SOT

SOT
  • 文章类型: Journal Article
    Phaeohyphomycosis comprises a variety of infections caused by pigmented fungi. Solid organ transplant (SOT) recipients are particularly at risk of invasive infections due to their prolonged immunosuppression. Here, we describe three cases of phaeohyphomycosis in SOT recipients who were successfully treated with surgical excision and/or antifungal therapy. We additionally carried out a narrative review of the literature on phaeohyphomycosis in 94 SOT recipients from 66 published studies describing 40 different species of fungi. The most reported fungus was Alternaria (21%). The median time from transplant to diagnosis was 18 months (IQR 8.25-48), and kidney transplants were the most reported. Antifungal regimens were not homogeneous, though there was a prevalence of itraconazole- and voriconazole-based treatments. Clinical outcomes included recovery in 81% and death in 5% of infected SOT recipients. Susceptibility testing was done in 26.6% of the cases, with heterogeneous results due to the variety of species isolated. While the wide diversity of dematiaceous fungi and their host range make it difficult to offer a uniform approach for phaeohyphomycosis, an early diagnosis and therapy are critical in preventing the dissemination of disease in the immunocompromised host.
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  • 文章类型: Case Reports
    诺卡氏菌主要被认为是一种机会性病原体,会影响免疫系统受损的患者,实体器官移植受者(SOTRs),和血液系统恶性肿瘤患者。我们提供了过去两年在我们中心诊断为诺卡心病的6例患者的病例,描述各种易感条件以及临床表现,诊断检查,和治疗过程。此外,我们建议对免疫受损宿主中的诺卡氏菌感染进行简短的文献综述,重点关注SOTR和造血干细胞移植受者,并突出危险因素,临床表现,可用的诊断工具,以及当前的治疗和预防指南。
    Nocardia is primarily considered an opportunistic pathogen and affects patients with impaired immune systems, solid-organ transplant recipients (SOTRs), and patients with haematologic malignancies. We present the cases of six patients diagnosed with nocardiosis at our center in the last two years, describing the various predisposing conditions alongside the clinical manifestation, the diagnostic workup, and the treatment course. Moreover, we propose a brief literature review on Nocardia infections in the immunocompromised host, focusing on SOTRs and haematopoietic stem cell transplantation recipients and highlighting risk factors, clinical presentations, the diagnostic tools available, and current treatment and prophylaxis guidelines.
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  • 文章类型: Case Reports
    Squamous odontogenic tumors (SOT) are rare, benign, odontogenic neoplasms of the jaws. The sporadically reported cases with multifocal SOTs seem to have a marked predilection for younger African American patients. In this case report a 14-year-old Caucasian male presented with swelling of the vestibular alveolar process, slight tooth divergence, and mobility. A multifocal squamous odontogenic tumor was diagnosed and subsequently treated twice with surgical enucleation. Two and a half years earlier his mother was diagnosed and treated for a similar multifocal SOT. Next-Generation-Sequencing targeted resequencing mutational analysis of the maternal surgical specimens was performed. No potential causal mutation could be identified. Postoperative follow-up of the patient showed no recurrence of the SOT after 2 years. This case report substantiates the possibility of a familial relationship in (multifocal) SOT, possibly changing current ideas concerning the etiology and treatment of these neoplasms.
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  • 文章类型: Journal Article
    本研究的目的是评估使用故意再植(IR)和牙周假体治疗牙周无望预后和继发性咬合创伤(SOT)的牙齿的纵向存活率。我们收集了1995年至2014年期间接受IR并参与研究的17名个体的数据。在受牙周极端条件影响的17颗牙齿中,有深角骨缺损,严重的牙槽骨丢失,延伸到或超过顶点,SOT,被认为预后毫无希望。这些牙齿依次使用包括基础牙周治疗在内的程序进行治疗,治疗性临时假体,IR,固定假牙,牙冠和套筒式伸缩假牙(CSCTD),或固定假体和CSCTD相结合。评估IR前后的临床参数和影像学骨变化的纵向评估。临床结果表明,IR治疗后(5-12年)被测牙齿的总累积生存率为88.2%。放射学估计的平均(±SD)牙槽骨丢失为根长的12.7±2.1mm(88.5%±13.3%),最初,最终估计放射学牙槽骨增益为4.0±2.2mm,在17颗用SOT重新种植的牙齿中。只有一颗牙齿(5.9%)表现出牙根吸收。在研究期间未观察到强直。根尖周X光片显示,所有使用SOT重新种植的牙齿均可获得满意的硬膜硬膜牙周愈合和骨填充。一般来说,治疗后牙齿活动度和SOT明显改善。在整个研究期间,大多数治疗的牙齿功能良好,并在临床上保持稳定。本研究记录了自体IR和17颗牙周病无望牙齿的假体周围治疗5-12年的有希望的结果。本研究显示良好的骨增益和SOT消除以及突出的咬合功能。我们得出结论,应用IR,米诺环素-HCL和牙周修复手术后来提高了这些原本没有希望的SOT牙齿的预后,这是在牙周极端情况下保留牙齿的有价值的选择。
    The purpose of the present study was to evaluate the longitudinal survival rate of the treatment of teeth affected with periodontally hopeless prognosis and secondary occlusal traumatism (SOT) using intentional replantation (IR) and periodontal prosthesis. We collected data from 17 individuals who received IR and participated in the study during 1995 to 2014. Of the 17 teeth affected by periodontally extreme conditions with deep angular bone defects, severe alveolar bone loss extending to or beyond the apex, and SOT, was recognized as having hopeless prognosis. Those teeth were treated sequentially using procedures that included basic periodontal therapy, therapeutic provisional prosthesis, IR, fixed dental prosthesis, crown and sleeve-coping telescopic dentures (CSCTDs), or fixed prosthesis and CSCTD combined. Longitudinal assessments of clinical parameters and radiographic bone change before and after IR were evaluated. Clinical results showed that the overall cumulative survival rate of assayed teeth after IR therapy (5-12 years) was 88.2%. The mean (±SD) estimated radiographic alveolar bone loss was 12.7 ± 2.1 mm (88.5% ± 13.3%) of the root length, initially, and estimated radiographic alveolar bone gain was 4.0 ± 2.2 mm ultimately, in 17 replanted teeth with SOT. Only one tooth (5.9%) exhibited root resorption. Ankylosis was not observed during the study. Periapical radiographs demonstrated that satisfactory periodontal healing of lamina dura and bone fills occurred in all replanted teeth with SOT. Generally, tooth mobility and SOT were significantly improved after therapy. Most treated teeth functioned well and remained stable clinically throughout the periods of study. The present study documented a promising outcome for autogenous IR and periprosthetic therapy of 17 periodontally hopeless teeth for 5-12 years. The present study revealed good bone gain and elimination of SOT and prominent occlusal function. We concluded that the application of IR, minocycline-HCL and periodontal prosthetic procedures later elevated the prognosis of these otherwise hopeless teeth with SOT, which are valuable options for retaining teeth with periodontally extreme situations.
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  • 文章类型: Case Reports
    Saccharomyces cerevisiae, an ascosporogenous yeast commonly used in the production of food, is an emerging infection in immunocompromised patients. We report the case of a 60-year-old man whose orthotopic liver transplant was complicated by S. cerevisiae fungemia and peritoneal abscess, successfully treated with caspofungin and drainage. We also review the literature of invasive saccharomycoses in recipients of hematologic and solid organ transplants.
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