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RoFo : Fortschritte Auf Dem Gebiete Der... Apr 2023Hematogenous osteomyelitis has increased over the past quarter century in frequency, virulence, and degree of soft-tissue involvement, bringing about changes in clinical... (Review)
Review
BACKGROUND
Hematogenous osteomyelitis has increased over the past quarter century in frequency, virulence, and degree of soft-tissue involvement, bringing about changes in clinical manifestations and management of the disease especially in children that should be reflected in the current imaging approach. Likewise, the global disease burden of diabetes has increased greatly in the same period, compounding the problem of ascertaining osteomyelitis in diabetic foot.
METHOD
This article provides an updated overview of imaging findings in hematogenous and contiguous osteomyelitis based on the literature and our institutional experience, along with salient features of recent recommendations from expert groups on the diagnostic algorithms and reporting terminology.
RESULTS AND CONCLUSION
Findings on radiography and especially magnetic resonance imaging (MRI) closely reflect pathophysiology in osteomyelitis, whereby the characteristic involvement of the metaphysis or metaphyseal-equivalents, the formation and subperiosteal extension of intramedullary pus collection, and the development of cloaca, sequestrum, and involucrum are all diagnostic clues. Non-enhancing foci within the medullary bone, the penumbra sign, intra- or extramedullary fat globules, and surrounding soft tissue inflammation or abscesses are among key MRI findings. Diabetic foot is a special condition with characteristic pathophysiologic and imaging features that suggest the likelihood of osteomyelitis and the main differential diagnostic consideration of acute on chronic neuropathic osteoarthropathy with or without osteomyelitis.
KEY POINTS
· Imaging closely reflects pathophysiology in hematogenous osteomyelitis.. · Acute hematogenous osteomyelitis predominantly involves metaphyses and metaphyseal equivalent sites.. · MRI clues for hematogenous osteomyelitis include central marrow non-enhancement, intra- or extramedullary fat globules, and the "penumbra" sign.. · An increased fluid-sensitive MRI bone signal abutting a soft tissue ulcer, abscess, or sinus tract suggests a high probability of contact osteomyelitis..
CITATION FORMAT
· Aydingoz U, Imaging Osteomyelitis: An Update. Fortschr Röntgenstr 2023; 195: 297 - 308.
Topics: Child; Humans; Diabetic Foot; Osteomyelitis; Bone Marrow; Magnetic Resonance Imaging; Radiography
PubMed: 36724804
DOI: 10.1055/a-1949-7641 -
Korean Journal of Ophthalmology : KJO Aug 2017Endophthalmitis is a rare but severe form of ocular inflammation due to infection of the intraocular cavity that can lead to irreversible visual loss if not treated... (Review)
Review
Endophthalmitis is a rare but severe form of ocular inflammation due to infection of the intraocular cavity that can lead to irreversible visual loss if not treated properly and timely. It can be classified as exogenous or endogenous based on the transmission route of the infectious source. Exogenous endophthalmitis occurs when infecting organisms gain entry into the eye via direct inoculation, while endogenous endophthalmitis occurs when infectious agents hematogenously spread into the eye from a distant focus of infection. The diagnosis of endophthalmitis depends mostly on the clinical findings on ophthalmological examination. Delayed diagnosis of endogenous endophthalmitis can lead to not only visual loss, but also increased risk of mortality. Since ocular and systemic symptoms of endophthalmitis are usually non-specific, early diagnosis relies on the alertness of clinicians. Early diagnosis and proper treatment are keys to saving the eye. Following advances in vitreoretinal pharmacotherapy and surgical technology, early surgical intervention is the current trend in the management of endophthalmitis.
Topics: Anti-Infective Agents; Endophthalmitis; Eye Infections; Global Health; Humans; Incidence
PubMed: 28752698
DOI: 10.3341/kjo.2017.0036 -
Gut Apr 2023Haematogenous dissemination is a prevalent route of colorectal cancer (CRC) metastasis. However, as the gatekeeper of vessels, the role of tumour pericytes (TPCs) in...
OBJECTIVE
Haematogenous dissemination is a prevalent route of colorectal cancer (CRC) metastasis. However, as the gatekeeper of vessels, the role of tumour pericytes (TPCs) in haematogenous metastasis remains largely unknown. Here, we aimed to investigate the heterogeneity of TPCs and their effects on CRC metastasis.
DESIGN
TPCs were isolated from patients with CRC with or without liver metastases and analysed by single-cell RNA sequencing (scRNA-seq). Clinical CRC specimens were collected to analyse the association between the molecular profiling of TPCs and CRC metastasis. RNA-sequencing, chromatin immunoprecipitation-sequencing and bisulfite-sequencing were performed to investigate the TCF21-regulated genes and mechanisms underlying integrin α5 on DNA hypermethylation. Pericyte-conditional -knockout mice were constructed to investigate the effects of TCF21 in TPCs on CRC metastasis. Masson staining, atomic force microscopy, second-harmonic generation and two-photon fluorescence microscopy were employed to observe perivascular extracellular matrix (ECM) remodelling.
RESULTS
Thirteen TPC subpopulations were identified by scRNA-seq. A novel subset of TCF21 TPCs, termed 'matrix-pericytes', was associated with liver metastasis in patients with CRC. TCF21 in TPCs increased perivascular ECM stiffness, collagen rearrangement and basement membrane degradation, establishing a perivascular metastatic microenvironment to instigate colorectal cancer liver metastasis (CRCLM). depletion in TPCs mitigated perivascular ECM remodelling and CRCLM, whereas the coinjection of TCF21 TPCs and CRC cells markedly promoted CRCLM. Mechanistically, loss of integrin α5 inhibited the FAK/PI3K/AKT/DNMT1 axis to impair DNA hypermethylation in TCF21 TPCs.
CONCLUSION
This study uncovers a previously unidentified role of TPCs in haematogenous metastasis and provides a potential diagnostic marker and therapeutic target for CRC metastasis.
Topics: Animals; Mice; Cell Line, Tumor; Colorectal Neoplasms; DNA; Gene Expression Regulation, Neoplastic; Integrin alpha5; Liver Neoplasms; Neoplasm Metastasis; Pericytes; Phosphatidylinositol 3-Kinases; Tumor Microenvironment
PubMed: 36805487
DOI: 10.1136/gutjnl-2022-327913 -
Microbiology Spectrum Dec 2016Tuberculous otitis media and mastoiditis, or tuberculous otomastoiditis, is a rare but well-described infectious process occasionally affecting individuals in the United... (Review)
Review
Tuberculous otitis media and mastoiditis, or tuberculous otomastoiditis, is a rare but well-described infectious process occasionally affecting individuals in the United States but more frequently seen in countries where tuberculosis is endemic. Infection may be primary and occur through mucus aspirated through the Eustachian tube. Alternatively, organisms may secondarily infect the nasopharynx when expectorated from the lungs and, less frequently, may be hematogenously spread. Chronic otorrhea and hearing loss are common symptoms, and extensive perforation of the tympanic membranes and facial nerve paralysis are routinely described. Diagnosis is made by direct culture of Mycobacterium tuberculosis, although more recently, molecular techniques have been used. Successful treatment of tuberculous otomastoiditis routinely involves surgical intervention combined with prolonged antituberculosis therapy.
Topics: Antitubercular Agents; Global Health; Humans; Mastoiditis; Mycobacterium tuberculosis; Otitis Media; Surgical Procedures, Operative; Tuberculosis
PubMed: 28084203
DOI: 10.1128/microbiolspec.TNMI7-0020-2016 -
Frontiers in Public Health 2020The microbiome of the female genital tract may undergo changes in pregnancy due to metabolic, endocrinological, and immunological alterations. These dysbiotic states may... (Review)
Review
The microbiome of the female genital tract may undergo changes in pregnancy due to metabolic, endocrinological, and immunological alterations. These dysbiotic states may cause infections which may ascend upwards to the feto-placental unit or may be seeded hematogenously. These low grade and often low virulent infectious states lead to chronic inflammatory states and maybe associated with adverse maternal and neonatal outcome. Organisms have been isolated from amniotic fluid and placentae from women delivering pre-term; however the possibility of contamination cannot be conclusively ruled out. Common vaginal dysbiotic states often cause symptoms that are overlooked and often untreated. Vulvovaginal Candidiasis (VVC), Bacterial Vaginosis (BV), and Trichomonas Vaginitis (TV) are the commonly occurring dysbiotic states leading to vaginal infective states in pregnancy. With the advent of novel technologies like Next Generation sequencing (NGS), it will soon be possible to comprehensively map the vaginal microbiome and assess the interplay of each microbial state with their effects in pregnancy. This may open new avenues for antibiotic recommendations, probiotics and potential alternate therapies for dysbiotic states leading to pregnancy complications.
Topics: Candidiasis, Vulvovaginal; Dysbiosis; Female; Humans; Pregnancy; Pregnancy Complications, Infectious; Prevalence; Trichomonas Vaginitis; Vaginosis, Bacterial
PubMed: 32612969
DOI: 10.3389/fpubh.2020.00225