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https://www.readbyqxmd.com/read/28938384/-iatrogenic-segmental-defect-how-i-debride-high-energy-open-tibial-fractures
#1
Brendan R Southam, Michael T Archdeacon
High-energy, open tibial shaft fractures may result in significant comminution, bone loss, and soft tissue injuries. Early, thorough debridement of all nonviable tissue is of critical importance in treating these fractures as an inadequate initial debridement increases the risk of infection and nonunion. Large iatrogenic bone and soft tissue defects can result from debridement and will require subsequent reconstruction by both orthopaedic and plastic surgeons. Although a variety of approaches exist to address these reconstructions, successful management of bone defects remains a considerable challenge...
October 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28933699/pyoderma-gangrenosum-an-uncommon-case-report-and-review-of-the-literature
#2
António Carlos Lemos, Debora Aveiro, Natália Santos, Vítor Marques, Luís Filipe Pinheiro
BACKGROUND: Pyoderma gangrenosum (PG) is a rare ulcerative condition that is diagnostically and therapeutically challenging, as debridement leads to ulcer deterioration (pathergy phenomenon); immunosuppression is considered the gold standard therapy. CASE REPORT: The authors present the case of a 42-year-old woman with PG and uncontrolled iatrogenic diabetes, secondary to a total pancreatectomy performed in another hospital in 1998 due to nesidioblastosis. In 2008, she was referred to the diabetic foot consultation at Centro Hospitalar Tondela-Viseu (Viseu, Portugal) due to an infected wound on the left leg thought to be related to a trauma from footwear, but the injury worsened despite treatment...
September 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28931199/maxillary-sinus-mucoceles-and-other-side-effects-of-external-beam-radiation-in-the-pediatric-patient-a-cautionary-tale
#3
Anthony Sheyn, Tate Naylor, Felicity Lenes-Voit, Eric Berg
A sinonasal mucocele can develop after the obstruction of a sinus ostium, which can occur secondary to trauma, infection, a neoplasm, or an iatrogenic cause. These mucoceles typically arise in the frontal and ethmoid sinuses. Sinonasal mucoceles are epithelium-lined cysts that can gradually expand to fill a paranasal sinus. They can present with ophthalmologic, rhinologic, and neurologic symptoms. There are reports in the literature of sinonasal mucocele development after radiation for nasopharyngeal carcinoma...
September 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28927823/t-cell-therapies-for-human-polyomavirus-diseases
#4
REVIEW
Sarah I Davies, Pawel Muranski
Rapid restoration of virus-specific T immunity via adoptive transfer of ex vivo generated T cells has been proven as a powerful therapy for patients with advanced cancers and refractory viral infections such as cytomegalovirus (CMV) and Epstein-Barr virus (EBV). BK virus (BKV), John Cunningham virus (JCV), and Merkel cell carcinoma virus (MCV) are the members of the rapidly growing human polyomavirus (hPyV) family that commonly infects most healthy humans. These viruses have a clearly established potential for causing severe end-organ damage or malignant transformation, especially in individuals with weakened immunity who are unable to mount or regain endogenous T-cell responses as a result of underlying leukemia or iatrogenic immunosuppression in autoimmunity, bone marrow and solid organ transplant settings...
September 15, 2017: Cytotherapy
https://www.readbyqxmd.com/read/28916122/myasthenia-gravis-and-crisis-evaluation-and-management-in-the-emergency-department
#5
Jamie Roper, M Emily Fleming, Brit Long, Alex Koyfman
BACKGROUND: Myasthenia gravis (MG) is an uncommon autoimmune disorder affecting the neuromuscular junction and manifesting as muscle weakness. A multitude of stressors can exacerbate MG. When symptoms are exacerbated, muscle weakness can be severe enough to result in respiratory failure, a condition known as myasthenic crisis (MC). OBJECTIVE: This review discusses risk factors, diagnosis, management, and iatrogenic avoidance of MC. DISCUSSION: MC can affect any age, ethnicity, or sex and can be precipitated with any stressor, infection being the most common...
September 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28892594/male-infertility-the-other-side-of-the-equation
#6
Darren J Katz, Patrick Teloken, Ohad Shoshany
BACKGROUND: A male factor contributes to infertility in approximately 50% of couples who fail to conceive, causing significant psychosocial and marital stress. OBJECTIVE: This article reviews the general practitioner's (GP's) evaluation of male infertility and indications for referral to a male infertility specialist, and gives an overview of the specialist management of male infertility. DISCUSSION: Male infertility can result from anatomical or genetic abnormalities, systemic or neurological diseases, infections, trauma, iatrogenic injury, gonadotoxins and development of sperm antibodies...
September 2017: Australian Family Physician
https://www.readbyqxmd.com/read/28890121/surgical-treatment-of-extra-articular-distal-third-diaphyseal-fractures-of-the-humerus-using-a-modified-posterior-approach-and-an-extra-articular-plate
#7
P Páramo-Díaz, M Arroyo-Hernández, V Rodríguez Vega, M Aroca-Peinado, J L León-Baltasar, P Caba-Doussoux
PURPOSE: To evaluate the clinical and radiological outcomes of these fractures treated through a modified posterior approach with a distal humerus plate. MATERIAL AND METHODS: Between 2013 and 2015 we performed a retrospective study of these fractures surgically treated in our centre. INCLUSION CRITERIA: older than 18 years old, no pathological fractures, follow up 1 year at least. 23 patients underwent surgery, mean age 45 years old, with an average follow-up of 18 months...
September 7, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28867817/vesico-adnexal-fistula-treated-with-transurethral-embolization-under-fluoroscopic-guidance
#8
Ma'moon H Al-Omari, Aws Shawkat Hamid
BACKGROUND Vesico-adnexal fistulae are rare. Potential causes of such fistulae include infection, endometriosis, and iatrogenic causes following pelvic surgeries. To the best of our knowledge, only 3 cases of vesico-adnexal fistulae have been reported, and all these patients were treated surgically by removing the involved adnexa, excising the fistulous duct, and suturing the bladder. We describe the first case of vesico-adnexal fistula that developed after pelvic surgery, and it was successfully treated by transurethral embolization under fluoroscopic guidance...
September 4, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28866346/surgical-management-of-deep-gluteal-syndrome-causing-sciatic-nerve-entrapment-a-systematic-review
#9
REVIEW
Jeffrey Kay, Darren de Sa, Laura Morrison, Emily Fejtek, Nicole Simunovic, Hal D Martin, Olufemi R Ayeni
PURPOSE: To assess the causes, surgical indications, patient-reported clinical outcomes, and complications in patients with deep gluteal syndrome causing sciatic nerve entrapment. METHODS: Three databases (PubMed, Ovid [MEDLINE], and Embase) were searched by 2 reviewers independently from database inception until September 7, 2016. The inclusion criteria were studies reporting on both arthroscopic and open surgery and those with Level I to IV evidence. Systematic reviews, conference abstracts, book chapters, and technical reports with no outcome data were excluded...
August 30, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28840094/the-risk-benefit-ratio-of-glucocorticoids-in-sle-have-things-changed-over-the-past-40-years
#10
G Stojan, M Petri
PURPOSE OF REVIEW: Glucocorticoids have been the mainstay of treatment in systemic lupus erythematosus for more than half a century. Despite advancements in knowledge concerning the pathophysiology of systemic lupus, the genomic/non-genomic actions of glucocorticoids, and the use of novel therapeutic agents in SLE, the burden of toxicity from glucocorticoid use remains unchanged. RECENT FINDINGS: SLE patients receiving long-term prednisone therapy are at significant risk of morbidity due to permanent organ damage and prednisone daily dosages above 6 mg have been shown to increase the risk of future organ damage by 50%...
September 2017: Current Treatment Options in Rheumatology
https://www.readbyqxmd.com/read/28838665/infectious-and-sporadic-prion-diseases
#11
Richard Knight
Prion diseases are progressive fatal encephalopathies characterized by a neurodegenerative pathology, the tissue deposition of abnormally folded prion protein and, in general, potential transmissibility. Creutzfeldt-Jakob disease (CJD) is the commonest human prion disease and occurs in three principal forms: sporadic (idiopathic), acquired (infectious), and inherited (genetic). This chapter concerns the sporadic and acquired forms. Sporadic CJD occurs worldwide and affects mainly the middle aged and elderly...
2017: Progress in Molecular Biology and Translational Science
https://www.readbyqxmd.com/read/28838299/peculiarities-of-feline-hyperadrenocorticism-update-on-diagnosis-and-treatment
#12
Lara A Boland, Vanessa R Barrs
Practical relevance: Hyperadrenocorticism (HAC) is a relatively uncommon endocrinopathy of older cats, with a mean age at diagnosis of 10 years. In addition to pituitary-dependent and adrenal-dependent hypercortisolism, clinical signs of HAC can result from adrenal sex steroid-producing tumours. Clinical challenges: While HAC in cats has many similarities to canine HAC, there are key differences in presentation, diagnosis and response to therapy. Most, but not all, cats with HAC have concurrent diabetes mellitus, which is often insulin resistant...
September 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/28834863/liver-transplantation-for-the-treatment-of-complicated-iatrogenic-biliary-injuries-a-national-review-from-the-unos-dataset
#13
Catherine R Garcia, Luis F Acosta, Xiaonan Mei, Jonathan Berger, Malay B Shah, Michael F Daily, Alla Grigorian, Roberto Gedaly
BACKGROUND: Liver transplantation (LT) is rarely indicated in the management of iatrogenic bile duct injuries (IBDI), but occasionally it becomes the only remaining therapy. The purpose of this study is to evaluate potential complications of IBDI and their impact on perioperative mortality, graft and patient survival after LT. METHODS: The UNOS database was queried for all LT performed in the United States between 1994 and 2014. Of the 101 238 liver transplants performed, 61 were related to IBDI...
August 22, 2017: Transplantation
https://www.readbyqxmd.com/read/28831521/-redo-urethroplasty-with-buccal-mucosa
#14
REVIEW
C M Rosenbaum, L Ernst, O Engel, R Dahlem, M Fisch, L A Kluth
Urethral strictures can occur on the basis of trauma, infections, iatrogenic-induced or idiopathic and have a great influence on the patient's quality of life. The current prevalence rate of male urethral strictures is 0.6% in industrialized western countries. The favored form of treatment has experienced a transition from less invasive interventions, such as urethrotomy or urethral dilatation, to more complex open surgical reconstruction. Excision and primary end-to-end anastomosis and buccal mucosa graft urethroplasty are the most frequently applied interventions with success rates of more than 80%...
August 22, 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/28830302/regenerative-medicine-approaches-for-the-treatment-of-pediatric-physeal-injuries
#15
Nichole Shaw, Christopher Erickson, Stephanie Bryant, Virginia Ferguson, Melissa Diane Krebs, Nancy Hadley-Miller, Karin A Payne
The physis, or growth plate, is a cartilaginous region at the end of children's long bones that serves as the primary center for longitudinal growth and characterizes the immature skeleton. Musculoskeletal injury including fracture, infection, malignancy, or iatrogenic damage has risk of physeal damage. Physeal injuries account for 30% of pediatric fractures and may result in impaired bone growth. Once damaged, cartilage tissue within the physis is often replaced by unwanted bony tissue, forming a 'bony bar' that can lead to complications such as complete growth arrest, angular or rotational deformities, and altered joint mechanics...
August 22, 2017: Tissue Engineering. Part B, Reviews
https://www.readbyqxmd.com/read/28821413/uterine-transplantation-surgical-innovation-in-the-treatment-of-uterine-factor-infertility
#16
REVIEW
R Flyckt, A Davis, R Farrell, S Zimberg, A Tzakis, T Falcone
Uterine factor infertility (UFI) is a condition that affects thousands of women and is estimated to have a prevalence as high as one in five hundred reproductive-aged women. A wide range of circumstances can lead to UFI and include women with congenital absence of a uterus (Mayer Rokitansky Kuster Hauser or MRKH syndrome), women who have undergone iatrogenic removal of the uterus, or women who have uteri that are in situ but have been damaged by infection or surgical instrumentation. There have been 17 published reports of human uterine transplantation in the world...
August 15, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28819694/thoracic-corpectomy-for-neoplastic-vertebral-bodies-using-a-navigated-lateral-extracavitary-approach-a-single-center-consecutive-case-series-technique-and-analysis
#17
Sebastian Hartmann, Christoph Wipplinger, Anja Tschugg, Pujan Kavakebi, Alexander Örley, Pierre Pascal Girod, Claudius Thomé
Thoracic myelopathy is often caused by vertebral body fractures resulting from neoplastic conditions, traumatic events, or infectious diseases. One of the preferred procedures for treating it is the lateral extracavitary approach (LECA) with single-level or multilevel decompressive corpectomy and reconstruction. The aim of this retrospective study was to analyze the thoracic lateral extracavitary approach with corpectomy using vertebral body replacement systems (VBR-S) and dorsal reconstruction. Twenty-four patients with metastatic or primary lesions of thoracic vertebrae T2-T12 underwent spinal decompression and ventral column reconstruction with correction of spinal deformity via a LECA...
August 17, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28798881/scrotal-abscess-drained-by-iatrogenic-urethral-fistula-in-an-adult-diabetic-male
#18
Marco Stizzo, Davide Arcaniolo, Carmelo Quattrone, Raffaele Balsamo, Marco Terribile, Celeste Manfredi, Vincenzo Mirone, Paolo Verze, Marco De Sio
A 46-year-old Caucasian male has been transferred to our urology department with a history of septic fever, uncompensated diabetes, pain, and scrotal swelling. On clinical examination, the left inguinal and scrotal area was swollen, tender, and painful; scrotal MR had been performed, showing the catheter tip in scrotal cavity and presence of gas. The case was diagnosed as scrotal abscess with urethroscrotal fistula. He was successfully treated with scrotal incision, drainage, catheter repositioning under fluoroscopic control, antibiotics, and insulin...
2017: Case Reports in Urology
https://www.readbyqxmd.com/read/28791720/infectivity-in-bone-marrow-from-sporadic-cjd-patients
#19
Alvina Huor, Jean Yves Douet, Caroline Lacroux, Séverine Lugan, Cécile Tillier, Naima Aron, Hervé Cassard, Mark Arnold, Juan Maria Torres, James W Ironside, Olivier Andréoletti
Prion infectivity was recently identified in the blood of both sporadic and variant Creutzfeldt-Jakob disease (CJD) patients. In variant CJD (vCJD) the widespread distribution of prions in peripheral tissues of both asymptomatic and symptomatic patients is likely to explain the occurrence of the observed prionaemia. However, in sporadic CJD (sCJD) prion infectivity is described to be located principally in the central nervous system. In this study, we investigated the presence of prion infectivity in bone marrow collected after death in patients affected with different sCJD agents...
August 9, 2017: Journal of Pathology
https://www.readbyqxmd.com/read/28779831/clostridium-difficile-infection
#20
REVIEW
John G Bartlett
Clostridium difficile infection is a major health care challenge in terms of patient and economic consequences. For the patient, it is a morbid and sometimes a life-threatening iatrogenic complication of antibiotic treatment. In the United States, the provider's institution may face financial penalties, because the Centers for Disease Control and Prevention views this as an iatrogenic health care-associated complication that may not be reimbursable by the Centers for Medicare and Medicaid Services; this has resulted in substantial incentives for new approaches to prevention and treatment...
September 2017: Infectious Disease Clinics of North America
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