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https://www.readbyqxmd.com/read/28731668/-azathioprine-induced-pancytopenia-case-series
#1
Cristina Martínez Faci, Ignacio Ros Arnal, José M Martínez de Zabarte Fernández, Jordi Sorribes Estorch, Mónica López Campos, Carmen Rodríguez-Vigil Iturrate
Azathioprine is an immunosuppressive drug that has shown effectiveness in inflammatory bowel disease treatment. Its metabolite, 6-mercaptopurine, is metabolized through thiopurine methyltransferase. Patients with low enzyme activity may have more frequent and severe side effects. The most common is leukopenia, and rarely pancytopenia. The thiopurine methyltransferase activity monitoring shows an individualized profile of enzymatic activity but it should not replace monitoring by performing serial blood counts...
August 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28729904/impact-of-a-sepsis-bundle-in-wards-of-a-tertiary-hospital
#2
F Teles, W G Rodrigues, M G T C Alves, C F T Albuquerque, S M O Bastos, M F A Mota, E S Mota, F J L Silva
BACKGROUND: Sepsis is a prevalent disease worldwide and still exhibits high rates of mortality. In the last years, many interventions aiming a positive impact on sepsis evolution have been studied. One of the main is the use of managed care protocols (sepsis bundles), which consist in systematization of diagnosis and treatment, such as standardization of antibiotics, collection of specific tests (cultures, lactate), and fluid replacement. Some studies have shown a reduction in hospital costs and lower mortality with the use of these tools...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28729377/abundant-dystrophic-calcifications-mimicking-aortic-valve-abscess-in-a-patient-undergoing-elective-aortic-valve-replacement
#3
Adam L Booth, Christine Q Li, Ghannam Ayed Al-Dossari, Heather L Stevenson
Dystrophic calcifications of the aortic valve may cause symptomatic aortic stenosis and account for a significant portion of patients who undergo elective valve replacement. Calcifications appearing grossly as a cloudy fluid surrounding the aortic valve leaflets are an uncommon finding. Normally, calcified aortic valves are characterised by large, nodular masses within the aortic cusps. We report a case of dystrophic calcifications on a stenotic aortic valve encountered intraoperatively, which was suggestive of infective endocarditis and abscess formation...
July 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28727736/persistent-damaged-bases-in-dna-allow-mutagenic-break-repair-in-escherichia-coli
#4
Jessica M Moore, Raul Correa, Susan M Rosenberg, P J Hastings
Bacteria, yeast and human cancer cells possess mechanisms of mutagenesis upregulated by stress responses. Stress-inducible mutagenesis potentially accelerates adaptation, and may provide important models for mutagenesis that drives cancers, host pathogen interactions, antibiotic resistance and possibly much of evolution generally. In Escherichia coli repair of double-strand breaks (DSBs) becomes mutagenic, using low-fidelity DNA polymerases under the control of the SOS DNA-damage response and RpoS general stress response, which upregulate and allow the action of error-prone DNA polymerases IV (DinB), II and V to make mutations during repair...
July 20, 2017: PLoS Genetics
https://www.readbyqxmd.com/read/28725124/reconstruction-of-the-distal-tibia-following-resection-of-aggressive-bone-tumours-using-a-custom-made-megaprosthesis
#5
P Yang, S Evans, Z Khan, A Abudu, L Jeys, R Grimer
OBJECTIVE: Largest, single-centre study of clinical and functional outcomes of patients who underwent endoprosthetic replacement (EPR) for aggressive distal tibial bone tumours. METHOD: Retrospective observational study of eight patients was undertaken. RESULTS: Median follow-up was 77 months (range 13-276). Cumulative five and ten year survival was 63% and 42% respectively. Three patients developed either disease recurrence or metastases post-surgery...
September 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28724376/sonication-contribution-to-identifying-prosthetic-joint-infection-with-ralstonia-pickettii-a-case-report-and-review-of-the-literature
#6
Rares Mircea Birlutiu, Mihai Dan Roman, Razvan Silviu Cismasiu, Sorin Radu Fleaca, Crina Maria Popa, Manuela Mihalache, Victoria Birlutiu
BACKGROUND: In the context of an increase number of primary and revision total hip and total knee arthroplasty performed yearly, an increased risk of complication is expected. Prosthetic joint infection (PJI) remains the most common and feared arthroplasty complication. Ralstonia pickettii is a Gram-negative bacterium, that has also been identified in biofilms. It remains an extremely rare cause of PJI. There is no report of an identification of R. pickettii on an extracted spacer loaded with antibiotic...
July 19, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28720734/lack-of-acrb-efflux-function-confers-loss-of-virulence-on-salmonella-enterica-serovar-typhimurium
#7
Xuan Wang-Kan, Jessica M A Blair, Barbara Chirullo, Jonathan Betts, Roberto M La Ragione, Alasdair Ivens, Vito Ricci, Timothy J Opperman, Laura J V Piddock
AcrAB-TolC is the paradigm resistance-nodulation-division (RND) multidrug resistance efflux system in Gram-negative bacteria, with AcrB being the pump protein in this complex. We constructed a nonfunctional AcrB mutant by replacing D408, a highly conserved residue essential for proton translocation. Western blotting confirmed that the AcrB D408A mutant had the same native level of expression of AcrB as the parental strain. The mutant had no growth deficiencies in rich or minimal medium. However, compared with wild-type SL1344, the mutant had increased accumulation of Hoechst 33342 dye and decreased efflux of ethidium bromide and was multidrug hypersusceptible...
July 18, 2017: MBio
https://www.readbyqxmd.com/read/28719354/thymol-and-carvacrol-strongly-inhibit-biofilm-formation-and-growth-of-carbapenemase-producing-gram-negative-bacilli
#8
P Raei, T Pourlak, M Y Memar, N Alizadeh, M Aghamali, E Zeinalzadeh, M Asgharzadeh, H S Kafil
Discovery of novel drugs with new mechanisms of action and without cross-reaction with current therapeutic agents is crucial in the management of infections caused by multi-drug resistant (MDR) bacteria. The aim of the present study was to investigate effects of carvacrol and thymol on biofilm formation and antimicrobial activity against different carbapenemase-producing Gram negative bacilli. The antimicrobial and antibiofilm effect of thymol and carvacrol was investigated against strains harboring different genes related to carbapenemase resistance...
May 20, 2017: Cellular and Molecular Biology
https://www.readbyqxmd.com/read/28716556/impact-of-pneumococcal-conjugate-vaccine-pcv7-and-pcv13-on-pneumococcal-invasive-diseases-in-italian-children-and-insight-into-evolution-of-pneumococcal-population-structure
#9
Romina Camilli, Fabio D'Ambrosio, Maria Del Grosso, Fernanda Pimentel de Araujo, Maria Grazia Caporali, Martina Del Manso, Giovanni Gherardi, Fortunato D'Ancona, Annalisa Pantosti
BACKGROUND: The use of PCV7 for children immunization was gradually implemented in the Italian regions starting from 2006 and was replaced by PCV13 in 2010-2011. In this study we aimed to assess the PCV impact on invasive pneumococcal diseases (IPD) incidence, serotype distribution and antibiotic resistance in Italian children under 5years old. METHODS: All IPD cases in children from 5 Italian regions (Emilia-Romagna, Lombardia, A. P. Bolzano, A. P. Trento, and Piemonte) reported through the nationwide surveillance system during 2008-2014 were included in this study...
July 14, 2017: Vaccine
https://www.readbyqxmd.com/read/28713524/forced-air-warming-discontinued-periprosthetic-joint-infection-rates-drop
#10
REVIEW
Scott D Augustine
Several studies have shown that the waste heat from forced-air warming (FAW) escapes near the floor and warms the contaminated air resident near the floor. The waste heat then forms into convection currents that rise up and contaminate the sterile field above the surgical table. It has been shown that a single airborne bacterium can cause a periprosthetic joint infection (PJI) following joint replacement surgery. We retrospectively compared PJI rates during a period of FAW to a period of air-free conductive fabric electric warming (CFW) at three hospitals...
June 23, 2017: Orthopedic Reviews
https://www.readbyqxmd.com/read/28713108/current-prescribing-practices-for-antibiotic-prophylaxis-a-survey-of-dental-practitioners
#11
Leah S Spittle, Kathleen B Muzzin, Patricia R Campbell, Janice P DeWald, Francisco Rivera-Hidalgo
AIM: Antibiotic prophylaxis guidelines have been developed for health care and dentistry. The authors examined whether dentists were following the 2007 American Heart Association (AHA) and the 2012 American Association of Orthopaedic Surgeons (AAOS) recommendations for antibiotic prophylaxis. MATERIALS AND METHODS: A survey was sent to 600 dentists in the south-central region of the United States. The survey examined dentists' prescribing practices for patients with cardiac and prosthetic joint replacements, antibiotic regimen prescribed, confidence in their prescription decisions, and dentistry's contribution to antibiotic resistance...
July 1, 2017: Journal of Contemporary Dental Practice
https://www.readbyqxmd.com/read/28711529/initial-treatment-strategy-for-intracranial-mycotic-aneurysms-two-case-reports-and-literature-review
#12
Makoto Ohtake, Kensuke Tateishi, Naoki Ikegaya, Junya Iwata, Shoji Yamanaka, Hidetoshi Murata
BACKGROUND: Intracranial mycotic aneurysm (IMA) is a rare neurovascular disease and a well-known complication following infective endocarditis. IMAs potentially carry a high mortality risk due to intracranial hemorrhage. Therefore, initial treatment is crucial for IMA patients, but an optimal treatment strategy remains unknown. Herein, we report two cases of IMA patients treated with the current usual modalities, and we provide a comprehensive literature review to propose an optimal initial treatment strategy for IMAs...
July 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28711389/population-genetic-structure-antibiotic-resistance-capsule-switching-and-evolution-of-invasive-pneumococci-before-conjugate-vaccination-in-malawi
#13
Chrispin Chaguza, Jennifer E Cornick, Cheryl P Andam, Rebecca A Gladstone, Maaike Alaerts, Patrick Musicha, Chikondi Peno, Naor Bar-Zeev, Arox W Kamng'ona, Anmol M Kiran, Chisomo L Msefula, Lesley McGee, Robert F Breiman, Aras Kadioglu, Neil French, Robert S Heyderman, William P Hanage, Stephen D Bentley, Dean B Everett
INTRODUCTION: Pneumococcal infections cause a high death toll in Sub Saharan Africa (SSA) but the recently rolled out pneumococcal conjugate vaccines (PCV) will reduce the disease burden. To better understand the population impact of these vaccines, comprehensive analysis of large collections of pneumococcal isolates sampled prior to vaccination is required. Here we present a population genomic study of the invasive pneumococcal isolates sampled before the implementation of PCV13 in Malawi...
July 12, 2017: Vaccine
https://www.readbyqxmd.com/read/28711311/bacterial-colonization-of-penile-prosthesis-after-its-withdrawal-due-to-mechanical-failure
#14
B Etcheverry-Giadrosich, J Torremadé-Barreda, L Pujol-Galarza, F Vigués-Julià
INTRODUCTION: Prosthetic surgery to treat erectile dysfunction has a risk of infection of up to 3%, but this risk can increase to 18% when the surgery involves replacement. This increased risk of infection is attributed to the bacterial colonization of the prosthesis during the initial surgery. OBJECTIVE: To analyse the presence of germs in the prosthesis that is withdrawn due to mechanical failure (not infection), as well as the surgical results and its progression...
July 12, 2017: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/28711272/the-infection-of-mycoplasma-hominis-after-total-knee-replacement-case-report-and-literature-review
#15
Hong-Jiu Qiu, Wei-Ping Lu, Min Li, Zi-Ming Wang, Quan-Yin Du, Ai-Min Wang, Yan Xiong
The Mycoplasma hominis infection is a rare postoperative complication after joint replacement. Based on our knowledge, there were only two cases reported by Korea all over the world currently. A case of postoperative Mycoplasma hominis infection after total knee replacement in our hospital was reported in this article. It was confirmed through mass spectrometer and Mycoplasma cultivation and treated by the first stage debridement, polyethylene insert replacement, and then drainage and irrigation combined with sensitive antibiotics after the operation...
June 22, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28706868/tricuspid-valve-endocarditis
#16
Syed T Hussain, James Witten, Nabin K Shrestha, Eugene H Blackstone, Gösta B Pettersson
Right-sided infective endocarditis (RSIE) is less common than left-sided infective endocarditis (IE), encompassing only 5-10% of cases of IE. Ninety percent of RSIE involves the tricuspid valve (TV). Given the relatively small numbers of TVIE cases operated on at most institutions, the purpose of this review is to highlight and discuss the current understanding of IE involving the TV. RSIE and TVIE are strongly associated with intravenous drug use (IVDU), although pacemaker leads, defibrillator leads and vascular access for dialysis are also major risk factors...
May 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28706393/cotrimoxazole-a-wonder-drug-in-the-era-of-multiresistance-case-report-and-review-of-literature
#17
Priyam Batra, Vishant Deo, Purva Mathur, Amit Kumar Gupta
Antimicrobial resistance is one of the greatest threats to human health worldwide. The rate of development of newer antibiotics is much slower than the rate of development of antibiotic resistance. A survey reported that it takes 15 years and US$800 million (including preclinical and clinical costs) to bring a single drug to the market, whereas the reuse of the older drugs for antimicrobial use takes $17 million, thereby circumventing 40% of the overall cost. The first case is a patient with nosocomial pyrexia of unknown origin who was given treatment with tigecycline and cefepime/tazobactam but failed to respond to the same...
July 2017: Journal of Laboratory Physicians
https://www.readbyqxmd.com/read/28704538/intestinal-calcium-and-bile-salts-facilitate-germination-of-clostridium-difficile-spores
#18
Travis J Kochan, Madeline J Somers, Alyssa M Kaiser, Michelle S Shoshiev, Ada K Hagan, Jessica L Hastie, Nicole P Giordano, Ashley D Smith, Alyxandria M Schubert, Paul E Carlson, Philip C Hanna
Clostridium difficile (C. difficile) is an anaerobic gram-positive pathogen that is the leading cause of nosocomial bacterial infection globally. C. difficile infection (CDI) typically occurs after ingestion of infectious spores by a patient that has been treated with broad-spectrum antibiotics. While CDI is a toxin-mediated disease, transmission and pathogenesis are dependent on the ability to produce viable spores. These spores must become metabolically active (germinate) in order to cause disease. C. difficile spore germination occurs when spores encounter bile salts and other co-germinants within the small intestine, however, the germination signaling cascade is unclear...
July 2017: PLoS Pathogens
https://www.readbyqxmd.com/read/28699240/the-prevalence-of-peripheral-intravenous-cannulae-and-pattern-of-use-a-point-prevalence-in-a-private-hospital-setting
#19
Kelvin Wong, Alannah Cooper, Janie Brown, Leanne Boyd, Michele Levinson
AIMS AND OBJECTIVES: to determine the prevalence and pattern of use of peripheral intravenous cannula (PIVC) in hospital wards. BACKGROUND: PIVC are commonly used in acute health care to directly access the bloodstream for the administration of medications, intravenous fluids (IVF) and blood products. PIVC are associated with multiple adverse events including hospital acquired bloodstream infection, thrombophlebitis, and pain/discomfort. Administration of IVF is associated with impaired mobility and nocturia which may increase falls risk in the elderly...
July 12, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28698418/-reconstruction-of-anterior-mitral-leaflet-using-fresh-autologous-pericardial-patch-for-active-infective-endocarditis-report-of-a-case
#20
Hideaki Kanda, Tamahiro Kinjo, Yosuke Hisashi
Several reports have described that the prognosis of patients with mitral valve regurgitation due to active infective endocarditis (IE) is better after mitral valve plasty (MVP) than replacement (MVR). However, extensive destruction of valve tissue might cause difficulties with MVP. We repaired a widely-affected anterior mitral leaflet (AML) using an autologous pericardial patch. A 44-year-old woman with mitral regurgitation presented with prolonged fever and backache. We made a diagnosis of active IE accompanied by mitral valve regurgitation...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
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