的临床特点及转归情况。方法收集2009年12月至2012年12月中国医科大学附属盛京医院PICU收治的诊断为无菌性脑炎的患儿101例,对其临床表现、体征、辅助检查及转归情况进行回顾性分析。结果101例患儿中,男54例,女47例,年龄1~6个月12例,~1岁12例,~3岁36例,~6岁12例,~14岁19例。发热为最常见的临床表现,共有92例(91.1%),其次为抽搐79例(78.2%),脑膜刺激征或病理征阳性63例(62.4%)。辅助检查中敏感性最高的为脑电图,共89例患儿行脑电图检查,异常75例(84.3%),其次为MRI平扫,共97例行头部MRI平扫,异常54例(55.7%),101例患儿均行脑脊液检查,白细胞增高或(和)蛋白增高50例(49.5%),敏感性最低的为CT平扫,63例行头部CT平扫,异常11例(17.5%)。所有患儿入院后均给予止惊、退热、降低颅压及营养脑细胞等综合治疗,治愈70例,留有神经系统后遗症20例,放弃治疗7例,死亡4例。结论儿童无菌性脑炎好发于婴幼儿,男女发病率相当,临床表现呈多样化,以发热及抽搐最为常见,脑电图及头部MRI检查敏感性较高,给予及时对症治疗,大部分患儿转归良好,少数病例留有意识障碍及运动障碍等不同程度的神经系统后遗症,个别病例脑干受累,出现呼吸衰竭、神经源性休克等,最终导致患儿死亡。%Objective To observe and discus the clinical features and outcome of aseptic encephali-tis in children. Methods One hundred and one cases treated in PICU of Shengjing Hospital of China Medi-cal University and diagnosed with aseptic encephalitis from December 2009 to December 2012 were enrolled. Results The clinical manifestations, signs, laboratory examinations and outcome were analyzed retrospec-tively. Among them, 54 cases were male,47 cases were female,12 cases aged from 1 month old to 6 months old,12 cases aged from 7 months old to 1 year old,36 cases aged from 2 years old to

  15. Elucidation of echovirus 30's origin and transmission during the 2012 aseptic meningitis outbreak in Guangdong, China, through continuing environmental surveillance.

    Science.gov (United States)

    Lu, Jing; Zheng, Huanying; Guo, Xue; Zhang, Yong; Li, Hui; Liu, Leng; Zeng, Hanri; Fang, Ling; Mo, Yanling; Yoshida, Hiromu; Yi, Lina; Liu, Tao; Rutherford, Shannon; Xu, Wenbo; Ke, Changwen

    2015-04-01

    An aseptic meningitis outbreak occurred in Luoding City of Guangdong, China, in 2012, and echovirus type 30 (ECHO30) was identified as the major causative pathogen. Environmental surveillance indicated that ECHO30 was detected in the sewage of a neighboring city, Guangzhou, from 2010 to 2012 and also in Luoding City sewage samples (6/43, 14%) collected after the outbreak. In order to track the potential origin of the outbreak viral strains, we sequenced the VP1 genes of 29 viral strains from clinical patients and environmental samples. Sequence alignments and phylogenetic analyses based on VP1 gene sequences revealed that virus strains isolated from the sewage of Guangzhou and Luoding cities matched well the clinical strains from the outbreak, with high nucleotide sequence similarity (98.5% to 100%) and similar cluster distribution. Five ECHO30 clinical strains were clustered with the Guangdong environmental strains but diverged from strains from other regions, suggesting that this subcluster of viruses most likely originated from the circulating virus in Guangdong rather than having been more recently imported from other regions. These findings underscore the importance of long-term, continuous environmental surveillance and genetic analysis to monitor circulating enteroviruses.

  16. Genomic characterization of echovirus 6 causing aseptic meningitis in Hokkaido, Japan: a novel cluster in the nonstructural protein coding region of human enterovirus B.

    Science.gov (United States)

    Miyoshi, Masahiro; Komagome, Rika; Ishida, Setsuko; Nagano, Hideki; Takahashi, Kenichi; Okano, Motohiko

    2013-04-01

    We determined four complete nucleotide sequences of echovirus 6 (E6) isolated from an epidemic of aseptic meningitis (AM) in Hokkaido, Japan, in 2011. Phylogenetic analysis of the genes encoding viral capsid protein 1 revealed that the strains were closely related to E6 strains isolated in China in recent years, but they were distantly related to E6 strains isolated from patients with AM in Osaka Prefecture, Japan, in 2011. The genes encoding the viral protease and RNA-dependent RNA polymerase (3CD) were closely related to those of several non-E6 strains of the species Human enterovirus B isolated in China, South Korea, and Australia from 1999 to 2010, resulting in a novel cluster in the phylogenetic tree. These results suggest that the incidence of AM in Japan in 2011 was caused by at least two lineages of E6 strains, and a lineage of the 3CD gene was interspersed among different serotypic strains isolated in Western Pacific countries.

  17. Storage stability of cashew apple juice preserved by hot fill and aseptic processes Estabilidade do suco de caju preservado pelo método ''hot fill'' e processo asséptico

    OpenAIRE

    Maria Cecília Oliveira Costa; Geraldo Arraes Maia; Raimundo Wilane de Figueiredo; Men de Sá Moreira de Souza Filho; Isabella Montenegro Brasil

    2003-01-01

    Cashew (Anacardium occidentale L.) apples from Pacajus, Ceará State, Brazil, were processed into high pulp content juice. The juice was packed either by hot fill or an aseptic process and evaluated for physical, physical-chemical, and sensorial changes during a 12-month storage period at room temperature. The results indicated that pH, soluble solids, total acidity, total sugar content and color did not change significantly during storage nor were affected by the type of filling. The sensoria...

  18. [Chronic hepatitis].

    Science.gov (United States)

    Figueroa Barrios, R

    1995-01-01

    Medical literature about chronic hepatitis is reviewed. This unresolving disease caused by viruses, drugs or unknown factors may progress to in cirrhosis and hepatocarcinoma. A classification based on liver biopsy histology into chronic persistent and chronic active types has been largely abandoned and emphasis is placed on recognizing the etiology of the various types. One is associated with continuing hepatitis B virus infection; another is related to chronic hepatitis C virus infection and the third is termed autoinmune, because of the association with positive serum autoantibodies. A fourth type with similar clinical functional and morphologic features is found with some drug reactions. Long term corticoesteroid therapy is usually successful in autoinmune type. Associations between antibodies to liver-kidney microsomes and the hepatitis C virus can cause diagnostic difficulties. Antiviral treatment of chronic hepatitis B and C with interpheron alfa is employed, controlling symptoms and abnormal biochemistry and the progression to cirrhosis and liver cancer in 30 to 40% patients. Alternative therapies or combinations with interpheron are being evaluated waiting for final results.

  19. Chronic meningitis with intracranial hypertension and bilateral neuroretinitis following Mycoplasma pneumoniae infection.

    Science.gov (United States)

    Karampatsas, Konstantinos; Patel, Himanshu; Basheer, Sheikh N; Prendergast, Andrew J

    2014-12-23

    A previously well 12-year-old boy presented with a 2-week history of headache, nausea, vomiting and left-sided weakness. He subsequently developed meningism, right abducens nerve palsy, persistent papilloedema and reduced visual acuity in association with a bilateral macular star, consistent with neuroretinitis. Cerebrospinal fluid (CSF) examination indicated chronic meningitis and serological testing confirmed recent Mycoplasma pneumoniae infection, although PCR in CSF was negative. He was treated for aseptic meningitis with ceftriaxone, aciclovir, azithromycin and acetazolamide for intracranial hypertension, with gradual improvement in clinical condition and visual acuity over several weeks. This is the first report of M. pneumoniae chronic meningitis further complicated with bilateral neuroretinitis and intracranial hypertension. Evidence of central nervous system inflammation in the absence of direct infection suggests an immune-mediated pathophysiology. Although the use of macrolides with antibiotic and immunomodulatory activity might be beneficial, it was not possible to ascertain whether it influenced clinical recovery in this case.

  20. Advances in diagnosis and treatment of aseptic meningitis after neurosurgical operation%神经外科术后无菌性脑膜炎的诊断及治疗进展

    Institute of Scientific and Technical Information of China (English)

    付东翔; 付强; 刘波

    2014-01-01

    Aseptic meningitis and bacterial meningitis after neurosurgical operation are the postoperative complications which are difficult to identify clinically. They have great differences in treatment and prognosis. The pathogenesis of the postoperative aseptic meningitis is not clear. Its clinical manifestations are similar to bacterial meningitis, but the prognosis is better. The traditional diagnostic methods for postoperative aseptic meningitis has a certain degree of the rate of missed diagnosis and misdiagnosis. In recent years, scholars of the world have conducted many studies on the diagnosis and treatment of postoperative aseptic meningitis, and made some progress, which has improved the diagnostic accuracy of postoperative aseptic meningitis to a certain degree, guided the treatment correctly and reduced patients unnecessary expenses and hospital stays.%神经外科术后无菌性脑膜炎与细菌脑膜炎一直是临床上较难鉴别的术后并发症,二者在治疗过程和预后方面有较大差异。术后无菌性脑膜炎的发病机制尚不明确,临床表现与细菌性脑膜炎相似,易被误诊为细菌性脑膜炎,但预后较好。传统的检查诊断方法对于术后无菌性脑膜炎存在一定程度的漏诊率和误诊率,近年来国内外学者对术后无菌性脑膜炎的诊断及治疗方法进行了多方面的研究,并取得了一些成果,在一定程度上提高了此类术后并发症诊断的准确率,正确指导此类术后并发症的治疗,减少患者不必要的花费及患者的住院时间。

  1. 系统性红斑狼疮并发无菌性股骨头坏死的相关因素研究%Risk factors of systemic lupus erythematosus patients with aseptic necrosis of the femoral head

    Institute of Scientific and Technical Information of China (English)

    石颜军

    2013-01-01

    目的 探讨系统性红斑狼疮并发无菌性股骨头坏死的相关因素.方法 选择本院收治的系统性红斑狼疮患者84例,分为并发无菌性股骨头坏死42例(观察组)和无并发无菌性股骨头坏死42例(对照组),分析系统性红斑狼疮并发无菌性股骨头坏死的相关因素.结果 观察组血管炎、雷诺现象以及Acl阳性的发生率均明显高于对照组,差异有统计学意义(P<0.05);观察组中19例患者使用激素冲击治疗,而对照组仅有8例,差异有统计学意义(P<0.05).结论 以血管炎、雷诺现象为主要临床表现的系统性红斑狼疮患者,其脉管系统对激素敏感性增加,大剂量激素冲击治疗容易并发无菌性股骨头坏死.%Objective To study the risk factors of systemic lupus erythematosus with aseptic necrosis of the femoral head.Methods Eighty-four patients with systemic lupus erythematosus in our hospital were divided into two groups,including 42 patients with aseptic femoral head necrosis (observation group) and 42 cases of without aseptic femoral head necrosis in patients (control group).Related factors concerning systemic lupus erythematosus with aseptic necrosis of the femoral head were analyzed.Results Occurrences of vasculitis,Raynaud's phenomenon,and the ACLpositive of the observation group were higher than those of the control group,the difference being statistically significant (P< 0.05).In the observation group,19 patients were applied with steroid pulse therapy,while in the control group,only eight cases,the difference between the two groups being statistically significant (P < 0.05).Conclusion For patients with systemic lupus erythematosus vasculitis,Raynaud's phenomenon as the main clinical manifestations,its vascular system is more sensitive to the hormone.Large-dose hormone therapy can easily lead to aseptic necrosis of the femoral head.

  2. Chronic gastritis.

    Science.gov (United States)

    Sipponen, Pentti; Maaroos, Heidi-Ingrid

    2015-06-01

    Prevalence of chronic gastritis has markedly declined in developed populations during the past decades. However, chronic gastritis is still one of the most common serious pandemic infections with such severe killing sequelae as peptic ulcer or gastric cancer. Globally, on average, even more than half of people may have a chronic gastritis at present. Helicobacter pylori infection in childhood is the main cause of chronic gastritis, which microbial origin is the key for the understanding of the bizarre epidemiology and course of the disease. A life-long and aggressive inflammation in gastritis results in destruction (atrophic gastritis) of stomach mucosa with time (years and decades). The progressive worsening of atrophic gastritis results subsequently in dysfunctions of stomach mucosa. Atrophic gastritis will finally end up in a permanently acid-free stomach in the most extreme cases. Severe atrophic gastritis and acid-free stomach are the highest independent risk conditions for gastric cancer known so far. In addition to the risks of malignancy and peptic ulcer, acid-free stomach and severe forms of atrophic gastritis may associate with failures in absorption of essential vitamins, like vitamin B12, micronutrients (like iron, calcium, magnesium and zinc), diet and medicines.

  3. Chronic Bronchitis

    Science.gov (United States)

    ... breathing. You may also have other tests. Chronic bronchitis is a long-term condition that keeps coming back or never goes away completely. If you smoke, it is important to quit. Treatment can help with your symptoms. It often includes ...

  4. 新疆阿魏种子无菌苗制备研究%Research on Aseptic Seedling Preparation of Feralu sinkiangensis Seed

    Institute of Scientific and Technical Information of China (English)

    朱军; 李晓瑾; 王月娥; 肖琼

    2011-01-01

    In order to obtain methods of aseptic seedling preparation by tissue culture for Feralu sinkiangensis.Differents plans of sterilization, hormone, temperature of chill and relative humidity were setted to study the effects on germination of Ferula sinkiangensis seed. The results showed that the best sterilization of Ferula sinkiangensis seed was 70% ethanol 30 s + 12% H2O2 15 min. The effect at 4 ℃ chilling temperature and in 50% relvtive humidity was better than others treatment, and seed germination rate declined with temperature hoisted. Seed didn't germinate when chill temperature preponderate over 20 ℃. Although GA3 could break dormancy of Ferula sinkiangensis seed, germination rate was lower.%为获得供新疆阿魏组织培养无菌苗制备的方法.研究了不同的消毒方法、激素、层积温度和相对湿度等条件下,对新疆阿魏无菌苗制作的影响.结果表明:新疆阿魏种子最佳消毒方法为70%酒精30 s+12%H2O2 15 min;层积温度4℃,相对湿度50%,新疆阿魏种子萌发最好;新疆阿魏种子经GA3处理可打破休眠,但发芽率低于低温层积处理.

  5. Incidence and clinical features of herpes simplex viruses (1 and 2) and varicella-zoster virus infections in an adult Korean population with aseptic meningitis or encephalitis.

    Science.gov (United States)

    Choi, Rihwa; Kim, Gyeong-Moon; Jo, Ik Joon; Sim, Min Seob; Song, Keun Jeong; Kim, Byoung Joon; Na, Duk L; Huh, Hee Jae; Kim, Jong-Won; Ki, Chang-Seok; Lee, Nam Yong

    2014-06-01

    Since there are limited data on the incidence and clinical findings of central nervous system (CNS) infection by three α-herpesviruses including human herpes simplex virus 1 (HSV-1), HSV-2 and varicella-zoster virus (VZV) in Korea, a retrospective analysis of clinical data and polymerase chain reaction (PCR) results was performed in patients who presented with suspicion of acute viral meningitis and/or encephalitis at the emergency department of a tertiary referral hospital in Seoul, Korea. During the 3-year study period, a total of 224 cerebrospinal fluid (CSF) samples from 224 patients were examined. Among the 224 patients, 135 (60.3%) patients were identified as having aseptic meningitis (n = 70, 51.9%), encephalitis (n = 41, 30.4%) or meningoencephalitis (n = 24, 17.8%) at discharge. Twenty-four (17.8%) patients were identified as having VZV meningitis (n = 16, 11.9%), VZV meningoencephalitis (n = 2, 1.5%), HSV-2 meningitis (n = 4, 3.0%), or HSV-1 encephalitis (n = 2, 1.5%). Of the 24 patients infected with the three herpesviruses, immunocompromised patients accounted for 33.3% (n = 8). Skin rashes were observed in half (n = 9) of the patients with VZV, and none with HSV-1 or HSV-2. One patient with VZV meningitis and four patients with brain parenchymal involvement had neurologic sequelae. In conclusion, three herpesviruses are important causative agents of CNS infectious disease with significant morbidity in adults, regardless of the immunologic status. Therefore, CSF should be examined for HSV-1, HSV-2, and VZV using sensitive diagnostic methods in all cases of adult patients with clinical manifestations of CNS disease in order to identify the correct etiology and to determine appropriate therapy.

  6. 肿瘤型假体无菌性松动的治疗现状%Current status of the treatment of aseptic loosening in tumor prostheses

    Institute of Scientific and Technical Information of China (English)

    高明; 张清; 牛晓辉

    2014-01-01

    Aseptic loosening ( AL ) is one of the most common complications in tumor prostheses. Loss of bone quantity and decline of bone quality are the main challenges that orthopedists encounter when they deal with AL. Based on the latest reports, prosthesis revision is the primary choice in the treatment of AL, and it can provide relatively satisfactory outcomes when compared with other methods. While it needs enough bone quantity and good bone quality for prosthetic stability. In some reports, it can get a median Musculoskeletal Tumor Society ( MSTS ) functional score of 96% ( range: 50%-100% ) after an average follow-up of 101 months ( range: 47-155 months ) after the surgery. Besides this, allograft-prosthesis composites ( APCs ) are another choice. Allograft segments are used to construct a certain ifxation arm to get a more stable ifxation. However, its outcomes are not as satisfactory as that of prosthesis revision. According to some reports, after an average follow-up of 59 months after the surgery, it can provide an average MSTS functional score of 62% ( range: 57%-67% ). While we must take account that these patients receiving APCs always have less bone quantity and worse bone quality, when compared with those only receiving prosthetic treatment. In recent years, a new type of prosthesis based on extra-cortical plate ifxation has been used in the revision, which is superior to the conventional intramedullary stem prosthesis. The current results illustrate that it has certain application prospects, but high-quality studies are needed to further demonstrate it. When the loss of bone quantity and decline of bone quality are too serious to perform limb salvage treatment, rotationplasty and amputation may be a choice. However, great attention must be paid to their indications.

  7. Chronic Pancreatitis in Children

    Science.gov (United States)

    ... Information > Children/Pediatric > Chronic Pancreatitis in Children test Chronic Pancreatitis in Children What symptoms would my child ... pancreatitis will develop diabetes in adolescence. Who gets chronic pancreatitis? Those at risk for chronic pancreatitis are ...

  8. Chronic Beryllium Disease

    Science.gov (United States)

    ... Science Education & Training Home Conditions Chronic Beryllium Disease Chronic Beryllium Disease Make an Appointment Find a Doctor ... MD, MSPH, FCCP (February 01, 2016) What is chronic beryllium disease (CBD)? Chronic beryllium disease (CBD) is ...

  9. Chronic motor tic disorder

    Science.gov (United States)

    Chronic vocal tic disorder; Tic - chronic motor tic disorder ... Chronic motor tic disorder is more common than Tourette syndrome . Chronic tics may be forms of Tourette syndrome. Tics usually start ...

  10. Chronic Pelvic Pain

    Science.gov (United States)

    ... Education & Events Advocacy For Patients About ACOG Chronic Pelvic Pain Home For Patients Search FAQs Chronic Pelvic Pain ... Pelvic Pain FAQ099, August 2011 PDF Format Chronic Pelvic Pain Gynecologic Problems What is chronic pelvic pain? What ...

  11. Chronic thyroiditis (Hashimoto disease)

    Science.gov (United States)

    Hashimoto thyroiditis; Chronic lymphocytic thyroiditis; Autoimmune thyroiditis; Chronic autoimmune thyroiditis; Lymphadenoid goiter - Hashimoto; Hypothyroidism - Hashimoto; Type 2 polyglandular autoimmune ...

  12. AUTOLOGOUS SERUM SKIN TESTING (ASST IN CHRONIC IDIOPATHIC URTICARIA

    Directory of Open Access Journals (Sweden)

    Arun

    2014-01-01

    Full Text Available Chronic idiopathic urticaria (CIU is a form of urticaria , in which there appears to be persistent activation of mast cells , but the mechanism of mast cell triggering is unknown. The Autologous serum skin test (ASST is an in vivo test which assesses auto reactivity. ASST could be good screening test for Autoreactive urticaria a subset of chronic idiopathic urticaria. AIMS : To study the clinical profile of chronic idiopathic urticaria and pattern of ASST among p atients of chronic idiopathic urticaria. METHODS : Study included 200 patients of CIU that were recruited from outpatient department (OPD. Patient s with a history of urticaria for more than 6 weeks were included in the study. The detailed history , cutaneou s and systemic examination was done. ASST was performed under strict aseptic precaution. RESULTS : Out of 200 patients 100 were male and 100 were female. Mean age of patients was 31.9 yrs. Most common age group was 25 - 34yrs. ASST was found positive in 36(18 % patients. In most of the patients duration of disease was less than 11months (42% with the mean duration of disease 21.74 months. Mean duration of wheal was 64.7 minutes , in which most of the patients (112 having duration of wheal less than 59 min. Hi story of angioedema was positive in 109(54.5% patients. Aggravating factors were positive in 50(25% patients in which drugs and cold were the most common. Family history of urticaria and angioedema was present in 35 patients. None of patient complained a ny adverse reactions during and after ASST. CONCLUSION : ASST is the easily available bed side test for the diagnosis of autoreactive urticaria. It is a simple , inexpensive , semi invasive and easy - to - perform test which can be done and recorded by the dermat ologist himself. ASST may help in diagnosis and management of chronic idiopathic urticaria.

  13. Acupuncture for Chronic Urinary Retention due to Spinal Cord Injury: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Jia Wang

    2016-01-01

    Full Text Available No systematic review has been published on the use of acupuncture for the treatment of chronic urinary retention (CUR due to spinal cord injury (SCI. The aim of this review was to assess the effectiveness and safety of acupuncture for CUR due to SCI. Three randomized controlled trials (RCTs including 334 patients with CUR due to SCI were included. Meta-analysis showed that acupuncture plus rehabilitation training was much better than rehabilitation training alone in decreasing postvoid residual (PVR urine volume (MD −109.44, 95% CI −156.53 to −62.35. Likewise, a combination of acupuncture and aseptic intermittent catheterization was better than aseptic intermittent catheterization alone in improving response rates (RR 1.23, 95% CI 1.10 to 1.38. No severe adverse events were reported. In conclusion, acupuncture as a complementary therapy may have a potential effect in CUR due to SCI in decreasing PVR and improving bladder voiding. Additionally, acupuncture may be safe in treating CUR caused by SCI. However, due to the lack of high quality RCTs, we could not draw any definitive conclusions. More well-designed RCTs are needed to provide strong evidence.

  14. 3种野生国兰无菌播种研究%Aseptic Seeding of Three Varieties of Native Orchids of China

    Institute of Scientific and Technical Information of China (English)

    卜朝阳; 何荆洲; 严华兵; 卢家仕; 闭志强; 董伟清

    2011-01-01

    选择广西野生春兰、豆瓣兰、独占春3个国兰品种进行种子预处理及培养基成分筛选等无菌播种技术研究.研究结果表明:种子预处理、培养基基本成分、培养基激素、培养基水果附加物对种子萌发都有一定的影响,其中,植物激素和添加椰子汁等对种子萌发有显著促进作用,氢氧化钠或次氯酸钠浸泡种子和低盐培养基可使兰花种子提早萌发并提高萌发数.较优试验处理为:种子在播种前用0.1 mol/L`氧化钠或1%次氯酸钠浸泡20 min,播种培养基采用改良Kyoto+ 6-BA2 mg/L+ NAA1 mg/L+椰子汁10%.%Aseptic seeding of three Guangxi native orchid species, namely, C. Goeringii, C. Serratumr and C. Ebumeum were studied. The results showed that, the seed pre-treatment, the basic media, the hormone combination and the fruit supplements of media had effects on seed germination. The hormone and coconut milk supplemented had significant effects on seed germination; Seeds pre-treatment with NaClO or NaOH and low salt medium made the seed germinate earlier and unproved the germination rate. The preferred pre-treatment method was that the seeds were soaked in the solution of 0.1 mol/L NaOH or 1 % NaClO for 20 min before sowing in the medium. The optimum media for seeding was modified Kyoto supplemented with 2 mg/L 6-BA, 1 mg/L NAA and 10 % coconut milk.

  15. Chronic recurrent multifocal osteomyelitis: how to suggest this diagnosis?; L`osteite chronique recurrente multifocale. Un diagnostic qu`il faut savoir evoquer

    Energy Technology Data Exchange (ETDEWEB)

    Saint-Martin, Ch. [UCL Cliniques Saint-Luc, Bruxelles (Belgium); Kurelovic, I.; Soler, C.; Geoffray, A. [Fondation Laval, 06 - Nice (France); Durckel, J. [Hopital Hautepierre, 67 - Strasbourg (France)

    1997-09-01

    Chronic recurrent multifocal osteomyelitis is a rare disorder that affects children and teenagers. Clinically, it is characterized by insidious onset of local swelling and pain in several metaphyses. A symmetric, recurrent and multifocal pattern is usual. Spinal involvement is possible. Inconstant association with a cutaneous affection (palmo-plantar pustulosis, acne fulminans, psoriasis), or less frequently with an inflammatory chronic gut disorder is described. Pathogenesis usually recognized is an enthesopathy. Enthesitis may progress to the osseous part of the enthese and produce an aseptic chronic osteomyelitis. Biopsy specimen with culture is certainly necessary to rule out bacterial osteomyelitis and bone tumor. It is particularly true when the bone lesion is isolated. Disease course is benign and self-limited. The clinical course is characterized by recurrences and remissions occurring for 6 to 10 years. Treatment based on non steroid anti-inflammatory drugs is usually effective. (authors). 17 refs.

  16. Infecções do esterno pós revascularização do miocárdio: tratamento com retalhos miocutâneos e musculares Sternal infections after myocardial revascularization: treatment by myocutaneous and muscle flaps

    Directory of Open Access Journals (Sweden)

    Rubens T. de Barros

    1989-08-01

    Full Text Available No período de outubro de 1986 a janeiro de 1989, realizamos 445 esternotomias, sendo 158 para revascularização do miocárdio; em 92 pacientes, a artéria mamária interna esquerda (AMIE foi utilizada. Dos 445 casos, sete pacientes tiveram infecção do esterno no período pós-operatório imediato. O tempo médio de aparecimento foi de 8,7 dias (4-15 dias, sendo que seis pacientes eram do sexo masculino e a idade média foi de 48,8 anos (35-60 anos. Em todos os casos, os pacientes estavam sendo submetidos à primeira cirurgia, tendo como possíveis fatores associados diabete (um caso, embolia pulmonar com insuficiência respiratória (um caso, síndrome de baixo débito (três casos, cirurgia prolongada (um caso e dissecção da AMIE (seis casos. Na correção desta complicação, a associação de técnicas de cirurgia plástica, com a utilização de retalhos miocutâneos ou musculares, permitiu mais rápida recuperação dos pacientes, sem que tivéssemos óbitos nesta série. Os resultados estético e funcional foram considerados excelentes, com três pequenas deiscências tratadas ambulatorialmente. A identificação do germe através de cultura e a orientação do tratamento pelo antibiograma também se mostraram de grande importância, ao lado das técnicas cirúrgicas empregadas. Concluindo, julgamos que a intervenção precoce e agressiva nas infecções do esterno contribuiu, efetivamente, na queda da morbi-mortalidade desta complicação.During the period of October 1986 to January 1989 we executed 445 sternotomies; 158 of these were for myocardial revascularization. In 92 cases the left internal mammary artery (LIMA was used. Of 445 cases, 7 patients developed sternal infection in the immediate post operative period. The average time for the infection to appear was 8.7 days (4-15 days. Of these, 6 patients were male with an average age of 48.8 years (35-60 years. All cases were first operations; complicating factors were diabetes

  17. Chronic inflammatory demyelinating polyneuropathy

    Science.gov (United States)

    Polyneuropathy - chronic inflammatory; CIDP; Chronic inflammatory polyneuropathy; Guillain-Barré - CIDP ... Health care providers also consider CIDP as the chronic form of Guillain-Barré syndrome. The specific triggers ...

  18. Dealing with chronic cancer

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000933.htm Dealing with chronic cancer To use the sharing features on this ... be controlled for a period of time. Controlling Chronic Cancer When you have a chronic cancer, the ...

  19. 川崎病并发无菌性脑膜炎31例临床治疗分析%Kawasaki disease complicated with aseptic meningitis clinical treatment of 31 cases were analyzed

    Institute of Scientific and Technical Information of China (English)

    罗云娇; 杜曾庆; 杨小涛

    2014-01-01

    objective the article is to review the 112 cases of Kawasaki disease (Kd) treaded in our department from January to december 2013 with the emphasis of their characteristics,diagnosis,treatment of patients with aseptic meningitis in 31 cases which were retrospectively analyzed. Methods according to Kawasaki disease and aseptic meningitis treatment, the patients were treated with aspirin 50mg/d/ kg,divided into 2 - 3 oral,and given mannitol intracranial pressure lowering treatment. all patients were given intravenous immunoglobulin therapy. Before discharging,cases in the group were given two dimensional echocardiogram Beckoning graph (2de) examination. results the clinical symptoms of all patients were disappeared,their condition improved and discharged. normal cardiac 2de examination of 5 cases of abnormal coronary artery:26 (83.87%) cases had different degrees of coronary artery lesions. conclusion the present (Kd) has replaced the wind damp heat and has become the most important cause of acquired heart disease for children. in recent years Kd with aseptic meningitis cases is increasing,Kd concurrent aseptic meningitis is Kawasaki disease in severe cases,in this group of cases were complicated with multiple organ injury. clinical attention should be paid. Pediatricians should raise awareness of Kd, especially Kd with aseptic meningitis cases. early diagnosis,early treatment is the key to reduce coronary artery disease complicated by Kd.%目的:对我科2013年1月至12月收治的112例川崎病(Kd)中并发无菌性脑膜炎31例病例的临床特征、诊断、治疗进行回顾性分析。方法本组病例入院后按川崎病并无菌性脑膜炎治疗,本组病例均给予阿司匹林50mg/d/㎏,分2~3次口服,并给予甘露醇脱水降颅压等治疗。全部病例均给予静脉丙种球蛋白治疗。出院前本组病例均做了心脏二维超声心动图(2de)检查。结果全部病例出院时临床症状消失

  20. Analysis of {sup 18} F-FDG uptake patterns in PET for diagnosis of septic and aseptic loosening after total hip arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Cremerius, U.; Niethard, F.U. [Rheinisch-Westfaelische Technische Hochschule Aachen (Germany). Klinik fuer Nuklearmedizin; Mumme, T.; Reinartz, P.; Wirtz, D. [Rheinisch-Westfaelische Technische Hochschule Aachen (Germany). Orthopaedische Klinik; Buell, U.

    2003-12-01

    Aim: Identification of typical patterns for fluorodeoxyglucose (FDG) uptake in positron emission tomography (PET) to detect aseptic loosening of hip prosthesis (acetabular and/or femoral component) and prosthetic infection. Methods: 18 patients with painful hip prosthesis underwent PET using a dedicated full ring scanner after application of 200-300 MBq FDG. The interface between bone and surrounding soft tissue or bone as displayed on coronal slices was divided into 12 segments in accordance with the classifications of Delee and Gruen. FDG uptake in each of the segments was scored (0-3) by two independent observers. Intraoperative findings were regarded as the gold standard. Results: After surgical revision 14 acetabular components and 9 femoral components were found to be loose and prosthetic infection was present in 7 prostheses. Loosening of the acetabular component was correlated to enhanced uptake in the middle of the acetabular interface, while loosening of the femoral component was correlated to enhanced uptake in the proximal and middle segment of the lateral femoral interface and the proximal segment of the medial femoral interface. A similar pattern was found in prosthetic infection with high uptake along the middle portion of the lateral femoral interface. In 6 of 7 infected prostheses loosening of the acetabular and of the femoral component was present. Taking the typical uptake patterns as criteria for loosening and grade 3 uptake as an additional criterion for septic loosening the accuracy of PET imaging in the detection of loosening of the acetabular or the femoral component and of prosthetic infection was 72, 78 and 89%, respectively. Conclusion: This pilot study presents FDG-PET as a promising diagnostic tool for patients with painful hip prostheses. Its clinical value should be evaluated in a larger patient population. (orig.) [German] Ziel: Identifikation von Befundmustern in der Positronenemissionstomographie (PET) mit {sup 18}F

  1. Chronic mucus hypersecretion

    DEFF Research Database (Denmark)

    Harmsen, L; Thomsen, S F; Sylvan Ingebrigtsen, Truls;

    2010-01-01

    Chronic mucus hypersecretion (CMH) is a common condition in patients with chronic respiratory diseases. Little is known about the incidence, prevalence and determinants of CMH in younger individuals....

  2. Chronic urticaria

    Directory of Open Access Journals (Sweden)

    Sandeep Sachdeva

    2011-01-01

    Full Text Available Chronic urticaria (CU is a disturbing allergic condition of the skin. Although frequently benign, it may sometimes be a red flag sign of a serious internal disease. A multitude of etiologies have been implicated in the causation of CU, including physical, infective, vasculitic, psychological and idiopathic. An autoimmune basis of most of the ′idiopathic′ forms is now hypothesized. Histamine released from mast cells is the major effector in pathogenesis and it is clinically characterized by wheals that have a tendency to recur. Laboratory investigations aimed at a specific etiology are not always conclusive, though may be suggestive of an underlying condition. A clinical search for associated systemic disease is strongly advocated under appropriate circumstances. The mainstay of treatment remains H1 antihistaminics. These may be combined with complementary pharmacopeia in the form of H2 blockers, doxepin, nifedipine and leukotriene inhibitors. More radical therapy in the form of immunoglobulins, plasmapheresis and cyclophosphamide may be required for recalcitrant cases. Autologous transfusion and alternative remedies like acupuncture have prospects for future. A stepwise management results in favorable outcomes. An update on CU based on our experience with patients at a tertiary care centre is presented.

  3. Urinary tract infection and aseptic meningitis:a case report with literature review%尿路感染合并无菌性脑膜炎1例报告及文献复习

    Institute of Scientific and Technical Information of China (English)

    胡笑月; 徐晓华; 华颖

    2014-01-01

    Objective To analyze and investigate clinical characteristics, pathogenesis and treatment of urinary tract infection and aseptic meningitis. Methods Clinical features and laboratory tests of a two-month-old baby girl with urinary tract infection and aseptic meningitis were reported. Results The patient complained of fever, neck stiffness and a bulging fontanel, accompanied by congestion and abnormal secretion of urethra. The cerebrospinal lfuid (CSF) white blood cell count was 30×106/L. The blood culture and the CSF culture were both negative. And the urine culture was positive for Enterococcus faecium. The patient received a 10-day course of intravenous antibiotic therapy. The prognosis is good with no recurrence of the disease. Conclusions Aseptic meningitis can be concomitant with urinary tract infection, The probable hypothesis may be that sterile CSF pleocytosis is mediated by urinary tract infection. Knowledge of this may prevent unnecessary antibiotics therapy for presumed bacterial meningitis.%目的:探讨尿路感染合并无菌性脑膜炎的临床特点、发病机制及诊治,以提高对此疾病的认识。方法分析1例尿路感染合并无菌性脑膜炎患儿的临床特点和实验室检查结果,并复习相关文献。结果患儿2月龄,临床表现为发热、颈抵抗及前囟隆起,伴有尿道口充血及异常分泌物。脑脊液白细胞计数30×106/L。患儿血培养、脑脊液培养均阴性。尿培养为屎肠球菌生长。经静脉抗感染治疗10 d,病情好转,随访病情无复发。结论尿路感染患儿可合并无菌性脑膜炎,其机制可能与细菌感染引起脑膜炎症反应有关,临床上需与细菌性脑膜炎进行鉴别,如明确为前者可适当缩短抗感染疗程。

  4. Chronic pain after hysterectomy

    DEFF Research Database (Denmark)

    Brandsborg, B.; Nikolajsen, L.; Kehlet, H.;

    2008-01-01

    BACKGROUND: Chronic pain is a well-known adverse effect of surgery, but the risk of chronic pain after gynaecological surgery is less established. METHOD: This review summarizes studies on chronic pain following hysterectomy. The underlying mechanisms and risk factors for the development of chronic...... post-hysterectomy pain are discussed. RESULTS AND CONCLUSION: Chronic pain is reported by 5-32% of women after hysterectomy. A guideline is proposed for future prospective studies Udgivelsesdato: 2008/3...

  5. Chronic pain after hysterectomy

    DEFF Research Database (Denmark)

    Brandsborg, B; Nikolajsen, L; Kehlet, Henrik;

    2008-01-01

    BACKGROUND: Chronic pain is a well-known adverse effect of surgery, but the risk of chronic pain after gynaecological surgery is less established. METHOD: This review summarizes studies on chronic pain following hysterectomy. The underlying mechanisms and risk factors for the development of chronic...... post-hysterectomy pain are discussed. RESULTS AND CONCLUSION: Chronic pain is reported by 5-32% of women after hysterectomy. A guideline is proposed for future prospective studies. Udgivelsesdato: 2008-Mar...

  6. Identificação da microbiota fúngica de ambientes considerados assépticos Identification of the fungic microbiota isolated in areas considered aseptic

    Directory of Open Access Journals (Sweden)

    Maria Elisabete Sbrogio de Almeida

    1988-06-01

    Full Text Available Objetivou-se isolar e identificar a microbiota fúngica em ambientes considerados assépticos, através de exposições com meios de cultivo adequados, em três épocas distintas do ano, antes e imediatamente após as manobras técnicas realizadas em três áreas de trabalho: ambiente aberto, ambiente fechado sem filtração de ar e ambiente fechado com filtração de ar, utilizadas em produção de imunobiológicos. Os meios ágar-Sabouraud e ágar-soja, enriquecidos com 0,2% de extrato de levedura e sem cloranfenicol, foram estudados quanto à sua eficácia no isolamento de bolores e leveduras, considerando-se o número de colônias desenvolvidas e a freqüência dos diversos fungos isolados. Isolaram-se 67 espécimens, sendo 64 fungos filamentosos (bolores e três leveduras. Dos bolores, 54 pertenciam a 22 gêneros da divisão Deuteromycota, famílias Moniliaceae e Dematiaceae, cinco amostras filamentosas foram incluídas na ordem Agonomycetales (Mycelia Sterilia, e uma amostra foi classificada na divisão Deuteromycota, ordem Sphaeropsidales, classe Coelomycetes. Da divisão Zygomycota, ordem Mucorales, família Mucoraceae, um único mucoráceo foi identificado até gênero. As três leveduras pertenciam também à divisão Deuteromycota (Fungi Imperfecti, família Cryptococcaceae, e foram identificadas como sendo duas Rhodotorula rubra e uma Torulopsis candida. Comprovou-se que o número de colônias isoladas aumentou após a realização das monobras técnicas e que a filtração de ar através de filtros tipo HEPA, reduzindo o número de colônias isoladas nos ambientes fechados, aumenta a segurança do trabalho; comumente é recomendada para áreas de atividade técnica cujos resultados satisfatórios estão diretamente relacionados com uma baixa incidência de contaminantes.The isolation and identification of the fungic microbiota present in areas considered aseptic (open and/or restricted, with or without air filtration (HEPA filters

  7. 品管圈活动在“降低无菌包不合格件数”中的应用%Application of QCC in"Reduce Aseptic Package Failed in the Number"

    Institute of Scientific and Technical Information of China (English)

    陈翠英; 李黎

    2015-01-01

    Objective To apply the qc circle management methods to reduce the unqualified aseptic package number. Methods Using quality management circle activity 1 ~ 28 July 2013 were retrospectively analyzed Japan hospital disinfection disinfection sterilization supply center 2500 sterile packet loss situation, put forward the cor esponding countermeasures for the cause of loss occur ed, and in 2013 October 1 ~ 28 strictly implemented. Comparing the circle of qc activity aseptic package unqualified number before and after intervention. Results October 2013 to 1 ~ 28 disinfection sterilization, 2500 aseptic package to intervene after the sterile package unqualified number by activity fel to 15.75 /weeks before 5.25 /weeks, compared with the same year 7 phases of the moon has dropped significantly, the dif erence statistical y significant ( < 0.01). Conclusion The quality control circle activities in reducing the aseptic package quantity of unqualified, the satisfactory ef ect, worthy of promotion. Al the members of the ability to solve the problem, the sense of responsibility, cohesion, motivation, communication, cooperation, pleasure, quality management technique, harmonious degree has been improved.%目的运用品管圈管理方法来降低无菌包不合格件数。方法利用品管圈活动回顾性分析2013年7月1日~28日本院消毒供应中心消毒灭菌的2500个无菌物品包缺失情况,针对缺失发生的原因提出相应的对策措施,并于2013年10月1日~28日严格执行。比较品管圈活动干预前后无菌包不合格件数。结果对2013年10月1日~28日消毒灭菌的2500个无菌包进行干预后无菌包不合格件数由活动前15.75件/w降至活动后的5.25件/w,与同年7月相比较有显著下降,差异具有统计学意义(<0.01)。结论品管圈活动在降低无菌包不合格件数中,取得满意效果,值得推广。全体圈成员对解决问题的能力、责任感、凝聚力、积极性、沟通配合、

  8. Accounting and management of aseptic materials at the central sterile supply department of hospital%医院消毒供应中心无菌物品的核算与管理

    Institute of Scientific and Technical Information of China (English)

    周彬; 王亚娟

    2015-01-01

    文章结合原国家卫生部2009年颁布的《消毒供应中心三项标准》和2012年颁布的《医院财务制度》和《医院会计制度》中的相关条款,探讨医院消毒供应中心无菌物品的核算与管理工作。%In the paper, the accounting and management of aseptic materials at the Center Sterile Supply Department of hospital is discussed in accordance with relevant provisions in the Three Standards for Central Sterile Supply Departments promulgated by the former Ministry of Health of China in 2009, as well as the Hospital Financial System and Hospital Accounting System issued in 2012.

  9. 3种植物无菌苗增殖与生根一体化技术研究%Studies on the Technology of Proliferation and Rooting Integration with Aseptic Seedlings in Three Species

    Institute of Scientific and Technical Information of China (English)

    梁称福

    2011-01-01

    Under conventional culture conditions ((25 ±3)℃, relative humidity 60%-70%, 1500-2000 lx for 10-12 h/d), aseptic buds or leaves from the plants of Aloe vera var.chinensis, Pelargonium citrosum vanleenii and triploid Populus tomentosa were respectively used to research the technology of proliferation and rooting integration.The results showed that: after 50 days when aseptic buds of Aloe vera var.chinensis were transferred in MS + 6-BA 2.0 mg/L+ NAA 0.1 mg/L+ AC 0.1%, the average number of differentiated buds reached 3.4 and the rooting rate reached 100% with 6.1 roots which were sturdy, long and yellow-white and 52.0 cm length of all roots per plant.After 45 days transferred in MS + 6-BA 3.0 mg/L + NAA 0.2 mg/L + AC 0.05%, aseptic buds of Pelargonium citrosum vanleenii proliferated most fastest with the average number of differentiated buds reaching 10.2, and the rooting rate amounted to 100% with dark-green leaves.After 55 days when aseptic leaves of triploid Populus tomentosa were transferred in MS + 6-BA 0.5 mg/L + KT 0.4 mg/L + NAA 0.2 mg/L + Ad 25.0 mg/L + AC 0.05%, differentiated buds arrived at an average of 8.6 and the rooting rate achieved 92% with more and longer, light-white roots.%在常规培养环境条件(温度(25士3)℃、湿度60%~70%、光强1500~2000lx,10-12h/天),以中华芦荟、驱蚊香草、三倍体毛杨无菌芽或叶片为材料,研究不同培养基对其无菌苗增殖、生根的影响,探讨其一体化成苗技术.结果表明:中华芦荟无菌芽转接在MS+6-BA2.0 mg/L+NAA 0.1 mg/L+AC 0.1%培养基中50天,分化芽数平均达3.4个;生根率达100%,单株根数达6.1条,单株总根长达52.0 cm,且根系粗长、黄白色.驱蚊香草无菌芽在MS+6-BA 3.0 mg/L+NAA 0.2 mg/L+AC 0.05%培养基中增殖速度最快,转接后45天分化芽数平均为10.2个;生根率为100%,生根苗叶片呈深绿色,生根质量好.三倍体毛白杨无菌叶片接种在MS+6-BA 0.5 mg/L+KT 0.4 mg/L+NAA 0.2 mg/L+Ad 25

  10. [Chronic otitis mediaChronic Otitis Media].

    Science.gov (United States)

    Kohles, N; Schulz, T; Eßer, D

    2015-11-01

    There are 2 different kinds of chronic otitis media: Otitis media chronica mesotympanalis and otitis media chronica epitympanalis (cholesteatoma). The incidence of chronic otitis media as reported in literature differs in a wide range. The incidence rates vary between 0.45 and 46%. Both, otitis media chronica mesotympanalis and cholesteatoma, lead to eardrum perforation due to lengthy and recurring inflammations. Furthermore, chronic otitis media is characterized by frequently recurring otorrhea and conductive hearing loss.

  11. Chronic Kidney Diseases

    Science.gov (United States)

    ... Room? What Happens in the Operating Room? Chronic Kidney Diseases KidsHealth > For Kids > Chronic Kidney Diseases Print ... re talking about your kidneys. What Are the Kidneys? Your kidneys are tucked under your lower ribs ...

  12. Diet - chronic kidney disease

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/002442.htm Diet - chronic kidney disease To use the sharing features on this page, ... make changes to your diet when you have chronic kidney disease. These changes may include limiting fluids, eating a ...

  13. Chronic granulomatous disease

    Science.gov (United States)

    CGD; Fatal granulomatosis of childhood; Chronic granulomatous disease of childhood; Progressive septic granulomatosis ... In chronic granulomatous disease (CGD), immune system cells called phagocytes are unable to kill some types of bacteria and ...

  14. Chronic mucus hypersecretion

    DEFF Research Database (Denmark)

    Ulrik, Charlotte Suppli; von Linstow, Marie-Louise; Nepper-Christensen, Steen;

    2005-01-01

    To investigate if chronic mucus hypersecretion (CMH) can be used as a marker of asthma in young adults.......To investigate if chronic mucus hypersecretion (CMH) can be used as a marker of asthma in young adults....

  15. Chronic tophaceous gout

    Directory of Open Access Journals (Sweden)

    Thappa D

    1993-01-01

    Full Text Available A rare case of chronic tophaceous gout, in a 27-year-old female on diuretics for chronic congestive cardiac failure with characteristic histopathological and radiological changes is reported.

  16. Chronic Pancreatitis in Children

    Science.gov (United States)

    ... maintaining good health. Can chronic pancreatitis give my child cancer? If your child has chronic pancreatitis, he or she will be at an increased risk of developing pancreatic cancer compared to the general population. The degree of ...

  17. People Experiencing Chronic Homelessness

    Science.gov (United States)

    ... Goals Ending Chronic Homelessness Share This: Ending Chronic Homelessness Last updated on January 19, 2017 We can ... the USICH newsletter. We know how to end homelessness. Let's do it, together. Sign up for our ...

  18. The treatment of sternal wound infection by internal fixation of sternum with titanium plate after cardiac surgery%钛板固定在心脏术后胸骨正中切口感染治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    亓发芝; 冯自豪; 张勇; 顾建英

    2013-01-01

    目的 探讨应用钛板内固定,增强胸骨稳定性,提高心脏手术后胸骨正中切口感染的临床治疗效果.方法 采用回顾性调查的方法,对26例应用钛板内固定,治疗胸骨切口感染的病例进行分析.结果 2009年1月至2011年12月应用钛板内固定治疗26例,均为慢性感染患者,感染持续时间均超过3个月.3例深部感染患者采用伤口持续负压吸引(VAC)的方法辅助创面准备.26例患者均行胸大肌肌瓣转移,无一例发生钛板感染需再次手术取出,且无一例因胸骨再次感染而需二次手术.结论 应用钛板内固定可以加强胸骨稳定性,减少局部组织渗出,提高心脏手术后胸骨正中切口感染的临床治疗效果.%Objective To investigate the internal fixation of sternum with titanium plate for the treatment of sternal wound infection after cardiac surgery.Methods A retrospective study of 26 patients from Jan 2009 to Dec 2011 was carried out.All the 26 cases with sternal wounds infection after cardiac surgery,were treated by internal fixation with titanium plates.Results All the patients had choronic infection,lasting for more than 3 months.3 patients received vacuum-assisted closure treatment after complete debridment.All the wounds were covered with pectoral major muscle flap.All the wounds healed completely with no recurrence of infection..Conclusions Internal fixation of sternum with titanium plate can increase the stability.It helps to improve the treatment efficacy of sternal wound infection after cardiac surgery.

  19. Radiation therapy for resistant sternal hydatid disease

    Energy Technology Data Exchange (ETDEWEB)

    Ulger, S.; Barut, H.; Tunc, M.; Aydinkarahaliloglu, E. [Ataturk Chest Disease and Thorasic Surgery Training and Research Hospital, Ankara (Turkey). Dept. of Radiation Oncology; Aydin, E.; Karaoglanoglu, N. [Ataturk Chest Disease and Thorasic Surgery Training and Research Hospital, Ankara (Turkey). Dept. of Thorasic Surgery; Gokcek, A. [Ataturk Chest Disease and Thorasic Surgery Training and Research Hospital, Ankara (Turkey). Dept. of Radiology

    2013-06-15

    Hydatid disease is a zoonotic infectious disease for which there are known treatment procedures and effective antibiotics; however, there are resistant cases that do not respond to medication or surgery. We report a case diagnosed as hydatid disease of the chest wall and treated with radiation therapy (RT) after medical and surgical therapy had failed. In conclusion, RT represents an alternative treatment modality in resistant cases. (orig.)

  20. Approaching chronic sinusitis.

    Science.gov (United States)

    Sarber, Kathleen M; Dion, Gregory Robert; Weitzel, Erik K; McMains, Kevin C

    2013-11-01

    Chronic sinusitis is a common disease that encompasses a number of syndromes that are characterized by sinonasal mucosal inflammation. Chronic sinusitis can be defined as two or more of the following symptoms lasting for more than 12 consecutive weeks: discolored rhinorrhea, postnasal drip, nasal obstruction, facial pressure or pain, or decreased sense of smell. Chronic sinusitis is further classified as chronic sinusitis with polyposis, chronic sinusitis without polyposis, or allergic fungal sinusitis using physical examination, and histologic and radiographic findings. Treatment methods for chronic sinusitis are based upon categorization of the disease and include oral and inhaled corticosteroids, nasal saline irrigations, and antibiotics in selected patients. Understanding the various forms of chronic sinusitis and managing and ruling out comorbidities are key to successful management of this common disorder.

  1. Metal on Metal Surface Replacement of Hip in Young Patients with Rheumatoid Arthritis of Aseptic Necrosis of Femoral Head%金属对金属人工全髋表面置换术的临床应用

    Institute of Scientific and Technical Information of China (English)

    夏庆; 陈统一; 姜晓幸; 姚振钧

    2001-01-01

    Purpose Present study investigated the role of metal on metal surface replacement of the hip in treating the young patients suffering rheumatoid arthritis or aseptic necrosis of femoral head. Methods Between Jan. 1995 and Dec. 1996.16 patients with 17 hips( rheumatoid arthritis 14, aseptic necrosis of femoral head 3) were resurfaced with hybrid metal on metal surface replacement prothesis. Patients were evaluated by self assessment form,hip function examination. Radiographs and Harris hip score. The average follow up time was 58.2 months. Results No patient received revision. Radiographs showed that all implants were in position satisfyingly. No loosening were revealed. The result of self assessment showed that patients were satisfied with 16 hips. The Harris score rose from preoperative 44(31 - 52) to postoperative 91 (79- 96). Conclusions The metal on metal surface replacement of hip is a useful treatment to release pain and keep the hip function of young patients suffering rheumatoid arthritis or aseptic necrosis of femoral head.%目的探讨金属对金属人工全髋表面置换术治疗类风湿性关节炎和股骨头无菌性坏死的临床价值。 方法从1995年1月至1996年12月,对16例患者17个髋关节(其中类风湿性关节炎14个,股骨头无菌性坏 死3个)行混合型金属对金属人工全髋表面置换术,术后行问卷调查、髋关节功能检查、X线和Harris评分分析, 平均随访58.2月。结果所有患者没有一例行翻修手术,X线显示所有表面置换假体植入位置满意,没有假体 松动、移位现象出现。问卷调查显示患者对16个髋关节的术后情况表示非常满意。Harris评分平均指数从术前 的44(31~52)分提高到术后的91(79~96)分。结论金属对金属人工全髋表面置换术不失为患类风湿性关节 炎和股骨头无菌性坏死的年青患者为保存关节功能,改善疼痛的一种有价值的治疗方法。

  2. Survey and analysis on the preventive use of antibiotics during perioperative period in aseptic operation%清洁手术围术期抗菌药物应用调查分析

    Institute of Scientific and Technical Information of China (English)

    孙丽; 王宾; 魏旭

    2013-01-01

    目的 了解广州医学院附属深圳沙井医院(以下简称“我院”)清洁手术围术期抗菌药物预防使用情况,评估其用药的合理性.方法 采用回顾性调查方法,对我院2011年1~12月出院的672例乳腺手术、甲状腺手术、骨折内固定取出术、精索静脉曲张高位结扎术、疝修补术手术患者病历资料进行统计分析,评价其抗菌药物应用的合理性.结果 我院清洁切口手术围术期抗菌药物预防应用率达90.33%,存在无指征用药、疗程过长、用药时机不当、药物选择不当、联合用药不规范等不合理用药情况.结论 我院清洁手术围术期预防性应用抗菌药物存在较严重的不合理现象,需引起重视,加强抗菌药物围术期使用管理,提高抗菌药物应用合理性.%Objective To investigate the preventive use of antibiotics during perioperative period in aseptic operation in Shenzhen Shajing Affiliated Hospital of Guangzhou Medical University ("our hospital" for short),in order to evaluate the rationalization of antibiotics use.Methods Retrospectively study was adopted.The case records of 672 patients underwent breast operation,thyroid operation,internal fixation of fracture removal,ligation of varicocele and hernia repair in our hospital from January to December 2011 were analyzed statistically,then the rationality of antibiotics use was evaluated.Results 90.33% of the patients with aseptic operation received antimicrobial prophylactically.The antibiotics use without indication,prolonged use of antibiotics,improper therapy timing and antibiotics chosen,nonstandard use in drug combination were included in the patterns of irrational preventive use of antibiotics.Conclusion The phenomenon of irrational prophylactic antimicrobials use in aseptic operation in our hospital is severe.Great importance should be attached by strengthening control on the management of antibiotics use,in order to improve rational use of antibiotics.

  3. Comparação funcional entre revisão de artroplastia de joelho séptica e asséptica Functional comparison between septic and aseptic knee arthroplasty review

    Directory of Open Access Journals (Sweden)

    Olavo Biraghi Letaif

    2009-01-01

    Full Text Available INTRODUÇÃO: A artroplastia total de joelho (ATJ não é um procedimento isento de riscos. A infecção na ATJ não é a complicação mais comum, porém é uma das mais graves. A revisão em 2 tempos é a escolha nos casos de infecção profunda da prótese de joelho. Por outro lado, a soltura asséptica chega a quase metade das indicações de revisão de artroplastias primárias. A queda do nível de satisfação do paciente pode cair nas revisões. OBJETIVO: O objetivo do presente estudo foi comparar através dos resultados obtidos nos escores funcionais e de qualidade de vida entre cirurgia de revisão de ATJ por soltura séptica e asséptica. MÉTODO: Realizamos escores HSS e SF-36 para avaliar a qualidade de vida e o resultado funcional entre pacientes submetidos à cirurgia de revisão da ATJ entre dois grupos, um que realizou a substituição da prótese em dois tempos (séptica e outro no qual a substituição ocorreu em tempo único (asséptica. RESULTADOS: A análise dos dados obtidos mostra melhor desempenho do segundo grupo na pontuação do HSS e em 06 dos 08 domínios do SF-36. Conclusão: A revisão de ATJ em tempo único apresenta melhores resultados funcionais.INTRODUCTION: Total knee arthroplasty (TKA imposes many risks. TKA infection is not the most frequent complication, but is probably the most serious one. Two-step review is the procedure of choice in deep knee prosthesis infection. On the other hand, aseptic prosthesis detachment represents almost half of the primary arthroplasty review indications. Patient's satisfaction level might diminish after reviews. OBJECTIVE: The objective of this study was to compare the quality of life and final result of TKA review for septic and aseptic failures. METHODS: The patients were assessed using the HSS and SF-36 scores. The patients were divided in two groups: one group submitted to two-step review (septic and the other to one-step review (aseptic. The analysis of the data

  4. Sternal and vertebral fractures, a well-known association, usually overlooked: review of six clinical cases Fracturas vertebrales y fracturas concomitantes del esternón: revisión de seis casos Fraturas vertebrais e fraturas concomitantes do esterno: revisão de seis casos

    Directory of Open Access Journals (Sweden)

    Alvaro Silva G.

    2010-09-01

    Full Text Available OBJECTIVE: the association of sternal and vertebral fractures has previously been described in the literature. These lesions are frequently overlooked at the initial evaluation. The purpose of this study was to review and discuss the diagnostic methods used to diagnose these lesions and to highlight the importance of early recognition of these fractures. METHODS: we performed a retrospective analysis of six patients who suffered sternal and concomitant vertebral fractures. Clinical charts and imaging studies were reviewed. RESULTS: all patients were diagnosed with sternal fractures at the initial evaluation, but only two were diagnosed with vertebral fractures. CONCLUSION: failure to recognize these fractures at initial evaluation may be associated with the fact that the upper thoracic region is difficult to explore. In the presence of sternal fractures, a vertebral fracture must be ruled out even though major injuries are not present. A computer tomography (CT scan and magnetic resonance imaging (MRI should be obtained despite negative X-rays if clinical suspicion is present.OBJETIVO: la asociación de las fracturas del esternón y vertebrales ha sido descrita previamente en la literatura. Estas lesiones son frecuentemente descuidadas en la evaluación inicial. El objetivo de este estudio fue analizar y discutir los métodos diagnósticos utilizados para estas lesiones y resaltar la importancia del reconocimiento precoz de estas fracturas. MÉTODOS: fue realizado un análisis retrospectivo de seis pacientes que sufrieron concomitantemente fracturas del esternón y vertebrales, por medio del análisis de las historias clínicas y exámenes de imagen. RESULTADOS: todos los pacientes fueron diagnosticados con fracturas del esternón en la evaluación inicial, pero solamente dos fueron diagnosticados con fracturas vertebrales. CONCLUSIONES: el hecho de no reconocer estas fracturas en la evaluación inicial puede estar asociado a la dificultad de

  5. Avaliação da qualidade de caldo de cana envasado a quente e por sistema asséptico Quality of sugarcane (Sacharum ssp. juice packed by hot fill and aseptic processes

    Directory of Open Access Journals (Sweden)

    Karin Samorano da Silva

    2006-12-01

    Full Text Available Dois processos térmicos foram aplicados ao caldo de cana com o objetivo de se obter um produto estável à temperatura ambiente. A variedade de cana de açúcar (Sacharum ssp. utilizada foi a RB72 - 454. A metodologia de planejamento fatorial foi aplicada a fim de se verificar a melhor combinação entre acidez (pH e doçura (°Brix. Houve uma tendência para melhor aceitação sensorial quando o pH foi maior que 4,0 e °Brix maior que 15. Primeiramente, o caldo foi submetido a 141 °C /10 s e envasado assepticamente em garrafas de vidro previamente esterilizadas. No segundo processo, o caldo foi submetido ao tratamento térmico a 110 °C /10 s e envasado a quente (90 ± 5 °C em garrafas de vidro. Análises físico-químicas, microbiológicas e sensoriais foram realizadas durante a estocagem dos lotes à temperatura ambiente. O lote processado assepticamente apresentou vida útil de 30 dias e o envasado a quente, 60 dias, não apresentando diferença estatística (p The objective of this work is to evaluate two thermal processes in order to obtain sugarcane (Sacharum ssp. juice stable at room temperature in glass bottles. An experimental methodology was applied to obtain the best combination between pH and °Brix based on the sensory results. There was a tendency for a better sensory acceptance for pH > 4.0 and °Brix > 15. Two thermal processes were applied to sterilize the juice. Firstly, the juice was submitted to 141 °C /10 s, and then aseptically filled in glass bottles previously sterilized. In the second process, the juice was submitted to 110 °C /10 s and filled into glass bottles at 90 ± 5 °C. Physical-chemical changes, microbiological counts and sensory acceptance were evaluated during the storage at room temperature. The shelf life of aseptically processed juice was 30 days and 60 days for the hot filled juice based on the sensory evaluation. These results indicated that the hot fill process was more efficient for sugarcane

  6. A Study to Assess the Association of Aseptic Practices Being Followed and its Effect on the Overall Outcome of Selected Special Care Newborn Units (SCNUs of Madhya Pradesh at Different Levels.

    Directory of Open Access Journals (Sweden)

    Mahore RK

    2015-04-01

    Full Text Available The neonatal mortality rate in India is high and stagnant. Special Care Newborn Units (SCNUs have been set up at different levels of Health Care Delivery System to provide quality newborn-care services in several hospitals to meet this challenge. Many units are located in the districts where the burden of neonatal deaths is high, and access to special newborn care is poor. The study was conducted to assess the functioning of SCNUs in six centers of India. The evaluation was based on an analysis of secondary data from the six units that had been functioning for at least three year. A cross-sectional survey was also conducted to assess the availability of Quality care and Aseptic practices implemented at different levels of SNCUs. Descriptive statistics were used for analyzing the inputs (Quality care and aseptic practices and outcomes (morbidity and mortality. The rate of mortality among admitted neonates was taken as the key outcome variable to assess the performance of the units. Chi-square test was used for analyzing the trend of case-fatality rate over a period of 3 years considering the first year of operationalization as the base. Correlation coefficients were estimated to understand the possible association of case-fatality rate with factors, such as bed:doctor ratio, bed:nurse ratio, average duration of stay, and bed occupancy rate, and the asepsis score was determined. The rates of admission increased from a median of 16.7 per 100 deliveries in 2012 to 19.5 per 100 deliveries in 2014. The case-fatality rate shows progressive decline in all the units in Last 3 years. Proportional mortality due to sepsis and low birthweight (LBW declined significantly over two years (LBW <2.5 kg. The major reasons for admission and the major causes of deaths were birth asphyxia, sepsis, and LBW/prematurity. The units had a varying nurse:bed ratio (1:1-1:2.14. The bed occupancy rate ranged from 83% to 121% (median 115%, and the average duration of stay

  7. Biofilms in chronic wounds.

    Science.gov (United States)

    James, Garth A; Swogger, Ellen; Wolcott, Randall; Pulcini, Elinor deLancey; Secor, Patrick; Sestrich, Jennifer; Costerton, John W; Stewart, Philip S

    2008-01-01

    Chronic wounds including diabetic foot ulcers, pressure ulcers, and venous leg ulcers are a worldwide health problem. It has been speculated that bacteria colonizing chronic wounds exist as highly persistent biofilm communities. This research examined chronic and acute wounds for biofilms and characterized microorganisms inhabiting these wounds. Chronic wound specimens were obtained from 77 subjects and acute wound specimens were obtained from 16 subjects. Culture data were collected using standard clinical techniques. Light and scanning electron microscopy techniques were used to analyze 50 of the chronic wound specimens and the 16 acute wound specimens. Molecular analyses were performed on the remaining 27 chronic wound specimens using denaturing gradient gel electrophoresis and sequence analysis. Of the 50 chronic wound specimens evaluated by microscopy, 30 were characterized as containing biofilm (60%), whereas only one of the 16 acute wound specimens was characterized as containing biofilm (6%). This was a statistically significant difference (p<0.001). Molecular analyses of chronic wound specimens revealed diverse polymicrobial communities and the presence of bacteria, including strictly anaerobic bacteria, not revealed by culture. Bacterial biofilm prevalence in specimens from chronic wounds relative to acute wounds observed in this study provides evidence that biofilms may be abundant in chronic wounds.

  8. Chronic Inflammatory Polyneuropathy

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2007-02-01

    Full Text Available Thirteen children with chronic inflammatory demyelinating polyneuropathy monitored between 1975 and 2005 are reported from Centre hospitalier universitaire Sainte-Justine, Montreal, Canada.

  9. The Progression of Chinese and Western Medicine Treatment of Aseptic Meningitis after Craniotomy Operation%开颅术后无菌性脑膜炎的中西医治疗进展

    Institute of Scientific and Technical Information of China (English)

    徐波; 袁俊

    2015-01-01

    无菌性脑膜炎(AM)为目前开颅术后常见的并发症,同时也是一个比较难解决的疾病。临床表现为发热、头痛、脑膜刺激征等。学者们经过多年的临床探索,在治疗方面已取得宝贵经验,现就对 AM的中医和西医治疗状况及其进展做一简要综述。%AbstractAseptic meningitis (AM)is a common complication after surgical operation,but thedisease is also more difficult to resolve.The clinical manifestations were fever,headache and meningeal irritation sign,etc.Scholars through the years of clinical exploration.In the treatment aspect has made valuable experience. We make a brief review of Chinese medicin -eand Western medicine in treatment of AMand its development status.

  10. Coping with Chronic Illness

    Science.gov (United States)

    Having a long-term, or chronic, illness can disrupt your life in many ways. You may often be tired and in pain. Your illness might affect your ... able to work, causing financial problems. For children, chronic illnesses can be frightening, because they may not ...

  11. Chronic Postoperative Roseomonas Endophthalmitis▿

    OpenAIRE

    Chen, Kuan-Jen; Lai, Chi-Chun; Kuo, Ya-Hui; WU, WEI-CHI; CHEN, TUN-LU

    2008-01-01

    We report one case with chronic postoperative endophthalmitis caused by Roseomonas species. Roseomonas spp. induced chronic endophthalmitis, which might result in misdiagnosis and delayed treatment and causes ocular damage and severe visual loss. This report is the first one related to a case with postoperative endophthalmitis secondary to Roseomonas infection.

  12. Chronic postoperative Roseomonas endophthalmitis.

    Science.gov (United States)

    Chen, Kuan-Jen; Lai, Chi-Chun; Kuo, Ya-Hui; Wu, Wei-Chi; Chen, Tun-Lu

    2009-01-01

    We report one case with chronic postoperative endophthalmitis caused by Roseomonas species. Roseomonas spp. induced chronic endophthalmitis, which might result in misdiagnosis and delayed treatment and causes ocular damage and severe visual loss. This report is the first one related to a case with postoperative endophthalmitis secondary to Roseomonas infection.

  13. [Chronic pancreatitis, acute pancreatitis].

    Science.gov (United States)

    Mabuchi, T; Katada, N; Nishimura, D; Hoshino, H; Shimizu, F; Suzuki, R; Sano, H; Kato, K

    1998-11-01

    MRCP has been recognized as a safe and noninvasive diagnostic method. In the present study we evaluated the usefulness of MRCP in diagnosis of chronic and acute pancreatitis. Two-dimensional fast asymmetric spin-echo (FASE) MRCP was performed in 40 patients with chronic pancreatitis and 13 with acute pancreatitis. In 29 patients (72.5%) with chronic pancreatitis and 9 (66.7%) with acute pancreatitis, main pancreatic duct (MPD) was visualized entirely. MRCP could demonstrate the characteristic findings of chronic pancreatitis such as dilatation and irregularity of MPD in most cases. In acute pancreatitis, MRCP indicated that MPD was normal in diameter, but irregular in configuration compared with that of the control group. MRCP may facilitate the diagnosis of chronic and acute pancreatitis.

  14. The Chronic Responsibility

    DEFF Research Database (Denmark)

    Ravn, Iben M; Frederiksen, Kirsten; Beedholm, Kirsten

    2016-01-01

    This article reports on the results of a Fairclough-inspired critical discourse analysis aiming to clarify how chronically ill patients are presented in contemporary Danish chronic care policies. Drawing on Fairclough’s three-dimensional framework for analyzing discourse, and using Dean’s concepts...... of governmentality as an interpretative lens, we analyzed and explained six policies published by the Danish Health and Medicines Authority between 2005 and 2013. The analysis revealed that discourses within the policy vision of chronic care consider chronically ill patients’ active role, lifestyle, and health...... behavior to be the main factors influencing susceptibility to chronic diseases. We argue that this discursive construction naturalizes a division between people who can actively manage responsible self-care and those who cannot. Such discourses may serve the interests of those patients who are already...

  15. Chronic gastritis - an update.

    Science.gov (United States)

    Varbanova, Mariya; Frauenschläger, Katrin; Malfertheiner, Peter

    2014-12-01

    Helicobacter pylori is the main aetiologic factor for chronic gastritis worldwide. The degree of inflammation and the evolution of this form of chronic gastritis can vary largely depending on bacterial virulence factors, host susceptibility factors and environmental conditions. Autoimmune gastritis is another cause of chronic inflammation in the stomach, which can occur in all age groups. This disease presents typically with vitamin B12 deficiency and pernicious anaemia. The presence of anti-parietal cell antibodies is highly specific for the diagnosis. The role of H. pylori as a trigger for autoimmune gastritis remains uncertain. Other rare conditions for chronic gastritis are chronic inflammatory conditions such as Crohn's disease or on the background of lymphocytic or collagenous gastroenteropathies.

  16. Chronic granulomatous disease associated with chronic glomerulonephritis

    DEFF Research Database (Denmark)

    Frifelt, J J; Schønheyder, Henrik Carl; Valerius, Niels Henrik

    1985-01-01

    A boy with chronic granulomatous disease (CGD) developed glomerulonephritis at the age of 12 years. The glomerulonephritis progressed to terminal uraemia at age 15 when maintenance haemodialysis was started. The clinical course was complicated by pulmonary aspergillosis and Pseudomonas septicaemia...... from which he eventually died. The glomerulonephritis was of unknown origin, and a possible relationship between CGD and glomerulonephritis is discussed....

  17. What Is Chronic Myeloid Leukemia?

    Science.gov (United States)

    ... Chronic Myeloid Leukemia (CML) About Chronic Myeloid Leukemia What Is Chronic Myeloid Leukemia? Cancer starts when cells ... their treatment is the same as for adults. What is leukemia? Leukemia is a cancer that starts ...

  18. What Is Chronic Lymphocytic Leukemia?

    Science.gov (United States)

    ... Chronic Lymphocytic Leukemia (CLL) About Chronic Lymphocytic Leukemia What Is Chronic Lymphocytic Leukemia? Cancer starts when cells ... body, including the lymph nodes, liver, and spleen. What is leukemia? Leukemia is a cancer that starts ...

  19. 不同材料人工髋关节关节面磨损对无菌性松动的影响%Effect of articular surface wear of different-material artificial hip joints on aseptic loosening

    Institute of Scientific and Technical Information of China (English)

    肖瑾瑛; 肖小燕; 唐方根; 刘建庭

    2011-01-01

    目的:分析各种人工髋关节假体材料在实际应用中的优势和存在的问题,对不同材料人工髋关节关节面的磨损对无菌性松动的影响进行评价.方法:以"生物材料,人工髋关节,假体,髋关节表面置换"为中文关键词,"biological materials,hip,prosthesis,hip resurfacing"为英文关键词,采用计算机检索1990-01/2009-12相关文章.纳入与不同材料人工髋关节关节面的磨损对无菌性松动的影响相关的文章;排除重复研究或Meta分析类文章.结果:人工髋关节的寿命和关节面的磨损密切相关,人工髋关节置换在临床应用研究过程中,出现无菌性松动等问题,这些问题的产生不但与假体的设计有关,而且与假体所用材料有着密切的关系,比较了不同人工髋关节假体材料的性能,为临床选择一种具耐磨损、生物相容性好的理想人工髋关节假体材料提供依据.结论:髋关节假体材料的表面改性和人体髋关节生物摩擦行为是未来研究的热点,髋关节假体材料性能评价体系的完善是亟待解决的问题.%OBJECTIVE: To analyze the advantage and problems of artificial hip joints made of different materials in clinical applications, andto evaluate the effects of articular surface wear on aseptic loosening.METHODS: A computer search of relevant articles published from January 1990 to December 2009 was performed by using thekeywords of “biological materials, hip, prosthesis, hip resurfacing” in Chinese and English. Repetitive studies or Meta analysis wereexcluded.RESULTS: The life of artificial hip joints is closely related to the articular surface wear. The appearance of aseptic loosening is notonly related to the design of prostheses, but also associated with prosthetic materials. Based on the comparison of different hipprosthesis material properties, we provide the basis for the selection of an ideal hip prosthesis material with good wear resistanceand biocompatibility

  20. Colagenopatía y meningitis aséptica recurrente en una paciente de 88 años Colagenopathy and recurrent aseptic meningitis in an 88 year old patient

    Directory of Open Access Journals (Sweden)

    Fernando J. VAzquez

    2004-02-01

    Full Text Available La meningitis aséptica recurrente (MAR en ancianos es rara y generalmente es secundaria a drogas. Su asociación a colagenopatías en ancianos ha sido raramente informada. El Síndrome de Sjögren (SS en ocasiones afecta el sistema nervioso central, pero la MAR asociada a SS es rara en este grupo etario. Se presenta una paciente de 88 años, autoválida, con antecedentes de xerostomía, xeroftalmos, Raynaud, disfagia y agrandamiento parotídeo recurrente autolimitado. En el año 2001 cursó una meningitis linfocítica y evolucionó con recuperación completa. Un año después volvió a presentar una meningitis linfocítica aséptica. Se descartaron causas infecciosas. Se demostró FAN 1/160 con patrón nucleolar moteado, Ac anti Ro y anti RNP positivos y anticoagulante lúpico positivo. Se confirmó sequedad ocular y la biopsia de labio fue compatible con SS. Evolucionó con resolución completa en 10 días sin tratamiento. Se interpretó como una enfermedad mixta del tejido conectivo (EMTC con síntomas predominantemente de SS, que cursó una MAR en su forma pura. La EMTC y el SS deberían ser considerados entre los diagnósticos diferenciales de la MAR, inclusive en ancianos.Recurrent aseptic meningitis (RAM infrequent in elderly patients and generally secondary to drugs. Its association with rheumatologic diseases is also seldom reported in the elderly. Sjögren Syndrome (SS sometimes affects the central nevous system, but the association between recurrent meningitis and SS is rare, specially in this age-group. We present an 88 year-old autovalid patient, with a history of xerostomia, xerophthalmia, Raynaud, dysphagia, and recurrent parotid enlargement. In 2001 she developed a lymphocytic meningitis with a complete remission. A year later, she developed again an aseptic lymphocytic meningitis. We ruled out infeccious causes. We found a FAN titer 1/160 with a nucleolar-mottled pattern, positive anti Ro and anti RNP antibodies and a positive

  1. Study on effect factors for multiplication and growth of aseptic buds of Vietnam Mesona blumes%越南凉粉草无菌芽增殖生长的影响因子

    Institute of Scientific and Technical Information of China (English)

    韦鹏霄; 谭木秀; 岑秀芬; 覃柳兰; 刘洁云; 周芳芳

    2013-01-01

    [Objective]The effect factors on multiplication and growth of the aseptic buds were studied in order to provide technical references for rapid propagation system in vitro of Vietnam Mesona blumes.[Method]The experiments were carried out from two aspects of media directions (different basic media,sucrose concentration and cytokinins) and explant materials (different inoculation positions).[Result]Comparison of the basic media of MS,Miller and modified White displayed that MS medium showed the best effect on bud multiplication and growth of the aseptic buds,in which bud proliferation multiple was 8.53 times.While sucrose concentration was 20.0 g/L,bud proliferation multiple peaked at 8.34 times.When sucrose concentration reached 25.0 g/L,bud proliferation multiple showed 7.05 times and bud growth was the best.The bud multiplication effect of CPPU was better than that of 6-BA and KT,in which bud proliferation multiple reached 9.80 times.Comparing the inoculated materials from stem upper position,the middle part of the stem and the stem base position,the bud multiplication effect of stem upper position was the best,in which the bud proliferation multiple was 9.35 times and the bud growth exhibited the best status.[Conclusion]It was suitable to the bud multiplication and growth of Vietnam Mesona blumes that the basic medium was MS medium,20.0-25.0 g/L sucrose concentration and 0.5 mg/L CPPU.The proper inoculated material was the stem upper position.%[目的]探讨越南凉粉草无菌芽增殖生长的影响因子,为越南凉粉草离体快繁体系的建立提供技术参考.[方法]从培养基配方(不同基本培养基、不同蔗糖浓度及不同细胞分裂素CPPU)和外植体材料(不同接种部位)两方面研究其对越南凉粉草无菌芽增殖的影响.[结果]在MS、Miller与改良White 3种基本培养基中,以MS对凉粉草芽增殖效果最好,芽增殖倍数达8.53倍;当蔗糖浓度为20.0 g/L时芽增殖倍数最高,为8.34

  2. Chronic hypersensitivity pneumonitis

    Science.gov (United States)

    Pereira, Carlos AC; Gimenez, Andréa; Kuranishi, Lilian; Storrer, Karin

    2016-01-01

    Hypersensitivity pneumonitis (HSP) is a common interstitial lung disease resulting from inhalation of a large variety of antigens by susceptible individuals. The disease is best classified as acute and chronic. Chronic HSP can be fibrosing or not. Fibrotic HSP has a large differential diagnosis and has a worse prognosis. The most common etiologies for HSP are reviewed. Diagnostic criteria are proposed for both chronic forms based on exposure, lung auscultation, lung function tests, HRCT findings, bronchoalveolar lavage, and biopsies. Treatment options are limited, but lung transplantation results in greater survival in comparison to idiopathic pulmonary fibrosis. Randomized trials with new antifibrotic agents are necessary. PMID:27703382

  3. Pesquisa de enterovírus em casos de síndrome de meningite asséptica de Belém, PA Investigation of enterovirus in cases of aseptic meningitis syndrome of Belém, PA

    Directory of Open Access Journals (Sweden)

    Letícia Martins Lamarão

    2005-10-01

    Full Text Available Com o objetivo de isolar e identificar os sorotipos de enterovírus, agentes etiológicos mais freqüentes da síndrome de meningite asséptica, foram estudadas amostras de líquor de pacientes da unidade de saúde de referência da Cidade de Belém-PA, do período de março de 2002 a março de 2003. As amostras foram inoculadas em cultivos celulares RD e HEp-2, e as positivas identificadas por neutralização ou imunofluorescência indireta. De 249 amostras, 33 (13,2% foram positivas sendo 57,6% (n=19 em pacientes menores de 11 anos (pWith the objective of isolating and identifying enteroviral serotypes, which are the most frequent etiologic agents of aseptic meningitis syndrome, cerebrospinal fluid samples were studied from patients referred to the health unit in the City of Belém (State of Pará, Brazil, from March 2002 to March 2003. The samples were inoculated in RD and HEp-2 cells line, and the positive were identified by neutralization test or indirect immunofluorescence. Out of 249 samples, 33 (13.2% were positive 57.6% (n = 19 in patients under 11 years of age (p <0.03 and predominantly (72.7% in males (p <0.008. The serotypes isolated were: Echovirus 30 (n = 31, Coxsackievirus B5 (n = 1 and Echovirus 30 and 4. In conclusion, this type of study also serves to determine the national picture, which is still little defined, regarding the most prevalent viral agents in AMS cases.

  4. Storage stability of cashew apple juice preserved by hot fill and aseptic processes Estabilidade do suco de caju preservado pelo método ''hot fill'' e processo asséptico

    Directory of Open Access Journals (Sweden)

    Maria Cecília Oliveira Costa

    2003-12-01

    Full Text Available Cashew (Anacardium occidentale L. apples from Pacajus, Ceará State, Brazil, were processed into high pulp content juice. The juice was packed either by hot fill or an aseptic process and evaluated for physical, physical-chemical, and sensorial changes during a 12-month storage period at room temperature. The results indicated that pH, soluble solids, total acidity, total sugar content and color did not change significantly during storage nor were affected by the type of filling. The sensorial analysis showed that juice acceptance remained high throughout the storage period regardless of the filling system. Differences in juice viscosity persisted between both processes.Pedúnculos de caju (Anacardium occidentale L. de Pacajus, Estado do Ceará, Brasil, foram processados na forma de suco com alto teor de polpa. O suco foi acondicionado através do processo hot fill ou asséptico e verificada as alterações físicas, físico-químicas e sensoriais durante armazenagem por doze meses à temperatura ambiente. Os resultados indicaram que pH, sólidos solúveis, acidez total, conteúdo de açúcar e cor não mudaram de modo significativo durante a armazenagem nem foram afetadas pelo modo de acondicionamento. Análise sensorial mostrou que a aceitação do suco foi mantida alta durante o período de armazenagem a despeito do sistema de enchimento. Diferenças na viscosidade dos sucos persistiram entre ambos processos.

  5. Effect of different cork puncture methods on aseptic storage period of normal saline%不同方法穿刺瓶塞生理盐水无菌存放时间研究

    Institute of Scientific and Technical Information of China (English)

    程翠年; 张卉; 吴胜林; 王懿睿; 王霞; 谢敏; 李绍婷; 李林; 易旭慧

    2011-01-01

    Objective To study the effect of different materials of cork, puncture methods and frequencies on the aseptic storage period of normal saline injection kept in PIVAS. Methods We grouped normal saline injection bottles according to the materials of the cork (butyl or polyisoprene ), puncture methods(stochastic puncture or repeated puncture of a single site of the cork) and puncture frequencies(three or five times). Sterility test were taken immediately after the puncture, and at 1 h, 2 h,3 h,4 h,5 h,6 h,8 h, 10h and 12 h within storage. Results The normal saline injection with polyisoprene cork stayed aseptic within 10 h after the corks were punctured 3 or 5 times randomly. The injection stayed sterile within 6 h after 3 times of, or within 5 h after 5 times of puncture through a single site of the cork. The normal saline injection with butyl cork stayed aseptic within 8 h after 3 times of, or within 6 h after 5 times of stochastic puncture. The injection with butyl cork stayed sterile within 5 h after 3 times of, or within 4 h after 5 times of puncture through a single site of the cork. Conclusion Normal saline injection with two different materials of the cork is able to stay sterile within 4 h regardless of the puncture methods or frequencies. The storage period of normal saline injection whose corks are repeatedly punctured at a single site is shortened with increasing puncture frequency. Normal saline injection with butyl cork shows shorter storage period compared with those with polyisoprene cork. The results indicate that we should strictly obeythe misalign rules during intravenous drug preparation. Meanwhile, the procedure calls for advisable arrangement of drug preparation time according to the drug properties and usage requirements.%目的 研究静脉药物配置中心环境下瓶塞材质、穿刺方法及穿刺次数对生理盐水无菌存放时间的影响.方法 将静脉输液用生理盐水按胶塞的材质(丁基胶塞和聚异戊二烯胶塞)

  6. Chronic Fatigue Syndrome

    Science.gov (United States)

    Chronic fatigue syndrome (CFS) is a disorder that causes extreme fatigue. This fatigue is not the kind of tired feeling that ... activities. The main symptom of CFS is severe fatigue that lasts for 6 months or more. You ...

  7. Chronic Kidney Disease

    Science.gov (United States)

    You have two kidneys, each about the size of your fist. Their main job is to filter wastes and excess water out of ... help control blood pressure, and make hormones. Chronic kidney disease (CKD) means that your kidneys are damaged ...

  8. Chronic sinusitis (image)

    Science.gov (United States)

    ... and cartilage and lined with a mucous membrane. Sinusitis occurs when the membranes becomes inflamed and painful, ... a result of a blocked sinus opening. Chronic sinusitis is often caused by inflammation and blockage due ...

  9. Chronic Condition Data Warehouse

    Data.gov (United States)

    U.S. Department of Health & Human Services — The CMS Chronic Condition Data Warehouse (CCW) provides researchers with Medicare and Medicaid beneficiary, claims, and assessment data linked by beneficiary across...

  10. Zabofloxacin for chronic bronchitis.

    Science.gov (United States)

    Kocsis, B; Szabo, D

    2016-09-01

    Treatment of lower respiratory tract infection poses as an ongoing challenge among respiratory tract diseases. Bacterial infections are causes of acute exacerbations in chronic bronchitis and indications for antibacterial therapy. Several antibiotics were applied to treat bacterial infections in chronic bronchitis, among them fluoroquinolones are considered potent, broad-spectrum agents with excellent tissue penetration. This monograph focuses on zabofloxacin, a novel fluoroquinolone agent recently approved and launched in South Korea, and summarizes the drug's antibacterial efficacy, pharmacokinetic properties and toxicity. Recent advances concerning fluoroquinolones in chronic bronchitis will be discussed, along with a comparison between zabofloxacin and moxifloxacin. Zabofloxacin has proved to be noninferior to moxifloxacin against major community-acquired Gram-positive and Gram-negative respiratory tract pathogens and found to be well tolerated in both oral and parenteral administrations. These features can make it a potential antimicrobial agent in therapy of chronic bronchitis and other lower respiratory tract infections.

  11. Living with Chronic Bronchitis

    Science.gov (United States)

    ... Health Topics » Bronchitis » Living With Chronic Bronchitis Explore Bronchitis What Is... Other Names Causes Who Is at Risk Signs & Symptoms Diagnosis Treatments Prevention Living With Clinical Trials Links Related Topics ...

  12. Chronic Critical Illness

    Science.gov (United States)

    ... the patient’s situation and on the hospital and city. Do Chronically Critically Ill Patients Regain the Ability ... as the patient. You may feel stress, worry, sadness, or fatigue. Some families worry about financial burdens. ...

  13. Chronic Conditions Dashboard

    Data.gov (United States)

    U.S. Department of Health & Human Services — The CMS Chronic Conditions Dashboard presents statistical views of information on the prevalence, utilization and Medicare spending for Medicare beneficiaries with...

  14. Chronic Myeloproliferative Neoplasms Treatment

    Science.gov (United States)

    ... way to treat some chronic myeloproliferative neoplasms. Platelet apheresis Platelet apheresis is a treatment that uses a special machine ... using interferon alfa or pegylated interferon alpha . Platelet apheresis . A clinical trial of a new treatment. Check ...

  15. Chronic penile strangulation

    Directory of Open Access Journals (Sweden)

    Lopes Roberto I

    2003-01-01

    Full Text Available Chronic penile strangulation is exceedingly rare with only 5 cases previously reported. We report an additional case of progressive penile lymphedema due to chronic intermittent strangulation caused by a rubber band applied to the penile base for 6 years. A 49-year-old man presented incapacity to exteriorize the glans penis. For erotic purposes, he had been using a rubber-enlarging band placed in the penile base for 6 years. With chronic use, he noticed that his penis swelled. Physical examination revealed lymphedema of the penis, phimosis and a stricture in the penile base. The patient was submitted to circumcision and the lymphedema remained stable 10 months postoperatively. Chronic penile incarceration usually causes penile lymphedema and urinary disturbance. Treatment consists of removal of foreign devices and surgical treatment of lymphedema.

  16. Chronic Illness & Mental Health

    Science.gov (United States)

    ... is present. For More Information Share Chronic Illness & Mental Health Download PDF Download ePub Order a free hardcopy ... For more information, see the National Institute of Mental Health (NIMH) booklet on Depression at http://www.nimh. ...

  17. Chronic obstructive pulmonary disease

    Science.gov (United States)

    ... and oxygen therapy Right-sided heart failure or cor pulmonale (heart swelling and heart failure due to chronic ... PA: Elsevier Saunders; 2016:chap 44. Read More Cor pulmonale Dilated cardiomyopathy Heart failure - overview Lung disease Patient ...

  18. Chronic Kidney Disease (CKD)

    Science.gov (United States)

    ... CKD treated? Kidney-friendly diet for CKD What causes chronic kidney disease (CKD)? Anyone can get CKD. Some people are ... and high blood pressure are the most common causes of CKD. If you have diabetes or high blood pressure, ...

  19. Sleep and Chronic Disease

    Science.gov (United States)

    ... message, please visit this page: About CDC.gov . Sleep About Us About Sleep Key Sleep Disorders Sleep ... Sheets Data & Statistics Projects and Partners Resources Events Sleep and Chronic Disease Recommend on Facebook Tweet Share ...

  20. Chronic Conditions PUF

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Chronic Conditions PUFs are aggregated files in which each record is a profile or cell defined by the characteristics of Medicare beneficiaries. A profile is...

  1. Chronic inflammatory demyelinative polyneuropathy

    DEFF Research Database (Denmark)

    Said, Gérard; Krarup, Christian

    2013-01-01

    Chronic inflammatory demyelinative polyneuropathy (CIDP) is an acquired polyneuropathy presumably of immunological origin. It is characterized by a progressive or a relapsing course with predominant motor deficit. The diagnosis rests on the association of non-length-dependent predominantly motor ...

  2. Chronic dysimmune neuropathies: Beyond chronic demyelinating polyradiculoneuropathy

    Directory of Open Access Journals (Sweden)

    Khadilkar Satish

    2011-01-01

    Full Text Available The spectrum of chronic dysimmune neuropathies has widened well beyond chronic demyelinating polyradiculoneuropathy (CIDP. Pure motor (multifocal motor neuropathy, sensorimotor with asymmetrical involvement (multifocal acquired demylinating sensory and motor neuropathy, exclusively distal sensory (distal acquired demyelinating sensory neuropathy and very proximal sensory (chronic immune sensory polyradiculopathy constitute the variants of CIDP. Correct diagnosis of these entities is of importance in terms of initiation of appropriate therapy as well as prognostication of these patients. The rates of detection of immune-mediated neuropathies with monoclonal cell proliferation (monoclonal gammopathy of unknown significance, multiple myeloma, etc. have been facilitated as better diagnostic tools such as serum immunofixation electrophoresis are being used more often. Immune neuropathies associated with malignancies and systemic vasculitic disorders are being defined further and treated early with better understanding of the disease processes. As this field of dysimmune neuropathies will evolve in the future, some of the curious aspects of the clinical presentations and response patterns to different immunosuppressants or immunomodulators will be further elucidated. This review also discusses representative case studies.

  3. Tolerance and chronic rejection.

    OpenAIRE

    Womer, K. L.; Lee, R S; Madsen, J. C.; Sayegh, M H

    2001-01-01

    The most common cause of chronic allograft loss is an incompletely understood clinicopathological entity called chronic rejection (CR). Recent reports suggest an improvement in long-term renal allograft survival, although it is not clear from these data whether a true reduction of biopsy-proven CR has occurred. Although newer immunosuppressive medications have greatly reduced the incidence of acute rejection (AR) in the early post-transplantation period, the ideal therapy for both AR and CR w...

  4. Chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008430 Effect of gas exchange at maximal intensity on exercise capacity in patients with chronic obstructive pulmonary disease. WANG Haoyan(王浩彦), et al. Dept Respir Dis, Beijing Friendship Hosp, Capital Med Sci Univ, Beijing 100050. Chin J Tuberc Respir Dis 2008;31(6):414-416. Objective To investigate the effect of gas exchange at maximal intensity on exercise capacity in patients with chronic obstructive pulmonary disease (COPD).

  5. Experimental chronic periodontitis morphogenesis

    OpenAIRE

    Schneider S.A.

    2011-01-01

    Morphogenesis of periodontium tissue in a model of chronic periodontitis was studied. Adult Wistar rats wereused in a model; chronic periodontitis was developed through mastication-related loading decrease. Histological assessmentof periodontium tissue was conducted at Days 7, 14, 21 and 30. It was demonstrated that dystrophic tissue changes prevailover the inflammatory one in this particular experimental model. The structural elements of periodontium were involved intothe pathologic process ...

  6. Understanding chronic heart failure

    OpenAIRE

    Fenton, Matthew; Burch, Michael

    2007-01-01

    The key principles of chronic heart failure and the development of clinical management strategies are described. The physiological changes in chronic heart failure and the clinical management of children with heart failure are considered, but the treatment of heart failure related to congenital heart disease or the intensive care management of heart failure are not mentioned as both topics require consideration in their own right. A greater understanding of the maladaptive responses to chroni...

  7. Treatment of Chronic Cough.

    Science.gov (United States)

    Soni, Resha S; Ebersole, Barbara; Jamal, Nausheen

    2017-01-01

    Objective Chronic cough remains a challenging condition, especially in cases where it persists despite comprehensive medical management. For these particular patients, there appears to be an emerging role for behavior modification therapy. We report a series of patients with refractory chronic cough to assess if there is any benefit of adding behavioral therapy to their treatment regimen. Study Design A case series with planned chart review of patients treated for chronic cough. Setting The review was performed with an outpatient electronic health record system at a tertiary care center. Subjects and Methods The charts of all patients treated for chronic cough by a single laryngologist over a 30-month period were analyzed. Patients' response to treatment and rate of cough improvement were assessed for those with refractory chronic cough who underwent behavior modification therapy. Results Thirty-eight patients with chronic cough were initially treated empirically for the most common causes of cough, of which 32% experienced improvement. Nineteen patients who did not significantly improve with medical management underwent behavior modification therapy with a speech-language pathologist. Of these patients, 84% experienced resolution or marked improvement of their symptoms. Conclusion Behavioral therapy may be underutilized in practice and could lead to improvement of otherwise recalcitrant cough.

  8. Chronic Osteomyelitis in Sternum Mimicking Bone Metastasis of Lung Cancer Patient

    Energy Technology Data Exchange (ETDEWEB)

    Im, Hyung Jun; Kim, Yu Keong; Lee, Sang Mi; Lee, Won Woo; Kim, Sang Eun [Seoul National University Bundang Hospital, Seoul (Korea, Republic of)

    2009-06-15

    Primary sternal osteomyelitis without predisposing factors is a rare condition, and it is hardly differentiated from metastatic bone tumor especially in patient with the history of primary malignancy because osteomyelitis shares frequently common findings with metastatic bone lesion on {sup 18}F-FDG PET and bone scan. Although there have been several publications of primary osteomyelitis mimicking bone metastasis in the spine or extremities, we report a case of primary sternal osteomyelitis in the patient with lung cancer, which has, to our knowledge, not been reported before.

  9. [Aseptic meningitis after isotope cisternography. 2 Cases].

    Science.gov (United States)

    Guy, G; Comoy, J; Chevet, D; Thomas, R; le Pogamp, P

    1976-01-01

    In these two patients, as in 13 others described in the literature, a typical meningitic syndrome with excitement, confusion and a fever of 104degrees F (40degrees C) appeared 4-6 hours following the intra-thecal injection. Subsequent lumbar puncture usually reveals a cloudy C.S.F. under increased pressure. The polymorphs and proteins are increased but the glucose remains normal. There are no bacteria either on direct examination or after culture. All the patients receive antibiotics. After a course of three days, the symptoms and the fever have disappeared and the C.S.F. became normal. Bacterial contamination can be ruled out. The relative roles of iodine, radio-acitivity itself, albumine and of the radio-active element which are only used for this radiotracer are discussed. The tracer contains neither stabilizer nor pH buffer. One must presume that the syndrome is due to a direct toxic action rather than to an immunological or allergic reaction. Furthermore, it is of interest that similar reactions, without infection, are seen after spinal anaesthesia and intra-thecal injection of such differing substances such as iodine contrast media, gamma globulins, other isotopes or toxic substances (Lysol) (111In-DTPA).

  10. Chronic prostatitis: Current concepts

    Directory of Open Access Journals (Sweden)

    Ram Vaidyanathan

    2008-01-01

    Full Text Available Purpose: Chronic prostatitis (CP is a common condition. It causes significant suffering to the patients and constitutes a sizeable workload for the urologists. The purpose of this review is to describe the currently accepted concepts regarding the aspects of CP. Materials and Methods: Relevant papers on the epidemiology, etiology, diagnosis, evaluation and management of CP were identified through a search of MEDLINE using text terms "prostatitis", "chronic prostatitis" and "chronic pelvic pain syndrome". The list of articles thus obtained was supplemented by manual search of bibliographies of the identified articles and also by exploring the MEDLINE option "Related Articles". Results: The salient points of the relevant articles on each aspect of CP have been summarized in the form of a non-systematic narrative review. Conclusion: Chronic prostatitis is caused by a variety of infective and non-infective factors and is characterized by a rather long remitting and relapsing clinical course. The diagnosis is based on symptoms comprising pain and nonspecific urinary and/or ejaculatory disturbances and microbiological tests to localize bacteria and/or leucocytes in segmented urinary tract specimens. The contemporary classification was proposed by the National Institutes of Health/National Institute of Diabetes Digestive Kidney Diseases (NIH/NIDDK. National Institutes of Health - Chronic Prostatitis Symptom Index (NIH-CPSI is the patient evaluation tool used extensively in clinical practice and research. Management should be individualized, multimodal and of an appropriate duration.

  11. Autoantibodies in chronic pancreatitis

    DEFF Research Database (Denmark)

    Rumessen, J J; Marner, B; Pedersen, N T

    1985-01-01

    In 60 consecutive patients clinically suspected of having chronic pancreatitis the serum concentration of the immunoglobulins (IgA, IgG, IgM), the IgG- and IgA-type non-organ-specific autoantibodies against nuclear material (ANA), smooth and striated muscle, mitochondria, basal membrane, and reti......In 60 consecutive patients clinically suspected of having chronic pancreatitis the serum concentration of the immunoglobulins (IgA, IgG, IgM), the IgG- and IgA-type non-organ-specific autoantibodies against nuclear material (ANA), smooth and striated muscle, mitochondria, basal membrane......, and reticulin, and the IgG- and IgA-type pancreas-specific antibodies against islet cells, acinus cells, and ductal cells (DA) were estimated blindly. In 23 of the patients chronic pancreatitis was verified, whereas chronic pancreatitis was rejected in 37 patients (control group). IgG and IgA were found...... in significantly higher concentrations in the patients with chronic pancreatitis than in the control group but within the normal range. ANA and DA occurred very frequently in both groups but with no statistical difference. Other autoantibodies only occurred sporadically. The findings of this study do not support...

  12. Management of chronic paronychia

    Directory of Open Access Journals (Sweden)

    Vineet Relhan

    2014-01-01

    Full Text Available Chronic paronychia is an inflammatory disorder of the nail folds of a toe or finger presenting as redness, tenderness, and swelling. It is recalcitrant dermatoses seen commonly in housewives and housemaids. It is a multifactorial inflammatory reaction of the proximal nail fold to irritants and allergens. Repeated bouts of inflammation lead to fibrosis of proximal nail fold with poor generation of cuticle, which in turn exposes the nail further to irritants and allergens. Thus, general preventive measures form cornerstone of the therapy. Though previously anti-fungals were the mainstay of therapy, topical steroid creams have been found to be more effective in the treatment of chronic paronychia. In recalcitrant cases, surgical treatment may be resorted to, which includes en bloc excision of the proximal nail fold or an eponychial marsupialization, with or without nail plate removal. Newer therapies and surgical modalities are being employed in the management of chronic paronychia. In this overview, we review recent epidemiological studies, present current thinking on the pathophysiology leading to chronic paronychia, discuss the challenges chronic paronychia presents, and recommend a commonsense approach to management.

  13. Chronic daily headaches

    Directory of Open Access Journals (Sweden)

    Fayyaz Ahmed

    2012-01-01

    Full Text Available Chronic Daily Headache is a descriptive term that includes disorders with headaches on more days than not and affects 4% of the general population. The condition has a debilitating effect on individuals and society through direct cost to healthcare and indirectly to the economy in general. To successfully manage chronic daily headache syndromes it is important to exclude secondary causes with comprehensive history and relevant investigations; identify risk factors that predict its development and recognise its sub-types to appropriately manage the condition. Chronic migraine, chronic tension-type headache, new daily persistent headache and medication overuse headache accounts for the vast majority of chronic daily headaches. The scope of this article is to review the primary headache disorders. Secondary headaches are not discussed except medication overuse headache that often accompanies primary headache disorders. The article critically reviews the literature on the current understanding of daily headache disorders focusing in particular on recent developments in the treatment of frequent headaches.

  14. Chronic hypersensitivity pneumonitis

    Directory of Open Access Journals (Sweden)

    Pereira CA

    2016-09-01

    Full Text Available Carlos AC Pereira,1 Andréa Gimenez,2 Lilian Kuranishi,2 Karin Storrer 2 1Interstitial Lung Diseases Program, 2Pulmonology Postgraduate, Federal University of São Paulo, São Paulo, Brazil Abstract: Hypersensitivity pneumonitis (HSP is a common interstitial lung disease resulting from inhalation of a large variety of antigens by susceptible individuals. The disease is best classified as acute and chronic. Chronic HSP can be fibrosing or not. Fibrotic HSP has a large differential diagnosis and has a worse prognosis. The most common etiologies for HSP are reviewed. Diagnostic criteria are proposed for both chronic forms based on exposure, lung auscultation, lung function tests, HRCT findings, bronchoalveolar lavage, and biopsies. Treatment options are limited, but lung transplantation results in greater survival in comparison to idiopathic pulmonary fibrosis. Randomized trials with new antifibrotic agents are necessary. Keywords: interstitial lung diseases, extrinsic allergic alveolitis, diffuse lung disease, lung immune response, HRCT, farmers lung

  15. Chronic pelvic floor dysfunction.

    Science.gov (United States)

    Hartmann, Dee; Sarton, Julie

    2014-10-01

    The successful treatment of women with vestibulodynia and its associated chronic pelvic floor dysfunctions requires interventions that address a broad field of possible pain contributors. Pelvic floor muscle hypertonicity was implicated in the mid-1990s as a trigger of major chronic vulvar pain. Painful bladder syndrome, irritable bowel syndrome, fibromyalgia, and temporomandibular jaw disorder are known common comorbidities that can cause a host of associated muscular, visceral, bony, and fascial dysfunctions. It appears that normalizing all of those disorders plays a pivotal role in reducing complaints of chronic vulvar pain and sexual dysfunction. Though the studies have yet to prove a specific protocol, physical therapists trained in pelvic dysfunction are reporting success with restoring tissue normalcy and reducing vulvar and sexual pain. A review of pelvic anatomy and common findings are presented along with suggested physical therapy management.

  16. Omalizumab for chronic urticaria

    DEFF Research Database (Denmark)

    Ivyanskiy, Ilya; Sand, Carsten; Thomsen, Simon Francis

    2012-01-01

    urticaria. We present a case series of 19 patients with chronic urticaria treated in a university department with omalizumab and give an overview of the existing literature comprising an additional 59 cases as well as a total of 139 patients enrolled in two randomized controlled trials comparing omalizumab...... with placebo. The collective evidence points to omalizumab as a safe and effective treatment option for patients with chronic urticaria who do not sufficiently respond to standard therapy as recommended by existing guidelines.......Omalizumab is a recombinant humanized monoclonal antibody that blocks the high-affinity Fc receptor of IgE. Omalizumab has been approved for the treatment of moderate to severe asthma; however, there is currently more and more data showing promising results in the management also of chronic...

  17. Estabilidade dos carotenoides,antocianinas e vitamina C presentes no suco tropical de acerola (Malpighia emarginata DC. adoçado envasado pelos processos Hot-Fill e asséptico Stability of carotenoids, anthocyanins and vitamin C presents in acerola sweetened tropical juice preserved by hot fill and aseptic processes

    Directory of Open Access Journals (Sweden)

    Claisa Andréa Silva de Freitas

    2006-10-01

    Full Text Available As frutas tropicais são muito aceitas pelos consumidores, e são importantes fontes de componentes antioxidantes. A acerola, conhecida por conter grandes quantidades de vitamina C, é também rica em antocianinas e carotenóides. O presente trabalho teve por objetivo avaliar a estabilidade dos carotenóides totais, antocianinas totais e vitamina C do suco tropical de acerola adoçado, elaborado pelos processos Hot Fill (garrafas de vidro e asséptico (embalagens cartonadas, durante 350 dias de armazenamento em condições similares às de comercialização (28ºC ± 2ºC. Ao final do experimento observou-se que não houve perdas de antocianinas totais para o processo Hot Fill, no entanto, para o processo asséptico constatou-se uma redução de 86,89% dos teores iniciais. Os valores de carotenóides totais permaneceram inalterados nas amostras do processo asséptico, enquanto nas do Hot Fill houve uma redução de 12,5%. Constatou-se redução nos teores de vitamina C da ordem de 23,61% para o processo Hot Fill e de 35,95% para o processo asséptico.Tropical fruits are widely accepted by consumers, and important sources of antioxidant compounds. Acerola, known to have high vitamin C levels, is also rich in anthocyanins and carotenoids. The purpose of this work was to evaluate the stability of the total carotenoids, total anthocyanins and ascorbic acid of the acerola sweetened tropical juice produced by the Hot Fill (glass bottles and aseptic (packings carton process during 350 days of storage in similar conditions of trade (28ºC ± 2ºC. It was observed that there were not losses of total anthocyanins for the process Hot Fill, however for the aseptic process a reduction of 86.89% of the initial values was observed. The values of total corotenoids stayed unaffected in the samples of the aseptic process, while in the one of the Hot Fill there was a reduction of 12.5%. A reduction in the values of ascorbic acid of 23.61% was observed for the Hot

  18. [Histaminergic angioedema and chronic urticaria].

    Science.gov (United States)

    Hacard, Florence; Nosbaum, Audrey; Bensaid, Benoit; Nicolas, Jean-François; Augey, Frédéric; Goujon, Catherine; Bérard, Frédéric

    2015-01-01

    Most angioedemas are histaminergic and correspond to deep urticarial swelling. Recurrent histaminergic angioedema led to the diagnosis of chronic urticaria, even when there are no superficial associated hives. Chronic urticaria is a benign disease, and autoimmune in 40 % of cases. The occurrence of angioedema in chronic urticaria is not a sign of severity. The occurrence of angioedema in chronic urticaria is associated with a longer duration of urticarial disease. NSAIDs and/or systemic corticotherapy are classic triggers of angioedema in chronic urticaria. In the absence of clinical endpoints, there is no need to make further assessment in chronic urticaria good responders to antihistamines.

  19. Rapid vascular uptake of contrast during a retrograde urethro-cystogram in a cat with chronic lower urinary tract disease

    Directory of Open Access Journals (Sweden)

    Xander Huizing

    2015-05-01

    Full Text Available Case summary A 9-year male neutered domestic longhair cat was referred to our hospital for investigation of recurrent urinary tract obstruction. The clinical signs had started 12 months earlier and the cat had been catheterised on multiple occasions. Clinical examination and abdominal ultrasound of the abdomen was unremarkable but examination of the penis revealed it to be prolapsed and extremely erythematous and friable. A retrograde contrast urethrocystogram was performed, showing extravasation of the contrast medium and establishing the presence of partial leakage or a tear of the urethra. In subsequent radiographs, the contrast was seen being rapidly absorbed into the pelvic and systemic vasculature via the penile veins, internal and external pudendal veins, internal and external iliac veins, and, ultimately, the caudal vena cava. Later, the contrast medium was seen within the renal pelves. Retrograde urethrocystography revealed stenosis and irregularities of the caudal urethral mucosa consistent with strictures. A routine perineal urethrostomy was performed and the cat recovered well. Conclusions and relevance Rapid vascular absorption of extravasated contrast medium has not been reported before. In this case, the increased blood supply to the distal urethra and penis is likely secondary to (chronic inflammation, as demonstrated by the urethral strictures and the friable, oedematous nature of the penis. Whether the inflammation was caused by chronic obstruction or repeated iatrogenic trauma, or a combination of these factors, will remain debatable. Nonetheless, this case demonstrates that when a retrograde contrast urethrocystogram is considered, it is imperative that a contrast medium (or other intraurethral medication such as local anaesthesia is chosen that is safe for intravascular use. Equally, an absolute aseptic technique is essential considering the potential for contaminants to be absorbed quite rapidly into the systemic

  20. Chronic obstructive pulmonary disease - adults - discharge

    Science.gov (United States)

    COPD - adults - discharge; Chronic obstructive airways disease - adults - discharge; Chronic obstructive lung disease - adults - discharge; Chronic bronchitis - adults - discharge; Emphysema - adults - discharge; Bronchitis - ...

  1. Chronic pancreatitis in dogs.

    Science.gov (United States)

    Watson, Penny

    2012-08-01

    Chronic pancreatitis used to be considered uncommon in dogs, but recent pathological and clinical studies have confirmed that it is in fact a common and clinically significant disease. Clinical signs can vary from low-grade recurrent gastrointestinal signs to acute exacerbations that are indistinguishable from classical acute pancreatitis. Chronic pancreatitis is a significant cause of chronic pain in dogs, which must not be underestimated. It also results in progressive impairment of endocrine and exocrine function and the eventual development of diabetes mellitus or exocrine pancreatic insufficiency or both in some affected dogs at end stage. The etiology is unknown in most cases. Chronic pancreatitis shows an increased prevalence in certain breeds, and recent work in English Cocker Spaniels suggests it is part of a polysystemic immune-mediated disease in this breed. The histological and clinical appearance is different in different breeds, suggesting that etiologies may also be different. Diagnosis is challenging because the sensitivities of the available noninvasive tests are relatively low. However, with an increased index of suspicion, clinicians will recognize more cases that will allow them to institute supportive treatment to improve the quality of life of the patient.

  2. Acetaminophen for Chronic Pain

    DEFF Research Database (Denmark)

    Ennis, Zandra Nymand; Dideriksen, Dorthe; Vaegter, Henrik Bjarke;

    2016-01-01

    strategies for acetaminophen use in chronic pain in both Embase and PubMed, 1,551 hits were obtained. Following cross-reference searches of both trials and 38 reviews, seven studies comparing acetaminophen in continuous dosing regimens of more than two weeks with placebo were included. The review...

  3. Refractory chronic migraine

    DEFF Research Database (Denmark)

    Martelletti, Paolo; Katsarava, Zaza; Lampl, Christian

    2014-01-01

    The debate on the clinical definition of refractory Chronic Migraine (rCM) is still far to be concluded. The importance to create a clinical framing of these rCM patients resides in the complete disability they show, in the high risk of serious adverse events from acute and preventative drugs...

  4. Diagnosing chronic rhinosinusitis

    DEFF Research Database (Denmark)

    Lange, B; Thilsing, T; Baelum, J;

    2013-01-01

    The European Position Paper on Rhinosinusitis and Nasal Polyps (EP3OS) incorporates symptomatic and endo- scopic criteria in the clinical diagnosis of chronic rhinosinusitis (CRS), while in epidemiological studies the definition is based on symptoms only. The aim of this study was to evaluate the...

  5. Chronic recurrent multifocal osteomyelitis

    NARCIS (Netherlands)

    Wedman, Jan; van Weissenbruch, Ranny

    2005-01-01

    We report what is, to our best knowledge, the first case of chronic recurrent multifocal osteomyelitis (CRMO) in which the frontal and sphenoid bones were involved. Characterized by a prolonged and fluctuating course of osteomyelitis at different sites, CRMO is self-limited, although sequelae can oc

  6. CHRONIC PROBLEM FAMILIES.

    Science.gov (United States)

    STONE, EDWARD

    THE REPORT POINTS OUT THAT, IN GENERAL, CHRONIC PROBLEM PARENTS GREW UP IN ENVIRONMENTS OF EMOTIONAL IMPOVERISHMENT, INCONSISTENCY, CONFUSION, AND DISORDER, OFTEN WITH DEPRIVATION OF FOOD, CLOTHING, AND SHELTER. THESE PARENTS CATEGORIZE PEOPLE AS THOSE WHO GIVE AND THOSE WHO TAKE. THEY BLAME THEIR PROBLEMS ON EXTERNAL CIRCUMSTANCES NOT UNDER THEIR…

  7. Chronic blood pressure control.

    Science.gov (United States)

    Brands, Michael W

    2012-10-01

    Chronic blood pressure is maintained within very narrow limits around an average value. However, the multitude of physiologic processes that participate in blood pressure control present a bewildering array of possibilities to explain how such tight control of arterial pressure is achieved. Guyton and Coleman and colleagues addressed this challenge by creating a mathematical model that integrated the short- and long-term control systems for overall regulation of the circulation. The hub is the renal-body fluid feedback control system, which links cardiac function and vascular resistance and capacitance with fluid volume homeostasis as the foundation for chronic blood pressure control. The cornerstone of that system is renal sodium excretory capability, which is defined by the direct effect of blood pressure on urinary sodium excretion, that is, "pressure natriuresis." Steady-state blood pressure is the pressure at which pressure natriuresis balances sodium intake over time; therefore, renal sodium excretory capability is the set point for chronic blood pressure. However, this often is misinterpreted as dismissing, or minimizing, the importance of nonrenal mechanisms in chronic blood pressure control. This article explains the renal basis for the blood pressure set point by focusing on the absolute dependence of our survival on the maintenance of sodium balance. Two principal threats to sodium balance are discussed: (1) a change in sodium intake or renal excretory capability and (2) a change in blood pressure. In both instances, circulatory homeostasis is maintained because the sodium balance blood pressure set point is reached.

  8. Chronic Kidney Disease

    Science.gov (United States)

    ... of the feet and ankles Causes & Risk FactorsWhat causes CKD?The most common causes of CKD are high blood pressure, diabetes and heart disease. ... caused by CKD.How else is CKD treated?Chronic kidney disease can cause other problems. Talk with your doctor about how ...

  9. EBV CHRONIC INFECTIONS

    Directory of Open Access Journals (Sweden)

    Eligio Pizzigallo

    2010-08-01

    Full Text Available The infection from Epstein-Barr virus (EBV or virus of infectious mononucleosis, together with other herpesviruses’ infections, represents a prototype of persistent viral infections characterized by the property of the latency. Although the reactivations of the latent infection are associated with the resumption of the viral replication and eventually with the “shedding”, it is still not clear if this virus can determine chronic infectious diseases, more or less evolutive. These diseases could include some pathological conditions actually defined as “idiopathic”and characterized by the “viral persistence” as the more credible pathogenetic factor. Among the so-called idiopathic syndromes, the “chronic fatigue syndrome” (CFS aroused a great interest around the eighties of the last century when, just for its relationship with EBV, it was called “chronic mononucleosis” or “chronic EBV infection”. Today CFS, as defined in 1994 by the CDC of Atlanta (USA, really represents a multifactorial syndrome characterized by a chronic course, where reactivation and remission phases alternate, and by a good prognosis. The etiopathogenetic role of EBV is demonstrated only in a well-examined subgroup of patients, while in most of the remaining cases this role should be played by other infectious agents - able to remain in a latent or persistent way in the host – or even by not infectious agents (toxic, neuroendocrine, methabolic, etc.. However, the pathogenetic substrate of the different etiologic forms seems to be the same, much probably represented by the oxidative damage due to the release of pro-inflammatory cytokines as a response to the triggering event (infectious or not infectious. Anyway, recently the scientists turned their’s attention to the genetic predisposition of the subjects affected by the syndrome, so that in the last years the genetic studies, together with those of molecular biology, received a great impulse

  10. Screening for Chronic Kidney Disease

    Science.gov (United States)

    Understanding Task Force Recommendations Screening for Chronic Kidney Disease The U.S. Preventive Services Task Force (Task Force) has issued a final recommendation on Screening for Chronic Kidney Disease (CKD) . This recommendation ...

  11. Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)

    Science.gov (United States)

    ... and abnormal sensations. CIDP is closely related to Guillain-Barre syndrome and it is considered the chronic counterpart ... and abnormal sensations. CIDP is closely related to Guillain-Barre syndrome and it is considered the chronic counterpart ...

  12. Chronic Fatigue Syndrome (CFS): Symptoms

    Science.gov (United States)

    ... CDC.gov . Chronic Fatigue Syndrome (CFS) Share Compartir Symptoms On this Page Primary Symptoms Other Symptoms What's ... a doctor distinguish CFS from other illnesses. Primary Symptoms As the name chronic fatigue syndrome suggests , fatigue ...

  13. Chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    V K Vijayan

    2013-01-01

    Full Text Available The global prevalence of physiologically defined chronic obstructive pulmonary disease (COPD in adults aged >40 yr is approximately 9-10 per cent. Recently, the Indian Study on Epidemiology of Asthma, Respiratory Symptoms and Chronic Bronchitis in Adults had shown that the overall prevalence of chronic bronchitis in adults >35 yr is 3.49 per cent. The development of COPD is multifactorial and the risk factors of COPD include genetic and environmental factors. Pathological changes in COPD are observed in central airways, small airways and alveolar space. The proposed pathogenesis of COPD includes proteinase-antiproteinase hypothesis, immunological mechanisms, oxidant-antioxidant balance, systemic inflammation, apoptosis and ineffective repair. Airflow limitation in COPD is defined as a postbronchodilator FEV1 (forced expiratory volume in 1 sec to FVC (forced vital capacity ratio <0.70. COPD is characterized by an accelerated decline in FEV1. Co morbidities associated with COPD are cardiovascular disorders (coronary artery disease and chronic heart failure, hypertension, metabolic diseases (diabetes mellitus, metabolic syndrome and obesity, bone disease (osteoporosis and osteopenia, stroke, lung cancer, cachexia, skeletal muscle weakness, anaemia, depression and cognitive decline. The assessment of COPD is required to determine the severity of the disease, its impact on the health status and the risk of future events (e.g., exacerbations, hospital admissions or death and this is essential to guide therapy. COPD is treated with inhaled bronchodilators, inhaled corticosteroids, oral theophylline and oral phosphodiesterase-4 inhibitor. Non pharmacological treatment of COPD includes smoking cessation, pulmonary rehabilitation and nutritional support. Lung volume reduction surgery and lung transplantation are advised in selected severe patients. Global strategy for the diagnosis, management and prevention of Chronic Obstructive Pulmonary Disease

  14. Defining and Measuring Chronic Conditions

    Centers for Disease Control (CDC) Podcasts

    2013-05-20

    This podcast is an interview with Dr. Anand Parekh, U.S. Department of Health and Human Services Deputy Assistant Secretary for Health, and Dr. Samuel Posner, Preventing Chronic Disease Editor in Chief, about the definition and burden of multiple chronic conditions in the United States.  Created: 5/20/2013 by Preventing Chronic Disease (PCD), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 5/20/2013.

  15. Treating Chronic Myeloid Leukemia by Phase

    Science.gov (United States)

    ... Myeloid Leukemia (CML) Treating Chronic Myeloid Leukemia Treating Chronic Myeloid Leukemia by Phase Treatment options for people ... a stem cell donor with matching tissue type. Chronic phase The standard treatment for chronic phase CML ...

  16. [Chronic inflammatory demyelinating polyradiculoneuropathy].

    Science.gov (United States)

    Franques, J; Azulay, J-P; Pouget, J; Attarian, S

    2010-06-01

    Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a demyelinating chronic neuropathy of immune origin whose diagnosis is based upon clinical, biological and electrophysiological data; previously critical to the diagnosis the nerve biopsy is now restricted to the rare situations where accurate diagnosis cannot be reached using these data alone. CIDP are mainly idiopathic, but a few associated diseases must be sought for as they require specific attention. Such associated diseases must particularly be discussed when the manifestations are severe or resistant to immunomodulating or immunosuppressive agents. Indeed, idiopathic CIDP are usually responsive to these treatments. The effectiveness of these treatments is limited by the importance of the secondary axonal loss. The dependence or the resistance may sometimes justify the association of several immunomodulating treatments. A single randomized controlled trial support the use of cytotoxic drugs and none with rituximab.

  17. Chronic intestinal pseudoobstruction syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Yeon, Kyung Mo; Seo, Jeong Kee; Lee, Yong Seok [Seoul National University Children' s Hospital, Seoul (Korea, Republic of)

    1992-03-15

    Chronic intestinal pseudoobstruction syndrome is a rare clinical condition in which impaired intestinal peristalsis causes recurrent symptoms of bowel obstruction in the absence of a mechanical occlusion. This syndrome may involve variable segments of small or large bowel, and may be associated with urinary bladder retention. This study included 6 children(3 boys and 3 girls) of chronic intestinal obstruction. Four were symptomatic at birth and two were of the ages of one month and one year. All had abdominal distension and deflection difficulty. Five had urinary bladder distension. Despite parenteral nutrition and surgical intervention(ileostomy or colostomy), bowel obstruction persisted and four patients expired from sepses within one year. All had gaseous distension of small and large bowel on abdominal films. In small bowel series, consistent findings were variable degree of dilatation, decreased peristalsis(prolonged transit time) and microcolon or microrectum. This disease entity must be differentiated from congenital megacolon, ileal atresia and megacystis syndrome.

  18. Bilateral chronic subdural hematoma

    DEFF Research Database (Denmark)

    Andersen-Ranberg, Nina Christine; Poulsen, Frantz Rom; Bergholt, Bo

    2017-01-01

    OBJECTIVE Bilateral chronic subdural hematoma (bCSDH) is a common neurosurgical condition frequently associated with the need for retreatment. The reason for the high rate of retreatment has not been thoroughly investigated. Thus, the authors focused on determining which independent predictors...... are associated with the retreatment of bCSDH with a focus on surgical laterality. METHODS In a national database of CSDHs (Danish Chronic Subdural Hematoma Study) the authors retrospectively identified all bCSDHs treated in the 4 Danish neurosurgical departments over the 3-year period from 2010 to 2012....... Univariate and multivariate analyses were performed to determine the relationship between retreatment of bCSDH and clinical, radiological, and surgical variables. RESULTS Two hundred ninety-one patients with bCSDH were identified, and 264 of them underwent unilateral (136 patients) or bilateral (128 patients...

  19. Chronic pneumonitis of infancy

    Energy Technology Data Exchange (ETDEWEB)

    Abe, Katsumi; Kamata, Noriko; Okazaki, Eiwa [Department of Radiology, Tokyo Metropolitan Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677 (Japan); Moriyama, Sachiko; Funata, Nobuaki [Department of Pathology, Tokyo Metropolitan Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677 (Japan); Takita, Junko; Yamada, Hideo; Takayama, Naohide [Department of Pediatrics, Tokyo Metropolitan Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677 (Japan)

    2002-07-01

    Chronic pneumonitis of infancy (CPI) is a very rare lung disease in infants and young children. We report a 33-day-old infant with CPI, focusing on the radiologic aspects of the disease. Chest radiographs showed variable and non-specific appearances including ground-glass shadowing, consolidation, volume loss, and hyperinflation. Dense alveolar opacities progressed as CPI advanced. The radiologic features of our case reflected pathologic changes. (orig.)

  20. Renal failure (chronic)

    OpenAIRE

    Clase, Catherine

    2011-01-01

    Chronic renal failure is characterised by a gradual and sustained decline in renal clearance or glomerular filtration rate (GFR). Continued progression of renal failure will lead to renal function too low to sustain healthy life. In developed countries, such people will be offered renal replacement therapy in the form of dialysis or renal transplantation. Requirement for dialysis or transplantation is termed end-stage renal disease (ESRD).Diabetes, glomerulonephritis, hypertension, pyelone...

  1. Chronic Stress and Performance

    Science.gov (United States)

    2011-09-01

    to the cannabinoid CB(1) receptor agonist HU-210 following chronic stress. European Journal of Pharmacology, 499(3), 291-295. Holscher, C. (1999...learning and memory, has the highest concentration of GC receptors in the brain and is involved in the stress response. Extensive research has... receptor levels than stressed male rodents (Konkle, 2003; Figueiredo, 2002; Handa, 1994). Males and females react to stress differently, so two models

  2. EBV CHRONIC INFECTIONS

    Directory of Open Access Journals (Sweden)

    Delia Racciatti

    2010-02-01

    Full Text Available

    The infection from Epstein-Barr virus (EBV or virus of infectious mononucleosis, together with other herpesviruses’ infections, represents a prototype of persistent viral infections characterized by the property of the latency. Although the reactivations of the latent infection are associated with the resumption of the viral replication and eventually with the “shedding”, it is still not clear if this virus can determine chronic infectious diseases, more or less evolutive. These diseases could include some pathological conditions actually defined as “idiopathic”and characterized by the “viral persistence” as the more credible pathogenetic factor. Among the so-called idiopathic syndromes, the “chronic fatigue syndrome” (CFS aroused a great interest around the eighties of the last century when, just for its relationship with EBV, it was called “chronic mononucleosis” or “chronic EBV infection”.

    Today CFS, as defined in 1994 by the CDC of Atlanta (USA, really represents a multifactorial syndrome characterized by a chronic course, where reactivation and remission phases alternate, and by a good prognosis

  3. Chronic arsenic poisoning.

    Science.gov (United States)

    Hall, Alan H

    2002-03-10

    Symptomatic arsenic poisoning is not often seen in occupational exposure settings. Attempted homicide and deliberate long-term poisoning have resulted in chronic toxicity. Skin pigmentation changes, palmar and plantar hyperkeratoses, gastrointestinal symptoms, anemia, and liver disease are common. Noncirrhotic portal hypertension with bleeding esophageal varices, splenomegaly, and hypersplenism may occur. A metallic taste, gastrointestinal disturbances, and Mee's lines may be seen. Bone marrow depression is common. 'Blackfoot disease' has been associated with arsenic-contaminated drinking water in Taiwan; Raynaud's phenomenon and acrocyanosis also may occur. Large numbers of persons in areas of India, Pakistan, and several other countries have been chronically poisoned from naturally occurring arsenic in ground water. Toxic delirium and encephalopathy can be present. CCA-treated wood (chromated copper arsenate) is not a health risk unless burned in fireplaces or woodstoves. Peripheral neuropathy may also occur. Workplace exposure or chronic ingestion of arsenic-contaminated water or arsenical medications is associated with development of skin, lung, and other cancers. Treatment may incklude the use of chelating agents such as dimercaprol (BAL), dimercaptosuccinic acid (DMSA), and dimercaptopanesulfonic acid (DMPS).

  4. Chronic Prostatitis/Chronic Pelvic Pain Syndrome Diagnosis and Treatment

    Directory of Open Access Journals (Sweden)

    Cem Nedim Yuceturk

    2014-08-01

    Full Text Available Chronic prostatitis is a chronic syndrome that effects men with a wide range of age. The etiology, natural history and appropriate therapy models are still unclear. According to the classification of National Institutes of Health; 4 types of prostatitis were defined; acute bacterial prostatitis (category I, chronic bacterial prostatitis (category II, chronic nonbacterial prostatitis/chronic pelvic pain syndrome (category III and asymptomatic prostatitis (category IV.Since microorganisms can only be isolated from a small percent of patients, empiric treatment is given to the most of the men. Multidisciplinary approach to the patients with suspected chronic prostatitis will help clinicians to play an active role in the treatment and prevent unnecessary medical therapies. [Archives Medical Review Journal 2014; 23(4.000: 691-702

  5. 基于层次分析法的面制主食杀菌及包装生产线设计与试验%Design and experiment of aseptic packaging line of staple wheat food with analytic hierarchy process method

    Institute of Scientific and Technical Information of China (English)

    徐雪萌; 屈凌波; 徐芸

    2016-01-01

    A design of aseptic packaging system integrated as the end part of the staple wheat food product line is studied, in order to keep the quality of the staple wheat food in the period of the distribution and sale.There are 3 basic parts in the aseptic packaging system, i.e. drying unit, compound sterilization units and packaging unit, considering influence factors for the food quality during storage and circulation as well as fresh-keeping packaging technology. Three basic parts can be freely used for different kinds of staple wheat food. Four technical schemes of aseptic packaging line are established according to different kinds of drying, sterilization and packaging techniques. The 4 schemes are studied with the analytic hierarchy process (AHP) method. In the AHP analysis process, the hierarchy with 3 criteria i.e. working performance, economic efficiency and reliability, and 9 sub-criteria is established. Through evaluation and priority considering, the optimum scheme is chosen. The aseptic packaging line is carefully designed, which is composed of the infrared drying unit, compound sterilization units of ultraviolet (UV), low temperature, Ozone, packaging machine, and reasonable product flow. In order to achieve industrial production of aseptic packaging for different kinds of staple wheat food, the line can be program-controlled with adjustable parameters, such as drying time, drying temperature, sterilization time, UV illumination intensity and Ozone intensity. The aseptic packaging system is set up in accordance with the above optimum scheme by the AHP method. Chinese steamed bread made of flour with primary moisture content of 43% have been processed by the compound sterilization units of aseptic packaging system under the condition of 4℃,relative humidity (RH) of 50%-70%, UV illumination intensity of 90-100µW/m2 and Ozone intensity of 40-60 mg/m3. For processed and the naturally placed Chinese steamed bread, the comparative tests of color, texture and

  6. Chronic radiation syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Akleyev, Alexander V. [Urals Research Centre for Radiation Medicine, Chelyabinsk (Russian Federation). Clinical Dept.

    2014-04-01

    Comprehensive analysis of chronic radiation syndrome, covering epidemiology, pathogenesis, pathoanatomy, diagnosis and treatment. Based on observations in a unique sample of exposed residents of the Techa riverside villages in the Urals. Casts new light on the condition. Of value for all practitioners and researchers with an interest in chronic radiation syndrome. This book covers all aspects of chronic radiation syndrome (CRS) based on observations in a unique sample of residents of the Techa riverside villages in the southern Urals who were exposed to radioactive contamination in the 1950s owing to releases of liquid radioactive wastes from Mayak Production Association, which produced plutonium for weapons. In total, 940 cases of CRS were diagnosed in this population and these patients were subjected to detailed analysis. The opening chapters address the definition and classification of CRS, epidemiology and pathogenesis, covering molecular and cellular mechanisms, radioadaptation, and the role of tissue reactions. The pathoanatomy of CRS during the development and recovery stages is discussed for all organ systems. Clinical manifestations of CRS at the different stages are then described in detail and the dynamics of hematopoietic changes are thoroughly examined. In the following chapters, principles of diagnosis (including assessment of the exposure doses to critical organs) and differential diagnosis from a wide range of other conditions are discussed and current and potential treatment options, described. The medical and social rehabilitation of persons with CRS is also covered. This book, which casts new light on the condition, will be of value for all practitioners and researchers with an interest in CRS.

  7. Approaching chronic cough.

    Science.gov (United States)

    Poulose, Vijo; Tiew, Pei Yee; How, Choon How

    2016-02-01

    Chronic cough is one of the most common reasons for referral to a respiratory physician. Although fatal complications are rare, it may cause considerable distress in the patient's daily life. Western and local data shows that in patients with a normal chest radiograph, the most common causes are postnasal drip syndrome, postinfectious cough, gastro-oesophageal reflux disease and cough variant asthma. Less common causes are the use of angiotensin-converting enzyme inhibitors, smoker's cough and nonasthmatic eosinophilic bronchitis. A detailed history-taking and physical examination will provide a diagnosis in most patients, even at the primary care level. Some cases may need further investigations or specialist referral for diagnosis.

  8. Chronic cough in children.

    Science.gov (United States)

    Acosta, Rigoberto; Bahna, Sami L

    2014-08-01

    Cough is probably the most common cause of seeking medical care in pediatric practice. Most acute cough is caused by infection and usually resolves within less than 4 weeks. If it lasts longer, it is considered chronic and deserves investigation to identify the underlying cause, which can be almost any of a wide variety of illnesses of the respiratory tract and certain extrathoracic conditions. This review provides an optimal approach for diagnosis through a skillful history taking, physical examination, and selection of appropriate tests.

  9. Variáveis clínicas e laboratoriais para o diagnóstico diferencial entre meningites asséptica e piogênica em crianças Laboratorial and clinical variables to the differential diagnosis between aseptic and pyogenic meningitis in children

    Directory of Open Access Journals (Sweden)

    Rita Lucena

    1997-09-01

    Full Text Available Foram estudadas informações obtidas do prontuário de 573 crianças com idade entre 1 mês e 15 anos e diagnóstico de meningite, internadas no Hospital Couto Maia, na cidade de Salvador-Bahia, no período de janeiro-1990 a dezembro-1992. Crises epilépticas, diminuição do nível de consciência e rigidez de nuca foram mais frequentes no grupo com meningite bacteriana. Glicorraquia menor que 45 mg/dL, proteinorraquia igual ou superior a 140 mg/dL e celularidade liquórica superior a 600 cels/mm³ mostraram-se preditores de meningite piogênica. A análise da curva ROC foi utilizada para estabelecer o melhor ponto de corte nas medidas liquóricas de celularidade, proteínas e glicose capaz de predizer meningite bacteriana. Os resultados encontrados enfatizam que informações clínicas, obtidas com a anamnese e o exame neurológico, e liquóricas simples, definidas pelos níveis de proteína, glicose e análise da celularidade, podem ser utilizadas como medidas de grande acurácia para diferenciar meningite piogênica de asséptica em crianças.We reviewed the charts of 573 children with a final diagnosis of pyogenic or aseptic meningitis, who were hospitalized in a large reference hospital for the treatment of infectious disease, from January 1990 to December 1992. Seizures, decreased consciousness, nuchal rigidity were more frequent in bacterial than in aseptic meningitis. A cerebrospinal fluid (CSF glucose level lower than 45 mg/dL, a protein level equal or greater than 140 mg/dL and cell count greater than 600/mm³ were predictors of pyogenic meningitis. Receiver operating characteristic curve analysis was used to assess the best point in CSF measures of leukocytes, glucose and protein that could predict bacterial meningitis. These results suggest that clinicians should differentiate bacterial from aseptic meningitis in children with greater accuracy utilizing only clinical and simple CSF data.

  10. The Chronic Poverty Report 2005

    OpenAIRE

    The Chronic Poverty Research Centre, CPRC

    2005-01-01

    The report examines what chronic poverty is and why it matters, who the chronically poor are, where they live, what causes poverty to be persistent and what should be done about it. It argues that approaches to development policy must acknowledge the agency of the chronically poor themselves in overcoming their poverty. But they also need real commitment, matched by actions and resources, to support their efforts to attain their rights and overcome the obstacles that trap them in poverty.

  11. Treatment Strategies for Chronic Cases

    Directory of Open Access Journals (Sweden)

    Susan M Lord

    2003-01-01

    Full Text Available The treatment of chronic somatic pain, including pain referred to the head, neck, shoulder girdle and upper limb from somatic structures, is addressed. Levels of evidence for the various treatments that have been prescribed for chronic whiplash associated disorders are considered. The challenge to find a treatment strategy for chronic pain after whiplash that completely relieves the condition and prevents its sequelae is reviewed.

  12. Late and chronic Lyme disease.

    Science.gov (United States)

    Donta, Sam T

    2002-03-01

    This article reviews the late and chronic manifestations of Lyme disease. Special attention is given to the chronic manifestations of the disease, detailing its pathogenesis, clinical spectrum, and laboratory criteria for the diagnosis. Based on experimental evidence and experience, approaches to the successful treatment of the late and chronic disease are outlined. Much additional work is needed to improve the understanding of the underlying pathophysiology of the disease, its diagnosis and treatment.

  13. Chronic avulsive injuries of childhood

    Energy Technology Data Exchange (ETDEWEB)

    Donnelly, L.F.; Helms, C.A. [Dept. of Radiology, Duke Univ. Medical Center, Durham, NC (United States); Bisset, G.S. III [Dept. of Radiology, Duke Univ. Medical Center, Durham, NC (United States)]|[Department of Pediatrics, Duke University Medical Center, Durham, NC (United States); Squire, D.L. [Department of Pediatrics, Duke University Medical Center, Durham, NC (United States)

    1999-03-01

    Children and adolescents are prone to avulsive injuries related to a combination of their propensity for great strength, ability to sustain extreme levels of activity, and immature growing apophyses. Appropriate interpretation of imaging studies showing chronic avulsive injuries is essential so that the irregularity and periostitis that can be associated with chronic avulsions is not misinterpreted as probable malignancy. This article reviews the chronic avulsive injuries of childhood. (orig.) With 12 figs., 8 refs.

  14. Understanding Biofilms in Chronic Sinusitis.

    Science.gov (United States)

    Tajudeen, Bobby A; Schwartz, Joseph S; Palmer, James N

    2016-02-01

    Chronic sinusitis is a burdensome disease that has substantial individual and societal impact. Although great advances in medical and surgical therapies have been made, some patients continue to have recalcitrant infections. Microbial biofilms have been implicated as a cause of recalcitrant chronic sinusitis, and recent studies have tried to better understand the pathogenesis of chronic sinusitis as it relates to microbial biofilms. Here, we provide an overview of biofilms in chronic sinusitis with emphasis on pathogenesis, treatment, and future directions. In addition, recent evidence is presented, elucidating the role of bitter taste receptors as a possible key factor leading to biofilm formation.

  15. Diagnostic dilemmas in chronic urticaria.

    Science.gov (United States)

    Toubi, E; Grattan, C; Zuberbier, T

    2015-06-01

    The European Academy of Allergy and Clinical Immunology (EAACI)/Global Allergy and Asthma European Network (GA(2) LEN)/European Dermatology Forum (EDF)/World Allergy Organization (WAO) recently published updated recommendations for the classification, diagnosis and management of chronic urticaria (CU). This article discusses several cases of CU that provide examples of how the recommendations in the guidelines can be implemented in the diagnosis of chronic spontaneous urticaria (CSU) (also called chronic idiopathic urticaria [CIU]), chronic inducible urticaria (CINDU) or CU with comorbidities.

  16. Meta-analysis of the risk factors of aseptic necrosis of bone in patients with systemic lupus erythematosus%系统性红斑狼疮并发无菌性骨坏死危险因素的Meta分析

    Institute of Scientific and Technical Information of China (English)

    李桂叶; 赵孟君; 马丽; 王国春; 吴东海

    2010-01-01

    目的 探讨系统性红斑狼疮(SLE)并发无菌性骨坏死的危险因素.方法 应用Meta分析方法 对国内外14篇关于SLE并发无菌性骨坏死危险因素的病例对照研究结果进行综合分析;运用Review Manager 4.2进行一致性检验及合并比值比(OR值)和95%可信区间(95%CI)的计算.结果 SLE合并无菌性骨坏死的危险因素的OR值及95%CI分别是:雷诺现象2.43(1.12~5.29),口腔溃疡2.33(1.11~4.88),肾脏受累1.76(1.27~2.44),血管炎4.65(1.62~13.33),高脂血症3.28(1.76~6.12),抗磷脂抗体2.06(0.84~5.06).结论 糖皮质激素是SLE患者发生无菌性骨坏死的重要因素,但不是唯一因素.雷诺现象、口腔溃疡、肾脏受累、血管炎、高脂血症是SLE并发无菌性骨坏死的主要危险因素.%Objective To investigate the major risk factors of aseptic necrosis of bone in patients with systemic lupus erythemattrsus (SLE),and thus provide evidence for decision-making on prevention.Methods Meta-analysis Was used to systemically evaluate the 14 case-control studies about the risk factors of aseptic necrosis of bone in patients with SLE.Review Manager 4.2 Was utilized to carry out homogeneity checking and calculate the pooled odds ratio (OR) with 95% confidence interval.Results The OR values of risk factor of AVN in patients with SLE and 95% CI were as follows:Raynaud's phenomenon 2.43(1.12~5.29):dental ulcer 2.33(1.11~4.88);renal involvement 1.76(1.27~2.44);vasculitis 4.65(1.62~13.33):hyperlipidemia 3.28(1.76~6.12);anti-phospholipid antibody(APL)2.06(0.84~5.06):hypocomplementemia 0.63(0.35~1.14).Conclusion Glucocorticosteroid is an important risk factor in inducing aseptic necrosis of bone in patients with SLE,but it is not the only factor.Raynaud's phenomenon,dental ulcer,renal involve-ment,vasculitis and hyperlipidemia are major risk factors of aseptic necrosis of bone in patients with SLE.

  17. Chronic diseases and mental disorder.

    NARCIS (Netherlands)

    Verhaak, P.F.M.; Heijmans, M.J.W.M.; Peters, L.; Rijken, M.

    2005-01-01

    The aim of this study was to achieve a better understanding of the relationship between chronic medical illness and mental distress. Therefore, the association between chronic medical illness and mental distress was analysed, taking into account the modifying effects of generic disease characteristi

  18. Anemia in Chronic Kidney Disease

    Science.gov (United States)

    ... High Blood Pressure Heart Disease Mineral & Bone Disorder Anemia in Chronic Kidney Disease What is anemia? Anemia is a condition in which the body ... function as well as they should. How is anemia related to chronic kidney disease? Anemia commonly occurs ...

  19. Chronic Kidney Disease and Medicines

    Science.gov (United States)

    ... from our online catalog. Alternate Language URL Español Chronic Kidney Disease and Medicines: What You Need to Know Page ... What you need to know Because you have chronic kidney disease, you should take steps to protect your kidneys. ...

  20. Obinutuzumab in chronic lymphocytic leukemia.

    Science.gov (United States)

    Dupuis, Jehan

    2015-09-01

    Obinutuzumab is the second next-generation monoclonal anti-CD20 antibody (after ofatumumab) to enter clinical practice in chronic lymphocytic leukemia. Its superiority in association with chlorambucil as compared with chlorambucil alone has led to its approval as a first-line treatment for chronic lymphocytic leukemia, for patients who are not candidates for a more intensive treatment.

  1. [Histopathologic study of chronic sinusitis].

    Science.gov (United States)

    Wayoff, M; Parache, R M; Bodelet, B; Gazel, P

    1983-01-01

    The conventional histopathology of the sinus is a criterium for the therapeutic indication, since it is possible to distinguish between granulomatous chronic sinusitis, chronic sinusitis with oedema and nasal polyposis. Each one of these clinical pictures has his own etiology and requires a specific therapeutic approach.

  2. [Chronic pyelonephritis in polycystic kidney].

    Science.gov (United States)

    Todorov, V; Penkova, S; Monov, A

    1989-01-01

    The characteristics of chronic pyelonephritis are studied in 37 patients out of a total of 53 patients with proved renal polycystosis. A group of 71 patients with chronic pyelonephritis selected at random are used as a control group. The frequency of chronic pyelonephritis among the patients with renal polycystosis is 69.8%. The difference between the mean age of the patients with renal polycystosis and chronic pyelonephritis and the patients with renal polycystosis without chronic pyelonephritis is 8.6 years. A significant difference is established between these two groups of patients concerning the frequency of symptomatic hypertension--89.2% for the patients with renal polycystosis and chronic pyelonephritis and 45% for the patients with uncomplicated renal polycystosis. A similar difference is established also for the renal failure--respectively 64.9% and 37.5%. The frequency of hypertension and chronic renal failure is lower in the control group of patients. 59% of the patients with renal polycystosis and chronic pyelonephritis have significant bacteriuria, E. coli and Proteus being the most frequently isolated bacteria but Pseudomonas shows the highest drug resistance. The isolated bacteria are most sensitive to nitroxoline and aminoglycoside antibiotics.

  3. Chronic Obstructive Pulmonary Disease (COPD)

    Science.gov (United States)

    ... term that is used to include chronic bronchitis, emphysema, or a combination of both conditions. Asthma is also a disease where it is difficult ... with COPD to also have some degree of asthma. What is chronic ... back to their original size. In emphysema, the walls of some of the alveoli have ...

  4. Pharmacologic Agents for Chronic Diarrhea

    OpenAIRE

    Lee, Kwang Jae

    2015-01-01

    Chronic diarrhea is usually associated with a number of non-infectious causes. When definitive treatment is unavailable, symptomatic drug therapy is indicated. Pharmacologic agents for chronic diarrhea include loperamide, 5-hydroxytryptamine type 3 (5-HT3) receptor antagonists, diosmectite, cholestyramine, probiotics, antispasmodics, rifaximin, and anti-inflammatory agents. Loperamide, a synthetic opiate agonist, decreases peristaltic activity and inhibits secretion, resulting in the reductio...

  5. Refractory chronic cluster headache

    DEFF Research Database (Denmark)

    Mitsikostas, Dimos D; Edvinsson, Lars; Jensen, Rigmor H

    2014-01-01

    Chronic cluster headache (CCH) often resists to prophylactic pharmaceutical treatments resulting in patients' life damage. In this rare but pragmatic situation escalation to invasive management is needed but framing criteria are lacking. We aimed to reach a consensus for refractory CCH definition...... for clinical and research use. The preparation of the final consensus followed three stages. Internal between authors, a larger between all European Headache Federation members and finally an international one among all investigators that have published clinical studies on cluster headache the last five years....... Eighty-five investigators reached by email. Proposed criteria were in the format of the International Classification of Headache Disorders III-beta (description, criteria, notes, comments and references). Following this evaluation eight drafts were prepared before the final. Twenty-four (28...

  6. [Chronic occupational metallic mercurialism].

    Science.gov (United States)

    Faria, Marcília de Araújo Medrado

    2003-02-01

    This is a review on current knowledge of chronic occupational mercurialism syndrome. Major scientific studies and reviews on clinical manifestation and physiopathology of mercury poisoning were evaluated. The search was complemented using Medline and Lilacs data. Erethism or neuropsychological syndrome, characterized by irritability, personality change, loss of self-confidence, depression, delirium, insomnia, apathy, loss of memory, headaches, general pain, and tremors, is seen after exposure to metallic mercury. Hypertension, renal disturbances, allergies and immunological conditions are also common. Mercury is found in many different work processes: industries, gold mining, and dentistry. As prevention measures are not often adopted there is an increasing risk of mercury poisoning. The disease has been under diagnosed even though 16 clinical forms of mercury poisoning are described by Brazilian regulations. Clinical diagnosis is important, especially because abnormalities in the central nervous, renal and immunological systems can be detected using current medical technology, helping to develop the knowledge and control measures for mercurialism.

  7. Chronic hypophosphatemic osteopathy

    Energy Technology Data Exchange (ETDEWEB)

    Koppers, B.; Schmid, L.; Hofmann, E.; Sauer, E.

    1980-07-01

    The process of chronic hypophosphatemic vitamine D-resistant rickets is described by observation of two cases. With the male patient - our first case - the disease was sporadic and had not been recognized for a long time. In his early adulthood it manifested itself as Umbauzonen (pseudofractures) in the larger context of active osteomalacia. It was possible to observe the pseudofractures before and while the patient was medicamentously treated. High doses of vitamine D 3 and dosage of phosphate mitigated the complaints although with respect to the radiological, scintigraphical, humoral and histological findings there was only slow improvement or no improvement at all. The patient's daughter is affected by the disease as well. In her case the pathological signs of her bones became better when treated with vitamine D 3.

  8. Chronic endometritis and infertility

    Science.gov (United States)

    Park, Hyun Jong; Kim, You Shin; Yoon, Tae Ki

    2016-01-01

    Chronic endometritis (CE) is a condition involving the breakdown of the peaceful co-existence between microorganisms and the host immune system in the endometrium. A majority of CE cases produce no noticeable signs or mild symptoms, and the prevalence rate of CE has been found to be approximately 10%. Gynecologists and pathologists often do not focus much clinical attention on CE due to the time-consuming microscopic examinations necessary to diagnose CE, its mild clinical manifestations, and the benign nature of the disease. However, the relationship between CE and infertility-related conditions such as repeated implantation failure and recurrent miscarriage has recently emerged as an area of inquiry. In this study, we reviewed the literature on the pathophysiology of CE and how it may be associated with infertility, as well as the literature regarding the diagnosis and treatment of CE. In addition, we discuss the value of hysteroscopic procedures in the diagnosis and treatment of CE. PMID:28090456

  9. Mozart's chronic subdural hematoma.

    Science.gov (United States)

    Drake, M E

    1993-11-01

    No commemoration of the bicentennial of Mozart's death would be complete without some consideration of that premature yet predictable demise. Mozart's premonitions of death are well known and apparently played a role in the composition of the K.626 Requiem and perhaps other works. His death has traditionally been ascribed to infectious causes, chiefly rheumatic fever or post-streptococcal glomerulonephritis, exacerbated by intemperance and chronic penury. Pathology has been difficult because of his supposed burial in a pauper's grave, the location and contents of which were later supposedly lost. Mozart's burial place in St. Mark's Cemetery in Vienna was known and, in the parlance of the day, "reorganized" a decade later, as the occupants of plots were disinterred to make room for the more recently decreased. A skull believed to the Mozart's was saved by the successor of the gravedigger who had supervised Mozart's burial, and then passed into the collections of the anatomist Josef Hyrtl, the municipality of Salzburg, and the Mozarteum museum (Salzburg). Forensic reconstruction of soft tissues related to this skull reveals substantial concordance with Mozart's portraits. The skull suggests premature closure of the metopic suture, which has been suggested on the basis of his physiognomy. A left temporal fracture and concomitant erosions raise the question of chronic subdural hematoma, which would be consistent with several falls in 1789 and 1790 and could have caused the weakness, headaches, and fainting he experienced in 1790 and 1791. Aggressive bloodletting to treat suspected rheumatic fever could have decompensated such a lesion to produce his death on December 5, 1791.

  10. [Conservative therapy of chronic sinusitis].

    Science.gov (United States)

    Reiss, Michael; Reiss, Gilfe

    2012-01-01

    The chronic rhinosinusitis is defined as chronic inflammation of the nose and nasal sinuses, with or without nasal polyps. Patients suffering from chronic rhinosinusitis report about nasal obstruction and secretion, olfactory impairment, head and facial pain. These symptoms cause also considerable impact on quality of life. Therefore, an adequate rhinological diagnostics as well as therapies are essential. This paper reviews the pharmacologic and non-pharmacologic therapy of chronic rhinosinusitis. First choice of therapy should be topical glucocorticoids. The application of glucocorticoids causes anti-inflammatory and certain curative effects. Hypertonic salt solutions improve nasal symptoms. Long-term therapy with oral macrolides might improve median to severe symptoms of chronic rhinosinusitis without nasal polyps. An additional therapy with antihistamines is possible in patients with an allergy. Adaptive desensitization in patients suffering from analgesic-intolerance associating among other with nasal polyps is currently the single causal therapy. Therefore, frequency of endonasal revision surgery is reduced after desensitization.

  11. Understanding anemia of chronic disease.

    Science.gov (United States)

    Fraenkel, Paula G

    2015-01-01

    The anemia of chronic disease is an old disease concept, but contemporary research in the role of proinflammatory cytokines and iron biology has shed new light on the pathophysiology of the condition. Recent epidemiologic studies have connected the anemia of chronic disease with critical illness, obesity, aging, and kidney failure, as well as with the well-established associations of cancer, chronic infection, and autoimmune disease. Functional iron deficiency, mediated principally by the interaction of interleukin-6, the iron regulatory hormone hepcidin, and the iron exporter ferroportin, is a major contributor to the anemia of chronic disease. Although anemia is associated with adverse outcomes, experimental models suggest that iron sequestration is desirable in the setting of severe infection. Experimental therapeutic approaches targeting interleukin-6 or the ferroportin-hepcidin axis have shown efficacy in reversing anemia in either animal models or human patients, although these agents have not yet been approved for the treatment of the anemia of chronic disease.

  12. Microbial Biofilms and Chronic Wounds

    Science.gov (United States)

    Omar, Amin; Wright, J. Barry; Schultz, Gregory; Burrell, Robert; Nadworny, Patricia

    2017-01-01

    Background is provided on biofilms, including their formation, tolerance mechanisms, structure, and morphology within the context of chronic wounds. The features of biofilms in chronic wounds are discussed in detail, as is the impact of biofilm on wound chronicity. Difficulties associated with the use of standard susceptibility tests (minimum inhibitory concentrations or MICs) to determine appropriate treatment regimens for, or develop new treatments for use in, chronic wounds are discussed, with alternate test methods specific to biofilms being recommended. Animal models appropriate for evaluating biofilm treatments are also described. Current and potential future therapies for treatment of biofilm-containing chronic wounds, including probiotic therapy, virulence attenuation, biofilm phenotype expression attenuation, immune response suppression, and aggressive debridement combined with antimicrobial dressings, are described. PMID:28272369

  13. Adjusting to Chronic Health Conditions.

    Science.gov (United States)

    Helgeson, Vicki S; Zajdel, Melissa

    2017-01-03

    Research on adjustment to chronic disease is critical in today's world, in which people are living longer lives, but lives are increasingly likely to be characterized by one or more chronic illnesses. Chronic illnesses may deteriorate, enter remission, or fluctuate, but their defining characteristic is that they persist. In this review, we first examine the effects of chronic disease on one's sense of self. Then we review categories of factors that influence how one adjusts to chronic illness, with particular emphasis on the impact of these factors on functional status and psychosocial adjustment. We begin with contextual factors, including demographic variables such as sex and race, as well as illness dimensions such as stigma and illness identity. We then examine a set of dispositional factors that influence chronic illness adjustment, organizing these into resilience and vulnerability factors. Resilience factors include cognitive adaptation indicators, personality variables, and benefit-finding. Vulnerability factors include a pessimistic attributional style, negative gender-related traits, and rumination. We then turn to social environmental variables, including both supportive and unsupportive interactions. Finally, we review chronic illness adjustment within the context of dyadic coping. We conclude by examining potential interactions among these classes of variables and outlining a set of directions for future research.

  14. Common Questions About Chronic Prostatitis.

    Science.gov (United States)

    Holt, James D; Garrett, W Allan; McCurry, Tyler K; Teichman, Joel M H

    2016-02-15

    Chronic prostatitis is relatively common, with a lifetime prevalence of 1.8% to 8.2%. Risk factors include conditions that facilitate introduction of bacteria into the urethra and prostate (which also predispose the patient to urinary tract infections) and conditions that can lead to chronic neuropathic pain. Chronic prostatitis must be differentiated from other causes of chronic pelvic pain, such as interstitial cystitis/bladder pain syndrome and pelvic floor dysfunction; prostate and bladder cancers; benign prostatic hyperplasia; urolithiasis; and other causes of dysuria, urinary frequency, and nocturia. The National Institutes of Health divides prostatitis into four syndromes: acute bacterial prostatitis, chronic bacterial prostatitis (CBP), chronic nonbacterial prostatitis (CNP)/chronic pelvic pain syndrome (CPPS), and asymptomatic inflammatory prostatitis. CBP and CNP/CPPS both lead to pelvic pain and lower urinary tract symptoms. CBP presents as recurrent urinary tract infections with the same organism identified on repeated cultures; it responds to a prolonged course of an antibiotic that adequately penetrates the prostate, if the urine culture suggests sensitivity. If four to six weeks of antibiotic therapy is effective but symptoms recur, another course may be prescribed, perhaps in combination with alpha blockers or nonopioid analgesics. CNP/CPPS, accounting for more than 90% of chronic prostatitis cases, presents as prostatic pain lasting at least three months without consistent culture results. Weak evidence supports the use of alpha blockers, pain medications, and a four- to six-week course of antibiotics for the treatment of CNP/CPPS. Patients may also be referred to a psychologist experienced in managing chronic pain. Experts on this condition recommend a combination of treatments tailored to the patient's phenotypic presentation. Urology referral should be considered when appropriate treatment is ineffective. Additional treatments include pelvic

  15. Correlation between Aminotransferase Ratio (AST/ALT and Other Biochemical Parameters in Chronic Liver Disease of Viral Origin

    Directory of Open Access Journals (Sweden)

    Shah Md Fazlul Karim

    2015-03-01

    Full Text Available Background: In recent years the ratio of aspartate aminotransferase (AST to alanine aminotransferase (ALT in patients of chronic liver disease (CLD of various origins has gained much attention. This variable is readily available, easy to interpret, and inexpensive and the clinical utility of the AST/ALT ratio in the diagnostic workup of patients with CLD is quite promising. Objective: The present study was designed to find out the link between aminotransferase (AST/ALT ratio with commonly measured biochemical parameters of liver function tests in CLD of viral origin. Materials and method: This cross sectional study was carried out in the department of Biochemistry, Sir Salimullah Medical College, Dhaka, Bangladesh. Forty four biopsy proven diagnosed subjects of chronic viral hepatitis without cirrhosis of both sex were selected purposively. With aseptic precaution 5 mL venous blood was collected from each subject and common liver function tests (serum AST, ALT, AST/ALT ratio, alkaline phosphatase, total bilirubin, serum total protein, serum albumin, serum globulin, serum albumin/globulin ratio, prothrombin time and viral serology (HBsAg, Anti HDV antibody, Anti HCV antibody were performed. Data were analyzed by SPSS version 19 for Windows. Pearson’s correlation test was done to determine association between AST/ALT with other biochemical parameters. Results: Mean(±SD age of the study subjects was 32.55±10.55 years (range 20-50 years with 48 (77.7% male and 14 (22.6% female subjects. Pearson’s correlation test was done between AST to ALT ratio with other biochemical parameters and prothrombin time showed significant positive correlation (p <0.01. Conclusion: In our study we found significant positive correlation between AST/ALT with prothrombin time in CLD subjects without cirrhosis.

  16. Laryngeal hypersensitivity in chronic cough.

    Science.gov (United States)

    Hull, J H; Menon, A

    2015-12-01

    Patients with chronic cough often report symptoms arising in the throat, in response to non-specific stimuli. Accordingly, the concept of a 'hypersensitivity' of the larynx in chronic cough has evolved over the past ten years. Patients with cough and laryngeal hypersensitivity frequently report features that overlap other laryngeal dysfunction syndromes, including a tendency for the vocal cords to inappropriately adduct. The mechanisms underlying laryngeal hypersensitivity in chronic cough are currently unclear, however recent studies provide new clinical and physiological techniques to aid detection and monitoring of laryngeal hypersensitivity. This review provides an overview of the current state of knowledge in this field.

  17. Multimodal Treatment of Chronic Pain.

    Science.gov (United States)

    Dale, Rebecca; Stacey, Brett

    2016-01-01

    Most patients with chronic pain receive multimodal treatment. There is scant literature to guide us, but when approaching combination pharmacotherapy, the practitioner and patient must weigh the benefits with the side effects; many medications have modest effect yet carry significant side effects that can be additive. Chronic pain often leads to depression, anxiety, and deconditioning, which are targets for treatment. Structured interdisciplinary programs are beneficial but costly. Interventions have their place in the treatment of chronic pain and should be a part of a multidisciplinary treatment plan. Further research is needed to validate many common combination treatments.

  18. [Chronic ataxia in childhood].

    Science.gov (United States)

    Erazo Torricelli, Ricardo

    2013-01-01

    Chronic ataxias are an heterogeneous group of disorders that affect the child at different ages. Thus, the congenital forms, generally non progressive are observed from first months of life and are expressed by hypotonia and motor delay long before the ataxia became evident. The cerebral magnetic resonance images (MRI) may be diagnostic in some pictures like Joubert syndrome. The group of progressive hereditary ataxias, usually begin after the infant period. The clinical signs are gait instability and ocular apraxia that can be associated with oculocutaneous telangiectasias (ataxia-telangiesctasia) or with sensory neuropathy (Friedreich ataxia). In this review are briefly described congenital ataxias and in more detailed form the progressive hereditary ataxias autosomal recessive, autosomal dominants and mitochondrials. The importance of genetic study is emphasized, because it is the key to obtain the diagnosis in the majority of these diseases. Although now there are no treatments for the majority of progressive hereditary ataxias, some they have like Refsum disease, vitamine E deficiency, Coenzyme Q10 deficiency and others, thus the diagnosis in these cases is even more important. At present the diagnosis of childhood hereditary ataxia not yet treatable is fundamental to obtain suitable handling, determine a precise outcome and to give to the family an opportune genetic counseling.

  19. [Chronic pain in geriatrics].

    Science.gov (United States)

    Kennes, B

    2001-06-01

    Pain is frequent in communicative or no-communicative, ambulatory, institutionalized or hospitalized veterans. It is associated with severe comorbidity so much more than chronic pain could be neglected and expressed of atypical manner or masked by the absence of classical symptoms in particular in case of dementia or of sensory disorders. Pain detection by clinic examination or by pain assessment's methods and adequate approach by pharmacological and non pharmacological therapies are essential for correct pain management. On pharmacological plan, the strategy of the O.M.S. landings is applicable owing to a more particular attention to secondary effects and drugs interactions. AINS must be manipulated with prudence. There are no reasons to exclude opioides from the therapeutic arsenal but with a reduction of the starting doses, a regular adaptation and a very attentive survey. In drugs of landing 2, tramadol reveals itself as efficient and better tolerated as the codeine and dextropropoxyphene has to be to avoid. The obtaining of a satisfactory result depends on a regular assessment of the pain in a context of polydisciplinar approach (physicians, nurses, paramedicals, other care givers).

  20. Chronic recurrent multifocal osteomyelitis.

    Science.gov (United States)

    Roderick, Marion R; Ramanan, Athimalaipet V

    2013-01-01

    Chronic recurrent multifocal osteomyelitis (CRMO) is an autoinflammatory bone disease occurring primarily in children and adolescents. Episodes of systemic inflammation occur due to immune dysregulation without autoantibodies, pathogens or antigen-specific T cells. CRMO is characterised by the insidious onset of pain with swelling and tenderness over the affected bones. Clavicular involvement was the classical description; however, the metaphyses and epiphyses of long bones are frequently affected. Lesions may occur in any bone, including vertebrae. Characteristic imaging includes bone oedema, lytic areas, periosteal reaction and soft tissue reaction. Biopsies from affected areas display polymorphonuclear leucocytes with osteoclasts and necrosis in the early stages. Subsequently, lymphocytes and plasma cells predominate followed by fibrosis and signs of reactive new bone forming around the inflammation. Diagnosis is facilitated by the use of STIR MRI scanning, potentially obviating the need for biopsy and unnecessary long-term antibiotics due to incorrect diagnosis. Treatment options include non-steroidal anti-inflammatory drugs and bisphosphonates. Biologics have been tried in resistant cases with promising initial results. Gene identification has not proved easy although research in this area continues. Early descriptions of the disease suggested a benign course; however, longer-term follow up shows that it can cause significant morbidity and longer-term disability. Although it has always been thought of as very rare, the prevalence is likely to be vastly underestimated due to poor recognition of the disease.

  1. Chronic lymphocytic leukaemia

    Science.gov (United States)

    Kipps, Thomas J.; Stevenson, Freda K.; Wu, Catherine J.; Croce, Carlo M.; Packham, Graham; Wierda, William G.; O’Brien, Susan; Gribben, John; Rai, Kanti

    2017-01-01

    Chronic lymphocytic leukaemia (CLL) is a malignancy of CD5+ B cells that is characterized by the accumulation of small, mature-appearing lymphocytes in the blood, marrow and lymphoid tissues. Signalling via surface immunoglobulin, which constitutes the major part of the B cell receptor, and several genetic alterations play a part in CLL pathogenesis, in addition to interactions between CLL cells and other cell types, such as stromal cells, T cells and nurse-like cells in the lymph nodes. The clinical progression of CLL is heterogeneous and ranges from patients who require treatment soon after diagnosis to others who do not require therapy for many years, if at all. Several factors, including the immunoglobulin heavy-chain variable region gene (IGHV) mutational status, genomic changes, patient age and the presence of comorbidities, should be considered when defining the optimal management strategies, which include chemotherapy, chemoimmunotherapy and/or drugs targeting B cell receptor signalling or inhibitors of apoptosis, such as BCL-2. Research on the biology of CLL has profoundly enhanced our ability to identify patients who are at higher risk for disease progression and our capacity to treat patients with drugs that selectively target distinctive phenotypic or physiological features of CLL. How these and other advances have shaped our current understanding and treatment of patients with CLL is the subject of this Primer. PMID:28102226

  2. Pregnancy and chronic kidney disease.

    Science.gov (United States)

    Davison, John M; Lindheimer, Marshall D

    2011-01-01

    This article reviews the association of chronic renal disease and pregnancy. Included are discussions of guidelines for counseling pregnant women with underlying chronic renal disease who are considering conceiving as well as management of those already pregnant. Specifically highlighted are recent studies that question the validity of using estimated glomerular filtration rate and other formulae and questions of whether we should strive to replace the classic counseling approaches based primarily on serum creatinine levels with guidelines based on chronic kidney disease classification. The article concludes with a review as well as a critique of recent research on the prevalence of preeclampsia in women with underlying chronic renal disease, as well as if women with preeclampsia and underlying kidney disease have accelerated courses toward end-stage renal disease.

  3. Nitazoxanide for chronic hepatitis C

    DEFF Research Database (Denmark)

    Nikolova, Kristiana; Gluud, Christian; Grevstad, Berit

    2014-01-01

    BACKGROUND: Hepatitis C infection is a disease of the liver caused by the hepatitis C virus. The estimated number of chronically infected people with hepatitis C virus worldwide is about 150 million people. Every year, another three to four million people acquire the infection. Chronic hepatitis C......) and ribavirin was the approved standard treatment for chronic hepatitis C. In 2011, first-generation direct-acting antivirals (DAAs) have been licensed, for use in combination with peginterferon and ribavirin for treating hepatitis C virus genotype 1 infection. Nitazoxanide is another antiviral drug with broad...... antiviral activity and may have potential as an effective alternative, or an addition to standard treatment for the treatment of the hepatitis C virus. OBJECTIVES: To assess the benefits and harms of nitazoxanide in people with chronic hepatitis C virus infection. SEARCH METHODS: We searched The Cochrane...

  4. Chronic Conditions among Medicare Beneficiaries

    Data.gov (United States)

    U.S. Department of Health & Human Services — The data used in the chronic condition reports are based upon CMS administrative enrollment and claims data for Medicare beneficiaries enrolled in the...

  5. Treatment of chronic inflammatory neuropathies

    NARCIS (Netherlands)

    F. Eftimov

    2015-01-01

    This thesis focuses on the efficacy of existing and alternative treatments in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and multifocal motor neuropathy (MMN) and explores predictors of treatment response in patients with CIDP treated with corticosteroids. The efficacy of intra

  6. Chronic diseases in elderly men

    DEFF Research Database (Denmark)

    Nielsen, Morten Frost Munk; Wraae, Kristian; Gudex, Claire

    2012-01-01

    OBJECTIVE: prevalence estimates for chronic diseases and associated risk factors are needed for priority setting and disease prevention strategies. The aim of this cross-sectional study was to estimate the self-reported and clinical prevalence of common chronic disorders in elderly men. STUDY......-reported data on risk factors and disease prevalence were compared with data from hospital medical records. RESULTS: physical inactivity, smoking and excessive alcohol intake were reported by 27, 22 and 17% of the study population, respectively. Except for diabetes, all the chronic diseases investigated......: the study showed a high prevalence of detrimental life style factors including smoking, excessive alcohol consumption and physical inactivity in elderly Danish men. Except for diabetes and respiratory disease, chronic diseases were underreported and in particular erectile dysfunction and osteoporosis were...

  7. Tai chi and chronic pain.

    Science.gov (United States)

    Peng, Philip W H

    2012-01-01

    In the last 2 decades, a growing body of research aimed at investigating the health benefits of Tai Chi in various chronic health conditions has been recognized in the literature. This article reviewed the history, the philosophy, and the evidence for the role of Tai Chi in a few selected chronic pain conditions. The ancient health art of Tai Chi contributes to chronic pain management in 3 major areas: adaptive exercise, mind-body interaction, and meditation. Trials examining the health benefit of Tai Chi in chronic pain conditions are mostly low quality. Only 5 pain conditions were reviewed: osteoarthritis, fibromyalgia, rheumatoid arthritis, low back pain, and headache. Of these, Tai Chi seems to be an effective intervention in osteoarthritis, low back pain, and fibromyalgia. The limitations of the Tai Chi study design and suggestions for the direction of future research are also discussed.

  8. Trulance Approved for Chronic Constipation

    Science.gov (United States)

    ... news/fullstory_163171.html Trulance Approved for Chronic Constipation Drug designed to stimulate upper gastrointestinal tract To ... U.S. Food and Drug Administration to treat persistent constipation of unknown (idiopathic) cause in adults. Some 42 ...

  9. Role of cerebrospinal fluid procalcitonin in identification of intracranial bacterial infection and aseptic meningitis%脑脊液降钙素原在鉴别颅内细菌性感染与无菌性脑膜炎中的作用

    Institute of Scientific and Technical Information of China (English)

    李幽然; 张国军; 高之宪; 季楠; 张力伟; 张扬; 王丽娟; 张洪欣; 康熙雄

    2015-01-01

    目的 探讨脑脊液降钙素原(PCT)在鉴别成人颅内细菌性感染与无菌性脑膜炎中的作用.方法 回顾性分析2013年10月至2014年3月首都医科大学附属北京天坛医院神经外科脑肿瘤术后48 ~ 72 h出现疑似细菌性颅内感染症状的患者178例.行脑脊液常规、生化及PCT的检测.按照颅内感染的诊断标准,将其分为细菌性感染组(50例)和无菌性脑膜炎组(128例).比较两组脑脊液PCT及传统脑脊液检测指标的变化情况,应用受试者工作特征曲线(ROC)分析脑脊液PCT对鉴别感染及无菌性脑膜炎的价值.结果 与无菌性脑膜炎组比较,细菌性感染组脑脊液中白细胞数量、多核细胞比例、蛋白质含量、PCT含量均增高,糖降低,差异均有统计学意义(均P<0.01);氯化物差异无统计学意义.其中感染组脑脊液PCT中位数(范围)为0.15 ng/ml(0 ~3.09 ng/ml),无菌性脑膜炎组为0 ng/ml(0 ~0.46 ng/ml).ROC结果显示,PCT鉴别诊断细菌性颅内感染曲线下面积为0.746,诊断阈值为0.075 ng/ml,敏感性为68.0%,特异性为72.7%,阳性预测值为49.3%,阴性预测值85.3%.脑脊液PCT与白细胞、多核细胞比例、蛋白含量呈正相关(r分别为0.446、0.453、0.482,均P<0.01;与糖呈负相关(r=-0.201,P=0.007).结论 脑脊液PCT检测对诊断神经外科术后细菌性颅内感染具有重要的临床应用价值.%Objective To investigate the role of the cerebrospinal fluid procalcitonin (PCT) in the identification of intracranial bacterial infection and aseptic meningitis in adults.Methods A total of 178 patients with the suspected symptom of intracranial bacterial infection at 48 to 72 h after neurosurgical brain tumor surgery at the Department of Neurosurgery,Beijing Tiantan Hospital,Capital Medical University from October 2013 to March 2014 were analyzed retrospectively.The cerebrospinal fluid routine,biochemical and procalcitonin tests were performed.According to the diagnostic

  10. The Ubiquity of Chronic Illness.

    Science.gov (United States)

    Fonseca, Claudia; Fleischer, Soraya; Rui, Taniele

    2016-01-01

    This is a review of five different books dealing with some aspect of what might be termed a "chronic illness" - Alzheimer's disease, lupus, addiction, erectile dysfunction, and leprosy. The array of different subjects examined in these books points to the negotiable limits of this hugely open category. What exactly constitutes an "illness"? Why not use a less biomedical term instead: "disturbance", "problem", or simply "condition"? And how are we to understand "chronic" - simply as the flipside of "acute" or "curable"?

  11. Occupational chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Omland, Oyvind; Würtz, Else Toft; Aasen, Tor Børvig

    2014-01-01

    Occupational-attributable chronic obstructive pulmonary disease (COPD) presents a substantial health challenge. Focusing on spirometric criteria for airflow obstruction, this review of occupational COPD includes both population-wide and industry-specific exposures.......Occupational-attributable chronic obstructive pulmonary disease (COPD) presents a substantial health challenge. Focusing on spirometric criteria for airflow obstruction, this review of occupational COPD includes both population-wide and industry-specific exposures....

  12. Neurovascular Unit in Chronic Pain

    Science.gov (United States)

    Radu, Beatrice Mihaela; Bramanti, Placido; Osculati, Francesco; Flonta, Maria-Luisa; Radu, Mihai; Bertini, Giuseppe; Fabene, Paolo Francesco

    2013-01-01

    Chronic pain is a debilitating condition with major socioeconomic impact, whose neurobiological basis is still not clear. An involvement of the neurovascular unit (NVU) has been recently proposed. In particular, the blood-brain barrier (BBB) and blood-spinal cord barrier (BSCB), two NVU key players, may be affected during the development of chronic pain; in particular, transient permeabilization of the barrier is suggested by several inflammatory- and nerve-injury-based pain models, and we argue that the clarification of molecular BBB/BSCB permeabilization events will shed new light in understanding chronic pain mechanisms. Possible biases in experiments supporting this theory and its translational potentials are discussed. Moving beyond an exclusive focus on the role of the endothelium, we propose that our understanding of the mechanisms subserving chronic pain will benefit from the extension of research efforts to the NVU as a whole. In this view, the available evidence on the interaction between analgesic drugs and the NVU is here reviewed. Chronic pain comorbidities, such as neuroinflammatory and neurodegenerative diseases, are also discussed in view of NVU changes, together with innovative pharmacological solutions targeting NVU components in chronic pain treatment. PMID:23840097

  13. Chronic Constipation: Current Treatment Options

    Directory of Open Access Journals (Sweden)

    Louis Wing Cheong Liu

    2011-01-01

    Full Text Available Chronic constipation is a common functional gastrointestinal disorder that affects patients of all ages. In 2007, a consensus group of 10 Canadian gastroenterologists developed a set of recommendations pertaining to the management of chronic constipation and constipation-dominant irritable bowel syndrome. Since then, tegaserod has been withdrawn from the Canadian market. A new, highly selective serotonin receptor subtype 4 agonist, prucalopride, has been examined in several large, randomized, placebo-controlled trials demonstrating its efficacy and safety in the management of patients with chronic constipation. Additional studies evaluating the use of stimulant laxatives, polyethylene glycol and probiotics in the management of chronic constipation have also been published. The present review summarizes the previous recommendations and new evidence supporting different treatment modalities – namely, diet and lifestyle, bulking agents, stool softeners, osmotic and stimulant laxatives, prucalopride and probiotics in the management of chronic constipation. A brief summary of lubiprostone and linaclotide is also presented. The quality of evidence is presented by adopting the Grading of Recommendations, Assessment, Development and Evaluation system. Finally, a management pyramid for patients with chronic constipation is proposed based on the quality of evidence, impact of each modality on constipation and on general health, and their availabilities in Canada.

  14. Chronic Cough in Otorhinolaryngologic Routine

    Directory of Open Access Journals (Sweden)

    Palheta Neto, Francisco Xavier

    2011-04-01

    Full Text Available Introduction: The chronic cough is sometimes manifested as an imprecise symptom, but of great importance for both the diagnosis and the prognosis. In an otorhinolaryngologic approach, several illnesses that can occur with it can be numbered, including 2 of the 3 main causes of chronic cough. Objective: To identify the main otorhinolaryngologic diseases showing the chronic cough as one of their manifestations. Method: A literature's revision was performed in several scientific articles, specialized books and consultation in Birene and Scielo databases. Literature's revision: cough production in the upper airways is usually associated with an inflammatory reaction by stimulating sensitive receptors of these areas or by mechanic stimulus. The main cause of the chronic cough in the otorhinolaryngology day-to-day is the post-nasal drip, gathering together by itself 02 of the most common diseases: rhinitis and sinusitis. Laryngitis as a result of gastroesophageal reflux (GER stands out in the index of chronic cough etiology, but it is not as severe as GER . Neoplasias are also somewhat frequent causes of cough, and the difficulty in diagnosing the cough cause is common in this disease group. Motility disorder, laryngeal irritation persistence, parasitic disease and injuries by inhalation of toxic products were also found as a cause of cough for longer than 03 months. Conclusion:Chronic cough is a frequent and important finding in otorhinolaryngology and cannot be underestimated, and a careful anamnesis is the best way to determine the etiology and perform a correct treatment for the patient's disease.

  15. Guideline of Chronic Urticaria Beyond.

    Science.gov (United States)

    Fine, Lauren M; Bernstein, Jonathan A

    2016-09-01

    Urticaria is a relatively common condition that if chronic can persist for weeks, months or years and affect quality of life significantly. The etiology is often difficult to determine, especially as it becomes chronic. Many cases of chronic urticaria are thought to be autoimmune, although there is no consensus that testing for autoimmunity alters the diagnostic or management strategies or outcomes. Many times, urticaria is easily managed with antihistamines and/or short courses of oral corticosteroids, but too often control is insufficient and additional therapies must be added. For years, immune modulating medications, such as cyclosporine and Mycophenolate Mofetil, have been used in cases refractory to antihistamines and oral corticosteroids, although the evidence supporting their efficacy and safety has been limited. Omalizumab was recently approved for the treatment of chronic urticaria unresponsive to H1-antagonists. This IgG anti-IgE monoclonal antibody has been well demonstrated to safely and effectively control chronic urticaria at least partially in approximately 2/3 of cases. However, the mechanism of action and duration of treatment for omalizumab is still unclear. It is hoped that as the pathobiology of chronic urticaria becomes better defined, future therapies that target specific mechanistic pathways will be developed that continue to improve the management of these often challenging patients.

  16. Neurovascular Unit in Chronic Pain

    Directory of Open Access Journals (Sweden)

    Beatrice Mihaela Radu

    2013-01-01

    Full Text Available Chronic pain is a debilitating condition with major socioeconomic impact, whose neurobiological basis is still not clear. An involvement of the neurovascular unit (NVU has been recently proposed. In particular, the blood-brain barrier (BBB and blood-spinal cord barrier (BSCB, two NVU key players, may be affected during the development of chronic pain; in particular, transient permeabilization of the barrier is suggested by several inflammatory- and nerve-injury-based pain models, and we argue that the clarification of molecular BBB/BSCB permeabilization events will shed new light in understanding chronic pain mechanisms. Possible biases in experiments supporting this theory and its translational potentials are discussed. Moving beyond an exclusive focus on the role of the endothelium, we propose that our understanding of the mechanisms subserving chronic pain will benefit from the extension of research efforts to the NVU as a whole. In this view, the available evidence on the interaction between analgesic drugs and the NVU is here reviewed. Chronic pain comorbidities, such as neuroinflammatory and neurodegenerative diseases, are also discussed in view of NVU changes, together with innovative pharmacological solutions targeting NVU components in chronic pain treatment.

  17. Chronic inflammatory demyelinating polyradiculoneuropathy.

    Science.gov (United States)

    Van den Bergh, Peter Y K; Rajabally, Yusuf A

    2013-06-01

    Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is the most common autoimmune neuropathy. The diagnosis depends on the clinical presentation with a progressive or relapsing course over at least 2 months and electrophysiological evidence of primary demyelination. Whereas typical CIDP is quite easily recognizable because virtually no other neuropathies present with both distal and proximal motor and sensory deficit, atypical CIDP, focal and multifocal variants in particular, may represent a difficult diagnostic challenge. CIDP very likely is an underdiagnosed condition as suggested also by a positive correlation between prevalence rates and sensitivity of electrophysiological criteria. Since no 'gold standard' diagnostic marker exists, electrophysiological criteria have been optimized to be at the same time as sensitive and as specific as possible. Additional supportive laboratory features, such as increased spinal fluid protein, MRI abnormalities of nerve segments, and in selected cases nerve biopsy lead to the correct diagnosis in the large majority of the cases. Objective clinical improvement following immune therapy is also a useful parameter to confirm the diagnosis. The pathogenesis and pathophysiology of CIDP remain poorly understood, but the available evidence for an inflammatory origin is quite convincing. Steroids, intravenous immunoglobulin (IVIG), and plasma exchange (PE) have been proven to be effective treatments. IVIG usually leads to rapid improvement, which is useful in severely disabled patients. Repeat treatment over regular time intervals for many years is often necessary. The effect of steroids is slower and the side-effect profile may be problematic, but they may induce disease remission more frequently than IVIG. An important and as of yet uncompletely resolved issue is the evaluation of long-term outcome to determine whether the disease is still active and responsive to treatment.

  18. Effect observation on locking plate combining with autologous iliac bone graft in the treatment of aseptic nonunion after surgery of long bone fractures of extremities%锁定钢板联合自体髂骨植骨治疗四肢长骨干骨折术后无菌性骨不连的效果观察

    Institute of Scientific and Technical Information of China (English)

    刘志军

    2014-01-01

    Objective To research and evaluate the effect of locking plate combining with autologous iliac bone graft on treating aseptic nonunion after surgery of long bone fractures of extremities. Methods 43 cases of patients with aseptic nonunion on limb long bone caused by bone fixation failure were accepted in our hospital from January 2006 to June 2013.All of patients were treated with locking plate combining with autologous iliac bone graft. Results All patients were followed up.The follow-up time ranged from 7 to 24 months,with an average of 12.6 months.All of nonunion were healed in (5.9±1.0) months.Cut surface infection occurred in 3 cases (6.9%),which were cured after treatment.The slow-ly healed wound were 2 cases (4.7%) and limb about 2 cm shortened in 1 case (2.3%).None of cases suffered from malunion.At the final follow-up,joint activity improved more significantly compared with before surgery,including 35 cases (81.4%) with excellent effect,7 cases (16.3%) moderate,and 1 case (2.3%) poor. Conclusion In the treatment of patients with aseptic nonunion after surgery of long bone fractures of extremities,using locking plate for internal fixation is a curative therapy.Locking plate combining with autologous iliac bone graft can provide reliable fixation stability for fractura,and shows good functions on bone induction and conduction,so it obtains a favorable effect.%目的:研究评价锁定钢板联合自体髂骨植骨治疗四肢长骨干骨折术后无菌性骨不连的临床效果。方法选取2006年1月~2013年6月因内固定失败而造成四肢长骨干无菌性骨不连患者43例,均采用锁定钢板固定联合自体髂骨植骨进行治疗。结果患者均获得随访,随访时间7~24个月,平均12.6个月。骨不连均愈合,愈合时间为(5.9±1.0)个月。3例(6.9%)出现切口表面感染,经治疗后均痊愈;2例(4.7%)切口延迟愈合;1例(2.3%)出现肢体短缩<2 cm,无一例发生骨折畸形愈合。末次随访时关节活

  19. Sternal development in the pediatric population: evaluation using computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Delgado, Jorge; Jaimes, Camilo; Gwal, Kriti [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Jaramillo, Diego; Ho-Fung, Victor [The Children' s Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Department of Radiology, Philadelphia, PA (United States)

    2014-04-15

    The normal development of the sternum using CT imaging is not known. To describe the normal development of the sternum in children on chest CT imaging. CT imaging of 300 patients (150 male, 150 female), mean age: 4.97 years (range: 0.01-9.9 years), were evaluated retrospectively. The presence and number of ossification centers in the manubrium, each individual mesosternal segment and the xiphoid were reviewed. Additionally, the vertical and horizontal fusion between ossification centers was evaluated. Differences among age and gender were calculated. Descriptive statistics, analysis of variances (ANOVA), chi-square and Fisher exact tests were performed for statistical analysis. Manubrium: A single ossification center was seen in 88% of cases and two or three ossification centers were seen in 12%. More manubrial ossification centers were correlated to a younger age (P < 0.001, R = -0.2). Mesosternum: Majority of patients had a single ossification center in the first segment (85%). The majority of patients had double ossification centers in the second and third segments (51% and 64%, respectively). No ossification center was seen in the fourth segment in 38% of patients. No significant difference among the age of vertical ossification between mesosternal segments was found. (ANOVA; P > 0.05). Xiphoid: Absence was seen in 67% of the patients. Bifid xiphoid was seen in 1% of the patients. The normal development of the different components of the sternum is a process with wide variation among children. The large variability of mesosternal ossification center types should not be confused with pathology. (orig.)

  20. 陕南3所三级甲等医院清洁手术预防使用抗菌药物的调查分析%Investigation on the preventive use of antibiotics in aseptic operation in three grade A class 3 hospitals in the south Shaanxi province

    Institute of Scientific and Technical Information of China (English)

    程建峰; 杨鹏

    2012-01-01

    目的 调查3所三级甲等医院清洁手术预防使用抗菌药物的情况,评价其应用的合理性.方法 抽取3所医院2011年9月清洁手术(甲状腺、乳腺、腹股沟疝、肾脏、颅脑手术)病例各50份,冠状动脉造影病例各20份,对病例是否使用抗菌药物、抗菌药物的品种、给药时机、给药时限及抗菌药物联合使用情况等进行统计分析.结果 清洁手术及冠状动脉造影诊断预防使用抗菌药物3所医院合计总体使用比例分别为67.3%和57.25%,品种选择合格率为60.8%,用药时机合格率为83.3%,使用疗程合格率为37.5%.结论 3所医院清洁手术预防使用抗菌药物,仅给药时机情况较好,抗菌药物的使用率、品种的选择及使用疗程都存在一定的不合理性.%Objective To investigate on the preventive use of antibiotics of three grade A class 3 hospitals,and to evaluate the rationality of the usage. Methods 50 cases of aseptic operations (thyroid,breast,inguinal hernia,kidney and brain operations) in September of 2011 of the three hospitals and 20 cases of coronary angiography were analyzed in the aspect of utilization,kinds,administration time, time of therapy and the combined use frequency of antibiotics. Results The frequency of preventive using antibiotics was 67. 3 % and 57. 25 % , respectively in the aseptic operation and coronary angiography. The reasonable chosen rate of kinds was 60. 8%, the reasonable chosen rate of administration time was 83. 3% ,and the reasonable chosen rate of time of therapy was 37. 5%. Conclusions The utilization frequency, chosen of kinds and time of therapy of antibiotics are not as reasonable as requested except the administration time of antibiotics in these three grade A class 3 hospitals.

  1. Chronic fatigue and chronic fatigue syndrome: shifting boundaries and attributions.

    Science.gov (United States)

    Lloyd, A R

    1998-09-28

    The subjective symptom of "fatigue" is one of the most widespread in the general population and is a major source of healthcare utilization. Prolonged fatigue is often associated with neuropsychological and musculoskeletal symptoms that form the basis of several syndromal diagnoses including chronic fatigue syndrome, fibromyalgia, and neurasthenia, and is clearly not simply the result of a lack of force generation from the muscle. Current epidemiologic research in this area relies predominantly on self-report data to document the prevalence and associations of chronic fatigue. Of necessity, this subjective data source gives rise to uncertain diagnostic boundaries and consequent divergent epidemiologic, clinical, and pathophysiologic research findings. This review will highlight the impact of the case definition and ascertainment methods on the varying prevalence estimates of chronic fatigue syndrome and patterns of reported psychological comorbidty. It will also evaluate the evidence for a true postinfective fatigue syndrome.

  2. Management of chronic refractory cough.

    Science.gov (United States)

    Gibson, Peter G; Vertigan, Anne E

    2015-12-14

    Chronic refractory cough (CRC) is defined as a cough that persists despite guideline based treatment. It is seen in 20-46% of patients presenting to specialist cough clinics and it has a substantial impact on quality of life and healthcare utilization. Several terms have been used to describe this condition, including the recently introduced term cough hypersensitivity syndrome. Key symptoms include a dry irritated cough localized around the laryngeal region. Symptoms are not restricted to cough and can include globus, dyspnea, and dysphonia. Chronic refractory cough has factors in common with laryngeal hypersensitivity syndromes and chronic pain syndromes, and these similarities help to shed light on the pathophysiology of the condition. Its pathophysiology is complex and includes cough reflex sensitivity, central sensitization, peripheral sensitization, and paradoxical vocal fold movement. Chronic refractory cough often occurs after a viral infection. The diagnosis is made once the main diseases that cause chronic cough have been excluded (or treated) and cough remains refractory to medical treatment. Several treatments have been developed over the past decade. These include speech pathology interventions using techniques adapted from the treatment of hyperfunctional voice disorders, as well as the use of centrally acting neuromodulators such as gabapentin and pregabalin. Potential new treatments in development also show promise.

  3. Periodontitis in Chronic Heart Failure.

    Science.gov (United States)

    Fröhlich, Hanna; Herrmann, Kristina; Franke, Jennifer; Karimi, Alamara; Täger, Tobias; Cebola, Rita; Katus, Hugo A; Zugck, Christian; Frankenstein, Lutz

    2016-08-01

    Periodontal disease has been associated with an increased risk of cardiovascular events. The purpose of our study was to investigate whether a correlation between periodontitis and chronic heart failure exists, as well as the nature of the underlying cause. We enrolled 71 patients (mean age, 54 ± 13 yr; 56 men) who had stable chronic heart failure; all underwent complete cardiologic and dental evaluations. The periodontal screening index was used to quantify the degree of periodontal disease. We compared the findings to those in the general population with use of data from the 4th German Dental Health Survey. Gingivitis, moderate periodontitis, and severe periodontitis were present in 17 (24%), 17 (24%), and 37 (52%) patients, respectively. Severe periodontitis was more prevalent among chronic heart failure patients than in the general population. In contrast, moderate periodontitis was more prevalent in the general population (P <0.00001). The severity of periodontal disease was not associated with the cause of chronic heart failure or the severity of heart failure symptoms. Six-minute walking distance was the only independent predictor of severe periodontitis. Periodontal disease is highly prevalent in chronic heart failure patients regardless of the cause of heart failure. Prospective trials are warranted to clarify the causal relationship between both diseases.

  4. [Chronic polyradiculoneuritis and its frontiers].

    Science.gov (United States)

    Vallat, J M; Tabaraud, F; Magy, L; Macian, F

    2002-12-01

    The Chronic Inflammatory Demyelinating Polyradiculoneuropathies (CIDP) constitute a syndrome whose incidence is difficult to evaluate, and is probably underestimated. In the course of this presentation, we deliberately restricted discussion to issues raised in recent years concerning the extent of this syndrome. We discuss diagnostic criteria, especially electrophysiological ones. As the criteria proposed by the ad hoc committee of the American Academy of Neurology in 1991 have been questioned due to lack of sensitivity, new ones have been proposed recently. We briefly discuss the different types of chronic dysimmune demyelinating neuropathy: not only the CIDP, but also the Lewis and Sumner syndrome or multifocal inflammatory demyelinating neuropathy and the multiple conduction block neuropathies. At last, we point out the consistent finding of axonal involvement in the course of a chronic demyelinating neuropathy; over time, it can become pre-dominant, which may make diagnosis difficult by suggesting a chronic axonal neuropathy that may be assumed to be primary. Consideration of these points may help clinicians recognize more chronic dysimmune neuropathies, for which immunosuppressive therapy has been found to be effective.

  5. Risk factors for sternal wound infections and application of the STS score in coronary artery bypass graft surgery Fatores de risco para infecção de ferida esternal e aplicação do escore da STS em pacientes submetidos à cirurgia de revascularização miocárdica

    Directory of Open Access Journals (Sweden)

    Pedro Silvio Farsky

    2011-12-01

    Full Text Available BACKGROUND: Sternal wound infection (SWI after coronary artery bypass graft (CABG surgery is a major complication. Identifying patients at risk of SWI is essential for the application of preventive measures. OBJECTIVE: To identify the pre- and intra-operative risk factors, apply the STS risk score and determine the correlation between the risk score and microorganisms isolated from surgical wounds in a Brazilian hospital. METHODS: This is a retrospective analysis of a database of all CABG surgeries performed in a single institution from 2006 to 2008. Chi-square analysis was used for categorical variables and Student's t-test was used for quantitative variables. Multivariate logistic regression model was used to identify independent risk factors for SWI. P 40 kg/m² (OR 6.27, 95%CI 2.53-15.48; P40 kg/m², number of affected coronary arteries and use of bilateral internal thoracic artery were associated with a higher risk of infection. The STS risk score can be successfully used and there was no correlation between microorganisms, the score and risk factors at our institution.FUNDAMENTO: A infecção de ferida operatória esternal após cirurgia de revascularização miocárdica (CRM é uma grave complicação. Identificar pacientes com risco elevado é fundamental para introdução de medidas de preventivas. OBJETIVO: Identificar os fatores de risco pré e intra-operatórios, avaliar o escore de risco da STS e correlação entre o escore e os microorganismos isolados em ferida operatória em hospital brasileiro. MÉTODOS: Análise retrospectiva de um banco de dados prospectivamente coletado de todas as CRM realizadas em centro único, no período de 2006 a 2008. Teste do qui-quadrado foi utilizado para variáveis categóricas e teste t-Student, para variáveis quantitativas. Modelo multivariado por regressão logística foi utilizado para identificação de fatores de risco independente para infecção de ferida esternal. P40 kg/m² (OR 5,38; IC

  6. Aminoadamantanes for chronic hepatitis C

    DEFF Research Database (Denmark)

    Lamers, Mieke H; Broekman, Mark; Drenth, Joost Ph

    2014-01-01

    BACKGROUND: Around 3% of the world's population (approximately 160 million people) are chronically infected with hepatitis C virus. The proportion of infected people who develop clinical symptoms varies between 5% and 40%. Combination therapy with pegylated interferon-alpha plus ribavirin...... response in genotype 1 infected patients to at least 70%. There is therefore an unmet need for drugs that can achieve a higher proportion of sustained virological response. Aminoadamantanes are antiviral drugs used for treatment of patients with chronic hepatitis C. OBJECTIVES: To assess the beneficial...... and harmful effects of aminoadamantanes for patients with chronic hepatitis C infection by conducting a systematic review with meta-analyses of randomised clinical trials, as well as trial sequential analyses. SEARCH METHODS: We conducted electronic searches of the Cochrane Hepato-Biliary Group Controlled...

  7. [Neurosurgical treatment of chronic pain].

    Science.gov (United States)

    Fontaine, D; Blond, S; Mertens, P; Lanteri-Minet, M

    2015-02-01

    Neurosurgical treatment of pain used two kind of techniques: 1) Lesional techniques interrupt the transmission of nociceptive neural input by lesionning the nociceptive pathways (drezotomy, cordotomy, tractotomy…). They are indicated to treat morphine-resistant cancer pain and few cases of selected neuropathic pain. 2) Neuromodulation techniques try to decrease pain by reinforcing inhibitory and/or to limit activatory mechanisms. Chronic electrical stimulation of the nervous system (peripheral nerve stimulation, spinal cord stimulation, motor cortex stimulation…) is used to treat chronic neuropathic pain. Intrathecal infusion of analgesics (morphine, ziconotide…), using implantable pumps, allows to increase their efficacy and to reduce their side effects. These techniques can improve, sometimes dramatically, selected patients with severe and chronic pain, refractory to all other treatments. The quality of the analgesic outcome depends on the relevance of the indications.

  8. Peripheral neuromodulation in chronic migraine.

    Science.gov (United States)

    Perini, F; De Boni, A

    2012-05-01

    Patients with chronic migraines are often refractory to medical treatment. Therefore, they might need other strategies to modulate their pain, according to their level of disability. Neuromodulation can be achieved with several tools: meditation, biofeedback, physical therapy, drugs and electric neurostimulation (ENS). ENS can be applied to the central nervous system (brain and spinal cord), either invasively (cortical or deep brain) or non-invasively [cranial electrotherapy stimulation, transcranial direct current stimulation and transcranial magnetic stimulation]. Among chronic primary headaches, cluster headaches are most often treated either through deep brain stimulation or occipital nerve stimulation because there is a high level of disability related to this condition. ENS, employed through several modalities such as transcutaneous electrical nerve stimulation, interferential currents and pulsed radiofrequency, has been applied to the peripheral nervous system at several sites. We briefly review the indications for the use of peripheral ENS at the site of the occipital nerves for the treatment of chronic migraine.

  9. Pharmacological challenges in chronic pancreatitis

    DEFF Research Database (Denmark)

    Olesen, Anne Estrup; Brokjaer, Anne; Fischer, Iben Wendelboe Deleuran

    2014-01-01

    Drug absorption in patients with chronic pancreatitis might be affected by the pathophysiology of the disease. The exocrine pancreatic insufficiency is associated with changes in gastrointestinal intraluminal pH, motility disorder, bacterial overgrowth and changed pancreatic gland secretion....... Together these factors can result in malabsorption and may also affect the efficacy of pharmacological intervention. The lifestyle of chronic pancreatitis patients may also contribute to gastrointestinal changes. Many patients limit their food intake because of the pain caused by eating and in some cases...... food intake is more or less substituted with alcohol, tobacco and coffee. Alcohol and drug interaction are known to influence the pharmacokinetics by altering either drug absorption or by affecting liver metabolism. Since patients suffering from chronic pancreatitis experience severe pain, opioids...

  10. Chronic recurrent multifocal osteomyelitis (CRMO) and synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome with associated neutrophilic dermatoses: a report of seven cases and review of the literature.

    Science.gov (United States)

    Tlougan, Brook E; Podjasek, Joshua O; O'Haver, Judith; Cordova, Katherine B; Nguyen, Xuan H; Tee, Ronald; Pinckard-Hansen, Kay C; Hansen, Ronald C

    2009-01-01

    A growing body of literature has identified the association between neutrophilic dermatoses and multifocal, aseptic bone lesions in children, termed chronic recurrent multifocal osteomyelitis (CRMO). Classically, patients present with swelling, pain, and impaired mobility of the affected area, with skin lesions developing concurrently or in the future. Bone biopsy reveals inflammatory changes consistent with infectious osteomyelitis, but cultures and histologic staining invariably fail to identify an infectious source. Patients are refractory to antibiotic therapy, but dramatically respond to systemic steroids and may need to be maintained on low-dose steroids to prevent relapse. Numerous authors have suggested that CRMO and synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome lie along the same clinical spectrum. In fact some believe that CRMO is the pediatric presentation of SAPHO. The two syndromes share numerous characteristics, including osteitis, a unifocal or multifocal presentation, hyperostosis, and pustulosis, which all occur in a generally healthy individual. Our seven patients, five of whom were diagnosed with CRMO, and two of whom were diagnosed with SAPHO syndrome further strengthen the idea that CRMO and SAPHO syndrome do indeed lie along the same clinical spectrum. In addition, we include two rare cases of pediatric Sweet's syndrome with evidence of pathergy.

  11. Chronic renal disease in pregnancy.

    Science.gov (United States)

    Ramin, Susan M; Vidaeff, Alex C; Yeomans, Edward R; Gilstrap, Larry C

    2006-12-01

    The purpose of this review was to examine the impact of varying degrees of renal insufficiency on pregnancy outcome in women with chronic renal disease. Our search of the literature did not reveal any randomized clinical trials or meta-analyses. The available information is derived from opinion, reviews, retrospective series, and limited observational series. It appears that chronic renal disease in pregnancy is uncommon, occurring in 0.03-0.12% of all pregnancies from two U.S. population-based and registry studies. Maternal complications associated with chronic renal disease include preeclampsia, worsening renal function, preterm delivery, anemia, chronic hypertension, and cesarean delivery. The live birth rate in women with chronic renal disease ranges between 64% and 98% depending on the severity of renal insufficiency and presence of hypertension. Significant proteinuria may be an indicator of underlying renal insufficiency. Management of pregnant women with underlying renal disease should ideally entail a multidisciplinary approach at a tertiary center and include a maternal-fetal medicine specialist and a nephrologist. Such women should receive counseling regarding the pregnancy outcomes in association with maternal chronic renal disease and the effect of pregnancy on renal function, especially within the ensuing 5 years postpartum. These women will require frequent visits and monitoring of renal function during pregnancy. Women whose renal disease is further complicated by hypertension should be counseled regarding the increased risk of adverse outcome and need for blood pressure control. Some antihypertensives, especially angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers, should be avoided during pregnancy, if possible, because of the potential for both teratogenic (hypocalvaria) and fetal effects (renal failure, oliguria, and demise).

  12. Prevention Of Chronic Renal Diseases

    Directory of Open Access Journals (Sweden)

    Fejzi Alushi

    2011-10-01

    Full Text Available It is easier to prevent a disease than to cure it. This postulate is a foundation stone of the contemporary medicine, furthermore its mission. The Chronic Kidney Diseases (CKD, amongst them the Chronic Pyelonephrites (CP and the mass kidney reduction  take an important  place in human pathologies in general, and in particular in renal ones. The Chronic Pyelonephrites  are chronic renal pathologies, which on one side are of various causes and on the other side are multi systemic. At the same time they tend, earlier or later, depending on their course, to bring the patient towards the Chronic Kidney Insufficiency  in stage of uremia, consequently in need of substitution therapies e.g. dialysis, peritoneum dialysis or transplant. It is worthy to emphasize that from the prevention and correct cure of CP make profit the patients, the family, the state and in the last analyses  the entire society, because in that way the budget expense destined for the fore going substitution cures, dialysis, peritoneum dialysis or transplant, is considerably  reduced. The same should be mentioned  in relation to the CP and the mass kidney reduction, speaking about our country, which are still at the first place as the very cause of Chronic Kidney  Insufficiencies (CRI, later on advancing toward uremia and terminal uremia along with its grave consequences. In general  the very foundation of the CP is on  the  infections of urinary roads, in particular on the complicated ones, among them it should be mentioned-congenital kidney anomalies, renal calculosis  so much present in our country, and pathologies of segment or vesical-ureteral reflux, and rarely the pathologies of prostate.

  13. Management of chronic visceral pain

    DEFF Research Database (Denmark)

    Olesen, Anne E; Farmer, Adam D; Olesen, Søren S

    2016-01-01

    ' symptoms, adopting an empathic approach and taking time to educate patients. To optimize treatment and outcomes in chronic visceral pain we need to move away from approaches exclusively based on dealing with peripheral nociceptive input toward more holistic strategies, taking into account alterations......Despite marked differences in underlying pathophysiology, the current management of visceral pain largely follows the guidelines derived from the somatic pain literature. The effective management of patients with chronic visceral pain should be multifaceted, including both pharmacological...... in central pain processing....

  14. Bendamustine Plus Alemtuzumab for Refractory Chronic Lymphocytic Leukemia (CLL)

    Science.gov (United States)

    2013-08-20

    Recurrent Small Lymphocytic Lymphoma; Refractory Chronic Lymphocytic Leukemia; Stage III Chronic Lymphocytic Leukemia; Stage III Small Lymphocytic Lymphoma; Stage IV Chronic Lymphocytic Leukemia; Stage IV Small Lymphocytic Lymphoma

  15. Chronic Venous Disease under pressure

    NARCIS (Netherlands)

    S.W.I. Reeder (Suzan)

    2013-01-01

    textabstractIn chapter 1 we provide a general introduction of this thesis. Chronic venous disease (CVD) is a common medical condition that affects 2-64% of the worldwide population and leads to leg ulcers in 1% of the Western population. Venous leg ulceration (VLU) has an unfavorable prognosis with

  16. Electroacupuncture treatment of chronic insomniacs

    Institute of Scientific and Technical Information of China (English)

    RUAN Jing-wen; WANG Chu-huai; LIAO Xin-xue; YAN Ying-shuo; HU Yue-hua; RAO Zhong-dong; WEN Ming; ZENG Xiao-xiang; LAI Xin-sheng

    2009-01-01

    Background Due to the quick rhythm of life and work pressure, more and more people suffer from sleep quality problems. In this study, we investigated the effect of electroacupuncture on sleep quality of chronic insomniacs and the safety of electroacupuncture therapy.Methods Four courses of electroacupuncture treatment were applied to 47 patients. With pre-treatment and post-treatment self-control statistical method, Pittsburgh sleep quality index (PSQI) scores were used for evaluating sleep quality. Polysomnogram was used for detecting insomniacs' changes in sleep architecture. The safety of electroacupuncture was evaluated by monitoring the self-designed adverse events and side effects during treatment and post-treatment.Results Electroacupuncture considerably improved insomniacs' sleep quality and social function during the daytime.Electroacupuncture had certain repairing effect on the disruption in sleep architecture. At the same time,electroacupuncture prolonged slow wave sleep (SWS) time and relatively rapid eye movement sleep (REM sleep) time.There was no hangover, addiction or decrements in vigilance during the daytime (incidence rate was 0). However,insomnia rebound rate was about 23% within one month.Conclusions These results suggest that electroacupuncture has beneficial effect on sleep quality improvement in the patients with chronic insomnia, which may be associated with repairing sleep architecture, reconstructing sleep continuity,as well as prolonging SWS time and REM sleep time. Electroacupuncture treatment for chronic insomnia is safe.Therefore, electroacupuncture therapy could be a promising avenue of treatment for chronic insomnia.

  17. [Chronic prostatitis and Bechterew's disease].

    Science.gov (United States)

    Kohlicek, J; Svec, V

    1977-11-01

    A group of patients between 35 and 65 years old with chronic prostatitis were examined for the presence of Becherew's disease. In this connection the New York and Roman criterions for morbus Bechterew were applied. There were found one ankyosing spondylarthritis, one ankylosis of the sacroiliac joint, and 11 times a tentative sacroileitis were stated. Altogether the proved and tentative findings were only 3.68 per cent of all examinations. In our countries the morbus Bechterew is found in 0,21 per cent of the normal population. So the protion of the Bechterew's disease in patients with chronic prostatitis is indeed a little higher than average, but not so frequent as often pretended in recent times. After a second series 58 patients being treated because of Bechterew's disease of different stages and different terms were examined for the possibility of a simultaneously elapsing chronic prostatitis. A chronic prostatitis was found in 38 per cent of these patients which correspondents to the incidence published in literature for the medium-age manhood. Nobody of the test persons had complaints on the part of the urologenital tract.

  18. Treatment of chronic lymphocytic leukemia.

    Science.gov (United States)

    Ferrajoli, Alessandra; O'Brien, Susan M

    2004-04-01

    Treatment options for patients with chronic lymphocytic leukemia have changed over the past two decades. This article reviews the experience accumulated with the use of alkylating agents alone and in combination; purine analogues alone and in combination and monoclonal antibodies such as rituximab, and alemtuzumab alone and in combination. The results obtained with different treatment strategies are summarized, compared, and reviewed.

  19. [Operative treatment of chronic pleuritis].

    Science.gov (United States)

    Duzhyĭ, I D; Hres'ko, I Ia; Chumak, S O; Elastal, R Z

    2008-09-01

    Basing on the literature data and own experience, grounded on results of follow-up on 2000 patients, suffering an acute pleuritis and performance of more than 200 operative interventions--pleurectomy, the clinic-radiological classification of chronic pleuritis, mostly answering the practical health care necessities, was proposed by the authors.

  20. Chronic sphenoid rhinosinusitis: management challenge

    Directory of Open Access Journals (Sweden)

    Charakorn N

    2016-11-01

    Full Text Available Natamon Charakorn, Kornkiat Snidvongs Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand Abstract: Chronic sphenoid rhinosinusitis is a spectrum of inflammatory diseases in isolated sphenoid sinus which may persist over a period of 12 weeks. It is a different entity from other types of rhinosinusitis because clinical presentations include headache, visual loss or diplopia, and patients may or may not have nasal obstruction or nasal discharge. Nasal endoscopic examination is useful, and computed tomography is mandatory. The disease requires comprehensive knowledge and appropriate imaging technique for diagnosis. To treat patients with chronic sphenoid rhinosinusitis, surgical treatment with endoscopic transnasal sphenoidotomy is often required. As there are no recent updated reviews of chronic sphenoid rhinosinusitis, in this article, we review the anatomy of the sphenoid sinus and its clinical relationship with the clinical signs and symptoms of the disease, the imaging findings of each diagnosis and the comprehensive surgical techniques. Keywords: sphenoid sinus, sphenoid sinusitis, chronic, rhinosinusitis, fungal rhinosinusitis, mucocele

  1. Management of chronic hand eczema

    NARCIS (Netherlands)

    Diepgen, Thomas L.; Agner, Tove; Aberer, Werner; Berth-Jones, John; Cambazard, Frederic; Elsner, Peter; McFadden, John; Coenraads, Pieter Jan

    2007-01-01

    Hand eczema (HE) is one of the most frequent skin diseases and has often a chronically relapsing course with a poor prognosis resulting in a high social and economic impact for the individual and the society. In this article, we highlight the results of an expert workshop on the 'management of sever

  2. Fibromyalgia and Chronic Pain Syndromes

    Science.gov (United States)

    Choy, Ernest; Clauw, Daniel J.; Goldenberg, Don L.; Harris, Richard E.; Helfenstein, Milton; Jensen, Troels Staehelin; Noguchi, Koichi; Silverman, Stuart L.; Ushida, Takahiro; Wang, Guochun

    2016-01-01

    This manuscript, developed by a group of chronic pain researchers and clinicians from around the world, aims to address the state of knowledge about fibromyalgia (FM) and identify ongoing challenges in the field of FM and other chronic pain syndromes that may be characterized by pain centralization/amplification/hypersensitivity. There have been many exciting developments in research studies of the pathophysiology and treatment of FM and related syndromes that have the potential to improve the recognition and management of patients with FM and other conditions with FM-like pain. However, much of the new information has not reached all clinicians, especially primary care clinicians, who have the greatest potential to use this new knowledge to positively impact their patients’ lives. Furthermore, there are persistent misconceptions about FM and a lack of consensus regarding the diagnosis and treatment of FM. This paper presents a framework for future global efforts to improve the understanding and treatment of FM and other associated chronic pain syndromes, disseminate research findings, identify ways to enhance advocacy for these patients, and improve global efforts to collaborate and reach consensus about key issues related to FM and chronic pain in general. PMID:27022674

  3. Children, Sports, and Chronic Disease.

    Science.gov (United States)

    Goldberg, Barry

    1990-01-01

    Discusses four chronic diseases (cystic fibrosis, congenital heart disease, rheumatoid arthritis, and asthma) that affect American children. Many have their physical activities unnecessarily restricted, though sports and exercise can actually alleviate symptoms and improve their psychosocial development. Physicians are encouraged to prescribe…

  4. Lymphocyte 'homing' and chronic inflammation.

    Science.gov (United States)

    Sakai, Yasuhiro; Kobayashi, Motohiro

    2015-07-01

    Chronic inflammation is a response to prolonged exposure to injurious stimuli that harm and destroy tissues and promote lymphocyte infiltration into inflamed sites. Following progressive accumulation of lymphocytes, the histology of inflamed tissue begins to resemble that of peripheral lymphoid organs, which can be referred to as lymphoid neogenesis or formation of tertiary lymphoid tissues. Lymphocyte recruitment to inflamed tissues is also reminiscent of lymphocyte homing to peripheral lymphoid organs. In the latter, under physiological conditions, homing receptors expressed on lymphocytes adhere to vascular addressin expressed on high endothelial venules (HEVs), initiating a lymphocyte migration process composed of sequential adhesive interactions. Intriguingly, in chronic inflammation, HEV-like vessels are induced de novo, despite the fact that the inflamed site is not originally lymphoid tissue, and these vessels contribute to lymphocyte recruitment in a manner similar to physiological lymphocyte homing. In this review, we first describe physiological lymphocyte homing mechanisms focusing on vascular addressins. We then describe HEV-like vessel-mediated pathogenesis seen in various chronic inflammatory disorders such as Helicobacter pylori gastritis, inflammatory bowel disease (IBD), autoimmune pancreatitis and sclerosing sialadenitis, as well as chronic inflammatory cell neoplasm MALT lymphoma, with reference to our work and that of others.

  5. Hyperglycemia, tumorigenesis, and chronic inflammation.

    Science.gov (United States)

    Chang, Shu-Chun; Yang, Wei-Chung Vivian

    2016-12-01

    Hyperglycemia is the most prominent sign that characterizes diabetes. Hyperglycemia favors malignant cell growth by providing energy to cancer cells. Clinical studies also showed an increased risk of diabetes being associated with different types of cancers. In addition, poorly regulated glucose metabolism in diabetic patients is often found with increased levels of chronic inflammatory markers, e.g., interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α, and emerging evidence has highlighted activation of the immune response in the progression and development of cancer cells. Therefore, uncontrolled proinflammatory responses could conceivably create a chronic inflammatory state, promoting a tumor-favorable microenvironment and potentially triggering immune overactivation and cancer growth. To further understand how hyperglycemia contributes to immune overactivation, the tumor microenvironment and the development of chronic inflammation-associated tumors may provide insights into tumor biology and immunology. This paper provides a brief introduction to hyperglycemia-associated diseases, followed by a comprehensive overview of the current findings of regulatory molecular mechanisms of glycosylation on proteoglycans in the extracellular matrix under hyperglycemic conditions. Then, the authors discuss the role of hyperglycemia in tumorigenesis (particularly in prostate, liver, colorectal, and pancreatic cancers), as well as the contribution of hyperglycemia to chronic inflammation. The authors end with a brief discussion on the future perspectives of hyperglycemia/tumorigenesis and potential applications of alternative/effective therapeutic strategies for hyperglycemia-associated cancers.

  6. Chronic Kidney Disease and Kidney Failure

    Science.gov (United States)

    ... Education Visitor Information RePORT NIH Fact Sheets Home > Chronic Kidney Disease and Kidney Failure Small Text Medium Text Large Text Chronic Kidney Disease and Kidney Failure YESTERDAY One third of diabetic ...

  7. Pregabalin for Pain Treatment in Chronic Pancreatitis

    DEFF Research Database (Denmark)

    Olesen, Søren Schou; Bowense, S; Wilder-Smith, Oliver

    2011-01-01

    Intractable pain usually dominates the clinical presentation of chronic pancreatitis (CP). Slowing of electroencephalogram (EEG) rhythmicity has been associated with abnormal cortical pain processing in other chronic pain disorders. The aim of this study was to investigate the spectral distribution...

  8. Helping a Child Manage a Chronic Illness

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_160011.html Helping a Child Manage a Chronic Illness Feeling they have control over their ... News) -- Children and teens who feel confident handling a chronic illness on their own appear better able ...

  9. Chronic Fatigue Syndrome in Gulf War Veterans

    Science.gov (United States)

    ... Enter ZIP code here Enter ZIP code here Chronic Fatigue Syndrome in Gulf War Veterans Gulf War ... and be at least 10 percent disabling. About Chronic Fatigue Syndrome CFS is an unexplained, severe and ...

  10. Chronic Condition Public Use File (PUF)

    Data.gov (United States)

    U.S. Department of Health & Human Services — This release contains the Chronic Conditions Public Use Files (PUF) with information from Medicare claims. The CMS Chronic Conditions PUF is an aggregated file in...

  11. Effects of Mindfulness Meditation on Chronic Pain

    DEFF Research Database (Denmark)

    la Cour, Peter; Petersen, Marian

    2015-01-01

    OBJECTIVE: This randomized controlled clinical trial investigated the effects of mindfulness meditation on chronic pain. DESIGN: A total of 109 patients with nonspecific chronic pain were randomized to either a standardized mindfulness meditation program (mindfulness-based stress reduction [MBSR...

  12. Communication About Chronic Critical Illness

    Science.gov (United States)

    Nelson, Judith E.; Mercado, Alice F.; Camhi, Sharon L.; Tandon, Nidhi; Wallenstein, Sylvan; August, Gary I.; Morrison, R. Sean

    2008-01-01

    Background Despite poor outcomes, life-sustaining treatments including mechanical ventilation are continued for a large and growing population of patients with chronic critical illness. This may be owing in part to a lack of understanding resulting from inadequate communication between clinicians and patients and families. Our objective was to investigate the informational needs of patients with chronic critical illness and their families and the extent to which these needs are met. Methods In this prospective observational study conducted at 5 adult intensive care units in a large, university-affiliated hospital in New York, New York, 100 patients with chronic critical illness (within 3–7 days of elective tracheotomy for prolonged mechanical ventilation) or surrogates for incapacitated patients were surveyed using an 18-item questionnaire addressing communication about chronic critical illness. Main outcome measures included ratings of importance and reports of whether information was received about questionnaire items. Results Among 125 consecutive, eligible patients, 100 (80%) were enrolled; questionnaire respondents included 2 patients and 98 surrogates. For all items, more than 78% of respondents rated the information as important for decision making (>98% for 16 of 18 items). Respondents reported receiving no information for a mean (SD) of 9.0 (3.3) of 18 items, with 95% of respondents reporting not receiving information for approximately one-quarter of the items. Of the subjects rating the item as important, 77 of 96 (80%) and 69 of 74 (93%) reported receiving no information about expected functional status at hospital discharge and prognosis for 1-year survival, respectively. Conclusions Many patients and their families may lack important information for decision making about continuation of treatment in the chronic phase of critical illness. Strategies for effective communication in this clinical context should be investigated and implemented. PMID

  13. Chinese medicinal herbs for chronic hepatitis B

    DEFF Research Database (Denmark)

    Liu, J; McIntosh, H; Lin, Haili

    2001-01-01

    Chronic hepatitis B is a serious health problem worldwide. Chinese medicinal herbs are widely used for treatment of chronic hepatitis B in China and many clinical trials have been conducted. This systematic review is to assess the efficacy and safety of Chinese medicinal herbs for chronic hepatitis...

  14. Shared genetic factors underlie chronic pain syndromes

    NARCIS (Netherlands)

    Vehof, Jelle; Zavos, Helena M. S.; Lachance, Genevieve; Hammond, Christopher J.; Williams, Frances M. K.

    2014-01-01

    Chronic pain syndromes (CPS) are highly prevalent in the general population, and increasingly the evidence points to a common etiological pathway. Using a large cohort of twins (n = 8564) characterized for chronic widespread musculoskeletal pain (CWP), chronic pelvic pain (PP), migraine (MIG), dry e

  15. Chronic pain management: nonpharmacological therapies for chronic pain.

    Science.gov (United States)

    Chang, Ku-Lang; Fillingim, Roger; Hurley, Robert W; Schmidt, Siegfried

    2015-05-01

    Nonpharmacologic therapies have become a vital part of managing chronic pain (CP). Although these can be used as stand-alone therapies, nonpharmacologic treatments often are used to augment and complement pharmacologic treatments (ie, multimodal therapy). Nonpharmacologic approaches can be classified as behavioral, cognitive, integrative, and physical therapies. Core principles in developing a treatment plan are explaining the nature of the CP condition, setting appropriate goals, and developing a comprehensive treatment approach and plan for adherence. Clinicians should become familiar with these interventions so that they can offer patients flexibility in the pain management approach. Effective noninvasive treatment modalities for CP include behavioral therapy for short-term pain relief; cognitive behavioral therapy for reducing long-term pain and disability; hypnosis as adjunctive therapy; guided imagery, diaphragmatic breathing, and muscle relaxation, especially for cancer-related pain; mindfulness-based stress reduction for patients with chronic low back pain; acupuncture for multiple pain conditions; combination manipulation, manual therapy, endurance exercise, stretching, and strengthening for chronic neck pain; animal-assisted therapy; and S-adenosyl-L-methionine for joint pain. Guidelines for use of these treatment modalities are based on expert panel recommendations in combination with data from randomized controlled trials.

  16. Chronic Pancreatitis and Neoplasia: Correlation or Coincidence

    Directory of Open Access Journals (Sweden)

    G. N. Zografos

    1997-01-01

    Full Text Available Any link between pancreatic carcinoma and chronic pancreatitis could reflect the malignant potential of a chronic inflammatory process. Four patients with ductal adenocarcinomas had a long history of pancreatic pain (median duration 5 years and showed clearcut evidence of chronic pancreatitis “downstream” of the tumour. Four were alcoholics and two heavy smokers. These four cases arose within a surgical series of approximately 250 patients with chronic pancreatitis, giving an incidence of 1.6 per cent. The incidence and anatomical distribution of carcinoma and chronic pancreatitis could possibly be consistent with a casual relationship.

  17. Magnetic resonance images of chronic patellar tendinitis

    Energy Technology Data Exchange (ETDEWEB)

    Bodne, D.; Quinn, S.F.; Murray, W.T.; Cochran, C.; Bolton, T.; Rudd, S.; Lewis, K.; Daines, P.; Bishop, J.

    1988-01-01

    Chronic patellar tendinitis can be a frustrating diagnostic and therapeutic problem. This report evaluates seven tendons in five patients with chronic patellar tendinitis. The etiologies included 'jumper's knee' and Osgood-Schlatter disease. In all cases magnetic resonance images (MRI) showed thickening of the tendon. Some of the tendons had focal areas of thickening which helped establish the etiology. All cases had intratendinous areas of increased signal which, in four cases, proved to be chronic tendon tears. MRI is useful in evaluating chronic patellar tendinitis because it establishes the diagnosis, detects associated chronic tears, and may help determine appropriate rehabilitation. (orig.)

  18. Prevalence of maternal chronic diseases during pregnancy

    DEFF Research Database (Denmark)

    Jølving, Line Riis; Nielsen, Jan; Kesmodel, Ulrik Schiøler

    2016-01-01

    chronic diseases were chronic lung diseases/asthma (1.73%), thyroid disorders (1.50%) and anxiety and personality disorders (1.33%). Taking increasing maternal age at birth into account, the relative risk for women to have a chronic disease from 2009 to 2013 was 4.14 (95% CI 4.05-4.22), compared...... pregnancy. We aimed to analyze the prevalence of chronic diseases during pregnancy. MATERIAL AND METHODS: This register-based cohort study included all women giving birth in Denmark between 1989 and 2013 based on data from Danish health registers. Maternal chronic diseases included 23 disease categories...

  19. Endothelins in chronic liver disease

    DEFF Research Database (Denmark)

    Møller, S; Henriksen, Jens Henrik Sahl

    1996-01-01

    This review describes recent progress in the accumulation of knowledge about the endothelins (ETs), a family of vasoactive 21-amino acid polypeptides, in chronic liver disease. Particular prominence is given to the dynamics of ET-1 and ET-3 and their possible relation to the disturbed circulation...... and neurohumoral dysregulation found in cirrhosis. Recent studies have shown that the ET system is highly activated in most cirrhotic patients. Circulating ET-1 and ET-3 levels have a positive relation to the severity of the disease and fluid retention, with the highest values recorded in patients with functional....... In addition, marked associations with disturbance of systemic haemodynamics and with abnormal distribution of blood volume have been reported. Although the pathophysiological importance of the ET system in chronic liver disease is not completely understood, similarities to other vasopressive...

  20. Endothelins in chronic liver disease

    DEFF Research Database (Denmark)

    Møller, Søren; Henriksen, Jens Henrik

    1996-01-01

    This review describes recent progress in the accumulation of knowledge about the endothelins (ETs), a family of vasoactive 21-amino acid polypeptides, in chronic liver disease. Particular prominence is given to the dynamics of ET-1 and ET-3 and their possible relation to the disturbed circulation....... In addition, marked associations with disturbance of systemic haemodynamics and with abnormal distribution of blood volume have been reported. Although the pathophysiological importance of the ET system in chronic liver disease is not completely understood, similarities to other vasopressive...... and neurohumoral dysregulation found in cirrhosis. Recent studies have shown that the ET system is highly activated in most cirrhotic patients. Circulating ET-1 and ET-3 levels have a positive relation to the severity of the disease and fluid retention, with the highest values recorded in patients with functional...

  1. Vouchers for chronic disease care.

    Science.gov (United States)

    Watts, Jennifer J; Segal, Leonie

    2008-08-01

    This paper explores the economic implications of vouchers for chronic disease management with respect to achieving objectives of equity and efficiency. Vouchers as a payment policy instrument for health care services have a set of properties that suggest they may address both demand-side and supply-side issues, and contribute to equity and efficiency. They provide a means whereby health care services can be targeted at selected groups, enabling consumer choice of provider, and encouraging competition in the supply of health services. This analysis suggests that, when structured appropriately, vouchers can support consumers to choose services that will meet their health care needs and encourage competition among providers. Although they may not be appropriate across the entire health care system, there are features of vouchers that make them a potentially attractive option, especially for the management of chronic disease.

  2. Chronic folliculitis in Sri Lanka

    Directory of Open Access Journals (Sweden)

    Kumarasinghe S

    1996-01-01

    Full Text Available Chronic folliculitis (CF is a chronic infection of hair follicles leading to atrophy and loss of the affected hairs. This study was done on 51 patients with CF presenting at the Dermatology Clinic at General Hospital Matara, Sri Lanka, to identify specific clinical features and aetiological factors, and to study histopathology. Pus cultures were done on 25 cases. Biopsies were done on 6 patients. CF was commoner in males (59%; 76% were under 34 years, and 39% had occupational exposure to possible irritants. Thirty five precent admitted of scrubbing legs with rough objects. Ichthyosis vulgaris was evident in 47%. All pus cultures revealed Staphylococcus aureus. Clinical features and histopathological features were similar to those described by Harman (1968. Rough scrubbing, ichthyosis and occupational exposure to irritants may be aetiologically relevant.

  3. Clinicomicrobiological study of chronic paronychia

    Directory of Open Access Journals (Sweden)

    Guha P

    1992-01-01

    Full Text Available A total of 261 digits affected in 100 patients of chronic paronychia were studied for clinical features. The bacteriological and mycological flora have been examined in 25 cases of the above 100 cases which were most severely affected. Aerobic bacteria were found in all cases. Staphylococcus aureus was seen in 60 percent. Klebsiella in 16 percent, Escherichia coli in 12 percent, Pseudomonas aeruginosa in 12 percent, Proteus mirabillis in 8 percent, Staphylococcus epidermidis in 4 percent and Streptococcus viridans in 4 percent. Culture for fungus revealed Candida albicans in 64 percent and other species such as C. krusei, C. stellatoides, C. viswanathi, C. parapsilosis and C. tropicalis were present in 1 case each. No fungus was detected in 4 cases(16percent. The present investigation was designed to compare the bacterial and mycotic flora of the nail folds of patients of chronic paronychia with that of western countries.

  4. Management of chronic Achilles tendinopathy.

    Science.gov (United States)

    2012-08-01

    Tendons transmit force between muscles and bones and, when stretched, store elastic energy that contributes to movement.(1) The tendinous portion of the gastrocnemius and soleus muscles merge to form the Achilles tendon, which is the largest and strongest in the body, but one of the most frequently injured.(2,3) Conservative management options for chronic Achilles tendinopathy include eccentric (lengthening) exercises, extracorporeal shockwave therapy (ESWT), topical nitroglycerin, low level laser therapy, orthoses, splints or injections (e.g. corticosteroids, hyperosmolar dextrose, polidocanol, platelet-rich plasma), while a minority of patients require surgery (using open, percutaneous or endoscopic methods).(4-8) Here we assess the management options for patients with chronic Achilles tendinopathy (lasting over 6 weeks).

  5. Lithium clearance in chronic nephropathy

    DEFF Research Database (Denmark)

    Kamper, A L; Holstein-Rathlou, N H; Leyssac, P P

    1989-01-01

    1. Lithium clearance measurements were made in 72 patients with chronic nephropathy of different aetiology and moderate to severely reduced renal function. 2. Lithium clearance was strictly correlated with glomerular filtration rate, and there was no suggestion of distal tubular reabsorption...... clearance data were independent of whether renal disease was of primarily glomerular or tubular origin and, further, were not influenced by long-term conventional antihypertensive treatment. 6. It is concluded that, even with a reduced kidney function, the data are compatible with the suggestion...... that lithium clearance may be a measure of the delivery of sodium and water from the renal proximal tubule. With this assumption it was found that adjustment of the sodium excretion in chronic nephropathy initially takes place in the distal parts of the nephron (loop of Henle, distal tubule and collecting duct...

  6. [Pharmacological treatment of chronic pain].

    Science.gov (United States)

    Willimann, Patrick

    2011-09-01

    The pharmacological treatment of chronic pain differs from acute pain management. In chronic non-cancer pain patients pharmacological treatment is only one element of an interdisciplinary approach. Not pain reduction only but gain in physical and social functioning is mandatory for continuation of therapy. The developpement of a strategy is the most important and difficult step toward an individual and sustained pharmacological pain treatment. Simple practical guidelines can help to find an individual therapeutic straight. Outcome parameters have to be determined. Check-ups for discontinuation of the therapy have to be done periodically. Exact documentation of effect and side effects prevents ungrateful and potential dangerous treatments. The WHO ladder remains the cornerstone of pharmacological pain treatment. Further analgesics as antidepressants and anticonvulsants are important in treatment of neuropathic or mixed pain states. Special considerations have to be done in opioid treatment of non-cancer pain regarding the lack of evidence in long term outcome and possible side effects and risks.

  7. Management of chronic visceral pain.

    Science.gov (United States)

    Olesen, Anne E; Farmer, Adam D; Olesen, Søren S; Aziz, Qasim; Drewes, Asbjørn M

    2016-10-01

    Despite marked differences in underlying pathophysiology, the current management of visceral pain largely follows the guidelines derived from the somatic pain literature. The effective management of patients with chronic visceral pain should be multifaceted, including both pharmacological and psychological interventions, thereby providing a mechanism-orientated approach to treatment. Patients can frequently become disenfranchised, and subsequently disengaged, with healthcare providers leading to repeated consultations. Thus, a key aspect of management is to break this cycle by validating patients' symptoms, adopting an empathic approach and taking time to educate patients. To optimize treatment and outcomes in chronic visceral pain we need to move away from approaches exclusively based on dealing with peripheral nociceptive input toward more holistic strategies, taking into account alterations in central pain processing.

  8. Chronic radiation enteritis and malnutrition.

    Science.gov (United States)

    Webb, Gwilym James; Brooke, Rachael; De Silva, Aminda Niroshan

    2013-07-01

    Radiation enteritis is defined as the loss of absorptive capacity of the intestine following irradiation, which is most commonly seen after radiotherapy for pelvic and abdominal malignancies. It is divided into acute and chronic forms and usually presents with diarrhea and malabsorption. Malnutrition is a common complication of chronic radiation enteritis (CRE). We reviewed the etiology, prevalence, symptoms, diagnosis and management of CRE and CRE with malnutrition in this article. Functional short bowel syndrome as a cause of malnutrition in CRE is also considered. The diagnostic work-up includes serum markers, endoscopy, cross-sectional imaging and the exclusion of alternative diagnoses such as recurrent malignancy. Management options of CRE include dietary manipulation, anti-motility agents, electrolyte correction, probiotics, parenteral nutrition, surgical resection and small bowel transplantation. Treatment may also be required for coexisting conditions including vitamin B12 deficiency, bile acid malabsorption and depression.

  9. Lithium clearance in chronic nephropathy

    DEFF Research Database (Denmark)

    Kamper, A L; Holstein-Rathlou, N H; Leyssac, P P

    1989-01-01

    1. Lithium clearance measurements were made in 72 patients with chronic nephropathy of different aetiology and moderate to severely reduced renal function. 2. Lithium clearance was strictly correlated with glomerular filtration rate, and there was no suggestion of distal tubular reabsorption...... of lithium or influence of osmotic diuresis. 3. Fractional reabsorption of lithium was reduced in most patients with glomerular filtration rates below 25 ml/min. 4. Calculated fractional distal reabsorption of sodium was reduced in most patients with glomerular filtration rates below 50 ml/min. 5. Lithium...... that lithium clearance may be a measure of the delivery of sodium and water from the renal proximal tubule. With this assumption it was found that adjustment of the sodium excretion in chronic nephropathy initially takes place in the distal parts of the nephron (loop of Henle, distal tubule and collecting duct...

  10. Nitric oxide and chronic colitis

    Directory of Open Access Journals (Sweden)

    Matthew B Grisham

    1996-01-01

    Full Text Available Nitric oxide (NO is thought to play an important role in modulating the inflammatory response by virtue of its ability to affect bloodflow, leukocyte function and cell viability. The objective of this study was to assess the role that NO may play in mediating the mucosal injury and inflammation in a model of chronic granulomatous colitis using two pharmacologically different inhibitors of nitric oxide synthase (NOS. Chronic granulomatous colitis with liver and spleen inflammation was induced in female Lewis rats via the subserosal (intramural injection of peptidoglycan/polysaccharide (PG/PS derived from group A streptococci. Chronic NOS inhibition by oral administration of NG-nitro-L-arginine methyl ester (L-NAME (15 µmol/kg/day or amino-guanidine (AG (15 µmol/ kg/day was found to attenuate the PG/PS-induced increases in macroscopic colonic inflammation scores and colonic myeloperoxidase activity. Only AG -- not L-NAME – attenuated the PG/PS-induced increases in colon dry weight. Both L-NAME and AG significantly attenuated the PG/PS-induced increases in spleen weight whereas neither was effective at significantly attenuating the PG/PS-induced increases in liver weight. Although both L-NAME and AG inhibited NO production in vivo, as measured by decreases in plasma nitrite and nitrate levels, only AG produced significantly lower values (38±3 versus 83±8 µM, respectively, P<0.05. Finally, L-NAME, but not AG, administration significantly increased mean arterial pressure from 83 mmHg in colitic animals to 105 mmHg in the PG/PS+ L-NAME-treated animals (P<0.05. It is concluded that NO may play an important role in mediating some of the pathophysiology associated with this model of chronic granulomatous colitis.

  11. DIAGNOSIS AND MANAGEMENT CHRONIC INSOMNIA

    Directory of Open Access Journals (Sweden)

    G.A Dian Puspitha Candra

    2013-03-01

    Full Text Available Insomnia is defined as difficulty to start sleeping, maintain it, or low quality sleeping, if the condition persist for more than one month, it is called chronic insomnia. Diagnosis is made through anamnesa and sleep wake diaries, aktigraphy, polisomnography. Pharmachologycally drugs that have been used to treat insomnia are benzodiazepin reseptor agonis, antihistamine, antidepressant. Non pharmacological ways include behavioural intervention for insomnia, give significant result in decreasing sleep latency, reducing awakness duration during the night and improving total sleeping time.

  12. Tackling chronic migraine: current perspectives

    Directory of Open Access Journals (Sweden)

    Carod-Artal FJ

    2014-04-01

    Full Text Available Francisco Javier Carod-Artal Neurology Department, Raigmore Hospital, Inverness, UK; Universitat Internacional de Catalunya, Barcelona, Spain Abstract: In the last decade, several diagnostic criteria and definitions have been proposed for chronic migraine (CM. The third edition of the International Classification of Headache Disorders–3 beta, published in 2013, has revised CM diagnostic criteria. CM is defined as “headache occurring on 15 or more days per month for more than 3 months, which has the features of migraine headache on at least 8 days per month.” Patients who meet the criteria for CM and for medication-overuse headache should be given both diagnoses. Worldwide, CM prevalence ranges 1%–3%, and its incidence has been estimated to be 2.5% per year. CM is associated with disability and poor quality of life. Modifiable risk factors include (among others: migraine progression (defined as an increase in frequency and severity of migraine attacks; medication and caffeine overuse; obesity; stressful life events; and snoring. CM patients have a significantly higher frequency of some comorbid conditions, including chronic pain, psychiatric disorders, respiratory illness, and some vascular risk factors. Management includes identification and control of comorbidities and risk factors that predispose to CM; treatment and prevention for medication overuse; early treatment for migraine attacks; and an adequate preventive therapy for CM. Several randomized controlled clinical trials have shown the efficacy of topiramate, amitriptyline, onabotulinumtoxinA, and cognitive-behavioral therapy in CM. Keywords: chronic daily headache, chronic migraine, epidemiology, medication overuse headache, risk factors, treatment

  13. Biomarkers in chronic adult hydrocephalus

    Directory of Open Access Journals (Sweden)

    Kitchen Neil D

    2006-10-01

    Full Text Available Abstract Awareness of the importance of chronic adult hydrocephalus has been raised again with the recent emergence of epidemiological studies. It is estimated that between 5 and 10% of patients suffering from dementia might, in fact, have chronic hydrocephalus. Although, surgical diversion of the cerebrospinal fluid (CSF represents the only known procedure able to treat the symptoms of this condition, the selection of surgical patients has always been problematic. In the last 40 years, we have become wiser in using appropriate diagnostic tests for the selection of these patients; however, the area of biological markers has so far been overlooked in this condition, in contrast to that for other neurodegenerative disorders and dementias. Biomarkers are biological substances that may be used to indicate either the onset or the presence, and the progression of a clinical condition, being closely linked to its pathophysiology. In such a setting they might assist in the more appropriate selection of patients for shunt surgery. In this article, we have reviewed research carried out in the last 25 years regarding the identification of serum and CSF biomarkers for chronic hydrocephalus, discussed the potential for each one, and finally discussed the limitations for use, as well as future directions and possibilities in this field. It is concluded that tumour-necrosis factor, tau protein, lactate, sulfatide and neurofilament triple protein are the most promising CSF markers for chronic hydrocephalus. At present however, none of these meet the criteria required to justify a change clinical practice. In the future, collaborative multi-centre projects will be needed to obtain more substantial data that overcome the problems that arise from small individual and uncoordinated studies.

  14. Chronic sphenoid rhinosinusitis: management challenge

    OpenAIRE

    2016-01-01

    Natamon Charakorn, Kornkiat Snidvongs Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand Abstract: Chronic sphenoid rhinosinusitis is a spectrum of inflammatory diseases in isolated sphenoid sinus which may persist over a period of 12 weeks. It is a different entity from other types of rhinosinusitis because clinical presentations include headache, visual loss or diplop...

  15. Uveitis in juvenile chronic arthritis.

    Science.gov (United States)

    Kanski, J J

    1990-01-01

    About 20% of patients with juvenile chronic arthritis develop uveitis which is frequently bilateral. Risk factors for uveitis are: female gender, pauciarticular onset of arthritis, presence of circulating antinuclear antibodies, and the antigens HLA-DW5 and HLA-DPw2. The visual prognosis in patients with uveitis is good in 25% and fair in 50%. The remaining 25% develop cataract and/or glaucoma. The management of glaucoma is unsatisfactory, but the results of cataract surgery by lensectomy are good.

  16. Conversations with chronic schizophrenic patients.

    Science.gov (United States)

    Morgan, R

    1979-02-01

    An account is given of some of the topics discussed during a small informal weekly open group meeting of chronic schizophrenic patients, based on occasional notes compiled over eleven years. The main feature of the patients' condition as displayed was poverty--clinical, social, behavioural, material and financial--and certain features suggested an organic aetiology. Reasons are given for considering that the patients' condition was predominantly caused by schizophrenia rather than by institutionalism.

  17. Comprehensive management of chronic pain in haemophilia.

    Science.gov (United States)

    Young, G; Tachdjian, R; Baumann, K; Panopoulos, G

    2014-03-01

    Chronic pain, most often due to haemophilic arthropathy, is a pervasive problem in persons with haemophilia (PWH) that adversely impacts function and quality of life. PWH with inhibitors and older PWH may be especially vulnerable to progressive arthropathy and resulting chronic pain. The development of chronic pain from acute pain involves a complex interplay of biological and psychosocial factors that may all contribute to the perpetuation of chronic pain and the outcome of therapy. In the absence of evidence-based guidelines, an individualized, multimodal approach to chronic pain management is proposed, as it is in individuals without haemophilia who have chronic pain. Pharmacological treatment is central to the management of chronic pain and must be modified based on pain intensity, ongoing response to therapy and the risk for adverse events. Non-pharmacological interventions, including physiotherapy, complementary treatments and surgical (e.g. orthopaedic) or other invasive procedures, may be integral to chronic pain management in this population. Ongoing psychosocial assessment is critical to identify those factors that may be contributing to the perpetuation of chronic pain or acting as barriers to effective management. Additional study is needed to identify optimal pharmacological treatments for chronic pain in PWH based on the unique pathophysiology of haemophilic arthropathy and on risk profile. Systematic determination of the particular psychosocial factors impacting the experience and management of chronic pain in PWH would likewise add value to the treatment of this pervasive problem.

  18. Chronic Daily Headache - A Reappraisal

    Directory of Open Access Journals (Sweden)

    Chakravarty A

    2004-01-01

    Full Text Available Chronic Daily Headache (CDH generally refers to frequent headache occuring more than 15 days/month for over three months. Such headaches may be primary or secondary - the latter referring to headaches related to identifiable intra and extracranial vascular or other pathologies or systemic illnesses. The primary type may be subclassified as short and long lasting ones, depending upon whether the headache spells are more or less than four hours in duration. The present review would deal with the four major types of long lasting primary CDH which include Chronic migraine (CM, Chronic tension type headache (CTTH, New daily persistent headache (NDPH and Hemicrania continua (HC. The first part of the article would focus on the clinical pattern recognising features of these types. The relationship of medication overuse to CM would be critically evaluated. In the second part, the status of CDH in the recently proposed classification of headache disorders by the International Headache Society would be briefly evaluated. In the next section the clinical Profile or CDH in Indian patients would be highlighted based on available published data. Lastly, the pathophysiology of this vexing condition would be discussed specially in relation to CM and postulating on how it may evolve from episodic migraine.

  19. Meditation's impact on chronic illness.

    Science.gov (United States)

    Bonadonna, Ramita

    2003-01-01

    Meditation is becoming widely popular as an adjunct to conventional medical therapies. This article reviews the literature regarding the experience of chronic illness, theories about meditation, and clinical effects of this self-care practice. Eastern theories of meditation include Buddhist psychology. The word Buddha means the awakened one, and Buddhist meditators have been called the first scientists, alluding to more than 2500 years of precise, detailed observation of inner experience. The knowledge that comprises Buddhist psychology was derived inductively from the historical figure's (Prince Siddhartha Gautama) diligent self-inquiry. Western theories of meditation include Jungian, Benson's relaxation response, and transpersonal psychology. Clinical effects of meditation impact a broad spectrum of physical and psychological symptoms and syndromes, including reduced anxiety, pain, and depression, enhanced mood and self-esteem, and decreased stress. Meditation has been studied in populations with fibromyalgia, cancer, hypertension, and psoriasis. While earlier studies were small and lacked experimental controls, the quality and quantity of valid research is growing. Meditation practice can positively influence the experience of chronic illness and can serve as a primary, secondary, and/or tertiary prevention strategy. Health professionals demonstrate commitment to holistic practice by asking patients about use of meditation, and can encourage this self-care activity. Simple techniques for mindfulness can be taught in the clinical setting. Living mindfully with chronic illness is a fruitful area for research, and it can be predicted that evidence will grow to support the role of consciousness in the human experience of disease.

  20. NAFLD and Chronic Kidney Disease.

    Science.gov (United States)

    Marcuccilli, Morgan; Chonchol, Michel

    2016-04-14

    Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in developed countries and it is now considered a risk factor for cardiovascular disease. Evidence linking NAFLD to the development and progression of chronic kidney disease (CKD) is emerging as a popular area of scientific interest. The rise in simultaneous liver-kidney transplantation as well as the significant cost associated with the presence of chronic kidney disease in the NAFLD population make this entity a worthwhile target for screening and therapeutic intervention. While several cross-sectional and case control studies have been published to substantiate these theories, very little data exists on the underlying cause of NAFLD and CKD. In this review, we will discuss the most recent publications on the diagnosis of NAFLD as well new evidence regarding the pathophysiology of NAFLD and CKD as an inflammatory disorder. These mechanisms include the role of obesity, the renin-angiotensin system, and dysregulation of fructose metabolism and lipogenesis in the development of both disorders. Further investigation of these pathways may lead to novel therapies that aim to target the NAFLD and CKD. However, more prospective studies that include information on both renal and liver histology will be necessary in order to understand the relationship between these diseases.

  1. Superoxide dismutases in chronic gastritis.

    Science.gov (United States)

    Švagelj, Dražen; Terzić, Velimir; Dovhanj, Jasna; Švagelj, Marija; Cvrković, Mirta; Švagelj, Ivan

    2016-04-01

    Human gastric diseases have shown significant changes in the activity and expression of superoxide dismutase (SOD) isoforms. The aim of this study was to detect Mn-SOD activity and expression in the tissue of gastric mucosa, primarily in chronic gastritis (immunohistochemical Helicobacter pylori-negative gastritis, without other pathohistological changes) and to evaluate their possible connection with pathohistological diagnosis. We examined 51 consecutive outpatients undergoing endoscopy for upper gastrointestinal symptoms. Patients were classified based on their histopathological examinations and divided into three groups: 51 patients (archive samples between 2004-2009) with chronic immunohistochemical Helicobacter pylori-negative gastritis (mononuclear cells infiltration were graded as absent, moderate, severe) divided into three groups. Severity of gastritis was graded according to the updated Sydney system. Gastric tissue samples were used to determine the expression of Mn-SOD with anti-Mn-SOD Ab immunohistochemically. The Mn-SOD expression was more frequently present in specimens with severe and moderate inflammation of gastric mucosa than in those with normal mucosa. In patients with normal histological finding, positive immunoreactivity of Mn-SOD was not found. Our results determine the changes in Mn-SOD expression occurring in the normal gastric mucosa that had undergone changes in the intensity of chronic inflammatory infiltrates in the lamina propria.

  2. THROMBOENDARTERECTOMY FOR CHRONIC PULMONARY THROMBOEMBOLISM

    Institute of Scientific and Technical Information of China (English)

    Hua Ren; Pi-xiong Su; Chao-ji Zhang; Song Gu; Heng Zhang; Chen Wang

    2005-01-01

    Objective To evaluate the improving reliability and safety of thromboendarterectomy and perioperative management for chronic pulmonary thromboembolism. Methods The clinical data of 12 cases with chronic pulmonary thromboembolism, who underwent thromboendarterec tomy assisted by low flow or circulation arrest with deep hypothermia, were reviewed retrospectively. Results Pulmonary artery pressure decreased 20 to 40 mmHg immediately after surgical procedures in 9 cases. The postoperative pulmonary edema at various degrees happened in 12 cases, among them, 1 died of severe lung infection and pulmonary re-embolism at 19 days postoperation. Computed tomography pulmonary angiography and angiography of 11 cases indicated that the original obstruction of pulmonary artery disappeared. During the follow-up period of 2 months to 5 years, the clinical symptoms and activity was improved. Conclusion Thromboendarterectomy is an effective treatment for chronic pulmonary thromboembolism. The outcome of the surgical procedure needs to be further investigated and followed up regularly according to an evaluative system, because it might be influenced by multiple factors.

  3. Ultrasonography in chronic renal failure

    Energy Technology Data Exchange (ETDEWEB)

    Buturovic-Ponikvar, Jadranka E-mail: jadranka.buturovic@mf.uni-lj.si; Visnar-Perovic, Alenka

    2003-05-01

    Many chronic renal diseases lead to the final common state of decrease in renal size, parenchymal atrophy, sclerosis and fibrosis. The ultrasound image show a smaller kidney, thinning of the parenchyma and its hyperechogenicity (reflecting sclerosis and fibrosis). The frequency of renal cysts increases with the progression of the disease. Ultrasound generally does not allow for the exact diagnosis of an underlying chronic disease (renal biopsy is usually required), but it can help to determine an irreversible disease, assess prognosis and avoid unnecessary diagnostic or therapeutic procedures. The main exception in which the ultrasound image does not show a smaller kidney with parenchymal atrophy is diabetic nephropathy, the leading cause of chronic and end-stage renal failure in developed countries in recent years. In this case, both renal size and parenchymal thickness are preserved until end-stage renal failure. Doppler study of intrarenal vessels can provide additional information about microvascular and parenchymal lesions, which is helpful in deciding for or against therapeutic intervention and timely planning for optimal renal replacement therapy option.

  4. [Nutrition and chronic renal failure].

    Science.gov (United States)

    Ayúcar Ruiz de Galarreta, A; Cordero Lorenzana, M L; Martínez-Puga y López, E; Gómez Seijo, A; Escudero Alvarez, E

    2000-01-01

    The causes of malnutrition in chronic terminal kidney failure are reviewed in the situation both before and after dialysis, as are the malnutrition rates in both circumstances and their treatment. Malnutrition has a high prevalence in terminal kidney patients, partly as a result of the therapeutic restriction on calories and proteins, but also due to the metabolic reactions typical of the disease and to anorexia. In patients subjected to dialytical methods, certain other mechanisms are added. In addition to malnutrition, there are alterations in the metabolism of calcium, phosphorus and potassium, as well as lipids, thus limiting nutritional therapy's ability to restore the nutritional status to normal. An awareness of energy expenditure in chronic terminal kidney failure and the consequences of malnutrition have led to new challenges in nutritional therapy, both in the dose and quality of the proteins, with a debate raging over the advantages of ketoanalogues, and also in the methods for providing nutrients. The ideal nutritional method for repletion is oral administration, but this can be enhanced with artificial support such as oral supplements, parenteral nutrition during dialysis or such alternatives as enteral nutrition at home in the case of chronic kidney problems in children, using percutaneous endoscopic gastrostomy (PEG), in order to nourish the patients and minimize growth disorders.

  5. Predictive risk factors for delayed sternal closure in the patients under the age of three months old with congenital cardiac disease%3个月内复杂先天性心脏病患儿术后延迟关胸的因素分析

    Institute of Scientific and Technical Information of China (English)

    张惠锋; 贾兵; 陈张根; 李炘; 叶明; 陶麒麟; 陈刚

    2008-01-01

    Objective To analyze the risk factors related with delayed sternal closure(DSC)in the patients under three months old with complex cardiac disease.Methods One hundred and nineteen patients underwent median sternotomy and cardiopulmonary bypass(CPB)between Jan 2000 to Oct 2006.The age ranged from 1 to 90 days(mean 44±26 days)and the weight ranged from 2.2 kg to 7.1 kg(mean 3.9±0.89 kg).SPSS v 11.5 software was used to analyze the factors including the age,gender,weight,preoperative conditions,diagnose,prematurity,requirement for preoperative mechanic ventilation,preoperative SPO2,cardia-thoracic area ratio,left ventricular faction,CPB duration,clamping time,total circulatory arrest with profound hypothermia.Results Forty-seven patients had DSC.The rate of DSC iS over 75% for IAA or TAPVD(infracardiac)or TGA/VSD.The risk factors including age(P=0.032),pre-operative mechanic ventilation(P=0.001),CPB duration(P=0.000),total circulatory arrest with profound hypothermia(P=0.001).They were statistically significant(multivariate logistic regression).Conclusions DSC is a simple,safe and efficient procedure for the complex cardiac diseases.DSC iS related to IAA or TAPVD(infracardiac)or TGA/VSD.Age,pre-operative mechanic ventilation,CPB duration,total circulatory arrest with profound hypothermia are the risk factors for DSC.Understanding the factors iS helpful in the clinical decision making process.%目的 探讨3个月内的复杂先天性心脏病患儿术后行延迟关胸的危险因素.方法 2000年1月~2006年10月收治119例胸骨正中切口并进行体外循环的患儿,男97例,女22例,年~龄1~90 d,平均(44±26)d,体重2.2~7.1 kg,平均(3.9±0.9)kg,分析年龄、性别、体重、术前胸围、诊断、是否为早产儿、术前是否机械通气、SpO2、胸片测得的心胸比例、心超测得的左心射血分数、体外循环时间、主动脉阻断时间、深低温停循环等因素与延迟关胸的相关性.结果 延迟关胸47

  6. Gut microbiome and chronic prostatitis/chronic pelvic pain syndrome.

    Science.gov (United States)

    Arora, Hans C; Eng, Charis; Shoskes, Daniel A

    2017-01-01

    Analysis of the human microbiome continues to reveal new and previously unrealized associations between microbial dysbiosis and disease. Novel approaches to bacterial identification using culture-independent methods allow practitioners to discern the presence of alterations in the taxa and diversity of the microbiome and identify correlations with disease processes. While some of these diseases that have been extensively studied are well-defined in their etiology and treatment methods (colorectal cancer), others have provided much more significant challenges in both diagnosis and treatment. One such condition, chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), has several etiological and potentiating contributions from infection, inflammation, central nervous system (CNS) changes, stress, and central sensitization-all factors that play important roles in the crosstalk between the human body and its microbiome. No singular cause of CP/CPPS has been identified and it is most likely a syndrome with multifactorial causes. This heterogeneity and ambiguity are sources of significant frustration for patients and providers alike. Despite multiple attempts, treatment of chronic prostatitis with monotherapy has seen limited success, which is thought to be due to its heterogeneous nature. Phenotypic approaches to both classify the disease and direct treatment for CP/CPPS have proven beneficial in these patients, but questions still remain regarding etiology. Newer microbiome research has found correlations between symptom scores and disease severity and the degree of dysbiosis in urine and gut (stool) microbiomes in these patients as compared to un-afflicted controls. These findings present potential new diagnostic and therapeutic targets in CP/CPPS patients.

  7. Physical Activity and Chronic Prostatitis/Chronic Pelvic Pain Syndrome

    Science.gov (United States)

    Zhang, Ran; Chomistek, Andrea K.; Dimitrakoff, Jordan D.; Giovannucci, Edward L.; Willett, Walter C.; Rosner, Bernard A.; Wu, Kana

    2014-01-01

    Purpose Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a prevalent urologic disorder among men, but its etiology is still poorly understood. Our objective was to examine the relationship between physical activity and incidence of CP/CPPS in a large cohort of male health professionals. Methods We conducted a prospective cohort study among men in the Health Professionals Follow-up Study followed from 1986 to 2008. The study population included 20,918 men who completed all CP/CPPS questions on the 2008 questionnaire. Leisure-time physical activity, including type and intensity of activity, was measured by questionnaire in 1986. A National Institute of Health Chronic Prostatitis Symptom Index pain score was calculated based on the responses on the 2008 questionnaire. Participants with pain scores ≥ 8 were considered CP/CPPS cases (n=689). Results Higher leisure-time physical activity was associated with lower risk of CP/CPPS. The multivariable-adjusted odds ratio (OR) comparing >35.0 to ≤3.5 MET-h/wk of physical activity was 0.72 (95% confidence interval (CI): 0.56, 0.92, p for trend <0.001). Observed inverse associations between physical activity and CP/CPPS were similar for both moderate- and vigorous-intensity activities. Sedentary behavior, measured as time spent watching television, was not associated with risk of CP/CPPS (p for trend 0.64). Conclusions Findings from this study, the first large scale and most comprehensive study to date on this association, suggest that higher levels of leisure-time physical activity may lower risk of CP/CPPS in middle-aged and older men. PMID:25116086

  8. Endoplasmic reticulum stress is chronically activated in chronic pancreatitis.

    Science.gov (United States)

    Sah, Raghuwansh P; Garg, Sushil K; Dixit, Ajay K; Dudeja, Vikas; Dawra, Rajinder K; Saluja, Ashok K

    2014-10-03

    The pathogenesis of chronic pancreatitis (CP) is poorly understood. Endoplasmic reticulum (ER) stress has now been recognized as a pathogenic event in many chronic diseases. However, ER stress has not been studied in CP, although pancreatic acinar cells seem to be especially vulnerable to ER dysfunction because of their dependence on high ER volume and functionality. Here, we aim to investigate ER stress in CP, study its pathogenesis in relation to trypsinogen activation (widely regarded as the key event of pancreatitis), and explore its mechanism, time course, and downstream consequences during pancreatic injury. CP was induced in mice by repeated episodes of acute pancreatitis (AP) based on caerulein hyperstimulation. ER stress leads to activation of unfolded protein response components that were measured in CP and AP. We show sustained up-regulation of unfolded protein response components ATF4, CHOP, GRP78, and XBP1 in CP. Overexpression of GRP78 and ATF4 in human CP confirmed the experimental findings. We used novel trypsinogen-7 knock-out mice (T(-/-)), which lack intra-acinar trypsinogen activation, to clarify the relationship of ER stress to intra-acinar trypsinogen activation in pancreatic injury. Comparable activation of ER stress was seen in wild type and T(-/-) mice. Induction of ER stress occurred through pathologic calcium signaling very early in the course of pancreatic injury. Our results establish that ER stress is chronically activated in CP and is induced early in pancreatic injury through pathologic calcium signaling independent of trypsinogen activation. ER stress may be an important pathogenic mechanism in pancreatitis that needs to be explored in future studies.

  9. Chronic pelvic pain: comorbidity between chronic musculoskeletal pain and vulvodynia

    Directory of Open Access Journals (Sweden)

    G. Biasi

    2014-06-01

    Full Text Available Chronic pelvic pain (CPP is a common condition that has a major impact on the quality of life of both men and women. Male CPP is usually attributable to well-defined urogenital conditions (most frequently infectious/non infectious prostatic diseases or musculoskeletal or bowel diseases, whereas the features of female CPP are much more complex and are of particular clinical and epidemiological importance. It is a multifactorial syndrome that can be due to diseases of the urogenital, gastrointestinal, or musculoskeletal systems, or to neurological or neuropsychiatric disorders. It is not always easy to identify its predominant pathogenesis, although it often occurs as a central sensitization syndrome triggered by an initial stimulus which is no longer detectable and only manifests itself clinically through pain. In this respect, there are some very interesting relationships between vulvodynia and fibromyalgic syndrome, as identified in a preliminary study of women with chronic musculoskeletal pain in which it was demonstrated that vulvar pain plays an important role, although it is often overlooked and undiagnosed.

  10. Nonpharmacologic Management of Chronic Insomnia.

    Science.gov (United States)

    Maness, David L; Khan, Muneeza

    2015-12-15

    Insomnia affects 10% to 30% of the population with a total cost of $92.5 to $107.5 billion annually. Short-term, chronic, and other types of insomnia are the three major categories according to the International Classification of Sleep Disorders, 3rd ed. The criteria for diagnosis are difficulty falling asleep, difficulty staying asleep, or early awakening despite the opportunity for sleep; symptoms must be associated with impaired daytime functioning and occur at least three times per week for at least one month. Factors associated with the onset of insomnia include a personal or family history of insomnia, easy arousability, poor self-reported health, and chronic pain. Insomnia is more common in women, especially following menopause and during late pregnancy, and in older adults. A comprehensive sleep history can confirm the diagnosis. Psychiatric and medical problems, medication use, and substance abuse should be ruled out as contributing factors. Treatment of comorbid conditions alone may not resolve insomnia. Patients with movement disorders (e.g., restless legs syndrome, periodic limb movement disorder), circadian rhythm disorders, or breathing disorders (e.g., obstructive sleep apnea) must be identified and treated appropriately. Chronic insomnia is associated with cognitive difficulties, anxiety and depression, poor work performance, decreased quality of life, and increased risk of cardiovascular disease and all-cause mortality. Insomnia can be treated with nonpharmacologic and pharmacologic therapies. Nonpharmacologic therapies include sleep hygiene, cognitive behavior therapy, relaxation therapy, multicomponent therapy, and paradoxical intention. Referral to a sleep specialist may be considered for refractory cases.

  11. Managing acute and chronic pancreatitis.

    Science.gov (United States)

    Skipworth, James R A; Shankar, Arjun; Pereira, Stephen P

    2010-10-01

    Pancreatitis may be acute or chronic. Although both can be caused by similar aetiologies, they tend to follow distinct natural histories. Around 80% of acute pancreatitis (AP) diagnoses occur secondary to gallstone disease and alcohol misuse. AP is commonly associated with sudden onset of upper abdominal pain radiating to the back that is usually severe enough to warrant the patient seeking urgent medical attention. Onset of pain may be related to a recent alcohol binge or rich, fatty meal. The patient may appear unwell, be tachycardic and have exquisite tenderness in the upper abdomen. Overall, 10-25% of AP episodes are classified as severe, leading to an associated mortality rate of 7.5%. Disease severity is best predicted from a number of clinical scoring systems which can be applied at diagnosis in association with repeated clinical assessment, measurement of acute inflammatory markers, and CT. All patients with suspected AP should be referred urgently. Chronic pancreatitis (CP) follows continued, repetitive or sustained injury to the pancreas and 70% of diagnoses occur secondary to alcohol abuse. The characteristic presenting feature of CP is insidious progression of chronic, severe, upper abdominal pain, radiating to the back, caused by a combination of progressive pancreatic destruction, inflammation and duct obstruction. Signs and symptoms include weight loss and steatorrhoea and later on diabetes. CP patients may also present with recurrent episodes mimicking AP, both symptomatically and metabolically. Diagnosis of CP should be based on symptom profile, imaging and assessment of exocrine and endocrine pancreatic function. CT should be the first-line imaging investigation.

  12. Chronic urticaria and Helicobacter pylori

    Directory of Open Access Journals (Sweden)

    Yadav Mukesh

    2008-04-01

    Full Text Available Background: Helicobacter pylori (HP have recently emerged as a novel eliciting factor for chronic urticaria (CU. The possible association between HP and CU has enormous potential, as eradicating HP could cure CU. Aims and Objectives: We conducted a study to assess the prevalence of HP infection and effect of bacterium eradication on skin lesions in patients of chronic idiopathic urticaria (CIU. Settings and Design: Four hundred sixty patients of CU attending the allergy clinic, SMS hospital, Jaipur during the period February 6, 2004, to February 6, 2006, were screened for possible eliciting factors. Patients with CIU were enrolled and others were excluded. Materials and Methods: Sixty-eight patients of CIU and similar number of age and sex matched controls, attending the allergy clinic, SMS Hospital, Jaipur were enrolled in the study. All patients underwent endoscopy with antral biopsy for urease and histopathology to identify HP-associated gastritis. Infected patients were given HP eradication therapy. Eradication of bacterium was confirmed by fecal antigen assay. Subjective response to treatment was judged using chronic urticaria quality-of-life questionnaire (CU-Q 2 oL while objective response to treatment was judged by need for ′rescue medication′ (antihistaminics. Statistical Analysis: Data were analyzed using Chi square and paired′t′ test for their level of significance. Results: HP associated gastritis was present in 48 (70.58% patients, out of which 39 (81.25% patients responded to eradication therapy. Ten (50.00% patients without HP associated gastritis showed response to symptomatic therapy. Overall 49 (72.05% patients responded and 19 (27.94% showed no response. The value of χ2 was 28.571 (P = 0.003, which showed significant association between presence of HP and response to eradication regimen. Conclusion: The response of HP eradication therapy in infected patients of CIU is significant. HP should be included in diagnostic

  13. Treatment of refractory chronic urticaria

    Directory of Open Access Journals (Sweden)

    Aayushi Mehta

    2015-01-01

    Full Text Available Chronic spontaneous urticaria is a distressing disease encountered frequently in clinical practice. The current mainstay of therapy is the use of second-generation, non-sedating antihistamines. However, in patients who do not respond satisfactorily to these agents, a variety of other drugs are used. This article examines the available literature for frequently used agents including systemic corticosteroids, leukotriene receptor antagonists, dapsone, sulfasalazine, hydroxychloroquine, H2 antagonists, methotrexate, cyclosporine A, omalizumab, autologous serum therapy, and mycophenolate mofetil, with an additional focus on publications in Indian literature.

  14. Perspectives on "chronic Lyme disease".

    Science.gov (United States)

    Baker, Phillip J

    2008-07-01

    There is much controversy about the treatment of Lyme disease with respect to 2 poorly defined entities: "chronic Lyme disease" and "posttreatment Lyme disease syndrome." In the absence of direct evidence that these conditions are the result of a persistent infection, some mistakenly advocate extended antibiotic therapy (>/=6 months), which can do great harm and has resulted in at least 1 death. The purpose of this brief report is to review what is known from clinical research about these conditions to assist both practicing physicians and lawmakers in making sound and safe decisions with respect to treatment.

  15. Chronic pancreatitis and pancreatic cancer.

    Science.gov (United States)

    Maisonneuve, Patrick; Lowenfels, Albert B

    2002-01-01

    Pancreatic cancer is the fourth leading cause of cancer deaths in the USA in both sexes. Early diagnosis is difficult and the overall mortality rate is high. Individuals at high risk for pancreatic cancer include smokers, and persons with all forms of chronic alcoholic, metabolic, tropical or hereditary pancreatitis. The duration of exposure to inflammation seems to be the major factor involved in the transition from benign to malignant condition. Smoking, which appears to further accelerate the carcinogenic transformation, remains the strongest risk factor amenable to preventive intervention.

  16. Myeloperoxidase in Chronic Kidney Disease

    OpenAIRE

    Madhusudhana Rao, A.; Anand, Usha; Anand, C. V.

    2010-01-01

    Numerous lines of evidence implicate a role of myeloperoxidase (MPO) in the pathogenesis of cardiovascular disease (CVD). It is a well accepted fact that patients with chronic kidney disease (CKD) are at an increased risk for CVD. MPO is a pro-oxidant enzyme which could be involved in the increased susceptibility of these patients to CVD. Hence, the levels of plasma MPO was determined in healthy controls as well as in patients with CKD [stratified with the level of their kidney failure as CKD...

  17. Chronic Venous Disease under pressure

    OpenAIRE

    Reeder, Suzan

    2013-01-01

    textabstractIn chapter 1 we provide a general introduction of this thesis. Chronic venous disease (CVD) is a common medical condition that affects 2-64% of the worldwide population and leads to leg ulcers in 1% of the Western population. Venous leg ulceration (VLU) has an unfavorable prognosis with regard to non-healing and recurrence rates. Annually 6% of the total healthcare costs are spent on the treatment of venous diseases. CVD results from ambulatory venous hypertension and is the conse...

  18. Neuropsychological functioning in chronic Lyme disease.

    Science.gov (United States)

    Westervelt, Holly James; McCaffrey, Robert J

    2002-09-01

    Lyme disease is currently the most common vector-borne illness in the United States. The disease is multisystemic, and chronic disease, in particular, may be associated with neuropsychological deficits. However, to date, only a few empirical studies exist, which examine the neuropsychological sequelae associated with chronic Lyme disease. A review of the literature shows that the deficits observed in adults with chronic Lyme disease are generally consistent with the deficits that can be seen in processes with primarily frontal systems involvement. These observations are generally consistent with neuroradiologic findings. The clinical presentation in chronic Lyme disease and the nature of the neuropsychological deficits are discussed, as are several central issues in understanding neuropsychological functioning in chronic Lyme disease, such as the impact of chronic illness, response to treatment, and the relationship between neuropsychological performance and depression, fatigue, and neurological indicators of disease.

  19. New Directions in Chronic Disease Management

    Directory of Open Access Journals (Sweden)

    Hun-Sung Kim

    2015-06-01

    Full Text Available A worldwide epidemic of chronic disease, and complications thereof, is underway, with no sign of abatement. Healthcare costs have increased tremendously, principally because of the need to treat chronic complications of non-communicable diseases including cardiovascular disease, blindness, end-stage renal disease, and amputation of extremities. Current healthcare systems fail to provide an appropriate quality of care to prevent the development of chronic complications without additional healthcare costs. A new paradigm for prevention and treatment of chronic disease and the complications thereof is urgently required. Several clinical studies have clearly shown that frequent communication between physicians and patients, based on electronic data transmission from medical devices, greatly assists in the management of chronic disease. However, for various reasons, these advantages have not translated effectively into real clinical practice. In the present review, we describe current relevant studies, and trends in the use of information technology for chronic disease management. We also discuss limitations and future directions.

  20. Is acute recurrent pancreatitis a chronic disease?

    OpenAIRE

    Mariani, Alberto; Testoni, Pier Alberto

    2008-01-01

    Whether acute recurrent pancreatitis is a chronic disease is still debated and a consensus is not still reached as demonstrated by differences in the classification of acute recurrent pancreatitis. There is major evidence for considering alcoholic pancreatitis as a chronic disease ab initio while chronic pancreatitis lesions detectable in biliary acute recurrent pancreatitis (ARP) seem a casual association. Cystic fibrosis transmembrane conductance regulator (CFTR) gene mutation, hereditary a...