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Iatrogen infections

Andrew Smith, Sandra Winter, David Lappin, Andrea Sherriff, Ian McIvor, Pamela Philp, Nigel Suttner, Sulisti Holmes, Alan Stewart
BACKGROUND: Currently UK vCJD cases total 178, with an estimated maximum 1:2,000 carriage rate based on archived appendix and tonsil tissue, implying infection maybe rare but carriage relatively common. Previous workers have identified that maintenance of surgical instruments in a humid atmosphere after use and prior to cleaning assists cleaning efficacy. Relatively recently the Department of Health/Advisory Committee on Dangerous Pathogens UK have recommended a surgical instrument cleanliness threshold post cleaning of <5μg protein per instrument side...
March 9, 2018: Journal of Hospital Infection
Luke D Plant, David McDonald Taylor, Thomas Worland, Arvind Puri, Antony Ugoni, Sheila K Patel, Douglas F Johnson, Louise M Burrell
BACKGROUND: We aimed to investigate the incidence, precipitants, and outcomes of acute decompensated heart failure (ADHF) that develops during the inpatient stay. METHODS: We undertook a case-control study in the medical, oncology, surgical, and orthopaedic wards of a tertiary referral hospital (February-May, 2016). Patients aged ≥18 years who developed ADHF during their inpatient stay were enrolled as cases. One control patient was matched to each case by age, gender, presenting complaint/surgery performed and co-morbidities...
December 23, 2017: Heart, Lung & Circulation
Kimi Okada, Shoji Asakura, Tomofumi Yano, Takumi Kishimoto
Primary effusion lymphoma (PEL) is a rare type of extranodal lymphoma, typically of a B-cell origin, which presents as lymphomatous effusion with no nodal enlargement or tumor masses. The development PEL is universally associated with human herpes virus-8 (HHV-8) infection. Cases of HHV-8-negative primary lymphomatous effusion have recently been reported and referred to as HHV-8-unrelated PEL-like lymphoma. Some cases of this disease have been reported in iatrogenic immunocompromised patients. The mechanisms responsible for the inhibitory effects of the discontinuation of immunosuppressants other than methotrexate (MTX) against the disease, which have been demonstrated for MTX-associated lymphoproliferative disorders, have not yet been elucidated...
March 7, 2018: International Journal of Hematology
X A Andrade, H E Fuentes, D M Oramas, H Mann, P Kovarik
Patients with rheumatoid arthritis are at increased risk of hematological malignancies, especially when exposed to immunosuppressive therapy. The mechanisms of lymphomagenesis remain poorly understood but factors implicated include high disease activity, exposure to antitumoral necrosis factor medications, and Epstein-Barr virus infection. Lymphoid malignancies of T-cell origin are uncommon in patients with rheumatoid arthirits. Clinical presentation with associated hemophagocytic lymphohistiocyotsis is rare and confers a poor prognosis...
2018: Case Reports in Hematology
Abdullah Alfawaz, Jun Tashiro, Danny Sleeman, Keith Jones, Jorge Rey
Aorto-enteric fistulae pose a challenging negative outcome of aortic intervention. Treatment involves graft excision, and recently, more enthusiasm has met in situ revascularization over extra-anatomic bypass. This has been traditionally performed through the transperitoneal approach via a midline abdominal incision. We propose an exclusively total retroperitoneal technique in managing this complication with regard to both the vascular and alimentary tract technical aspects of the procedure. This involves exclusion and bypass of the affected segment followed by en-mass resection of the affected segment with the duodenum, and finally, bowel anastomosis...
2018: SAGE Open Medical Case Reports
Razek Georges Coussa, Susan M Wakil, Hady Saheb, David E Lederer, Karin M Oliver, Devinder P Cheema
Purpose: To report the occurrence and management of severe infectious scleritis in a 75 year-old woman following intravitreal ranibizumab injection. Observations: A 75 year-old monocular woman receiving monthly intravitreal ranibizumab injection for wet age related macular degeneration in the left eye presented with severe dull pain, decreased vision, and scleral melt with discharge 2 weeks after her last injection. The dilated fundus exam was devoid of vitritis...
April 2017: American Journal of Ophthalmology Case Reports
Tinnakorn Pluemvitayaporn, Sarun Jindahra, Warongporn Pongpinyopap, Sombat Kunakornsawat, Chaiyot Thiranon, Weerasak Singhatanadgige, Apinan Uthaipaisanwong
Introduction: Concomitant mycotic abdominal aortic aneurysm and lumbar tuberculous spondylitis with psoas abscess and cauda equina syndrome is extremely rare. This condition can cause serious life-threatening problems if not diagnosed and treated properly. Case presentation: We report an unusual case of a 79-year-old Thai male, who was diagnosed with concomitant mycotic abdominal aortic aneurysm and lumbar tuberculous spondylitis at the L2-L3 level with left psoas abscess and cauda equina syndrome...
2018: Spinal Cord Series and Cases
Jennifer T Higa, Jaehoon Choe, Deborah Tombs, Michael Gluck, Andrew S Ross
BACKGROUND/AIMS: Iatrogenic infections related to duodenoscopes remain a top concern for medical centers where ERCP is performed. We assess the long-term results and the impact of key interventions in the optimization of a rigorous "culture and quarantine" program for duodenoscope reprocessing. METHODS: Review of a prospectively collected, quality assurance database of all duodenoscope cultures (N = 4307) obtained for the initial 3-year duration of culture and quarantine from 2014 to 2017 in a single U...
February 21, 2018: Gastrointestinal Endoscopy
Yu-Cheng Zhou, Lin-Xin Yu, Hong Duan, Jie Min, Xiao-Feng Yuan, Peng Yu, Bang-Xu Nie, Jun Hu
OBJECTIVE: To investigate the clinical results of scapula fractures with lateral incision combined with bridge internal fixation system. METHODS: From October 2012 to December 2016, 20 cases of scapular fractures were treated through the lateral incision combined with bridge fixation system, including 15 males and 5 females, with an average age of 31.6 years old(ranged, 21 to 52 years old). Fourteen cases were scapular body fracture, 10 were scapular neck fracture, 6 were scapular fracture, 1 was acromion fracture, 1 was coracoid fracture, 4 were the glenoid rim fracture, 3 were the glenoid fossa fracture...
October 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
L Chtourou, L Ayedi, H Rejab, M Boudabous, L Mnif, A Grati, T Boudaouara, R Mzali, A Amouri, N Tahri
Kaposi sarcoma is an unusual tumor associated to a human herpes virus-8 infection involving the skin or internal organs. Iatrogenic Kaposi's sarcoma often occurs in patients receiving immunosuppressive therapy. So far, a few Kaposi's sarcoma cases have been reported in the literature associated with inflammatory bowel diseases. We report a 53-year-old male diagnosed with a severe refractory ulcerative colitis who was treated with corticosteroids and azathioprine. The patient underwent a colectomy after the failure of medical treatment...
December 2017: Pathologica
Maowia Mukhtar, Sababil S Ali, Salah A Boshara, Audrey Albertini, Séverine Monnerat, Paul Bessell, Yasuyoshi Mori, Yutaka Kubota, Joseph M Ndung'u, Israel Cruz
BACKGROUND: Confirmatory diagnosis of visceral leishmaniasis (VL), as well as diagnosis of relapses and test of cure, usually requires examination by microscopy of samples collected by invasive means, such as splenic, bone marrow or lymph node aspirates. This causes discomfort to patients, with risks of bleeding and iatrogenic infections, and requires technical expertise. Molecular tests have great potential for diagnosis of VL using peripheral blood, but require well-equipped facilities and trained personnel...
February 14, 2018: PLoS Neglected Tropical Diseases
Julie Le, Nicholas S Adams, John A Girotto, John W Polley, Robert J Mann
Nasal stenosis is an uncommon and challenging deformity. Most common etiologies for nasal stenosis include congenital, iatrogenic, trauma, and infection. Repair techniques typically include tissue replacement with grafts or flaps with subsequent stent placement. These procedures often require general anesthesia and carry high rates of restenosis. We describe a case of a 10-year-old girl with Teebi syndrome and iatrogenic nasal stenosis who underwent successful nasal dilation with inexpensive, minimally invasive steel gauge earrings...
March 2018: Cleft Palate-craniofacial Journal
Emma M McCall, Fiona Alderdice, Henry L Halliday, Sunita Vohra, Linda Johnston
BACKGROUND: Newborn admission temperature is a strong predictor of outcomes across all gestations. Hypothermia immediately after birth remains a worldwide issue and, if prolonged, is associated with harm. Keeping preterm infants warm is difficult even when recommended routine thermal care guidelines are followed in the delivery room. OBJECTIVES: To assess the efficacy and safety of interventions designed for prevention of hypothermia in preterm and/or low birth weight infants applied within 10 minutes after birth in the delivery room, compared with routine thermal care or any other single/combination of intervention(s) also designed for prevention of hypothermia in preterm and/or low birth weight infants applied within 10 minutes after birth in the delivery room...
February 12, 2018: Cochrane Database of Systematic Reviews
Hao Zhang, Bing Xie, Hai-Peng Xue, Chao Yang, Bing Liu, Xin Ma, Jing Tian, Da-Peng Zhou, Liang-Bi Xiang
OBJECTIVE: To investigate clinical effects of chronic anterolateral ankle instability by reconstructing lateral ligament with semitendinosus autograft. METHODS: From September 2014 to November 2016, 28 patients with chronic anterolateral ankle instability underwent lateral ligament reconstruction with semitendinosus autograft. Among them, including 20 males and 8 females with an average age of 28.6 years(18 to 47 years old). Preoperative complications were recorded...
June 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Youngjin Han, Tae-Won Kwon, Sang Jun Park, Min-Jae Jeong, Kyunghak Choi, Gi-Young Ko, Sang-Oh Lee, Yong-Pil Cho
BACKGROUND: Infected aortic disease is a serious clinical condition associated with significant morbidity and mortality. This study reviewed the outcomes of in situ aortic replacement with a prosthetic graft for infected aortic disease, including primary infected abdominal aortic aneurysms (PIAAA), infected aortic prosthetic grafts (IAPG), and infected aortic stent grafts (IASG). METHODS: Twenty-eight consecutive patients who underwent in situ aortic replacement with a prosthetic graft for PIAAA, IAPG, and IASG at a single center from January 2001 to December 2015 were retrospectively analyzed...
February 6, 2018: World Journal of Surgery
Paul S Petrungaro, Santiago Gonzalez, Carlos Villegas
As dental implants become more popular for the treatment of partial and total edentulism and treatment of "terminal dentitions," techniques for the management of the atrophic posterior maxillae continue to evolve. Although dental implants carry a high success rate long term, attention must be given to the growing numbers of revisions or retreatment of cases that have had previous dental implant treatment and/or advanced bone replacement procedures that, due to either poor patient compliance, iatrogenic error, or poor quality of the pre-existing alveolar and/or soft tissues, have led to large osseous defects, possibly with deficient soft-tissue volume...
February 2018: Compendium of Continuing Education in Dentistry
Abdullah Algin, Mehmet Ozgur Erdogan, Kaan Yusufoglu, Huseyin Avni Findikli, Hakan Aydin
Femoral artery pseudoaneurysms are commonly iatrogenic due to increasing use of the artery for arterial interventions. Other reasons of pseudoaneurysm formation are intravenous drug use and penetrating trauma. Here, we have discussed the management strategy of a femoral artery pseuodoaneursym and the modalities for preventing the misdiagnoses of the pseudoaneurysm in the emergency department. A 50-year-old male patient was referred to our emergency department (ED) with claudication and severe local swelling...
January 2018: JPMA. the Journal of the Pakistan Medical Association
Bo Langhoff Hønge, Cecilie Blenstrup Patsche, Mads Mose Jensen, Frederik Schaltz-Buchholzer, Thomas Baad-Hansen, Christian Wejse
A 47-year-old man was stung on the left ankle by a stingray while on vacation on the Island of Bubaque, Guinea-Bissau. The affected limb was initially treated with an attempt to suck out the venom and application of chewed plant root. The following 3 days, local pain gradually diminished, but then high fever erupted together with generalized symptoms and intense pain from the ankle. After initiating antibiotic treatment, the patient was evacuated. Because of sustained symptoms and fever, the wound was surgically debrided, and culture revealed infection with oral flora bacteria...
January 22, 2018: American Journal of Tropical Medicine and Hygiene
Kan Liu, Liyan Ye, Wei Sun, Libo Hao, Yanping Luo, Jiying Chen
BACKGROUND Synovial fluid culture (SFC) is recommended as one of the major diagnostic criteria by the Musculoskeletal Infection Society (MSIS) for diagnosing periprosthetic joint infection (PJI). Local anesthetic agents are used for anesthesia and analgesia in some clinical settings to relieve pain. As a local anesthetic, lidocaine is safely used in arthrocentesis to obtain synovial fluid. The goal of this study was to determine if infiltration anesthesia with additive-free lidocaine 2% has antibacterial effects that might interfere with subsequent SFC...
January 23, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Han-Chi Tseng, Chun-Bing Chen, Ji-Chen Ho, Yu-Wen Cheng, Hsin-Wei Huang, Pei-Lun Sun, Chih-Hung Lee
BACKGROUND: Protothecosis is an uncommon infection caused by the achlorophyllic algae found more commonly in tropical areas. Only a limited number of cases have been reported. OBJECTIVE: We aimed to evaluate the clinicopathological features and treatment outcomes of cutaneous protothecosis. METHODS: We retrospectively identified 20 pathology-confirmed cases of cutaneous protothecosis based on skin biopsies in two tertiary medical centers in Taiwan from 1997 to 2015...
January 22, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
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