RESUMO
Bone homeostasis in physiology depends on the balance between bone formation and resorption, and in pathology, this homeostasis is susceptible to disruption by different influences, especially under ageing condition. Gut microbiota has been recognized as a crucial factor in regulating host health. Numerous studies have demonstrated a significant association between gut microbiota and bone metabolism through host-microbiota crosstalk, and gut microbiota is even an important factor in the pathogenesis of bone metabolism-related diseases that cannot be ignored. This review explores the interplay between gut microbiota and bone metabolism, focusing on the roles of gut microbiota in bone ageing and aging-related bone diseases, including osteoporosis, fragility fracture repair, osteoarthritis, and spinal degeneration from different perspectives. The impact of gut microbiota on bone metabolism during aging through modification of endocrinology system, immune system and gut microbiota metabolites are summarized, facilitating a better grasp of the pathogenesis of aging-related bone metabolic diseases. This review offers innovative insights into targeting the gut microbiota for the treatment of bone ageing-related diseases as a clinical therapeutic strategy.
Assuntos
Envelhecimento , Doenças Ósseas , Osso e Ossos , Microbioma Gastrointestinal , Humanos , Envelhecimento/metabolismo , Envelhecimento/fisiologia , Microbioma Gastrointestinal/fisiologia , Osso e Ossos/metabolismo , Osso e Ossos/microbiologia , Doenças Ósseas/microbiologia , Doenças Ósseas/metabolismo , Animais , Osteoporose/metabolismo , Osteoporose/microbiologiaRESUMO
Periodontitis is an inflammatory disease induced by local infection in tooth-supporting tissue. Periodontitis is associated with systemic bone diseases, but little is known about the mechanism of the causal effect of periodontitis on systemic bone resorption. Bacteria-derived extracellular vesicles (EVs) act as natural carriers of virulence factors that are responsible for systemic inflammation. In this study, we investigated the role of EVs derived from Filifactor alocis, a Gram-positive, anaerobic periodontal pathogen, in systemic bone loss and osteoclast differentiation. F. alocis EVs accumulated in the long bones of mice after intraperitoneal administration. These EVs induced proinflammatory cytokines, osteoclastogenesis, and bone resorption via Toll-like receptor 2 (TLR2). The phase separation of F. alocis EVs showed that amphiphilic molecules were responsible for the induced bone resorption and osteoclastogenesis. The osteoclastogenic effects of F. alocis EVs were reduced by lipoprotein lipase. Proteomic analysis of the amphiphilic molecules identified seven lipoproteins. Our results indicate that lipoprotein-like molecules in F. alocis EVs may contribute to systemic bone loss via TLR2.
Assuntos
Doenças Ósseas/microbiologia , Vesículas Extracelulares/metabolismo , Periodontite/microbiologia , Receptor 2 Toll-Like/metabolismo , Animais , Clostridiales , Humanos , CamundongosRESUMO
OBJECTIVES: An important clindamycin-rifampicin pharmacokinetic (PK) interaction has been reported, but the potential influence of the clindamycin administration route on that interaction is unknown. This prospective, observational, comparative PK study was undertaken to characterize and analyse the impact of the route, comparing the rifampicin enzyme-inductor effects on clindamycin clearance (CLclin) for oral versus intravenous (IV) administration. METHODS: Patients with bone-and-joint infections (BJIs) were treated with clindamycin monotherapy (n = 20) or clindamycin-rifampicin combination therapy (n = 19). Patients received continuous IV clindamycin infusion for 2-6 weeks, followed by an oral regimen. Liquid chromatography-mass spectrometry was used to measure plasma clindamycin concentrations at the end of IV and after 2 weeks of oral treatment. The ratios of the mean CLclin for the combination and monotherapy groups were calculated for IV (Riv) and oral (Rpo) routes, with the final ratio, Rf = Rpo/Riv, representing the fold change of the rifampicin-inducing effect from the IV to the oral route. RESULTS: Comparing monotherapy with combination-therapy groups, the former's median steady-state concentration was two-fold higher after IV administration (8.49 versus 3.82 mg/L, p < 0.001) and its median AUC0-8h was 12 times higher after oral intake (37.7 versus 3.1 mg.h/L, p < 0.001). Riv, Rpo and Rf were 2.68, 18.8 and 7.0 respectively. CONCLUSION: The magnitude of this interaction was markedly increased by oral intake, questioning the use of oral treatment for difficult-to-treat infections like BJIs. Nevertheless, the clindamycin-rifampicin combination seems possible provided that clindamycin is administered by continuous IV infusion.
Assuntos
Clindamicina , Rifampina , Administração Intravenosa , Administração Oral , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções Bacterianas/tratamento farmacológico , Doenças Ósseas/microbiologia , Clindamicina/administração & dosagem , Clindamicina/farmacocinética , Feminino , Humanos , Artropatias/microbiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Rifampina/farmacocinéticaRESUMO
The objective of this study was to evaluate antimicrobial therapy outcomes of bone and joint infections (BJI) caused by Clostridium perfringens. We investigated remission of symptoms and the absence of relapse or reinfection during follow-up. Among the 8 patients with C. perfringens BJI, the type of infection was early prosthesis infection (n = 2), osteosynthetic device infection (n = 4), and chronic osteomyeletis (n = 2). Clindamycin-rifampicin combination was given in 4 cases and metronidazole in 4 cases. The overall success rate was 87.5%. Among the 7 patients who completed antibiotic treatment, the success rate was 100%. The clindamycin-rifampicin combination appeared to be effective in patients with C. perfringens BJI.
Assuntos
Doenças Ósseas/microbiologia , Infecções por Clostridium/microbiologia , Clostridium perfringens/isolamento & purificação , Artropatias/microbiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Doenças Ósseas/tratamento farmacológico , Clindamicina/uso terapêutico , Infecções por Clostridium/tratamento farmacológico , Clostridium perfringens/efeitos dos fármacos , Clostridium perfringens/genética , Feminino , Humanos , Artropatias/tratamento farmacológico , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Rifampina/uso terapêuticoRESUMO
PURPOSE OF REVIEW: Patients with diabetes mellitus (DM) are at increased risk of developing osteopathogenesis and skeletal fragility. The role of the gut microbiota in both DM and osteopathy is not fully explored and may be involved in the pathology of both diseases. RECENT FINDINGS: Gut microbiota alterations have been observed in DM and osteopathogenic disorders as compared with healthy controls, such as significantly lower abundance of Prevotella and higher abundance of Lactobacillus, with a diminished bacterial diversity. Other overlapping gastro-intestinal features include the loss of intestinal barrier function with translocation of bacterial metabolites to the blood stream, induction of immunological deficits and changes in hormonal and endocrinal signalling, which may lead to the development of diabetic osteopathy. Signalling pathways involved in both DM and osteopathy are affected by gut bacteria and their metabolites. Future studies should focus on gut microbiota involvement in both diseases.
Assuntos
Doenças Ósseas/microbiologia , Complicações do Diabetes/microbiologia , Microbioma Gastrointestinal , Humanos , Transdução de SinaisRESUMO
Bone and joint infections (BJI) of the lower limb can cause functional sequelae and in some cases have an impact on patient's life prognostic. One of the main objectives of multidisciplinary consultation team meetings (MTM) in the treatment of bone and joint infections is to provide an appropriate medical-surgical care, pooling skills of different organ specialists: infectious disease physicians, microbiologists, orthopedic surgeons and plastic surgeons. Treatment is based on aggressive debridement, bone stabilization, adequate antibiotic therapy, long-term coverage of the loss of skin substance and close clinical monitoring. The authors present their multidisciplinary diagnostic and therapeutic approaches to BJI complicating an open fracture at a referent center in the management of complex bone and joint infections.
Assuntos
Infecções Bacterianas/diagnóstico , Infecções Bacterianas/terapia , Doenças Ósseas/diagnóstico , Doenças Ósseas/terapia , Fraturas Expostas/cirurgia , Artropatias/diagnóstico , Artropatias/terapia , Ossos da Perna/lesões , Ossos da Perna/cirurgia , Equipe de Assistência ao Paciente , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/terapia , Doenças Ósseas/microbiologia , Humanos , Artropatias/microbiologia , Complicações Pós-Operatórias/microbiologiaRESUMO
CASE: We describe a case of biopsy-proven blastomycosis in a patient residing in Upstate New York with osseous and skin lesions and no pulmonary or constitutional symptoms. The patient had a rapid resolution of symptoms after the initiation of antifungal treatment, followed by curettage and cementation of her distal femoral lesion. CONCLUSIONS: Orthopaedic surgeons should be aware of the presence of blastomycosis in nonendemic areas, especially since bone involvement may be the predominant manifestation. Tissue should be submitted for both histologic and microbiologic analysis. Antifungal therapy and surgical management if needed can result in a good outcome.
Assuntos
Blastomicose/diagnóstico , Doenças Ósseas/diagnóstico , Doenças Ósseas/microbiologia , Blastomyces/isolamento & purificação , Blastomicose/terapia , Doenças Ósseas/terapia , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: To examine the infectious features of patients with urinary pubic symphysis fistula (UPF) and their association with osteomyelitis. METHODS: We conducted a review of our quality improvement database for 36 patients with UPF undergoing bone resection and extirpative surgery from October 2012 to January 2019. An assessment of bone and urine cultures was carried out along with surgical, radiologic, and demographic data. We analyzed descriptive statistics and used Fisher Exact Tests and unpaired Welch t tests to assess for associations with positive bone cultures. RESULTS: In our cohort, 33 patients (91.7%) had positive bone cultures with the 3 most common organisms being candida (22.0%), enterococcus (18.0%), and pseudomonas (10.0%). There was a correlation between positive preoperative urine culture and positive bone culture (P <.01), with 63.0% of those with positive urine cultures growing the same organism on bone culture. CONCLUSION: In this series, 91.7% of patients undergoing extirpative surgery for UPF at our institution have positive bone cultures at time of pubic bone debridement. Additionally, we demonstrate a statistically significant correlation between positive urine cultures and positive bone cultures in these patients. This supports the need for a multidisciplinary approach including infectious disease, orthopedic surgery and reconstructive urology in order to address this complex clinical condition.
Assuntos
Doenças Ósseas/microbiologia , Fístula/microbiologia , Osteomielite/microbiologia , Neoplasias da Próstata , Osso Púbico , Sínfise Pubiana , Fístula Urinária/microbiologia , Idoso , Idoso de 80 Anos ou mais , Sobreviventes de Câncer , Humanos , Masculino , Pessoa de Meia-Idade , Osteomielite/cirurgia , Estudos RetrospectivosRESUMO
This is a case of coccidioidomycosis in a dog, examined for vomiting and labored breathing. Physical examination and thoracic and abdominal imaging revealed pleural and peritoneal effusions, both of which exhibited neutrophilic inflammation with a substantial eosinophilic component. The dog had positive IgM and IgG coccidioidomycosis titers at initial evaluation. The eosinophilic component of the inflammation was attributed to coccidioidomycosis. The dog underwent approximately 6 months of fluconazole treatment, with both effusions and clinical signs improving after 6 weeks. Three months after cessation of antifungal treatment, the dog developed a mid-diaphyseal lytic and proliferative lesion in the left radius caused by Coccidioides spp. This case illustrates the importance of consideration of coccidioidomycosis when an eosinophilic cavitary effusion is present in dogs that live in or have traveled to endemic regions.
Assuntos
Líquido Ascítico , Coccidioidomicose/veterinária , Doenças do Cão/diagnóstico , Derrame Pleural/veterinária , Animais , Antifúngicos/uso terapêutico , Doenças Ósseas/microbiologia , Doenças Ósseas/veterinária , Coccidioides/isolamento & purificação , Coccidioidomicose/diagnóstico , Coccidioidomicose/tratamento farmacológico , Doenças do Cão/tratamento farmacológico , Cães , Exsudatos e Transudatos/química , Exsudatos e Transudatos/citologia , Fluconazol/uso terapêutico , Masculino , RecidivaAssuntos
Abscesso , Doenças Ósseas , Cefazolina , Infecções Estafilocócicas , Tíbia , Abscesso/diagnóstico por imagem , Abscesso/tratamento farmacológico , Abscesso/microbiologia , Abscesso/cirurgia , Adulto , Antibacterianos/uso terapêutico , Doenças Ósseas/diagnóstico por imagem , Doenças Ósseas/tratamento farmacológico , Doenças Ósseas/microbiologia , Doenças Ósseas/cirurgia , Cefazolina/uso terapêutico , Feminino , Humanos , Imageamento por Ressonância Magnética , Infecções Estafilocócicas/diagnóstico por imagem , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/cirurgia , Staphylococcus aureus , Tíbia/diagnóstico por imagem , Tíbia/microbiologia , Tíbia/cirurgia , Resultado do TratamentoRESUMO
BACKGROUND: The performance of multiplex PCR (mPCR) for detection of antimicrobial resistance from clinical isolates is unknown. We assessed the ability of mPCR to analyse resistance genes directly from clinical samples. Patients with orthopedic infections were prospectively included. Phenotypical and genotypical resistance was evaluated in clinical samples (synovial and sonication fluid) where identical pathogens were identified by culture and mPCR. RESULT: A total of 94 samples were analysed, including 60 sonication fluid and 34 synovial fluid samples. For coagulase-negative staphylococcus strains, mPCR detected resistance to oxacillin in 10 of 23 isolates (44%) and to rifampin in none of 6 isolates. For S. aureus isolates, detection rate of oxacillin and rifampin-resistance was 100% (2/2 and 1/1, respectively). Fluoroquinolone-resistance was confirmed by mPCR in all 3 isolates of Enterobacteriaceae, in enterococci resistance to aminoglycoside-high level was detected in 1 of 3 isolates (33%) and in streptococci resistance to macrolides/lincosamides in none of 2 isolates. The overall sensitivity for different pathogens and antimicrobials was 46% and specificity 95%, the median concordance was 80% (range, 57-100%). Full agreement was observed for oxacillin in S. aureus, vancomycin in enterococci, carbapenems/cephalosporins in Enterobacteriaceae and rifampin in Cutibacterium species. CONCLUSION: The overall sensitivity for detection of antimicrobial resistance by mPCR directly from clinical samples was low. False-negative mPCR results occurred mainly in coagulase-negative staphylococci, especially for oxacillin and rifampin. However, the specificity of mPCR was high and a positive result reliably predicted antimicrobial resistance. Including universal primers in the PCR test assay may improve the detection rate but requires additional sequencing step. TRIAL REGISTRATION: www.clinicaltrials.gov No. NCT02530229, registered at 21 August 2015 (retrospectively registered).
Assuntos
Antibacterianos/farmacologia , Doenças Ósseas/microbiologia , Farmacorresistência Bacteriana , Enterobacteriaceae/efeitos dos fármacos , Técnicas de Genotipagem/métodos , Infecções Relacionadas à Prótese/diagnóstico , Staphylococcus/efeitos dos fármacos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Fixação Interna de Fraturas/efeitos adversos , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase Multiplex , Estudos Prospectivos , Sensibilidade e Especificidade , Sonicação , Líquido Sinovial/microbiologiaAssuntos
Doenças Ósseas/diagnóstico , Vértebras Cervicais/microbiologia , Infecção por Mycobacterium avium-intracellulare/diagnóstico , Esterno/microbiologia , Idoso de 80 Anos ou mais , Doenças Ósseas/microbiologia , Doenças Ósseas/patologia , Vértebras Cervicais/patologia , Feminino , Humanos , Complexo Mycobacterium avium , Infecção por Mycobacterium avium-intracellulare/patologia , Esterno/patologiaRESUMO
OBJECTIVE: We aimed to describe the use of subcutaneous teicoplanin as an alternative for the treatment of staphylococcal bone and joint infections. METHODS: A retrospective multicentric cohort (2002-2015) was conducted with patients receiving subcutaneous teicoplanin for a staphylococcal bone and joint infection. RESULTS: Forty patients were assessed. A median loading dose of 9.4 mg/kg/12h (IQR, 6.1-13.1) was administered to 35 patients, subcutaneously for 18 of them. Thirteen of these patients received three injections per week. No excess risk of failure was identified. The trough level was not significantly different between the various routes (p=0.462), and was significantly higher if the loading dose was≥9 mg/kg/injection (p<10-3). CONCLUSION: The use of subcutaneous teicoplanin seems to be acceptable as an alternative to other routes of administration for antibiotics.
Assuntos
Antibacterianos/administração & dosagem , Doenças Ósseas/tratamento farmacológico , Doenças Ósseas/microbiologia , Artropatias/tratamento farmacológico , Artropatias/microbiologia , Infecções Estafilocócicas/tratamento farmacológico , Teicoplanina/administração & dosagem , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Injeções Subcutâneas , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
BACKGROUND: Community acquired-methicillin resistant Staphylococcus aureus (MRSA) clones, including ST1, ST8, and ST30 are reported worldwide. However, data among Korean children are limited. Thus, we investigated the molecular characteristics of S. aureus among children in Korea. METHODS: S. aureus isolated from Korean children diagnosed with skin and soft tissue infection (SSTI) or bone and joint infection due to S. aureus infection at Seoul National University Bundang Hospital, from August 2010 to November 2016, were analyzed for multilocus sequence type (ST) and SCCmec typing. Polymerase chain reaction of Panton-Valentine leukocidin (PVL), qac A/B, smr and mupA genes were also performed. Electronic medical records were reviewed for clinical data and antibiotic susceptibility results. Cases were classified into three groups: health care-associated community-onset (HACO) infections, hospital-onset (HO) infections, and community-acquired (CA) infections. RESULTS: A total of 67 strains from children with SSTI (41/67, 61.2%) and bone and joint infection (26/67, 38.8%) were included. Among all isolates, 29.9% (20/67) were MRSA, and 70% (14/20) were classified as CA, 20% (4/20) as HACO and 10% (2/20) as HO infections. MRSA rate according to disease was 34.1% (14/41) for SSTI and 23.1% (6/26) for bone and joint infection. MRSA strains included ST72-SCCmec IV (14/20, 70.0%), ST5-SCCmec II (3/20, 15.0%) and ST1-SCCmec IV (2/20, 10.0%). ST30 was the most common cause of SSTI and bone and joint infections and 96.6% (28/29) were methicillin-susceptible Staphylococcus aureus (MSSA). PVL genes were detected in 3 strains (3.8%, ST30-SCCmec IV n = 1, MSSA ST30 n = 2), qac A/B in 3 (MRSA = 3), smr in 3 (MSSA = 1, MRSA = 2) and mupA in 7 (MRSA = 5, MSSA = 2). CONCLUSION: Molecular epidemiology of S. aureus in Korean children with SSTI and bone and joint infection showed that ST30 was predominant and mostly MSSA. Among MRSA, ST72-SCCmec type IV was the most common strain.
Assuntos
Doenças Ósseas/diagnóstico , Artropatias/diagnóstico , Infecções dos Tecidos Moles/diagnóstico , Infecções Cutâneas Estafilocócicas/diagnóstico , Adolescente , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Proteínas de Bactérias/genética , Doenças Ósseas/epidemiologia , Doenças Ósseas/microbiologia , Criança , Pré-Escolar , Infecção Hospitalar/diagnóstico , Infecção Hospitalar/epidemiologia , Farmacorresistência Bacteriana/genética , Feminino , Humanos , Lactente , Recém-Nascido , Artropatias/epidemiologia , Artropatias/microbiologia , Masculino , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Tipagem de Sequências Multilocus , República da Coreia/epidemiologia , Infecções dos Tecidos Moles/epidemiologia , Infecções dos Tecidos Moles/microbiologia , Infecções Cutâneas Estafilocócicas/epidemiologia , Infecções Cutâneas Estafilocócicas/microbiologia , Staphylococcus aureus/efeitos dos fármacos , Staphylococcus aureus/genética , Staphylococcus aureus/isolamento & purificaçãoRESUMO
Microbiologic confirmation of pediatric extrapulmonary tuberculosis remains challenging, leading to diagnostic delays. In our retrospective case series, real-time molecular testing (Xpert MTB/RIF) on respiratory and extrapulmonary specimens resulted in a more rapid diagnosis of extrapulmonary tuberculosis in a nonendemic, high resource setting.
Assuntos
Sistemas Computacionais , Técnicas de Diagnóstico Molecular/métodos , Tuberculose/diagnóstico , Adolescente , Antibióticos Antituberculose/farmacologia , Doenças Ósseas/diagnóstico , Doenças Ósseas/microbiologia , Colúmbia Britânica , Criança , Pré-Escolar , Farmacorresistência Bacteriana , Diagnóstico Precoce , Feminino , Humanos , Lactente , Masculino , Prontuários Médicos , Testes de Sensibilidade Microbiana , Técnicas de Diagnóstico Molecular/estatística & dados numéricos , Mycobacterium tuberculosis , Estudos Retrospectivos , Sensibilidade e Especificidade , Tuberculose/líquido cefalorraquidiano , Tuberculose dos Linfonodos/diagnóstico , Tuberculose Meníngea/diagnósticoRESUMO
Bone infection and inflammation leads to the infiltration of immune cells at the site of infection, where they modulate the differentiation and function of osteoclasts and osteoblasts by the secretion of various cytokines and signal mediators. In recent years, there has been a tremendous effort to understand the cells involved in these interactions and the complex pathways of signal transduction and their ultimate effect on bone metabolism. These crosstalk mechanisms between the bone and immune system finally emerged, forming a new field of research called osteoimmunology. Diseases falling into the category of osteoimmunology, such as osteoporosis, periodontitis, and bone infections are considered to have a significant implication in mortality and morbidity of patients, along with affecting their quality of life. There is a much-needed research focus in this new field, as the reported data on the immunomodulation of immune cells and their signaling pathways seems to have promising therapeutic benefits for patients.
Assuntos
Doenças Ósseas/microbiologia , Sistema Imunitário/fisiologia , Remodelação Óssea/imunologia , Diferenciação Celular , Humanos , Imunomodulação , Modelos Imunológicos , Osteoblastos/citologia , Osteoblastos/imunologia , Osteoclastos/citologia , Osteoclastos/imunologia , Linfócitos T/imunologiaRESUMO
Magnesium biometals exhibit great potentials for orthopeadic applications owing to their biodegradability, bioactive effects and satisfactory mechanical properties. However, rapid corrosion of Mg implants in vivo combined with large amount of hydrogen gas evolution is harmful to bone healing process which seriously confines their clinical applications. Enlightened by the superior biocompatibility and corrosion resistance of passive titanium oxide layer automatically formed on titanium alloy, we employ the Ti and O dual plasma ion immersion implantation (PIII) technique to construct a multifunctional TiO2 based nano-layer on ZK60 magnesium substrates for enhanced corrosion resistance, osteoconductivity and antimicrobial activity. The constructed nano-layer (TiO2/MgO) can effectively suppress degradation rate of ZK60 substrates in vitro and still maintain 94% implant volume after post-surgery eight weeks. In animal study, a large amount of bony tissue with increased bone mineral density and trabecular thickness is formed around the PIII treated group in post-operation eight weeks. Moreover, the newly formed bone in the PIII treated group is well mineralized and its mechanical property almost restores to the level of that of surrounding mature bone. Surprisingly, a remarkable killing ratio of 99.31% against S. aureus can be found on the PIII treated sample under ultra-violet (UV) irradiation which mainly attributes to the oxidative stress induced by the reactive oxygen species (ROS). We believe that this multifunctional TiO2 based nano-layer not only controls the degradation of magnesium implant, but also regulates its implant-to-bone integration effectively. STATEMENT OF SIGNIFICANCE: Rapid corrosion of magnesium implants is the major issue for orthopaedic applications. Inspired by the biocompatibility and corrosion resistance of passive titanium oxide layer automatically formed on titanium alloy, we construct a multifunctional TiO2/MgO nanolayer on magnesium substrates to simultaneously achieve superior corrosion resistance, satisfactory osteoconductivity in rat intramedullary bone defect model and excellent antimicrobial activity against S. aureus under UV irradiation. The current findings suggest that the specific TiO2/MgO nano-layer on magnesium surface can achieve the three objectives aforementioned and we believe this study can demonstrate the potential of biodegradable metals for future clinical applications.
Assuntos
Ligas/química , Anti-Infecciosos/administração & dosagem , Regeneração Óssea/efeitos dos fármacos , Magnésio/química , Propriedades de Superfície , Titânio/química , Células 3T3 , Implantes Absorvíveis , Animais , Doenças Ósseas/microbiologia , Doenças Ósseas/cirurgia , Proliferação de Células , Corrosão , Eletroquímica , Feminino , Teste de Materiais , Metais , Camundongos , Nanotecnologia , Osteoblastos/metabolismo , Ratos , Ratos Sprague-Dawley , Espécies Reativas de Oxigênio/metabolismo , Staphylococcus aureus , Infecção da Ferida Cirúrgica/prevenção & controle , Raios Ultravioleta , Microtomografia por Raio-XRESUMO
Inflammatory and infectious osteoarticular diseases can cause serious consequences for the patient if they are not diagnosed on time. In the last decades, different modalities of nuclear medicine have allowed to study the physiopathology of these processes, and nowadays, they play an important role in diagnosis, characterization and monitoring of musculoskeletal infectious diseases. Therefore, it is essential that every nuclear medicine physician have a vision of the advantages and disadvantages of each method and know how to use them correctly in the diagnosis of the patient. This article highlights the role of nuclear medicine in standardizing the diagnostic approach in patients with infectious/inflammatory diseases, in particular in peripheral osteomyelitis, septic arthritis, prosthetic joint infections, infected diabetic foot and spinal infections. The authors reveal the role of the most common radionuclides tests, with their advantages and clinical indications, to achieve an adequate diagnosis of infection and inflammation.
Assuntos
Infecções Bacterianas/diagnóstico por imagem , Doenças Ósseas/diagnóstico por imagem , Doenças Ósseas/microbiologia , Doenças Musculares/diagnóstico por imagem , Doenças Musculares/microbiologia , Fluordesoxiglucose F18 , Humanos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Compostos RadiofarmacêuticosRESUMO
The induced membrane technique is a simple and effective method for reconstructing bone defects in limbs. It is suited to low resource settings, if sufficient care is taken in preparing and performing the technique. Key points for the success of this procedure are described here. In austere environments, its use is mostly limited by possibilities for treatment of bone infection, but also by access to surgical cement and available bone stock. Alternatives for overcoming these last two obstacles are presented.
Assuntos
Doenças Ósseas/cirurgia , Transplante Ósseo/métodos , Osso e Ossos/lesões , Osso e Ossos/cirurgia , Regeneração Tecidual Guiada/métodos , Doenças Ósseas/microbiologia , Recursos em Saúde , Humanos , MembranasRESUMO
A wild adult Eurasian scops owl (Otus scops), which was unable to fly, was rescued. Physical examination revealed a sticky exudate around the glottis. Heterophilic leukocytosis was identified through complete blood count, and radiography revealed a marked elevated density of posterior air sacs and inner cavities in both sides of the humerus and femur. Fungal cultures of samples taken from the owl suggested a respiratory fungal infection. Through molecular typing, the fungus was identified as Epicoccum nigrum. The owl was treated with oral itraconazole and broad-spectrum antibiotics. After one month, the inner cavities of pneumatic bones were slightly distinguishable by radiography and the owl started to fly well. Two months later, the air sac and all pneumatic bones displayed normal appearance.