UNASSIGNED: Chronic Osteomyelitis is a well-known clinical entity affecting patients holistically and presents with multiple treatment challenges. Local antibiotic delivery with biodegradable drug carriers has shown promising results.
UNASSIGNED: Prospective multicenter study performed at 2 centers from November 2021 to January 2023 on 95 osteomyelitis patients treated with surgical debridement & STIMULAN™ for local antibiotic delivery. Patients were randomized into 3 groups. Authors compared antibiotic combinations, bead quality, bead setting, and resorption time for calcium sulfate beads- STIMULAN™. Additionally, organisms isolated, WBC Turnover time, Hypersensitivity Reactions, Recurrence, and Revision Rates were documented.
UNASSIGNED: 95 patients underwent surgical debridement and STIMULAN™ bead application for chronic osteomyelitis. The proximal 1/3rd tibia was commonly affected. The most common symptoms were sinus and pus discharge in 96.84 % & 86.31 % of patients respectively (p < 0.001). Staphylococcus aureus & MRSA were isolated in 37.8 % & 29.4 % of the patient\'s wound culture respectively. Bead setting time in Descending order was Group 3 > Group 2 > Group 1 (p < 0.001). Bead setting first in Group 1 followed by Group 3 & 2. On compression, Group-1 beads withstood maximum compression forces & had smooth even bead surfaces. On radiographs, 1/3rd bead volume in ascending order was Group 3 > Group 2 > Group 1 (p < 0.001). 2/3rd reduction in ascending order was Group 3 > Group 2 > Group 1. Complete bead absorption was earliest seen in Group 3 followed by Group 2 & Group 1 (p < 0.001). Recurrence in 2 patients (Group 2) at 6 weeks. Revision rate: 2.10 %. There were no incidences of hypersensitivity. Suture removal was done at 16 ± 2 days.
UNASSIGNED: STIMULAN™ combination with tobramycin, vancomycin, and gentamycin is stable, and forms uniform beads with predictable drug elution & bead resorption with negligible side effects. A mixture with higher liquid content sets later, forms softer beads, and resorbs earlier.

The management of postoperative wound infections is a major problem in hospitals due to the frequent ineffectiveness of antibiotic treatment. The objectives of this study are to identify the bacteria responsible for postoperative wound infections and to describe these antibiotic resistances in order to improve the management of these infections. It is a prospective study of 52 bacteriological results of postoperative wounds for a period of six months from January 2021 to June 2021 in the laboratory of the University Hospital of Befelatanana. This study showed 26 (50%) isolates of staphylococci, 17 (32.7%) isolates of enterobacteria, 6 (11.5%) isolates of streptococci and 3 (5.8%) isolates of nonfermenting gram-negatif bacilli. Antibiotic resistance, varies from 0% (vancomycin) to 92.3% (penicillin G) for staphylococci isolates, 0% (imipenem, amikacin) to 94.1% (amoxicillin) for enterobacteria isolates, 0% (vancomycin) to 50% (penicillin G) for streptococci isolates and 33% (imipenem, amikacin) to 100% (cotrimoxazole) for the isolates of nonfermenting gram-negatif bacilli. The knowledge of antibiotic resistance of bacteria responsible for postoperative wound infections allows better patient management.

BACKGROUND: Peritonsillar abscess (PTA) is often seen as a complication of acute tonsillitis and is defined as pus retention between the tonsillar capsule and the peritonsillar tissue. The etiology and pathogenesis have not yet been fully elucidated. A connection between certain weather conditions and temperature fluctuations and the occurrence of abscesses in the head and neck region has been discussed for years. The question here is whether higher temperature fluctuations are predisposing for the formation of abscesses.
METHODS: A retrospective evaluation of all patients hospitalized with peritonsillitis or PTA in the Department of Otorhinolaryngology of the Klinikum Rechts der Isar of the Technical University of Munich during a period of 10 years (2012-2021) was performed. Each patient was individually correlated with daily temperature data from the statistical meteorological office of the City of Munich.
RESULTS: A total of 1450 patients were included, 270 patients (18.62%) with peritonsillitis and 1180 patients (81.38%) with PTA. A correlation between the occurrence of peritonsillitis or PTA and major temperature fluctuations could be excluded in this large patient population. Moreover, a similar frequency of peritonsillitis and PTA was seen throughout the year.
CONCLUSIONS: The myth of a temperature dependence of the development of peritonsillitis or PTA and a so-called abscess weather could be negated in this study.
UNASSIGNED: HINTERGRUND: Der Peritonsillarabszess (PTA) wird häufig als Komplikation der akuten Tonsillitis gesehen und ist definiert als Eiterverhalt zwischen der Tonsillenkapsel und dem peritonsillären Gewebe. Die Ätiologie und Pathogenese sind bisher noch nicht vollständig geklärt. Ein Zusammenhang zwischen bestimmten Wetterbedingungen und Temperaturschwankungen und dem Auftreten von Abszessen im Kopf-Hals-Bereich wird seit Jahren diskutiert. Hierbei ist die Frage, ob höhergradige Temperaturschwankungen prädisponierend sind für die Ausbildung von Abszessen.
METHODS: Es erfolgte eine retrospektive Auswertung aller Patienten, die in einem Zeitraum von 10 Jahren (2012–2021) in der Klinik und Poliklinik für Hals, Nasen‑, Ohrenheilkunde des Klinikums rechts der Isar der Technischen Universität München mit einer Peritonsillitis oder einem PTA stationär behandelt wurden. Jeder Patient wurde einzeln mit den täglichen Temperaturdaten des statistischen Wetteramts für die Stadt München korreliert.
UNASSIGNED: Insgesamt konnten 1450 Patienten in die Studie eingeschlossen werden. Von den 1450 Patienten hatten 270 Patienten (18,62 %) eine Peritonsillitis, 1180 Patienten (81,38 %) einen PTA. Eine Korrelation zwischen dem Auftreten von Peritonsillitiden oder PTA und größeren Temperaturschwankungen konnte in diesem großen Patientenkollektiv ausgeschlossen werden. Auch zeigte sich über das ganze Jahr eine ähnliche Häufigkeit von Peritonsillitiden und PTA.
UNASSIGNED: Peritonsillitiden oder Peritonsillarabszesse entwickeln sich nach Datenlage der vorliegenden Studie wetterunabhängig.

暂无摘要。

Acute bacterial meningoencephalitis is still prevalent despite the widespread vaccination and still fatal despite the advances in antimicrobial therapy. Identifying patients at risk, lowering the threshold of clinical diagnosis and early treatment of such a curable disease will save patients\' lives.

UNASSIGNED: To evaluate the accuracy of Mycobacterium tuberculosis (MTB)-RNA in the rapid diagnosis of lymph node tuberculosis (LNTB). Moreover, the difference in the diagnostic accuracy of MTB-RNA using different specimens was determined.
UNASSIGNED: We included patients with suspected LNTB who met the inclusion criteria and retrospectively analyzed their clinical data. The sensitivity, specificity, positive-predictive value (PPV), negative-predictive value (NPV), and area under the curve (AUC) of MTB-RNA and culture were calculated and its diagnostic accuracy for LNTB was evaluated in comparison with the final clinical diagnosis.
UNASSIGNED: Overall, 285 patients were included in the study. The overall sensitivity, specificity, PPV, NPV, and AUC of MTB-RNA were 40.6%, 100.0%, 100.0%, 17.0%, and 0.70, respectively. These values were 30.8%, 100.0%, 100.0%, 16.0%, and 0.65, respectively, for tissue specimens; 34.2%, 100.0%, 100.0%, 24.6%, and 0.67, respectively, for puncture specimens; and 57.14%, 100.0%, 100.0%, 5.3%, and 0.79, respectively, for pus specimens. These values of culture were 24.4%, 100.0%, 100.0%, 13.9%, and 0.62, respectively, for all specimens; 17.6%, 100.0%, 100.0%, 13.8%, and 0.59, respectively, for tissue specimens; 25.3%, 100.0%, 100.0%, 22.4%, and 0.63, respectively, for puncture specimens; and 31.0%, 100.0%, 100.0%, 3.3%, and 0.65, respectively, for pus specimens.
UNASSIGNED: The diagnostic efficacy of MTB-RNA for the rapid diagnosis of LNTB was moderate, but its sensitivity was low. The lymph node pus specimens were the most sensitive for MTB-RNA testing, followed by puncture specimens; tissues were the least sensitive. Pus specimens should be preferably obtained in case only this test is to be used for diagnosis.

暂无摘要。

CONCLUSIONS: None. The authors declare that there are no potential conflicts of interest.

Cystic glioblastomas are aggressive primary brain tumors that may both destroy and displace the surrounding brain tissue as they grow. The mechanisms underlying these tumors\' destructive effect could include exposure of brain tissue to tumor-derived cytokines, but quantitative cytokine data are lacking. Here, we provide quantitative data on leukocyte markers and cytokines in the cyst fluid from 21 cystic glioblastomas, which we compare to values in 13 brain abscess pus samples. The concentration of macrophage/microglia markers sCD163 and MCP-1 was higher in glioblastoma cyst fluid than in brain abscess pus; lymphocyte marker sCD25 was similar in cyst fluid and pus, whereas neutrophil marker myeloperoxidase was higher in pus. Median cytokine levels in glioblastoma cyst fluid were high (pg/mL): TNF-α: 32, IL-6: 1064, IL-8: 23585, tissue factor: 28, the chemokine CXCL1: 639. These values were not significantly different from values in pus, pointing to a highly pro-inflammatory glioblastoma environment. In contrast, levels of IFN-γ, IL-1β, IL-2, IL-4, IL-10, IL-12, and IL-13 were higher in pus than in glioblastoma cyst fluid. Based on the quantitative data, we show for the first time that the concentrations of cytokines in glioblastoma cyst fluid correlate with blood leukocyte levels, suggesting an important interaction between glioblastomas and the circulation. Preoperative MRI of the cystic glioblastomas confirmed both destruction and displacement of brain tissue, but none of the cytokine levels correlated with degree of brain tissue displacement or peri-tumoral edema, as could be assessed by MRI. We conclude that cystic glioblastomas are highly pro-inflammatory environments that interact with the circulation and that they both displace and destroy brain tissue. These observations point to the need for neuroprotective strategies in glioblastoma therapy, which could include an anti-inflammatory approach.

OBJECTIVE: The purpose of our study was to evaluate the ability of ureteral stents with different diameters to drain pus that accumulates in an obstructed kidney using an in vitro model.
METHODS: We developed an in vitro model of an obstructed kidney filled with pus. The model included a silicon kidney unit based on computed tomography (CT) data, a 3D printed ureteral stone based on a real extracted ureteral stone, a latex ureter model, a bladder vessel, and a fluid with qualities resembling pus. Identical printed stones were inserted into four ureter models containing stents with varying diameters (4.8F, 6F, 7F, 8F), each of which was connected to the kidney unit and the bladder vessel. The kidney unit was filled with artificial pus to pressures of 30 cmH2O to simulate an infected and obstructed kidney. The obstruction was relieved with stents in place, while artificial urine was pumped into the kidney; pressure in the kidney and remaining pus were measured continuously.
RESULTS: The rate of pressure drop and the final pressure measured in the kidney were unaffected by the diameter of the stent. For all stent diameters, the pressure reached non-obstructed levels within 30 s, final pressure was reached within 90-120 s, and minimal amounts of pus remained in the kidney after 120 min.
CONCLUSIONS: In vitro experiments demonstrate that all stent diameters drain pus-filled, obstructed kidneys with the same efficacy. The common perception that larger diameter tubes are more effective under such circumstances should be re-examined.