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  1 / 20147 MEDLINE  
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[PMID]: 29524388
[Au] Autor:Psallidas I; Kanellakis NI; Bhatnagar R; Ravindran R; Yousuf A; Edey AJ; Mercer RM; Corcoran JP; Hallifax RJ; Asciak R; Shetty P; Dong T; Piotrowska HEG; Clelland C; Maskell NA; Rahman NM
[Ad] Address:Oxford Centre for Respiratory Medicine, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK; Laboratory of Pleural and Lung Cancer Translational Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK; Oxford Respiratory Trials Unit, Nuffield Departme
[Ti] Title:A pilot feasibility study in establishing the role of ultrasound-guided pleural biopsies in pleural infection (The AUDIO study).
[So] Source:Chest;, 2018 Mar 07.
[Is] ISSN:1931-3543
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Pleural infection is a common complication of pneumonia associated with high mortality and poor clinical outcome. Treatment of pleural infection relies on the use of broad-spectrum antibiotics, since reliable pathogen identification occurs infrequently. We performed a feasibility interventional clinical study assessing the safety and significance of ultrasound (US)-guided pleural biopsy culture to increase microbiological yield. In an exploratory investigation, the 16S rRNA technique was applied to assess its utility on increasing speed and accuracy versus standard microbiological diagnosis. METHODS: 20 patients with clinically established pleural infection were recruited. Participants underwent a detailed US scan and US-guided pleural biopsies before chest drain insertion, alongside standard clinical management. Pleural biopsies and routine clinical samples (pleural fluid and blood) were submitted for microbiological analysis. RESULTS: US-guided pleural biopsies were safe with no adverse events. US-guided pleural biopsies increased microbiological yield by 25% in addition to pleural fluid and blood samples. The technique provided a substantially higher microbiological yield compared to pleural fluid and blood culture samples (45% compared to 20% and 10% respectively). The 16S rRNA technique was successfully applied to pleural biopsy samples, demonstrating high sensitivity (93%) and specificity (89.5%). CONCLUSIONS: Our findings demonstrate the safety of US-guided pleural biopsies in patients with pleural infection and a substantial increase in microbiological diagnosis, suggesting potential niche of infection in this disease. qPCR primer assessment of pleural fluid and biopsy appears to have excellent sensitivity and specificity.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  2 / 20147 MEDLINE  
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[PMID]: 29523026
[Au] Autor:Hauge T; Kleven OC; Johnson E; Hofstad B; Johannessen HO
[Ad] Address:a Department of Surgery , Drammen Hospital , Drammen , Norway.
[Ti] Title:Outcome after stenting and débridement for spontaneous esophageal rupture.
[So] Source:Scand J Gastroenterol;:1-5, 2018 Mar 09.
[Is] ISSN:1502-7708
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:OBJECTIVES: Surgical repair has been the most common treatment of esophageal effort rupture (Boerhaave syndrome). Stent-induced sealing of the perforation has increasingly been used with promising results. We present our eight years´ experience with stent-based and organ-preserving treatment. MATERIALS AND METHODS: Medical records of 15 consecutive patients with Boerhaave syndrome from February 2007 to May 2015 were retrospectively registered in a database. Treatment was sealing of the perforation by stenting, chest tube drainage and débridement of the contaminated thorax. After median 25 months nine out of 10 patients responded to questions on fatigue and Ogilvie's dysphagia score. RESULTS: Fifteen patients, aged median 67.5 years (range 39-88), had a primary hospital stay of 20 days (range 1-80 days). Overall in-hospital mortality was 13%. Observation time was 44 months (range 0-87) and 10 patients were alive of August 2017. Ten patients (67%) needed surgical chest débridement. Five patients (33%) were restented for leakage, migration and for stent removal. Eleven patients (73%) had complications, which included pleural empyema (n = 4), fatal aortic bleeding, lung arterial bleeding, lung embolism, drain-induced lung laceration and respiratory failure. Dysphagia score was low (median 0.5) meaning that they were able to feed themselves. Total fatigue score (mean 14.6) was slightly increased (p = .05) compared with a reference population. CONCLUSIONS: The mortality rate after initial stenting of effort rupture seems to be comparable to standard surgical repair. Most patients required further intervention, either by restenting and/or surgical débridement. The functional result in these patients was satisfactory.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher
[do] DOI:10.1080/00365521.2018.1448886

  3 / 20147 MEDLINE  
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[PMID]: 29371096
[Au] Autor:Duport P; Miltgen G; Kebbabi C; Belmonte O; Coolen-Allou N; Allyn J; Allou N
[Ad] Address:Réanimation Polyvalente, Centre Hospitalier Universitaire Félix Guyon, Allée des Topazes, 97405 Saint Denis, France. Electronic address: pauline.duport@chu-reunion.fr.
[Ti] Title:First case of pleural empyema and pulmonary abscess caused by Eggerthia catenaformis.
[So] Source:Anaerobe;50:9-11, 2018 Jan 25.
[Is] ISSN:1095-8274
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Few data are available on the anaerobic bacterium Eggerthia catenaformis. Here we report the first clinical case of a patient with sepsis caused by pulmonary infection with E. catenaformis, and present the minimal inhibitory concentrations of different antimicrobial agents.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher

  4 / 20147 MEDLINE  
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[PMID]: 29325875
[Au] Autor:Noël A; Verroken A; Belkhir L; Rodriguez-Villalobos H
[Ad] Address:Department of Microbiology, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium. Electronic address: audrey.noel@uclouvain.be.
[Ti] Title:Fatal thoracic empyema involving Campylobacter rectus: A case report.
[So] Source:Anaerobe;49:95-98, 2018 Feb.
[Is] ISSN:1095-8274
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:We report the case of a 69-year-old man admitted for septic shock secondary to necrotic pneumoniae complicated by thoracic empyema of fatal issue. Microbiological examination of pleural liquid revealed a mixed anaerobic flora involving Campylobacter rectus and Actinomyces meyeri. Campylobacter rectus is an infrequent anaerobic pathogen of oral origin To our knowledge, this is the first case report of fatal C. rectus - associated thoracic empyema, and only the second reported case in which identification was successfully performed by MALDI-TOF MS.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Process

  5 / 20147 MEDLINE  
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[PMID]: 29203735
[Au] Autor:Shaprynskyi VO; Shaprinskiy YV; Karyi YV; Lysenko SA
[Ad] Address:Vinnitsa National Pirogov Memorial Medical University, Vinnitsa, Ukraine.
[Ti] Title:Histomorphologic changes of esophageal mucosa in experimental third degree stricture.
[So] Source:Wiad Lek;70(5):891-894, 2017.
[Is] ISSN:0043-5147
[Cp] Country of publication:Poland
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Nowadays the level of early and late complications after the operations for esophageal corrosive strictures such as esophago-organ anastomotic leak, development of infections, pneumonia, pleural empyema, mediastinitis, peritonitis, postoperative corrosive stricture development etc. remains rather high. Besides, postoperative mortality rate is high as well - 3.5-30 %. For that reason, an experimental model of esophageal stricture was suggested and ultrastructural mucosal changes in the stricture itself were studied to elaborate the unified pathogenic approach in treatment of esophageal stricture and improvement of its results. The aim of our work was to study the dynamics of ultrastructural changes both in normal esophageal walls and in third degree esophageal stricture Materials and Methods: The experiment was carried out on white male rats weighting 250-300 grams, to whom the third degree esophageal stricture model was created. After layer-by-layer incision of anterior abdominal wall abdominal portion of the esophagus was completely ligated (10 rats). In the control group (6 rats) anterior abdominal wall was opened with its subsequent layered closure. The animals were withdrawn from the experiment on the third day by ketamine overdose, and the samples were taken for ultrastructural study. RESULTS: Electron microscopic study of submicroscopic organization of basal, prickle, superficial epithelial cells in stratified non-squamous epithelium, smooth myocytes of muscle plate and contractile elements in esophageal muscular layer was carried out. Nuclear membrane, membranes of mitochondria, endoplasmic reticulum and cytoplasmic Golgi complex were found to be subjected to focal lysis. The third degree esophageal stricture caused destructive lesions in ultrastructural architectonics of stratified non-squamous epithelium cells, smooth myocytes of muscle plate and contractile elements in esophageal muscular layer of rats. CONCLUSION: Thus, catabolic processes leading to organelle disintegration develop in esophageal cells of rats with third degree stricture.
[Mh] MeSH terms primary: Esophageal Mucosa/ultrastructure
Esophageal Stenosis/pathology
Esophagus/ultrastructure
[Mh] MeSH terms secundary: Animals
Constriction, Pathologic/pathology
Disease Models, Animal
Esophageal Mucosa/pathology
Esophagus/pathology
Male
Microscopy, Electron
Rats
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[Js] Journal subset:IM
[Da] Date of entry for processing:171206
[St] Status:MEDLINE

  6 / 20147 MEDLINE  
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[PMID]: 29194832
[Au] Autor:Gendron K; McDonough SP; Flanders JA; Tse M; Scrivani PV
[Ad] Address:Department of Clinical Sciences, Cornell University, Ithaca, NY, 14853.
[Ti] Title:The pathogenesis of paraesophageal empyema in dogs and constancy of radiographic and computed tomography signs are linked to involvement of the mediastinal serous cavity.
[So] Source:Vet Radiol Ultrasound;59(2):169-179, 2018 Mar.
[Is] ISSN:1740-8261
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:The mediastinal serous cavity is a normal anatomic space in the caudal mediastinum. Aims of this anatomic and case series study were to describe the signs of pathologic expansion of the mediastinal serous cavity observed during computed tomography (CT), review the underlying anatomy, perform a literature review, and evaluate the medical records of several dogs with mediastinal serous cavity empyema (paraesophageal empyema). The mesothelial lined mediastinal serous cavity is a cranial extension of the omental bursa, separated from the peritoneal cavity by the diaphragm, in the dorsal part of the caudal mediastinum, to the right of the esophagus, between the heart base and diaphragm. In five adult, large-breed dogs with surgically and histologically confirmed paraesophageal empyema, macroscopic plant material was found at surgery in two dogs, adherence to adjacent lung was present in three different dogs, accessory lobectomy was performed in two dogs with subacute-chronic pyogranulomatous pneumonia, and one dog had concurrent pyothorax and mediastinitis, but none had esophageal abnormalities. This study expands our understanding of the pathogenesis and basis for the imaging appearance of paraesophageal empyema in dogs by clarifying the underlying anatomic structures that direct development of this condition. The term empyema accurately describes this condition because the purulent material accumulates within an existing body cavity. The study also provides initial evidence that the development of paraesophageal empyema might be due to local extension of lung disease, such as foreign body migration or pneumonia. Computed tomography was helpful for diagnosis, assessing size, and determining the spread of disease.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Process
[do] DOI:10.1111/vru.12582

  7 / 20147 MEDLINE  
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Amantea, Sergio Luis
SciELO Brazil full text

[PMID]: 29513814
[Au] Autor:Silva SSD; Peterson GE; Amantéa SL; Miorelli P; Ulbrich JM; Roesch E; Sanches PR; Fraga JC
[Ad] Address:Fellow Master degree, Postgraduate Program in Surgical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre-RS, Brazil. Scientific, intellectual, conception and design of the study; technical procedures; acquisition, analysis and interpretation of data; manus
[Ti] Title:Transforming growth factor beta1 (TGF-ß1) levels in a rat model of induced pleural empyema.
[So] Source:Acta Cir Bras;33(2):156-162, 2018 Feb.
[Is] ISSN:1678-2674
[Cp] Country of publication:Brazil
[La] Language:eng
[Ab] Abstract:PURPOSE: To evaluate the concentration of transforming growth factor beta 1 (TGFB1) levels in a rat pleural effusion obtained by inoculation of intrapleural bacteria or turpentine through thoracentesis. METHODS: Thirty-Nine Wistar rats were divided into three groups: Staphylococcus aureus (SA, n = 17); Streptococcus pneumoniae (SP, n = 12); and turpentine (control, n = 10). Pleural fluid was collected through ultrasound-guided thoracentesis 12 h, 24 h, and 36 h after instillation of bacteria or turpentine. Levels of TGFB1 were measured in pleural fluid. RESULTS: At 12 h, mean TGFB1concentrations were 5.3450 pg/mL in the SA group, 5.3449 pg/mL in the SP group, and 5.3450 pg/mL in controls. At 24 h, they were 4.6700 pg/mL in the SA group, 4.6700 pg/mL in the SP group, and 4.6700 pg/mL in controls. At 36 h, they were 4.6699 pg/mL in the SA group and in control. No difference was observed among the groups in mean TGFB1concentration (p = 0.12); however, a significant intragroup reduction in mean TGFB1 was observed between 12 and 24 h (p < 0.01). CONCLUSION: The transforming growth factor beta 1 concentrations were not useful as a diagnostic tool or an early marker of infected pleural effusion.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:In-Process

  8 / 20147 MEDLINE  
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[PMID]: 29498974
[Au] Autor:Zanotti B; Zingaretti N; Verlicchi A; Alfieri A; Parodi PC
[Ad] Address:Neurosurgery Clinic.
[Ti] Title:Successful Strategies for Dealing With Infected, Custom-Made Hydroxyapatite Cranioplasty.
[So] Source:J Craniofac Surg;, 2018 Mar 01.
[Is] ISSN:1536-3732
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:When a cranioplasty implant becomes infected, standard operating procedure dictates its removal and the initiation of a long course of antibiotic therapy. However, removing such a prosthesis can have a series of adverse consequences, including delayed cognitive and motor recovery, lack of brain tissue protection, unsightly deformity, and the need for two additional surgical procedures, not to mention the additional costs involved. To maintain the advantages of cranioplasty, we opted for a conservative approach (levofloxacin and rifampicin every 24 hours for 8 weeks) in a 68-year-old woman whose custom-made porous hydroxyapatite implant, fitted following aneurysm clipping, had become infected. The tissues overlying the implant were curettaged, and the patient's clinical condition, blood markers, and infection course were continuously monitored (local monitoring was performed by single-photon emission computed tomography [SPECT]/computed tomography [CT after intravenous administration of Tc-labeled antigranulocyte antibody). Blood tests and SPECT/CT evidenced a progressive reduction in phlogosis indices and infection locus, even 1 month after antibiotic therapy was commenced, and at 2 years from cranioplasty, the same tests and clinical examination were negative. At 6-year follow-up, clinical assessment revealed nothing out of the ordinary.Hence, specific cases (hydroxyapatite prosthesis, intact dura, cranial CT and magnetic resonance imaging negative for empyema, well-vascularized scalp, antibiotic-responsive bacteria) of infected cranial implant can be treated using a conservative approach consisting of appropriate antibiotic therapy, accompanied by local debridement where necessary, and assiduous monitoring of phlogosis indices and local verification via labeled-leukocyte scintigraphy. Our report, which was compiled after a long-term follow-up period, shows that this conservative procedure appears to be a viable option in cases of infected, custom-made hydroxyapatite cranioplasty, provided that some basic rules concerning clinical and instrumental standards are adhered to, as clearly stated in our report.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1097/SCS.0000000000004415

  9 / 20147 MEDLINE  
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[PMID]: 29309553
[Au] Autor:Oligbu G; Collins S; Andrews N; Sheppard CL; Fry NK; Slack MPE; Borrow R; Ladhani SN
[Ad] Address:Paediatric Infectious Diseases Research Group, Institute for Infection and Immunity, St George's, University of London.
[Ti] Title:Characteristics and Serotype Distribution of Childhood Cases of Invasive Pneumococcal Disease Following Pneumococcal Conjugate Vaccination in England and Wales, 2006-2014.
[So] Source:Clin Infect Dis;65(7):1191-1198, 2017 Oct 01.
[Is] ISSN:1537-6591
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Background: The 7-valent and 13-valent pneumococcal conjugate vaccines (PCV7 and PCV13, respectively) are highly effective in preventing invasive pneumococcal disease (IPD) caused by vaccine serotypes. Vaccine failure (vaccine-type IPD after age-appropriate immunization) is rare. Little is known about the risk, clinical characteristics, or outcomes of PCV13 compared to PCV7 vaccine failure. Methods: Public Health England conducts IPD surveillance and provides a national reference service for serotyping pneumococcal isolates in England and Wales. We compared the epidemiology, rates, risk factors, serotype distribution, clinical characteristics, and outcomes of IPD in children with PCV13 and PCV7 vaccine failure. Results: A total of 163 episodes of PCV failure were confirmed in 161 children over 8 years (4 September 2006 to 3 September 2014) in 10 birth cohorts. After 3 vaccine doses, PCV7 and PCV13 failure rates were 0.19/100000 (95% confidence interval [CI], .10-.33 [57 cases]) and 0.66/100000 (95% CI, .44-.95 [104 cases]) vaccinated person-years, respectively. Children with PCV13 failure were more likely to be healthy (87/105 [82.9%] vs 37/56 [66.1%]; P = .02), present with bacteremic lower respiratory tract infection (LRTI) (61/105 [58.1%] vs 11/56 [19.6%]; P < .001), and develop empyema (41/61 [67.2%] vs 1/11 [9.1%]; P < .001) compared to PCV7 failures. Serotypes 3 (n = 38 [36.2%]) and 19A (n = 30 [28.6%]) were responsible for most PCV13 failures. Six children died (4% [95% CI, 1%-8%]), including 5 with comorbidities. Conclusions: PCV failure is rare and, compared to PCV7 serotypes, the additional PCV13 serotypes are more likely to cause bacteremic LRTI and empyema in healthy vaccinated children.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Data-Review
[do] DOI:10.1093/cid/cix418

  10 / 20147 MEDLINE  
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[PMID]: 29244096
[Au] Autor:Giller DB; Giller BD; Giller GV; Shcherbakova GV; Bizhanov AB; Enilenis II; Glotov AA
[Ad] Address:Department of Phthisiopulmonology and Thoracic Surgery, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.
[Ti] Title:Treatment of pulmonary tuberculosis: past and present.
[So] Source:Eur J Cardiothorac Surg;, 2017 Dec 12.
[Is] ISSN:1873-734X
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:OBJECTIVES: Surgical interventional has been key in the treatment of tuberculosis (TB) for a long time. Its importance diminished after the emergence of chemotherapy. However, the spread of rapid multidrug-resistant (MDR) and extensively drug-resistant (XDR) TB has led us to return to surgery to treat TB. Today, every second patient in Russia with destructive TB has either MDR or XDR TB, which is the reason for the low efficacy of conservative treatment. In 2015, treatment with drugs resulted in clinical recovery in only 29.8% of new cases of destructive TB acid-fast bacilli (AFB)+. METHODS: The author's data from 1999 to 2016 have been analysed. The author performed 5599 surgeries on patients with pulmonary TB aged from 1 to 87 years (mean age 34.6 years). The most common reasons for surgical treatment were fibrotic cavitary and cavitary pulmonary TB, tuberculoma with destruction, tuberculous pleural empyema, caseous pneumonia and intrathoracic lymph nodes. The strategy of early collapse therapy and the use of surgery to treat TB was proposed in the Penza region of Russia; the results were analysed to estimate the long-term outcomes of treatment. RESULTS: In 5599 surgeries, the full clinical effect was achieved in 93% of operated patients with MDR TB, in 92.1% of those with XDR TB and in 98% of patients without MDR or XDR resistance. According to the data from the Penza region, 3 years after surgery, 93.9% (149 of 159 cases) of the operated patients exhibited clinical recovery. CONCLUSIONS: Taking into account the data from the World Health Organization on the insufficient level of therapeutic success in the treatment of MDR and XDR pulmonary TB, surgical treatment is necessary in regions with a high frequency of drug-resistant cases.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1093/ejcts/ezx447


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