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1

Cellulitis  

MedlinePLUS

... the eyelid skin and/or the eye socket (orbit). What is the orbital septum? The orbital septum ... eyelid skin from the deeper structures of the orbit. What is preseptal cellulitis? Preseptal cellulitis is an ...

2

Cellulitis  

MedlinePLUS

... the back of thighs! Cellulitis (say: sel-yuh-LY-tus) is actually a common infection of the ... The Nemours Foundation, iStock, Getty Images, Corbis, Veer, Science Photo Library, Science Source Images, Shutterstock, and Clipart. ...

3

Tumeur à cellules granuleuses  

Microsoft Academic Search

Résumé  La tumeur à cellules granuleuses est une tumeur englobant un groupe hétérogène d’entités caractérisé par la prolifération\\u000a de grandes cellules aux cytoplasmes abondants granuleux éosinophiles. Nous rapportons l’observation d’une femme âgée de 39\\u000a ans, hospitalisée pour un nodule unique du bras à surface pigmentée de 2 cm de diamètre, évoluant depuis un an, et pour lequel\\u000a une exérèse chirurgicale a

S. Belhaj; N. Bennani-Guebessi; M. Karkouri; L. Moutaoui; S. Chiheb; H. Benchikhi; S. Zamiati

2010-01-01

4

The Hot Orbit: Orbital Cellulitis  

PubMed Central

Orbital cellulitis is an uncommon condition previously associated with severe complications. If untreated, orbital cellulitis can be potentially sight and life threatening. It can affect both adults and children but has a greater tendency to occur in the pediatric age group. The infection most commonly originates from sinuses, eyelids or face, retained foreign bodies, or distant soources by hematogenous spread. It is characterized by eyelid edema, erythema, chemosis, proptosis, blurred vision, fever, headache, and double vision. A history of upper respiratory tract infection prior to the onset is very common especially in children. In the era prior to antibiotics, vision loss from orbital cellulitis was a dreaded complication. Currently, imaging studies for detection of orbital abcess, the use of antibiotics and early drainage have mitigated visual morbidity significantly. The purpose of this review is to describe current investigative strategies and management options in the treatment of orbital cellulitis, establish their effectiveness and possible complications due to late intervention. PMID:22346113

Chaudhry, Imtiaz A.; Al-Rashed, Waleed; Arat, Yonca O.

2012-01-01

5

Orbital Meningocele Presenting as Periorbital Cellulitis  

Microsoft Academic Search

A case of orbital meningocele in a 15-day-old infant presenting as periorbital cellulitis, followed by meningitis, is described. Unlike other cases with the same anomaly, signs were not noted in the involved eye, neither before the cellulitis nor after recovery following antibiotic treatment. Preoperative diagnosis was confirmed by tomography of the orbit. On operation a bony defect was found in

Z. Weizman; A. Tenembaum; M. Perlman; A. Sahar

1981-01-01

6

Midline granuloma presenting as orbital cellulitis  

Microsoft Academic Search

? Background: Lethal midline granuloma usually presents with rhinorrhoea and redness of the skin above the nose. Early ocular symptoms are very rare. We here describe a patient who presented with acute orbital cellulitis. ? Patient: A 73-year-old woman had a 24-h history of severe pain around her left eye. We saw the typical clinical picture of orbital cellulitis. A

Jiirg Heinrieh Meyer; Bernhard Scharf; Jiirgen Gerling

1996-01-01

7

Skin Squamous Cell Carcinoma Presenting as Cellulitis  

PubMed Central

In general, skin squamous cell carcinoma (SCC) presents as papules or plaques with erythematous or pigmented appearance that may ulcerate the skin. Cellulitis caused by metastatic deposit from a known primary skin SCC has been reported once.1 We describe a patient who presented with cellulitis on the face that did not respond well to full course of antibiotics treatment, and turned out to be a newly diagnosed SCC after biopsy. Other differential diagnoses, such as malignancy, should be suspected in all unusual presentations and biopsy should be taken if patients do not show an optimal and desired improvement after receiving a full-course of antibiotic therapy for cellulitis.

Zhao, Min; Sasikumar, Katamreddy; Kinoshita, Masanosuke; Abdullah, Mahdi; Alhusaini, Hiyard; Alaie, Dariush; Petrillo, Richard L

2015-01-01

8

Postoperative pneumococcal cellulitis in systemic lupus erythematosus.  

PubMed

This paper reports a case of nosocomial pneumococcal cellulitis that developed following a lymph-node biopsy in a woman being treated with high-dose intravenous corticosteroids for systemic lupus erythematosis (SLE). Her rapid and severe clinical deterioration was similar to that caused by group A streptococcus. The risk factors for the development of nosocomial pneumococcal cellulitis as a complication of SLE are reviewed and preventive measures discussed. PMID:12693569

Page, Kathleen R; Karakousis, Petros C; Maslow, Joel N

2003-01-01

9

Orbital cellulitis caused by Fusobacterium necrophorum  

Microsoft Academic Search

PURPOSE: To report the case of a previously healthy young female who developed orbital cellulitis caused by Fusobacterium necrophorum. We are unaware of previous reports of this condition caused by the same anaerobic, gram-negative, nonsporeforming bacterium and could find no reference to it in a computer search using MEDLINE.METHODS: Case report.RESULTS: In the case of orbital cellulitis presented here, the

J. A. Escardó; A. Feyi-Waboso; J. E. Morgan

2001-01-01

10

Cellulitis  

MedlinePLUS

... SI, Gilchrest BA, Paller AS, Leffell DJ, eds. Fitzpatrick's Dermatology in General Medicine . 7th ed. New York, ... New York: Mosby, 2003. Freedberg, Irwin M., ed. Fitzpatrick's Dermatology in General Medicine . 6th ed, pp. 1845, ...

11

Idiopathic orbital myositis mimicking orbital cellulitis.  

PubMed

Idiopathic orbital myositis (IOM) is a subtype of orbital inflammatory disease characterized by primarily involving the extraocular muscle. The signs and symptoms of IOM may also be seen in such processes as orbital cellulitis, primary or metastatic orbital neoplasm, carotid-cavernous fistulae, arteriovenous malformations, cavernous sinus thrombosis, and thyroid eye disease, and because there is no pathognomonic sign, symptoms, laboratory test, or radiologic findings, its diagnosis is often provisional. In our case, diagnosis of IOM was more difficult because our patient presented with proptosis after alloplastic implant insertion in the blow-out fracture. After considering radiologic and physical findings, we concluded that cellulitis was more likely as initial diagnosis. To remove foreign body or pus, surgical exploration was done, but intraoperative findings did not show any pus or sign of infection but diffuse enlargement and swelling of inferior rectus muscle. The diagnosis was confirmed as IOM, and the patient was treated with systemic corticosteroid. Although proptosis after alloplastic insertion in blow-out fracture is usually a sign of cellulitis, this case illustrates that it may also occur in patients with IOM. PMID:20485087

Kim, Dong Seok; Lee, Jung Ho; Oh, Deuk Young; Seo, Je Won; Ahn, Sang Tae; Rhie, Jong Won

2010-05-01

12

Risk factors for bacteremia in patients with limb cellulitis  

Microsoft Academic Search

The aim of this study was to identify the risk factors for bacteremia in patients with limb cellulitis. Using the administrative and microbiology laboratory databases of a community teaching hospital, a review was conducted of all cases of community-acquired limb cellulitis that occurred during the period 1997–2004 and in which blood cultures had been performed. A comparison of demographical, clinical,

G. Peralta; E. Padrón; M. P. Roiz; I. De Benito; J. C. Garrido; F. Talledo; M. J. Rodríguez-Lera; L. Ansorena; M. B. Sánchez

2006-01-01

13

Skin and Soft Tissue Infection (Cellulitis) (Beyond the Basics)  

MedlinePLUS

... articles are best for patients who want in-depth information and are comfortable with some medical jargon. ... tissue, and bone infections Soft tissue infections following water exposure Breast cellulitis: Clinical manifestations, diagnosis, and management ...

14

Challenges of cellulitis in a lymphedematous extremity: a case report  

PubMed Central

Introduction Lymphedema is a relatively common phenomenon. It is important that clinicians appreciate the relative risks imposed by this condition. While for some it may only represent a flaw in appearance, this condition can potentially have fatal consequences. Our case reports on the challenges of cellulitis in a lymphedematous extremity that progressed to septic shock. Case presentation A 37-year-old Hispanic male was transferred to the Burn Unit from an outside hospital for wound care of an extremely severe case of cellulitis. He suffered massive lymphedema of his lower extremity, with innumerable nodules and chronic skin changes. After 3 days of cellulitis, he was in critical condition and required intubation and vasopressors. With intense wound care and systemic antibiotics, he gradually recovered and was discharged in 16 days with his cellulitis resolved and ambulating independently. Conclusion Our case highlights the special care and attention that chronic lymphedema deserves. These patients can exhibit marked disfigurement and physical disability affecting them on both social and physical levels. They also are at great medical risk, as cellulitis almost cost our patient his life. Evidence indicates that lymphedema, no matter the etiology, is susceptible to cellulitis with both great propensity and virulence. Physicians should be aware of the great risk of lymphedema, strive to prevent deterioration and complications, and be prepared to educate and closely monitor these patients. PMID:20062550

2009-01-01

15

Nonpigmented Chromobacterium violaceum bacteremic cellulitis after fish bite.  

PubMed

A case of nonpigmented Chromobacterium violaceum bacteremic cellulitis after fish bite in Taiwan is reported. The patient was successfully treated with ciprofloxacin and doxycycline for an extended period. Chromobacterium violaceum should be listed in the differential diagnosis of patients with nonspecific cellulitis associated with marked leukocytosis and rapid progression to septicemia either with or without a distinct history of exposure to water or soil. A combination of prompt diagnosis, optimal antimicrobial therapy, and adequate therapeutic duration for C violaceum infection is the key for successful therapy. PMID:21524969

Yang, Ching-Huei

2011-10-01

16

Descending necrotizing mediastinitis and thoracic cellulitis due to varicella.  

PubMed

A 22-year-old man with varicella had associated cervical enlargement, right upper thoracic anterior and suprascapular cellulitis, and mediastinitis. A tracheostomy, right posterolateral thoracotomy, cervicotomy, and upper thoracic fasciotomy were performed 14 h after admission, draining purulent exudates from all sites. The patient was discharged on postoperative day 22. PMID:22371953

Dajer-Fadel, Walid L; Borrego-Borrego, Rafael; Flores-Calderon, Octavio; Ibarra-Perez, Carlos

2012-02-01

17

Is it necrotizing fasciitis or necrotizing cellulitis after varicella zoster infection? Two case reports.  

PubMed

Necrotizing fasciitis and necrotizing cellulitis are serious cutaneous complications in varicella patients. Differentiation of necrotizing cellulitis from necrotizing fasciitis can initially be challenging because of indistinct clinical course at the onset of infection and the lack of definitive diagnostic criteria. This paper reports 2 children with necrotizing cellulitis that developed after varicella infection to draw the attention of health care providers to necrotizing cellulitis that showed slower clinical course than necrotizing fasciitis and recovered with conservative treatment approaches without aggressive surgical intervention. PMID:25014327

Gundeslioglu, Ayse Ozlem; Selimoglu, Muhammed Nebil; Toy, Hatice

2014-08-01

18

Neisseria meningitidis as a cause of facial cellulitis.  

PubMed

A 68-year-old man presented with facial cellulitis and found to have Neisseria meningitidis bacteraemia with no evidence of infection outside of the facial soft tissue. He was treated with a course of intravenous ceftriaxone and transitioned to oral amoxicillin on discharge with significant improvement of his symptoms. N meningitidis is best recognised as a causal agent of bacterial meningitis. To our knowledge N meningitidis cellulitis has only been described in 12 other cases. In this case series we describe and summarise our case, along with the 12 cases already reported in the literature. We report this case series to highlight the importance of recognising N meningitidis in the differential in patients presenting with acute skin and soft tissue infections especially involving the periorbital, head and neck regions. PMID:24626385

Ozaki, Brent; Kittai, Adam; Chang, Suzanne

2014-01-01

19

Posttraumatic Fat Necrosis Presented as Cellulitis of the Leg  

PubMed Central

Cellulitis, a diffuse inflammation of connective tissue with severe inflammation of dermal and subcutaneous layers of the skin, is a common lesion in children, usually responsive to systemic antibiotic therapy. However, an unusual course of healing or some nontypical features should call the treating physician to consider and investigate for other diagnoses that might prevent unnecessary treatment and alleviate parental stress. We present a case of posttraumatic fat necrosis, demonstrating some pitfalls in the process of diagnosis. PMID:23050184

Haikin Herzberger, Einat; Aviner, Shraga; Cherniavsky, Evgenia

2012-01-01

20

Orbital cellulitis following silicone-sponge scleral buckles  

PubMed Central

Background Acute or chronic infection of the scleral explant is rare. We report seven cases of scleral explant infections that caused orbital cellulitis. Materials and methods This was a retrospective chart review of oculoplastics at oculoplastics and vitreo-retinal units in a secondary referral hospital. All subjects had orbital cellulitis secondary to scleral buckle in the range of January 1990 to March 2010. Demographics, imaging studies, and pathology specimens were reviewed. Results A total of 841 silicone-sponge scleral buckle implants for rhegmatogenous retinal detachment were performed. Forty were extracted (4.75%; annual rate of 1.9 cases). Seven (0.83%) had orbital cellulitis. The mean time from implantation to presentation was 5.7 years. There was bacterial growth in all specimens, with Staphylococcus aureus in four. Conclusions Patients who are operated on with silicone-sponge scleral buckling for rhegmatogenous retinal detachment sometimes require removal of the implant because of infection. However, the infection rate is low. Patients should be followed in the long term for possible complications. PMID:24204118

Nemet, Arie Y; Ferencz, Joseph R; Segal, Ori; Meshi, Amit

2013-01-01

21

Persistence of cellulitis-associated Escherichia coli DNA ngerprints in successive broiler  

E-print Network

is primarily caused by Escherichia coli. Previous research found that the E. coli isolates of cellulitis origin were unique to each ranch, suggesting that these E. coli were endemic within the ranch environment. To test the hypothesis that the E. coli associated with cellulitis are endemic in the litter

Singer, Randall

22

Eosinophilic cellulitis (Wells’ syndrome) caused by a temporary henna tattoo  

PubMed Central

Eosinophilic cellulitis (Wells’ syndrome) is an uncommon condition of unknown etiology. Wells’ syndrome is usually seen in adulthood but very rare in childhood. Although pathogenesis of the disease is not very clear, it is a hypersensitivity reaction developing against a variety of exogenous and endogenous antigenic stimuli. Paraphenylenediamine is a strong allergen frequently used as a temporary henna tattoo, which makes the color darker. Here, a 9-year-old male patient with Wells’ syndrome is presented, which developed following a temporary henna tattoo and shown by the patch test sensitivity to paraphenylenediamine. PMID:25395929

Celegen, Mehmet; Kark?ner, Canan Sule Unsal; Günay, Ilker; Diniz, Güllden; Can, Demet

2014-01-01

23

Eosinophilic cellulitis (Wells' syndrome) caused by a temporary henna tattoo.  

PubMed

Eosinophilic cellulitis (Wells' syndrome) is an uncommon condition of unknown etiology. Wells' syndrome is usually seen in adulthood but very rare in childhood. Although pathogenesis of the disease is not very clear, it is a hypersensitivity reaction developing against a variety of exogenous and endogenous antigenic stimuli. Paraphenylenediamine is a strong allergen frequently used as a temporary henna tattoo, which makes the color darker. Here, a 9-year-old male patient with Wells' syndrome is presented, which developed following a temporary henna tattoo and shown by the patch test sensitivity to paraphenylenediamine. PMID:25395929

Nacaroglu, Hikmet Tekin; Celegen, Mehmet; Kark?ner, Canan Sule Unsal; Günay, Ilker; Diniz, Güllden; Can, Demet

2014-10-01

24

Cellules photo-lectrochimiques lectrodes semiconductrices pour la conversion et le stockage de l'nergie solaire  

E-print Network

463 Cellules photo-électrochimiques à électrodes semiconductrices pour la conversion et le stockage : les cellules autorégénérées, fournissant de l'énergie électrique, et les cellules de stockage stockage photo-électrochimique (PEC) de l'énergie solaire a crû de façon spectaculaire. Plusieurs congrès

Boyer, Edmond

25

Evidence of streptococcal origin of acute non-necrotising cellulitis: a serological study.  

PubMed

Bacteriological diagnosis is rarely achieved in acute cellulitis. Beta-haemolytic streptococci and Staphylococcus aureus are considered the main pathogens. The role of the latter is, however, unclear in cases of non-suppurative cellulitis. We conducted a serological study to investigate the bacterial aetiology of acute non-necrotising cellulitis. Anti-streptolysin O (ASO), anti-deoxyribonuclease B (ADN) and anti-staphylolysin (ASTA) titres were measured from acute and convalescent phase sera of 77 patients hospitalised because of acute bacterial non-necrotising cellulitis and from the serum samples of 89 control subjects matched for age and sex. Antibiotic treatment decisions were also reviewed. Streptococcal serology was positive in 53 (69 %) of the 77 cases. Furthermore, ten cases without serological evidence of streptococcal infection were successfully treated with penicillin. Positive ASO and ADN titres were detected in ten (11 %) and three (3 %) of the 89 controls, respectively, and ASTA was elevated in three patients and 11 controls. Our findings suggest that acute non-necrotising cellulitis without pus formation is mostly of streptococcal origin and that penicillin can be used as the first-line therapy for most patients. PMID:25403372

Karppelin, M; Siljander, T; Haapala, A-M; Aittoniemi, J; Huttunen, R; Kere, J; Vuopio, J; Syrjänen, J

2014-11-18

26

Extranodal NK/T-cell lymphoma mimicking cellulitis.  

PubMed

NK/T-cell lymphoma is difficult to diagnose because there is no characteristic cytology to help the diagnosis in tissue sections, particularly when there is polymorphic cellular infiltration in the early stage of the disease. However, the nasal type of extranodal NK/T-cell lymphoma has a characteristic histologic pattern, which is angiocentric, angioinvasive and angiodestructive. Therefore, many cases of this tumor may show extensive necrosis that mimics infectious process. Furthermore, because the immunosuppressive status of these patients, they may, in fact, have superimposed infections. We are reporting a case that presented as cellulitis and only after careful examination with immunohistochemistry that a correct diagnosis of extranodal NK/T-cell lymphoma, nasal type, was established. Since this lymphoma is incurable and immunophenotyping is instrumental for the diagnosis and prediction of the prognosis, a high index of suspicion for this tumor is needed when an angiocentric lesion is found in the midline of the head and neck region, and a thorough immunohistological study should always be conducted in these cases. PMID:15359650

Jia, Hongchen; Sun, Tsieh

2004-07-01

27

Delayed breast cellulitis: An evolving complication of breast conservation  

SciTech Connect

Purpose: Delayed breast cellulitis (DBC) is characterized by the late onset of breast erythema, edema, tenderness, and warmth. This retrospective study analyzes the risk factors and clinical course of DBC. Methods and Materials: From 1985 through 2004, 580 sequential women with 601 stage T0-2N0-1 breast cancers underwent breast conserving therapy. Cases of DBC were identified according to accepted clinical criteria: diffuse breast erythema, edema, tenderness, and warmth occurring >3 months after definitive surgery and >3 weeks after radiotherapy. Potential risk factors analyzed included patient comorbidity, operative technique, acute complications, and details of adjunctive therapy. Response to treatment and long-term outcome were analyzed to characterize the natural course of this syndrome. Results: Of the 601 cases, 16%, 52%, and 32% were Stage 0, I, and II, respectively. The overall incidence of DBC was 8% (50/601). Obesity, ecchymoses, T stage, the presence and aspiration of a breast hematoma/seroma, removal of >5 axillary lymph nodes, and arm lymphedema were significantly associated with DBC. The median time to onset of DBC from the date of definitive surgery was 226 days. Ninety-two percent of DBC patients were empirically treated with antibiotics. Fourteen percent required more invasive intervention. Twenty-two percent had recurrent episodes of DBC. Ultimately, 2 patients (4%) underwent mastectomy for intractable breast pain related to DBC. Conclusion: Although multifactorial, we believe DBC is primarily related to a bacterial infection in the setting of impaired lymphatic drainage and may appear months after completion of radiotherapy. Invasive testing before a trial of antibiotics is generally not recommended.

Indelicato, Daniel J. [Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, FL (United States); Grobmyer, Stephen R. [Department of Surgery, University of Florida, Gainesville, FL (United States); Newlin, Heather [Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, FL (United States); Morris, Christopher G. [Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, FL (United States); Haigh, Linda S. [Department of Surgery, University of Florida College of Medicine, Jacksonville, FL (United States); Copeland, Edward M. [Department of Surgery, University of Florida, Gainesville, FL (United States); Mendenhall, Nancy Price [Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, FL (United States)]. E-mail: mendenan@shands.ufl.edu

2006-12-01

28

Comparison of characteristic CT findings of lymphedema, cellulitis, and generalized edema in lower leg swelling.  

PubMed

To determine the different computed tomography (CT) findings of lymphedema, cellulitis, and generalized edema in the lower leg. CT images of 44 patients with confirmed lymphedema (n = 19), cellulitis (n = 11), or generalized edema (n = 14) were retrospectively reviewed. The following characteristics were evaluated: extent of edema, laterality, skin thickening, honeycombing, taller than wide appearance, muscle edema, conglomeration of septum of fat lobule, fluid collection, fascial enhancement, inguinal lymph node (LN) enlargement, medullary fat obliteration of inguinal LN, trunk subcutaneous edema, and bone marrow edema. Fisher's exact test with Bonferroni correction was used for multiple comparisons. Honeycombing and taller than wide appearance of fat lobules were more common in lymphedema (P < 0.01). Fat obliteration of inguinal LN and inguinal LN enlargement at the affected side were more common in cellulitis (P < 0.01). Bone marrow and subcutaneous edema of the trunk were more common in generalized edema (P < 0.01). Honeycombing is commonly seen in lymphedema, but is not a specific finding. Inguinal LN enlargement is a specific sign of cellulitis. Truncal edema and bone marrow edema were specific findings of generalized edema. PMID:24293042

Shin, Sung Ui; Lee, Whal; Park, Eun-Ah; Shin, Cheong-Il; Chung, Jin Wook; Park, Jae Hyung

2013-12-01

29

Effets de la prolactine sur la scrtion des lipides du lait dans les cellules pithliales mammaires  

E-print Network

Effets de la prolactine sur la sécrétion des lipides du lait dans les cellules épithéliales-en-Josas, France. Summary. Effect of prolactin on milk lipid secretion in lactating rabbit mammary gland epithelial cells. Milk lipids of lactating rabbit mammary epithelial cells were labelled in vitro during a 3- min

Boyer, Edmond

30

ETUDE DE L'EXPRESSION DES KINASES AURORA DANS LE CARCINOME A CELLULES RENALES  

E-print Network

ETUDE DE L'EXPRESSION DES KINASES AURORA DANS LE CARCINOME A CELLULES RENALES Romain Mathieu rénales, kinases Aurora, thérapies ciblées, envahissement ganglionnaire Nombre de mots total : 2092 Nombre OF THE EXPRESSION OF AURORA KINASES IN RENAL CELL CARCINOMA Romain Mathieu(a), Jean-Jacques Patard(a,b), Nathalie

Paris-Sud XI, Université de

31

AVIAN DISEASES 46:4852, 2002 Virulence Factors of Escherichia coli from Cellulitis or  

E-print Network

E. coli in order to clarify whether E. coli associated with cellulitis comprise a unique subset of pathogenic E. coli. Isolates were tested for serotype, capsule, aerobactin production, colicin production observed between groups. Cluster analysis showed that 90% of the E. coli isolates had greater than 42

Singer, Randall

32

Neurohumoral control of gastrointestinal motility Laboratoire de Biologie et Physiologie des Cellules digestives,  

E-print Network

peptides are present in both the digestive tract and the central nervous system. In spite of the work des Cellules digestives, (FRA 49 INSERM), Faculté de Médecine X Bichat, 16, rue H.-Huchard, 75018 produced a whole new collection of peptide molecules extracted from the digestive tract. Two facts

Paris-Sud XI, Université de

33

Insufficiency fractures of the distal tibia misdiagnosed as cellulitis in three patients with rheumatoid arthritis  

SciTech Connect

We describe 3 patients with rheumatoid arthritis who presented with diffuse pain, swelling, and erythema of the distal aspect of the lower extremity, suggestive of either cellulitis or thrombophlebitis, but were found to have insufficiency fractures of the distal tibia. The value of technetium-99m diphosphonate bone scintigraphy in the early recognition of these fractures and a possible explanation for the associated inflammatory symptoms are discussed.

Straaton, K.V.; Lopez-Mendez, A.; Alarcon, G.S. (Univ. of Alabama, Birmingham (USA))

1991-07-01

34

Management of fulminant dissecting cellulitis of the scalp in the pediatric population: Case report and literature review  

PubMed Central

A case of fulminant dissecting cellulitis of the scalp in a fifteen-year-old African American male is reported. The presentation was refractory to standard medical treatment such that treatment required radical subgaleal excision of the entire hair-bearing scalp. Reconstruction was in the form of split-thickness skin grafting at the level of the pericranium following several days of vacuum-assisted closure dressing to promote an acceptable wound bed for skin grafting and to ensure appropriate clearance of infection. Numerous nonsurgical modalities have been described for the treatment of dissecting cellulitis of the scalp, with surgical intervention reserved for patients refractory to medical treatment. The present paper reports a fulminant form of the disease in an atypical age of presentation, adolescence. The pathophysiology, etiology, natural history, complications and treatment options for dissecting cellulitis of the scalp are reviewed, and the authors suggest this method of treatment to be efficacious for severe presentations refractory to medical therapy. PMID:19554179

Arneja, Jugpal S; Vashi, Christopher N; Gursel, Eti; Lelli, Joseph L

2007-01-01

35

[Diagnosis and therapy of a dog with an atypical eosinophilic cellulitis].  

PubMed

A 6 years old female bernese mountain dog was seen for a nodular and erythemato-edematous dermatosis resistant to therapy. The histopathological exam showed a eosinophilic cellulitis with flame figures, which are caracteristic for the Wells' syndrome in human. A combined treatment with marbofloxacin and prednisolone brought first a stabilisation of the disease. The cutaneous lesions worsened however at the end of the antibiotic treatment, after reduction of the steroid dosage. The prescription of dapsone did not change the clinical image, which motivated the owner to euthanize the dog. This case report is presented to make practitioners aware of a rare but particularly challenging dermatological problem. PMID:21043027

Glardon, O; Pin, D

2010-11-01

36

Psoas abscess and cellulitis of the right gluteal region resulting from carcinoma of the cecum.  

PubMed

Although retroperitoneal or psoas abscess is an unusual clinical problem, the insidious and occult characteristics of this abscess sometimes cause diagnostic delays, resulting in considerably high morbidity and mortality. In particular, psoas abscess caused by perforated colon carcinoma is uncommon. We report a case of psoas abscess caused by a carcinoma of the cecum. A 72-year-old Japanese woman was admitted to our hospital, with pain in the right groin and buttock. The pain had appeared 6 months before admission, and the symptoms had then been relieved by oral antibiotics. On March 25, 1999, inflammatory signs in the right buttock indicated localized cellulitis, and incision and drainage was performed at a local hospital. The patient was referred to our hospital on the same day. On admission to our hospital, computed tomography (CT) scan revealed a thick right-sided colonic wall and enlargement of the right ileopsoas muscle. Barium enema and colonofiberscopy revealed an ulcerated tumor occupying the entire circumference of the cecum. A retroperitoneal abscess and fistula had been formed by the retroperitoneal perforation of cecum carcinoma: surgical resection was performed after remission of the local inflammatory signs. Operative findings indicated that the cancerous lesion and its surrounding tissues were firmly attached to the right iliopsoas and major psoas muscle, and en-bloc resection, including adjacent muscular tissue, was performed. The fact that carcinoma of the colon could be a cause of psoas abscess and cellulitis in the gluteal region should be considered when an unexplained psoas abscess is diagnosed. PMID:11578067

Kobayashi, H; Sakurai, Y; Shoji, M; Nakamura, Y; Suganuma, M; Imazu, H; Hasegawa, S; Matsubara, T; Ochiai, M; Funabiki, T

2001-09-01

37

Regional and national review of factors associated with burn wound cellulitis.  

PubMed

Burn wound cellulitis (BWC) is the second leading complication reported in burns. In this study we sought to identify demographic variables, burn factors, and other factors that may predispose patients to BWC. Regional data was obtained through retrospective medical record review of burn patients treated between May 2009 to April 2013 for BWC within 8 days of the injury. The patients were matched 1:2 with contemporaneously treated patients. Similarly, the National Burn Repository was queried to identify burn patients with BWC between the years 2002 to 2011, which were then compared to the remaining entries who did not have BWC reported. The data sets were analyzed separately. Univariate and multiple variable analyses were performed to evaluate risk factors for BWC. The risk factors that were consistent regionally and nationally were older age, male sex, African-American race (protective), lower extremity burns, scald burns, and full thickness burns. The treatment delay was only collected regionally, and was associated with an eight times increased risk. The factors that were inconsistent or significant in one sample only were smoking status, psychiatric conditions, upper extremity burns, and the place of injury. Cellulitis remains a significant problem for the burn community. Future prospective analyses need to clarify the impact of these factors as well as other factors on the development of BWC. Preventing BWC from occurring through earlier intervention or targeted prophylactic antibiotics may help reduce morbidity and decrease associated healthcare costs. PMID:25102232

Heard, Jason P; McDonald, Kara M; Xing, Yunfan; Kluesner, Karen M; Liao, Junlin; Wibbenmeyer, Lucy A

2015-01-01

38

Radiorésistance liée à l'hypoxie : de la cellule à l'homme  

NASA Astrophysics Data System (ADS)

Most experimental tumours contain experimental hypoxic cells located either far from the vessels or close to collaped vessels. The radioresistance of these cellscan be reduced by different treatments and, the best one will depend on the proportion of cells in the two categories of hypoxia. In patients, hypoxic areas have been detected in most solid tumours. The outcome of hypoxia during the course of an accelerated radiotherapy treatment is in progresse as well as the efficacy of carbogen (95% O2 5% CO2) to improve radiotherapy. We participate to the development of predictive assays of the tumour response to an irradiation. La plupart des tumeurs expérimentales renferment des cellules hypoxiques clonogènes situées soit à une certaine distance des vaisseaux soit au contact de vaisseaux collabés. La radiorésistance de ces cellules peut être réduite par différents procédés ; le meilleur traitement dépend de la proportion de celles dans les deux catégories d'hypoxie. Chez l'homme, des zones hypoxiques ont été mises en évidence dans la plupart des tumeurs solides. Le devenir de l'hypoxie au cours d'une radiothérapie accélérée ainsi que l'efficacité du carbogène (95 % O2- 5 % CO2) pour améliorer la radiothérapie sont en cours d'étude. Nous participons également au développement de teste prédicitifs de la réponse tumorale à une irradiation.

Guichard, M.; Stern, S.; Lartigau, E.

1998-04-01

39

Comparing short to standard duration of antibiotic therapy for patients hospitalized with cellulitis (DANCE): study protocol for a randomized controlled trial  

PubMed Central

Background Recommended therapy duration for patients hospitalized with cellulitis is 10–14 days. Unnecessary use of antibiotics is one of the key factors driving resistance. Recent studies have shown that antibiotic therapy for cellulitis in outpatients can safely be shortened, despite residual inflammation. This study will compare in hospitalized patients the safety and effectiveness of shortening antibiotic therapy for cellulitis from 12 to 6 days. Methods/design In a multicenter, randomized, double-blind, non-inferiority trial, adult patients admitted with cellulitis will be included. Cellulitis is defined as warmth, erythema, and induration of the skin and/or subcutaneous tissue, with or without pain (including erysipelas). All patients will initially be treated with intravenous flucloxacillin, and will be evaluated after 5–6 days. Those who have improved substantially (defined as being afebrile, and having a lower cellulitis severity score) will be randomized at day 6 between additional 6 days of oral flucloxacillin (n?=?198) or placebo (n?=?198). Treatment success is defined as resolution of cellulitis on day 14 (disappearance of warmth and tenderness, improvement of erythema and edema), without the need of additional antibiotics for cellulitis by day 28. Secondary endpoints are relapse rate (up to day 90), speed of recovery (using a cellulitis severity score until day 28, and VAS scores on pain and swelling until day 90), quality of life (using the SF-36 and EQ-5D questionnaires) and costs (associated with total antibiotic use and health-care resource utilization up to day 90). Discussion Inclusion is planned to start in Q2 2014. Trial registration ClinicalTrials.gov (NCT02032654) and the Netherlands Trial Register (NTR4360). PMID:24885384

2014-01-01

40

Combination of cyclosporin A and prednisolone for juvenile cellulitis concurrent with hindlimb paresis in 3 English cocker spaniel puppies  

PubMed Central

Three 7-week-old, English cocker spaniel littermates were diagnosed as having juvenile cellulitis with concurrent neurologic signs based on history, histopathology, and therapeutic response. The puppies were treated with cyclosporin A and prednisolone. Skin lesions and hindlimb paresis improved following treatment. PMID:21286328

Park, Chul; Yoo, Jong-Hyun; Kim, Ha-Jung; Kang, Byeong-Teck; Park, Hee-Myung

2010-01-01

41

The acute orbit: differentiation of orbital cellulitis from subperiosteal abscess by computerized tomography.  

PubMed

A series of 65 patients suffering from acute inflammatory disease of the orbit was studied by CT. Ethmoiditis was the cause in the vast majority; trauma and dental extraction played a lesser role in causation. Orbital cellulitis was diagnosed in 17 and subperiosteal abscess in the remaining 48. It was not possible to differentiate 33 pus-containing abscesses from the six with inflammatory masses (phlegmons). The satisfactory response to aggressive medical treatment in those patients with inflammatory masses that were not drained justifies a more conservative approach; surgical drainage being reserved for those with a deterioration in proptosis, ocular movements or vision. Six abscesses arose de novo, of which some were in the orbital fat rather than the subperiosteal space. PMID:2027437

Handler, L C; Davey, I C; Hill, J C; Lauryssen, C

1991-01-01

42

Cemento-ossifying Fibroma Of Paranasal Sinus Presenting Acutely As Orbital Cellulitis  

PubMed Central

Fibro-osseous lesions of the face and paranasal sinuses are relatively uncommon. These lesions have overlapping clinical, radiologic and pathologic features causing difficulty in diagnosis. Neoplastic fibro-osseous paranasal sinus lesions can be benign or malignant. The benign fibro-osseous lesions described are: ossifying fibroma (and its histologic variants) and fibrous dysplasia. The variants of ossifying fibroma differ in the nature of calcified material (i.e. cementum versus bone), in the location of the lesion (oral versus paranasal sinus or orbital), other morphologic variations (presence of psammomatoid concretions) and biologic behavior (aggressive versus stable). Presence of cementum or bone classifies the lesion as cementifying fibroma or ossifying fibroma respectively while lesions with mixture of both cementum and bone are called cemento-ossifying fibroma. We describe a case of a young adult male with cemento-ossifying fibroma of paranasal sinus presenting acutely as left orbital cellulitis with proptosis. PMID:22470655

Khanna, Maneesh; Buddhavarapu, Shanker Rao; Hussain, Sheik Akbar; Amir, Emran

2009-01-01

43

Facial and Periorbital Cellulitis due to Skin Peeling with Jet Stream by an Unauthorized Person  

PubMed Central

Technologies and devices for cosmetic procedures are developing with each passing day. However, increased and unauthorized use of such emerging technologies may also lead to increases in unexpected results and complications as well. Here, we report a case of facial cellulitis after a “beauty parlor” session of skin cleaning with jet stream peeling device in 19-year old female patient for the first time. Complications due to improper and unauthorized use of jet stream peeling devices may also cause doubts about the safety and impair the reputation of the technology as well. In order to avoid irreversible complications, local authorities should follow the technology and update the regulations where the dermatologists should take an active role. PMID:24822131

Kaptanoglu, Asli Feride; Mullaaziz, Didem; Suer, Kaya

2014-01-01

44

Detection d'adduits benzoralpyrene-ADN dans les cellules mononucleaires peripheriques d'ouvriers de cokeries : correlation a la  

E-print Network

Detection d'adduits benzoralpyrene-ADN dans les cellules mononucleaires peripheriques d'ouvriers de ä l'ADN humain.La formation d'adduits de l'ADN etant consideree comme un ^venement critique de la formation d'adduits benzo[a3pyrene-ADN peut jouer un röle etiologique,tout au moins chez certaines personnes

Boyer, Edmond

45

Risk Factors for Community-associated Methicillin-resistant Staphylococcus Aureus Cellulitis - and the Value of Recognition  

PubMed Central

Objectives To identify the risk factors for community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) cellulitis. Methods A review of risk factors for CA-MRSA skin and soft tissue infection in previously published literature was first performed. A retrospective cohort study was then conducted in a teaching ambulatory-care clinic of a tertiary medical center in Honolulu, Hawai‘i. Results Of 137 cases with cellulitis diagnosed from January 2005 to December 2007, MRSA was recovered from 85 (62%) of patients who presented with either abscesses or skin ulcers. The recovery of MRSA was significantly associated with obesity (p=0.01), presence of abscesses (p=0.01), and lesions involving the head and neck (p=0.04). Independent risk factors by multivariate logistic regression analysis included the presence of abscesses [adjusted odds ratio (aOR) 2.72; 95% confidence interval (CI) 1.27–5.83; p=0.01] and obesity (aOR 2.33; 95% CI 1.10–4.97; p =0.03). Patients with CA-MRSA were less likely to receive an appropriate antibiotic (p=0.04) and were more likely to require antibiotic change at evaluation in one week (p=0.04) compared with patients infected with non-MRSA bacteria. Conclusions The presence of abscesses and obesity were signifi cantly associated with CA-MRSA cellulitis. Empiric therapy with antibiotics active against MRSA should be guided by these risk factors. PMID:21229486

Tice, Alan D; Grandinetti, Andrew; Chow, Dominic

2010-01-01

46

Hypertrophic Osteoarthropathy Presenting as Unilateral Cellulitis with Successful Treatment Using Pamidronate Disodium  

PubMed Central

Hypertrophic pulmonary osteoarthropathy is a paraneoplastic syndrome seen in patients with lung cancer. This condition is characterized by the presence of digital clubbing, periosteal thickening, synovial thickening, and severe pain of the affected joints. Other syndromes exhibiting clubbing may or may not have underlying diseases causing their manifestation. An example is primary hypertrophic osteoarthropathy, or pachydermoperiostosis. While clubbing makes up part of the clinical picture in both hypertrophic pulmonary osteoarthropathy and hypertrophic osteoarthropathy, the latter has no underlying disease associations. Rather, primary hypertrophic osteoarthropathy is familial, idiopathic, and has a chronic course often beginning during puberty in males. Secondary hypertrophic osteoarthropathy is an acquired form of clubbing that is classically associated with lung disease. However, it has also been associated with diseases of the heart, liver, and intestines. In the setting of pulmonary malignancy, secondary hypertrophic osteoarthropathy is known as hypertrophic pulmonary osteoarthropathy. Hypertrophic pulmonary osteoarthropathy has a distinct constellation of clinical findings that includes intractable pain often refractory to treatments other than resolution of the underlying disease process. The authors herein report a case of hypertrophic pulmonary osteoarthropathy masquerading as recurrent lower extremity cellulitis with chronic hand and foot pain in the setting of pulmonary malignancy that responded dramatically to intravenous pamidronate disodium (a bisphosphonate). Given the rarity of hypertrophic osteoarthropathy associated with lung cancer and the difficulty with pain management in such circumstances, the authors present the following case in which pain was mitigated by treatment with bisphosphonate therapy. PMID:23050033

Bernardo, Sebastian G.; Burnett, Mark E.; Gordon, Marsha

2012-01-01

47

A case of cellulitis of the hands caused by a predatory bird attack  

PubMed Central

Many species have been drastically affected by rapid urbanization. Harris's hawks from their natural habitat of open spaces and a supply of rodents, lizards and other small prey have been forced to change their natural environment adapting to living in open spaces in sub- and peri-urban areas. Specific areas include playgrounds, parks and school courtyards. The migration of this predatory species into these areas poses a risk to individuals, and especially the children are often attacked by claws, talons and beaks intentionally or as collateral damage while attacking rodent prey. In addition, the diverse micro-organisms harbored in the beaks and talons can result in wound infections, presenting a challenge to clinical management. Here we would like to present a case of an 80-year-old man with cellulitis of both hands after sustaining minor injuries from the talons of a Harris's hawk and review the management options. We would also like to draw attention to the matter that, even though previously a rarity, more cases of injuries caused by birds of prey may be seen in hospital settings. PMID:23569751

Khan, M Adil Abbas; Farid, Mohammed; Sobani, Zain A; Ali, Syed Nadir; Malick, Huzaifa; Baqir, Maryam; Sharif, Hasanat; Beg, M Asim

2011-01-01

48

Sarcome à cellules claires du rein : À propos d’un cas chez un jeune de 17 ans  

PubMed Central

Résumé Le sarcome à cellules claires du rein (SCCR) se voit très rarement chez les jeunes. Il est caractérisé par une évolution agressive marquée par un taux élevé de récidive et de mortalité. Nous rapportons le cas d’un SCCR chez un patient de 17 ans et nous discutons de son apport et de son intérêt médical en vue d’une bonne prise en charge thérapeutique. L’agressivité du SCCR et la prolifération de métastases surtout osseuses impliquent qu’il ne faut pas méconnaître ce diagnostic afin de mettre en place un traitement adapté. PMID:24940474

Mazdar, Adil; Sakel, Adil Ait; Essatara, Younes; Beddouche, Ali; Elsayegh, Hachem; Iken, Ali; Benslimane, Lounis; Nouini, Yassine

2014-01-01

49

Cassures double-brin de l'ADN, cassures chrosomiques et létalité des cellules humaines irradiées  

NASA Astrophysics Data System (ADS)

DNA double-strand breaks (DSB) are the likely event which may explain the radiation-induced killing effect in mammalian cells. An overview of the litterature shows that, to the exception of a small group of human tumours, the repair defect rather than the induction rate of DSB plays the major role. However, the arguments supporting the relationship between DSB and intrinsic radiosensitivity are most often indirect. Our results dealing with intrinsic radiosensitivity, residual DNA DSB and chromosome breaks have been achieved with untransformed human fibroblasts (5 control and 18 hypersensitive cell lines). We describe a quantitative relationship between the intrinsic radiosensitivity and the residual breaks. The death of a human fibroblast is linked to 1.3 unrepaired chromosome break and 6.6 unrepaired DSB. Les cassures double-brin (CDB) de l'ADN constituent l'événement-clé susceptible d'expliquer l'effet létal des radiations ionisantes. Une revue générale de la littérature montre que, à l'exception d'un groupe minoritaire de tumeurs humaines, c'est surtout une déficience de réparation plutôt que l'incidence des dégâts qui est associée à la mort des cellules de mammifères irradiées. Toutefois, les arguments en faveur d'un lien entre radiosensibilité et CDB sont généralement indirects. À partir de 23lignées fibroblastiques humaines (5témoins et 18hypersensibles), nous décrivons une relation quantifiée entre la radiosensibilité intrinsèque et les cassures résiduelles de l'ADN et des chromosomes. La mort d'un fibroblaste humain irradié est associée à 6,6 CDB et 1,3 cassure chromosomique non réparées.

Foray, N.; Arlett, C. F.; Malaise, E. P.

1998-04-01

50

Tests of Nacelle-Propeller Combinations in Various Positions with Reference to Wings V : Clark Y Biplane Cellule - NACA Cowled Nacelle - Tractor Propeller  

NASA Technical Reports Server (NTRS)

This report is the fifth of a series giving the results obtained from wind tunnel tests on the interference drag and propulsive efficiency of nacelle-propeller-wing combinations. This report gives results of tests of an NACA cowled air-cooled engine nacelle with tractor propeller located in 12 positions with reference to a Clark Y biplane cellule.

Valentine, E Floyd

1935-01-01

51

Isolation of a Fastidious Bergeyella Species Associated with Cellulitis after a Cat Bite and a Phylogenetic Comparison with Bergeyella zoohelcum Strains  

Microsoft Academic Search

Bergeyella zoohelcum is an uncommon zoonotic pathogen typically associated with cat or dog bites. Previously, only five cases of B. zoohelcum infection have been reported. We report the isolation and characterization of a fastidious Bergeyella species from acute cellulitis in the upper extremity of a 60-year-old woman. The organism was too fastidious for identification and susceptibility testing with traditional culture

Sanjay K. Shukla; David L. Paustian; Patrick J. Stockwell; Roger E. Morey; Jean G. Jordan; Paul N. Levett; Daniel N. Frank; Kurt D. Reed

2004-01-01

52

Les cellules de la lignée germinale humaine ont la capacité d'internaliser la sex steroid-binding protein humaine (SBPh): Etude par autohistoradiographie en microscopie électronique à transmission (MET)  

Microsoft Academic Search

Resume  Il a été récemment démontré que les cellules spermatogénétiques de rat sont capables de lier et d'internaliser spécifiquement\\u000a l'androgen-binding protein de rat (ABPr). De même les cellules spermatogénétiques du macaque, sont capables de lier et d'internaliser\\u000a spécifiquement la sex steroid-binding protein humaine (SBPh).\\u000a \\u000a Cette étude consiste à tester si des interactions entre les cellules spermatogénétiques et les protéines de liaison

R. Bedjou; A. Gerard; F. Felden; P. Franck; Th Durriez; J. Hubert; H. Lejeune; J. L. Gueant; H. Gerard

1995-01-01

53

Genotypes and Pathogenicity of Cellulitis Isolates Reveal Traits That Modulate APEC Virulence  

PubMed Central

We characterized 144 Escherichia coli isolates from severe cellulitis lesions in broiler chickens from South Brazil. Analysis of susceptibility to 15 antimicrobials revealed frequencies of resistance of less than 30% for most antimicrobials except tetracycline (70%) and sulphonamides (60%). The genotyping of 34 virulence-associated genes revealed that all the isolates harbored virulence factors related to adhesion, iron acquisition and serum resistance, which are characteristic of the avian pathogenic E. coli (APEC) pathotype. ColV plasmid-associated genes (cvi/cva, iroN, iss, iucD, sitD, traT, tsh) were especially frequent among the isolates (from 66.6% to 89.6%). According to the Clermont method of ECOR phylogenetic typing, isolates belonged to group D (47.2%), to group A (27.8%), to group B2 (17.4%) and to group B1 (7.6%); the group B2 isolates contained the highest number of virulence-associated genes. Clonal relationship analysis using the ARDRA method revealed a similarity level of 57% or higher among isolates, but no endemic clone. The virulence of the isolates was confirmed in vivo in one-day-old chicks. Most isolates (72.9%) killed all infected chicks within 7 days, and 65 isolates (38.1%) killed most of them within 24 hours. In order to analyze differences in virulence among the APEC isolates, we created a pathogenicity score by combining the times of death with the clinical symptoms noted. By looking for significant associations between the presence of virulence-associated genes and the pathogenicity score, we found that the presence of genes for invasins ibeA and gimB and for group II capsule KpsMTII increased virulence, while the presence of pic decreased virulence. The fact that ibeA, gimB and KpsMTII are characteristic of neonatal meningitis E. coli (NMEC) suggests that genes of NMEC in APEC increase virulence of strains. PMID:23977279

Barbieri, Nicolle Lima; de Oliveira, Aline Luísa; Tejkowski, Thiago Moreira; Pavanelo, Daniel Brisotto; Rocha, Débora Assumpção; Matter, Letícia Beatriz; Callegari-Jacques, Sidia Maria; de Brito, Benito Guimarães; Horn, Fabiana

2013-01-01

54

Supermicrosurgical anastomosis of superficial lymphatic vessel to deep lymphatic vessel for a patient with cellulitis-induced chronic localized leg lymphedema.  

PubMed

Supermicrosurgical lymphaticovenular anastomosis (LVA) has been reported to be useful for the treatment of obstructive lymphedema. However, LVA has a potential risk of anastomosis site thrombosis. It is more physiological to use a lymphatic vessel as a recipient vessel of lymphatic bypass surgery, because there is no chance for blood to contact the anastomosis site. We report a chronic localized lower leg lymphedema case treated with supermicrosurgical superficial-to-deep lymphaticolymphatic anastomosis (LLA). A 66-year-old male with a 60-year history of cellulitis-induced left lower leg lymphedema suffered from very frequent episodes of cellulitis and underwent LLA under local infiltration anesthesia. LLA was performed at the dorsum of the left foot. A dilated superficial lymphatic vessel was found in the fat layer, and a nondilated intact deep lymphatic vessel was found along the dorsalis pedis artery below the deep fascia. The superficial lymphatic vessel was supermicrosurgically anastomosed to the deep lymphatic vessel in a side-to-end fashion. After the surgery, the patient had no episodes of cellulitis, and the left lower leg lymphedematous volume decreased. Superficial-to-deep LLA may be a useful option for the treatment of secondary lymphedema due to obstruction of only the superficial lymphatic system. © 2014 Wiley Periodicals, Inc. Microsurgery 35:68-71, 2015. PMID:25197031

Yamamoto, Takumi; Koshima, Isao

2015-01-01

55

Life of lesions in eosinophilic cellulitis (wells' syndrome)-a condition that may be missed at first sight.  

PubMed

: Eosinophilic cellulitis is an inflammation of, until now, unknown etiology that was first described by George Wells in 1971. Its dominating histological hallmarks are so-called "flame figures" and an eosinophilic infiltrate. Here, we report the case of a 46-year-old man who initially presented with excoriated papules that were histologically interpreted as consistent with "arthropod reactions." Later on, the clinical presentation changed to erythematous plaques, partially with cockade-like aspects. At this time, new biopsies were performed showing a superficial and deep perivascular lymphocytic and heavily eosinophilic infiltrate and flame figures, thus allowing to establish the diagnosis of Wells' syndrome. Under treatment with oral prednisolone and dapsone, the patient showed a rapid improvement of the condition. The presented case demonstrates both the clinical and histopathologic life of lesions of Well's syndrome in the course of the disease from unspecific to distinctive. The need for repeated biopsies is discussed. Current understanding of the pathogenesis of Wells' syndrome and its correlating histological features are elucidated. PMID:25238447

Peckruhn, Melanie; Tittelbach, Joerg; Schliemann, Sibylle; Elsner, Peter

2015-02-01

56

Etude des phenomenes chimiques au contact entre le bloc cathodique et la barre collectrice d'une cellule d'electrolyse d'aluminium  

NASA Astrophysics Data System (ADS)

La production d'aluminium est une industrie importante au Québec. Les propriétés de ce métal le vouent à de multiples usages présents et futurs dans le cadre d'une économie moderne durable. Toutefois, le procédé Hall-Héroult est très énergivore et des progrès demeurent donc nécessaires pour en diminuer les coûts financiers et environnementaux. Parmi les améliorations envisageables de la cellule d'électrolyse se trouve le contact entre la cathode et la barre collectrice, qui doit offrir une faible résistivité au passage du courant électrique. En cours d'opération de la cellule, ce contact a tendance à se dégrader, générant des pertes énergétiques significatives. Les causes de cette dégradation, pouvant provenir de phénomènes chimiques, thermiques, mécaniques et/ou électriques, demeurent mal comprises. Le but du présent projet était donc d'étudier les phénomènes chimiques se produisant au contact bloc-barre de la cellule d'électrolyse Hall-Héroult. En premier lieu, un aspect crucial à considérer est la pénétration du bain électrolytique dans la cathode, car des composés de bain atteignent éventuellement la barre collectrice et peuvent y réagir. A cet effet, une méthode novatrice a été développée afin d'étudier les cathodes et la pénétration du bain dans celles-ci à l'aide de la microtomographie à rayons X. Cette méthode rapide et efficace s'est avérée fort utile dans le projet et a un potentiel important pour l'étude future des cathodes et des phénomènes qui s'y produisent. Ensuite, une cellule d'électrolyse rectangulaire à petite échelle a été développée. Plusieurs phénomènes observés 'en industrie sur des autopsies de cellules post-opération et rapportés dans la littérature ont été reproduis avec succès à l'aide de cette cellule expérimentale. Puis, des tests sans électrolyse, ciblant l'effet du bain électrolytique sur l'acier, ont aussi été conçus et complétés afin de ségréger l'influence des différents paramètres en jeu. L'analyse des résultats de l'ensemble de ces tests a permis de constater différents phénomènes au contact bloc-barre, dont la présence systématique de NaF et, surtout, de ?-Al 2O3. Outre la carburation inévitable de la barre collectrice, la formation d'une couche Fe-Al a aussi été observée, favorisée par une pénétration rapide du bain électrolytique dans la cathode ainsi que par une composition de bain acide en surface de la barre. Cette couche comportait par ailleurs des cristaux de ?-Al 2O3 pouvant nuire à sa conductivité électrique. Ensuite, à des ratios de bain entre 2.5 et 4.9, une mince couche contenant les éléments Al et N peut se former en surface de la barre. Pour un bain très basique (> 6.0), c'est plutôt une couche Na 2O qui a été observée. En conditions d'électrolyse mais sans une pénétration rapide du bain dans la cathode, du Na a pu carrément pénétrer dans la barre collectrice, préférentiellement avec le carbone. De plus, de la corrosion ainsi que des couches de fer et d'oxyde de fer peuvent se former sur la barre et potentiellement dégrader la qualité du contact électrique. Pour la suite des travaux, des mesures de résistivité ainsi que l'analyse des échantillons industriels permettraient d'évaluer l'impact de ces phénomènes sur la qualité du contact. Mots-clés : Électrolyse, aluminium, Hall-Héroult, interface barre-cathode, bain électrolytique.

Lebeuf, Martin

57

Oral flucloxacillin and phenoxymethylpenicillin versus flucloxacillin alone for the emergency department outpatient treatment of cellulitis: study protocol for a randomised controlled trial  

PubMed Central

Background Oral flucloxacillin, either alone or in combination with phenoxymethylpenicillin, is a commonly prescribed antibiotic for the treatment of cellulitis, particularly in Ireland and the United Kingdom. This study aims to establish the non-inferiority of oral monotherapy (flucloxacillin alone) to dual therapy (flucloxacillin and phenoxymethylpenicillin) for the outpatient treatment of cellulitis in adults. Methods/design This study is a multicentre, randomised, double-blind, placebo-controlled trial of adults who present to the emergency department (ED) with cellulitis that is deemed treatable on an outpatient basis with oral antibiotics. After fulfilling specified inclusion and exclusion criteria, informed consent will be taken. Patients will be given a treatment pack containing 7 days of treatment with flucloxacillin 500 mg four times daily and placebo or flucloxacillin 500 mg four times daily and phenoxymethylpenicillin 500 mg four times daily. The primary outcome measure under study is the proportion of patients in each group in which there is greater than or equal to a 50% reduction in the area of diameter of infection from the area measured at enrolment at the end-of-treatment visit (7 to 10 days). Secondary endpoints include a health-related quality of life measurement as rated by the SF-36 score and the Extremity Soft Tissue Infection Score (not validated), compliance and adverse events. Patients will be followed up by telephone call at 3 days, end-of-treatment visit (EOT) at 7 to 10 days and test-of-cure (TOC) visit at 30 days. To achieve 90% power, a sample size of 172 patients per treatment arm is needed. This assumes a treatment success rate of 85% with oral flucloxacillin and phenoxymethylpenicillin, an equivalence threshold ? = 12.5% and an ? = 0.025. Non-inferiority will be assessed using a one-sided confidence interval on the difference of proportions between the two groups. Standard analysis including per-protocol and intention-to-treat will be performed. Discussion This trial aims to establish the non-inferiority of flucloxacillin monotherapy to dual therapy in the treatment of uncomplicated cellulitis among ED patients. In doing so, this trial will bridge a knowledge gap in this understudied and common condition and will be relevant to clinicians across several different disciplines. Trial registration EudraCT Number 2008-006151-42 PMID:23732051

2013-01-01

58

Dissecting cellulitis (Perifolliculitis Capitis Abscedens et Suffodiens): a comprehensive review focusing on new treatments and findings of the last decade with commentary comparing the therapies and causes of dissecting cellulitis to hidradenitis suppurativa.  

PubMed

Dissecting cellulitis (DC) also referred to as to as perifolliculitis capitis abscedens et suffodiens (Hoffman) manifests with perifollicular pustules, nodules, abscesses and sinuses that evolve into scarring alopecia. In the U.S., it predominantly occurs in African American men between 20-40 years of age. DC also occurs in other races and women more rarely. DC has been reported worldwide. Older therapies reported effective include: low dose oral zinc, isotretinoin, minocycline, sulfa drugs, tetracycline, prednisone, intralesional triamcinolone, incision and drainage, dapsone, antiandrogens (in women), topical clindamycin, topical isotretinoin, X-ray epilation and ablation, ablative C02 lasers, hair removal lasers (800nm and 694nm), and surgical excision. Newer treatments reported include tumor necrosis factor blockers (TNFB), quinolones, macrolide antibiotics, rifampin, alitretinoin, metronidazole, and high dose zinc sulphate (135-220 mg TID). Isotretinoin seems to provide the best chance at remission, but the number of reports is small, dosing schedules variable, and the long term follow up beyond a year is negligible; treatment failures have been reported. TNFB can succeed when isotretinoin fails, either as monotherapy, or as a bridge to aggressive surgical treatment, but long term data is lacking. Non-medical therapies noted in the last decade include: the 1064 nm laser, ALA-PDT, and modern external beam radiation therapy. Studies that span more than 1 year are lacking. Newer pathologic hair findings include: pigmented casts, black dots, and "3D" yellow dots. Newer associations include: keratitis-ichthyosis-deafness syndrome, Crohn disease and pyoderma gangrenosum. Older associations include arthritis and keratitis. DC is likely a reaction pattern, as is shown by its varied therapeutic successes and failures. The etiology of DC remains enigmatic and DC is distinct from hidradenitis suppurativa, which is shown by their varied responses to therapies and their histologic differences. Like HS, DC likely involves both follicular dysfunction and an aberrant cutaneous immune response to commensal bacteria, such as coagulase negative staphylococci. The incidence of DC is likely under-reported. The literature suggests that now most cases of DC can be treated effectively. However, the lack of clinical studies regarding DC prevents full understanding of the disease and limits the ability to define a consensus treatment algorithm. PMID:24852785

Scheinfeld, Noah

2014-05-01

59

Cellules tumorales circulantes et cancer du sein : mthodes de dtection et rsultats cliniques. Franois-Clment Bidard (1,2,3), Antoine-Emmanuel Saliba (4), Laure Saias (4), Armelle Degeorges  

E-print Network

'ensemble des étapes successives du processus de dissémination : invasion locale, extravasation, interaction des cellules tumorales circulantes (CTC) avec les éléments figurés du sang, arrêt des CTC et extravasation

60

Isolation of a Fastidious Bergeyella Species Associated with Cellulitis after a Cat Bite and a Phylogenetic Comparison with Bergeyella zoohelcum Strains  

PubMed Central

Bergeyella zoohelcum is an uncommon zoonotic pathogen typically associated with cat or dog bites. Previously, only five cases of B. zoohelcum infection have been reported. We report the isolation and characterization of a fastidious Bergeyella species from acute cellulitis in the upper extremity of a 60-year-old woman. The organism was too fastidious for identification and susceptibility testing with traditional culture methods. The isolate was characterized further by PCR amplification and sequencing of the 16S rRNA gene with broad-range eubacterial primers. Phylogenetic analysis of the 16S ribosomal DNA sequence indicated that this isolate was a member of the species B. zoohelcum (previously Weeksella zoohelcum), a gram-negative bacillus that is rarely associated with infections in humans. Despite sharing a close genetic relationship with other B. zoohelcum strains, this isolate was extremely fastidious in nature, raising the possibility that similar strains from cat or dog bite wound infections have been underreported. PMID:14715767

Shukla, Sanjay K.; Paustian, David L.; Stockwell, Patrick J.; Morey, Roger E.; Jordan, Jean G.; Levett, Paul N.; Frank, Daniel N.; Reed, Kurt D.

2004-01-01

61

Campylobacter fetus infection presenting with bacteremia and cellulitis in a 72-year-old man with an implanted pacemaker: a case report  

PubMed Central

Introduction Campylobacter is an important causative agent of intestinal infections in humans. Bacteremia is detected in less than 1% of patients, mainly in immunocompromised patients and in extreme age groups. Cellulitis is a relatively common manifestation of Campylobacter infection, but concomitant bacteremia is a rare event. Infections of the pacemaker area are caused primarily by staphylococci, followed by fungi, streptococci and Gram-negative rods. To the best of our knowledge, this is the first case report of pacemaker pocket infection and bacteremia caused by Campylobacter fetus. Case presentation A 72-year-old Croatian Caucasian man with myelodysplasia, impaired fasting glucose levels and a recently implanted permanent pacemaker was admitted to hospital after six days of fever, development of red swelling of the pacemaker pocket area and worsening of his general condition. No antibiotic therapy was introduced in the outpatient setting. He denied any recent gastrointestinal disturbances. With the exception of an elevated leukocyte count, erythrocyte sedimentation rate, and C-reactive protein and blood glucose levels, other laboratory findings were normal. Treatment with vancomycin plus netilmicin was introduced, and a surgical incision with drainage of the pacemaker pocket was performed. The entire pacemaker system was removed and a new one re-implanted after 14 days of antibiotic therapy. Transesophageal echocardiography showed no pathological findings. Three subsequent blood cultures obtained on admission as well as swab culture of the incised pacemaker area revealed Campylobacter fetus; stool and pacemaker lead cultures were negative. According to the microbiological results, antibiotic therapy was changed to ciprofloxacin plus netilmicin. A clinical examination and the results of a laboratory analysis performed after two weeks of therapy were within normal limits. Conclusion Myelodysplasia, impaired fasting glucose levels and older age could be contributing factors for the development of bacteremic Campylobacter fetus cellulitis. Emergent surgical and antibiotic treatment are mandatory and provide the optimal outcome for such types of pacemaker pocket infection. PMID:23198848

2012-01-01

62

What Is Cellulitis?  

MedlinePLUS

... org Diseases & Conditions A to Z Age-related Macular Degeneration (AMD) Allergies Amblyopia (Lazy Eye) Astigmatism Bacterial Keratitis Bell's Palsy Blepharitis Cataracts Contact Lens-Related Infections Detached & Torn Retina Diabetic ...

63

Perianal streptococcal cellulitis  

MedlinePLUS

... inflammation of the anus and rectum caused by Streptococcus bacteria. ... Gerber MA. Group A streptococcus. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; ...

64

Löfgren's syndrome misdiagnosed as cellulitis.  

PubMed

Löfgren's syndrome is an acute-onset presentation of sarcoidosis that can be easily missed in an ED setting. A case is reported of Löfgren's syndrome presenting as erythema nodosum with bilateral ankle oedema. Although rare, this diagnosis should be considered when examining a patient with erythema nodosum and articular symptoms. PMID:21668726

Cheng, Daryl Ray; Maini, Amit

2011-06-01

65

AnimAl BehAvior AnimAl Biology Anthropology AviAn ScienceS BiochemiStry, moleculAr, cellulAr AnD DevelopmentAl Biology BiologicAl SyStemS engineering BiomeDicAl engineering BiophySicS BioStAtiSticS clinicAl reSeArch  

E-print Network

AnimAl BehAvior § AnimAl Biology § Anthropology § AviAn ScienceS § BiochemiStry, moleculAr, cellulAnAgement* § epiDemiology § FooD Science § ForenSic Science § gloBAl heAlth* § heAlth inFormAticS § immunology, anthropology, ecology, entomology, neurobiology, psychology, physiology, veterinary science, wildlife biology

Schladow, S. Geoffrey

66

Hemophilus orbital cellulitis and panophthalmitis simulating mucormycosis.  

PubMed

A 47-year-old uncontrolled diabetic presented with proptosis, pain, immobility of the globe, and a perforated corneal ulcer. The clinical impression of mucormycosis was erroneous. Hemophilus aegyptius was grown from the orbit, the vitreous and oropharynx. This is believed to be the first report of panophthalmitis due to this organism. PMID:911115

Mushen, R L; Poirier, R H

1977-06-01

67

Infantile Maxillary Sinus Osteomyelitis Mimicking Orbital Cellulitis  

PubMed Central

Periorbital soft tissue swelling may result due to primary orbital pathology or from adjacent facio-maxillary or sino-nasal inflammatory causes. Osteomyelitis of maxilla in the pediatric age group is a rare entity in this era of antibiotics. We present an 11-month-old female infant who was brought with peri-orbital selling and purulent nasal discharge. Computed Tomography showed erosions of the walls of maxillary sinus suggestive of osteomyelitis. Culture of sinus scraping showed Staphylococcus aureus growth and the child improved with intravenous cloxacillin therapy. This case is presented due to the rarity of its presentation in this age group and for awareness to consider this entity in children having fever and peri-orbital swelling. PMID:25191055

Krishnan, Nagarajan; Ramamoorthy, Nathan; Panchanathan, Suresh; Balasundaram, Jothiramalingam S

2014-01-01

68

Vésicules polymères biomimétiques : du virus à la cellule.  

E-print Network

??Les polymersomes, obtenus par auto-assemblage en solution aqueuse de copolymères à blocs amphiphiles en structure vésiculaire, sont présentés comme d’excellent mimes synthétiques des virus, dont… (more)

Marguet, Maïté

2012-01-01

69

Pathology Case Study: Fatigue, Easy Bruising, and Cellulitis  

NSDL National Science Digital Library

This is a case study presented by the University of Pittsburgh Department of Pathology in which a 51-year-old man, with a history of pancytopenia, presented with âÂÂfatigue, easy bruising, and a left lower leg cellulitesâÂÂ. Results from a blood count along with a microscopic description and images of a marrow biopsy are provided here to help aid in understanding the diagnosis. The âÂÂFinal Diagnosisâ section contains the attending doctorâÂÂs final diagnosis of the patient with commentary, and a detailed pathology. References are also included in this section. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student knowledge of neuropathology.

Graur, Octavia

2009-01-08

70

Cellules souches et thérapie cellulaire. Contribution au débat éthique  

Microsoft Academic Search

Divergent and sometimes conflicting positions with respect to human stem cells and cell therapy do not merely reflect disagreement among scientists and conflicts of interest. They attest the ethical tension resulting from recent progress in understanding the earliest stages of development of the human being that can be observed in vitro. Can the extremely potent notion of the human person

Denys Pellerin

2002-01-01

71

Association cellules–matériaux pour thérapies cellulaires osseuses  

Microsoft Academic Search

Although autologous or allogenous bone grafting materials are widely used to repair skeletal tissue, their limitations induce surgeons to look for more advanced therapies such as tissue engineering. However, bone tissue engineering still lacks proofs of clinical efficacy, possibly due to the inadequate design of the tissue-engineered constructs in relation to the natural tissue. Our aim is therefore to design

G. Daculsi; S. Baroth; L. Sensebé; P. Rosset; M. Durand; O. Boisteau; P. Layrolle

2011-01-01

72

Cellules photovoltaques utilises en sparation spectrale 2014 I. Comparaison  

E-print Network

air-mass one yields a maximum efficiency of 30.4 % with solar concentration of 750, and the GaAs-Ge coupled system yields a maximum efficiency of 25.5 % with solar concentration of 600. Revue Phys. Appl. 18

Boyer, Edmond

73

Cellules solaires au silicium sous concentration Elments de conception  

E-print Network

of the design rules of the conducting grid for concentrated Silicon Solar Cells. Including both conduction fois des pertes par conduction et du taux d'ombre, elle fait appa- raître que le dessin de la grille la'ombre qui pour être acceptable doit rester dans la zone de 10 % valeur numérique que nous adopterons pour la

Paris-Sud XI, Université de

74

Necrotising fasciitis and cellulitis after traditional Samoan tattooing: case reports  

Microsoft Academic Search

Traditional Samoan tattooing, ta tatau, is a vital part of Samoan culture. It is being performed with greater frequency on New Zealand resident Samoans. Unfortunately, ta tatau has recently been the causal factor in two significant infectious cases, in one of which death resulted. The two cases were clinically reviewed. An investigation into the history and practice of ta tatau

Christopher J. W. Porter; Jeremy W. Simcock; Craig A. MacKinnon

2005-01-01

75

Influence de revetements bioactifs sur les cellules endotheliales: Vers des protheses vasculaires non thrombotiques  

NASA Astrophysics Data System (ADS)

Developing vascular prostheses of small diameter to replace vessels closed by atherosclerosis remains a challenge because of the risk of thrombosis. Seeding of endothelial cells, which have antithrombogenic properties, is a promising solution, but we must create surfaces which promote their adhesion and retention to resist shear stresses created by the blood flow on the surface. This master's project aimed at investigating the effect of a plasma polymerized coating rich in primary amines (called LP), with or without elements of the extracellular matrix (Fibronectin (FN) or chondroitin sulphate (CS)) on the endothelial cells and hemocompatibility of polyethylene terephthalate (PET). The adhesion, growth and retention of human umbilical vein endothelial cells (HUVECs) on PET and LP, in the presence and absence of FN or CS, have been studied. In addition, platelet adhesion on different surfaces was evaluated by a perfusion test with whole blood, platelets being previously labeled with rhodamine. Finally a double fluorescent labeling (using Cellview Maroon to mark the HUVECs and CD61 antibody for platelets) was developed to study the retention of endothelial cells, under blood flow and verify their non thrombogenic character. The results obtained show that both the LP coating and the adsorbed FN, strongly increase both the cellular adhesion and growth on PET; however they have no additional effect when the two are combined. They also augment cellular retention to surface, but this remains incomplete. Moreover we observed that the plasma coating (LP) greatly increases the thrombogenicity of the surface, with strong platelet adhesion and activation. This thrombogenicity is extremely reduced when endothelial cells cover the surface, but cell loss under the effect of shear produced by the perfusion creates significant areas of platelet adhesion. The grafting of CS on LP also permits good HUVECs adhesion, growth and retention under shear stress on HUVEC, with no difference from the LP alone. In addition, the CS sharply decreases the platelet adhesion, which is found below the value observed for PET. The double cell labeling also showed that cells adhered on LP+CS has an anti-thrombotic phenotype and can resist blood flow. These studies suggest that a coating of CS is a promising strategy for vascular prosthesis given the combination of the good adhesion of endothelial cells and the low thrombogenicity of the underlying surface. Keywords: vascular prostheses, polymers, bioactive coating, thrombogenicity, HUVECs.

Fadlallah, Hicham

76

Una Struttura Comparabile Con I Lomasomi Nelle Cellule Austoriali di Cuscuta Pentagona Engelm  

Microsoft Academic Search

A structure comparable with the lomasomes in baustorial cells of « Cuscuta pentagona » Engelm. — Electron microscopic observations of haustorial cells in « Cuscuta pentagona » revealed to the A. the presence of some vesicular structures, outside the plasma membrane, comparable to the lomasomes of Moore and McAlear. The vesicles usually group in a bag of the plasma membrane

Giacomo Tripodi

1967-01-01

77

Universit Paris XI Discipline Biologie Cellulaire et Molculaire cole doctorale Gnes, Gnomes, Cellules  

E-print Network

is observable after one day while the animal follows the chordate body plan. However, a sequence found neurectoderm. This is a relatively high proportion compared to much more complex prediction approaches reported;Acknowledgments The great thing about human language is that it prevents us from sticking to the matter at hand

Paris-Sud XI, Université de

78

Platyhelminthes (vers plats) Acoelomate,Amplification larvaire, Cellule flamme, Cphalisation, Cercaire, Cestodes,  

E-print Network

Brachiopoda Phoronida Arthropoda Onychophora Tardigrada Nematomorpha Nematoda Priapulida Kinorhyncha Sipuncula Nemertea Bryozoa Brachiopoda Phoronida Arthropoda Onychophora Tardigrada Nematomorpha Nematoda

Blouin-Demers, Gabriel

79

Acide urique,Ammoniac,Anus,Aschelminthes, Cellules de Rnette, Cloaque, Collagne, Cuticule, piderme syncitial,  

E-print Network

Nemertea Bryozoa Brachiopoda Phoronida Arthropoda Onychophora Tardigrada Nematomorpha Nematoda Priapulida Nemertea Bryozoa Brachiopoda Phoronida Arthropoda Onychophora Tardigrada Nematomorpha Nematoda Priapulida · Nematomorpha · Kinorhyncha · Priapulida · Loricifera · Rotifera · Acanthocephala · Gastrotricha · Entoprocta

Blouin-Demers, Gabriel

80

Pressure Distribution Tests on a Series of Clark Y Biplane Cellules with Special Reference to Stability  

NASA Technical Reports Server (NTRS)

The pressure distribution data discussed in this report represents the results of part of an investigation conducted on the factors affecting the aerodynamic safety of airplanes. The present tests were made on semispan, circular-tipped Clark Y airfoil models mounted in the conventional manner on a separation plane. Pressure readings were made simultaneously at all test orifices at each of 20 angles of attack between -8 degrees and +90 degrees. The results of the tests on each wing arrangement are compared on the bases of maximum normal force coefficient, lateral stability at a low rate of roll, and relative longitudinal stability. Tabular data are also presented giving the center of pressure location of each wing.

Noyes, Richard W

1933-01-01

81

UNIVERSITE PARIS-SUD COLE DOCTORALE : GNES GNOMES, CELLULES (ED 426)  

E-print Network

..........................................10 I.2.1.3. Transcription termination..........................................11 I.3. Translation.2. Translation initiation factors.............................................15 I.4. Global transcription...................................................................7 I.2.1. Transcription..................................................................8 I.2

Paris-Sud XI, Université de

82

Orbital roof fracture and orbital cellulitis secondary to halo pin penetration: case report.  

PubMed

Study Design?Case report. Objective?To report and discuss a rare complication after a patient was treated conservatively with a halo vest. Methods?A 51-year-old man sustained a hangman's injury of the C2 vertebra following a motor vehicle collision. He was treated conservatively in a halo vest appliance and following mobilization was discharged from the hospital. Two weeks after discharge, the patient presented to the emergency department complaining of proptosis, ptosis, diplopia, and pin loosening. He was readmitted to the hospital, the halo vest was removed, and urgent imaging studies including computed tomography scan and magnetic resonance imaging were performed. They revealed that one of the halo pins had penetrated the orbital roof with active infection of the extraocular soft tissues. In consultation with the ophthalmologist, he was treated conservatively with antibiotics for 10 days. Results?His ophthalmologic complaints resolved gradually and his eye returned to normal appearance and function. In the meantime, he was immobilized in a sterno-occipital mandibular immobilizer brace. Conclusion?Though rare, penetrating injuries after cranial pin insertion can occur. Halo devices must be applied by, or under close supervision of, experienced personnel to avoid such complications, and halo vests should be reviewed frequently to detect such incidents early. PMID:25648519

Menon, K Venugopal; Al Rawi, Asif Esam; Taif, Sawsan; Al Ghafri, Khalifa; Mollahalli, Kishore Kumar

2015-02-01

83

Nouveautes Dans la Reconstruction Cutanee: Cultures de Cellules et Substituts Dermiques et Revue de la Litterature  

PubMed Central

Summary La prise en charge de patients souffrant de brûlures profondes et étendues reste un défi important pour les chirurgiens reconstructeurs. Ceci est d'autant plus vrai que les grands progrès réalisés dans la réanimation assurent actuellement la survie de patients brûlés sur plus de 90% de leur surface corporelle. De ce fait la reconstruction moderne a dû innover et est devenue une chirurgie complexe nécessitant un plan stratégique impliquant des matériaux et des méthodes chirurgicales multiples adaptées à chaque situation clinique. Ce type de prise en charge nécessite aussi la collaboration étroite et coordonnée de plusieurs équipes hautement spécialisées. Le taux de survie ainsi que de la qualité de vie de ces patients sont alors nettement améliorés. De même nous observons clairement que le nombre de complications secondaires telles que les rétractions et les instabilités cicatricielles ont également diminué de façon significative. Mots-clés: brûlure, greffe, culture, substitut dermique, reconstruction PMID:21991212

Koch, N.; Erba, P.; Benathan, M.; Raffoul, W.

2010-01-01

84

Synthetic cell elements from block copolymers hydrodynamic aspectsÉléments de cellules synthétiques provenant de copolymères enbloc  

NASA Astrophysics Data System (ADS)

Amphiphilic block copolymers can self-assemble in water into various stable morphologies which resemble key cell structures, notably filaments and membranes. Filamentous 'worms' of copolymer, microns-long, are briefly introduced, and related dynamics of copolymer vesicle 'polymersomes' are reviewed. Fluorescence visualization of single worms stretched under flow demonstrates their stability as well as a means to control conformation. Polymersome membranes have been more thoroughly studied, especially copolymer molecular weight effects. We summarize results suggestive of a transition from Rouse-like behavior to entangled chains. Viewed together, the results ask the question: what physics are needed next to mimic cell activities such as crawling? To cite this article: P. Dalhaimer et al., C. R. Physique 4 (2003).

Dalhaimer, Paul; Bates, Frank S.; Aranda-Espinoza, Helim; Discher, Dennis

2003-03-01

85

Rpercussion de la dure d'clairement journalier sur l'volution des cellules nourricires et de la ligne mle  

E-print Network

photoperiods i.e. long-day : 18 h (JL), short-day : 8 h (JC) immediately after a 4 month hibernation sépare la sortie de l'hibernation de l'entrée en reproduction. Matériel et méthodes. ' Les animaux. Des

Paris-Sud XI, Université de

86

jections dbit constant. Pour cela on dispose d'une cellule de contrle qui reoit une partie de la lumire  

E-print Network

est pesée avant et après la vaporisation. De l'augmentation de poids de la lamelle, on déduit « l'on fait varier alternative- ment la pression. Ces quelques remarques montrent le peu de crédit que l'Alger. Lors d'une précédente communication (2) nous avons exposé certains résultats relatifs à des éléments

Paris-Sud XI, Université de

87

La "conversione" delle cellule della cute che producono insulina: nuova arma contro diabete e tumore del pancreas  

E-print Network

tumore del pancreas Uno studio dell'Università degli Studi di Milano su PNAS scopre un metodo, sicuro alterarne il DNA. Straordinarie le potenzialità nella terapia del diabete e del tumore al pancreas. La i vari tipi di diabete e per il tumore del pancreas. La ricerca, finanziata da AIRC, MIUR e Regione

De Cindio, Fiorella

88

Caractrisation fonctionnelle de la protine ASPM dans la prolifration des cellules souches tumorales des gliomes de haut grade  

E-print Network

DUYCKAERTS DIRECTEUR : Pr Jean-Yves DELATTRE Co-DIRECTEUR : Pr Marc SANSON RAPPORTEUR : Pr Antoine CARPENTIER. Profonds remerciements aux rapporteurs, Pr Antoine Carpentier et Dr Jean- Sébastien Guillamo, pour avoir coups de gueules...Blandine ton soutien technique à été précieux dans ce travail. Yannick pour ton

Paris-Sud XI, Université de

89

Combined enzyme mediated fermentation of cellulous and xylose to ethanol by Schizosaccharoyces pombe, cellulase, .beta.-glucosidase, and xylose isomerase  

DOEpatents

A process for producing ethanol from mixed sugar streams from pretreated biomass comprising xylose and cellulose using enzymes to convert these substrates to fermentable sugars; selecting and isolating a yeast Schizosaccharomyces pombe ATCC No. 2476, having the ability to ferment these sugars as they are being formed to produce ethanol; loading the substrates with the fermentation mix composed of yeast, enzymes and substrates; fermenting the loaded substrates and enzymes under anaerobic conditions at a pH range of between about 5.0 to about 6.0 and at a temperature range of between about 35.degree. C. to about 40.degree. C. until the fermentation is completed, the xylose being isomerized to xylulose, the cellulose being converted to glucose, and these sugars being concurrently converted to ethanol by yeast through means of the anaerobic fermentation; and recovering the ethanol.

Lastick, Stanley M. (Longmont, CO); Mohagheghi, Ali (Northglen, CO); Tucker, Melvin P. (Lakewood, CO); Grohmann, Karel (Winter Haven, FL)

1994-01-01

90

chiaux rsultant surtout par fusion centrique des chromosomes monobranchiaux habituels chez le chien. Dans les deux sexes, de nombreuses cellules tumorales interphasiques portent un chro-  

E-print Network

chromosome in pig. The effect of Feeding Various Levels of Aflatoxin B1 on the chromosome Pattern of Rats which Aspergillus flavus, producing aflatoxin, is a hazard in particular. To date, the data on negative effects of aflatoxin on chromosome pattern have been scanty, being based merely on the effects produced

Paris-Sud XI, Université de

91

Sur l'action d'enzymes au niveau des pores nucléaires et d'autres structures de cellules sécrétrices prothoraciques incluses en épon  

Microsoft Academic Search

Enzymatic extraction, according to Monneron's method (1966a, b), in ultrathin sections of prothoracic glands embedded in Epon has shown that some cellular structures are rapidly attacked by pepsin after glutaraldehydic-osmium tetroxide fixation. These are the typical mitochondria whose matrix is extracted by the moderate action of pepsin at 40° C and the nuclear pores with dense annuli which are digested

Jacques Beaulaton

1968-01-01

92

Etude ab initio des proprietes electroniques et optiques d'un systeme donneur-accepteur organique utilise dans les cellules photovoltaiques  

NASA Astrophysics Data System (ADS)

The search for new sources of clean and renewable energy has recently been encouraged by the growing energy demand caused by the industrialization of developing countries and by population growth. In this context, the generation of electricity through the exploitation of solar energy with photovoltaic cells is particularly interesting, since this energy source is largely unused compared to its full potential. Nevertheless, large scale electricity generation with the current design of photovoltaic cells based on silicon is hindered by the large manufacturing cost of these devices. A new generation of photovoltaic cells, which includes organic photovoltaic cells that use semiconducting polymers, is under intense development in order to significantly reduce the manufacturing costs. The replacement of conventional materials with conjugated polymers in photovoltaic cells opens the possibility of using large scale manufacturing processes to produce large-area devices at low cost. However, the power conversion efficiency and the lifetime of organic photovoltaic cells are currently too low for these devices to be cost effective. A better understanding of the organic photovoltaic process is therefore necessary to improve the power conversion efficiency of these devices. The operating principle of photovoltaic cells requires the charge transfer between a polymer acting as an electron donor and a molecule acting as an electron acceptor to enable the dissociation of photogenerated excitons into free charge carriers. Furthermore, to ensure that the majority of the photogenerated excitons dissociates, the active region of an organic photovoltaic cell is typically formed by a bulk heterojunction between the donor and the acceptor. Many experimental studies have shown that the power conversion efficiency of these devices, which is proportional to the product of their short-circuit current Isc with their open circuit potential Voc, is strongly governed by the microstructure of the bulk heterojunction defined as the local order of the two phases and the organization of the donor-acceptor interfaces. Even though these studies have helped to increase the efficiency of organic photovoltaic cells, the relations linking the microstructure of the bulk heterojunction to their electronic and optical properties are still to be established. The objective of the research project is to computationally study the electronic and optical properties of organic bulk heterojunctions composed of regioregular poly(3-hexylthiophene) (rrP3HT) and C60, two materials typically used in organic photovoltaic cells. In this study, the microstructure of the donor-acceptor systems can be directly controlled, which facilitates the systematic study of the influence of this parameter on the electronic and optical properties of the organic bulk heterojunctions. The density functional theory (DFT) is used to study the ground state geometric and electronic properties of multiple bulk heterojunction systems, while the time dependent density functional theory (TDDFT) is used to study the optical properties of these systems. The SIESTA software package is used to study periodic systems representing perfectly crystalline materials. The results obtained in this research project show that the power conversion efficiency of organic photovoltaic cells is strongly modulated by the microstructure of the bulk heterojunctions. Indeed, the size of the rrP3HT crystalline domains must be optimized to maximize the efficiency of the photovoltaic devices, since Voc and Isc have opposite behaviors with respect to ?-stacking of the rrP3HT chains. In addition, the efficiency of organic photovoltaic cells could be improved by imposing geometrical constraints in the bulk heterojunctions through manufacturing methods in order to increase the value of Voc without altering the value of Isc. (Abstract shortened by UMI.).

Maillard, Arnaud

93

Eyes - bulging  

MedlinePLUS

... sign. It should be checked immediately. Hyperthyroidism (particularly Graves disease ) is the most common cause of bulging eyes. ... Glaucoma Graves disease Hemangioma Histiocytosis Hyperthyroidism ... Neuroblastoma Orbital cellulitis or periorbital cellulitis ...

94

COLE DOCTORALE SCIENCES ET TECHNOLOGIES LABORATOIRE Gamtogense Apoptose et Gnotoxicit  

E-print Network

Stimulating Factor 1 CSG : Cellule Souche Germinale CSH : Cellule Souche Hématopoïétique CXCR4 : Chemokine (C : Ets variant gene 5, Erm FGF : beta Fibroblast growth factor GATA-2 : GATA binding protein 2 G

Paris-Sud XI, Université de

95

Amethyst violet as a stain for distinguishing cells with a damaged membrane from normal cells  

Microsoft Academic Search

Riassunto Per distinguere le cellule a membrana integra da quelle con membrana alterata può essere vantaggiosamente usata una soluzione isotonica di violetto ametista: il colorante trova utile applicazione nel conteggio delle cellule vive e morte per il trapianto del cancro ascite di Ehrlich. Modificando la permeabilità delle cellule mediante azoto liquido si possono inoltre ottenere delle buone colorazioni delle strutture

A. Novelli

1962-01-01

96

UNIVERSITE BLAISE PASCAL UNIVERSITE D'AUVERGNE N D.U. : 1926 Anne 2009  

E-print Network

polyols des cellules laticifères chez Hevea brasiliensis, en relation avec la production de latex physiologique et moléculaire des transporteurs de sucres et de polyols des cellules laticifères chez Hevea et moléculaire des transporteurs de sucres et de polyols des cellules laticifères d'Hevea

Boyer, Edmond

97

Sur l'utilisation d'une electrode ponctuelle dans les cellules à oxyde electrolyte solide . I. Application aux mesures thermodynamiques et à la détermination du nombre de transport electronique de l'electrolyte  

Microsoft Academic Search

Sous faible pression gazeuse, les réactions d'échange d'oxygène entre le contact triple d'une électrode du type: métal, O2\\/oxyde électrolyte et la phase gazeuse environnante sont très lentes. Nous avons pu vérifier que ce phénomène peut conduire à des erreurs dans le calcul des nombres de transport électronique des oxydes solides lorsque des systèmes gazeux sont utilisés pour effectuer la mesure.

P. Fabry; M. Kleitz; C. Deportes

1972-01-01

98

Violence et normes : le conflit notionnel dans les rapports familiaux L'on a coutume d'admettre que la famille se prsente comme la cellule vitale de la  

E-print Network

1 Violence et normes : le conflit notionnel dans les rapports familiaux L'on a coutume d la forme de conflits, ou, ce que l'on est légitime de qualifier en droit de « violences »2 . Deux , définit les contours de la violence familiale, et prévoit des règles de sanction, lorsque les individus

Paris-Sud XI, Université de

99

La chromatine rserve bien des surprises: cet assemblage complexe qui, en liant des protines l'ADN des cellules, forme une gaine autour de nos chromosomes, ne joue pas seulement un rle  

E-print Network

La chromatine réserve bien des surprises: cet assemblage complexe qui, en liant des protéines à l'ADN transcription des gènes, comme on le pensait. Depuis une dizaine d'années, on sait qu'elle sert à réparer l'ADN façon ciblée des cassures sur les brins d'ADN. Cet outil inédit lui a permis d'obtenir des financements

van Tiggelen, Bart

100

La russite d'un tel programme repose aussi sur la faisabilit de l'injection de vecteurs. Pour atteindre les cellules germinales, il est ncessaire d'intervenir prcocement dans l'oeuf embryonn, mais cette  

E-print Network

d'injections des embryons de 24 h et les conditions d'incubation des oeufs. Nous sommes parvenus à in selection for high egg production. Poult Sci 59:2165-2178. Hughes SH, Kosik E, Fadly AM, Salter DN AM, Wilter RL, Crittenden LB, 1986. Gene insertion into the chicken germ line by retroviruses. Poult

Paris-Sud XI, Université de

101

Organisation et nature de l'inclusion cristalline des organites du type «crystal-containing body» rencontrés dans les cellules de l'épithème des hydathodes de Cichorium intybus L. et Taraxacum officinale Weber  

Microsoft Academic Search

Summary Single-membrane-bounded organelles containing crystalline inclusions surrounded by a granular matrix are found abundantly in the cells of epithem. Special attention is devoted to changes which occured in the fine structure of these crystalline inclusions and variations in their morphology are described.

André Perrin

1972-01-01

102

Optimising Diagnosis and Antibiotic Prescribing for Acutely Ill Children in Primary Care  

ClinicalTrials.gov

Sepsis; Bacteraemia; Meningitis; Abscess; Pneumonia; Osteomyelitis; Cellulitis; Gastro-enteritis With Dehydration; Complicated Urinary Tract Infection; Viral Respiratory Infection Complicated With Hypoxia

2013-12-30

103

Lait 84 (2004) 333341 INRA, EDP Sciences, 2004  

E-print Network

serocolostrum, is crystal clear, free of blood and somatic cells as well as fat globules and casein micelles limpide, il ne contient ni cellule sanguine, ni cellule somatique, ni globule gras, ni micelle de caséine during these three days [1, 6]. Total solids, protein, casein, fat and mineral salts, expressed

Boyer, Edmond

104

Classification: Biologie du dveloppement et de la reproduction Development and reproduction biology  

E-print Network

cellules cardiaques mesodermiques cellules pancreatiques endodermiques Key words CD34+ stem cell,version2-14Dec2010 #12;Abstract Cell therapy for tissue regeneration requires cells with high self stem cells (ESCs) and adult somatic cells induced to pluripotency (iPSCs) by genetic manipulation. Here

105

Rgulation affrente et effrente des CTLs antipaternelles durant l'allogestation, G. CHAOUAT J.-P. KOLB, Unit INSERM U 255, Immunologie cellulaire et clinique,  

E-print Network

'autres (Smith, 1983), la lyse de cellules trophoblastiques traitées à la trypsine ou à la neuraminidase. Fait interférer avec une CTL, après 24 ou 48 h de culture. Les cellules traitées à la neuraminidase, elles

Paris-Sud XI, Université de

106

Ecole Doctorale des Sciences et de Technologie  

E-print Network

cellules à pigment photosensible (en anglais DSSC, Dye-Sensitized Solar Cell). En 1991, Grätzel a réintroduit l'effet photo- électrochimique en développant la première DSSC, une des cellules solaire troisième

Paris-Sud XI, Université de

107

The influence of phytochrome in the water exchange of epidermal cells of Taraxacum officinale  

Microsoft Academic Search

Résumé La qualité de la lumière a modifié le passage de l'eau dans les cellules épidermiques des pétioles deTaraxacum officinale. L'irradiation par du rouge sombre a augmenté la rapidité avec laquelle l'eau entre dans la cellule et la lumière rouge clair a renversé cet effet.

M. S. Carceller; R. A. Sánchez

1972-01-01

108

Spinal Epidural Abscess Associated With Moxibustion-Related Infection of the Finger  

PubMed Central

Objective: To describe a spinal epidural abscess that originated from cellulitis after moxibustion. Methods: Case report. Findings: A 78-year-old woman with diabetes mellitus was diagnosed with tetraplegia due to a cervical spinal epidural abscess extending to the thoracic spinal epidural space. The abscess was caused by osteomyelitis and cellulitis of the right third finger, which had been cauterized repeatedly with moxa. After surgical decompression and drainage of the spinal epidural abscess and comprehensive rehabilitation, motor strength and functional level improved. Conclusions: This case illustrates the risk of spinal epidural abscess in persons with diabetes mellitus who present with focal cellulitis and osteomyelitis. PMID:18795486

Lee, Kyung Whan; Han, Soo Jeong; Kim, Dong Jun; Lee, Mee Jin

2008-01-01

109

La fibrose en deux parties : de la paillasse à la souris.  

E-print Network

??L’apoptose des cellules endothéliales (CE) représente un évènement initial dans le développement de plusieurs pathologies fibrotiques telles que le rejet chronique d’allogreffe et la sclérose… (more)

Laplante, Patrick

2009-01-01

110

Group A Streptococcal Infections  

MedlinePLUS

... Share this: Main Content Area Group A streptococcal (GAS) infections can range from a mild skin infection ... mild infections (throat and skin) occur every year. GAS infections include Cellulitis and Erysipelas Impetigo Scarlet Fever ...

111

BANDO DI SELEZIONE PER IL CONFERIMENTO DI 1 ASSEGNO PER LA COLLABORAZIONE AD ATTIVITA' DI RICERCA  

E-print Network

in left ventricular assist device (LVAD) and autologous stem cell combined therapy in left ventricular assist device (LVAD) and autologous stem cell combined therapy (LVAD) e cellule staminali autologhe" ­ "Boosting cardiac regeneration: breakthrough

Guidoni, Leonardo

112

N ENSC-2004/01 THESE DE DOCTORAT  

E-print Network

est un champ disciplinaire qui ´etudie les ´ecoulements de liquides ou gaz dans des canaux de comparable aux objets qui y circulent (bulles, cellules, gouttes, polym`eres). Au sens large, il s'agit d

Paris-Sud XI, Université de

113

Genetics Home Reference: Klippel-Trenaunay syndrome  

MedlinePLUS

... cellulitis, swelling caused by a buildup of fluid (lymphedema), and internal bleeding from abnormal blood vessels. Less ... Trenaunay syndrome? congenital ; embolism ; embryonic ; gene ; infection ; inherited ; lymphedema ; mosaicism ; polydactyly ; pulmonary ; pulmonary embolism ; sporadic ; syndactyly ; syndrome ; ...

114

SHEWANELLA AND PHOTOBACTERIUM IN OYSTERS AND SEAWATER FROM THE DELAWARE BAY  

Technology Transfer Automated Retrieval System (TEKTRAN)

Shewanella algae, S. putrefaciens, and Photobacterium damselae subsp. damselae are indigenous marine bacteria and human pathogens causing cellulitis, necrotizing fasciitis, abscesses, septicemia, and death. Infections are rare and are most often associated with the immunocompromized host. A study ...

115

LUDWIG’S ANGINA FOLLOWING SELF APPLICATION OF AN ACIDIC CHEMICAL  

PubMed Central

Ludwig’s angina is a potentially life threatening diffuse cellulitis usually resulting from odontogenic infection. We report a case of Ludwig’s angina resulting from self administration of an acidic chemical to treat toothache. PMID:25161404

Gbolahan, O.O.; Olowookere, S.; Aboderin, A.; Omopariola, O.

2012-01-01

116

Streptococcal Infections  

MedlinePLUS

... throat. It causes a red rash on the body. Impetigo - a skin infection Toxic shock syndrome Cellulitis and necrotizing fasciitis (flesh-eating disease) Group B strep can cause blood infections, pneumonia ...

117

Inhibition of protein synthesis in ehrlich ascites tumor cells by irradiation (365 nm) in the presence of skin-photosensitizing furocoumarins  

Microsoft Academic Search

Riassunlo La sintesi proteica nelle cellule del tumore ascitico di Ehrlich viene inhibita dall'irradiazione a 365 nm in presenza di furocumarine fotosensibilizzatrici cutanee (psoralene, xantotossina e 8-metilpsoralene).

F. Bordin; F. Baccichetti; R. Bevilacqua; L. Musajo

1973-01-01

118

Pets and Your Health  

MedlinePLUS

... Doctors usually treat cellulitis with antibiotics. Back Continue Birds Even if pet birds are kept in cages, they can sometimes pass certain infections to people. Fortunately, getting infections from birds is rare, especially if you are young and ...

119

CROISSANCE DES TISSUS DU RAT ET RDUCTION DE L'APPORT NERGTIQUE DE LA RATION;  

E-print Network

désoxyribonucléique (ADN), proportionnelle au nombre de cellules, du rapport poids frais/ADN proportionnel à la taille des cellules - des rapports protéines/ADN et ARN/ADN. En comparant témoins et restreints de même poids témoins, la concentration de l'ADN est peu modifiée ; concentration des protéines est légèrement augmentée

Boyer, Edmond

120

Les bactriophages comment les bactries tombent maladescomment les bactries tombent malades.  

E-print Network

repliement Composition déterminée par l'ADN #12;ADN Chromosome Cellule eucaryote Hélice d'ADN Informations nécessaires à la production des protéines Séquence ADN Code génétique Chaîne (protéine) Cytosine Guanine + queue Tê idTête ou capside ADN QueueQueue Fibres #12;· Les bactéries (et autres cellules) se

Paris-Sud 11, Université de

121

La citologia della cellula epatica in rapporto alla qualità dell'alimento introdotto  

Microsoft Academic Search

1.Fu ricercato come si trasformi I'intima struttura delle cellule epatiche del ratto per alimentazioni differenti e negli animali nutriti in modo insufficente.2.In massima fu constatato che i condriosomi mantengono costantemente forma allungata nei ratti in inanizione, come pure in quelli alimentati con grasso, zucchero. albume d'uovo.3.Nei ratti alimentati con grasso da un lato e con zucchero dall'altro, le cellule epatiche

Giulio Muggia; Lorenzo Masuelli

1932-01-01

122

10.March.2004, phone A.Fabich 1 Technical drawings of TT2A  

E-print Network

10.March.2004, phone A.Fabich 1 Technical drawings of TT2A and adjacent galleries Detail ­ CDD, ----SOG108010006 #12;10.March.2004, phone A.Fabich 2 18kV cellule 18kV cellule #12;10.March.2004, phone A.Fabich 3 #12;10.March.2004, phone A.Fabich 4 About60mfromtargetplacetosurface #12;10.March.2004, phone A

McDonald, Kirk

123

Inadvertent injection of formalin mistaken for local anesthetic agent: report of a case.  

PubMed

Chemical facial cellulitis, while commonly seen in domestic accidents or attempted suicide, is uncommon in the dental office and hence rarely addressed in the dental literature. We present an unusual case of chemical facial cellulitis caused by inadvertent injection of formalin into the soft tissues of the oral cavity, which was mistaken for local anesthesia solution. This report comprises the immediate symptoms, possible root cause, and management of the difficult situation. We also provide some guidelines to avoid such unfortunate events. PMID:22676982

Arakeri, Gururaj; Brennan, Peter A

2012-05-01

124

Original article Experimental attempts to extend the current  

E-print Network

embryonic cells gave increased yields of chromosome spreads (up to 51% of the initial D1­D2 cell number chromosomes (jusqu'à 51 % du nombre initial de cellules). En ce qui concerne les cellules de 3 et 4 jours) cultivation is not yet opti- mal. Moreover, on D5­D7 the zona pellucida (ZP) is thickened and broken while

Paris-Sud XI, Université de

125

ALERTEES PAR LA MORT CELLULAIRE, NOS DEFENSES ANTIVIRALES METTENT LE TURBO  

E-print Network

MORT CELLULAIRE, NOS DEFENSES ANTIVIRALES METTENT LE TURBO Genève, le 9 février 2012 SOUS EMBARGO JUSQU marche après que certaines cellules ont été détruites par l'ennemi viral. A leur mort, elles relâchent associated molecular pattern). Ces DAMP se distinguent du reste des débris de la cellule morte par leur

Loewith, Robbie

126

Propriétés optiques du silicium mésoporeux et ses applications potentielles  

NASA Astrophysics Data System (ADS)

Une couche de silicium poreux formée électrochimiquement à la surface de l'émetteur d'une jonction p-n+ peut jouer efficacement le rôle d'une couche antireflet pour les cellules solaires au silicium. En ajustant la densité de courant et le temps de formation, des simple et double-couches antireflet aux propriétés optiques optimisées ont pu être réalisées, conduisant à des réflectivités effectives respectives de 7.3 et 2.7 % sur l'ensemble du spectre solaire utile pour les cellules (400-1000 nm). De hauts rendements de conversion de l'énergie solaire, de l'ordre de 13-13.4 %, sont ainsi actuellement obtenus pour des cellules au silicium multicristallin avec une couche antireflet de silicium poreux.

Lévy-Clément, C.; Bastide, S.

2002-04-01

127

Evolution du Sexe : le Maintien de la Sexualit.  

E-print Network

de deux cellules. Echange d'ADN entre cellules au cours du processus de reproduction. #12;2 Bactéries génétiques L'ADN est soumis de façon chronique à des dommages. La réparation de la molécule d'ADN demande une, précédant les phénomènes de sexualité. - Mécanisme de réparation de l'ADN N.B. La méiose est monophylétique

Laloi, David

128

Obtaining polarized liquid helium 3 from optically oriented gas G. Tastevin, P.J. Nacher, L. Wiesenfeld*, M. Leduc and F. Lalo  

E-print Network

1 Obtaining polarized liquid helium 3 from optically oriented gas G. Tastevin, P.J. Nacher, L suivre le mouvement de liquide qui coule le long des parois de la cellule. Abstract.2014 Spin polarized liquid helium three can be obtained by liquefaction of a gas polarized by laser optical pumping. We show

Paris-Sud XI, Université de

129

PATHOLOGIE VGTALE Interactions entre virus ou entre virus et leurs  

E-print Network

PATHOLOGIE V�G�TALE SYNTH�SE Interactions entre virus ou entre virus et leurs satellites chez un 84140 Montfavet R�SUM� Deux ou plusieurs virus, apparentés ou non, peuvent se multiplier ensemble dans une même plante et également dans une même cellule. Les interactions entre virus qui en résultent

Paris-Sud XI, Université de

130

Bacteroides isolated from four mammalian hosts lack host specific 16S rRNA gene phylogeny and carbon and nitrogen utilization patterns  

Technology Transfer Automated Retrieval System (TEKTRAN)

Within the distal gut of mammals are trillions of microbes that utilize nutrients from diet, intestinal mucosa, and other gut microbes. One hundred three (103) isolates of B. ovatus, B. thetaiotaomicron, and B. xylanisolvens were recovered from cow, goat, human, and pig fecal enrichments with cellul...

131

Quality Control in Chronic Wound Management: The Role of Local PovidoneIodine (Betadine®) Therapy  

Microsoft Academic Search

Background: The treatment of venous leg ulcers is often inadequate, because of incorrect diagnosis, overuse of systemic antibiotics and inadequate use of compression therapy. Stasis dermatitis related to chronic venous insufficiency accompanied by infected superficial ulcers must be differentiated from erysipelas, cellulitis and contact eczema. Objectives: To assess the effectiveness of (1) topical povidone-iodine with and (2) without compression bandages,

Judit Daróczy

2006-01-01

132

INTRODUCTION SUR LA CARCINOGENESE BRONCHIQUE p. 10 I. Epidmiologie des cancers pulmonaires p. 10  

E-print Network

1 SOMMAIRE INTRODUCTION SUR LA CARCINOGENESE BRONCHIQUE p. 10 I. Epidémiologie des cancers pulmonaires p. 10 II. Histologie des cancers pulmonaires et classification pTNM p. 12 1. carcinomes épidermoïdes p. 13 2. carcinomes à petites cellules p. 13 3. adénocarcinomes p. 14 4. carcinomes à grandes

Paris-Sud XI, Université de

133

ACTION DE DEUX INSECTICIDES SUR MELITTOBIA ACASTA WALK.  

E-print Network

des cellules au sortir de l'hibernation dans les solutions insecticides élimi- ne en 8 heures explications de la gravité des attaques qui peuvent aller jusqu'à la perte totale de la population. Pendant l'hibernation

Boyer, Edmond

134

Periphyton response to long-term nutrient enrichment in a shaded headwater stream  

E-print Network

un contenu plus élevé de chlorophylle par cellule, car le biovolume total des algues ne change pas) sont aussi maximaux dans les conditions d'enrichissement. Les peuplements d'algues sont dominés par les'enrichissement. Bien que les nutriments stimulent les taux de croissance des algues, les effets à long terme de l

Rosemond, Amy Daum

135

The untold truth about "bath salt" highs: A case series demonstrating local tissue injury.  

PubMed

The epidemic of injecting cathinone derivatives, marketed as "bath salts", by intravenous drug users among inner city Dubliners led to an associated rise in soft tissue complications. The spectrum of the cases encountered, ranging from self-limiting cellulitis to extensive abscess formation, at a single institution is described. PMID:22079081

Dorairaj, J J; Healy, C; McMenamin, M; Eadie, P A

2012-02-01

136

On the determination of intestinal epithelial cell generation time from labeling index and DNA synthesis duration  

Microsoft Academic Search

Résumé Dans l'épithélium de la souris, la durée des phases de génération fut déterminée théoriquement par la relation Tg=Ts\\/LI. Les résultats, sans tenir compte des cellules caliciformes, furent comparés aux données obtenues par les courbes PLM.

J. W. Cooper; R. F. Hagemann; G. J. Brodmerkel

1974-01-01

137

Wind Tunnel Pressure Distribution Tests on a Series of Biplane Wing Models  

NASA Technical Reports Server (NTRS)

This report is on the changes in forces on each wing of a biplane cellule when either the stagger or the gap is varied. Since each test was carried up to a 90 degree angle of attack, the results may be used in the study of stalled flight and of spinning as well as in the structural design of biplane wings.

Knight, Montgomery; Noyes, Richard

1929-01-01

138

Children's Ophthalmologic Problems.  

ERIC Educational Resources Information Center

The author points out the need for early screening for ophthalmologic disorders and reviews symptoms of various eye disorders. Among the types of eye pathology considered are retinoblastoma, retrolental fibroplasia, congenital glaucoma, congenital cataracts, congenital strabismus, chlamydia oculogenitalis, orbital cellulitis, and eye injuries.…

Robb, Richard M.

1977-01-01

139

Stratigraphie -La retombe de La Moutade, marqueur stratigraphique de l'Allerd en limagne septentrionale (Massif central,France).  

E-print Network

.30 m) with interstratified ancient tephra ("Cellule tephra"), deformed by frost action. Palynology). The Palynology indicates the beginning of a very mild and humid climatic period. Levels 2 and 3 are eroded of the channel (0.35 m). the Palynology indicates a mild and humid climate (Alleröd), 5 - organic level (0.10 m

Paris-Sud XI, Université de

140

Tecniche per ilTecniche per il sequenziamentosequenziamento degli acidi nucleicidegli acidi nucleici  

E-print Network

;La scoperta degli enzimi di restrizione DNA E.coli di ceppo B in E.coli di ceppo C digestione 1966: si osserva la "sopravvivenza" di un DNA virale in E.coli enzima di modificazione basi metilate) plasmide modificato é inserito in una cellula di E.coli le cellule con il plasmide chimera sono individuate

Morante, Silvia

141

Roles and ta interactions  

E-print Network

. ushweller, PhD and Functional B lopment; Structu D et in brain tumor EN/mutant-p53 in tumors al arterial of epilepsy using y. on & processing Disease; Cellul y gulate Tumor G o Anticancer Age PhD o Virus Infection and Cell kidney function; ergic system; ren molecular biolog Protein Secretion em and Epitheliu s. n

Acton, Scott

142

Micropropagation The European plant tissue culture industry -1990  

E-print Network

Micropropagation The European plant tissue culture industry - 1990 F Ã? Ríordáin Kinsealy Research / micropropagation / plant tissue culture Résumé — L'industrie européenne de la culture des tissus végétaux. Le'annuaire. enquête / annuaire / micropropagation / culture de cellules végétales INTRODUCTION Information

Paris-Sud XI, Université de

143

Ceftriaxone versus cefazolin with probenecid for severe skin and soft tissue infections  

Microsoft Academic Search

To evaluate the hypothesis that a single daily administration of cefazolin and probenecid and a single daily administration of ceftriaxone and probenecid would be equally effective, in combination with oral antibiotics, for the outpatient treatment of skin and soft tissue infections, a randomized, double-blind study was completed. Patients presenting to the Emergency Department with the primary diagnosis of cellulitis or

Glen Brown; Robert Chamberlain; Jim Goulding; Allison Clarke

1996-01-01

144

Gas gangrene infection of the eyes and orbits  

Microsoft Academic Search

The literature on Clostridium perfringens infections is reviewed up to 1983. An additional case is reported with bilateral clostridial infections of the eye and orbit. One eye followed the classical course of relentless panophthalmitis, amaurosis, and orbital cellulitis ending in enucleation. The second eye contained intracameral mud and gas bubbles that were removed by vitrectomy instrumentation. Subsequent removal of the

G W Crock; W J Heriot; P Janakiraman; J M Weiner

1985-01-01

145

Increased Serum Levels of Epidermal Growth Factor in Children with Autism  

ERIC Educational Resources Information Center

The etiology of autism is unclear, however autism is considered as a multifactorial disorder that is influenced by neurological, environmental, immunological and genetic factors. Growth factors, including epidermal growth factor (EGF), play an important role in the celluler proliferation and the differentiation of the central and peripheral…

Iseri, Elvan; Guney, Esra; Ceylan, Mehmet F.; Yucel, Aysegul; Aral, Arzu; Bodur, Sahin; Sener, Sahnur

2011-01-01

146

UNIVERSITE DE BOURGOGNE UFR Mdecine  

E-print Network

in cancer: it can not only suppress tumor growth by destroying cancer cells, but also promote tumor suppressor cells). In this work, we explored strategies to reduce the number of these cells during tumor Médecine ROLES DES CELLULES MYELOÏDES SUPPRESSIVES ET DES INFILTRATS IMMUNITAIRES DANS LE CANCER Directeur

Paris-Sud XI, Université de

147

The Virtual Liver: Modeling Chemical-Induced Liver Toxicity  

EPA Science Inventory

The US EPA Virtual Liver (v-Liver) project is aimed at modeling chemical-induced processes in hepatotoxicity and simulating their dose-dependent perturbations. The v-Liver embodies an emerging field of research in computational tissue modeling that integrates molecular and cellul...

148

Lait (1993) 73, 465-472 Elsevier/INRA  

E-print Network

counts and low pH. A program is currently being implemented to im- prove the quality 01 goat's milk. Milk cellules somatiques, et un pH bas. Pour améliorer cette qualité, un programme de paiement du lait enLait (1993) 73, 465-472 © Elsevier/INRA 465 Hygienic quality of goat's milk Bacteriological quality

Boyer, Edmond

149

Curr Med Chem . Author manuscript Pertinence of apoptosis markers for the improvement of in vitro  

E-print Network

of in vitro fertilization (IVF) Delphine Haouzi 1 2 3 , Samir Hamamah 1 2 3 * Bioth rapie des cellules souches), the pregnancy and birth rates following fertilization (IVF) attempts are still low.in vitro Recently, apoptotic ; Biological Markers ; Embryonic Development ; Female ; Fertilization in Vitro ; Humans ; Male ; Oocytes

Paris-Sud XI, Université de

150

Intelligence Artificielle. Espce en voie d'apparition ?  

E-print Network

-action entrées sorties #12;John von Neumann 1903 - 1953 #12;Jeu de la Vie Une cellule à l'état 0 passe à l ? ? = #12;2007 #12;2001 #12;1997 #12;1980 #12;1976 #12;1964 #12;1957~1960 #12;1956 We propose that a 2 month

Dutech, Alain

151

Presence of modified fibroblasts in granulation tissue and their possible role in wound contraction  

Microsoft Academic Search

Résumé Au cours de la contraction du tissu de granulation, de nombreux fibroblastes acquièrent des caractéristiques ultrastructurelles qui les rendent semblables à des cellules musculaires lisses. Il est probable que ces éléments modifiés jouent un rôle dans le processus de contraction des plaies.

G. Gabbiani; G. B. Ryan; G. Majno

1971-01-01

152

Relapsing polychondritis  

Microsoft Academic Search

Relapsing polychondritis is a rare disease most commonly presenting as inflammation of the cartilage of the ears and nose. Auricular chondritis, with red ears resembling infectious cellulitis, is the most common initial finding. Antibodies to type II collagen in cartilage are found, and the earlobes are classically spared. Chronic disease may result in a flabby, droopy ear, cauliflower ear, or

Ronald P. Rapini; Noranna B. Warner

2006-01-01

153

rapide de l'IL6, du mme ordre de grandeur que celui de la CRP.  

E-print Network

réponse à diffé- &dquo;ents stimuli. Le syndrome inflammatoire en- traîne différents processus cellulaires synthèse de novo de facteur tissulaire (TF) (Edwards et Rickles, 1980). Activation des cellules vasculaires

Boyer, Edmond

154

Bacterial infections: uncommon presentations  

Microsoft Academic Search

The essence of dermatology is morphology. The most important instrument in the practice of dermatology has always been, and still is, the naked eye; however, “We see only what we are ready to see, what we have been taught to see” (Jean Martin Charcot). Although most practitioners will easily correctly diagnose common bacterial skin diseases (such as cellulitis, erysipelas, impetigo,

Hagit Matz; Edith Orion; Ronni Wolf

2005-01-01

155

Le Lait (1985), 65 (649-650), 185-199 Etude de l'immobilisation  

E-print Network

'emploi de glutaraldéhyde, polyéthylèneimine et de tannins se sont révélés trop toxiques pour les cellules ou with glutaraldehyâe, polyethyle- neimine and tannins as hardening agents were not satisfactory and no further employed

Paris-Sud XI, Université de

156

Staphylococcus aureus Infections in Injection Drug Users: Risk Factors and Prevention Strategies  

Microsoft Academic Search

Infections, in particular soft tissue infections (cellulitis, skin abscesses), are the leading cause for emergency department visits and hospital admissions of drug injection users (IDUs). Staphylococcus aureus is the most relevant bacterial pathogen in this population. It is the main cause of soft tissue infections and of severe infections such as endocarditis and bacteremia. Moreover, epidemic spread of methicillin-resistant S.

S. Bassetti; M. Battegay

2004-01-01

157

UNIVERSIT PARIS DIDEROT (PARIS VII) COLE DOCTORALE : Interdisciplinaire pour le Vivant (iViv)  

E-print Network

�NERG�TIQUE DES SUBSTRATS DANS L'ADHESION ET LA DIFF�RENCIATION DES CELLULES NEURONALES MOD�LES PC12 Thèse propos m'ont permis d'avancer à la fois tête baissée et yeux grands ouverts. En deux mots : mille mercis

Paris-Sud XI, Université de

158

Gliose de mylinisation et glioses ractionnelles au cours du dveloppement du nerf optique chez le rat  

E-print Network

results obtained with light and electron microscopy confirmed that the oligodendrocytes are the only cells. The oligodendrocyte, whose differ- entiation requires the intervention of an axonal signal, causes myelination gliosis, astrocytes, oligodendrocytes et cellules microgliques. Les glioblastes (fig. 1 D) apparaissent comme les

Paris-Sud XI, Université de

159

UNIVERSITE JOSEPH FOURIER GRENOBLE IUNIVERSITE JOSEPH FOURIER GRENOBLE I UFR DE BIOLOGIEUFR DE BIOLOGIE  

E-print Network

développement du lignage oligodendrocytaire_____________________________ 31 3.1 Du précurseur à l'oligodendrocyte _______________________________________________ 33 3.1.2 Les cellules progénitrices d'oligodendrocytes _____________________________________ 35 3.1.3 Le pro-oligodendrocyte et le pré-oligodendrocyte __________________________________ 38 3.1.4 L'oligodendrocyte

Paris-Sud XI, Université de

160

Original article Exopolysaccharides from Lactobacillus rhamnosus  

E-print Network

Original article Exopolysaccharides from Lactobacillus rhamnosus RW-9595M stimulate TNF, IL-6) from Lactobacillus rhamnosus RW- 9595M have been pre- pared from bacterial cultures, isolated exopolysaccharides du Lactobacillus rhamnosus RW-9595M. Différence entre les réponses de cellules de sang

Paris-Sud XI, Université de

161

A pressure cell for inelastic neutron scattering up to 35 kbar II. Physikalisches Institut, Universitt zu Kln, Zlpicherstrae 77, D-5000 Kln 41, F.R.G.  

E-print Network

833 A pressure cell for inelastic neutron scattering up to 35 kbar U. Walter II. Physikalisches expériences de diffusion inélastique de neutrons avec une telle cellule à pression. Abstract. 2014 A pressure experiments with such a pressure cell. Revue Phys. Appl. 19 (1984) 833-836 SEPTEMBRE 1984, It is obviously

Paris-Sud XI, Université de

162

THIN FILM SOLAR CELLS AND A REVIEW OF RECENT RESULTS ON GaAs By PAUL RAPPAPORT,  

E-print Network

154. THIN FILM SOLAR CELLS AND A REVIEW OF RECENT RESULTS ON GaAs By PAUL RAPPAPORT, RCA semiconducteurs aptes à former des films minces photovoltaïques, compte tenu notamment de leur coefficient d cellules, obtenues avec des films de GaAs formés chimiquement sur une feuille de Mo et recouverts de

Paris-Sud XI, Université de

163

TUDE DES TRANSFERTS D'ORIENTATION ET D'ALIGNEMENT DANS LA FLUORESCENCE SENSIBILISE MERCURE-CADMIUM  

E-print Network

'une lampe a vapeur de mercure excitee dans une cavite micro-onde. Un courant gazeux produit par evaporation. Les longueurs d'onde sont exprimees en nano- metre. [First energy levels of Hg, Cd and Zn. Wave lengths are in nano- meters.] FIG. 2. - Schema du montage experimental. C cellule; Mimono- chromateur

Paris-Sud XI, Université de

164

Superoxide release by confluent endothelial cells, an electron spin resonance (ESR) study  

NASA Astrophysics Data System (ADS)

In the present study we used ESR to detect the release of oxygen radicals by endothelial cells stimulated with calcium ionophore A23187. Dimethyl-1-pyrroline-N-oxide (DMPO) was used as a spin trap. Although the observed adduct (DMPO-OH) suggested the presence of the hydroxyl radical, the use of superoxide dismutase and catalase revealed that superoxide anion was released in the medium. Superoxide production was more efficient when the cells were post-confluent for a few days. The release of superoxide was 3-fold greater in growth arrested cells (D6-D9) than in proliferating cells (D0). Although two inhibitors of the mitochondrial respiratory chain carbanyl cyanide m-chlorophenylhydrazone (CCCP), antimycine decreased the ESR signal by 35%, the use of superoxide dismutase (SOD) and tumor necrosis factor (TNF) suggested that the release of O2- occurred in the cell membrane. The physiological significance of this extracellular superoxide release by post-confluent cells deserves further study. Ce travail présente une étude par RSE de la libération des radicaux oxygénés par les cellules endothéliales bovines (BAEC) sous l'effet de l'ionophore calcique A23187. Le diméthyl-1-pyrroline-N-oxyde (DMPO) est utilisé comme piégeur de spin. Bien que l'adduit formé (DMPO-OH) semble traduire la présence du radical hydroxyle .OH, l'utilisation de superoxyde dismutase et de catalase a révélé que les cellules endothéliales libéraient l'anion superoxyde. La production du radical superoxyde est plus abondante lorsque les cellules sont à confluence depuis plusieurs jours. Lorsque les cellules sont entre J6 et J9, la production de superoxyde est trois fois supérieure à celle observée lorsque les cellules sont en prolifération (J0). Bien que deux inhibiteurs de la chaîne mitochondriale 1-carbonyldinitrile-m-chlorophenylhydrazone (CCCP), antimycineinhibent de 35 % le signal RPE, l'utilisation de superoxyde dismutase (SOD) et du tumor necrosis factor (TNF) suggèrent que la libération de O2- provient de la membrane cellulaire. La signification physiologique de cette production extracellulaire de l'anion superoxyde par des cellules post-confluentes reste à élucider.

Barbacanne, M.-A.; Margeat, E.; Arnal, J.-F.; Nepveu, F.; Souchard, J.-P.

1999-01-01

165

A Classic Clinical Case: Neutrophilic Eccrine Hidradenitis  

PubMed Central

Background Neutrophilic eccrine hidradenitis (NEH) is a rare condition described mostly in adult patients receiving chemotherapy for acute myelogenous leukemia. When it affects the facial region, it can mimic cellulitis and delay the diagnostic, thus proper recognition is essential. Objective This article describes a classic case of NEH. We will review the diagnostic, the differential diagnostic (mostly cellulitis) and the management of this condition. Methods After a literature review, the patient's file was properly studied in order to portray a clear picture of this condition. Medical photographs and appropriate physical examination upon presentation are also included. Results The diagnostic for NEH was suggested by the clinical presentation and confirmed histopathologically (skin biopsy). Conclusion The diagnostic of NEH is essential in order to prevent multiple unnecessary antibiotics. PMID:24474918

Copaescu, Ana-Maria; Castilloux, Jean-François; Chababi-Atallah, Myrna; Sinave, Christian; Bertrand, Janie

2013-01-01

166

Pressure-Distribution Measurements on O-2H Airplane in Flight  

NASA Technical Reports Server (NTRS)

Results are given of pressure-distribution measurements made over two different horizontal tail surfaces and the right wing cellule, including the slipstream area, of an observation-type biplane. Measurements were also taken of air speed, control-surface positions, control-stick forces, angular velocities, and accelerations during various abrupt maneuvers. These maneuvers consisted of push-downs and pull-ups from level flight, dive pull-outs, and aileron rolls with various thrust conditions. The results from the pressure-distribution measurements over the wing cellule are given on charts showing the variation of individual rib coefficients with wing coefficients; the data from the tail-surface pressure-distribution measurements are given mainly as total loads and moments. These data are supplemented by time histories of the measured quantities and isometric views of the rib pressure distributions occurring in abrupt maneuvers.

Pearson, H A

1937-01-01

167

Streptococcus dysgalactiae subsp. equisimilis bacteremia: an emerging infection.  

PubMed

The importance of group C and G Streptococcus dysgalactiae subspecies equisimilis (S. dysgalactiae subsp. equisimilis) as a significant pathogen has recently been better recognized. S. dysgalactiae subsp. equisimilis disease can range in severity from milder skin and soft-tissue conditions such as wound infection, erysipelas, and cellulitis, to life-threatening necrotizing fasciitis and streptococcal toxic shock syndrome, thus sharing the clinical picture with S. pyogenes. The most common clinical manifestation of bacteremia is cellulitis. An increase in the incidence of S. dysgalactiae subsp. equisimilis bacteremia has been recognized. Invasive forms of this infection are most commonly found in elderly patients with underlying comorbidities and skin breakdown. The case fatality in bacteremia has been reported to be 15-18%. In this review, the epidemiology, clinical characteristics, and emm types of S. dysgalactiae subsp. equisimilis bacteremia are summarized. PMID:24682845

Rantala, S

2014-08-01

168

Uncomplicated Skin and Soft Tissue Infections  

Microsoft Academic Search

\\u000a Uncomplicated skin and soft tissue infections (SSTI) include the following: impetigo, folliculitis, carbuncles, furuncles,\\u000a simple abscesses, and cellulitis\\/erysipelas [1]. This chapter outlines the common bacterial etiologies of these infections\\u000a as well as reviews current guidelines for their treatment as related to outpatient management. Information regarding the management\\u000a of bites from animals and from humans will also be presented. Community-associated methicillin-resistant

Ivar L. Frithsen; Cassandra D. Salgado

169

Skin Disease Presenting as an Outbreak of Pseudobacteremia in a Laboratory Worker  

Microsoft Academic Search

An outbreak of pseudobacteremia due to Streptococcus pyogenes (group A streptococci (GAS)) and methicil- lin-susceptible Staphylococcus aureus (MSSA) was traced to the venting procedure for aerobic bottles prior to their loading into the incubator of the BacT\\/Alert analyzer (Organon Teknika). Bacteria shed by a laboratory worker suffering from impetigo and cellulitis contaminated the aerobic bottles of 10 patients. All blood

A. Simhon; G. Rahav; M. Shapiro; C. Block

2001-01-01

170

Métastase anale d'un adénocarcinome du sigmoïde: la partie visible de l'iceberg  

PubMed Central

Les auteurs rapportent l'observation d'une métastase anale d'un adénocarcinome sigmoïdien dont le traitement a consisté en une amputation abdominopérinéale du rectum, étendue au côlon sigmoïde avec colostomie iliaque gauche définitive. Les différents mécanismes d'extension tumorale sont discutés et la greffe de cellules tumorales viables exfoliées dans la lumière colique est le mécanisme le plus souvent retenu. PMID:25419304

El Barni, Rachid; Lahkim, Mohamed; Fihri, Jawad Fassi; Mejdane, Abdelhadi; Bouchama, Rachid; Achour, Abdessamad

2014-01-01

171

Measurement of the Boltzmann constant by the Doppler broadening technique at a 3.8 5  

E-print Network

source is an ultra- stable CO2 laser with a wavelength 10 m . The absorption cell is placed in a thermostat keeping the temperature at 273.15 K within 1.4 mK. We were able to measure with a relative spectroscopique est réalisée à l'aide d'un laser à CO2 ultra-stable de longueur d'onde 10 m . La cellule d

Boyer, Edmond

172

Development of Specific Nested Oligonucleotide PCR Primers for the Streptococcus iniae 16S-23S Ribosomal DNA Intergenic Spacer  

PubMed Central

Streptococcus iniae is a cause of septicemia, meningoencephalitis, and death in farmed fish and of cellulitis in human beings. A set of nested oligonucleotide PCR primers that specifically amplified a 373-bp subunit from a variety of clinical isolates from farmed fish and human patients were constructed from a 524-bp consensus sequence of the S. iniae 16S-23S ribosomal DNA intergenic spacer. PMID:9705438

Berridge, Brian R.; Fuller, Jeffrey D.; de Azavedo, Joyce; Low, Donald E.; Bercovier, Herve; Frelier, Paul F.

1998-01-01

173

Razungles J, Cavaills V, Jalaguier S, Teyssier C. I.R.C.M, Inserm U896, 208, rue des Apothicaires, 34298 Montpellier, France .  

E-print Network

cancérologie The Warburg effect: fromtheory to therapeutic applications in cancer I/ De la théorie à l, 34298 Montpellier, France . L'effet Warburg: de la théorie du canceraux applications thérapeutiques en'effet Warburg: Dans les années 1930, lors de ses observations sur des cellules cancéreuses, O.H. Warburg (Figure

Boyer, Edmond

174

en vue de l'obtention du grade de Docteur de l'cole Normale Suprieure de Lyon -Universit de Lyon  

E-print Network

-échelle de l'ADN, de la double-hélice à la chromatine Dans le noyau des cellules eucaryotes, l'ADN s double-hélice de l'ADN jusqu'aux chromosomes micrométriques, sont essentielles aux mécanismes com- plexes utilisons des simulations de dynamique moléculaire d'oligomères d'ADN pour étudier l'ADN double-hélical à

Paris-Sud XI, Université de

175

Le gnome doit tre rpliqu en deux exemplaires lors de la division cellulaire. Ce processus s'effectue au niveau des fourches de rplica-  

E-print Network

long des brins d'ADN séparés. Dans les cellules tumorales, les fourches de ré- plication sont souvent endommagées, ce qui provoque des cassures des deux brins d'ADN. Une étude internationale pilotée par Thanos'abord répliquer son ADN, soit quelque 6,4 milliards de paires de nucléotides. Le double brin d'ADN s'ouvre, comme

Rochaix, Jean-David

176

NOTE TECHNIQUE INHIBITION DE LA SPERMATOGENSE DU GUPPY  

E-print Network

injection ou dans l'eau de l'aquarium) sur les différentes catégories de cellules germi- nales chez le Guppy sont répartis en lots de io dans des aquariums en chlorure de polyvinyle contenant i litre d'eau ; le contenu de ces aquariums est renouvelé tous les 2 jours par de l'eau prélevée dans un grand bassin où

Paris-Sud XI, Université de

177

Primary Cutaneous Cryptococcosis and Secondary Antigenemia in a Patient with Long-Term Corticosteroid Therapy  

Microsoft Academic Search

\\u000a Abstract\\u000a   We report a case of a 71-year-old male who developed severe cellulitis of his right forearm and hand after he had an accidental injury from the sharp edge of a metal plate of a birdhouse. The patient suffers from chronic asthma and has been treated with systemic corticosteroids for years. Culture of aspirates from two sites of the wound

C. Hafner; H.-J. Linde; T. Vogt; G. Breindl; K. Tintelnot; K. Koellner; M. Landthaler; R.-M. Szeimies

2005-01-01

178

[Cheek perforation of dental origin and the effect of anti-inflammatory drug treatment during self-medication. Apropos of a case].  

PubMed

Complications of dental caries not treated and mal-treated are frequent in Africa (cellulitis, osteitis, etc...). Patients consult late due to effective automedication with anti-inflammatory agents but the continuing pathological process leading to fistulae, perforation and persistent pain are finally the reasons of consultation. We present a case of a young Ivorian student of 22 years we have received after one year of erratic treatment with a right jaw perforation. PMID:11372091

Kouame, P; Souaga, K; Amantchi, D

1999-06-01

179

A cluster of seven cases of Clostridium tertium septicemia in neutropenic patients  

Microsoft Academic Search

A cluster of seven febrile and severely neutropenic patients who developedClostridium tertium septicemia during a 13-month period is described. The patients had received third generation cephalosporins for 7 to 13 days (mean 9 days) at the timeClostridium tertium was isolated from blood cultures. Two patients had perirectal and one patient pericaecal cellulitis. The organism was also isolated from bronchial secretions

M. Valtonen; A. Sivonen; E. Elonen

1990-01-01

180

Dcembre 2010 51 Dossier Aspects techniques du dveloppement des Accs trs hAut dbit  

E-print Network

une augmentation massive de la densité du réseau, une solution qui n'est ni économique ni écologique dans le cadre des réseaux de communication actuels. Le concept des réseaux à petites cellules (SCN alternative possible. Cet article discute des bénéfices financiers et écologiques potentiels ainsi que des

Paris-Sud XI, Université de

181

TUDE DES PROPRITS PHYSIQUES DES COUCHES MINCES PHOTOSENSIBLES DE SULFURE DE CADMIUM  

E-print Network

757 �TUDE DES PROPRI�T�S PHYSIQUES DES COUCHES MINCES PHOTOSENSIBLES DE SULFURE DE CADMIUM Par G. - Pour reconnaître si les cellules au sulfure de cadmium étaient aptes à la photométrie des petits flux substances photo- conductrices, le sulfure de cadmium est l'une des plus sensibles. On entend par là d

Paris-Sud XI, Université de

182

THESE DE DOCTORAT DE L'UNIVERSITE PIERRE ET MARIE CURIE Spcialit : Physiologie et physiopathologie (ED394)  

E-print Network

et de la composition de la matrice extracellulaire via CXCR4. Récemment, il a été démontré que la, CXCR3 et CXCR4 par les cellules trabéculaires dans les trabéculums humains glaucomateux et dans une lignée trabéculaire glaucomateuse. Nous démontrons l'existence d'une balance entre le système CXCL12/CXCR

Boyer, Edmond

183

Sensitivity to mutagens of Rumex acetosa chromosomes  

Microsoft Academic Search

Résumé Des graines deRumex acetosa ont été soit irradiées par les rayons ? du60Co (100 à 3000 rads) soit traitées par deux agents mutagènes chimiques: le MMS et le MNU. Le MNU est plus efficace que le MMS comme inducteur de lésions chromosomiques. Les spectres des différents types d'aberrations chromosomiques produites par les 3 agents sont différents et les cellules

N. Degaraeve; J. Moutschen

1973-01-01

184

Conception d'un bioracteur perfusion pour la production de volumes cliniques de substituts osseux  

E-print Network

Conception d'un bioréacteur à perfusion pour la production de volumes cliniques de substituts (biohybrides) en tissu osseux a conduit à évaluer l'intérêt de ces cellules comme substituts de l comme substituts de l'autogreffe osseuse. L'intérêt de l'utilisation de matériaux biohybrides dans le

Bezerianos, Anastasia

185

Lime-induced phytophotodermatitis  

PubMed Central

This case describes a scenario of lime-induced phytophotodermatitis. Phytophotodermatitis is a dermatitis caused after the skin is exposed to photosensitizing compounds in plants and then exposed to sunlight. Many common plants including citrus fruits, celery, and wild parsnip contain these photosensitizing compounds which cause phytophotodermatitis. It is important for a physician to be aware of phytophotodermatitis because it may often be misdiagnosed as other skin conditions including fungal infection, cellulitis, allergic contact dermatitis, and even child abuse. PMID:25317269

Hankinson, Andrew; Lloyd, Benjamin; Alweis, Richard

2014-01-01

186

A VLU complicated by severe group a streptococcal infection resulting in necrotising fasciitis and septic shock: a case report.  

PubMed

This case study outlines the management of a patient with a venous leg ulcer whose swabs cultured Staphylococcus aureus and beta-haemolytic streptococcus group A while in hospital with cellulitis, which was treated with antibiotics as per sensitivities. However, the patient presented at the emergency department five weeks later with a diagnosis of invasive group A streptococcal disease resulting in necrotising fasciitis and streptococcal toxic shock syndrome. This paper describes the holistic care and wound management that the patient received. PMID:25289649

Meagher, H; Corkery, M; Concannon, L; Kavanagh, E

2014-10-01

187

Posttonsillectomy pain in children.  

PubMed

Tonsillectomy, used to treat a variety of pediatric disorders, including obstructive sleep apnea, peritonsillar cellulitis or abscesses, and very frequent throat infection, is known to produce nausea, vomiting, and prolonged, moderate-to-severe pain. The authors review the causes of posttonsillectomy pain, current findings on the efficacy of various pharmacologic and nonpharmacologic interventions in pain management, recommendations for patient and family teaching regarding pain management, and best practices for improving medication adherence. PMID:24445532

Sutters, Kimberly A; Isaacson, Glenn

2014-02-01

188

SPECTRE DE L'THYLAMINE C2H5NH2 Par M. MATRICON,  

E-print Network

. Le spectroscope utilisé est du type maintenant classique à modulation par effet Stark. On sait que d'absorption déplacées par effet Stark. Dans le cas de l'éthylamine, les conditions expérimentales alternative appliquée pour la modulation Stark : 200 à 30o V sur une électrode placée au centre d'une cellule

Paris-Sud XI, Université de

189

Beta-Hemolytic Streptococcal Erythroderma Syndrome: A Clinical and Pathogenic Analysis  

PubMed Central

The syndrome of erythroderma due to beta-hemolytic streptococci is rarely seen and should be distinguished from cellulitis and toxic shock-like syndrome. We describe a novel syndrome of non-group A, beta-hemolytic streptococcal infection truncal erythroderma. The characteristics of this syndrome suggest that local factors were likely operative in the cutaneous manifestations of an exotoxin-associated erythroderma. PMID:21841465

Tyner, Harmony L; Schlievert, M; Baddour

2011-01-01

190

Enzymatic oxidation of cyclopropylbenzene: structures of new metabolites and possible  

E-print Network

was subjected to whole-cell fermentation with either Escherichia coli JM109 (pDTG601) or E. coli JM109 (pDTG602 cyclopropylbenzène à une fermentation à l'aide de cellules entières d'Escherichia coli JM109 (pDTG601) ou d'E. coli applications of E. coli JM109 (pDTG602) to the practical preparation of substituted catechols (2), com- pounds

Hudlicky, Tomas

191

Is Leclercia adecarboxylata a New and Unfamiliar Marine Pathogen?  

PubMed Central

Leclercia adecarboxylata infection is rarely reported in the context of human infections. In the scant cases reported in the literature, it usually involves individuals who are immunocompromised with infections of a polymicrobial nature. Recently, data have begun to accumulate suggesting that L. adecarboxylata is a pathogen associated with water environments. We review the literature regarding L. adecarboxylata infections and present a case of cellulitis and soft-tissue infection in the foot of a healthy surfer. PMID:24523466

Keshet, Doron; Eidelman, Mark; Geffen, Yuval; Raz-Pasteur, Ayelet; Hussein, Khetam

2014-01-01

192

Lime-induced phytophotodermatitis.  

PubMed

This case describes a scenario of lime-induced phytophotodermatitis. Phytophotodermatitis is a dermatitis caused after the skin is exposed to photosensitizing compounds in plants and then exposed to sunlight. Many common plants including citrus fruits, celery, and wild parsnip contain these photosensitizing compounds which cause phytophotodermatitis. It is important for a physician to be aware of phytophotodermatitis because it may often be misdiagnosed as other skin conditions including fungal infection, cellulitis, allergic contact dermatitis, and even child abuse. PMID:25317269

Hankinson, Andrew; Lloyd, Benjamin; Alweis, Richard

2014-01-01

193

UNIVERSITE PARIS-SUD 11 LABORATOIRE DES SCIENCES DU CLIMAT ET DE L'ENVIRONNEMENT  

E-print Network

Examinateur : Mme. Coralie SCHOEMAECKER Chargée de Recherche, PC2A Lille Directeur de thèse : M. Bernard Tanneau pour la rapidité avec laquelle j'ai toujours eu mes cellules de réaction en avance par rapport au longs weekends à La Charmois avec notre Pépétte débordante d'énergie et de m'avoir permis d'avancer sur

Paris-Sud XI, Université de

194

TH`ESE DE DOCTORAT UNIVERSITE PARIS DESCARTES  

E-print Network

synaptique et non-synaptique entre neurones et cellules pr´ecurseurs d'oligodendrocytes dans le cortex/R´esum´e vii Acknowledgments xi Preface xiii I Introduction 1 1 Oligodendrocyte Precursor Cells (OPCs) 3 1-01017183,version1-9Jul2014 #12;vi tel-01017183,version1-9Jul2014 #12;Abstract/R´esum´e Oligodendrocyte

Boyer, Edmond

195

Toxigenic Corynebacterium ulcerans in a fatal human case and her feline contacts, France, March 2014.  

PubMed

In March 2014, a person in their eighties who was diagnosed with extensive cellulitis due to toxigenic Corynebacterium ulcerans died from multiple organ failure. Environmental investigation also isolated C. ulcerans in biological samples from two stray cats in contact with the case. This finding provides further evidence that pets can carry toxigenic C. ulcerans and may be a source of the infection in humans. PMID:25306877

Vandentorren, S; Guiso, N; Badell, E; Boisrenoult, P; Micaelo, M; Troché, G; Lecouls, P; Moquet, M J; Patey, O; Belchior, E

2014-01-01

196

A Case of Community-Associated Methicillin-Resistant Staphylococcus Aureus Infections in a Community Hospital  

PubMed Central

Infections caused by methicillin-resistant Staphylococcus Aureus (MRSA) have recently occurred in communities in people lacking known healthcare risk factors. This MRSA infection is referred to as community-associated MRSA (CA-MRSA) infection, and is distinct from hospital-associated MRSA infection, which occurs in people with risk factors. We experienced a patient diagnosed with CA-MRSA cellulitis, as culture of pus revealed MRSA and he had not been exposed to healthcare environments for the past year. The patient was a previously healthy 38-year-old man with suppurative cellulitis in his right index finger following injury to the finger at his worksite. The cellulitis was successfully managed with incision and drainage (I&D), followed by cefazolin during a 10-day clinical course, although the patient’s MRSA strain was resistant to cefazolin. There are several reports that suggest that I&D followed by antibiotic treatment for CA-MRSA skin infection produces equivalent clinical outcomes, whether the antibiotic prescribed was effective or not. Given that MRSA emerged in an outpatient setting, CA-MRSA should be considered a possible etiology of skin infection in healthy individuals with no classical risk factors for acquisition of MRSA.

Kawabata, Hidenobu; Murakami, Manabu; Kisa, Kengo; Kimura, Yuya; Maezawa, Masaji

2010-01-01

197

Annual progress report, July 1, 1983-June 30, 1984  

SciTech Connect

Research in the Laboratory of Biomolecular and Celluler Sciences deals with proliferation, gene expression and differentiation in normal cells and in cells exposed to pollutants, carcinogens or tumor promoters. The research program of the Laboratory of Environmental Biology presents an integrated approach to studies of the functional interactions of the physical and biotic components of arid land ecosystems. Nuclear Medicine research has focussed on development of positron emission tomography, preparation of short-lived isotopes of oxygen, nitrogen, carbon and fluorine, use of these isotopes to label physiological substrates, tracer studies of cerebral biochemistry and physiology, measurement of regional myocardial fatty acid metabolism and blood flow. (AER)

Not Available

1984-01-01

198

Three eyelid localized cutaneous anthrax cases.  

PubMed

Anthrax is primarily seen in the developing countries, but it can be a worldwide medical concern due to bioterrorism threats. Palpebral anthrax is a rare form of cutaneous anthrax. Untreated cutaneous anthrax can be lethal. Patients with palpebral anthrax can develop complications including cicatrisation and ectropion. Thus, anthrax should be considered in differential diagnosis for patients presenting with preseptal cellulitis in high-risk regions. Herein, we report three anthrax cases (with different age) involving eyelids that were cured without any complications due to early diagnosis and treatment. PMID:24641116

Esmer, Oktay; Karadag, Remzi; Bilgili, Serap Gunes; Gultepe, Bilge; Bayramlar, Huseyin; Karadag, Ayse Serap

2014-12-01

199

I. Analyse de squences biologiques Catherine Matias  

E-print Network

/08/11 20:33 chromosome télomère centromère télomère chromatides paires de bases histones ADN double brins nucléosomes cellule noyau #12;L'information génétique : l'ADN Chez l'Homme : 3.4 milliards de nucléotides;Réplication de l'ADN et variabilité de l'information génétique réplication très dèle, dite semi

200

Modlisation de ractions chimiques dans les rseaux de gnes. Problme de convergence de processus markoviens  

E-print Network

cellule contient un matériel génétique : l'ADN. L'ADN : L'ADN est une macromolécule complexe, constituée d bactéries, l'ADN est en général présent dans le cytoplasme sous la forme d'un seul chromosome circulaire. Chez les eucaryotes, l'ADN est généralement sous forme de plusieurs chromosomes. Cet ADN se situe dans

Boyer, Edmond

201

Graduat en Biologie mdicale, options chimie clinique et cytologie. Haute Ecole Andr Vsale Quai du Barbou, 2 4020 Lige -: 04/344 7812/14  

E-print Network

du Barbou, 2 à 4020 Liège - : 04/344 7812/14 Extraction de l'ADN de cellules végétales Matériel · Un blanc muqueux d'ADN genre « méduse ». · Prendre une pipette Pasteur dont on a replié l'extrémité effilée filament d'ADN. Retirer l'ADN et le déposer sur une lame pour microscope. · Si on dispose du colorant

Liège, Université de

202

Bien que les rcents progrs technologiques aient considrablement rduit le cot du squenage de l'ADN, ce procd a jusqu' prsent  

E-print Network

l'ADN, ce procédé a jusqu'à présent été peu exploité. «1000 génomes» est le premier projet de grande'être passé de l'accomplissement du pre- mier séquençage de l'ADN humain en 2003 à celui de plus de 1000 des cellules vivantes provenant des 1092 individus dont l'ADN a été séquencé. Tout l'intérêt est d

Loewith, Robbie

203

COLE CENTRALE DES ARTS ET MANUFACTURES  

E-print Network

de surveillance de l'ADN et analyse des interrégulations entre le mécanisme de surveillance de l'ADN l'intégrité de l'ADN et d'autre part la répartition équitable du génome dupliqué dans les cellules checkpoint du fuseau mitotique, tandis que les checkpoints de l'ADN sont activés suite à des lésions de l'ADN

Paris-Sud XI, Université de

204

Streptococcus Dysgalactiae Subspecies Dysgalactiae Infection after Total Knee Arthroplasty: A Case Report  

PubMed Central

Streptococcus dysgalactiae subspecies dysgalactiae (SDSD), Lancefield group C streptococcus, is an animal pathogen which often causes pyogenic infection in domestic animals. Human infection by SDSD has been reported as a cellulitis on the upper arm, but a prosthetic joint infection caused by SDSD after total knee arthroplasty (TKA) has not yet been reported in the literature demonstrating that its clinical manifestation and management have not been well established. In this case report, we aimed to present a case of SDSD prosthetic joint infection after TKA, which was successfully treated by two-stage re-implantation with an application of antibiotic-impregnated cement spacer. PMID:22708114

Park, Man Jun; Jung, Chul-Young; Ko, Young-Chul; Kim, Young-June; Kim, Chang-kyu; Kang, Eun-Jin

2012-01-01

205

Ruptured popliteal cyst diagnosed by ultrasound before evaluation for deep vein thrombosis.  

PubMed

Most popliteal cysts are asymptomatic. However, cysts may rupture, resulting in pain and swelling of the leg that could also arise from other diseases, including deep vein thrombosis, lymphedema, cellulitis, and tear of a muscle or tendon. Therefore, it is difficult to diagnose a ruptured popliteal cyst based on only a patient's history and physical examination. Musculoskeletal ultrasound has been regarded as a diagnostic tool for ruptured popliteal cyst. Here, we describe a patient who was rapidly diagnosed as ruptured popliteal cyst by ultrasonography. Therefore, ultrasound could be used to distinguish a ruptured popliteal cyst from other diseases in patients with painful swollen legs before evaluation for deep vein thrombosis. PMID:25566485

Kim, Joon Sung; Lim, Seong Hoon; Hong, Bo Young; Park, So Young

2014-12-01

206

Acquired lymphangiectasis following surgery and radiotherapy of breast cancer.  

PubMed

Acquired lymphangiectasia (AL) is a significant and rare complication of surgery and radiotherapy. We report lymphangiectasia in a 40-year-old woman who had undergone radical mastectomy and radiotherapy. After 4 years of combined therapy, she developed multiple vesicles and bullae. Skin biopsy confirmed the diagnosis of lymphangiectasia. The case is unique as it is not associated with lymphedema, which is a usual accompaniment of lymphangiectasia following surgery and radiotherapy. AL is usually asymptomatic, but trauma may cause recurrent cellulitis. Treatment modalities include electrodessication, surgical excision, sclerotherapy and carbon dioxide laser ablation. PMID:25657438

Rao, Angoori Gnaneshwar

2015-01-01

207

Ruptured Popliteal Cyst Diagnosed by Ultrasound Before Evaluation for Deep Vein Thrombosis  

PubMed Central

Most popliteal cysts are asymptomatic. However, cysts may rupture, resulting in pain and swelling of the leg that could also arise from other diseases, including deep vein thrombosis, lymphedema, cellulitis, and tear of a muscle or tendon. Therefore, it is difficult to diagnose a ruptured popliteal cyst based on only a patient's history and physical examination. Musculoskeletal ultrasound has been regarded as a diagnostic tool for ruptured popliteal cyst. Here, we describe a patient who was rapidly diagnosed as ruptured popliteal cyst by ultrasonography. Therefore, ultrasound could be used to distinguish a ruptured popliteal cyst from other diseases in patients with painful swollen legs before evaluation for deep vein thrombosis. PMID:25566485

Kim, Joon Sung; Lim, Seong Hoon; Hong, Bo Young

2014-01-01

208

Acquired Lymphangiectasis Following Surgery and Radiotherapy of Breast Cancer  

PubMed Central

Acquired lymphangiectasia (AL) is a significant and rare complication of surgery and radiotherapy. We report lymphangiectasia in a 40-year-old woman who had undergone radical mastectomy and radiotherapy. After 4 years of combined therapy, she developed multiple vesicles and bullae. Skin biopsy confirmed the diagnosis of lymphangiectasia. The case is unique as it is not associated with lymphedema, which is a usual accompaniment of lymphangiectasia following surgery and radiotherapy. AL is usually asymptomatic, but trauma may cause recurrent cellulitis. Treatment modalities include electrodessication, surgical excision, sclerotherapy and carbon dioxide laser ablation.

Rao, Angoori Gnaneshwar

2015-01-01

209

Garenoxacin in Skin and Skin Structure Infections Sustained due to Road Traffic Accident  

PubMed Central

Skin and soft tissue infections represent a continuum of symptoms that range from uncomplicated cellulitis to the potentially lethal entity necrotizing fasciitis that is often considered to be microbial invasions of the epidermis, dermis and subcutaneous tissues. Garenoxacin, a newer oral des-fluoroquinolone having potent antimicrobial activity against wide variety of common pathogens involved in skin and skin structure infections (SSTIs), including the resistant strains offer the advantage of broad spectrum of coverage including gram positive, gram negative and anaerobic organisms. This case study indicates the utility of garenoxacin in treating skin and soft tissue infections caused by road traffic accidents. PMID:25121004

Krishnaprasad, K; Bhargava, Amit Indra

2014-01-01

210

Necrotizing Fasciitis - Report of ten cases and review of recent literature  

PubMed Central

Necrotizing fasciitis is an uncommon disease that results in gross morbidity and mortality if not diagnosed and treated in its early stages. At onset, however, it is difficult to differentiate from other superficial skin conditions such as cellulitis. Family physicians must have a high level of suspicion and low threshold for surgical referral when confronted with cases of pain, fever, and erythema. We present ten cases of necrotizing fasciitis managed in a provincial secondary hospital in Oman over 3 years ago. A review of recent literature is also presented. PMID:23904882

Al Shukry, S; Ommen, J

2013-01-01

211

Multiple nontuberculous scrofulodermas showing dramatic response to clarithromycin  

PubMed Central

Atypical mycobacteria are distinct from the Mycobacterium tuberculosis. Mycobacterium chelonae, a non-pigment producing rapid grower, can be found in many cutaneous sites; infection occurs most commonly after skin trauma from surgery, injections, or minor injuries. In immune competent patients, the infection is more frequently localized as a cellulitis or a nodule, whereas, in the immunocompromised patient, dissemination (more than five lesions) can occur. Because the organism is resistant to antituberculous therapy, abscess can develop and follow a chronic, indolent course. We report a case of multiple scrofuloderma due to nontuberculous infection caused by M. chelonae showing dramatic response to clarithromycin.

Parimalam, Kumar; Senthil, G.; Vinnarasan, M.; Arumugakani, V.; Amutha, B. M.; Lalitha, S.; Swarna, S.

2015-01-01

212

Aerotolerant Clostridium tertium brain abscess following a lawn dart injury.  

PubMed

A young girl developed an intracranial abscess and necrotizing cellulitis following penetrating injury from a lawn dart. Initial identification of a gram-positive rod growing aerobically from clinical specimens was as a Bacillus organism, but the observation that the isolate grew poorly in subcultures for susceptibility testing but quite well under standard anaerobic culture techniques led to the identification of the organism as an aerotolerant Clostridium tertium. Early management of penetrating head trauma should include cranial imaging studies to detect fractures and intracranial pathology. Clinical microbiologists and clinicians should be aware of the phenomenon of aerotolerance in anaerobic bacteria to avoid errors in choice of antibiotic therapy. PMID:2229397

Lew, J F; Wiedermann, B L; Sneed, J; Campos, J; McCullough, D

1990-09-01

213

Clostridium tertium septicemia in patients with neutropenia.  

PubMed

Eighteen adult patients with hematologic malignancy developed bacteremia due to Clostridium tertium while neutropenic. Fifteen had accompanying abdominal pain, colonic bleeding, or diarrhea, and three had perianal cellulitis. Fourteen recovered with antibiotic therapy alone; no patient was treated by surgery. C. tertium is an unusual Clostridium because it is resistant to many beta-lactam antibiotics and to metronidazole but is susceptible to vancomycin, trimethoprim-sulfamethoxazole, and ciprofloxacin. It is possible that use of third-generation cephalosporins (cefotaxime, ceftizoxime, ceftazidime) for treating febrile episodes in the absence of any selective intestinal decontamination with trimethoprim-sulfamethoxazole or ciprofloxacin may have resulted in selection for C. tertium in our patients. PMID:3198941

Speirs, G; Warren, R E; Rampling, A

1988-12-01

214

Carcinome neuroendocrine du sein: à propos d'un cas et revue de la littérature  

PubMed Central

Le carcinome neuroendocrine primitif du sein est une tumeur rare qui a été reconnue par la dernière édition de la classification OMS du cancer du sein publiée en 2003. Le diagnostic est évoqué sur des critères morphologiques et confirmé par l'expression des marqueurs neuroendocrines (chromogranine et synaptophysine) par plus de 50% des cellules tumorales. Nous rapportons un nouveau cas de carcinome neuroendocrine primitif du sein, et à travers une revue de la littérature, nous détaillons les aspects épidémiologiques, morphologiques et immuno-histochimiques de cette tumeur rare. PMID:23330031

El Fatemi, Hinde; Hammas, Nawal; Moumna, Kaoutar; Bedahou, Mouhcine; Mellas, Nawfel; Mesbahi, Omar

2012-01-01

215

Massive localized lymphedema: A soft tissue process that may present to dermatologists.  

PubMed

Massive localized lymphedema (MLL) is a clinically and histologically distinct entity seen in morbidly obese patients. We describe two obese patients with MLL in the lower abdomen and suprapubic area. Biopsies showed characteristic histologic features of an expanded dermis with lymphangiectases, fibrotic septae and focal fat necrosis. One patient had long-standing hypothyroidism, an association previously reported. This disease is frequently complicated by recurrent cellulitis and may be amenable to surgery. Patients with MLL may present to dermatologists, and this disease has characteristic histopathologic findings that may mimic liposarcoma to the unaware dermatopathologist. PMID:20514680

Wang, Nadia S; Walters, Ruth F; Warren, Simon J

2010-06-01

216

Case series on tropical diabetic hand syndrome.  

PubMed

Tropical diabetic hand syndrome is a term used to describe diabetes complication of the hand affecting people in the tropics. It consists of localized cellulitis with variable swelling and ulceration of the hands, progressive, fulminant hand sepsis and gangrene in extreme cases. This syndrome is not well-recognized and is therefore less frequently reported. The authors describe three different female patients who were known diabetics of varying duration presenting with this syndrome at our tertiary health center and who were successfully managed by both the surgical and medical units. The need for early diagnosis and aggressive management is emphasized. PMID:24909485

Ezeani, I U; Edo, A E

2014-01-01

217

NOUVELLESMAGAZINE M/S n 8-9, vol. 22, aot-septembre 2006  

E-print Network

infectés après la liaison des glycoprotéines d'enveloppe du VIH-1 sur le co-récepteur CXCR4. Lorsque l'accumulationd'autophagosomesdanslecytoplasmedeslymphocytesTCD4noninfectés après liaison de Env sur CXCR4. B. Western-blot montrant l'accumulation de la protéine autophagi- que ATG6/Beclin 1 dans les lymphocytes T CD4 non infectés après liaison de Env sur CXCR4. Cellule

Paris-Sud XI, Université de

218

Submasseteric Infection: A Rare, Deep Space Cheek Infection Causing Trismus.  

PubMed

Submasseteric space infections are rare at any age but particularly so in primary school children. The origin of the infection is usually odontogenic, from pericoronitis in a third molar. Submasseteric inflammation is a deep facial space inflammation, often progressing to mature abscess, and usually misdiagnosed as staphylococcal or streptococcal lymphadenitis or pyogenic parotitis. The hallmark of a masticatory space infection is trismus. The cardinal signs of this infection include a firm mass in the body of the masseter muscle with overlying cellulitis with trismus. PMID:25411856

Schwartz, Richard H; Bahadori, Robert S; Willis, Andrea

2014-11-19

219

Tropical diabetes hand syndrome with autoamputation of the digits: case report and review of literature  

PubMed Central

The tropical diabetes hand syndrome is a complication affecting patients with diabetes mellitus in the tropics, and consists of localized cellulitis, swelling and ulceration of the hands which may progress to fulminant sepsis and gangrene of the whole limb. It is associated with a poor outcome. We report a 32 year old woman with tropical diabetes hand infection with autoamputation of the digits, review the relevant literature, and highlight the need for prevention and early hospital presentation in diabetics with hand infection, in order to prevent potentially crippling or fatal complications. PMID:25419326

Raimi, Taiwo Hussean; Alese, Oluwole Ojo

2014-01-01

220

[Penetrating transorbital intracranial foreign body].  

PubMed

We report a seven year-old boy who suffered left orbital penetration of an industrial sewing machine needle. The needle passing through the left orbit and sphenoid bone at the posterior was extending into the layers of the dura of the left temporal lobe. In this patient, we preferred surgical approach and there was no complication after surgery. Penetrating intraorbital foreign materials with intracranial extension may lead to complications such as intracerebral hematoma, brain abscess, CSF fistula, proptosis of the eye, diplopia, orbital cellulitis and periorbital abscess. They have to be removed by surgical approach to prevent potential complications. PMID:16850365

Civelek, Erdinç; Bilgiç, Salih; Kabata?, Serdar; Hepgül, Kemal Tanju

2006-07-01

221

Clopidogrel-induced systemic inflammatory response syndrome.  

PubMed

Clopidogrel bisulfate, a widely used inhibitor of platelet aggregation, is considered at least as safe as aspirin. We describe a patient who developed a systemic inflammatory response syndrome consisting of high fever, tachycardia, cellulitis-like rash, impaired liver function, and mild leukopenia after receiving clopidogrel before coronary angiography and stent implantation. The reaction resolved promptly after withdrawal of the drug and recurred shortly after a rechallenge dose was administered, thus making the diagnosis of a clopidogrel-induced reaction highly probable. Recognition of this clopidogrel-induced syndrome is extremely important, both for rapid discontinuation of the offending drug and for avoidance of unnecessary drug therapy or invasive procedures. PMID:12744550

Wolf, Ido; Mouallem, Meir; Rath, Shmuel; Farfel, Zvi

2003-05-01

222

New developments in clinical aspects of lymphatic disease  

PubMed Central

The lymphatic system is fundamentally important to cardiovascular disease, infection and immunity, cancer, and probably obesity — the four major challenges in healthcare in the 21st century. This Review will consider the manner in which new knowledge of lymphatic genes and molecular mechanisms has demonstrated that lymphatic dysfunction should no longer be considered a passive bystander in disease but rather an active player in many pathological processes and, therefore, a genuine target for future therapeutic developments. The specific roles of the lymphatic system in edema, genetic aspects of primary lymphedema, infection (cellulitis/erysipelas), Crohn’s disease, obesity, cancer, and cancer-related lymphedema are highlighted. PMID:24590276

Mortimer, Peter S.; Rockson, Stanley G.

2014-01-01

223

Bisphosphonate-related osteonecrosis of the jaw complicated by Ludwig's angina.  

PubMed

Ludwig's angina is a life-threatening cellulitis that involves the submandibular and sublingual spaces. It often occurs after an infection of the roots of the teeth. However, modern dental care and use of antibiotics for oral infections have made Ludwig's angina rare. We present here a cancer patient exhibiting the sequential features of bisphosphonate related osteonecrosis of the jaw on bone scan complicating with Ludwig's angina. This report highlights the need for medical practitioners to be alert to these rare combinations in the compromised patient after bisphosphonate therapy. To the best of our knowledge, no case of Ludwig's angina secondary to osteonecrosis of the jaw has been reported. PMID:25074798

Yang, Rong-Hsin; Shen, Shu-Huei; Li, Wing-Yin; Chu, Yum-Kung

2015-01-01

224

Management of Large Erupting Complex Odontoma in Maxilla  

PubMed Central

We present the unusual case of a large complex odontoma erupting in the maxilla. Odontomas are benign developmental tumours of odontogenic origin. They are characterized by slow growth and nonaggressive behaviour. Complex odontomas, which erupt, are rare. They are usually asymptomatic and are identified on routine radiograph but may present with erosion into the oral cavity with subsequent cellulitis and facial asymmetry. This present paper describes the presentation and management of an erupting complex odontoma, occupying the maxillary sinus with extension to the infraorbital rim. We also discuss various surgical approaches used to access this anatomic area. PMID:25580339

Murphy, Colm; O'Connell, John Edward; Cotter, Edward; Kearns, Gerard

2014-01-01

225

Appendico-cutaneous fistula presenting clinically as right loin necrotizing fasciitis: a case report.  

PubMed

Acute appendicitis and its subsequent complications continue to pose a surgical challenge. One such complication, the appendico-cutaneous fistula, represents a very rare form of enterocutaneous fistula. Very few cases have been reported thus far in the literature. The clinical presentation of this case before the final diagnosis was made makes interesting reading. The report describes a unique case that presented with the onset of cellulitis around the right lumbar/loin region, spreading down the right posterior back to the posterior gluteal area, and appearing as necrotizing fasciitis. There were no abdominal signs at all. The patient was then taken to the operating room (OR) for incision and drainage through a right flank incision, which could be extended. At drainage, there was a feculent smell with discharge that immediately raised the possibility of colonic connection with the abscess cavity. Swab sent for culture and sensitivity grew E. coli and Bacteroides. The final diagnosis proved to be a perforated appendix. Therefore, perforated appendix should always be considered in the differential diagnosis of any spreading cellulitis in the right lumbar area or right lower abdominal quadrant in the presence of limited urinary symptoms and little or no abdominal signs. PMID:14584764

Awe, Julius A; Soliman, Mohammed A; Gourdie, Ronald W

2003-01-01

226

Tumeur brune du maxillaire révélatrice d'hyperparathyroidie primaire: à propos d'un cas et revue de la littérature  

PubMed Central

Les tumeurs brunes sont des lésions ostéolytiques rarement révélatrices des hyperparathyroïdies. Elles surviennent habituellement au stade terminal de l'hyperparathyroïdie primaire ou secondaire. Durant les 3 dernières décennies, le diagnostic des hyperparathyroïdies est le plus souvent fait à la phase asymptomatique grâce aux dosages systématiques du calcium et l'avènement des nouvelles techniques, de dosage de la parathormone. Nous rapportons l'observation d'une patiente avec hyperparathyroïdie primaire révélée par une tumeur du maxillaire, dont la TDM avait mis en évidence un processus ostéolytique agressif. L'intervention chirurgicale a consisté en une maxillectomie droite avec reconstruction. Le résultat anatomo-pathologique a conclu en une tumeur à cellule géantes bénigne du maxillaire. Le diagnostic de tumeur brune a été évoqué et confirmé après la réalisation d'un bilan phosphocalcique qui a mis en évidence une hypercalcémie, avec une hypophosphorémie. La recherche étiologique a objectivé à la TDM cervicale un processus en situation rétro et infra thyroïdienne droite en faveur d'un adénome parathyroïdien. Le dosage de la parathormone: 322 pmol/L a confirmé le diagnostic. Nous rappelons à travers cette observation la difficulté d’établir un diagnostic correct chez les patients avec un processus ostéolytique du maxillaire et la nécessité de rechercher une hyperparathyroïdie devant une lésion à cellules géantes vue le caractère insidieux de cette endocrinopathie. PMID:23503933

Malika, Fassih; Taali, Loubna; Akssim, Mohamed; Reda, Abada; Rouadi, Sami; Mahtar, Mohamed; Roubal, Mohamed; Essaadi, Mustapha; Kadiri, Mohamed Fatmi El

2013-01-01

227

Les biofilms bactériens : leur importance en santé animale et en santé publique  

PubMed Central

Résumé Les biofilms bactériens sont des amas structurés de cellules bactériennes enrobés d’une matrice polymérique et attachés à une surface. Le biofilm protège les bactéries et leur permet de survivre dans des conditions environnementales hostiles. Les bactéries du biofilm peuvent résister à la réponse immunitaire de l’hôte et sont beaucoup plus résistantes aux antibiotiques et aux désinfectants que les cellules bactériennes planctoniques. La capacité de former un biofilm est maintenant reconnue comme une caractéristique propre à plusieurs microorganismes. La présence de biofilms lors d’infections demande donc de nouvelles méthodes de prévention, de diagnostic et de traitement. De même, la présence de biofilms sur des surfaces retrouvées à la ferme, à l’abattoir ou à l’usine de transformation affectera l’efficacité du protocole de désinfection. De façon surprenante, la formation de biofilms chez les bactéries pathogènes des animaux et les bactéries zoonotiques est un sujet relativement peu étudié. Ce bref compte rendu a pour objectif de sensibiliser les intervenants en santé animale à l’importance des biofilms. PMID:24688172

Tremblay, Yannick D.N.; Hathroubi, Skander; Jacques, Mario

2014-01-01

228

Diagnosis of skin lesions in condemned or downgraded broiler carcasses - a microscopic and macroscopic study.  

PubMed

Eight hundred skin samples from broiler carcasses condemned or downgraded for skin lesions were collected at five processing plants. Histologically, 45.25% were cellulitis, 19.00% were atypical fowlpox, 3.25% were dermal squamous cell carcinoma (DSCC), 17.00% were non-specific dermatitis, 0.5% were focal haemorrhages and 0.25% were haemangiomas. Of the samples, 14.75% were histologically normal. Macroscopically, increased thickening of the skin was a frequent finding occurring in all the skin diseases, as well as skin discoloration, dark nodules in feather follicles and crusts. Skin scratches were associated with all of the diseases, except DSCC. Crater-like ulcers occurred in DSCC and fowlpox. Cellulitis was more frequent on the abdomen, fowlpox on the dorsum, DSCC in thighs, and non-specific dermatitis on the dorsum, thighs, legs and breast. It was concluded that macroscopic changes are not specific and examinations at slaughterhouses do not allow classification of broiler skin diseases. Histological examination appears to be an important tool to provide more accurate data. PMID:19184851

Fallavena, L C; Moraes, H L; Salle, C T; Silva, A B; Vargas, R S; Nascimento, V P; Canal, C W

2000-12-01

229

A Case of Elephantiasis Nostras Verrucosa  

PubMed Central

Elephantiasis nostras verrucosa (ENV) is a rare clinical condition associated with chronic non-filarial lymphedema caused by bacterial or non-infectious lymphatic obstruction. A variety of etiologies, including infection, tumor obstruction, trauma, radiation, chronic venous stasis, congestive heart failure, and obesity, can lead to chronic lymphatic obstruction and edema. Mossy papules, plaques, and cobblestone-like nodules are clinically impressive features of ENV, but biopsy reveals only moderately abnormal findings such as pseudoepitheliomatous hyperplasia, dilated lymphatic spaces, fibrous tissue hyperplasia, and chronic inflammation. We present a case of ENV in a 67-year-old man with a 10-year history of multiple nodules and verrucous plaques on both feet. Microbiology ruled out a filarial infection. Nodule biopsy revealed pseudoepitheliomatous hyperplasia, marked dermal fibrosis, and a chronic inflammatory infiltrate. No evidence of carcinoma was identified. Both venous stasis and recurrent cellulitis could contribute to the dermal fibrotic changes of the lesions. However, before the recurrent cellulitis, he did not have any nodular lesions on his feet despite a 10-year history of venous disease. Therefore, this case suggests that venous stasis alone cannot produce the fibrotic nodular lesions of ENV. PMID:20523817

Yang, Yun-Seok; Ahn, Jae-Jun; Haw, Sik; Shin, Min-Kyung

2009-01-01

230

Skin disease presenting as an outbreak of pseudobacteremia in a laboratory worker.  

PubMed

An outbreak of pseudobacteremia due to Streptococcus pyogenes (group A streptococci [GAS]) and methicillin-susceptible Staphylococcus aureus (MSSA) was traced to the venting procedure for aerobic bottles prior to their loading into the incubator of the BacT/Alert analyzer (Organon Teknika). Bacteria shed by a laboratory worker suffering from impetigo and cellulitis contaminated the aerobic bottles of 10 patients. All blood culture isolates, in addition to the isolates from the laboratory worker, were of the same GAS M and T types. All MSSA isolates from blood cultures and the index case's hands had the same lytic phage profile. Procedural breakdowns were identified in the laboratory. Bottles were vented outside the biological safety cabinet, gloves were not worn, and unprotected needles were used for the venting procedure. The source of the aspirated bacteria that contaminated the bottles was identified and the index case was treated promptly. PMID:11136810

Simhon, A; Rahav, G; Shapiro, M; Block, C

2001-01-01

231

Non healing leg ulcer infected with Stenotrophomonas maltophilia: first reported case from India.  

PubMed

Stenotrophomonas maltophilia is a recently described organism which was mainly reported either in nosocomial setup, or in immunosuppresed individuals. This was rarely reported as cutaneous pathogenic organism causing cellulitis-like lesion, paronychia, mucocutaneous ulcers and ecthyma gangrenosum in immunocompromised individuals. Here we describe a case of leg ulcer caused by S. maltophilia in an immuno-competent patient. The infection was possibly community acquired as the patient had no exposure to hospital environment. The bacillus was sensitive to cotrimoxazole and levofloxacin, and the patient was successfully treated with cotrimoxazole. Our case is unique not only because it is probably the first ever case of leg ulcer caused by S. maltophilia, but also because of its unusual occurrence in immunocompetent patient. PMID:22289105

Nag, Falguni; De, Abhishek; Banerjee, Kokila; Chatterjee, Gobinda

2013-06-01

232

[The thermal cure at Bagnoles-de-l'Orne].  

PubMed

The spa of Bagnoles-de-l'Orne is one of the few French watering-places north of the Loire. It specializes in the treatment of complications of venous affections. The basic crenotherapeutic treatment consists of the main thermal bath, plus treatments such as showers, aero-massages, manual massages. The thermal water of Bagnoles-de-l'Orne is of medium temperature. It has the following recognized properties: -- sedative properties -- used in the treatment of pain associated with chronic venous insufficiency, cramps, sympatheticalgic phenomena; -- anti-oedematous properties, of prime importance in the treatment of oedema of postthrombotic illness and hydroplasmic obesity; -- anti-inflammation properties, especially anti-cellulitis, more particularly associated with post-thrombotic illness; -- a mitotic effect used in the healing of ulcers of circulatory origin in the lower limbs. The effect of the thermal water of Bagnoles-de-l'Orne is enhanced by a climatic factor: the cool climate of the Norman Bocage. PMID:7111427

Vezard, C

1982-01-01

233

Fatal clostridium septicum myonecrosis in a captive canada lynx (Lynx canadensis).  

PubMed

A 1-yr-old female Canada lynx (Lynx canadensis) presented for sudden onset of rapidly progressive bilateral pelvic limb paralysis. The lynx was chemically immobilized to perform a physical examination but expired shortly thereafter. On postmortem radiographs, there were myriad small irregular, round-to-spherical gas densities within the skeletal muscle of the right thigh and epaxial musculature. At gross necropsy, the muscles of the right thigh, right lateral abdominal wall, and epaxial region were emphysematous and necrohemorrhagic, with subcutaneous and muscular crepitant swelling. Multiple skin puncture wounds, consistent with bites, were present over the affected tissues. Clostridium septicum was isolated in pure anaerobic culture from the musculature of the right hind limb. Histopathologic examination confirmed the diagnosis of acute, severe necrohemorrhagic and gangrenous myositis and cellulitis. Gram stains demonstrated large gram-positive bacilli with subterminal spores. This is the first known documented case of C. septicum myonecrosis in a nondomestic felid. PMID:25314833

Izer, Jenelle M; Wilson, Ronald P; Cooper, Timothy K

2014-09-01

234

A review of dental treatment of head and neck cancer patients, before, during and after radiotherapy: part 1.  

PubMed

The incidence of head and neck cancer is on the rise. Most head and neck cancers are treated with surgery, radiotherapy, chemotherapy or a combination of these modalities. Patients undergoing radiotherapy can experience several unwanted oral side effects, which have both short and long term implications. Dental general practitioners should be aware of these implications and should liaise closely with the restorative consultants and the oncology team to establish the best oral care pathway. This two-part series is a review of the oral changes that occur during and after radiotherapy and the oral management of head and neck oncology before, during and after radiotherapy. This article deals with both immediate sequelae such as cellulitis, mucositis, dysphagia, dysguesia and weight loss as well as long term sequelae such as rampant caries, trismus, xerostomia and osteoradionecrosis. It also encompasses the importance and need for pre-radiotherapy assessment. PMID:25613260

Jawad, H; Hodson, N A; Nixon, P J

2015-01-23

235

Kaposiform hemangioendothelioma with Kasabach-Merritt syndrome mistaken for child abuse in a newborn.  

PubMed

Kaposiform hemangioendothelioma is a rare vascular neoplasm of childhood that may have an alarming and potentially misleading clinical presentation. Awareness of this entity is important to provide appropriate and immediate medical care. We report the case of a 24-day-old female newborn who presented with a large bruiselike lesion on the left leg. A diagnosis of cellulitis suspected to be secondary to child abuse was made and the patient subsequently was placed in foster care; however, the lesion did not resolve after treatment and relocation. On reevaluation at our institution, physical examination revealed a round, 3 x 4-cm, violaceous, indurated, fixed, nonblanching, nontender plaque with an ivory center and peripheral erythema over the anteromedial aspect of the left leg. Biopsy demonstrated a vascular neoplasm consistent with kaposiform hemangioendothelioma (KHE), and laboratory evaluation revealed thrombocytopenia, low fibrinogen levels, and elevated D-dimer levels, confirming a diagnosis of Kasabach-Merritt syndrome (KMS). PMID:24738105

Cyrulnik, Amanda A; Dawkins, Manju C; Smalberger, Gert J; Young, Scott; Mann, Ranon E; Jacobson, Mark I; Friedman, Adam J

2014-03-01

236

Diabetic muscle infarction in a 57 year old male: a case report  

PubMed Central

Background Diabetic muscle infarction is a rare complication of diabetes mellitus (DM) and is often misdiagnosed as cellulitis. This complication is usually associated with poor disease prognosis and high mortality with previous studies reporting a risk of 50% recurrence or another macrovascular complication occurring within one year. Thus, there needs to be greater awareness of this complication of diabetes. Case presentation In the current work, we present a case report and literature review of DMI occurring in a calf of a 57 year old male. However, unlike the suspected trend, our patient has performed well after this incident and has not sustained another macrovascular event now > 15 month since his original diabetic muscle infarction. Conclusion Even though diabetic muscle infarction is an uncommon condition, it is important to consider this diagnosis in a diabetic patient. We hope that our findings and literature review will aid clinicians to better diagnose and manage this condition. PMID:23270501

2012-01-01

237

Erythema nodosum migrans successfully treated with indomethacin: A rare entity  

PubMed Central

Erythema nodosum migrans (subacute nodular migratory panniculitis) is a panniculitis characterized by migrating subcutaneous nodules or plaque on the lower extremity. We describe a 75-year-old woman with idiopathic erythema nodosum migrans which was manifest centrifugally spreading, slightly morpheaform erythematous plaque on the lower left leg successfully treated with indomethacin. She was initially diagnosed and treated as a case with cellulitis and with poor clinical response. A biopsy specimen from this lesion showed that the septal was thickening; fibrous tissue was also seen with lymphohistiocytic infiltrate and occasional multinucleated giant cells with some inflammatory cells infiltrated into the periphery of the fat lobules. Erythema nodosum migrans should be kept in mind in the differential diagnosis of any morpheaform centrifugally expended plaque, especially in the lower extremities in cases of unknown etiology. PMID:25625103

Mokhtari, Fatemeh; Abtahi-Naeini, Bahareh; Pourazizi, Mohsen

2014-01-01

238

Pyoderma gangrenosum of the breast: a diagnosis not to be missed.  

PubMed

Pyoderma gangrenosum (PG) is a non-infectious purulent ulcerative disease triggered mainly by chronic inflammatory bowel disease, monoclonal gammapathy, polyarthritis and haematological malignancies; exceptionally, it can be triggered by surgery alone. When PG is associated with fever, it can mimic infectious cellulitis. When it is located on the breast, unnecessary and deleterious surgical debridement may be performed. We present two cases of PG of the breast. The first is a postoperative PG and the second was associated with acute myeloid leukaemia - both led to unnecessary surgery. Several elements may have helped to make the diagnosis: nipples little affected by PG, symmetrical lesions on both breasts, other similar lesions elsewhere on the body, resistance to wide spectrum antibiotherapy, complete blood count abnormalities and negativity of bacterial culture. We propose an index to help the surgeon in his decision to realise a surgical debridement or to postpone it and consider the diagnosis of PG. PMID:20851068

Duval, A; Boissel, N; Servant, J M; Santini, C; Petit, A; Vignon-Pennamen, M D

2011-01-01

239

Neoadjuvant intra-arterial chemotherapy in patients with primary lacrimal adenoid cystic carcinoma  

PubMed Central

Background We describe four cases of primary lacrimal adenoid cystic carcinoma (ACC) treated with neoadjuvant intra-arterial chemotherapy (NAIC). Methods The outcomes and complications of NAIC were reviewed. Several treatment-related local and/or systemic complications were noted. Results One patient experienced ipsilateral eyelid and eyeball necrosis and permanent facial palsy; the second patient developed ipsilateral facial swelling and jaw claudication; and the third patient had febrile neutropenia, cellulitis, and phlebitis. These three patients underwent total exenteration. The fourth patient experienced neutropenia and thrombocytopenia and underwent tumour removal without exenteration. All patients were followed for more than 4 years and were alive at the last follow-up. Conclusion Neoadjuvant intra-arterial chemotherapy may be an alternative treatment that will improve the survival rate of ACC. However, careful and close observation is needed to minimise the risk of side effects. Further investigations are needed to justify the use of chemotherapy-related treatments and the associated costs. PMID:25609190

2014-01-01

240

Differential diagnosis of leukocoria and strabismus, first presenting signs of retinoblastoma  

PubMed Central

Leukocoria in infants is always a danger signal as retinoblastoma, a malignant retinal tumor, is responsible for half of the cases in this age group. More common signs should also be considered suspicious until proved otherwise, such as strabismus, the second most frequent sign of retinoblastoma. Less frequent manifestations are inflammatory conditions resistant to treatment, hypopyon, orbital cellulitis, hyphema or heterochromia. Other causal pathologies, including persistent hyperplastic primary vitreous (PHPV), Coats’ disease, ocular toxocariasis or retinopathy of prematurity, may also manifest the same warning signs and require specialized differential diagnosis. Members of the immediate family circle are most likely to notice the first signs, the general practitioner, pediatrician or general ophthalmologist the first to be consulted. On their attitude will depend the final outcome of this vision and life-threatening disease. Early diagnosis is vital. PMID:19668520

Balmer, Aubin; Munier, Francis

2007-01-01

241

Septic shock due to Fournier’s gangrene of the scrotum  

PubMed Central

A 57-year-old morbidly obese (160 kg) man presented with a 12 h history of severe bilateral scrotal pain and swelling. His scrotum was erythematous, with cellulitis advancing superiorly along the anterior abdominal wall. He was in septic shock. Following resuscitation with intravenous fluids, commencement of vasopressor infusion and broad-spectrum antimicrobials, he underwent surgical exploration and debridement. This revealed a devitalised gangrenous scrotum with abscess formation noted in the ischio-rectal spaces. This was debrided posteriorly to the wall of the rectum. The penis was de-gloved. Both testicles were spared. A colostomy was performed on day 3 to maintain a clean environment for healing. Subsequent scrotal reconstruction and grafting was performed with a pedicled gracilis flap and split skin grafting. The colostomy was reversed at 5 months. PMID:22675057

Callaghan, Michael Andrew; Baggott, Richard; D’Arcy, Frank T

2011-01-01

242

Bullae and Sweat Gland Necrosis in the Differential Diagnosis for Vibrio vulnificus Infection in an Alcoholic Patient  

PubMed Central

Bullae and sweat gland necrosis remain rare cutaneous manifestation, and these conditions can be misdiagnosed as Vibrio vulnificus infections or other soft tissue infections because of their low index of suspicion. A 46-yr-old man with a history of continued alcohol consumption presented with erythematous and hemorrhagic bullous lesions on his left arm. The patient reported that after the ingestion of clams, he slept for 12 hr in a heavily intoxicated state. Then the skin lesions started as a reddish patch that subsequently became hemorrhagic bullae. V. vulnificus infection, cellulitis, and necrotizing fasciitis were considered in initial differential diagnosis. However, on the basis of sweat gland necrosis on histopathologic examinations and negative results on bacterial cultures, we made the diagnosis of bullae and sweat gland necrosis. Therefore, bullae and sweat gland necrosis should also be considered in chronic alcoholic patients who present with bullae and a previous history of unconsciousness. PMID:21394318

Kim, Gun-Wook; Park, Hyun-Je; Kim, Hoon-Soo; Kim, Su-Han; Ko, Hyun-Chang; Kim, Moon-Bum

2011-01-01

243

Bacteremia due to Campylobacter in renal transplantation: a case report and review of literature.  

PubMed

Campylobacter species are the leading cause of acute bacterial diarrhea in industrialized countries. However, bacteremia is detected in <1% of patients with Campylobacter enteritis and is most likely to occur in patients who are immunocompromised or of older age. To our knowledge, only 2 cases of Campylobacter jejuni bacteremia have been reported in renal transplant recipients (RTRs). We present a case of an RTR with C. jejuni bacteremia presenting as self-limiting diarrhea followed by fever and cellulitis. The patient was successfully treated with a 2-week course of imipenem and developed no other complications. We review all cases of Campylobacter bacteremia in RTRs, and discuss clinical presentation and treatment of this potentially fatal disease. PMID:25296529

Pereira, L; Sampaio, S; Tavares, I; Bustorff, M; Pestana, M

2014-12-01

244

[Historical meanings of Santiago Ramón y Cajal's Rétine des vertébrés. Summary of his first scientific].  

PubMed

The retina was one of the main objects of study in the first stage of the scientific work of Ramón y Cajal. As culmination of his previous works Cajal published in 1893 in the journal La Cellule an article titled "La rétine des Vertébrés". This article on the retina is a perfect example of Cajal's ability for the systematic study of the cellular types of the nervous centers, its morphological description and its intercellular contacts, as well as for the formulation of physiological interpretations and hypothesis on the development of the neuronal prolongations. Finally some comments are made on the influence of the evolutionary thinking of Haeckel and Herbert Spencer on the work of Ramón y Cajal. PMID:11640477

Baratas Díaz, L A

1994-01-01

245

The Charcot foot: medical and surgical therapy.  

PubMed

Charcot neuro-osteoarthropathy (CN) is among the most devastating complications of neuropathy and now most commonly occurs in the feet of diabetic patients. Because it is relatively rare and because most patients and practitioners do not expect major bone pathology in the absence of significant pain, CN is often misdiagnosed as cellulitis, deep venous thrombosis, or gout. Also, radiographs early in the process are often relatively unremarkable. Although MRI findings are characteristic, treatment should not wait for the MRI result. The hot swollen erythematous neuropathic foot suspected to be CN should be emergently mechanically protected, usually in an irremovable total contact cast. Mechanical protection is the mainstay of conservative therapy, but surgical reconstruction of a deformed foot can usually also be successful. Unless diagnosed very early, significant decrements in quality of life result. Controlled studies are urgently needed to identify best practices. PMID:18990300

Ulbrecht, Jan S; Wukich, Dane K

2008-12-01

246

A cluster of seven cases of Clostridium tertium septicemia in neutropenic patients.  

PubMed

A cluster of seven febrile and severely neutropenic patients who developed Clostridium tertium septicemia during a 13-month period is described. The patients had received third generation cephalosporins for 7 to 13 days (mean 9 days) at the time Clostridium tertium was isolated from blood cultures. Two patients had perirectal and one patient pericaecal cellulitis. The organism was also isolated from bronchial secretions in one patient. No patient had diarrhea. Five of six strains tested were resistant to clindamycin (MIC 2-8 micrograms/ml), and six of seven strains moderately resistant to penicillin (MIC 1-4 micrograms/ml). In one patient Clostridium tertium grew from blood cultures although metronidazole had been administered for two days. Six patients recovered on antibiotic therapy. In view of the unusual susceptibility pattern of Clostridium tertium, an accurate diagnosis of infection with this organism is important for the choice of an appropriate antimicrobial treatment. PMID:2303065

Valtonen, M; Sivonen, A; Elonen, E

1990-01-01

247

Tumeur neuroendocrine mammaire primitive: à propos d'un cas rare  

PubMed Central

Les carcinomes neuroendocrine primitifs du sein sont des tumeurs rares et représentent 2 à 5% des cancers mammaires. Nous rapportons le cas de localisation mammaire chez une patiente de 50 ans. Il s'agit d'une tumeur classée T4d N1 M0. La tumeur est suspecte radiologiquement. Une microbiopsie est réalisée. L’étude anatomopathologique et immunohistochimique est en faveur d'une tumeur neuroendocrine primitive du sein à grande cellules exprimant les récepteurs progestéroniques seulement. Vu le caractère inflammatoire de la tumeur une chimiothérapie est démarrée avec bonne évolution clinique. A la fin de la chimiothérapie on prévoit de réaliser une mastectomie avec curage axillaire et en fonction des résultats définitifs, une radiothérapie. Une hormonothérapie sera envisagée une 2ème étude immunohistochimique sur la pièce de mastectomie. Vu la rareté des carcinomes neuroendocrines mammaires primitifs, il n'existe pas de standard thérapeutique et le pronostic demeure difficile à déterminer. PMID:24772221

Laabadi, Kamilia; Jayi, Sofia; El Houari, Aziza; Tawfic, Harmouch; Bouguern, Hakima; Chaara, Hikmat; Melhouf, Abdilah; Amarti, Afaf

2013-01-01

248

An aggressive primary orbital natural killer/T-cell lymphoma case: poor response to chemotherapy.  

PubMed

Natural killer/T-cell lymphoma (NKTCL) and its presentation with extranodal orbital involvement as a single lesion are extremely rare. The aim of this article was to describe the presentation, diagnosis, and systemic treatment of a primary orbital NKTCL. A 67-year-old Caucasian woman presented with left exophthalmos, pain, periorbital swelling, and limited extrinsic ocular motility. Orbital cellulitis was suspected, but finally orbital biopsy was performed due to no response to initial antibiotic and anti-inflammatory standard treatment. The pathologic diagnosis was NKTCL. Systemic evaluations were negative. CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) chemotherapy was initiated, but after 2 cycles of treatment, tumoral progression was observed. SMILE (dexamethasone, methotrexate, ifosfamide, L-asparaginase, etoposide) rescue chemotherapy was then administered. Lymphoma progression was inevitable. She died 10 months later. Although more nasal NKTCL cases have been described, the nonnasal primary orbital NKTCL is an uncommon neoplasm with high mortality rate, despite the recent use of more potent chemotherapy regimens. PMID:24317101

Marchino, Tizana; Ibáñez, Núria; Prieto, Sebastián; Novelli, Silvana; Szafranska, Justyna; Mozos, Anna; Graell, Xavier; Buil, José A

2014-01-01

249

Erysipelas: a common potentially dangerous infection.  

PubMed

Erysipelas is an acute superficial cutaneous cellulitis that commonly occurs not only in elderly and immunocompromised persons, but also in neonates and small children subsequent to bacterial inoculation through a break in the skin barrier. Group A Beta-hemolytic streptococcus (GABHS, Streptoccocus pyogenes) is the usual etiologic agent. Factors that predispose pediatric patients to the development of erysipelas include very young age, diabetes mellitus, an immunocompromised state, and nephrotic syndrome. Patients typically have a well-demarcated, erythematous, indurated, rapidly spreading patch with a palpable advancing border on the face or extremities. Fever with chills and general malaise may be prominent symptoms. Antibiotics are usually effective. Patients handled in a timely manner tend to recover without problems. However, potential complications include abscess formation, necrotizing fasciitis, septicemia, recurrent infection, and lymphedema. PMID:17994173

Celestin, R; Brown, J; Kihiczak, G; Schwartz, R A

2007-09-01

250

Ludwig's Angina – An emergency: A case report with literature review  

PubMed Central

Ludwig's angina is a form of severe diffuse cellulitis that presents an acute onset and spreads rapidly, bilaterally affecting the submandibular, sublingual and submental spaces resulting in a state of emergency. Early diagnosis and immediate treatment planning could be a life-saving procedure. Here we report a case of wide spread odontogenic infection extending to the neck with elevation of the floor of the mouth obstructing the airway which resulted in breathlessness and stridor for which the patient was directed to maintain his airway by elective tracheostomy and subsequent drainage of the potentially involved spaces. Late stages of the disease should be addressed immediately and given special importance towards the maintenance of airway followed by surgical decompression under antibiotic coverage. The appropriate use of parenteral antibiotics, airway protection techniques, and formal surgical drainage of the infection remains the standard protocol of treatment in advanced cases of Ludwig's angina. PMID:23225990

Candamourty, Ramesh; Venkatachalam, Suresh; Babu, M. R. Ramesh; Kumar, G. Suresh

2012-01-01

251

Severe penile erosion after use of a vacuum suction device for management of erectile dysfunction in a spinal cord injured patient. Case report.  

PubMed

We report a case of severe erosion and cellulitis at the base of the penis as a result of vacuum suction device constriction bands left on for 4 hours in a spinal cord injured patient with paraplegia and hypesthesia of the genital area. All patients using vacuum suction devices need to be properly educated regarding usage and risks with adequate follow up; patients with hypesthesias and spinal cord injuries need information specifically related to their decreased or absent level of sensation. Only two out of seven vacuum suction device brochures reviewed warn of the risk to patients with decreased sensation in the penis, but none specifically address usage or risks to men with spinal cord injuries. PMID:8015845

LeRoy, S C; Pryor, J L

1994-02-01

252

Kawasaki Disease with Retropharyngeal Edema following a Blackfly Bite  

PubMed Central

We describe a patient with Kawasaki disease (KD) and retropharyngeal edema following a blackfly bite. An 8-year-old boy was referred to our hospital because of a 3-day-history of fever and left neck swelling and redness after a blackfly bite. Computed tomography of the neck revealed left cervical lymph nodes swelling with edema, increased density of the adjacent subcutaneous tissue layer, and low density of the retropharyngeum. The patient was initially presumed to have cervical cellulitis, lymphadenitis, and retropharyngeal abscess. He was administered antibiotics intravenously, which did not improve his condition. The patient subsequently exhibited other signs of KD and was diagnosed with KD and retropharyngeal edema. Intravenous immunoglobulin therapy and oral flurbiprofen completely resolved the symptoms and signs. A blackfly bite sometimes incites a systemic reaction in humans due to a hypersensitive reaction to salivary secretions, which may have contributed to the development of KD in our patient. PMID:25349761

Watanabe, Toru

2014-01-01

253

Hand infections: anatomy, types and spread of infection, imaging findings, and treatment options.  

PubMed

Infections of the hand are common, particularly in immunocompromised patients, and can lead to significant morbidity, including amputation, if not treated properly. Hand infection can spread far and wide from the original site of inoculation through interconnections between the synovium-lined and nonsynovial potential spaces. Because surgery is the mainstay of treatment, knowledge of the pertinent anatomy is imperative for accurately describing the presence, location, and extent of infection. The authors review the pertinent anatomy of the spaces of the hand and describe different types of infection-including cellulitis, necrotizing fasciitis, paronychia, felon, pyogenic flexor tenosynovitis, deep space infections, septic arthritis, and osteomyelitis-and common causative organisms of these infections. They also describe various modes of spread; the common radiologic appearances of hand infections, with emphasis on findings at magnetic resonance imaging and ultrasonography; and the role of radiology in the management of these infections, along with a brief overview of treatment options. PMID:25384296

Patel, Dakshesh B; Emmanuel, Neelmini B; Stevanovic, Milan V; Matcuk, George R; Gottsegen, Christopher J; Forrester, Deborah M; White, Eric A

2014-01-01

254

Antimicrobial Prophylaxis in Adults  

PubMed Central

Antimicrobial prophylaxis is commonly used by clinicians for the prevention of numerous infectious diseases, including herpes simplex infection, rheumatic fever, recurrent cellulitis, meningococcal disease, recurrent uncomplicated urinary tract infections in women, spontaneous bacterial peritonitis in patients with cirrhosis, influenza, infective endocarditis, pertussis, and acute necrotizing pancreatitis, as well as infections associated with open fractures, recent prosthetic joint placement, and bite wounds. Perioperative antimicrobial prophylaxis is recommended for various surgical procedures to prevent surgical site infections. Optimal antimicrobial agents for prophylaxis should be bactericidal, nontoxic, inexpensive, and active against the typical pathogens that can cause surgical site infection postoperatively. To maximize its effectiveness, intravenous perioperative prophylaxis should be administered within 30 to 60 minutes before the surgical incision. Antimicrobial prophylaxis should be of short duration to decrease toxicity and antimicrobial resistance and to reduce cost. PMID:21719623

Enzler, Mark J.; Berbari, Elie; Osmon, Douglas R.

2011-01-01

255

Le syndrome de Vogt-Koyanagi Harada dans sa forme purement oculaire: à propos d'un cas  

PubMed Central

Le syndrome de Vogt-Koyanagi-Harada (VKH) est une affection systémique rare, sévère mettant en jeu le pronostic visuel malgré les traitements agressifs, caractérisée par l'association de plusieurs symptômes: oculaires, méningés, auditifs et cutanés secondaire à une auto-immunisation où le mélanocyte serait la cellule cible. Nous rapportons un nouveau cas rare où l'atteinte oculaire est isolée. La sévérité de l'uvéite réside dans la fréquence des récidives, dans la cortico-résistance et dans la forte incidence des complications qui conditionnent le pronostic et expliquent les acuités visuelles finales médiocres. La prise en charge doit être précoce afin d'essayer d'améliorer le pronostic visuel. PMID:25667692

Louaya, Shamil; Bennouk, Youssef; Kriet, Mohamed; Oubaaz, Abdelbarre

2014-01-01

256

Orbital Relapsing Polychondritis: A Unique Presentation, Complication, and Treatment.  

PubMed

An 87-year-old man with a history of relapsing polychondritis presented to the emergency department after 4 days of worsening left periorbital swelling and erythema. On examination, he demonstrated clinical features consistent with orbital cellulitis and was treated with a trial of intravenous antibiotics. His condition did not improve over the next 36 hours and intravenous methylprednisolone was initiated. This led to rapid improvement in orbital symptoms and signs, and a diagnosis of specific orbital inflammation secondary to relapsing polychondritis was made. The patient was discharged on a tapering dose of prednisone. As a steroid-sparing measure, adalimumab was initiated; however, the patient developed Sweet Syndrome. Adalimumab was subsequently discontinued, steroid dose was increased, and anakinra treatment was initiated. This therapeutic course led to significant clinical improvement. Since initiating anakinra, the patient has had no recurrences of Sweet Syndrome. Anakinra may be a useful adjunct therapy for ophthalmic manifestations of relapsing polychondritis. PMID:25072220

Moore, Grant H; Rootman, Daniel B; Roybal, Nathaniel; Goldberg, Robert A

2014-07-28

257

A Rare Case of Soft-Tissue Infection Caused by Raoultella planticola  

PubMed Central

Raoultella species are Gram-negative, non-motile bacilli primarily considered to be environmental bacteria. Raoultella planticola is a rare cause of human infections. We report a case of serious soft-tissue infection in a young male tiler who presented with cellulitis of his left thumb. He had sustained a crush injury to his left thumb 10 days earlier in a soiled environment. He noted a minor break in the skin and he washed the wound out with running water. One week later, he experienced pain, erythema, and swelling of his thumb and attended his general practitioner who prescribed oral flucloxacillin and penicillin V. Despite this treatment, he noticed progressive erythema and swelling of his thumb requiring hospital admission 3 days later. He underwent washout and debridement of his thumb. Tissue obtained intraoperatively cultured Raoultella planticola. He was treated with broad-spectrum antibiotics including ciprofloxacin and made a full and rapid recovery. PMID:20811592

O' Connell, Karina; Kelly, Jack; NiRiain, Una

2010-01-01

258

Wrist drop: an atypical presentation of renal cell carcinoma.  

PubMed

Renal cell carcinoma (RCC) causing metastasis to the skeletal muscles is extremely rare. The authors describe a patient with history of RCC treated 5 years ago with radical nephrectomy who presented with left arm swelling after receiving seasonal flu shot. He was initially diagnosed with cellulitis, treated with intravenous antibiotics and discharged home. One month later, he presented with persistent left arm swelling accompanied by wrist drop. Subsequently he developed increased swelling, decreased pulse and wrist drop. He was diagnosed with compartment syndrome, for which fasciotomy was performed, and tissue samples were sent for analysis. Histopathological analysis confirmed metastatic clear cell RCC. The authors described a literature review of previously described cases of metastasis of renal cell cancer to the skeletal muscles. The authors also discussed the rarity of muscle metastasis and unpredictable behavior of RCC after being dormant for long periods. PMID:21795958

Ali, Syed H; Chughtai, Haroon; Alali, Fadi; Diaczok, Benjamin; Verardi, Mary

2011-08-01

259

[Classification of lymphedema].  

PubMed

Classification of lymphedema is debated, because authors don't agree with the disordered physiology. Kinmonth divided all cases into primary and secondary lymphedema. Three types of primary lymphedema have been recognized: congenital, precox and tarda. Secondary lymphedema develops as a consequence of disruption or obstruction of the lymphatic pathways. Iatrogenic lymphedema are caused by surgery and/or radiation therapy. Post-infectious lymphedema are mainly caused by filariasis in tropical areas, and by cellulitis in occidental areas. Neoplastic disease (breast, prostatic cancer, Kaposi's sarcoma) are a major cause of secondary lymphedema. Less frequent etiologies are rheumatoid lymphedema, pathomimic lymphedema, pretibial myxoedema. Reduced lymphatic drainage is associated with severe chronic venous insufficiency and contributes to the leg swelling and the risk of infection. PMID:12162199

Lazareth, I

2002-06-01

260

Orbital inflammatory disease: Pictorial review and differential diagnosis  

PubMed Central

Orbital inflammatory disease (OID) represents a collection of inflammatory conditions affecting the orbit. OID is a diagnosis of exclusion, with the differential diagnosis including infection, systemic inflammatory conditions, and neoplasms, among other conditions. Inflammatory conditions in OID include dacryoadenitis, myositis, cellulitis, optic perineuritis, periscleritis, orbital apicitis, and a focal mass. Sclerosing orbital inflammation is a rare condition with a chronic, indolent course involving dense fibrosis and lymphocytic infiltrate. Previously thought to be along the spectrum of OID, it is now considered a distinct pathologic entity. Imaging plays an important role in elucidating any underlying etiology behind orbital inflammation and is critical for ruling out other conditions prior to a definitive diagnosis of OID. In this review, we will explore the common sites of involvement by OID and discuss differential diagnosis by site and key imaging findings for each condition. PMID:24778772

Pakdaman, Michael N; Sepahdari, Ali R; Elkhamary, Sahar M

2014-01-01

261

[A case of fasciitis localized in the calf muscles associated with Edwardsiella tarda sepsis].  

PubMed

A 49-year-old man presented with fever and pain, redness, swelling, and difficulty in walking. The serum C-reactive protein (CRP), creatin kinase (CK), and endotoxin levels were elevated. A blood culture revealed Edwardsiella tarda(E. tarda). Computed tomography (CT) showed subfascial and subcutaneous low-density areas in the lower legs, suggesting focal abscesses and edema. The patient was likely to have necrotizing fasciitis or cellulitis. He was successfully treated with several antibiotics and discharged after 43 days. Because E. tarda causes sepsis and fulminating necrotizing fasciitis with a high mortality rate in patients with an underlying illness, it should be considered a potentially important pathogen. The lack of an underlying illness may be a factor for a good outcome in this case. PMID:21946427

Hara, Kenju; Ouchi, Haruka; Kitahara, Makiko; Shibano, Ken; Miyauchi, Takaharu; Ishiguro, Hideaki

2011-09-01

262

[Infectious diseases].  

PubMed

The recommendations for the treatment of gonorrhea have been changed: ceftriaxone 500 mg IM plus azithromycin 1 g PO is recommended. Prophylaxis of recurrent cellulitis with penicillin 250 mg 2 x/d PO may be considered. E. coli ESBL does not require contact isolation anymore. Fecal transplantation seems so far to be the most effective treatment of recurrent C. dificile. Two new respiratory viruses, Middle East Coronavirus (MERS-CoV) and avian-origin Influenza A (H7N9) have been reported. Oral valganciclovir treatment reduces the risk of hearing loss in congenital CMV infection. An outbreak of mould infections of the central nervous system has been described in the United States following injection of contaminated steroids. PMID:24558901

Voide, Cathy; Asner, Sandra; Giulieri, Stefano; Cavassini, Matthias; Merz, Laurent; Tissot, Frédéric; Orasch, Christina

2014-01-15

263

Étude des anomalies chromosomiques après radiothérapie chez des patients traités pour lymphome malin non-Hodgkinien  

NASA Astrophysics Data System (ADS)

Structural chromosome defects were evaluated in the lymphocytes of 30 patients (pts) who had undergone radiotherapy for non Hodgkin's lymphoma (NHL). Twelve had received 20 Grays (Gy) over the abdomen (group I), 12 whole body irradiation at 1.5 Gy (group II) and 6 whole body irradiation at 15 Gy (group III). A cohort of 468 unirradiated pts served as controls. For the irradiated group, 7% of cells had aberrations compared to 0.4% in controls {P <10-6}. The frequency of abnormal cells was statistically higher in group I (12%) than in group II (3.5%) and III (2.5%) . In group I, frequency of aberrations was statistically higher in pts who had additionnal extra-abdominal involved field irradiation, those with evolutive NHL and those receiving chemotherapy at the time of the cytogenetic analysis. Les aberrations chromosomiques ont ,été, mesurées sur les lymphocytes de 30 patients (pts) irradiés pour lymphome malin non-hodgkinien (LNH) selon 3 modalités : 20 Grays (Gy) sur l'abdomen (groupe I : 12 pts), Irradiation corporelle totale 1,5 Gy (groupe II : 12 pts), ou 15 Gy (groupe III : 6 pts). Une population non irradiée de 468 pts a servi de témoin. Dans le groupe irradié, 7 % des cellules présentaient des anomalies contre 0,4 % dans le groupe témoin {P <10-6}. Les aberrations ,étaient statistiquement plus nombreuses dans le groupe I (12 % des cellules) que dans les groupes II (3,5 %) et III (2,5 %). Dans le groupe I, les anomalies , étaient statistiquement plus fréquentes chez les pts ayant eu une irradiation localisée extra-abdominale en complément de celle de l'abdomen ainsi que chez ceux en rechute de leur LNH et ceux recevant une chimiothérapie lors de l',étude cytogénétique.

Mahe, M. A.; André, M. J.; Moyon, E.; Le Mevel, A.; Soubeyran, P.; Hamidou, M.; Milpied, N.; Bourdin, S.; Cuillière, J. C.; Chatal, J. F.

1998-04-01

264

Invasive Streptococcus iniae Infections Outside North America  

PubMed Central

Streptococcus iniae, a fish pathogen causing infections in aquaculture farms worldwide, has only been reported to cause human infections in North America. In this article, we report the first two cases of invasive S. iniae infections in two Chinese patients outside North America. While the first patient presented with bacteremic cellulitis, which is the most common presentation in previous cases, the second patient represents the first recognized case of S. iniae osteomyelitis. Both S. iniae strains isolated from the two patients were either misidentified or unidentified by three commercial systems and were only identified by 16S rRNA gene sequencing. Since no currently available commercial system for bacterial identification includes S. iniae in its database, 16S rRNA gene sequencing is the most practical and reliable method to identify the bacterium at the moment. In contrast to the distinct genetic profile described previously in clinical isolates from Canada, the present two isolates and a clinical isolate from a Canadian patient were found to be genetically unrelated, as demonstrated by pulsed-field gel electrophoresis. Morphologically, colonies of both isolates were also larger, more beta-hemolytic and mucoid, which differ from the usual morphotype described for S. iniae. Owing to their habit of cooking and eating fresh fish, the Asian population is strongly associated with S. iniae infections. As a result of the difficulty in making microbiological diagnosis in patients with cellulitis and the problem of identification in most clinical microbiology laboratories, the prevalence of S. iniae infections, especially in the Asian population, may have been under-estimated. PMID:12624022

Lau, Susanna K. P.; Woo, Patrick C. Y.; Tse, Herman; Leung, Kit-Wah; Wong, Samson S. Y.; Yuen, Kwok-Yung

2003-01-01

265

Mycobacterium fortuitum Infection following Reconstructive Breast Surgery: Differentiation from Classically Described Red Breast Syndrome  

PubMed Central

Background: Red breast syndrome (RBS) has been described as an erythema that may be associated with 2-stage prosthetic reconstructive breast surgery using biologic mesh. RBS is differentiated from infectious cellulitis through absence of fever and laboratory abnormalities and usually has a self-limiting course. There have been no clinical reports on etiology, risk factors, or management of RBS. This report describes patient data that raise the need to rule out mycobacterial infection when RBS is being considered as a diagnosis. Methods: We present 6 cases of Mycobacterium fortuitum infection occurring after prosthetic breast reconstruction performed with a human-derived acellular dermal matrix, including the timing and course of erythema, laboratory results, treatments used, and long-term outcomes. We also describe the differential diagnoses of RBS in the context of these cases, including emergence of acid-fast bacilli and diagnostic and treatment considerations. Exact two-tailed 95% confidence intervals based on the F-distribution are provided with estimates of the incidence rates of infection. Results: The 6 cases presented here do not fit the typical description of RBS and were caused by mycobacterium infection. Statistical evaluation of the estimated incidence rate of M. fortuitum infection in a patient thought to have RBS, which occurred 100% of the time in this series, revealed a 95% confidence interval of 54.1–100%. Conclusions: When presented with possible RBS, surgeons must rule out cellulitis, culture for acid-fast bacilli such as mycobacterium species, and then determine the best course of treatment. Patient counseling regarding potential household sources of infection is warranted to minimize postoperative infection risk. PMID:25289245

Foles, Van Brandon; Sieger, Barry; Musselman, Kelly

2013-01-01

266

Facteurs influençant l'initiation au traitement antirétroviral des personnes vivant avec le VIH dans les Centres de Traitement Agréés de Bamenda et de Bertoua au Cameroun  

PubMed Central

Introduction L'objectif de ce travail était de déterminer les facteurs influençant l'initiation au traitement antirétroviral des personnes vivant avec le VIH (PVVIH) dans les centres de traitements agrées (CTA) de Bamenda et de Bertoua au Cameroun. Méthodes Il s'agissait d'une étude transversale, analytique réalisée de Janvier à Avril 2011, dans les CTA de Bamenda et de Bertoua. Pour cette étude, nous avons obtenu une clairance éthique. Résultats Nous avons étudiés 460 dossiers de patients séropositifs en phase d'initiation au traitement antirétroviral dans les CTA de Bamenda et de Bertoua, 53,9% et 46,1% respectivement. L ‘âge médian était de 36 ans. La plupart des séropositifs à Bertoua (41) avaient fait un dépistage volontaire du VIH par rapport à ceux de Bamenda (22) (p= 0.008). Il y ‘avait plus de VIH de type 1 et 2 dans le CTA de Bamenda (15) par rapport à Bertoua (3) (p= 0.011). La majorité des patients était classé au stade clinique II à Bamenda (54,0%) tandis qu ‘à Bertoua le stade clinique III était prédominant (52,4%) (p = 0,000). Le taux médian de CD4 était de 133 cellules/mm3 dans le CTA de Bamenda et de 175 cellules/mm3 à Bertoua (p = 0,008). La Zidovudine était plus prescrit à Bamenda et le Ténofovir à Bertoua (p = 0,000). L ‘Efavirenz était plus prescrit à Bertoua tandis que la Névirapine l ‘était plus à Bamenda (p = 0,000). Le Lopinavir/r était plus prescrit à Bamenda qu ‘à Bertoua (p = 0,017). Conclusion Il apparait urgent de standardiser la prise en charge des PVVIH dans les CTA du Cameroun. PMID:25184023

Mbopi-Keou, Francois-Xavier; Voundi, Esther Voundi; Kalla, Ginette Claude Mireille; Emah, Irène; Angwafo, Fru; Muna, Walinjom

2014-01-01

267

Longitudinal Analysis of Methicillin-Resistant and Methicillin-Susceptible Staphylococcus aureus Carriage in Healthy Adolescents  

PubMed Central

To determine the long-term carriage patterns, strain relatedness, and incidence of subsequent infections among methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) carriers, we screened 154 high school students for nasal carriage of S. aureus on 8 occasions over 11 months. Persistent carriage was defined as a positive culture on ?7 occasions. Two consecutive isolates from the same subject comprised a pair, and strain relatedness was determined for each pair by molecular typing. Of 1,232 nasal swab cultures obtained on 8 occasions, 323 (26.2%) were positive for S. aureus. Forty-five isolates (3.7%) were MRSA and 278 isolates (22.6%) were MSSA from 12 and 63 subjects, respectively. Thirty-five (77.8%) MRSA isolates harbored a type IV or VT staphylococcal chromosomal cassette mec element. Among the 154 subjects, 52 (33.8%) were intermittent (1 to 6 positive swabs) carriers. Persistent carriage was identified in 23 (14.9%) subjects, and the incidence was not significantly different for MRSA and MSSA carriers (3/12 [25%] versus 20/63 [31.7%]; P = 0.7449). The MRSA and MSSA isolates were composed of 33 and 215 strain pairs, respectively. Of them, an indistinguishable genotype was identified in 33 (100%) MRSA pairs and 173 (80.5%) MSSA pairs (P = 0.0053). Five subjects developed cellulitis, and the incidence of this was higher for MRSA carriers (2/12 [16.7%]) than for MSSA carriers (1/63 [1.58%]; P = 0.0632) and noncarriers (2/79 [2.56%]; P = 0.0828). In conclusion, the long-term carriage patterns for MRSA and MSSA in healthy individuals were similar. MRSA carriers were more likely to carry a single strain, with a trend toward a higher chance of developing cellulitis than for MSSA carriers. PMID:23678067

Wang, Shao-Chung; Chang, Hsin-Yu; Huang, Yhu-Chering

2013-01-01

268

Use of opioid analgesics in skin disorders: Results from a nationally representative US sample.  

PubMed

Abstract Introduction: Increasing and inappropriate use of opioid analgesics (OA) have been declared a public health concern in the United States. There are no epidemiologic studies of OA use in skin disorders. We examined OA use in a nationally representative sample of US patient visits with only physician-diagnosed skin disorders. Methods: Retrospective cross-sectional study of 56?751 patient visits from 1995 to 2010 (International Classification of Diseases, 9th Revision, Clinical Modification codes 680-709 denoting "Diseases of the Skin and Subcutaneous Tissue"; 172, 173, 216 and 232 denoting malignant and benign skin neoplasms). Results: An estimated 3.1%?±?0.2% of skin disorders visits were associated with OA use; 52.7%?±?5.4% were Schedule III opioids; 11.4%?±?1.4% of OA visits involved skin neoplasms and 45.4%?±?2.3% cellulitis and abscess. OA use increased from 1995 to 2010 (adjusted OR?=?1.82, 95% CI: 1.49-2.22), even after controlling for increase in the frequency of skin infections from 1995 to 2010. Discussion: The most frequent use OA for cellulitis and abscess is entirely consistent with their Food and Drug Administration (FDA)-approved indications for pain management. The almost two-fold increase in OA use in skin disorders from 1995 to 2010 may suggest that OA are being considered for pain management earlier in therapy. Conclusions: Only a minority of patient visits with OA had primary dermatologic disease. OA are being used in dermatology primarily for FDA-approved indications. PMID:25088470

Gupta, Madhulika A; Gupta, Aditya K; Vujcic, Branka; Piccinin, Meghan

2014-08-26

269

Elaboration du Ge mesoporeux et etude de ses proprietes physico-chimiques en vue d'applications photovoltaiques  

NASA Astrophysics Data System (ADS)

Le sujet de cette these porte sur l'elaboration du nouveau nanomateriau par la gravure electrochimique bipolaire (BEE) --- le Ge mesoporeux et sur l'analyse de ses proprietes physico-chimiques en vue de son utilisation dans des applications photovoltaiques. La formation du Ge mesoporeux par gravure electrochimique a ete precedemment rapportee dans la litterature. Cependant, le verrou technologique important des procedes de fabrication existants consistait a obtenir des couches epaisses (superieure a 500 nm) du Ge mesoporeux a la morphologie parfaitement controlee. En effet, la caracterisation physico-chimique des couches minces est beaucoup plus compliquee et le nombre de leurs applications possibles est fortement limite. Nous avons developpe un modele electrochimique qui decrit les mecanismes principaux de formation des pores ce qui nous a permis de realiser des structures epaisses du Ge mesoporeux (jusqu'au 10 mum) ayant la porosite ajustable dans une large gamme de 15% a 60%. En plus, la formation des nanostructures poreuses aux morphologies variables et bien controlees est desormais devenue possible. Enfin, la maitrise de tous ces parametres a ouvert la voie extremement prometteuse vers la realisation des structures poreuses a multi-couches a base de Ge pour des nombreuses applications innovantes et multidisciplinaires grace a la flexibilite technologique actuelle atteinte. En particulier, dans le cadre de cette these, les couches du Ge mesoporeux ont ete optimisees dans le but de realiser le procede de transfert de couches minces d'une cellule solaire a triple jonctions via une couche sacrificielle en Ge poreux. Mots-cles : Germanium meso-poreux, Gravure electrochimique bipolaire, Electrochimie des semi-conducteurs, Report des couches minces, Cellule photovoltaique

Tutashkonko, Sergii

270

Implications of adult hippocampal neurogenesis in antidepressant action  

PubMed Central

In the dentate gyrus of the hippocampus, cell birth and maturation into neurons, or neurogenesis, occur throughout the lifetime of animals and humans. Multiple factors have been shown to regulate adult neurogenesis, and a number of findings in this field have had a large impact on basic and clinical research in depression. It has been reported that both physical and psychosocial stress paradigms, as well as some animal models of depression, produce a decrease in hippocampal cell proliferation and neurogenesis. Conversely, long-term, but not short-term, treatment with different classes of antidepressant drug increases cell proliferation and neurogenesis. Patients with depressive disorders or post-traumatic stress disorder have reduced hippocampal volume. Given this interaction of stress, depression and neurogenesis, a current hypothesis is that reduced adult hippocampal cell proliferation or neurogenesis may be involved in the pathophysiology of depression and that reversal or prevention of the decrease in neurogenesis may be one way in which the antidepressant drugs exert their effects. Research from this emerging field will further our understanding of the effects of stress and depression on the brain and the mechanism of action of antidepressant drugs. Dans le gyrus denté de l'hippocampe, la naissance des cellules et leur maturation en neurones, ou neurogenèse, se produisent pendant toute la vie des animaux et des êtres humains. On a démontré que de multiples facteurs régularisent la neurogenèse chez l'adulte, et de nombreuses constatations dans ce domaine ont eu un effet important sur la recherche fondamentale et clinique sur la dépression. On a signalé que des paradigmes de stress à la fois physique et psychosocial, ainsi que certains modèles animaux de dépression, entraÎnent une diminution de la prolifération des cellules dans l'hippocampe et une baisse de la neurogenèse. Par ailleurs, le traitement avec différentes catégories d'antidépresseurs augmente la prolifération cellulaire et la neurogenèse pendant la durée d'un traitement chronique, mais non pendant la durée d'un traitement de plus courte durée. Le volume de l'hippocampe diminue chez les patients atteints de troubles dépressifs ou du syndrome de stress posttraumatique. Compte tenu de cette interaction entre le stress, la dépression et la neurogenèse, on pose actuellement comme hypothèse que la réduction de la prolifération des cellules ou de la neurogenèse dans l'hippocampe de l'adulte peut jouer un rôle dans la pathophysiologie de la dépression et que l'inversion et la prévention de la diminution de la neurogenèse peuvent être un moyen d'action des antidépresseurs. La recherche qui émanera de ce nouveau domaine améliorera notre compréhension des effets du stress et de la dépression sur le cerveau et le mode d'action des antidépresseurs. PMID:15173896

Malberg, Jessica E.

2004-01-01

271

Cellular effects produced by internal contamination of rats with tritiated water  

NASA Astrophysics Data System (ADS)

The activity of the erythrocyte glucose-6-phosphate dehydrogenase (G6PDH) and the thymidine (TdR) incorporation in the bone marrow cells have been investigated in rats internally contaminated with tritiated water (HTO). The total doses (4.2cGy; 19.4cGy and respectively 5cGy; 20cGy) were delivered as chronic (100days) and acute (5 days) contamination. It was observed a significant increase of Glucose-6-Phosphate- Dehydrogenase (G6PDH) activity for 4.2cGy (0.4mGy/day). Both types of contamination produced the reduced incorporation of TdR in the bone marrow cells. These results would allow us to speculate that the reduction of the TdR incorporation could be determined by the changes at the level of membrane transport functions for the lower doses (4.2cGy; 5cGy), and by radiation induced phenomena at the intracellular level for the larger doses (19.4cGy; 20cGy). Nous avons etudié les effets de l'irradiation des rats par contamination interne à l'eau tritiée, sur l'activité enzymatique de glucose-6-phosphate deshydrogénase (G6PDH) érytrocytaire et sur l'incorporation de thymidine (TdR) dans des cellules de la moelle osseuse. Les doses accumulées par contamination chronique (100 jours) sont 4.2 cGy et 19.4 cGy et par contamination aiguë (5 jours) sont 5 cGy et 20 cGy. Nous avons observé une augmentation significative de l'activité de la Glucose-6-Phosphate-Dehydrogenase (G6PDH) pour la dose d'irradiation de 4.2 cGy (0.04 cGy/jour). Les deux types de contamination ont induit la diminution de l'incorporation de TdR dans les cellules de la moelle osseuse. Ces résultats suggèrent que la diminution de l'incorporation de TdR peut être liée à des modifications au niveau du transport transmembranaire pour des irradiations chronique de 4.2 cGy et aiguë de 5 cGy. Des phénomènes radioinduites intracellulaires sont probablement à l'origine de la diminution de l'incorporation de TdR pour les doses de 19.4 cGy et 20 cGy.

Savu, D.; Moisoi, N.; Petcu, I.

1999-01-01

272

Évolution nycthémérale des composantes biochimiques du phytoplancton de la retenue du barrage Idriss premier (Fès, Maroc)  

NASA Astrophysics Data System (ADS)

The diel changes of the biochemical composition of the phytoplankton were studied in the Idriss first reservoir (located on the Inaouen river at thirty Km from the city of Fes, Morrocco) during September 1994. Several biomass and metabolic indicators (proteins, carbohydrates, lipids, chlorophyll a and primary production) were assessed every fourth hour over tow days (7, 8 and 9 September). Since the Protein/Carbohydrates ratio (P/C) is largely recognised as a good integrator of the metabolic functions of the cells, we examined its distribution pattern concomitantly with aforementioned parameters. The results demonstrated enhanced P/C ratios clearly indicating that nutrients were sufficiently available for growth. In addition, this index showed a diel significant variation with levels higher in the night than in the day. Moreover, these results suggest that phytoplankton species during the night used the day-synthesised carbohydrates to insure the cell metabolic functioning. The P/C presents relatively high values in proposition to the ones that have been recorded in temperate regions, and seems to be related to azotic inputs of the Inaouen river. Dans le but de parfaire nos connaissances sur le fonctionnement du sous écosystème phytoplancton, nous nous sommes intéressés à étudier son cycle nycthéméral et son métabolisme cellulaire dans la retenue du barrage Idriss premier. Cette dernière, construite sur l'Oued Inaouène, est située à une trentaine de Km de la ville de Fès. Au cours de ce cycle, les prélèvements ont été effectués selon une séquence temporelle de 4 heures pendant 48 heures, les 7, 8 et 9 septembre 1994. L'étude de l'évolution des composantes biochimiques des cellules phytoplanctoniques à savoir les protéines, les glucides et les lipides a permis de mettre en évidence des variations nycthémérales importantes. Ces variations sont d'autant plus importantes que les variations spatiales observées entre les profondeurs. De plus, le rapport protéines/glucides (P/G), reconnu comme un bon indicateur de l'état physiologique des algues, présente des valeurs plus élevées la nuit que le jour au niveau du fond du lac. Ce résultat suggère que le phytoplancton utilise les produits de réserve synthétisés le jour pour assurer le fonctionnement métabolique des cellules. De plus, les valeurs de ce rapport sont relativement élevées par rapport à celle enregistrées dans les régions tempérés et semblent être liées aux ressources azotées du milieu en particulier les apports de l'Oued Inaouène.

Bahhou, J.; Alaoui Mhamdi, M.

1999-03-01

273

Defining parasite biodiversity at high latitudes of North America: new host and geographic records for Onchocerca cervipedis (Nematoda: Onchocercidae) in moose and caribou  

PubMed Central

Background Onchocerca cervipedis is a filarioid nematode of cervids reported from Central America to boreal regions of North America. It is found primarily in subcutaneous tissues of the legs, and is more commonly known as ‘legworm’. Blackflies are intermediate hosts and transmit larvae to ungulates when they blood-feed. In this article we report the first records of O. cervipedis from high latitudes of North America and its occurrence in previously unrecognized host subspecies including the Yukon-Alaska moose (Alces americanus gigas) and the Grant’s caribou (Rangifer tarandus granti). Methods We examined the subcutaneous connective tissues of the metacarpi and/or metatarsi of 34 moose and one caribou for parasitic lesions. Samples were collected from animals killed by subsistence hunters or animals found dead in the Northwest Territories (NT), Canada and Alaska (AK), USA from 2005 to 2012. Genomic DNA lysate was prepared from nematode fragments collected from two moose. The nd5 region of the mitochondrial DNA was amplified by PCR and sequenced. Results Subcutaneous nodules were found in 12 moose from the NT and AK, and one caribou from AK. Nematodes dissected from the lesions were identified as Onchocerca cervipedis based on morphology of female and male specimens. Histopathological findings in moose included cavitating lesions with multifocal granulomatous cellulitis containing intralesional microfilariae and adults, often necrotic and partially mineralized. Lesions in the caribou included periosteitis with chronic cellulitis, eosinophilic and lymphoplasmacytic infiltrate, and abundant granulation associated with intralesional adult nematodes and larvae. Sequences of the nd5 region (471bp), the first generated for this species, were deposited with Genbank (JN580791 and JN580792). Representative voucher specimens were deposited in the archives of the United States National Parasite Collection. Conclusions The geographic range of O. cervipedis is broader than previously thought, and extends into subarctic regions of western North America, at least to latitude 66°N. The host range is now recognized to include two additional subspecies: the Yukon-Alaska moose and Grant’s caribou. Accelerated climate change at high latitudes may affect vector dynamics, and consequently the abundance and distribution of O. cervipedis in moose and caribou. Disease outbreaks and mortality events associated with climatic perturbations have been reported for other filarioids, such as Setaria tundra in Fennoscandia, and may become an emerging issue for O. cervipedis in subarctic North America. PMID:23110962

2012-01-01

274

An atlas of the morphological manifestations of hidradenitis suppurativa.  

PubMed

This article is dermatological atlas of the morphologic presentations of Hidradenitis Suppurativa (HS). It includes: superficial abscesses (boils, furnucles, carbuncles), abscesses that are subcutaneous and suprafascial, pyogenic granulomas, cysts, painful erythematous papules and plaques, folliculitis, open ulcerations, chronic sinuses, fistulas, sinus tracts, scrotal and genital lyphedema, dermal contractures, keloids (some that are still pitted with follicular ostia), scarring, skin tags, fibrosis, anal fissures, fistulas (i.e. circinate, linear, arcuate), scarring folliculitis of the buttocks (from mild to cigarette-like scarring), condyloma like lesions in intertrigous areas, fishmouth scars, acne inversa, honey-comb scarring, cribiform scarring, tombstone comedones, and morphia-like plaques. HS can co-exist with other follicular diseases such as pilonidal cysts, dissecting cellulitis, acne conglobata, pyoderma gangrenosum, and acanthosis nigricans. In sum, the variety of presentations of HS as shown by these images supports the supposition that HS is a reaction pattern.HS is a follicular based diseased and its manifestations involve a multitude of follicular pathologies [1,2]. It is also known as acne inversa (AI) because of one manifestation that involves the formation of open comedones on areas besides the face. It is as yet unclear why HS is so protean in its manifestations. HS severity is assessed using the Hurley Staging System (Table 1). It also remains unclear why hidradentitis may remain limited to Hurley Stage 1, evolve to the more confluent (Hurley Stage 2), or progress even further to the fully confluent (Hurley Stage 3).In addition, HS can be associated with other follicular based diseases such as pilonidal cysts (PCs) of the sacrum and buttocks, dissecting cellulitis (DC), and acne conglobata (AC), which usually involves the face, chest, When HS occurs with PCs, DC, and/or AC it is referred to as the follicular occlusion triad or tetrad [2]. HS can more rarely be associated with pyoderma gagrenosum (PG) or Crohn disease (CD), other inflammatory diseases of the skin that are not follicular. The reason for this is unclear [2]. What AC, DC, HS, CD, and PG share is that they occur in bacterially rich environments. HS probably occurs with acanthosis nigricans because many HS patients are obese [2]. This concurrence seems under reported. PMID:24746309

Scheinfeld, Noah

2014-01-01

275

Increasing Hospitalizations and General Practice Prescriptions for Community-onset Staphylococcal Disease, England  

PubMed Central

Rates of hospital-acquired staphylococcal infection increased throughout the 1990s; however, information is limited on trends in community-onset staphylococcal disease in the United Kingdom. We used Hospital Episode Statistics to describe trends in hospital admissions for community-onset staphylococcal disease and national general practice data to describe trends in community prescribing for staphylococcal disease. Hospital admission rates for staphyloccocal septicemia, staphylococcal pneumonia, staphylococcal scalded-skin syndrome, and impetigo increased >5-fold. Admission rates increased 3-fold for abscesses and cellulitis and 1.5-fold for bone and joint infections. In primary care settings during 1991–2006, floxacillin prescriptions increased 1.8-fold and fusidic acid prescriptions 2.5-fold. The increases were not matched by increases in admission rates for control conditions. We identified a previously undescribed but major increase in pathogenic community-onset staphylococcal disease over the past 15 years. These trends are of concern given the international emergence of invasive community-onset staphylococcal infections. PMID:18439352

Knott, Felicity; Petersen, Irene; Livermore, David M.; Duckworth, Georgia; Islam, Amir; Johnson, Anne M.

2008-01-01

276

Incorporating novel solutions to lower-limb problems into compression formularies.  

PubMed

This study investigates the effect of a new short-stretch two-layer compression system in eight patients with common chronic lower-limb conditions in three locations in the UK. Chronic leg ulcers are the most common type of lower-limb ulceration with 70% caused by chronic venous hypertension. An appropriate level of compression is proven to heal chronic venous leg ulcers. The study was only a small sample of patients; however, the underlying conditions included chronic venous eczema, diabetes, sarcoma, cellulitis and mixed-aetiology ulcers. During the study, the UK experienced some of the hottest temperatures in the last 30 years. This had an impact on five patients, who noted an increase in malodour associated with their leg ulcers. CoFlex TLC (Aspen Medical Europe Ltd) foam comfort layer is impregnated with cyclodextrin-a naturally based oligosaccharide known to reduce malodour. The zinc-impregnated foam bandages in this study were viewed very favourably by both patients and staff, particularly those who had chronic venous eczema. PMID:24912834

Smith, Glenn; Simon, Deborah; McDermott, Emma; Gibson, Elaine

2014-06-01

277

Successful medical treatment for globe penetration following tooth extraction in a dog.  

PubMed

A five-year-old entire male Tibetan Terrier was referred for left-sided periorbital swelling and blepharospasm 4 days following ipsilateral maxillary tooth extraction. Examination of the left eye revealed mild exophthalmos, pain on retropulsion, and absent menace response and pupillary light reflexes. Examination of the posterior segment was not possible owing to the anterior segment pathology. Differential diagnoses considered were iatrogenic globe penetration and peribulbar abscess/cellulitis. Ocular ultrasound was consistent with a penetrating wound to the globe. Treatment with systemic prednisolone and marbofloxacin, and topical atropine sulfate 1%, prednisolone acetate, and brinzolamide was started. Marked clinical improvement allowed visual confirmation of the perforation. Oral prednisolone was tapered over the following 10 weeks. At final re-examination (10 months), the patient was visual, and fundic examination revealed an additional chorioretinal scar, most likely an exit wound that was obscured by vitreal debris on initial examinations. Neither scar was associated with retinal detachment. To the authors' knowledge, this is the first reported case of successful medical management of iatrogenic globe penetration following exodontic procedures. PMID:23869648

Guerreiro, Cleo E; Appelboam, Helen; Lowe, Robert C

2014-03-01

278

The prognosis and possible cause of severe primary lymphoedema.  

PubMed Central

We studied 372 patients with primary lymphoedema in order to predict the extent and severity of the disease. We found that the limits of oedema were defined early in the process and that the loss of distal lymphatics alone did not lead to severe oedema. Severe lymphoedema was associated with pelvic lymphatic 'obstruction' on lymphography and 26% of these patients eventually required surgery. Lymphography suggested that the 'obstruction' was related to lymph nodes and inguinal node biopsies were taken at the time of lymphography in 72 patients. In patients with pelvic lymphatic 'obstruction' we found a severe nodal fibrosis which was not apparent in those with distal lymphatic disease alone. This fibrosis was not related to episodes of cellulitis and since it was present in the early stages of the disease it is unlikely to be due to slow obliteration of distal lymphatics. Furthermore it could not be reproduced by ligating either afferent or efferent lymphatics of the rabbit popliteal lymph node. This suggests that severe primary lymphoedema may develop as a result of disease of the pelvic lymph nodes. Images Fig. 3 Fig. 4 Fig. 5 PMID:6742737

Wolfe, J. H.

1984-01-01

279

A huge fecalith associated with dialysis-related gastrointestinal amyloidosis.  

PubMed

A 60-year-old man who had been receiving dialysis for more than 30 years was admitted for treatment of cellulitis in his right thigh on November 7, 2003. He suffered from an ileus on December 14 and was found to have a huge, 7-cm-diameter, well-circumscribed fecalith, incarcerated at the splenic flexure of the colon. It was proving difficult to pass this naturally and surgical removal was thought to be too risky. Using a colonoscope and a water-jet probe, the fecalith was broken up; the ileus then improved and the patient was able to take oral fluids. Unfortunately, he died of cardiac failure on February 13, 2004. We conducted an autopsy, with his family's consent, and found generalized amyloidosis. Deposits of amyloid were seen in all layers of the colon. Because of this, we hypothesized that peristalsis had been poor and this had led to paralytic ileus due to stasis, which, in turn, had led to the formation of the huge fecalith. In Japan it is not rare for a patient to be on dialysis for more than 25 years and it may be that this is a cause of generalized amyloidosis. There have been no such cases of fecalith associated with gastrointestinal amyloidosis described previously, which is why we decided to report this case here. PMID:17593521

Ono, Takashi; Narikiyo, Takefumi; Nishida, Eiichi; Yanagida, Taihei; Yasunaga, Chikao; Hisaoka, Masanori; Sakino, Ikuo; Osamura, Shunji; Nakamoto, Masahiko

2007-06-01

280

Outcomes of Percutaneous Endoscopic Gastrostomy in Hospitalized Patients at a Tertiary Care Hospital in Turkey  

PubMed Central

BACKGROUND / OBJECTIVES The aim of this study was to perform a retrospective analysis characterizing patients receiving tube feeding following percutaneous endoscopic gastrostomy ( PEG) tube placement between 2004 and 2012 at Erciyes University Hospital in Turkey. METHODS Patients above the age of 18 years, who required long term enteral tube feeding were studied. All PEGs were performed using the pull-through technique by one experienced endoscopist Demographic, clinical outcomes, and PEG-related complication data were collected. RESULTS Of the 128 subjects studied, 91 were male (71%) and 37 were female (29%). The mean age of this patient population was 54±19 years. The most common reason for PEG tube insertion was inability to consume oral diet due to complications of cerebrovascular disease (CVD; 27%), while cerebral hypoxia, occuring after non-neurological medical disorders, was the second most common indication (23%). A total of 70 patients (55%) had chronic comorbidities, with hypertension the most common (20%). The most common procedure related complication was insertion site bleeding, which occurred in 4 % of patients. Long term complications, during one year were insertion site cellulitis, gastric contents leakage, and peristomal ulceration occurred in 14%, 5%, and 0.5% of patients, respectively. There were no PEG insertion-related mortalities; one-year mortality was unrelated to the indication for PEG tube insertion. CONCLUSIONS PEG tube insertion was a safe method to provide enteral access for nutrition support in this hospitalized patient population. PMID:24518749

Gundogan, Kursat; Yurci, Alper M.; Coskun, Ramazan; Baskol, Mevlut; Gursoy, Sebnem; Hebbar, Gautam; Sungur, Murat; Ziegler, Thomas R.

2014-01-01

281

[Skin complications of stonefish envenomation in 6 travellers returning from the Indo-Pacific maritime region].  

PubMed

Stonefish (Synanceja verrucosa) sting has been known for a long time to be a medical hazard. It is a common cause of severe marine envenomation. Immediate complications (collapsus, pulmonary oedema) have been described extensively. Late complications (oedema, tissue necrosis) have not been studied in details although they are common and a cause of invalidity and pain. We have observed six travellers with complications of stonefish sting over a 10 year-period in our department. All the patients were coming back from the Indo-Pacific maritime region. They presented with cutaneous abcess (in one) or necrotic complications (foot ulcers in two, cellulitis in three) associated with painfull oedema in two and lymphangitis in three. Surgery has been performed in four patients, two of them undergoing many operations. Two had long term sequelae. Such complications could be avoided. Appropriate initial treatment (i.e., neutralization of the venom by hot water, disinfection, antivenom and antibioprophylaxis) seems to be able to reduce late complications. Antivenom is indicated in severe systemic manifestations which are life threatening and in case of crucial pains. Prevention is the most important part of therapy and relies on appropriate information of the travellers. PMID:15015852

Louis-Francois, C; Mathoulin, C; Halbwachs, C; Grivois, J P; Bricaire, F; Caumes, E

2003-01-01

282

Early Presentation of Heterotopic Ossification Mimicking Pyomyositis - Two Case Reports -  

PubMed Central

Early diagnosis and treatment of heterotopic ossification (HO) is essential to the prevention of complications. It is difficult to diagnose HO in its initial phase because non-specific clinical manifestations, laboratory findings and imaging findings of immature HO may mimic other diseases such as cellulitis, osteomyelitis, thrombophlebitis, deep vein thrombosis and local infection with abscess. We experienced two cases of HO, which were misdiagnosed as pyomyositis at first by clinical signs and MRI findings indicating the deep infection; the extensive intramuscular ossification appeared later on. We observed an increase of C-reactive protein and creatine kinase followed by the elevation of alkaline phosphatase with abnormal triphasic bone scan. The trajectory of these biomarkers was analyzed to get more insight into the early stages of HO along with the imaging findings. Although our cases cannot be generalized as typical of immature HO, they clearly demonstrate that the change of specific biomarkers with a careful history taking and physical examination should be noted to detect HO as early as possible while avoiding confusion with other mimicking conditions. PMID:23185738

Choi, Yoon-Hee; Kim, Kyoung-Eun; Lim, Sung-Hoon

2012-01-01

283

Fatal skin and soft tissue infection of multidrug resistant Acinetobacter baumannii: A case report  

PubMed Central

INTRODUCTION Acinetobacter baumannii is usually associated with respiratory tract, urinary tract and bloodstream infections. Recent reports suggest that it is increasingly causing skin and soft tissue infections. It is also evolving as a multidrug resistant organism that can be difficult to treat. We present a fatal case of multidrug resistant A. baumannii soft tissue infection and review of relevant literature. PRESENTATION OF CASE A 41 year old morbidly obese man, with history of alcoholic liver disease presented with left superficial pre-tibial abrasions and cellulitis caused by multidrug resistant (MDR) A. baumannii. In spite of early antibiotic administration he developed extensive myositis and fat necrosis requiring extensive and multiple surgical debridements. He deteriorated despite appropriate antibiotic therapy and multiple surgical interventions with development of multi-organ failure and died. DISCUSSION Managing Acinetobacter infections remains difficult due to the array of resistance and the pathogens ability to develop new and ongoing resistance. The early diagnosis of necrotizing soft tissue infection may be challenging, but the key to successful management of patients with necrotizing soft tissue infection are early recognition and complete surgical debridement. CONCLUSION A. baumannii is emerging as an important cause of severe, life-threatening soft tissue infections. Multidrug resistant A. baumannii soft tissue infections may carry a high mortality in spite of early and aggressive treatment. Clinicians need to consider appropriate early empirical antibiotic coverage or the use of combination therapy to include MDR A. baumannii as a cause of skin and soft tissue infections. PMID:25016080

Ali, Aqsa; Botha, John; Tiruvoipati, Ravindranath

2014-01-01

284

X-linked hyper-IgM syndrome with CD40LG mutation: Two case reports and literature review in Taiwanese patients.  

PubMed

Hyper-IgM syndrome (HIGM) is a rare primary immunodeficiency disorder characterized by elevated or normal serum IgM and decreased IgG, IgA, and IgE due to defective immunoglobulin class switching. X-linked HIGM (XHIGM, HIGM1) is the most frequent type, is caused by mutations in the CD40 ligand gene, and is regarded as a combined T and B immunodeficiency. We report an 18-year-old male who was diagnosed initially with hypogammaglobulinemia in infancy, but developed repeated pneumonia, sepsis, cellulitis, perianal abscess, pericarditis, and bronchiectasis despite regular intravenous immunoglobulin replacement therapy. The patient died at age 18 years due to pneumonia and tension pneumothorax. Mutation analysis revealed CD40L gene mutation within Exon 5 at nucleotide position 476 (cDNA 476G > A). This nonsense mutation predicted a tryptophan codon (TGG) change to a stop codon (TGA) at position 140 (W140X), preventing CD40L protein expression. Sequence analysis in the family confirmed a de novo mutation. The second case of 6-month-old male infant presented as Pneumocystis jiroveci pneumonia and acute respiratory distress syndrome. Gene analysis of the CD40L gene revealed G to C substitution in Intron 4 (c.409 + 5G > C) and mother was a carrier. Hematopoietic stem cell transplantation, the only cure for XHIGM, was arranged in the second case. PMID:23010537

Tsai, Hu-Yuan; Yu, Hsin-Hui; Chien, Yin-Hsiu; Chu, Kuan-Hua; Lau, Yu-Lung; Lee, Jyh-Hong; Wang, Li-Chieh; Chiang, Bor-Luen; Yang, Yao-Hsu

2015-02-01

285

Rotational flap closure of first and fifth metatarsal head plantar ulcers: adjunctive procedure when performing first or fifth ray amputation.  

PubMed

Partial ray amputation is a common treatment of diabetes-related neuropathic ulcers located beneath the metatarsal heads. The standard incision for partial first or fifth ray amputation involves a tennis racket incision, with the proximal arm made mid-line along the respective medial or lateral side of the metatarsal head and neck, creating equal dorsal and plantar flaps. This incision works well when the ulcer is located within the excised soft tissue distal to the incision or when the plantar ulcer is superficial and will heal secondarily once the underlying bone has been removed. This standard first or fifth ray amputation incision does not, however, allow excision and closure of plantar ulcers located beneath the first or fifth metatarsal head. Two cases are presented to demonstrate our surgical protocol for partial first or fifth ray amputation using a local rotational flap to cover plantar metatarsal head ulcers. These cases highlight our patient selection criteria, staging protocol when cellulitis or abscess is present, rotational flap design, surgical technique pearls, and the typical postoperative healing progress. PMID:23246295

Boffeli, Troy J; Peterson, Matthew C

2013-01-01

286

Design and Development of a Telerehabilitation Self-Management Program for Persons with Chronic Lower Limb Swelling and Mobility Limitations: Preliminary Evidence  

PubMed Central

This paper describes design and development of a self-management program, delivered by telerehabilitation (TR), to address the problem of chronic lower limb swelling in persons with limited mobility. The 18.6 million persons with limited mobility in the USA are at increased risk for chronic lower limb swelling and related secondary complications, including cellulitis and skin ulcers. Over time, chronic swelling often progresses to lymphedema, an incurable condition requiring lifelong care. Without successful self-management, lymphedema and its related complications inevitably worsen. Access and adherence to appropriate treatment are challenging for persons with limited mobility. Program development involved a structured process to establish content validity (videos and manuals), readability, suitability, and selection of a TR platform to deliver the educational program. Our goal was to develop a program that would engage patients in self-management skills. The TR software platform chosen, Versatile and Integrated System for Telerehabilitation (VISYTER) was designed to facilitate face-to-face delivery of an interactive home-based self-management program via the internet in real time. Results demonstrated validity of the educational program and ease of use with TR. Future plans are to evaluate ability of this approach to promote self-management skills, home monitoring, and improved management of persons with lymphedema and limited mobility. PMID:23227323

Faett, Becky L.; Geyer, Mary Jo; Hoffman, Leslie A.; Brienza, David M.

2012-01-01

287

Necrotizing fasciitis – a diagnostic dilemma: two case reports  

PubMed Central

Introduction Necrotizing soft tissue infections can affect various tissue planes. Although predisposing etiologies are many, they mostly center on impaired immunity occurring directly or indirectly and loss of integrity of protective barriers which predispose to infection. The nonspecific presentation may delay diagnosis and favor high mortality. Case presentation Two case vignettes are presented. The first patient, a 44-year-old healthy South Asian man with a history of repeated minor traumatic injury presented to a primary health care center with a swollen left lower limb. He was treated with antibiotics with an initial diagnosis of cellulitis. Because he deteriorated rapidly and additionally developed intestinal obstruction, he was transferred to our hospital which is a tertiary health care center for further evaluation and management. Prompt clinical diagnosis of necrotizing soft tissue infection was made and confirmed on magnetic resonance imaging as necrotizing fasciitis. Urgent debridement was done, but the already spread infection resulted in rapid clinical deterioration with resultant mortality. The second patient was a 35-year-old South Asian woman with systemic lupus erythematous receiving immunosuppressive therapy who developed left lower limb pain and fever. Medical attention was sought late as she came to the hospital after 4 days. Her condition deteriorated rapidly as she developed septic shock and died within 2 days. Conclusions Necrotizing fasciitis can be fatal when not recognized and without early intervention. Clinicians and surgeons alike should have a greater level of suspicion and appreciation for this uncommon yet lethal infection. PMID:24965382

2014-01-01

288

Follicular and scarring disorders in skin of color: presentation and management.  

PubMed

Skin of color, also known as ethnic skin, is described as skin of individuals of African, Asian, Hispanic, Native-American, Middle Eastern, and Pacific Island backgrounds. Differences in hair morphology, hair grooming, cultural practices, and susceptibility to keloid scarring exist within these populations and have been implicated in hair, scalp, and skin disorders. Acne keloidalis (AK), central centrifugal cicatricial alopecia (CCCA), dissecting cellulitis of the scalp (DCS), pseudofolliculitis barbae (PFB), traction alopecia (TA), and keloids are the most prevalent follicular and scarring disorders in skin of color. They have been associated with disfigurement, permanent hair loss, emotional distress, and decreased quality of life. Hair grooming practices, such as the use of chemical relaxers, heat straightening, and tight braiding and weaving can cause scalp irritation and follicular damage and are linked to the pathogenesis of some of these conditions. Consequently, patient education and behavior modifications are integral to the prevention and management of these disorders. Scarring disorders are also of concern in ethnic populations. Keloid scarring is more prevalent in individuals of African, Asian, and Hispanic descent. The scarring alopecia CCCA is almost exclusively seen in patients of African descent. Therapeutic regimens such as intralesional corticosteroids, surgical excision, and laser therapy can be effective for these follicular and scarring disorders, but carry a risk of dyspigmentation and keloid scarring. Ethnic skin and hair may present unique challenges to the clinician, and knowledge of these differences is essential to providing quality care. PMID:24820821

Madu, Pamela; Kundu, Roopal V

2014-08-01

289

Our experiences with saphenoperitoneal shunts in the treatment of intractable ascites.  

PubMed

Because of significant expenses and complication rates of traditional pumps (LeVeen, Denver, Agishi) used in the surgical treatment of refractory ascites a simple and cheap operative method has to be found. In saphenoperitoneal shunts the one-way flow is maintained by biologically given double saphenous valves. In our department 11 saphenoperitoneal shunts have been performed on 9 patients (2 female, 7 male) in the past one and a half years. Their ascites have been associated with cirrhosis of the liver (secondary to aethylism in 8, to HBV infection in 1). During the follow-up period significant reduction in body weight and abdominal girth, and increase in diuresis with standard diuretics were seen in 6 patients. The minor complications (3 seromas, 3 hematomas, 2 cellulitis) have been self-limiting in general. In the presence of major complications (1 peritoneal reflux, 1 severe hypoproteinaemia, 3 shunt occlusion) interventions were needed several times. In one of the occlusions contralateral fistula was created with PTFE prosthesis implantation, in another case desobliteration happened with a silicone drain left in the shunt. The saphenoperitoneal shunts could improve quality of life significantly in successful instances with minimal negative operative effects without the adverse effects of insertion of foreign material. PMID:15966232

Vizsy, Laszlo; Beznicza, Henrietta; Batorfi, Jozsef

2005-01-01

290

Esophageal adenocarcinoma and urothelial carcinoma orbital metastases masquerading as infection.  

PubMed

Abstract Orbital metastases can masquerade as other orbital processes. We present two cases of orbital metastases, the first being the first reported adenocarcinoma of the esophagus presenting as an orbital metastasis prior to the primary being known, and the other as the first urothelial carcinoma to present as orbital cellulitis. The first patient presented with left upper eyelid pain. CT scan identified a superolateral subperiosteal fluid collection without concomitant sinus disease, which was drained in the operating room. Two weeks later repeat CT scan showed recurrent orbital subperiosteal fluid. It was drained and a biopsy showed necrotic adenocarcinoma. The second case presented with a painless right proptosis, decreased vision, and globally decreased ocular motility 3 days after bladder resection for urothelial carcinoma. CT scan demonstrated pan sinusitis with a soft tissue mass in the apex of the right orbit with extension through the superior orbital fissure. After no improvement on antibiotics endoscopic drainage was performed. Pathology revealed metastatic urothelial carcinoma within the orbital fat. PMID:25325392

Magrath, George N; Proctor, Charles M; Reardon, Wade A; Patel, Krishna G; Lentsch, Eric J; Eiseman, Andrew S

2015-02-01

291

Cryptococcal necrotizing fasciitis in a patient after renal transplantation--a case report.  

PubMed

A 50-year-old man, who had received an ABO-incompatible living related preemptive renal transplantation 1 year before, presented with painful lesions on both lower extremities and fever. At first, bacterial cellulitis was suspected and antibiotic therapy was initiated, but it was not effective. The serum cryptococcal antigen titer was 1:4,098, and pathologic examination of debrided tissue and wound pus culture revealed cryptococcal necrotizing fasciitis. Liposomal amphotericin B and fluconazole were started, and repeated debridement and skin grafting were performed. Because his graft function deteriorated because of antibody-mediated rejection and polyoma viral nephropathy, hemodialysis was induced on day 9 of hospitalization. During the treatment, he suffered repeated urinary tract infections, which were treated with antibiotics, and cytomegalovirus retinopathy, which was treated with ganciclovir. His cryptococcal necrotizing fasciitis was successfully cured by the combination of antimicrobial treatment and surgical procedures. He could walk with a cane and was discharged on day 298 of hospitalization. Cryptococcal necrotizing fasciitis in renal transplant recipients is so rare that only 14 cases have been reported. The mortality is not very high, but the prognosis of the patient is complicated by worsening of the cryptococcal infection of the central nervous system (CNS). Early detection and treatment to prevent spreading to other sites, especially the CNS or disseminated disease, is very important in cases of cryptococcal necrotizing fasciitis. PMID:24656028

Yoneda, T; Itami, Y; Hirayama, A; Saka, T; Yoshida, K; Fujimoto, K

2014-01-01

292

A Challenge for Diagnosing Acute Liver Injury with Concomitant/Sequential Exposure to Multiple Drugs: Can Causality Assessment Scales Be Utilized to Identify the Offending Drug?  

PubMed Central

Drug-induced hepatotoxicity most commonly manifests as an acute hepatitis syndrome and remains the leading cause of drug-induced death/mortality and the primary reason for withdrawal of drugs from the pharmaceutical market. We report a case of acute liver injury in a 12-year-old Hispanic boy, who received a series of five antibiotics (amoxicillin, ceftriaxone, vancomycin, ampicillin/sulbactam, and clindamycin) for cervical lymphadenitis/retropharyngeal cellulitis. Histopathology of the liver biopsy specimen revealed acute cholestatic hepatitis. All known causes of acute liver injury were appropriately excluded and (only) drug-induced liver injury was left as a cause of his cholestasis. Liver-specific causality assessment scales such as Council for the International Organization of Medical Sciences/Roussel Uclaf Causality Assessment Method scoring system (CIOMS/RUCAM), Maria and Victorino scale, and Digestive Disease Week-Japan were applied to seek the most likely offending drug. Although clindamycin is the most likely cause by clinical diagnosis, none of causality assessment scales aid in the diagnosis. PMID:25506455

Lim, Roxanne; Conner, Kim; Karnsakul, Wikrom

2014-01-01

293

Radiation-induced morphea - a literature review.  

PubMed

Radiation-induced morphea (RIM) is a rare and under-recognized skin complication of radiotherapy. It is commonly wrongly diagnosed as other dermatological conditions or malignancy because of similar clinical characteristics. This literature review analyses 66 cases that have been reported in the literature since 1989. The clinical appearance often includes pain and disfiguration of affected area, which may influence the patient's quality of life. There is no clear connection between the radiotherapy dose, the fractionation scheme, the use of a boost, age, the presence of other dermatological conditions or other connective tissue diseases and the occurrence of RIM. Its pathogenesis is still unclear, but several theories are proposed to explain this phenomenon. The available data suggest that the abnormally high secretion of some cytokines (interleukin 4, interleukin 5, transforming growth factor) induced by radiation causes an extensive fibrosis after an activation of fibroblasts. Histological confirmation is crucial in distinguishing RIM from similar-looking diseases, such as chronic radiation dermatitis, cancer recurrence, radiation, recall dermatitis, new carcinoma or cellulitis. There is no clear treatment regimen for this condition. Clinical outcome after therapy is often unsatisfactory. The commonly used methods and agents include: topical and systemic steroids, calcineurin inhibitors, systemic immunosuppressants including methotrexate, tacrolimus, heparin, hyaluronidase, phototherapy (UVA, UVA1, UVB, PUVA), systemic antibiotics, imiquimod, mycophenolate mofetil, photophoresis. The differential diagnosis is challenging and requires a multidisciplinary approach to avoid misdiagnosis and to plan appropriate treatment. PMID:25174551

Spalek, M; Jonska-Gmyrek, J; Ga?ecki, J

2015-02-01

294

MRI in necrotizing fasciitis of the extremities  

PubMed Central

Necrotizing fasciitis is a life-threatening soft-tissue infection of bacterial origin, which involves mainly the deep fascia. Early recognition of this condition may be hampered by the uncommon nature of the disease and non-specificity of initial clinical signs and symptoms in less fulminant cases, making the role of imaging important. MRI is the most useful imaging modality in the diagnosis of necrotizing fasciitis. The presence of thick (>3?mm) hyperintense signal in the deep fascia (particularly intermuscular fascia) on fat-suppressed T2 weighted or short tau inversion–recovery images is an important marker for necrotizing fasciitis. Contrast enhancement of the thickened necrotic fascia can be variable, with a mixed-pattern of enhancement being more commonly encountered. Involvement of multiple musculofascial compartments increases the likelihood of necrotizing fasciitis. It is important to remember that T2-hyperintense signal in the deep fascia is not specific to necrotizing fasciitis and can also be seen in cases such as non-infective inflammatory fasciitis or muscle tear. In this pictorial essay, we aim to review the MRI findings in necrotizing fasciitis, discuss its limitations and pitfalls and identify differentiating features from non-necrotizing soft-tissue infections, such as cellulitis and infective myositis/pyomyositis, conditions which may clinically mimic necrotizing fasciitis. PMID:24288403

Srinivasan, S; Peh, W C G

2014-01-01

295

Pressure Distribution Tests on PW-9 Wing Models from -18 Degree Through 90 Degree Angle of Attack  

NASA Technical Reports Server (NTRS)

At the request of the Army Air Corps, an investigation of the pressure distribution over PW-9 wing models was conducted in the atmospheric wind tunnel of the National Advisory Committee for Aeronautics. The primary purpose of these tests was to obtain wind-tunnel data on the load distribution on the cellule to be correlated with similar information obtained in flight tests, both to be used for design purposes. Because of the importance of the conditions beyond the stall as affecting the control and stability, this investigation was extended through 90 degree angle of attack. The results for the range of normal flight have been given in NACA Technical Report No. 271. The present paper presents the same results in a different form and includes, in addition, those over the greater range of angle of attack, -18 degrees through 90 degrees. The results show that: (1) at angles of attack above maximum lift, the biplane upper wing pressures are decreased by the shielding action of the lower wing. (2) the burble of the biplane lower wing, with respect to the angle of attack, is delayed, due to the shielding action of the lower wing. (3) the center of pressure of the biplane upper wing (semispan) is, in general, displaced forward and outward with reference to that of the wing as a monoplane, while for the lower wing there is but slight difference for both conditions. (4) the overhanging portion of the upper wing is little affected by the presence of the lower wing.

Loeser, Oscar E , Jr

1929-01-01

296

Successful Treatment of a Severe Case of Fournier's Gangrene Complicating a Perianal Abscess  

PubMed Central

A 67-year-old male patient with diabetes mellitus and nephritic syndrome under cortisone treatment was admitted to our hospital with fever and severe perianal pain. Upon physical examination, a perianal abscess was identified. Furthermore, the scrotum was gangrenous with extensive cellulitis of the perineum and left lower abdominal wall. Crepitations between the skin and fascia were palpable. A diagnosis of Fournier's gangrene was made. He was treated with immediate extensive surgical debridement under general anesthesia. The patient received broad-spectrum antibiotics, and repeated extensive debridements were performed until healthy granulation was present in the wound. Due to the fact that his left testicle was severely exposed, it was transpositioned into a subcutaneous pocket in the inner side of the left thigh. He was finally discharged on the 57th postoperative day. Fournier's gangrene is characterized by high mortality rates, ranging from 15% to 50% and is an acute surgical emergency. The mainstay of treatment should be open drainage and early aggressive surgical debridement of all necrotic tissue, followed by broad-spectrum antibiotics therapy. PMID:21317986

Papaconstantinou, Ioannis; Yiallourou, Anneza I.; Dafnios, Nicolaos; Grapsa, Irini; Polymeneas, George; Voros, Dionysios

2011-01-01

297

Enhanced pore filling of spiro-OMeTAD by enlarging the porosity of TiO2 films and its effects on the photovoltaic performance of ss-DSCs  

NASA Astrophysics Data System (ADS)

Four kinds of TiO2 electrodes with different porosities were prepared by adding different ratios of ethyl cellulous into a Dyesol 18-NRT paste. Higher polymer ratios contributed to the higher porosity of TiO2 films. All electrodes were spin-coated with spiro-OMeTAD and fabricated into solid-state dye-sensitized solar cells (ss-DSCs). This simple method allowed more spiro-OMeTAD penetrated into the more porous TiO2 films. This result demonstrated the pore-filling effect of hole transport materials on the photovoltaic performance of ss-DSCs. Photoluminescence and electrical impedance spectra measurements were introduced to investigate the dye regeneration, charge transport, and recombination kinetics of the solar cells. The increased pore filling of spiro-OMeTAD could enhance hole injection, hole transport, and recombination retardation, thus providing good charge collection efficiency and long recombination lifetime and resulting in the high short-circuit current density, open-circuit voltage, fill factor, and energy conversion efficiency of the solar cells. An efficiency enhancement of 34 % was obtained by using this method. However, further increasing the TiO2 porosity decreased the electron transport, thus causing a low charge collection and reducing cell performance.

Fang, Yanling; Wang, Qi; Huang, Jianguo; Wu, Tao

2014-11-01

298

Tungiasis presenting as a soft tissue oral lesion  

PubMed Central

Background The sand flea Tunga penetrans usually infects the feet and affects primary school-age children and elderly persons in rural Uganda. Tungiasis occurs nationwide but disease outbreaks have been reported in the Busoga sub-Region of eastern Uganda, associated with poor sanitation and proximity between humans and domestic animals. Ectopic tungiasis, usually seen with extensive infection and at weight-bearing body surfaces often follows exposure in highly infested environments. For patients who present abroad treatment may be surgical excision or amputation. Case presentation An adult female Musoga by tribe, resident in a Kampala City suburb presented at Mulago National Referral and Teaching Hospital’s Oral Surgery and Jaw Injuries Unit with a discoloured swollen tongue, facial cellulitis and submandibular lymphadenopathy. A swelling palpable in the body of her tongue was excised and sent for histology. Tungiasis of the tongue was diagnosed after microscopic examination of formalin-fixed paraffin-embedded Haematoxylin and Eosin-stained tissue sections. Conclusion Lingual tungiasis is a rare diagnosis that was made on histological examination. Atypical presentation outside an endemic area predisposed the patient to partial glossectomy instead of the less invasive flea enucleation. Ectopic disease in a city-resident highlights the plight not only of visitors to infested areas but also of the communities and their domestic animals. PMID:25186303

2014-01-01

299

Noninvasive evaluation of the swollen extremity: Experiences with 190 lymphoscintigraphic examinations  

SciTech Connect

Lymphoscintigraphy (LS), performed with technetium 99m-labeled antimony trisulfide colloid, was used as a noninvasive diagnostic examination to evaluate the lymphatic circulation in 190 extremities of 115 patients. Forty-six patients had primary lymphedema, 48 had secondary lymphedema, and 21 patients had other causes of limb swelling. To determine the value of LS in surgical decision making, preoperative and postoperative LS of 16 patients who underwent surgical repair of the lymphatic abnormality were studied separately. Semiquantitative evaluation of the lymphatic drainage and visual interpretation of the image patterns were reliable to differentiate lymphedema from edemas of other origin (sensitivity: 92%, specificity: 100%). Although certain image patterns were characteristic of either primary or secondary lymphedema, LS could not consistently differentiate between the two types. Episodes of cellulitis in lymphedema clearly delayed lymph transport. LS was helpful in patient selection and follow-up after lymphatic surgery, but it did not prove patency of lymphovenous anastomoses. It was diagnostic in the evaluation of lymphangiectasia and was used to document successful surgical treatment of reflux of chyle. LS is safe and reliable and has no side effects. It should replace contrast lymphangiography in the routine evaluation of the swollen extremity.

Gloviczki, P.; Calcagno, D.; Schirger, A.; Pairolero, P.C.; Cherry, K.J.; Hallett, J.W.; Wahner, H.W.

1989-05-01

300

Clinical characteristics of invasive Haemophilus aphrophilus infections.  

PubMed

Haemophilus aphrophilus, an oral fastidious Gram-negative commensal with low pathogenicity, is a member of the HACEK group (H. aphrophilus, H. paraphrophilus, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella spp.), and a rare cause of human infections. We reviewed the characteristics of 8 cases of H. aphrophilus infections diagnosed in our hospital from 1990-2003, and an additional 20 cases identified from the MEDLINE database, from 1990 to 2003. Their mean age was 47.4 years (range, 7-73 years), and 21 cases (75%) were male. The major manifestation was bone and joint infections (9 cases, 32%), including osteomyelitis, discitis, epidural abscess, spondylodiscitis, septic arthritis and prevertebral infection. Seven cases (25%) presented with infective endocarditis, involving native valves, and one underwent valvular replacement. Of note, 3 cases (10%) had ophthalmic infections (endophthalmitis in 2 cases and canaliculitis in 1), and 2 of them had previous ophthalmic procedures. Other manifestations included bacteremia, meningitis, brain abscess, cervical lymphadenitis, facial cellulitis, empyema, and purulent pericarditis and tamponade. All patients except 1 survived. Recent dental procedure was recalled by 11 cases (39%), and may be a predisposing factor for invasive H. aphrophilus infection. Appropriate antimicrobial therapy, such as a beta-lactam/beta-lactamase inhibitor, ceftriaxone or cefotaxime or a fluoroquinolone, can lead to a favorable clinical outcome. PMID:16118675

Huang, Shao-Tsung; Lee, Hsin-Chun; Lee, Nan-Yao; Liu, Kung-Hung; Ko, Wen-Chien

2005-08-01

301

Infective endocarditis complicated by aortic graft infection and osteomyelitis: case report and review of literature  

PubMed Central

Primary aortic graft infection early after aortic graft insertion is well described in the literature. Here, we present a unique case of late aortic graft infection 5 years after insertion secondary to mitral valve endocarditis, resulting from cellulitis in a patient with severe venous varicosities. A 63-year-old male presented for severe low back pain, constipation, and low-grade fever. An abdominal computed tomography scan with oral and intravenous contrast showed a normal spine and urinary tract. Blood and urine cultures, done at the same time, grew Staphylococcus aureus. A transesophageal echocardiogram confirmed the diagnosis of endocarditis. Subsequently, a gallium scan showed increased uptake in the vertebral bodies, aortic graft, left patella, and left ankle. After 3 months of antibiotic therapy, the patient’s low back pain resolved with normalization of his laboratory values. He remained free of infection at a 2-year follow-up. We reviewed the literature concerning the atypical presentation of infective endocarditis, with a focus on distant metastases at initial presentation, such as osteomyelitis and aortic graft infection, as well as the different treatment modalities. This report describes successful medical treatment with intravenous followed by oral antibiotics for an infected endovascular graft without any surgical intervention. PMID:22866008

Zouein, Elie; Wetz, Robert; Mobarakai, Neville; Hassan, Samer; Tong, Iris

2012-01-01

302

Hydroa Vacciniforme-Like Lymphoma With Primarily Periorbital Swelling: 7 Cases of an Atypical Clinical Manifestation of this Rare Cutaneous T-Cell Lymphoma.  

PubMed

: Hydroa vacciniforme-like lymphoma (HVL) is a rare cutaneous T-cell lymphoma that is usually seen in children of Hispanic or Asian origin. Association between chronic latent Epstein-Barr virus infection in both hydroa vacciniforme (HV) and HVL has been demonstrated and has recently been categorized by the World Health Organization as one of the Epstein Barr virus-positive lymphoproliferative disorders of childhood. Patients with HVL present with a cutaneous rash characterized by edema, blisters, ulcers, and scars mainly seen on the face and extremities that mimic HV; however, unlike in HV, the lesions tend to be extensive and deeper and are associated with severe scarring, necrosis, and systemic manifestations. We are reporting 7 cases of an unusual clinical variant of HVL with primarily periorbital edema. All of our patients in this series presented with progressive periorbital edema that was accompanied with systemic symptoms including fever, malaise, and lymphadenopathy. Most cases were initially misinterpreted as inflammatory processes including cellulitis, arthropod bite reactions, and periorbital lupus erythematosus. The biopsy of these lesions revealed an atypical lymphocytic infiltrate predominantly distributed in the deep dermis and in subcutaneous fat. Immunohistochemistry studies revealed a cytotoxic T-cell (CD8) profile. All cases were associated with Epstein-Barr virus infection. Our study presents a rare clinical variant of HVL with predominant periorbital edema. This variant could potentially be overlooked and misdiagnosed as an inflammatory condition; thus, it needs to be included in the differential diagnosis of periorbital edema in young patients. PMID:25162933

Plaza, Jose A; Sangueza, Martin

2015-01-01

303

The role of primary care prescribers in the diagnosis and management of community-associated methicillin-resistant Staphylococcus aureus skin and soft tissue infections.  

PubMed

Nosocomial infections caused by methicillin-resistant Staphylococcus aureus were first reported in the United States in the early 1960s. Beginning in the 1990s, healthy individuals from the community with no risk factors for resistant bacteria began presenting with methicillin-resistant Staphylococcus aureus infections, acquiring the name "community-associated methicillin-resistant Staphylococcus aureus" (CA-MRSA). CA-MRSA has a tendency to affect the skin and skin structures, generally in the form of abscesses and furuncles, carbuncles, and cellulitis. Cases of invasive infections including bacteremia, endocarditis, and necrotizing pneumonia have also been reported. A patient complaint of a "spider bite" is frequently associated with CA-MRSA. CA-MRSA and the traditional health care-associated methicillin-resistant Staphylococcus aureus are distinguished by their genetic composition, virulence factors, and susceptibility patterns to non-beta-lactam antibiotics. Appropriate management of CA-MRSA skin and skin structure infections includes incision and drainage of infected tissue and appropriate antimicrobial therapy. It has been suggested that when prevalence of CA-MRSA within a community eclipses 10%-15%, empiric use of non-beta-lactam antibiotics with in vitro activity against CA-MRSA be initiated when treating skin and skin structure infections. CA-MRSA retains susceptibility to a range of older antibiotics available in oral formulations such as minocycline, doxycycline, sulfamethoxazole-trimethoprim, moxifloxacin, levofloxacin, and clindamycin. Local susceptibility patterns and individual patient factors should guide the selection of antibiotics. PMID:19617720

Lawrence, Kenneth R; Golik, Monica V; Davidson, Lisa

2009-01-01

304

The first leg video endoscopic groin lymphadenectomy in vulvar cancer: A case report  

PubMed Central

INTRODUCTION The current management of vulvar cancer depends on the extension of disease, and includes primary tumor resection with safety margin as well as inguinofemoral lymph node staging. We report the case of the first leg videoendoscopic inguinal lymphadenectomy performed in a woman with a squamous cell vulvar carcinoma. PRESENTATION OF CASE A 74 years old female referred to our institution complaining of vulvar mass associated with bleeding and swelling from external genitals, vaginal burning sensation and dysuria for 5 months. A vulvar–vaginal examination under narcosis reported a right major labium lesion of 5 cm with an irregular and ulcerated surface, easily bleeding on palpation, involving anteriorly the clitoral region and with a histological finding of a poorly differentiated squamous cell invasive carcinoma of the vulva ulcerating the surface epithelium. We performed, after adequate informed consent, a radical vulvectomy with a standard right inguinofemoral lymphadenectomy and a contralateral simultaneous video endoscopic inguinal lymphadenectomy-Leg procedure. DISCUSSION Our minimally invasive VEIL-Leg approach, performed for the first time in literature in a woman with vulvar cancer, could reduce the presence of high risk factors represented by surgical incision and by procedure-related complications, including wound infection and breakdown, hematoma, cellulitis and hernia formation. CONCLUSION A multicenter prospective randomized study will be helpful to clarify how this procedure could replace the standard laparotomic approach to inguinal lymphadenectomy in the vulvar cancer treatment and staging. PMID:24973526

Naldini, Angelica; Rossitto, Cristiano; Morciano, Andrea; Panico, Giovanni; Campagna, Giuseppe; Paparella, Pierluigi; Scambia, Giovanni

2014-01-01

305

The death of Henry II, King of France (1519-1559). From myth to medical and historical fact.  

PubMed

On 30 June 1559, Henry II, King of France, was mortally wounded in the head by a lance during a jousting match. Despite the best efforts of his physicians, Ambroise Paré and Andreas Vesalius, King Henry died 11 days later. This article, based on previously unpublished evidence, aims at examining the historical account of his death against modern medical practice to establish the probable cause of the king's death. We also discuss what treatments the doctors in the sixteenth century may have had to offer. Historical accounts of the joust provide details of the incident including the position of the visor of the king's helmet. Descriptions of the wood fragments removed from the right orbit by Italian observers and a new translation of the autopsy by Andreas Vesalius allow an accurate description of the actual injury. Our research counters previous theories and concludes that Henry II was the victim of craniofacial trauma involving the right eye and that he died from periorbital cellulitis caused by a retained foreign body in the wound, complicated by a left interhemispheric empyema preceded by a traumatic interhemispheric haematoma. It would appear that the royal court doctors advocated a wait-and-see strategy, with little actual input from Ambroise Paré or Andreas Vesalius, with a clearly regrettable outcome. PMID:25421951

Zanello, Marc; Charlier, Philippe; Corns, Robert; Devaux, Bertrand; Berche, Patrick; Pallud, Johan

2015-01-01

306

Management of malignant pleural effusion associated with trapped lung syndrome.  

PubMed

Management of recurrent malignant pleural effusion associated with trapped lung syndrome remains problematic. An alternative treatment using a pleural catheter has been advocated. Between August 1999 and August 2002, 127 patients underwent thoracoscopy for malignant pleural effusion. Of these, 52 (41%) with trapped lung were managed by insertion of a pleural catheter. Mean age was 66 years (range, 42-89 years). The most frequent diagnosis was breast cancer. Spontaneous pleurodesis (drainage < 10 mL) occurred in 25 (48%) patients whose catheter was removed after 30 to 255 days (mean, 93.8 days). Symptomatic relief was achieved in 49 (94%) patients. Mean dyspnea score improved significantly from 3.0 to 1.9. Complications comprised catheter blockage, surgical emphysema, cellulitis, and loculated effusion in 2 patients each. Mean length of hospital stay was 3 days (range, 1-16 days). Median survival was 126 days (range, 10-175 days). We conclude that long-term placement of a pleural catheter provides effective palliation for malignant pleural effusion associated with trapped lung syndrome. PMID:18381869

Qureshi, Rizwan A; Collinson, Sandra L; Powell, Roy J; Froeschle, Peter O; Berrisford, Richard G

2008-04-01

307

Orbital mucormycosis in an immunocompetent individual  

PubMed Central

Background Orbital mucormycosis caused by Zygomycetes is a rare and fatal infection that generally affects the patients who are immunocompromised. Despite antifungal therapy and aggressive surgical intervention, mucormycosis can cause serious and rapidly fatal infections if delayed diagnosis or therapeutic management occurs. Here, we report orbital mucormycosis in a healthy boy, with a favorable outcome after aggressive treatment. He has had no recurrence since the end of his treatment. Case present A 2-year old healthy boy, some days after entry of dust particle to his left eye presented with swelling and redness of the eye. With diagnosis of “periorbital cellulitis” intravenous antibiotics vancomycin (40 mg/kg/day) and ceftriaxone (75 mg/kg/day) were started but no improvement was observed. The results of biopsy and tissue culture led us to a diagnosis of mucormycosis. Orbital exenteration, combined with intravenous amphotericin B (1 mg/kg/day), resulted in the patient's survival. Conclusion Due to the high mortality rate of mucormycosis, early diagnosis based on clinical findings and biopsy could be effective for management of the patients suffering from this infection. PMID:23205254

Badiee, P; Jafarpour, Z; Alborzi, A; Haddadi, P; Rasuli, M; Kalani, M

2012-01-01

308

A Case Report of Herpetic Whitlow with Positive Kanavel's Cardinal Signs: A Diagnostic and Treatment Difficulty.  

PubMed

Herpetic whitlow is an acute viral infection of the hand caused by either herpes simplex virus (HSV) 1 or 2. Its characteristic findings are significant pain and erythema with overlying nonpurulent vesicles. The differential diagnosis includes flexor tenosynovitis. We present a case of recurrent infection of the middle finger in an immunocompetent 19-year-old girl. Multiple painful pustules with tracking cellulitis were partially treated by oral antibiotics. A recurrence with positive Kanavel's signs suggested flexor tenosynovitis at seven months. Her symptoms improved transiently following emergent surgical open flexor sheath exploration and washout however, she required two further washouts; at eleven and thirteen months to improve symptoms. Viral cultures were obtained from the third washout as HSV infection was disclosed from further history taking. These were positive for HSV2. Treatment with acyclovir at thirteen months after presentation led to a complete resolution of her symptoms with no further recurrences to date. This rare case highlights the similarity in presentation between flexor sheath infection and herpetic whitlow which can lead to diagnostic confusion and mismanagement. We emphasise the importance of careful past medical history taking as well as considering herpetic whitlow as a differential diagnosis despite the presence of strongly positive Kanavel's signs. PMID:25436164

Brkljac, Milos; Bitar, Samer; Naqui, Zafar

2014-01-01

309

Going Out on a Limb: Do Not Delay Diagnosis of Necrotizing Fasciitis in Varicella Infection.  

PubMed

Necrotizing fasciitis (NF) is a rare complication of varicella zoster (chicken pox) infection. Its diagnosis can be delayed or missed, which increases mortality and morbidity, because it initially presents similarly to cellulitis. We present the case of a 5-year-old boy who presented with a swollen leg, the difficulties in the diagnosis of NF, and a review of the literature. Necrotizing fasciitis complicating varicella zoster in children is associated with 3.4% mortality, although this rises to 13.6% in streptococcal toxic shock syndrome. Seventy-one percent of cases are confirmed as being caused by group A ?-hemolytic Streptococcus. The association of NF with chicken pox is discussed along with the difficulties in diagnosis and treatment options. Necrotizing fasciitis is a surgical emergency and should be considered by all emergency department acute care practitioners in cases of varicella in which fever is enduring and swelling or pain is disproportionate. Because of the difficulty in diagnosis, senior opinion should be sought early. PMID:25356828

Sturgeon, Jonathan P; Segal, Laura; Verma, Anita

2014-10-29

310

Transvaginal Sacrospinous Ligament Fixation for Pelvic Organ Prolapse Stage III and Stage IV Uterovaginal and Vault Prolapse  

PubMed Central

The result of transvaginal sacrospinous ligament fixation technique, as part of the vaginal repair procedure for massive uterovaginal (Pelvic Organ Prolapse stage III and stage IV and vault prolapse) is evaluated. A total of 32 women were included in the present case series. Marked uterovaginal prolapse was present in 28 women and four had vault prolapse following hysterectomy. Patients with vault prolapse and marked uterovaginal prolapse underwent sacrospinous colpopexy. The mean follow-up period was 2.5 years. Out of the 28 patients with previous marked uterovaginal prolapse, only one had small cystocele 3 years after the surgery. This patient was asymptomatic and did not require repeat surgery. One woman had post-operative urinary tract infection and two had buttock discomfort, one had ischiorectal abscess and two had cuff cellulitis. All complications were dealt with successfully. No other major intra- and post-operative complications occurred. Transvaginal sacrospinous colpopexy can be performed together with vaginal hysterectomy, with marked uterovaginal prolapse and vault prolapse.

Gupta, Pratiksha

2015-01-01

311

Rarely seen infections.  

PubMed

There are many rare cutaneous infections of the face. This phrase seems irrelevant, because rare infections in certain parts of the world are common in others. This is more apparent if applied to different sites of the body (eg, face). For instance, cutaneous leishmaniasis (CL) is common in Central and South America and uncommon in the United States. Because most medical practitioners in this country have never seen a case, it is easy for them to miss a diagnosis. Cutaneous leishmaniasis, a protozoan infection transmitted by phlebotomine sand flies, is typically divided into two forms: one found in the Middle East, Asia, Africa, and southern Europe, called Old World leishmaniasis, and one found in Latin and Central America, called New World leishmaniasis. Also atypical mycobacterial infection has been described in the medical literature since the mid-1950s. The development and introduction of a rapid radiometric mycobacterial detection system has advanced the field of mycobacteriology over the past 20 years. This method has allowed the distinction of Mycobacterium tuberculosis from other mycobacteria and enabled the performance of antimicrobial susceptibility testing of mycobacteria. The increased frequency of atypical mycobacterial infection stems from advances in the diagnostic procedures concerning the infection paired with the prevalence of mycobacterial disease in immunocompromised patients infected with HIV. Erysipelas and facial cellulitis are covered briefly in this paper. PMID:25441467

Amer, Mohamed; Amer, Amin

2014-01-01

312

Infusion of noradrenaline through the proximal line of a migrated central venous catheter.  

PubMed

A 41-year-old, obese, patient was admitted to Accident and Emergency with a history of leg cellulitis. A central line was inserted. Documented aspiration of blood from all lines, central venous pressure trace obtained and correct position noted on the chest X-ray (CXR). The patient became increasingly septic despite antibiotic therapy. He was subsequently commenced on a noradrenaline infusion; however, the blood pressure was unresponsive. On admission to the intensive care unit (ICU), it was noted he had an area of white skin over the right clavicle. The infusions were stopped and a CXR confirmed proximal migration of the line. The central line was re-sited and his noradrenaline recommenced with an improvement in his blood pressure. Acute renal failure developed which required haemofiltration for 24 hours. The condition improved and the patient was discharged from ICU. It took several weeks for his renal function to return to normal, but he was discharged home with no permanent damage. PMID:22859814

Freer, M; Noble, S

2012-08-01

313

Cogan's syndrome associated with orbital inflammation.  

PubMed

Cogan's syndrome is a relatively rare inflammatory disorder presenting with a combination of ocular and vestibuloauditory symptoms. The first cases were described by David Cogan in 1945. Typically the ocular signs involve the anterior segment; however there are no descriptions of orbital inflammation associated with Cogan's syndrome. We describe such a case. A 66-year-old immunosuppressed male patient with known Cogan's syndrome presented to the eye department with right-sided proptosis, chemosis and ocular injection. Ocular motility was reduced. Other than Cogan's syndrome there were no other systemic disorders. Medical treatment included: Azathioprine 125 mg/day and low dose Tab Prednisolone 30 mg/day. A provisional diagnosis of orbital cellulitis was made and intravenous antibiotics started. Blood investigations showed raised CRP levels 475 mg/L and raised WCC (24 × 10(9)/l). An urgent CT scan of the head and orbits ruled out orbital cellulititis. The diagnosis was revised and the patient was treated for orbital inflammatory disease. Pulsed intravenous methlyprednisolone was commenced and oral steroids were increased to 60 mg/day, the Azathioprine was continued. Over the following week, the proptosis had resolved, and oral steroids were reduced back to the maintenance dose. To our knowledge this is the first description of orbital inflammatory disease associated with Cogan's syndrome. PMID:23617562

Shahid, Fatema Lucy; Mukherjee, Rita; Knapp, Christopher

2013-06-01

314

Report on an outbreak of postinjection abscesses due to Mycobacterium abscessus, including management with surgery and clarithromycin therapy and comparison of strains by random amplified polymorphic DNA polymerase chain reaction.  

PubMed

An outbreak of postinjection abscesses occurred in Barranquilla, Colombia, and was associated with local injections of lidocaine given in a single physician's office. Over a 5-month period, 350 (18%) of approximately 2,000 injected patients developed localized cutaneous abscesses or cellulitis; of 210 abscess specimens that were cultured, 205 were positive for rapidly growing mycobacteria, subsequently identified as Mycobacterium abscessus. The source of the outbreak was not identified. M. abscessus could not be characterized by pulsed-field gel electrophoresis, but all isolates were identical in terms of drug and heavy metal resistance patterns and random amplified polymorphic DNA PCR profiles. We believe this is the first report of the use of this latter technique for investigation of an outbreak due to M. abscessus. Therapy with a combination of surgical excision and 3-6 months' administration of clarithromycin was successful for 95% of 148 patients treated in this manner; in contrast, therapy was successful for less than one-third of patients treated with surgery alone or clarithromycin alone. This is the largest of the nine known outbreaks of postinjection abscesses that have occurred due to rapidly growing mycobacteria and is the first in which an effective method of therapy was demonstrated. PMID:9195073

Villanueva, A; Calderon, R V; Vargas, B A; Ruiz, F; Aguero, S; Zhang, Y; Brown, B A; Wallace, R J

1997-06-01

315

Microscopie par rayons X dans la fenêtre de l'eau : faisabilité et intérêt pour la biologie d'un instrument de laboratoire  

NASA Astrophysics Data System (ADS)

La biologie étudie des structures ou des phénomènes sub-cellulaires. Pour cela la microscopie est la technique d'observation privilégiée. La résolution spatiale de la microscopie optique s'avère bien souvent insuffisante pour de telles observations. Les techniques plus résolvantes, comme la microscopie électronique par transmission sont souvent destructrices et d'une complexité peu adaptée aux besoins des biologistes. La microscopie par rayons X dans la fenêtre de l'eau permet l'imagerie rapide de cellules dans leur milieu naturel, nécessite peu de préparation et offre des résolutions de quelques dizaines de nanomètres. De plus, il existe un bon contraste naturel entre les structures carbonées (protéines, lipides) et l'eau. Actuellement cette technique est limitée aux centres de rayonnement synchrotron, ce qui impose une planification et des déplacements incompatibles avec les besoins de la biologie. Un tel microscope fonctionnant avec uns source de laboratoire serait d'une grande utilité. Ce document présente un état de l'art de la microscopie par rayons X dans la fenêtre de l'eau. Un cahier des charges détaillé pour un appareil de laboratoire ayant les performances optiques requises par les biologistes est présenté et confronté aux microscopes X de laboratoire déjà existants. Des solutions concernant la source et les optiques sont également discutées.

Adam, J. F.; Moy, J. P.

2005-06-01

316

Advancement flap as a novel treatment for a pododermatitis lesion in a red-tailed hawk (Buteo jamaicensis).  

PubMed

Pododermatitis is a pathologic condition commonly reported in captive raptors and characterized by swelling, excoriation, ulceration, cellulitis, or abscessation of the plantar aspect of the foot. Its cause can be multifactorial, often involving abnormal weight bearing or poor sanitation, and medical and surgical techniques, in addition to environmental alterations, are hallmarks of treatment. In this case, a single pedicle advancement flap was used to treat chronic, nonresponsive grade V/VII pododermatitis of the right metatarsal pad in a red-tailed hawk (Buteo jamaicensis). The advancement flap was formed by using the interdigital skin between digits 3 and 4. The double layer of skin was incised and separated, and the leading edge of the flap was then advanced over the defect and secured with simple interrupted subcutaneous and skin sutures. The foot was bandaged after surgery to take pressure off the surgical site. At 58 days after the surgery, the hawk was deemed medically sound with no signs of pododermatitis and was released to a wildlife rehabilitator. The use of a single pedicle advancement flap has not previously been reported for the treatment of pododermatitis. PMID:24640931

Sander, Samantha; Whittington, Julia K; Bennett, Avery; Burgdorf-Moisuk, Anne; Mitchell, Mark A

2013-12-01

317

Skin, Soft Tissue and Systemic Bacterial Infections Following Aquatic Injuries and Exposures.  

PubMed

: Bacterial infections following aquatic injuries occur commonly in fishermen and vacationers after freshwater and saltwater exposures. Internet search engines were queried with the key words to describe the epidemiology, clinical manifestations, diagnostic and treatment strategies and outcomes of both the superficial and the deeper invasive infections caused by more common, newly emerging and unusual aquatic bacterial pathogens. Main findings included the following: (1) aquatic injuries often result in gram-negative polymicrobial infections with marine bacteria; (2) most marine bacteria are resistant to 1st- and 2nd-generation penicillins and cephalosporins; (3) nontuberculous, mycobacterial infections should be considered in late-onset, culture-negative and antibiotic-resistant marine infections; (4) superficial marine infections and pre-existing wounds exposed to seawater may result in deeply invasive infections and sepsis in immunocompromised patients. With the exception of minor marine wounds demonstrating localized cellulitis, most other marine infections and all gram-negative and mycobacterial marine infections will require therapy with antibiotic combinations. PMID:25374398

Diaz, James H; Lopez, Fred A

2014-11-01

318

Preliminary results of a phase I/II clinical trial using in situ photoimmunotherapy combined with imiquimod for metastatic melanoma patients  

NASA Astrophysics Data System (ADS)

In Situ Photoimmunotherapy (ISPI), a newly developed modality for cancer therapy, has been shown to be able to modulate the body's own immune response. This clinical trial was designed to evaluate the safety and therapeutic effect of ISPI, using imiquimod as its immunoadjuvant for metastatic melanoma patients. ISPI consisted of three main components applied directly to the cutaneous metastases: 1) local application of topical imiquimod; 2) injection of indocyanine green; and 3) an 805 nm laser for local irradiation. All patients completed at least one cycle of treatment. All the patients completed at least one cycle of treatments; one patient received 6 cycles. The most common adverse effects were rash, pruritus, pain, fatigue and anorexia. Fever, chills, vomiting and cellulitis were relative rare. No grade 4 toxicity was observed. Complete Response (CR) was observed in 6 patients. Median overall survival of the 11 evaluated patients was 12.2 months. Six of the eleven patients were still alive at the time of this report. Treatment of ISPI using imiquimod is safe and well tolerant. Our preliminary clinical results suggest that this new method can be a promising modality for metastatic melanoma.

Li, Xiaosong; Naylor, Mark F.; Nordquist, Robert E.; Teague, T. Kent; Howard, C. Anthony; Murray, Cynthia; Chen, Wei R.

2010-02-01

319

Une maladie immunoproliférative de l'intestin grêle révélée par une invagination intestinale aigue: à propos d'un cas  

PubMed Central

La maladie immunoproliférative de l'intestin grêle IPSID est un lymphome rare qui se développé à partir du système lymphoïde associé aux muqueuses au niveau de l'intestin grêle. Sa révélation par une invagination intestinale aigue est exceptionnelle et n'a jamais été rapporté dans la littérature auparavant. Nous rapportons le cas d'un patient de 65ans, admis aux urgences dans un tableau d'invagination intestinale aigue. Le scanner abdominal a mis en évidence masse grêlique à paroi concentrique avec incarcération du segment mésentérique au sein de la lésion fortement évocatrice d'une invagination intestinale. Le patient a été opéré et a bénéficié d'une résection iléale emportant le boudin d'invagination. L'examen histologique de la masse a été en faveur d'une maladie des chaines alpha transformée en un lymphome B diffus à grandes cellules. Les auteurs rapportent un cas rare d'une IPSID révélée par une invagination intestinale aigue et à travers cette observation, mettent en relief les principaux aspects cliniques, histologiques, thérapeutiques de cette entité avec une revue de la littérature. PMID:24932323

Bennani, Amal; Znati, Kaoutar; Rezzouk, Salima; Bouhadouti, Hicham; Maazaz, Khalid; Amarti, Affaf

2014-01-01

320

Georges Marinesco (1863-1938): neurologist, neurohistologist and neuropathologist.  

PubMed

Gheorghe Marinescu (Georges Marinesco, in French) is a Romanian physician, founder of the School of Neurology in that country. He begins his medical studies in Bucharest, then has the opportunity to reach Paris and join the School of Neurology in La Salpêtrière Hospital, lead by Jean-Martin Charcot. This trip will forever imprint the mind of Marinescu, a great friend of France, a respectful student of Charcot and a friendly colleague of many Parisian neurologists. Marinescu's works are multiple and very important. He describes the succulent hand in syringomyelia and the palmar-jaw reflex. Marinescu is also one of the first to use the cinema for medical purposes. His work as an anatomo-clinician, a method developed by Charcot, is important. We denote the description of the locus niger affected by tuberculosis in a case of parkinsonism (this description paving Etienne Brissaud's way to highlight the anatomical origin of Parkinson's disease), the original clinical description of Marinesco-Sjögren syndrome, and that of medullomyoblastoma. Marinescu is also a famous neurocytologist as evidenced by his work, La Cellule Nerveuse, published in 1909. The first volume of the book is devoted to the aspects of the normal nervous tissue: the neurofibrillar network, the chromatophilic elements, and the paranucleolar corpuscles (now known as Marinescu's bodies). The second volume of the book is almost related to features revealed by experimental lesions: chromatolysis and neuronophagia. Furthermore, Marinescu describes with Oscar Blocq, small nodules than are now regarded as the first description of senile plaques. PMID:23303009

Catala, M; Poirier, J

2012-01-01

321

The fleur-de-lis upper gracilis flap for breast reconstruction: flap design and outcome.  

PubMed

We evaluated a fleur-de-lis design for the gracilis myocutaneous flap to improve flap volume for breast reconstruction. Thirty-one flaps were used in 17 consecutive patients undergoing the procedure for either thin body habitus (23 flaps) or prior abdominal surgery (8 flaps). The flap success rate was 100%. The fleur-de-lis flap provided proportionate breast reconstructions in all patients. Complications included 6 (19.3%) donor-site dehiscence and 4 (12.9%) episodes of cellulitis. Applying a negative pressure dressing to the donor site (n=26) significantly reduced the initially high dehiscence rate to 7.7% (P<0.01). There was no incidence of lower extremity edema or sensory loss. The fleur-de-lis gracilis flap can be performed with a low flap related complication rate and acceptable donor-site morbidity. Because of its standardized flap design, improved volume, and favorable breast shaping, it may allow autologous breast reconstruction to be offered to a greater number of patients. PMID:22868308

McKane, Brice W; Korn, Peter T

2012-10-01

322

Cutaneous leishmaniasis in expatriates in northern Saudi Arabia.  

PubMed

Cutaneous leishmaniasis is a protozoal disease transmitted by sandflies. It is endemic across the desert of the Middle East to Afghanistan and Africa. This paper reviews the findings in 148 expatriates with cutaneous leishmaniasis seen in Arar, northern Saudi Arabia, during a five year period. Cutaneous leishmaniasis was seen in all age groups. Farm workers, labourers and military personnel stationed in the region during the Gulf war were most affected. There was a seasonal variation with maximum incidence between November and January. The lesions were commonly multiple, the number of lesions per patient ranged from one to twelve. 18% of the lesions were located on the face, 34% on the upper extremity, 42% on the lower extremity and six per cent on other sites. The average duration of the lesions before diagnosis was two months. The most common complications were secondary bacterial skin infection (pyoderma and cellulitis) and residual scarring. The response to sodium stibogluconate was good. There has been a gradual reduction in the number of cases from a peak of 64 in 1991 to twelve in 1995. As compared to studies in the indigenous population, cutaneous leishmaniasis tends to be more frequent and server in expatriates from non endemic areas. There is a need for increased awareness of this disorder, especially in the home countries of these expatriates. PMID:9299828

Kubeyinje, E P; Belagavi, C S; Jamil, Y A

1997-04-01

323

Dermatopathology: LC07-1 PANNICULITIS.  

PubMed

The subcutaneous fat is a metabolic depot and also provides insulation from trauma. The subcutis is divided into lobules by fibrous septa. Within the fibrous septae course the small arteries, arterioles, veins and small nerve fibres. The nutrient artery supplies the centre of the lobule and drains to venules within the septum. Inflammatory disorders of the subcutaneous fat can be grouped into three main categories: 1) Septal panniculitis. 2) Lobular panniculitis. 3) Panniculitis associated with large vessel vasculitis.Most panniculitis are strictly speaking mixed but the classification is based on the predominant area of involvement.In septal panniculitis the inflammation is centred upon the connective tissue septa. There is often some spill over of the inflammatory cells into the periphery of the lobule. Erythema nodosum (EN) is the prototype of septal panniculitis. Other disorders associated with a septal panniculitis include necrobiosis lipoidica, factitial panniculitis, nephrogenic systemic fibrosis, cellulitis and microscopic polyangiitis.In the lobular panniculitides the inflammation is centered mainly within the lobule. Examples of lobular panniculitis include nodular vasculitis, lupus panniculitis, subcutaneous fat necrosis of the newborn, sclerema neonatorum, cold panniculitis, a1 anti-trypsin deficiency and pancreatic panniculitis. PMID:25188048

Calonje, Eduardo

2014-10-01

324

Elephantiasis nostras verrucosa in a patient with systemic sclerosis.  

PubMed

Elephantiasis nostras verrucosa (ENV) is an unusual skin condition characterized by dermal fibrosis and hyperkeratotic verrucous lesions resulting from chronic nonfilarial lymphoedema. The condition is similar to 'elephantiasis tropica', in which elephantiasis develops secondary to filariasis. Lymphatic obstruction can be primary or due to various causes such as surgery, tumour, radiation, congestive heart failure or obesity. Recurrent attacks of cellulitis lead to further impairment of lymphatic drainage, causing permanent swelling, dermal fibrosis and epidermal thickening. We report a case of a 56-year-old man with systemic sclerosis (SS), who presented with painful lesions on both legs, consistent with ENV. He developed extensive, fungating, papillomatous lesions on the skin of the legs, toes and dorsa of the feet over a period of 3 years. Histology revealed dense dermal fibrosis, oedema of the papillary dermis and extensive pseudo-epitheliomatous changes. To our knowledge, this is the first report of ENV in which SS was considered to be the primary cause for the impairment of lymphatic flow. PMID:20055839

Chatterjee, S; Karai, L J

2009-12-01

325

Postvaccinal reovirus infection with high mortality in breeder chicks.  

PubMed

A broiler breeder flock was subcutaneously vaccinated at the hatchery with a live avian orthoreovirus (ARV) vaccine against viral arthritis. Chicks began to die at 3 days of age and postmortem examination revealed massive subcutaneous hemorrhages and edema on the dorsal aspect of the neck at the site of vaccination, a severe necrotic hepatitis, and pulmonary edema. Microscopically, the main lesion was a multifocal vacuolar degeneration and necrosis of randomly distributed small groups of hepatocytes with presence of apoptotic and multinucleated syncytial cells. Necrotic foci were also found in the lungs as well as a hemorrhagic, granulomatous, and heterophilic cellulitis and myositis of the neck and a generalized depletion and lymphocytolysis of lymphoid organs. At 8 days of age, birds also began to show hock swelling histologically characterized by a fibrinoleucocytic inflammation of the articulation and tendon sheaths, with hyperplasia of the synovial membrane, and lymphoplasmocytic infiltration. PCR and viral culture of livers were positive for ARV. Partial sequencing of the S1 gene from the virus isolate showed 99.2% to 99.8% homology with three vaccinal strains (ARV S1133, 1733, and 2408). Viral particles compatible with reovirus virions were observed at transmission electron microscopy. Investigation at the hatchery revealed that chicks were inadvertently administered an S1133 reovirus vaccine labeled for water administration in 10- to 17-week-old chickens. This human error is most likely the reason for this unusually severe viremic reovirus infection that affected this flock at such an early age. PMID:25619015

Chénier, Sonia; Boulianne, Martine; Gagnon, Carl A

2014-12-01

326

Multisystemic toxoplasmosis associated with a type II-like Toxoplasma gondii strain in a New Zealand fur seal (Arctocephalus forsteri) from New South Wales, Australia.  

PubMed

We report the first confirmed case of toxoplasmosis in an Australian pinniped. Presence of Toxoplasma gondii DNA was detected in the brain of a free-ranging subadult New Zealand fur seal (Arctocephalus forsteri) with nonsuppurative meningoencephalitis, hypophysitis, posterior uveitis, retrobulbar cellulitis, and myocarditis associated with protozoan cysts and tachyzoites. The emaciated seal stranded moribund on a beach in northern Sydney in New South Wales. Histopathology coupled with specific immunohistochemistry and PCR assays confirmed the presence of T. gondii. The T. gondii sample (NZfs8825) identified in this study has an identical genotype as the type II (ToxoDB PCR-RFLP genotype #1) based on the direct sequencing and virtual RFLP of multilocus DNA markers including SAG1, 5'- and 3'-SAG2, alt.SAG2, SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1, and Apico. Direct sequencing of T. gondii B1 DNA marker from the T. gondii sample (NZfs8825) identified a type II-like strain, based on presence of non-archetypal B1 gene polymorphisms previously reported as unique to Australia. This study suggests that T. gondii oocysts originating from mainland Australia, which has a large population of feral cats, may act as a disease threat to native marine fauna. Therefore, emerging toxoplasmosis in the Arctic has a relevant parallel in the Southern Ocean within Australian waters with yet unknown relevance to Antarctica. PMID:25123611

Donahoe, Shannon L; Rose, Karrie; Slapeta, Jan

2014-09-15

327

Guideline for the management of wounds in patients with lower-extremity venous disease: an executive summary.  

PubMed

This article provides an executive summary of the lower extremity venous disease (LEVD) evidence-based guideline produced by the WOCN Wound Guidelines Task Force. The target audience for this guideline is health care professionals who specialize in, direct, or provide wound care for patients at risk for or with lower-extremity venous disease. The full guideline opens with an overview of definitions of LEVD, its prevalence, clinical relevance, etiology, related physiology and pathophysiology, and overall management goals for patients at risk for developing venous leg ulcers. A detailed assessment section describes how to conduct a full clinical history and physical examination. Two approaches to interventions are provided: one addresses prevention strategies to reduce the risk of developing LEVD with ulcers. Methods to prevent ulcer recurrence are summarized including compression therapy, adjunctive therapies, medications, and patient education. A second approach presents treatment interventions including wound cleansing, debridement, infection control, antibiotic use, along with management of the periwound skin, nutrition, pain, and edema. This section also discusses limb elevation, surgical options, adjunctive therapies, patient education, and health care provider follow-up. A comprehensive reference list, glossary of terms, and appendices on cellulitis and venous eczema, types of edema, and compression therapy are available at the end of the guideline. This article provides an executive summary of the essential features of the guideline. PMID:23138493

Kelechi, Teresa J; Johnson, Jan J

2012-01-01

328

Shewanella and Photobacterium spp. in oysters and seawater from the Delaware Bay.  

PubMed

Shewanella algae, S. putrefaciens, and Photobacterium damselae subsp. damselae are indigenous marine bacteria and human pathogens causing cellulitis, necrotizing fasciitis, abscesses, septicemia, and death. Infections are rare and are most often associated with the immunocompromised host. A study was performed on the microbiological flora of oysters and seawater from commercial oyster harvesting sites in the Delaware Bay, New Jersey. From 276 water and shellfish samples tested, 1,421 bacterial isolates were picked for biochemical identification and 170 (12.0%) of the isolates were presumptively identified as S. putrefaciens, 26 (1.8%) were presumptively identified as P. damselae subsp. damselae, and 665 (46.8%) could not be identified using the API 20E identification database. Sequencing of the 16S rRNA genes of 22 S. putrefaciens-like isolates identified them as S. abalonesis, S. algae, S. baltica, S. hafniensis, S. marisflavi, S. putrefaciens, Listonella anguillarum, and P. damselae. Beta-hemolysis was produced by some S. algae and P. damselae isolates, while isolates of S. baltica and L. anguillarum, species perceived as nonpathogenic, also exhibited beta-hemolysis and growth at 37 degrees C. To our knowledge, this is the first time these beta-hemolytic strains were reported from shellfish or seawater from the Delaware Bay. Pathogenic Shewanella and Photobacterium species could pose a health threat through the ingestion of contaminated seafood, by cuts or abrasions acquired in the marine environment, or by swimming and other recreational activities. PMID:18378645

Richards, Gary P; Watson, Michael A; Crane, Edward J; Burt, Iris G; Bushek, David

2008-06-01

329

Foot ischemia after a free fibula flap harvest: immediate salvage with an interpositional sapheneous vein graft.  

PubMed

The most dreaded major donor-site complication of free fibula flap is a foot ischemia, which is fortunately rare. Various authors have discussed the efficacy of the use of preoperative imaging methods including color Doppler, magnetic resonance angiography, and conventional angiography. A 25-year-old man presented with a 10-cm mandibular defect after a facial gunshot injury. Lower extremity color Doppler revealed triphasic peroneal, tibialis anterior, and posterior artery flows. A fibula osteocutaneous flap was harvested, and the mandible was reconstructed. However, the suture sites at the donor site began to demonstrate signs of necrosis, abscess formation, and widespread cellulitis beginning from postoperative day 9. Angiogram of the lower extremity on the 13th day demonstrated no flow in the right posterior tibial artery distal to the popliteal artery, whereas the anterior tibial artery had weak flow with collateral filling distally. An emergency bypass with a saphenous vein graft between the popliteal artery and the distal posterior tibial artery was performed. Repeated debridements, local wound care, and vacuum-assisted closure were applied. A skin graft was placed eventually. The extremity healed without severe functional disability. In conclusion, although the arterial anatomy is completely normal in preoperative evaluation, vascular complications may still ocur at the donor fibula free flap site. In addition, emergency cardiovascular bypass surgery, as we experienced, may be necessary for limb perfusion. PMID:25119400

Saydam, Funda Akoz; Basaran, Karaca; Ceran, Fatih; Mert, Bulent

2014-09-01

330

Sialendoscopy With Holmium:YAG Laser Treatment for Multiple Large Sialolithiases of the Wharton Duct: A Case Report and Literature Review.  

PubMed

Sialolithiasis is defined as calcified stone(s) in the salivary duct or glands. Submandibular gland sialolithiasis is the most common (80 to 90%), followed by parotid gland sialolithiasis (5 to 15%). The typical clinical presentation is salivary gland swelling after eating. As the swelling persists, symptoms owing to local inflammation, such as pain and trismus, emerge. In severe cases, cellulitis and even abscess formation occur and subsequently lead to salivary gland atrophy or fistula formation if the sialolithiasis remains untreated. The most common treatment is complete excision of the affected gland together with the stone(s). In some cases, intraoral sialolithotomy is performed when the stone is solitary and easily palpable through the oral cavity. Sialendoscopy is increasingly performed because of its minimal invasiveness. The major limitation of endoscopic laser lithotripsy of the salivary glands is the size of the stone. Often, for a stone larger than 4 mm, multiple fragmentations of the stone into small pieces is necessary before the pieces can be removed by wire basket or grasping forceps. Recently, the holmium:YAG laser has been reported as quite effective in removing larger salivary gland stones. However, sialoendoscopic laser lithotripsy is a very time-consuming procedure and in most cases, when there are multiple large stones in a single gland, entire gland excision is recommended. This report describes a male patient diagnosed with multiple large stones in his left submandibular gland who was successfully treated under sialendoscopy with holmium:YAG laser lithotripsy. PMID:25216563

Sun, Yu-Ting; Lee, Kuo-Sheng; Hung, Shih-Han; Su, Chin-Hui

2014-12-01

331

Clinical Predictors of Acute Kidney Injury Following Snake Bite Envenomation  

PubMed Central

Background: Snake bite envenomation is a major public health concern in developing countries. Acute kidney injury (AKI) is as important cause of mortality in patients with vasculotoxic snake bite. Aims: This study was to evaluate the clinical profile of snake bite patients and to determine the predictors of developing AKI following snake bite. Materials and Methods: Two hundred and eighty-one patients with snake envenomation were included. Eighty-seven patients developed AKI (Group A) and 194 (Group B) did not. History, examination findings and investigations results were recorded and compared between the two groups. Results: In group A, 61 (70.11%) patients were male and in group B, 117 (60.30%) patients were male. Out of 281 patients, 232 had cellulitis, 113 had bleeding tendencies, 87 had oliguria, 76 had neuroparalysis, and 23 had hypotension at presentation. After multivariate analysis, bite to hospital time (P = 0.016), hypotension (P = 0.000), albuminuria (P = 0.000), bleeding time (P = 0.000), prothrombin time (P = 0.000), hemoglobin (P = 0.000) and total bilirubin (P = 0.010) were significant independent predictors of AKI. Conclusions: AKI developed in 30.96% of patients with snake bite, leading to mortality in 39.08% patients. Factors associated with AKI are bite to hospital time, hypotension, albuminuria, prolonged bleeding time, prolonged prothrombin time, low hemoglobin and a high total bilirubin. PMID:24350071

Dharod, Mrudul V; Patil, Tushar B; Deshpande, Archana S; Gulhane, Ragini V; Patil, Mangesh B; Bansod, Yogendra V

2013-01-01

332

Renal Dysfunction Induced by Bacterial Infection other than Spontaneous Bacterial Peritonitis in Patients with Cirrhosis: Incidence and Risk Factor  

PubMed Central

Background/Aims Deterioration of renal function in cirrhotic patients with spontaneous bacterial peritonitis (SBP) is a predictor for in-hospital mortality; however, the clinical significance of renal dysfunction during bacterial infection other than SBP is unknown. The aim of this study was to investigate the prevalence and clinical significance of renal dysfunction due to bacterial infections other than SBP in patients with liver cirrhosis. Methods Retrospective data from inpatients with bacterial infections other than SBP were analyzed. Results Eighty patients were recruited for the analysis. The types of infections included that of urinary tract (37.5%), pneumonia (23.8%), biliary tract (20%), cellulitis (12.5%), and bacteremia of unknown origin (6.3%). Renal dysfunction developed in 29 patients (36.3%), of which 11 patients had irreversible renal dysfunction. The initial MELD score, neutrophil count, albumin, and blood pressure were significant risk factors in the univariate analysis, whereas only the MELD score was an independent risk factor for the development of renal dysfunction (p<0.001) after multivariate analysis. Conclusions The prevalence of renal dysfunction during bacterial infection other than SBP in patients with liver cirrhosis was 36.3%, and its development was related to the severity of the liver disease. Occurrence of irreversible renal dysfunction seemed to affect the prognosis of these patients. PMID:20431763

Kim, Jong Hoon; Lee, Seuk Hyun; Bae, Won Ki; Kim, Nam-Hoon; Kim, Kyung-Ah; Moon, Young-Soo

2009-01-01

333

Organ preservation at low temperature: a physical and biological problem  

NASA Astrophysics Data System (ADS)

Before reporting the preliminary results obtained by our group, we first review the main problems to be solved in the preservation of organs at very low temperature, before being transplanted. This cryopreservation is being presently explored in order to increase the preservation tiine of transplants and to contribute to a better control of the donor recipient compatibility. We recall that, for the isolated cells to be preserved at nitrogen liquid temperatures, as now successfully performed at industrial scale, it is necessary to immerse the cells in a solution containing more or less t,oxical additives (so-called cryopro tect ants). Furthermore cooling and warming rates must be specific of each type of cells. We then show that cryo preservation could be extrapolated to whole organs by means of vitrification, the only way to avoid any ice crystallization. This vitrification will be the result of two directions of research, the one on the elaboration of cryoprotective solutions, the least toxic possible, the other on the obtention of high enough and homogeneous cooling and warming rates. After having briefly summarized the state of research on the heart and kidneys of small mammals, we present the first results that we have obtained on perfusion at 4 ^{circ}C and the auto-transplantation of rabbit kidneys, on the toxicity of a new cryoprotectant, 2,3-butanediol, on the heart rate, and on the cooling of experimental models of organs. Avant de présenter les résultats préliminaires obtenus par notre groupe, nous passons d'abord en revue les principaux problèmes à résoudre pour conserver à très basse température des organes en vue de leur transplantation. Cette cryopréservation est une voie de recherche actuellement explorée pour augmenter la durée de conservation des greffons et permettre ainsi de mieux contrôler la compatibilité donneur-receveur. Nous rappelons que la conservation des cellules isolées à la température de l'azote liquide, actuellement réalisée avec succès à l'échelle industrielle, ne peut se faire qu'en présence de substances plus ou moins toxiques dites cryoprotectrices, et à condition de respecter des vitesses de refroidissement et de réchauffement adaptées à chaque type de cellule. Nous montrons ensuite que l'extension de la cryopréservation au cas des organes entiers ne pourra se faire qu'au moyen de la vitrification, seule solution pour éviter toute formation de glace. Cette vitrification sera l'aboutissement de 2 axes de recherche, l'un sur l'élaboration de solutions cryoprotectrices les moins toxiques possibles, l'autre sur l'obtention de vitesses de refroidissement et de réchauffement suffisamment élevées et homogènes. Après avoir brièvement résumé l'état des recherches sur le coeur et le rein de petits mammifères, nous présentons les premiers résultats que nous avons obtenus sur la perfusion à 4 ^{circ}C et l'autotransplantation de reins de lapin, sur la toxicité sur le coeur de rat d'un nouveau cryoprotecteur le 2,3-butanediol, et sur le refroidissement de systèmes modèles expérimentaux d'organes.

Aussedat, J.; Boutron, P.; Coquilhat, P.; Descotes, J. L.; Faure, G.; Ferrari, M.; Kay, L.; Mazuer, J.; Monod, P.; Odin, J.; Ray, A.

1993-02-01

334

Hydrodynamic model of cells for designing systems of urban groundwater drainage  

NASA Astrophysics Data System (ADS)

An improved mathematical hydrodynamic quasi-two-dimensional model of cells, CELSUB3, is presented for simulating drainage systems that consist of pumping well fields or subsurface drains. The CELSUB3 model is composed of an assemblage of algorithms that have been developed and tested previously and that simulate saturated flow in porous media, closed conduit flow, and flow through pumping stations. A new type of link between aquifer cells and drainage conduits is proposed. This link is verified in simple problems with well known analytical solutions. The correlation between results from analytical and mathematical solutions was considered satisfactory in all cases. To simulate more complex situations, the new proposed version, CELSUB3, was applied in a project designed to control the water-table level within a sewer system in Chañar Ladeado Town, Santa Fe Province, Argentina. Alternative drainage designs, which were evaluated under conditions of dynamic recharge caused by rainfall in a critical year (wettest year for the period of record) and a typical year, are briefly described. After analyzing ten alternative designs, the best technical-economic solution is a subsurface drainage system of closed conduits with pumping stations and evacuation channels. Résumé. Un modèle hydrodynamique perfectionné de cellules en quasi 2D, CELSUB3, est présenté dans le but de simuler des systèmes de drainage qui consistent en des champs de puits de pompage ou de drains souterrains. Le modèle CELSUB3 est composé d'un assemblage d'algorithmes développés et testés précédemment et qui simulent des écoulements en milieu poreux saturé, en conduites et dans des stations de pompage. Un nouveau type de lien entre des cellules d'aquifères et des drains est proposé. Ce lien est vérifié dans des problèmes simples dont les solutions analytiques sont bien connues. La corrélation entre les résultats des solutions analytiques et des solutions mathématiques a été considérée comme satisfaisante dans tous les cas. Afin de simuler des situations plus complexes, la nouvelle version proposée, CELSUB3, a été mise en œuvre dans un projet destiné à contrôler le niveau de la nappe à l'intérieur d'un système d'égouts, dans la ville de Chaar Ladeado (province de Santa Fe, Argentine). Différentes organisations du projet de drainage, qui ont été testées pour des conditions de recharge dynamique causées par la pluie au cours d'une année critique (la plus humide de la chronique disponible) et une année typique, sont brièvement décrites. Après analyse de dix organisations différentes, la meilleure solution technico-économique retenue est un système de drainage souterrain de conduites avec des stations de pompage et des canaux d'évacuation. Resumen. Se presenta un modelo matemático hidrodinámico cuasi-bidimensional de celdas, CELSUB3, apto para la simulación integral de sistemas de drenaje subterráneo basados en campos de bombeo o drenes subsuperficiales. El modelo de simulación presenta un ensamble de algoritmos, previamente desarrollados y testeados, que representan al escurrimiento a través del medio poroso saturado, escurrimiento en conducciones cerradas, estaciones de bombeo, etc. En la estructura del modelo se propone un nuevo tipo de vinculación entre celdas acuíferas y conductos de drenaje, la cual es verificada en problemas simples con solución analítica conocida arrojando, en todos los casos, resultados satisfactorios. Abordando situaciones más complejas, la nueva versión propuesta fue aplicada en un proyecto de control de niveles freáticos que acompaña un sistema de conductos cloacales, en la localidad de Chañar Ladeado, Santa Fe, Argentina. Se describen las alternativas de drenaje consideradas las cuales fueron evaluadas bajo recargas dinámicas provocadas por años críticamente lluviosos y en situaciones típicas. Los resultados derivados permitieron definir, tras analizar una decena de proyectos alternativos, la mejor solución técnico-económica consistente en un sistema de drenes subte

Zimmermann, Eric; Riccardi, Gerardo

2000-08-01

335

The effects of topical mesenchymal stem cell transplantation in canine experimental cutaneous wounds  

PubMed Central

Background Adult stem cells have been widely investigated in bioengineering approaches for tissue repair therapy. We evaluated the clinical value and safety of the application of cultured bone marrow-derived allogenic mesenchymal stem cells (MSCs) for treating skin wounds in a canine model. Hypothesis Topical allogenic MSC transplantation can accelerate the closure of experimental full-thickness cutaneous wounds and attenuate local inflammation. Animals Adult healthy beagle dogs (n = 10; 3–6 years old; 7.2–13.1 kg) were studied. Methods Full-thickness skin wounds were created on the dorsum of healthy beagles, and allogenic MSCs were injected intradermally. The rate of wound closure and the degree of collagen production were analysed histologically using haematoxylin and eosin staining and trichrome staining. The degree of cellular proliferation and angiogenesis was evaluated by immunocytochemistry using proliferating cell nuclear antigen-, vimentin- and ?-smooth muscle actin-specific antibodies. Local mRNA expression levels of interleukin-2, interferon-?, basic fibroblast growth factor and matrix metalloproteinase-2 were evaluated by RT-PCR. Results Compared with the vehicle-treated wounds, MSC-treated wounds showed more rapid wound closure and increased collagen synthesis, cellular proliferation and angiogenesis. Moreover, MSC-treated wounds showed decreased expression of pro-inflammatory cytokines (interleukin-2 and interferon-?) and wound healing-related factors (basic fibroblast growth factor and matrix metalloproteinase-2). Conclusion and clinical importance Topical transplantation of MSCs results in paracrine effects on cellular proliferation and angiogenesis, as well as modulation of local mRNA expression of several factors related to cutaneous wound healing. Résumé Contexte Les cellules souches adultes ont été largement étudiées dans les approches de bio-ingénierie pour la thérapie de réparation tissulaire. Nous évaluons l'efficacité clinique et la sécurité de l'application de cellules souches mésenchymateuses allogéniques en culture dérivées de moelle osseuse (MSCs) pour le traitement de plaies cutanées dans un modèle canin. Hypothèse La transplantation de MSC allogénique topique peut accélérer la fermeture en toute épaisseur de plaies cutanées expérimentales et atténuer l'inflammation locale. Sujets Des chiens beagles adultes sains (n = 10; 3–6 ans; 7.2–13.1 kg) ont été étudiés. Méthodes Des plaies cutanées en pleine épaisseur ont été crées sur la face dorsale des beagles sains et des MSCs allogènes ont été injectées par voie intradermique. Le taux de cicatrisation et le degré de production de collagène ont été analysés sur le plan histologique par colorations à l'hématoxyline et éosine et par trichrome. Le degré de prolifération cellulaire et d'angiogénèse ont été évalués par immunohistochimie à l'aide d'anticorps spécifiques d'antigène nucléaire de prolifération cellulaire, de vimentine et d'actine de muscle lisse ?. Les taux d'expression local d'ARNm d'interleukine-2, d'interféron-?, du facteur de croissance basique de fibroblaste et de métalloprotéinase-2 de matrice, ont été évalués par RT-PCR. Résultats Comparé avec les plaies traitées par excipient, les plaies traitées par les MSCs ont montré une plus rapide cicatrisation et une augmentation de synthèse de collagène, de prolifération cellulaire er d'angiogénèse. En outre, Les plaies traitées au MSC ont montré une expression diminuée de cytokines pro-inflammatoires (interleukine-2 et interféron-?) et des facteurs liés à la cicatrisation (facteur de croissance basique de fibrob

Kim, Ju-Won; Lee, Jong-Hwan; Lyoo, Young S; Jung, Dong-In; Park, Hee-Myung

2013-01-01

336

Variation du coefficient de collage de l'argent et de l'or durant leur condensation sur film de MgO  

NASA Astrophysics Data System (ADS)

The incidence rate dependence of the sticking coefficient during the growth of gold (or silver) condensate on MgO film is experimentally investigated for a substrate kept at room temperature. This MgO substrate is deposited on quartz monitor by evaporation under UHV from a Knudsen cell. Then, from another cell, the flux of metal atoms impinges on the MgO film which covers the quartz. Under this flux of incident metal atoms, the changes (respectively ? and f) of the temperature and of the frequency of the quartz oscillator are then simultaneously recorded. Both continuous measurements enable us to calculate, at different times t, the sticking coefficient ? (t) defined as the ration between the condensed metal rate q and the incident rate R. We use the results to plot ? versus t and examine the slope of ?-rise until the time t at which ? (t) reaches unity. The progression of ? (t) reaches unity. The progression of ? (t) from zero to unity during the metal deposition is explained by assuming that the nucleation on preferred sites with capture of adatoms at the edge of stable germs is the prevailing condensation mechanism at the initial stage of the condensation. Our experimental results could be fitted better by assuming an exponential growth of the site occupation than an increase of the number density n_s(t) with (Rt)^{1/3}. On étudie expérimentalement la dépendance que peut présenter, par rapport au flux métallique incident, la progression vers l'unité du coefficient de collage. Pour cela, on suit cette progression pour l'or et l'argent condensés sur film de MgO à température proche de l'ambiante. Le substrat de MgO est déposé sur un quartz de pesée par évaporation sous ultra-vide à partir d'une cellule de Knudsen. Une autre cellule est utilsée pour déposer l'un de ces métaux sur le film de MgO couvrant le quartz. Les variations ? et f de la température et de la fréquence d'oscillations du quartz de pesée sous le flux d'atomes incidents sont simultanement enregistrées. De telles mesures continues de ? et f permettent de calculer, à tout instant t, le coefficient ? (t), défini comme le rapport du flux métallique condensé q(t) au flux d'atomes incidents R. Nous pouvons, de cette manière, représenter ? (t) et examiner le changement d'allure de sa progression vers l'unité lorsque R croît. Pour interpréter cette progression, nous examinons les effets de la nucléation sur sites préférentiels et de la capture d'adatomes par les germes stables. Un modèle de croissance exponentielle de l'occupation des sites permet un meilleur ajustement théorique des résultats expérimentaux que celui obtenu avec une croissance de la densité de germes stables n_s(t) en (Rt)^{1/3}.

Desrousseaux, G.; Carlan, A.; Jiang, Z.

1993-10-01

337

Comparing Cutaneous Research Funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases with 2010 Global Burden of Disease Results  

PubMed Central

Importance Disease burden data helps guide research prioritization. Objective To determine the extent to which grants issued by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) reflect disease burden, measured by disability-adjusted life years (DALYs) from Global Burden of Disease (GBD) 2010 project. Design Two investigators independently assessed 15 skin conditions studied by GBD 2010 in the NIAMS database for grants issued in 2013. The 15 skin diseases were matched to their respective DALYs from GBD 2010. Setting The United States NIAMS database and GBD 2010 skin condition disability data. Main Outcome(s) and Measure(s) Relationship of NIAMS grant database topic funding with percent total GBD 2010 DALY and DALY rank for 15 skin conditions. Results During fiscal year 2013, 1,443 NIAMS grants were issued at a total value of $424 million. Of these grants, 17.7% covered skin topics. Of the total skin disease funding, 82% (91 grants) were categorized as “general cutaneous research.” Psoriasis, leprosy, and “other skin and subcutaneous diseases” (ie; immunobullous disorders, vitiligo, and hidradenitis suppurativa) were over-represented when funding was compared with disability. Conversely, cellulitis, decubitus ulcer, urticaria, acne vulgaris, viral skin diseases, fungal skin diseases, scabies, and melanoma were under-represented. Conditions for which disability and funding appeared well-matched were dermatitis, squamous and basal cell carcinoma, pruritus, bacterial skin diseases, and alopecia areata. Conclusions and Relevance Degree of representation in NIAMS is partly correlated with DALY metrics. Grant funding was well-matched with disability metrics for five of the 15 studied skin diseases, while two skin diseases were over-represented and seven were under-represented. Global burden estimates provide increasingly transparent and important information for investigating and prioritizing national research funding allocations. PMID:25003335

Karimkhani, Chante; Boyers, Lindsay N.; Margolis, David J.; Naghavi, Mohsen; Hay, Roderick J.; Williams, Hywel C.; Naldi, Luigi; Coffeng, Luc E.; Weinstock, Martin A.; Dunnick, Cory A.; Pederson, Hannah; Vos, Theo; Murray, Christopher J. L.; Dellavalle, Robert P.

2014-01-01

338

Tetracyclines as an Oral Treatment Option for Patients with Community Onset Skin and Soft Tissue Infections Caused by Methicillin-Resistant Staphylococcus aureus?  

PubMed Central

Few data exist on the clinical utility of the expanded-spectrum tetracyclines doxycycline and minocycline for the treatment of community-associated methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections (SSTI). We performed a retrospective cohort study of 276 patients who presented with 282 episodes of MRSA SSTI to the emergency room or outpatient clinic at two tertiary medical centers between October 2002 and February 2007. The median percentage of patients infected with MRSA strains that were susceptible to tetracycline was 95%. Time zero was defined as the time of the first incision and drainage procedure or, if none was performed, the time of the first positive wound culture. The median patient age was 48 years. Abscesses constituted the majority of clinical presentations (75%), followed by furuncles or carbuncles (13%) and cellulitis originating from a purulent focus of infection (12%). A total of 225 patients (80%) underwent incision and drainage. Doxycycline or minocycline was administered in 90 episodes (32%); the other 192 SSTI were treated with ?-lactams. Treatment failure, defined as the need for a second incision and drainage procedure and/or admission to the hospital within at least 2 days after time zero, was diagnosed in 28 episodes (10%) at a median of 3 days after time zero. On logistic regression analysis, receipt of a ?-lactam agent was the only clinical characteristic associated with treatment failure (adjusted odds ratio, 3.94; 95% confidence interval, 1.28 to 12.15; P = 0.02). The expanded-spectrum tetracyclines appear to be a reasonable oral treatment option for patients with community onset MRSA SSTI in areas where MRSA strains are susceptible to the tetracyclines. PMID:17576834

Ruhe, Jörg J.; Menon, Anupama

2007-01-01

339

Skin and Soft Tissue Infections and Associated Complications among Commercially Insured Patients Aged 0–64 Years with and without Diabetes in the U.S.  

PubMed Central

Introduction Skin and soft tissue infections (SSTIs) are common infections occurring in ambulatory and inpatient settings. The extent of complications associated with these infections by diabetes status is not well established. Methods Using a very large repository database, we examined medical and pharmacy claims of individuals aged 0–64 between 2005 and 2010 enrolled in U.S. health plans. Diabetes, SSTIs, and SSTI-associated complications were identified by ICD-9 codes. SSTIs were stratified by clinical category and setting of initial diagnosis. Results We identified 2,227,401 SSTI episodes, 10% of which occurred in diabetic individuals. Most SSTIs were initially diagnosed in ambulatory settings independent from diabetes status. Abscess/cellulitis was the more common SSTI group in diabetic and non-diabetic individuals (66% and 59%, respectively). There were differences in the frequencies of SSTI categories between diabetic and non-diabetic individuals (p<0.01). Among SSTIs diagnosed in ambulatory settings, the SSTI-associated complication rate was over five times higher in people with diabetes than in people without diabetes (4.9% vs. 0.8%, p<0.01) and SSTI-associated hospitalizations were 4.9% and 1.1% in patients with and without diabetes, respectively. Among SSTIs diagnosed in the inpatient setting, bacteremia/endocarditis/septicemia/sepsis was the most common associated complication occurring in 25% and 16% of SSTIs in patients with and without diabetes, respectively (p<0.01). Conclusions Among persons with SSTIs, we found SSTI-associated complications were five times higher and SSTI-associated hospitalizations were four times higher, in patients with diabetes compared to those without diabetes. SSTI prevention efforts in individuals with diabetes may have significant impact on morbidity and healthcare resource utilization. PMID:23593162

Fang, Christy

2013-01-01

340

Utilisation de traceurs radioactifs pour l'évaluation du recrutement des leucocytes et des échanges vasculaires au niveau d'organes in~vivo. Description d'une méthode et discussion des problèmes d'interprétation sur quelques exemples  

NASA Astrophysics Data System (ADS)

An experimental method using simultaneously different ? emiter tracers was developed to evaluate inflammation in vivo. Experiments were performed on the anaesthetized guinea-pig to test pulmonary effects of inflammatory agents. Red blood cells, albumin and inflammatory cells (platelets or leucocytes) radiolabelled with 99m technetium, 131 iodine and 111 indium respectively were injected i.v. Their radioactivities were measured on a pulmonary region by external detection and on blood samples in a well type counter. From these measurements variations of the lung contents in red blood cells, extravascular albumin and non circulating leucocytes during inflammatory stimulation were evaluated. These parameters axe indexes of blood perfusion, vascular exchanges and leucocyte sequestration respectively. Fiability of the method and meaning of the parameters evaluated are discussed. Une méthode expérimentale utilisant simultanément différents traceurs ? a été développée pour évaluer l'inflammation in vivo. Des expériences ont été réalisées chez le cobaye anesthésié pour tester l'effet pulmonaire d'agents inflammatoires. Des globules rouges, de l'albumine et des cellules inflammatoires (plaquettes ou leucocytes) radiomarqués respectivement au technetium 99m, à l'iode 131 et à l'indium 111 sont injectés i.v. Leurs radioactivités sont mesurées sur une région pulmonaire par détection externe et sur des échantillons sanguins au compteur puit. À partir de ces mesures sont évaluées les variations des contenus pulmonaires en globules rouges, en albumine extravasculaire et en leucocytes non circulants lors d'une stimulation inflammatoire. Ces paramètres sont corrélés aux modifications de la perfusion, des échanges vasculaires et de la séquestration leucocytaire. La fiabilité de la méthode et la signification des paramètres évalués sont discutées.

Bureau, M. F.

1997-03-01

341

Flower-shaped ZnO nanoparticles synthesized by a novel approach at near-room temperatures with antibacterial and antifungal properties  

PubMed Central

Due to enormous applications of metal oxide nanoparticles in research and health-related applications, metal oxide nanoparticles are increasingly being developed through cheaper and more user-friendly approaches. We have formulated a simple route to synthesize zinc oxide nanoparticles (ZNPs) by a sol–gel method at near-room temperatures 25°C, 35°C, 55°C, and 75°C. The results are analyzed by X-ray diffraction, scanning electron microscopy with energy-dispersive X-ray spectroscopy, and ultraviolet-visible absorption spectroscopy. The effect of different temperature conditions (25°C–75°C) on the particulate sizes (23.7–88.8 nm), pH levels (11.7–11.9), and morphologies (slender needle–broad arrow) of flower-shaped ZNP colonies is studied. A possible mechanism depicting the growth rates at different temperatures and of different facets, mainly towards the <0 0 0 I> and <0 I ? 0> planes of the ZNPs has also been discussed. The values of ?max (293–298 nm) suggest that ZNPs prepared at 55°C are the most effective ultraviolet B absorbers, and that they can be used in sunscreens. Highly significant antimicrobial activity against medically important Gram-positive (Staphylococcus aureus) and Gram-negative (Escherichia coli) bacteria and fungi (Candida albicans) by these ZNPs was also revealed. As S. aureus and C. albicans are responsible for many contagious dermal infections such as abscesses, furuncles, carbuncles, cellulitis, and candidiasis, we can postulate that our fabricated ZNPs may be useful as antimicrobial agents in antiseptic creams and lotions for the treatment of skin diseases. PMID:24550675

Khan, Mohd Farhan; Hameedullah, M; Ansari, Akhter H; Ahmad, Ejaz; Lohani, MB; Khan, Rizwan Hasan; Alam, M Mezbaul; Khan, Wasi; Husain, Fohad Mabood; Ahmad, Iqbal

2014-01-01

342

Bone marrow blood vessel ossification and "microvascular dead space" in rat and human long bone.  

PubMed

Severe calcification of the bone microvascular network was observed in rats, whereby the bone marrow blood vessels appeared ossified. This study sought to characterize the magnitude of ossification in relation to patent blood vessels and adipocyte content in femoral diaphyses. Additionally, this study confirmed the presence of ossified vessels in patients with arteriosclerotic vascular disease and peripheral vascular disease and cellulitis. Young (4-6 month; n=8) and old (22-24 month; n=8) male Fischer-344 rats were perfused with barium sulfate to visualize patent bone marrow blood vessels. Femoral shafts were processed for bone histomorphometry to quantify ossified (Goldner's Trichrome) and calcified (Alizarin Red) vessels. Adipocyte content was also determined. Additional femora (n=5/age group) were scanned via ?CT to quantify microvascular ossification. Bone marrow blood vessels from the rats and the human patients were also isolated and examined via microscopy. Ossified vessels (rats and humans) had osteocyte lacunae on the vessel surfaces and "normal" vessels were transitioning into bone. The volume of ossified vessels was 4800% higher (p<0.05) in the old vs. young rats. Calcified and ossified vessel volumes per tissue volume and calcified vessel volume per patent vessel volume were augmented (p<0.05) 262%, 375% and 263%, respectively, in the old vs. young rats. Ossified and patent vessel number was higher (171%) and lower (40%), respectively, in the old vs. young rats. Finally, adipocyte volume per patent vessel volume was higher (86%) with age. This study is the first to report ossification of bone marrow blood vessels in rats and humans. Ossification presumably results in "microvascular dead space" in regard to loss of patency and vasomotor function as opposed to necrosis. Progression of bone microvascular ossification may provide the common link associated with age-related changes in bone and bone marrow. The clinical implications may be evident in the difficulties treating bone disease in the elderly. PMID:24680721

Prisby, Rhonda D

2014-07-01

343

[Importance of microbiologic examination of vaginal secretions in the reproductive period].  

PubMed

Vaginal infections, during reproductive period are frequent and although not life treating, they can affect their normal functions. They can also affect women's fertility as well as the course of pregnancy. The outcome of pregnancy can be endangered due to the possibility of infection of newborn while passing trough birth canal of the infected mother. As statistically shown, bacterial vaginosis is considerably more often found with the patients having precancerous changes on cervix, or diagnosed cancer of cervix, comparing with women with healthy cervix. It can also cause the appearance of postoperative pelvic cellulitis after hysterectomy. On the other side, the presence of S. agalactiae in vaginal secretion may cause very serious and lethal infections of the newborn such as meningitis, pneumonia and sepsis. As for protozoa T. vaginalis it has been shown that it could cause reduced fertility ability and that during pregnancy it could damage fetal membranes and bring to its premature rupture and premature birth. There is also increased risk of cervix cancer. During reproductive period of women especially if risk factors are existing such as hormone therapy, diabetes mellitus type 1 and applications of wide range antibiotics, vaginal fungal infections caused by Candida can frequently appear. These infection apart from the discomfort like itch and affluent secretion they can also mean diagnostic and therapeutical problem. Regular microbiological test of women are highly recommended during reproductive period as standard for bacterial vaginosis, fungal and trichomonas infections. If those results appear negative, further microbiological tests are necessary. Such tests which are more elaborate, more timely and more expensive are referring to tests on chlamydia, microplasma and some viruses that can also be the cause of vaginal secretion disbalance in women during reproductive period. PMID:15227966

Arsi?-Arsenijevi?, Valentina; Radonji?, Ivana; Mijac, Vera; Cirkovi?, Ivana

2004-01-01

344

Évolution des conditions d’initiation du traitement antirétroviral des patients infectés par le VIH en Afrique de l’Ouest  

PubMed Central

Résumé Objectif Étudier entre 1996 et 2006, l’évolution des schémas thérapeutiques et du profil clinique et immunologique des patients infectés par le VIH au début du traitement antirétroviral (TARV) en Afrique de l’Ouest. Cadre et méthode Les données issues de 12 centres cliniques adultes (IeDEA West Africa réseau collaboratif de prise en charge de l’infection à VIH) de cinq pays (Bénin, Cote d’Ivoire, Sénégal, Gambie, Mali) ont été mises en commun et analysées. Les patients âgés de 16 ans et plus dont le sexe, la date de naissance et la date d’initiation du TARV étaient connus ont été inclus dans cette étude. Résultats Quatorze mille quatre-cent-quatre-vingt-seize patients avaient débuté un TARV entre 1996–2006 avec 55 % des patients l’ayant débuté entre 2005–2006. La proportion de femmes était de 46 % en 1996–2000 et de 63 % en 2005–2006. L’âge médian à la mise sous traitement était constant: 35 ans chez les femmes et 40 ans chez les hommes. La proportion de patients qui ont débuté le TARV avec un taux de CD4 inférieur à 200 cellules/µl était de 54 % en 1996–2000 et de 64 % en 2005–2006. Les combinaisons thérapeutiques les plus prescrites étaient: AZT/3TC (ou d4T/DDI)/IDV (27 %) en 1996–2000; d4T (ou AZT)/3TC/EFV (59 %) en 2003–2004; et d4T/3TC/NVP (49 %) en 2005–2006. Les traitements de première ligne recommandés par l’OMS étaient débutés dans 83 % de cas en 2005–2006. Conclusion De nouvelles approches pour débuter un TARV plus précocement doivent être développées pour améliorer la survie des patients sous TARV. PMID:20045273

Bashi, J.; Balestre, E.; Messou, E.; Maiga, M.; Coffie, P.A.; Zannou, D.M.; Ba-Gomis, O.; Traore, H.A.; Eholie, S.; Minga, A.; Sow, P.S.; Bissagnene, E.; Dabis, F.; Ekouevi, D.K.

2013-01-01

345

Emergency department usage by uninsured patients in Galveston County, Texas  

PubMed Central

The number of uninsured Texas residents who rely on the medical emergency department as their primary health care provider continues to increase. Unfortunately, little information about the characteristics of this group of emergency department users is available. Using an administrative billing database, we conducted a descriptive study to examine the demographic and clinical features of 17,110 consecutive patients without medical insurance who presented to the emergency department of the University of Texas Medical Branch in Galveston over a 12-month period. We also analyzed the risk of multiple emergency department visits or hospitalization according to demographic characteristics. Twenty percent of the study population made two or more emergency department visits during the study period; 19% of the population was admitted to the hospital via the emergency department. The risk of multiple emergency department visits was significantly elevated among African Americans and increased in a stepwise fashion according to age. The risk of being hospitalized was significantly reduced among females, African Americans, and Hispanics. There was an age-related monotonic increase in the risk of hospitalization. Abdominal pain, cellulitis, and spinal disorders were the most common primary diagnoses in patients who made multiple emergency department visits. Hospitalization occurred most frequently in patients with a primary diagnosis of chest pain, nonischemic heart disease, or an affective disorder. Additional studies of emergency department usage by uninsured patients from other regions of Texas are warranted. Such data may prove helpful in developing effective community-based alternatives to the emergency department for this growing segment of our population. Local policymakers who are responsible for the development of safety net programs throughout the state should find this information particularly useful. PMID:18628970

Paar, David; Giordano, Thomas P.; Zachariah, Brian; Rudkin, Laura L.; Wu, Z. Helen; Raimer, Ben G.

2008-01-01

346

Fournier's gangrene developing secondary to infected hydrocele: A unique clinical scenario  

PubMed Central

We report the first case of Fournier's gangrene (FG) developing secondary to an infected hydrocele worldwide. We present a case report with a brief overview of the literature relating to FG and its aetiology, diagnosis and management. A 70 year-old male was referred by his General Practitioner with a 2 week history of worsening symptoms of scrotal discomfort and swelling. Following clinical examination, an initial diagnosis of an infected right-sided hydrocele was made and treatment, consisting of antibiotics, was initiated. Despite showing good clinical improvement, several days later, necrotic areas were observed over the right hemiscrotum with spreading cellulitis. A diagnosis of FG was made. The patient was started on triple–therapy antibiotics and taken to the operating room for urgent surgical debridement. Necrotic skin and subcutaneous tissue extending over the perineum and lower anterior abdomen was debrided down to healthy tissue. A further debridement took place 2 days later. The patient continued to improve and was eventually discharged under the care of Plastic Surgeons for reconstruction of the soft tissue defect. FG is a type of necrotising fasciitis predominantly affecting the male perineal, perianal, genital and anterior abdominal wall regions. It has a significant mortality rate, and the key to survival is early detection and treatment consisting of antibiotics and surgical debridement of the affected area. To the best of our knowledge, this is the first reported case of FG developing secondary to an existing hydrocele without any prior urological intervention. The case highlights the important clinical diagnostic and therapeutic interventions required to prevent complications associated with this, potentially fatal, condition. PMID:22629017

Sarwar, Umran; Akhtar, Nadeem

2012-01-01

347

Through Knee Amputation: Technique Modifications and Surgical Outcomes  

PubMed Central

Background Knee disarticulations (KD) are most commonly employed following trauma or tumor resection but represent less than 2% of all lower extremity amputations performed in the United States annually. KDs provide enhanced proprioception, a long lever arm, preservation of adductor muscle insertion, decreased metabolic cost of ambulation, and an end weight-bearing stump. The role for KDs in the setting of arterial insufficiency or overwhelming infection is less clear. The purpose of this study is to describe technique modifications and report surgical outcomes following KDs at a high-volume Limb Salvage Center. Methods A retrospective study of medical records for all patients who underwent a through-knee amputation performed by the senior author (C.E.A.) between 2004 and 2012 was completed. Medical records were reviewed to collect demographic, operative, and postoperative information for each of the patients identified. Results Between 2004 and 2012, 46 through-knee amputations for 41 patients were performed. The mean patient age was 68 and indications for surgery included infection (56%), arterial thrombosis (35%), and trauma (9%). Postoperative complications included superficial cellulitis (13%), soft tissue infection (4%), and flap ischemia (4%) necessitating one case of surgical debridement (4%) and four trans-femoral amputations (9%). 9 (22%) patients went on to ambulate. Postoperative ambulation was greatest in the traumatic cohort and for patients less than 50 years of age, P<0.05. Alternatively, diabetes mellitus and infection reduced the likelihood of postoperative ambulation, P<0.01. Conclusions Knee disarticulations are a safe and effective alternative to other lower extremity amputations when clinically feasible. For patient unlikely to ambulate, a through-knee amputation maximizes ease of transfers, promotes mobility by providing a counterbalance, and eliminates the potential for knee flexion contracture with subsequent skin breakdown. PMID:25276650

Albino, Frank P; Seidel, Rachel; Brown, Benjamin J; Crone, Charles G

2014-01-01

348

In Vivo Bioluminescence Imaging To Evaluate Systemic and Topical Antibiotics against Community-Acquired Methicillin-Resistant Staphylococcus aureus-Infected Skin Wounds in Mice  

PubMed Central

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) frequently causes skin and soft tissue infections, including impetigo, cellulitis, folliculitis, and infected wounds and ulcers. Uncomplicated CA-MRSA skin infections are typically managed in an outpatient setting with oral and topical antibiotics and/or incision and drainage, whereas complicated skin infections often require hospitalization, intravenous antibiotics, and sometimes surgery. The aim of this study was to develop a mouse model of CA-MRSA wound infection to compare the efficacy of commonly used systemic and topical antibiotics. A bioluminescent USA300 CA-MRSA strain was inoculated into full-thickness scalpel wounds on the backs of mice and digital photography/image analysis and in vivo bioluminescence imaging were used to measure wound healing and the bacterial burden. Subcutaneous vancomycin, daptomycin, and linezolid similarly reduced the lesion sizes and bacterial burden. Oral linezolid, clindamycin, and doxycycline all decreased the lesion sizes and bacterial burden. Oral trimethoprim-sulfamethoxazole decreased the bacterial burden but did not decrease the lesion size. Topical mupirocin and retapamulin ointments both reduced the bacterial burden. However, the petrolatum vehicle ointment for retapamulin, but not the polyethylene glycol vehicle ointment for mupirocin, promoted wound healing and initially increased the bacterial burden. Finally, in type 2 diabetic mice, subcutaneous linezolid and daptomycin had the most rapid therapeutic effect compared with vancomycin. Taken together, this mouse model of CA-MRSA wound infection, which utilizes in vivo bioluminescence imaging to monitor the bacterial burden, represents an alternative method to evaluate the preclinical in vivo efficacy of systemic and topical antimicrobial agents. PMID:23208713

Guo, Yi; Ramos, Romela Irene; Cho, John S.; Donegan, Niles P.; Cheung, Ambrose L.

2013-01-01

349

A Phase 2 Trial of Once-Weekly Hypofractionated Breast Irradiation: First Report of Acute Toxicity, Feasibility, and Patient Satisfaction  

SciTech Connect

Purpose: To report on early results of a single-institution phase 2 trial of a 5-fraction, once-weekly radiation therapy regimen for patients undergoing breast-conserving surgery (BCS). Methods and Materials: Patients who underwent BCS for American Joint Committee on Cancer stage 0, I, or II breast cancer with negative surgical margins were eligible to receive whole breast radiation therapy to a dose of 30 Gy in 5 weekly fractions of 6 Gy with or without an additional boost. Elective nodal irradiation was not permitted. There were no restrictions on breast size or the use of cytotoxic chemotherapy for otherwise eligible patients. Patients were assessed at baseline, treatment completion, and at first posttreatment follow-up to assess acute toxicity (Common Terminology Criteria for Adverse Events, version 3.0) and quality of life (European Organization for Research and Treatment of Cancer QLQ-BR23). Results: Between January and September 2011, 42 eligible patients underwent weekly hypofractionated breast irradiation immediately following BCS (69.0%) or at the conclusion of cytotoxic chemotherapy (31.0%). The rates of grade ?2 radiation-induced dermatitis, pain, fatigue, and breast edema were 19.0%, 11.9%, 9.5%, and 2.4%, respectively. Only 1 grade 3 toxicity—pain requiring a course of narcotic analgesics—was observed. One patient developed a superficial cellulitis (grade 2), which resolved with the use of oral antibiotics. Patient-reported moderate-to-major breast symptoms (pain, swelling, and skin problems), all decreased from baseline through 1 month, whereas breast sensitivity remained stable over the study period. Conclusions: The tolerance of weekly hypofractionated breast irradiation compares well with recent reports of daily hypofractionated whole-breast irradiation schedules. The regimen appears feasible and cost-effective. Additional follow-up with continued accrual is needed to assess late toxicity, cosmesis, and disease-specific outcomes.

Dragun, Anthony E., E-mail: aedrag01@louisville.edu [Department of Radiation Oncology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States); Quillo, Amy R. [Department of Surgical Oncology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States)] [Department of Surgical Oncology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States); Riley, Elizabeth C. [Department of Medical Oncology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States)] [Department of Medical Oncology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States); Roberts, Teresa L.; Hunter, Allison M. [Department of Radiation Oncology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States)] [Department of Radiation Oncology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States); Rai, Shesh N. [Department of Biostatistics and Epidemiology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States)] [Department of Biostatistics and Epidemiology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States); Callender, Glenda G. [Department of Surgical Oncology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States)] [Department of Surgical Oncology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States); Jain, Dharamvir [Department of Medical Oncology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States)] [Department of Medical Oncology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States); McMasters, Kelly M. [Department of Surgical Oncology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States)] [Department of Surgical Oncology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States); Spanos, William J. [Department of Radiation Oncology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States)] [Department of Radiation Oncology, University of Louisville School of Medicine, James Graham Brown Cancer Center, Louisville, Kentucky (United States)

2013-03-01

350

In vivo bioluminescence imaging to evaluate systemic and topical antibiotics against community-acquired methicillin-resistant Staphylococcus aureus-infected skin wounds in mice.  

PubMed

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) frequently causes skin and soft tissue infections, including impetigo, cellulitis, folliculitis, and infected wounds and ulcers. Uncomplicated CA-MRSA skin infections are typically managed in an outpatient setting with oral and topical antibiotics and/or incision and drainage, whereas complicated skin infections often require hospitalization, intravenous antibiotics, and sometimes surgery. The aim of this study was to develop a mouse model of CA-MRSA wound infection to compare the efficacy of commonly used systemic and topical antibiotics. A bioluminescent USA300 CA-MRSA strain was inoculated into full-thickness scalpel wounds on the backs of mice and digital photography/image analysis and in vivo bioluminescence imaging were used to measure wound healing and the bacterial burden. Subcutaneous vancomycin, daptomycin, and linezolid similarly reduced the lesion sizes and bacterial burden. Oral linezolid, clindamycin, and doxycycline all decreased the lesion sizes and bacterial burden. Oral trimethoprim-sulfamethoxazole decreased the bacterial burden but did not decrease the lesion size. Topical mupirocin and retapamulin ointments both reduced the bacterial burden. However, the petrolatum vehicle ointment for retapamulin, but not the polyethylene glycol vehicle ointment for mupirocin, promoted wound healing and initially increased the bacterial burden. Finally, in type 2 diabetic mice, subcutaneous linezolid and daptomycin had the most rapid therapeutic effect compared with vancomycin. Taken together, this mouse model of CA-MRSA wound infection, which utilizes in vivo bioluminescence imaging to monitor the bacterial burden, represents an alternative method to evaluate the preclinical in vivo efficacy of systemic and topical antimicrobial agents. PMID:23208713

Guo, Yi; Ramos, Romela Irene; Cho, John S; Donegan, Niles P; Cheung, Ambrose L; Miller, Lloyd S

2013-02-01

351

Effects of boceprevir and telaprevir on the pharmacokinetics of dolutegravir  

PubMed Central

Aims The aim was to evaluate the effect of boceprevir and telaprevir on dolutegravir pharmacokinetics (PK); the effect of dolutegravir on boceprevir and telaprevir PK was assessed through comparison with historical data for each hepatitis?C virus (HCV) drug's prescribing information alone. Methods This was a single-centre, randomized, open-label, two-cohort, two-period, one-way study in healthy adult subjects. Dolutegravir 50?mg once daily was administered for 5 days in Period?1, and dolutegravir 50?mg once daily was coadministered with either boceprevir 800?mg every 8?h (Cohort?1) or telaprevir 750?mg every 8?h (Cohort?2) for 10?days in Period?2. Results No deaths or serious adverse events were reported during the study. Four subjects were withdrawn from the study because of adverse events (elevated alanine aminotransferase, cellulitis, increased serum creatinine and dizziness). One subject became pregnant during the study. Coadministration of dolutegravir with boceprevir had no effect on dolutegravir area under the plasma concentration–time curve (AUC) and maximal plasma concentration (Cmax) and caused a small increase in concentration at the end of the dosing interval (C?; 8%). Coadministration of dolutegravir with telaprevir resulted in increased dolutegravir plasma exposures compared with those after administration of dolutegravir alone; AUC0–?, Cmax and C? increased by 25, 19 and 37%, respectively. Coadministration of boceprevir or telaprevir with dolutegravir had no clinically significant effect on dolutegravir PK. Plasma boceprevir and telaprevir PK data for either combined treatment were similar to historical data, indicating no effect of dolutegravir on boceprevir or telaprevir exposure. Conclusions Dolutegravir can be coadministered with boceprevir or telaprevir in patients coinfected with HIV and HCV with no dose adjustment. PMID:24838177

Johnson, Mark; Borland, Julie; Chen, Shuguang; Savina, Paul; Wynne, Brian; Piscitelli, Stephen

2014-01-01

352

Incidence of Community-associated Methicillin-resistant Staphylococcus aureus Infections in a Regional Hospital  

PubMed Central

Background and Objective: Since the early 2000s, the incidence of methicillin-resistant Staphylococcus aureus (MRSA) infections among the community of people lacking known healthcare risk factors has increased. This MRSA infection is referred to as community-associated MRSA (CA-MRSA) infection and is distinct from hospital-associated MRSA (HA-MRSA) infection, which occurs among people with known healthcare risk factors. Understanding the epidemiology of CA-MRSA infections is critical; however, this has not been investigated in detail in Japan. Our objective was to investigate the incidence of CA-MRSA infections in a regional hospital. Patients and Methods: We investigated CA-MRSA isolates and infections in a rural regional hospital by reviewing medical records of one year. Infections were classified as CA-MRSA if no established risk factors were identified. Results: During 2008, 31 Staphylococcus aureus (S. aureus) isolates were detected in 29 unique patients, with 1 methicillin-sensitive S. aureus (MSSA) isolates obtained from 19 patients (66%) and MRSA obtained from 10 patients (34%). In the 10 patients with MRSA, the number of HA-MRSA and CA-MRSA cases were nine (32% of patients with S. aureus isolates) and one (3%), respectively. The patient with CA-MRSA was diagnosed with cellulitis due to CA-MRSA. All nine patients with HA-MRSA exhibited colonization. Conclusion: We observed a CA-MRSA case in a regional hospital in Japan, suggesting that incidence trends of CA-MRSA should be considered in future research and treatment.

Kawabata, Hidenobu; Murakami, Manabu; Kisa, Kengo; Maezawa, Masaji

2011-01-01

353

Lymphedema Prevalence and Treatment Benefits in Cancer: Impact of a Therapeutic Intervention on Health Outcomes and Costs  

PubMed Central

Background Lymphedema is a common complication of cancer therapeutics; its prevalence, treatment outcomes, and costs have been poorly defined. The objective of this study was to examine lymphedema prevalence among cancer survivors and to characterize changes in clinical outcomes and costs associated with a defined therapeutic intervention (use of a pneumatic compression devices [PCD]) in a representative, privately insured population. Methods and Findings Retrospective analysis of de-identified health claims data from a large national insurer for calendar years 2007 through 2013. Patients were required to have 12 months of continuous insurance coverage prior to PCD receipt (baseline), as well as a 12-month follow-up period. Analyses were performed for individuals with cancer-related lymphedema (n?=?1,065). Lymphedema prevalence was calculated: number of patients with a lymphedema claim in a calendar year divided by total number of enrollees. The impact of PCD use was evaluated by comparing rates of a pre-specified set of health outcomes and costs for the 12 months before and after, respectively, PCD receipt. Lymphedema prevalence among cancer survivors increased from 0.95% in 2007 to 1.24% in 2013. PCD use was associated with decreases in rates of hospitalizations (45% to 32%, p<0.0001), outpatient hospital visits (95% to 90%, p<0.0001), cellulitis diagnoses (28% to 22%, p?=?0.003), and physical therapy use (50% to 41%, p<0.0001). The average baseline health care costs were high ($53,422) but decreased in the year after PCD acquisition (?$11,833, p<0.0001). Conclusions Lymphedema is a prevalent medical condition that is often a defining attribute of cancer survivorship. The problem is associated with high health care costs; Treatment (in this instance, use of PCD) is associated with significant decreases in adverse clinical outcomes and costs. PMID:25470383

Brayton, Kimberly M.; Hirsch, Alan T.; O?Brien, Patricia J.; Cheville, Andrea; Karaca-Mandic, Pinar; Rockson, Stanley G.

2014-01-01

354

High-Dose-Rate Intraoperative Radiation Therapy for Recurrent Head-and-Neck Cancer  

SciTech Connect

Purpose: To report the use of high-dose-rate intraoperative radiation therapy (HDR-IORT) for recurrent head-and-neck cancer (HNC) at a single institution. Methods and Materials: Between July 1998 and February 2007, 34 patients with recurrent HNC received 38 HDR-IORT treatments using a Harrison-Anderson-Mick applicator with Iridium-192. A single fraction (median, 15 Gy; range, 10-20 Gy) was delivered intraoperatively after surgical resection to the region considered at risk for close or positive margins. In all patients, the target region was previously treated with external beam radiation therapy (median dose, 63 Gy; range, 24-74 Gy). The 1- and 2-year estimates for in-field local progression-free survival (LPFS), locoregional progression-free survival (LRPFS), distant metastases-free survival (DMFS), and overall survival (OS) were calculated. Results: With a median follow-up for surviving patients of 23 months (range, 6-54 months), 8 patients (24%) are alive and without evidence of disease. The 1- and 2-year LPFS rates are 66% and 56%, respectively, with 13 (34%) in-field recurrences. The 1- and 2-year DMFS rates are 81% and 62%, respectively, with 10 patients (29%) developing distant failure. The 1- and 2-year OS rates are 73% and 55%, respectively, with a median time to OS of 24 months. Severe complications included cellulitis (5 patients), fistula or wound complications (3 patients), osteoradionecrosis (1 patient), and radiation-induced trigeminal neuralgia (1 patient). Conclusions: HDR-IORT has shown encouraging local control outcomes in patients with recurrent HNC with acceptable rates of treatment-related morbidity. Longer follow-up with a larger cohort of patients is needed to fully assess the benefit of this procedure.

Perry, David J.; Chan, Kelvin; Wolden, Suzanne; Zelefsky, Michael J. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Chiu, Johnny; Cohen, Gilad; Zaider, Marco [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Kraus, Dennis; Shah, Jatin [Division of Head and Neck Surgery, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Lee, Nancy, E-mail: Leen2@mskcc.or [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)

2010-03-15

355

Modulation de l'apoptose radioinduite par Ac-DEVD-CHO, un inhibiteur de protéases ``ice-like"  

NASA Astrophysics Data System (ADS)

The “ICE-like" proteases, recently renamed caspases, are the human homologues of the Caenorhabditis elegans ced-3 gene product and are activated in the early steps of apoptosis. The aim of this work is to determine whether the inhibition of one of these proteases, namely caspase-3, is able to modify the cell sensitivity toward radiation-induced apoptosis. Murine spleen lymphocytes submitted to ?-radiations in presence of Ac-DVED-CHO, a caspase-3 specific inhibitor, exhibit a sharply reduced number of radiation-induced hypodiploid particules as compared to the controls and an almost total inhibition of the internucleosomal DNA fragmentation. However, both the anionic phospholipids externalisation, another specific hallmark of apoptosis, and the viability remain unchanged. Les protéases “ICE-like" ou caspases, sont les homologues humaines du produit du gène ced-3 du ver Caenorhabditis elegans et sont activées lors des étapes précoces de l'apoptose. L'objectif de ce travail vise à déterminer dans quelle mesure l'inhibition de l'une d'entre elles, la caspase-3 est susceptible de modifier la sensibilité des cellules vis-à-vis de l'apoptose radioinduite. Des lymphocytes spléniques murins irradiés en présence de Ac-DVED-CHO un inhibiteur spécifique de la caspase-3 présentent un taux de particules hypodiploïdes radioinduites bien inférieur à celui des contrôles et une diminution drastique de la fragmentation internucléosomale de l'ADN. Toutefois, ni l'externalisation des phospholipides anioniques, autre marqueur spécifique de l'apoptose, ni la viabilité ne sont affectées.

Weltin, D.; Holl, V.; Hyun, J. W.; Marchal, J.; Jung, G. M.; Dufour, P.; Bischoff, P.

1998-04-01

356

Linezolid versus Vancomycin in Treatment of Complicated Skin and Soft Tissue Infections  

PubMed Central

Skin and soft tissue infections (SSTIs) are a common cause of morbidity in both the community and the hospital. An SSTI is classified as complicated if the infection has spread to the deeper soft tissues, if surgical intervention is necessary, or if the patient has a comorbid condition hindering treatment response (e.g., diabetes mellitus or human immunodeficiency virus). The purpose of this study was to compare linezolid to vancomycin in the treatment of suspected or proven methicillin-resistant gram-positive complicated SSTIs (CSSTIs) requiring hospitalization. This was a randomized, open-label, comparator-controlled, multicenter, multinational study that included patients with suspected or proven methicillin-resistant Staphylococcus aureus (MRSA) infections that involved substantial areas of skin or deeper soft tissues, such as cellulitis, abscesses, infected ulcers, or burns (<10% of total body surface area). Patients were randomized (1:1) to receive linezolid (600 mg) every 12 h either intravenously (i.v.) or orally or vancomycin (1 g) every 12 h i.v. In the intent-to-treat population, 92.2% and 88.5% of patients treated with linezolid and vancomycin, respectively, were clinically cured at the test-of-cure (TOC) visit (P = 0.057). Linezolid outcomes (124/140 patients or 88.6%) were superior to vancomycin outcomes (97/145 patients or 66.9%) at the TOC visit for patients with MRSA infections (P < 0.001). Drug-related adverse events were reported in similar numbers in both the linezolid and the vancomycin arms of the trial. The results of this study demonstrate that linezolid therapy is well tolerated, equivalent to vancomycin in treating CSSTIs, and superior to vancomycin in the treatment of CSSTIs due to MRSA. PMID:15917519

Weigelt, John; Itani, Kamal; Stevens, Dennis; Lau, William; Dryden, Matthew; Knirsch, Charles

2005-01-01

357

Complications in tissue expander breast reconstruction: a comparison of AlloDerm, DermaMatrix, and FlexHD acellular inferior pole dermal slings.  

PubMed

Acellular dermal matrix (ADM) is frequently used in tissue expander breast reconstruction (TEBR) for coverage of the inferior pole. Several published studies have suggested increased rates of complications with the use of ADM. It is unknown, however, if the type of ADM used for TEBR impacts complication rates. The aim of this study is to compare 3 different types of ADM for TEBR in regard to clinically significant complications, specifically infection. We performed a retrospective analysis of primary breast cancer-related TEBR with or without ADM. Exclusion criteria consisted of prior major breast surgery, inadequate data, or loss to follow-up. Reconstructions were grouped by dermal sling type, AlloDerm, DermaMatrix (DM), FlexHD (FHD), or no ADM. Complications included cellulitis, abscess, seroma, expander leak or puncture, skin necrosis, wound dehiscence, or hematoma. Those requiring admission to hospital or reoperation were considered significant. Of 284 breasts reconstructed, 49 used AlloDerm, 110 used DM, 62 used FHD, and 64 used no ADM. The total complication rate with AlloDerm was 22% [95% confidence interval (CI), 11-34], with DM was 15% (95% CI, 8-21), and with FHD was 18% (95% CI, 8-28) (P=0.47). Infectious complication rates for AlloDerm, DM, and FHD were equal at 10% (P=0.97). The total complication rate of all ADM reconstructions as a grouped cohort was 17% compared to 11% without ADM (P=0.48). The overall incidence of infectious complications with ADM was 10% compared to 2% without ADM (P=0.09). There is no difference in the clinically significant overall complication rate or incidence of infection between AlloDerm, DM, and FHD. Isolating infectious complications, there is a trend toward increased incidence with ADM compared to reconstructions without. PMID:22868313

Brooke, Sebastian; Mesa, John; Uluer, Mehmet; Michelotti, Brett; Moyer, Kurtis; Neves, Rogerio I; Mackay, Donald; Potochny, John

2012-10-01

358

Characteristics Associated with Inpatient Death  

PubMed Central

Objective More than half of pediatric deaths occur in the hospital inpatient setting. An analysis of pediatric deaths can potentially help with understanding why children die and provide opportunities to improve the care for this patient population. This study’s primary objective was to obtain a broad understanding of inpatient mortality across academic, children’s hospitals. Patients and Methods A non-concurrent cohort study of hospitalized children from 37 academic, children’s hospitals during calendar year 2005. The primary outcome measure was death. Associated patient level characteristics included age, gender, race, diagnostic grouping, and insurance status. Important epidemiologic measures included standardized mortality and standardized mortality ratios (SMRs). Results There were 427,615 patients discharged from participating institutions during the study period of which 4,529 (1.1%) died. Neonates had the highest mortality rate (4.03%; OR 8.66; p < .001) followed by those > 18 years (1.4%; OR 2.86; P < .001). The standardized mortality ranged from 0.46 (APR-DRG 663: Other Anemia and Disorders of Blood) to 30.0 (APR-DRG 383: Cellulitis and Other Bacterial Skin Infection). When deaths were compared by institution, there was considerable variability in both the number of children who died and the SMRs at those institutions. Conclusions Patient characteristics, like age, severity, and diagnosis, were all substantive factors associated with the death of children. Opportunities to improve the environment of care by reducing variability within and between hospitals may improve mortality for hospitalized children. PMID:20457682

Khandelwal, Sachin; He, Jianping; Hall, Matthew; Stockwell, David C.; Turenne, Wendy M.; Shah, Samir S.

2011-01-01

359

Adverse effects of extra-articular corticosteroid injections: a systematic review  

PubMed Central

Background To estimate the occurrence and type of adverse effects after application of an extra-articular (soft tissue) corticosteroid injection. Methods A systematic review of the literature was made based on a PubMed and Embase search covering the period 1956 to January 2010. Case reports were included, as were prospective and retrospective studies that reported adverse events of corticosteroid injection. All clinical trials which used extra-articular corticosteroid injections were examined. We divided the reported adverse events into major (defined as those needing intervention or not disappearing) and minor ones (transient, not requiring intervention). Results The search yielded 87 relevant studies:44 case reports, 37 prospective studies and 6 retrospective studies. The major adverse events included osteomyelitis and protothecosis; one fatal necrotizing fasciitis; cellulitis and ecchymosis; tendon ruptures; atrophy of the plantar fat was described after injecting a neuroma; and local skin effects appeared as atrophy, hypopigmentation or as skin defect. The minor adverse events effects ranged from skin rash to flushing and disturbed menstrual pattern. Increased pain or steroid flare after injection was reported in 19 studies. After extra-articular injection, the incidence of major adverse events ranged from 0-5.8% and that of minor adverse events from 0-81%. It was not feasible to pool the risk for adverse effects due to heterogeneity of study populations and difference in interventions and variance in reporting. Conclusion In this literature review it was difficult to accurately quantify the incidence of adverse effects after extra-articular corticosteroid injection. The reported adverse events were relatively mild, although one fatal reaction was reported. PMID:20836867

2010-01-01

360

Clinical and genomic evaluation of 201 patients with Phelan-McDermid syndrome.  

PubMed

This study is the first to describe age-related changes in a large cohort of patients with Phelan-McDermid syndrome (PMS), also known as 22q13 deletion syndrome. Over a follow-up period of up to 12 years, physical examinations and structured interviews were conducted for 201 individuals diagnosed with PMS, 120 patients had a focused, high-resolution 22q12q13 array CGH, and 92 patients' deletions were assessed for parent-of-origin. 22q13 genomic anomalies include terminal deletions of 22q13 (89 %), terminal deletions and interstitial duplications (9 %), and interstitial deletions (2 %). Considering different age groups, in older patients, behavioral problems tended to subside, developmental abilities improved, and some features such as large or fleshy hands, full or puffy eyelids, hypotonia, lax ligaments, and hyperextensible joints were less frequent. However, the proportion reporting an autism spectrum disorder, seizures, and cellulitis, or presenting with lymphedema or abnormal reflexes increased with age. Some neurologic and dysmorphic features such as speech and developmental delay and macrocephaly correlated with deletion size. Deletion sizes in more recently diagnosed patients tend to be smaller than those diagnosed a decade earlier. Seventy-three percent of de novo deletions were of paternal origin. Seizures were reported three times more often among patients with a de novo deletion of the maternal rather than paternal chromosome 22. This analysis improves the understanding of the clinical presentation and natural history of PMS and can serve as a reference for the prevalence of clinical features in the syndrome. PMID:24481935

Sarasua, Sara M; Boccuto, Luigi; Sharp, Julia L; Dwivedi, Alka; Chen, Chin-Fu; Rollins, Jonathan D; Rogers, R Curtis; Phelan, Katy; DuPont, Barbara R

2014-07-01

361

Ambulatory Percutaneous Nephrolithotomy: What Is the Rate of Readmission?  

PubMed

Abstract Background and Purpose: Tubeless percutaneous nephrolithotomy (PCNL) has gained popularity in an attempt to decrease morbidity and accelerate discharge. Recently, ambulatory tubeless PCNL has been reported. There are no data, however, regarding readmission rates of patients who had ambulatory PCNL. Therefore, the aim of this study was to assess rates of emergency department (ED) visits and readmissions postambulatory PCNL. Patients and Methods: A retrospective chart review of all ambulatory PCNL cases at two institutions between March 2007 and December 2013 was performed. Preoperative, intraoperative, and postoperative data were collected including the amount of narcotics used, length of hospital stay, postoperative complications, returns to the ED, and readmissions. Results: Fifty patients underwent ambulatory PCNL, including two bilateral cases, making up a total of 52 renal units. All patients were discharged home on the same day with a mean hospital stay of 208.32±73.43 minutes. The mean narcotic requirement was 41.13±46.76?mg of oral morphine equivalents. Six patients (12%) returned to the ED, all within 7 days. Four of these 6 patients were discharged; three with stent colic and one with wound cellulitis. Only two (4%) patients were readmitted-one with multiresistant Escherichia coli and one with uncomplicated stent colic. Overall stone-free rate was 90.4%. There were no major complications, while low grade (I-II) Clavien complications developed in 9 (18%) patients. Conclusion: Ambulatory PCNL is safe in highly selected patients with a stone-free rate of 90% and readmission rate of 4%. Prospective studies comparing standard PCNL with ambulatory PCNL are warranted. PMID:25221917

Beiko, Darren; Elkoushy, Mohamed A; Kokorovic, Andrea; Roberts, Gregory; Robb, Sylvia; Andonian, Sero

2014-10-23

362

Left thigh phlegmon caused by Nocardia farcinica identified by 16S rRNA sequencing in a patient with Leprosy: a case report  

PubMed Central

Background In recent years, Nocardia farcinica has been reported to be an increasingly frequent cause of localized and disseminated infections in the immunocompromised patient. However, recent literature is limited. We report a case of left thigh phlegmon caused by N. farcinica that occurred in a patient with Leprosy undergoing treatment with prednisone for leprosy reaction. Case presentation We describe the case of left thigh phlegmon caused by Nocardia farcinica in a 54-year-old Italian man affected by multi-bacillary leprosy. The patient had worked in South America for 11 years. Seven months after his return to Italy, he was diagnosed with Leprosy and started multi-drug antibiotic therapy plus thalidomide and steroids. Then, during therapy with rifampicin monthly, minocycline 100 mg daily, moxifloxacin 400 mg daily, and prednisone (the latter to treat type 2 leprosy reaction), the patient complained of high fever associated with erythema, swelling, and pain in the left thigh. Therefore, he was admitted to our hospital with the clinical suspicion of cellulitis. Ultrasound examination and Magnetic Resonance Imaging showed left thigh phlegmon. He was treated with drainage and antibiotic therapy (meropenem and vancomycin replaced by daptomycin). The responsible organism, Nocardia farcinica, was identified by 16S rRNA sequencing in the purulent fluid taken out by aspiration. The patient continued treatment with intravenous trimethoprim/sulfamethoxazole and imipenem followed by oral trimethoprim/sulfamethoxazole and moxifloxacin. A whole-body computed tomography did not reveal dissemination to other organs like the lung or brain. The patient was discharged after complete remission. Oral therapy with trimethoprim/sulfamethoxazole, moxifloxacin, rifampicin monthly, clofazimine and thalidomide was prescribed to be taken at home. One month after discharge from the hospital the patient is in good clinical condition with complete resolution of the phlegmon. Conclusion N. farcinica is a rare infectious agent that mainly affects immunocompromised patients. Presentation of phlegmon only without disseminated infection is unusual, even in these kinds of patients. In any case, a higher index of suspicion is needed, as diagnosis can easily be missed due to the absence of characteristic symptoms and the several difficulties usually encountered in identifying the pathogen. PMID:23556433

2013-01-01

363

A ten-year review of lower extremity burns in diabetics: small burns that lead to major problems.  

PubMed

Diabetes mellitus with its resulting neurovascular changes may lead to an increased risk of burns and impaired wound healing. The purpose of this article is to review 10 years of experience with foot and lower leg burns in patients with diabetes at a single adult burn center. Patients with lower extremity burns and diabetes mellitus, between May 1999 and December 2009, were identified in the Trauma Registry of the American College of Surgeons database, and their charts were reviewed for data related to their outcomes. Sixty-eight diabetic patients, 87% male, with a mean age of 54 years, sustained foot or lower extremity burns with 37 having burns resulting from insensate feet. The pathogenesis included walking on a hot or very cold surface (8), soaking feet in hot water (22), warming feet on or near something hot such as a heater (13), or spilling hot water (7). The majority of patients were taking insulin (59.6%) or oral hyperglycemic medications (34.6%). Blood sugar levels were not well controlled (mean glucose, 215.8 mg/dl; mean hemoglobin A1c, 9.08%). Renal disease was common with admission serum blood urea nitrogen (27.5 mg/dl) and creatinine (2.21 mg/dl), and 13 were on dialysis preinjury. Cardiovascular problems were common with 39 (57%) having hypertension or cardiac disease, 3 having peripheral vascular disease, and 9, previous amputations. The mean burn size was 4.2% TBSA (range, 0.5-15%) with 57% being full thickness. Despite the small burn, the mean length of stay was 15.2 days (range, 1-95), with 5.65 days per 1% TBSA. Inability to heal these wounds was evident in 19 patients requiring readmission (one required 10 operative procedures). At least one patient sustained more than one burn. There were 62 complications with 30 episodes of infection (cellulitis, 28; osteomyelitis, 4; deep plantar infections, 2; ruptured Achilles tendon, 1) and 3 deaths. Eleven patients needed amputations (7 below-knee amputations, 4 transmetatarsal amputations, and 20 toe amputations) with several needing revisions or higher amputations. Patients with diabetes have an increased risk for lower extremity complications, but the risk of burns is not well known. The majority of lower extremity burns result from intentional exposure to sources of heat without recognition for the risk of burns. Once a burn occurs, morbidity and cost to the patient and society are severe. Prevention programs should be initiated to make diabetic patients and their doctors aware of the significant risk for burns. PMID:22929524

Barsun, Alura; Sen, Soman; Palmieri, Tina L; Greenhalgh, David G

2013-01-01

364

Skin Infections and Antibiotic Stewardship: Analysis of Emergency Department Prescribing Practices, 2007–2010  

PubMed Central

Introduction: National guidelines suggest that most skin abscesses do not require antibiotics, and that cellulitis antibiotics should target streptococci, not community-associated MRSA (CA-MRSA). The objective of this study is to describe antimicrobial treatment of skin infections in U.S. emergency departments (EDs) and analyze potential quality measures. Methods: The National Hospital Ambulatory Medical Care Survey (NHAMCS) is a 4-stage probability sample of all non-federal U.S. ED visits. In 2007 NHAMCS started recording whether incision and drainage was performed at ED visits. We conducted a retrospective analysis, pooling 2007–2010 data, identified skin infections using diagnostic codes, and identified abscesses by performance of incision and drainage. We generated national estimates and 95% confidence intervals using weighted analyses; quantified frequencies and proportions; and evaluated antibiotic prescribing practices. We evaluated 4 parameters that might serve as quality measures of antibiotic stewardship, and present 2 of them as potentially robust enough for implementation. Results: Of all ED visits, 3.2% (95% confidence interval 3.1–3.4%) were for skin infection, and 2.7% (2.6–2.9%) were first visits for skin infection, with no increase over time (p=0.80). However, anti-CA-MRSA antibiotic use increased, from 61% (56–66%) to 74% (71–78%) of antibiotic regimens (p<0.001). Twenty-two percent of visits were for abscess, with a non-significant increase (p=0.06). Potential quality measures: Among discharged abscess patients, 87% were prescribed antibiotics (84–90%, overuse). Among antibiotic regimens for abscess patients, 84% included anti-CA-MRSA agents (81–89%, underuse). Conclusion: From 2007–2010, use of anti-CA-MRSA agents for skin infections increased significantly, despite stable visit frequencies. Antibiotics were over-used for discharged abscess cases, and CA-MRSA-active antibiotics were underused among regimens when antibiotics were used for abscess. [West J Emerg Med. 2014;15(3):282–289.] PMID:24868305

Pallin, Daniel J.; Camargo, Carlos A.; Schuur, Jeremiah D.

2014-01-01

365

Reducing length of stay for acute diabetic foot episodes: employing an extended scope of practice podiatric high-risk foot coordinator in an acute foundation trust hospital  

PubMed Central

Background To enhance the acute management of people with diabetic foot disease requiring admission, an extended scope of practice, podiatric high-risk foot coordinator position, was established at the Great Western Hospital, Swindon in 2010. The focus of this new role was to facilitate more efficient and timely management of people with complex diabetic foot disease. The aim of this project was to investigate the impact of the podiatric high-risk foot coordinator role on length of stay, rate of re-admission and bed cost. Method This study evaluated the difference in length of stay and rate of re-admission between an 11- month pre-pilot period (November 2008 to October 2009) and a 10-month pilot period (August 2010 to June 2011). The estimated difference in bed cost between the pre-pilot and pilot audits was also calculated. Inclusion criteria were restricted to inpatients admitted with a diabetic foot ulcer, gangrene, cellulitis or infection as the primary cause for admission. Eligible records were retrieved using ICD-10 (V9) coding via the hospital clinical audit department for the pre-pilot period and a unique database was used to source records for the pilot phase. Results Following the introduction of the podiatric high-risk foot coordinator, the average length of stay reduced from 33.7 days to 23.3 days (mean difference 10.4 days, 95% CI 0.0 to 20.8, p = 0.050). There was no statistically significant difference in re-admission rate between the two study periods, 17.2% (95% CI 12.2% to 23.9%) in the pre-pilot phase and 15.4% (95% CI 12.0% to 19.5%) in the pilot phase (p = 0.820). The extrapolated annual cost saving following the implementation of the new coordinator role was calculated to be £234,000 for the 2010/2011 year. Conclusions This audit found that the extended scope of practice coordinator role may have a positive impact on reducing length of stay for diabetic foot admissions. This paper advocates the role of a podiatric high-risk foot coordinator utilising an extended scope of practice model, although further research is needed. PMID:24330601

2013-01-01

366

First case of infective endocarditis caused by Helicobacter cinaedi.  

PubMed

BackgroundUp to 20% of all infective endocarditis are blood culture-negative and therefore a diagnostic challenge. Here we present the case of an infective endocarditis due to Helicobacter cinaedi finally diagnosed using different molecular methods. This highly fastidious gram-negative spiral rod is increasingly recognized as a human pathogen, above all in immunocompromised patients. So far H. cinaedi has been associated with bacteremia, cellulitis, arthritis and meningitis.Case presentationA 71-year-old man presented with fever and progressive dyspnea for weeks. He was immunocompromised by long-term steroid therapy. As one major and two minor Duke¿s criteria (vegetation, fever and aortic valve stenosis as predisposition) were present, an infective endocarditis was suspected and an empiric therapy with amoxicillin/clavulanic acid and gentamicin was established. The persistent severe aortic regurgitation resulted in a valve replacement. Histological evaluation of the aortic valve showed a polypous-ulcerative endocarditis. Gram stain and culture remained negative. Broad-range bacterial PCR targeting the 16S rRNA gene on the biopsy of the aortic valve identified H. cinaedi as the causative agent. The antibiotic therapy was simplified accordingly to ceftriaxone and gentamicin with a recommended duration of 6 weeks. Ten days after valve replacement the patient was discharged. To complete our molecular finding, we sequenced nearly the complete 16S rRNA gene (accession number KF914917) resulting in 99.9% identity with H. cinaedi reference sequences. Based on this result, 2 species-specific PCR tests amplifying part of the ctd gene were established and applied to the valve specimen. The 2 PCRs confirmed H. cinaedi. In addition, we analyzed stool, urine and saliva from the patient using H. cinaedi PCR. The fecal and urine specimen showed a positive signal, saliva was PCR-negative.ConclusionWe identified H. cinaedi as causative agent of a culture-negative endocarditis in an immunocompromised patient using broad-range and specific PCR. In addition to 2 cases from Japan presented on international meetings in 2010 and 2013, our case report shows that H. cinaedi should be recognized as additional causative organism of infective endocarditis. The use of molecular diagnostic techniques proved to be a powerful complement for the detection of blood culture-negative infective endocarditis. PMID:25403102

Bartels, Hanni; Goldenberger, Daniel; Reuthebuch, Oliver; Vosbeck, Juerg; Weisser, Maja; Frei, Reno; Bättig, Veronika

2014-11-18

367

Effets des electrons secondaires sur l'ADN  

NASA Astrophysics Data System (ADS)

Les interactions des electrons de basse energie (EBE) representent un element important en sciences des radiations, particulierement, les sequences se produisant immediatement apres l'interaction de la radiation ionisante avec le milieu biologique. Il est bien connu que lorsque ces radiations deposent leur energie dans la cellule, elles produisent un grand nombre d'electrons secondaires (4 x 104/MeV), qui sont crees le long de la trace avec des energies cinetiques initiales bien inferieures a 20 eV. Cependant, il n'y a jamais eu de mesures directes demontrant l'interaction de ces electrons de tres basse energie avec l'ADN, du principalement aux difficultes experimentales imposees par la complexite du milieu biologique. Dans notre laboratoire, les dernieres annees ont ete consacrees a l'etude des phenomenes fondamentaux induits par impact des EBE sur differentes molecules simples (e.g., N2, CO, O2, H2O, NO, C2H 4, C6H6, C2H12) et quelques molecules complexes dans leur phase solide. D'autres travaux effectues recemment sur des bases de l'ADN et des oligonucleotides ont montre que les EBE produisent des bris moleculaires sur les biomolecules. Ces travaux nous ont permis d'elaborer des techniques pour mettre en evidence et comprendre les interactions fondamentales des EBE avec des molecules d'interet biologique, afin d'atteindre notre objectif majeur d'etudier l'effet direct de ces particules sur la molecule d'ADN. Les techniques de sciences des surfaces developpees et utilisees dans les etudes precitees peuvent etre etendues et combinees avec des methodes classiques de biologie pour etudier les dommages de l'ADN induits par l'impact des EBE. Nos experiences ont montre l'efficacite des electrons de 3--20 eV a induire des coupures simple et double brins dans l'ADN. Pour des energies inferieures a 15 eV, ces coupures sont induites par la localisation temporaire d'un electron sur une unite moleculaire de l'ADN, ce qui engendre la formation d'un ion negatif transitoire dans un etat electronique dissociatif, cette localisation est suivie d'une fragmentation. A plus haute energie, la dissociation dipolaire (i.e., la formation simultanee d'un ion positif et negatif) et l'ionisation jouent un role important dans le dommage de l'ADN. L'ensemble de nos resultats permet d'expliquer les mecanismes de degradation de l'ADN par les EBE et d'obtenir des sections efficaces effectives des differents types de dommages.

Boudaiffa, Badia

368

Effets du vieillisement de la batterie Li-ion sur les performances d'un vehicule recreatif hybride branchable a trois roues  

NASA Astrophysics Data System (ADS)

La prediction de l'evolution du vieillissement de la batterie lithium-ion est source d'un grand defi, dans les applications liees aux vehicules electriques et hybrides. Sa meconnaissance est un risque considerable compromettant la viabilite d'un tel systeme. Invoquant les couts substantiels de la densite d'energie, liee a la degradation considerable des performances de la batterie au cours de sa duree de vie, il devient important d'en tenir compte des le processus de conception. La dependance de la strategie de controle du vehicule aux parametres de la batterie justifie aussi la necessite d'une telle prediction. Il est connu que le vieillissement, sensible aux facteurs tels que le courant, la temperature et la profondeur de decharge, a un impact considerable sur la perte de capacite de la batterie ainsi que sur l'augmentation de la resistance interne. Le premier est directement lie a l'autonomie electrique du vehicule, alors que le second mene a une surchauffe de la batterie, a une augmentation des pertes en puissance qui se manifeste par une diminution de la tension de bus. A cet egard, implique dans la conception d'un vehicule recreatif hybride branchable a trois roues, le Centre de Technologies Avancees s'interesse a l'etude du vieillissement de la batterie Li-ion pour une telle application. Pour ce faire, au contraire de la plupart des estimations empiriques de la duree de vie, basees sur des profils de decharge a courant constant, un profil de courant plus approprie pour l'application donnee, base sur un cycle de vitesse representatif de la conduite d'une motocyclette, a ete utilise. Par le biais d'un simulateur complet du vehicule, le cycle de courant a ete extrait du cycle de vitesse. Ainsi, les travaux menes impliquent l'analyse experimentale de la decharge cyclique de quatre cellules LiFePO 4. Pendant plus de 1400 cycles, un banc d'essai complet a permis l'acquisition de la capacite, de la resistance interne, du courant, de la tension ainsi que de la temperature de surface. Mots-cles : vieillissement, batterie, lithium-ion, LiFePO4, capacite, resistance interne, PHEV, vehicule

Nadeau, Jonathan

369

EMANI, ERAM and Other European Activities Contributing to a Global Digital Library in Mathematics.  

NASA Astrophysics Data System (ADS)

With the rapidly growing activities in electronic publishing ideas came up to install global repositories which deal with three mainstreams in this enterprise: storing the electronic material currently available, pursuing projects to solve the archiving problem for this material with the ambition to preserve the content in readable form for future generations, and to capture the printed literature in digital versions providing good access and search facilities for the readers. Long-term availability of published research articles in mathematics and easy access to them is a strong need for researchers working with mathematics. Hence in this domain some pioneering projects have been established addressing the above mentioned problems. The talk will describe some of these activities and the plan to develop a global Digital Library in Mathematics (DLM). For example, in the archiving area as a special project for mathematics the Electronic Mathematics Archives Network Initiative (EMANI) had been designed. Having in mind that a distributed architecture would be more suitable and reduce the load on the partners for such a project, a network is proposed, which also might be a more open approach for extending the project from a initially restricted solution to a more comprehensive enterprise. For the core of the network, a co-operational system of reference libraries and content providers like publishers and editors has been be set up. On the side of the libraries the following partners have agreed to set up a prototype for the archive: the Tsinghua University Library in Beijing, the Cornell University Library in Ithaca (N. Y.), the Mathematical Library at Orsay in Paris and the Lower Saxony State and University Library in Goettingen. The first group of content providers consists of the Springer publishing house, associated publishers and journals posted in the Electronic Library of EMIS. The Electronic Research Archive in Mathematics (ERAM) is a German project dealing with capturing the content of a classical bibliographic service in mathematics in a database, and combining this with the retro-digitisation of selected mathematical publications. This is extended now by further projects which shall try to retro-digitise the national mathematical heritage in several countries world-wide. In particular ideas to cover the Russian publications in a digital repository called RusDLM are investigated at present, and they may contribute to a bigger programme for the Russian Federation, called "Electronic Russia", As further digitisation projects the French activity NUMDAM, pursued by Cellule MathDoc in Grenoble, and the European Cooperation in DIEPER have to be mentioned.

Wegner, Bernd

370

Evaluation of craniofacial surgery in the treatment of facial deformities.  

PubMed Central

Surgical access to the cranial, orbital, and facial areas, as developed by Tessier, has produced not only definitive repair of previously uncorrectable congenital deformities such as orbital hypertelorism and facial stenosis (e.g., Crouzon's, Apert's syndromes) but also has improved markedly the treatment of traumatic and neoplastic defects. The surgical approach allows complete dissection of facial soft tisses including the orbits from the underlying bones followed by corrective osteotomies and fixation. Mobilization of the frontal lobes through a frontal bone flap exposure may be required. The ramifications of this latest intrusion by surgeons into a previously inviolate anatomic area have involved neurosurgeons, ophthalmologists, anesthesiologists, and dental and psycho-social disciplines. The disciplines of genetics and embryology are being influenced by this new field of surgery, much as the study of immunology was influenced by transplantation surgery two decades ago. This report analyzes a 10 year experience with over 100 patients with emphasis on patient selection by disease, age, intellectual status, morbidity, complications, and the psycho-social reactions of patient and family. Procedures initially planned to correct dental and aesthetic defects are proving beneficial for other functions including hearing, taste and smell, articulation and tongue movement, respiratory function, vision, and possibly bone growth. The development of self image, a normal process always in operation, is also strikingly altered. These operations may last as long as 14 to 16 hours. We have had no deaths or postoperative blindness. One postoperative cerebrospinal fluid leak was successfully repaired. Three partial losses of bone grafts and four instances of late cellulitis have occurred. Prevention of infection seems related to avoidance of dead spaces and primary closure of all mucosal, dural, conjunctival and skin surfaces. Images Figs. 1 a and b. Fig. 1c., Fig. 1d. Fig. 1f. Fig. 1g. Fig. 1h. Fig. 1i. Fig. 1m. Fig. 2a. Fig. 2b., Fig. 2c., Fig. 2d. Fig. 2e. Figs. 3 a and b. Fig. 3d., Fig. 3e. Fig. 3f. Fig. 4a., Fig. 4b. Fig. 5a. Fig. 5b., Fig. 5c. Figs. 5d and e. Fig. 5f. Figs. 5g. and 5h. Fig. 6a., Fig. 6b. Fig. 6c. Fig. 7a. Fig. 7b. Figs. 7e and f. Fig. 8a. Fig. 8b. Fig. 8c. Fig. 8d., Fig. 8e. Fig. 9a. Fig. 9b. Figs. 9c. and d. Fig. 9e. Fig. 9f. Figs. 9g. and h. Figs. 11a, b, and c. Figs. 11d, e, f. PMID:169753

Murray, J E; Swanson, L T; Strand, R D; Hricko, G M

1975-01-01

371

Self care integrative treatment demonstrated in rural community setting improves health related quality of life of lymphatic filariasis patients in endemic villages.  

PubMed

This study assessed impact of community based self care integrative treatment provided through mass camps in villages of three districts of Kerala, India endemic for lymphatic filariasis (LF). Two most endemic Primary Health centres (PHCs) were selected from each of the three districts, where maximum concentration of LF patients is recorded. Fourteen one day LF camps, each attended by 30-40 patients were conducted. Trained Accredited Social Health Activists encouraged LF patients to attend camps. Skin wash and drying, care of bacterial entry points using dermatology drugs, and simple yoga and breathing exercises were demonstrated in these camps. Patients were advised to continue these self care activities daily at home for six months. The quality of life (QoL) of LF patients was determined for Indian life style domains using validated and pretested specific questionnaire (LF-specific QoL questionnaire-LFSQQ). It addressed conditions and state of individuals with reference to LF. The questionnaire had 7 domains and each domain consisted of a series of questions with likert scale (no problem, mild, moderate, severe, most severe). 446 patients attended one day camps to get training on integrative self care treatment. 425 patients (95.3%) were followed up after six months and QoL was reassessed. Each patient's QoL in mobility, self care, usual activity, pain and discomfort and social relationship significantly improved (P value <0.01). Psychological health showed no significant change. The disease burden, for the purpose of the study was measured by asking questions about history of painful redness, swelling and cellulitis of legs (filarial fever), foul smell (odor), itching (eczema/discharge from limb), wound (non healing ulcer) and weight/size of the limb. The difference in disease burden as recorded during the sixth month follow up was measured using dependent t test, reduced significantly (P value <0.01) in 409 (96.2%) patients. 103 (24.2%) patients experienced fever during follow up. Severity of inflammatory episodes reduced from severe problem to no problem, after six months of home based self care. There was significant relation between treatment regularity and QoL status (P value=0.003). The community based one day camps that trained LF patients on skin care and daily yoga and breathing practices improved QoL. PMID:23499714

Aggithaya, Madhur Guruprasad; Narahari, Saravu R; Vayalil, Sudha; Shefuvan, Mohammed; Jacob, Neethu K; Sushma, Kandathu Valappil

2013-06-01

372

Orbital complications in children: differential diagnosis of a challenging disease.  

PubMed

Orbital swelling in children presents diagnostic and therapeutic challenges. Most are associated with acute sinusitis with complicating factors possibly including: amaurosis, meningitis, intracranial abscess or even cavernous sinus thrombosis. However not all acute orbital swelling is associated with acute sinusitis. A careful evaluation is critical prior to initiating therapy. Clinical records of 49 children (27 girls, 22 boys, with an average age of 11.8 years) were retrospectively reviewed. Historical data evaluated included all available information from parents and previous treating physicians. All patients underwent intensive pediatric, ophthalmologic, and otorhinolaryngologic examinations. Computed tomography (CT scans) were additionally performed in 40 % of children. The results of any examinations were also evaluated. Eighteen of the 49 patients had an orbital complication due to acute sinusitis. All 18 had elevated body temperature, C-Reactive Protein (CRP) values and white blood cell counts. Endoscopy of the nose revealed pus in the middle meatus in each case. According to Chandlers' classification, ten children presented with a preseptal, and eight children had a postseptal orbital cellulitis. All patients were admitted to the hospital and treated with intravenous antibiotics. CT scans further demonstrated signs of subperiostal abscess in four children. Functional endoscopic sinus surgery (FESS) was required in six children, including all patients with subperiostal abscess. Twenty children experienced orbital swelling unrelated to acute sinusitis, i.e. atheroma, inflammed insect stings, dental related abscess, conjunctivitis, and Herpes simplex associated superinfection. In three children, acute orbital swelling was caused by an orbital tumor. Orbital complications of an acute sinusitis occur often in the pediatric patient group, and most of these patients can be treated conservative with intravenous antibiotics. Indications for FESS include failure to improve or worsening of clinical symptoms during 24 h of therapy, signs for subperiostal abscess in CT scan, and/or vision loss. Patients with infectous orbital complications had fever, elevated CRP and white blood cell counts. This symptom complex is key in making the correct diagnosis. Interestingly, 61 % of patients in this study demonstrated non-sinusitis related diseases leading to acute orbital swelling, which also required prompt recognition and appropriate therapy. PMID:25056021

Welkoborsky, Hans-J; Graß, Sylvia; Deichmüller, Cordula; Bertram, Oliver; Hinni, Michael L

2014-07-24

373

Diabetic myonecrosis: likely an underrecognized entity.  

PubMed

Diabetic myonecrosis is a rare complication of long-standing diabetes mellitus that presents as acute onset of swelling and pain of the affected muscles. The differential diagnosis includes cellulitis/pyomyositis, necrotizing fasciitis, neoplasm, and deep venous thrombosis (DVT). Missed diagnoses can lead to unnecessary invasive diagnostic procedures and inappropriate treatment. The diagnosis is established by the clinical presentation and findings on magnetic resonance imaging (MRI) scan. A 30-year-old African-American man presented with a painful mass affecting the medial aspect of the right thigh for several months. Initial laboratory studies showed white blood cell count of 8800 cells/mm(3), D-dimer value of 0.55 µg/mL, HgBA1c level of 15.1%, glucose level of 352 mg/dL, erythrocyte sedimentation rate of 22 mm/h, and C-reactive protein level of 222 mg/L. An MRI scan was obtained, and diabetic myonecrosis was diagnosed and treated. One year later, the patient had similar symptoms of pain in the contralateral thigh. Repeat workup and MRI scan were obtained. The MRI abnormalities originally seen in the right thigh 1 year earlier were present in the left thigh, with complete resolution of the abnormalities seen in the right thigh. Treatment with bed rest and analgesics resulted in symptom resolution. Patients with diabetic myonecrosis typically have no fever, normal white blood cell count, mildly increased erythrocyte sedimentation rate, and elevated C-reactive protein level in 50% of cases. They lack the radiologic signs of fascial enhancement or well-defined, rim-enhancing collections that are seen in necrotizing fasciitis and pyomyositis/abscess. The onset of severe pain and the lack of mass effect on imaging differentiate diabetic myonecrosis from tumor-like conditions such as vascular malformations or soft tissue tumors. Normal D-dimer levels and ultrasound Doppler examination of the extremity help to rule out DVT. The typical MRI scan findings and clinical presentation can lead to the diagnosis of diabetic myonecrosis, allowing the physician to avoid invasive tests, such as muscle biopsy, and to reassure patients that this condition is self-limiting with appropriate treatment. PMID:25275984

Mazoch, Mathew J; Bajaj, Gitanjali; Nicholas, Richard; Pandey, Tarun; Jambhekar, Kedar; Ram, Roopa; Montgomery, Corey

2014-10-01

374

Quasi-Elastic Light Scattering Study of Highly Swollen Lamellar and ``Sponge" Phases  

NASA Astrophysics Data System (ADS)

We investigate experimentally, using quasi elastic light scattering the dynamical properties of highly swollen lamellar and “sponge" phases. In our system the structural sizes smectic period for lamellar phases or characteristic cell size for “sponge" phases may be changed continuously by adding solvent up to scales of the order of optical wavelengths, i.e. several thousand Å. We observe the usual hydrodynamic behaviour, with monoexponential relaxation in time and q^2 scaling in reciprocal space when working with moderately dilute systems. At higher dilutions, the behaviour is no longer hydrodynamic: a q^3 universal scaling is observed for both lamellar and “sponge" samples, with stretched exponential relaxation in time and universal exponents for unoriented lamellar or “sponge" samples. The undulation mode is identified in our data on oriented lamellar phases, both in its hydrodynamic limit and beyond, which leads to a measurement of the bilayer bending modulus kappa. A tentative interpretation is given for our data on “sponge" phases, also leading to an estimate for kappa. Nous étudions expérimentalement, par diffusion quasi-élastique de la lumière, les propriétés dynamiques de phases lamellaires et “éponge" très diluées. Les dimensions structurales période smectique en phase lamellaire, taille caractéristique de la cellule en phase “éponge" peuvent être accrues de façon continue, par adjonction de solvant, jusqu'à atteindre des échelles de plusieurs milliers d'angströms, c'est-à-dire comparables à la longueur d'onde de la lumière. Avec des échantillons de dilution moyenne nous observons le comportement hydrodynamique habituel : relaxation temporelle mono exponentielle et loi de puissance en q^2 dans l'espace réciproque. Aux dilutions plus élevées, le comportement n'est plus hydrodynamique : une loi de puissance en q^3 est observée en phase lamellaire comme en phase “éponge" ; la relaxation temporelle suit une loi en exponentielle étirée, avec un exposant universel pour les phases lamellaires non orientées et les phases “éponge". Le mode d'ondulation est identifié, dans sa limite hydrodynamique et au delà, à partir de nos données sur les phases lamellaires orientées ce qui donne lieu à une mesure du module kappa d'élasticité de courbure de la bicouche. Nous proposons une interprétation de nos données en phase “éponge" conduisant également à une estimation de kappa.

Freyssingeas, Éric; Roux, Didier; Nallet, Frédéric

1997-06-01

375

Critical limb ischaemia in a diabetic population from an Asian Centre: angiographic pattern of disease and 3-year limb salvage rate with percutaneous angioplasty as first line of treatment  

PubMed Central

Purpose: Lower extremity amputation prevention (LEAP) is an ongoing program in our institution aimed at salvaging limbs in patients with critical limb ischemia (CLI). Patients in the LEAP program with reconstructible anatomy on initial Doppler imaging received either bypass surgery or percutaneous transluminal balloon angioplasty (PTA). We present the 3 year limb salvage rate and angiographic disease patterns in 42 consecutive diabetic patients with CLI who received PTA in 2005. Methods and Material: 26 women and 16 men with diabetes between the ages of 45 and 91 years old (mean age, 70.8 years) received PTA in 2005. Presenting symptoms were rest pain (n = 22), pre-existing gangrene (n = 17), non-healing ulcer (n = 16) and cellulitis (n = 2). The aim of the PTA was to achieve straight-line flow from the abdominal aorta down to the patent dorsalis pedis or plantar arch, with limb salvage as the ultimate outcome. Failure of treatment was defined as any amputation above the level of a Syme’s amputation or the need for further surgical bypass. Technical success was achieved in 90% (38 out of 42 patients). Results: Limb salvage rates were 93% at 1 month, 87% at 3 months, 82% at 6 months, 78% at 1 year, 69% at 2 years and 66% at 3 years. Mortality was 17% (n = 7) at 3 years. Of the 13 patients with failed therapy, 3 underwent bypass, 9 had amputations and 1 had bypass followed by amputation. Four of the cases required further intervention due to worsening gangrene and infection, while the remaining was due to persistent rest pain. The rest of the 32 patients had no lower limb related issues at the end of 3 years, with improvement of the presenting symptoms. Patterns of treated segments were aortoiliac occlusions (n = 3), pure infrapopliteal disease (n = 3), femoropopliteal with at least 1 good infrapopliteal run-off vessel (n = 14) and combined femoropopliteal and infrapopliteal disease (n = 25). Conclusion: Involvement of infrapopliteal vessels that needs to be treated is common in Asian diabetics. While early limb salvage rates up to 1 year are similar, the 3 year limb salvage rates in Asian diabetics are lower than the western population. PMID:21611069

Tan, M; Pua, U; Wong, DES; Punamiya, SJ; Chua, GC; Teo, N

2010-01-01

376

Le diagnostic anténatal de la trisomie 21 par l'hybridation in situ en fluorescence (FISH): à propos des premiers tests réalisés au Maroc  

PubMed Central

Introduction Le but de cette étude était de présenter les premiers résultats de diagnostic anténatal de la trisomie 21 par la technique d'hybridation in situ en fluorescence (FISH) au Maroc et discuter son intérêt dans le diagnostic rapide de cette aneuploïdie. Méthodes Ce travail a été réalisé chez 23 femmes avec des grossesses à haut risque de trisomie 21. La moyenne d’âge des gestantes étaient de 37,43 ans avec des extrêmes de 21 et 43 ans. Toutes étaient musulmanes mariées, mariage légitimé par la Charia, dont trois mariages consanguins, sauf une originaire de la République Démocratique du Congo qui était chrétienne et concubine. La majorité des femmes étaient fonctionnaires et avaient un niveau de scolarisation moyen à élevé. Toutes les patientes ont bénéficié d'une consultation de génétique médicale au cours de laquelle il leur a été donné des informations sur la technique, son intérêt et ses limites. Il s'agit de femmes enceintes qui avaient soit un âge maternel élevé ou des signes d'appel échographiques et/ ou biochimiques. Une des patientes était porteuse d'une translocation robertsonienne t(14;21) équilibrée. Une amniocentèse a été réalisée chez toutes les gestantes et aucun avortement n'a était induit par ce geste invasif. L’âge gestationnel moyen à la première consultation était de 14 semaines d'aménorrhée (SA) et à l'amniocentèse était de 16 SA et 5 jours. L'analyse FISH a été réalisée, après consentement des couples, sur des cellules non cultivées à partir des échantillons de liquides amniotiques, en utilisant des sondes spécifiques du chromosome 21. Résultats Parmi les 23 patientes qui ont bénéficiées d'un diagnostic anténatal de la trisomie 21 par la technique FISH, nous avons pu rassurer 21 d'entre elles, et nous avons détecté deux cas de trisomie 21 fœtal. Conclusion La technique FISH permet un diagnostic anténatal rapide, en moins de 48h, de la trisomie 21 sur une faible quantité de liquide amniotique. Elle offre aux couples l'avantage de prendre, dans des délais raisonnables, la décision qui leur convient concernant la poursuite ou non de la grossesse. Elle permet souvent, avec un résultat normal, de rassurer rapidement les femmes enceintes trop angoissées. PMID:23330029

Lamzouri, Afaf; Natiq, Abdelhafid; Tajir, Mariam; Sendid, Mohamed; Sefiani, Abdelaziz

2012-01-01

377

Clinical use of Dieletrophoresis separation for live Adipose derived stem cells  

PubMed Central

Background Microelectrode dieletrophoresis capture of live cells has been explored in animal and cellular models ex-vivo. Currently, there is no clinical data available regarding the safety and efficacy of dielectrophoresis (DEP) buffers and microcurrent manipulation in humans, despite copious pre-clinical studies suggesting its safety. The purpose of this study was to determine if DEP isolation of SVF using minimal manipulation methods is safe and efficacious for use in humans using the hand lipotransfer model. Methods Autologous stromal vascular fraction cells (SVF) were obtained from lipoaspirate by collagenase digestion and centrifugation. The final mixture of live and dead cells was further processed using a custom DEP microelectrode array and microcurrent generator to isolate only live nucleated cells. Lipotransfer was completed using fat graft enhanced with either standard processed SVF (control) versus DEP filtered SVF (experimental). Spectral photography, ultrasound and biometric measurements were obtained at post operatively days 1, 4, 7, 14, 30, 60 and 90. Results The DEP filter was capable of increasing SVF viability counts from 74.3?±?2.0% to 94.7?±?2.1%. Surrogate markers of inflammation (temperature, soft tissue swelling, pain and diminished range of motion) were more profound on the control hand. Clinical improvement in hand appearance was appreciated in both hands, though the control hand exclusively sustained late phase erosive skin breaks on post operative day 7. No skin breaks were appreciated on the DEP-SVF treated hand. Early fat engraftment failure was noted on the control hand thenar web space at 3?months post surgery. Discussion No immediate hypersensitivity or adverse reaction was appreciated with the DEP-SVF treated hand. In fact, the control hand experienced skin disruption and mild superficial cellulitis, whereas the experimental hand did not experience this complication, suggesting a possible “protective” effect with DEP filtered SVF. Late ultrasound survey revealed larger and more frequent formation of oil cysts in the control hand, also suggesting greater risk of engraftment failure with standard lipotransfer. Conclusion Clinical DEP appears safe and efficacious for human use. The DEP microelectrode array was found to be versatile and robust in efficiently isolating live SVF cells from dead cells and cellular debris in a time sensitive clinical setting. PMID:22594610

2012-01-01

378

Diseases associated with hidranitis suppurativa: part 2 of a series on hidradenitis.  

PubMed

Hidradenitis suppurativa (HS), a pathologic follicular disease, impacts patients' lives profoundly and usually occurs in isolation. The diseases with the strongest association are obesity, depression, and pain. HS is associated with many diseases including acne conglobata (AC), dissecting cellulitis, pilonidal cysts, and obesity. Pyoderma fistulans sinifica (fox den disease) appears to be the same entity as Hurley Stage 2 of 3 HS. The rate of acne vulgaris in HS patients mirrors unaffected controls. The most common, albeit still uncommon, association is with seronegative, haplotype unlinked arthritis (most importantly B27), in particular spondolyarthritis. Crohn disease and HS occur together at a rate that varies from 0.6% to 38% in retrospective cases series. Ulcerative colitis occurred with HS in 14% of patients in one series. The next most common association is with pyoderma gangrenosum, but this association is likely under-reported. Synovitis-Acne-Pustulosis Hyperostosis-Osteitis (SAPHO) syndrome, which is rare, has more than 10 reports linking it to HS. Nine case reports have linked Dowling-Degos disease (DDD) to HS and two reports related HS to Fox-Fordyce disease (FF), but because both occur in the axilla this might be a mere coincidence. HS is rarely associated with ophthalmic pathology. Specifically, more than 5 reports link it to Keratitis-Ichthyosis-Deafness syndrome (KID); greater than10 cases link it to interstitial keratitis and 2 cases are linked to Behçet's disease. The presence of proteinuria and acute nephritis link HS to the kidney, especially since and reports have documented resolution of HS after renal transplant. Florid steatocystoma multiplex, Sjogren Syndrome, and HS have been linked and their reports likely underestimate their coincidence because all these entities involve occlusion (albeit by different mechanisms). Three reports link HS and amyloid, but both share some common genetic underpinnings and thus the coincidence of these diseases is likely underreported. Pyoderma vegetans has been noted in 2 cases of HS and 4 cases of Inflammatory Bowel Disease (IBD) and is likely a clue to the linkage of the pathology of IBD and HS. Pityriasis rubra pilaris, in particular Type VI related to HIV, has a relationship more commonly with acne conglobata, but with HS also. Single case reports of diseases associated with HS include systemic lupus erythematosus, acromegaly, Down syndrome, Bazex-Dupre´-Christol, and prurtis ani, but these might be coincidences. Pyogenic Arthritis, Pyoderma gangrenosum, and Acne (PAPA Syndrome) and Pyoderma gangrenosum, Acne, and Suppurative Hidradenitis (PASH Syndrome) are pyodermic-arthritic syndromes that are associated with HS. Erythema nodosum and granulomatous lobular mastitis have been reported with HS but the significance of these reports is uncertain. Because of scarring, HS can result in lymphedema including scrotal elephantiasis and verrucous lymphedema. HS is sometimes accompanied by obesity, hypertension, and anemia and can be considered a disease in the spectrum of metabolic syndrome, a skin disease with systemic consequences. HS, like other types of chronic inflammation when long standing in the perianal and perineal areas, can result in squamous cell cancer. A variety of drugs can induce HS. These include lithium, sirolimus, cyclosporine, vemurafenib, and oral contraceptives. Inverse psoriasis or psoriasis vulgaris as a side effect of infliximab therapy may be associated with HS. These associations aside, most cases of HS occur in isolation without coincident morbidity. PMID:24011308

Scheinfeld, Noah

2013-06-01

379

Protection des ions organiques contre les dommages induits a l'ADN par les electrons de basse energie  

NASA Astrophysics Data System (ADS)

Il a ete demontre que les electrons de basse energie (EBE) peuvent induire des cassures simple brin (CSB) a l'ADN, via la formation d'anions transitoires qui decroissent par attachement dissociatif, ou dans d'autres etats electroniques dissociatifs menant a la fragmentation. Afin d'effectuer une etude complete des effets des electrons de basse energie sur la matiere biologique, il est necessaire de comprendre leur mecanismes d'interaction non seulement avec l'ADN, mais avec les constituants de son environnement. Les histones sont une composante importante de l'environnement moleculaire de l'ADN. Leur charge positive leur permet de s'associer aux groupements phosphate anionique de l'ADN. Le role principal de ces proteines basiques consiste a organiser l'ADN et l'empaqueter afin de former la chromatine. Les cations sont une autre composante importante de la cellule; ils jouent un role dans la stabilisation de la conformation B de l'ADN in vitro par leurs interactions avec les petits et grands sillons de l'ADN, ainsi qu'avec le groupement phosphate charge negativement. Avec les histones, ils participent egalement a la compaction de l'ADN pour former la chromatine. Cette etude a pour but de comprendre comment la presence d'ions organiques (sous forme de Tris et d'EDTA) a proximite de l'ADN modifie le rendement de cassures simple brin induit par les electrons de basse energie. Le Tris et l'EDTA ont-ete choisis comme objet d'etude, puisqu'en solution, ils forment le tampon standard pour solubiliser l'ADN dans les experiences in vitro (10mM Tris, 1mM EDTA). De plus, la molecule Tris possede un groupement amine alors que l'EDTA possede 4 groupements carboxyliques. Ensembles, ils peuvent se comporter comme un modele simple pour les acides amines. Le ratio molaire de 10 :1 de Tris par rapport a l'EDTA a pour but d'imiter le comportement des histones qui sont riches en arginine et lysine, acides amines possedant un groupement amine charge positivement additionnel. Des films d'ADN de differentes epaisseurs, possedant entre 0 et 32 ions organiques/ nucleotide, ont ete irradies avec des electrons de 10eV. Les dommages induits par les electrons, sous forme de cassures, ont ete detectes par electrophorese. Nous avons demontre que le rendement de cassure simple brin diminuait de facon dramatique en fonction du nombre d'ions organiques/ nucleotide. Aussi peu que 2 ions organiques/ nucleotide sont suffisant pour decroitre le rendement de SSB de 70%. Cet effet radioprotecteur est en partie explique par l'augmentation de l'epaisseur des films, mais surtout par la modification du champ electrique a proximite de l'ADN, due a l'ajout de molecules chargees positivement. La modification du champ electrique pres de l'ADN altere les parametres de resonance comme le temps de vie de l'anion transitoire et la limite de dissociation, qui influent directement sur la section efficace d'attachement dissociatif. L'effet protecteur peut egalement etre explique par la restauration des bases anioniques deshydrogenees induites par l'attachement dissociatif de l'electron sur une base (G(-H)-). Ce sont les molecules Tris qui, en transferant un atome d'hydrogene ou un proton, restaurent les bases deshydrogenees et inhibent par le fait meme la formation de cassures simple brin. Ces resultats indiquent que les histones peuvent egalement participer a la reparation de dommages precoces induits a l'ADN avant qu'elles ne menent a des dommages encore plus nocifs et difficiles a reparer, comme les cassures simples brins. Mots cles : Electrons de basse energie, dommage a l'ADN, ions organiques, attachement dissociatif de l'electron.

Dumont, Ariane

380

Group A streptococcal infections in injection drug users in Barcelona, Spain: epidemiologic, clinical, and microbiologic analysis of 3 clusters of cases from 2000 to 2003.  

PubMed

An unexplained resurgence of Group A streptococci (GAS) infections has been observed since the mid-1980s in the United States and Europe, particularly among intravenous drug users (IDUs). Several risk factors have been identified. Mutations in the capsule synthesis regulator genes (csrRS) have been associated with an increase in virulence. From January 1998 to December 2003, we conducted a prospective and retrospective descriptive analysis of invasive GAS soft-tissue infections in IDUs in Barcelona, Spain. Clinical features were collected, and we conducted a surveillance study to identify risk factors associated with GAS soft-tissue infections. We analyzed chromosomal DNA by low cleavage restriction enzymes and used pulsed-field gel electrophoresis (PFGE) and variable gene sequence typing (VGST) of the emm gene to disclose the epidemiologic relationship between the strains. We analyzed the influence of clonality (M-type) and mutations in csrRS genes of these strains on clinical features. We identified 44 cases, all of which were grouped in 3 clusters: fall 2000, fall 2002, and fall 2003. Cellulitis with or without abscesses (75%) and fever (90.9%) were the most common clinical manifestations. Distant septic complications were infrequent (18.2%). Although all patients had severe infections (mainly bacteremic needle abscesses), their outcome with antibiotic therapy, usually beta-lactam, was successful in all cases. However, surgery was needed in 40.9% of patients. Through the surveillance study we found that infected patients had a higher number of drug injections per day (odds ratio [OR], 18.84; 95% confidence interval [CI], 4.83-79.4; p<0.00001), shared paraphernalia for drug use more frequently (OR, 11.11; 95% CI, 3.24-39.04; p<0.0001), were in a higher proportion both currently unemployed and homeless (OR, 4.22; 95% CI, 1.5-12.15; p<0.0001), were not in a methadone maintenance program (OR, 0.03; 95% CI, 0-0.19; p<0.00001), and more often bought drugs at a specific site (OR, 33.92; 95% CI, 7.44-174.93; p<0.00001) and from a specific dealer (OR, 72; 95% CI, 8-3090; p<0.00001), compared with patients not infected. The fall 2000 cluster was polyclonal, whereas the other 2 clusters were mainly due to the same strain of GAS (emm 25.2), and were defined as epidemic outbreaks. Clinically, the cases due to the clonal strain presented abscesses and needed surgery more frequently (p<0.001 and p=0.005, respectively). On the other hand, mutations in the csrRS genes were not associated with invasive GAS soft-tissue infection. There has been an increase in the number of cases of invasive GAS soft-tissue infections in IDUs in Barcelona, which seems to be related to drug users' habits and their socioeconomic status. Clonality (emm 25.2) but not mutations in the csrRS genes was associated with more severe GAS soft-tissue infections. PMID:16721256

Sierra, Josep M; Sánchez, Francesca; Castro, Pedro; Salvadó, Margarita; de la Red, Gloria; Libois, Agnes; Almela, Manuel; March, Francesca; Español, Montserrat; Sambeat, Maria Antonia; Romeu, Joan; Brugal, Maria Teresa; García de Olalla, Patricia; Gatell, Jose Maria; Vila, Jordi; García, Felipe; López Colomés, Jose Luís; Caylà, Joan A; Coll, Pere

2006-05-01

381

Validation and Analysis of a Multi-site MIS Prospective Registry Through Sub-analysis of an MIS TLIF Subgroup  

PubMed Central

Study Design Retrospective analysis of multi-site, prospectively collected database. Objective To assess the validity and utility of a prospective spine registry by sub-analysis of patients treated with MIS TLIF. Background The MIS registry is a large-scale, multi-center series of prospectively collected clinical information on outcomes, complications, and adverse events for minimally invasive spine procedures for the treatment of degenerative lumbar conditions. Methods Analysis was performed on the MIS Prospective Registry database. A subgroup of patients treated by MIS TLIF technique was identified. Statistical analyses were performed on pre and post-operative data collected using validated health related quality of life outcome tools. Missing 1-year patient follow-up data was obtained through progressive correspondence modalities. Results Data analysis was performed on 98 MIS TLIF patients (56 female, 42 male) with a median age of 64.5 years (range 25-91 years) which were extracted from a total registry population of 478 patients. The one year follow-up rate was 87%. A total of 64 single-level, 23 two-level, 3 three-level, and 3 combined TLIFs staged with an MIS lateral procedure were included. The primary surgical indications were spondylolisthesis (27%), central stenosis (25%), foraminal stenosis (14%), post-laminectomy syndrome (14%) and degenerative scoliosis (6%). The peri-operative blood transfusion rate was 3%. Complications included intraoperative dural tear (n = 3), deep wound infection (n = 2), superficial dehiscence/cellulitis (n = 2). There was a 4% re-operation rate at the 1 year post-operative time point. Half of patients were discharged within 2 days (range 1-11 days, mean 2.97 days, median 2 days). All patients that were discharged on the first post-operative day (n = 14) underwent a single-level MIS TLIF procedure and had significantly lower pre-op disability index score than those discharged on POD 3-5 (43.7 ± 15.5 vs. 56.0 ± 18.3, p = 0.04). Average ODI scores in the subgroup of patients that had reached the one year postoperative time point were 46.5 pre-op (n = 46), and 26.2 at 1 year post-op (n = 40, p = 0.0001). There was significant improvement in VAS scores: pre-operative (back = 6.7, leg = 5.4, n = 46), and 1 year post-operative (back = 3.2, leg = 1.7, n = 40, p = 0.0001). Patients with pre-operative ODI scores greater than 50 demonstrated significant improvement starting at the 6 week post-operative time point (24 point improvement, n = 46, p < 0.001). A pre-operative ODI between 35-50 showed significant improvement starting at 3 months (15.5 point improvement, n = 29, p = 0.05). Patients with a pre-operative ODI score less than 35 had an initial period of increased disability with a trend towards significant improvement by 3 months post-op (n = 20). Conclusions Initial findings of the MIS Prospective Registry show patients can be enrolled in a relatively short time period and patient based questionnaires can successfully be obtained through a combination of clinic follow-up appointments and remote correspondence. Outcomes of the MIS Registry MIS TLIF subgroup were consistent with previously published MIS TLIF studies. Sub-analysis of data collected through level-specific patient diagnosis and treatment modalities permits outcome analysis of a wide breadth of spinal conditions and interventions.

Raiszadeh, Kamshad; Raiszadeh, Ramin; Kim, Paul; Doerr, Todd; Siddiqi, Farhan; LaMotta, Ivan; Park, Paul; Templin, Cary; Gill, Sandeep; Liang, Kevin; Kim, Choll W.

2014-01-01

382

Efficacy and safety of solifenacin succinate 10 mg once Daily: A multicenter, phase III, randomized, double-blind, placebo-controlled, parallel-group trial in patients with overactive bladder  

PubMed Central

Background: Solifenacin succinate is an antimuscarinic drug with reported efficacy and tolerability at a recommended starting dose of 5 mg QD in patients with overactive bladder (OAB). Objective: The objective of this trial was to investigate the efficacy, safety, and tolerability of solifenacin 10 mg QD in patients with OAB. Methods: In this multicenter, Phase III, double-blind, placebo-controlled, parallel-group trial, patients aged ?18 years with OAB were randomized at a 1:1 ratio to receive solifenacin 10 mg or placebo QD for 12 weeks. The patients were instructed to complete a micturition diary for the 3 days preceding each scheduled visit (weeks 4, 8, and 12). The primary end point was the change from baseline in the mean number of micturitions per 24 hours; secondary end points included the mean change from baseline in the number of episodes per 24 hours of urgency, incontinence, nocturnal voiding, and nocturia and the mean volume voided per micturition. Tolerability was monitored through adverse events (AEs), vital sign measurements, ECGs, laboratory assessments, and physical examination. Results: A total of 672 patients were randomized and received ?1 dose of study drug (solifenacin, n = 340; placebo, n = 332). The mean (SE) decrease from baseline to study end in the number of micturitions per 24 hours was significantly greater in the solifenacin group compared with the placebo group (?3.0 [0.2] vs ?1.5 [0.2], respectively; P < 0.001). The mean decrease in the number of episodes of incontinence was significantly greater in the solifenacin group compared with the placebo group (?2.0 [0.2] vs ?1.1 [0.2]; P < 0.001), as was the mean decrease in the number of episodes of urgency (?4.1 [0.2] vs ?2.1 [0.2]; P < 0.001). Of the patients with ?1 incontinence episode per 24 hours at baseline, significantly more patients in the solifenacin group achieved complete continence at study end than did patients in the placebo group (119/225 [52.9%] vs 80/237 [33.8%]; P < 0.001). The change from baseline to study end in the mean volume voided per micturition increased significantly in the solifenacin group compared with the placebo group (47.2 vs 2.7 mL; P < 0.001). Most AEs were mild or moderate in intensity. The AEs that were most commonly reported in the solifenacin-treated group were anticholinergic in nature: dry mouth (91 [26.8%] vs 13 patients [3.9%] in the placebo group; P < 0.001); constipation (58 [17.1%] vs 11 [3.3%]; P < 0.001); and blurred vision (12 [3.5%] vs 4 [1.2%]; P < 0.05). Serious AEs (SAEs) were reported for 5 patients in the solifenacin group and 3 patients in the placebo group. In the solifenacin group, 2 patients experienced chest pain, 1 had cellulitis, 1 had dehydration, and 1 had colonic obstruction; only 1 SAE (colonic obstruction) was judged to be possibly related to the study drug. In the placebo group, 1 patient had chest pain, 1 had bacterial meningitis, and 1 had hemopericardium. Conclusions: This study found that solifenacin 10 mg QD for 12 weeks was associated with significantly reduced symptoms of OAB, including the frequency of micturition, and episodes of urgency and of incontinence. With solifenacin, the volume voided per micturition increased by 47.2 mL, and 53% of patients with ?1 incontinence episode per 24 hours at baseline achieved complete continence. This efficacy was accompanied by a favorable safety and tolerability profile. PMID:24692834

Chu, Franklin; Smith, Neila; Uchida, Takeshi

2009-01-01

383

Characterization of Forty Seven Years of Particulate Chemical Composition in the Finnish Arctic  

NASA Astrophysics Data System (ADS)

Forty seven years of weekly total suspended particle filters collected at Kevo, Finland from October 1964 through 2010 by the Finnish Meteorological Institute were analyzed for near-total trace elements, soluble trace elements, black carbon (BC), and major ions and methane sulfonic acid (MSA). Kevo is located in Northern Finland, 350 km north of the Arctic Circle. The samples from 1964-1978 were collected with Whatman 42 cellulous filters and the samples from 1979-2010 collected on Whatman GF/A glass-fiber filters. A portion of the filters was microwave acid-digested (ad) and analyzed for near-total trace elements were determined by inductively coupled plasma mass spectrometry (ICP-MS). Another portion was water extracted (we) and analyzed for soluble trace elements by ICP-MS and ionic species by ion chromatography (IC). Black carbon (BC) was determined using optical and thermal optical techniques at SUNY Albany. A clear seasonal trend with winter/spring maxima and summer minima is observed for most species attributed to enhanced transport of pollutants from anthropogenic mid-latitude sources to the Arctic in the winter and early spring. Compared to more remote Arctic sampling sites, species of anthropogenic origin (V, Co, Cu, Ni, As, Cd, Pb, SO4) have significantly higher concentrations and a less pronounced seasonality. High concentrations of Cu (14.1 ng/m3), Ni (0.97 ng/m3), and Co (0.04 ng/m3) indicate the influence of non-ferrous metal smelters on the Kola Peninsula, although Cu unexpectedly did not correlate with Ni or Co. Ni and Co were highly correlated. Significant long-term decreasing trends were detected for most species. All constituents except Sn-ad, Re-ad, Sn-we, Mo-we, V-we, have significant (p < 0.001) decreasing trends from 1964-2010. The largest decreases were Sb (-3.90 %/yr), Pb (-3.87 %/yr), Mn (-3.45 %/yr), Cd (-3.42 %/yr), and Ca (-3.13 %/yr ). As, Pb, and Cd concentrations at Kevo were consistent with the reported time-trends of European emissions inventories. Pb concentrations at Kevo have dramatically decreased (92%) in the past 47 years due to the reduced use of leaded gasoline in automobiles. Non sea salt SO4 concentrations were found to have a very similar trend to European and Former Soviet Union SO2 emissions. SO4 concentrations declined dramatically in the early 1990s a result of the collapse of the Soviet Union. Potential source contribution function (PSCF) analysis was used to estimate source locations of the species. PSCF plots for anthropogenic species (V, Cd, Mn, Mo, Sb, Tl, W, and SO4) suggest source areas predominantly in Eastern Europe, European Russia, and the Baltics. Markers of stationary fuel combustion (V, Mn, Mo, Sb, Se, Tl, and SO4) also pointed towards possible source regions in the Pechora Basin and Ural industrial areas in Russia, and near gas and oil fields in western Kazakhstan. Methane sulfonic acid (MSA) is marker of marine planktonic algae. MSA concentrations at Kevo peak from May to July and have estimated source locations in the Barents, Norwegian, and Greenland Seas, coinciding with warmer waters and increased biogenic activity. Using monthly averages from June and Jul, MSA concentrations were found to be positively correlated (r2 = 0.200; p < 0.001) with sea surface temperature anomalies in the surrounding seas and negatively (r2 = 0.280; p = 0.0018) with sea ice extent. The chemical composition dataset was analyzed by Positive Matrix Factorization (PMF5). The entire dataset (1964-2010) was modeled as well as three separate time periods, 1964-1978, 1979-1990, and 1991-2010. The dataset was split in 1979 due to a change from Whatman 42 cellulose filters to a glass fiber filters, and in 1990 due to drops in concentrations related to the economic collapse of the Soviet Union. Two factors representing non-ferrous metal smelters were found for all time periods. One factor was dominated by Cu and the other by Ni and Co. Each of the time periods contained a factor describing stationary fuel combustion with high percentages of V, BC, and nss-SO4; a ferrous metal f

Laing, James