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The role of Cutibacterium acnes in auto-inflammatory bone disorders.

Chronic nonbacterial osteomyelitis (CNO) and SAPHO (synovitis, acne, pustulosis, hyperostosis and osteitis) syndrome are auto-inflammatory disorders manifesting as chronic inflammation of bones and joints, which in SAPHO is often accompanying by skin changes. The aetiology of these diseases is unknown, but includes genetic, infectious and immunological components. It has been proposed that Cutibacterium (formerly Propionibacterium) acnes plays a role in the pathogenesis. In this review, we summarise reported cases of CNO or SAPHO syndrome in which C. acnes has been isolated from bones. To iden…

Development of an Achievable Benchmarks of Care Report Card for Pediatric Hospital Medicine.

OBJECTIVES: To develop an Achievable Benchmarks of Care (ABCs) report card for common conditions managed by pediatric hospital medicine (PHM). METHODS: We performed a retrospective cross-sectional study of encounters for 13 common pediatric conditions between January 1, 2023, and December 31, 2024, using the Pediatric Health Information System database. Conditions included bronchiolitis, asthma, pneumonia, urinary tract infection, constipation, gastroenteritis, cervical lymphadenitis, skin and soft tissue infection, orbital cellulitis, osteomyelitis, septic arthritis, neonatal fever, and simp…

Melioidosis in dogs and cats: 18 cases.

BACKGROUND: The clinical manifestations and outcomes in dogs and cats with melioidosis have not been described. HYPOTHESIS/OBJECTIVES: Desc … bscesses or open wounds, and 6/15 (40%) had prostatitis or prostatic abscessation. In cats, 2/3 had osteomyelitis and 1/3 had pyelonephritis. Of the cases, 5/15 (33%) dogs and none of the cats were considered potentially immunocompromised. Of the 17 cases with >4 weeks of follow-up, death or euthanasia attributed to melioidosis occurred in 8/17 (47%). Of the su …

Mythbusters in Microsurgery: Evaluating Evidence and Debunking Dogma-A Practical Review: Part II.

BACKGROUND: The first part of this 2-part practical review critically appraised 8 common perioperative practices in reconstructive microsurgery, revealing that several were unsupported by evidence. This second part evaluated the remaining 9 frequently cited dogmas in microsurgical reconstruction. METHODS: A comprehensive review of all major databases was performed to identify studies addressing vein grafts, number and sequence of anastomoses, vasodilator selection, flap choice for osteomyelitis, vessel selection in trauma, caffeine use, postoperative mobilization, and showering with drains af…

Management and sequelae of a local skene's gland adenocarcinoma recurrence.

BACKGROUND: Primary adenocarcinoma of the Skene's gland is exceedingly rare, with only about two dozen well-documented cases in medical lite … revealed progressive destructive changes of the pubic symphysis, a large pelvic abscess, and septic osteomyelitis. After treatment with antibiotics, subsequent MRI and PET findings suggested chronic osteomyelitis and radiation-induced necrosis. The patient underwent anterior pelvic exenteration with cystectomy, resection of the pubic symphysis, neovagina creati …

Окрелизумаб Деконтинуация После периодических серьезных инфекций в клинической стабилизированной начальной прогрессивной множественной склероз: доклад по делу.

Долгосрочная антиCD20-терапия в первичном прогрессивном множественном склерозе (ППМС) требует сбалансированного учета ожидаемой неврологической выгоды от инфекционного риска по мере возраста пациентов и накопления инвалидности. В течение примерно пяти месяцев в больнице трижды госпитализировалась 61-летняя женщина, имеющая ПМПС и не имеющая в последнее время клинических или радиографических данных о провокационной деятельности в связи с заболеваниями, при этом каждые шесть месяцев она получала острелизумаб. Первая госпитализация была осложнена вириданской группой стрептокококковой бактерии, св

Совпадение в аннотации оригинала
Long-term anti-CD20 therapy in primary progressive multiple sclerosis (PPMS) requires balancing expected neurologic benefit against infectio … ssure injury complicated by a methicillin-resistant Staphylococcus aureus (MRSA) abscess and sacral osteomyelitis. Serial neurologic evaluations showed no evidence of relapse, and magnetic resonance imaging revealed no active demyelination throughout. Although ocrelizumab may have increased susceptibility to infection, multiple coexisting risk factors, includin …

Comprehensive Analysis of the Spectrum of Osteoarticular Infections in Children.

BACKGROUND: Studies of pediatric osteoarticular infections (OAIs) mostly focus on acute hematogenous osteomyelitis (AHO) and acute bacterial arthritis (ABA). A comprehensive descriptive analysis of pediatric OAIs, including subacute, chronic, and non-hematogenous types, is lacking. METHODS: A detailed analysis of all pediatric OAIs was undertaken at 2 academic centers, Hasbro Children's Hospital, Providence, RI, and Nationwide Children's Hospital, Columbus, OH. Infections were classified as AHO (with or without suppurative arthritis), isolated ABA, subacute or chronic hematogenous osteomyelit…

Risk factors for therapeutic failure in adults with methicillin-resistant Staphylococcus aureus (MRSA) infection treated with vancomycin in a high-complexity hospital in Cali, Colombia.

OBJECTIVE: To determine the risk factors associated with therapeutic failure of vancomycin in hospitalized adult patients with methicillin-r … 6%) of participants were men. The following variables: age (OR 1.034; 95% CI 1.007-1.061, p=0.011), osteomyelitis/ septic arthritis (OR 6.035; 95% CI 2.282-15.956, p=0.000) and minimum inhibitory concentration (MIC) (OR 5.971; 95% CI 1.321-26.979, p=0.020) were found to be independent risk factors associated with therapeutic failure of vancomycin. Vancomycin tr …

Anti-IL12p40 autoantibodies in a teenage girl with multiple recurrent abscesses.

More frequent among adults, phenocopies may be caused by somatic mutations or anti-cytokine autoantibodies, mimicking the phenotypes of primary immunodeficiencies. A fourteen-year-old girl was referred for a two-year history of weight loss and multiple recurrent abscesses, complicated recurrent pneumonia, pyelonephritis, osteomyelitis, and septic shock, without fever. She had started with nausea, hyporexia, and weight loss, then with abscesses in her hands, knee, ankle, and spleen. She also developed a rib fracture and left thoracic herpes zoster. The patient was cachectic, with normal vital s…

Comparison of the efficacy and safety of standard- and high-dose daptomycin: A systematic review and meta-analysis.

AIMS: Standard doses of daptomycin at 4 and 6 mg/kg were used for the treatment of skin and soft tissue for infections and bacteraemia, respectively. However, increased doses of daptomycin are recommended for complicated infections by Gram-positive organisms. METHODS: A systematic review was conducted using 4 databases. We compared treatment success between standard-dose (SD, 4-6 mg/kg) and high-dose (HD, >6 mg/kg) daptomycin in patients with all-cause bacteraemia, complicated bacteraemia, infective endocarditis, osteomyelitis and foreign body/prosthetic infection as the primary outcome. We a…

Evaluating the Use of Dalbavancin for Off-Label Indications.

(1) Background: Dalbavancin is a long-acting lipoglycopeptide antibiotic approved for skin and soft-tissue infections. Post-marketing experi … rd IV therapy was given. (3) Results: Forty-eight patients met study criteria. Indications included osteomyelitis (54%), endocarditis (23%), bacteremia (15%), and prosthetic joint infection (8%). The predominant organism was S. aureus (60%), with 42% caused by methicillin-resistant S. aureus. Overall, 41 (85%) patients achieved clinical success at 90 days, incl …

Outcomes of Free Muscle Flaps versus Free Fasciocutaneous Flaps for Lower Limb Reconstruction following Trauma: A Systematic Review and Meta-Analysis.

BACKGROUND: Free flap reconstruction of the lower limb following trauma often suffers higher complication rates than other areas of the body … sciocutaneous flaps. The majority of studies found no significant difference in complication rates, osteomyelitis, time to fracture union, or time to functional recovery. Most, 82.4% (14/17), of the included studies were of high methodological quality. CONCLUSION: The rate of total flap failure, reoperation, or limb salvage is not significantly different betwe …

An novel and alternative treatment method for large heel ulceration in diabetic patients: Proximal tibial cortex transverse distraction.

Heel ulceration in patients with diabetes mellitus (DM) is a major clinical challenge, manifesting with a protracted and uncertain healing p … healing time was 128.62 ± 16.76 days (range: 91-160 days). 16 out of 21 patients without calcaneal osteomyelitis achieved ulcer healing with a mean duration of 124.69 ± 14.42 days (range: 91-143 days), while the other five patients with calcaneal osteomyelitis were 141.20 ± 19.12 days (range: 110-160 days). 2 out of 21 patients got superficial rupture at the p …

Bovine Hydroxyapatite-Based Bone Scaffold with Gentamicin Accelerates Vascularization and Remodeling of Bone Defect.

Osteomyelitis is an infectious disease which is also a major complication of bone defects. This study aims to determine the effect of bovine hydroxyapatite-gelatin-based bone implants with gentamicin as an antibiotic (BHA-GEL-GEN implant) on the regeneration of bone defects in vivo. The BHA-GEL-GEN and BHA-GEL implants were made by direct compression. In vivo study was carried out with Wistar rats. The rats were divided into three groups: negative control, BHA-GEL implant, and BHA-GEL-GEN implants. The defect model used was the burr hole defect model with diameter 2.2 mm and 2 mm deep. After 2…

Native bone and joint infections caused by extended-spectrum β-lactamase-producing Enterobacterales: experience of a reference centre in the Greater Paris area.

Antibiotic treatment of native osteomyelitis caused by extended-spectrum β-lactamase-producing Enterobacterales (ESBL-PE) is a challenge. Limited epidemiological and outcome data are available. This retrospective cohort study included osteomyelitis patients with ESBL-PE infections treated in a reference centre for bone and joint infections (BJIs) between 2011-2019. Twenty-nine patients with native BJI (mean age, 44.4 ± 15.7 years) were analysed. Fifteen cases were paraplegic patients with ischial pressure sores breaching the hip capsule. Other cases included eight other hip infections, four ti…

Clinicoradiographic predictors of percutaneous bone biopsy results among patients with suspected thoracolumbar spine infection.

BACKGROUND: Image-guided percutaneous thoracolumbar spine biopsy is frequently performed in the setting of suspected septic facet arthritis or discitis osteomyelitis (DOM). There are limited data regarding factors associated with a positive biopsy result among these patients. MATERIALS AND METHODS: Patients with suspected DOM who underwent spine biopsy were identified. Samples yielding a positive culture and/or histopathology suggestive of acute osteomyelitis were considered positive. The associations between selected medical comorbidities, laboratory values, pre-biopsy antibiotic administrat…

Host nutrient milieu drives an essential role for aspartate biosynthesis during invasive Staphylococcus aureus infection.

The bacterial pathogen Staphylococcus aureus is capable of infecting a broad spectrum of host tissues, in part due to flexibility of metabol … -induced hypoxia, and a metabolic profile skewed toward aerobic glycolysis. Using a murine model of osteomyelitis, we examined survival of S. aureus mutants deficient in central metabolic pathways, including glycolysis, gluconeogenesis, the tricarboxylic acid (TCA) cycle, and amino acid synthesis/catabolism. Despite the high glycolytic demand of skeletal cells, …

Limb loss in individuals with chronic spinal cord injury.

Objective: The purpose of this study is to describe a population of individuals with chronic spinal cord injury (SCI), who underwent lower l … . Thirty-seven (71.2%) had paraplegia, and 34 (65.3%) had motor-complete SCI. Pressure injuries and osteomyelitis were most common indications for amputation. Amputations were primarily (83%) at the transtibial level or more proximal, with the most common amputation level at transfemoral/through-knee (29;55.8%). Postoperative complications occurred in five indi …

Efficacy and safety of dalbavancin in the treatment of Gram-positive bacterial infections.

OBJECTIVES: In this meta-analysis, we assessed the clinical efficacy and safety of dalbavancin compared with commonly used anti-Gram-positiv … SSIs) and the other two included patients with catheter-related bloodstream infections (CRBSIs) and osteomyelitis, respectively. Clinical and microbiological responses to dalbavancin were similar to other antibiotics in treating infections caused by Gram-positive bacteria, including the SSSI subgroup. Clinical response to dalbavancin showed superiority in the C …

Long-term outcome of persons with diabetic and non-diabetic neuro-osteoarthropathy after foot correction using external fixation.

AIM: Diabetic neuro-osteoarthropathy (Charcot foot) is a serious form of diabetic foot syndrome, often leading to severe deformity of the foot and subsequently to ulcers and osteomyelitis. The aim of this retrospective study was to determine the success rate and long-term outcomes for a Charcot foot operation using external fixation in 115 individuals who underwent surgery between July 2008 and December 2012. METHODS: Some 115 consecutive persons, 78 (68%) men and 37 (32%) women, were enrolled in this study. The eligibility criterion for this retrospective study was reconstructive foot surger…