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Tunnel infection

Grace M Tabatabai, Peter Karempelis, Jennifer C Hsia
Implantation rates of hypoglossal nerve stimulators, such as INSPIRE, are increasing. The device is still in its early stages of complication reporting, which to date includes implant related infection requiring device removal, and stimulation lead cuff dislodgement requiring replacement. Here we present a 48-year-old female who experienced generator migration and stimulator lead tension requiring an additional operation in order to resecure the generator device. This proved unsuccessful and a second surgery was performed with complete relocation of the device generator to inhibit device migration...
June 11, 2018: American Journal of Otolaryngology
Peter J Ciolek, Brandon L Prendes, Michael A Fritz
INTRODUCTION: The reconstructive goals following radical parotidectomy include restoration of symmetry, reanimation of the face, and reestablishment of oral competence. We present our experience utilizing the anterolateral thigh (ALT) free flap, orthodromic temporalis tendon transfer (OTTT), and facial nerve cable grafting to reestablish form and function. MATERIAL AND METHODS: From 2010 to 2016, 17 patients underwent radical parotidectomy followed by immediate reconstruction...
June 7, 2018: American Journal of Otolaryngology
Ivana Rabbone, Nicola Minuto, Sonia Toni, Fortunato Lombardo, Dario Iafusco, Marco Marigliano, Riccardo Schiaffini, G Maltoni, Anna Paola Frongia, Marco Scardapane, Antonio Nicolucci, Valentino Cherubini, Riccardo Bonfanti, Andrea E Scaramuzza
AIMS: Incidence of insulin pump failures in a cohort of children and adolescents with type 1 diabetes was evaluated prospectively during a 1-yr follow-up. MATERIALS AND METHODS: Insulin pump breakdown and infusion set failures were prospectively registered in a cohort of 1046 children and adolescents from 25 tertiary pediatric diabetes centers (50% males, mean age 12.2±4.1 yrs), with type 1 diabetes since 6.7±3.6 yrs, and using insulin pump since 3.3±2.2 yrs...
June 12, 2018: Diabetes, Obesity & Metabolism
Yoshihito Uchida, Shugo Nakamura, Jun-Ichi Kouyama, Kayoko Naiki, Daisuke Motoya, Kayoko Sugawara, Mie Inao, Yukinori Imai, Nobuaki Nakayama, Tomoaki Tomiya, Charlotte Hedskog, Diana Brainard, Hongmei Mo, Satoshi Mochida
To evaluate the effects of HCV NS5B amino acid substitutions on treatment outcome in Ledipasvir (LDV)/Sofosbuvir (SOF) for Japanese patients with genotype 1b HCV infection, NS5B sequences were examined in i) seven patients experiencing virologic failure after LDV/SOF in real-world practice, ii) 109 SOF-naïve patients, iii) 165 patients enrolled in Phase-3 LDV/SOF trial. A218S and C316N were detected in all patients with viral relapse; the percentages of these substitutions in SOF-naïve patients were 64.2% and 55...
June 11, 2018: Scientific Reports
Anton Sculean, Edward P Allen
Predictable coverage of deep isolated mandibular gingival recessions is one of the most challenging endeavors in plastic-esthetic periodontal surgery, and limited data is available in the literature. The aim of this paper is to present the rationale, the step-by-step procedure, and the results obtained in a series of 24 patients treated by means of a novel surgical technique (the laterally closed tunnel [LCT]) specifically designed for deep isolated mandibular recessions. A total of 24 healthy patients (21 women and 3 men, mean age 25...
July 2018: International Journal of Periodontics & Restorative Dentistry
Roberto Gabrielli, Franco Ciocca, Angelica Dante, Aldo Musilli, Maurizio Maiorano, Marco Ventura
BACKGROUND: Redo area region operation is associated with a significant morbidity such as neurovascular injury, infection and lymphorrhea. The traditional management of occluded femoro-popliteal grafts often includes redissection of a scarred groin to obtain adequate inflow via the common femoral artery. These procedures are more technically demanding and require more expertise and judgment than the primary operation. We describe a case of using the ipsilateral iliac branch prosthesis of aorto-bifemoral as inflow for iliac-peroneal bypass, avoiding the previous groin incisions, to minimize the local complications related to a redo groin dissection and to decrease the operative time required to obtain an adequate inflow source...
June 7, 2018: Annals of Vascular Surgery
Takeshi Saraya, Kazuhito Fukuoka, Hideto Maruno, Yoshinori Komagata, Masachika Fujiwara, Shinya Kaname, Yoshihiro Arimura, Akira Yamada, Hajime Takizawa
BACKGROUND Rheumatoid arthritis tenosynovitis is difficult to discriminate from non-tuberculous tenosynovitis on the basis of radiological and pathological findings. CASE REPORT A 74-year-old woman with a 4-year history of rheumatoid arthritis was referred to our hospital to undergo treatment for uncontrollable tenderness and swelling in her right third metacarpophalangeal joint, right wrist, and left knee joint. In the previous year, she underwent surgery at a local hospital for the swelling in her right metacarpophalangeal joint, the information of which was not known precisely, but the swelling subsided in due course after an operation...
June 7, 2018: American Journal of Case Reports
Shang-Yi Lin, Hung-Pin Tu, Tun-Chieh Chen, Mei-Chiou Shen, Yi-Wen Chiu, Yen-Hsu Chen, Po-Liang Lu
OBJECTIVES: Methicillin-resistant Staphylococcus aureus (MRSA) infections in the hemodialysis (HD) population are epidemiologically classified as healthcare-associated infections. The data about the clinical impact and bacterial characteristics of hospital-onset (HO)- and community-onset (CO)-MRSA in HD patients are scarce. The current study analyzed the difference in the clinical and molecular characteristics of HO-MRSA and CO-MRSA. METHODS: We performed a retrospective review and molecular analysis of clinical isolates from 106 HD patients with MRSA bacteremia from 2009 to 2014...
2018: PloS One
Badri M Shrestha, Donna Shrestha, Avneesh Kumar, Alice Shrestha, Simon A Boyes, Martin E Wilkie
BACKGROUND: The optimal methodology of establishing access for peritoneal dialysis (PD) remains controversial. Previously published randomized controlled trials and cohort studies do not demonstrate an advantage for 1 technique over another. Four published meta-analyses comparing outcomes of laparoscopic versus open PD catheter (PDC) insertion have given inconsistent conclusions and are flawed since they group basic and advanced laparoscopy together. The aim of this systematic review and meta-analysis is to examine whether advanced laparoscopic interventions consisting of rectus sheath tunneling and adjunctive procedures produce a better outcome than open insertion or basic laparoscopy used only to verify the catheter position...
May 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Julien Fernandes, Fatima Hamidi, Remi Beau, Remi Leborgne, Yves Castier, Pierre Mordant, Amira Boukkerou, Jean Paul Latgé, Marina Pretolani
The airway epithelium is the first barrier interacting with Aspergillus fumigatus conidia after their inhalation, suggesting that this structure functions as point of entry of this fungus to initiate pulmonary aspergillosis. To study epithelial entry by A. fumigatus, primary human reconstituted pseudo-stratified epithelium cultured in air-liquid interface as well as bronchial epithelial cell monolayers were infected with conidia. Under these experimental conditions, we found that A. fumigatus hyphae traversed the bronchial epithelium through a mechanism involving the recruitment of actin, which formed a tunnel that allows hyphae entering the cells without disturbing their integrity...
May 26, 2018: Journal of Infectious Diseases
Jun Li, Liangjie Du, Hongwei Liu, Feng Gao, Lu Liu, Yun Guo, Chong Wang, Mingliang Yang, Jianjun Li, Youle Zhang
Objective: To explore the effectiveness of functional reconstruction of hand grasp and pinch by tendon transfers in patients with cervical spinal cord injury. Methods: Between July 2013 and January 2016, tendon transfer surgery were performed in 21 patients (41 hands) with cervical spinal injury that motion level was located at C 6 to reconstruct hand grasp and pinch function. There were 18 males and 3 females with a mean age of 42.3 years (range, 17-65 years). Nineteen patients were with complete spinal cord injury [American Spinal Injury Association (ASIA) grading A], 1 patient was with central cord syndrome whose bilateral hands were completely paralyzed and lower limbs were normal (ASIA grading D), and 1 patient was with cervical spondylotic myelopathy (AISA grading D)...
May 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
Penghe Liu, Zhipeng Dai, Jiajun Zhao, Zhen Zhang, Suizhu Huang
Objective: To observe the effect and significance of autologous fibrin clot on tendon-bone healing after anterior cruciate ligament (ACL) reconstruction. Methods: Between October 2014 and January 2016, 34 patients (34 knees) with ACL injury were enrolled in the study. During ACL reconstruction, autologous fibrin clot was used in 17 cases (trial group) and was not used in 17 cases (control group). The anterior drawer test, Lachman test, and axial displa-cement test were positive in 2 groups before operation...
July 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
Christopher L Camp, Collin C Tebo, Ryan M Degen, Joshua S Dines, David W Altchek, Brian C Werner
Background: Although cubital tunnel release is a commonly performed orthopaedic procedure, the overall incidence of and independent risk factors for infection largely remain undefined in the current literature. Purpose: To establish the rate of postoperative infection after isolated cubital tunnel release and define relevant patient-related risk factors. Study Design: Case-control study; Level 3. Methods: All Medicare-insured patients undergoing ulnar nerve decompression at the cubital tunnel from 2010 through 2012 were identified...
May 2018: Orthopaedic Journal of Sports Medicine
Zheng Wen-Jian, L I Liang-Ming, Hu Zi-Hui, Liao Wei, Lin Qi-Chang, Zhu Yong-Hua, Lin Shao-Hua
BACKGROUND: Ventriculostomy-associated cerebrospinal fluid infection (VAI) is a major complication limiting the use of an external ventricular drain (EVD) in intraventricular hemorrhage (IVH). Risk factors of VAI are still under wide discussion. METHODS: We performed a retrospective review of 84 IVH patients who underwent EVD at our center between January 2012 and January 2017. Preoperative clinical parameters, surgeon status, number of catheters and catheter-days, subgaleal tunneling distance, frequency of urokinase flush, and prophylactic antibiotics were compared between the infective and non-infective groups...
May 14, 2018: World Neurosurgery
Didier Vilette, Josquin Courte, Jean Michel Peyrin, Laurent Coudert, Laurent Schaeffer, Olivier Andréoletti, Pascal Leblanc
Prions are infectious agents that cause fatal neurodegenerative diseases. Current evidence indicates that they are essentially composed of an abnormally folded protein (PrPSc ). These abnormal aggregated PrPSc species multiply in infected cells by recruiting and converting the host PrPC protein into new PrPSc . How prions move from cell to cell and progressively spread across the infected tissue is of crucial importance and may provide experimental opportunity to delay the progression of the disease. In infected cells, different mechanisms have been identified, including release of infectious extracellular vesicles and intercellular transfer of PrPSc -containing organelles through tunneling nanotubes...
May 14, 2018: Cellular and Molecular Life Sciences: CMLS
Weichun Wu, David H Hsi, Haiping Wang, Chao Dong, LiLi Niu, Hao Wang
We report a very rare case of mitral valve dissection and aortic-left ventricular tunnel caused by possible autoimmune vasculitis. We suspected Behcet's disease in this patient. There was no obvious clinical evidence of infective endocarditis. Echocardiography is the diagnostic tool of choice to recognize valvular dysfunction, related pathology, and possible complications. The patient may require immunosuppressive therapy due to the high likelihood of recurrence in the perioperation period.
May 14, 2018: Echocardiography
Zengbing Liu, Kai Ma, Dong Huang
OBJECTIVE: To investigate the clinical effect of treating mallet finger deformity using a modified palmaris longus tendon graft through a bone tunnel. METHODS: Altogether, 21 patients with mallet finger deformity (16 men, 5 women; average age 31 years, range 19-47 years) were treated with a modified palmaris longus tendon graft through a bone tunnel during 18 months (2014-2016). Four index fingers, seven middle fingers, eight ring fingers, and two little fingers were treated for four cutting injuries, eleven finger sprains, four crush injuries, and two twist injuries (7 open and 14 closed injuries)...
2018: International Journal of Burns and Trauma
Hossam Abubeih, Mohamed Khaled, Waleed Riad Saleh, Galal Z Said
PURPOSE: The aim of this study is to evaluate the clinical outcome of single-incision flexor hallucis longus tendon transfer in chronic Achilles tendon rupture. METHODS: A prospective study of a series of cases of chronic Achilles tendon rupture that were treated with single-incision flexor hallucis longus tendon transfer, from April 2015 to December 2016. The study included 21 patients (15 men and 6 women), with mean age 40.3 ± 17.5 years. The average follow-up time was 15 (12-24) months...
May 12, 2018: International Orthopaedics
Shuichi Yoshitake, Osamu Kinoshita, Kan Nawata, Yasuhiro Hoshino, Yoshifumi Itoda, Mitsutoshi Kimura, Haruo Yamauchi, Minoru Ono
BACKGROUND: The most prevalent and serious infection related to left ventricular assist devices (LVADs) is driveline infection (DLI). From 2014, we employed a revised surgical technique (triple tunnel method), which deployed a longer subfascial driveline (DL) route. METHODS AND PATIENTS: We retrospectively analyzed 34 patients fitted with either of the two types of axial pumps: HeartMate II (n=23) and Jarvik 2000 (n=11). Prior to 2014, the DL proceeded from the pump pocket just above the posterior sheath of the rectus muscle toward a vertical skin incision at the right lateral border of the rectus muscle...
May 3, 2018: Journal of Cardiology
Siri Tribler, Christopher F Brandt, Kristian A Fuglsang, Michael Staun, Per Broebech, Claus E Moser, Thomas Scheike, Palle B Jeppesen
Background: In intestinal failure (IF) patients receiving home parenteral support (HPS), catheter-related bloodstream infections (CRBSIs) frequently result in replacement of their tunneled central venous catheters (CVCs), which may lead to future loss of central venous access. Objective: This observational study investigated the consequences of a catheter-salvage strategy related to CRBSIs. Design: All CRBSIs from 2002 to 2016 in the Copenhagen IF and microbiological databases were retrospectively analyzed...
May 1, 2018: American Journal of Clinical Nutrition
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