Base de dados : MEDLINE
Pesquisa : C01.539.160.762.301 [Categoria DeCS]
Referências encontradas : 1852 [refinar]
Mostrando: 1 .. 10   no formato [Detalhado]

página 1 de 186 ir para página                         

  1 / 1852 MEDLINE  
              next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28449655
[Au] Autor:Tsai TT; Yang SC; Niu CC; Lai PL; Lee MH; Chen LH; Chen WJ
[Ad] Endereço:Department of Orthopaedic Surgery, Spine Section, Bone and Joint Research Center, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No. 5, Fusing St., Gueishan, Taoyuan, 333, Taiwan. tsai1129@gmail.com.
[Ti] Título:Early surgery with antibiotics treatment had better clinical outcomes than antibiotics treatment alone in patients with pyogenic spondylodiscitis: a retrospective cohort study.
[So] Source:BMC Musculoskelet Disord;18(1):175, 2017 04 27.
[Is] ISSN:1471-2474
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Pyogenic spondylodiscitis is a form of spinal infection that can result in severe back pain and even death. However, information is lacking on the relative effectiveness of various therapies. A retrospective chart review was conducted to investigate whether early surgical treatment of pyogenic spondylodiscitis coupled with intravenous antibiotics results in better patient prognoses than intravenous antibiotics therapy alone. METHODS: All patients treated for pyogenic spondylodiscitis at a single medical center from July 2006 to July 2011 were retrospectively reviewed. The inclusion criteria consisted of diagnosis of an early stage infection without neurological deficit, and patients without severe sepsis who were suitable candidates for early surgery as determined by a Pittsburgh bacteremia score < 4, and patients with delayed diagnosis and lost to outpatient follow-up were excluded. Clinical outcomes included patient demographic data, kyphosis angle, length of treatment, Oswestry Disability Index and visual analogue pain scale were analyzed. RESULTS: Of 90 enrolled patients, Group 1 (n = 47) received only antibiotic therapy and Group 2 (n = 43) received early surgery with post-surgery antibiotics for 2 to 4 weeks. Group 2 exhibited significantly better results than Group 1 for mean antibiotic administration period, mean hospitalization period, kyphotic angle correction. Of 61 patients who participated in telephone follow-up after discharge, Group 2 (n = 26) had significant lower mean ODI score, and mean back pain score than Group 1 (n = 35). CONCLUSIONS: While infection control was similar for both groups, patients treated with early surgery and antibiotics were hospitalized for fewer days and required less antibiotics than those treated with antibiotics alone, also having better functional outcomes. In short, early surgical treatment of pyogenic spondylodiscitis typically achieves a better prognosis, shorter hospitalization period, and subsequent significant improvement in kyphotic deformity and quality of life.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Doenças Transmissíveis/tratamento farmacológico
Doenças Transmissíveis/cirurgia
Discite/tratamento farmacológico
Discite/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Doenças Transmissíveis/diagnóstico por imagem
Discite/diagnóstico por imagem
Método Duplo-Cego
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1186/s12891-017-1533-1


  2 / 1852 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29049254
[Au] Autor:Kao FC; Tsai TT; Niu CC; Lai PL; Chen LH; Chen WJ
[Ad] Endereço:Department of Orthopaedic Surgery, Spine Section, Bone and Joint Research Center, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan.
[Ti] Título:One-stage posterior approaches for treatment of thoracic spinal infection: Transforaminal and costotransversectomy, compared with anterior approach with posterior instrumentation.
[So] Source:Medicine (Baltimore);96(42):e8352, 2017 Oct.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Treating thoracic infective spondylodiscitis with anterior surgical approaches carry a relatively high risk of perioperative and postoperative complications. Posterior approaches have been reported to result in lower complication rates than anterior procedures, but more evidence is needed to demonstrate the safety and efficacy of 1-stage posterior approaches for treating infectious thoracic spondylodiscitis.Preoperative and postoperative clinical data, of 18 patients who underwent 2 types of 1-stage posterior procedures, costotransversectomy and transforaminal thoracic interbody debridement and fusion and 7 patients who underwent anterior debridement and reconstruction with posterior instrumentation, were retrospectively assessed.The clinical outcomes of patients treated with 1-stage posterior approaches were generally good, with good infection control, back pain relief, kyphotic angle correction, and either partial or solid union for fusion status. Furthermore, they achieved shorter surgical time, fewer postoperative complications, and shorter hospital stay than the patients underwent anterior debridement with posterior instrumentation.The results suggested that treating thoracic spondylodiscitis with a single-stage posterior approach might prevent postoperative complications and avoid respiratory problems associated with anterior approaches. Single-stage posterior approaches would be recommended for thoracic spine infection, especially for patients with medical comorbidities.
[Mh] Termos MeSH primário: Infecções do Sistema Nervoso Central/cirurgia
Discite/cirurgia
Procedimentos Cirúrgicos Torácicos/métodos
Vértebras Torácicas/cirurgia
[Mh] Termos MeSH secundário: Desbridamento/métodos
Feminino
Seres Humanos
Tempo de Internação
Masculino
Duração da Cirurgia
Complicações Pós-Operatórias/epidemiologia
Fusão Vertebral/métodos
Procedimentos Cirúrgicos Torácicos/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171122
[Lr] Data última revisão:
171122
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171020
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008352


  3 / 1852 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28650419
[Au] Autor:Fernandes Machado SA; Ferreira Freitas JM; Alegrete da Silva NP; Coutinho Costa Moreira JM; Peixoto Pinto RA; de Melo Costa FG
[Ad] Endereço:From the *Orthopaedic Department, Centro Hospitalar de São João, Porto, Portugal; and †Anatomy Institute and ‡Orthopaedic Department, Oporto University, Porto, Portugal.
[Ti] Título:Spondylodiscitis by Kingella Kingae: An Emerging Pathogen in an Older Pediatric Population.
[So] Source:Pediatr Infect Dis J;36(11):1096-1097, 2017 Nov.
[Is] ISSN:1532-0987
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:In children, greater than 95% of Kingella kingae infections are diagnosed between 6 and 48 months of age. K. kingae has not been systematically investigated, especially in older children. We describe a case of spondylodiscitis by K. kingae in an 8-year-old child.
[Mh] Termos MeSH primário: Discite
Kingella kingae
Infecções por Neisseriaceae
[Mh] Termos MeSH secundário: Antibacterianos/uso terapêutico
Criança
Doenças Transmissíveis Emergentes
Seres Humanos
Masculino
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171024
[Lr] Data última revisão:
171024
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170627
[St] Status:MEDLINE
[do] DOI:10.1097/INF.0000000000001666


  4 / 1852 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28569143
[Au] Autor:Gaschignard J; Geslain G; Mallet C; Lorrot M; Blot N; Alison M; Bonacorsi S
[Ad] Endereço:Service de Pédiatrie Générale, Hôpital Robert-Debré, Paris, France.
[Ti] Título:Spondylodiscitis in a healthy 12-year-old girl with Extraintestinal pathogenic Escherichia coli (ExPEC) bacteraemia.
[So] Source:BMC Infect Dis;17(1):380, 2017 May 31.
[Is] ISSN:1471-2334
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Escherichia coli (E. coli) is rarely implicated in bone or joint infections in children. CASE PRESENTATION: We discuss the case of a healthy 12-year-old girl with an E. coli bacteraemia and a T11-T12 spondylodiscitis revealed by magnetic resonance imaging. The strain harboured serogroup O1:K1 and virulence factors common to highly virulent extra intestinal pathogenic E. coli (ExPEC). Immunological work-up was normal. CONCLUSION: The identification of E. coli in a spondylodiscitis should lead to the search for immunosuppression of the host and virulence factors of the strain, particularly those of ExPEC.
[Mh] Termos MeSH primário: Bacteriemia/microbiologia
Discite/microbiologia
Infecções por Escherichia coli/etiologia
Escherichia coli Extraintestinal Patogênica/patogenicidade
[Mh] Termos MeSH secundário: Animais
Bacteriemia/etiologia
Criança
Discite/diagnóstico por imagem
Proteínas de Escherichia coli/genética
Escherichia coli Extraintestinal Patogênica/genética
Feminino
Seres Humanos
Imagem por Ressonância Magnética
Sorogrupo
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Escherichia coli Proteins)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170602
[St] Status:MEDLINE
[do] DOI:10.1186/s12879-017-2486-6


  5 / 1852 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28559082
[Au] Autor:Foreman SC; Schwaiger BJ; Meyer B; Gersing AS; Zimmer C; Gempt J; Kirschke JS
[Ad] Endereço:Department of Neuroradiology, Technische Universität München, Munich, Germany. Electronic address: Scforeman@hotmail.com.
[Ti] Título:Computed Tomography and Magnetic Resonance Imaging Parameters Associated with Poor Clinical Outcome in Spondylodiscitis.
[So] Source:World Neurosurg;104:919-926.e2, 2017 Aug.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Prognostic factors for the disease course of patients with spondylodiscitis have not been well studied. METHODS: The prognostic value of initial magnetic resonance imaging (MRI) and computed tomography imaging parameters was analyzed in 62 patients (47% women; mean age ± SD, 71.6 ± 9.6 years) with a confirmed diagnosis of spondylodiscitis. The disease course was separately evaluated during initial treatment response during hospitalization, relapse, and clinical short-term follow-up at 3 months. RESULTS: Overall CT findings graded as definitely inflammatory (P = 0.006), reduced disc height on MRI (P = 0.044) and fluid-equivalent hyperintensity of discs on T2 short tau inversion recovery-weighted sequences (P = 0.047) were associated with poor initial treatment response. High initial C-reactive protein value (>10.1 mg/dL) was associated with a higher relapse rate (P = 0.038). Risk factors for poor outcome were infection with low-virulence bacteria (P = 0.040) and overall MRI findings atypical for infection (P = 0.027). CONCLUSIONS: Compared with MRI, CT imaging parameters have a higher prognostic value regarding the disease course. Patients infected with low-virulence bacteria and atypical MRI findings are at higher risk for poor clinical outcome and thus warrant closer monitoring.
[Mh] Termos MeSH primário: Discite/diagnóstico por imagem
Discite/cirurgia
Imagem por Ressonância Magnética
Avaliação de Resultados da Assistência ao Paciente
Tomografia Computadorizada por Raios X
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Antibacterianos/uso terapêutico
Terapia Combinada
Feminino
Seguimentos
Seres Humanos
Interpretação de Imagem Assistida por Computador
Disco Intervertebral/diagnóstico por imagem
Masculino
Meia-Idade
Readmissão do Paciente
Complicações Pós-Operatórias/diagnóstico por imagem
Complicações Pós-Operatórias/cirurgia
Prognóstico
Recidiva
Reoperação
Sensibilidade e Especificidade
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170601
[St] Status:MEDLINE


  6 / 1852 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28402132
[Au] Autor:Crockett MT; Kelly BS; van Baarsel S; Kavanagh EC
[Ad] Endereço:1 Department of Radiology, Mater Misercordiae University Hospital, Eccles St, Dublin D7, Ireland.
[Ti] Título:Modic Type 1 Vertebral Endplate Changes: Injury, Inflammation, or Infection?
[So] Source:AJR Am J Roentgenol;209(1):167-170, 2017 Jul.
[Is] ISSN:1546-3141
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: In the 29 years since the initial description of Modic type 1 vertebral endplate changes there has been ongoing debate regarding their cause. Studies have attributed Modic type 1 vertebral endplate changes to traumatic injury to the vertebral endplate, localized action of proinflammatory mediators, and more recently low-grade bacterial infection. Can we reconcile these conflicting data about the underlying cause of Modic type 1 vertebral endplate changes? Are we now in a position to conclude whether Modic type 1 vertebral endplate changes are secondary to injury, inflammation, or infection? CONCLUSION: We argue that the processes are not disparate but are in fact closely linked, each potentially instigating a chain of events leading to the MRI findings of Modic type 1 vertebral endplate change. A method of delineating which process is predominantly at play in an individual patient is required so that tailored treatment options can be offered with huge potential benefit to individuals and society alike.
[Mh] Termos MeSH primário: Disco Intervertebral/diagnóstico por imagem
Disco Intervertebral/patologia
Dor Lombar/diagnóstico por imagem
Dor Lombar/patologia
Vértebras Lombares/diagnóstico por imagem
Vértebras Lombares/patologia
Imagem por Ressonância Magnética/métodos
[Mh] Termos MeSH secundário: Meios de Contraste
Discite/diagnóstico por imagem
Discite/patologia
Progressão da Doença
Seres Humanos
Inflamação
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Contrast Media)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170801
[Lr] Data última revisão:
170801
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170413
[St] Status:MEDLINE
[do] DOI:10.2214/AJR.16.17403


  7 / 1852 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28401158
[Au] Autor:Yuan Y; Zhou Z; Jiao Y; Li C; Zheng Y; Lin Y; Xiao J; Chen Z; Cao P
[Ad] Endereço:Department of Orthopedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases with Integrated Chinese-Western Medicine, Shanghai Institute of Traumatology and Orthopedics, Ruijin Hospital
[Ti] Título:Histological Identification of in Nonpyogenic Degenerated Intervertebral Discs.
[So] Source:Biomed Res Int;2017:6192935, 2017.
[Is] ISSN:2314-6141
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:. Low-virulence anaerobic bacteria, especially the , have been thought to be a new pathogeny for a series of disc diseases. However, until now, there has been no histological evidence to confirm this link. The purpose of this study was to confirm the presence of in nonpyogenic intervertebral discs via histological observation. . Degenerated intervertebral discs were harvested from 76 patients with low back pain and/or sciatica but without any symptoms of discitis or spondylodiscitis. The samples were cultured under anaerobic conditions and then examined using 16S rDNA PCR to screen for . Samples found to be positive for were stained with hematoxylin-eosin (HE) and modified Brown-Brenn staining and observed under a microscope. . Here, 16 intervertebral discs were found to be positive for via 16S rDNA PCR and the prevalence was 21.05% (16/76). Among them, 7 samples had visible microbes stained with HE and modified Brown-Brenn staining. Morphological examination showed the bacteria to be Gram-positive and rod-shaped, so they were considered . . is capable of colonizing some degenerated intervertebral discs without causing discitis, and its presence could be further confirmed by histological evidence. Targeting these bacteria may be a promising therapy method for some disc diseases.
[Mh] Termos MeSH primário: Bactérias Anaeróbias/isolamento & purificação
Degeneração do Disco Intervertebral/patologia
Disco Intervertebral/microbiologia
Propionibacterium acnes/isolamento & purificação
[Mh] Termos MeSH secundário: Idoso
Bactérias Anaeróbias/patogenicidade
Discite/patologia
Feminino
Seres Humanos
Disco Intervertebral/patologia
Degeneração do Disco Intervertebral/microbiologia
Dor Lombar/microbiologia
Dor Lombar/patologia
Masculino
Meia-Idade
Propionibacterium acnes/patogenicidade
RNA Ribossômico 16S/genética
Ciática/microbiologia
Ciática/patologia
Técnicas de Cultura de Tecidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (RNA, Ribosomal, 16S)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170428
[Lr] Data última revisão:
170428
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170413
[St] Status:MEDLINE
[do] DOI:10.1155/2017/6192935


  8 / 1852 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28389466
[Au] Autor:Miraclin AT; Perumalla SK; Daniel J; Sathyendra S
[Ad] Endereço:Department of General Medicine, Christian Medical College and Hospital, Vellore, India angel_miraclin@yahoo.com.
[Ti] Título: endarteritis with infective spondylodiscitis in an adult patient with patent ductus arteriosus.
[So] Source:BMJ Case Rep;2017, 2017 Apr 07.
[Is] ISSN:1757-790X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Endarteritis is a major complication in patients with patent ductus arteriosus, causing significant morbidity and mortality. We report an adult patient with asymptomatic patent ductus arteriosus and endarteritis involving the main pulmonary artery and secondary infective spondylodiscitis at the L5-S1 intervertebral disc caused by , commonly referred to as nutritionally variant streptococci, cannot be identified easily by conventional blood culture techniques from clinical specimens. Its isolation was confirmed by 16S ribosomal RNA sequencing. The patient was successfully managed with a combination of penicillin G and gentamicin, pending surgical repair of the patent ductus arteriosus.
[Mh] Termos MeSH primário: Abiotrophia/isolamento & purificação
Discite/microbiologia
Endarterite/microbiologia
Infecções por Bactérias Gram-Positivas/diagnóstico
[Mh] Termos MeSH secundário: Abiotrophia/classificação
Abiotrophia/genética
Discite/tratamento farmacológico
Permeabilidade do Canal Arterial/complicações
Endarterite/tratamento farmacológico
Feminino
Infecções por Bactérias Gram-Positivas/tratamento farmacológico
Seres Humanos
Vértebras Lombares/microbiologia
Meia-Idade
Penicilina G/uso terapêutico
Sacro/microbiologia
Análise de Sequência de RNA
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
Q42T66VG0C (Penicillin G)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170606
[Lr] Data última revisão:
170606
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170409
[St] Status:MEDLINE


  9 / 1852 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28359323
[Au] Autor:Liang Y; Tang X; Zhao Y; Wang Z
[Ad] Endereço:Orthopedic Department, The General Hospital of Chinese People's Liberation Army (301 hospital) Beijing, No.28.Fu Xing Rd, Hai Dian District, 100853, Beijing, China.
[Ti] Título:Posterior wedge osteotomy and debridement for Andersson lesion with severe kyphosis in ankylosing spondylitis.
[So] Source:J Orthop Surg Res;12(1):54, 2017 Mar 31.
[Is] ISSN:1749-799X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Andersson lesion is a well-known complication in ankylosing spondylitis. Recently, owing to the worry about the healing of fracture, some scholars advocated additional anterior surgery or other procedures were necessary, which increase the risk of the nerve injury. The purpose of this study is to introduce our experience and to explore the efficacy and feasibility of posterior wedge osteotomy and debridement through Andersson Lesion for surgical treatment of severe kyphosis in ankylosing spondylitis. METHODS: From January 2012 to January 2014, a retrospective study of 14 Andersson lesion patients with severe kyphosis in ankylosing spondylitis treated with surgery was completed with an at least 2-year follow-up. The debridement procedure, before posterior wedge osteotomy in posterior approach, must scrape all sclerosis bone until healthy cancellous bone appears. Radiographic and clinical results and complications were assessed with an average follow-up of 24 months. The CT scan was obtained preoperatively and at the final follow-up to assess the displacement of the fracture preoperatively, the safety of screw insertion, the healing of the fracture at the final follow-up. The Bridwell interbody fusion grading system was used to assess the healing of the fracture. RESULTS: Local kyphosis was substantially corrected from 51.7 ± 15.6 to 7.1 ± 19.5, with a mean correction of 44°. The global kyphosis (GK) changed from 60.6 ± 28.3 to 20.3 ± 10.3 (P = 0.000). The mean VAS back pain scores decreased from 6.7 ± 0.8 preoperatively to 0.75 ± 0.6 after a 2-year follow-up (P = 0.000). The ODI score improved from 60.56 ± 15.1% preoperatively to 23.46 ± 8.2% after a 2-year follow-up (P = 0.000). The CT scan showed solid fusion at the level of the AL, and no internal fixation loose. All patients achieved grade 1 fusion. No major complication occurred. CONCLUSIONS: The posterior wedge osteotomy and debridement through AL can be used to correct the severe kyphosis in ankylosing spondylitis, achieving favorable clinical outcomes, good fusion, and satisfactory deformity correction.
[Mh] Termos MeSH primário: Discite/cirurgia
Cifose/cirurgia
Osteotomia/métodos
Espondilite Anquilosante/cirurgia
[Mh] Termos MeSH secundário: Adulto
Desbridamento/métodos
Discite/diagnóstico por imagem
Discite/etiologia
Estudos de Viabilidade
Feminino
Seguimentos
Seres Humanos
Cifose/diagnóstico por imagem
Cifose/etiologia
Masculino
Radiografia
Estudos Retrospectivos
Espondilite Anquilosante/complicações
Espondilite Anquilosante/diagnóstico por imagem
Tomografia Computadorizada por Raios X
Adulto Jovem
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170612
[Lr] Data última revisão:
170612
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170401
[St] Status:MEDLINE
[do] DOI:10.1186/s13018-017-0556-5


  10 / 1852 MEDLINE  
              first record previous record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28337426
[Au] Autor:Sheikh AF; Khosravi AD; Goodarzi H; Nashibi R; Teimouri A; Motamedfar A; Ranjbar R; Afzalzadeh S; Cyrus M; Hashemzadeh M
[Ad] Endereço:Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical SciencesAhvaz, Iran; Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical SciencesAhvaz, Iran.
[Ti] Título:Pathogen Identification in Suspected Cases of Pyogenic Spondylodiscitis.
[So] Source:Front Cell Infect Microbiol;7:60, 2017.
[Is] ISSN:2235-2988
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:Pyogenic spinal infection continues to represent a worldwide problem. In approximately one-third of patients with pyogenic spondylodiscitis, the infectious agent is never identified. Of the cases that lead to organismal identification, bacteria are more commonly isolated from the spine rather than fungi and parasites. This study applied universal prokaryotic PCR as a rapid diagnostic tool for the detection of bacterial agents in specimens from patients suspected of pyogenic spondylodiscitis. Gram and Ziehl-Neelsen staining were used as a preliminary screening measure for microbiologic evaluation of patient samples. PCR amplification targeting gene was performed on DNA extracted from 57 cases including specimens from epidural abscesses, vertebral, and disc biopsies. Positive samples were directly sequenced. MRI findings demonstrated that disc destruction and inflammation were the major imaging features of suspected pyogenic spondylodiscitis cases, as 44 cases showed such features. The most common site of infection was the lumbar spine (66.7%), followed by thoracic spine (19%), the sacroiliac joint (9.5%), and lumbar-thoracic spine (4.8%) regions. A total of 21 samples amplified the -PCR product. Sanger sequencing of the PCR products identified the following bacteriological agents: ( = 9; 42.9%), ( = 6; 28.5%), ( = 5; 23.8%), and ( = 1; 4.8%). 36 samples displayed no visible PCR signal, which suggested that non-bacterial infectious agents (e.g., fungi) or non-infectious processes (e.g., inflammatory, or neoplastic) may be responsible for some of these cases. The L3-L4 site (23.8%) was the most frequent site of infection. Single disc/vertebral infection were observed in 9 patients (42.85%), while 12 patients (57.15%) had 2 infected adjacent vertebrae. Elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) inflammatory markers were noted in majority of the patients. In conclusion, microbiological methods and MRI findings are vital components for the proper diagnosis of pyogenic spondylodiscitis. Our findings suggest that molecular methods such as clinical application of PCR and sequencing may be useful as adjunctive diagnostic tools for pyogenic spondylodiscitis. The rapid turnaround time of PCR and sequencing submission and results can potentially decrease the time to diagnosis and improve the therapeutic management and outcome of these infections. Although and were the most common causes of pyogenic spinal infections in this study, other infectious agents and non-infectious etiologies should be considered. Based on study results, we advise that antibiotic therapy should be initiated after a definitive etiological diagnosis.
[Mh] Termos MeSH primário: Bactérias/classificação
Bactérias/isolamento & purificação
Infecções Bacterianas/diagnóstico
Técnicas Bacteriológicas/métodos
Discite/diagnóstico
Técnicas de Diagnóstico Molecular/métodos
Reação em Cadeia da Polimerase/métodos
[Mh] Termos MeSH secundário: Bactérias/citologia
Bactérias/genética
Infecções Bacterianas/diagnóstico por imagem
Infecções Bacterianas/microbiologia
Infecções Bacterianas/patologia
DNA Bacteriano/genética
DNA Ribossômico/genética
Discite/diagnóstico por imagem
Discite/microbiologia
Seres Humanos
Imagem por Ressonância Magnética
RNA Ribossômico 16S/genética
Análise de Sequência de DNA
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (DNA, Bacterial); 0 (DNA, Ribosomal); 0 (RNA, Ribosomal, 16S)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170921
[Lr] Data última revisão:
170921
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170325
[St] Status:MEDLINE
[do] DOI:10.3389/fcimb.2017.00060



página 1 de 186 ir para página                         
   


Refinar a pesquisa
  Base de dados : MEDLINE Formulário avançado   

    Pesquisar no campo  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde