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From the nephrologist's point of view: diversity of causes and clinical features of acute kidney injury.

Acute kidney injury (AKI) is a clinical syndrome with multiple entities. Although AKI implies renal damage, functional impairment or both, diagnosis is solely based on the functional parameters of serum creatinine and urine output. The latest definition was provided by the Kidney Disease Improving Global Outcomes (KDIGO) working group in 2012. Independent of the underlying disease, and even in the case of full recovery, AKI is associated with an increased morbidity and mortality. Awareness of the patient's individual risk profile and the diversity of causes and clinical features of AKI is pivo

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… Septic shock secondary to ß-hemolytic streptococcus-induced necrotizing fasciitis treated with a novel cytokine adsorption therapy. Int J Artif Organs 2014; 37: 422–426 34. Leemans JC, Kors L, Anders HJ, et al. Pattern recognition receptors and the inflammasome in kidney disease. …

Diagnosis and treatment of diabetic foot infections.

EXECUTIVE SUMMARY: 1. Foot infections in patients with diabetes cause substantial morbidity and frequent visits to health care professionals … ss, extensive bone or joint involvement, crepitus, substantial necrosis or gangrene, or necrotizing fasciitis (A-II). Evaluating the limb's arterial supply and revascularizing when indicated are particularly important. Surgeons with experience and interest in the field should be recruited by the foot-care team, if possible. 15. Providing optimal wound care, …

The Musculoskeletal Tumor Society Scoring system is a valid subjective and objective tool to evaluate outcomes of surgical treatment of patients affected by upper and lower extremity tumors.

PURPOSE: The main purpose of the present study was to evaluate if there is a difference between objective or subjective administration of the MSTS score in a cohort of patients affected by musculoskeletal oncological diseases. MATERIALS AND METHODS: All patients who underwent surgery for bone or soft tissue localization of neoplastic disease in lower or upper limb from June 2015 to June 2020 were considered eligible. In order to administer the score as a PROM, the MSTS was first translated and cross-culturally adapted in Italian. During follow up visits, all patients filled out Italian versio

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… Osteosarcoma | 2 (4) Chondrosarcoma | 1 (2) Liposarcoma | 2 (4) Other soft tissue sarcomas | 4 (8) Lipoma | 7 (14) Fibrolipoma | 5 (10) Enchondroma | 3 (6) Schwannoma | 5 (10) Angiolipoma | 2 (4) Well differentiated liposarcoma | 1 (2) Cyst | 1 (2) Giant cell tumor | 8 (16) Neurofibroma | 1 (2) Nodular fasciitis …

Osteonecrosis of the Jaws (ONJ) after Bisphosphonate Treatment in Patients with Multiple Myeloma: Decreasing ONJ Incidence after Adoption of Preventive Measures.

Bisphosphonates (BPs) are administered to Multiple Myeloma (MM) patients with bone lytic lesion. Osteonecrosis of the Jaw (ONJ) is a complication reported since 2003 in patients treated with intravenous (IV) BPs such as zoledronic acid and pamidronate, with 6%-26.3% frequency in early literature series, before some preventive measures were recommended. We evaluated the occurrence of ONJ with and without dental preventive measures in MM patients treated with BPs in our centre between 1996 and 2015. Since 2005, MM patients (already under treatment or before treatment) underwent a baseline mouth

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… Necrotizing fasciitis as a rare complication of osteonecrosis of the jaw in a patient with multiple myeloma treated with lenalidomide: Case report and review of the literature. Springerplus. 2014;3:123. doi: 10.1186/2193-1801-3-123. …

Radiolucent lesions of the mandible: a pattern-based approach to diagnosis.

ObjectivesRadiolucent mandibular lesions seen on panoramic radiographs develop from both odontogenic and non-odontogenic structures. They represent a broad spectrum of lesions with a varying degree of malignant potential. The purpose of this review is to illustrate the characteristic imaging findings-as well as the clinical and histological features-of common and uncommon radiolucent lesions of the mandible.MethodsThis review article is based on the retrospective evaluation of 11,725 panoramic radiographs seen in our institution during the past 6 years. It provides a comprehensive, practical a

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… CT is helpful to analyse the bone structure, to search for associated abscesses and to identify soft tissue extension (myositis, fasciitis, cellulitis). …

Rehabilitation after Allogeneic Haematopoietic Stem Cell Transplantation: A Special Challenge.

The general population is getting older and suffer more haematological malignancies despite being physically fit. These malignancies are mainly only curable via an alloHCT, and they are now carried out more frequently. Patients benefit from intensive rehabilitation earlier and may need it repeatedly in cases of severe side effects (e.g., graft-versus-host disease). They can suffer many problems that other cancer patients do not experience, such as severe infections, continued immunosuppression, nutritional restrictions, acute or chronic GvHD, or organ impairments (e.g., lung, eyes). They may a

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… Scleroderma is the skin manifestation, producing Sjögren-syndrome-like changes in the eyes and a dry mouth, or there can be fasciitis, myositis, obstructive lung disease, and so on. …

Therapeutic plasma exchange as rescue therapy in severe sepsis and septic shock: retrospective observational single-centre study of 23 patients.

BackgroundSeveral case series and small randomized controlled trials suggest that therapeutic plasma exchange (TPE) improves coagulation, hemodynamics and possibly survival in severe sepsis. However, the exact role of TPE in modern sepsis therapy remains unclear.MethodsWe performed a retrospective observational single-centre study on the use of TPE as rescue therapy in 23 consecutive patients with severe sepsis or septic shock from 2005 to 2012. Main surrogate markers of multiple organ failure (MOF) before, during and after TPE as well as survival rates are reported.ResultsAt baseline, mean SO

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… Necrotising fasciitis and group A streptococcus toxic shock-like syndrome in pregnancy: treatment with plasmapheresis and immunoglobulin. Int J Obstet Anesth. 1999;8:125–30. doi: 10.1016/S0959-289X(99)80009-0. Hjorth V, Stenlund G. Plasmapheresis as part of the treatment for septic shock. …

Neutrophil diversity and function in health and disease.

Neutrophils, the most abundant type of granulocyte, are widely recognized as one of the pivotal contributors to the acute inflammatory response. Initially, neutrophils were considered the mobile infantry of the innate immune system, tasked with the immediate response to invading pathogens. However, recent studies have demonstrated that neutrophils are versatile cells, capable of regulating various biological processes and impacting both human health and disease. Cytokines and other active mediators regulate the functional activity of neutrophils by activating multiple receptors on these cells,

Burning Issues/Hot Topics: The Charcot Foot.

Charcot neuro-osteoarthropathy remains one of the most serious complications of diabetic neuropathy, with the potential for rapid progression to deformity, ulceration and limb-threatening outcomes. The earliest signs and symptoms are often subtle and easily missed, yet early recognition provides a narrow window of opportunity to prevent irreversible structural change. Contemporary diagnostic pathways are underpinned by close clinical observation and correlation of bedside findings with detailed imaging analysis, enabling earlier identification of active disease before collapse occurs. This art

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… It is important to rule out other conditions, such as fasciitis and tendinitis, which may present with similar clinical signs and symptoms but typically do not show osteoarticular abnormalities on radiological imaging [ 46 ]. …

Hematopoietic stem cell transplantation.

More than 25,000 hematopoietic stem cell transplantations (HSCTs) are performed each year for the treatment of lymphoma, leukemia, immune-deficiency illnesses, congenital metabolic defects, hemoglobinopathies, and myelodysplastic and myeloproliferative syndromes. Before transplantation, patients receive intensive myeloablative chemoradiotherapy followed by stem cell "rescue." Autologous HSCT is performed using the patient's own hematopoietic stem cells, which are harvested before transplantation and reinfused after myeloablation. Allogeneic HSCT uses human leukocyte antigen (HLA)-matched stem

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… The clinical findings may overlap with aGvHD, as both disorders affect similar organs. cGvHD has other features that resemble autoimmune disorders, such as systemic lupus erythematosus, scleroderma, sicca syndrome, eosinophilic fasciitis, rheumatoid arthritis, primary biliary sclerosis, bronchiolitis …

Overview of Ankle Arthropathy in Hereditary Hemochromatosis.

Hereditary hemochromatosis (HH) is an autosomal recessive bleeding disorder characterized by tissue overload of iron. Clinical systemic manifestations in HH include liver disease, cardiomyopathy, skin pigmentation, diabetes mellitus, erectile dysfunction, hypothyroidism, and arthropathy. Arthropathy with joint pain is frequently reported at diagnosis and mainly involves the metacarpophalangeal and ankle joints, and more rarely, the hip and knee. Symptoms in ankle joints are in most cases non-specific, and they can range from pain and swelling of the ankle to deformities and joint destruction.

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… Evaluation and Treatment of Chronic Plantar Fasciitis. Foot Ankle Orthop. 2020;5:2473011419896763. doi: 10.1177/2473011419896763. 74. Ward S.T., Williams P.L., Purkayastha S. Intra-Articular Corticosteroid Injections in the Foot and Ankle: A Prospective 1-Year Follow-up Investigation. J. …

New Approaches for the Treatment of Chronic Graft-Versus-Host Disease: Current Status and Future Directions.

Chronic graft-versus-host disease (cGvHD) is a severe complication of allogeneic hematopoietic stem cell transplantation that affects various organs leading to a reduced quality of life. The condition often requires enduring immunosuppressive therapy, which can also lead to the development of severe side effects. Several approaches including small molecule inhibitors, antibodies, cytokines, and cellular therapies are now being developed for the treatment of cGvHD, and some of these therapies have been or are currently tested in clinical trials. In this review, we discuss these emerging therapi

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… As in systemic rheumatologic diseases, its clinical manifestations are variable, varying from lichen planus-like lesions to full sclerosis, muscle pain or joint fasciitis, vulvo-vaginitis, bronchiolitis obliterans (BO), in addition to damage of gastrointestinal tract and liver ( 3 ). … Imatinib is effective for prevention and improvement of fibrotic fasciitis as a manifestation of chronic GVHD. Bone Marrow Transplant (2012) 47:139–40. 10.1038/bmt.2011.10 103. Galeotti L, Ceccherini F, Domingo D, Laurino M, Polillo M, Di Paolo A, et al. …

Herpes Zoster and Cardiovascular Disease: Exploring Associations and Preventive Measures through Vaccination.

Herpes zoster, induced by the reactivation of the varicella-zoster virus (VZV), is a unilaterally distributed vesicular rash that can cause multiple complications. VZV not only causes neurological problems, including postherpetic neuralgia and ocular zoster, but also causes inflammatory vasculopathy and increases the incidence of hemorrhagic or ischemic complications. Therefore, understanding the association between the development of herpes zoster and the subsequent occurrence of acute stroke or cardiovascular diseases, including myocardial infarction and heart failure, is of great interest.

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… It is important to highlight that herpes zoster has been linked to the onset of other significant infections, such as pneumonia and necrotizing fasciitis. 3.8. …

Denosumab in pediatric bone disorders and the role of RANKL blockade: a narrative review.

BACKGROUND AND OBJECTIVE: Denosumab is a valuable and safe therapy for skeletal disorders in adults and has received regulatory approval to treat osteoporosis and bone metastases. However, denosumab is not licensed for pediatric use due to a lack of high-quality prospective research on children. This study aimed to describe and discuss the benefits and disadvantages of denosumab in treating bone diseases in children and to summarize the current understanding of the role of denosumab therapy in children. METHODS: A narrative review was conducted using the literature retrieved from the PubMed,

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… USP6-induced neoplasms: the biologic spectrum of aneurysmal bone cyst and nodular fasciitis. Hum Pathol 2014;45:1-11. 10.1016/j.humpath.2013.03.005 56. Oliveira AM, Perez-Atayde AR, Dal Cin P, et al. …

Hematology

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… cystitis, eosinophilic prostatitis rheumatologic —eosinophilia–myalgia syndrome and idiopathic eosinophilic synovitis, Churg–Strauss syndrome dermatologic —eosinophilic panniculitis, episodic angioedema with eosinophilia, Kimura disease and angiolymphoid hyperplasia with eosinophilia, eosinophilic fasciitis … Vein Thrombosis NEJM 2004 351:3 Differential Diagnosis of Unilateral Leg Swelling/Deep Vein Thrombosis VASCULAR —DVT, venous insufficiency, superficial thrombophlebitis (chronic) LYMPHATIC —lymphedema (chronic) DRUGS —drug-induced edema (calcium channel blockers) OTHER —cellulitis, necrotizing fasciitis …

Infectious Complications of Cancer Therapy

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… Early recognition of potentially fatal necrotizing fasciitis. The use of frozen-section biopsy. N Engl J Med. 1984;310:1689–1693. doi: 10.1056/NEJM198406283102601. 56. Bodey G.P. Unusual presentations of infection in neutropenic patients. …

Autologous growth factor injections in chronic tendinopathy.

REFERENCE: de Vos RJ, van Veldhoven PLJ, Moen MH, Weir A, Tol JL. Autologous growth factor injections in chronic tendinopathy: a systematic … sed in different combinations: tendinopathy, tendinosis, tendinitis, tendons, tennis elbow, plantar fasciitis, platelet rich plasma, platelet transfusion, and autologous blood or injection. The search was limited to human studies in English. All bibliographies from the initial literature search were also viewed to identify additional relevant studies. STUD …

Diabetes mellitus and the skin.

Several dermatoses are routinely associated with diabetes mellitus, especially in patients with chronic disease. This relationship can be easily proven in some skin disorders, but it is not so clear in others. Dermatoses such necrobiosis lipoidica, granuloma annulare, acanthosis nigricans and others are discussed in this text, with an emphasis on proven link with the diabetes or not, disease identification and treatment strategy used to control those dermatoses and diabetes.

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… The glycosaminoglycan deposit histologically corresponds to an hyperintensity on magnetic resonance. 58 Clinically, the differential diagnosis must be established with scleroderma, eosinophilic fasciitis and scleromyxedema. 59 In SAB, the main mechanism of accumulation of extracellular matrix components …

The choice of new treatments in autoimmune hemolytic anemia: how to pick from the basket?

Autoimmune hemolytic anemia (AIHA) is defined by increased erythrocyte turnover mediated by autoimmune mechanisms. While corticosteroids remain first-line therapy in most cases of warm-antibody AIHA, cold agglutinin disease is treated by targeting the underlying clonal B-cell proliferation or the classical complement activation pathway. Several new established or investigational drugs and treatment regimens have appeared during the last 1-2 decades, resulting in an improvement of therapy options but also raising challenges on how to select the best treatment in individual patients. In severe w

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… usually ITP (Evans’syndrome) Solid tumors | Ovarian dermoid cyst or carcinoma Thymoma Non-hematologic autoimmune and inflammatory diseases | Rheumatologic diseases (SLE, Rheumatoid arthritis, Sjögren syndrome) Antiphospholipid syndrome Autoimmune hepatitis Ulcerative colitis Sarcoidosis Eosinophilic fasciitis …

Nanovesicular Drug Delivery Systems for Overcoming Antibiotic Resistance.

Despite the early success of treating bacterial infections with antibiotics, resistance development has become a global problem. Treatment of organisms that have become resistant to common antibacterial agents is challenging and can cause severe and extended illness, longer hospital stays, and increased medical costs. Bacteria may develop antibiotic resistance by multiple biochemical pathways, including target-site gene mutations, decreased permeability, drug uptake or efflux mechanisms that remove the drug from the host cells, and alterations in metabolic pathways. Several strategies to overc

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… Multidrug-resistant organisms such as MRSA can penetrate deeper into skin and soft tissues, leading to cellulitis, abscesses, or necrotizing fasciitis. This may require the development of dosage forms that will allow for enhanced delivery and absorption at the site of infection. …