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https://www.readbyqxmd.com/read/28077503/european-association-for-cardio-thoracic-surgery-expert-consensus-statement-on-the-prevention-and-management-of-mediastinitis
#1
Yasir Abu-Omar, Gregor J Kocher, Paolo Bosco, Cristina Barbero, David Waller, Tomas Gudbjartsson, Miguel Sousa-Uva, Peter B Licht, Joel Dunning, Ralph A Schmid, Giuseppe Cardillo
Mediastinitis continues to be an important and life-threatening complication after median sternotomy despite advances in prevention and treatment strategies, with an incidence of 0.25-5%. It can also occur as extension of infection from adjacent structures such as the oesophagus, airways and lungs, or as descending necrotizing infection from the head and neck. In addition, there is a chronic form of 'chronic fibrosing mediastinitis' usually caused by granulomatous infections. In this expert consensus, the evidence for strategies for treatment and prevention of mediatinitis is reviewed in detail aiming at reducing the incidence and optimizing the management of this serious condition...
January 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28070877/idiopathic-retroperitoneal-fibrosis-and-its-overlap-with-igg4-related-disease
#2
REVIEW
Giovanni Maria Rossi, Rossana Rocco, Eugenia Accorsi Buttini, Chiara Marvisi, Augusto Vaglio
Retroperitoneal fibrosis (RPF) is a rare disease characterised by fibrous tissue proliferation in the retroperitoneum, with encasement of the ureters and large vessels of the abdomen as the most destructive of potentially severe complications. It can either be idiopathic, or secondary to infections, malignancies, or the use of certain drugs. The idiopathic form accounts for approximately 75% of the cases, and is usually responsive to immunosuppressive therapy. In recent years, the emergence of a new clinical entity, IgG4-related disease (IgG4-RD), shed light on many fibro-inflammatory disorders once thought to be separate clinical entities, although frequently associated in the so-called multifocal fibrosclerosis...
January 9, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28063673/-coronary-artery-bypass-graft-surgery-with-bilateral-internal-mamary-artery-short-term-results
#3
Josías Caleb Ríos Ortega, Paul Castañeda Castillo, Luisa Talledo Paredes, Franz Soplopuco Palacios, Necemio Aranda Pretell, Yemmy Pérez Valverde, Julio Morón Castro, Andrés Reyes Torres
INTRODUCTION: Coronary artery bypass graft (CABG) surgery remains the gold standard in the treatment of multivessel coronary disease. Several studies have shown that CABG with bilateral internal mammary arteries (BIMA) has better results in long-term survival. METHODOLOGY: We conducted a retrospective investigation in CABG surgeries with BIMA, performed from January 2012 to December 2015 in the National Cardiovascular Institute, INCOR, EsSalud. The objectives were determine the mortality and major cardiovascular events at 30 days follow up...
January 4, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28061951/role-and-contribution-of-pulmonary-cd103-dendritic-cells-in-the-adaptive-immune-response-to-mycobacterium-tuberculosis
#4
Vanessa Hui Qi Koh, See Liang Ng, Michelle Lay Teng Ang, Wenwei Lin, Christiane Ruedl, Sylvie Alonso
Despite international control programmes, the global burden of tuberculosis remains enormous. Efforts to discover novel drugs have largely focused on targeting the bacterium directly. Alternatively, manipulating the host immune response may represent a valuable approach to enhance immunological clearance of the bacilli, but necessitates a deeper understanding of the immune mechanisms associated with protection against Mycobacterium tuberculosis infection. Here, we examined the various dendritic cells (DC) subsets present in the lung and draining lymph nodes (LN) from mice intra-tracheally infected with M...
January 2017: Tuberculosis
https://www.readbyqxmd.com/read/28054893/utility-of-omentoplasty-in-mediastinitis-treatment-following-sternotomy
#5
Abdurrahim Colak, Ugur Kaya, Münacettin Ceviz, Necip Becit, Fehimcan Sevil, Hikmet Kocak
BACKGROUND: Mediastinal infection is one of the most serious complications that occurs following open-heart surgery by sternotomy. In the present study, omentoplasty was initially and aggressively used to treat the infection and prevent the recurrence caused by bones in cases of mediastinitis following open-heart surgery at our clinic. METHODS: Among the 3656 patients who underwent surgery at our department of cardiovascular surgery between January 1996 and December 2012, omentoplasty as a treatment for mediastinitis was applied to 19 (0...
1, 2016: Heart Surgery Forum
https://www.readbyqxmd.com/read/28054135/-community-acquired-pneumonia
#6
S Poetter-Lang, C J Herold
CLINICAL ISSUE: The diagnosis of community-acquired pneumonia (CAP) is often not possible based only on the clinical symptoms and biochemical parameters. STANDARD RADIOLOGICAL METHODS: For every patient with the suspicion of CAP, a chest radiograph in two planes should be carried out. Additionally, a risk stratification for the decision between outpatient therapy or hospitalization is recommended. METHODICAL INNOVATIONS: Based on the evaluation of the different radiological patterns as well as their extent and distribution, a rough allocation to so-called pathogen groups as well as a differentiation between viral and bacterial infections are possible; however, because different pathogens cause different patterns an accurate correlation is not feasible by relying purely on imaging...
January 4, 2017: Der Radiologe
https://www.readbyqxmd.com/read/28043632/mycobacterial-coinfection-and-persisting-bovine-tuberculosis-has-the-time-arrived-for-a-policy-review
#7
Nader Mosavari, Morad Moradi Geravand, Keyvan Tadayon, Rohollah Keshavarz
OBJECTIVE/BACKGROUND: Bovine tuberculosis (BTb) is mainly a disease of cattle, although it continues to infect human populations across the world. Operation of a test and slaughter plan in Iran since 1981 has lowered the frequency of BTb from >5% to <0.14% at the national scale. In 2015, unusual uncontrollable epidemics of BTb were detected in two cattle farms in municipal suburbs of Qazvin and Isfahan. These farms had a tuberculin-test-certified record of BTb-free status for the past 5 consecutive years, with no new cattle registered with either of the two herds during this time period...
December 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28043582/mediastinal-lymphadenopathy-in-pediatric-tuberculosis-in-computed-tomography-scan
#8
Payam Mehrain, Amin Momeni Moghaddam, Elham Tavakol, Afshin Amini, Mehrdad Moghimi, Ali Kabir, Ali Akbar Velayati
BACKGROUND/OBJECTIVES: Pediatric tuberculosis is usually a primary infection presenting mainly as mediastinal or hilar adenopathy in computed tomography (CT) scan. In this study, we study the distribution and other CT scan characteristics of mediastinal lymphadenopathy in childhood tuberculosis. METHODS: Chest CT scans of 75 cases of pediatric tuberculosis at Masih Daneshvari Hospital in Tehran, Iran, from 2009 to 2013 were studied regarding characteristics of mediastinal lymphadenopathy...
December 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28043581/common-features-of-tuberculosis-and-sarcoidosis
#9
Esmaeil Mortaz, Mohammad Reza Masjedi, Atefeh Abedini, Soheila Matroodi, Arda Kiani, Dina Soroush, Ian M Adcock
Tuberculosis (TB) is a disease caused by Mycobacterium tuberculosis. Despite the availability of novel therapeutic approaches, TB is considered as one of the leading causes of death due to infectious diseases worldwide. Alveolar macrophages are the first line of defense against M. tuberculosis; they ingest and sequester the bacilli within granulomatous structures. Control and resolution of the infection requires activated T lymphocytes as well as Th1 cytokines. There are two forms of TB: active TB and latent TB...
December 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28034523/prognostic-significance-of-epstein-barr-virus-ebv-infection-in%C3%A2-hodgkin-lymphoma-patients
#10
Ben Dhiab Myriam, Ziadi Sonia, Saad Hanene, Louhichi Teheni, Trimeche Mounir
INTRODUCTION: The prognostic significance of Epstein-Barr virus (EBV) infection in Hodgkin lymphoma (HL) is still controversial. In this work we sought to examine the prognostic differences between EBV-positive and -negative HL through a series of 131 cases from Tunisia. METHODS: The status of EBV was assessed by EBV-encoded RNA (EBER) in situ hybridization. Results were correlated to patients' characteristics and outcome. RESULTS: EBV was detected in the malignant cells in 62 of 131 HL cases (47...
December 26, 2016: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/28031841/long-term-outcome-of-nitinol-stenting-to-treat-asphyxia-caused-by-postpneumonectomy-syndrome
#11
Jiro Abe, Toru Hasumi, Ryota Tanaka, Yasuki Saito, Keishi Kanma, Satomi Takahashi
The long-term outcome of nitinol stents introduced into a patient with postpneumonectomy syndrome is described. Postpneumonectomy syndrome is a rare but crucial complication after pneumonectomy characterized by severe dyspnoea and recurrent airway infection caused by compression of the main bronchus. Surgical correction of mediastinal displacement and endobronchial stent placement are two major treatments for this complication; however, endobronchial stenting may be limited to those who are not suitable for operative procedures because long-term management is difficult in terms of controlling airway infections...
January 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28024958/outer-membrane-vesicles-harboring-modified-lipid-a-moiety-augment-the-efficacy-of-an-influenza-vaccine-exhibiting-reduced-endotoxicity-in-a-mouse-model
#12
Tae-Young Lee, Chang-Ung Kim, Eun-Hye Bae, Sang-Hwan Seo, Dae Gwin Jeong, Sun-Woo Yoon, Kyu-Tae Chang, Young Sang Kim, Sang-Hyun Kim, Doo-Jin Kim
Influenza is an acute respiratory disease and a major health problem worldwide. Since mucosal immunity plays a critical role in protection against influenza virus infection, mucosal immunization is considered a promising vaccination route. However, except for live-attenuated vaccines, there are no effective killed or recombinant mucosal influenza vaccines to date. Outer membrane vesicles (OMVs) are nano-sized vesicles produced by gram-negative bacteria, and contain various bacterial components capable of stimulating the immune system of the host...
December 23, 2016: Vaccine
https://www.readbyqxmd.com/read/28024656/validation-of-bleeding-classifications-in-coronary-artery-bypass-grafting
#13
Debora Brascia, Daniel Reichart, Francesco Onorati, Andrea Perrotti, Vito G Ruggieri, Karl Bounader, Jean Philippe Verhoye, Giuseppe Santarpino, Theodor Fischlein, Daniele Maselli, Carmelo Dominici, Giovanni Mariscalco, Riccardo Gherli, Antonino S Rubino, Marisa De Feo, Ciro Bancone, Giuseppe Gatti, Francesco Santini, Magnus Dalén, Matteo Saccocci, Giuseppe Faggian, Tuomas Tauriainen, Eeva-Maija Kinnunen, Francesco Nicolini, Tiziano Gherli, Stefano Rosato, Fausto Biancari
Perioperative bleeding is a determinant of poor outcome in patients undergoing coronary artery bypass grafting (CABG), but there is a lack of adequate stratification of its severity. The ability of the European registry of Coronary Artery Bypass Grafting (E-CABG), Universal Definition of Perioperative Bleeding (UDPB), Study of Platelet Inhibition and Patient Outcomes (PLATO), Clopidogrel and Aspirin Optimal Dose Usage to Reduce Recurrent Events-Seventh Organization to Assess Strategies in Ischemic Syndromes (CURRENT-OASIS 7), Efficacy and Safety of Subcutaneous Enoxaparin in Non-Q Wave Coronary Events (ESSENCE), and SafeTy and Efficacy of Enoxaparin in Percutaneous coronary intervention patients, an internationaL randomized Evaluation (STEEPLE) bleeding classifications to predict early mortality, stroke, acute kidney injury (AKI) stage 3, and deep sternal wound infection/mediastinitis was investigated in 3,730 patients from the prospective, multicentre E-CABG registry...
December 3, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/28008902/-management-of-post-sternotomy-mediastinitis-in-cardiac-patients
#14
V A Gorbunov, R K Dzhordzhikiya, M N Mukharyamov, I I Vagizov
Post-sternotomy mediastinitis is a severe complication of cardiac surgery and accompanied by high mortality and cost of treatment. To date, there are no large clinical trials defining treatment of these patients. In this study the authors offer early postoperative wound sanitation, use of vacuum drainage in all cases and surgical repair with local tissues. Sternal destruction is cured by osteosynthesis with wire sutures and perforated metal plates. Proposed algorithm showed low incidence of reccurent wound infection, mortality and duration of treatment...
2016: Khirurgiia
https://www.readbyqxmd.com/read/27957362/mycoplasma-hominis-induces-mediastinitis-after-a-tonsillar-abscess
#15
Anna Grancini, Manuela Colosimo, Antonella Restelli, Rosaria Colombo, Anna Maraschini, Cristina Pozzi, Giuseppe Breda, Alessandro Protti, Milena Arghittu, Luca Gallelli, Rita Maiavacca
Mycoplasma hominis is commonly involved in genitourinary tract infections. We report a 59-year-old man who developed a M. hominis-associated mediastinitis following acute tonsillar infection.
2016: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/27938890/hybrid-nuss-procedure-for-pectus-excavatum-with-severe-retrosternal-adhesions-after-sternotomy
#16
Shuai Li, Dehua Yang, Yazhen Ma, Shao-Tao Tang, Li Yang, Shiwang Li, Guoqing Cao, Kang Li, Xi Zhang, Xingjian Hu
BACKGROUND: The most striking feature of pectus excavatum (PE) after previous congenital heart disease (CHD) surgery through a median sternotomy is the postsurgical adhesions between the sternum and heart. For patients with severe adhesions, passing the introducer can be difficult and hazardous when performing a Nuss repair. We describe a hybrid Nuss procedure using a small subxiphoid incision for blunt and sharp anterior mediastinal dissection and using a thoracoscope to ensure the whole process of dissection is under direct visualization...
December 6, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27935768/hypertrophic-osteoarthropathy-clinical-and-imaging-features
#17
Felix Y Yap, Matthew R Skalski, Dakshesh B Patel, Aaron J Schein, Eric A White, Anderanik Tomasian, Sulabha Masih, George R Matcuk
Hypertrophic osteoarthropathy (HOA) is a medical condition characterized by abnormal proliferation of skin and periosteal tissues involving the extremities and characterized by three clinical features: digital clubbing (also termed Hippocratic fingers), periostosis of tubular bones, and synovial effusions. HOA can be a primary entity, known as pachydermoperiostosis, or can be secondary to extraskeletal conditions, with different prognoses and management implications for each. There is a high association between secondary HOA and malignancy, especially non-small cell lung cancer...
January 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/27931007/a-case-report-of-unusual-pneumomediastinum-after-endoscopic-sinus-surgery
#18
Ahmad I Alomari, Firas Q Alzoubi, Abdullah Khatatbeh
INTRODUCTION: Endoscopic sinus surgery is a minimally invasive procedure used to restore normal sinus ventilation and mucociliary function. It is a routine otolaryngology procedure with a success rate of about 90% for symptomatic improvement in patients with refractory chronic rhinosinusitis. Because of the proximity of the paranasal sinuses to the brain and the orbit, it cannot be performed without a potential risk of complications. In our case, without early clinical suspicion, proper diagnosis and management, this unusual occurrence of pneumomediastinum after endoscopic sinus surgery may have led to major complications or even death...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27929384/noninvasive-treatment-of-acquired-subglottic-stenosis
#19
Kayhan Ozturk, Omer Erdur, Fuad Sofiyev, Ibrahim Ozkan Onal, Ali Annagur
A 23-day-old infant referred to the neonatal intensive care unit with difficulty breathing and inspiratory stridor increasing with exercise. Medical history included a cardiothoracic surgery for transposition of the great arteries, patent ductus arteriosus, atrial septal defect, and a history of intensive care unit from surgery. Flexible fiberoptic transnasal laryngoscopy revealed subglottic stenosis that was probably caused by prolonged intubation with a higher airway pressure. Computed tomographic scan of the neck showed a tiny stenosis without cartilage deformity and limited in subglottic region...
July 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27928262/non-hodgkin-s-lymphoma-presenting-as-constrictive-pericarditis-a-rare-case-report
#20
Maryam Nabati, Keyvan Yosofnezhad, Morteza Taghavi, Ali Abbasi, Ali Ghaemian
Constrictive pericarditis (CP) is an uncommon post inflammatory disorder. It is described as pericardial thickening, myocardial constriction, and impaired diastolic filling. The most common etiologies are idiopathy, mediastinal radiotherapy, and prior cardiac surgery. Less common etiologies include viral infections, collagen vascular disorders, renal failure, sarcoidosis, tuberculosis, and blunt chest trauma. CP can less commonly be caused by malignancy. We report a very rare case of non-Hodgkin's lymphoma (NHL) presenting twice with attacks of decompensated heart failure...
April 13, 2016: Journal of Tehran Heart Center
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