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Affiliation(s)
- Liwen Deng
- Harvard Medical School, Blavatnik Institute, Department of Immunology, Boston, Massachusetts, United States of America
| | - Isaac M. Chiu
- Harvard Medical School, Blavatnik Institute, Department of Immunology, Boston, Massachusetts, United States of America
- * E-mail:
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Meng J, Banerjee S, Zhang L, Sindberg G, Moidunny S, Li B, Robbins DJ, Girotra M, Segura B, Ramakrishnan S, Roy S. Opioids Impair Intestinal Epithelial Repair in HIV-Infected Humanized Mice. Front Immunol 2020; 10:2999. [PMID: 32010125 PMCID: PMC6978907 DOI: 10.3389/fimmu.2019.02999] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 12/06/2019] [Indexed: 12/20/2022] Open
Abstract
Intestinal barrier dysfunction and subsequent microbial translocation play crucial roles in persistent immune activation leading to HIV disease progression. Opioid use is associated with worse outcome in HIV-infected patients. The exacerbated disease progression by opioids is mainly driven by excessive intestinal inflammation and increased gut permeability. The objective of this study is to investigate how opioids potentiate HIV disease progression by compromising intestinal barrier function and impairing intestinal epithelial self-repair mechanism. In the present study, abnormal intestinal morphology and reduced epithelial proliferation were observed in bone marrow-liver-thymus humanized mice and in HIV-infected patients who were exposed to opioids. In bone marrow-liver-thymus mice, HIV, and morphine independently, and additively induced gut dysbiosis, especially depletion of Lachnospiraceae, Ruminococcaceae, and Muribaculaceae. We also observed that the abundance of Lachnospiraceae, Ruminococcaceae, and Muribaculaceae negatively correlated with apoptosis of epithelial cells, and intestinal IL-6 levels. Previous studies have shown that these bacterial families play crucial roles in maintaining intestinal homeostasis because they include most short-chain fatty acid-producing members. Short-chain fatty acids have been shown to maintain stem cell populations and suppress inflammation in the gut by inhibiting histone deacetylases (HDAC). In addition, we demonstrate that morphine exposure inhibited growth of intestinal organoids derived from HIV transgenic mice by suppressing Notch signaling in an HDAC-dependent manner. These studies implicate an important role for HDAC in intestinal homeostasis and supports HDAC modulation as a therapeutic intervention in improving care of HIV patients, especially in opioid-abusing population.
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Affiliation(s)
- Jingjing Meng
- Department of Surgery, University of Miami, Miami, FL, United States
- Department of Surgery, University of Minnesota, Minneapolis, MN, United States
| | - Santanu Banerjee
- Department of Surgery, University of Miami, Miami, FL, United States
- Department of Surgery, University of Minnesota, Minneapolis, MN, United States
| | - Li Zhang
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, United States
| | - Greg Sindberg
- Department of Veterinary Biosciences, University of Minnesota, Saint Paul, MN, United States
| | | | - Bin Li
- Department of Surgery, University of Miami, Miami, FL, United States
| | - David J. Robbins
- Department of Surgery, University of Miami, Miami, FL, United States
| | - Mohit Girotra
- Division of Gastroenterology, University of Miami, Miami, FL, United States
| | - Bradley Segura
- Department of Surgery, University of Minnesota, Minneapolis, MN, United States
| | | | - Sabita Roy
- Department of Surgery, University of Miami, Miami, FL, United States
- Department of Surgery, University of Minnesota, Minneapolis, MN, United States
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Röttgering JG, Herderscheê D, Lionarons DA, de Vries PJ. [An unvaccinated man with a painful arm and jaw]. Ned Tijdschr Geneeskd 2020; 164:D3932. [PMID: 32186824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Clostridium tetani is a gram-positive spore-forming bacterium that produces toxins and grows under anaerobic conditions. Infections with this bacterium can lead to local or generalised forms of tetanus. CASE DESCRIPTION An 83-year-old man presented to the acute cardiac care unit with a painful left arm and jaw. Because the patient had a hypertonic left arm and was unable to open his mouth fully, the neurologist was consulted. The patient had been to the emergency department 9 days earlier for an infected wound after falling in the garden. He had not been actively or passively immunised against tetanus at that time. On inquiry, it appeared that the patient had also not been vaccinated as a child. We made a clinical diagnosis of tetanus. The patient was admitted and treated with tetanus immunoglobulin, metronidazole, diazepam and painkillers. He was also administered tetanus toxoid and the wound was cleaned. After 1 month and 7 months, the patient was again administered tetanus toxoid. CONCLUSION Patients with a wound that may have come into contact with road grime, dirt or manure, should always be asked for their vaccination status, especially people from high-risk groups, such as the elderly.
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Affiliation(s)
- J G Röttgering
- Tergooi, afd. Neurologie, Blaricum
- Contact: J.G. Röttgering
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Zhao Q, Wang J, Yin C, Zhang P, Zhang J, Shi M, Shen K, Xiao Y, Zhao Y, Yang X, Zhang Y. Near-Infrared Light-Sensitive Nano Neuro-Immune Blocker Capsule Relieves Pain and Enhances the Innate Immune Response for Necrotizing Infection. Nano Lett 2019; 19:5904-5914. [PMID: 31389707 DOI: 10.1021/acs.nanolett.9b01459] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Sensory neurons promote profound suppressive effects on neutrophils during Streptococcus pyogenes infection and contribute to the pathogenesis of necrotizing infection ("flesh-eating disease"). Thus, the development of new antibacterial agents for necrotizing infection is promising because of the clear streptococcal neuro-immune communication. Herein, based on the immune escape membrane exterior and competitive membrane functions of the glioma cell membrane, a novel nano neuro-immune blocker capsule was designed to prevent neuronal activation and improve neutrophil immune responses for necrotizing infection. These nano neuro-immune blockers could neutralize streptolysin S, suppress neuron pain conduction and calcitonin gene-related peptide release, and recruit neutrophils to the infection site, providing a strong therapeutic effect against necrotizing infection. Furthermore, nano neuro-immune blockers could serve as an effective inflammatory regulator and antibacterial agent via photothermal effects under near-infrared irradiation. In the Streptococcus pyogenes-induced necrotizing fasciitis mouse model, nano neuro-immune blockers showed significant therapeutic efficacy by ameliorating sensitivity to pain and promoting the antibacterial effect of neutrophils.
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Affiliation(s)
- Qin Zhao
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine, Ministry of Education, School and Hospital of Stomatology , Wuhan University , Wuhan 430079 , China
| | - Jinyang Wang
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine, Ministry of Education, School and Hospital of Stomatology , Wuhan University , Wuhan 430079 , China
| | - Chengcheng Yin
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine, Ministry of Education, School and Hospital of Stomatology , Wuhan University , Wuhan 430079 , China
| | - Peng Zhang
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine, Ministry of Education, School and Hospital of Stomatology , Wuhan University , Wuhan 430079 , China
| | - Jinglun Zhang
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine, Ministry of Education, School and Hospital of Stomatology , Wuhan University , Wuhan 430079 , China
| | - Miusi Shi
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine, Ministry of Education, School and Hospital of Stomatology , Wuhan University , Wuhan 430079 , China
| | - Kailun Shen
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine, Ministry of Education, School and Hospital of Stomatology , Wuhan University , Wuhan 430079 , China
| | - Yin Xiao
- Institute of Health and Biomedical Innovation , Queensland University of Technology , Kelvin Grove , Queensland 4059 , Australia
| | - Yanbing Zhao
- National Engineering Research Center for Nanomedicine, Hubei Key Laboratory of Bioinorganic Chemistry and Materia Medica, College of Life Science and Technology , Huazhong University of Science and Technology , Wuhan 430074 , China
| | - Xiangliang Yang
- National Engineering Research Center for Nanomedicine, Hubei Key Laboratory of Bioinorganic Chemistry and Materia Medica, College of Life Science and Technology , Huazhong University of Science and Technology , Wuhan 430074 , China
| | - Yufeng Zhang
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine, Ministry of Education, School and Hospital of Stomatology , Wuhan University , Wuhan 430079 , China
- Medical Research Institute, School of Medicine , Wuhan University , Wuhan , 430071 , China
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Kanstrup C, Perregaard H, Bertelsen CA. [Perianal abscess after anal intercourse should raise suspicion of rectal gonorrhoeae infection]. Ugeskr Laeger 2019; 181:V10180736. [PMID: 30799811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Neisseria gonorrhoeae infection is a sexually transmitted disease. Rectal gonorrhoea is often asymptomatic, the most common symptoms are anal pain, bleeding and purulent discharge. This case report describes a younger man, who experienced increasing anal pain and later fever after anal intercourse. N. gonorrhoeae infection was verified, before a clinical examination revealed a perianal abscess. During incision of the abscess an anal fistula was suspected, and six weeks after primary surgery and treatment with relevant antibiotics, transanal ultrasonography showed perianal scarring and no signs of anocutaneous fistula.
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Gardner H, Potisek NM. A young girl with a painful rash. J Fam Pract 2019; 68:E25-E27. [PMID: 30724913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The speed with which this rash spread and the fact that the patient's skin sloughed off when pressure was applied made the diagnosis clear.
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Affiliation(s)
- Hannah Gardner
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Nicholas M Potisek
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA.
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Fujita S, Hayashi H, Kodama S, Mukai T, Morita Y. Bacteremia Possibly Caused by Helicobacter cinaedi and Associated with Painful Erythema in Rheumatoid Arthritis with Malignant Lymphoma. Intern Med 2018; 57:3663-3666. [PMID: 30146580 PMCID: PMC6355406 DOI: 10.2169/internalmedicine.1196-18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
We herein report the case of a 69-year-old woman with rheumatoid arthritis (RA) and malignant lymphoma who developed Helicobacter cinaedi bacteremia after starting rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy. She had a recurrent fever and painful erythema for 13 months before the diagnosis was made. This delayed diagnosis was attributable to the underlying RA, which typically presents with various cutaneous manifestations and elevated C-reactive protein levels. The erythema on the thighs, abdomen, and left forearm improved following treatment with intravenous aminobenzyl penicillin; she received antibiotics for six weeks. This case emphasizes the importance of recognizing this opportunistic infection in immunocompromised patients.
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Affiliation(s)
| | | | - Shoko Kodama
- Department of Rheumatology, Kawasaki Medical School, Japan
| | - Tomoyuki Mukai
- Department of Rheumatology, Kawasaki Medical School, Japan
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Abstract
This case highlights the need for doctors to be aware of tuberculosis (TB) as a cause of monarthritis and highlights the potential for serious complications to occur if TB arthritis is not managed appropriately.
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Affiliation(s)
- Sandeep Bawa
- Department of Rheumatology, The Royal Berkshire Hospital NHS Foundation Trust, London Road, Reading RG1 5AN, UK.
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Partain DK, Enzler M. 72-Year-Old Woman With Redness, Swelling, and Pain of the Forearms and Hands. Mayo Clin Proc 2016; 91:678-82. [PMID: 26906651 DOI: 10.1016/j.mayocp.2015.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 11/30/2015] [Accepted: 12/03/2015] [Indexed: 11/15/2022]
Affiliation(s)
- Daniel K Partain
- Resident in Internal Medicine, Mayo School of Graduate Medical Education, Mayo Clinic, Rochester, MN
| | - Mark Enzler
- Advisor to resident and Consultant in Infectious Diseases, Mayo Clinic, Rochester, MN.
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Abstract
Salmonella is a foodborne pathogen that commonly causes intestinal symptoms. Bacteraemia and extraintestinal infections have been documented within the literature, and are more frequently associated with immunodeficiency and general debilitation. We discuss the case of a previously well 36-year-old man who presented with a septic knee and new-onset diabetes. Imaging confirmed osteomyelitis and a Brodie's abscess, with blood and tissue cultures revealing the isolate Salmonella enterica newport. He denied any previous gastrointestinal symptoms, recent travel, change in usual dietary habit or symptoms of diabetes. So far there have only been three reported cases of S. newport causing osteomyelitis. We discuss the incidence of Salmonella infections, including extraintestinal symptoms, its relation to immunodeficiency and the disease burden of S. newport.
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Affiliation(s)
| | - Ed Moran
- Department of Infectious Diseases and Tropical Medicine, Birmingham Heartlands Hospital, Heart of England NHS Hospital Trust, Birmingham, UK
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Carrega G, Antonini A, Burastero G, Casalino-Finocchio G, Ronca A, Salomone C, Riccio G. [Diagnosis in patients with a painful arthroplasty]. Infez Med 2015; 23:140-147. [PMID: 26110294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The differential diagnosis between asepting loosening or prosthetic joint infection is not always easy. Tc-99m-labelled leucocyte scans, frozen section and histology can help recognise doubtful cases. We report the experience of the Unit for Infectious Diseases and Septic Orthopaedics of the ASL-2 Liguria, Italy, with a Tc-99m-labelled leucocyte scan and intraoperative frozen section to choose the best therapeutic approach: one-stage or two-stage exchange or arthrodesis-arthroplastica. All cases underwent histology and intraoperative cultures to confirm the diagnosis, and the effectiveness of the approach was evaluated at follow up after 18 months. From January 2011 to December 2012, 36 patients were evaluated (21 hip and 15 knee arthroprosthesis). The Tc-99m-labelled leukocyte scan was positive in 31 and negative in 5 patients. Frozen section was negative in 7 patients. Five of them were patients with a negative Tc-99m-labelled leucocyte scan and were treated successfully with one-stage exchange, even if, in one of them, Enterococcus faecalis was isolated at replacement and suppressive antibiotic treatment was needed. The other 31 patients were treated with arthrodesis arthroplasty (3 patients) or a two-stage exchange. In this group the Tc-99m-labelled leucocyte scan was positive in all patients and the frozen section was positive in 29/31 cases with 6% false negative. Histology was positive in 27/31 with 13% of false negative. The sensitivity and specificity value was respectively 90% and 100% in the frozen section, 84% and 100% in histology. Cultures were positive in 23/31 cases. Patients subjected to two-stage exchange were evaluated again during prosthesis replacement but the results of the Tc-99m-labelled leucocyte scan and histology showed unclear results more frequently: the Tc-99m-labelled leucocyte scan was positive in two cases, the frozen section in three and histology in seven in spite of positive culture in three cases and one relapse in a patient with a frozen section and histology positive but negative culture. In the second step sensitivity and specificity were respectively 67% and 96% in the frozen section, 75% and 88% in histology. Finally, our experience suggests the utility of nuclear and histological tests during diagnostic work-up for differential diagnosis of aseptic loosening or prosthetic joint infection. The same tests produce more uncertain data when performed in two-stage exchange during the second step.
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Affiliation(s)
- Giuliana Carrega
- Malattie Infettive e Ortopedia Settica, ASL 2 Liguria, Ospedale S. M. Misericordia, Albenga, Savona, Italy
| | - Andrea Antonini
- Malattie Infettive e Ortopedia Settica, ASL 2 Liguria, Ospedale S. M. Misericordia, Albenga, Savona, Italy
| | - Giorgio Burastero
- Malattie Infettive e Ortopedia Settica, ASL 2 Liguria, Ospedale S. M. Misericordia, Albenga, Savona, Italy
| | | | - Agostina Ronca
- Malattie Infettive e Ortopedia Settica, ASL 2 Liguria, Ospedale S. M. Misericordia, Albenga, Savona, Italy
| | - Carlo Salomone
- Malattie Infettive e Ortopedia Settica, ASL 2 Liguria, Ospedale S. M. Misericordia, Albenga, Savona, Italy
| | - Giovanni Riccio
- Malattie Infettive e Ortopedia Settica, ASL 2 Liguria, Ospedale S. M. Misericordia, Albenga, Savona, Italy
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Dudnyk VM, Rudenko GM. [THE EFFECTIVENESS OF A 10-DAY DRUG THERAPY IN CHILDREN WITH CHRONIC GASTRODUODENAL PATHOLOGY ASSOCIATED WITH CAGA-POSITIVE STRAINS OF HELICOBACTER PYLORI]. Lik Sprava 2015:147-148. [PMID: 26118054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The results of triple Helicobacter-therapy (omeprazole, amoxicillin, nifuratel) in the treatment of chronic gastroduodenal pathology in children depending on the duration of it's use. The effectiveness of drug therapy was evaluated in terms of eradication of Helicobacter pylori and dynamics of pain, dyspeptic syndrome and astenovegetative syndrome.
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Aberle SJ, Colletti JE. A painful periurethral mass. J Emerg Med 2014; 46:e179-e180. [PMID: 24548470 DOI: 10.1016/j.jemermed.2013.11.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Revised: 11/02/2013] [Accepted: 11/17/2013] [Indexed: 06/03/2023]
Affiliation(s)
- Sara J Aberle
- Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota
| | - James E Colletti
- Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota
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Crozier JA, Palmer WC, Petrucelli OM. 23-year-old man with fever and a sore thumb. Mayo Clin Proc 2013; 88:e145-9. [PMID: 24290129 DOI: 10.1016/j.mayocp.2013.04.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 04/10/2013] [Accepted: 04/16/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Jennifer A Crozier
- Resident in Internal Medicine, Mayo School of Graduate Medical Education, Mayo Clinic, Jacksonville, FL.
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Forde R, Ashman H, Williams EW, Williams-Johnson J. Idiopathic nasal septal abscess--a case report. W INDIAN MED J 2012; 61:832-833. [PMID: 23757906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- R Forde
- Department of Surgery, Radiology, Anaesthesia and Intensive Care Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica.
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Reis FJJ, Saadi LMV, Gomes MK, Gosling AP, Cunha AJLA. Pain in leprosy patients: shall we always consider as a neural damage? LEPROSY REV 2011; 82:319-321. [PMID: 22125942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Amir LH, Cullinane M, Garland SM, Tabrizi SN, Donath SM, Bennett CM, Cooklin AR, Fisher JRW, Payne MS. The role of micro-organisms (Staphylococcus aureus and Candida albicans) in the pathogenesis of breast pain and infection in lactating women: study protocol. BMC Pregnancy Childbirth 2011; 11:54. [PMID: 21777483 PMCID: PMC3151214 DOI: 10.1186/1471-2393-11-54] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Accepted: 07/22/2011] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The CASTLE (Candida and Staphylococcus Transmission: Longitudinal Evaluation) study will investigate the micro-organisms involved in the development of mastitis and "breast thrush" among breastfeeding women. To date, the organism(s) associated with the development of breast thrush have not been identified. The CASTLE study will also investigate the impact of physical health problems and breastfeeding problems on maternal psychological health in the early postpartum period. METHODS/DESIGN The CASTLE study is a longitudinal descriptive study designed to investigate the role of Staphylococcus spp (species) and Candida spp in breast pain and infection among lactating women, and to describe the transmission dynamics of S. aureus and Candida spp between mother and infant. The relationship between breastfeeding and postpartum health problems as well as maternal psychological well-being is also being investigated. A prospective cohort of four hundred nulliparous women who are at least thirty six weeks gestation pregnant are being recruited from two hospitals in Melbourne, Australia (November 2009 to June 2011). At recruitment, nasal, nipple (both breasts) and vaginal swabs are taken and participants complete a questionnaire asking about previous known staphylococcal and candidal infections. Following the birth, participants are followed-up six times: in hospital and then at home weekly until four weeks postpartum. Participants complete a questionnaire at each time points to collect information about breastfeeding problems and postpartum health problems. Nasal and nipple swabs and breast milk samples are collected from the mother. Oral and nasal swabs are collected from the baby. A telephone interview is conducted at eight weeks postpartum to collect information about postpartum health problems and breastfeeding problems, such as mastitis and nipple and breast pain. DISCUSSION This study is the first longitudinal study of the role of both staphylococcal and candidal colonisation in breast infections and will help to resolve the current controversy about which is the primary organism in the condition known as breast thrush. This study will also document transmission dynamics of S. aureus and Candida spp between mother and infant. In addition, CASTLE will investigate the impact of common maternal physical health symptoms and the effect of breastfeeding problems on maternal psychological well-being.
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Affiliation(s)
- Lisa H Amir
- Mother & Child Health Research, La Trobe University, Melbourne, VIC 3000, Australia
| | - Meabh Cullinane
- Mother & Child Health Research, La Trobe University, Melbourne, VIC 3000, Australia
| | - Suzanne M Garland
- Women's Centre for Infectious Diseases, Bio 21 Institute, Parkville, VIC 3052, Australia
- University of Melbourne Department of Obstetrics and Gynaecology, The Royal Women's Hospital, Parkville, VIC 3052, Australia
- Murdoch Childrens Research Institute, The Royal Children's Hospital, Parkville, VIC 3052, Australia
| | - Sepehr N Tabrizi
- Women's Centre for Infectious Diseases, Bio 21 Institute, Parkville, VIC 3052, Australia
- University of Melbourne Department of Obstetrics and Gynaecology, The Royal Women's Hospital, Parkville, VIC 3052, Australia
- Murdoch Childrens Research Institute, The Royal Children's Hospital, Parkville, VIC 3052, Australia
| | - Susan M Donath
- Murdoch Childrens Research Institute, The Royal Children's Hospital, Parkville, VIC 3052, Australia
- University of Melbourne Department of Paediatrics, The Royal Children's Hospital, Parkville, VIC 3052, Australia
| | | | | | - Jane RW Fisher
- Jean Hailes Research Unit, Monash University, Clayton, VIC 3168, Australia
- Centre for Women's Health, Gender and Society, University of Melbourne, Carlton, VIC 3053, Australia
| | - Matthew S Payne
- Mother & Child Health Research, La Trobe University, Melbourne, VIC 3000, Australia
- Women's Centre for Infectious Diseases, Bio 21 Institute, Parkville, VIC 3052, Australia
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Jones W, Breward S. Thrush and breastfeeding. Identifying and treating thrush in breastfeeding mothers and babies. Community Pract 2010; 83:42-43. [PMID: 21049756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Klein-Kremer A, Jassar H, Nachtigal A, Zeina AR. Primary pyomyositis in a young boy: clinical and radiologic features. Isr Med Assoc J 2010; 12:511-513. [PMID: 21337825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- Adi Klein-Kremer
- Department of Pediatrics, Hillel Yaffe Medical Center, Hadera, affiliated with Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Nguyen RHN, Swanson D, Harlow BL. Urogenital infections in relation to the occurrence of vulvodynia. J Reprod Med 2009; 54:385-392. [PMID: 19639929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To determine whether antecedent urogenital infections and their frequency are associated with the development of vulvodynia. STUDY DESIGN Data were obtained from a case-control study of 191 case and 171 control women in the Boston area from 2000 to 2005. Using questionnaire data, we examined self-reported urogenital infections occurring before onset of vulvar pain (cases) and reference age (controls), using unconditional logistic regression accounting for matched variables (current age and residence). RESULTS Analysis was restricted to women reporting intercourse before first vulvar pain (cases) or reference age (controls). After adjusting for race, age at first intercourse, coital frequency and number of sex partners, a history of genital warts (adjusted odds ratio [OR] = 3.4, 95% CI 1.3-8.8), trichomoniasis (OR = 5.7, 95% CI 1.1-29, urinary tract infection (OR = 2.0, 95% CI 1.3-3.1) or yeast infection (OR = 2.1, 95% CI 1.3-3.3) were associated with increased estimated risk for vulvodynia. With an increasing number of types of antecedent infections (1, 2 or 3+), ORs = 1.3, 2.6 or 8.3, respectively, were observed. CONCLUSION Our data suggest that diverse urogenital infections may precede onset of vulvodynia, with multiple assaults significantly compounding risk. However, prospective studies documenting urogenital infections and treatment are warranted.
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Affiliation(s)
- Ruby H N Nguyen
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South 2nd Street, Suite 300, Minneapolis, MN 55454, USA.
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Abstract
Bilateral sporotrichoid mycobacterial cutaneous infection is unusual and has been reported in only three cases involving different species and with an unknown route of infection in the literature.We report a case of bilateral sporotrichoid dermatosis in an immunocompetent patient with a history of intravenous heroin injection before development of the skin lesions. Both special stain and culture of biopsy specimen were negative. Finally, Mycobacterium fortuitum was identified by a polymerase chain reaction-based method. The patient responded well to clarithromycin and ciprofloxacin therapy. This case represents an unusual primary cutaneous M. fortuitum infection manifested as bilateral sporotrichoid lesions of the limbs. Review of previous reported cases of bilateral sporotrichoid mycobacterial infection shows different isolated organisms and routes of infection to that found in our case.
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Affiliation(s)
- Shyue-Luen Chang
- Department of Dermatology, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taipei, Taiwan
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Saunders NA, Reed BD, Haefner HK. McGill pain questionnaire findings among women with vulvodynia and chronic yeast infection. J Reprod Med 2008; 53:385-389. [PMID: 18664053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To determine whether patients referred for vulvar pain or candidiasis had different characteristics of pain as measured by the McGill Pain Scale or the number of McGill categories chosen. STUDY DESIGN Data were collected at the University of Michigan Center for Vulvar Diseases between April 1998 and March 2003. The association between the McGill pain score and the number of McGill categories selected with the diagnostic categories of vestibulodynia, generalized vulvodynia and chronic yeast infections were evaluated. RESULTS A total of 196 women presented with vulvodynia (105 women with vestibulodynia, 91 women with generalized vulvodynia) and 50 women presented with Candida vulvovaginitis. The vulvodynia groups had McGill scores and numbers of categories selected that were increased compared with the Candida group (24.16+/-13.03 and 24.37+/-12.82 vs. 16.20+/-10.21 for the McGill score, p<0.001, and 9.22+/-4.11 and 9.87+/-4.44 vs. 7.30+/-3.70 for the numbers of categories selected, p = 0.002). CONCLUSION Patients presenting with complaints of a yeast infection have a statistically lower McGill pain score and McGill pain indicators compared with patients with vulvar pain.
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Affiliation(s)
- Natalie A Saunders
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan 48109-0276, USA.
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Andrews JI, Fleener DK, Messer SA, Hansen WF, Pfaller MA, Diekema DJ. The yeast connection: is Candida linked to breastfeeding associated pain? Am J Obstet Gynecol 2007; 197:424.e1-4. [PMID: 17904988 DOI: 10.1016/j.ajog.2007.05.053] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2007] [Revised: 04/24/2007] [Accepted: 05/31/2007] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The objective of the study was to determine whether the isolation of Candida from breastfeeding women is associated with self-reported pain. STUDY DESIGN A prospective cohort study was conducted from May 2004 to July 2006. Ninety-eight breastfeeding women were enrolled: 20 women reported breastfeeding associated pain, and 78 women were asymptomatic. Cultures were obtained from breast milk, areolae, and infants' oropharynx. RESULTS Six of the 20 symptomatic women had breast milk cultures positive for yeast, compared with 6 of 78 controls (30% vs 7.7%, P = .015). Among the 12 women from whom yeast was isolated, 11 grew Candida albicans. Incidence of Staphylococcus aureus isolation did not differ significantly between groups (5 of 20 vs 15 of 78, P > .05). CONCLUSION C. albicans is found more often in breastfeeding mothers who report pain as compared with asymptomatic breastfeeding mothers. Further studies, including treatment trials, are needed to determine whether Candida plays an etiologic role in breastfeeding associated pain.
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Affiliation(s)
- Janet I Andrews
- Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
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Abstract
INTRODUCTION Implantable pain therapy devices for chronic pain include spinal cord stimulators (SCS) and intrathecal drug delivery systems (IDDS). A number of different complications can occur after implantation of these devices, but among the most serious is infection. Based on Centers for Disease Control and Prevention guidelines for prevention of surgical site infection, published literature on infection risk with implantable pain therapy devices, and recommendations from groups within our own our institution, we introduced infection control measures for all patients receiving either SCS or IDDS. METHODS After approval from the Institutional Review Board, we performed a retrospective review of patients undergoing primary implantation of SCS or IDDS before and after introduction at our institution of safety measures designed to reduce device-related infection. We compared infection incidence and compliance to infection precautions before and after introduction of these measures. RESULTS Thirty-four SCS or IDDS were implanted before implementation of the infection control measures and 58 were placed after. Five device-related infections occurred. Adherence to most infection precautions improved during the study period, but 100% compliance was seen only with venue used for implantation. Infection incidence declined after introduction of the safety measures, but the reduction was not statistically significant. CONCLUSIONS Introduction of infection control measures for implantable pain therapy devices improved adherence to most infection precautions in our practice. Lack of specific documentation could have hindered practice surveillance within our group. A tool to document performance of infection control measures would be useful not only as a marker of compliance but could also serve as a reminder to perform certain safety measures.
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Affiliation(s)
- Abram H Burgher
- Department of Anesthesiology, Division of Pain Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA
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28
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Harmsen M, Wensing M, van der Wouden JC, Grol RPTM. Parents' awareness of and knowledge about young children's urinary tract infections. Patient Educ Couns 2007; 66:250-5. [PMID: 17445745 DOI: 10.1016/j.pec.2006.12.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2006] [Revised: 12/14/2006] [Accepted: 12/22/2006] [Indexed: 05/15/2023]
Abstract
OBJECTIVE To provide insight into parents' awareness of and knowledge about urinary tract infections (UTIs) in young children. METHODS Twenty interviews with parents who had a child recently diagnosed with a UTI were audiotaped, transcribed verbatim, and qualitatively analysed. RESULTS Most parents knew the typical symptoms related to UTI. But, according to the parents, neither they nor all general practitioners (GPs) thought of a UTI in case of atypical symptoms. The awareness that UTI can be a serious illness usually came to parents later, partly because health care workers often did not explicitly mention this. According to the parents, health care workers should be more aware of UTIs in children. Parents felt that health education or mass screening might not be desirable because it would increase anxiety or would be perceived as not relevant. CONCLUSION Parents could not consistently recognise UTI in their children and were most times unaware of the possible consequences of a UTI. Nevertheless, parents were sceptical about health education and mass screening. PRACTICE IMPLICATIONS There seems little scope for health education addressed at parents or screening for UTI in young children. Instead, physicians and nurses should be alert for the possibility of UTIs in young children, and more information should be given once a UTI is diagnosed.
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Affiliation(s)
- Mirjam Harmsen
- Centre for Quality of Care Research (WOK), Radboud University Nijmegen Medical Centre, P.O. Box 9101 (114 kwazo), 6500 HB Nijmegen, The Netherlands.
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Eglash A, Plane MB, Mundt M. History, physical and laboratory findings, and clinical outcomes of lactating women treated with antibiotics for chronic breast and/or nipple pain. J Hum Lact 2006; 22:429-33. [PMID: 17062789 DOI: 10.1177/0890334406293431] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This chart review study describes the history, physical and laboratory findings, and clinical outcomes in patients who presented to a lactation specialist between 1997 and 2002 and were treated with antibiotics for their chronic breast and/or nipple pain. A total of 69 charts were reviewed. Five were excluded because of loss of follow-up. Eighty-two percent of patients described postpartum breast tenderness, 74% had nipple sores postpartum, and 79% were tender on physical examination. Nipple lesions were present among 73% of the women. Breast milk or nipple cultures were performed for 60 of 64 patients and were positive for pathogenic bacteria among 50% of the patients cultured. The average duration of antibiotic treatment was 5.7 weeks, and 94% of the women had pain resolution. Symptoms of deep breast aching, breast tenderness on palpation, and nipple lesions may be suggestive of a bacterial lactiferous duct infection. Treatment with antibiotics for 4 to 6 weeks may be appropriate.
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Affiliation(s)
- Anne Eglash
- University of Wisconsin Medical School, Meriter Hospital Outpatient Lactation Clinic, Mt. Horeb, Wisconsin 53572, USA
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Gomes BPFA, Jacinto RC, Pinheiro ET, Sousa ELR, Zaia AA, Ferraz CCR, Souza-Filho FJ. Molecular analysis of Filifactor alocis, Tannerella forsythia, and treponema denticola associated with primary endodontic infections and failed endodontic treatment. J Endod 2006; 32:937-40. [PMID: 16982268 DOI: 10.1016/j.joen.2006.05.003] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2006] [Revised: 05/04/2006] [Accepted: 05/04/2006] [Indexed: 11/18/2022]
Abstract
The aim of this study was to investigate the presence of strict anaerobes such as Filifactor alocis, Tannerella forsythia, and Treponema denticola in primary and secondary root-infected canals with periapical lesions by molecular analysis and the association of these species with specific endodontic signs and symptoms. Microbial samples were taken from 100 root canals, 50 with necrotic pulp tissues (NPT, primary infection), and 50 with failed endodontic treatment (FET, secondary infection). DNA was extracted from the samples, which were analyzed for the presence of three endodontic pathogens using species-specific primers and PCR. F. alocis were isolated from 23 canals with NPT and 12 canals with FET; T. forsythia from 12 canals with NPT and three canals with FET; T. denticola from 19 canals with NPT and 12 canals with TEP. Suggested associations were found between primary infection and the presence of F. alocis and T. forsythia (both p < 0.05). In particular, associations were found between: pain and F. alocis; swelling and F. alocis; tenderness to percussion and T. forsythia; mobility and T. forsythia and T. denticola; wet canals and F. alocis, T. forsythia, and T. denticola; purulent exsudate and F. alocis, T. forsythia and T. denticola; abscess and F. alocis, T. forsythia, and T. denticola (all p < 0.05). The findings of this study indicated that F. alocis, T. forsythia, and T. denticola seem to be associated with endodontic signs and symptoms. Additionally, F. alocis and T. forsythia were detected more frequently in teeth with necrotic pulp than in teeth with failing endodontic treatment.
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Affiliation(s)
- Brenda P F A Gomes
- Department of Restorative Dentistry, Endodontic Area, Piracicaba Dental School, State University of Campinas-UNICAMP, Piracicaba, SP, Brazil.
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Siraj CA, Krishnan J, Nair RR, Girija AS. Invasive aspergillosis producing painful ophthalmoplegia. J Assoc Physicians India 2005; 53:901-2. [PMID: 16459537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Painful ophthalmoplegia is caused by the lesions of orbital apex and anterior cavernous sinus. Cavernous sinus syndrome can be produced by intracranial invasive aspergillosis. A case of painful ophthalmoplegia due to invasive aspergillosis caused by Aspergillus niger in a diabetic patient is presented.
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Affiliation(s)
- C A Siraj
- Department of Neurology, Medical College Hospital, Kozhikode, India-673 008
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Jacinto RC, Gomes BP, Shah HN, Ferraz CC, Zaia AA, Souza-Filho FJ. Quantification of endotoxins in necrotic root canals from symptomatic and asymptomatic teeth. J Med Microbiol 2005; 54:777-783. [PMID: 16014432 DOI: 10.1099/jmm.0.45976-0] [Citation(s) in RCA: 88] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The purpose of this investigation was to quantify the concentration of endotoxin in necrotic root canals and investigate the possible relationship between the concentration of endotoxin and endodontic signs and symptoms. Samples were collected from root canals of 50 patients requiring endodontic treatment due to necrosis of the pulpal tissue. Anaerobic techniques were used to determine the number of c.f.u. in each sample. A quantitative chromogenic Limulus amoebocyte lysate assay was used to measure the concentration of endotoxin in each sample. The presence of c.f.u. was detected by culture in all samples (range 10(2)-5x10(6)). In samples from cases of patients with spontaneous pain, the mean c.f.u. was 1.43x10(6) while in asymptomatic cases it was 9.1x10(4). Endotoxin was present in all the samples studied [range 2390.0-22100.0 endotoxin units (EU) ml-1]. The mean concentration of endotoxin in samples from patients with spontaneous pain was 18540.0 EU ml-1 while in asymptomatic cases it was 12030.0 EU ml-1. Asymptomatic cases generally had lower levels of endotoxin (i.e. a negative association). A positive association was found between endotoxin and symptomatic cases (e.g. spontaneous pain, tenderness to percussion, pain on palpation, swelling and purulent exudates). This study showed that endotoxin is present in high concentrations in root canals of symptomatic teeth. There was a positive correlation between the concentration of endotoxin in the root canal and the presence of endodontic signs and symptoms.
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Affiliation(s)
- Rogerio C Jacinto
- Endodontic Department, Piracicaba Dental School, State University of Campinas, UNICAMP, Avenida Limeira 901, Piracicaba 13414-018, Brazil 2NCTC - Molecular Identification Service Unit, Centre for Infections, Health Protection Agency, London NW9 5HT, UK
| | - Brenda Pfa Gomes
- Endodontic Department, Piracicaba Dental School, State University of Campinas, UNICAMP, Avenida Limeira 901, Piracicaba 13414-018, Brazil 2NCTC - Molecular Identification Service Unit, Centre for Infections, Health Protection Agency, London NW9 5HT, UK
| | - Haroun N Shah
- Endodontic Department, Piracicaba Dental School, State University of Campinas, UNICAMP, Avenida Limeira 901, Piracicaba 13414-018, Brazil 2NCTC - Molecular Identification Service Unit, Centre for Infections, Health Protection Agency, London NW9 5HT, UK
| | - Caio C Ferraz
- Endodontic Department, Piracicaba Dental School, State University of Campinas, UNICAMP, Avenida Limeira 901, Piracicaba 13414-018, Brazil 2NCTC - Molecular Identification Service Unit, Centre for Infections, Health Protection Agency, London NW9 5HT, UK
| | - Alexandre A Zaia
- Endodontic Department, Piracicaba Dental School, State University of Campinas, UNICAMP, Avenida Limeira 901, Piracicaba 13414-018, Brazil 2NCTC - Molecular Identification Service Unit, Centre for Infections, Health Protection Agency, London NW9 5HT, UK
| | - Francisco J Souza-Filho
- Endodontic Department, Piracicaba Dental School, State University of Campinas, UNICAMP, Avenida Limeira 901, Piracicaba 13414-018, Brazil 2NCTC - Molecular Identification Service Unit, Centre for Infections, Health Protection Agency, London NW9 5HT, UK
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Ansari A, Becker DA, Francke E. Diagnosing suppurative arm pain. Am J Med 2005; 118:972-3. [PMID: 16164880 DOI: 10.1016/j.amjmed.2005.03.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2005] [Accepted: 03/31/2005] [Indexed: 11/26/2022]
Affiliation(s)
- Azam Ansari
- Department of Medicine and Surgery, Abbott Northwestern Hospital, Minneapolis, MN, USA
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Abstract
AIMS AND OBJECTIVES The aim is to devise a decision-making model to help nurses and allied professionals treat the symptoms of infectious diseases in a logical way that maximizes the benefits of symptoms and minimizes any harm that they might do. BACKGROUND This paper considers the symptoms of infectious diseases from an evolutionary perspective, applying theories from ecology and evolution to nursing. Building upon evolutionary theories that suggest symptoms occur as the result of host defences, pathogen manipulations or as pure side-effects, it is suggested that those symptoms that have evolved as host defences should not always be treated because of their beneficial effects. However, clinical decision-making is more complex because of the rapid changes in environment and behaviour, which may impact upon the usefulness of symptoms to the host. CONCLUSIONS Although some symptoms can be identified as being beneficial adaptations, this alone is not sufficient indication to decide which symptoms should or should not be treated. Other considerations include any negative outcomes and behavioural and environmental changes that may affect the significance of any adaptation. RELEVANCE TO CLINICAL PRACTICE Nurses should aim to maximize the host defences of the patients they are caring for in order to speed recovery and to reduce transmission and the need for antibiotics. This model helps nurses to identify factors that should be considered when these decisions are made and suggests some principles that might be followed in other situations.
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Abstract
A 39 year-old vaginal multipara status postpubovaginal sling in 2002 and a transobturator tape procedure in 2004 presented with persistent stress incontinence and vaginal polypropylene mesh erosion. Ten days later, she presented to the emergency room with severe right groin pain, difficulty walking, fever, and chills. She described shooting pain originating from the right inguinal ligament radiating down her right leg anteriorly. Although her neurologic examination was normal, palpation of the right obturator internus muscle reproduced her pain. MRI clearly revealed the course of the mesh tape through the obturator muscles and marked increase in the size of the right adductor and obturator internus muscles, apparently compressing the adjacent neurovascular fascicle. The patient was taken to the operating room where the polypropylene tape was easily removed through the vaginal erosion. Mesh cultures were positive for bacteroides fragilis. She experienced complete symptom resolution within 1 week of tape removal.
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Affiliation(s)
- Sangeeta T Mahajan
- Division of Female Pelvic Medicine and Reconstructive Surgery Department of Obstetrics and Gynecology, Loyola University Medical Center, Maywood, IL 60153, USA.
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Chen L, Thompson K, Taxy JB. Pathologic quiz case: a 56-year-old woman with anterior nasal pain and intermittent epistaxis. Alternaria alternate infection of the nasal sinus. Arch Pathol Lab Med 2005; 128:1451-2. [PMID: 15578896 DOI: 10.5858/2004-128-1451-pqcayw] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Longwen Chen
- Department of Pathology, The University of Chicago Hospitals, Chicago, IL, USA.
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Arévalo MI, Escribano E, Calpena A, Domenech J, Queralt J. Thermal hyperalgesia and light touch allodynia after intradermal Mycobacterium butyricum administration in rat. Inflammation 2005; 27:293-9. [PMID: 14635786 DOI: 10.1023/a:1026076426664] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
We examined the time course (7 weeks) of thermal hyperalgesia and light touch allodynia in rats after intradermal administration of Mycobacterium butyricum. Nociceptive thresholds to heat and light touch were assessed. Paw edema and temperature, motor function, body weight, and propioception were also tested. Some rats developed arthritis (named AA rats) but others did not (named non-AA rats). Both groups were compared with healthy animals. Persistent hyperalgesia was found in both groups; in AA rats it appeared before clinical evidence of arthritis. Transient allodynia ocurred only after edema development and fell when edema decreased. Motor function was impaired only in AA rats. The results of this study demonstrate that hyperalgesia, but not allodynia, appeared after Mycobacterium butyricum in both groups, suggesting that changes in sensitivity were not merely the result of local hypersensitivity of the inflamed tissue, but may also be due to alterations in nociception in the central nervous system.
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Affiliation(s)
- Maria Isabel Arévalo
- Departament de Fisiologia-Divisió IV, Unitat de Biofarmàcia i Farmacocinètica, Universitat de Barcelona, Barcelona, Spain
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Urculo E, Aranzadi MJ, Ruiz I, Villanua J. Aspergillus granuloma of the cavernous sinus: magnetic resonance imaging with pathologic correlation. Acta Neurochir (Wien) 2005; 147:341-2; discussion 342. [PMID: 15630520 DOI: 10.1007/s00701-004-0449-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This case illustrates the correlation between Magnetic Resonance Imaging (MRI) and the pathological findings in a case of cavernous sinus (CS) aspergilloma.
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Affiliation(s)
- E Urculo
- Department of Neurosurgery, Hospital Donostia, San Sebastian, Spain.
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Cutting KF, White RJ. Criteria for identifying wound infection--revisited. Ostomy Wound Manage 2005; 51:28-34. [PMID: 15695833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
The accurate identification of wound infection provides a clinical challenge to those involved in patient care and would appear to have not kept pace with other developments in the field of wound care. Attempts have been made to improve on the situation but diverse opinions together with lack of consensus prevail. The literature on infection criteria was reviewed and a set of criteria were collated; a number of criteria at the time were described as subtle in nature and have undergone validation studies. This article suggests a new perspective on the clinical identification of wound infection--ie, the signs of infection are closely associated with the wound type. Infection criteria for six wound types are explored and presented. This approach is intended for consideration together with the results of an impending Delphi study that will raise awareness of this issue, promote discussion, and lead to validation of an accurate set of clinical criteria.
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Affiliation(s)
- Keith F Cutting
- Tissue Viability, Buckinghamshire Chilterns University College, Chalfont St. Giles, UK.
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Lancaster S. Necrotizing fasciitis. Quick response vital to prevent fatal outcomes. Adv Nurse Pract 2005; 13:67-9. [PMID: 15679297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Affiliation(s)
- Sabrina Lancaster
- Family Nurse Practitioner Program, Brenau University, Gainesville, Ga., USA
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Lopes Consolaro ME, Aline Albertoni T, Shizue Yoshida C, Mazucheli J, Peralta RM, Estivalet Svidzinski TI. Correlation of Candida species and symptoms among patients with vulvovaginal candidiasis in Maringá, Paraná, Brazil. Rev Iberoam Micol 2004; 21:202-5. [PMID: 15709802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023] Open
Abstract
Vulvovaginal candidiasis (VVC) is an infection caused by abnormal yeast growth in the mucosa of the female genital tract which is commonly diagnosed in gynecology. The aim of this study was to correlate the frequency of yeasts and their respective species in asymptomatic women with different clinical manifestation of VVC; evaluate possible relationships between number of fungus colonies and symptoms in this pathology. All patients who visited the laboratory within a period of five months, for routine examinations of vaginal secretion, independent of the presence or absence of symptoms of VVC were included in this study. Of these, women with immunodeficiency or with an infection of the genital tract by another agent were excluded. Candida albicans was the most frequently yeast isolated (60%). Among non-C. albicans yeasts, 61.5% were isolated of the asymptomatic women, 38.7% from patients with VVC and 11.1% of those from patients with RVVC. C. albicans was associated with symptoms of VVC and while, the presence of non-C. albicans yeasts with asymptomatic women. However, there was no association between the number of fungal colonies and symptoms.
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Affiliation(s)
- Márcia Edilaine Lopes Consolaro
- Division of Medical Mycology, Departament of Clinical Analysis, Teaching and Research in Clinical Analysis Laboratoy, State University of Maringá, Paraná, Brazil
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Abstract
Neuropathic pain appears to be much more common in leprosy than has been generally appreciated. Emphasis in leprosy control programs has been on the distribution of multi-drug therapy, on early and better detection, and on the prevention of disability related to anesthetic limbs. Most have thus been inattentive to the problem of neuropathic pain in leprosy patients. Neuropathic pain does not respond to the usual analgesics employed for reactions, for example, and so it is important that those treating leprosy patients give this problem the special attention it requires, both in diagnosis and in treatment.
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Abstract
The introduction of multidrug therapy by the World Health Organization has dramatically reduced the world prevalence of leprosy but the disease is still a public health problem in many countries, with a world prevalence of almost 600,000 cases in 2001. Damage to peripheral nerves is a key component of leprosy and the sensory and motor loss that follows is the basis for many of the classical features of this disease, such as skin wounds, cracks, plantar ulcers, clawed hands, drop foot, and incomplete closure of the eyelids. One of the most remarkable aspects of leprosy to lay persons and health care workers alike is that patients are reputed to feel no pain. However, neuropathic pain is arising as a major problem among leprosy patients. It can be nociceptive due to tissue inflammation, which mostly occurs during episodes of immune activation or neuropathic due to damage or dysfunction of the nervous system. This study, conducted among 358 leprosy patients, reveals a considerable prevalence of neuropathic pain and presents evidence that this common problem should be a high priority of those in charge of leprosy control programs.
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Henry GD, Wilson SK, Delk JR, Carson CC, Silverstein A, Cleves MA, Donatucci CF. Penile prosthesis cultures during revision surgery: a multicenter study. J Urol 2004; 172:153-6. [PMID: 15201759 DOI: 10.1097/01.ju.0000132141.48587.f1] [Citation(s) in RCA: 92] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Initial implantation of inflatable penile prosthesis has a 3% risk of infection. Reoperation of penile implants has a higher rate of infection, estimated between 10% and 18%. To explain the higher risk in revision surgery in this prospective study we cultured clinically uninfected prostheses requiring revision. Prosthesis pain was also investigated as a predictor of positive culture. MATERIALS AND METHODS At 3 institutions cultures were prospectively obtained from 77 clinically uninfected penile prostheses at revision surgery. Immediately upon surgical exposure of the pump cultures were obtained. If a bacterial biofilm was noted on any component it was additionally cultured. All culture isolates positive for a staphylococcus species were tested for sensitivity to rifampin and tetracycline (minocycline). An implant is now available that is coated with these antibiotics. Patient history of chronic prosthesis pain was ascertained. RESULTS Culture positive bacteria were found in 54 of 77 (70%) patients with clinically uninfected penile prostheses. In some patients more than 1 organism grew and, occasionally, the pump culture was negative but the biofilm was positive. Of 54 patients 49 had positive (90%) culture for staphylococcus genus with 10 different species. All staphylococcal species were sensitive to rifampin and/or tetracycline. We did not find a significant association between prosthesis related pain and culture laboratory results. CONCLUSIONS The majority of clinically uninfected penile prostheses have organisms growing in the implant spaces at reoperation. Most of these organisms are staphylococcal species that are sensitive to rifampin/minocycline.
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Affiliation(s)
- Gerard D Henry
- Institute for Urologic Excellence, Van Buren, Arkansas, USA.
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Beutin L, Krause G, Zimmermann S, Kaulfuss S, Gleier K. Characterization of Shiga toxin-producing Escherichia coli strains isolated from human patients in Germany over a 3-year period. J Clin Microbiol 2004; 42:1099-108. [PMID: 15004060 PMCID: PMC356890 DOI: 10.1128/jcm.42.3.1099-1108.2004] [Citation(s) in RCA: 282] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We have investigated 677 Shiga toxin-producing Escherichia coli (STEC) strains from humans to determine their serotypes, virulence genes, and clinical signs in patients. Six different Shiga toxin types (1, 1c, 2, 2c, 2d, and 2e) were distributed in the STEC strains. Intimin (eae) genes were present in 62.6% of the strains and subtyped into intimins alpha1, beta1, gamma1, epsilon, theta, and eta. Shiga toxin types 1c and 2d were present only in eae-negative STEC strains, and type 2 was significantly (P < 0.001) more frequent in eae-positive STEC strains. Enterohemorrhagic E. coli hemolysin was associated with 96.2% of the eae-positive strains and with 65.2% of the eae-negative strains. Clinical signs in the patients were abdominal pain (8.7%), nonbloody diarrhea (59.2%), bloody diarrhea (14.3%), and hemolytic-uremic syndrome (HUS) (3.5%), and 14.3% of the patients had no signs of gastrointestinal disease or HUS. Infections with eae-positive STEC were significantly (P < 0.001) more frequent in children under 6 years of age than in other age groups, whereas eae-negative STEC infections dominated in adults. The STEC strains were grouped into 74 O:H types by serotyping and by PCR typing of the flagellar (fliC) genes in 221 nonmotile STEC strains. Eleven serotypes (O157:[H7], O26:[H11], O103:H2, O91:[H14], O111:[H8], O145:[H28], O128:H2, O113:[H4], O146:H21, O118:H16, and O76:[H19]) accounted for 69% of all STEC strains. We identified 41 STEC strains belonging to 31 serotypes which had not previously been described as human STEC. Twenty-six of these were positive for intimins alpha1 (one serotype), beta1 (eight serotypes), epsilon (two serotypes), and eta (three serotypes). Our study indicates that different types of STEC strains predominate in infant and adult patients and that new types of STEC strains are present among human isolates.
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Affiliation(s)
- Lothar Beutin
- Division of Microbial Toxins, Department of Biological Safety, Robert Koch Institute, D-13353 Berlin, Germany.
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Gomes BPFA, Pinheiro ET, Gadê-Neto CR, Sousa ELR, Ferraz CCR, Zaia AA, Teixeira FB, Souza-Filho FJ. Microbiological examination of infected dental root canals. ACTA ACUST UNITED AC 2004; 19:71-6. [PMID: 14871344 DOI: 10.1046/j.0902-0055.2003.00116.x] [Citation(s) in RCA: 277] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the root canal microbiota of primary and secondary root-infected canals and the association of constituent species with specific endodontic signs and symptoms. METHODS Microbial samples were taken from 60 root canals, 41 with necrotic pulp tissues (primary infection) and 19 with failed endodontic treatment (secondary infection). Strict anaerobic techniques were used for serial dilution, plating, incubation and identification. RESULTS A total of 224 cultivable isolates were recovered belonging to 56 different bacterial species. Individual root canals yielded a maximum of 10 bacterial species. Of the bacterial isolates, 70% were either strict anaerobes or microphilic. The anaerobes most frequently isolated were: Peptostreptococcus micros (35%), Fusobacterium necrophorum (23.3%), Fusobacterium nucleatum (11.7%), Prevotella intermedia/nigrescens (16.7%), Porphyromonas gingivalis (6.7%) and Porphyromonas endodontalis (5%). The root canal microflora of untreated teeth with apical periodontitis was found to be mixed, comprising gram-negative and gram-positive and mostly anaerobic microorganisms and usually containing more than 3 species per canal. On the other hand, facultative anaerobic and gram-positive bacteria predominated in canals with failed endodontic treatment, which harbored 1-2 species per canal. Suggested relationships were found between anaerobes, especially gram-negatives, and the presence or history of pain, tenderness to percussion and swelling (P<0.05). In particular, associations were found between: a) pain (n=29) and P. micros (P<0.01), P. intermedia/nigrescens and Eubacterium spp. (both P<0.05); b) history of pain (n=31) and P. micros (P<0.01) Porphyromonas and Fusobacterium spp. (P<0.05); c) tenderness to percussion (n=29) and Porphyromonas spp. (P<0.01), Peptostreptococcus and Fusobacterium spp. (P<0.001); d) swelling (n=20) and Peptostreptococcus spp. (P<0.01), Porphyromonas and Enterococcus spp. (P<0.05); e) wet canals (n=33) and Porphyromonas and Fusobacterium spp. (P<0.05); f) purulent exudate (n=20) and Porphyromonas, Peptostreptococcus and Fusobacterium spp. (P<0.05); previous endodontic treatment and Enterococcus faecalis, Streptococcus spp., P. micros, F. necrophorum (P<0.05). CONCLUSIONS Our findings indicate potential complex interactions of species resulting in characteristic clinical pictures which cannot be achieved by individual species alone. They also indicate that the microbiota of primary infected canals with apical periodontitis differs in number and in species from the secondary infected canals by using the culture technique.
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Affiliation(s)
- B P F A Gomes
- Endodontics, Dental School of Piracicaba, State University of Campinas-UNICAMP, Piracicaba, SP, Brazil.
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Jacinto RC, Gomes BPFA, Ferraz CCR, Zaia AA, Filho FJS. Microbiological analysis of infected root canals from symptomatic and asymptomatic teeth with periapical periodontitis and the antimicrobial susceptibility of some isolated anaerobic bacteria. Oral Microbiol Immunol 2003; 18:285-92. [PMID: 12930519 DOI: 10.1034/j.1399-302x.2003.00078.x] [Citation(s) in RCA: 90] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The purpose of the present study was to investigate the correlation between the composition of the bacterial flora isolated from infected root canals of teeth with apical periodontitis with the presence of clinical signs and symptoms, and to test the antibiotic susceptibility of five anaerobic bacteria mostly commonly found in the root canals of symptomatic teeth against various substances using the E-test. Microbial samples were taken from 48 root canals, 29 symptomatic and 19 asymptomatic, using adequate techniques. A total of 218 cultivable isolates were recovered from 48 different microbial species and 19 different genera. Root canals from symptomatic teeth harbored more obligate anaerobes and a bigger number of bacterial species than the asymptomatic teeth. More than 70% of the bacterial isolates were strict anaerobes. Statistical analysis used a Pearson Chi-squared test or a one-sided Fisher's Exact test as appropriate. Suggested relationships were found between specific microorganisms, especially gram-negative anaerobes, and the presence of spontaneous or previous pain, tenderness to percussion, pain on palpation and swelling amoxicillin, amoxicillin + clavulanate and cephaclor were effective against all the strains tested. The lowest susceptibility rate was presented by Prevotella intermedia/nigrescens against Penicillin G. Our results suggested that specific bacteria are associated with endodontic symptoms of infected teeth with periapical periodontitis and the majority of the anaerobic bacterial species tested were susceptible to all antibiotics studied.
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Affiliation(s)
- R C Jacinto
- Endodontic Area, Dental School of Piracicaba, University of Campinas, Piracicaba, SP, Brazil
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Abstract
Neurogenic pain with radiculitis is often the starting symptom in adult patients with tick-borne Lyme neuroborreliosis and in some cases the only clinical manifestation. Cranial paresis and other neurologic signs usually occur after the onset of pain. The present paper describes four patients who had severe pain as the main presenting symptom of Lyme neuroborreliosis. Opioids had good short-term effect in two of the cases. Oral doxycycline treatment was used successfully to eliminate the infection.
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Affiliation(s)
- Leif Dotevall
- Department of Infectious Diseases, Sahlgrenska University Hospital/Ostra, SE-416 85 Göteborg, Sweden.
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Demeulenaere A, Antoun H, Perret C, Fadel Y, Deschamps B, Leblanc A, Busy F. [Quiz? Subacute osteomyelitis with articular involvement]. J Radiol 2002; 83:1781-2. [PMID: 12469019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Affiliation(s)
- A Demeulenaere
- Service de Radiologie, Hôpital Louise Michel, Quartier du Canal, Courcouronnes, 91014 Envy Cedex, France
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