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https://www.readbyqxmd.com/read/29138696/use-of-common-inflammatory-markers-in-the-long-term-screening-of-total-hip-arthroprosthesis-infections-our-experience
#1
Gabriele Falzarano, Antonio Piscopo, Predrag Grubor, Giuseppe Rollo, Antonio Medici, Valerio Pipola, Michele Bisaccia, Auro Caraffa, Elizabeth Mary Barron, Francesco Nobile, Raffaele Cioffi, Luigi Meccariello
Orthopedic implants have become essential components of modern medicine. The risk of infection of total hip arthroplasty (THA) is 1.5%-2%. Are the C-reactive protein (CRP), the erythrocyte sedimentation rate (ESR), and procalcitonin (PCT) good markers for THA infection screenings? From February 2009 to December 2012 at our Department of Orthopedics and Traumatology, 1248 patients were treated with THA. No prosthesis was cemented. All patients received antibiotic prophylaxis. All patients were discharged approximately 7...
2017: Advances in Orthopedics
https://www.readbyqxmd.com/read/29114643/analytical-evaluation-of-a-vancomycin-immunoassay-in-synovial-fluid
#2
REVIEW
Francesca Luceri, Fiamma Balboni, Giovanni Balato, Paola Pezzati, Nicoletta Cini, Gianni Virgili, Andrea Baldini
In clinical laboratories performing routine activities, the need to answer the burning clinical question in emerging field may be limited by lack of technology support or assays accessibility. Commercially available methods, although originally validated for specific biological matrices, may be employed for other matrices, following appropriate guidelines such as Clinical and Laboratory Standards Institute (CLSI) EP 19. We investigated the use of a vancomycin assay with synovial fluid samples, in view of a possible employment in vancomycin release study...
June 2017: Joints
https://www.readbyqxmd.com/read/29104387/evaluation-of-antimicrobial-efficacy-of-various-intracanal-medicaments-in-primary-teeth-an-in-vivo-study
#3
Brahmananda Dutta, Kanika S Dhull, Debasmita Das, P V Samir, Rajnish K Verma, Nipa Singh
Introduction: Bacteria and their products play a primary etiological role in the initiation and perpetuation of pulpoperiapical pathosis. Intracanal medication is important for endodontic success as it eliminates microorganisms that persist after chemomechanical preparation. Aim: To compare antimicrobial efficacy of calcium hydroxide powder, triple antibiotic paste, calcium hydroxide with 2% chlorhexidine solution, and triple antibiotic paste with 2% chlorhexidine solution...
July 2017: International Journal of Clinical Pediatric Dentistry
https://www.readbyqxmd.com/read/29103776/systemic-absorption-of-antibiotics-from-antibiotic-loaded-cement-spacers-for-the-treatment-of-periprosthetic-joint-infection
#4
Adam I Edelstein, Kamil T Okroj, Thea Rogers, Craig J Della Valle, Scott M Sporer
BACKGROUND: Two-stage treatment of periprosthetic joint infections involves placement of high-dose antibiotic-loaded cement spacers (ACSs). Reports of ACS-induced nephrotoxicity have raised concern regarding systemic absorption of antibiotics after ACS placement. We sought to characterize the serum concentrations of antibiotics that occur after ACS placement. METHODS: We performed a prospective study of patients with an infected primary total hip (THA) or knee arthroplasty (TKA) treated with standardized ACSs with vancomycin, gentamicin, and tobramycin...
October 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29090391/prevention-of-coronal-discoloration-induced-by-regenerative-endodontic-treatment-in-an-ex-vivo-model
#5
Noushin Shokouhinejad, Mehrfam Khoshkhounejad, Marzieh Alikhasi, Parisa Bagheri, Josette Camilleri
OBJECTIVES: The aim of this study was to assess the effect of sealing the pulp chamber walls with a dentin-bonding agent (DBA) on prevention of discoloration induced by regenerative endodontic procedures (REPs) in an ex vivo model. MATERIALS AND METHODS: Ninety-six bovine incisors were prepared and randomly divided into two groups. In one group, the pulp chamber walls were sealed with DBA before placement of triple antibiotic paste (TAP) containing minocycline inside the root canals, but in the other group, DBA was not applied...
October 31, 2017: Clinical Oral Investigations
https://www.readbyqxmd.com/read/29075808/the-kidney-liver-index-surgery-and-c-reactive-protein-score-is-a-predictor-of-treatment-response-in-acute-prosthetic-joint-infection
#6
C Jiménez-Garrido, J M Gómez-Palomo, I Rodriguez-Delourne, F J Durán-Garrido, E Nuño-Álvarez, E Montañez-Heredia
PURPOSE: This work seeks to verify the utility of the KLIC score as a predictor of treatment success or failure in patients with knee and hip acute prosthetic joint infections (APJI). These patients were treated in our centre, which is not a prosthetic joint infection reference centre. The KLIC score assesses factors such as chronic kidney failure (2 points) (Kidney), liver disease (1.5 points) (Liver), revision surgery or femoral neck fracture (1.5 points)and cemented prosthesis (2 points) (Index surgery) and a C-reactive protein level (CRP) greater than 11...
October 26, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/29072088/the-association-between-cement-type-and-the-subsequent-risk-of-revision-surgery-in-primary-total-hip-replacement
#7
Lea Trela-Larsen, Adrian Sayers, Ashley William Blom, Jason Crispin John Webb, Michael Richard Whitehouse
Background and purpose - To further improve the success of joint replacement surgery, attention needs to be paid to variations associated with improved or worsened outcomes. We investigated the association between the type of bone cement used and the risk of revision surgery after primary total hip replacement. Methods - We conducted a prospective study of data from the National Joint Registry for England and Wales between April 1, 2003 and December 31, 2013. 199,205 primary total hip replacements performed for osteoarthritis where bone cement was used were included...
October 26, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/29067626/the-influence-of-antibiotic-loaded-cement-spacers-on-the-risk-of-reinfection-after-septic-two-stage-hip-revision-surgery
#8
Kevin Staats, Florian Sevelda, Alexandra Kaider, Christoph Böhler, Irene K Sigmund, Stephan E Puchner, Reinhard Windhager, Johannes Holinka
PURPOSE: The aim of this study was the evaluation of possible outcome differences of patients undergoing two-stage hip exchange with antibiotic-loaded spacers, compared to patients without an interim spacer implantation. METHODS: We evaluated 46 patients undergoing two-stage hip revision surgery. Twenty-five patients received an interim ALS. Additional to a Kaplan-Meier survival analysis, a competing risk analysis was performed to estimate the cumulative incidence function for re-revisions due to infection accounting for death as a competing event...
October 24, 2017: Infection
https://www.readbyqxmd.com/read/29050162/-two-stage-total-hip-arthroplasty-using-an-antibiotic-loaded-cement-spacer-for-infected-internal-fixation-of-hip-fractures
#9
X Li, M Ni, H Li, J L Song, X G Song, J Fu, K Liu, B Z Yu, J Y Chen
Objective: To evaluate the application and clinical results of two-stage total hip arthroplasty in the treatment of the deep hip infection following the internal fixation of hip fractures. Methods: From May 2007 to November 2014, 21 patients with active hip infection secondary to internal fixation of hip fractures were treated with two-stage total hip arthroplasty using a temporary antibiotic-loaded cement spacers. Of 21 cases, 15 were males and 6 were females, aged from 27 to 64 years (mean, 45); there are 18 cases of femoral neck fractures and 3 cases of intertrochanteric fractures...
October 10, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29042719/a-novel-conservative-approach-combining-sealbio-and-surgical-fenestration-for-healing-of-large-periapical-cystic-lesions-of-endodontic-origin-a-pilot-study
#10
Naseem Shah
OBJECTIVES: To evaluate the treatment outcome of large periapical cystic lesions treated by combining two novel, conservative approaches, "SealBio" and "Surgical Fenestration". MATERIALS AND METHODS: Five cases (4M:1F, age range 14-38 years, mean age 24.5 years) of large periapical cystic lesions, diagnosed on clinical and radiographic examination, were included in the study. After informed consent, endodontic treatment was initiated; chemo-mechanical preparation and intra-canal dressing of calcium hydroxide was given...
July 2017: Contemporary Clinical Dentistry
https://www.readbyqxmd.com/read/29021886/antibiotic-laden-arthroplasty-with-a-novel-design-of-cement-mould-and-metallic-endoskeleton-for-treatment-of-hip-infection-an-inexpensive-alternative-a-preliminary-report-of-two-cases
#11
Cch William, S Simmrat, A M Suhaeb
Infection of the hip after implant fixation is an uncommon yet devastating complication that results in poor long-term outcome. The gold standard treatment for chronic infection after hip arthroplasty is a two-stage protocol: eradication of infection, follow by re-implantation arthroplasty. The use of interim antibiotic-laden cement spacer has become a popular procedure to maintain hip joint function and provide antibiotic elution simultaneously before re-implantation. However, antibiotic cement spacer is mechanically weak and breaks if overloaded...
July 2017: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/28990203/drug-induced-immune-hemolytic-anemia-associated-with-anti-vancomycin-complicated-by-a-paraben-antibody
#12
Thomas J Gniadek, Patricia A Arndt, Regina M Leger, Daniel Zydowicz, Edward Y Cheng, Nicole D Zantek
BACKGROUND: Drug-induced immune hemolytic anemia (DIIHA) is rare, but potentially life-threatening. A high index of clinical suspicion is required for diagnosis, since the number of medications known to induce DIIHA continues to expand. Additionally, in vitro antibody reactivity against reagent additives has been reported, which may complicate test interpretation. CASE REPORT: A 61-year-old group A, D+ woman with a history of negative antibody detection tests developed hemolytic anemia on Postoperative Day 7 after repeat incision and drainage of a chronically infected right knee prosthesis...
October 8, 2017: Transfusion
https://www.readbyqxmd.com/read/28970004/intercalary-diaphyseal-endoprosthetic-reconstruction-for-tibial-septic-non-union-in-an-elderly-patient-a-case-report
#13
Y Herry, O Reynaud, T Ferry, E Servien, P Neyret, S Lustig
The surgical treatment of septic non-union is challenging and carries a high failure rate. Bone defect management and fracture site stabilisation are key treatment objectives. We report the case of a 75-year-old woman who underwent intercalary endoprosthetic reconstruction of a large tibial defect due to septic non-union after two previous treatment failures. The two-stage procedure involved extensive excision of infected tissues and implantation of an antibiotic-loaded cement spacer followed by insertion of an intercalary endoprosthesis...
September 29, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28944144/osteomyelitis-due-to-multiple-rare-infections-in-a-patient-with-idiopathic-cd4-lymphocytopenia
#14
Nitin Gupta, Sayantan Banerjee, Timitrov, Rohini Sharma, Shambo Guha Roy, Trupti M Shende, Mohammed Tahir Ansari, Gagandeep Singh, Neeraj Nischal, Naveet Wig, Manish Soneja
A 26-year-old male patient presented with features suggestive of osteomyelitis involving the entire left femur, hip joint and knee joint. Culture from the debrided tissue grew Acinetobacter spp. and he was treated with sensitivity based antibiotics but the symptoms did not resolve. The synovial biopsy showed multinucleated giant cells and acid fast bacilli on Ziehl Neelsen stain. Cartridge based nucleic acid amplification test (GeneXpert) was negative. The Mycobacteria growth indicator tube culture was found to be positive for Mycobacterium abscessus...
August 2017: Intractable & Rare Diseases Research
https://www.readbyqxmd.com/read/28894615/chronic-osteomyelitis-of-the-distal-femur-treated-with-resection-and-delayed-endoprosthetic-reconstruction-a-report-of-three-cases
#15
Sean Ryan, William Eward, Brian Brigman, Robert Zura
Chronic osteomyelitis involving the distal femur often results in amputation or arthrodesis. This article presents three cases of chronic osteomyelitis treated with a staged approach culminating in endoprosthetic reconstruction. Stage one involved resection of infected bone and placement of an intramedullary nail spanning the bony defect between proximal femur and tibia, with antibiotic cement packed around the nail. Patients were then placed on long-term IV +/- oral antibiotics to clear the infection. A "cooldown" period was then used between stages where patients were off antibiotics and inflammatory markers were monitored for signs of remaining infection...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28876459/antibiotic-elution-from-acrylic-bone-cement-loaded-with-high-doses-of-tobramycin-and-vancomycin
#16
Joshua Slane, Bradley Gietman, Matthew Squire
Two-stage revision treatment of prosthetic joint infection (PJI) frequently employs the use of a temporary bone cement spacer loaded with multiple antibiotic types. Tobramycin and vancomycin are commonly used antibiotics in cement spacers, however, there is no consensus on the relative concentrations and combinations that should be used. Therefore, the purpose of this study was to investigate the influence of dual antibiotic loading on the total antibiotic elution and compressive mechanical properties of acrylic bone cement...
September 6, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28866230/strontium-doped-injectable-bone-cement-for-potential-drug-delivery-applications
#17
Ali Taha, Muhammad Akram, Zaidoon Jawad, Ammar Z Alshemary, Rafaqat Hussain
Microwave assisted wet precipitation method was used to synthesize calcium deficient strontium doped β-tricalcium phosphate (Sr-βTCP) with a chemical formula of Ca2.96-xSrx(PO4)2. Sr-βTCP was reacted with monocalcium phosphate monohydrate [Ca(H2PO4)2.H2O, MCPM] in presence of water to furnish corresponding Sr containing brushite cement (Sr-Brc). The samples were characterized by using X-ray diffractometry (XRD), Fourier transform infrared spectroscopy (FTIR) and field emission scanning electron microscopy (FESEM)...
November 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28865450/elution-kinetics-of-vancomycin-and-gentamicin-from-carriers-and-their-effects-on-mesenchymal-stem-cell-proliferation-an-in-vitro-study
#18
Tomas Kucera, Lenka Ryskova, Tomas Soukup, Jana Malakova, Eva Cermakova, Pavel Mericka, Jakub Suchanek, Pavel Sponer
BACKGROUND: Musculoskeletal infections remain a major complication in orthopedic surgery. The local delivery of antibiotics provides the high levels required to treat an infection without systemic toxicity. However, the local toxicity of antibiotic carriers to the mesenchymal stem cells, as a result of both the peak concentrations and the type of carrier, may be significant. METHODS: To address this concern, the elution kinetics of vancomycin and gentamicin from several commercially available antibiotic carriers and several carriers impregnated by a surgeon (10 ml of each sterile carrier were manually mixed with a 500 mg vancomycin and an 80 mg gentamicin solution, and the duration of impregnation was 30 min) were assessed...
September 2, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28861853/corr-insights-%C3%A2-how-long-does-antimycobacterial-antibiotic-loaded-bone-cement-have-in-vitro-activity-for-musculoskeletal-tuberculosis
#19
Enrico Pola
No abstract text is available yet for this article.
November 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28853767/a-large-animal-model-for-a-failed-two-stage-revision-of-intramedullary-nail-related-infection-by-methicillin-resistant-staphylococcus-aureus
#20
T F Moriarty, T Schmid, V Post, E Samara, S Kates, E M Schwarz, S Zeiter, R G Richards
The treatment of chronic orthopaedic device-associated infection (ODRI) often requires multiple surgeries and prolonged antibiotic therapy. Despite this extensive treatment protocol, the procedure is associated with significant failure rates. Currently, no large animal model is available that recapitulates a failed revision. Therefore, our aim was to establish a large animal model for failed treatment of an ODRI in order to serve as a testbed for future interventional strategies. Adult Swiss Alpine sheep received an intramedullary nail in the tibia and a localised inoculum of either a methicillin-sensitive or methicillin-resistant Staphylococcus aureus (MSSA, MRSA respectively)...
August 30, 2017: European Cells & Materials
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