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Medicine Oct 2022Fungal empyema is a chronic refractory disease. It is difficult to control thoracic infection, and it is faced with the problem of recurrence. How to control the...
RATIONALE
Fungal empyema is a chronic refractory disease. It is difficult to control thoracic infection, and it is faced with the problem of recurrence. How to control the infection and reduce the probability of recurrence is a difficult problem. Surgical operation combined with endobronchial therapy was used to control infection, seal the fistula and eliminate residual cavity and achieved good results.
PATIENT CONCERNS
A total of 5 patients with fungal empyema were treated from 2019 to 2021, aged 27 to 72 years, with an average age of 54.8 ± 7.6 years. Two cases were on the left side and 3 cases on the right side.
DIAGNOSIS
While meeting the diagnostic criteria of empyema, the diagnosis of fungus in pus culture or the discovery of fungus in deep tissue pathology confirmed the diagnosis of fungal empyema in the 5 cases.
INTERVENTIONS
Through surgical operations combined with bronchoscopy and individualized treatment, the infection was controlled, the fistulas were blocked, and the pus cavity was filled.
OUTCOMES
After 11 to 30 months of follow-up, the muscle flap in the abscess cavity was mildly atrophied, and there was no recurrence of empyema. Three patients who completed the second-stage operation had their chest tubes removed and returned to normal life. The 2 patients who did not complete the second-stage operation had no recurrence of thoracic infection and no recurrence of cough or fever, and their quality of life was greatly improved.
LESSONS
Surgical operation combined with bronchoscopy is a reliable method for the treatment of fungal empyema, which can find and plug the fistula more efficiently and eliminate the residual cavity by surgery to avoid recurrence. Therefore, it is a recommended treatment method.
Topics: Humans; Middle Aged; Bronchoscopy; Quality of Life; Empyema; Chest Tubes; Fistula; Chronic Disease; Empyema, Pleural; Bronchial Fistula
PubMed: 36281178
DOI: 10.1097/MD.0000000000031080 -
Italian Journal of Pediatrics Jan 2024In 2021, the Task Force on Breastfeeding of the Italian Ministry of Health released a document calling for the provision of breastfeeding support in case of...
BACKGROUND
In 2021, the Task Force on Breastfeeding of the Italian Ministry of Health released a document calling for the provision of breastfeeding support in case of re-hospitalization of the child after birth. Since type and quality of breastfeeding support during re-hospitalization in Italian Pediatric Units (PUs) is largely unknown, the Breastfeeding Section of the Italian Society of Pediatrics (TASIP) conducted an ad hoc national survey.
METHODS
In March 2023, a specifically designed electronic questionnaire was sent to the Directors of 328 PUs, who were requested to fill it online.
RESULTS
Data from 161 PUs were received, with a response rate of 48.7%. Our results highlighted that 18.6% of units do not provide training on breastfeeding for healthcare professionals and 46% of PUs lack of an ad hoc policy on breastfeeding support in case of re-hospitalization of the child. Although 88.2% of PUs provide breast pumps to the mothers of the re-hospitalized young children, 34.8% lack of a protocol on the storage of expressed breast milk.
CONCLUSIONS
Breastfeeding support for the mothers of hospitalized breastfed young children appears to be suboptimal in Italian PUs. Interventions aimed to structure and improve the quality of breastfeeding support for the mother-child dyad are needed, particularly developing protocols and providing a training on breastfeeding to the majority of healthcare professionals.
Topics: Female; Pregnancy; Humans; Child; Child, Preschool; Breast Feeding; Italy; Postnatal Care; Surveys and Questionnaires; Suppuration
PubMed: 38191497
DOI: 10.1186/s13052-023-01573-x -
Physiological Research Dec 2023Pressure ulcers (PUs), also known as pressure injuries, are chronic wounds that represent potential lifelong complications. Pressure ulcers of a deep category (III and...
Pressure ulcers (PUs), also known as pressure injuries, are chronic wounds that represent potential lifelong complications. Pressure ulcers of a deep category (III and IV) are often indicated for surgical treatment - debridement and surgical reconstruction. Sharp surgical debridement is widely used in the debridement of PUs; however, the Versajet® hydrosurgery system is becoming an increasingly popular tool for tangential excision in surgery due to its numerous advantages. This work focused on the expression of selected genes, especially those associated with oxidative stress, in PUs debrided by two approaches - sharp surgical debridement and debridement using Versajet® hydrosurgery system. Expression of following genes was evaluated: NFE2L2, ACTA2, NFKB1, VEGFA, MKI67, HMOX1, HMOX2, HIF1A, and SOD2. ACTB and PSMB were used as housekeeping genes. So far, five patients have been enrolled in the study. Preliminary results suggest no significant difference in gene expression with different pressure ulcer treatment approaches except NFE2L2, despite the macroscopic differences. However, the results revealed correlations between the expression of some genes, namely HIF1A and SOD2, VEGFA and SOD2 and VEGFA and HIF1A. These results may indicate a connection between hypoxia, oxidative stress, pressure ulcer healing processes and angiogenesis.
Topics: Humans; Wound Healing; Debridement; Pressure Ulcer; Pilot Projects; Treatment Outcome; Gene Expression; Suppuration
PubMed: 38165757
DOI: 10.33549/physiolres.935222 -
Arthritis Research & Therapy 2011
Topics: Body Fluids; Extracellular Space; Humans; Intracellular Space; Neutrophils; Suppuration
PubMed: 22029909
DOI: 10.1186/ar3477 -
Annals of Surgery Jun 1993This study determines whether there are any differences in several immunologic parameters in circulating peripheral blood leukocytes, serum, and plasma compared with pus...
OBJECTIVE
This study determines whether there are any differences in several immunologic parameters in circulating peripheral blood leukocytes, serum, and plasma compared with pus leukocytes, and supernatant of various types of abscess.
SUMMARY BACKGROUND DATA
Although there have been reports of high lysozyme levels and low complement levels within pus, there has been no systemic comparison of concentrations of these substances and others within pus compared with those within peripheral blood.
METHODS
Peripheral blood and abscess pus were collected from 31 patients with abscesses and percent and mean channel of monocytes expressing complement receptor and major histocompatibility antigen HLA-DR, the percent and mean channel of polymorphonuclear leukocytes (PMN) expressing complement receptor, lysozyme level, and levels of total hemolytic complement, iC3b, C5b-9, and immunoglobulins were measured within both pus and peripheral blood.
RESULTS
Percent of monocytes expressing HLA-DR and percent of monocytes and PMN expressing complement receptor, total hemolytic complement, and IgM were reduced within pus compared with peripheral blood, whereas the mean channel of monocytes expressing HLA-DR and the mean channel of PMNs expressing CR3, C5b-9, and lysozyme were increased in pus.
CONCLUSIONS
There are marked differences in immunologic parameters measured within pus of abscesses versus that seen in peripheral blood.
Topics: Abdomen; Abscess; Complement C3b; Complement Hemolytic Activity Assay; Complement Membrane Attack Complex; Drainage; Empyema, Pleural; HLA-DR Antigens; Humans; Immunoglobulin M; Leukocytes; Macrophage-1 Antigen; Muramidase; Prospective Studies; Superoxides; Suppuration
PubMed: 8389537
DOI: 10.1097/00000658-199306000-00004 -
Sensors (Basel, Switzerland) Sep 2022The rapid growth in wireless communications, coupled with insufficient utilization of the spectrum, led to the development of new wireless services and the promising...
The rapid growth in wireless communications, coupled with insufficient utilization of the spectrum, led to the development of new wireless services and the promising technology of cognitive radio (CR) networks, which facilitate periodic access to the unoccupied spectrum bands and thus increases spectral efficiency. A fundamental task in CR networks is spectrum sensing, through which unauthorized secondary users (SUs) detect unoccupied bands in the spectrum. To achieve this, an accurate estimate of the power spectrum is necessary. From this perspective, and given that many other factors can affect individual detection, such as pathloss and receiver uncertainty, we aim to improve its estimate by exploiting the spatial diversity in the SUs' observations. Spectrum sensing is treated as a parameters estimation problem, assuming that the parameters' vector of each SU consists of some global and partially common parameters. To exploit this modeling, distributed and cooperative spectrum sensing is the subject of interest in this study. Diffusion techniques, and especially the Adapt-Then-Combine (ATC) method will be exploited, where each SU cooperates with a group of nodes in its neighborhood that share the same parameters of interest. We consider a network of three static PUs with overlapping power spectrums, and thus, frequency bands. The performance of the employed method will be evaluated under two scenarios: (i) when the PUs spectrum varies, since some frequency bands are not yet utilized, and (ii) when the frequency bands of the PUs are fixed, but there is a mobile SU in the network, changing regions and parameters of interest. Experimental results and performance analysis reveal the ATC algorithm robustness and efficiency.
Topics: Algorithms; Cognition; Computer Communication Networks; Humans; Suppuration; Wireless Technology
PubMed: 36081150
DOI: 10.3390/s22176692 -
Revista Portuguesa de Pneumologia 2009Complicated parapneumonic effusion is one in which an invasive procedure is necessary for its resolution and empyema means pus in the pleural space. An early diagnosis... (Review)
Review
Complicated parapneumonic effusion is one in which an invasive procedure is necessary for its resolution and empyema means pus in the pleural space. An early diagnosis and therapy of these conditions results in less morbidity and mortality. CT of the chest is important to study complex pleural effusions. Loculated effusions, those occupying more than 50% of the thorax, or which show positive Gram stain or bacterial culture, or a purulent effusion with a pH below 7.20, with a glucose level below 60 mg/dl or a LDH level more than three times the upper limit of normal for serum, are indications for an invasive procedure. These characteristics result from the evolution of a not well treated parapneumonic effusion, through the three stages: (1) exsudative; (2) fibrinopurulent; (3) fibrotic. Depending on the stage therapeutic methods vary from therapeutic thoracentesis, insertion of a chest tube with or without instillation of fibrinolytics, video-assisted thoracoscopic surgery, and lung decortication. A review of all these aspects are done based on a series of three cases reports with very different clinical presentation: one patient with empyema by Streptococcus pyogenes and that died rapidly due to massive hemoptysis; a patient with empyema due to acute pneumonia developing during an airflight; a patient with empyema and bacteraemia by Streptococcus pneumonia leading to the diagnosis of an unknown HIV infection.
Topics: Adult; Empyema, Pleural; Female; Humans; Male; Middle Aged
PubMed: 19401798
DOI: No ID Found -
Revista Do Instituto de Medicina... 2022A 35-year-old immunocompetent woman from southern China went to the hand surgery clinic with a six-month history of progressive swelling in her right index finger. She...
A 35-year-old immunocompetent woman from southern China went to the hand surgery clinic with a six-month history of progressive swelling in her right index finger. She had been pinched by a lobster and had received several treatments without any improvement. Pus specimens were taken from the swollen parts of her finger, and the pathology showed granulomatous inflammation. Ziehl-Neelsen staining revealed positive bacillus in the pus specimens. The bacteria grew well on Columbia blood agar. However, the MALDI-TOF MS and 16S rRNA gene sequencing were not able to distinguish between Mycobacterium marinum and Mycobacterium ulcerans because of their close genetic relationship. Photochromogenicity testing can help differentiate between these species based on the alteration in colony color after light exposure. For our patient, the colonies turned yellow after 18h of incubation in the sun, identifying the species as M. marinum. Besides surgical drainage, the patient received rifampicin and clarithromycin for three months, and her symptoms resolved without relapse after six months of follow-up.
Topics: Humans; Female; Adult; RNA, Ribosomal, 16S; Mycobacterium Infections, Nontuberculous; Mycobacterium marinum; Suppuration
PubMed: 36383898
DOI: 10.1590/S1678-9946202264076 -
Medicine Apr 2023Descending necrotizing mediastinitis (DNM) is a rare but severe mediastinal infection. If not diagnosed and treated promptly, the consequences can be very serious. Here,... (Review)
Review
RATIONALE
Descending necrotizing mediastinitis (DNM) is a rare but severe mediastinal infection. If not diagnosed and treated promptly, the consequences can be very serious. Here, we shared a successful diagnosis and treatment case of DNM that originates from oral to neck and mediastinum caused by Streptococcus constellatus (S constellatus). S constellatus is a clinically uncommon gram-positive coccus and is known for its ability to form abscesses. Timely surgical drainage and the correct use of antibiotics are key to successful treatment.
PATIENT CONCERNS
A 53-year-old male admitted to hospital with painful swelling of the right cheek, persistent oral pus and moderate fever lasting 1 week, followed by rapid development of a mediastinal abscess.
DIAGNOSES
He was diagnosed with DNM caused by S constellatus.
INTERVENTIONS
On the evening of admission, an emergency tracheotomy and thoracoscopic exploration and drainage of the right mediastinum, floor of the mouth, parapharynx and neck abscess were performed. Antibiotics were administered immediately.
OUTCOMES
At 28 days post-operatively, the abscess was absorbed, bilateral lung exudate decreased and the patient temperature, aspartate transaminase, alanine transaminase, bilirubin and platelets returned to normal. The patient was discharged after completing 4 weeks of antibiotic therapy. Follow-up at 3 months after discharge revealed no recurrence of the abscess.
LESSONS
Early surgical drainage and antibiotics treatment are important in mediastinal abscesses and infectious shock due to Streptococcus asteroids.
Topics: Male; Humans; Middle Aged; Mediastinitis; Abscess; Streptococcus constellatus; Mediastinum; Mediastinal Diseases; Drainage; Anti-Bacterial Agents; Necrosis
PubMed: 37026905
DOI: 10.1097/MD.0000000000033458 -
The Journal of Veterinary Medical... Sep 2022A 5-month-old intact female mixed cat presented with repetitive paraplegia and drainage of pus from the back despite continuous antibiotic medication. Neurologic...
A 5-month-old intact female mixed cat presented with repetitive paraplegia and drainage of pus from the back despite continuous antibiotic medication. Neurologic examination was consistent with below T3-L3 myelopathy. Computed tomography and magnetic resonance imaging revealed a contrast-enhanced mass in the L1-3 spinal canal, and bone fragments in the T13 and L1 spinal canal. Spinal epidural empyema was suspected, and hemilaminectomy was performed for T12-L2 on the right side and T11-12 on the left side. Bone fragments were diagnosed as sequestrum infected with Bacteroides sp. The cat recovered enough to ambulate next day. One month after surgery, there was no deficit in neurological function. This is the first report of spinal epidural empyema concurrent with sequestrum in a cat.
Topics: Animals; Anti-Bacterial Agents; Cat Diseases; Cats; Empyema; Epidural Abscess; Female; Laminectomy; Magnetic Resonance Imaging; Spinal Canal
PubMed: 35989304
DOI: 10.1292/jvms.22-0264