Bacterial infection is a major issue after artificial bone transplantation due to the absence of antibacterial function of bone scaffold,which seriously causes the transplant failure and even amputation in severe case...Bacterial infection is a major issue after artificial bone transplantation due to the absence of antibacterial function of bone scaffold,which seriously causes the transplant failure and even amputation in severe cases.In this study,oxygen vacancy(OV)defects Fe-doped Ti O2(OV-FeTiO2)nanoparticles were synthesized by nano TiO2and Fe3O4via high-energy ball milling,which was then incorporated into polycaprolactone/polyglycolic acid(PCLGA)biodegradable polymer matrix to construct composite bone scaffold with good antibacterial activities by selective laser sintering.The results indicated that OV defects were introduced into the core/shell-structured OV-FeTiO2nanoparticles through multiple welding and breaking during the high-energy ball milling,which facilitated the adsorption of hydrogen peroxide(H2O2)in the bacterial infection microenvironment at the bone transplant site.The accumulated H2O2could amplify the Fenton reaction efficiency to induce more hydroxyl radicals(·OH),thereby resulting in more bacterial deaths through·OH-mediated oxidative damage.This antibacterial strategy had more effective broad-spectrum antibacterial properties against Gram-negative Escherichia coli(E.coli)and Gram-positive Staphylococcus aureus(S.aureus).In addition,the PCLGA/OV-FeTiO2scaffold possessed mechanical properties that match those of human cancellous bone and good biocompatibility including cell attachment,proliferation and osteogenic differentiation.展开更多
Lipocalin 2(LCN2)plays a pivotal role in iron metabolism,particularly in the context of microbial infection resistance(e.g.,viruses,bacteria,parasites,etc.).LCN2 combats microbial infection by directly assisting the b...Lipocalin 2(LCN2)plays a pivotal role in iron metabolism,particularly in the context of microbial infection resistance(e.g.,viruses,bacteria,parasites,etc.).LCN2 combats microbial infection by directly assisting the body in competing with microorganisms for iron,inducing immune cells to secrete various cytokines to enhance systemic immune responses,or recruiting neutrophils to infectious sites.The liver serves as the primary organ for LCN2 secretion during microbial infections.This review encapsulates recent advances in dynamic changes,clinical values,and the effects of LCN2 in infectious liver diseases caused by various microbial microorganisms.展开更多
In view of the demographic changes and projected increase of arthroplasty procedures worldwide,the number of prosthetic joint infection cases will naturally grow.Therefore,in order to counteract this trend more rigid ...In view of the demographic changes and projected increase of arthroplasty procedures worldwide,the number of prosthetic joint infection cases will naturally grow.Therefore,in order to counteract this trend more rigid rules and a stricter implementation of effective preventive strategies is of highest importance.In the absence of a"miracle weapon"priorities should lie in evidence-based measures including preoperative optimization of patients at higher infection risks,the fulfilment of strict hygiene rules in the operating theatre and an effective antibiotic prophylaxis regimen.Instead of a"one size fits all"philosophy,it has been proposed to adjust the antibiotic prophylaxis protocol to major infection risks taking into account important patient-and procedure-related risk factors.A stronger focus on the local application mode via use of high dose dual antibioticloaded bone cement in such risk situations may have its advantages and is easy to apply in the theatre.The more potent antimicrobial growth inhibition in vitro and the strong reduction of the prosthetic joint infection rate in risk for infection patients with aid of dual antibiotic-loaded bone cement in clinical studies align with this hypothesis.展开更多
Chronic gastritis ( CG ) and peptic ulcer ( PU ) are frequently-occurring diseases. It is now well recognized that Helicobacter pylori (Hp) is a major factor that leads to CG and PU[1-8] In order to study the relation...Chronic gastritis ( CG ) and peptic ulcer ( PU ) are frequently-occurring diseases. It is now well recognized that Helicobacter pylori (Hp) is a major factor that leads to CG and PU[1-8] In order to study the relationship among T lymphocyte subsets, NO, Hexosamine and Hp infection in patients with chronic gastric diseases, the levelsof blood T lymphocyte subsets, plasma NO and hexosamine in gastric mucosa were measured respectively in 30 patients with CG and 32 patients of PU + CG.展开更多
Reactivation of hepatitis B virus(HBV)replication is characterized by increased HBV-DNA serum values of about 1 log or by HBV DNA turning positive if previously undetectable in serum,possibly associated with liver dam...Reactivation of hepatitis B virus(HBV)replication is characterized by increased HBV-DNA serum values of about 1 log or by HBV DNA turning positive if previously undetectable in serum,possibly associated with liver damage and seldom life-threatening.Due to HBV reactivation,hepatitis B surface antigen(HBsAg)-negative/anti-HBc-positive subjects may revert to HBsAg-positive.In patients with hemo-lymphoproliferative disease,the frequency of HBV reactivation depends on the type of lymphoproliferative disorder,the individual's HBV serological status and the potency and duration of immunosuppression.In particular,it occurs in 10%-50%of the HBsAg-positive and in 2%-25%of the HBsAg-negative/anti-HBc-positive,the highest incidences being registered in patients receiving rituximab-based therapy.HBV reactivation can be prevented by accurate screening of patients at risk and by a pharmacological prophylaxis with anti-HBV nucleo(t)sides starting 2-3 wk before the beginning of immunosuppressive treatment and covering the entire period of administration of immunosuppressive drugs and a long subsequent period,the duration of which depends substantially on the degree of immunodepression achieved.Patients with significant HBV replication before immunosuppressive therapy should receive anti-HBV nucleo(t)sides as a long-term(may be life-long)treatment.This review article is mainly directed to doctors engaged every day in the treatment of patients with onco-lymphoproliferative diseases,so that they can broaden their knowledge on HBV infection and on its reactivation induced by the drugs with high immunosuppressive potential that they use in the care of their patients.展开更多
In the past few years,a variety of extradigestive disorders, including cardiovascular,skin,rheumatic and liver diseases, have been associated with Helicobacter pylori(H.pylori) infection.The activation of inflammatory...In the past few years,a variety of extradigestive disorders, including cardiovascular,skin,rheumatic and liver diseases, have been associated with Helicobacter pylori(H.pylori) infection.The activation of inflammatory mediators by H.pylori seems to be the pathogenetic mechanism underlying the observed associations.The present review summarizes the current literature,including our own studies,concerning the association between H.pyloriinfection and respiratory diseases. A small number of epidemiological and serologic,case- control studies suggest that H.pylori infection may be associated with the development of chronic bronchitis.A frequent coexistence of pulmonary tuberculosis and H.pylori infection has also been found.Moreover,recent studies have shown an increased H.pyloriseroprevalence in patients with bronchiectasis and in those with lung cancer.On the other hand,bronchial asthma seems not to be related with H.pylori infection. All associations between H.pylori infection and respiratory diseases are primarily based on case-control studies, concerning relatively small numbers of patients.Moreover, there is a lack of studies focused on the pathogenetic link between respiratory diseases and H.pylori infection. Therefore,we believe that larger studies should be undertaken to confirm the observed results and to clarify the underlying pathogenetic mechanisms.展开更多
Discriminating sterile inflammation from infection, especially in cases of aseptic loosening versus an actual prosthetic joint infection, is challenging and has significant treatment implications. Our goal was to eval...Discriminating sterile inflammation from infection, especially in cases of aseptic loosening versus an actual prosthetic joint infection, is challenging and has significant treatment implications. Our goal was to evaluate a novel human monoclonal antibody(mAb) probe directed against the Gram-positive bacterial surface molecule lipoteichoic acid(LTA). Specificity and affinity were assessed in vitro. We then radiolabeled the anti-LTA mAb and evaluated its effectiveness as a diagnostic imaging tool for detecting infection via immuno PET imaging in an in vivo mouse model of prosthetic joint infection(PJI). In vitro and ex vivo binding of the anti-LTA mAb to pathogenic bacteria was measured with Octet, ELISA, and flow cytometry. The in vivo PJI mouse model was assessed using traditional imaging modalities, including positron emission tomography(PET) with [^(18)F]FDG and [^(18)F]Na F as well as X-ray computed tomography(CT), before being evaluated with the zirconium-89-labeled antibody specific for LTA([^(89)Zr]SAC55).The anti-LTA mAb exhibited specific binding in vitro to LTA-expressing bacteria. Results from imaging showed that our model could reliably simulate infection at the surgical site by bioluminescent imaging, conventional PET tracer imaging, and bone morphological changes by CT. One day following injection of both the radiolabeled anti-LTA and isotype control antibodies, the anti-LTA antibody demonstrated significantly greater(P 〈 0.05) uptake at S. aureus-infected prosthesis sites over either the same antibody at sterile prosthesis sites or of control non-specific antibody at infected prosthesis sites. Taken together, the radiolabeled anti-LTA mAb, [^(89)Zr]SAC55, may serve as a valuable diagnostic molecular imaging probe to help distinguish between sterile inflammation and infection in the setting of PJI. Future studies are needed to determine whether these findings will translate to human PJI.展开更多
Cytomegalovirus(CMV) infection is an important contributor to the morbidity and mortality associated with bone marrow transplantation(BMT). Infection may lead to CMV disease involving multiple organs such as pneumonia...Cytomegalovirus(CMV) infection is an important contributor to the morbidity and mortality associated with bone marrow transplantation(BMT). Infection may lead to CMV disease involving multiple organs such as pneumonia, gastroenteritis, retinitis, central nervus system involvement and others. CMV seropositivity is an important risk factor and approximately half of BMT recipients will develop clinically significant infection most commonly in the first 100 d post-transplant. The commonly used tests to diagnose CMV infection in these patients include the pp65 antigenemia test and the CMV DNA polymerase chain reaction(PCR) assay. Because of its greater sensitivity and lesser turnaround time, the CMV PCR is nowadays the preferred test and serves as a main guide for pre-emptive therapy. Methods of CMV prevention include use of blood products from seronegative donors or leukodepleted products. Prophylaxis or pre-emptive therapy strategies for CMV prevention may be used post-transplant with the latter becoming more common. The commonly used antivirals for pre-emptive therapy and CMV disease management include intravenous gancyclovir and foscarnet. The role of intravenous immunoglobulin, although used commonly in CMV pneumonia is not clear.展开更多
AIM: To review and conduct a meta-analysis of the existing literature on the relationship between Helicobacter pylori (H. pylori), atopy and allergic diseases.
Bone is a complex tissue that undergoes constant remodeling to maintain homeostasis,which requires coordinated multilineage differentiation and proper proliferation of mesenchymal stromal cells(MSCs).Mounting evidence...Bone is a complex tissue that undergoes constant remodeling to maintain homeostasis,which requires coordinated multilineage differentiation and proper proliferation of mesenchymal stromal cells(MSCs).Mounting evidence indicates that a disturbance of bone homeostasis can trigger degenerative bone diseases,including osteoporosis and osteoarthritis.In addition to conventional genetic modifications,epigenetic modifications(i.e.,DNA methylation,histone modifications,and the expression of noncoding RNAs)are considered to be contributing factors that affect bone homeostasis.Long noncoding RNAs(lncRNAs)were previously regarded as‘transcriptional noise’with no biological functions.However,substantial evidence suggests that lncRNAs have roles in the epigenetic regulation of biological processes in MSCs and related diseases.In this review,we summarized the interactions between lncRNAs and epigenetic modifiers associated with osteo-/adipogenic differentiation of MSCs and the pathogenesis of degenerative bone diseases and highlighted promising lncRNA-based diagnostic and therapeutic targets for bone diseases.展开更多
Real-time disease prediction has emerged as the main focus of study in the field of computerized medicine.Intelligent disease identification framework can assist medical practitioners in diagnosing disease in a way th...Real-time disease prediction has emerged as the main focus of study in the field of computerized medicine.Intelligent disease identification framework can assist medical practitioners in diagnosing disease in a way that is reliable,consistent,and timely,successfully lowering mortality rates,particularly during endemics and pandemics.To prevent this pandemic’s rapid and widespread,it is vital to quickly identify,confine,and treat affected individuals.The need for auxiliary computer-aided diagnostic(CAD)systems has grown.Numerous recent studies have indicated that radiological pictures contained critical information regarding the COVID-19 virus.Utilizing advanced convolutional neural network(CNN)architectures in conjunction with radiological imaging makes it possible to provide rapid,accurate,and extremely useful susceptible classifications.This research work proposes a methodology for real-time detection of COVID-19 infections caused by the Corona Virus.The purpose of this study is to offer a two-way COVID-19(2WCD)diagnosis prediction deep learning system that is built on Transfer Learning Methodologies(TLM)and features customized fine-tuning on top of fully connected layered pre-trained CNN architectures.2WCD has applied modifications to pre-trained models for better performance.It is designed and implemented to improve the generalization ability of the classifier for binary and multi-class models.Along with the ability to differentiate COVID-19 and No-Patient in the binary class model and COVID-19,No-Patient,and Pneumonia in the multi-class model,our framework is augmented with a critical add-on for visually demonstrating infection in any tested radiological image by highlighting the affected region in the patient’s lung in a recognizable color pattern.The proposed system is shown to be extremely robust and reliable for real-time COVID-19 diagnostic prediction.It can also be used to forecast other lung-related disorders.As the system can assist medical practitioners in diagnosing the greatest number of patients in the shortestamount of time, radiologists can also be used or published online to assistany less-experienced individual in obtaining an accurate immediate screeningfor their radiological images.展开更多
Oral lesions are highly correlated with the occurrence and development of many diseases. In addition, the treatment of systemic diseases may aggravate oral focal infections, affect the life quality of patients, interf...Oral lesions are highly correlated with the occurrence and development of many diseases. In addition, the treatment of systemic diseases may aggravate oral focal infections, affect the life quality of patients, interfere with the treatment of systemic diseases, and even cause systemic infection in serious cases. Treatment strategies for systemic diseases may induce or aggravate oral local lesion infections. In specific, administration of oral anti-epileptic drugs and immunosuppressive drugs may induce gingivitis, radiotherapy or chemotherapy for malignant tumors may cause oral mucositis, long-term use of bisphosphonates for inhibition of tumor bone metastasis or prevention of osteoporosis may cause osteonecrosis of the jaw, and allogeneic hematopoietic stem cell transplantation that may cause oral rejection reactions.展开更多
AIM To compare infection rates in primary and revision total knee arthroplasty(TKA) procedures using antibiotic impregnated bone cement(AIBC) to those rates in procedures not using AIBC.METHODS A systematic review and...AIM To compare infection rates in primary and revision total knee arthroplasty(TKA) procedures using antibiotic impregnated bone cement(AIBC) to those rates in procedures not using AIBC.METHODS A systematic review and meta-analysis was conducted in search for randomized controlled trials/studies(RCTs) pertaining to the field of antibiotic AIBC vs non-AIBC groups in both primary and revision TKA procedures. The primary literature search performed was to identify all RCTs that assessed AIBC in primary and revision TKA procedures. This search was done strictly through the Pub Med database using the article "filters" setting that identified and separated all RCTs from the overall search. The original search was "Primary/revision total knee arthroplasty using AIBC". Other key terms and phrases were included in the search as well. Eligible articles that were used in the "results" of this review met the following criteria:(1) Involved primary or revision TKA procedures(for any reason);(2) included TKA outcome infection rate information;(3) analyzed an AIBC group vs a non-AIBC control group;(4) were found through the RCT filter or hand search in Pub Med; and(5) published 1985-2017. Exclusion criteria was as follows:(1) Patients that were not undergoing primary or revision TKA procedures;(2) articles that did not separate total hip arthroplasity(THA) vs TKA results if both hip and knee revisions were evaluated;(3) papers that did not follow up on clinical outcomes of the procedure;(4) extrapolation of data was not possible given published results;(5) knee revisions not done on human patients;(6) studies that were strictly done on THAs;(7) articles that were not found through the RCT filter or through hand search in Pub Med;(8) articles that did not evaluate AIBC used in a prosthesis or a spacer during revision;(9) articles that did not compare an AIBC group vs a non-AIBC control group; and(10) articles that were published before 1985.RESULTS In total, 11 articles were deemed eligible for this analysis. Nine of the 11 studies dealt with primary TKA procedures comparing AIBC to non-AIBC treatment. The other two studies dealt with revision TKA procedures that compared such groups. From these papers, 4092 TKA procedures were found. 3903 of these were primary TKAs, while 189 were revision TKAs. Of the 3903 primary TKAs, 1979 of these used some form of AIBC while 1924 were part of a non-AIBC control group. Of the 189 revision TKAs, 96 of these used some form of AIBC while 93 were part of a non-AIBC control group. Average followup times of 47.2 mo and 62.5 mo were found in primary and revision groups respectively. A two-tailed Fisher's exact test was done to check if infection rates differed significantly between the groups. In the primary TKA group, a statistically significant difference between AIBC and non-AIBC groups was not found(AIBC infection rate = 23/1979, non-AIBC infection rate = 35/1924, P = 0.1132). In the revision TKA group, a statistically significant difference between the groups was found(AIBC infection rate = 0/96, non-AIBC infection rate = 7/93, P = 0.0062). No statistically significant differences existed in Knee Society Scores, Hospital for Special Surgery Scores, or Loosening Rates.CONCLUSION AIBC did not have a significant effect on primary TKA infection rates. AIBC did have a significant effect on revision TKA infection rates.展开更多
This study aims to investigate various aspects of the treatment of chronic bone infections and the challenges in their management. The characterization of treatment of 73 patients with chronic bone infection was repor...This study aims to investigate various aspects of the treatment of chronic bone infections and the challenges in their management. The characterization of treatment of 73 patients with chronic bone infection was reported. The four management challenges including consultation delay, immune depression, extreme variety of clinical manifestations and non-use of CT or MRI were discussed in this study. We conducted a retrospective study at Aristide Le Dantec Hospital on 90 cases of chronic bone infection in 73 patients. The mean duration of symptoms before consultation was 36 months. More than half of the patients had a productive fistula at the first consultation. Sickle cell anemia was found in 6 patients. Multiple lesions were found in 10 patients;and long bones were affected in 90% of cases. The bacterial culture was positive in 93.15%. Staphylococcus aureus was the most isolated germ (68.35%). Seventy-two out of seventy-three patients were operated on. The procedure depended on anatomical and radiological lesions. Surgical treatment was associated with antibiotherapy which was firstly probabilistic and secondarily adapted to the results of bacterial culture. A favorable trend was found in 41 patients (56.16%). 32 cases of adverse effects were noted (43.83%), and 27 patients had recurrence after a favorable outcome. Several complications and sequelae were observed demonstrating the tenacity of these chronic infections.展开更多
Campylobacter species are one of the major causes of global bacterial-related diarrheal disease worldwide. The disease is most frequently associated with the ingestion of contaminated meat, raw milk, pets, contaminate...Campylobacter species are one of the major causes of global bacterial-related diarrheal disease worldwide. The disease is most frequently associated with the ingestion of contaminated meat, raw milk, pets, contaminated water, and the organism may be frequently cultured from the faeces of chicken and other domesticated farm animals. Of the 17 established Campylobacter species, the most important pathogens for humans are Campylobacter jejuni(C. jejuni), Campylobacter coli(C. coli) and Campylobacter fetus(C. fetus), which are all associated with diarrheal disease. Further, C. jejuni and C. coli are also associated with the neuroparalytic diseases Guillain-Barré syndrome and Miller Fischer syndrome, respectively, whereas C. fetus is linked with psoriatic arthritis. The discovery of both "molecular mimicry" and translocation-related virulence in the pathogenesis of C. jejuni-induced disease, indicates, that Campylobacter-related gastrointestinal infections may not only generate localized, acute intestinal infection in the human host, but may also be involved in the establishment of chronic inflammatory diseases. Indeed, pathogenicity studies on several Campylobacter species now suggest that molecular mimicry and translocation-related virulence is not only related to C. jejuni, but may play a role in human disease caused by other Campylobacter spp. In this review, the authors provide a review based on the current literature describing the potential links between Campylobacter spp. and(chronic) inflammatory diseases, and provide their opinions on the likely role of Campylobacter in such diseases.展开更多
BACKGROUND The most commonly ingested foreign body in Asians is fish bone.The vast majority of patients have obvious symptoms and can be timely diagnosed and treated.Cases of pyogenic cervical spondylitis and diskitis...BACKGROUND The most commonly ingested foreign body in Asians is fish bone.The vast majority of patients have obvious symptoms and can be timely diagnosed and treated.Cases of pyogenic cervical spondylitis and diskitis with retropharyngeal and epidural abscess resulting in incomplete quadriplegia due to foreign body ingestion have been rarely reported.The absence of pharyngeal or esophageal discomfort and negative computed tomography(CT)findings of fish bone have not been reported.We report the case of an elderly female patient with delayed cervical infection and incomplete quadriplegia who had a history of fish bone ingestion.CASE SUMMARY A 73-year-old woman presented with right neck pain and weakness of four limbs for a week,and had a history of fish bone ingestion and negative findings on laryngoscopic examination one month previously.She did not complain of any pharyngeal or esophageal discomfort.Cervical magnetic resonance imaging showed C4/C5 spondylitis and diskitis along with retropharyngeal and ventral epidural abscesses.No sign of fish bone was detected on lateral cervical radiography and CT scans.The muscle strength of the patient’s right lower limb receded to grade 1 and other limbs to grade 2 suddenly on the 10th day of hospitalization.Emergency surgery was performed to drain the abscess and decompress the spinal cord by removing the anterior inflammatory necrotic tissue.Simultaneously,flexible esophagogastroduodenoscopy was carried out and a hole in the posterior pharyngeal wall was found.The motor weakness of the right lower limb improved to grade 3 and the other limbs to grade 4 within 2 d postoperatively.CONCLUSION This rare case highlights the awareness of the posterior pharyngeal or esophageal wall perforation in patients with cervical pyogenic spondylitis along with a history of fish bone ingestion,even though local discomfort symptoms are absent and the radiological examinations are negative.展开更多
BACKGROUND Hemiarthroplasty is the most common treatment in elderly patients with displaced intra-capsular femoral neck fracture(FNF).Prosthetic joint infection(PJI)is one of the most feared and frequent complications...BACKGROUND Hemiarthroplasty is the most common treatment in elderly patients with displaced intra-capsular femoral neck fracture(FNF).Prosthetic joint infection(PJI)is one of the most feared and frequent complications post-surgery because of the frail health status of these patients and the need for fast track surgery.Therefore,priorities should lie in effective preventive strategies to mitigate this burden.AIM To determine how much the implementation of the routine use of antibioticloaded bone cement(ALBC)as a relatively easy-to-apply amendment to the surgical practice reduces the infection rate in our hemiarthroplasty cohort.METHODS We retrospectively assessed all demographic,health status and treatment-related data of our FNF patients undergoing cemented hemiarthroplasty in the period from 2011 to 2017;241 patients were further analyzed after exclusion of patients with cancer-related sequelae and those who died before the end of the 1-year observation period.The PJI rate as diagnosed on basis of the Musculoskeletal Infection Society(MSIS)criteria 2011 was determined for each included patient and compared in function of the bone cement used for hip stem fixation.Patients were split into a group receiving a plain bone cement in the period from January 2011 to June 2013(non-ALBC group)and into a group receiving an ALBC in the period July 2013 to December 2017(ALBC group).Data analysis was performed with statistical software.We further calculated the cost-efficacy of the implementation of routine use of ALBC in the second group balancing the inhospital infection related treatment costs with the extra costs of use of ALBC.RESULTS In total 241 FNF patients who received cemented hemiarthroplasty in the period from January 2011 to January 2017 were eligible for inclusion in this retrospective study.There were 8 PJI cases identified in the ALBC group among n=94 patients,whereas 28 PJI cases were observed in the non-ALBC group among n=147 patients.The statistical analysis showed an infection risk reduction of 55.3%(in particular due to the avoidance of chronic delayed infections)in the ALBC group(95%CI:6.2%-78.7%;P=0.0025).The cost-evaluation analysis demonstrated a considerable cost saving of 3.500€per patient,related to the implementation of routine use of ALBC in this group.CONCLUSION Use of ALBC is a potent infection preventive factor in FNF patients receiving cemented hemiarthroplasties.It was further found to be highly cost-effective.展开更多
Background: Autoimmune diseases are a vast array of organ-specific as well as systemic diseases, whose pathogenesis results from the activation of B and T lymphocytes reacting against antigens of the body’s own tissu...Background: Autoimmune diseases are a vast array of organ-specific as well as systemic diseases, whose pathogenesis results from the activation of B and T lymphocytes reacting against antigens of the body’s own tissues (defined as self). Objective: To record skin tumors and infections in all autoimmune diseases gathered together in a one pathological state, compared with renal transplant recipients and normal control. Patients and Methods: Four hundred patients with different autoimmune diseases were examined. Fifty patients with pemphigus (15 males, 35 females) are aged from 20 - 70 (41.23 ± 3.89) years. Fifty patients with systemic lupus erythematosus (50 females) are aged from 17 - 45 (30.58 ± 10.08) years. One hundred patients with vitiligo (59 males, 41 females) are aged from 9 - 71 (42.89 ± 5.28) years. One hundred patients with alopecia areata (42 males, 58 females) are aged from 7 - 52 (38.67 ± 9.52) years. One hundred patients with psoriasis (56 males, 44 females) are aged from 7 - 71 (47.36 ± 8.62) years were evaluated. One hundred twenty kidney transplant recipients’ (101 males, 19 females) ages ranged from 14 - 70 (45.43 ± 4.63) years. All patients were examined thoroughly for any cutaneous manifestations and tumors and the findings were compared with the general population as a control group, which consisted of 500 healthy control individuals whose ages ranged from 20 - 71 (44.53 ± 11.48) years. This case series, descriptive, controlled study was performed in Baghdad Teaching Hospital from June 2014 to October 2015. Results: In renal transplant recipients, the findings were observed as follow herpetic infection in 30(25%), bacterial 12(10%) while fungal 24(20%) patients. These infections appeared early in the course of immunosuppression. While the tumors were noticed, the benign tumors were the commonest manifestations, which included viral warts in 45(37.5%) followed by actinic keratosis 15(12.5%), seborrheic keratosis 14(11.6%), sebaceous hyperplasia 13(10.8%) and keratoacanthoma 1(0.8%). While the malignant tumors were basal cell carcinoma 4(3.3%) followed by squamous cell carcinoma 3(2.5%), and kaposi’s sarcoma 4(3.3%), Bowen’s disease 1(0.8%). These malignancy usually appeared late in the course of immunosuppression. In pemphigus, viral warts were observed in 4(8%) cases;fungal infection was seen in 4(8%) cases and bacterial infections in 2(4%) of cases and herpetic infection in only 1(2%) of case;no tumors were found in all patients. In vitiligo, viral warts were observed in 2(2%) cases, while seborrhic keratosis and sebaceous hyperplasia were observed in 1(1%) case;herpetic and fungal infections were seen in 3(3%) of cases while bacterial infections were recorded in 2(2%) of cases but no tumors were found in all patients. In alopecia areata viral warts were observed in 9(9%) of cases, sebaceous hyperplasia in 1(1%) case, herpetic and bacterial in 3(3%) of cases and fungal in 4(4%) of cases;no tumors were found in all patients. In systemic lupus erythymatosus (SLE) viral warts were observed in 4(8%) of cases, herpetic infection in 12(12%) of cases, fungal infection in 10(20%) of cases, bacterial infection in 3(3%) of cases and sebaceous hyperplasia in only 1(2%) of case, but no tumors were seen. In psoriasis, viral warts were observed in 14(14%) of cases, herpetic infection in 10(10%) of cases, bacterial infection in 3(3%) of cases, fungal infection in 2(2%) of cases, sebaceous hyperplasia in 2(2%) of cases and seborrhiec hyperkeratosis in 1(1%) case, while no tumors were demonstrated. In healthy control individuals, herpetic infection was present in 36(7.2%) and viral warts in 52(10.4%) individuals, fungal infection in 29(5.8%) of individuals and regarding tumors solar keratosis was present in 24(4.8%);basal cell carcinoma and squamous cell carcinoma were present in 2(0.4%) individuals of each. Conclusions: Patients with autoimmune diseases were protected against infections and tumors while kidney transplant recipients had no such protection although all these groups were on prolonged immunosuppression.展开更多
Variations in host traits that influence their exposure and susceptibility may impact probability of vector-transmitted diseases.Therefore,identifying the predictors of infection probability is necessary to understand...Variations in host traits that influence their exposure and susceptibility may impact probability of vector-transmitted diseases.Therefore,identifying the predictors of infection probability is necessary to understand the risk of disease outbreaks during expanding environmental perturbation.Here,we conducted a large survey based on microscopic examination and molecular analysis of haemosporidian parasite infection in raptors rescued at the Beijing Raptor Rescue Centre.Combining these data with biological and ecological variables of the raptors,we determined predictors that affect the probability of haemosporidian infection using generalized linear mixed models and multimodel inference.Our results showed that infection probability exhibited considerable variation across host species in raptors,and body mass,sex,and evolutionary history played relatively weaker roles in driving infection probability.Instead,activity pattern,age,geographic range size,migration distance,and nest type were important predictors of the probability of haemosporidian infection,and the role of each predictor differed in the three main haemosporidian genera(Plasmodium,Haemoproteus,and Leucocytozoon).This macro-ecological analysis will add to our understanding of host traits that influence the probability of avian haemosporidian infection and will help inform risk of emerging diseases.展开更多
AIM:To investigate the association between central serous chorioretinopathy(CSC)and Helicobacter pylori(Hp)by summarizing all available evidence.METHODS:The Scopus,Embase,EBSCO,PubMed,Web of Science,and Cochrane Libra...AIM:To investigate the association between central serous chorioretinopathy(CSC)and Helicobacter pylori(Hp)by summarizing all available evidence.METHODS:The Scopus,Embase,EBSCO,PubMed,Web of Science,and Cochrane Library databases for all relevant studies published from inception to October 2022 were searched,and manually searched for relevant reference lists as a supplement.Studies investigating the association between CSC and Hp infection were included.Finally,8 case-control studies were included in the Meta-analysis after study selection.RESULTS:The results showed no significant correlation between Hp infection and CSC[odds ratio(OR)1.89,95%confidential interval(CI)0.58–6.15,I2=96%,P=0.29].After subgroup analysis based on the degree of development of the study(developing/developed countries),it was found that the results of the two subgroups were the same as the whole,and no significant difference between the two subgroups existed.Meta-regression showed that the effect of sample size on heterogeneity among studies was more prominent(P<0.01,adjusted R^(2)=89.72%),which can explain 89.72%of the sources of heterogeneity.CONCLUSION:This Meta-analysis reveals no significant correlation between Hp infection and CSC,which still warrants further well-designed extensive sample studies to reach a more reliable conclusion and promote a better understanding of the treatment of CSC.展开更多
基金supported by the following funds:The Natural Science Foundation of China(52275393,51935014,82072084)Hunan Provincial Natural Science Foundation of China(2021JJ20061)+4 种基金Jiangxi Provincial Natural Science Foundation of China(20224ACB204013)The Project of State Key Laboratory of Precision Manufacturing for Extreme Service PerformanceTechnology Innovation Platform Project of Shenzhen Institute of Information Technology 2020(PT2020E002)Guangdong Province Precision Manufacturing and Intelligent production education Integration Innovation Platform(2022CJPT019)Independent Exploration and Innovation Project of Central South University(1053320220553)。
文摘Bacterial infection is a major issue after artificial bone transplantation due to the absence of antibacterial function of bone scaffold,which seriously causes the transplant failure and even amputation in severe cases.In this study,oxygen vacancy(OV)defects Fe-doped Ti O2(OV-FeTiO2)nanoparticles were synthesized by nano TiO2and Fe3O4via high-energy ball milling,which was then incorporated into polycaprolactone/polyglycolic acid(PCLGA)biodegradable polymer matrix to construct composite bone scaffold with good antibacterial activities by selective laser sintering.The results indicated that OV defects were introduced into the core/shell-structured OV-FeTiO2nanoparticles through multiple welding and breaking during the high-energy ball milling,which facilitated the adsorption of hydrogen peroxide(H2O2)in the bacterial infection microenvironment at the bone transplant site.The accumulated H2O2could amplify the Fenton reaction efficiency to induce more hydroxyl radicals(·OH),thereby resulting in more bacterial deaths through·OH-mediated oxidative damage.This antibacterial strategy had more effective broad-spectrum antibacterial properties against Gram-negative Escherichia coli(E.coli)and Gram-positive Staphylococcus aureus(S.aureus).In addition,the PCLGA/OV-FeTiO2scaffold possessed mechanical properties that match those of human cancellous bone and good biocompatibility including cell attachment,proliferation and osteogenic differentiation.
文摘Lipocalin 2(LCN2)plays a pivotal role in iron metabolism,particularly in the context of microbial infection resistance(e.g.,viruses,bacteria,parasites,etc.).LCN2 combats microbial infection by directly assisting the body in competing with microorganisms for iron,inducing immune cells to secrete various cytokines to enhance systemic immune responses,or recruiting neutrophils to infectious sites.The liver serves as the primary organ for LCN2 secretion during microbial infections.This review encapsulates recent advances in dynamic changes,clinical values,and the effects of LCN2 in infectious liver diseases caused by various microbial microorganisms.
文摘In view of the demographic changes and projected increase of arthroplasty procedures worldwide,the number of prosthetic joint infection cases will naturally grow.Therefore,in order to counteract this trend more rigid rules and a stricter implementation of effective preventive strategies is of highest importance.In the absence of a"miracle weapon"priorities should lie in evidence-based measures including preoperative optimization of patients at higher infection risks,the fulfilment of strict hygiene rules in the operating theatre and an effective antibiotic prophylaxis regimen.Instead of a"one size fits all"philosophy,it has been proposed to adjust the antibiotic prophylaxis protocol to major infection risks taking into account important patient-and procedure-related risk factors.A stronger focus on the local application mode via use of high dose dual antibioticloaded bone cement in such risk situations may have its advantages and is easy to apply in the theatre.The more potent antimicrobial growth inhibition in vitro and the strong reduction of the prosthetic joint infection rate in risk for infection patients with aid of dual antibiotic-loaded bone cement in clinical studies align with this hypothesis.
文摘Chronic gastritis ( CG ) and peptic ulcer ( PU ) are frequently-occurring diseases. It is now well recognized that Helicobacter pylori (Hp) is a major factor that leads to CG and PU[1-8] In order to study the relationship among T lymphocyte subsets, NO, Hexosamine and Hp infection in patients with chronic gastric diseases, the levelsof blood T lymphocyte subsets, plasma NO and hexosamine in gastric mucosa were measured respectively in 30 patients with CG and 32 patients of PU + CG.
文摘Reactivation of hepatitis B virus(HBV)replication is characterized by increased HBV-DNA serum values of about 1 log or by HBV DNA turning positive if previously undetectable in serum,possibly associated with liver damage and seldom life-threatening.Due to HBV reactivation,hepatitis B surface antigen(HBsAg)-negative/anti-HBc-positive subjects may revert to HBsAg-positive.In patients with hemo-lymphoproliferative disease,the frequency of HBV reactivation depends on the type of lymphoproliferative disorder,the individual's HBV serological status and the potency and duration of immunosuppression.In particular,it occurs in 10%-50%of the HBsAg-positive and in 2%-25%of the HBsAg-negative/anti-HBc-positive,the highest incidences being registered in patients receiving rituximab-based therapy.HBV reactivation can be prevented by accurate screening of patients at risk and by a pharmacological prophylaxis with anti-HBV nucleo(t)sides starting 2-3 wk before the beginning of immunosuppressive treatment and covering the entire period of administration of immunosuppressive drugs and a long subsequent period,the duration of which depends substantially on the degree of immunodepression achieved.Patients with significant HBV replication before immunosuppressive therapy should receive anti-HBV nucleo(t)sides as a long-term(may be life-long)treatment.This review article is mainly directed to doctors engaged every day in the treatment of patients with onco-lymphoproliferative diseases,so that they can broaden their knowledge on HBV infection and on its reactivation induced by the drugs with high immunosuppressive potential that they use in the care of their patients.
文摘In the past few years,a variety of extradigestive disorders, including cardiovascular,skin,rheumatic and liver diseases, have been associated with Helicobacter pylori(H.pylori) infection.The activation of inflammatory mediators by H.pylori seems to be the pathogenetic mechanism underlying the observed associations.The present review summarizes the current literature,including our own studies,concerning the association between H.pyloriinfection and respiratory diseases. A small number of epidemiological and serologic,case- control studies suggest that H.pylori infection may be associated with the development of chronic bronchitis.A frequent coexistence of pulmonary tuberculosis and H.pylori infection has also been found.Moreover,recent studies have shown an increased H.pyloriseroprevalence in patients with bronchiectasis and in those with lung cancer.On the other hand,bronchial asthma seems not to be related with H.pylori infection. All associations between H.pylori infection and respiratory diseases are primarily based on case-control studies, concerning relatively small numbers of patients.Moreover, there is a lack of studies focused on the pathogenetic link between respiratory diseases and H.pylori infection. Therefore,we believe that larger studies should be undertaken to confirm the observed results and to clarify the underlying pathogenetic mechanisms.
基金supported in part by National Institutes of Health T32 AR067708,RO1CA201035the MRB Molecular Imaging Service Center(P50 CA103175)
文摘Discriminating sterile inflammation from infection, especially in cases of aseptic loosening versus an actual prosthetic joint infection, is challenging and has significant treatment implications. Our goal was to evaluate a novel human monoclonal antibody(mAb) probe directed against the Gram-positive bacterial surface molecule lipoteichoic acid(LTA). Specificity and affinity were assessed in vitro. We then radiolabeled the anti-LTA mAb and evaluated its effectiveness as a diagnostic imaging tool for detecting infection via immuno PET imaging in an in vivo mouse model of prosthetic joint infection(PJI). In vitro and ex vivo binding of the anti-LTA mAb to pathogenic bacteria was measured with Octet, ELISA, and flow cytometry. The in vivo PJI mouse model was assessed using traditional imaging modalities, including positron emission tomography(PET) with [^(18)F]FDG and [^(18)F]Na F as well as X-ray computed tomography(CT), before being evaluated with the zirconium-89-labeled antibody specific for LTA([^(89)Zr]SAC55).The anti-LTA mAb exhibited specific binding in vitro to LTA-expressing bacteria. Results from imaging showed that our model could reliably simulate infection at the surgical site by bioluminescent imaging, conventional PET tracer imaging, and bone morphological changes by CT. One day following injection of both the radiolabeled anti-LTA and isotype control antibodies, the anti-LTA antibody demonstrated significantly greater(P 〈 0.05) uptake at S. aureus-infected prosthesis sites over either the same antibody at sterile prosthesis sites or of control non-specific antibody at infected prosthesis sites. Taken together, the radiolabeled anti-LTA mAb, [^(89)Zr]SAC55, may serve as a valuable diagnostic molecular imaging probe to help distinguish between sterile inflammation and infection in the setting of PJI. Future studies are needed to determine whether these findings will translate to human PJI.
文摘Cytomegalovirus(CMV) infection is an important contributor to the morbidity and mortality associated with bone marrow transplantation(BMT). Infection may lead to CMV disease involving multiple organs such as pneumonia, gastroenteritis, retinitis, central nervus system involvement and others. CMV seropositivity is an important risk factor and approximately half of BMT recipients will develop clinically significant infection most commonly in the first 100 d post-transplant. The commonly used tests to diagnose CMV infection in these patients include the pp65 antigenemia test and the CMV DNA polymerase chain reaction(PCR) assay. Because of its greater sensitivity and lesser turnaround time, the CMV PCR is nowadays the preferred test and serves as a main guide for pre-emptive therapy. Methods of CMV prevention include use of blood products from seronegative donors or leukodepleted products. Prophylaxis or pre-emptive therapy strategies for CMV prevention may be used post-transplant with the latter becoming more common. The commonly used antivirals for pre-emptive therapy and CMV disease management include intravenous gancyclovir and foscarnet. The role of intravenous immunoglobulin, although used commonly in CMV pneumonia is not clear.
文摘AIM: To review and conduct a meta-analysis of the existing literature on the relationship between Helicobacter pylori (H. pylori), atopy and allergic diseases.
基金the National Natural Science Foundation of China,No.81870743 and No.81771048.
文摘Bone is a complex tissue that undergoes constant remodeling to maintain homeostasis,which requires coordinated multilineage differentiation and proper proliferation of mesenchymal stromal cells(MSCs).Mounting evidence indicates that a disturbance of bone homeostasis can trigger degenerative bone diseases,including osteoporosis and osteoarthritis.In addition to conventional genetic modifications,epigenetic modifications(i.e.,DNA methylation,histone modifications,and the expression of noncoding RNAs)are considered to be contributing factors that affect bone homeostasis.Long noncoding RNAs(lncRNAs)were previously regarded as‘transcriptional noise’with no biological functions.However,substantial evidence suggests that lncRNAs have roles in the epigenetic regulation of biological processes in MSCs and related diseases.In this review,we summarized the interactions between lncRNAs and epigenetic modifiers associated with osteo-/adipogenic differentiation of MSCs and the pathogenesis of degenerative bone diseases and highlighted promising lncRNA-based diagnostic and therapeutic targets for bone diseases.
基金This work was funded by the Researchers Supporting Project Number(RSP-2021/300),King Saud University,Riyadh,Saudi Arabia.
文摘Real-time disease prediction has emerged as the main focus of study in the field of computerized medicine.Intelligent disease identification framework can assist medical practitioners in diagnosing disease in a way that is reliable,consistent,and timely,successfully lowering mortality rates,particularly during endemics and pandemics.To prevent this pandemic’s rapid and widespread,it is vital to quickly identify,confine,and treat affected individuals.The need for auxiliary computer-aided diagnostic(CAD)systems has grown.Numerous recent studies have indicated that radiological pictures contained critical information regarding the COVID-19 virus.Utilizing advanced convolutional neural network(CNN)architectures in conjunction with radiological imaging makes it possible to provide rapid,accurate,and extremely useful susceptible classifications.This research work proposes a methodology for real-time detection of COVID-19 infections caused by the Corona Virus.The purpose of this study is to offer a two-way COVID-19(2WCD)diagnosis prediction deep learning system that is built on Transfer Learning Methodologies(TLM)and features customized fine-tuning on top of fully connected layered pre-trained CNN architectures.2WCD has applied modifications to pre-trained models for better performance.It is designed and implemented to improve the generalization ability of the classifier for binary and multi-class models.Along with the ability to differentiate COVID-19 and No-Patient in the binary class model and COVID-19,No-Patient,and Pneumonia in the multi-class model,our framework is augmented with a critical add-on for visually demonstrating infection in any tested radiological image by highlighting the affected region in the patient’s lung in a recognizable color pattern.The proposed system is shown to be extremely robust and reliable for real-time COVID-19 diagnostic prediction.It can also be used to forecast other lung-related disorders.As the system can assist medical practitioners in diagnosing the greatest number of patients in the shortestamount of time, radiologists can also be used or published online to assistany less-experienced individual in obtaining an accurate immediate screeningfor their radiological images.
文摘Oral lesions are highly correlated with the occurrence and development of many diseases. In addition, the treatment of systemic diseases may aggravate oral focal infections, affect the life quality of patients, interfere with the treatment of systemic diseases, and even cause systemic infection in serious cases. Treatment strategies for systemic diseases may induce or aggravate oral local lesion infections. In specific, administration of oral anti-epileptic drugs and immunosuppressive drugs may induce gingivitis, radiotherapy or chemotherapy for malignant tumors may cause oral mucositis, long-term use of bisphosphonates for inhibition of tumor bone metastasis or prevention of osteoporosis may cause osteonecrosis of the jaw, and allogeneic hematopoietic stem cell transplantation that may cause oral rejection reactions.
基金the University of Toledo College of Medicine and Life Sciences’ Medical Student Summer Research Program
文摘AIM To compare infection rates in primary and revision total knee arthroplasty(TKA) procedures using antibiotic impregnated bone cement(AIBC) to those rates in procedures not using AIBC.METHODS A systematic review and meta-analysis was conducted in search for randomized controlled trials/studies(RCTs) pertaining to the field of antibiotic AIBC vs non-AIBC groups in both primary and revision TKA procedures. The primary literature search performed was to identify all RCTs that assessed AIBC in primary and revision TKA procedures. This search was done strictly through the Pub Med database using the article "filters" setting that identified and separated all RCTs from the overall search. The original search was "Primary/revision total knee arthroplasty using AIBC". Other key terms and phrases were included in the search as well. Eligible articles that were used in the "results" of this review met the following criteria:(1) Involved primary or revision TKA procedures(for any reason);(2) included TKA outcome infection rate information;(3) analyzed an AIBC group vs a non-AIBC control group;(4) were found through the RCT filter or hand search in Pub Med; and(5) published 1985-2017. Exclusion criteria was as follows:(1) Patients that were not undergoing primary or revision TKA procedures;(2) articles that did not separate total hip arthroplasity(THA) vs TKA results if both hip and knee revisions were evaluated;(3) papers that did not follow up on clinical outcomes of the procedure;(4) extrapolation of data was not possible given published results;(5) knee revisions not done on human patients;(6) studies that were strictly done on THAs;(7) articles that were not found through the RCT filter or through hand search in Pub Med;(8) articles that did not evaluate AIBC used in a prosthesis or a spacer during revision;(9) articles that did not compare an AIBC group vs a non-AIBC control group; and(10) articles that were published before 1985.RESULTS In total, 11 articles were deemed eligible for this analysis. Nine of the 11 studies dealt with primary TKA procedures comparing AIBC to non-AIBC treatment. The other two studies dealt with revision TKA procedures that compared such groups. From these papers, 4092 TKA procedures were found. 3903 of these were primary TKAs, while 189 were revision TKAs. Of the 3903 primary TKAs, 1979 of these used some form of AIBC while 1924 were part of a non-AIBC control group. Of the 189 revision TKAs, 96 of these used some form of AIBC while 93 were part of a non-AIBC control group. Average followup times of 47.2 mo and 62.5 mo were found in primary and revision groups respectively. A two-tailed Fisher's exact test was done to check if infection rates differed significantly between the groups. In the primary TKA group, a statistically significant difference between AIBC and non-AIBC groups was not found(AIBC infection rate = 23/1979, non-AIBC infection rate = 35/1924, P = 0.1132). In the revision TKA group, a statistically significant difference between the groups was found(AIBC infection rate = 0/96, non-AIBC infection rate = 7/93, P = 0.0062). No statistically significant differences existed in Knee Society Scores, Hospital for Special Surgery Scores, or Loosening Rates.CONCLUSION AIBC did not have a significant effect on primary TKA infection rates. AIBC did have a significant effect on revision TKA infection rates.
文摘This study aims to investigate various aspects of the treatment of chronic bone infections and the challenges in their management. The characterization of treatment of 73 patients with chronic bone infection was reported. The four management challenges including consultation delay, immune depression, extreme variety of clinical manifestations and non-use of CT or MRI were discussed in this study. We conducted a retrospective study at Aristide Le Dantec Hospital on 90 cases of chronic bone infection in 73 patients. The mean duration of symptoms before consultation was 36 months. More than half of the patients had a productive fistula at the first consultation. Sickle cell anemia was found in 6 patients. Multiple lesions were found in 10 patients;and long bones were affected in 90% of cases. The bacterial culture was positive in 93.15%. Staphylococcus aureus was the most isolated germ (68.35%). Seventy-two out of seventy-three patients were operated on. The procedure depended on anatomical and radiological lesions. Surgical treatment was associated with antibiotherapy which was firstly probabilistic and secondarily adapted to the results of bacterial culture. A favorable trend was found in 41 patients (56.16%). 32 cases of adverse effects were noted (43.83%), and 27 patients had recurrence after a favorable outcome. Several complications and sequelae were observed demonstrating the tenacity of these chronic infections.
文摘Campylobacter species are one of the major causes of global bacterial-related diarrheal disease worldwide. The disease is most frequently associated with the ingestion of contaminated meat, raw milk, pets, contaminated water, and the organism may be frequently cultured from the faeces of chicken and other domesticated farm animals. Of the 17 established Campylobacter species, the most important pathogens for humans are Campylobacter jejuni(C. jejuni), Campylobacter coli(C. coli) and Campylobacter fetus(C. fetus), which are all associated with diarrheal disease. Further, C. jejuni and C. coli are also associated with the neuroparalytic diseases Guillain-Barré syndrome and Miller Fischer syndrome, respectively, whereas C. fetus is linked with psoriatic arthritis. The discovery of both "molecular mimicry" and translocation-related virulence in the pathogenesis of C. jejuni-induced disease, indicates, that Campylobacter-related gastrointestinal infections may not only generate localized, acute intestinal infection in the human host, but may also be involved in the establishment of chronic inflammatory diseases. Indeed, pathogenicity studies on several Campylobacter species now suggest that molecular mimicry and translocation-related virulence is not only related to C. jejuni, but may play a role in human disease caused by other Campylobacter spp. In this review, the authors provide a review based on the current literature describing the potential links between Campylobacter spp. and(chronic) inflammatory diseases, and provide their opinions on the likely role of Campylobacter in such diseases.
基金the Key Project of Social Development of Jiangsu province of China-Clinical Frontier Technology,No.BE2017661the 333 Talents Project of Jiangsu province of China,No.BRA2017057.
文摘BACKGROUND The most commonly ingested foreign body in Asians is fish bone.The vast majority of patients have obvious symptoms and can be timely diagnosed and treated.Cases of pyogenic cervical spondylitis and diskitis with retropharyngeal and epidural abscess resulting in incomplete quadriplegia due to foreign body ingestion have been rarely reported.The absence of pharyngeal or esophageal discomfort and negative computed tomography(CT)findings of fish bone have not been reported.We report the case of an elderly female patient with delayed cervical infection and incomplete quadriplegia who had a history of fish bone ingestion.CASE SUMMARY A 73-year-old woman presented with right neck pain and weakness of four limbs for a week,and had a history of fish bone ingestion and negative findings on laryngoscopic examination one month previously.She did not complain of any pharyngeal or esophageal discomfort.Cervical magnetic resonance imaging showed C4/C5 spondylitis and diskitis along with retropharyngeal and ventral epidural abscesses.No sign of fish bone was detected on lateral cervical radiography and CT scans.The muscle strength of the patient’s right lower limb receded to grade 1 and other limbs to grade 2 suddenly on the 10th day of hospitalization.Emergency surgery was performed to drain the abscess and decompress the spinal cord by removing the anterior inflammatory necrotic tissue.Simultaneously,flexible esophagogastroduodenoscopy was carried out and a hole in the posterior pharyngeal wall was found.The motor weakness of the right lower limb improved to grade 3 and the other limbs to grade 4 within 2 d postoperatively.CONCLUSION This rare case highlights the awareness of the posterior pharyngeal or esophageal wall perforation in patients with cervical pyogenic spondylitis along with a history of fish bone ingestion,even though local discomfort symptoms are absent and the radiological examinations are negative.
文摘BACKGROUND Hemiarthroplasty is the most common treatment in elderly patients with displaced intra-capsular femoral neck fracture(FNF).Prosthetic joint infection(PJI)is one of the most feared and frequent complications post-surgery because of the frail health status of these patients and the need for fast track surgery.Therefore,priorities should lie in effective preventive strategies to mitigate this burden.AIM To determine how much the implementation of the routine use of antibioticloaded bone cement(ALBC)as a relatively easy-to-apply amendment to the surgical practice reduces the infection rate in our hemiarthroplasty cohort.METHODS We retrospectively assessed all demographic,health status and treatment-related data of our FNF patients undergoing cemented hemiarthroplasty in the period from 2011 to 2017;241 patients were further analyzed after exclusion of patients with cancer-related sequelae and those who died before the end of the 1-year observation period.The PJI rate as diagnosed on basis of the Musculoskeletal Infection Society(MSIS)criteria 2011 was determined for each included patient and compared in function of the bone cement used for hip stem fixation.Patients were split into a group receiving a plain bone cement in the period from January 2011 to June 2013(non-ALBC group)and into a group receiving an ALBC in the period July 2013 to December 2017(ALBC group).Data analysis was performed with statistical software.We further calculated the cost-efficacy of the implementation of routine use of ALBC in the second group balancing the inhospital infection related treatment costs with the extra costs of use of ALBC.RESULTS In total 241 FNF patients who received cemented hemiarthroplasty in the period from January 2011 to January 2017 were eligible for inclusion in this retrospective study.There were 8 PJI cases identified in the ALBC group among n=94 patients,whereas 28 PJI cases were observed in the non-ALBC group among n=147 patients.The statistical analysis showed an infection risk reduction of 55.3%(in particular due to the avoidance of chronic delayed infections)in the ALBC group(95%CI:6.2%-78.7%;P=0.0025).The cost-evaluation analysis demonstrated a considerable cost saving of 3.500€per patient,related to the implementation of routine use of ALBC in this group.CONCLUSION Use of ALBC is a potent infection preventive factor in FNF patients receiving cemented hemiarthroplasties.It was further found to be highly cost-effective.
文摘Background: Autoimmune diseases are a vast array of organ-specific as well as systemic diseases, whose pathogenesis results from the activation of B and T lymphocytes reacting against antigens of the body’s own tissues (defined as self). Objective: To record skin tumors and infections in all autoimmune diseases gathered together in a one pathological state, compared with renal transplant recipients and normal control. Patients and Methods: Four hundred patients with different autoimmune diseases were examined. Fifty patients with pemphigus (15 males, 35 females) are aged from 20 - 70 (41.23 ± 3.89) years. Fifty patients with systemic lupus erythematosus (50 females) are aged from 17 - 45 (30.58 ± 10.08) years. One hundred patients with vitiligo (59 males, 41 females) are aged from 9 - 71 (42.89 ± 5.28) years. One hundred patients with alopecia areata (42 males, 58 females) are aged from 7 - 52 (38.67 ± 9.52) years. One hundred patients with psoriasis (56 males, 44 females) are aged from 7 - 71 (47.36 ± 8.62) years were evaluated. One hundred twenty kidney transplant recipients’ (101 males, 19 females) ages ranged from 14 - 70 (45.43 ± 4.63) years. All patients were examined thoroughly for any cutaneous manifestations and tumors and the findings were compared with the general population as a control group, which consisted of 500 healthy control individuals whose ages ranged from 20 - 71 (44.53 ± 11.48) years. This case series, descriptive, controlled study was performed in Baghdad Teaching Hospital from June 2014 to October 2015. Results: In renal transplant recipients, the findings were observed as follow herpetic infection in 30(25%), bacterial 12(10%) while fungal 24(20%) patients. These infections appeared early in the course of immunosuppression. While the tumors were noticed, the benign tumors were the commonest manifestations, which included viral warts in 45(37.5%) followed by actinic keratosis 15(12.5%), seborrheic keratosis 14(11.6%), sebaceous hyperplasia 13(10.8%) and keratoacanthoma 1(0.8%). While the malignant tumors were basal cell carcinoma 4(3.3%) followed by squamous cell carcinoma 3(2.5%), and kaposi’s sarcoma 4(3.3%), Bowen’s disease 1(0.8%). These malignancy usually appeared late in the course of immunosuppression. In pemphigus, viral warts were observed in 4(8%) cases;fungal infection was seen in 4(8%) cases and bacterial infections in 2(4%) of cases and herpetic infection in only 1(2%) of case;no tumors were found in all patients. In vitiligo, viral warts were observed in 2(2%) cases, while seborrhic keratosis and sebaceous hyperplasia were observed in 1(1%) case;herpetic and fungal infections were seen in 3(3%) of cases while bacterial infections were recorded in 2(2%) of cases but no tumors were found in all patients. In alopecia areata viral warts were observed in 9(9%) of cases, sebaceous hyperplasia in 1(1%) case, herpetic and bacterial in 3(3%) of cases and fungal in 4(4%) of cases;no tumors were found in all patients. In systemic lupus erythymatosus (SLE) viral warts were observed in 4(8%) of cases, herpetic infection in 12(12%) of cases, fungal infection in 10(20%) of cases, bacterial infection in 3(3%) of cases and sebaceous hyperplasia in only 1(2%) of case, but no tumors were seen. In psoriasis, viral warts were observed in 14(14%) of cases, herpetic infection in 10(10%) of cases, bacterial infection in 3(3%) of cases, fungal infection in 2(2%) of cases, sebaceous hyperplasia in 2(2%) of cases and seborrhiec hyperkeratosis in 1(1%) case, while no tumors were demonstrated. In healthy control individuals, herpetic infection was present in 36(7.2%) and viral warts in 52(10.4%) individuals, fungal infection in 29(5.8%) of individuals and regarding tumors solar keratosis was present in 24(4.8%);basal cell carcinoma and squamous cell carcinoma were present in 2(0.4%) individuals of each. Conclusions: Patients with autoimmune diseases were protected against infections and tumors while kidney transplant recipients had no such protection although all these groups were on prolonged immunosuppression.
基金funded by the National Natural Science Foundation of China(No.210100191).
文摘Variations in host traits that influence their exposure and susceptibility may impact probability of vector-transmitted diseases.Therefore,identifying the predictors of infection probability is necessary to understand the risk of disease outbreaks during expanding environmental perturbation.Here,we conducted a large survey based on microscopic examination and molecular analysis of haemosporidian parasite infection in raptors rescued at the Beijing Raptor Rescue Centre.Combining these data with biological and ecological variables of the raptors,we determined predictors that affect the probability of haemosporidian infection using generalized linear mixed models and multimodel inference.Our results showed that infection probability exhibited considerable variation across host species in raptors,and body mass,sex,and evolutionary history played relatively weaker roles in driving infection probability.Instead,activity pattern,age,geographic range size,migration distance,and nest type were important predictors of the probability of haemosporidian infection,and the role of each predictor differed in the three main haemosporidian genera(Plasmodium,Haemoproteus,and Leucocytozoon).This macro-ecological analysis will add to our understanding of host traits that influence the probability of avian haemosporidian infection and will help inform risk of emerging diseases.
基金Supported by 1.3.5 Project for Disciplines of Excellence,West China Hospital,Sichuan University(No.ZYJC21025)。
文摘AIM:To investigate the association between central serous chorioretinopathy(CSC)and Helicobacter pylori(Hp)by summarizing all available evidence.METHODS:The Scopus,Embase,EBSCO,PubMed,Web of Science,and Cochrane Library databases for all relevant studies published from inception to October 2022 were searched,and manually searched for relevant reference lists as a supplement.Studies investigating the association between CSC and Hp infection were included.Finally,8 case-control studies were included in the Meta-analysis after study selection.RESULTS:The results showed no significant correlation between Hp infection and CSC[odds ratio(OR)1.89,95%confidential interval(CI)0.58–6.15,I2=96%,P=0.29].After subgroup analysis based on the degree of development of the study(developing/developed countries),it was found that the results of the two subgroups were the same as the whole,and no significant difference between the two subgroups existed.Meta-regression showed that the effect of sample size on heterogeneity among studies was more prominent(P<0.01,adjusted R^(2)=89.72%),which can explain 89.72%of the sources of heterogeneity.CONCLUSION:This Meta-analysis reveals no significant correlation between Hp infection and CSC,which still warrants further well-designed extensive sample studies to reach a more reliable conclusion and promote a better understanding of the treatment of CSC.