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Musculoskeletal infection

Arun Gundmi Maiya, Shubha Gundmi, Prabhath Matpady, Radhika Jadhav, Ramachandra Lingadakai, Manjunatha Hande, Veena G Kamath, K N Shivashankar, P Chinmayee, Animesh Hazari, Nagarathna Shastri, Rohini Hande, Mads Mundt Loftager, Sundar Kumar Veluswamy, Edward Jude
The objective of the study was to determine the prevalence of foot complications among people with type 2 diabetes mellitus in the rural part of Udupi district, Karnataka, India. A cross-sectional observational study design was conducted in the rural area of Udupi district. In the study, accredited social health activists were trained to screen people with type 2 diabetes mellitus for diabetic foot complications at a community level. Adults over 35 years of age were screened for the presence of type 2 diabetes mellitus by accredited social health activists who reside in the rural part of Udupi district...
August 16, 2018: International Journal of Lower Extremity Wounds
Lee C Mangum, Nathan A Franklin, Gerardo R Garcia, Kevin S Akers, Joseph C Wenke
BACKGROUND: Dakin's solution (buffered sodium hypochlorite) has been used as a topical adjunct for the treatment of invasive fungal infections in trauma patients. Prudent use of Dakin's solution (DS) for complex musculoskeletal wound management implies balancing antimicrobial efficacy and human tissue toxicity, but little empirical evidence exists to inform clinical practice. To identify potentially efficacious DS concentrations and application methods, we conducted two animal studies to evaluate the ability of DS to reduce bacterial burden in small and large animal models of contaminated musculoskeletal wounds...
August 6, 2018: Injury
Anselm Mak
Over the past two decades it has been increasingly recognized that vitamin D, aside from its crucial involvement in calcium and phosphate homeostasis and the dynamics of the musculoskeletal system, exerts its influential impact on the immune system. The mechanistic roles that vitamin D plays regarding immune activation for combating infection, as well as pathologically and mediating autoimmune conditions, have been progressively unraveled. In vitro and in vivo models have demonstrated that the action of vitamin D on various immunocytes is not unidirectional...
August 10, 2018: International Journal of Molecular Sciences
Robert Hotman Sirait, Mochammad Hatta, Muhammad Ramli, Andi Asadul Islam, Syafrie Kamsul Arief
Background: Severe musculoskeletal trauma can trigger an inflammatory response, and an excessive inflammatory response can lead to systemic inflammatory response syndrome and multiorgan failure. High-mobility group box 1 (HMGB1) is an early mediator pro-inflammatory cytokine in sterile injuries and a late cytokine mediator in infection and sepsis. Previous research has shown that administration of systemic lidocaine can inhibit HMGB1 expression in macrophages of septic rats. The aim of this study was to demonstrate the efficacy of systemic lidocaine to inhibit HMGB1 mRNA and protein in a BALB/c mouse model of sterile inflammation due to closed fracture musculoskeletal injury...
July 2018: Saudi Journal of Anaesthesia
Noam Shohat, Karan Goswami, Yale Fillingham, Timothy L Tan, Tyler Calkins, Craig J Della Valle, Jaiben George, Carlos Higuera, Javad Parvizi
BACKGROUND: Despite concern over the interpretation of serum and synovial fluid tests to screen and diagnose periprosthetic joint infection (PJI) in patients with inflammatory arthritis, only a single study has investigated this area. We aimed to assess accuracy of clinical and laboratory markers for PJI diagnosis in the context of underlying inflammatory arthritis. METHODS: This multicenter study was conducted on total joint arthroplasty patients at 3 different centers between 2001 and 2016...
July 24, 2018: Journal of Arthroplasty
Michael M Kheir, Timothy L Tan, Colin T Ackerman, Ronuk Modi, Carol Foltz, Javad Parvizi
BACKGROUND: Owing to the difficulty isolating microorganisms in periprosthetic joint infection (PJI), current guidelines recommend that 3-5 intraoperative samples be cultured and maintained for 3-14 days. We investigated (1) the optimal number of culture samples and growth duration to diagnose PJI and (2) the microbiology profile at our institution. METHODS: A retrospective review of 711 patients (329 hips, 382 knees) with PJI that met Musculoskeletal Infection Society criteria from 2000 to 2014 was performed...
July 11, 2018: Journal of Arthroplasty
Daniel J Miller, Patrick J Cahill, Joseph A Janicki, Lindsay P Stephenson, Paul D Choi
BACKGROUND: Enhancing the safety, quality, and value of care provided is a point of emphasis for modern health care systems. We performed a review of recent literature to highlight those efforts relevant to pediatric musculoskeletal care. METHODS: We searched the PubMed database for all papers related to quality improvement, patient safety, and/or value in pediatric orthopaedics published from October 1, 2012 to October 31, 2017, yielding 193 papers. RESULTS: A total of 36 papers were selected for review based upon new findings...
August 1, 2018: Journal of Pediatric Orthopedics
Stefan Pilz, Winfried März, Kevin D Cashman, Mairead E Kiely, Susan J Whiting, Michael F Holick, William B Grant, Pawel Pludowski, Mickael Hiligsmann, Christian Trummer, Verena Schwetz, Elisabeth Lerchbaum, Marlene Pandis, Andreas Tomaschitz, Martin R Grübler, Martin Gaksch, Nicolas Verheyen, Bruce W Hollis, Lars Rejnmark, Spyridon N Karras, Andreas Hahn, Heike A Bischoff-Ferrari, Jörg Reichrath, Rolf Jorde, Ibrahim Elmadfa, Reinhold Vieth, Robert Scragg, Mona S Calvo, Natasja M van Schoor, Roger Bouillon, Paul Lips, Suvi T Itkonen, Adrian R Martineau, Christel Lamberg-Allardt, Armin Zittermann
Vitamin D deficiency can lead to musculoskeletal diseases such as rickets and osteomalacia, but vitamin D supplementation may also prevent extraskeletal diseases such as respiratory tract infections, asthma exacerbations, pregnancy complications and premature deaths. Vitamin D has a unique metabolism as it is mainly obtained through synthesis in the skin under the influence of sunlight (i.e., ultraviolet-B radiation) whereas intake by nutrition traditionally plays a relatively minor role. Dietary guidelines for vitamin D are based on a consensus that serum 25-hydroxyvitamin D (25[OH]D) concentrations are used to assess vitamin D status, with the recommended target concentrations ranging from ≥25 to ≥50 nmol/L (≥10-≥20 ng/mL), corresponding to a daily vitamin D intake of 10 to 20 μg (400-800 international units)...
2018: Frontiers in Endocrinology
S Gupta, A Malhotra, N Mittal, S K Garg, R Jindal, R Kansay
Aims: The aims of this study were to establish whether composite fixation (rail-plate) decreases fixator time and related problems in the management of patients with infected nonunion of tibia with a segmental defect, without compromising the anatomical and functional outcomes achieved using the classical Ilizarov technique. We also wished to study the acceptability of this technique using patient-based objective criteria. Patients and Methods: Between January 2012 and January 2015, 14 consecutive patients were treated for an infected nonunion of the tibia with a gap and were included in the study...
August 2018: Bone & Joint Journal
B Barenius, C Inngul, Z Alagic, A Enocson
Aims: The aim of this study was to compare the functional and radiological outcomes in patients with a displaced fracture of the hip who were treated with a cemented or a cementless femoral stem. Patients and Methods: A four-year follow-up of a randomized controlled study included 141 patients who underwent surgery for a displaced femoral neck fracture. Patients were randomized to receive either a cemented (n = 67) or a cementless (n = 74) stem at hemiarthroplasty (HA; n = 83) or total hip arthroplasty (THA; n = 58)...
August 2018: Bone & Joint Journal
E Carlos Rodriguez-Merchan
INTRODUCTION: Tobacco use is related to augmented morbidity and mortality. People who smoke heavily before orthopedic surgery may have more nonmedical complications than nonsmokers. Therefore, all orthopedic surgery patients should be screened for tobacco use. AIM: To investigate the musculoskeletal effects of perioperative smoking. METHODS: A narrative review of the literature on the topic was performed. RESULTS: Orthopedic perioperative complications of smoking include impaired wound healing, augmented infection, delayed and/or impaired fracture union and arthrodesis, and worst total knee and hip arthroplasty results...
August 9, 2018: Hospital Practice (Minneapolis)
Binoy J Paul, Shajit Sadanand
Chikungunya (CHIK) is an arboviral infection caused by the chikungunya virus. An unusual feature of CHIK is its long periods of quiescence followed by an epidemic of devastating severity that can involve millions of people. Manifestations of CHIK range from a mild self-limiting febrile illness with arthralgia and rash to crippling acute and lingering debilitating arthritis. In about 10-60% of patients, musculoskeletal symptoms may persist for up to 3-5 years. Management is mainly symptomatic, with analgesics, antipyretics and non-steroidal anti-inflammatory agents...
July 25, 2018: Rheumatology and Therapy
Yennifer Cortes, Karin Amilon, Elisabeth Rink, Georgina Black, Zofia Lisowski, Xavier Donadeu, Cristina L Esteves
Equine Mesenchymal stem/stromal cells (MSCs) are multipotent cells that are widely used for treatment of musculoskeletal injuries, and there is significant interest in expanding their application to non-orthopedic conditions. MSCs possess antibacterial and immunomodulatory properties which may be relevant for combatting infection, however, comparative studies using MSCs from different origins have not been carried out in the horse, and this was the focus of the present study. Our results showed that MSC-conditioned media attenuated the growth of Escherichia coli, and that this effect was, on average, more pronounced for endometrium (EM)- and adipose tissue (AT)- than for bone marrow (BM)-derived MSCs...
July 25, 2018: Stem Cells and Development
Joshua T Bram, Keith D Baldwin, Todd J Blumberg
BACKGROUND: The diagnosis of pediatric septic arthritis (SA) can be challenging due to wide variability in the presentation of musculoskeletal infection. Synovial fluid Gram stain is routinely obtained and often used as an initial indicator of the presence or absence of pediatric SA. The purpose of this study was to examine the clinical utility of the Gram stain results from a joint aspiration in the diagnosis and management of pediatric SA. METHODS: All patients with suspected SA who underwent arthrocentesis and subsequent surgical irrigation and debridement at an urban tertiary care children's hospital between January 2007 and October 2016 were identified...
July 20, 2018: Journal of Pediatric Orthopedics
Anna L Burgemeister, Eva Daumiller, Gabriele du Bois, Luitgard M Graul-Neumann, Birgit Köhler, Susanne Knecht, Stefan Burgemeister, Sarah Gronwald, Martin H Maurer, Birgit Zirn
49,XXXXY syndrome is a rare sex chromosome aneuploidy syndrome. Cognitive impairment with expressive language deficits in combination with developmental and speech dyspraxia are cardinal symptoms. Testicular insufficiency becomes apparent during adolescence. Neurological, musculoskeletal, genital, orthodontic and immunological anomalies are common and a higher incidence of congenital malformations has been described. Here we show the evolving clinical and facial phenotype of eight boys and men with 49,XXXXY, demonstrating an increasingly perceptible distinct facial gestalt over time...
July 18, 2018: European Journal of Medical Genetics
Tao Bian, Hongyi Shao, Yixin Zhou, Yong Huang, Yang Song
BACKGROUND: Several tests are used before reimplantation to detect persistent infection in patients with periprosthetic joint infection (PJI) undergoing two-stage revision. However, there is no consensus as to the optimal tests for excluding persistent infection or predicting successful reimplantation by stage. We aimed to determine the accuracy of different tests used to detect persistent infection after the first stage, and/or predicting failure following reimplantation in patients with PJI...
July 17, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Jiabin Liu, David H Kim, Daniel B Maalouf, Jonathan C Beathe, Answorth A Allen, Stavros G Memtsoudis
BACKGROUND AND OBJECTIVES: The need for hospital-based acute care following outpatient surgical procedures is expensive and measured as marker for quality. However, little information is available about events leading to emergency department visit or inpatient admission after ambulatory anterior cruciate ligament (ACL) surgery. METHODS: We studied adult patients who underwent outpatient ACL surgery in New York State between 2009 and 2013 using the Healthcare Cost and Utilization Project database...
July 20, 2018: Regional Anesthesia and Pain Medicine
Irene Katharina Sigmund, Katsiaryna Yermak, Carsten Perka, Andrej Trampuz, Nora Renz
BACKGROUND: Alpha defensin was proposed as a new biomarker in synovial fluid for the diagnostic workup of failed joint prostheses. To our knowledge, no comparative study of the performance of the quantitative enzyme-linked immunosorbent assay (ELISA) and qualitative lateral flow alpha defensin test has been reported. QUESTIONS/PURPOSES: (1) Using the proposed European Bone and Joint Infection Society (EBJIS) criteria for defining periprosthetic joint infection (PJI), is there a difference in the diagnostic accuracy of quantitative ELISA and qualitative lateral flow alpha defensin tests? (2) Is there a difference in the performance of the two alpha defensin tests when using three definition classification systems (Musculoskeletal Infection Society [MSIS], Infectious Diseases Society of America [IDSA], and proposed EBJIS)? METHODS: In this retrospective study of samples collected earlier as part of a related longitudinal study, we included patients in whom aspiration of the prosthetic hip or knee was performed as routine investigation before every revision arthroplasty...
August 2018: Clinical Orthopaedics and related Research
Alex McLaren, Arvind D Nana, Antonia F Chen, Sandra B Nelson
No abstract text is available yet for this article.
July 18, 2018: Journal of Bone and Joint Surgery. American Volume
William Z Stone, Chancellor F Gray, Hari K Parvataneni, Mamun Al-Rashid, Richard G Vlasak, MaryBeth Horodyski, Hernan A Prieto
BACKGROUND: Diagnosing periprosthetic joint infection after total joint arthroplasty is often challenging. The alpha defensin test has been recently reported as a promising diagnostic test for periprosthetic joint infection. The goal of this study was to determine the diagnostic accuracy of alpha defensin testing. METHODS: One hundred and eighty-three synovial alpha defensin and synovial fluid C-reactive protein (CRP) tests performed in 183 patients undergoing evaluation for periprosthetic joint infection were reviewed...
July 18, 2018: Journal of Bone and Joint Surgery. American Volume
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