Copper Bead Therapy in Severe Bone Infection: A Rabbit Tibial Model.

OBJECTIVE: We investigated the benefits of a local preventive therapy based on copper beads against severe bone infection using a rabbit open tibial fracture model. MATERIALS AND METHODS: Cotton mesh balls soaked in a very high concentration of Staphylococcus aureus ATCC 6538 culture were inoculated in drilled holes of the tibiae of treated and control groups. The treated group was also implanted with small copper beads simultaneously, as prevention therapy. RESULTS: Survival rate in the treated group was 67% compared with 25% in the control group (difference 40%, for a 95% confidence interval: 40%, 93.4%). The few remaining animals in the control group had bone lesions which developed into osteomyelitis, while the tibiae of treated group had clear signs of reparatory processes. Sixty days after inoculation, signs of local-only toxicity were observed in healthy tibia of a separate non-infected control group. Drawbacks of copper toxicity were weighed against the threat of septicaemia and also against prolonged use of powerful systemic antibiotic medications in severe bone contamination. CINICAL SIGNIFICANCE: It was found that the proposed therapy prevented septicaemia and the spread of infection, and it also induced reparatory processes. The findings of this study may be relevant in antisepsis of open fractures in less appropriate medical settings (such as military camps or remote locations), as well as in severe bone infections.

All about Imagistic Exploration in Cholesteatoma.

Cholesteatoma is an expansive tissular process, non-neoplastic, well demarcated, developed in the temporal bone, with destructive effect. Cholesteatoma is diagnosed based on clinical, otoscopic examinations, sectional imaging examinations (computerized tomography in high resolution -HRCT and magnetic resonance imaging-MRI). Examination HRCT on the temporal bone is an exam with high sensitivity, important spatial resolution, it can detect small tissue damage, describes the local architecture, complications, but have low specificity, unable differentiate between tissue masses from different origins. MRI brings additional information, using conventional sequences in the preoperative evaluation about extension of the lesion, vascular complications but not in residual lesions or relapses. These new data are brought by using new type sequences Echo planar diffusion weighted. (DW-EPI) and non-Echo planar diffusion weighted (DW non-EPI), sequences that have high sensitivity and specificity even for small lesions (5 mm) with avoidance of a second-look surgery. This article aims to show cholesteatoma aspects, including the definition, history and etymology, classification, histology, clinical signs and the most important imagistic aspects.

Prostaglandin e1 on infradiaphragmatic type of total anomalous pulmonary venous connection - a case report.

We present the case of a newborn with severe pulmonary hypertension, diagnosed with infradiaphragmatic type of total anomalous pulmonary venous connection (TAPVC). The onset was in the first 10 days of life. Diagnosis was made by echocardiography and AngioCT. The pulmonary venous collector was surgically implanted into the left atrium in Germany, but the next month after surgery he developed cardiopulmonary insufficiency and died several days later. We would like to emphasize the importance of prostaglandin E1 administration in this particular case of infradiaphragmatic type of TAPVC and its usefulness in patient's stabilization until surgery. The prognosis in TAPVC, infradiaphragmatic type, is poor and is related mainly to the existence of pulmonary venous obstruction.