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1

Cellulitis  

MedlinePLUS

... case of cellulitis (with symptoms such as a fever or red streaks on skin) may need to stay in the hospital for a while and get antibiotic medicine through an intravenous (say: in-truh-VEE-nus) line (a thin plastic tube that goes into a vein, also called ...

2

Understanding pediatric bacterial preseptal and orbital cellulitis.  

PubMed

Pediatric preseptal and orbital cellulitis are infectious disorders that result in periorbital inflammation. Preseptal cellulitis is often associated with breaches in the skin barrier whereas orbital cellulitis is commonly associated with paranasal sinusitis. Orbital cellulitis may be associated with subperiosteal abscess. It is important to distinguish between preseptal from orbital cellulitis. Clinical examination and diagnostic imaging are useful in determining appropriate management. Patients are usually treated with broad spectrum antibiotics and surgery when indicated. PMID:20616919

Gonzalez, Mithra O; Durairaj, Vikram D

2010-04-01

3

Necrotizing periorbital cellulitis following septorhinoplasty  

Microsoft Academic Search

The complication of infection after a septorhinoplasty is extremely rare. An unusual occurrence of necrotizing periorbital cellulitis after a routine septorhinoplasty in a 30-year-old pediatrician is presented. It consisted of marked swelling and superficial necrosis of the left eyelids and high fever that started one day after surgery. Hemolytic streptococcus was identified as the causative pathogen. The patient responded well

R. Moscona; Y. Ullmann; I. Peled

1991-01-01

4

LA REVUE DE L'EPI N 93 LA CELLULE ANIMALE LA CELLULE ANIMALE  

E-print Network

193 LA REVUE DE L'EPI N° 93 LA CELLULE ANIMALE LA CELLULE ANIMALE (Cédérom niveau Bac, Bac +1 la suite d'une première pratique de classe portant sur le fonctionnement de la cellule animale (en de l'élève. CONTENU DU C?D?ROM Le cédérom « La Cellule Animale » comprend 5 parties essentielles. Une

Paris-Sud XI, Université de

5

Case Report: Cellulitis Due to Salmonella infantis.  

E-print Network

1 Case Report: Cellulitis Due to Salmonella infantis. Authors Satish R Patil, Associate Professor. Cellulitis Due to Salmonella infantis. Online J Health Allied Scs. 2012;11(4):12. Available at URL Salmonella are highly adapted for the growth in both humans and animals and cause a wide spectrum of disease

Carr, Leslie

6

Cellulitis  

MedlinePLUS

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7

Fatal cellulitis caused by Apophysomyces elegans.  

PubMed

A case of cellulitis of the left lateral side of the face caused by the zygomycete Apophysomyces elegans in a healthy male following a road traffic accident is reported. The contaminated soil was the source of fungus. Broad aseptate fungal hyphae were seen in the necrosed tissues. Extensive tissue debridement and treatment with amphotericin B were not successful in controlling the rapid invasion of the tissues by the fungus. Patient developed angioinvasion, severe cellulitis and finally succumbed to the infection three weeks after admission. PMID:17901654

Kindo, A J; Shams, N R; Kumar, K; Kannan, S; Vidya, S; Kumar, A R; Kalyani, J

2007-07-01

8

LES CELLULES DE SERTOLI DES POISSONS TLOSTENS  

E-print Network

Salvelinus fontinalis HENDERSON (1962) qualifie également les cellules de la paroi des lobules de « lobules'espace extralobulaire). Il s'agit de : Esox lucius, Salvelinus willughbü et Labeo (MARSH!,r, et LOFTS, ig56 ; LOFTS et

Paris-Sud XI, Université de

9

Serratia marcescens cellulitis in a patient on hemodialysis.  

PubMed

Serratia marcescens is an infrequent cause of cellulitis with only 5 reported cases. Four of the 5 patients were immunocompromised. Additionally, the cellulitis usually occurred at a site contiguous with a wound. We report a case of S. marcescens cellulitis in a patient with end-stage renal disease on chronic hemodialysis. The initial presentation was a soft tissue infection that progressed to septic shock. Ultimately, the patient responded to antibiotics and surgical debridement of infected tissue. This case serves as a reminder to consider infections due to gram-negative bacilli as a cause of cellulitis in immuno-compromised patients regardless of the presentation. PMID:1489009

Bornstein, P F; Ditto, A M; Noskin, G A

1992-01-01

10

Facial cellulitis revealing choreo-acanthocytosis: a case report  

PubMed Central

We report a 62 year-old-man with facial cellulitis revealing choreo-acanthocytosis (ChAc). He showed chorea that started 20 years ago. The orofacial dyskinisia with tongue and cheek biting resulted in facial cellulitis. The peripheral blood smear revealed acanthocytosis of 25%. The overall of chorea, orofacial dyskinetic disorder, peripheral neuropathy, disturbed behavior, acanthocytosis and the atrophy of caudate nuclei was suggestive of a diagnosis of ChAc. To our knowledge no similar cases of facial cellulitis revealing choreo-acanthocytosis (ChAc) were found in a review of the literature. PMID:25332750

Samia, Younes; Yosra, Cherif; Foued, Bellazreg; Mouna, Aissi; Olfa, Berriche; Jihed, Souissi; Hammadi, Braham; Mahbouba, Frih-Ayed; Amel, Letaief; Habib, Sfar Mohamed

2014-01-01

11

Staphylococcus aureus cellulitis: an unusual presentation.  

PubMed

Staphylococcus aureus has long been known as one of the most virulent microbes, with capabilities that make it threatening in both nosocomial and community-acquired infections. It remains the most frequent cause of skin-structure and traumatic infections in the community. S. aureus infections in the maxillofacial region are likely to be associated with a known portal of entry, but this is not always the case. Once invasion occurs, the organism may produce virulent enzymes including coagulase, hyaluronidase, proteases, DNA-ase, lipases, hemolysins, and lysozyme as well as exotoxins. Markel et al point out that cellulitis associated with coagulase-positive staphylococci will often resolve without abscess formation. Hence, there is often no site from which to obtain specimens, making this infection a diagnostic and therapeutic challenge. This report describes an infection in which the etiologic organism was identified as S. aureus. The source of the infection, however, remained unclear. PMID:8050264

Geunes, P M; Brooks, J H; Huttula, C S; Chesney, P J

1994-05-01

12

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

13

Ambient ozone and emergency department visits for cellulitis.  

PubMed

Objectives were to assess and estimate an association between exposure to ground-level ozone and emergency department (ED) visits for cellulitis. All ED visits for cellulitis in Edmonton, Canada, in the period April 1992-March 2002 (N = 69,547) were examined. Case-crossover design was applied to estimate odds ratio (OR, and 95% confidence interval) per one interquartile range (IQR) increase in ozone concentration (IQR = 14.0 ppb). Delay of ED visit relating to exposure was probed using 0- to 5-day exposure lags. For all patients in the all months (January-December) and lags 0 to 2 days, OR = 1.05 (1.02, 1.07). For male patients during the cold months (October-March): OR = 1.05 (1.02, 1.09) for lags 0 and 2 and OR = 1.06 (1.02, 1.10) for lag 3. For female patients in the warm months (April-September): OR = 1.12 (1.06, 1.18) for lags 1 and 2. Cellulitis developing on uncovered (more exposed) skin was analyzed separately, observed effects being stronger. Cellulitis may be associated with exposure to ambient ground level ozone; the exposure may facilitate cellulitis infection and aggravate acute symptoms. PMID:21139878

Szyszkowicz, Mieczys?aw; Porada, Eugeniusz; Kaplan, Gilaad G; Rowe, Brian H

2010-11-01

14

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

E-print Network

Persistence of cellulitis-associated Escherichia coli DNA ®ngerprints in successive broiler chicken in revised form 31 March 2000; accepted 31 March 2000 Abstract Avian cellulitis in broiler chickens of the broiler house, we designed a study to determine whether E. coli DNA ®ngerprints associated with cellulitis

Singer, Randall

15

Anaerobic orbital cellulitis: a clinical and experimental study.  

PubMed Central

In this article we have reviewed the clinical and bacteriologic aspects of anaerobic orbital cellulitis and have presented six patients to illustrate these points. Physicians who treat patients with orbital cellulitis should have a high index of suspicion for possible instances involving anaerobes, so that appropriate management can be started early. To investigate this problem further, we created an animal model of anaerobic orbital cellulitis. This model may be useful in future studies of the pathogenesis and treatment of this serious and often devastating disease. Images FIGURE 1 FIGURE 2 FIGURE 3 FIGURE 4 FIGURE 5 FIGURE 6 FIGURE 7 FIGURE 8 FIGURE 9 FIGURE 10 FIGURE 11 FIGURE 12 FIGURE 13 FIGURE 14 FIGURE 15 FIGURE 16 FIGURE 17 FIGURE 18 FIGURE 19 PMID:1808813

Jedrzynski, M S; Bullock, J D; McGuire, T W; Elder, B L; Bullock, J D

1991-01-01

16

Cellule: Lightweight Execution Environment for Accelerator-based Systems  

E-print Network

Cellule: Lightweight Execution Environment for Accelerator-based Systems Vishakha Gupta Georgia The increasing prevalence of accelerators is changing the high per- formance computing (HPC) landscape to one virtualiza- tion to create high performance, low noise SEEs for accelerators. The paper describes important

Lee, Hsien-Hsin "Sean"

17

Diagnostic accuracy in patients admitted to hospitals with cellulitis.  

PubMed

Misdiagnosis of non-infectious conditions such as cellulitis is a common error and can result in unnecessary hospitalization and antibiotic use. We sought to prospectively determine the misdiagnosis rate of cellulitis among hospitalized patients and to determine if a visually-based computerized diagnostic decision support system (VCDDSS, also named VisualDx) could generate an improved differential diagnosis (DDx) for misdiagnosed patients. In two separate institutions, attending dermatologists or infectious disease specialists evaluated all consecutive patients hospitalized for "cellulitis" by the emergency department. Among 145 subjects enrolled, misdiagnosis occurred in 41 (28%) patients. The diagnosis most commonly mistaken as cellulitis was stasis dermatitis (37%). At one center, in cases that were misdiagnosed by the emergency department, the VCDDSS included the correct diagnosis in the DDx more frequently than the admitting team (18/28 cases (64%) compared to 4/28 cases (14%), p=0.0003). These results demonstrate the capability of this VCDDSS to assist primary care physicians with generating a more accurate DDx when confronted with patients presenting with possible skin infections. Misdiagnoses may result in a significant source of healthcare costs and misdiagnosis-related patient harm. Inclusion of decision support tools early in the diagnostic workflow may reduce misdiagnosis and result in more efficient healthcare management. PMID:21426867

David, Consuelo V; Chira, Sandy; Eells, Samantha J; Ladrigan, Manasi; Papier, Art; Miller, Loren G; Craft, Noah

2011-01-01

18

Staphylococcus intermedius cellulitis and toxic shock in a dog.  

PubMed Central

A Labrador retriever was examined for sudden lameness and cellulitis of the right forelimb. Bacterial culture of the dermis yielded a large number of Staphylococcus intermedius. The association of this bacterium with toxic shock is discussed. Images Figure 1. Figure 2. PMID:10416072

Girard, C; Higgins, R

1999-01-01

19

Cellulitis on face in a patient with congenital afibrinogenemia.  

PubMed

Congenital afibrinogenemia is a rare coagulation disorder, with an estimated prevalence of 1 : 1,000,000, characterized by a complete absence to reduced level of circulating fibrinogen. This article presents a case of congenital afibrinogenemia, which presented as cellulitis on the face. PMID:21521918

Chandan, G D; Annaji, A G; Bhatnagar, S; Mohandas, U; Dave, P

2011-01-01

20

Infected orthokeratinized odontogenic cyst: a rare cause of facial cellulitis.  

PubMed

Orthokeratinized odontogenic cysts (OOCs) are relatively uncommon developmental cysts lined with orthokeratinized epithelium consisting of a prominent granular layer and a basal layer of low cuboidal flattened cells that show no tendency for nuclear palisading. These cysts have been considered a distinct entity from odontogenic keratocysts since they exhibit a less aggressive behavior and a very low rate of recurrence. Developmental odontogenic cysts can become infected but serious complications, such as potentially life-threatening cellulitis, are rare. This report describes a rare case of facial cellulitis secondary to an infected OOC located in the mandible of a 27-year-old man. The relevant literature about the clinical-pathological features of OOC is reviewed. PMID:23306244

Carvalho, Cyntia Helena Pereira de; Aquino, Ana Rafaela Luz de; Nonaka, Cassiano Francisco Weege; Silva, Jos Sandro Pereira da; Germano, Adriano da Rocha; Pinto, Leo Pereira

2012-01-01

21

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

22

Orbital cellulitis with abscess formation following surgical treatment of canaliculitis.  

PubMed

The authors report a case of orbital cellulitis with abscess formation that developed after surgical management of canaliculitis. The patient developed pain, erythema, proptosis, and limited eye movements 3 days after canalicular debridement. She required urgent drainage of an orbital abscess and was treated with intravenous antibiotics for 2 weeks. Complications from surgical management of canaliculitis are unusual. Clinicians should be aware of the rare but serious risk of spread of the infection to the orbit. PMID:18645442

Hatton, Mark P; Durand, Marlene L

2008-01-01

23

Injectable silicone: Cause of facial nodules, cellulitis, ulceration, and migration  

Microsoft Academic Search

Fifty-four patients with problems following medical grade silicone injections into the face and legs were seen from 1974\\u000a until 1995. Complications consisted of chronic cellulitis, nodules, foreign body reactions, and movement of material to near\\u000a and distant parts of the body. These difficulties usually demonstrated themselves many years after injection. It is suggested\\u000a that problems occur despite good technique, good

Marvin J. Rapaport; Charles Vinnik; Harvey Zarem

1996-01-01

24

Rduction et oxydation in situ de cellules de pile combustible oxyde solide dans un Titan ETEM  

E-print Network

Réduction et oxydation in situ de cellules de pile à combustible à oxyde oxyde solide (SOFC) est basée sur des cellules à supports anode. Le support élevée par exemple, l'oxydation du nickel peut se produire pendant l

Dunin-Borkowski, Rafal E.

25

Risk factors of cellulitis in cirrhosis and antibiotic prophylaxis in preventing recurrence  

PubMed Central

Background Cellulitis is a commonly encountered bacterial infection among cirrhotic patients apart from spontaneous bacterial peritonitis, urinary tract and respiratory infections. This study aimed to determine the risk factors of cellulitis in cirrhosis and whether antibiotic prophylaxis helps prevent recurrence of cellulitis. Methods The study was conducted in two phases. In phase 1, all cirrhotic patients admitted with cellulitis from August 2011 to August 2013 were taken as cases (n=70) and cirrhotic patients without cellulitis were included as controls (n=73). Baseline demographic data, comorbidities and investigations were noted and compared. In phase 2, the cases of phase 1 were divided into two groups, based on initiation of antibiotic prophylaxis at the time of discharge and were followed up for six months for recurrence of cellulitis. Results The main etiology of cirrhosis was alcohol and 68% of cases were Child C. Factors which showed significance in univariate analysis were presence of diabetes mellitus, hepatic encephalopathy, platelet count, albumin level and model for end-stage liver disease (MELD) score. Using logistic regression, hepatic encephalopathy (OR 2.95, CI 1.01-8.45), albumin level <2.5 g/dL (OR 2.80, CI 1.32-5.92) and MELD >15 (OR 2.95, CI 1.39-6.27) emerged as significant factors associated with cellulitis. Cellulitis recurred in 20% and recurrence was significantly low among antibiotic prophylaxis group (15% vs. 50% P=0.048). Conclusions Hypoalbuminemia, and high MELD score are the risk factors for cellulitis in cirrhosis. Antibiotic prophylaxis can reduce the recurrence of cellulitis as in the case of spontaneous bacterial peritonitis.

Hamza, Rooby Erachamveettil; Villyoth, Mashhood Padincharepurathu; Peter, George; Joseph, Deni; Govindaraju, Chethan; Tank, Devang Chandrakanth; Sreesh, Sreejaya; Narayanan, Premalatha; Vinayakumar, Kattoor Ramakrishnan

2014-01-01

26

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; Gnay, Ilker; Diniz, Gllden; Can, Demet

2014-10-01

27

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.

Celegen, Mehmet; Kark?ner, Canan Sule Unsal; Gunay, Ilker; Diniz, Gullden; Can, Demet

2014-01-01

28

Isolation of Escherichia coli from cellulitis and other lesions of the same bird in broilers at slaughter.  

PubMed Central

Cellulitis results in substantial losses to the broiler industry due to condemnations at slaughter. This study was conducted to clarify the association between Escherichia coli isolated from cellulitis and other lesions caused by E. coli in individual birds. Fourteen flocks were sampled and 118 birds with cellulitis were examined. Escherichia coli was isolated from all but 2 of the cellulitis lesions, and serogroups O78, O1, and O2 predominated. Thirty-six birds had at least 1 other lesion in addition to the cellulitis lesion. Isolation of E. coli from cellulitis and other lesions occurred in 7 of the 14 flocks. Escherichia coli of the same serogroup were isolated from cellulitis and other lesions in some birds, suggesting that a single E. coli may sometimes be responsible for both types of lesions. PMID:9056066

Gomis, S M; Goodhope, R; Kumor, L; Caddy, N; Riddell, C; Potter, A A; Allan, B J

1997-01-01

29

Le contrle de commutations dans une cellule bidirectionnelle bicommandable  

NASA Astrophysics Data System (ADS)

A Power electronics static converter modulate the energy flowing between two different source types. This induce constraints in converter topology which need to be taken into account to drive the switches specially during the changeover between two switches belonging to the same cell. If the control logic is well known when using current or voltage bidirectionnal switches, we propose a method which fits to bidrivable, current and voltage bidirectionnal switches. Petri net are usefull tools to describe the switches themselves. Aplied to the cell description they permit us to generate a component logic drive in respect with energy constraints. Un convertisseur statique ralise une fonction de modulation de l'nergie transitant entre deux sources de nature diffrente. La ncessaire continuit nergtique induit des contraintes dans la topologie du convertisseur qui se rpercutent sur la commande des composants qui le constituent, notamment lors de la phase de commutation entre deux interrupteurs d'une mme cellule. Si les principes de commande sont bien connus pour les interrupteurs bidirectionnels en courant ou en tension, nous proposons dans cet article une mthode s'appliquant aux interrupteurs bicommandables et bidirectionnels la fois en courant et en tension. Les rseaux de Petri constituent d'abord un outil de description prcis des interrupteurs. Appliqus ensuite la description du fonctionnement d'une cellule de commutation, ils deviennent alors un outil de synthse conduisant l'laboration d'une logique de commande respectant les contraintes nergtiques dans tous les cas de figure.

Guillaud, X.; Deleu, A.; Degobert, P.; Hautier, J. P.

1996-01-01

30

First reported case of cellulitis due to Cryptococcus gattii in lung transplantation recipient: a case report.  

PubMed

Cryptococcus gattii are closely related species of encapsulated yeast-like fungi involved in the etiology of cryptococcosis, especially in immunocompetent individuals. Dissemination with involvement of many organ systems is common. On the other hand, cellulitis in an immunossupressed patient caused by C. gattii is rare. We present a case of disseminated disease caused by Cryptococcus gattii in a lung transplant recipient who manifested cellulitis. The disease was also complicated by a lung carcinoma. We emphasize that cryptococcal cellulitis related to C. gattii in solid organ transplant (SOT) recipients should be considered in the differential diagnosis of acute bacterial skin infections. PMID:24314772

Dall Bello, Aline Gehlen; Severo, Cecilia Bittencourt; Schio, Sadi; Severo, Luiz Carlos

2013-11-01

31

Florid osseous dysplasia: report of a case presenting acute cellulitis.  

PubMed

In this review, we examined a 45-year-old Asian man who had been diagnosed with florid osseous dysplasia (FOD) of the mandible and acute perimandibular cellulitis. This presentation occurred after a history of off-and-on swellings of the jaw and multiple treatments received at another hospital. An aggressive resection of the jaw was planned; however, the patient denied the treatment and came to our clinic to seek a second opinion. The patient was successfully treated by conservative surgery and antibiotic treatment with preservation of the jaw integrity and the mandibular neurovascular canal. Intraoperatively, a piece of a calcified mass was removed and submitted for histopathological examination. The specimen showed woven bone and densely sclerotic mass of calcified materials exhibiting reversal lines and inflammatory cell infiltration of the connective tissue. The definitive diagnosis was FOD with a secondary infection. Treatments for FOD were discussed. PMID:19718010

Pitak-Arnnop, Poramate; Dhanuthai, Kittipong; Chaine, Andr; Bertrand, Jacques-Charles; Bertolus, Chlo

2009-09-01

32

Anaerobic orbital abscess/cellulitis in a Yorkshire Terrier dog.  

PubMed

A retrobulbar abscess/cellulitis occurred in a Yorkshire Terrier dog. The clinical signs were exophthalmos, prolapsed nictitating membrane and purulent ocular discharge. Ultrasonography showed a marked soft tissue swelling of the retrobulbar tissues as well as echogenic parallel lines between the globe and the medial orbital rim. Surgical exploration of the orbit was performed and no foreign body was found. The pterygopalatine fossa was incised and therapeutic retrobulbar drainage attempted. A drain was placed to encourage ventral drainage of the abscess. Anaerobic cultures revealed heavy growth of gram negative rods (prevotella bivia and prevotella buccae were isolated). Recovery was successful but subsequent treatment for keratoconjunctivitis sicca was necessary. A full recovery of tear production occurred after several weeks. PMID:11073084

Homma, K; Schoster, J V

2000-10-01

33

Early recognition and successful management of pelvic cellulitis following hemorrhoidal banding  

Microsoft Academic Search

Reports have focused attention on a rare but potentially serious complication following rubber band ligation of internal hemorrhoids:\\u000a pelvic cellulitis with progression to shock and death. This report documents the successful treatment of pelvic cellulitis.\\u000a The timely use of broad-spectrum antibiotics at an early stage is critical. Emphasis is placed on early recognition and treatment\\u000a of this potentially fatal complication.

Lucius D. Clay; John J. White; J. Thomas Davidson; James J. Chandler

1986-01-01

34

Cellules souches pluripotentes de rat : so what ? Rat embryonic stem cells. So what ?  

E-print Network

Cellules souches pluripotentes de rat : so what ? Rat embryonic stem cells. So what ? John De Vos modification génétique, c'est à dire que chaque cellule porte alors l'altération génétique désirée. Celle avec transmission germinale du patrimoine des ES. La solution du problème est passé par la découverte

Paris-Sud XI, Université de

35

Neonatal retroauricular cellulitis as an indicator of group B streptococcal bacteremia: a case report  

PubMed Central

Introduction The relation between cellulitis and Group B streptococcus infection in newborns and small infants was first reported during the early 1980s and named cellulitis-adenitis syndrome. We report a case of a neonate with cellulitis-adenitis syndrome in an unusual location (retroauricular). Case presentation A 21-day-old Caucasian female infant was brought to the emergency department with fever, irritability and a decreased appetite. Physical examination revealed erythema and painful, mild swelling in the right retroauricular region. The blood count and C-reactive protein level were normal. She was treated with ceftriaxone. The fever and irritability were resolved after 24 hours, and the cellulitis was clearly reduced after two days of hospitalization. Blood culture yielded Group B streptococcus. Conclusion A thorough evaluation must be done, and lumbar punctures for infants with cellulitis must be considered. We emphasize the lack of data about acute phase reactants to predict bacteremia and meningitis and to adjust the duration of parenteral antibiotic therapy to address this syndrome. PMID:20062760

2009-01-01

36

Concurrent hidradenitis suppurativa, inflammatory acne, dissecting cellulitis of the scalp, and pyoderma gangrenosum in a 16-year-old boy.  

PubMed

We report the case of a 16-year-old boy who presented to our clinic with concomitant hidradenitis suppurativa, inflammatory acne, dissecting cellulitis of the scalp, and pyoderma gangrenosum. Recent reports describe the co-occurrence of pyoderma gangrenosum, acne, and hidradenitis suppurativa. This case further expands the spectrum of concomitant pyoderma gangrenosum and dissecting cellulitis of the scalp. PMID:24118007

Koshelev, Misha V; Garrison, Paige A; Wright, Teresa S

2014-01-01

37

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

38

Multifocal Cellulitis due to Disseminated Neisseria Gonorrhoeae in a Male Patient  

PubMed Central

We report a rare case of disseminated gonococcal infection in a 37-year-old man presenting with multifocal cellulitis. The patient presented with fever and painful swelling of the right foot and left hand, and was admitted to our hospital. CT scanning of the extremities revealed multifocal cellulitis. Transthoracic echocardiography findings were normal, and piperacilin/tazoactam therapy was initiated. On antibiotic day 4, Neisseria gonorrhoeae was cultured from a purulent effusion collected from a focal site. Chlamydia trachomatis was detected in urine samples by PCR. We made the diagnosis of multifocal cellulitis due to N. gonorrhoeae in a patient with chlamydia urethritis. The antibiotic agent was changed from piperacilin/tazobactam to ceftriaxone. Levofloxacin was also administered for chlamydia urethritis. By admission day 14, all lesions had resolved and administration of antibiotic agents was terminated. Disseminated gonococcal infection, although rare, should be included in the differential diagnosis of all sexually active patients who present with multifocal cellulitis - also a rare condition, particularly in light of the fact that in recent times, patterns of sexual activity have changed, which was a pertinent factor in this case. PMID:24734149

Yoshino, Yusuke; Abe, Minami; Seo, Kazunori; Koga, Ichiro; Kitazawa, Takatoshi; Ota, Yasuo

2014-01-01

39

Quelques aspects de l'interaction des hormones strodes avec leurs cellules cibles  

E-print Network

Quelques aspects de l'interaction des hormones stéroïdes avec leurs cellules cibles E.-E. BAULIEU Inserm U 33, Faculté de Médecine, Université Paris-Sud, Lab. Hormones, 94270 Bicêtre, France. Summary. Some aspects of steroid hormone-target cell interaction. Specific steroid hormone binding proteins

Paris-Sud XI, Université de

40

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

41

A Prospective Study of Management and Litter Variables Associated with Cellulitis in California  

E-print Network

between farm, LR, DT, ambient temperature during the brooding period, gram-negative bacteria load the effect of environmental factors on the prevalence of cellulitis in California broiler flocks. Environmental variables included temperature, wind velocity, and relative humidity (RH) at the litter surface

Singer, Randall

42

Prophylactic Antibiotics to Prevent Cellulitis of the Leg: Economic Analysis of the PATCH I & II Trials  

PubMed Central

Background Cellulitis (erysipelas) is a recurring and debilitating bacterial infection of the skin and underlying tissue. We assessed the cost-effectiveness of prophylactic antibiotic treatment to prevent the recurrence of cellulitis using low dose penicillin V in patients following a first episode (6 months prophylaxis) and more recurrent cellulitis (12 months prophylaxis, or 6 months in those declining 12 months). Methods Within-trial cost-effectiveness analysis was conducted using the findings of two randomised placebo-controlled multicentre trials (PATCH I and PATCH II), in which patients recruited in the UK and Ireland were followed-up for up to 3 years. Incremental cost, reduction in recurrence, cost per recurrence prevented and cost/QALY were estimated. National unit and reference costs for England in 2010 were applied to resource use, exploring NHS and societal perspectives. A total of 397 patients from the two trials contributed to the analysis. Results There was a 29% reduction in the number of recurrences occurring within the trial (IRR: 0.71 95%CI: 0.53 to 0.90, p?=?0.02), corresponding to an absolute reduction of recurrence of 0.31 recurrences/patient (95%CI: 0.05 to 0.59, p?=?0.02). Incremental costs of prophylaxis suggested a small cost saving but were not statistically significant, comparing the two groups. If a decision-maker is willing to pay up to 25,000/QALY then there is a 66% probability of antibiotic prophylaxis being cost-effective from an NHS perspective, rising to 76% probability from a secondary, societal perspective. Conclusion Following first episode or recurrent cellulitis of the leg, prophylactic low dose penicillin is a very low cost intervention which, on balance, is effective and cost-effective at preventing subsequent attacks. Antibiotic prophylaxis reduces cellulitis recurrence by nearly a third but is not associated with a significant increase in costs. PMID:24551029

Mason, James M.; Thomas, Kim S.; Crook, Angela M.; Foster, Katharine A.; Chalmers, Joanne R.; Nunn, Andrew J.; Williams, Hywel C.

2014-01-01

43

Subcutaneous cellulitis of the thigh due to grass awn migration in a German shepherd dog  

Microsoft Academic Search

Cellulitis is a severe, deep, suppurative infection that is poorly defined and tends to dissect through tissue planes. When\\u000a a foreign body enters the body, white blood cells attack the site and fight the invading agent. Sometimes, this collection\\u000a of blood cells forms a packed of pus or an abscess within the bodys tissues, organs, or confined spaces. Chronic sinus

A. S. Bigham; H. Nourani

2009-01-01

44

Development and Validation of ARKAS cellule: An Advanced Core-Bowing Analysis Code for Fast Reactors  

SciTech Connect

An advanced analysis code, ARKAS cellule, has been developed to determine the core distortion and the mechanical behavior of fast reactors. In this code, each hexagonal subassembly duct is represented by a folded thin plate structure divided into a user-specified number of shell elements so that the interduct contact forms and the cross-sectional distortion effect of each duct are properly taken into account. In this paper, the numerical model of the ARKAS cellule code is introduced, and the analytical results for two validation problems are presented. From a single duct compaction analysis, the first validation problem, it is clarified that the new analytical model is applicable to simulating the change of duct compaction stiffness that depends on the loading conditions such as the loading pad forms and the number of contact faces. The second validation analysis has been conducted by comparison with the experimental values obtained by the National Nuclear Corporation Limited in the United Kingdom using the core restraint uniplanar experimental rig (CRUPER), an ex-reactor rig in which a cluster of 91 short ducts is compressed by 30 movable peripheral rams toward the center of the cluster in seven stages. The analysis clarified that the predictions obtained using ARKAS cellule agree well with the measured ram loads and interwrapper gap widths during the compaction sequence. One may conclude that ARKAS cellule is valid for quantitative analysis of the core mechanical behavior and will be particularly useful for the evaluation of transient deformation of core assemblies during accidents in which the distortion of loading pads have important effects on obtaining favorable reactivity feedback.

Ohta, Hirokazu [Central Research Institute of Electric Power Industry (Japan); Yokoo, Takeshi [Central Research Institute of Electric Power Industry (Japan); Nakagawa, Masatoshi [AITEL Corporation (Japan); Matsuyama, Shinichiro [Toshiba Corporation (Japan)

2004-05-15

45

Necrotizing cellulitis caused by Apophysomyces elegans at a patch test site.  

PubMed

Plant material occasionally is used in patch testing to diagnose contact dermatitis. Serious adverse reactions to this practice are extremely uncommon. The authors report on a 68-year-old non-insulin-dependent diabetic gentleman with hand dermatitis in whom severe necrotizing cellulitis developed caused by Apophysomyces elegans, a subtype of mucormycosis, at the site of a patch test to a snapdragon plant from his garden. PMID:12165933

Lesueur, Benjamin W; Warschaw, Karen; Fredrikson, Lorna

2002-09-01

46

Necrotizing cellulitis caused by Apophysomyces elegans at a patch test site  

Microsoft Academic Search

Plant material occasionally is used in patch testing to diagnose contact dermatitis. Serious adverse reactions to this practice are extremely uncommon. The authors report on a 68-year-old non[ndash ]insulin-dependent diabetic gentleman with hand dermatitis in whom severe necrotizing cellulitis developed caused by Apophysomyces elegans, a subtype of mucormycosis, at the site of a patch test to a snapdragon plant from

Benjamin W. LeSueur; Karen Warschaw; Lorna Fredrikson

2002-01-01

47

Hyperbaric oxygen therapy as adjunctive treatment for postoperative cellulitis involving intrapelvic mesh.  

PubMed

Placement of intrapelvic mesh has become an integral tool in pelvic reconstructive surgery. Infection is a serious complication of mesh placement, which not only compromises the surgical objective, but also may be disfiguring or potentially lethal. We report a case of serious postoperative cellulitis, where the combination of antibiotics and hyperbaric oxygen contributed to the patient's recovery with complete preservation of her surgical repair. A 45-year-old woman underwent surgery for the treatment of cystocele, rectocele, and stress urinary incontinence. Surgical polypropylene and porcine acellular mesh was placed intraoperatively, and intravenous antibiotics were given preoperatively and postoperatively, followed by a course of oral prophylaxis. On postoperative day 8 the patient reported temperature elevation and a painful swelling in her left buttock. She had an area of cellulitis involving the operative site at the buttock extending anteriorly to the labia majora and posterior to the midgluteal area. Intravenous antibiotics were administered along with hyperbaric oxygen. The patient made an uneventful recovery during the following 9 days, preserving her repair. Cellulitis involving operative sites with artificial or naturally derived materials is a serious complication that may pose a threat to the repair at minimum, and may be life threatening at worst. The case reported illustrates the value of adjunctive hyperbaric therapy where the infection is presumed to be aggressive. PMID:19249714

Douso, Michael L

2009-01-01

48

Orbital Cellulitis Presenting as a First Sign of Incomplete Kawasaki Disease  

PubMed Central

A 6-year-old boy was referred to our hospital with orbital cellulitis. He had a history of 7 days of fever despite antibiotherapy. At first, he only had pharyngitis and conjunctivitis, but then an orbital mass evolved which restricted the movement of his right eye and there was also periorbital inflammation resembling orbital cellulitis. Examination at presentation revealed conjunctivitis with secretion, periocular inflammation and edema, right-preauricular lymphadenopathy and restriction of upgaze in the right eye. Laboratory findings included a white blood cell count of 19,000 cells per mm3, with 81.5% neutrophils, 15.0% lymphocytes, 1.2% monocytes and 0.4% basophils. The erythrocyte sedimentation rate was 52 mm/h and the C-reactive protein level was 46.3 mg/dl. Magnetic resonance imaging confirmed orbital cellulitis and pansinusitis. Vancomycin (60 mg/kg/day) and meropenem (100 mg/kg/day) were administered, but desquamation on his fingertips and a rash appeared on the tenth day. A pediatric consultation resulted in a diagnosis of incomplete Kawasaki disease (KD). After administration of aspirin, the orbital inflammation regressed in 3 days. No coronary artery lesions were detected on the first echocardiography, but these did appear 6 weeks later. This confirmed the KD diagnosis. PMID:24474931

Cerman, Eren; Eraslan, Muhsin; Turhan, Semra Akkaya; Usta, Sinem Altinyuva; Akalin, Figen

2013-01-01

49

[Cervico-facial cellulitis during pregnancy: about a series of 10 cases in Mali].  

PubMed

The objective of this work was to analyze the predisposing factors, diagnostic and therapeutic aspects of cervico-facial cellulitis on pregnancies and to determine maternal-fetal prognosis. We conducted a longitudinal observational descriptive study from January 2011 to March 2013 including records from pregnant women with cervicofacial cellulitis treated at the Oto-Rhino-Laryngology (ORL) and cervico-facial surgery department at Gabriel Tour Hospital in Bamako. Ten women met our inclusion criteria. The median age was 23 years. The entry way was dental in all cases. Three women had taken antibiotics and 3 others antibiotics associated with non steroidal anti-inflammatory. The medico-surgical treatment had permitted to cure 8 cases. Two cases of death were recorded and 4 cases of stillbirths. The cervico-facial cellulitis during pregnancy is a serious pathology that can be life-threatening to the mother and or child. Prevention is based on the control of dental status and informing women about the importance of dental hygiene. PMID:25304000

Doumbia-Singare, K; Timbo, S K; Keita, M; Ag Mohamed, A; Guindo, B; Soumaoro, S

2014-12-01

50

PCR Offers No Advantage Over Culture for Microbiologic Diagnosis in Cellulitis  

PubMed Central

Purpose Most cases of cellulitis are traditionally attributed to ?-hemolytic streptococci and Staphylococcus species, although in most cases, no organism is identified. Development of PCR using the conserved bacterial 16s-rRNA DNA permits identification of bacteria independent of conventional culture approaches and prior use of antibiotics. Methods We used PCR-based techniques to identify cellulitis etiology using aspirate samples from affected skin. Saline was infiltrated and aspirated at the site of greatest erythema or at the cellulitic border. Samples were tested for 16s-rRNA DNA and organism-specific probes used to identify bacteria commonly seen in skin infections. Results Aspirates from 32 patients were studied and16s-rRNA DNA was detected in 9/32 of the cases (28.1%). Bacterial species were identified by PCR methods in 6/9 (66.6%). S. aureus was identified in 4/6 samples, and 2/6 were methicillin-resistant S. aureus (MRSA). Of patients with positive aspirate bacterial cultures (3/9, 33.3%), S. aureus was present on culture in 2/3 (66.6%) positive samples, and coagulase-negative Staphylococcus (CoNS) was present on culture in 2/3 (66.6%) positive samples. Only in one of the three positive bacterial cultures did the PCR method detect the same organism as was detected by culture. Among patients with positive provider-collected clinical cultures, MRSA was the predominant organism (11/18, 61.1%) and when present, it was found as the sole organism. Where S. aureus or Streptococcus species were detected by molecular methods, clinical cultures yielded a positive result as well. Conclusions PCR-based techniques do not appear to be more sensitive than aspirate cultures for detection of pathogens in cellulitis. PMID:22802097

Johnson, Kristine E.; Kiyatkin, Dmitry E.; An, Amanda T.; Riedel, Stefan; Melendez, Johan; Zenilman, Jonathan M.

2012-01-01

51

[Generalized morphea-like progressive systemic sclerosis with anticentromere antibodies and eosinophilic cellulitis].  

PubMed

A 67-year-old woman without any history of exposure to organic solvents suffered from Raynaud's phenomenon, sclerodactylia, contracture of finger joints, diffuse pigmentation, pulmonary fibrosis, and generalized morphea-like eruptions on the trunk; she was diagnosed as generalized morphea-like progressive systemic sclerosis. She had a high titer of anticentromere antibody in her serum without any symptoms of CREST syndrome. She also had eosinophilic cellulitis on her extremities, which subsided within 6 months, and seemed to be due to a hypersensitivity reaction to mosquito bites. The occurrence of these two diseases together in our case may suggest some similarities in their pathogenesis. PMID:2614990

Sasaki, T; Nakajima, H; Kameda, Y

1989-04-01

52

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 1014 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 6days. 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 56 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 6days 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

53

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

E-print Network

generate energetic chemical species. The PEC solar cells reported in the litterature, and the power, an important research effort has developed on the photoelectrochemical (PEC) conversion of solar energy. PEC performances de ces cellules se dégradaient assez rapidement, car on observait une décomposition des électrodes

Boyer, Edmond

54

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

55

Intrasinus wood foreign body causing orbital cellulitis in congenital insensitivity to pain with anhidrosis syndrome.  

PubMed

A 2-year-old boy with congenital insensitivity to pain with anhidrosis (CIPA) was referred with a 2-day history of left periorbital swelling and mucoid conjunctival discharge. Marked worsening was noted despite intramuscular ceftriaxone treatment for 3 days, with marked proptosis, conjunctival chemosis, and a frozen eye. Orbital cellulitis was suspected. Ceftriaxone was intravenously administered. Orbital computed tomography (CT) disclosed an inflammatory process in the medial aspect of the left orbit with ethmoiditis. Improvement was not noted after external ethmoidectomy and drainage of the intraconal abscess. Repeat CT showed a recurrent intraconal abscess. A revision external ethmoidectomy was performed, and a bent wooden match was removed from the posterior aspect of the ethmoidal sinus, after which significant clinical improvement was noted. In patients with CIPA, accidental or self-penetrated foreign bodies must be kept in mind when treating all types of wounds. PMID:14752319

Levy, Jaime; Monos, Tova; Levy, Jacov; Shelef, Ilan; Nash, Michael; Lifshitz, Tova

2004-01-01

56

Revetements antireflet-passivation a base de nitrure de silicium PECVD pour cellules solaires triple-jonction III-V/ Ge  

NASA Astrophysics Data System (ADS)

Dans le contexte environnemental actuel, le photovoltaque bnficie de l'augmentation des efforts de recherche dans le domaine des nergies renouvelables. Pour rduire le cot de la production d'lectricit par conversion directe de l'nergie lumineuse en lectricit, le photovoltaque concentr est intressant. Le principe est de concentrer une grande quantit d'nergie lumineuse sur des petites surfaces de cellules solaires multi-jonction haute efficacit. Lors de la fabrication d'une cellule solaire, il est essentiel d'inclure une mthode pour rduire la rflexion de la lumire la surface du dispositif. Le design d'un revtement antireflet (ARC) pour cellules solaires multi-jonction prsente des dfis cause de la large bande d'absorption et du besoin d'galiser le courant produit par chaque sous-cellule. Le nitrure de silicium dpos par PECVD en utilisant des conditions standards est largement utilis dans l'industrie des cellules solaires base de silicium. Cependant, ce dilectrique prsente de l'absorption dans la plage des courtes longueurs d'onde. Nous proposons l'utilisation du nitrure de silicium dpos par PECVD basse frquence (LFSiN) optimis pour avoir un haut indice de rfraction et une faible absorption optique pour l'ARC pour cellules solaires triple-jonction III-V/Ge. Ce matriau peut aussi servir de couche de passivation/encapsulation. Les simulations montrent que l'ARC double couche SiO2/LFSiN peut tre trs efficace pour rduire les pertes par rflexion dans la plage de longueurs d'onde de la sous-cellule limitante autant pour des cellules solaires triple-jonction limites par la sous-cellule du haut que pour celles limites par la sous-cellule du milieu. Nous dmontrons aussi que la performance de la structure est robuste par rapport aux fluctuations des paramtres des couches PECVD (paisseurs, indice de rfraction). Mots-cls : Photovoltaque concentr (CPV), cellules solaires multi-jonction (MJSC), revtement antireflet (ARC), passivation des semiconducteurs III-V, nitrure de silicium (Si?Ny), PECVD.

Homier, Ram

57

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

58

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

59

Recurrent lymphangitic cellulitis syndrome: A quintessential example of an immunocompromised district.  

PubMed

Recurrent lymphangitic cellulitis syndrome (RLCS) occurs when a disordered lymphatic system renders a leg vulnerable to recurrent infection. The underlying immunologic defect is the result of accidental or iatrogenic penetrating wounds on the medial aspect of the thigh or lower limb overlying the greater saphenous vein, because the primary lymphatic drainage vessels are adjacent to this structure. Cracking/fissuring of the skin associated with chronic fungal infection of the feet ("athlete's foot"), most commonly mixed bacterial/fungal interdigital involvement, provides a portal of entry for opportunistic organisms. Bacteria and their products are cleared more slowly in the lymphatic-disrupted and therefore immunologically impaired limb, producing broad areas of dermatitis and around the scars quite distinct from other forms of superficial infection. This rarely develop in otherwise normal limbs. The dermatitis of RLCS and its systemic effects clear with antibiotics but recur intermittently until the tinea pedis is eradicated. The contralateral limb with normal lymphatic structures never develops clinical evidence of infection even though bilateral tinea infection is almost always present. This confirms the central role of an anatomically induced immunocompromised district (ICD) in this syndrome. PMID:25160103

Brodell, Lindsey Ann; Brodell, James David; Brodell, Robert Thomas

2014-01-01

60

Phenotypic and genotypic characterization of virulence factors of Escherichia coli isolated from broiler chickens with simultaneous occurrence of cellulitis and other colibacillosis lesions.  

PubMed Central

The objective of this study was to characterize virulence factors of Escherichia coli isolates from broilers with simultaneous occurrence of cellulitis and other colibacillosis lesions. Thirty flocks were sampled and 237 birds with cellulitis were examined. Eighty-two (34.6%) of 237 birds condemned for cellulitis had gross lesions in the heart, air sacs, joints, or liver. In 58 chickens, E. coli was isolated from both the cellulitis and other lesions of colibacillosis, and 18.9% of the E. coli isolates from the 2 types of lesions belonged to the same O group. Escherichia coli of serogroups O78, O1, and O2 predominated. Isolates of the same serogroup that were derived from different lesions in the same birds had similar patterns of biotype, aerobactin production, serum sensitivity profile, antibiotic sensitivity, and K1 capsule production. Escherichia coli derived from cellulitis lesions produced virulence factors similar to those found in E. coli isolated from other colibacillosis lesions in poultry. PMID:11227188

Gomis, S M; Riddell, C; Potter, A A; Allan, B J

2001-01-01

61

Cassures double-brin de l'ADN, cassures chrosomiques et ltalit des cellules humaines irradies  

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'vnement-cl susceptible d'expliquer l'effet ltal des radiations ionisantes. Une revue gnrale de la littrature montre que, l'exception d'un groupe minoritaire de tumeurs humaines, c'est surtout une dficience de rparation plutt que l'incidence des dgts qui est associe la mort des cellules de mammifres irradies. Toutefois, les arguments en faveur d'un lien entre radiosensibilit et CDB sont gnralement indirects. partir de 23lignes fibroblastiques humaines (5tmoins et 18hypersensibles), nous dcrivons une relation quantifie entre la radiosensibilit intrinsque et les cassures rsiduelles de l'ADN et des chromosomes. La mort d'un fibroblaste humain irradi est associe 6,6 CDB et 1,3 cassure chromosomique non rpares.

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

1998-04-01

62

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

chiaux résultant surtout par fusion centrique des chromosomes monobranchiaux habituels chez le des causes dif- férentes pour leur formation : i) contamination des cellules à deux chromosomes X par translocation d'un chromosome X sur un autre chromosome ou fragment chromosomique, ainsi que cela semble

Paris-Sud XI, Université de

63

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

64

Istituzioni di Matematica C. d. L. in Biotecnologie 1. Un brodo di coltura `e infetto da N0 batteri. Le cellule dei batteri si dividono  

E-print Network

da N0 batteri. Le cellule dei batteri si dividono ogni quattro ore. (a) Quanti batteri ci saranno nel brodo dopo 24 h? (b) Determinare il parametro (in h-1 ) in modo tale che il numero N dei batteri parametro µ (in h-1 ) in modo tale che il numero N dei batteri presenti dopo t ore possa essere approssimata

Achilles, Rüdiger

65

Istituzioni di Matematica C. d. L. in Biotecnologie 1. Un brodo di coltura `e infetto da N0 batteri. Le cellule dei batteri si dividono  

E-print Network

da N0 batteri. Le cellule dei batteri si dividono ogni tre ore. (a) Quanti batteri ci saranno nel brodo dopo 24 h? (b) Determinare il parametro (in h-1 ) in modo tale che il numero N dei batteri parametro µ (in h-1 ) in modo tale che il numero N dei batteri presenti dopo t ore possa essere approssimata

Achilles, Rüdiger

66

Clinical Features and Risk Factors of Oedematous Mycobacterium ulcerans Lesions in an Australian Population: Beware Cellulitis in an Endemic Area  

PubMed Central

Introduction Oedematous lesions are a less common but more severe form of Mycobacterium ulcerans disease. Misdiagnosis as bacterial cellulitis can lead to delays in treatment. We report the first comprehensive descriptions of the clinical features and risk factors of patients with oedematous disease from the Bellarine Peninsula of south-eastern Victoria, Australia. Methods Data on all confirmed Mycobacterium ulcerans cases managed at Barwon Health, Victoria, were collected from 1/1/199831/12/2012. A multivariate logistic regression model was used to assess associations with oedematous forms of Mycobacterium ulcerans disease. Results Seventeen of 238 (7%) patients had oedematous Mycobacterium ulcerans lesions. Their median age was 70 years (IQR 1782 years) and 71% were male. Twenty-one percent of lesions were WHO category one, 35% category two and 41% category three. 16 (94%) patients were initially diagnosed with cellulitis and received a median 14 days (IQR 917 days) of antibiotics and 65% required hospitalization prior to Mycobacterium ulcerans diagnosis. Fever was present in 50% and pain in 87% of patients. The WCC, neutrophil count and CRP were elevated in 54%, 62% and 75% of cases respectively. The median duration of antibiotic treatment was 84 days (IQR 6796) and 94% of cases required surgical intervention. On multivariable analysis, there was an increased likelihood of a lesion being oedematous if on the hand (OR 85.62, 95% CI 13.69535.70; P<0.001), elbow (OR 7.83, 95% CI 1.3943.96; p<0.001) or ankle (OR 7.92, 95% CI 1.2849.16; p<0.001), or if the patient had diabetes mellitus (OR 9.42, 95% CI 1.6254.74; p?=?0.02). Conclusions In an Australian population, oedematous Mycobacterium ulcerans lesions present with similar symptoms, signs and investigation results to, and are commonly mistakenly diagnosed for, bacterial limb cellulitis. There is an increased likelihood of oedematous lesions affecting the hand, elbow or ankle, and in patients with diabetes. PMID:24392172

O'Brien, Daniel P.; Friedman, N. Deborah; McDonald, Anthony; Callan, Peter; Hughes, Andrew; Athan, Eugene

2014-01-01

67

Mucormycosis caused by Rhizopus microsporus var. microsporus: cellulitis in the leg of a diabetic patient cured by amputation.  

PubMed Central

Mucormycosis accompanied the development of bacterial infection in the leg of a diabetic African-American man. Local injury, diabetic ketoacidosis, renal insufficiency, and antimicrobial therapy were factors that contributed to the pathogenesis of the mucormycosis. The cellulitis was caused in part by Rhizopus microsporus var. microsporus and was cured by amputation. We report this unusual case of mucormycosis to emphasize the value of fungal identification, to illustrate a dramatic and successful clinical result, and to draw attention to an apparent role for bacterial infection and its treatment in the pathogenesis of mucormycosis. It is the third case report of mucormycosis in a human in which R. microsporus var. microsporus was definitively identified as the etiologic agent. PMID:8586734

West, B C; Oberle, A D; Kwon-Chung, K J

1995-01-01

68

A Homeopathic Arnica Patch for the Relief of Cellulitis-derived Pain and Numbness in the Hand  

PubMed Central

Objectives: Arnica montana, belonging to the Compositae family, is a plant with a longstanding tradition of relieving pain and/or inflammation in muscles and joints and may thus represent an alternative to nonsteroidal antiinflammatory drugs, which are often ineffective or lead to a number of adverse effects. A homeopathic arnica patch (3X dilution according to the Homeopathic Pharmacopoeia of the United States) was developed to alleviate pain symptoms in the back and neck muscles and joints. Case Presentation: The present case report describes the treatment outcome after administration of the arnica patch in a 55-year-old female patient with pain in the right hand and numbness in the fourth finger after cellulitis in the palmar area. The cellulitis was treated with antibiotics, but pain symptoms remained at 7 points on a 0-to-10point visual analog scale (VAS) for pain despite intake of oral ibuprofen and oral and topical application of an arnica-containing complex homeopathic ointment. Ten arnica patches were dispensed to the patient. She cut the patch into strips to cover all painful areas of the hand and applied them at night. After 3 days, she reported a substantial decrease in pain symptoms (VAS = 1) and a marked decrease in numbness and in the size of a tender nodule on the third metacarpal area. Moreover, the patient was able to sleep through the night without being awakened by the pain. The symptoms declined further during the next 2 days. Conclusion: This case demonstrates that after a relatively short period of time, the administration of the arnica patch on the hand provided a marked reduction of pain and recovery of functionality of the hand. PMID:24278813

Kaszkin-Bettag, Marietta

2012-01-01

69

Feasibility study to inform the design of a UK multi-centre randomised controlled trial of prophylactic antibiotics for the prevention of recurrent cellulitis of the leg  

PubMed Central

Background This paper describes the results of a feasibility study for a randomised controlled trial (RCT). Methods Twenty-nine members of the UK Dermatology Clinical Trials Network (UK DCTN) expressed an interest in recruiting for this study. Of these, 17 obtained full ethics and Research & Development (R&D) approval, and 15 successfully recruited patients into the study. A total of 70 participants with a diagnosis of cellulitis of the leg were enrolled over a 5-month period. These participants were largely recruited from medical admissions wards, although some were identified from dermatology, orthopaedic, geriatric and general surgery wards. Data were collected on patient demographics, clinical features and willingness to take part in a future RCT. Results Despite being a relatively common condition, cellulitis patients were difficult to locate through our network of UK DCTN clinicians. This was largely because patients were rarely seen by dermatologists, and admissions were not co-ordinated centrally. In addition, the impact of the proposed exclusion criteria was high; only 26 (37%) of those enrolled in the study fulfilled all of the inclusion criteria for the subsequent RCT, and were willing to be randomised to treatment. Of the 70 participants identified during the study as having cellulitis of the leg (as confirmed by a dermatologist), only 59 (84%) had all 3 of the defining features of: i) erythema, ii) oedema, and iii) warmth with acute pain/tenderness upon examination. Twenty-two (32%) patients experienced a previous episode of cellulitis within the last 3 years. The median time to recurrence (estimated as the time since the most recent previous attack) was 205 days (95% CI 102 to 308). Service users were generally supportive of the trial, although several expressed concerns about taking antibiotics for lengthy periods, and felt that multiple morbidity/old age would limit entry into a 3-year study. Conclusion This pilot study has been crucial in highlighting some key issues for the conduct of a future RCT. As a result of these findings, changes have been made to i) the planned recruitment strategy, ii) the proposed inclusion criteria and ii) the definition of cellulitis for use in the future trial. PMID:17257411

Thomas, Kim S; Cox, Neil H; Savelyich, Boki SP; Shipley, Debbie; Meredith, Sarah; Nunn, Andrew; Reynolds, Nick; Williams, Hywel C

2007-01-01

70

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

71

Colloque cellules souches: conclusion  

Microsoft Academic Search

The stem cell data presented and discussed during the symposium raise the hope that important medical progress can be made in several fields: neuro-degenerative diseases, those linked to cellular deficit, some aspects of aging linked to cellular degeneration, and the treatment of cancers that may harm normal tissues at risk of being infiltrated by malignant cells. Three main types of

Maurice Tubiana

2002-01-01

72

Cellulitis and Erysipelas  

MedlinePLUS

... the NIAID Institute of Allergy and Infectious Diseases web site to work incorrectly. Please visit your browser settings and turn ... is inflammation of the skin and deep underlying tissues. Erysipelas is an inflammatory disease of ...

73

What Is Cellulitis?  

MedlinePLUS

... Guidelines Home Remedies for Simple Eye Problems Medical Marijuana for Glaucoma Pregnancy Preventing Eye Injuries Smokers Sports ... is strictly prohibited by US and international copyright law. You may link from your website to any ...

74

Breaking the mold of orbital cellulitis.  

PubMed

A 52-year-old, immune-suppressed man presented with painful proptosis. Orbital imaging revealed enhancement of his right inferior rectus muscle and mild ethmoidal sinus disease. Sinus washings and turbinectomy demonstrated Curvularia. Despite aggressive intravenous antimicrobials, the patient remained febrile. Repeat imaging demonstrated a well-defined intramuscular abscess without contiguous orbital or paranasal involvement. Following surgical drainage, the patient improved. Cultures of the material expressed from the abscess confirmed a co-infection with Fusarium. Although rare, fungal abscess of the extraocular muscle should be considered in patients (particularly if immunosuppressed) with extraocular muscle enlargement resistant to conventional antimicrobial therapy. Prompt diagnosis and treatment could potentially prevent further serious morbidity or mortality. PMID:19026322

Peden, Marc C; Neelakantan, Arvind; Orlando, Christine; Khan, Shahab A; Lessner, Alan; Bhatti, M Tariq

2008-01-01

75

Infantile maxillary sinus osteomyelitis mimicking orbital cellulitis.  

PubMed

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

2014-07-01

76

UNIVERSITE PARIS-SUD COLE DOCTORALE : Gnes Gnomes Cellules  

E-print Network

. ...................................................................................................................................... 15 I.1.4. Ciliopathies: pathologies related to ciliary dysfunction

Paris-Sud XI, Université de

77

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 âfatigue, easy bruising, and a left lower leg cellulitesâ. 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 âFinal Diagnosisâ section contains the attending doctorâs 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

78

Les cellules gonadotropes chez les salmonids Madeleine OLIVEREAU  

E-print Network

. The gonadotropic cells of Salmonidae. Pituitaries of Salmo gairdneri and Salmo fario were examined at several gairdneri et Salmo fario. Matériel et méthodes. Salmo gairdneri et S. fario âgés de 3 ans, provenant d Van Overbeeke, 1972) et l'Epinoche (Slijkhuis, 1977). Les résultats rapportés ici concernent Salmo

Paris-Sud XI, Université de

79

Cellule dabsorption pour talon passif de frquence  

Microsoft Academic Search

\\u000a SummaryAn original helicoidal guide microwave absorption cell is described. Principal features are low insertion losses, one-mode\\u000a propagation, good electromagnetic shielding, large interaction volume, chemical inertia and low gas pressure capability. Typical\\u000a performances are given.

M. Valentin; J. Hardin; J.-C. Mollier

1980-01-01

80

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

MedlinePLUS

... incorporate new medical findings Related articles Patient information: Animal bites (Beyond the Basics) Patient information: Methicillin-resistant ... aureus (MRSA) (Beyond the Basics)" and "Patient information: Animal bites (Beyond the Basics)" .) SKIN INFECTION RISK FACTORS ...

81

Cellules souches et thrapie cellulaire. Contribution au dbat thique  

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

82

Cellules photovoltaques utilises en sparation spectrale 2014 I. Comparaison  

E-print Network

of the photovoltaic behaviour of a set two systems each of which has two solar cells Ga1-xAlxAs-Si and GaAs-Ge coupled with a dichroic mirror in sunlight The model of each system shows the influence of physical and technological. The minimization of losses gives the optimum of the grid metallic pattern profile. The Ga0.7Al0.3As-Si system under

Boyer, Edmond

83

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

84

Migrazione di cellule dell'epidermide e dell'epitelio intestiuale durante la rigenerazione dei Lombricidi  

Microsoft Academic Search

In th epresent work, caudal regeneration in Allulobophora caliginosa has been studied, following a simple tranverse cut two or three segments behind the elitellum. It is pointed out that all the data put forward (ecllular migrations) requires a confirmation by means of the use of a more adequate technique: this data show, anyhow, a high degree of probability.If one could

Ginevra Tiiermes

1960-01-01

85

Thysanoptera infestation on skin and periorbital cellulitis in ostriches (Struthio camelus) aged 14 months  

Microsoft Academic Search

AIM: To report the infestation of Thysanoptera (Limothrips denticornis) on ostriches (Struthio camelus) and to determine their relative density.METHODS: A farm in Poland was studied on which ostriches aged 14 months were severely infested with L. denticornis (thrips). Thrips were collected and their density on the neck, torso and legs (10 cm) of 85 ostriches determined at 0600, 1200 and

RG Cooper

2007-01-01

86

les protocoles d'isolement des lignes de cel-lules pithliales hpatiques sont dlicats  

E-print Network

phéno- liques utilisés comme additifs alimentaires, le BHT et le BHA, ainsi que le phénobarbital, pris pour le BHT 3 x 10 ! M. A ce stade, l'induction de la y-GT semble encore réversible. Références

Paris-Sud XI, Université de

87

A case of unilateral periorbital cellulitis and mandibular osteomyelitis in a turkey flock.  

PubMed

A farm of meat turkeys was affected by a condition, clinically characterized by unilateral inflammation of the orbital region and progressive crossing of the beak, observed in three successive flocks in 2010. While no toxic, genetic, technical, or diet causes could be found, pathologic and bacteriologic analyses were conducted to investigate the case. Pathologic analyses of the heads of affected birds showed blepharitis and exudative sinusitis as well as severe chronic osteomyelitis of all skull bones and mandibula. Staphylococcus aureus was consistently isolated from these lesions. It is supposed that the severe bacterial osteomyelitis induced deviation of some bones, thereby leading to deviation of the beak. Further investigations remain to be carried out to explain these successive outbreaks of staphylococcal osteomyelitis in skull bones. PMID:22856207

Corrand, L; Lucas, M N; Douet, J Y; Etienne, C L; Albaric, A O; Cadec, A; Gurin, J L

2012-06-01

88

Centre des Technologies au service de l'Enseignement Cellule TICE  

E-print Network

Bruxelles 50, avenue Franklin D. Roosevelt CP 160/26 B 1050 Bruxelles Tél: 02/650.35.10 Fax: 02/étudiant...................................................................................................................................... 12 Page d'accueil de la plate.............................................................................................................................. 13 Création d'un compte

Cerf, Nicolas

89

L'ultra-structure du nuclole de quelques cellules animales, rvle par le microscope lectronique  

Microsoft Academic Search

Zusammenfassung Elektronenoptische Untersuchungen von Ultrafeinschnitten der Rattenleber sowie einiger anderer Gewebe dieses Tieres, ferner eines Mammakarzinoms der Maus und der Niere des Menschen haben ergeben, da der Nukleolus des Zellkerns oft eine besondere Struktur aufweist: Auf gengend dnnen Schnitten (0,2>) erscheint sehr hufig ein Knuel fadiger Elemente von verschiedener Lnge, aber annhernd gleicher Dicke, die fr die Gesamtheit des Nukleolus

W. Bernhard; F. Haguenau; Ch. Oberling

1952-01-01

90

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

E-print Network

and the gastrointestinal tract. There is thus a large wave of interest in the so-called brain-gut axis and in the relations between brain and gut and between nerves and hormones. The motile system of the gastrointestinal tractNeurohumoral control of gastrointestinal motility C. ROZ? Laboratoire de Biologie et Physiologie

Paris-Sud XI, Université de

91

Un modle non-linaire de prolifration cellulaire : extinction des cellules et invariance  

Microsoft Academic Search

This Note analyses a nonlinear age-maturity structured system which arises as a model of the blood cellular production in the bone marrow. The resulting model is a nonlinear first-order partial differential equation in which there is a distributed temporal delay and a retardation in the maturation variable. We prove that uniqueness of solutions depends only on small maturity cells (stem

Mostafa Adimy; Fabien Crauste

2003-01-01

92

THESE DE DOCTORAT DE L'UNIVERSITE PARIS XI ECOLE DOCTORALE GENES, GENOMES, CELLULES  

E-print Network

: Primary ciliary dyskinesia PDGFR : Platelet-Derived Growth Factor Receptors alpha PKD : Polycystic Kidney-Darby Canine Kidney MKS : Meckel Syndrom MTOC : MicroTubule Organizing Center NLS : Nuclear Localisation Signal Disease Pp : Physcomitrella patens PPB : Pre-Prophase Band Pt : Paramecium tetraurelia RFP : Red

Paris-Sud XI, Université de

93

LES CELLULES A HORMONES GLYCOPROTIDIQUES DU LOBE ANTRIEUR DE L'HYPOPHYSE  

E-print Network

. ?tude immunologique de l'Ac. Elle est effectuée avec les techniques suivantes : a) Test de précipitation) a été modifiée comme suit : Après blocage de la réaction par 0,7 ml d'une solution isotonique de citrate

Boyer, Edmond

94

ANALYSE A PRESSION RDUITE DU RAYONNEMENT MIS PAR LES CELLULES DE GRANDE RSISTANCE LECTRIQUE (1)  

E-print Network

pressions supérieures à quelques centimètres de mercure. 3° Les résultats obtenus à des pressions où général, de l'oxyde jaune de mercure, sauf dans les dernières expériences où on lui a substitué du carbonate de soude, qui présente sur l'oxyde de mercure l'avantage de se fatiguer moins vite. Les radiations

Boyer, Edmond

95

Cellule Veille scientifique et technologique http://www.inrp.fr/vst Lettre d'information  

E-print Network

­ September 2006 subscribe see the on-line newsletter Basic skills and the psychology of education: highly of the XXth century, scientific psychologists have been attempting to shed light on the mechanisms this inventory The basic skills To understand the concept of basic skills here, we need to take a closer look

Paris-Sud XI, Université de

96

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

97

tude CEM d'une cellule de commutation avec interrupteurs en Si et SiC.  

E-print Network

composants a été réalisée. Mots-clés : Carbure de Silicium (SiC), CEM conduite, ?lectronique de puissance 1 carbure de silicium (SiC) comme une solution adaptée. L'utilisation des composants SiC dans les

Boyer, Edmond

98

Ultrastructure de l'pithlium tgumentaire de Glossiphonia complanata (L.) (Hirudine): cellules pithliales et organes sensoriels de Bayer  

Microsoft Academic Search

The integument of Glossiphonia complanata, built up by epithelial cells, contains numerous particular organs (Bayer organs), mainly on the dorsal side of the animal. They consist of a protuberant apical cell, which is surrounded by a ring-shaped muscle cell. All the integumentary formations are studied from an ultrastructural point of view. From the epithelial cells issue afferent nerve fibres, considered

Denise Damas

1973-01-01

99

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

100

Un mod\\\\`ele non-lin\\\\'eaire de prolif\\\\'eration cellulaire : extinction des cellules et invariance  

Microsoft Academic Search

This paper analyses a nonlinear age-maturity structured system which arises as a model of the blood cellular production in the bone marrow. The resulting model is a nonlinear first-order partial differential equation in which there is a distributed temporal delay and a retardation in the maturation variable. We prove that uniqueness of solutions depends only on small maturity cells (stem

Mostafa Adimyet; Fabien Crauste

2009-01-01

101

diant la cintique de croissance des cellules, il s'accompagne, pour tous les inducteurs, d'une  

E-print Network

diesters in human breast MCF-7 cell line. Mol. Cell. Endo. 56, 157-163 Sutherland R.L., Hall R.E. & Taylor-phorbol-13-acetate on proliferation and matura- tion of human breast carcinoma cells (MCF-7) : rela- tionship augmentation permanente des lympho- cytes sanguins (lymphocytose persistante) ou à une affection

Paris-Sud XI, Université de

102

Etude du rle du rcepteur de chimiokine CX3CR1 dans la mobilisation monocytaire induite par chimiothrapie.  

E-print Network

??Les chimiokines (CKs) jouent un rle important dans l'orchestration de la rponse immunitaireen contrlant notamment la mobilisation des cellules immunitaires. Les cellules mylodes et, enparticulier, (more)

Jacquelin, Sbastien

2013-01-01

103

Etude du rle du rcepteur de chimiokine CX3CR1 dans la mobilisation monocytaire induite par chimiothrapie.  

E-print Network

??Les chimiokines (CKs) jouent un rle important dans lorchestration de la rponse immunitaireen contrlant notamment la mobilisation des cellules immunitaires. Les cellules mylodes et, enparticulier, (more)

Jacquelin, Sbastien

2013-01-01

104

IGF I (INSULIN-LIKE GROWTH FACTOR I) INDUIT LA PRODUCTION DU CORTISOL ET DE L'ANDROSTENEDIONE DANS LA CELLULE CORTICO-SURRENALIENNE BOVINE  

E-print Network

IGF I (INSULIN-LIKE GROWTH FACTOR I) INDUIT LA PRODUCTION DU CORTISOL ET DE L'ANDROSTENEDIONE DANS étudiée. Les niveaux de glucocorticoldes (cortisol + corticosterone) obtenus avec l'IGF 1 (750 ng+ 106, n = 8). Le rapport cortisol/corticostérone, augmentait à chaque fois sous l'effet de l'IGF 1, et s

Paris-Sud XI, Université de

105

MODIFICATIONS ULTRASTRUCTURALES DES CELLULES S?CR?TRICES DE LA GLANDE PROTHORACIQUE DE VERS ? SOIE AU COURS DES DEUX DERNIERS ?GES LARVAIRES  

PubMed Central

Ultrastructural study of the prothoracic glands of silkworms (Antheraea pernyi and Bombyx mori) at the last two larval stages has shown that the essential modifications which take place during each intermolt affect the chondriome of secretory cells. A description is given of the differentiation of macromitochondria from typical mitochondria by a general swelling, a clearing of the matrix, and the formation of a complex tubular network. The hypothesis of fixation or anaesthesia artifacts has been dismissed because of the persistence of these transformations after different fixations and because of the existence of numerous intermediary stages between these two types of chondriosomes which imply the progressiveness of differentiation. The cytochemical demonstration of mitochondrial DNA fibers suggests that the genetic information, probably present in this type of nucleic acid, controls the differentiation and the specific metabolic activity of these organelles. The frequent relationships observed in Antheraea between the tubules of agranular reticulum and the macromitochondria which are reminiscent of the vacuoles-mitochondria associations of the adrenal cortex, may be related to the transfer of cholesterol and other precursors of steroidogenesis. In the last stages, the macromitochondria become transformed into vacuoles by a disappearance of the tubular network. The correlation revealed between mitochondrial transformations and the cyclical release of ecdysone (65) leads to the conclusion that a prominent fraction of chondriosomes is involved, in relation to the agranular reticulum, in the elaboration of steroid hormones such as ecdysone. PMID:5699930

Beaulaton, J. A.

1968-01-01

106

Processus de gurison dune maladie chronique: la drpanocytose traite par allogreffe de cellules souches hmatopotiques. Principaux rsultats chez les adolescents  

Microsoft Academic Search

Sickle cell disease (SCD) is an autosomal recessive hemoglobinopathy affecting young infants during early childhood. So far, the only cure for SCD involves hematopoietic stem cell transplantation (HCT). Recovery from this treatment represents a major change for the child and the child's family. How do they deal with it? What are the consequences for the development of the young adolescent?

E. Drain; J. Pradre; O. Taieb; B. Dutray; M. Champion; D. Bonnet; F. Bernaudin; M.-R. Moro

2008-01-01

107

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

E-print Network

for cell replacement therapy. Embryonic stem cells (ESCs) exhibit pluripotency [1,2], but because cellules cardiaques mesodermiques cellules pancreatiques endodermiques Key words CD34+ stem cell pluripotent cell cell replacement therapy mesodermal cardiac cell endodermal pancreatic cell hal-00545219

108

Java, OCaml Programmation  

E-print Network

unique (canal) + port (état) + cellule Java, OCaml Java, Oz Programmation concurrente par état partagé + journal + cellule (état) + cellule locale avec objets actifs Programmation Programmation orientée objet Programmation concurrente par capacité objet Programmation par boucle d

Bonaventure, Olivier

109

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

110

L'analyse cytofluorimtrique nous a permis de confirmer que nos prparations d'IEL contenaient moins de 5 % de cellules B (lg+), seulement 20 30 % de lymphocytes exprimant les marqueurs de  

E-print Network

ressembles natural cytotoxic (NC) activity. Fed Proc 44:10177 5. Razin E et al, 1984. Cloned mouse mast cells of a novel Thy-1-, lyt-2+, granu- lated subpopulation to natural killer cells and mast cells. Eur J Immunol leukocytes population. J Immunol 136:2121-2126 4. Ernst PB et al, 1985. Mast cell mediated cytotoxicity

Paris-Sud XI, Université de

111

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

112

Anaerobic bacteria in 118 patients with deep-space head and neck infections from the University Hospital of Maxillofacial Surgery, Sofia, Bulgaria  

Microsoft Academic Search

The aim of this study was to assess the incidence and susceptibility to antibacterial agents of anaerobic strains in 118 patients with head and neck abscesses (31) and cellulitis (87). Odontogenic infection was the most common identified source, occurring in 73 (77?7%) of 94 patients. The incidence of anaerobes in abscesses and cellulitis was 71 and 75?9%, respectively, and that

Lyudmila Boyanova; Rossen Kolarov; Galina Gergova; Elitsa Deliverska; Jivko Madjarov; Milen Marinov; Ivan Mitov

2006-01-01

113

Universit degli Studi di Roma "La Sapienza" Dipartimento Medicina Sperimentale  

E-print Network

ricerca : "Studio delle vie di traduzione attivate in cellule microgliali dal legame CCX3CL1/CX3CR1 e in cellule microgliali dal legame CCX3CL1/CX3CR1 e coinvolte nell'attivazione di funzioni cellulari quali

Guidoni, Leonardo

114

Poste rserv dans le cadre du dispositif de la loi Sauvadet Profil de poste  

E-print Network

des parasites (leishmanies, trypanosomes), cellules humaines et animales dans le cadre des programmes et cultiver des cellules humaines et animales, analyser leur activation et leur prolifération à domaine biologique en hygiène et Sécurité, mutants génétiquement modifiés et expérimentation animale

115

CUTANEOUS TUBERCULOSIS PRESENTING AS NECROTIZING FASCIITIS IN AN ELDERLY PATIENT  

Microsoft Academic Search

SUMMARY We report a case of cutaneous tuberculosis presenting as cellulitis and necrotizing fasciitis of the bilateral lower legs. The patient was a 79-year-old male who denied any history of chronic medical diseases such as hyperten- sion, diabetes or old cerebrovascular accident. He had developed itchy skin papules since August 2008. His clin- ical cellulitis failed to respond to antibiotic

Wen-Chin Cho; Yung-Chia Pai; Yung Hsiung; Wai-Mau Choi

2008-01-01

116

Pets and Pasteurella Infections  

MedlinePLUS

... the infectious organism. Treatment Your pediatrician will prescribe antibacterial treatment as soon as cellulitis is found. In ... require a 7- to 10-day dose of antibacterials, occasionally longer. Your pediatrician also may drain and ...

117

ARRAYS FOR BIOMONITORING ENVIRONMENTAL AND REPRODUCTIVE TOXICOLOGY  

EPA Science Inventory

DNA arrays are receiving increasing interest as a tool for monitoring the developmental and reproductive impact of xenobiotics and other hazardous materials on human and wildlife populations. The primary tenet of toxicogenomics is that effects of environmental exposure on cellul...

118

Genetics Home Reference: Milroy disease  

MedlinePLUS

... condition that affects the normal function of the lymphatic system. The lymphatic system produces and transports fluids and immune cells ... damage the thin tubes that carry lymph fluid (lymphatic vessels). Episodes of cellulitis can cause further swelling ...

119

Nikolsky sign  

MedlinePLUS

Pasternack MS, Swartz MN. Cellulitis, necrotizing fasciitis, and subcutaneous tissue infections. In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases . ...

120

Universit des Sciences et Technologies de Lille Thse de doctorat  

E-print Network

des N- glycannes dans des cellules Sf9. L'utilisation d'inhibiteurs de la maturation ou du trafic to "humanize" the glycoproteins produced in Lepidopteran cells. Our first concern was to understand the N

Paris-Sud XI, Université de

121

Hib Photos  

MedlinePLUS

... www.vaccineinformation.org/photos/hib_aap001.jpg Copyright American Academy of Pediatrics Haemophilus influenzae type b. Cellulitis of the arm proven by blood culture www.vaccineinformation.org/photos/hib_aap002.jpg Copyright ...

122

Hib Disease (Haemophilus Influenzae Type b)  

MedlinePLUS

... to a vaccine that became common in the 1980s, Hib is pretty rare in U.S. kids and ... TOPIC Sickle Cell Anemia Cellulitis Pneumonia HIV and AIDS Meningitis Why Should I Care About Germs? Immunizations ...

123

AVVIO ALLA RICERCA ESERCIZIO FINANZIARIO 2012 N. AREA DIPARTIMENTO DOCENTE TITOLO  

E-print Network

domotico basata su un paradigma di presentazione rapida e seriale di stimoli visivi 1.500,00 4 B MEDICINA nella maturazione e nella distribuzione tissutale di cellule Natural Killer 2.000,00 15 A CHIMICA

Guidoni, Leonardo

124

Folliculitis  

MedlinePLUS

... Irritation from shaving Friction from tight clothing A pre-existing skin condition, such as eczema, acne, or ... Trusted Links Related diseases: Abscess Boils (Furunculosis) Cellulitis Heat Rash or Prickly Heat (Miliaria Rubra) Hot Tub ...

125

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

AnAgement* § epiDemiology § FooD Science § ForenSic Science § gloBAl heAlth* § heAlth inFormAticS § immunology AnD heAlth-cAre leADerShip § nutritionAl Biology § phArmAceuticAl chemiStry § phArmAcology AnD toxicology/ or toxicology. Graduates pursue careers in academia, government, industry, and non- governmental organizations

Schladow, S. Geoffrey

126

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

. Usant de cultures de courte durée (24 h), de cellules trophoblastiques préparées par dissociation à la interférer avec une CTL, après 24 ou 48 h de culture. Les cellules traitées à la neuraminidase, elles., Mitchell G. F., 1978. Maternal alloimmunisation in pregnancy : ln vitro studies of T cell dependent

Paris-Sud XI, Université de

127

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

128

J. Phys. III Franc-e 3 (1993) 859-861 APRIL 1993, PAGE 859 Classification  

E-print Network

trique directe qui conduit h : AH~~~ j29g,15 K) = 13,05 ± 0,1 kJlatome-gramme. Abstract. An effusion cell sensibilit6 du microcalorim~tre Calvet et les propri6t6s d'effusion en r6gime mol£culaire des cellules de plac£e une tubulure contenant la cellule d'effusion. Apr~s la mise sous vide de la tubulure et l

Paris-Sud XI, Université de

129

UNIVERSITE BLAISE PASCAL UNIVERSITE D'AUVERGNE Anne 2010 N d'ordre  

E-print Network

traitement de l'insuffisance cardiaque III- Les types cellulaires proposés 1-Cellules autologues 2-Cellules anciens Egyptiens et le Traité d'anatomie d'Hérophile, - tentée en 1492 par le pape Innocent VIII, qui Innocent VIII - réussie en 1667, par Jean Baptiste Denis, médecin privé de Louis XIV, qui injecta neuf

Paris-Sud XI, Université de

130

[Skin diseases as a reason for condemnation of broiler carcasses].  

PubMed

The analysis of losses in slaughtered broilers based on the results of poultry meat inspection in a poultry slaughterhouse in 1991-1993 has shown that skin diseases are the main reason for condemnation of carcasses, followed by polyserositis and aerosacculitis, underdevelopment, skeletal diseases, and ascites syndrome. The incidence of skin diseases increased continuously between 1991 and 1993. Amongst the skin diseases eight separate diagnoses were differentiated. Dermatitis with cellulitis, dermal carcinomatosis, skin tears, scabby hip, and breast blisters are the most frequent ones. However, the permanent increasing dermatitis with cellulitis as well as the frequency rank following dermal carcinomatosis are of utmost importance. PMID:8578570

Bergmann, V; Koglin, K; Valentin, A

1995-08-01

131

Fatal necrotizing fasciitis and myositis in a captive common bottlenose dolphin (Tursiops truncatus) associated with Streptococcus agalactiae  

Microsoft Academic Search

A common bottlenose dolphin (Tursiops truncatus) was presented for necropsy after acute onset of gastrointestinal signs and cutaneous lesions that rapidly progressed to death. Gross and microscopic findings were characterized by locally extensive severe necrohemorrhagic fasciitis and cellulitis, and severe necrotizing myositis in the head and dorsocranial thorax, with numerous disseminated gram-positive cocci. Streptococcus agalactiae was isolated from the lesions

Valentina Zappulli; Sandro Mazzariol; Laura Cavicchioli; Claudio Petterino; Luca Bargelloni; Massimo Castagnaro

132

A SIMPLE METHOD FOR THE EXTRACTION OF POLYSACCHARIDE B FROM BRUCELLA CELLS FOR USE IN THE RADIAL  

E-print Network

méthode de préparation rapide, simple et sans danger est proposée. Elle utilise des cellules tuées par le antigen has made possible the identification of infected cattie in recently vaccinated herds which had

Paris-Sud XI, Université de

133

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

Microsoft Academic Search

Rsum Au cours de la contraction du tissu de granulation, de nombreux fibroblastes acquirent des caractristiques ultrastructurelles qui les rendent semblables des cellules musculaires lisses. Il est probable que ces lments modifis jouent un rle dans le processus de contraction des plaies.

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

1971-01-01

134

Pour obtenir le grade de DOCTEUR DE L'UNIVERSIT DE GRENOBLE  

E-print Network

cellule "technique" : les personnes de l'ate- lier et du magasin, Danièle pour les circuits en salle blanche, Mathilde pour la chimie, et surtout Patrice Ballet, ingénieur de choc (et "voisin" de bureau aux

Paris-Sud XI, Université de

135

Tumori: identificato ruolo proteina nello sviluppo del Glioblastoma Uno studio nato dalla collaborazione tra Universit Statale di Milano e Istituto Europeo di  

E-print Network

Tumori: identificato ruolo proteina nello sviluppo del Glioblastoma Uno studio nato dalla della Proteina CLIC1 nelle cellule staminali tumorali di Glioblastoma. Una ricerca nata dalla sviluppo del Glioblastoma umano (GBM), il tumore cerebrale più aggressivo nell'adulto. A causa della sua

De Cindio, Fiorella

136

Squamous cell carcinoma arising from pilonidal sinus.  

PubMed

Pilonidal sinus is usually present in the sacrococcygeal region. The common presentations are cellulitis, abscess or sinus. Rarely malignant change may be seen in chronic pilonidal sinus. We report a case of chronic pilonidal sinus complicated with squamous cell carcinoma. PMID:23050944

Pandey, Mithilesh K; Gupta, Puneet; Khanna, Ajay K

2014-08-01

137

FRICTION BLISTERS: PATHOPHYSIOLOGY, RISK FACTORS, AND PREVENTION  

Microsoft Academic Search

Friction blisters are one of the most common injuries an active individual can experience. They are usually a minor annoyance, generally requiring only simple first aid and a short period of limited activity. However, it is possible for blisters to develop into more serious problems such as cellulitis or sepsis (1). This article reviews the pathogenesis of blisters, examines factors

Joseph J. Knapik

138

CELULITIS Y ERISIPELA  

Microsoft Academic Search

Among soft tissue infections, cellulitis and erysipelas are very important for being a frequent infection that involves the skin and underlying soft tissue, characterized by edema, erythema, pain and acute initiation usually associated to systemic symptoms such as fever, chills and malaise. The most com- mon cause of both conditions is gram positive bacteria, such as Group A Streptococci or

Edgar Olmos Olmos; Diego Andrs; Bonilla Gonzlez

2008-01-01

139

Erisipelas y celulitis. Estudio retrospectivo de 122 casos  

Microsoft Academic Search

BackgroundErysipelas and cellulitis are relatively common cutaneous infections that can sometimes be the cause of a prolonged hospital admission. The objective of this study was to determine the most relevant epidemiologic factors and their influence on the length of hospital stay, comparing our results with those of previous studies.

J. Concheiro; M. Loureiro; D. Gonzlez-Vilas; J. Garca-Gavn; D. Snchez-Aguilar; J. Toribio

2009-01-01

140

CELULITIS POR CITOMEGALOVIRUS  

Microsoft Academic Search

Cytomegalovirus cellulitis. Cutaneous lesions in CMV infection are rare, often a late manifestation of systemic infection, and usually herald a fatal course. A 70 year-old woman received a kidney transplantation one month before consulting and immunosuppressive therapy that included cyclosporine A and methylprednisone. She complained of fever, local pain in her right leg, and an erythematous and swelling plaque. She

ALEJANDRO RUIZ LASCANO; RAQUEL KUZNITZKY; ILIANA GARAY; MARIA KURPIS; PABLO MASSARI

141

Celulitis facial en paciente anciano. A propsito de un caso  

Microsoft Academic Search

Cellulitis is a skin infection with some degree of extension into the subcutaneous cellular tissue. It is usually caused by a cut on the skin of elderly, diabetic patients, with immunological disease, patients with lymph stasis and children. This case is of interest because of the need for a rapid diagnostic orientation as well as early treatment of the condition

J. P. Moreno; A. Martnez; S. Jimnez

2010-01-01

142

PATHOGENESIS AND EPIDEMIOLOGY OF BOVINE VIRUS DIARRHOEA VIRUS INFECTION OF CATTLE  

E-print Network

effets en culture de cellules. L'infection intra-utérine du foetus par une souche non cytopathogène peut of gestation; in early pregnancy it could result in abortion or stillbirth, whereas later the foetus could make

Paris-Sud XI, Université de

143

The role of chromosome abnormalities in reproductive failure  

E-print Network

pregnancies is given. Data on the parental origin of sex chromosome abnormalities and certain autosomal cellules en culture. Cependant, les récents développements des sondes dADN ont permis de déterminer l wastage that is present at all stages of pregnancy. The fecundity of man has been estimated to be around

Boyer, Edmond

144

Neonatal orbital abscess after sinus surgery: case report and brief review.  

PubMed

Orbital abscess formation in neonates is rare, with only 12 cases reported in the literature. We present a case of orbital cellulitis with orbital abscesses following repair of congenital choanal atresia in a 2-week-old neonate. This is the first reported case of an orbital abscess following a sinus procedure in a neonate. PMID:23875775

Yang, Elizabeth; Fisher, Mark; Servat, Juan; Levin, Flora

2013-10-01

145

Original article Inhibitory effect of interferon-? activated ovine  

E-print Network

Original article Inhibitory effect of interferon-? activated ovine umbilical vein endothelial endothelial cells with bovine recombinant y-interferon (IFN-y) blocked the growth of T gondii. Growth cellules endoth�liales de la veine ombilicale ovine activ�es par l'interf�ron gamma (IFN-y) recombinant

Paris-Sud XI, Université de

146

lffiA Snpteruzn W/ t;Ntvt-R\\ll^ t)l RoMA  

E-print Network

and tissue engineering for ischemic heart disease: regional and global left ventricular quantitative analysis and tissue engineering for ischemic heart disease: regional and global left ventricular quantitative analysis cellule staminali cardiache nell'ambito del progetto di ricerca "Evaluation ofregenerative cell therapy

Guidoni, Leonardo

147

16S rRNA sequence analysis of an isolate of Mycobacterium haemophilum from a heart transplant patient  

Microsoft Academic Search

Summary. Biopsy samples from a heart transplant patient with cellulitis and bursitis yielded an isolate of Mycobacterium haemophilum. The isolate was identified on the basis of a growth requirement for haemin or ferric ammonium citrate, growth at 30C but not at 37\\

CATHERINE H. ZAPPE; D. Barlow; H. Zappe; I. J. Bolton; D. Roditi; L. M. Steyn

1995-01-01

148

TUDE DE POST-DCHARGES DANS L'HLIUM ET LE NON (1) Par DAHO ALLAB (2),  

E-print Network

de la densité. Abstract. 2014 In a previous paper [1], we have described a centimetric wavelength:0196800290102200 #12;23 Photographie 1 : Allure des signaux détectés. - En haut : Cas d'une cellule de longueur 2

Boyer, Edmond

149

Escherichia coli heat-stable enterotoxin b (STb) in vivo internalization within rat intestinal epithelial cells  

E-print Network

Short note Escherichia coli heat-stable enterotoxin b (STb) in vivo internalization within rat distributed within the cell. Escherichia coli / STb enterotoxin / internalization Résumé ­ Internalisation in vivo de l'entérotoxine b (STb) d'Escherichia coli dans les cellules épithéliales d'intestin de rat. L

Boyer, Edmond

150

1478 THE NEW ENGLAND JOURNAL OF MEDICINE May 30, 1996 ide, and there is one case report of long-term nitric oxide in-  

E-print Network

from cellulitis. The distinction is critical, since the former infection requires surgical débridement tomography (CT) or magnetic resonance imaging (MRI) "is useful in locating the site and depth of infection-stage pulmonary hypertension. Am J Respir Crit Care Med 1995; 151:1263-6. STREPTOCOCCAL SKIN INFECTIONS

Nizet, Victor

151

Obtention of ovine IgE from heterohybridoma H Yilmaz K Haverson, KL Morgan  

E-print Network

pertussis vaccine were fused with mouse myeloma cell lines, P3-X63-Ag8.653, NSO.U and NS1.1.Ag1.1. One combinaison avec une pr�paration vacci- nale de Bordetella pertussis. Les cellules des ganglions lymphatiques- bination with Bordetella pertussis vaccine were fused with mouse myeloma cell lines, at the time

Paris-Sud XI, Université de

152

ENERGIA SOLAR Introduccio  

E-print Network

ENERGIA SOLAR · Introducci´o · Usos t`ermics. Baixa temperatura · Sistemes de conversi´o t) Cuines Solars http://www.solarcooking.org #12;DESSALADORS SOLARS #12;APLICACIONS T`ERMIQUES BAIXA TEMPERATURA Col.lectors solars plans per a ACS #12;CONVERSI´O DIRECTA EN ELECTRICITAT C`el.lules i panells

Batiste, Oriol

153

INSTITUT NATIONAL DES SCIENCES APPLIQUES DE ROUEN Prsente par  

E-print Network

) de l'INSA de Rouen sous la direction de Monsieur le Professeur Fabrice BUREL. Je lui témoigne toute au CNRS, pour m'avoir accueilli au sein de son équipe «Biofilms Résistances Interactions Cellules

Paris-Sud XI, Université de

154

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

155

ANALYSIS OF FREQUENCY RESPONSE AND NOISE OF CCD STRUCTURES S. DONATI and F. MONTECCHI  

E-print Network

691 ANALYSIS OF FREQUENCY RESPONSE AND NOISE OF CCD STRUCTURES S. DONATI and F. MONTECCHI Istituto cellules pour le CCD dans le cas des faibles signaux, qui rend compte complètement de la fonction de (analogique ou numérique), soit au CCD à image, et comprend les effets des : retard d'horloge, inefficacité du

Paris-Sud XI, Université de

156

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

157

JOURNAL DE PHYSIQUE Colloque C6, supplkment au no 11-12, Tome 33, Nouembre-Ddcembre 1972,page 48 THE POHLMAN CELL AND ITS USE IN HOLOGRAPHY  

E-print Network

lentille acoustique liquide a focale variable. La cellule de Pohlman utilise le couple exerce par un champ photographic emulsion and holography with sound waves may be said to be in search of an (( acoustical emulsion exerted on the disc in a sound field is given by - L = - + p o a 3I V l2sin2n, where p, is the density

Paris-Sud XI, Université de

158

Endocrine Responses to Resistance Exercise,  

National Technical Information Service (NTIS)

The purpose of this brief review is to examine resistance training responses of selected hormones related to acute stress and growth promoting actions. Hormonal mechanisms appear to be involved with both short-term homeostatic control and long-term cellul...

W. J. Kraemer

1987-01-01

159

Original article Distribution of ?CDCP-immunoreactive neurons  

E-print Network

) Summary ― aCDCP is a neuropeptide produced by the caudodorsal cells of Lymnaea stagnalis) of the basommatophoran snail Lymnaea stagnalis produce a number of peptides among which the best studied is the ovulation'escargot Helix aspersa. aCDCP est un neuropeptide synthétisé par les cellules caudodor- sales de Lymnaea

Boyer, Edmond

160

Cathelicidin LL37 in Severe Streptococcus pyogenes Soft Tissue Infections in Humans  

Microsoft Academic Search

Severe soft tissue infections, such as necrotizing fasciitis and severe cellulitis, caused by group A streptococci (GAS) are rapidly progressing life-threatening infections characterized by massive bacterial loads in the tissue even late after the onset of infection. Antimicrobial peptides are important components of the innate host defense, and cathelicidins have been shown to protect against murine necrotic skin infections caused

Linda Johansson; Pontus Thulin; Parham Sendi; Erika Hertzen; Adam Linder; P. Akesson; Donald E. Low; Birgitta Agerberth; Anna Norrby-Teglund

2008-01-01

161

MAINTIEN ET RESTAURATION DE LA SPERMATOGENESE PAR UN EXTRAIT ACTONIQUE HYPOPHYSAIRE  

E-print Network

LE CYPRIN (CARASSIUS AURATUS) TRAIT? AU M?THALLIBURE R. BILLARD, B. BRETON Anne-Marie ESCAFFRE rouge (Carassius auratus) une inhibition de la spermatogenèse qui intéresse toutes les cellules germi'inhiber la spermatogenèse des poissons ; chez Gasteyosteus acculeatus et Carassius auyatus (HoAR et al., 1967

Paris-Sud XI, Université de

162

Case report Combined sphenoid and frontal sinus aplasia accompanied by bilateral maxillary and ethmoid sinus hypoplasia  

Microsoft Academic Search

We describe CT scans of a case with bilateral aplasia of frontal and sphenoid sinuses with symmetrical hypoplasia of the ethmoid cellules and maxillary sinuses. This case appears to be first in the English-language literature with these combined findings. Paranasal sinuses are prone to a great diversity of anomalies. It is important for surgeons to be aware of variations that

A HAKTANIR; M ACAR; A YUCEL; A AYCICEK; B DEGIRMENCI; R ALBAYRAK

2005-01-01

163

Cutaneous zygomycosis caused by Saksenaea vasiformis in a diabetic patient.  

PubMed Central

A 49-year-old woman with diabetes mellitus rapidly developed necrotizing cellulitis with fat necrosis and vasculitis after minor trauma to the right arm. Zygomycosis was diagnosed histologically. The lesion responded to aggressive debridement, amphotericin B, and normalization of blood glucose. Cultures yielded structures characteristic of Saksenaea vasiformis only after transfer to saline agar. Images PMID:7929783

Bearer, E A; Nelson, P R; Chowers, M Y; Davis, C E

1994-01-01

164

Overview of the etiology of wound infections with particular emphasis on community-acquired illnesses  

Microsoft Academic Search

Wound cultures represent a general catchall category for a group of extremely diverse anatomic samples that range from superficial specimens of cutaneous structures (folliculitis, cellulitis) to specimens revealing invasive infections involving deep fascial planes and muscle (myonecrosis). Because of the complex nature of these infective processes, the terminology associated with such infections is often imprecise and confusing. Wounds are the

J. M. Janda; S. L. Abbott; R. A. Brenden

1997-01-01

165

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

166

Istituzioni di Matematica C. d. L. in Biotecnologie 1. Alcune molecole di RNA consistono soltanto di A = adenina, C = citosina,  

E-print Network

infetto da N0 batteri. Le cellule dei batteri si dividono ogni sei ore. (a) Quanti batteri ci saranno nel brodo dopo 24 h? (b) Determinare il parametro (in h-1 ) in modo tale che il numero N dei batteri parametro µ (in h-1 ) in modo tale che il numero N dei batteri presenti dopo t ore possa essere approssimata

Achilles, Rüdiger

167

Paris, le 20 juin 2014 Information presse  

E-print Network

donne d'autres types de cellules sanguines. Ces travaux sont publi�s dans la revue Cell Stem Cell. La solutions pour pallier ces manques avec en ligne de mire l'espoir de pouvoir cr�er � l'infini globules

van Tiggelen, Bart

168

The history holds the key in this gardener with a skin infection Staphylococci and streptococci are the most common causes of skin infectionsbut when the patient is immunocompromised, keep other causative organisms in mind as well. CASE REPORT  

Microsoft Academic Search

CASE The patient is a 75-year-old retired white male with a 3- day history of a papular abscess on and cellulitis of the ulnar aspect of the fifth digit on the right hand. He had presented to the emergency department (ED) and was referred to orthopedic surgery for consultation. At the con- sultation, the patient reported increased redness, streaking, and

Tara A. Lykowski; Emil R. Orpilla; Richard J. Hayek

169

Collge doctoral N attribu par la bibliothque  

E-print Network

de DSC : à gauche, DSC plateau, à droite, DSC type Calvet expérimental basé sur l'appareil SETARAM DSC 111............... 28 Figure II- 2: Section d'une cellule à pression contrôlée, placée dans le bloc thermostatique du DSC 111

Paris-Sud XI, Université de

170

The effects of peripheral vascular disease with osteomyelitis in the diabetic foot  

Microsoft Academic Search

BACKGROUND: Osteomyelitis in the diabetic foot is a difficult problem with multiple etiologies. The effects of peripheral vascular disease, neuropathy, and repetitive trauma all interact to produce complex lesions with exposed bone, surrounding cellulitis, and gangrenous changes.METHODS:We performed a retrospective study over a 14-year period at a community hospital looking at osteomyelitis in the diabetic foot. We looked at the

Stephen L Hill; Golde I Holtzman; Roxanne Buse

1999-01-01

171

LA PERIPHERINE, PROTEINE DE FILAMENT INTERNEDIAIRE, MARQUEUR DE DIFFERENCIATION NEURONALE Portier M.M. Eseurat M LandonF Hue C. DjabaliK.  

E-print Network

périphérine au cours du développement em- bryonnaire du rat, et de comparer cette expression à celle de la fait discuter deux origines à ces lésions cutanées : - soit une prolifération des cellules de Merkel

Paris-Sud XI, Université de

172

PHOTOLECTROCHIMIE SUR LECTRODE DE PHOSPHURE DE GALLIUM DE TYPE p  

E-print Network

, soit NaOH IN. 11 a ainsi obtenu la decomposition de 1'eau, mais signale des deteriorations des very high illuminations after several hours, of operation. However this electrode is not suitable performances de la cellule au cours du temps. L'etude que nous presentons montre le comporte- ment d

Paris-Sud XI, Université de

173

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

174

Surgical Site Infection (SSI) After Breast Surgery: Impact of 2010 CDC Reporting Guidelines  

PubMed Central

Introduction Reported surgical site infection (SSI) rates after breast operations range from 0.826% in the literature. Aims of the present study were to characterize SSI after breast/axillary operations and determine the impact on the SSI rate of the 2010 Centers for Disease Control and Prevention (CDC) reporting guidelines that now specifically exclude cellulitis. Methods Retrospective chart review identified 368 patients, with 449 operated sides, between 07/2004 and 6/2006. SSI was defined using CDC criteria: purulent drainage (CDC #1), positive aseptically collected culture (CDC #2), signs of inflammation with opening of incision and absence of negative culture (CDC#3), or physician diagnosis of infection (CDC #4). The impact of excluding cellulitis was assessed. Results Using prior CDC reporting guidelines, among 368 patients, 32 (8.7%) experienced SSI in 33/449 (7.3%) operated sides. Of these, 11 (33%) met CDC criteria 13, while 22 (67%) met CDC criterion 4. Excluding cellulitis cases per 2010 CDC SSI reporting guidelines eliminates 21 of the 22 infections previously meeting CDC criterion 4. Under the new reporting guidelines, the SSI rate is 12/449 (2.7%) operated sides. SSI rates varied by procedure but these differences were not statistically significant. Conclusions Cellulitis after breast and axillary surgery is much more common than other criteria for SSI, and SSI rates are reduced almost three-fold if cellulitis cases are excluded. Recently revised CDC reporting guidelines may result in underestimates of the clinical burden of SSI after breast/axillary surgery. PMID:22732837

Degnim, Amy C.; Throckmorton, Alyssa D.; Boostrom, Sarah Y.; Boughey, Judy C.; Holifield, Andrea; Baddour, Larry M.; Hoskin, Tanya L.

2014-01-01

175

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

176

Cutaneous metastasis of invasive ductal carcinoma of the breast to an infusaport site.  

PubMed

Cutaneous metastasis of a primary internal malignancy is a relatively common phenomenon, occurring in up to 10% of patients with noncutaneous cancer. Cutaneous metastasis can occur via direct extension, hematologic or lymphatic dissemination, or surgical implantation. The most common internal malignancy associated with the development of cutaneous metastases in females is breast cancer. We present a patient with widely metastatic invasive ductal carcinoma of the breast, status postpalliative mastectomy and chest wall coverage with a vertical rectus abdominus myocutaneous flap, who acquired cellulitis and, subsequently, noncontiguous cutaneous metastasis of her breast cancer to the site of her central venous access device (ie, infusaport). We hypothesize that the local inflammation associated with her recent bout of cellulitis and operations, in conjunction with the presence of a foreign body, may have predisposed the infusaport site to seeding by metastatic tumor cells. This case highlights the importance of considering cutaneous metastasis in the differential diagnosis of new skin eruptions in patients with cancer. PMID:18441844

Lehman, Julia S; Benacci, Joseph C

2008-03-01

177

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

178

Cowpox infection of the nose.  

PubMed

A case of cowpox infection presenting as a necrotising cellulitis of the nasal tip and vestibule is reported. Diagnosis was established by identification of the pox virus particles from tissue culture of the nasal biopsy using electronic microscopy and the characteristic lesions on chorio-allantoic membrane produced by the virus. Cowpox of the external nose and transmission of the infection from a dog have not to our knowledge been reported previously. PMID:8869617

Lee, W C; Manjaly, G; Skinner, D W; O'Neill, P M

1996-08-01

179

Sensitivity to mutagens of Rumex acetosa chromosomes  

Microsoft Academic Search

Rsum Des graines deRumex acetosa ont t soit irradies par les rayons ? du60Co (100 3000 rads) soit traites par deux agents mutagnes chimiques: le MMS et le MNU. Le MNU est plus efficace que le MMS comme inducteur de lsions chromosomiques. Les spectres des diffrents types d'aberrations chromosomiques produites par les 3 agents sont diffrents et les cellules

N. Degaraeve; J. Moutschen

1973-01-01

180

MR imaging of urgent inflammatory and infectious conditions affecting the soft tissues of the musculoskeletal system  

Microsoft Academic Search

Soft tissue infections and inflammatory conditions of the musculoskeletal system are a group of disorders commonly seen by\\u000a emergency room physicians and radiologists. Many of these entities can either be limb- or life-threatening. Magnetic resonance\\u000a imaging is currently the best imaging modality to evaluate these conditions. In this review, the characteristic imaging findings\\u000a of cellulitis, abscess formation, necrotizing fasciitis, pyomyositis,

Joseph S. Yu; Paula Habib

2009-01-01

181

Sternocostoclavicular hyperostosis: two cases with differing dermatologic syndromes.  

PubMed

Sternocostoclavicular hyperostosis is a rare rheumatic condition characterized by ossification and erosion of the clavicle and the first rib, that has been shown to be associated with pustular skin lesions. We present 2 cases, one of which had features of pustulosis palmaris et plantaris and the other dissecting cellulitis of the scalp. Although the dermatologic manifestations differ, both cases have rheumatologic and roentgenographic features diagnostic of sternocostoclavicular hyperostosis. PMID:2254905

Ongchi, D R; Fleming, M G; Harris, C A

1990-10-01

182

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

183

Rle du microbiote dans les maladies inflammatoires de lintestin  

Microsoft Academic Search

RsumLa maladie de Crohn et la rectocolite ulcro-hmorragique sont des affections inflammatoires des voies digestives et reprsentent ensemble un spectre de maladies appeles maladies inflammatoires chroniques de lintestin (MICI). Lintestin humain est colonis par un microbiote commensal des concentrations excdant le nombre de cellules de la totalit de lorganisme. Dans des conditions physiologiques normales, il existe une interaction entre

Irit Chermesh; Raanan Shamir

2009-01-01

184

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

185

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

E-print Network

de Lyon Discipline : SciencesTechnologie Santé - Sciences de la vie Unité de Biologie des InfectionsVirales _____________________________________________ Cellules NK et fièvres hémorragiques virales : Etude de leur rôle dans la mise en place des réponses immunes et dans la pathogenèse lors de l'infection par les virus Lassa et Ebola

Paris-Sud XI, Université de

186

21me Congrs Franais de Mcanique Bordeaux, 26 au 30 aot 2013 A second order finite-volume scheme on cartesian grids for  

E-print Network

�es pr�s de la fronti�re avec le solide, nous r�solvons un probl�me de Riemann ad hoc qui tient compte des conditions aux limites � imposer. Pour �viter les oscillations de pression pr�s du solide, nous'angle entre la normale au solide et celle � la cellule de la grille cart�sienne. Le sch�ma est simple � impl

Boyer, Edmond

187

FICHE DE POSTE ENSEIGNANT-CHERCHEUR CAMPAGNE DE RECRUTEMENT 2014  

E-print Network

particulier sur l'étude des bactéries sporulées, plus particulièrement sur Bacillus cereus, pathogène végétatives et des spores de B. cereus en réponse aux facteurs environnementaux (physico-chimiques (pH, Redox. cereus en réponse à un bas potentiel d'oxydoréduction (cellules végétatives et spores). Il s'agira dans

Avignon et des Pays de Vaucluse, Université de

188

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

189

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

190

Characterization of transcription within sdr region of Staphylococcus aureus  

Microsoft Academic Search

Staphylococcus aureus is an opportunistic pathogen responsible for various infections in humans and animals. It causes localized and systemic infections,\\u000a such as abscesses, impetigo, cellulitis, sepsis, endocarditis, bone infections, and meningitis. S. aureus virulence factors responsible for the initial contact with host cells (MSCRAMMsmicrobial surface components recognizing\\u000a adhesive matrix molecules) include three Sdr proteins. The presence of particular sdr genes

Izabela Sitkiewicz; Ireneusz Babiak; Waleria Hryniewicz

2011-01-01

191

SUR L'ORIGINE DES MACLES D'OXALATE DE CAICIUM CONTENUES DANS LES MIELS DE TILLEUL  

E-print Network

SUR L'ORIGINE DES MACLES D'OXALATE DE CAICIUM CONTENUES DANS LES MIELS DE TILLEUL Z. DEMIANOWICZ mis en évidence, en r96z, la Frésence de macles cI'oxalate de calcium dans les miels de 'l espèces sauvages que chez les Batsaiuines cultivées, on trouve des cellules contenant des raphides d'oxalate

Paris-Sud XI, Université de

192

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

193

The introducer technique is the optimal method for placing percutaneous endoscopic gastrostomy tubes in head and neck cancer patients  

Microsoft Academic Search

BackgroundPercutaneous endoscopic gastrostomy (PEG) tubes are often placed in head and neck cancer patients to provide nutritional support,\\u000a but studies have found the complication rates to be higher than other subsets of patients who undergo PEG placement. Complication\\u000a rates as high as 50% have been reported, with the bulk of these complications being PEG site issues (i.e., cellulitis, abscess,\\u000a fascitis,

Jason M. Foster; Peter Filocamo; Hector Nava; Michael Schiff; Wesley Hicks; Nestor Rigual; Judy Smith; Thom Loree; John F. Gibbs

2007-01-01

194

Police drug crackdowns and hospitalisation rates for illicit-injection-related infections in New York City  

Microsoft Academic Search

Using longitudinal data, this analysis tests the hypothesis that eight police drug crackdowns implemented in 27 New York City police precincts between 1995 and 1999 were associated with subsequent increases in monthly precinct-specific hospitalisation rates for illicit-injection-related abscesses, cellulitis, and endocarditis. Crackdowns are sustained police initiatives designed to reduce the possession and sale of illicit drugs through heightened surveillance and

Hannah L. F. Cooper; David Wypij; Nancy Krieger

2005-01-01

195

CTLA-4 et Toll-like rcepteurs: de nouvelles cibles en immunothrapie  

Microsoft Academic Search

Plusieurs donnes cliniques suggrent que la modulation des rponses immunitaires peut tre une stratgie anti-tumorale efficace.\\u000a Ldministration de BCG est reconnue comme un traitement efficace des cancers superficiels de la vessie. Par analogie avec\\u000a les vaccinations contre certains pathognes intracellulaires, des protocoles de vaccination ont utilis le BCG comme adjuvant\\u000a et permis ?obtention de rsultats cliniques intressants. ?allogreffe de cellules

R. Bedel; C. Borg; P. Saas

196

Myrrhe: activit thrapeutique en cancrologie  

Microsoft Academic Search

Rsum: Les rcentes acquisitions sur la spectroscopie et sur les communications intercellulaires nous ont amens considrer lactivit dune gomme-rsine, la myrrhe, en cancrologie. Le mcanisme daction qui implique la rgularisation des systmes psycho-neuro-endocrino-immunologiques est multifactoriel. travers la restauration de la communication, la rsonance des rcepteurs de membrane dtermine le phnomne dapoptose des cellules noplasiques quexprime la protine Bcl-2.

M. Grandi; M. Vernay; L. Roselli; A. Congiu Castellano; S. Gaudenzi; P. Toro

2004-01-01

197

Disseminated Infection due to Cylindrocarpon ( Fusarium ) lichenicola in a Neutropenic Patient with Acute Leukaemia: Report of a Case and Review of the Literature  

Microsoft Academic Search

\\u000a Described here is an unusual case of disseminated Cylindrocarpon lichenicola (Fusarium lichenicola) infection originating from a toenail lesion of a neutropenic woman with cellulitis of the foot and underlying acute leukaemia.\\u000a A computed tomography scan of the chest showed multiple, ill-defined, nodular infiltrates with alveolar consolidation. The\\u000a fungus was isolated from both the nail and the skin of the

H. Rodrguez-Villalobos; A. Georgala; H. Beguin; C. Heymans; G. Pye; F. Crokaert; M. Aoun

2003-01-01

198

Rsum de la thse de Salma Hasan Les Noplasies Myloproliferatives JAK2V617F : Modlisation chez la souris knock-  

E-print Network

les patients Introduction : Les néoplasies myéloprolifératifs (NMP) sont des maladies malignes cellules matures vers une ou plusieurs lignées myéloïdes spécifique à chaque type de NMP. Les NMP granuleux, respectivement. Cette thèse s'intéresse particulièrement au NMP classique non LMC. Ces NMPs

Paris-Sud XI, Université de

199

[Extra-intestinal infections caused by Vibrio spp. in The Netherlands].  

PubMed

Six patients with serious cellulitis or ear infection due to Vibrio vulnificus, V. parahaemolyticus or V. alginolyticus are described. Four patients were infected during the summer in the Netherlands and two outside the Netherlands. Contact with seawater was the most probable source in four patients. In two patients the infection, caused by V. vulnificus, was transmitted by eel. This is a new way of transmission. PMID:8469298

Veenstra, J; Rietra, P J; Goudswaard, J; Kaan, J A; van Keulen, P H; Stoutenbeek, C P

1993-03-27

200

TUDE DE LA BANDE 203BD3 DE L'OXYDE AZOTEUX A 2,26 03BC Par M. G. AMAT, M. P. BARCHEWITZ  

E-print Network

563 ?TUDE DE LA BANDE 203BD3 DE L'OXYDE AZOTEUX A 2,26 03BC Par M. G. AMAT, M. P. BARCHEWITZ et MmeBD3 de l'oxyde azoteux, enregistrée en utilisant un spectrographe à réseau-échelette et à cellule 563. Nous avons étudié la structure rotationnelle de la bande 2)3 de l'oxyde azoteux à 4417 cm-1. L

Boyer, Edmond

201

Programmation des activits pdagogiques  

E-print Network

Programmation des activités pédagogiques B.Sc. Biochimie de la santé Version 9 S'adresse aux 411 *Enzymologie de la cellule humaine (BCM 318).....................2 BCM 420 *Bio-informatique (BCL dans le programme. 22 mai 2014 Activités pédagogiques à option (16 crédits) Automne CHM 400 Biochimie

Spino, Claude

202

Follicular occlusion tetrad  

PubMed Central

Follicular occlusion tetrad is a symptom complex consisting of four conditions having a similar pathophysiology. It includes Hidradenitis suppurativa, acne conglobata, dissecting cellulitis of the scalp and pilonidal sinus. The exact pathogenesis of this group of disease is unknown but evidence suggests that they share the same pathological process initiated by follicular occlusion in apocrine gland bearing areas. Though each of these conditions is commonly encountered singly, follicular occlusion tetrad as a symptom complex has been rarely reported in the literature.

Vasanth, Vani; Chandrashekar, Byalakere Shivanna

2014-01-01

203

DTECTION OPTIQUE DE LA RSONANCE MAGNTIQUE NUCLAIRE DU MERCURE 201 Par B. CAGNAC,  

E-print Network

863. D?TECTION OPTIQUE DE LA R?SONANCE MAGN?TIQUE NUCL?AIRE DU MERCURE 201 Par B. CAGNAC appliqué ces méthodes à l'orientation nucléaire de l'isotope 201 du mercure dont l'état fondamental mercure et les parois de quartz de la cellule ne désorientent pas les noyaux alors que dans le cas des

Boyer, Edmond

204

Article de synthse Systme rnine/angiotensine de l'utrus  

E-print Network

of blood pressure and electrolyte metabo- lism. Renin, a proteolytic enzyme, synthesized in the kidney from. L'enzyme rénine, synthétisée dans la cellule en- docrine juxtaglomérulaire, initie dans le plasma la. rénine / angiotensine Il I atrésie 1 ovaire / utérus Summary ― Ovarian and uterine renin

Boyer, Edmond

205

Glomrulopathie extramembraneuse par immunisation materno-foetale MOTS CLES : ALLO-IMMUNISATION MATERNO-FOETALE, CD10, ENDOPEPTIDASE NEUTRE, ALLO-  

E-print Network

contre l'endopeptidase neutre (EPN)/CD10. Les mères, apparemment bien portantes, sont génétiquement déficientes en EPN et s'immunisent dès la première grossesse contre l'EPN/CD10 présente sur les cellules10 [endopeptidase neutre (EPN)], [1, 2]. La maladie rénale est une glomérulopathie extramembraneuse

Paris-Sud XI, Université de

206

Post-traumatic osteomyelitis due to aeromonas species.  

PubMed

We report a case of Aeromonas osteomyelitis due to injury in a sewage worker. He presented with cellulitis of the left foot. Radiographs showed evidence of osteomyelitis involving the head and neck of the fifth metatarsal. Aeromonas species was isolated from the tissue and swab from the foot. The head and neck of the fifth metatarsal were excised and the patient improved on 4 weeks of intravenous meropenem followed by 4 weeks of oral clindamycin and ciprofloxacin. PMID:19384045

Gunasekaran, L; Ambalkar, S; Samarji, R A; Qamruddin, A

2009-01-01

207

"Dry tap" during spinal anaesthesia turns out to be epidural abscess  

PubMed Central

We report a case of dry tap during spinal anaesthesia in a patient posted for incision and drainage of lower limb with cellulitis. When the patient was being given sub-arachnoid block (SAB) for regional anaesthesia, it turned out to be a case of pyogenic ilio-psoas abscess extended up to the paravertebral and epidural spaces. The causative organism was Staphylococcus aureus. This is probably the first case reported when epidural abscess is diagnosed during SAB. PMID:22923830

Sahu, Dinesh Kumar; Kaul, Vinca; Parampill, Reena

2012-01-01

208

Follicular occlusion tetrad.  

PubMed

Follicular occlusion tetrad is a symptom complex consisting of four conditions having a similar pathophysiology. It includes Hidradenitis suppurativa, acne conglobata, dissecting cellulitis of the scalp and pilonidal sinus. The exact pathogenesis of this group of disease is unknown but evidence suggests that they share the same pathological process initiated by follicular occlusion in apocrine gland bearing areas. Though each of these conditions is commonly encountered singly, follicular occlusion tetrad as a symptom complex has been rarely reported in the literature. PMID:25396138

Vasanth, Vani; Chandrashekar, Byalakere Shivanna

2014-10-01

209

Emergence of the community-acquired methicillin-resistant Staphylococcus aureus USA300 clone in a Japanese child, demonstrating multiple divergent strains in Japan  

Microsoft Academic Search

In 2008 we isolated methicillin-resistant Staphylococcus aureus (MRSA) from an 11-month-old Japanese girl who lived in Saitama, Japan, and suffered from cellulitis of the lower thigh and\\u000a sepsis. The MRSA (strain NN47) belonged to multilocus sequence type (ST) 8 and exhibited spa363 (t024), agr1, staphylococcal cassette chromosome mec (SCCmec) type IVa, and coagulase type III. It was positive for PantonValentine

Wataru HiguchiShigenao; Shigenao Mimura; Yoshihiro Kurosawa; Tomomi Takano; Yasuhisa Iwao; Shizuka Yabe; Olga Razvina; Akihito Nishiyama; Yurika Ikeda-Dantsuji; Fuminori Sakai; Hideaki Hanaki; Tatsuo Yamamoto

2010-01-01

210

Anti-infective treatment in HIV-infected patients during perioperative period  

PubMed Central

Objective To investigate anti-infective treatments in HIV-infected surgical patients during the perioperative period. Methods A retrospective study of sepsis and surgical site infections (SSIs) was conducted in 266 HIV-infected patients. The patients were divided into 3 groups based on CD4+ T cells counts in the preoperative period: group A (0199 cell/ul), group B (200349 cell/ul) and group C ([greater than or equal to] 350 cell/ul). When the CD4 count was below 350 cells/uL, anti-retrovirus therapy was started. For patients whose preoperative CD4 counts were [less than or equal to] 200 cells/uL, preoperative antibiotic medication was started. Results Patients in group A were more likely to get sepsis than patients in the other two groups (p0.01). Among 82 patients with clean wounds, only one patient got SSIs. All patients with dirty wounds had acquired SSIs after surgery. There were only 6 patients dead at 30 days after surgery, a death rate of 2.3%. Sepsis appeared in 110 patients (41%). Conclusions Complete evaluation of surgical risk and suitable perioperative anti-infective treatment may lead to better outcome for HIV-infected surgical patients. PMID:23181440

2012-01-01

211

Orbital Inflammation Developing from Epidemic Keratoconjunctivitis in an Adult  

PubMed Central

Introduction We report a rare case of epidemic keratoconjunctivitis (EKC) that developed into an orbital inflammation in an adult. Case Presentation A 67-year-old Korean man, who had been diagnosed with EKC and treated for conjunctival injection and chemosis in the right eye for 4 days, was referred to Oculoplastics as orbital cellulitis was suspected. At the point of referral, clinical features such as decreased visual acuity, severe eyelid swelling, chemosis, follicles, corneal edema, limitations in lateral eye movement, and diplopia were observed in the right eye. Orbital cellulitis was suspected according to orbital computed tomography scan images, but there was no response to systemic antibiotics. Systemic steroid was administered instead, and then his symptoms and signs started to improve. The final diagnosis of this patient was orbital inflammation related to EKC based on the facts that there was no response to antibiotics, that he presented with contralateral symptoms and signs, that pseudomembrane formation occurred in both eyes, and that the symptoms resolved completely after 2 weeks. Conclusion Clinicians need to consider the possibility of orbital inflammation developing from EKC, even in an adult patient, and treat the patient properly if the EKC symptoms and signs, such as conjunctival injection and follicles, are accompanied with symptoms and signs similar to orbital cellulitis. PMID:24019793

Kim, Sung In; Lee, Kyeong Wook

2013-01-01

212

Comparison between Freeze-dried and Ready-to-use AlloDerm in Alloplastic Breast Reconstruction  

PubMed Central

Background: AlloDerm, a brand of acellular dermal matrix, is commonly used as an internal hammock to support the tissue expander or permanent implant in breast reconstruction. The aim of our study is to evaluate the complication rates associated with the freeze-dried (FD) AlloDerm and the ready-to-use (RTU) AlloDerm. Methods: This institutional review boardapproved retrospective study involved 103 patients who underwent immediate postmastectomy breast reconstructions from June 2011 to August 2012. The first 51 patients underwent 96 immediate breast reconstructions with FD AlloDerm. The subsequent 52 patients underwent 100 immediate breast reconstructions with RTU AlloDerm. Patient demographics, postoperative complication rates in study cohort, and complication rates stratified by body mass index (BMI) were analyzed. Results: Multiple patient demographics in the 2 cohorts are closely matched (P > 0.05). RTU AlloDerm was associated with higher rates of seroma and cellulitis compared with FD AlloDerm (22.0% vs 18.8%, P = 0.599 and 21.0% vs 12.5%, P = 0.129, respectively). Significantly higher rates of seroma and cellulitis were found in patients with BMI ? 30 compared with BMI < 30 (34.5% vs 9.2%, P < 0.001 and 29.9% vs 6.4%, P < 0.001, respectively). A generalized linear mixed model shows that obesity and RTU AlloDerm are statistically significant predictors of cellulitis (adjusted odds ratio = 10.413, P < 0.001 and adjusted odds ratio = 3.712, P = 0.011, respectively). Conclusions: Our study demonstrates a clinically higher postoperative complication rate in immediate breast reconstruction with RTU AlloDerm compared with FD AlloDerm and highlights the unfavorable risk factor correlation with significant obesity. PMID:25289313

Yue, Connie J.; Erickson, Stephen W.; Cooper, Shannon; Boneti, Cristiano; Henry-Tillman, Ronda; Klimberg, Suzanne

2014-01-01

213

Computed tomographic detection of sinusitis responsible for intracranial and extracranial infections  

SciTech Connect

Computed tomography (CT) is now used extensively for the evaluation of orbital, facial, and intracranial infections. Nine patients are presented to illustrate the importance of detecting underlying and unsuspected sinusitis. Prompt treatment of the sinusitis is essential to minimize the morbidity and mortality associated with complications such as brain abscess, meningitis, orbital cellulitis, and osteomyelitis. A review of the literature documents the persistence of these complications despite the widespread use of antibiotic therapy. Recognition of the underlying sinusitis is now possible with CT if the region of the sinuses is included and bone-window settings are used during the examination of patients with orbital and intracranial infection.

Carter, B.L.; Bankoff, M.S.; Fisk, J.D.

1983-06-01

214

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

215

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

216

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

217

Cutaneous manifestations of infection in returning travelers.  

PubMed

Dermatologic problems are common in returning travelers who seek medical care. Some common illnesses such as cellulitis or abscesses occur in travelers but are not unique to this patient group. Additionally, dermatologic illnesses not due to infection such as drug eruptions or phototoxicity are seen. Skin manifestations occur in many tropical illnesses such as dengue, schistosomiasis, and leishmaniasis. This article reviews the common causes of cutaneous illnesses associated with travel including non-infectious causes, infections that are not limited to travelers, and infections that are almost exclusively seen in travelers. PMID:25129114

Eldridge, Matthew; Cohen, Stuart H

2014-10-01

218

Cutaneous bacterial infections caused by Staphylococcus aureus and Streptococcus pyogenes in infants and children.  

PubMed

Acute bacterial skin and skin structure infections (SSSIs) are among the most common bacterial infections in children. The medical burden of SSSIs, particularly abscesses, has increased nationwide since the emergence of community-acquired methicillin-resistant Staphylococcus aureus. SSSIs represent a wide spectrum of disease severity. Prompt recognition, timely institution of appropriate therapy, and judicious antimicrobial use optimize patient outcomes. For abscesses, incision and drainage are paramount and might avoid the need for antibiotic treatment in uncomplicated cases. If indicated, empiric antimicrobial therapy should target Streptococcus pyogenes for nonpurulent SSSIs, such as uncomplicated cellulitis, and S aureus for purulent SSSIs such as abscesses. PMID:24636656

Larru, Beatriz; Gerber, Jeffrey S

2014-04-01

219

BET 1: bedside ultrasound for the diagnosis of necrotising fasciitis.  

PubMed

A short-cut review was carried out to establish whether bedside ultrasound was accurate at diagnosing necrotising fasciitis in patients with limb infections. A total of 187 papers were found using the reported searches, of which one presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of this paper is tabulated. It is concluded that there is limited evidence supporting the use of bedside ultrasound as an adjunct diagnostic tool in differentiating cellulitis from necrotising fasciitis in patients with a limb infection. PMID:25022918

2014-08-01

220

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

221

Squamous cell carcinoma and eosinophilia in a long-term course of pansclerotic morphea.  

PubMed

Pansclerotic morphea is a rare subtype of localised scleroderma. Very few cases have been reported in the literature. This case discusses a young man with a 15-year history of pansclerotic morphea, illustrating the clinical course and complications of this disease. Notably, recurrent squamous cell carcinomas with several high-risk features and frequent cellulitis were the basis of many admissions. As often seen with this disease, autoimmune markers were negative. However, marked eosinophilia was noted late in the course. Furthermore, this disease is quite resistant to treatment. Immunosuppressive therapy thus far has perhaps slowed the progression, although not cured the disease in this patient. PMID:25312894

Grewal, Inderjote; Khan, Omar; Davis, William

2014-01-01

222

Parenteral organophosphorus poisoning in a rural emergency department: a case report  

PubMed Central

Background Poisoning is a common presentation in the emergency department. Oral exposures to organophosphorus compounds are especially frequent in rural and agricultural regions of South Asia and throughout the developing world. Case presentation Here we report a case of deliberate self-harm with an organophosphorus pesticide via the relatively uncommon parenteral route. A young woman injected herself with chlorpyriphos. Although the cholinergic effects were mild, cellulitis and abscess development were noted as a result. Conclusion Resource limited agricultural countries like Nepal present health care workers with numerous challenges in poisoning management. This case represents a rare but potentially morbid method of agrochemical poison exposure. PMID:24321121

2013-01-01

223

Bilateral parotid enlargement following snake bite: A rare sign  

PubMed Central

Snakebite is a common medical emergency in India. Unusual complications may occur after viper bite. Bilateral parotid enlargement after viper bite is a rare entity. An 18-year old gentleman presented to our hospital with history of viper bite. On examination he had cellulitis of right lower limb. He developed swelling of both the parotid glands 12 h after admission. He developed coagulopathy, acute renal failure and died within 48 h of hospital admission. Development of parotid swelling after snake bite is associated with poor prognosis. This case is found worth reporting as it is an unusual complication having prognostic value. PMID:23593596

Deepak, Madi; Basavaprabhu, Achappa; Ramapuram, John T; Nithyananda, Chowta; Mahalingam, Soundarya

2013-01-01

224

ENZYMOLOGIE SRIQUE DE LA CHVRE : VALEURS USUELLES DE CPK, LDH, ICDH et SDH1  

E-print Network

level of milk production, the authors determined the enzymic activities of CPK, LDH, ICDH and SDH.1.1.42). libérée de façon très précoce par les cellules lors d'affections aiguës du foie. - Sorbitol deshydrogénase dans la production laitière de haut niveau (élevage A: 800 kg/an; élevage B: 820 kg/an). ?levés en

Paris-Sud XI, Université de

225

Short-term results of Karydakis flap for pilonidal sinus disease  

Microsoft Academic Search

BackgroundBecause of the higher quality of life that the Karydakis flap provides compared to excision-only treatment, it became a recommended\\u000a closure technique for pilonidal sinus disease. This study aimed to evaluate whether Karydakis flap technique can be performed\\u000a in potentially infected tissue if the surrounding cellulitis allows wound closure.\\u000a \\u000a \\u000a \\u000a Methods188 patients with pilonidal sinus who underwent excision only (n=91, 48%)

S. Petersen; G. Aumann; A. Kramer; D. Doll; M. Sailer; G. Hellmich

2007-01-01

226

Evaluation of granulocyte-colony stimulating factor (Filgrastim) in infected diabetic foot ulcers  

Microsoft Academic Search

Abstract\\u000a \\u000a \\u000a Aims\\/hypothesis. To re-evaluate the use of Granulocyte-Colony Stimulating Factor (G-CSF) in the treatment of infected diabetic foot ulcers.\\u000a \\u000a \\u000a \\u000a \\u000a Methods. Thirty-seven diabetic subjects were randomised to Granulocyte-Colony Stimulating Factor (G-CSF) (n=20) or placebo (n=17). The primary endpoint was resolution of cellulitis, which was evaluated clinically and with an infection summary score.\\u000a Patients were hospitalised for 10 days and received subcutaneously

T. Kstenbauer; B. Hrnlein; G. Sokol; K. Irsigler

2003-01-01

227

Recurrent deep venous thrombosis in a patient with agenesis of inferior vena cava  

PubMed Central

Background: Agenesis of the inferior vena cava (IVC) as a cause of recurrent deep vein thrombosis (DVT) is uncommon. Case: A 33-year-old male with no family history of thrombophilia, who had experienced multiple recurrent episodes of DVT over a 15-year period of unknown cause, was admitted into our hospital because of cellulitis in the right leg. Computer tomography with contrast of the abdomen showed an absence of IVC. Conclusion: Congenital absence of the IVC could be a rare risk factor for idiopathic DVT, especially in young individuals. PMID:21760745

Nseir, William; Mahamid, Mahmud; Abu-Rahmeh, Zuhair; Markel, Arieh

2011-01-01

228

Human Dirofilaria repens Infection in Romania: A Case Report.  

PubMed

Human dirofilariasis is a zoonotic infectious disease caused by the filarial nematodes of dogs Dirofilaria repens and Dirofilaria immitis. Depending on the species involved, human infections usually manifest as one cutaneous or visceral larva migrans that forms a painless nodule in the later course of disease. Dirofilariae are endemic in the Mediterranean, particularly in Italy. They are considered as emerging pathogens currently increasing their geographical range. We present one of the few known cases of human dirofilariasis caused by D. repens in Romania. The patient developed unusual and severe clinical manifestations that mimicked pathological conditions like cellulitis or deep venous thrombosis. PMID:22567488

Popescu, Ioana; Tudose, Irina; Racz, Paul; Muntau, Birgit; Giurcaneanu, Calin; Poppert, Sven

2012-01-01

229

Human Dirofilaria repens Infection in Romania: A Case Report  

PubMed Central

Human dirofilariasis is a zoonotic infectious disease caused by the filarial nematodes of dogs Dirofilaria repens and Dirofilaria immitis. Depending on the species involved, human infections usually manifest as one cutaneous or visceral larva migrans that forms a painless nodule in the later course of disease. Dirofilariae are endemic in the Mediterranean, particularly in Italy. They are considered as emerging pathogens currently increasing their geographical range. We present one of the few known cases of human dirofilariasis caused by D. repens in Romania. The patient developed unusual and severe clinical manifestations that mimicked pathological conditions like cellulitis or deep venous thrombosis. PMID:22567488

Popescu, Ioana; Tudose, Irina; Racz, Paul; Muntau, Birgit; Giurcaneanu, Calin; Poppert, Sven

2012-01-01

230

DURE DE VIE DU NIVEAU 61P1 DU MERCURE TUDE DE LA DIFFUSION MULTIPLE COHRENTE  

E-print Network

611. DUR?E DE VIE DU NIVEAU 61P1 DU MERCURE ?TUDE DE LA DIFFUSION MULTIPLE COH?RENTE DE LA LUMI?RE magnétique (effet Hanle) de la lumière de résonance optique de la transition 61S0-61P1 du mercure (1 850 ?'atomes de mercure dans la cellule de résonance. On compare les résultats obtenus avec la théorie de la

Paris-Sud XI, Université de

231

IFT1025 Hiver 2011 --Devoir 3 Miklos Csuros  

E-print Network

´essus l´egers Dans ce TP, vous avez `a implanter une version asyncronis´ee du «Jeu de la vie» (voir Devoir case occup´ee par la cellule en question, et aux case vides `a c^ot´e. 3.1 Threads Dans l'implantation sont en g´en´eral possible, mais avec trop de threads, l'application ´echouera avec OutOfMemoryError1

Csürös, Miklós

232

Invasive infection due to Apophysomyces elegans in immunocompetent hosts.  

PubMed

A previously well 59-year-old man developed necrotizing, invasive cellulitis and subsequent osteomyelitis at what was judged to be the site of a bite or sting. The pathogen isolated was Apophysomyces elegans. Eventually, in addition to treatment with intravenous amphotericin B, en bloc resection was required for cure. Only six previous cases of A. elegans infection have been reported in the literature. The lack of underlying disease in six of the total of seven cases contrasts with the usual findings for other zygomycoses. This article describes all seven reported cases as well as the characteristics of this unique fungal pathogen. PMID:8286630

Weinberg, W G; Wade, B H; Cierny, G; Stacy, D; Rinaldi, M G

1993-11-01

233

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

234

Brown recluse spider bite to the upper lip.  

PubMed

Brown recluse spiders are predominantly found in south central United States. Their bites usually cause mild self-limiting reactions, although localized tissue necrosis and rare systemic, potentially fatal, envenomations are known to occur. Herein, we report an atypical presentation of a brown recluse bite in a 20 year old female who was admitted to the intensive care unit due to angioedema and cellulitis. We photographically document the bite site for twenty-four hours following envenomation. She received glucocorticoids, antihistamines, antibiotics and dapsone while hospitalized and was subsequently discharged with complete resolution of symptoms without the development of tissue necrosis or scarring. PMID:22479977

Dare, Ryan K; Conner, Kelly B; Tan, Poliana C; Hopkins, Robert H

2012-03-01

235

Red or uncomfortable eye.  

PubMed Central

1. A red, uncomfortable eye may be accompanied by other symptoms such as blurred, decreased, or double vision, haloes, photophobia, pain or discharge. 2. A careful history and brief systematic examination will sort out most problems. 3. Examine eyelids, the conjunctivae and corneas. Checking visual acuity is often important. 4. The most common underlying causes can usually be managed within general practice, though a few patients will require urgent eye assessment, or routine referral to ophthalmic outpatients. 5. The following are typical eye problems which require urgent referral: History of pain as opposed to discomfort, Trauma including foreign bodies, chemicals and suspected penetrating injury, Unexplained drop in visual acuity of two lines or more in a painful eye. Specific conditions: preseptal cellulitis, herpes simplex ulcer, scleritis, orbital cellulitis, herpes zoster, bacterial corneal ulcer, dacryocystitis. 6. The following are typical problems which may require routine referral: Persistence of the problem not relieved by simple measures, Recurrent disorders of uncertain diagnosis, Eyelid swelling such as chalazion, cysts, basal cell carcinoma, Gradual loss of vision, for example cataract, macular degeneration. PMID:1345157

Davey, C.; Hurwitz, B.

1992-01-01

236

Les biofilms bact?riens : leur importance en sant? animale et en sant? publique  

PubMed Central

Rsum Les biofilms bactriens sont des amas structurs de cellules bactriennes enrobs dune matrice polymrique et attachs une surface. Le biofilm protge les bactries et leur permet de survivre dans des conditions environnementales hostiles. Les bactries du biofilm peuvent rsister la rponse immunitaire de lhte et sont beaucoup plus rsistantes aux antibiotiques et aux dsinfectants que les cellules bactriennes planctoniques. La capacit de former un biofilm est maintenant reconnue comme une caractristique propre plusieurs microorganismes. La prsence de biofilms lors dinfections demande donc de nouvelles mthodes de prvention, de diagnostic et de traitement. De mme, la prsence de biofilms sur des surfaces retrouves la ferme, labattoir ou lusine de transformation affectera lefficacit du protocole de dsinfection. De faon surprenante, la formation de biofilms chez les bactries pathognes des animaux et les bactries zoonotiques est un sujet relativement peu tudi. Ce bref compte rendu a pour objectif de sensibiliser les intervenants en sant animale limportance des biofilms. PMID:24688172

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

2014-01-01

237

Morbidity of Inguinofemoral Lymphadenectomy in Vulval Cancer  

PubMed Central

Background. The aim of this study is to detect possible risk factors for development of short- and long-term local complications after inguinofemoral lymphadenectomy for vulval cancer. Methods. This retrospective cohort study included 34 vulval cancer patients that received inguinofemoral lymphadenectomy. The detected complications were wound cellulitis, wound seroma formation, wound breakdown, wound infection, and limb lymphoedema. Followup of the patient ran up to 84 months after surgery. Results. Within a total of 64 inguinofemoral lymphadenectomies, 24% of the inguinal wounds were affected with cellulitis, 13% developed a seroma, 10% suffered wound breakdown, 5% showed lower limb edema within a month of the operation, and 21.4% showed lower limb edema during the long-term followup. No significant correlation could be found between saphenous vein ligation and the development of any of the local complications. The 3-year survival rate in our cohort was 89.3%. Conclusions. Local complications after inguino-femoral lymphadenectomy are still very high, with no single pre-, intra-, or postoperative factor that could be incriminated. Saphenous vein sparing provided no significant difference in decreasing the rate of local complications. More trials should be done to study the sentinel lymph node detection technique. PMID:22262953

Soliman, A. A.; Heubner, M.; Kimmig, R.; Wimberger, P.

2012-01-01

238

Aetiology and management of proptosis in young Jordanians.  

PubMed

Sixty-two cases of proptosis in children and adolescents were prospectively evaluated in a specialized practice at Irbid, North Jordan, during the period between 1990 and 1994. Inflammatory orbital conditions were seen in 27 patients (43.5%). The causes of orbital cellulitis were identified in 15 out of 25 cases. Predisposing factors and outcome were analyzed. Vasculogenic lesions were encountered in 15 cases, five of which were subperiosteal orbital haematomas. Twelve cases with structural lesions ranging from a benign cystic dermoid to craniostenosis were managed in various ways. A rare case of primary hydatid disease in the orbit was also seen. Results of surgical treatment and outcome in each condition were assessed. Eight cases (14%) were neoplastic in nature. A rare case of retinoblastoma which presented as orbital cellulitis is included. Orbitotomies were performed for excision biopsy, mass removal and decompression or exenterations of the orbit, with no serious complications. No cases of proptosis owing to thyroid ophthalmopathy or systemic diseases were seen. The relatively low frequency of secondary orbital retinoblastoma among Jordanian children is compared with that in related reports from other countries. PMID:8790681

al-Salem, M; Obedat, H; Maayaaeh, A; Haboob, H; al-Khyel, A B

1996-06-01

239

Pressure ulcers: prevention, evaluation, and management.  

PubMed

A pressure ulcer is a localized injury to the skin or underlying tissue, usually over a bony prominence, as a result of unrelieved pressure. Predisposing factors are classified as intrinsic (e.g., limited mobility, poor nutrition, comorbidities, aging skin) or extrinsic (e.g., pressure, friction, shear, moisture). Prevention includes identifying at-risk persons and implementing specific prevention measures, such as following a patient repositioning schedule; keeping the head of the bed at the lowest safe elevation to prevent shear; using pressure-reducing surfaces; and assessing nutrition and providing supplementation, if needed. When an ulcer occurs, documentation of each ulcer (i.e., size, location, eschar and granulation tissue, exudate, odor, sinus tracts, undermining, and infection) and appropriate staging (I through IV) are essential to the wound assessment. Treatment involves management of local and distant infections, removal of necrotic tissue, maintenance of a moist environment for wound healing, and possibly surgery. Debridement is indicated when necrotic tissue is present. Urgent sharp debridement should be performed if advancing cellulitis or sepsis occurs. Mechanical, enzymatic, and autolytic debridement methods are nonurgent treatments. Wound cleansing, preferably with normal saline and appropriate dressings, is a mainstay of treatment for clean ulcers and after debridement. Bacterial load can be managed with cleansing. Topical antibiotics should be considered if there is no improvement in healing after 14 days. Systemic antibiotics are used in patients with advancing cellulitis, osteomyelitis, or systemic infection. PMID:19035067

Bluestein, Daniel; Javaheri, Ashkan

2008-11-15

240

Evaluation of extremity pain in children using technetium-99m MDP bone scan: A general hospital experience  

SciTech Connect

This study was undertaken to evaluate the efficacy of three-phase bone scan in detection of significant pathology i.e., osteomyelitis (OM), septic joint, cellulitis, etc., in children with symptoms of extremity pain. A total of 100 consecutive patients (age 9 days - 16 yrs, 63 boys and 37 girls) were studied. The authors reviewed their scans, x-rays and hospital records. The final diagnoses were based on the findings of needle aspiration, surgical drainage, biopsy, culture, and on the therapeutic response. In 87%, sufficiently long clinical follow-up was available to confirm the final diagnoses. In the remaining 13%, the symptoms resolved quickly and follow-up was not felt necessary. The scan was essential in pinpointing the lesions in pts with referred or nonlocalizing extremity pain. The +ve and -ve predictive values of the scan and OM were 89% and 96% respectively. One spiral fracture was misinterpreted as diffuse OM. One ''Subacute epiphyseal OM'' was not detected. In two cases, cellulitis and septic joint obscured underlying OM. Prior antibotic therapy resulted in one equivocal scan. Although less sensitive (29%) in early OM, radiographs play an important complimentary role. Bone scans detected underlying pathology for extremity pain in 61% of all pts studied.

Park, H.M.; Rothschild, P.A.; Kernek, C.B.

1984-01-01

241

Tumeur brune du maxillaire r?v?latrice d'hyperparathyroidie primaire: ? propos d'un cas et revue de la litt?rature  

PubMed Central

Les tumeurs brunes sont des lsions ostolytiques rarement rvlatrices des hyperparathyrodies. Elles surviennent habituellement au stade terminal de l'hyperparathyrodie primaire ou secondaire. Durant les 3 dernires dcennies, le diagnostic des hyperparathyrodies est le plus souvent fait la phase asymptomatique grce aux dosages systmatiques du calcium et l'avnement des nouvelles techniques, de dosage de la parathormone. Nous rapportons l'observation d'une patiente avec hyperparathyrodie primaire rvle par une tumeur du maxillaire, dont la TDM avait mis en vidence un processus ostolytique agressif. L'intervention chirurgicale a consist en une maxillectomie droite avec reconstruction. Le rsultat anatomo-pathologique a conclu en une tumeur cellule gantes bnigne du maxillaire. Le diagnostic de tumeur brune a t voqu et confirm aprs la ralisation d'un bilan phosphocalcique qui a mis en vidence une hypercalcmie, avec une hypophosphormie. La recherche tiologique a objectiv la TDM cervicale un processus en situation rtro et infra thyrodienne droite en faveur d'un adnome parathyrodien. Le dosage de la parathormone: 322 pmol/L a confirm le diagnostic. Nous rappelons travers cette observation la difficult dtablir un diagnostic correct chez les patients avec un processus ostolytique du maxillaire et la ncessit de rechercher une hyperparathyrodie devant une lsion cellules gantes vue le caractre 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

242

Puffy Hand Syndrome Revealed by a Severe Staphylococcal Skin Infection  

PubMed Central

Puffy hand syndrome develops after long-term intravenous drug addiction. It is characterized by a nonpitting edema, affecting the dorsal side of fingers and hands with puffy aspect. Frequency and severity of the complications of this syndrome are rarely reported. Local infectious complications such as cellulitis can be severe and can enable the diagnosis. Herein, we report the case of a 41-year-old man who went to the emergency department for abdominal pain, fever, and bullous lesions of legs and arms with edema. Bacteriologic examination of a closed bullous lesion evidenced a methicillin sensitive Staphylococcus aureus. The abdomen computed tomography excluded deep infections and peritoneal effusion. The patient was successfully treated by intravenous oxacillin and clindamycin. He had a previous history of intravenous heroin addiction. We retained the diagnosis of puffy hand syndrome revealed by a severe staphylococcal infection with toxic involvement mimicking a four limbs cellulitis. Puffy hand syndrome, apart from the chronic lymphedema treatment, has no specific medication available. Prophylactic measures against skin infections are essential. PMID:24198977

Amode, Reyhan; Bilan, Paul; Sin, Carole; Marchal, Anais; Sigal, Michele-Lea; Mahe, Emmanuel

2013-01-01

243

Tufted folliculitis of the scalp: a distinctive clinicohistological variant of folliculitis decalvans.  

PubMed

Tufted folliculitis is an uncommon folliculitis of the scalp that resolves with patches of scarring alopecia within which multiple hair tufts emerge from dilated follicular orifices. The clinicohistological data from a group of 15 patients with tufted folliculitis were reviewed and compared with those of seven patients with folliculitis decalvans, five with acne keloidalis nuchae, four with dissecting cellulitis of the scalp, three with kerion celsi and 20 with follicular lichen planus. It was found that tufted folliculitis could be differentiated from folliculitis decalvans only by finding several hair tufts scattered within patches of scarring alopecia. Histologically, a single tuft consisted of peculiar clustering of adjacent follicular units opening at the bottom of an epidermal depression. Conversely, the presence of keloidal plaques in acne keloidalis nuchae, coalescing nodules discharging purulent material in dissecting cellulitis of the scalp, erythematous plaques covered by pustules replete with fungal elements in kerion celsi, and the absence of follicular pustules in follicular lichen planus distinguished these diseases from tufted folliculitis. On the basis of these findings, it is suggested that tufted folliculitis should be considered as a distinctive clinicohistological variant of folliculitis decalvans. Tufting of hair is caused by clustering of adjacent follicular units due to a fibrosing process and to retention of telogen hairs within the involved follicular units. PMID:9666825

Annessi, G

1998-05-01

244

From ophthalmologist to dentist via radiology  

PubMed Central

Summary Background: The aim of this paper was to analyze the causes of orbital cellulitis in connection with covert dental changes as well as to establish the role of radiological procedures in the final diagnosis and further treatment of such cases. Material/Methods: Thirty-two patients, aged 2556, 22 women and 10 men were diagnosed and treated between January 2007 and April 2011 at the Pomeranian Medical University in Szczecin. The patients were examined in the infirmary of the ophthalmological department due to unilateral blepharo-oedema, abrupt pain and vision disturbances; in 5 cases, body temperature increased up to 37.8C was observed. Next, the patients underwent conventional X-ray examinations of the orbit to exclude any foreign bodies in the eyeball, as well as pantomographies to evaluate the dental status. Visible periapical or periodontal changes in dentition were analyzed with intraoral X-rays with the use of DIGORA System 2.1. Changes found in 3 patients on pantomograms and connected with iatrogenic procedures were further evaluated with CT (64 lines and 128 layers) in frontal, sagittal and axial projections. Orbital disorders were also diagnosed by an ophthalmologist and radiologist with Doppler ultrasound (US) examinations. A linear transducer of 7.510 MHz to observe the morphology and vascularity of the eyeball was applied. Results: Iatrogenic treatment was the cause of sinusitis and cellulitis in three cases: incorrectly implanted dental implant in one case, root of the 3rd molar pushed into the sinus in the second case, and communication between the maxillary alveolar process and the sinus after extraction in case of the third patient. Asymptomatic periapical osteolysis, periodontal disease or dead teeth were found in all cases. Diagnosis of orbital cellulitis of dental origin was determined on the basis of clinical, radiographic and ultrasound findings. Ophthalmologic and dental treatment was applied simultaneously. Conclusions: Co-operation between ophthalmologists, radiologists and dentists is necessary during the treatment of such orbital diseases. PMID:22802862

Wilk, Grazyna; Modrzejewska, Monika; Lachowicz, Ewelina; Lisiecka-Opalko, Krystyna; Mysliwiec, Leszek; Rutkowski, Donald; Kotrych, Katarzyna; Burzynska, Katarzyna; Golubinska, Elzbieta

2012-01-01

245

Necrotizing black tattoo reaction: what's in a name?  

PubMed

We report the rare case of an 18-year-old man who developed a necrotizing cutaneous reaction 5 days after having a permanent black tattoo on his left forearm spelling his name. Three cases of reactions to permanent black tattoos have been reported within the literature. These cases described the development of cellulitis of the skin adjacent to the tattoo but none reported florid necrotizing cutaneous reactions. The initial management with oral antibacterials failed to resolve the symptoms and use of intravenous antibacterials and topical corticosteroids was needed. Six weeks after presentation the tattoo lettering showed the presence of hyperpigmented skin. Subsequent patch testing confirmed that the patient had no allergy to black tattoo pigments suggesting that the necrotizing cutaneous reaction was secondary to infection. We show that successful treatment of this rare infective complication of permanent black tattoos involves the early institution of intravenous antibacterial agents and topical corticosteroids. PMID:19222254

Bhogal, Ricky Harminder; Thomas, Sunil Solomon

2009-01-01

246

Transfert d'nergie linique et radiosensibilit cellulaire  

NASA Astrophysics Data System (ADS)

The response of human tumour cell lines to in vitro irradiation by high LET particles depends on several factors. For charged particles, there is an increase in radio-sensitivity with LET up to LET values of about 200 KeV/m, then it decreases for higher values. In clinical practice, the increase in the average LET value with depth leads to a continuous increase in relative biological effectiveness (RBE). The probability of particle traversal through the nucleus producing lethal damage is almost 1 for particles with very high LET values such as 7 MeV Ar (LET = 1500 KeV/?m); it is only 0.02 for 400 MeV O ions (LET = 20 KeV/?m). RBE is inversely related with dose, this relation being more marked for cells with small ?/beta values after photon irradiation according to the linear-quadratic formula. Particles that are less efficient than photons in terms of average cell death induce heavy individual cell damage, as shown by the yield of multiple micronuclei (MN). With regard to RBE and intrinsic radiosensitivity, recent data using both the clonogenic method and the MN assay indicate that the higher the radioresistance to photon irradiation, the higher the RBE. La rponse des cellules tumorales humaines l'irradiation in vitro par des particules de TEL lev dpend de plusieurs facteurs. Pour les particules charges, la radiosensibilit augmente avec le TEL jusqu' des valeurs de TEL voisines de 200 KeV/?m, puis diminue pour des valeurs de TEL suprieures. En clinique, l'augmentation du TEL moyen de la particule charge en profondeur est responsable d'une efficacit biologique relative (EBR) croissante. La probabilit de mortalit de la cellule par une particule traversant le noyau est proche de 1 pour les particules de TEL trs lev comme l'Ar de 7 MeV par nuclon (TEL = 1500 KeV/?m) ; elle n'est que de 0,02 pour les ions d'O de 400 MeV (TEL = 20 KeV/?m). L'EBR est plus leve pour les petites doses, la relation EBR/dose tant plus marque dans les cellules ayant un rapport ?/beta plus faible aprs exposition aux photons, selon le modle linaire-quadratique. Les particules moins efficaces que les photons en terme de mortalit cellulaire moyenne induisent des dgts individuels importants, rvls par la production de micronoyaux (MN) multiples. Concernant le lien entre l'EBR et la radio-sensibilit intrinsque, les donnes rcentes utilisant la fois la technique des colonies et la mthode des MN, montrent que l'EBR est d'autant plus leve que les cellules sont radiorsistantes aux photons.

Courdi, A.; Pignol, J. P.; Iborra-Brassart, N.; Hrault, J.; Fares, G.; Hachem, A.; Chauvel, P.

1998-04-01

247

Dens evaginatus: the hornet's nest of adolescent orthodontics.  

PubMed

Dens evaginatus is a rare dental anomaly that occurs during tooth development and results in an abnormal protrusion from the occlusal surface of the affected tooth, often in the area of the central groove between the buccal and lingual cusps. Of clinical importance to the orthodontist is that these occlusal tubercles fracture easily or can be worn away, resulting in direct pulp exposure in a noncarious tooth. This can cause severe complications, including loss of tooth vitality, facial infection in the form of an abscess or cellulitis, or osteomyelitis of the jaw. If extraction of premolars is indicated for orthodontic treatment after careful diagnosis and treatment planning, it is paramount to establish the health of the premolars that will remain in the dentition before extracting the teeth. PMID:23561419

Turner, John W; Kluemper, G Thomas; Chance, Kenneth; Long, Linwood Sonny

2013-04-01

248

TRACHEOSTOMAPLASTY: A SURGICAL METHOD FOR IMPROVING RETENTION OF AN INTRALUMINAL STOMA BUTTON FOR HANDS-FREE TRACHEOESOPHAGEAL SPEECH  

PubMed Central

Background We describe a minimally invasive surgical technique, tracheostomaplasty, to overcome anatomical deformities of the stoma that preclude successful retention of a stoma button for hands free tracheoesophageal (TE) speech. Methods We conducted a retrospective analysis of 21 patients who underwent tracheostomaplasty after laryngectomy to accommodate an intraluminal valve attachment for hands-free TE speech. Results Sixteen men and 5 women (median age, 65 years; median follow-up, 27.7 months) underwent tracheostomaplasty; 6 patients developed a mild cellulitis that required therapy and 5 patients required a minor revision surgery. At last follow-up, 15 (71%) patients successfully achieved hands-free TE speech using an intraluminal stoma button. Three patients only retained the intraluminal device to facilitate digital occlusion. Tracheostomaplasty failed in 3 patients because of granulation tissue formation or stomal stenosis. Conclusions Tracheostomaplasty is a successful technique to improve intraluminal retention of a stoma button for hands-free TE speech in laryngectomy patients. PMID:20848405

Moreno, Mauricio A.; Lewin, Jan S.; Hutcheson, Katherine A.; Bishop Leone, Julie K.; Barringer, Denise A.

2014-01-01

249

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

250

Antibiotic overuse and resistance in dermatology.  

PubMed

Antibiotics have a significant role in dermatology, treating a wide range of diseases, including acne, rosacea, inflammatory skin conditions and skin structure infections, such as cellulitis, folliculitis, carbuncles, and furuncles. Because of their consistent use, utility, and availability, antibiotics are susceptible to overuse within the medical practice, and, specific to this discussion, in the dermatologic setting. The issue of continuously increasing risk of antibiotic resistance remains an important concern to the dermatologist. The scope of this review will be to provide an overview of the common antibiotics used in the dermatologic setting with an emphasis on identifying areas of overuse, reported bacterial resistance, and discussion of clinical management aimed at decreasing antibiotic resistance. PMID:22591499

Chon, Susan Y; Doan, Hung Q; Mays, Rana Majd; Singh, Selina M; Gordon, Rachel A; Tyring, Stephen K

2012-01-01

251

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. RSNA, 2014. 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

252

Bordetella holmesii meningitis in an asplenic patient with systemic lupus erythematosus.  

PubMed

Bordetella holmesii is a slow-growing, Gram-negative, non-oxidizing bacillus with colonies that produce a brown soluble pigment and was originally described by Weyant et al. (1995) as CDC nonoxidizer group 2 (NO-2). It has recently been shown that B. holmesii may be isolated from nasopharyngeal specimens of up to 20% of patients with pertussis-like symptoms. However, invasive B. holmesii has rarely been reported and in the vast majority of cases the patients were immune deficient, mostly as a result of splenectomy or functional asplenia. Clinical presentations have included endocarditis, pneumonia, cellulitis, suppurative arthritis, pyelonephritis and septicaemia but no previous reports have documented meningitis secondary to this organism. Here we report what we believe to be the first clinical description of an adult with B. holmesii meningitis and bacteraemia with a brief review of published cases. PMID:22556329

Livovsky, Dan M; Leibowitz, David; Hidalgo-Grass, Carlos; Temper, Violeta; Salameh, Shaden; Korem, Maya

2012-08-01

253

Possible disease transmission by contaminated mouthguards in two young football players.  

PubMed

Previous studies have demonstrated that athletic mouthguards worn by ice hockey and football players harbor large numbers of bacteria, yeasts, and molds, some of which are either opportunistic or frank pathogens. This article details the clinical history of two junior high school football players. The first player had cellulitis of the leg after a non-break injury. The same unusual bacterium was isolated from both the athletic mouthguard and abscess cultures from the wound. The second patient suffered an attack of exercise-induced asthma so severe that his inhaler could not control the symptoms enough for him to resume play. This child's mouthguard was contaminated with five different species of mold. The clinical implications of mouthguard contamination, possible avenues of disease transmission, and recommendations for mouthguard care are discussed. PMID:17899722

Glass, R Thomas; Wood, C Rieger; Bullard, James W; Conrad, Robert S

2007-01-01

254

Clostridium septicum myositis in a western lowland gorilla (Gorilla gorilla gorilla).  

PubMed

A 10-yr-old male gorilla (Gorilla gorilla gorilla) with a history of conspecific bite wounds was evaluated for acute onset of depression, anorexia, and right hemiparesis. The animal was immobilized for diagnostic examination and treatment for suspected toxic shock from a necrotizing, emphysematous wound infection, but was euthanized due to complications during recovery. Gross and histopathologic examination revealed acute necrotizing myositis, fasciitis, cellulitis, and emphysema in the affected wound area, with large numbers of large Gram-positive rods among necrotic muscle fibers. Severe pulmonary edema with airways containing fibrin, acute hemorrhage in multiple body sites, thrombosis in blood vessels in the skeletal muscle, liver, and lung, and lymph node hyperplasia with lymphoid necrosis and hemorrhage. Immunohistochemical fluorescent antibody staining of muscle from the wound site was positive for PMID:17312773

Fontenot, Deidre K; Terrell, Scott P; Miller, Michele; Robbins, Patricia K; Stetter, Mark; Weber, Martha

2005-09-01

255

[Panniculitic T-cell lymphoma].  

PubMed

Panniculitic T-cell lymphoma is a rare, aggressive variant of cutaneous T-cell lymphoma, with fewer than 100 cases described. The main problem is its diagnosis, as both the clinical and the histological features may simulate benign panniculitis. We present the case of a 34-year-old male patient, who had presented with an indurated plaque, sclerodermiform in appearance, on the front of the right thigh for 4 months, later accompanied by fever and constitutional symptoms. The initial diagnosis was cellulitis, but no clinical improvement was seen despite systemic antibiotic therapy. After two skin biopsies, the patient was diagnosed with panniculitic cutaneous T-cell lymphoma. The patient was treated with 8 cycles of CHOP chemotherapy, with resolution of the symptoms. PMID:16476344

Rodrguez-Vzquez, Mara; Garca-Arpa, Mnica; Martn, Francisco; Calle, Carmen; Marchn, Enrique; Romero, Guillermo; Cortina, Pilar

2005-03-01

256

Necrotizing Fasciitis: The Howard University Hospital Experience  

PubMed Central

All surgical cases from 1965 to 1980 and autopsy cases from 1974 to 1980 diagnosed at Howard University Hospital as necrotizing fasciitis (NF) were reviewed. Eight patient fulfilled the criteria for NF, which included (1) fascial necrosis, (2) spreading cellulitis with undermining of fascial planes, and (3) systemic toxicity as evidenced by altered mental state and hyperthermia. Bacteroides fragilis was commonly found in our most recent cases. Poor prognostic signs included (1) documented bacteremia, (2) preoperative hypotension (systolic blood pressure lower than 80 mmHg), and (3) hypocalcemia (serum calcium less than 7.0 mg/dL). Therapy consisted of wide debridement with systemic antibiotics and delayed skin grafting when needed. ImagesFigure 1Figure 2Figure 3 PMID:6827608

Walker, Mark; Hall, Macy

1983-01-01

257

Clinical outcomes of open heart surgery in patients with atopic dermatitis.  

PubMed

Atopic dermatitis is a skin condition often complicated by colonization with Staphylococcus aureus, which increases the risk of infective endocarditis, skin cellulitis and osteomyelitis. Positive cultures for Staphylococcus aureus are obtained from 70% to 80% of wounds in patients with mediastinitis. Thus sternotomy carries increased risk of mediastinitis in patients with atopic dermatitis. We retrospectively reviewed 25 patients with atopic dermatitis who underwent cardiac surgery via a median sternotomy or thoracotomy from January 1997 to September 2010 at our institution. Postoperative mediastinitis due to methicillin-resistant Staphylococcus aureus was found in 3 patients who had a median sternotomy. They were ultimately discharged in good condition. No mediastinitis occurred in patients undergoing thoracotomy. Mediastinitis may occur due to direct exposure of the bone marrow to methicillin-resistant Staphylococcus aureus in patients with atopic dermatitis whose skin is colonized with such bacteria. Thoracotomy may be a better surgical approach in patients with atopic dermatitis who require thoracic surgery. PMID:22499959

Fukunaga, Naoto; Yuzaki, Mitsuru; Shomura, Yu; Fujiwara, Hiroshi; Nasu, Michihiro; Okada, Yukikatsu

2012-04-01

258

Soft tissue injury of the lower extremity complicated by type II necrotising fasciitis highlighting the need for astute clinical practices and proper treatment.  

PubMed

Necrotising fasciitis (NF) is a soft tissue bacterial-derived infection characterised clinically by fulminant tissue destruction of the poorly blood-supplied muscle fascia and overlying subcutaneous fat. Although these infections first appear as minor superficial manifestations, they are capricious in nature and often lead to sepsis, organ failure and high mortality. We report a case of type II necrotising fasciitis in a 39-year-old Caucasian female patient who presented to the emergency department with cellulitis of her right foot and lower leg that rapidly developed into tissue necrosis. The patient course is of unique interest due to progressive history over a 104?days time frame with complications following surgical treatments and outpatient follow-up. We highlight the importance of early detection and pertinent clinical awareness from a wide range of medical specialties that were involved in this case, and how this process is critical, in order to properly diagnose and treat NF-derived tissue infections. PMID:24973350

Sabre, Alexander; Robles, Carlos G; Krisar-White, Patricia; Farricielli, Laurie

2014-01-01

259

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

260

Chronic osteomyelitis of the clavicle  

SciTech Connect

Osteomyelitis of the clavicle is an uncommon disease, but it should be considered in patients who present with pain, cellulitis, or drainage in the sternoclavicular area following head and neck surgery, irradiation, subclavian vein catheterization, or immunosuppression. An idiopathic presentation is possible. In contrast to primary osteomyelitis of the clavicle, which is occasionally seen in children, secondary osteomyelitis is quite rare. It is often mistaken for a fracture or a possible neoplasm on plain x-rays. Tomograms and CT scanning are confirmatory, and in early cases, technetium-99m bone scanning can be helpful. Treatment must include early, aggressive surgical debridement of all affected tissues, followed by wound coverage with a well-vascularized flap and perioperative antibiotics.

Granick, M.S.; Ramasastry, S.S.; Goodman, M.A.; Hardesty, R.

1989-07-01

261

Fasciotomy following total knee arthroplasty: beware of terrible outcome.  

PubMed

There is a paucity of literature on compartment pressure thresholds and complications following fasciotomy in postoperative Total Knee Arthroplasty (TKA) patients. The purpose of this study is to identify the postoperative course in a series of patients who had surgical decompression following TKA. We identified six patients who underwent fasciotomy for proven or suspected compartment syndrome following primary TKA between 2000 and 2010. The etiology of compartment syndrome was indirect (5 cases) vascular injury and one unknown. Complications after fasciotomy were: periprosthetic infection (2), foot drop (2), fasciitis (1), cellulitis (1), above the knee amputation due to periprosthetic infection (1). Currently, it is unknown if the same principles in the trauma patient apply for both diagnosis and treatment of compartment syndrome after TKA. We conclude that surgeons need to maintain a relatively higher threshold for performing a fasciotomy following TKA. PMID:23786987

Vegari, David N; Rangavajjula, Ashwin V; Diiorio, Timothy M; Parvizi, Javad

2014-02-01

262

Acquired haemophilia A: the importance of early recognition in cases of spontaneous bleeding in the elderly.  

PubMed

We describe the case of a 79-year-old man who presented 'off legs' with acute right leg pain. He was initially treated for suspected cellulitis but subsequently found to have spontaneous soft tissue bleeding into the right thigh. He was eventually diagnosed with idiopathic acquired haemophilia A and treated with activated prothrombin complex concentrates to control acute bleeding followed by immunosuppressant therapy. Acquired haemophilia A is a potentially life-threatening and under-recognised bleeding disorder that results from the immune-mediated development of autoantibodies directed against coagulation factor VIII. The disease is more common in elderly individuals where early recognition and treatment is compounded by the presence of other comorbid conditions, including other potential causes of bleeding. These confounding factors and lack of awareness among non-specialists accounts for the delay in diagnosis that is common in this disease and contributes to the persistently high mortality in this age group. PMID:25414221

Patel, Neeral; Wyrko, Zoe; Naqvi, Syeda; Croft, Adam P

2014-01-01

263

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

264

[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, Frdric; Orasch, Christina

2014-01-15

265

Complicated coexisting pyogenic and tuberculous otitis media affecting the temporozygomatic, infratemporal, and parotid areas: report of a rare entity.  

PubMed

We report an unusual case in which a 28-year-old woman presented with a long-standing history of ear discharge, hearing loss, facial weakness with ipsilateral facial swelling and cellulitis, a postauricular fistula, and an abscess of the temporozygomatic, infratemporal, and parotid areas. The pus stained positive for bacteria and acid-fast bacilli, and culture was positive for Proteus vulgaris and mycobacteria. Based on these findings, a diagnosis of tuberculous otitis media with complications was made. Computed tomography showed extensive destruction of the tympanic and mastoid part of the temporal bone, as well as lytic lesions in the skull. The patient was placed on antituberculosis drug therapy. Although her facial nerve palsy and hearing loss persisted, she otherwise responded well and did not require surgery. PMID:23354894

Brar, Tripti; Mrig, Sumit; Passey, J C; Agarwal, A K; Jain, Shayma

2013-01-01

266

Relapsing polychondritis.  

PubMed

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 saddle nose deformity. Acute involvement of the tracheal cartilage may cause collapse of the airway with obstruction and pulmonary infections. Arthritis may be oligoarticular or polyarticular, most often involving the costochondral junctions. Other manifestations include audiovestibular damage; heart valve disease; and neurologic, ocular, and renal disease. Corticosteroids remain the major treatment. Other therapies include nonsteroidal anti-inflammatory drugs, dapsone, colchicine, azathioprine, methotrexate, cyclophosphamide, hydroxychloroquine, cyclosporine, and infliximab. PMID:17113965

Rapini, Ronald P; Warner, Noranna B

2006-01-01

267

Multimodality imaging of the postpartum or posttermination uterus: evaluation using ultrasound, computed tomography, and magnetic resonance imaging.  

PubMed

Postpartum and posttermination complications are common causes of morbidity and mortality in women of reproductive age. These complications can be broadly categorized into vascular, infectious, surgical, and neoplastic etiologies, or are due to ectopic implantation of placental or endometrial tissue. Causes of postpartum vascular complications include retained products of conception, arteriovenous malformation, and pseudoaneurysm. Infectious entities include endometritis, abscess, wound cellulitis, and pelvic septic thrombophlebitis. Postsurgical complications include uterine scar dehiscence, bladder flap hematoma, and subfascial hematoma. Neoplastic complications include the spectrum of gestational trophoblastic neoplasms. Ectopic tissue implantation complications include abnormal placentation and uterine scar endometriosis. Imaging is essential for diagnosis, and radiologists must be familiar with and aware of these entities so that accurate treatment and management can be obtained. In this review, we illustrate the imaging findings of common postpartum and posttermination complications on ultrasound, computed tomography, and magnetic resonance imaging. PMID:25041975

Laifer-Narin, Sherelle L; Kwak, Ellie; Kim, Hyonah; Hecht, Elizabeth M; Newhouse, Jeffrey H

2014-01-01

268

Disseminated Mycobacterium chelonae infection: Complicating a case of hidradenitis suppurativa  

PubMed Central

Mycobacteium chelonae is a rapidly growing atypical mycobacteria known to be pathogenic in humans. We report a case of Hidradenitis Suppurativa (HS) with diabetes complicated by infection of the lesions with Staphylococcus aureus and M. chelonae leading to non-healing and discharging lesions. HS is a rare, insidious and debilitating disease characterized by swollen, painful, inflamed lesions in the axillae, groin, and other parts of the body that contain apocrine glands. Discharge from HS lesions are often found to be sterile, however, polymicrobial bacterial colonization commonly occurs within sinus tracts which can lead to offensive smelling discharge, infection, cellulitis, and superinfection. The incidence of HS is very low and the association with M. chelonae makes it a rare and interesting case. PMID:24350020

Patnaik, Satyadarshi; Mohanty, Indrani; Panda, Pritilata; Sahu, Susmita; Dash, Muktikesh

2013-01-01

269

Standard test method for water absorption of core materials for structural sandwich constructions  

SciTech Connect

This method covers the determination of the relative rate of absorption of water by various types of core materials when immersed. The method is intended to apply to the testing of all types of core materials, including honeycomb structures, wood, cellulated materials, resin-impregnated reinforcing materials, etc. but does not apply to loose mineral fillers. The test specimen shall be in the form of a square 7.62 cm (3 in.) in length by 7.62 cm (3 in.) in width by the thickness of the material. The dimensions shall be measured to an accuracy of +-0.5 percent. Three specimens are weighed individually and conditioned as prescribed before immersion in a container of distilled water maintained at a temperature of 23 +- 3/sup 0/C. At the end of 24 hour, specimens are removed from the water, wiped dry, weighed and calculations are made from data.

Not Available

1980-01-01

270

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

271

Disseminated infection due to Cylindrocarpon (Fusarium) lichenicola in a neutropenic patient with acute leukaemia: report of a case and review of the literature.  

PubMed

Described here is an unusual case of disseminated Cylindrocarpon lichenicola (Fusarium lichenicola) infection originating from a toenail lesion of a neutropenic woman with cellulitis of the foot and underlying acute leukaemia. A computed tomography scan of the chest showed multiple, ill-defined, nodular infiltrates with alveolar consolidation. The fungus was isolated from both the nail and the skin of the infected toe. Susceptibility testing revealed low minimum inhibitory concentrations for amphotericin B (0.78 micro g/ml) and voriconazole (1.56 micro g/ml) and high minimum inhibitory concentrations (>100 micro g/ml) for fluconazole, ketoconazole and itraconazole. The infection resolved after treatment with a total dose of 1 g of amphotericin B followed by oral itraconazole and bone marrow regeneration. PMID:12582748

Rodrguez-Villalobos, H; Georgala, A; Beguin, H; Heymans, C; Pye, G; Crokaert, F; Aoun, M

2003-01-01

272

Disseminated abscessation complicated with bone marrow abscess caused by Arcanobacterium pyogenes in a goat.  

PubMed

An 8-month-old, Nubian wether with a history of systemic illness was euthanatized for a pathological examination. At necropsy, the presence of disseminated abscessation and cellulitis in the limbs was noted. Other postmortem findings associated with the visceral disease in this animal included multiple abscess lesions, mainly in the lungs, kidneys, phalanxes and vertebrae. Histopathologically, lesions of arteriolitis were found as evidenced by bacterial embolisms in pulmonary and renal arteriola, indicating a bacteremia in the patient. Arcanobacterium pyogenes was consistently isolated from 8 lesions of abscessations, including the lesions of subcutaneous abscesses as well as bone marrow abscess in phalanxes and thoracic vertebrae. This is the first published report of disseminated arcanobacterial infection with bone marrow abscess of both the phalanxes and vertebrae in goat. PMID:20467209

Lin, Cheng-Chung; Chen, Ter-Hsin; Shyu, Ching-Lin; Su, Nan-Yu; Chan, Jacky Peng-Wen

2010-08-01

273

Septic shock due to Fournier's gangrene of the scrotum.  

PubMed

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

274

Cortical lesions of the tibia: characteristic appearances at conventional radiography.  

PubMed

Lesions that involve the cortex of the tibia are fairly common in radiology practice. However, the number of diseases that involve the tibial cortex is great, and it can be difficult to arrive at a limited differential diagnosis from radiographic findings. Categorization of lesions of the tibia into those that cause cortical destruction and those that cause cortical proliferation can help narrow the broad differential diagnosis. Lesions that cause cortical destruction include nonossifying fibroma, fibrous dysplasia, osteofibrous dysplasia, aneurysmal bone cyst, giant cell tumor, eosinophilic granuloma, Ewing sarcoma, neurofibromatosis, adamantinoma, osteoblastoma, chondromyxoid fibroma, hemangioendothelioma, renal cell metastatic disease, hemangioma, and hemangiopericytoma. Lesions that cause cortical proliferation include osteochondroma, stress fracture, osteoid osteoma, periosteal osteogenic sarcoma, diaphyseal dysplasia, venous stasis, cellulitis, chronic osteomyelitis, osteopathia striatum, and melorheostosis. Conventional radiography along with clinical and pathologic data can aid in diagnosis of the wide variety of disease processes that involve the tibial cortex. PMID:12533651

Levine, Scott M; Lambiase, Robert E; Petchprapa, Catherine N

2003-01-01

275

Infective endocarditis and septic pulmonary embolism following scorpion sting envenoming in an 11-year-old child.  

PubMed

Scorpion sting is one of the common paediatric toxicological problems encountered in southern India. This rural emergency often results in an autonomic storm causing peripheral circulatory failure and/or congestive cardiac failure, leading to pulmonary oedema. A rare case of scorpion sting envenoming in an 11-year-old boy that led to local cellulitis, dyspnoea and congestive heart failure is presented. This was followed by a persistent high-grade fever which lasted for more than 2 weeks and was complicated by fatal Staphylococcus aureus infective endocarditis and septic pulmonary embolism. Although infective endocarditis has been reported occasionally in adults following scorpion sting, this is the first case of infective endocarditis in a native valve in a child following scorpion sting. The literature is reviewed and the mechanisms for this association are discussed. PMID:24199685

Prakash, Vellasamy; Krishnamurthy, Sriram; Mahadevan, Subramanian; Bethou, Adhisivam; Deepak Barathi, S

2014-05-01

276

Complex Regional Pain Syndrome (CRPS type-1) in an Adolescent Following Extravasation of Dextrose Containing Fluid-an Underdiagnosed Case  

PubMed Central

Due to its complex pathophysiology and wide spectrum of clinical manifestations, the diagnosis of CRPS is often missed in the early stage by primary care physicians. After being treated by a primary care physician for 5 months for chronic cellulitis, a 16-year-old girl was referred to our hospital with features of type-1 CRPS of the right upper extremity. Inability to diagnose early caused prolonged suffering to the girl with all the consequence of CRPS. The patient responded well with marked functional recovery from multimodal therapy. Ability to distinguish CRPS from other pain conditions, referral for specialty care at the appropriate time and full awareness of this condition and its clinical features among various healthcare professionals are essential in reducing patient suffering and stopping its progression towards difficult-to-treat situations. PMID:21716610

Bhattarai, Balkrishna; Biswas, Binay K; Khatiwada, Sindhu

2011-01-01

277

Canaliculitis in supernumerary puncta and canaliculi  

PubMed Central

We report the first case of supernumerary puncta and canaliculi presented with canaliculitis. A-59 year-old gentleman presented with painful swelling of the left lower lid for a week, which was associated with epiphora. The swelling was confined to the nasal aspect of the left lower lid (0.50.5 mm) with inflamed overlying skin. Two puncta (0.5 mm apart) were noted. The outer punctum at the normal anatomical position was a cul-de-sac while the inner punctum it the caruncle was patent. We described the embryology leading to supernumerary puncta and canaliculi to explain the paradoxical patency of the abnormally located punctum as well as the pathomechanism leading to canaliculitis. The patient was treated with oral cloxacillin 500 mg, 6 hourly for 5 days; the cellulitis subsided after three days. PMID:24765320

Yong, Ku Chui; Kah, Tan Aik; Annuar, Faridah Hanom

2011-01-01

278

Atraumatic painless compartment syndrome.  

PubMed

Acute compartment syndrome is a time-sensitive diagnosis and surgical emergency because it poses a threat to life and the limbs. It is defined by Matsen et al (Surg Gynecol Obstet. 1978;147(6):943949) as "a condition in which increased pressure within a limited space compromises the circulation and function of the tissues within that space." The most common cause of compartment syndrome is traumatic injury. A variety of other conditions such as vascular injuries, bleeding disorders, thrombosis, fasciitis, gas gangrene, rhabdomyolysis, prolonged limb compression, cellulitis, and nephrotic syndrome may also cause compartment syndrome. Patients who are elderly, have preexisting nerve damage, or have psychopathology may have an atypical presentation. This case highlights the first report of a 75-year-old woman who developed painless bilateral compartment syndrome in the absence of traumatic injury. PMID:24041642

Blanchard, Scott; Griffin, Gregory D; Simon, Erin L

2013-12-01

279

Upper body pain and functional disorders in patients with breast cancer.  

PubMed

Upper body pain and dysfunction are common in survivors of breast cancer. Disorders of the upper body can result directly from breast cancer or from the surgery, chemotherapy, radiotherapy, or hormonal therapies used in its treatment. Although considerable information is available regarding impairments such as pain and restricted shoulder range of motion associated with breast cancer and its treatment, relatively little information is available about the specific neuromuscular, musculoskeletal, lymphovascular, and other diagnostic entities that underlie those impairments. This article will detail the common and specific causes of upper body pain and dysfunction in breast cancer survivors, including postsurgical pain, rotator cuff disease, adhesive capsulitis, arthralgias, cervical radiculopathy, brachial plexopathy, mononeuropathy, postmastectomy pain syndrome, lymphedema, axillary web syndrome, deep vein thrombosis, and cellulitis. Diagnostic specificity is a key first step to safely and effectively restore function and quality of life to breast cancer survivors. PMID:24360839

Stubblefield, Michael D; Keole, Nandita

2014-02-01

280

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.

Watanabe, Toru

2014-01-01

281

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

282

Dermatology for the practicing allergist: Tinea pedis and its complications  

PubMed Central

Tinea pedis is a chronic fungal infection of the feet, very often observed in patients who are immuno-suppressed or have diabetes mellitus. The practicing allergist may be called upon to treat this disease for various reasons. Sometimes tinea infection may be mistaken for atopic dermatitis or allergic eczema. In other patients, tinea pedis may complicate allergy and asthma and may contribute to refractory atopic disease. Patients with recurrent cellulitis may be referred to the allergist/immunologist for an immune evaluation and discovered to have tinea pedis as a predisposing factor. From a molecular standpoint, superficial fungal infections may induce a type2 T helper cell response (Th2) that can aggravate atopy. Th2 cytokines may induce eosinophil recruitment and immunoglobulin E (IgE) class switching by B cells, thereby leading to exacerbation of atopic conditions. Three groups of fungal pathogens, referred to as dermatophytes, have been shown to cause tinea pedis: Trychophyton sp, Epidermophyton sp, and Microsporum sp. The disease manifests as a pruritic, erythematous, scaly eruption on the foot and depending on its location, three variants have been described: interdigital type, moccasin type, and vesiculobullous type. Tinea pedis may be associated with recurrent cellulitis, as the fungal pathogens provide a portal for bacterial invasion of subcutaneous tissues. In some cases of refractory asthma, treatment of the associated tinea pedis infection may induce remission in airway disease. Very often, protracted topical and/or oral antifungal agents are required to treat this often frustrating and morbid disease. An evaluation for underlying immuno-suppression or diabetes may be indicated in patients with refractory disease. PMID:15050029

Al Hasan, Muhannad; Fitzgerald, S Matthew; Saoudian, Mahnaz; Krishnaswamy, Guha

2004-01-01

283

METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS INFECTIONS OF THE EYE AND ORBIT (AN AMERICAN OPHTHALMOLOGICAL SOCIETY THESIS)  

PubMed Central

Purpose To ascertain if methicillin-resistant Staphyloccocus aureus (MRSA) ophthalmic infections are increasing. Methods A retrospective review of all patients with a culture positive for MRSA in the Parkland Health and Hospital System, the urban public healthcare system for Dallas County, Texas, for the years 2000 through 2004 was performed. Patients with ocular, orbital, and ocular adnexal infection were identified, and isolates were categorized as nosocomial or community-acquired (CA). Results A total of 3,640 patients with a culture positive for MRSA were identified, with 1,088 patients (30%) considered to have acquired the isolate via nosocomial transmission and 2,552 patients (70%) considered to have CA-MRSA. Forty-nine patients (1.3%) had ophthalmic MRSA involvement. For both ophthalmic and nonophthalmic cases, the number of CA-MRSA patients increased each year, whereas the numbers of nosocomial patients remained fairly constant. Patients with ophthalmic MRSA tended to be younger than other MRSA patients (P = .023). The most common manifestation of ophthalmic MRSA infection was preseptal cellulitis and/or lid abscess followed by conjunctivitis, but sight-threatening infections, including corneal ulcers, endophthalmitis, orbital cellulitis, and blebitis, also occurred. Empirical antibiotic coverage was initially prescribed in 48 (98%) of ophthalmic cases and did not adequately cover for the MRSA isolate in 24 (50%). Conclusions CA-MRSA is becoming increasingly prevalent, and ophthalmologists will see more ophthalmic MRSA infections. Although ophthalmic CA-MRSA commonly presents as preseptal lid infection and conjunctivitis, sight-threatening infections also occur. Ophthalmologists must identify MRSA patients, adjust empirical treatment regimens where MRSA is endemic, and take steps to control emergence of resistant organisms in both inpatient and outpatient practices. PMID:17471350

Blomquist, Preston Howard

2006-01-01

284

Wound infections on board ship--prevention, pathogens, and treatment.  

PubMed

Wounds are common in seafarers and they can easily become infected in the marine environment. Pre-sea tetanus immunization is essential. Without diagnostic facilities and only a limited range of antibiotics onboard, injury prevention and early treatment to reduce the likelihood of infection are important measures. Suturing clean cuts reduces healing time and risk of infection. Fresh, clean cuts, especially on the face or head, can be closed by adhesive tape or sutures, but if infection arises, then one or more sutures should be removed to enable drainage. Most wounds must be considered contaminated and should not be closed, just covered with sterile dressing after cleaning. Antibiotic treatment should be started immediately in seafarers with hand and puncture wounds. The primary treatment for a simple abscess is incision and drainage. Antibiotic treatment is recommended for abscesses if the infection spreads to the surrounding tissue (associated cellulitis), if there is lack of response to incision and drainage alone, or if the abscess is in an area difficult or dangerous to drain (e.g. face, palm, genitalia). Recommended therapy for cellulitis is 5-10 days of dicloxacillin, cephalexin, clindamycin, or erythromycin, but if there is no improvement after 2-3 days, methicillin-resistant Staphylococcus aureus (MRSA) should be suspected. Bites and burn wounds require special attention. Since wound infections can deteriorate rapidly, a telemedicine advice service (TMAS) should be consulted during the early stages, and serial digital photographs of the affected area, transmitted by e-mail to TMAS, are often useful during treatment at sea. PMID:22258845

Dahl, Eilif

2011-01-01

285

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

286

Erysipelas after breast cancer treatment (26 cases).  

PubMed

Erysipelas is a bacterial hypodermal cellulitis usually associated with Streptococcal infection. Erysipelas of the upper limbs in women treated for breast cancer is relatively rare. We undertook a 10-year retrospective study identifying 26 cases of erysipelas of the upper limb following treatment for breast cancer; we describe the clinical, therapeutic, and evolutionary aspects. The age of our patients ranged from 37 to 80 years with a mean age of 53. All patients had a breast surgery and lymphadenectomy. Fifteen patients had chemotherapy and 23 had radiotherapy. The erysipelas appeared with an average of 5.23 years after cancer treatment (3 months to 15 years) and was recurrent in nine cases. Lymphedema occurred in eighteen patients. The first signs were fever and shivering in 25 patients. The clinical aspect was an inflammatory plaque. The physical findings of erysipelas included a raised edge (6 cases), blisters (1 case), purpura (1 case), and cellulitis (1 case). The portal of entry was not found in eleven patients. The upper limb was affected in all cases. Involvement of the axillary folds or the chest was observed in eight cases. Treatment with penicillin was undertaken for all patients; the length of treatment varied from 11 to 26 days. Lympadenectomy and radiotherapy in breast cancer may lead to lymphedema, which can be evident or sometimes discrete. Those patients who developed erysipelas in our series usually fared well with treatment, but many had recurrences attributed to persistent lymphedema. It was also of note that for many patients in this series, the portal of entry was not identified. PMID:16409908

Masmoudi, A; Maaloul, I; Turki, H; Elloumi, Y; Marrekchi, S; Bouassida, S; Ben Jemaa, M; Zahaf, A

2005-01-01

287

A prospective, multicenter, observational study of complicated skin and soft tissue infections in hospitalized patients: clinical characteristics, medical treatment, and outcomes  

PubMed Central

Background Complicated skin and soft tissue infections (cSSTIs) occur frequently, but limited data do not allow any consensus on an optimal treatment strategy. We designed this prospective, multicenter, observational study to to explore the current epidemiology, treatment, and resulting clinical outcomes of cSSTIs to help develop strategies to potentially improve outcomes. Methods From June 2008 to December 2009 we enrolled a pre-specified number of adults treated in 56 U.S. hospitals with intravenous antibiotic(s) for any of the following cSSTIs: diabetic foot infection (DFI); surgical site infection (SSI); deep soft tissue abscess (DSTA); or, cellulitis. Investigators treated all patients per their usual practice during the study and collected data on a standardized form. Results We enrolled 1,033 patients (DFI 27%; SSI 32%; DSTA 14%; cellulitis 27%; mean age 54 years; 54% male), of which 74% had healthcare-associated risk factors. At presentation, 89% of patients received initial empiric therapy with intravenous antibiotics; ~20% of these patients had this empiric regimen changed or discontinued based on culture and sensitivity results. Vancomycin was the most frequently used initial intravenous antibiotic, ordered in 61% of cases. During their stay 44% of patients underwent a surgical procedure related to the study infection, usually incision and drainage or debridement. The mean length of stay was 7.1 days, ranging from 5.8 (DSTA) to 8.1 (SSI). Conclusion Our findings from this large prospective observational study that characterized patients with cSSTIs from diverse US inpatient populations provide useful information on the current epidemiology, clinical management practices and outcomes of this common infection. PMID:23009247

2012-01-01

288

Catfish spine envenomation and bacterial abscess with Proteus and Morganella: a case report  

PubMed Central

Introduction Abscess formation and cellulitis in the setting of envenomation are rare complications of handling catfish. To the best of our knowledge, isolation of Proteus vulgaris has not been previously recorded, and recovery of Morganella morganii has been reported in only one prior case from wound cultures in patients injured by catfish stings. We report a case of catfish envenomation characterized by abscess formation and cellulitis, in which wound cultures grew these unusual organisms. Case presentation A 52-year-old Chinese-American man was hospitalized with erythema and swelling of his right arm of 10?days duration after skin penetration by a catfish barb. An abscess of his right thumb had undergone incision and drainage, with purulent drainage sent for wound culture immediately prior to admission. Laboratory studies revealed elevated white blood count, sedimentation rate, and C-reactive protein. The patient was treated with intravenous ampicillin-sulbactam and vancomycin during his hospitalization, and symptoms improved. Wound cultures obtained prior to presentation grew many Proteus vulgaris and Morganella morganii. He was subsequently discharged on a 10-day course of oral ciprofloxacin and amoxicillin-clavulanate. At a 12-month telephone follow-up, the patient denied developing further symptoms and reported that the wound had healed completely without complication. Conclusion Although envenomation and secondary infection are not uncommon sequelae of handling catfish, the present case is unique by virtue of the infecting organisms isolated. Given the prevalence of injury from catfish stings, a review of the literature is presented in order to provide recommendations for prevention and treatment of catfish envenomation. PMID:23631594

2013-01-01

289

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 54.1100%. 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

290

tude des anomalies chromosomiques aprs radiothrapie chez des patients traits 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 ,t, mesures sur les lymphocytes de 30 patients (pts) irradis pour lymphome malin non-hodgkinien (LNH) selon 3 modalits : 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 irradie de 468 pts a servi de tmoin. Dans le groupe irradi, 7 % des cellules prsentaient des anomalies contre 0,4 % dans le groupe tmoin {P <10-6}. Les aberrations ,taient 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 , taient statistiquement plus frquentes chez les pts ayant eu une irradiation localise extra-abdominale en complment de celle de l'abdomen ainsi que chez ceux en rechute de leur LNH et ceux recevant une chimiothrapie lors de l',tude cytogntique.

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

1998-04-01

291

Approche exprimentale nouvelle pour l'tude de cintiques ractionnalles de surface hautes tempratures (2?000-3?000K)  

NASA Astrophysics Data System (ADS)

A fraction of the material sputtered from a sample by an ion beam is collected in a tantalum cell brought at a high temperature where it is thermalized and partly ionized. Ions are extracted from the cell and analyzed in a mass spectrometer. A method based on this principle was proposed a few years ago for the analysis of thin layers. Here we are using the same device for studying the surface reaction kinetics of atoms injected in the cell with the tantalum walls. The interaction of uranium with tantalum is described in the present study. From 3 000 K to 2 700 K we have observed an adsorption process characterized by an activation energy E_a=2.4 eV and a pre-exponential factor of the resident time 1/?0simeq 3 10^{-6} s. At a lower temperature a chemical diffusion of uranium in the tantalum wall is observed with the formation of a solid solution, the concentration limit of which imposes a permanent diffusion flux J_{DT}(trightarrowinfty)ne 0. The thickness of this phase is growing in proportion to the diffusion time with a velocity which increases when the temperature is decreasing (from 1.8 10^{-2} /s at 2 600 K to 1.4 10^{-1} /s at 1 850 K). La matire d'un chantillon prleve par pulvrisation ionique pntre en partie dans une cellule en tantale porte haute temprature dans laquelle elle est thermalise et en partie ionise. Les ions produits sont extraits de la cellule et identifis par spectromtrie de masse. Ce dispositif qui a donn lieu une mthode d'analyse de couches minces est utilis ici pour tudier la cintique ractionnelle de surface des atomes introduits dans la cellule avec la paroi de Ta. La prsente tude porte sur l'interaction uranium-tantale. Entre 3 000 K et 2 700 K on observe un simple processus d'adsorption dsorption dont l'nergie d'activation est gale E_a=2,4 eV et dont le coefficient pr-exponentiel du temps de rsidence a pour valeur 1/?0simeq 3 10^{-6} s. A plus basse temprature, on observe une diffusion chimique de l'uranium dans le tantale marque par la formation d'une solution solide dont la limite de concentration impose un flux permanent de diffusion J_{DT}(trightarrowinfty)ne 0. L'paisseur de cette phase crot proportionnellement au temps de diffusion avec une vitesse qui augmente lorsque la temprature diminue (1,8 10^{-2} /s 2 600 K 1,4 10^{-1} /s 1 850 K).

Blaise, G.; Seghrouchni, E.

1991-06-01

292

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 Grants 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 66N. The host range is now recognized to include two additional subspecies: the Yukon-Alaska moose and Grants 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

293

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 etudi les effets de l'irradiation des rats par contamination interne l'eau tritie, sur l'activit enzymatique de glucose-6-phosphate deshydrognase (G6PDH) rytrocytaire et sur l'incorporation de thymidine (TdR) dans des cellules de la moelle osseuse. Les doses accumules par contamination chronique (100 jours) sont 4.2 cGy et 19.4 cGy et par contamination aigu (5 jours) sont 5 cGy et 20 cGy. Nous avons observ une augmentation significative de l'activit 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 rsultats suggrent que la diminution de l'incorporation de TdR peut tre lie des modifications au niveau du transport transmembranaire pour des irradiations chronique de 4.2 cGy et aigu de 5 cGy. Des phnomnes radioinduites intracellulaires sont probablement 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

294

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

295

A Study on the Acute Kidney Injury in Snake Bite Victims in A Tertiary Care Centre  

PubMed Central

Introduction: Snake bite is a common medical emergency and an occupational hazard, more so in tropical India, where farming is a major source of employment. Viper bites are more common than other poisonous snakebites in humans. The World Health Organization has estimated that there are approximately 1,25,000 deaths among 2,50,000 poisonous snake bites worldwide every year, of which India accounts for 10,000 deaths. Acute kidney Injury (AKI) is an important consequence of a snake bite and its proper supportive management after the anti-venom administration is of utmost importance, for a good patient outcome. Aims and Objectives: 1. To assess the risk factors and the prognostic factors in snake-bite induced Acute Kidney Injury.2. To determine the outcome of snake bite patients with AKI in a tertiary care centre in Karnataka, India. Methodology: This prospective study was carried out at Vijaynagar Institute of Medical Sciences, Bellary, Karnataka, India. This institute is a referral government hospital in north Karnataka, India. Study Design: This was a prospective and descriptive type of study. Results: A total of 246 cases of venomous snakebite were included in this study, who were admitted in the hospital from November 2007 to October 2008. Among the AKI and the non-AKI patients, Illiteracy was more among the patients who suffered from AKI (75%). In our study, among all the patients (both AKI and non-AKI patients), viper bite was the commonest and it was seen in 31(91.6%) cases among the AKI patients and in 142 (67.6%) cases among the non-AKI patients. In our study, a majority of the patients who developed AKI had initially visited traditional healers before visiting our hospital, which was found to be statistically significant. In the present study, disseminated intravascular coagulation (DIC) and intravascular haemolysis were found to be predominant among the AKI patients. The Bite to Needle time was significantly more in the patients who developed AKI as compared to that in those who developed non-AKI. Out of 36 patients who suffered from AKI, 28 (77.7%) patients survived. Among them, 27(96.7%) patients developed cellulitis, 25(89.5%) had regional lymphadenopathy, 22(81.2%) were bitten at their lower limbs, and 6 (23.8%) patients developed bleeding manifestations. Conclusion: This study concludes that acute kidney injury occurs in 14.6% of the victims of snake bite. The common manifestations include cellulitis, bleeding manifestations and gangrene at the site of the bite. PMID:23814727

L, Harshavardhan; A J, Lokesh; H L, Tejeshwari; B R, Halesha; Metri, Siddharama S

2013-01-01

296

Group G Beta-Hemolytic Streptococcal Bacteremia Characterized by 16S Ribosomal RNA Gene Sequencing  

PubMed Central

Little is known about the relative importance of the four species of Lancefield group G beta-hemolytic streptococci in causing bacteremia and the factors that determine the outcome for patients with group G beta-hemolytic streptococcal bacteremia. From 1997 to 2000, 75 group G beta-hemolytic streptococcal strains were isolated from the blood cultures of 66 patients. Sequencing of the 16S rRNA genes of the group G beta-hemolytic streptococci showed that all 75 isolates were Streptococcus dysgalactiae subspecies equisimilis. The API system (20 STREP) and Vitek system (GPI) successfully identified 65 (98.5%) and 62 (93.9%) isolates, respectively, as S. dysgalactiae subspecies equisimilis with >95% confidence, whereas the ATB Expression system (ID32 STREP) only successfully identified 49 isolates (74.2%) as S. dysgalactiae subspecies equisimilis with >95% confidence. The median age of the patients was 76 years (range, 33 to 99 years). Fifty-six patients (85%) were over 60 years old. All patients had underlying diseases. No source of the bacteremia was identified (primary bacteremia) in 34 patients (52%), whereas 17 (26%) had cellulitis and 8 (12%) had bed sore or wound infections. Fifty-eight patients (88%) had community-acquired group G streptococcal bacteremia. Sixty-two patients (94%) had group G Streptococcus recovered in one blood culture, whereas 4 patients (6%) had it recovered in multiple blood cultures. Fifty-nine patients (89%) had group G Streptococcus as the only bacterium recovered in their blood cultures, whereas in 7 patients other bacteria were recovered concomitantly with the group G Streptococcus in the blood cultures (Staphylococcus aureus in 3, Clostridium perfringens in 2, Citrobacter freundii in 1, and Bacteroides fragilis in 1). Overall, 10 patients (15%) died. Male sex, diagnosis other than cellulitis, hospital-acquired bacteremia, and multiple positive blood cultures were associated with mortality {P < 0.005 (relative risk [RR] = 7.6), P < 0.05 (RR = 3.7), P < 0.005 (RR = 5.6), and P < 0.05 (RR = 5.6), respectively}. Unlike group C beta-hemolytic streptococcal bacteremia, group G beta-hemolytic streptococcal bacteremia is not a zoonotic infection in Hong Kong. PMID:11526143

Woo, Patrick C. Y.; Fung, Ami M. Y.; Lau, Susanna K. P.; Wong, Samson S. Y.; Yuen, Kwok-Yung

2001-01-01

297

Recent incarceration linked to cutaneous injection-related infections among active injection drug users in a Canadian setting.  

PubMed

Cutaneous injection-related infections (CIRI), such as abscesses and cellulitis, are the cause of a substantial burden of morbidity and mortality among injection drug users (IDU). The possible contribution of exposure to correctional environments to CIRI risk has not been fully investigated. Thus, we sought to test the possible relationship between incarceration and CIRI using data from a community-based sample of IDU. Data for these analyses was from the Scientific Evaluation of Supervised Injecting (SEOSI) cohort, linked with administrative records of a local ED in Vancouver, Canada. Using longitudinal analysis we assessed the relationship between the number of ED visits for CIRI care and recent incarceration in a multivariate model including information on possible confounders. Between June 2004 and December 2006, 901 individuals were eligible for our analysis. Of these, 214 (9.6%) visited the ED for CIRI care at least once during the study period. The incidence of ED care for CIRI was 72.9 per 100 person years. In a multivariate model, recent incarceration was associated with a greater number of ED visits for CIRI care (adjusted relative rate = 1.56, 95% confidence interval: 1.31-1.85, P < 0.001). The need for ED treatment for CIRI was common among a sample of local IDU. Exposure to correctional environments was an independent risk factor for visiting the ED for CIRI care, suggesting improvements in infection control in local prisons is urgently needed. PMID:20364303

Milloy, M-J; Wood, Evan; Lloyd-Smith, Elisa; Grafstein, Eric; Tyndall, Mark; Montaner, Julio; Kerr, Thomas

2010-12-01

298

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 5419 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

299

Methicillin Resistant Staphylococcus Aureus Infection as a causative agent of fistula formation following total laryngectomy for advanced head & neck cancer  

PubMed Central

Aims The purpose of this paper was to investigate the impact of Methicillin Resistant Staphylococcus Aureus (MRSA) infection in the aetiology of pharyngo-cutaneous fistula (PCF) formation following total laryngectomy for advanced laryngeal cancer. Methods This was a retrospective uncontrolled case study series of 31 consecutive patients based in a single institution tertiary referral head and neck oncology centre. Results Pharyngo-cutaneous fistulas (PCF) following total laryngectomy occurred in 10 (32%) patients. MRSA was identified in 80% of patients with a PCF compared to 9% of patients that did not develop a fistula (p = 0.0001255 Fisher exact test). MRSA infection (p = 0.00012) and previous radiotherapy (p = 0.00025) were the only significant factors found to be important in fistula formation on multivariate analysis. Post-operative infections such as cellulitis, chest infection and carotid fistula were also associated with MRSA infections. Conclusion MRSA infection following total laryngectomy for laryngeal cancer can lead to potential serious complications such as PCF. Patients who underwent total laryngectomy following radiotherapy failure are at a higher risk of acquiring MRSA. PMID:20584326

2010-01-01

300

Bacterial colonization of laryngectomy stomas.  

PubMed

Infections with organisms resistant to conventional antibiotics are of increasing concern. This observational study investigates the bacterial colonization of the peristomal area of laryngectomy patients. Thirty-two consecutive patients who had previously undergone laryngectomy were recruited from the Head and Neck Clinic of a teaching hospital. Swabs were taken from the laryngectomy stoma site, the mouth and both nasal cavities. Microbiological culture and isolation were performed following standard procedures. Despite no clinical sign of infection, 27 patients were found to be carriers of one or more organism (84.4 per cent). Staphylococcus aureus was detected in the peristomal area of 15 patients (46.9 per cent). Methicillin-resistant Staphylococcus aureus (MRSA) was isolated in seven (21.9 per cent) cases. In this series the authors found a high incidence of colonization with potentially pathogenic bacteria in laryngectomy stomas with no clinical signs of infection. In a significant number of patients, Gram positive organisms were identified that could potentially cause cellulitis or wound infections. PMID:15509369

Wild, D C; Mehta, D; Conboy, P J

2004-09-01

301

Multiple skin ulcers due to Serratia marcescens in a immunocompetent patient.  

PubMed

Serratia marcescens is a species of gram negative bacillus, classified as a member of the Enterobacteriaceae, mainly involved in opportunistic infections, particulary in the hospital environment. Cutaneous infections have rarely reported in literature and are predominantly observed in elderly or in immunocompromised patients. The clinical manifestations of skin infections include granulomatous lesions, necrotizing fasciitis, nodules, cellulitis, ulcers, dermal abscesses. Infections caused by S. marcescens may be difficult to treat because of resistance to a variety of antibiotics, including ampicillin and first and second generation cephalosporins. Aminoglycosides have good activity against S. marcescens, but resistant strains have also been described. We report a very intriguing case of S. marcescens infection, in an immunocompetent 18-year-old man, causing multiple rounded ulcers of varying sizes, along with few pustular lesions that both clinically and histopathologically mimic a pyoderma gangrenosum (PG). This is a non infectious neutrophilic skin disorder, characterized by painful and rapidly progressing skin ulceration. According to our experience, we would strongly recommend to perform cultures of multiple skin ulcers resembling PG, even in young healthy patients, to ensure correct diagnosis and treatment, since resistant to conventional antibiotics bacteria such as S. marcescens may be the cause of these lesions, like in the case here reported. PMID:24819766

Carlesimo, M; Pennica, A; Muscianese, M; Bottoni, U; Abruzzese, C; Giubettini, M; Pranteda, G; Pranteda, G

2014-06-01

302

A case of Helicobacter cinaedi bacteremia in an asplenic patient.  

PubMed

Helicobacter cinaedi is an enterohepatic species. It can cause bacteremia, gastroenteritis, and cellulitis, particularly in immunocompromised individuals, such as those with acquired immunodeficiency syndrome, malignancy, or alcoholism. There are no previous reports of H. cinaedi infection in Korea. A 71-yr-old man was admitted to the emergency room because of dyspnea on November 9, 2011. He had undergone splenectomy 3 yr ago because of immune hemolytic anemia. Chest plain radiography revealed bilateral pleural effusion. He developed fever on hospital day (HD) 21. Three sets of blood cultures were taken, and gram-negative spiral bacilli were detected in all aerobic vials. The isolate grew in tiny colonies on chocolate agar after 3-day incubation under microaerophilic conditions. This organism tested positive for catalase and oxidase, and negative for urease. The 16S rRNA gene sequence of this isolate exhibited 99.8% homology with the published sequence of H. cinaedi CCUG 18818(T) (GenBank accession no. ABQT01000054) and 98.5% homology with the sequence of Helicobacter bilis Hb1(T) (GenBank accession no. U18766). The patient was empirically treated with piperacillin/tazobactam and levofloxacin, and discharged with improvement on HD 31. To our knowledge, this is the first report of H. cinaedi bacteremia in an asplenic patient. Asplenia appears to be a risk factor for H. cinaedi bacteremia. PMID:23130344

Kim, Soo-Kyung; Cho, Eun-Jung; Sung, Heungsup; An, Dongheui; Park, Sook-Ja; Kim, Mi-Na; Nam, Gi-Byoung

2012-11-01

303

Invasive infections due to Streptococcus pyogenes: seasonal variation of severity and clinical characteristics, Iceland, 1975 to 2012.  

PubMed

Epidemiology and clinical characteristics of invasive Group A streptococcal infections (IGASI) are highly variable. Long-term studies are needed to understand the interplay between epidemiology and virulence. In a population-based study of IGASI in Iceland from 1975 to 2012, 288 cases were identified by positive cultures from normally sterile body sites. Charts were reviewed retrospectively and emm-types of viable Streptococcus pyogenes isolates (n=226) determined. Comparing the first and last decade of the study period, IGASI incidence increased from 1.09 to 3.96 cases per 100,000 inhabitants per year. The most common were emm types 1 (25%), 28 (11%) and 89 (11%); emm1 strains were most likely to cause severe infections. Infections in adults were significantly more likely to be severe during the seasonal peak from January to April (risk ratio: 2.36, 95% confidence interval: 1.344.15). Significant seasonal variability in severity was noted among patients with diagnosis of sepsis, respiratory infection and cellulitis, with 38% of severe infections in January to April compared with 16% in other months (p<0.01). A seasonal increase in severity of IGASI suggested that generalised seasonal increase in host susceptibility, rather than introduction of more virulent strains may play a role in the pathogenesis of these potentially fatal infections. PMID:24821122

Olafsdottir, L B; Erlendsdttir, H; Melo-Cristino, J; Weinberger, D M; Ramirez, M; Kristinsson, K G; Gottfredsson, M

2014-01-01

304

Advances in vaccination against avian pathogenic Escherichia coli respiratory disease: potentials and limitations.  

PubMed

Avian pathogenic Escherichia coli (APEC) is one of the most economically devastating pathogens affecting the poultry industry. This group of extra-intestinal E. coli causes a variety of clinical conditions including airsacculitis and cellulitis. The economic impact of APEC is mainly due to mortality, slower growth rates, and carcass downgrading. In commercial broiler operations, APEC infections are controlled indirectly by vaccination against other respiratory diseases and minimizing stress conditions, and directly by administration of antimicrobial agents to suppress the infection in already infected flocks. The fact that most APEC strains possess some common virulence factors suggests that an effective vaccine against APEC is a viable option. The most important virulence factors that have been investigated over the years include type I and P fimbriae, aerobactin iron-acquisition system, and serum resistance traits. Despite the potential for developing an efficacious vaccine to combat this economically important poultry disease, several obstacles hinder such efforts. Those obstacles include the cost, vaccine delivery method and timing of vaccination as the birds should be immune to APEC by 21 days of age. Herein, we review the various attempts to develop an effective vaccine against the respiratory form of APEC diseases in poultry. We also discuss in-depth the potentials and limitations of such vaccines. PMID:24878325

Ghunaim, Haitham; Abu-Madi, Marwan Abdelhamid; Kariyawasam, Subhashinie

2014-08-01

305

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

306

The global burden of skin disease in 2010: an analysis of the prevalence and impact of skin conditions.  

PubMed

The Global Burden of Disease (GBD) Study 2010 estimated the GBD attributable to 15 categories of skin disease from 1990 to 2010 for 187 countries. For each of the following diseases, we performed systematic literature reviews and analyzed resulting data: eczema, psoriasis, acne vulgaris, pruritus, alopecia areata, decubitus ulcer, urticaria, scabies, fungal skin diseases, impetigo, abscess, and other bacterial skin diseases, cellulitis, viral warts, molluscum contagiosum, and non-melanoma skin cancer. We used disability estimates to determine nonfatal burden. Three skin conditions, fungal skin diseases, other skin and subcutaneous diseases, and acne were in the top 10 most prevalent diseases worldwide in 2010, and eight fell into the top 50; these additional five skin problems were pruritus, eczema, impetigo, scabies, and molluscum contagiosum. Collectively, skin conditions ranged from the 2nd to 11th leading cause of years lived with disability at the country level. At the global level, skin conditions were the fourth leading cause of nonfatal disease burden. Using more data than has been used previously, the burden due to these diseases is enormous in both high- and low-income countries. These results argue strongly to include skin disease prevention and treatment in future global health strategies as a matter of urgency. PMID:24166134

Hay, Roderick J; Johns, Nicole E; Williams, Hywel C; Bolliger, Ian W; Dellavalle, Robert P; Margolis, David J; Marks, Robin; Naldi, Luigi; Weinstock, Martin A; Wulf, Sarah K; Michaud, Catherine; J L Murray, Christopher; Naghavi, Mohsen

2014-06-01

307

Infected facial tissue fillers: case series and review of the literature.  

PubMed

Since 2007, 21 female and 1 male patient aged 25 to 55 years, who either did not have any obvious causative infection source or, despite the presence of nonvital teeth, did not display typical symptoms of odontogenic infection, were treated for acute facial inflammation. All these patients admitted previous application of injectable soft tissue fillers (ISTFs) performed in either private plastic surgery and dermatology practices or cosmetic salons. The period between injection and infection varied from 1 week to 6 years. The injected substance remained unknown in many cases. Of the 22 patients, 3 were diagnosed with facial cellulitis, 4 with periorbital abscess, and 15 with a buccal space abscess. ISTFs provide an attractive option in facial rejuvenation. With their increasing use, the prevalence of complications is also expected to increase. Infectious complications of ISTFs were previously unknown in Kuwait. Although these products are primarily meant for treatment of the aging face, the age pattern of our patients suggests their frequent misuse and spurious indications. Especially worrisome is the recently observed application of fillers in cosmetic salons. We believe that the use of ISTFs should be regulated and their administration in nonmedical facilities prohibited. Patients with an atypical course of facial inflammation should be questioned about a history of cosmetic procedures. PMID:22342250

Schtz, Petr; Ibrahim, Hussein Hassan Hamed; Hussain, Sabreyah Saleh; Ali, Tamer Sabry; El-Bassuoni, Khalid; Thomas, John

2012-10-01

308

Post-operative constrictive pericarditis complicated with lymphocytopenia and hypoglobulinemia.  

PubMed

A 71-year-old man who had a history of open chest surgery was admitted due to anasarca and bilateral pleural effusions. Although imaging modalities could not demonstrate any pericardial abnormalities, right-sided cardiac catheterization revealed 'dip and plateau' in diastolic pressure waveform. He was admitted frequently because of the episodic right-sided congestive heart failure and hypoproteinemia due to protein-losing enteropathy. The peripheral lymphocyte count and serum gamma-globulin concentration were gradually decreased, and finally showed lymphocytopenia and hypoglobulinemia. On the last admission, the patient showed extensive cellulitis on both legs, and he developed septicemia, and finally died due to septic shock. Post-mortem examination showed that both visceral and parietal layers of the pericardium adhered tightly with mediastinal fibrosis. This case report suggested that constrictive pericarditis should be considered even if there is a lack of typical abnormal pericardial imaging findings when patients have a history of open chest surgery and recurrent right-sided congestive heart failure. In addition, we should be aware of a serious outcome due to immune compromised conditions such as lymphocytopenia and dysglobulinemia in this disorder. PMID:15497516

Ohsawa, Masaki; Nakamura, Motoyuki; Pan, Li-hua; Shizuka, Takehito; Nakagawa, Jun-ichi; Ishida, Hirobumi; Ouchi, Mami; Shiroto, Takahiro; Hotta, Kazuhiko; Sawai, Takashi; Hiramori, Katsuhiko

2004-09-01

309

Diagnostic patterns in hospital use by an urban homeless population.  

PubMed Central

Because patterns of disease and health care system usage by the homeless constitute a neglected area of research in the medical literature, we undertook a retrospective analysis of inpatient records on medically indigent adults, controlling for housing status, to add to the growing body of research in the area of homeless health care. Data on all 4,243 indigent patients admitted over 2 fiscal years (1985 and 1986) under the county medical services program of San Diego County, California, revealed 5.3% (226) to be homeless. The commonest major diagnostic category among the homeless discharges was "diseases and disorders of the skin, subcutaneous tissue, and breast," constituting 21.2% as compared with only 8.7% of the discharge diagnoses for housed indigent persons. Within this major diagnostic category, the predominant diagnosis-related group was cellulitis, accounting for 12.8% of diagnoses in the homeless and only 4.0% of discharge diagnoses in other medically indigent persons. A homeless housing status was also correlated with a higher percentage of discharges with the major diagnostic category of "substance use and substance-induced organic mental disorders" but was negatively correlated with that of "diseases and disorders of the circulatory system." PMID:2588589

Morris, W; Crystal, S

1989-01-01

310

Reconstruction of syndactyly and polysyndactyly of the toes with a dorsal pentagonal island flap: a technique that allows primary skin closure without the use of skin grafting.  

PubMed

Syndactyly and polysyndactyly are common congenital conditions involving the foot, and surgery to reconstruct the toes may be indicated for cosmetic, psychological, and practical reasons. A dorsal flap is traditionally used for web space reconstruction, with skin grafts for the bases of the toes. Skin grafting has associated morbidity and can result in pigmentation mismatch. Single-stage direct closure with a specially designed flap has advantages including a reduction of morbidity from avoidance of skin grafting and shorter surgery. Four patients (6 feet) were included in the study. There were 2 cases of syndactyly and 2 cases of polysyndactyly. Bilateral involvement occurred in 2 patients. The average age was 18 months at time of first surgery. Direct closure was achieved with a dorsal pentagonal island flap with dorsal and plantar triangular flaps. The average duration of follow-up was 19.8 months. At final follow-up, all patients had acceptable web depth and pulp contour. The distance between the proximal interphalangeal joints of adjacent toes and the web slope of the reconstructed web space were acceptable. Complications included partial synechiae, cellulitis, and keloid formation. The dorsal pentagonal island flap is an acceptable technique in providing another means for single-stage reconstruction of the web space in syndactyly and polysyndactyly. Good functional and cosmetic outcomes can be expected. However, the potential complication of keloid formation can affect cosmesis and overall outcome, and must be understood by patients and parents. PMID:17331867

Lim, Yi-Jia; Teoh, Lam Chuan; Lee, Eng Hin

2007-01-01

311

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

312

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

313

Acute infection of a total knee arthroplasty caused by Pasteurella multocida: a case report and a comprehensive review of the literature in the last 10 years.  

PubMed

Total knee arthroplasty (TKA) infection are most commonly due Staphylococcus aureus followed by coagulase-negative staphylococci, and streptococci, while gram-negative rods are seldom isolated.(1,3,4) In the last 20 years, cases of Pasteurella multocida TKA and total hip arthroplasty (THA) infection resulting from cat and dog bites, scratches, or licks have been published reporting varying presentations and treatment options. Most commonly, P. multocida infected arthroplasties result in local tenderness, cellulitis, and purulent discharge followed by regional adenopathy, and in immunocompromised patients it may progress to septicemia, meningitis, and septic arthritis.(5) Treatment antibiotics include penicillins or 2nd and 3rd generation cephalosporins, and surgical options involve one-stage, or two-stage revision arthroplasties.(6,9,17,19) We report a case of P. multocida TKA infection in a patient who was treated successfully with a 3rd generation cephalosporin, synovectomy and tibial interspacer exchange, along with a review of the literature published in the last 10 years. Our findings show that there is usually a history of exposure to the animal, early appearance of cat bite related infections, and multifactorial decision making for the treatment of P. multocida joint infections. PMID:20116315

Heydemann, John; Heydemann, Jacob S; Antony, Suresh

2010-09-01

314

Which Dermatological Conditions Present to an Emergency Department in Australia?  

PubMed Central

Background/Objectives. There is minimal data available on the types of dermatological conditions which present to tertiary emergency departments (ED). We analysed demographic and clinical features of dermatological presentations to an Australian adult ED. Methods. The St. Vincent's Hospital Melbourne (SVHM) ED database was searched for dermatological presentations between 1 January 2009 and 31 December 2011 by keywords and ICD-10 diagnosis codes. The lists were merged, and the ICD-10 codes were grouped into 55 categories for analysis. Demographic and clinical data for these presentations were then analysed. Results. 123?345 people presented to SVHM ED during the 3-year period. 4817 (3.9%) presented for a primarily dermatological complaint. The most common conditions by ICD-10 diagnosis code were cellulitis (n = 1741, 36.1%), allergy with skin involvement (n = 939, 19.5%), boils/furuncles/pilonidal sinuses (n = 526, 11.1%), eczema/dermatitis (n = 274, 5.7%), and varicella zoster infection (n = 161, 3.3%). Conclusion. The burden of dermatological disease presenting to ED is small but not insignificant. This information may assist in designing dermatological curricula for hospital clinicians and specialty training organisations as well as informing the allocation of dermatological resources to ED. PMID:24800080

Weiland, Tracey J.; Chong, Alvin H.; Jelinek, George A.

2014-01-01

315

The Role of Colour Doppler Ultrasonography in the Diagnosis of Fascial Space Infections - A Cross Sectional Study  

PubMed Central

Aims and Objectives: (1) To evaluate the role of ultrasonography with colour Doppler in the diagnosis of fascial space infections, (2) To determine the nature, size and extent of the odontogenic infections which involve the primary and secondary fascial spaces of the maxilla and the mandible (3) To evaluate the sensitivity of ultrasonography in determining whether the inflammatory process is in a stage of cellulitis or abscess and to thus determine the appropriate time for a surgical intervention during the course of the infection and to correlate the clinical and radiographic findings with the ultrasonographic findings and (4) to determine the treatment plan. Methodology: Thirty four patients with odontogenic infections which involved the superficial and the deep fascial spaces of the head and neck were subjected to ultrasonographic examinations over the suspected area in the transverse and axial directions to determine the stage of the infection, its anatomic location and the treatment plan. Results: Ultrasonography showed 95.7% sensitivity and 100% specificity as compared to the clinical and radiographic diagnoses and it proved to be an effective investigation modality in the diagnosis of fascial space infections. PMID:23814756

Nisha V., Aarthi; J., Parthiban; N., Santana; A.G, Giridhar; Devi B.K., Yashoda; Reddy S., Sujatha; N., Rakesh

2013-01-01

316

Keratitis with Kocuria palustris and Rothia mucilaginosa in Vitamin A Deficiency  

PubMed Central

Purpose To present a case of unusual corneal infection early in the course of peripheral ulcerative keratitis in a patient with severe vitamin A deficiency. Method Single observational case report in urban USA. Case Presentation An alcoholic patient with pancreatitis, chronic diarrhea, and vitamin A deficiency presented with a marginal corneal ulcer from which two bacteria of the family Micrococcaceae were cultured and identified by genome sequence analysis, namely Kocuria palustris and Rothia mucilaginosa. Soon after, severe bilateral peripheral ulcerative keratitis developed, later accompanied by eyelid cellulitis of one lid. These conditions improved with antibiotics, treatment of the underlying gastrointestinal conditions, and treatment of the vitamin deficiency. Conclusion Susceptibility to keratitis with unusual bacteria of the Micrococcaceae family can occur in the setting of alcoholism-related gastrointestinal disease with severe vitamin A deficiency. To our knowledge, K. palustris is a species not previously identified in any human disease, and the Kocuria genus has not previously been reported as a participant in eye infection. Documented cases of R. mucilaginosa in ocular disease are rare. These unusual infections heralded the onset of severe marginal corneal melts. PMID:24707276

Mattern, R.M.; Ding, Jiaxi

2014-01-01

317

Magnetic Resonance Imaging of Diabetic Muscle Infarction: Report of Two Cases  

PubMed Central

Diabetic muscle infarction (DMI) occurs as a rare complication of long standing or severe diabetes mellitus. The condition usually occurs spontaneously and patients usually present with acute pain and swelling of affected muscles which persists for weeks, and resolves spontaneously without intervention. Magnetic resonance (MR) imaging is the modality of choice in patients with suspected DMI based on appropriate clinical setting and plays a major role in the diagnosis, assessing the extent of involvement and differentiating DMI from other conditions. The DMI affected muscles are bulky and appear heterogeneous with hyperintense signals on T2-weighted and STIR sequences, hypo or isointense on T1-weighted images with loss of normal fatty intramuscular septae. Subcutaneous and perifascial edema can be present. On postgadolinium scans, there is diffuse heterogeneous enhancement with non-enhancing foci, which may represent areas of necrosis. Biopsy can be avoided as MR findings are highly sensitive and specific. Treatment is usually conservative. Surgical intervention is required only in patients who do not respond to conservative management. The common differential diagnosis includes cellulitis, abscess, necrotizing fasciitis and polymyositis. We present two cases below to highlight the clinical, MR imaging findings and differential diagnosis of DMI. PMID:25328463

Jawahar, Anugayathri; Balaji, Ravikanth

2014-01-01

318

Comparison of VITEK2, MALDI-TOF MS, and 16S rDNA sequencing for identification of Myroides odoratus and Myroides odoratimimus.  

PubMed

The genus Myroides comprises the 2 medically relevant species Myroides odoratus and Myroides odoratimimus that are rare opportunistic pathogens and cause infections in immunocompromised patients. A fast identification of Myroides is of importance because these bacterial strains show multiple resistance against antibiotics and therefore limit treatment options. They are associated, for instance, with urinary tract infections, sepsis, meningitis, pneumonia, and infectious cellulitis. Since more and more Myroides spp. are being described, additional potentially pathogenic bacteria may be identified in the future demanding the need for fast and reliable identification methods at species level. However, to date, only molecular approaches meet these demands. In this study, we, therefore, attempt to define an appropriate method other than DNA fingerprinting that will permit a comparable efficacy and, possibly, a more economical strain identification. For this purpose, we compared 2 widely used automated diagnostic systems (VITEK 2 [bioMrieux, Nrtingen, Germany] and Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS) [Bruker Daltonics, Bremen, Germany]) and correlated the results to 16S rDNA sequencing data. In total, we analyzed 22 strains collected in the course of routine diagnostics. In this study, we demonstrate that VITEK 2 reliably identifies the genus Myroides but cannot differentiate between M. odoratimimus and M. odoratus. In contrast to this, both MALDI-TOF MS and 16S rDNA sequencing efficiently distinguish between the 2 species. PMID:24666701

Schrttner, Percy; Rudolph, Wolfram W; Eing, Bodo R; Bertram, Sebastian; Gunzer, Florian

2014-06-01

319

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

320

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

321

Mthodologie d'approche pour la conception des transistors VDMOS de puissance  

NASA Astrophysics Data System (ADS)

In this paper, a design method for Power MOSFET devices, based on the physical phenomena and electrical properties of the structure, is presented. This method is implemented in a software called Power MOSFET's Designer, which only needs three inputs : the layout (cells, design rules, chip area), the breakdown voltage and the technological family characteristics, to define the SPICE equivalent circuit of the transistor. It is well suited to the simulation of power electronics circuits. Application examples are given. Cette communication prsente une approche de conception de transistor MOS de puissance base sur les proprits physiques et lectriques du dispositif. On propose partir i) de la gomtrie (dimensionnement des cellules, rgles de dessin, taille de puce), ii) de la tenue en tension et iii) du processus technologique, de dterminer a priori les performances lectriques du composant. Cette approche passe par la topologie d'un schma quivalent prouv et aboutit des caractristiques lectriques statiques et en commutation dans des circuits typiques de l'lectronique de puissance. Des exemples d'application sont proposs.

Beydoun, B.; Tranduc, H.; Oms, F.; Peyre Lavigne, A.; Rossel, P.

1994-10-01

322

Contribution la modlisation des convertisseurs statiques pour la simulation topologie variable  

NASA Astrophysics Data System (ADS)

This paper presents a simple and structured method of static converter modelling with variable topology, for the simulation of controlled converter-machine drives. The methodology is based on the notion of switching cells which enables a modular decomposition of converters in structures easy to be studied and henceforth called independent converter legs. These independent legs will be stored in libraries (algorithms or programs, and models) in order to be re-used for the study of other converters. Cet article propose une mthode simple et structure pour la modlisation des convertisseurs statiques par des modles topologie variable, en vue de la simulation d'associations machine-convertisseur-commande compltes. Cette dmarche s'appuie sur la notion de cellule de commutation pour permettre de dgager une dcomposition modulaire du convertisseur en structures lmentaires, faciles tudier, qui seront appeles bras indpendants. Ces derniers sont stocks en bibliothque (sous forme d'algorithme ou programme, et sous forme de modle), pour tre rutiliss dans l'tude d'autres convertisseurs.

Sahraoui, Omar; Gerbaud, Laurent; Normand, Olivier; Roudet, James

1993-06-01

323

Protocol for treatment of diabetic foot ulcers.  

PubMed

Each year, 82,000 limb amputations are performed in patients with diabetes mellitus. The majority of these amputations could be avoided by following strict protocols. The collective experience treating patients with neuropathic diabetic foot ulcers of 4 major diabetic foot programs in the United States and Europe were analyzed. The following protocol has been developed for patients with diabetic foot ulcers: (1) measurement of the wound by planimetry; (2) optimal glucose control; (3) surgical debridement of all hyperkeratotic, infected, and nonviable tissue; (4) systemic antibiotics for deep infection, drainage, and cellulitis; (5) offloading; (6) moist-wound environment; and (7) treatment with growth factors and/or cellular therapy if the wound is not healing after 2 weeks with this protocol and a new epithelial layer is not forming. In addition, the pathogenesis of diabetic foot ulcers is discussed, as well as the associated costs and complications, including amputation. Debridement, wound-bed preparation, antibiotics, various types of dressings, biological therapies, growth factors, and offloading are described as treatment modalities for patients with diabetic foot ulcers. In diabetic foot ulcers, availability of the above modalities, in combination with early recognition and comprehensive treatment, ensure rapid healing and minimize morbidity, mortality, and costs, as well as eliminate amputation in the absence of ischemia and osteomyelitis. PMID:15147985

Brem, Harold; Sheehan, Peter; Boulton, Andrew J M

2004-05-01

324

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

325

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

326

Characterization of transcription within sdr region of Staphylococcus aureus.  

PubMed

Staphylococcus aureus is an opportunistic pathogen responsible for various infections in humans and animals. It causes localized and systemic infections, such as abscesses, impetigo, cellulitis, sepsis, endocarditis, bone infections, and meningitis. S. aureus virulence factors responsible for the initial contact with host cells (MSCRAMMs-microbial surface components recognizing adhesive matrix molecules) include three Sdr proteins. The presence of particular sdr genes is correlated with putative tissue specificity. The transcriptional organization of the sdr region remains unclear. We tested expression of the sdrC, sdrD, or sdrE genes in various in vitro conditions, as well as after contact with human blood. In this work, we present data suggesting a separation of the sdr region into three transcriptional units, based on their differential reactions to the environment. Differential reaction of the sdrD transcript to environmental conditions and blood suggests dissimilar functions of the sdr genes. SdrE has been previously proposed to play role in bone infections, whilst our results can indicate that sdrD plays a role in the interactions between the pathogen and human immune system, serum or specifically reacts to nutrients/other factors present in human blood. PMID:20571861

Sitkiewicz, Izabela; Babiak, Ireneusz; Hryniewicz, Waleria

2011-02-01

327

Ventral hernia repair with simultaneous panniculectomy.  

PubMed

The repair of a ventral hernia in an obese patient presents an interesting clinical challenge. We retrospectively reviewed the charts of 55 patients who, over a 12-year period from 1983 to 1995, concomitantly underwent both ventral herniorrhaphy and panniculectomy or abdominoplasty. In six of 55 patients, the hernia was recurrent. Forty-six patients had primary abdominal wall hernias or diastasis recti. Nineteen of 55 patients had weight greater than 200 lbs. This last subset of patients had a significantly higher incidence of complications, such as seroma, cellulitis, and persistent wound drainage. In our 55 patients, we experienced only two hernia recurrences (3.6%) during an average patient follow-up of 53 weeks. From this experience, we believe that simultaneous ventral hernia repair and panniculectomy is a safe and efficacious approach to these two problems so commonly found in the obese patient. Patients with a preoperative weight greater than 200 lbs can be expected to have a greater risk of wound complications. In all cases, the wounds eventually healed with no long-term sequelae. PMID:8712568

Hughes, K C; Weider, L; Fischer, J; Hopkins, J; Antonetti, A; Manders, E K; Dunn, E

1996-08-01

328

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

329

[Infected pressure ulcers: evaluation and management].  

PubMed

Pressure ulcers in elderly individuals can cause significant morbidity and mortality and are a major economic burden to the health care system. Prevention should be the ultimate objective of pressure ulcer care, and it requires an understanding of the pathophysiology leading to pressure ulcers and the means of reducing both intrinsic and extrinsic risk factors. Clinical examination often underestimates the degree of deep-tissue involvement, and its findings are inadequate for the detection of associated osteomyelitis. Microbiological data, if obtained from deep-tissue biopsy, are useful for directing antimicrobial therapy, but they are insufficient as the sole criterion for the diagnosis of infection. Imaging studies, such as computed tomography and magnetic resonance imaging, are useful, but bone biopsy and histopathological evaluation remain the "gold standard" for the detection of osteomyelitis. The goals of treatment of pressure ulcers should be resolution of infection and promotion of wound healing. A combination of surgical debridement and medical interventions may be required. Systemic antimicrobial therapy should be used for patients with serious pressure ulcers infections, including those with spreading cellulitis, bacteremia or osteomyelitis. PMID:20428024

Iori, Ido; Pizzini, Attilia Maria; Arioli, Dimitriy; Favali, Davide; Leone, Maria Cristina

2009-09-01

330

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

331

Diagnosis and successful treatment of fusariosis in the compromised host.  

PubMed

We present six cases of fusariosis caused by Fusarium solani that were diagnosed over a three-year period in 166 adult patients undergoing chemotherapy for acute leukemia. Necrotic skin lesions were evident in four patients, fungemia in three, and a deep cellulitis around a great toe nail at the time of a febrile illness in two. The mean minimal inhibitory concentration (MIC) of amphotericin B was 3.3 micrograms/mL and of miconazole, 5.3 micrograms/mL; all isolates were resistant to 5-fluorocytosine. All patients received amphotericin B (1.0-1.5 mg/kg per d) plus 5-fluorocytosine. In contrast to results found in the literature, five patients had resolution of their infections, and the one patient who died had necropsy evidence of disseminated fusariosis. Review of our cases and of the literature did not reveal a definitive source for the organism or its portal of entry. Fusarium spp. must be recognized as opportunistic pathogens that cause a potentially fatal infection in compromised patients. PMID:3053920

Merz, W G; Karp, J E; Hoagland, M; Jett-Goheen, M; Junkins, J M; Hood, A F

1988-11-01

332

Dtermination de la pression de vapeur de HgCl_2 par la mthode d'effusion de Knudsen  

NASA Astrophysics Data System (ADS)

The mercuric chloride (HgCl2) vapor pressure was measured between 343 and 454 K by the Knudsen cell method at relatively high pressures where the flow rate is not purely molecular. Four cells with different orifice sizes were used. Knudsen equation cannot explain accurately the experimental mass loss by using molecular plus hydrodynamical equations. Calculations from our measurements were performed taking into account of an effective radius for our orifices, and this radius depends on the relative weight of the two contributions. We compare our results with those existing in literature. La pression de vapeur du chlorure mercurique (HgCl2) a t mesure entre 343 et 454 K par la mthode d'effusion de Knudsen pour des pressions relativement leves o le rgime d'effusion n'est pas purement molculaire. Quatre cellules avec des orifices de diffrentes dimensions ont t utilises. La somme des termes d'effusion molculaire et hydrodynamique de l'quation de Knudsen ne permet pas de rendre compte, de faon prcise, des pertes de masse exprimentales. Nous avons exploit nos mesures en attribuant nos orifices un rayon effectif dpendant du poids relatif des deux termes. Nos rsultats sont compars ceux existant dans la littrature.

Bernard, L.; Awitor, K. O.; Badaud, J. P.; Bonnin, O.; Coupat, B.; Fournier, J. P.; Verdier, P.

1997-02-01

333

Socioeconomic profile of diabetic patients with and without foot problems  

PubMed Central

Introduction To identify the differences in a socioeconomic profile between two cohorts of diabetic patients one with diabetic foot problems and another without diabetic foot problems. Materials and methods The cohort with diabetic foot problems (including cellulitis, abscess, osteomyelitis, septic arthritis, gangrene, ulcers, or Charcot joint disease) consisted of 122 diabetic patients, while the other cohort without foot problems consisted of 112 diabetic patients. Both were seen at the National University Hospital from January to April 2007. A detailed protocol was designed and the factors studied included patient profile, average monthly household income, education, compliance to diabetic medication, attendance at clinics for diabetic treatment, exercise, smoking, alcohol consumption, gender, and glycosylated haemoglobin (HbA1C) level. These were studied for significant differences using univariate and stepwise multivariate logistic regression analysis. Results With multivariate analysis, Malay ethnicity (p<0.001), education of up to secondary school only (p=0.021), low average monthly household income of less than SGD $2,000 (p=0.030), lack of exercise (at least once a week, p=0.04), and elevated HbA1C level (>7.0%; p=0.015) were found to be significantly higher in the cohort with diabetic foot problems than the cohort without. Conclusions There are significant differences in the socioeconomic factors between diabetic patients with diabetic foot problems and those without. PMID:22396814

Nather, Aziz; Siok Bee, Chionh; Keng Lin, Wong; Qi Odelia, Koh Si; Yiong Huak, Chan; Xinyi, Li; Nambiar, Ajay

2010-01-01

334

Bortezomib for refractory autoimmunity in pediatrics.  

PubMed

Therapy of refractory autoimmunity remains challenging. In this study, we evaluated the therapeutic effect of bortezomib, a proteasome inhibitor, by targeting plasma cells in 7 patients (median age, 9.9 years). Four doses of bortezomib were administered at a dose of 1.3 mg/m(2) intravenously (n= 6) or subcutaneously (n= 1) every 72 hours. Bortezomib was administered at a median of 120 days from laboratory confirmation of autoantibodies. All patients had failed 2 or more standard therapies. Rituximab was administered on the first day if B cells were present, and all patients received plasmapheresis 2 hours before bortezomib administration. Six patients experienced resolution of cytopenias. Two of 6 patients experienced recurrence of cytopenias after initial response. Adverse effects include nausea (n= 1), thrombocytopenia (n= 2), Clostridium difficile colitis (n= 1)), febrile neutropenia (n= 1), and cellulitis at the subcutaneous injection site (n= 1). Our experience suggests that bortezomib may be beneficial in the treatment of refractory autoimmunity in children. PMID:24979732

Khandelwal, Pooja; Davies, Stella M; Grimley, Michael S; Jordan, Michael B; Curtis, Brian R; Jodele, Sonata; Marsh, Rebecca; Filipovich, Alexandra J

2014-10-01

335

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

336

[AIDS prevention by a youth association in Ivory Coast: impact, successes and disappointments].  

PubMed

Over the last few years, the number of associations involved in AIDS prevention has dramatically increased in Ivory Coast, especially in Abidjan. This article describes an experiment in the prevention of AIDS and STDs among young people in Abidjan by means of peer education. It follows the management and progress of a youth organization for AIDS prevention, CESAM (Cellule Scolaire Anti-SIDA et MST), the School-based Anti-AIDS and STD Unit. Critical review of the activities of this association identifies a number of methodological, planning, human and material problems, which have received little attention in the past. CESAM is one of the first anti-AIDS associations in Ivory Coast to target young people and to have young members. This may be the reason for some of its successes and some of its failures and disappointments. The association's successes include the provision of information to more than 25,000 people between 1992 and 1996, and the overall satisfaction of the public and local AIDS institutions. The young people involved have taken on a new social identity, which has developed from the motivation of association members and the personal experiences of some with respect to AIDS, STDs and problems associated with contraception. However, this new identity is threatened by rivalry between members and the search for funding, as the substantial funding obtained in 1994-1995 can show it. PMID:10623875

Deniaud, F; Fampou-Toundji, J C

1999-01-01

337

Fournier's Gangrene: a clinical and bacteriological study.  

PubMed

Bacteriological studies were conducted in patients presenting with Fournier's Gangrene (FG) in our Department during a period of 11 years. These studies showed high numbers of anaerobes (96%) and the ratio of aerobes to anaerobes was reported to be 1.4: 3.2. Among the anaerobes,Peptostreptococci, Bacteroides and Prevotella were more frequently isolated. The predominant facultative aerobic microorganisms were Streptococci and Escherichia coli. Clinical investigation showed necrotic cellulitis and fasciitis of the scrotum due to mixed aerobic-anaerobic infection. Patients with complicated paraproctitis and periurethral abscesses and urinary phlegmones who also presented with symptoms of FG were treated during this same period. Microbiological studies gave similar results and clinical studies showed that the process had spread to the scrotum. The question was then raised whether FG should be diagnosed as an independent nosological entity in cases where the underlying cause of the disease was obscure or if FG should be the result of different pathological processes which occurred within the scrotal surfaces. In other cases, FG is secondary and occurred after reaching the scrotum per continuitatem. PMID:16887589

Fichev, G; Kostov, V; Marina, M; Tzankova, M

1997-01-01

338

Type I Interferon Production Induced by Streptococcus pyogenes-Derived Nucleic Acids Is Required for Host Protection  

PubMed Central

Streptococcus pyogenes is a Gram-positive human pathogen that is recognized by yet unknown pattern recognition receptors (PRRs). Engagement of these receptor molecules during infection with S. pyogenes, a largely extracellular bacterium with limited capacity for intracellular survival, causes innate immune cells to produce inflammatory mediators such as TNF, but also type I interferon (IFN). Here we show that signaling elicited by type I IFNs is required for successful defense of mice against lethal subcutaneous cellulitis caused by S. pyogenes. Type I IFN signaling was accompanied with reduced neutrophil recruitment to the site of infection. Mechanistic analysis revealed that macrophages and conventional dendritic cells (cDCs) employ different signaling pathways leading to IFN-beta production. Macrophages required IRF3, STING, TBK1 and partially MyD88, whereas in cDCs the IFN-beta production was fully dependent on IRF5 and MyD88. Furthermore, IFN-beta production by macrophages was dependent on the endosomal delivery of streptococcal DNA, while in cDCs streptococcal RNA was identified as the IFN-beta inducer. Despite a role of MyD88 in both cell types, the known IFN-inducing TLRs were individually not required for generation of the IFN-beta response. These results demonstrate that the innate immune system employs several strategies to efficiently recognize S. pyogenes, a pathogenic bacterium that succeeded in avoiding recognition by the standard arsenal of TLRs. PMID:21625574

Gratz, Nina; Hartweger, Harald; Matt, Ulrich; Kratochvill, Franz; Janos, Marton; Sigel, Stefanie; Drobits, Barbara; Li, Xiao-Dong; Knapp, Sylvia; Kovarik, Pavel

2011-01-01

339

Type I interferon production induced by Streptococcus pyogenes-derived nucleic acids is required for host protection.  

PubMed

Streptococcus pyogenes is a Gram-positive human pathogen that is recognized by yet unknown pattern recognition receptors (PRRs). Engagement of these receptor molecules during infection with S. pyogenes, a largely extracellular bacterium with limited capacity for intracellular survival, causes innate immune cells to produce inflammatory mediators such as TNF, but also type I interferon (IFN). Here we show that signaling elicited by type I IFNs is required for successful defense of mice against lethal subcutaneous cellulitis caused by S. pyogenes. Type I IFN signaling was accompanied with reduced neutrophil recruitment to the site of infection. Mechanistic analysis revealed that macrophages and conventional dendritic cells (cDCs) employ different signaling pathways leading to IFN-beta production. Macrophages required IRF3, STING, TBK1 and partially MyD88, whereas in cDCs the IFN-beta production was fully dependent on IRF5 and MyD88. Furthermore, IFN-beta production by macrophages was dependent on the endosomal delivery of streptococcal DNA, while in cDCs streptococcal RNA was identified as the IFN-beta inducer. Despite a role of MyD88 in both cell types, the known IFN-inducing TLRs were individually not required for generation of the IFN-beta response. These results demonstrate that the innate immune system employs several strategies to efficiently recognize S. pyogenes, a pathogenic bacterium that succeeded in avoiding recognition by the standard arsenal of TLRs. PMID:21625574

Gratz, Nina; Hartweger, Harald; Matt, Ulrich; Kratochvill, Franz; Janos, Marton; Sigel, Stefanie; Drobits, Barbara; Li, Xiao-Dong; Knapp, Sylvia; Kovarik, Pavel

2011-05-01

340

Seeing is believing: an educational outreach activity on disinfection practices  

PubMed Central

Background Skin and soft-tissue infections are very common among persons who inject drugs. They occur when microbes pass under the protective layer of the skin and proliferate. This happens when harm reduction recommendations such as skin aseptia before injection and sterile injection equipment usage are not properly followed. Methods A group of active drug users involved in a health promotion project as peer educators were asked about their formation needs. To address their inquiries concerning skin and soft-tissue infections, we devised with them a series of workshops touching upon common infections, the microflora, and microbial transmission. Results Participants learned to identify common infections and how to properly react in case of an abscess, cellulitis or phlebitis. They saw microscopic objects, found out about the high prevalence of microbes in their environment and on their skin, and could appreciate the efficiency of different washing and disinfection techniques. They visualized how easily microbes can spread from person to person and from contaminated objects to persons. Conclusion In the weeks following this activity, some participants demonstrated and reported healthy behavioural changes regarding their own injection practices. Furthermore, they shared their newfound knowledge and began enforcing its application among people they inject drugs with. Most participants greatly appreciated this activity and valued it as being highly efficient and tangible. Note: A French version of this paper is available on the Journal's web site [see Additional file 1]. PMID:18269745

Mercure, Sarah-Amelie; Tetu, Isabelle; Lamonde, Steeve; Cote, Francoise

2008-01-01

341

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 vulvarvaginal examination under narcosis reported a right major labium lesion of 5cm 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

342

Collagenolytic (necrobiotic) granulomas: part 1--the "blue" granulomas.  

PubMed

A collagenolytic or necrobiotic non-infectious granuloma is one in which a granulomatous infiltrate develops around a central area of altered collagen and elastic fibers. The altered fibers lose their distinct boundaries and exhibit new staining patterns, becoming either more basophilic or eosinophilic. Within the area of altered collagen, there may be deposition of acellular substances such as mucin (blue) or fibrin (red), or there may be neutrophils with nuclear dust (blue), eosinophils (red), or flame figures (red). These color distinctions can be used as a simple algorithm for the diagnosis of collagenolytic granulomas, i.e. "blue" granulomas vs. "red" granulomas. Eight diagnoses are included within these two groupings, which are discussed in this two-part article. In this first part, the clinical presentation, pathogenesis, and histologic features of the "blue" collagenolytic granulomas are discussed. These are the lesions of granuloma annulare, Wegener's granulomatosis, and rheumatoid vasculitis. In the subsequent half of this two-part series, the "red" collagenolytic granulomas will be discussed; these are the lesions of necrobiosis lipoidica, necrobiotic xanthogranuloma, rheumatoid nodules, Churg-Strauss syndrome, and eosinophilic cellulitis (Well's syndrome). PMID:15059219

Lynch, Jane M; Barrett, Terry L

2004-05-01

343

Collagenolytic (necrobiotic) granulomas: part II--the 'red' granulomas.  

PubMed

A collagenolytic or necrobiotic non-infectious granuloma is one in which a granulomatous infiltrate develops around a central area of altered collagen and elastic fibers. The altered fibers lose their distinct boundaries and exhibit new staining patterns, becoming either more basophilic or eosinophilic. Within the area of altered collagen, there may be deposition of acellular substances such as mucin (blue) or fibrin (red), or there may be neutrophils with nuclear dust (blue), eosinophils (red), or flame figures (red). These color distinctions can be used as a simple algorithm for the diagnosis of collagenolytic granulomas, i.e. 'blue' granulomas vs. 'red' granulomas. Eight diagnoses are included within these two groupings, which are discussed in this two-part article. In the previously published first part, the clinical presentation, pathogenesis and histologic features of the 'blue' collagenolytic granulomas were discussed. These are the lesions of granuloma annulare, Wegener's granulomatosis, and rheumatoid vasculitis. In this second half of the series, the 'red' collagenolytic granulomas are discussed; these are the lesions of necrobiosis lipoidica, necrobiotic xanthogranuloma, rheumatoid nodules, Churg-Strauss syndrome, and eosinophilic cellulitis (Well's Syndrome). PMID:15186429

Lynch, Jane M; Barrett, Terry L

2004-07-01

344

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 Hospitals 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

345

[Surgical therapy for hand infections. Part I].  

PubMed

Due to its function, anatomy, and exposition to multiple pathogens, the hand is highly susceptible to infection. Most of these infections are post-traumatic. Isolates of pathogens from infected hands contain mainly Staphylococcus aureus and beta-hemolytic group A streptococci. We find Pasteurella canis and P. multocida from cat and dog bite wounds and Eikenella corrodens from human bite wounds. The "fight-bite clenched fist" wound, with penetration of the metacarpophalangeal joint and its high risk of septic arthritis, has always to be suspected when patients present with human bites. The therapy of hand infection is based on three principles: surgical treatment, adequate antimicrobial therapy, and early physiotherapy. Early infectious conditions of the hand, e.g. cellulitis and early paronychia, may be treated without surgery. Antimicrobial treatment must be specific for the pathogen and its resistance to antimicrobial agents. Bite wounds should be treated with beta-lactam antibiotics and beta-lactamase inhibitors. Staphylococci and streptococci can be covered by first and second generation cephalosporins. The increasing resistance of staphylococci to antibiotics has to be taken into account. Infections with anaerobic and gas-producing bacteria are rare but occur predominantly in diabetics and immune-compromised individuals. PMID:15928956

Kall, S; Vogt, P M

2005-06-01

346

Cathelicidin LL-37 in severe Streptococcus pyogenes soft tissue infections in humans.  

PubMed

Severe soft tissue infections, such as necrotizing fasciitis and severe cellulitis, caused by group A streptococci (GAS) are rapidly progressing life-threatening infections characterized by massive bacterial loads in the tissue even late after the onset of infection. Antimicrobial peptides are important components of the innate host defense, and cathelicidins have been shown to protect against murine necrotic skin infections caused by GAS. However, it has been demonstrated that the streptococcal cysteine protease SpeB proteolytically inactivates the human cathelicidin LL-37 in vitro. Here we have investigated the expression of LL-37 and its interaction with GAS and SpeB during acute severe soft tissue infections by analyses of patient tissue biopsy specimens. The results showed large amounts of LL-37, both the proform (hCAP18) and the mature peptide, in the tissue. Confocal microscopy identified neutrophils as the main source of the peptide. A distinct colocalization between the bacteria and LL-37 could be noted, and bacterial loads showed positive correlation to the LL-37 levels. Areas with high LL-37 levels coincided with areas with large amounts of SpeB. Confocal microscopy confirmed strong colocalization of GAS, SpeB, and LL-37 at the bacterial surface. Taken together, the findings of this study provide in vivo support of the hypothesis that SpeB-mediated inactivation of LL-37 at the streptococcal surface represents a bacterial resistance mechanism at the infected tissue site in patients with severe GAS tissue infections. PMID:18490458

Johansson, Linda; Thulin, Pontus; Sendi, Parham; Hertzn, Erika; Linder, Adam; Akesson, Per; Low, Donald E; Agerberth, Birgitta; Norrby-Teglund, Anna

2008-08-01

347

Skin mucormycosis presenting as an erythema-nodosum-like rash in a renal transplant recipient: a case report  

PubMed Central

Introduction Cutaneous mucormycosis is a rare entity related to kidney transplantation. It usually presents with ecthyma-like lesions and black necrotic cellulitis. We report an unusual case of primary cutaneous mucormycosis presenting as erythema-nodosum-like lesions in a woman who had received a renal transplant. Case presentation A 49-year-old woman with diabetes received a living-unrelated kidney transplant. Her clinical course was uneventful for the first six months after transplantation. She then developed multiple, painful, erythema-nodosum-like lesions on her right leg and thigh following an episode of minor trauma. Mucormycosis was diagnosed by skin biopsy. Microscopic examination also showed panniculitis. The patient was treated successfully with amphotericin B and surgical resection. To our knowledge, this is the first description of primary cutaneous mucormycosis with erythema-nodosum-like lesions and panniculitis after renal transplantation. Conclusion Cutaneous mucormycosis should be considered in the differential diagnosis when a kidney transplant recipient develops erythema-nodosum-like lesions with panniculitis. PMID:18423044

Nouri-Majalan, Nader; Moghimi, Mansour

2008-01-01

348

Emerging Infections: Shewanella - A Series of Five Cases  

PubMed Central

Background: Shewanella spp. are unusual cause of disease in humans; however, reports of Shewanella infections have been increasing. Shewanella is a ubiquitous organism that has been isolated from many foods, sewage, and both from fresh and salt water. Earlier it was named as Pseudomonas putrefaciens or Shewanella putrefaciens. There are several reports describing this organism causing human infections such as cellulitis, abscesses, bacteremia, wound infection, etc. It is oxidase and catalase-positive non-fermenter gram-negative rod that produces hydrogen sulfide. Aims: The study was conducted to identify Shewanella spp., which was wrongly reported as Pseudomonas spp. Materials and Methods: Clinical samples were cultured as per standard clinical laboratory procedure. We tested the non-lactose-fermenting colonies for oxidase positivity. Oxidase-positive colony was inoculated in triple sugar iron slant (TSI) to know the hydrogen sulfide production. Hydrogen sulfide positive colonies were further tested for citrate, urease, indole, and amino acid decarboxylation and acid and gas production from sugars. Results: Five isolates identified as Pseudomonas spp. during preliminary testing were proved to be Shewanella spp. on further testing. Conclusions: It will help in better understanding the epidemiology, pathogenesis and risk factors associated with these and prevention of the rare pathogenic organisms. PMID:21346897

Sharma, Krishna Kanchan; Kalawat, Usha

2010-01-01

349

A case of Mycobacterium goodii prosthetic valve endocarditis in a non-immunocompromised patient: use of 16S rDNA analysis for rapid diagnosis  

PubMed Central

Background Mycobacterium goodii is a rare cause of significant infection. M. goodii has mainly been associated with lymphadenitis, cellulitis, osteomyelitis, and wound infection. Case presentation A case of a 76-year-old Caucasian female is presented. The patient developed a prosthetic valve endocarditis caused by M. goodii. She had also suffered from severe neurological symptoms related to a septic emboli that could be demonstrated as an ischemic lesion found on CT of the brain. Transesophageal echocardiography verified a large vegetation attached to the prosthetic valve. Commonly used blood culture bottles showed growth of the bacteria after 3?days. Conclusions Although M. goodii is rarely involved in these kinds of severe infections, rapidly growing mycobacteria should be recognized during conventional bacterial investigations and identified by molecular tools such as analysis of 16S rDNA. Species identification of nontuberculous mycobacteria is demanding and is preferably done in collaboration with a mycobacterial laboratory. An early diagnosis provides the opportunity for adequate treatment. In the present case, prolonged antimicrobial treatment and surgery with replacement of the prosthetic valve was successful. PMID:23151090

2012-01-01

350

The treatment of diabetic foot infections: focus on ertapenem  

PubMed Central

Clinically, 3 distinct stages of diabetic foot infection may be recognized: localized infection, spreading infection and severe infection. Each of these presentations may be complicated by osteomyelitis. Infection can be caused by Gram-positive aerobic, and Gram-negative aerobic and anaerobic bacteria, singly or in combination. The underlying principles are to diagnose infection, culture the bacteria responsible and treat aggressively with antibiotic therapy. Localized infections with limited cellulitis can generally be treated with oral antibiotics on an outpatient basis. Spreading infection should be treated with systemic antibiotics. Severe deep infections need urgent admission to hospital for wide-spectrum intravenous antibiotics. Clinical and microbiological response rates have been similar in trials of various antibiotics and no single agent or combination has emerged as most effective. Recently, clinical and microbiological outcomes for patients treated with ertapenem were equivalent to those for patients treated with piperacillin/tazobactam. It is also important to judge the need for debridement and surgery, to assess the arterial supply to the foot and consider revascularization either by angioplasty or bypass if the foot is ischemic. It is also important to achieve metabolic control. Thus infection in the diabetic foot needs full multidisciplinary treatment. PMID:19997576

Edmonds, Michael

2009-01-01

351

Receipt of Care and Reduction of Lower Extremity Amputations in a Nationally Representative Sample of U.S. Elderly  

PubMed Central

Objective To determine effectiveness of receipt of care from podiatrist and lower extremity clinician specialists (LEC specialists) on diabetes mellitus (DM)-related lower extremity amputation. Data Sources Medicare 5 percent sample claims, 19912007. Study Design Individuals with DM-related lower extremity complications (LECs) were followed 6 years. Visits with podiatrists, LEC specialists, and other health professionals were tracked to ascertain whether receipt of such care reduced the hazards of an LEC amputation. Data Collection Individuals were stratified based on disease severity, Stage 1neuropathy, paresthesia, pain in feet, diabetic amyotrophy; Stage 2cellutis, charcot foot; Stage 3ulcer; Stage 4osteomyelitis, gangrene. Principal Findings Half the LEC sample died within 6 years. More severe lower extremity disease increased risk of death and amputation. Persons visiting a podiatrist and an LEC specialist within a year before developing all stage complications were between 31 percent (ulceration) and 77 percent (cellulitis and charcot foot) as likely to undergo amputation compared with individuals visiting other health professionals. Conclusions Individuals with an LEC had high mortality. Visiting both a podiatrist and an LEC specialist in the year before LEC diagnosis was protective of undergoing lower extremity amputation, suggesting a benefit from multidisciplinary care. PMID:20722748

Sloan, Frank A; Feinglos, Mark N; Grossman, Daniel S

2010-01-01

352

Sertaconazole nitrate cream 2% for the treatment of tinea pedis.  

PubMed

Tinea pedis, both in its acute and chronic phase, is a common skin condition that often is overlooked but can lead to onychomycosis and acute bacterial cellulitis if left untreated. Therefore, aggressive treatment with a topical antifungal agent is warranted. Sertaconazole nitrate cream 2% is a newer imidazole agent that possesses both fungicidal and fungistatic properties to eradicate existing infections. In addition to antifungal properties, it exhibits anti-inflammatory and antipruritic effects. Controlled clinical trials have confirmed its safety, tolerability, and efficacy in participants with tinea pedis. We report 2 patients with chronic tinea pedis of many years' duration and demonstrate the usefulness of sertaconazole nitrate cream 2% in the clinical setting. Tinea pedis was confirmed by results of a potassium hydroxide preparation. Both patients experienced marked improvement by the second week of twice-daily treatment with sertaconazole nitrate cream 2%. Clinical cure was achieved in both patients. These findings suggest that sertaconazole nitrate cream 2% is an effective option for the treatment of tinea pedis. PMID:19537285

Ribotsky, Bret M

2009-05-01

353

Bacterial vaginosis.  

PubMed Central

Bacterial vaginosis (BV) is the most common of the vaginitides affecting women of reproductive age. It appears to be due to an alteration in the vaginal ecology by which Lactobacillus spp., the predominant organisms in the healthy vagina, are replaced by a mixed flora including Prevotella bivia, Prevotella disiens, Porphyromonas spp., Mobiluncus spp., and Peptostreptococcus spp. All of these organisms except Mobiluncus spp. are also members of the endogenous vaginal flora. While evidence from treatment trials does not support the notion that BV is sexually transmitted, recent studies have shown an increased risk associated with multiple sexual partners. It has also been suggested that the pathogenesis of BV may be similar to that of urinary tract infections, with the rectum serving as a reservoir for some BV-associated flora. The organisms associated with BV have also been recognized as agents of female upper genital tract infection, including pelvic inflammatory disease, and the syndrome BV has been associated with adverse outcome of pregnancy, including premature rupture of membranes, chorioamnionitis, and fetal loss; postpartum endometritis; cuff cellulitis; and urinary tract infections. The mechanisms by which the BV-associated flora causes the signs of BV are not well understood, but a role for H2O2-producing Lactobacillus spp. in protecting against colonization by catalase-negative anaerobic bacteria has been recognized. These and other aspects of BV are reviewed. PMID:1747864

Spiegel, C A

1991-01-01

354

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

355

Community-acquired methicillin-resistant Staphylococcus aureus: a potential diagnosis for a 16-year-old athlete with knee pain  

PubMed Central

Objective This case report aims to raise awareness in chiropractic physicians of the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in adolescents who participate in sports activities and to alert the chiropractic physician of the necessity to consider potential diagnoses that are not within their typical clinical heuristic. Clinical Features A 16-year-old adolescent girl entered the clinic with a complaint of left knee pain that had an insidious onset during her involvement in sports activities. Later that same day, her knee became enlarged, red, and had pustular formations with a discharge. She was taken to an urgent care facility and subsequently diagnosed with MRSA. Her history included treatment of a left knee musculoskeletal condition 6 weeks prior to which she had responded favorably. Interventions and Outcomes She was treated medically with an aggressive course of antibiotic therapy and excision of the furuncle. The chiropractic physician played a role in patient education and notifying local school authorities of the case. Conclusion Doctors of chiropractic must prepare themselves for the unexpected and remain open to diagnostic possibilities outside of the normal scope of practice. Knee pain or cellulitis of any type may require additional diagnostic and patient care protocols to make the correct diagnosis. With the incidence of community-acquired MRSA increasing at an alarming rate, it is certainly a diagnosis doctors of chiropractic should be aware of when treating patients, especially those involved in sports activities. PMID:21629397

Larkin-Thier, Susan M.; Barber, Virginia A.; Harvey, Phyllis; Livdans-Forret, Anna B.

2010-01-01

356

Complications and outcomes of brown recluse spider bites in children.  

PubMed

Brown recluse spider bites may cause severe local and systemic morbidity, but data regarding morbidity in children are limited. This study reviewed inpatient medical records (n = 26; 10 years) with a discharge diagnosis of "spider bite" from a tertiary pediatric hospital. The majority (85%) of children had an inflammatory response accompanying necrosis, usually with signs of secondary cellulitis (77%). Hemolytic anemia (50%), rhabdomyolysis (27%), and acute renal failure (12%) were the most prevalent systemic effects. Hemolytic anemia was bimodal in distribution relative to the time-of-onset of the bite (early, 2.2 0.4; late, 6.9 1.5 days postbite, respectively; P = .004). Although no fatalities occurred in the population, 65% of children had major morbidity, including wound complications requiring surgical care and acute orbital compartment syndrome. The findings emphasize the importance of anticipatory patient/family education for outpatients and careful monitoring for systemic morbidity in inpatients. Timely and appropriate supportive care should yield favorable outcomes in most cases. PMID:21307081

Hubbard, Jonathan J; James, Laura P

2011-03-01

357

Developing a nurse-led integrated 'red legs' service.  

PubMed

This project was developed to set up a nurse-led service based on the needs of patients diagnosed with 'red legs'. These patients are often wrongly admitted into hospital for treatment of cellulitis. Representatives from the specialties involved in caring for those individuals with red legs were invited to participate with patients to create a stakeholder group whose purpose was to develop integrated care pathways focused on referral criteria, diagnostics and treatment to inform a new nurse-led service. There was a commitment to utilising a number of facilitation techniques and practice-development methods in the progression of the project with the support of the Foundation of Nursing Studies. Much of the prescribed care can be carried out by the patients at home and only 25% patients have required a follow-up appointment within the new service. The service has now been fully commissioned and a secondment opportunity has been developed to lead the new service. Significant savings have been demonstrated and regular revision of the integrated care pathways with all groups, including the patients, will take place. PMID:24800322

Elwell, Rebecca

2014-01-01

358

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; 36 years old; 7.213.1 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. Rsum Contexte Les cellules souches adultes ont t largement tudies dans les approches de bio-ingnierie pour la thrapie de rparation tissulaire. Nous valuons l'efficacit clinique et la scurit de l'application de cellules souches msenchymateuses allogniques en culture drives de moelle osseuse (MSCs) pour le traitement de plaies cutanes dans un modle canin. Hypothse La transplantation de MSC allognique topique peut acclrer la fermeture en toute paisseur de plaies cutanes exprimentales et attnuer l'inflammation locale. Sujets Des chiens beagles adultes sains (n = 10; 36 ans; 7.213.1 kg) ont t tudis. Mthodes Des plaies cutanes en pleine paisseur ont t cres sur la face dorsale des beagles sains et des MSCs allognes ont t injectes par voie intradermique. Le taux de cicatrisation et le degr de production de collagne ont t analyss sur le plan histologique par colorations l'hmatoxyline et osine et par trichrome. Le degr de prolifration cellulaire et d'angiognse ont t valus par immunohistochimie l'aide d'anticorps spcifiques d'antigne nuclaire de prolifration cellulaire, de vimentine et d'actine de muscle lisse ?. Les taux d'expression local d'ARNm d'interleukine-2, d'interfron-?, du facteur de croissance basique de fibroblaste et de mtalloprotinase-2 de matrice, ont t valus par RT-PCR. Rsultats Compar avec les plaies traites par excipient, les plaies traites par les MSCs ont montr une plus rapide cicatrisation et une augmentation de synthse de collagne, de prolifration cellulaire er d'angiognse. En outre, Les plaies traites au MSC ont montr une expression diminue de cytokines pro-inflammatoires (interleukine-2 et interfron-?) et des facteurs lis 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

359

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 prsenter les rsultats prliminaires obtenus par notre groupe, nous passons d'abord en revue les principaux problmes rsoudre pour conserver trs basse temprature des organes en vue de leur transplantation. Cette cryoprservation est une voie de recherche actuellement explore pour augmenter la dure de conservation des greffons et permettre ainsi de mieux contrler la compatibilit donneur-receveur. Nous rappelons que la conservation des cellules isoles la temprature de l'azote liquide, actuellement ralise avec succs l'chelle industrielle, ne peut se faire qu'en prsence de substances plus ou moins toxiques dites cryoprotectrices, et condition de respecter des vitesses de refroidissement et de rchauffement adaptes chaque type de cellule. Nous montrons ensuite que l'extension de la cryoprservation au cas des organes entiers ne pourra se faire qu'au moyen de la vitrification, seule solution pour viter toute formation de glace. Cette vitrification sera l'aboutissement de 2 axes de recherche, l'un sur l'laboration de solutions cryoprotectrices les moins toxiques possibles, l'autre sur l'obtention de vitesses de refroidissement et de rchauffement suffisamment leves et homognes. Aprs avoir brivement rsum l'tat des recherches sur le coeur et le rein de petits mammifres, nous prsentons les premiers rsultats que nous avons obtenus sur la perfusion 4 ^{circ}C et l'autotransplantation de reins de lapin, sur la toxicit sur le coeur de rat d'un nouveau cryoprotecteur le 2,3-butanediol, et sur le refroidissement de systmes modles exprimentaux 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

360

Impact of antiretroviral therapy on decreasing hospitalization rates of HIV-infected patients in 2001.  

PubMed

Effective antiretroviral therapy initially resulted in large decreases in hospitalization rates of HIV-infected patients. The goal of this study was to determine whether these gains were being maintained in 2001. A cross-sectional study of hospital admission characteristics during four time periods was performed. All patients receiving care at the HIV clinics of New York Presbyterian Hospital-Cornell Medical Center (NYPH) in New York City were included. In 1995, 883 outpatients were receiving care for HIV infection at NYPH; this increased to 1990 outpatients by 2001. Demographic and laboratory information was obtained for these outpatients, and diagnoses were recorded for all patients requiring hospitalization on at NYPH during the time periods January 1 through June 30, in 1995, 1997, 1999, and 2001. The incidence of hospital admission declined in all four time periods: 1995 (95 per 100 patient-years [pt-yr]), 1997 (48 per 100 pt-yr), 1999 (38 per 100 pt-yr, p < 0.05), and 2001 (25 per 100 pt-yr). The incidence of bacterial pneumonia and opportunistic infections (OIs) decreased in all four time periods. The median hospitalization were CD4(+) cell count for outpatients increased from 231 (1995) to 364 (2001). Important predictors of hospitalization were CD4(+) < 200, and IVDU as an HIV risk factor. Since 1995 and the introduction of highly active antiretroviral therapy, continuing increases in CD4(+) cell counts of outpatients has been reflected in persistent declines in hospitalization rates. Large decreases in OIs and pneumonia have been minimally offset by stable rates of hospital admissions for diagnoses such as hepatitis, cirrhosis, and cellulitis. PMID:12015903

Paul, Simon; Gilbert, Holly M; Lande, Leah; Vaamonde, Carlos M; Jacobs, Jonathan; Malak, Sharp; Sepkowitz, Kent A

2002-05-01

361

Magnetic resonance imaging for local complications of acute pancreatitis: A pictorial review  

PubMed Central

Acute pancreatitis is a common disease characterized by sudden upper abdominal pain and vomiting. Alcoholism and choledocholithiasis are the most common factors for this disease. The choice of treatment for acute pancreatitis might be affected by local complications, such as local hemorrhage in or around the pancreas, and peripancreatic infection or pseudoaneurysm. Diagnostic imaging modalities for acute pancreatitis have a significant role in confirming the diagnosis of the disease, helping detect the extent of pancreatic necrosis, and for diagnosing local complications. Magnetic resonance imaging (MRI) might be indicated in acute pancreatitis for detecting and characterizing local complications of acute pancreatitis that involve necrotic, hemorrhagic, infectious, vascular, and pseudocyst disorders. The general MRI sequences for pancreatitis require the combined use of T1-weighted, T2-weighted sequences, and magnetic resonance cholangiopancreatography. For imaging of pancreatic necrosis, the combination of T1-weighted and T2-weighted findings with dynamic contrast-enhanced imaging gives a comprehensive evaluation of the extent of necrosis and full range of inflammatory extension. For imaging of infectious complications, dynamic contrast-enhanced examinations might help differentiate pancreatic cellulitis or abscesses, from pancreatic fluid collection or simple pseudocysts. For vascular abnormalities, the combination of cross-sectional pancreatic parenchyma imaging with MRA represents a single diagnostic modality for the full evaluation of peripancreatic artery and vein involvement, such as arterial pseudoaneurysms and venous thromboses. The purpose of this pictorial review is to examine the MRI appearances of various local complications of acute pancreatitis and to discuss the practical setup of MRI in local complications of acute pancreatitis. PMID:20533593

Xiao, Bo; Zhang, Xiao-Ming; Tang, Wei; Zeng, Nan-Lin; Zhai, Zhao-Hua

2010-01-01

362

Optimisation of Arabidopsis thaliana DNA extraction for the analysis of 8-oxo-7,8-dihydro-2'-deoxyguanosine formation after gamma irradiation  

NASA Astrophysics Data System (ADS)

8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodGuo) is a major oxidative DNA lesion. Plant DNA extraction protocols were improved in order to quantify 8-oxodGuo in the overall DNA of a cell suspension of Arabidopsis thaliana using the method of high performance liquid chromatography with electrochemical detection (HPLC-EC). Our results show that DNA can be artefactually oxidised during the extraction procedure. Metal chelating agents were efficient to decrease the 8-oxodGuo background level to 3.3 0.1 8-oxodGuo/105Gua and to improve experiment reproducibility. It was observed that DNA guanine oxidation in plant cells by ?-rays is very low in vivo (15 8-oxodGuo/10^9Gua formation per Gy). La 8-oxo-7,8-dihydro-2'-dsoxyguanosine (8-oxodGuo) est une lsion oxydative majeure de l'ADN. Divers protocoles d'extraction d'ADN vgtal ont t optimiss dans le but de quantifier la 8-oxodGuo dans l'ADN total d'une suspension cellulaire d'Arabidopsis thaliana en utilisant la chromatographie liquide haute prformance couple un dtecteur lectrochimique (CLHP-EC). Nos rsultats montrent que l'ADN peut tre oxyd artfactuellement au cours de son extraction. L'utilisation de chlateurs de mtaux permet de rduire le niveau de base de 8-oxodGuo 3,30,1 8-oxodGuo/10^5Gua et d'augmenter la reproductibilit des expriences. L'tude des effets des rayons ? sur les cellules de plantes a mis en vidence que l'oxydation de la guanine de l'ADN est trs faible in vivo (formation de 15 8-oxodGuo/10^9Gua par Gy).

Dany, A. L.; Triantaphylids, C.; Cadet, J.; Douki, T.

1999-01-01

363

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

364

Report of wood decay fungus Inonotus tropicalis (phylum Basidiomycota) from a dog with a granulomatous mediastinal mass.  

PubMed

A 75.9-kg, 3.5-year-old male Irish Wolfhound dog with a 2-3-week history of gagging and eating difficulties was referred to the University of Florida Veterinary Medical Hospital (Gainesville, Florida) for evaluation of a large cranial mediastinal mass suspected to be a thymoma or lymphosarcoma. The patient had 4 months of nearly 10 kg progressive weight loss with severe flank sensitivity and radiographically apparent lumbar vertebral changes interpreted as discospondylitis. Lab work revealed hyperglobulinemia, mild proteinuria, normal T4, negative Brucella canis titer, and negative blood and urine bacterial cultures. A thoracotomy revealed a nonresectable, destructive, space-occupying mediastinal mass resulting in euthanasia without surgical recovery. Biopsies from the mass were collected during surgery for histology. Microscopic examination revealed extensive granulomatous cellulitis and lymphadenitis characterized by central cavitated necrotic areas containing debris and degenerate neutrophils, intermediate zones of fibrovascular proliferation with marked mixed inflammation, peripheral fibrosis, frequent multinucleated macrophages, and scattered mineralization. The necrotic material contained dense mats of 2 m wide by 8-15 m long fungal hyphae with parallel walls, acute angle branching, frequent septae, and occasional bulb-like dilations. DNA sequencing and phylogenetic analysis of the internal transcribed spacer region confirmed the presence of a fungus in the Inonotus tropicalis group. Inonotus tropicalis is primarily a wood decay fungus that is found on dead wood from angiosperms in tropical and subtropical habitats. Isolates of the I. tropicalis group have been detected a few times from immunosuppressed human beings with X-linked granulomatous disease. PMID:23929678

Sheppard, Barbara J; McGrath, Elizabeth; Giuffrida, Michelle; Craft, Serena L M; Kung, Chung Yee; Smith, Matthew E

2013-09-01

365

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 solgel method at near-room temperatures 25C, 35C, 55C, and 75C. 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 (25C75C) on the particulate sizes (23.788.8 nm), pH levels (11.711.9), and morphologies (slender needlebroad 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 (293298 nm) suggest that ZNPs prepared at 55C 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

366

Occult renal cell carcinoma with acrometastasis and ipsilateral juxta-articular knee lesions mimicking acute inflammation.  

PubMed

Generally, skeletal peripheral metastases below the elbow and the knee are rare. Skeletal metastases to the hand or foot are very rare; but when they do it may be a revealing clinical finding. Purely lytic lesions are commonly seen in metastases from lung, renal, and thyroid tumors, but they are also known to occur in primary myeloma, brown tumor and lymphomas. A 70-year-old man was brought to the emergency department with acute painful swelling involving his right hand and the right knee. Due to significant accompanying soft tissue swellings cellulitis, acute osteomyelitis and gouty arthropathy were included in the initial differential diagnosis. Radiographs showed pure lytic bony lesion with complete disappearance of lower two third of the second metacarpal, trapezium and trapezoid bones of the right hand along with a lytic subarticular lesion of medial condyle of ipsilateral femur. Chest X-ray (CXR) was normal but sonography of the abdomen readily demonstrated a large renal mass, later confirmed at biopsy as renal cell carcinoma (RCC). Clinicians should be cognizant of the strong association between digital acrometastases and renal cell carcinoma in male patients with normal CXR findings. In suspected hand acrometastasis associated with a soft tissue component outside the contours of normal bone, screening the abdomen by sonography should be done prior to bone biopsy and before costly or time-consuming investigations are offered. Metastatic RCC should be included in the differential diagnosis of all unilateral expansile bony lesions of the digit. It is particularly important if such lesion/lesions are accompanied by local inflammation. Screening the abdomen by sonography may be of particular value in such elderly male patient when Chest X-ray shows no abnormality. PMID:23326779

Borgohain, Bhaskar; Borgohain, Nitu; Khonglah, Tashi; Bareh, Jerryson

2012-01-01

367

Multimodal percutaneous intervention for critical venous occlusive disease.  

PubMed

Critical deep venous thrombosis and occlusion constitutes a small percentage of patients with venous disease, who exhibit severe symptomatology. This study examined the results of multimodal percutaneous therapy for the treatment of complex critical venous thrombotic and occlusive disease. Twenty-five patients presented with critical venous thromboses or occlusions (11 with debilitating unilateral lower extremity edema causing ambulatory impairment, 2 with debilitating bilateral lower extremity edema, 3 with phlegmasia cerulea dolens, 2 with venous claudication, 2 with superior vena cava (SVS) syndrome with respiratory compromise, 4 with debilitating upper extremity edema, and 1 with renal insufficiency). Therapeutic modalities including thrombolysis, mechanical thrombectomy, percutaneous venoplasty and stent placement, temporary inferior vena cava filtration, and ultrasound guidance were used in all cases in conjunction with long-term systemic anticoagulation. The venous access site was determined by the anatomic location of the lesion and included popliteal, femoral, brachial, and lesser saphenous. Patients were followed with clinical exam and duplex surveillance. Resolution of symptoms was achieved in 18 of 25 patients (72%) and partial resolution occurred in 4 of 25 (16%). Failure of treatment identified as both lack of clinical response and evidence of continued venous thrombosis occurred 3 of 25 patients (12%). Restoration of arterial pulses and limb salvage was achieved in the three patients with phlegmasia cerulea dolens and acute limb-threatening ischemia. Both patients with SVC syndrome experienced resolution of respiratory compromise and facial edema. The mean length of follow-up was 11 +/- 2.7 months. Complications included transfusion requirement (2), hematuria (2), retroperitoneal hematoma (1), and cellulitis (1). Acute critical venous thrombotic and occlusive disease is responsive to multimodal percutaneous treatment. The relief of pain and resolution of acutely life and limb-threatening conditions in this most severely symptomatic subset of patients represents the immediate goal of treatment. PMID:15770366

Dayal, Rajeev; Bernheim, Joshua; Clair, Daniel G; Mousa, Albeir Y; Hollenbeck, Scott; DeRubertis, Brain; McKinsey, James; Morrissey, Nicholas J; Kent, K Craig; Faries, Peter L

2005-03-01

368

Study of the refirming effect of a plant complex.  

PubMed

Loss of skin elasticity is one of the main problems of ageing. This is a mechanical property influenced by elastin, a protein in the dermis which, together with collagen and glycosaminoglycans, makes up the connective tissue. This tissue is affected by a large number of events (such as cutaneous ageing, pregnancy, slimming processes and cellulitis) which eventually cause it to change. At the same time, the metabolism of the proteins of the connective tissue decreases and there is an ever greater presence of enzymes, principally elastases and collagenases, which are responsible for breaking down the elastin and the collagen. One way to prevent such a loss of elasticity is to use active ingredients that are able to inhibit elastase enzymes. A plant complex was prepared using the following plants: lady's thistle (Silybum marianum GAERTN), alchemilla or yarrow (Alchemilla vulgaris L.), horsetail (Equisetum arvense L.) as well as germinated seeds (Glycine soja Siebold and Zucc., Triticum vulgare Vilars, Medicago sativa L., Raphanus sativus L.). The complex was standardized to give the corresponding active principles, silybin, tannins, silicon and peptides, respectively, and in vitro enzymatic tests were carried out to establish its ability to inhibit elastase. The study of enzymatic inhibition was carried out using two enzymes: (1) porcine pancreatic elastase (PPE), and (2) human leukocyte elastase (HLE). The results showed that the plant complex presents non-competitive inhibition in the order of 41.0% against PPE and 50.0% against HLE. An in vivo test was made alongside the in vitro test using an SEM 474 Cutometer (Courage & Khazaka) to study the elasticity of the skin, and positive effects were obtained when applying a cosmetic formulation containing 5% of the plant complex. Image analysis of duplicates of the cutaneous surface, before and after treatment began with a product containing 5% of plant complex and showed that wrinkles were decreased by 36.7%. PMID:18505506

Benaiges, A; Marcet, P; Armengol, R; Betes, C; Girons, E

1998-08-01

369

Phase 2, Randomized, Double-Blind, Dose-Ranging Study Evaluating the Safety, Tolerability, Population Pharmacokinetics, and Efficacy of Oral Torezolid Phosphate in Patients with Complicated Skin and Skin Structure Infections?  

PubMed Central

Torezolid (TR-700) is the active moiety of the prodrug torezolid phosphate ([TP] TR-701), a second-generation oxazolidinone with 4- to 16-fold greater potency than linezolid against Gram-positive species including methicillin-resistant Staphylococcus aureus (MRSA). A double-blind phase 2 study evaluated three levels (200, 300, or 400 mg) of oral, once-daily TP over 5 to 7 days for complicated skin and skin structure infections (cSSSI). Patients 18 to 75 years old with cSSSI caused by suspected or confirmed Gram-positive pathogens were randomized 1:1:1. Of 188 treated patients, 76.6% had abscesses, 17.6% had extensive cellulitis, and 5.9% had wound infections. S. aureus, the most common pathogen, was isolated in 90.3% of patients (139/154) with a baseline pathogen; 80.6% were MRSA. Cure rates in clinically evaluable patients were 98.2% at 200 mg, 94.4% at 300 mg, and 94.4% at 400 mg. Cure rates were consistent across diagnoses, regardless of lesion size or the presence of systemic signs of infection. Clinical cure rates in patients with S. aureus isolated at baseline were 96.6% overall and 96.8% for MRSA. TP was safe and well tolerated at all dose levels. No patients discontinued treatment due to an adverse event. Three-stage hierarchical population pharmacokinetic modeling yielded a geometric mean clearance of 8.28 liters/h (between-patient variability, 32.3%), a volume of the central compartment of 71.4 liters (24.0%), and a volume of the peripheral compartment of 27.9 liters (35.7%). Results of this study show a high degree of efficacy at all three dose levels without significant differences in the safety profile and support the continued evaluation of TP for the treatment of cSSSI in phase 3 trials. PMID:21115795

Prokocimer, P.; Bien, P.; Surber, J.; Mehra, P.; DeAnda, C.; Bulitta, J. B.; Corey, G. R.

2011-01-01

370

Predictors of suppurative complications for acute sore throat in primary care: prospective clinical cohort study  

PubMed Central

Objective To document whether elements of a structured history and examination predict adverse outcome of acute sore throat. Design Prospective clinical cohort. Setting Primary care. Participants 14?610 adults with acute sore throat (?2 weeks duration). Main outcome measures Common suppurative complications (quinsy or peritonsillar abscess, otitis media, sinusitis, impetigo or cellulitis) and reconsultation with new or unresolving symptoms within one month. Results Complications were assessed reliably (inter-rater ?=0.95). 1.3% (177/13?445) of participants developed complications overall and 14.2% (1889/13?288) reconsulted with new or unresolving symptoms. Independent predictors of complications were severe tonsillar inflammation (documented among 13.0% (1652/12?717); odds ratio 1.92, 95% confidence interval 1.28 to 2.89) and severe earache (5% (667/13?323); 3.02, 1.91 to 4.76), but the model including both variables had modest prognostic utility (bootstrapped area under the receiver operator curve 0.61, 0.57 to 0.65), and 70% of complications (124/177) occurred when neither was present. Clinical prediction rules for bacterial infection (Centor criteria and FeverPAIN) also predicted complications, but predictive values were also poor and most complications occurred with low scores (67% (118/175) scoring ?2 for Centor; 126/173 (73%) scoring ?2 for FeverPAIN). Previous medical problems, sex, temperature, and muscle aches were independently but weakly associated with reconsultation with new or unresolving symptoms. Conclusion Important suppurative complications after an episode of acute sore throat in primary care are uncommon. History and examination and scores to predict bacterial infection cannot usefully identify those who will develop complications. Clinicians will need to rely on strategies such as safety netting or delayed prescription in managing the uncertainty and low risk of complications. PMID:24277339

2013-01-01

371

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

372

Wound-healing protocols for diabetic foot and pressure ulcers.  

PubMed

Diabetic foot and pressure ulcers are chronic wounds by definition. They share similar pathogeneses; i.e., a combination of increased pressure and decreased angiogenic response. Neuropathy, trauma, and deformity also often contribute to development of both types of ulcers. Early intervention and proper treatment should result in complete healing of non-ischemic diabetic foot and pressure ulcers, as defined by 100% epithelialization and no drainage (if no osteomyelitis is present). The authors developed the following paradigm, which has proved to be highly effective for complete healing of these wounds: 1) recognition that all patients with limited mobility are at risk for a sacral, ischial, trochanteric, or heel pressure ulcer; 2) daily self-examination of the sacral, ischium, buttocks, hips, and heels of all bed-bound patients and the feet of patients with diabetes with risk factors (e.g., neuropathy); 3) initiation of a treatment protocol immediately upon recognition of a break in the skin (i.e., emergence of a new wound); 4) objective measurement by planimetry of every wound (at a minimum, weekly) and documentation of its progress; 5) establishment of a moist wound-healing environment; 6) relief of pressure from the wound; 7) debridement of all non-viable tissue in the wound; 8) elimination of all drainage and cellulitis; 9) cellular therapy or growth factors for patients with wounds that do not heal rapidly after initial treatment; and 10) continuous physical and psychosocial support for all patients. If this paradigm is followed, most diabetic foot and pressure ulcers are expected to heal. PMID:12931288

Brem, Harold; Jacobs, Tom; Vileikyte, Loretta; Weinberger, Sarah; Gibber, Mark; Gill, Kiran; Tarnovskaya, Alina; Entero, Hyacinth; Boulton, Andrew J M

2003-01-01

373

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

374

[The outcomes of program based on complex decongestive physiotherapy for a patient with secondary lymphedema caused by infection on the leg].  

PubMed

Lymphedema is a chronic problem causing distress and loss of functions throughout the lifespan. Complex decongestive physiotherapy (CDP) is in common use in developed countries but has only recently been used in Japan for people in outpatient settings. CDP is a representative conservative treatment for lymphedema, conducted by combining four kinds of physical therapies: skin care, manual lymph drainage (MLD), bandage and exercise. This research project lead by a nurse is underway using CDP in an outpatient department. We report a case of secondary lymphedema caused by infection successfully treated by CDP. A 22-year-old man suffered from cellulitis of unknown origin when he was a high school student. After this event, he had been repeatedly admitted to hospital with infections as a result of the lymphedema. He underwent MLD once or twice monthly and received health education for skin care, self-massage and exercise, and was advised to wear compression stockings. Within 7 months the leg swelling had significantly reduced and his feelings of malaise and pain disappeared. Fourteen months later the circumferences of his knee and ankle had kept the sizes, and he has not re-entered hospital for infections. For this man, CDP had a positive outcome, as it has for many others around the world. Our experience has found it very important to establish adequate support systems for such people in outpatient and community settings. However, more research and knowledge sharing are required to understand the usefulness and effectiveness about this program as a primary treatment combined with health education in community settings in Japan. PMID:19670806

Nakao, Fujiko; Furutani, Akira; Yoshimura, Koichi; Hamano, Kimikazu; Kinoshita, Yumiko; Kawamoto, Rieko; Nakao, Hisako; Suzuki, Shizue

2009-06-01

375

HMGB1 in severe soft tissue infections caused by Streptococcus pyogenes  

PubMed Central

Extracellular High Mobility Group Box 1 (HMGB1) has been associated with acute and chronic inflammatory conditions. However, little is known about HMGB1 in necrotizing bacterial infections. We hypothesized that the local HMGB1 response is excessive in severe soft tissue infections (STIs), which are characterized by necrosis and hyperinflammation. To explore this, tissue biopsies were collected from patients with varying severity of Streptococcus pyogenes skin and STIs, including erysipelas, cellulitis, and necrotizing fasciitis. Tissue sections were immunostained for HMGB1, S. pyogenes, and inflammatory cell infiltrates and results quantified by acquired computerized image analysis (ACIA). HMGB1 expression increased in parallel to disease severity and was significantly higher in necrotizing fasciitis than in erysipelas (p = 0.0023). Confocal microscopy of sections co-stained for HMGB1 and cell markers revealed both extracellular and cytoplasmic HMGB1, the latter of which was found predominantly in macrophages. To further verify macrophages as main source of activation triggered HMGB1 release, human macrophages were infected with clinical S. pyogenes isolates. The results demonstrated infection triggered release of HMGB1. Dual staining's visualized HMGB1 in areas close to, but not overlapping, with neutrophils, indicating a potential chemotactic role. In vitro transmigration experiments showed a chemotactic effect of HMGB1 on neutrophils. The data furthermore provided in vivo support that HGMB1 may form immunostimulatory complexes with IL-1?. Taken together, the findings provide the first in vivo evidence that HMGB1 is abundant at the local site of severe bacterial STIs and its levels correlated to severity of infections; hence, indicating its potential value as a biomarker for tissue pathology. PMID:24524027

Johansson, Linda; Snll, Johanna; Sendi, Parham; Linnr, Anna; Thulin, Pontus; Linder, Adam; Treutiger, Carl-Johan; Norrby-Teglund, Anna

2014-01-01

376

HMGB1 in severe soft tissue infections caused by Streptococcus pyogenes.  

PubMed

Extracellular High Mobility Group Box 1 (HMGB1) has been associated with acute and chronic inflammatory conditions. However, little is known about HMGB1 in necrotizing bacterial infections. We hypothesized that the local HMGB1 response is excessive in severe soft tissue infections (STIs), which are characterized by necrosis and hyperinflammation. To explore this, tissue biopsies were collected from patients with varying severity of Streptococcus pyogenes skin and STIs, including erysipelas, cellulitis, and necrotizing fasciitis. Tissue sections were immunostained for HMGB1, S. pyogenes, and inflammatory cell infiltrates and results quantified by acquired computerized image analysis (ACIA). HMGB1 expression increased in parallel to disease severity and was significantly higher in necrotizing fasciitis than in erysipelas (p = 0.0023). Confocal microscopy of sections co-stained for HMGB1 and cell markers revealed both extracellular and cytoplasmic HMGB1, the latter of which was found predominantly in macrophages. To further verify macrophages as main source of activation triggered HMGB1 release, human macrophages were infected with clinical S. pyogenes isolates. The results demonstrated infection triggered release of HMGB1. Dual staining's visualized HMGB1 in areas close to, but not overlapping, with neutrophils, indicating a potential chemotactic role. In vitro transmigration experiments showed a chemotactic effect of HMGB1 on neutrophils. The data furthermore provided in vivo support that HGMB1 may form immunostimulatory complexes with IL-1?. Taken together, the findings provide the first in vivo evidence that HMGB1 is abundant at the local site of severe bacterial STIs and its levels correlated to severity of infections; hence, indicating its potential value as a biomarker for tissue pathology. PMID:24524027

Johansson, Linda; Snll, Johanna; Sendi, Parham; Linnr, Anna; Thulin, Pontus; Linder, Adam; Treutiger, Carl-Johan; Norrby-Teglund, Anna

2014-01-01

377

Reconstruction of congenital microtia-atresia: outcomes with the Medpor/bone-anchored hearing aid-approach.  

PubMed

Ideal surgery for congenital microtia-atresia would offer excellent cosmetic and hearing rehabilitation, with minimal morbidity. Classic approaches require multiple procedures, including rib cartilage harvest and aural atresia repair. Our facial plastic and otologic team approach incorporates a high-density porous polyethylene (Medpor, Porex Surgical, Newnan, GA) auricular framework, followed by single-stage bone-anchored hearing aid (BAHA) implantation. We evaluated the efficacy, safety, and morbidity of this 2-stage dual system approach. A prospective database of microtia patients was used to identify patients undergoing combined Medpor/BAHA auricular reconstruction and hearing rehabilitation between 2003 and 2006. The first stage involves placement of a Medpor framework beneath a temporoparietal fascia flap, followed by a second-stage procedure for lobule transposition and BAHA implantation. Twenty-five patients (28 ears) were evaluated. Aesthetic quality of the implants was excellent, with a high degree of framework detail visible, and a postauricular crease created in all patients. All patients were satisfied with the cosmetic result. There were no major Medpor complications such as infection, extrusion, loss of implant, or flap necrosis, and a 10.7% incidence of minor complications requiring operative revision. BAHA significantly improved hearing in all patients, with a complication rate of 31.8%, mainly skin overgrowth and cellulitis. The Medpor/BAHA dual plastic-otologic approach to microtia-atresia has produced excellent cosmetic results and hearing outcomes, which compare favorably to traditional microtia-atresia repair. This is a 2-stage aesthetic and functional protocol with an acceptably low rate of complications, which safely and efficiently achieves both aesthetic and functional goals. PMID:19325342

Romo, Thomas; Morris, Luc G T; Reitzen, Shari D; Ghossaini, Soha N; Wazen, Jack J; Kohan, Darius

2009-04-01

378

A retrospective study of mortality in Pennsylvania captive white-tailed deer (Odocoileus virginianus): 20000--2003.  

PubMed

The postmortem records of 160 white-tailed deer (Odocoileus virginianus) submitted for necropsy examination from 59 separate Pennsylvania captive deer farms over a 3.5-year period were reviewed to determine the primary cause of death of each animal. The most common causes of death were bronchopneumonia (39 cases), enterocolitis (30 cases), malnutrition (13 cases), and trauma (11 cases). Other causes of mortality included severe gastrointestinal parasitism (6 cases), cellulitis with septicemia (5 cases), degenerative myopathy (4 cases), ruminal acidosis (4 cases), and nephritis (4 cases). The cause of death was undetermined in 13 of the 160 animals. Arcanobacterium pyogenes (19 cases), Fusobacterium necrophorum (10 cases), Escherichia coli (7 cases), and Mannheimia haemolytica (4 cases) were the most commonly isolated bacteria from the pneumonic lungs. Bacterial agents associated with enterocolitis included Clostridium perfringens (15 cases), E. coli (12 cases), and Mycobacterium avium subsp. paratuberculosis (2 cases). The majority (52.2%) of the death loss in white-tailed deer of known ages occurred in animals 1 year of age or less, with 46.2% of the bronchopneumonia cases and 50.0% of the enterocolitis cases occurring during this time period. Cases of degenerative myopathy, myocardial degeneration, hepatic necrosis, meningoencephalitis, peritonitis, and urolithiasis considered severe enough to be the primary cause of death appeared early in life, affecting deer 6 months of age or less in all cases. In conclusion, bronchopneumonia, enterocolitis, malnutrition, and trauma were considered the most common causes of death in confined white-tailed deer in this study. PMID:15586566

Hattel, Arthur L; Shaw, Daniel P; Love, Brenda C; Wagner, Donald C; Drake, Thomas R; Brooks, Jason W

2004-11-01

379

Totally implantable venous access devices in cystic fibrosis: complications and patients' opinions.  

PubMed

The introduction of totally implantable venous access devices (TIVAD) has provided a solution to difficult venous access in patients with cystic fibrosis. Early reports have, however, recognized a number of complications with their use. We report our experience with five devices used over 8 yrs with regard to complications and patient attitudes. Patients' notes were reviewed to record the details of TIVAD insertion, duration of function, and complications. In January 1996 the surviving 30 patients were surveyed on their attitudes to TIVAD and complications by written questionnaire. Sixty one ports were implanted in 42 patients (aged 16-47 yrs) between June 1988 and January 1996, giving a total of 1,510 patient-months' experience. The duration of function ranged from 2 weeks to 6 yrs. Survival analysis showed that the median survival of ports was 53 months, 42 out of 61 (69%) had not failed in service at the end of follow-up or patient death. Twenty-three complications occurred in 19 patients. These included: line occlusion (10 patients), venous thrombosis (4), difficult access (3), infection (2), cellulitis (1), inversion of port chamber (2) and pneumothorax (1). The questionnaire showed that patients had strong views on the positioning of their port. Lifestyle issues included interference with seatbelts (8 patients), sport (4), clothing (2), sexual relations (2) and cosmetic appearance (15). Complication rates were similar to those in other studies, although infection rates and salvage of an occluded port were lower. The survey highlighted a number of lifestyle issues, with cosmetic appearance deemed unsatisfactory by half of the patients. However, the majority (28 out of 30) believed their totally implantable venous access devices to be a better alternative to cannulae or long lines. PMID:9701441

Rodgers, H C; Liddle, K; Nixon, S J; Innes, J A; Greening, A P

1998-07-01

380

Use of a soluble epoxide hydrolase inhibitor as adjunctive analgesic in a laminitic horse  

PubMed Central

A 4-year old, 500 kg Thoroughbred female horse diagnosed with bilateral forelimb laminitis and cellulitis on the left forelimb became severely painful and refractory to non-steroidal anti-inflammatory therapy (flunixin meglumine on days 1, 2, 3 and 4; and phenylbutazone on days 5, 6 and 7) alone or in combination with gabapentin (days 6 and 7). Pain scores assessed independently by three individuals with a visual analog scale (VAS; 0= no pain and 10=worst possible pain) were 8.5 on day 6, and it increased to 9.5 on day 7. Non-invasive blood pressure monitoring revealed severe hypertension. As euthanasia was being considered for humane reasons as well as technical and financial constraints, a decision was made to add an experimental new drug, trans-4-{4-[3-(4-Trifluoromethoxy-phenyl)-ureido]-cyclohexyloxy}-benzoic acid (t-TUCB), which is an inhibitor of soluble epoxide hydrolase (sEH), to the treatment protocol. Dose and frequency of administration were selected to produce plasma concentrations within the range of 2.5 ?M and 30 nM based on the drug potency against equine sEH. Pain scores decreased sharply and remarkably following t-TUCB administration and blood pressure progressively decreased to physiologic normal values. Plasma concentrations of t-TUCB, measured daily, were within the expected range, whereas phenylbutazone and gabapentin plasma levels were below the suggested efficacious concentrations. No adverse effects were detected on clinical and laboratory examinations during and after t-TUCB administration. The mare did not get any episode of laminitis in the three months following the treatment. PMID:23463912

Guedes, Alonso G. P.; Morisseau, Christophe; Sole, Albert; Soares, Joao H. N.; Ulu, Arzu; Dong, Hua; Hammock, Bruce D.

2014-01-01

381

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

382

Polyester (Parietex) mesh for total extraperitoneal laparoscopic inguinal hernia repair: initial experience in the United States.  

PubMed

Polypropylene mesh is the most commonly used mesh for open and laparoscopic hernia repair in the United States. A variety of newly developed polyester mesh products have recently become available. This is the first U.S. multiinstitutional study evaluating the initial experience of polyester mesh use for total extraperitoneal (TEP) laparoscopic inguinal hernia repair. Between January 2000 and June 2001, 337 patients underwent 495 TEP laparoscopic inguinal hernia repairs using polyester mesh. There were 309 men and 28 women in the study, whose average age was 45 years (range, 17-80 years). The average operative time for all cases was 54.3 min (range, 18-157 min). There were no conversions to open repair and no mortality. Complications included 12 seromas/hematomas (six aspirated), chronic pain in three patients, urinary retention in two patients, and one incidence each of the following: epididimitis, prostatitis, hydrocele, and port-site cellulitis. Additionally, one patient had carbon dioxide (CO2) in the Foley bag at the end of the surgery, but a normal cystogram showed no identified bladder injury. There has been one recurrence (0.2%), occurring 4 months after surgery, which was repaired using a transabdominal laparoscopic approach. The mean follow-up period was 11 months (range, 2-22 months). There have been no documented infections of the mesh, and no mesh has been removed. This study documents a favorable initial experience with polyester mesh for TEP laparoscopic inguinal hernia repair. There were no complications related to the mesh. There may be technical and long-term advantages with the use of polyester mesh for laparoscopic inguinal hernia repair. Longer follow-up evaluation and additional studies are warranted to evaluate these potential advantages. PMID:12436235

Ramshaw, B; Abiad, F; Voeller, G; Wilson, R; Mason, E

2003-03-01

383

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 toxicitypain requiring a course of narcotic analgesicswas 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

384

Necrotizing fasciitis  

PubMed Central

Abstract OBJECTIVE To describe the defining characteristics and treatment of necrotizing fasciitis (NF), emphasizng early diagnostic indications. QUALITY OF EVIDENCE PubMed was searched using the terms necrotizing fasciitis and necrotizing soft tissue infections, paired with early diagnosis. Results were limited to human studies in English. Additional articles were obtained from references within articles. Evidence is levels II and III. MAIN MESSAGE Necrotizing fasciitis is classified according to its microbiology (polymicrobial or monomicrobial), anatomy, and depth of infection. Polymicrobial NF mostly occurs in immunocompromised individuals. Monomicrobial NF is less common and affects healthy individuals who often have a history of trauma (usually minor). Patients with NF can present with symptoms of sepsis, systemic toxicity, or evidence of skin inflammation, with pain that is disproportional to the degree of inflammation. However, these are also present in less serious conditions. Hyperacute cases present with sepsis and quickly progress to multiorgan failure, while subacute cases remain indolent, with festering soft-tissue infection. Because the condition is rare with minimal specific signs, it is often misdiagnosed. If NF is suspected, histology of tissue specimens is necessary. Laboratory and radiologic tests can be useful in deciding which patients require surgical consultation. Once NF is diagnosed, next steps include early wound debridement, excision of nonviable tissue, and wide spectrum cover with intravenous antibiotics. CONCLUSION Necrotizing fasciitis is an uncommon disease that results in gross morbidity and mortality if not 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. PMID:19826154

Puvanendran, Rukshini; Huey, Jason Chan Meng; Pasupathy, Shanker

2009-01-01

385

Skin/nail infections with the addition of pertuzumab to trastuzumab-based chemotherapy.  

PubMed

We report a series of breast cancer patients with invasive skin and nail infections with Staphylococcus species that we attribute to the addition of pertuzumab to trastuzumab-based therapy. With the suspicion of an increased incidence of cutaneous infection in patients treated with pertuzumab and trastuzumab-based chemotherapy, treating medical oncologists identified patients receiving therapy who experienced infection. Between March and October 2014, 18 patients treated with pertuzumab and trastuzumab-based chemotherapy were found to have 21 separate skin/nail infections. Treatment was administered as neoadjuvant therapy in 12 (67%) patients, adjuvant therapy in four (22%) patients, and for metastatic disease in two (11%) patients. Granulocyte growth factors were administered in 11 (61%) patients and no patients were documented to be neutropenic. New skin and nail lesions developed as early as cycle 1 and as late as 8months from initial therapy. The 21 separate infections documented were folliculitis and "bite-like" lesions (10), abscess (6), paronychia (3), and cellulitis (2). The appearance of these lesions was distinct from typical EGFR-associated skin changes. When cultures were obtained, Staphylococcus species were isolated. Quantitative immunoglobulins were assessed in 14 (78%) patients and were abnormally low in six (43%) of these patients. The skin infections resulted in treatment delay in two (11%) patients and premature discontinuation of therapy in one patient. We believe that the skin/nail infections reported here in patients treated with the combination of pertuzumab and trastuzumab represent a previously unrecognized toxicity of adding pertuzumab to trastuzumab-based therapies. PMID:25385180

Mortimer, Joanne; Jung, Jae; Yuan, Yuan; Kruper, Laura; Stewart, Daphne; Chung, Samuel; Yu, Kim Wai; Mendelsohn, Mary; D'Apuzzo, Massimo; Tegtmeier, Bernard; Dadwal, Sanjeet

2014-12-01

386

Aerobic and anaerobic microbiology of infections after trauma in children.  

PubMed Central

OBJECTIVE: To review the recovery of aerobic and anaerobic bacteria from infections after trauma in children over a 20 year period. METHODS: Only specimens that were studied for both aerobic and anaerobic bacteria were included in the analysis. They were collected from seven separate centres in which the microbiology laboratories only accepted specimens that were properly collected without contamination and were submitted in appropriate transport media. Anaerobes and aerobic bacteria were cultured and identified using standard techniques. Clinical records were reviewed to identify post-trauma patients. RESULTS: From 1974 to 1994, 175 specimens obtained from 166 children with trauma showed bacterial growth. The trauma included blunt trauma (71), lacerations (48), bites (42), and open fractures (5). Anaerobic bacteria only were isolated in 38 specimens (22%), aerobic bacteria only in 51 (29%), and mixed aerobic-anaerobic flora in 86 (49%); 363 anaerobic (2.1/specimen) and 158 aerobic or facultative isolates (0.9/specimen) were recovered. The predominant anaerobic bacteria included Peptostreptococcus spp (115 isolates), Prevotella spp (68), Fusobacterium spp (52), B fragilis group (42), and Clostridium spp (21). The predominant aerobic bacteria included Staph aureus (51), E coli (13), Ps aeruginosa (12), Str pyogenes (11) and Klebsiella pneumoniae (9). Principal infections were: abscesses (52), bacteraemia (3), pulmonary infections (30, including aspiration pneumonia, tracheostomy associated pneumonia, empyema, and ventilator associated pneumonia), wounds (36, including cellulitis, post-traumatic wounds, decubitus ulcers, myositis, gastrostomy and tracheostomy site wounds, and fasciitis), bites (42, including 23 animal and 19 human), peritonitis (4), osteomyelitis (5), and sinusitis (3). Staph aureus and Str pyogenes were isolated at all sites. However, organisms of the oropharyngeal flora predominated in infections that originated from head and neck wounds and abscesses, and bites, and those from the gastrointestinal tract predominated in infections that originated from peritonitis, abdominal abscesses, and decubitus ulcers. CONCLUSIONS: Many infections that follow trauma in children involve multiple organisms. PMID:9639177

Brook, I

1998-01-01

387

Methodology for evaluating Insite: Canada's first medically supervised safer injection facility for injection drug users  

PubMed Central

Many Canadian cities are experiencing ongoing infectious disease and overdose epidemics among injection drug users (IDUs). In particular, Human Immunodeficiency Virus (HIV) and hepatitis C Virus (HCV) have become endemic in many settings and bacterial and viral infections, such as endocarditis and cellulitis, have become extremely common among this population. In an effort to reduce these public health concerns and the public order problems associated with public injection drug use, in September 2003, Vancouver, Canada opened a pilot medically supervised safer injecting facility (SIF), where IDUs can inject pre-obtained illicit drugs under the supervision of medical staff. The SIF was granted a legal exemption to operate on the condition that its impacts be rigorously evaluated. In order to ensure that the evaluation is appropriately open to scrutiny among the public health community, the present article was prepared to outline the methodology for evaluating the SIF and report on some preliminary observations. The evaluation is primarily structured around a prospective cohort of SIF users, that will examine risk behavior, blood-borne infection transmission, overdose, and health service use. These analyses will be augmented with process data from within the SIF, as well as survey's of local residents and qualitative interviews with users, staff, and key stakeholders, and standardised evaluations of public order changes. Preliminary observations suggest that the site has been successful in attracting IDUs into its programs and in turn helped to reduce public drug use. However, each of the indicators described above is the subject of a rigorous scientific evaluation that is attempting to quantify the overall impacts of the site and identify both benefits and potentially harmful consequences and it will take several years before the SIF's impacts can be appropriately examined. PMID:15535885

Wood, Evan; Kerr, Thomas; Lloyd-Smith, Elisa; Buchner, Chris; Marsh, David C; Montaner, Julio SG; Tyndall, Mark W

2004-01-01

388

Immediate permanent implant reconstruction following mastectomy with capsule preservation in patients with prior augmentation mammoplasty.  

PubMed

Prior breast augmentation in patients desiring post-mastectomy reconstruction provides a unique opportunity for capsular preservation and immediate, single-step implant reconstruction. We report a case series of a single-surgeon experience with immediate implant reconstruction after skin-sparing mastectomy in patients with prior subpectoral augmentation. Final implant volumes, complications, and outcomes were examined. Twenty patients (15 bilateral, total 35 breasts) were included. Eighteen (90%) patients were treated for cancer. Mean augmentation-to-reconstruction interval was 9 years (range, 3-19 years). Mean patient age was 45.1 years (range, 37-64 years). Eight patients (40%) received postoperative chemotherapy and two (10%) radiation. Mean mastectomy weight was 321 g. Mean weight of the implants removed was 346 g. Mean volume of new implants was 487 mL. All patients underwent capsulotomy (100% superior, 85% medial, 30% inferior, 5% lateral). Mean operative time was less than 1 hour for bilateral reconstruction. With average follow-up of 25.6 months, 2 patients were re-operated on for asymmetry (implant malposition, synmastia). Thirty-day complications included 1 implant loss due to infection, 1 drain placement with implant salvage, 1 hematoma requiring evacuation, and 1 cellulitis treated with antibiotics. There were no late complications and no capsular contractures. None have required further oncologic surgery. No cancer recurrences have been detected. In patients who desire prosthetic reconstruction similar to their original submuscular augmentation, capsule preservation and implant replacement with a larger prosthetic inserted within the old capsule is safe, fast, and aesthetically pleasing without compromising oncologic principles. PMID:24401813

Elliott, L Franklyn; Chu, Carrie K; Daniel, Jarrod; Harper, Garrett; Bergey, Patricia

2014-06-01

389

Recurrences in Laparoscopic Incisional Hernia Repairs: A Personal Series and Review of the Literature  

PubMed Central

Objective: Laparoscopic repair of incisional ventral hernias with ePTFE mesh continues to evolve, with variable reporting of surgical techniques and outcomes. This report of 34 cases discusses, with a literature review of laparoscopic incisional hernia repair, specific factors associated with three recurrences. Methods: Retrospective analysis and review of the literature. Results: Thirty-two patients (16 female, 16 male), under-went 34 laparoscopic repairs: average age54 years (27-80), average weight207 lbs (100-300). Nineteen patients (62%) were undergoing first time repairs, 38% were redo cases and 5 cases (14%) involved previous mesh. Operating times averaged 101 minutes (45-220), and average length of stay was 1.9 days (0.6 days excluding 5 patients who required readmission), with 13 patients (38%) being discharged same-day. Two patients developed cellulitis (6%) treated without patch removal. Two enterotomies occurred (6%) both requiring patch removal. Five patients required readmission (14%), and one patient died postoperative day 29 secondary to end-stage liver disease. Three recurrences developed (9%): one secondary to missed enterotomy with reoperation, patch removal and hernia recurrence; one due to omission of suspension suture fixation; and one recurrence developed in a section of the intact old previous incision that extended beyond the original patch. Follow up has averaged 20 months (4-36). Conclusions: The laparoscopic repair of ventral and incisional hernias utilizing transabdominal placement of ePTFE patch can achieve excellent results with low morbidity in comparison with open surgical approaches. In reviewing the experience of other investigators, adequate fixation of the mesh, extension to cover the entire previous incision and standardizing the placement interval of the sutures are critical to the success of the repair. PMID:10694076

Voeller, Guy

1999-01-01

390

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

391

Five-year experience with burns from glass fireplace doors in the pediatric population.  

PubMed

Burns from contact with glass doors of gas fireplaces have been previously reported. The purpose of this study is to examine the incidence and severity of this injury in our population. Patients were identified for inclusion in the retrospective chart review study using the National Trauma Registry of the American College of Surgeons (NTRACS) and our local outpatient database. Criteria for inclusion were burn injuries sustained from contact with fireplace glass doors treated at our pediatric burn center from 2007 through 2011. Fifty children met these criteria, including two children whose burns were caused by electric fireplace glass doors. BSA burned was 1.5 1.5% (mean SD), range 0.5 to 10%. Age was 27.2 27.3 months, range 8 months to 13 years. Forty-five children (90%) had hand burns; of these, 18 children had bilateral hand involvement. Facial burns were found in three children (6%), and eight children (16%) had other areas burned. One patient developed cellulitis. Two patients required surgery. Six children (12%) required hospitalization; mean length of stay was 5.8 5 days, range 1 to 5 days. Although the number of inpatient admissions was relatively few, 329 outpatient visits and 309 rehabilitation visits were required for treatment of these children. Nineteen patients (38%) required splints and six patients (12%) required scar treatment with pressure garments. Burns from contact with fireplace glass doors are a recurring problem. Toddlers are most at risk. Directed preventive strategies including parent education, safety warnings, and design modifications such as temperature sensors and barrier screens could be potentially helpful in reducing the incidence of this injury. PMID:24043229

Baryza, Mary Jo; Hinson, Michelle; Conway, Jennifer; Ryan, Colleen M

2013-01-01

392

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

393

A study of factors affecting the steady spin of an airplane  

NASA Technical Reports Server (NTRS)

Data from wind-tunnel tests on a model of the NY-1 airplane were used in a study of the effect on the steady spin of a number of factors considered to be important. The factors were of two classes, mass distribution effects and aerodynamic effects. The study indicated that mass extended along the longitudinal axis has no detrimental effect or is even slightly beneficial, mass extended along the lateral axis is detrimental if the airplane spins with the inner wing tip far down, and mass extended along the normal axis, if of considerable magnitude, has a strong favorable effect. The aerodynamic effects considered in terms of rolling, pitching, and yawing moments added to those for a conventional airplane showed that added stable rolling moment could contribute favorable effect on the spin only in decreasing the amount of inward sideslip required for equilibrium. Negative pitching moment of moderate magnitude has unfavorable effect on a high-angle-of-attack spin, and stable yawing moment has pronounced beneficial effect on the spin. Experimental data from various sources were available to verify nearly all the deductions resulting from the study of the curves. When these results were considered for the purpose of deciding upon the best means to be developed for controlling the spin, the yawing-moment equilibrium was found to offer the most promising field for research. The wing-cellule yawing moment, of which the shape of the chord-force curve is an approximate measure, should be made as small as possible in the unstable sense and the damping yawing moment of the tail should be made as large as possible. The most serious unfavorable effect on the damping yawing moment of the tail is the blanketing of the vertical surfaces by the other parts of the tail.

Scudder, Nathan F

1933-01-01

394

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

395

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

396

Dispersal of Group A Streptococcal Biofilms by the Cysteine Protease SpeB Leads to Increased Disease Severity in a Murine Model  

PubMed Central

Group A Streptococcus (GAS) is a Gram-positive human pathogen best known for causing pharyngeal and mild skin infections. However, in the 1980's there was an increase in severe GAS infections including cellulitis and deeper tissue infections like necrotizing fasciitis. Particularly striking about this elevation in the incidence of severe disease was that those most often affected were previously healthy individuals. Several groups have shown that changes in gene content or regulation, as with proteases, may contribute to severe disease; yet strains harboring these proteases continue to cause mild disease as well. We and others have shown that group A streptococci (MGAS5005) reside within biofilms both in vitro and in vivo. That is to say that the organism colonizes a host surface and forms a 3-dimensional community encased in a protective matrix of extracellular protein, DNA and polysaccharide(s). However, the mechanism of assembly or dispersal of these structures is unclear, as is the relationship of these structures to disease outcome. Recently we reported that allelic replacement of the streptococcal regulator srv resulted in constitutive production of the streptococcal cysteine protease SpeB. We further showed that the constitutive production of SpeB significantly decreased MGAS5005?srv biofilm formation in vitro. Here we show that mice infected with MGAS5005?srv had significantly larger lesion development than wild-type infected animals. Histopathology, Gram-staining and immunofluorescence link the increased lesion development with lack of disease containment, lack of biofilm formation, and readily detectable levels of SpeB in the tissue. Treatment of MGAS5005?srv infected lesions with a chemical inhibitor of SpeB significantly reduced lesion formation and disease spread to wild-type levels. Furthermore, inactivation of speB in the MGAS5005?srv background reduced lesion formation to wild-type levels. Taken together, these data suggest a mechanism by which GAS disease may transition from mild to severe through the Srv mediated dispersal of GAS biofilms. PMID:21547075

Connolly, Kristie L.; Roberts, Amity L.; Holder, Robert C.; Reid, Sean D.

2011-01-01

397

Efficacy and Safety of Tunneled Pleural Catheters in Adults with Malignant Pleural Effusions: A Systematic Review  

PubMed Central

Background Malignant pleural effusions (MPE) are a frequent cause of dyspnea and discomfort at the end of cancer patients' lives. The tunneled indwelling pleural catheter (TIPC) was approved by the FDA in 1997 and has been investigated as a treatment for MPE. Objective To systematically review published data on the efficacy and safety of the TIPC for treatment of MPE. Design We searched the MEDLINE, EMBASE, and ISI Web of Science databases to identify studies published through October 2009 that reported outcomes in adult patients with MPE treated with a TIPC. Data were aggregated using summary statistics when outcomes were described in the same way among multiple primary studies. Main Measures Symptomatic improvement and complications associated with use of the TIPC. Key Results Nineteen studies with a total of 1,370 patients met criteria for inclusion in the review. Only one randomized study directly compared the TIPC with the current gold standard treatment, pleurodesis. All other studies were case series. Symptomatic improvement was reported in 628/657 patients (95.6%). Quality of life measurements were infrequently reported. Spontaneous pleurodesis occurred in 430/943 patients (45.6%). Serious complications were rare and included empyema in 33/1168 patients (2.8%), pneumothorax requiring a chest tube in 3/51 (5.9%), and unspecified pneumothorax in 17/439 (3.9%). Minor complications included cellulitis in 32/935 (3.4%), obstruction/clogging in 33/895 (3.7%) and unspecified malfunction of the catheter in 11/121 (9.1%). The use of the TIPC was without complication in 517/591 patients (87.5%). Conclusions Based on low-quality evidence in the form of case series, the TIPC may improve symptoms for patients with MPE and does not appear to be associated with major complications. Prospective randomized studies comparing the TIPC to pleurodesis are needed before the TIPC can be definitively recommended as a first-line treatment of MPE. PMID:20697963

McKee, Kanako Y.; Kohlwes, R. Jeffrey

2010-01-01

398

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 Symes 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

399

Incidence and Predictors of Hospitalization for Bacterial Infection in Community-Based Patients with Type 2 Diabetes: The Fremantle Diabetes Study  

PubMed Central

Background The few studies that have examined the relationship between diabetes and bacterial infections have utilized administrative databases and/or have had limited/incomplete data including recognized infection risk factors. The aim of this study was to determine the incidence and associates of bacterial infection severe enough to require hospitalization in well-characterized community-based patients with type 2 diabetes. Methods and Findings We studied a cohort of 1,294 patients (meanSD age 64.111.3 years) from the longitudinal observational Fremantle Diabetes Study Phase I (FDS1) and 5,156 age-, gender- and zip-code-matched non-diabetic controls. The main outcome measure was incident hospitalization for bacterial infection as principal diagnosis between 1993 and 2010. We also examined differences in statin use in 52 FDS1 pairs hospitalized with pneumonia (cases) or a contemporaneous non-infection-related cause (controls). During 12.05.4 years of follow-up, 251 (19.4%) patients were hospitalized on 368 occasions for infection (23.7/1,000 patient-years). This was more than double the rate in matched controls (incident rate ratio (IRR) (95% CI), 2.13 (1.882.42), P<0.001). IRRs for pneumonia, cellulitis, and septicemia/bacteremia were 1.86 (1.552.21), 2.45 (1.923.12), and 2.08 (1.413.04), respectively (P<0.001). Among the diabetic patients, older age, male sex, prior recent infection-related hospitalization, obesity, albuminuria, retinopathy and Aboriginal ethnicity were baseline variables independently associated with risk of first hospitalization with any infection (P?0.005). After adjustment for these variables, baseline statin treatment was not significant (hazard ratio (95% CI), 0.70 (0.391.25), P?=?0.22). Statin use at hospitalization for pneumonia among the case-control pairs was similar (23.1% vs. 13.5%, P?=?0.27). Conclusions The risk of severe infection is increased among type 2 diabetic patients and is not reduced by statin therapy. There are a number of other easily-accessible sociodemographic and clinical variables that could be used to optimize infection-related education, prevention and management in type 2 diabetes. PMID:23536910

Hamilton, Emma J.; Martin, Natalie; Makepeace, Ashley; Sillars, Brett A.; Davis, Wendy A.; Davis, Timothy M. E.

2013-01-01

400

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 g/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

2014-09-01

401

Multiple Intramuscular Gouty Tophi Mimicking Deep Tissue Abscesses: A Case Report  

PubMed Central

Introduction: Gout is a common metabolic disorder resulting from supersaturation of uric acid in extracellular fluid and deposition of monosodium urate monohydrate crystals in tissues triggering inflammatory response. Depositions of uric acid crystal outside articular structures cause tophi and are commonly found at peripheral areas of the body which have a lower temperature. Deposition of uric acid crystals in the central area of the body is not uncommon and may be overlooked. Case presentation: A 55-year-old Pacific Islander man with a history of chronic tophaceous gout was admitted because of acute right knee pain. Physical examination revealed signs of inflammation over the right knee. Arthrocentesis was performed but no synovial fluid obtained. The patient was empirically treated with prednisone, colchicine, and febuxostat. On the next day, there was progression of inflammation up to the right mid-thigh. MRI of the right femur was obtained to exclude abscess and necrotizing faciitis. Multiple pockets of abscesses were identified within the vastus medialis and vastus intermedius adjacent to the femoral shaft. This prompted immediate surgical consultation and incision and drainage. Intraoperative findings revealed healthy muscles and deposition of soft-tan material in the vastus medialis and vastus intermedius along and above the shaft of the femur. Culture of the surgical aspirate was negative and pathology showed needle-shaped structures consistent with uric acid crystals. Empiric antibiotic was discontinued. The patient's condition improved after treatment for acute gout. Pegloticase was also added to the treatment regimen during an outpatient follow up visit with his rheumatologist. At six month follow up, the patient reported excellent improvements in clinical symptoms. Discussion: Atypical presentations of chronic tophaceous gout can be a great mimicker, causing diagnostic challenges for clinicians. Our patient who had multiple intramuscular tophi presented with abrupt signs and symptoms of inflammation of lower extremity resembling cellulitis, abscess, or necrotizing fasciitis. On MRI, tophi typically exhibit low signal on T1-weighted images and medium to high signal on T2-weighted images, indicating the presence of cellular tissues surrounding or infiltrating the crystalline mass. The vascularity of this tissue influences the degree of MRI post-contrast enhancement on T2-weighted images. With varying degrees of cellular response and vascularity, distinguishing tophi from abscesses by MRI is still difficult. Conclusion: Our report focuses on the fact that tophi can also trigger acute inflammatory responses mimicking those of acute infection. At atypical locations, it can lead to misdiagnosis and inappropriate treatment. MRI is not a sensitive tool to differentiate abscess from tophaceous gout. Tissue diagnosis obtained from biopsy or aspiration is warranted to guide appropriate treatment and distinguish these different entities.

Luu, Van T

2014-01-01

402

Comparative study of the efficacy and safety of two polyvalent, caprylic acid fractionated [IgG and F(ab')2] antivenoms, in Bothrops asper bites in Colombia.  

PubMed

The efficacy and safety of two polyvalent horse-derived antivenoms in Bothrops asper envenomings were tested in a randomized, double-blind, clinical trial performed in Colombia. Both antivenoms were manufactured from the same pool of hyperimmune plasma. Antivenom A was made of F(ab')2 fragments, generated by pepsin digestion and caprylic acid precipitation, whereas antivenom B consisted of whole IgG molecules produced by caprylic acid precipitation followed by ion-exchange chromatography. Besides the different nature of the active substance, antivenom B had higher protein concentration, slightly higher turbidity and aggregate content. No significant differences were observed in the efficacy of antivenoms. Both halted local and systemic bleeding (P = 0.40) within 6-12 h of treatment in 100% of the cases, and restored blood coagulation (P = 0.87) within 6-24 h in 84.7% of patients, and within 48 h in all of them, in agreement with restoration of plasma fibrinogen concentration. Venom concentrations in serum dropped significantly (P < 0.001), to very low levels, 1 h after antivenom infusion. Nevertheless, eight patients (11.1%), four for each antivenom, presented recurrence of venom antigenaemia at different times, from 6 to 96 h, with clinical significance (recurrent coagulopathy) only in one group B patient (2.9%). Serum creatine kinase (CK) activity was increased, as a consequence of local myonecrosis. There was no significant difference (P = 0.51) in the incidence of early adverse reactions to antivenom administration (28.9% for patients of group A and 20.6% for patients of group B), most of the reactions being mild, mainly cutaneous. The most frequent complications were cellulitis (16.7%), abscess formation (5.6%), acute renal failure (8.3%), and compartmental syndrome (5.6%). In conclusion, IgG and F(ab')2 antivenoms, prepared by caprylic acid fractionation, presented similar efficacy and safety profiles for the treatment of B. asper envenomings in Colombia. PMID:22146491

Otero-Patio, Rafael; Segura, Alvaro; Herrera, Mara; Angulo, Yamileth; Len, Guillermo; Gutirrez, Jos Mara; Barona, Jacqueline; Estrada, Sebastin; Pereaez, Andrs; Quintana, Juan Carlos; Vargas, Leidy J; Gmez, Juan Pablo; Daz, Abel; Surez, Ana Mara; Fernndez, Jorge; Ramrez, Patricia; Fabra, Patricia; Perea, Monica; Fernndez, Diego; Arroyo, Yobana; Betancur, Dalila; Pupo, Lady; Crdoba, Elkin A; Ramrez, C Eugenio; Arrieta, Ana Berta; Rivero, Alcides; Mosquera, Diana Carolina; Conrado, Nectty Lorena; Ortiz, Rosina

2012-02-01

403

Tungiasis: a neglected epidermal parasitic skin disease of marginalized populations--a call for global science and policy.  

PubMed

Tungiasis (sand flea disease) is an ectoparasitic skin disease caused by the female sand flea/jigger flea (Tunga penetrans). As poverty is the major driving force of the disease, it can be called as a poverty-associated plague. It is one of the emerging neglected diseases in Latin America, Caribbean, sub-Saharan Africa, and India. The aim of the present scrutiny was to assess the public health impact of tungiasis, associated risk factors, and emerging opportunities to prevent and control tungiasis. Searches of PubMed, Google Scholar, and online search engines (Google, AOL, and Yahoo) using keywords "parasitic skin disease," "tungiasis," "sand flea," " tungiasis-associated risk factors," "tungiasis prevention and control," and their synonyms were used as a source of references. Searches were made without time limitations. Of 167 potential articles identified by these criteria, 51 appropriate were selected for review. Tungiasis is widespread in the resource-constrained settings of low-income economies. In the tropics, it is highly prevalent among the impoverished populations, but the associated risk factors are often poorly identified and remain uncontrolled. Though it is a self-limiting disease with considerable morbidity, the parasite may cause subsequent secondary morbidity through life-threatening complications and infections like cellulitis, tetanus, and death. However, the direct and indirect sociocultural, economic, and health impact of tungiasis is often undervalued and misunderstood. A systematic assessment on disease burden is still dearth and deficient. Over the decades, tungiasis has been largely neglected by the scientific community, policy makers, and healthcare stakeholders. In the endemic regions, even tungiasis is not listed for the disease control priorities in the regional, national, and international agenda. The majority of the epidermal parasitic skin diseases particularly tungiasis needs a sustainable global scientific research and control policy. This urges intensive efforts to develop a road map that delivers a clear vision towards zero new infection by designing low-cost prevention and control strategies. Besides, there is an urgency to develop culturally appropriate communication techniques and workable collaboration on a global scale by bringing all the stakeholders of endemic countries. PMID:23949241

Karunamoorthi, Kaliyaperumal

2013-10-01

404

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

405

A case of a patient with stage III familial hidradenitis suppurativa treated with 3 courses of infliximab and died of metastatic squamous cell carcinoma.  

PubMed

Although rare, severe hidradenitis suppurativa (HS) of the anal, perianal, gluteal, thigh, and groin regions can evolve into squamous cell carcinoma (SCC). This usually does not occur until the HS has been present for more than 20 years. Malignant degeneration of HS in the axilla has not been reported. SCC has developed in dissecting cellulitis, acne conglobata, and pilonidal cysts (other members of the follicular tetrad). Whereas the male to female ratio of HS is 1:3, SCC in HS has a male to female ration of 5:1. The reasons behind malignant degeneration in HS are complex and might differ from the malignant degeneration causing Marjolin ulcers. It likely involves the presence of human papilloma virus (HPV) in affected areas (a rarity in the axilla), and impaired defensins, which combat HPV, in the skin of Hurley Stage III HS. In familial HS, the odds of developing SCC are likely greater because of independent loss-of-function mutations in the ?-secretase multiprotein complex, which regulates the Notch signaling pathway. Compromise of the Notch signaling pathway can undermine immune function and increase the risk of neoplastic development. Coincident SCC with use of tumor necrosis factor ? blockers has been reported. I report a patient with long standing Hurley Stage III, familial HS, wwho developed metastatic SCC after 3 courses of infliximab and expired 11 months after the infliximab was started. A 47-year-old male presented with progressive HS since early adulthood. His stage III hidradenitis suppurativa (HS) involved his groin, legs buttocks, and perineal areas. Interestingly, his HS was familial; one daughter also suffered from HS. A pilonidal cyst had been excised in the past. He suffered from hypertension for which he took ramipril, 2.5 mg per day. He did not admit to smoking. He had undergone numerous surgeries and courses of clindamycin with rifampin and clindamycin with minocycline. He used pregablin among other stronger medications for pain control. He had also taken isotretinoin years before without substantial long-term benefit. The various treatments were palliative but the HS always returned. He expressed that the pain from his HS was not bearable. He decided in consultations with his doctors to try infliximab owing to the positive clinical data for its efficacy in HS. He took 3 courses of infliximab 500mg, each of which was followed by surgical debridement of the perineal and anal areas. At the 3rd surgical debridement his physician noted the presence of squamous cell carcinoma (SCC) on July 28, 2008. The infliximab was stopped. However, the patient developed the patient underwent scanning soon after that showed soon after that the SCC had metastasized. He expired in June of 2009. PMID:24656278

Scheinfeld, Noah

2014-03-01

406

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 33.7days to 23.3days (mean difference 10.4days, 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 2010/2011year. 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

407

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

408

Autologous fat transfer in aesthetic facial recontouring.  

PubMed

Autologous fat graft transplantation has become increasingly popular in recent years. The recognition that soft tissue volume loss contributes to the aging of the face has driven the use of this procedure. Tumescent lipoaspirate provides ready accessibility of tissue for this transplantation, despite some perceived deficiencies in the predictability of volume maintenance with this method. We report our experience with immediately processed sedimented fat transfer for facial grooves and volume correction. A retrospective review of a consecutive series of 75 autologous fat transfers from October 2008 to July 2011 in 8 female patients between ages 46 and 73 years was conducted at Georgia Health Sciences University. The grafting was performed to improve facial aesthetic contours. Twenty-two were performed for correction of grooves and creases: 12 for nasolabial fold, 4 glabella, and 6 nasojugal. Fifty-three transfers were performed for volume augmentation: 17 malar, 14 submalar, 11 lip, 8 temple, 2 chin, and 1 jowl. A tumescent technique with manual syringe harvest was used. The abdomen was the most frequently used donor site. The tumescent was decanted from the lipoaspirate. Oil and nonviable fat were excluded. Care was taken to reduce the time from harvest to transplantation, with no syringe transfers, minimizing potential oxidation and injury of the tissue. The mean volume of fat transferred was 24 mL (range, 4-54 mL). Mean follow-up was 25 months (range, 6-36 months). A second session of fat transfer was required in a small percentage. Complications included minor asymmetry in 1 patient (resolved with graft manipulation) and prolonged swelling in another. No postoperative cellulitis or fat necrosis was reported. Clinical evaluations and patients reported a satisfactory result 88% of the time. Patients universally reported (100%) a desire to have the procedure performed again. Autologous fat transfer for facial soft tissue contouring is simple, safe, inexpensive, and effective. Its ready availability, natural integration into host tissues, and potentially permanent correction make it particularly useful for this application. All patients were satisfied with the soft, natural appearance. PMID:23542845

Gamboa, Gloria Mabel; Ross, William A

2013-05-01

409

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 20072010 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 3.13.4%) were for skin infection, and 2.7% (2.62.9%) were first visits for skin infection, with no increase over time (p=0.80). However, anti-CA-MRSA antibiotic use increased, from 61% (5666%) to 74% (7178%) 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 (8490%, overuse). Among antibiotic regimens for abscess patients, 84% included anti-CA-MRSA agents (8189%, underuse). Conclusion: From 20072010, 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):282289.] PMID:24868305

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

2014-01-01

410

Comparison of the Efficacy and Safety of Oritavancin Front-Loaded Dosing Regimens to Daily Dosing: an Analysis of the SIMPLIFI Trial ?  

PubMed Central

Oritavancin is a novel lipoglycopeptide with demonstrated effectiveness against complicated skin and skin structure infections (cSSSI) caused by Gram-positive pathogens, including those caused by methicillin-resistant Staphylococcus aureus (MRSA). The pharmacokinetic and pharmacodynamic profile of oritavancin is favorable for single or infrequent dosing. A phase 2, multicenter, randomized, double-blind, parallel, active-comparator study (ClinicalTrials.gov identifier, NCT00514527) of single and infrequent dosing of intravenous (i.v.) oritavancin for the treatment of cSSSI caused by Gram-positive pathogens (wound infections, major abscess, and cellulitis) was undertaken to evaluate the noninferiority of front-loaded dosing regimens compared to a daily-dosing regimen. A total of 302 patients ?18 years of age were randomized equally to one of three oritavancin treatment groups, receiving either a daily dose (200 mg) administered for 3 to 7 days, a single dose (1,200 mg), or an infrequent dose (800-mg dose, with the option for an additional 400 mg on day 5). The primary efficacy was defined as a clinical response in clinically evaluable (CE) patients assessed at days 21 to 29 (test of cure [TOC]). The cure rates in the CE population were 72.4% (55/76) in the daily-dose group, 81.5% (66/81) in the 1,200-mg-single-dose group, and 77.5% (55/71) in the infrequent-dose group. In patients with MRSA at baseline, the cure rates were 78.3% (18/23), 73.0% (27/37), and 87.0% (20/23) in the daily-, 1,200-mg-single-, and infrequent-dose groups, respectively; however, the study was not powered to assess outcomes in the MRSA subpopulation, and given the heterogeneity of the types of infection and the small sample size, these do not suggest any true differences in efficacy rates for these pathogens. The frequencies of adverse events were similar among treatment groups. The results of this study show that single- and infrequent-dosing schedules of oritavancin were as efficacious as daily administration and had a similar safety profile in treating cSSSI caused by Gram-positive pathogens, including MRSA. PMID:21537018

Dunbar, Lala M.; Milata, Joe; McClure, Ty; Wasilewski, Margaret M.

2011-01-01

411

Immunohistochemical expression of CD44s in human neuroblastic tumors: Moroccan experience and highlights on current data  

PubMed Central

Background Peripheral neuroblastic tumors (pNTs), including neuroblastoma (NB), ganglioneuroblastoma (GNB) and ganglioneuroma (GN), are extremely heterogeneous pediatric tumors responsible for 15 % of childhood cancer death. The aim of the study was to evaluate the expression of CD44s (s: standard form) cell adhesion molecule by comparison with other specific prognostic markers. Methods An immunohistochemical profile of 32 formalin-fixed paraffin-embedded pNTs tissues, diagnosed between January 2007 and December 2010, was carried out. Results Our results have demonstrated the association of CD44s negative pNTs cells to lack of differentiation and tumour progression. A significant association between absence of CD44s expression and metastasis in human pNTs has been reported. We also found that expression of CD44s defines subgroups of patients without MYCN amplification as evidenced by its association with low INSS stages, absence of metastasis and favorable Shimada histology. Discussion These findings support the thesis of the role of CD44s glycoprotein in the invasive growth potential of neoplastic cells and suggest that its expression could be taken into consideration in the therapeutic approaches targeting metastases. Virtual Slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1034403150888863 Rsum Introduction les tumeurs neuroblastiques priphriques (TNPs), comprenant le neuroblastome (NB), le ganglioneuroblastome (GNB) et le ganglioneurome (GN), sont des tumeurs pdiatriques extrmement htrognes responsables de 15% des dcs par cancer chez les enfants. Le but de cette tude tait dvaluer lexpression de la molcule dadhsion cellulaire CD44s (s: pour standard) par rapport dautres facteurs pronostiques spcifiques. Mthodes Un profil immunohistochimique de 32 TNPs fixes au formol et incluses en paraffine, diagnostiques entre Janvier 2007 et Dcembre 2010, a t ralis. Rsultats Nos rsultats ont mis en vidence lassociation des TNPs nexprimant pas le CD44s avec une perte de diffrenciation et une progression tumorale et nous avons rapport une association significative entre labsence dexpression du CD44s et la prsence de mtastases. Nous avons galement constat que lexpression du CD44s dfinit des sous-groupes de patients dans les tumeurs namplifiant pas le MYCN, comme en tmoigne son association avec les stades INSS bas, labsence de mtastases et lhistologie favorable de Shimada. Discussion Ces rsultats appuient lhypothse du rle de la glycoprotine CD44s dans le potentiel de croissance invasive des cellules noplasiques et suggrent que son expression pourrait tre prise en considration dans des voies thrapeutiques ciblant les mtastases. PMID:23445749

2013-01-01

412

Feasibility and Effectiveness of Indicator Condition-Guided Testing for HIV: Results from HIDES I (HIV Indicator Diseases across Europe Study)  

PubMed Central

Improved methods for targeting HIV testing among patients most likely to be infected are required; HIDES I aimed to define the methodology of a European wide study of HIV prevalence in individuals presenting with one of eight indicator conditions/diseases (ID); sexually transmitted infection, lymphoma, cervical or anal cancer/dysplasia, herpes zoster, hepatitis B/C, mononucleosis-like illness, unexplained leukocytopenia/thrombocytopenia and seborrheic dermatitis/exanthema, and to identify those with an HIV prevalence of >0.1%, a level determined to be cost effective. A staff questionnaire was performed. From October 2009 February 2011, individuals, not known to be HIV positive, presenting with one of the ID were offered an HIV test; additional information was collected on previous HIV testing behaviour and recent medical history. A total of 3588 individuals from 16 centres were included. Sixty-six tested positive for HIV, giving an HIV prevalence of 1.8% [95% CI: 1.422.34]; all eight ID exceeded 0.1% prevalence. Of those testing HIV positive, 83% were male, 58% identified as MSM and 9% were injecting drug users. Twenty percent reported previously having potentially HIV-related symptoms and 52% had previously tested HIV negative (median time since last test: 1.58 years); which together with the median CD4 count at diagnosis (400 cell/uL) adds weight to this strategy being effective in diagnosing HIV at an earlier stage. A positive test was more likely for non-white individuals, MSM, injecting drug users and those testing in non-Northern regions. HIDES I describes an effective strategy to detect undiagnosed HIV infection. All eight ID fulfilled the >0.1% criterion for cost effectiveness. All individuals presenting to any health care setting with one of these ID should be strongly recommended an HIV test. A strategy is being developed in collaboration with ECDC and WHO Europe to guide the implementation of this novel public health initiative across Europe. PMID:23341910

Sullivan, Ann K.; Raben, Dorthe; Reekie, Joanne; Rayment, Michael; Mocroft, Amanda; Esser, Stefan; Leon, Agathe; Begovac, Josip; Brinkman, Kees; Zangerle, Robert; Grzeszczuk, Anna; Vassilenko, Anna; Hadziosmanovic, Vesna; Krasnov, Maksym; Sonnerborg, Anders; Clumeck, Nathan; Gatell, Jose; Gazzard, Brian; Monforte, Antonella d'Arminio; Rockstroh, Jurgen; Lundgren, Jens D.

2013-01-01

413

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

414

Une porte optique intensificatrice picoseconde a gain eleve: Caracterisation et application potentielle en imagerie de petits objets places dans des milieux diffusants  

NASA Astrophysics Data System (ADS)

Dans cette etude, nous avons developpe un amplificateur a colorant possedant ces deux caracteristiques. Le colorant choisi, l'iodure de 3,3'-dimethyloxatricarbocyanine (methyl-DOTCI), possede un epaulement dans la bande d'absorption a 620 nm ce qui convient bien a notre pompe femtoseconde. De plus, son maximum de fluorescence est a 720 nm ce qui est particulierement interessant dans le cas des etudes avec des tissus biologiques humains. En effet, la fenetre dite "therapeutique" se situe dans les longueurs d'onde rouge et proche infrarouge. Le phenomene d'amplification, qui se produit dans des conditions experimentales precises, est en fait une emission stimulee du colorant qui est largement favorisee par rapport a sa fluorescence naturelle (emission spontanee). L'arrivee du signal incident, dont la longueur d'onde correspond au saut energetique entre l'etat fondamental et l'etat excite ou se trouvent les molecules, provoque une avalanche coherente de celles-ci vers l'etat fondamental generant ainsi l'emission stimulee. Une des conditions necessaires pour l'obtention d'un gain eleve est que la duree de l'impulsion de pompe soit inferieure au temps de relaxation des molecules ainsi qu'inferieure au temps requis pour effectuer un trajet dans la cellule de colorant. Ceci nous a permis d'amplifier un signal incident par un facteur entre 103 et 104. De plus, ce gain eleve n'est observe qu'a l'interieur d'une fenetre temporelle d'environ 10 picosecondes. Nous avons integre cet amplificateur a notre montage de transillumination afin d'acquerir des images d'un patron de lignes opaques immerge dans un milieu diffusant liquide. Des images de lignes ayant une resolution spatiale de 200 mum ont ete obtenues. La cible etait placee au centre d'un melange contenant des proportions variables de lait et d'eau. Deux longueurs de trajet optique dans la solution ont ete utilisees: 30 et 50 mm. Pour determiner les proprietes optiques de notre milieu diffusant, nous avons mis au point une technique de caracterisation basee sur la distribution radiale des photons transmis a travers le milieu. Deux parametres de transport, les coefficients de diffusion effectif (mus') et d'absorption (mu a), caracterisent la forme et l'amplitude du profil radial. Le fit des courbes experimentales a des courbes simulees nous a permis d'extraire ces coefficients. Les courbes simulees ont ete realisees grace a une simulation Monte Carlo qui incorpore les conditions experimentales de notre montage de caracterisation. (Abstract shortened by UMI.)

Marengo, Stephanie

415

Community-acquired methicillin-resistant Staphylococcus aureus skin infections: implications for patients and practitioners.  

PubMed

Dermatologists and other healthcare providers need to be aware of the epidemiology, clinical features, management, and prevention of community-acquired methicillin-resistant Staphylococcus aureus (CAMRSA) infection. Currently, infection caused by CAMRSA is considered to represent a worldwide epidemic and infectious skin lesions are a frequent occurrence. Athletes, certain ethnic populations, children, homeless persons, homosexual men, household members of infected people, HIV-infected patients, intravenous drug abusers, military personnel, newborns, pregnant and postpartum women, tattoo recipients, and urban dwellers of lower socioeconomic status in crowded living conditions are individuals at increased risk of developing CAMRSA infection. Although the observed incidence of cutaneous CAMRSA lesions in patients with atopic dermatitis or other conditions that are characterized by a non-intact skin barrier is less than that reported in other groups of people at risk for this skin infection, close surveillance for the emergence of CAMRSA skin infection in children and adults with atopic dermatitis and other patients whose skin barrier is disrupted is justified since colonization by S. aureus in these individuals represents a potential reservoir for CAMRSA. It is also important to note that infection-associated risk factors are absent in many individuals who develop cutaneous CAMRSA infection. CAMRSA skin lesions are pleomorphic. The most common presentations of CAMRSA infection are abscess, cellulitis, or both. These infectious lesions are not uncommonly misinterpreted by the patient as spider bites or insect bites. Other manifestations of cutaneous CAMRSA infection are impetigo, folliculitis, and paronychia. Incision and drainage of abscesses, systemic antibacterial therapy, and adjunctive topical antibacterial treatment are the essential components of management of CAMRSA skin infections. At the initial visit, a bacterial culture of the infectious lesion is recommended to confirm identification of the pathogen and to determine antimicrobial susceptibility. Subsequently, based upon the reported antibacterial sensitivity, alteration (if necessary) of the patient's empiric systemic antimicrobial treatment can be initiated. Direct skin-to-skin transmission of the causative bacteria, damage to the skin's surface, sharing of personal items, and a humid environment are potential mechanisms for the acquisition and transmission of CAMRSA skin infection. The spread of cutaneous CAMRSA infection can potentially be prevented by incorporating personal, environmental, and healthcare measures that strive to eliminate the causes of acquisition and transmission of the bacteria. PMID:17902728

Cohen, Philip R

2007-01-01

416

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 Behet'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

417

Transport quantique dans des nanostructures  

NASA Astrophysics Data System (ADS)

Quantum transport in nanostructures This work is devoted to the design, fabrication and magnetotransport investigations of mesoscopic devices. The sample are obtain by e-beam lithography and the measurements are performed at low temperature in a dilution refrigerator in the presence of a magnetic field. We have used MBE grown AlGaAs/GaAs heterojonctions as starting material to fabricate a bipartite tiling of rhombus called mathcal{T}3 lattice. We observe for the first time large amplitude h/e oscillations in this network as compared to the one measured in square lattices of similar size. These oscillations are the signature of a recently predited localization phenomenon induced by Aharonov-Bohm interferences on this peculiar topology. For particular values of the magnetic field the propagation of the electron wave function is bounded in a small number of cells, called Aharonov-Bohm cages. More strikingly, at high magnetic field, h/2e oscillations appear whose amplitude can be much higher than the fundamental period. Their temperature dependence is similar to that of the h/e signal. These observations withdraw a simple interpretation in terms of harmonics generation. The origin of this phenomenon is still unclear and needs more investigations. The influence electrical width of the wire defining the network and so the rule of the number of channels can be studied using a gate deposited over the lattice. In particular we have measured the amplitude dependence of the h/e and h/2e signal versus the gate voltage. Ce travail est consacr la ralisation d'chantillons msoscopiques partir de la lithographie lectronique ainsi qu' leur caractrisation trs basse temprature en magntotransport. Nous avons pour cela exploit le gaz bidimensionnel d'lectrons situ l'interface d'une htrojonction AlGaAs/GaAs pour raliser un rseau de boucle d'une gomtrie particulire baptise la gomtrie mathcal{T}3. Nous avons observ sur cette structure des oscillations de conductance en fonction du flux du champ magntique de priode h/e dont l'amplitude est beaucoup plus importante que celle mesure sur un rseau carr de mme dimension. Cette diffrence constitue une signature d'un effet de localisation induit par le champ magntique sur la topologie mathcal{T}3. Pour des valeurs spcifiques du champ magntique, du fait des interfrences destructives Aharonov-Bohm, la propagation des fonctions d'ondes est limite un ensemble fini de cellule du rseau appel cage. De la dpendance en temprature des oscillations de priode h/e mesures sur le rseau mathcal{T}3 nous avons tir une longueur caractristique qui peut tre rattache au primtre des cages. Un phnomne inattendu fut l'observation, pour des champs magntiques plus importants, d'un doublement de frquence des oscillations. Ces oscillations de priode h/2e pouvant avoir une amplitude suprieure aux oscillations de priode h/e, une interprtation en terme d'harmonique n'est pas possible. Enfin, l'influence de la largeur lectrique des fils constituant le rseau et donc celle du nombre de canaux par brin a t tudie en ralisant des grilles lectrostatique. Les variations de l'amplitude des signaux en h/e et h/2e en fonction de la tension de grille ont t mesurs.

Naud, C.

2002-09-01

418

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; Snchez, Francesca; Castro, Pedro; Salvad, Margarita; de la Red, Gloria; Libois, Agnes; Almela, Manuel; March, Francesca; Espaol, Montserrat; Sambeat, Maria Antonia; Romeu, Joan; Brugal, Maria Teresa; Garca de Olalla, Patricia; Gatell, Jose Maria; Vila, Jordi; Garca, Felipe; Lpez Coloms, Jose Lus; Cayl, Joan A; Coll, Pere

2006-05-01

419

Developpement et application d'un systeme mobile de laser terrestre pour quantifier le bilan sedimentaire des plages  

NASA Astrophysics Data System (ADS)

Au Qubec maritime, l'rosion ctire est une problmatique d'envergure, notamment sur les ctes de formations meubles. Les plages ont un rle de zone tampon ayant comme fonction naturelle d'absorber l'nergie des vagues et donc d'assurer l'quilibre de certains cosystmes et le maintien de l'coumne en rduisant l'rosion de la cte. Les mthodes d'acquisition conventionnelles ne permettent pas de quantifier convenablement les changements morphosdimentaires d'une plage l'chelle des cellules hydrosdimentaires. Le manque de mthode d'acquisition fiable et de donnes quantitatives mne une surestimation ou une sous-estimation de la disponibilit sdimentaire d'un systme ctier. Pour contrer ces lacunes et afin de minimiser les cots d'acquisition, un nouveau systme mobile de LiDAR terrestre a t mis en place, permettant d'acqurir des donnes topographiques de l'estran, de la haute plage et des falaises. Le systme multicapteurs comprend un LiDAR, un systme de navigation haute prcision (IMU et D-GPS) et une camra. L'ensemble des instruments et capteurs sont monts sur un vhicule de type tout-terrain. Le systme a t valu sur la zone ctire de la pninsule de Manicouagan. La comparaison des donnes LiDAR avec 1 050 points de rfrence gopositionns au D-GPS montre une erreur verticale moyenne de 0,1 m sur les secteurs de plage. Les rsultats montrent que le volume sdimentaire moyen des plages devant les zones o la ligne de rivage prsente un ouvrage de protection en enrochement (12 m 3/m) est plus de trois fois plus faible que devant les secteurs l'tat naturel (35,5 m3/m). La moyenne des secteurs en transition, constituant les segments o une zone artificielle et une zone naturelle se chevauchent prsentent un volume moyen de 28 m3/m. Aussi, les plages devant les secteurs anthropiss sont en moyenne prs de 2 fois plus troites (12,7 m) que devant les secteurs naturels (25,4 m). Un indice de bilan sdimentaire des plages a t test et il constitue un excellent proxy pour valuer la disponibilit sdimentaire des plages ainsi qu'identifier les secteurs dficitaires. La ralisation d'une couverture complte au LiDAR a permis de constater que des profils de plage raliss un intervalle de plus de 200 m sur des ctes diversifies mnent des rsultats significativement diffrents de la ralit. Par contre, il semble que l'intervalle des profils peu d'impact sur de longs secteurs de plages uniformes.

Van-Wierts, Stefanie

420

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

421

[A study on fall accident].  

PubMed

The study was conducted from November 1995 to May 1996 at the one general hospital in Seoul. The total subjects of this study were 412 patients who have the experience of fall accident, among them 31 was who have fallen during hospitalization and 381 was who visited emergency room and out patient clinic. The purposes of this study were to determine the characteristics, risk factors and results of fall accident and to suggest the nursing strategies for prevention of fall. Data were collected by reviewing the medical records and interviewing with the fallers and their family members. For data analysis spss/pc+ program was utilized for descriptive statistics, adjusted standardized X2-test. The results of this study were as follows: 1) Total subjects were 412 fallers, of which 245 (59.5%) were men and 167 (40.5%) were women. Age were 0-14 years 79 (19.2%), 15-44 years 125 (30.4%), 45-64 years 104 (25.2%), over 65 years 104 (25.2%). 2) There was significant association between age and the sexes (X2 = 39.17, P = 0.00). 3) There was significant association between age and history of falls (X2 = 44.41, P = .00). And history of falls in the elderly was significantly associated with falls. 4) There was significant association with age and medical diagnosis (X2 = 140.66, P = .00), chief medical diagnosis were hypertension (34), diabetes mellitus (22), arthritis (11), stroke (8), fracture (7), pulmonary tuberculosis (6), dementia (5) and cataract (5). 5) There was significant association between age and intrinsic factors: cognitive impairment, mobility impairment, insomnia, emotional problems, urinary difficulty, visual impairments, hearing impairments, use of drugs (sedatives, antihypertensive drugs, diuretics, antidepressants) (P < 0.05). But there was no significant association between age and dizziness (X2 = 2.87, P = .41). 6) 15.3% of total fallers were drunken state when they were fallen. 7) Environmental factors of fall accident were unusual posture (50.9%), slips (35.2%), trips (9.5%) and collision (4.4%). 8) Most of falls occurred during the day time, peak frequencies of falls occurred from 1 pm to 6 pm and 7 am to 12 am. 9) The places of fall accident were roads (22.6%), house-stairs (16.7%), rooms, floors, kitchen (11.2%), the roof-top, veranda, windows (10.9%), hospital (7.5%), ice or snowy ways (5.8%), bathroom (4.9%), playground, park (4.9%), subway-stairs (4.4%) and public-bathrooms (2.2%). 10) Activities at the time of fall accident were walking (37.6%), turning around or reaching for something (20.9%), going up or down stairs (19.2%), exercise, working (17.4%), up or down from a bed (2.7%), using wheelchair or walking aids, standing up or down from a chair (2.2%) and standing still (2.2%). 11) Anatomical locations of injuries by falls were head, face, neck (31.3%), lower extremities (29.9%), upper extremities (20.6%), spine, thorax, abdomen or pelvic contents (11.4%) and unspecified (2.9%). 12) Types of injures were fracture (47.6%), bruises (13.8%), laceration (13.3%), sprains (9.0%), headache (6.6%), abrasions (2.9%), intracranial hemorhage (2.4%) and burns (0.5%). 13) 41.5% of the fallers were hospitalized and average of hospitalization was 22.3 days. 14) The six fallers (1.46%) died from fall injuries. The two fallers died from intracranial hemorhage and the four fallers died of secondary infection; pneumonia (2), sepsis (1) and cellulitis (1). It is suggested that 1) Further study is needed with larger sample size to identify the fall risk factors. 2) After the fall accident, comprehensive nursing care and regular physical exercise should be emphasized for the elderly person. 3) Safety education and safety facilities of the public place and home is necessary for fall prevention. PMID:10437605

Lee, H S; Kim, M J

1997-01-01