PREVALENCE AND RISK FACTORS OF EXTENDED SPECTRUM BETA LACTAMASE ORGANISMS IN COMMUNITY-ACQUIRED URINARY TRACT INFECTIONS IN LEBANON: A CASE CONTROL STUDYWritten by Elie El-Hajj et al.
In Lebanon, clinical information about community-acquired urinary tract infections (CAUTI) caused by extended-spectrum beta-lactamase (ESBL)-producing Gram negative bacteria (GNB), is scarce. A population based case-control study was conductedwhereby42 cases were matched to 42 controls. The prevalence of ESBL producing strains was 14.15%. Univariate analysis showed two statistically significant independent risk factors for ESBL producing strains: antibiotic use during the last three months (p<0.0001), and urinary catheterization during the last six months (p=0.0034); and one protective factor: age group 18-50 years (p=0.011). Multivariate analysis showed antibiotic use as the strongest predictor for CAUTI due to ESBL-producing GNB. Coresistance of ESBL producing strains to antibiotics was significantly higher compared with non ESBL strains: ciprofloxacin (75% vs 21.4%), trimethropin-sulfamethoxazole (71.1% vs 35.7%) and amoxicillin-clavulanate (77.7% vs 9.5%).This study confirms that ESBL-producing GNB strains constitute a notable cause of CAUTI in Lebanon. These results can be used to guide appropriate treatment of CAUTI and targeted infection control measures
Introduction. This study aimed to analyze the influence of Platelet-Rich Plasma (PRP) on bone growth in experimental instrumented interbody spinal fusion (IISF).
Methods. 16 adult sheep underwent IISF at L3–L4 level using a cylindrical threaded expanding titanium cage with morselized iliac crest cancellous autograft. In 8 animals (Group I) this was augmented with PRP, in the remaining 8 (Group II), it was not. Ra-diographs of the spine were taken preoperatively and at 1, 3, and 6 months, moreover autoptic vertebral samples were obtained and evaluated histologically and by CT scan at 8 months.
Results. Histological analysis revealed more evident new bone formation with bony bridge into the cages in Group I than Group II. There were relevant differences be-tween the groups with regard to interbody fusion calculated using trabecular bone score (p<0.05).
DISCRIMINATING DIABETIC PTs OF SOME RURAL & URBAN AREAS OF BANGLADESH:DISCRIMINANT ANALYSIS APPROACHWritten by Jannatul Fardus et al.
The present analysis was conducted in the American International University of Bang-ladesh using the data collected from 900 respondents. Among the respondents 70.6 percent are diabetic patients. Finding reveals that the largest percentage of patients is of the age group ≥ 50+ years. About 34 percent patients are suffering from Type II diabetes and among them 63.3 percent are in the age group ≥50+ years. Higher prevalence rates of diabetes are observed among farmers and retired persons. The diabetic patients are discriminated from non-diabetic respondents due to the variables age, residence and work type. Most important variables for discriminating diabetic pa-tients are age, education and work-type.
The tumour of Warthin (WT) is the second parotid tumour for frequency after the pleomorphic adenoma, it represents about 2% to 15% of all parotid tumors. The pathogenesis of familial Warthin Tumour is unknown, even if cytogenetic abnormali-ties have been identified in Warthin Tumour. Among the inducing factors there is the smoke which has an important role. Familial occurrence of Warthin Tumour is rare, only five reports in the literature. Two of them were reported in brothers, two in a mother and son and one in monozygotic twins. We quote a case of familiar Warthin Tumour arisen in two brothers and we present a review of the Literature.
Nutraceuticals constitute a group of functional foods that provide added health bene-fits for various disorders including inflammatory bowel disease (IBD) and colorectal cancer (CRC). The main groups of nutraceuticals include probiotics, prebiotics, omega 3 and antioxidants. Studies on Nutraceutical showed that this type of food possessed similar proprieties to drugs but with the benefit of not having side effects.
This mini review shows that probiotics and prebiotics, when administered simultane-ously with traditional therapies, reduce IBD symptoms and reduce synthesis of en-zymes probably involved in colorectal carcinogenesis. Moreover, Omega 3 reduces the synthesis of inflammation mediators and prevents carcinogenesis through interaction with the signaling pathway NOTCH1/MMP9. Moreover, antioxidants reduce the inflam-matory process by inhibiting the synthesis of inflammatory mediators, and inhibit the mechanisms of cell proliferation by inducing apoptosis.
In brief, nutraceuticals have gained a huge clinical interest since they could be used along with traditional therapy. Bioavailability studies of nutraceutical supplements guarantee a correct intake of the substance by oral administration, a matter which would not have been possible to have entirely with the consumption of regular food only.
Prune Belly Syndrome (PBS) is a rare congenital syndrome characterized by three main features: abdominal wall flaccidity, bilateral intra-abdominal cryptorchidism, and urologic abnormalities.
In this study we describe the case of a 2,600 gr baby, born at the Central Hospital of Beira, Mozambique.
Our study confirms that in a low-income country only conservative management can be delivered, and therefore prognosis is worse and less effective than high-income countries.
The intestinal inflammatory bowel disease (IBD) are a group of inflammatory patholo-gies of the digestive line with chronicity and recurrent characteristics. The IBDs mostly recognized are the ulcerative colitis and Crohn’s disease; they are more frequent in the industrialized countries and among the caucasian populations that among those africans or oriental. The secondary artropaties to IBD recognize a multifactorial gene-sis in subjects predisposed as a result genetically of environmental factors; a funda-mental role of the intestinal dysbiosis they are hypothesized.
A 16-year-old girl had been undergoing intensive chemotherapy (ALL 2009) for Early T -cell precursor acute lymphoblastic leukemia (ETP). At 22:00 of the 26th day of induc-tion phase IA, she was found to have developed febrile neutropenia. After blood cul-tures were obtained, empirical therapy with ceftriaxone and amikacin was initiated, according to internal protocol. Clinical condition improved and she remained afebrile for 24 hours. The following day, at 04:00, she suddenly developed a cough with hemoptysis. At this time, fibrinogen was 167 mg/dL, and platelets 35000/uL. A chest X-ray showed thickening in the middle of the right lower zone, and a chest CT scan showed a nodule with central hypodense area (necrotic-colliquative evolution of the infiltrate). In spite of supplementation with platelets, red blood cells, plasma, fibrino-gen, antithrombin, and activated factor VII, the patient's clinical condition worsened rapidly and the pulmonary hemorrhage became uncontrollable. She died at 12:00. Blood cultures yielded a strain of Pseudomonas aeruginosa, with reduced sensitivity to antibiotics.
Aspergillosis is the most frequent infectious cause of massive pulmonary hemorrhage in pediatric leukemias, while bacterial pneumonia or TBC are by far less frequent. As-pergillus requires the presence of neutrophils to cause hemoptysis or cavitation, while bacteria (Gram-positive or -negative) can cause pulmonary necrosis also in patients with neutropenia.
According to current literature, sentinel lymph node identification technique is a sim-ple procedure that allows predicting the location of the axillary lymph nodes without under-staging neoplastic disease.
In clinical practice, the radio-guided surgery has been spreading also to diagnose the occult malignancy, giving space to the nuclear method for those injuries that, with a lot of difficulties for all the team's specialists, were detected using a guide-wire.
Currently the Radio-guided Occult Lesion Localization (ROLL) has become the choice procedure for all small lesions. Therefore, dedicated centers for study and treatment of breast disease use ROLL and Sentinel Node and Occult Lesion Localization (SNOLL) to resolve in a single surgery both breast disease and axillary nodal spread.
For this reason, the authors intend to prove, through this work, the idea that this method should be applied routinely in the current clinical practice of all operative units
The high incidence of HIV, especially in sub-Saharan African countries, and the in-crease of life expectancy due to effectiveness antiretroviral therapies, have led to an increase of patients undergoing surgery interventions. To date there is still no defini-tive data on role, outcome and management of HIV positive surgical subjects. This paper reviews the more recent literature about HIV infection, highlighting the main pathologies treated by thoracic, abdominal and orthopedic surgery, without forgetting about other surgery branches. Particular attention was paid to Mozambique, a devel-oping country with one of the highest levels of HIV incidence.
This is a retrospective cohort study with the aim of evaluating fluconazole efficacy in preventing invasive fungal infections in very low birth weight newborns, in our NICU setting. Neonates weighing less than 1500g at birth, born between January 2013 and Decem-ber 2014, were enrolled in the study. The primary aim was to assess the prevalence of fungal infections. The secondary aim was to identify newborns with a higher risk of invasive fungal infections as well as the incidence of complications after invasive fungal infection. 59 newborns were included in the study. Routine fluconazole prophylaxis at the dose of 3mg/kg i.v. every 72 hours was administered to 47/59 (79,7%). The overall pro-portion of invasive fungal infections was 17%, with no significant difference between neonates who underwent fluconazole prophylaxis (19,1%) and those who did not (8,3%) (p = 0,4). Candida parapsilosis was the most common isolated strain (90%). Lower gestational age, lower birth weight, surgery interventions and delayed initiation of enteral feeding were associated with invasive fungal infections. All septic newborns developed complications: bronchopulmonary dysplasia, retinopa-thy of prematurity and periventricular leukomalacia. None died due to Candida infec-tion. Our findings do not appear to support routine fluconazole prophylaxis in very-low-birth-weight infants.
THE MANAGEMENT OF PIN-CARE IN EXTERNAL FIXATION TECHNIQUE: POVIDONEIODINE VERSUS SODIUM HYPOCHLORITE 0,05% (AMUKINA-MED®) MEDICATIONS.Written by Michele Bisaccia et al.
Purpose: Currently, there is no universal approach to pin-site care for preventing infection. The medication of these pins is essential for obtaining good external fixation results. The purpose of this study is to evaluate the results obtained after pins were medicated with two different disinfectants: povidone-iodine (10%) and sodium hypochlorite 0,05% (Amukina-med®).
Methods: 237 pins of 40 patients treated with Hoffmann II external fixation have been analyzed in our study. The average age was 41.3 (ranging from 19-71). All pins were inserted by hand pre-drilling together with continuous irrigation with cold saline to reduce the risk of thermal necrosis. Patients were divided into 2 groups consisting of 20 patients each: in group A, 109 pins were medicated with povidone-iodine and in group B, 128 pins were medicated with sodium hypochlorite 0,05%.
Results: 24 pins (22%) medicated with povidone-iodine became infected, as well as 13 pins (10,1%) medicated with sodium hypochlorite. A few pins mobilized: 13 in group A and 6 in group B. In all cases, infections were resolved with oral antibiotic therapy.
Conclusions: Our study showed that medication with sodium hypochlorite 0,05% reduced the per-centage of pin-tract infection and mobilization with respect to povidone-iodine, dem-onstrated by significant statistical evidence (Chi-square's test: p<0.05).
Historically, only the energy storage function had been attributed to adipose tissue. However, recent studies have shown that it is also able to secrete several substances which act in a paracrine or endocrine manner, contributing to the maintenance of or-ganism’s homeostasis. It has been reported that the visceral fat has distinctive secret-ing characteristics. Based on previous scientific observations, here we shall describe the possible functional role of epiploic appendages. The epiploic appendages may play an important role in the metabolic regulation and/or in immune defense through the secretion of specific factors, such as leptin and some inflammatory cytokines. Leptin has been seen to be involved both in the regulation of hunger signals, in coordination with the hypothalamus, and in complex immune defense processes. The exact under-standing of the behavior of this hormone could play a key role in understanding the functions ascribed to the epiploic appendages.
Introduction: Thoracic splenosis is an acquired rare condition, resulting from het-erotopic autotransplantation of splenic parenchyma into chest, usually after traumatic spleen and diaphragm rupture. Methods and Results: This paper describes the thoracic splenosis, as an incidental di-agnosis and asymptomatic condition, 34 years after a thoracoabdominal trauma in a patient who underwent radiological investigations due to a 15 kg weight loss in the previous four months: the only abnormalities found were thoraco-parapericardial and abdominal nodules of splenosis. Discussion: Thoracic splenosis is a rare condition, usually following a thoracoabdomi-nal trauma with concomitant lesions of the spleen and diaphragm, which allow tho-racic implantation of splenic tissue. Patients are generally asymptomatic, and the con-dition is discovered incidentally during radiological investigations, which allow certain diagnosis without using invasive methods. Excision of splenosis should be considered for symptomatic patients or unconfirmed diagnosis. Conclusions: Thoracic splenosis is a rare condition. Imaging investigations allow to diagnose the condition, and excision of splenosis is not suggested for asymptomatic patients