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1.
Semin Immunopathol ; 41(5): 607-618, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31520179

RESUMO

The inflammasomes are intracellular protein complexes that are assembled in response to a variety of perturbations including infections and injuries. Failure of the inflammasomes to rapidly clear the insults or restore tissue homeostasis can result in chronic inflammation. Recurring inflammation is also provoked by mutations that cause the constitutive assembly of the components of these protein platforms. Evidence suggests that chronic inflammation is a shared mechanism in bone loss associated with aging, dysregulated metabolism, autoinflammatory, and autoimmune diseases. Mechanistically, inflammatory mediators promote bone resorption while suppressing bone formation, an imbalance which over time leads to bone loss and increased fracture risk. Thus, while acute inflammation is important for the maintenance of bone integrity, its chronic state damages this tissue. In this review, we discuss the role of the inflammasomes in inflammation-induced osteolysis.


Assuntos
Suscetibilidade a Doenças , Inflamassomos/metabolismo , Osteíte/etiologia , Osteíte/metabolismo , Animais , Biomarcadores , Reabsorção Óssea , Citocinas/metabolismo , Gerenciamento Clínico , Regulação da Expressão Gênica , Humanos , Proteína 3 que Contém Domínio de Pirina da Família NLR/genética , Proteína 3 que Contém Domínio de Pirina da Família NLR/metabolismo , Osteíte/diagnóstico , Osteíte/terapia , Transdução de Sinais
2.
Skeletal Radiol ; 48(6): 837-857, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30806723

RESUMO

Advanced imaging has become just as vital for diagnosing, staging, and monitoring disease in rheumatoid arthritis (RA) patients as it is for cancer patients. Part 1 of this review discussed synovitis, tenosynovitis, erosions, and osteitis-key imaging findings that occur in patients with RA. Part 2 will now show how these features, in combination with clinical and serologic data, can assist clinical decision-making at various stages of a patient's disease course. Specifically, assessing current disease activity and prognosticating future aggressiveness inform treatment decisions at initial presentation, during medical treatment, and at clinical remission. In addition to summarizing the current literature on advanced imaging in RA, clinical examples from different stages throughout the disease course will illustrate practical approaches for applying these research results. Last, this review will describe potential future roles of imaging in RA patients.


Assuntos
Artrite Reumatoide/diagnóstico por imagem , Artrite Reumatoide/terapia , Mãos/diagnóstico por imagem , Imagem por Ressonância Magnética , Artrite Reumatoide/patologia , Tomada de Decisões , Previsões , Mãos/patologia , Humanos , Osteíte/diagnóstico por imagem , Osteíte/patologia , Osteíte/terapia , Prognóstico , Tenossinovite/diagnóstico por imagem , Tenossinovite/patologia , Tenossinovite/terapia , Punho/diagnóstico por imagem , Punho/patologia
3.
J Dermatol ; 46(2): 144-148, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30549087

RESUMO

Pustulotic arthro-osteitis, occasionally complicated with palmoplantar pustulosis, affects patients' activities of daily living. Granulocyte and monocyte adsorption apheresis selectively removes activated granulocytes and monocytes by means of extracorporeal circulation. Although the efficacy of granulocyte and monocyte adsorption apheresis in the treatment of generalized pustular psoriasis has been proved, very few reports have assessed its efficacy in the treatment of palmoplantar pustulosis and pustulotic arthro-osteitis. Ten pustulotic arthro-osteitis patients with five palmoplantar skin manifestations were treated with weekly granulocyte and monocyte adsorption apheresis over 5 weeks. Skin manifestations were assessed using palmoplantar pustulosis area and severity index, and joint symptoms were assessed using a visual analog scale of joint pain, tender joint count, swollen joint count and C-reactive protein immediately before, after and at the 3-month follow up of the five granulocyte and monocyte adsorption apheresis sessions. Two out of five patients with skin manifestations achieved more than 50% improvement in their score (remarkably improved). However, in two patients, deterioration was noted, in one of whom the skin manifestations remained unchanged at the 3-month follow up. In five out of the 10 patients, the joint symptoms were assessed as better than improved at the 3-month follow up. No deterioration was noted at the 3-month follow up. In three patients, reduction or cessation of medication for arthralgia was possible. We concluded that granulocyte and monocyte adsorption apheresis is a therapeutic option to consider when pustulotic arthro-osteitis is recalcitrant to conventional therapy.


Assuntos
Artrite Psoriásica/terapia , Leucaférese , Osteíte/terapia , Adulto , Idoso , Artrite Psoriásica/complicações , Feminino , Granulócitos , Humanos , Masculino , Pessoa de Meia-Idade , Monócitos , Osteíte/etiologia , Estudos Retrospectivos
4.
J Pediatr ; 207: 97-102, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30577978

RESUMO

OBJECTIVE: To evaluate the clinical manifestations, management, and outcomes of Mycobacterium bovis Bacillus Calmette-Guérin (BCG) osteitis/osteomyelitis. STUDY DESIGN: We reviewed 71 cases of BCG osteitis/osteomyelitis registered in Taiwan's vaccine injury compensation program (VICP) in 1998-2014. Demographic, clinical, laboratory, treatment, and outcome data were compared according to site(s) of infection. RESULTS: Involvement of a long bone of the lower extremity was present in 36.6% of the children, followed by foot bone (23.9%), rib or sternum (15.5%), upper extremity long bone (9.9%), hand bone (7%), multiple bones (4.2%), and vertebrae (2.8%). Children with lower extremity long bone involvement had a longer interval from receipt of BCG vaccine to presentation (median, 16.0 months; P = .02), and those with foot bone infection had higher rates of swelling (94.1%; P = .02) and local tenderness (76.5%; P = .004). Surgical intervention was performed in 70 children, with no significant difference in the number of procedures by site (median, 1.0 procedure per patient). Among the 70 children who received antimicrobial therapy, those with vertebral and multifocal infections had a longer duration of treatment (P < .001) and/or second-line antituberculosis medications (P = .002). Three children with vertebral and multifocal infections had major sequelae with kyphosis or leg length discrepancy. Outcomes were good for children with involvement of the ribs, sternum, and peripheral bones without multifocal involvement. The average time for functional recovery was 6.2 ± 3.9 months. CONCLUSION: Children with BCG osteitis/osteomyelitis in different bones had distinct presentations and outcomes. Pediatricians should consider BCG bone infection in young vaccinated children with insidious onset of signs and symptoms, and consider affected site(s) in the management plan.


Assuntos
Adjuvantes Imunológicos/efeitos adversos , Vacina BCG/efeitos adversos , Osteíte/induzido quimicamente , Osteomielite/induzido quimicamente , Antibacterianos/uso terapêutico , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Mycobacterium bovis/isolamento & purificação , Osteíte/fisiopatologia , Osteíte/terapia , Osteomielite/fisiopatologia , Osteomielite/terapia , Sistema de Registros , Estudos Retrospectivos , Taiwan , Tuberculose/prevenção & controle
6.
J Orthop Sports Phys Ther ; 47(9): 683-690, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28774219

RESUMO

Study Design Case series. Background Pubic bone stress (PBS) is a common acute or chronic response of the pelvis in sports where sprinting, kicking, twisting, and cutting are the dominant movements. There are few nonoperative rehabilitation strategies for the condition reported in the literature, and the outcome of conservative treatment has not been documented. Case Description Five professional and academy soccer players complaining of pubic symphysis pain, confirmed as PBS on magnetic resonance imaging and objective assessment, were treated with a nonoperative rehabilitation program that featured functional and clinical objective markers as progression criteria. Interventions in the acute phase included pharmacological and physical therapeutic modalities to reduce pain initially. Rehabilitation management focused on improving range of motion at the hips and thorax, adductor strengthening, trunk and lumbopelvic stability, gym-based strength training, and field-based rehabilitation and conditioning. Clinical follow-up was performed at least 8 months following return to play. Outcomes All players demonstrated reduced or resolved pain, increased adductor squeeze strength, and return to pain-free training and match play. Return-to-training time averaged 40.6 days (range, 30-60 days) and return to play averaged 49.4 days (range, 38-72 days) within the 5 players. At final follow-up (mean, 29.6 months; range, 16-33 months), there had been no recurrences. Discussion This report of 5 cases suggests that a nonoperative protocol, using clinical and functional progression criteria, may be successful in rehabilitating athletes with PBS for return to sport within 11 weeks. Level of Evidence Therapy, level 4. J Orthop Sports Phys Ther 2017;47(9):683-690. Epub 3 Aug 2017. doi:10.2519/jospt.2017.7314.


Assuntos
Osteíte/terapia , Modalidades de Fisioterapia , Osso Púbico , Futebol/lesões , Adolescente , Adulto , Humanos , Osteíte/tratamento farmacológico , Osteíte/reabilitação , Manejo da Dor , Sínfise Pubiana , Volta ao Esporte , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
7.
Vet Clin North Am Equine Pract ; 33(2): 299-314, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28687092

RESUMO

Despite differences in etiology and diagnostics, the mainstay of therapy in the foal is similar to the adult: local lavage and/or debridement and local antimicrobial therapy. When musculoskeletal infection is concurrent with neonatal sepsis, the prognosis for survival is fair. When musculoskeletal infection is the primary problem, the prognosis is fair to good for survival of synovial, bony, and physeal infections with appropriate and aggressive local therapy. Recent literature may indicate that prognosis for survival and potential athleticism in foals that are treated expediently with local therapies and are without comorbidities may be more favorable than has been previously indicated.


Assuntos
Artrite Infecciosa/veterinária , Doenças dos Cavalos/diagnóstico , Doenças dos Cavalos/terapia , Osteíte/veterinária , Osteomielite/veterinária , Animais , Animais Recém-Nascidos , Artrite Infecciosa/diagnóstico , Artrite Infecciosa/terapia , Feminino , Cavalos , Masculino , Osteíte/diagnóstico , Osteíte/terapia , Osteomielite/diagnóstico , Osteomielite/terapia , Prognóstico , Estudos Retrospectivos
8.
Expert Rev Clin Immunol ; 13(2): 133-142, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27487860

RESUMO

INTRODUCTION: Modern imaging may aid in the diagnosis, prognosis and monitoring of therapeutic response in psoriatic arthritis (PsA). Detection of osteitis and technical advances like whole body magnetic resonance imaging (MRI) exemplify the value of this technology. Areas covered: Ultrasound (US) provides a clinic-based tool for evaluating both joint pathologies and extra-articular structures (especially enthesitis) including skin and nail disease. Recent studies have demonstrated subclinical disease in psoriasis without arthritis, as well as in PsA, with implications for diagnosis and treatment classification. Modern imaging can also facilitate decisions on tapering of expensive biologics, though real-world clinical studies are still lacking. Expert commentary: The increase in novel PsA therapies should increase the utilization of modern imaging, providing both increased validation of imaging biomarkers as well as responsive outcome measures.


Assuntos
Artrite Psoriásica/diagnóstico por imagem , Osteíte/diagnóstico por imagem , Animais , Artrite Psoriásica/terapia , Produtos Biológicos/uso terapêutico , Humanos , Imagem por Ressonância Magnética , Osteíte/terapia , Prognóstico , Ultrassonografia
9.
Orthopade ; 46(3): 263-274, 2017 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-27492137

RESUMO

BACKGROUND: The treatment of non-unions with large bone defects or osteitis is a major challenge in orthopedic and trauma surgery. A new concept of therapy is a two-step procedure: Masquelet technique according to the diamond concept. METHODS: Between February 2010 and June 2014, 55 patients with tibia non-unions or infections were treated in a two-step Masquelet technique in our center. The patients' average age was 48 (median 50; minimum 15-maximum 72) with an average BMI (body mass index) of 28 (27; 18-52). There were 10 (18 %) female and 45 (82 %) male patients in the group. All study patients went through a follow up. Bone healing and clinical functional data were collected, as well as data according to subjective patient statements about pain and everyday limitations. RESULTS: In 42 cases (76.4 %) the outcome was a sufficient bony consolidation. On average, the time to heal was 10.3 (8, 5; 3-40) months, defect gaps were 4 cm (3 cm; 0,6-26 cm), and on average the patients had had 6 (median 4; range 1-31) previous operations . In all cases patients received osteosynthesis as well as a defect filling with RIA (reamer-irrigator-aspirator), and growth factor BMP-7 (bone morphogenetic protein-7). In 13 cases (23.6 %) there was no therapeutic success. In the evaluation of the SF12 questionnaire the mental health score increased from 47.4 (49.1; 27.6-65.7) to 49.8 (53.0; 28.7-69.4) and the well-being score from 32.7 (32.7;16.9-55.7) to 36.6 (36.5; 24.6-55.9). CONCLUSION: The two-step bone grafting method in the Masquelet technique used for tibia non-unions according to the diamond concept is a promising treatment option. Its application for tibia shaft non-unions with large bone defects or infections means a high degree of safety for the patient.


Assuntos
Cimentos para Ossos/uso terapêutico , Transplante Ósseo/métodos , Fraturas Mal-Unidas/terapia , Osteíte/terapia , Fraturas da Tíbia/terapia , Adolescente , Adulto , Transplante Ósseo/instrumentação , Terapia Combinada/instrumentação , Terapia Combinada/métodos , Feminino , Consolidação da Fratura , Fraturas Mal-Unidas/complicações , Fraturas Mal-Unidas/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Osteíte/complicações , Fraturas da Tíbia/complicações , Fraturas da Tíbia/diagnóstico , Resultado do Tratamento , Adulto Jovem
10.
Claves odontol ; 23(75): 65-73, 2017. ilus
Artigo em Espanhol | LILACS | ID: biblio-972619

RESUMO

En la actualidad, la principal causa por la que acuden los pacientes al odontólogo es el dolor dental, endonde la mayoría presenta un padecimiento pulpar o periapical irreversibles, que pueden estar asociados a factores traumáticos e irritativos. Sin embargo, pocosde ellos son asintomáticos, como la osteítis condensante que es escasamente mencionada en elámbito de la Endodoncia; por lo tanto, el objetivo de este caso clínico es el de proporcionar información acerca de la osteítis condensante siguiendo los lineamientos internacionales de Case Report (CARE). La osteítis condensante tiene una incidencia muy baja en pacientes y se debe diagnosticar correctamente al momento de tratar este tipo de lesiones con las diferentes herramientas de diagnóstico que se conocen. En este caso, se presenta un paciente del sexo femenino de 58 años de edad con un estado prediabético, que refiere un fractura del segundo molar inferior derecho, al cual radiográficamente se le encontróuna lesión periapical radiopaca en la raíz distal. Se muestra la secuencia del tratamiento, el manejo clínico y la rehabilitación.


At present, the main reason for patients to visit adentist is dental pain, where most of them presenta pulp or periapical irreversible condition, whichmay be associated with traumatic and irritative factors. However, few of them are asymptomatic as osteitiscondensing that is barely mentioned in thefield of endodontics. The aim of this case report isto provide information about the condensing osteitisfollowing international Case Report (CARE)guidelines. Condensing osteitis has a very low incidence in patients and should be correctly diagnosed with the different available diagnostic tools. In thiscase a 58-years-old female patient, with prediabeticstate, referred of a right lower second molar fracturewhich radiographically showed a radiopaque periapicallesion in the distal root of the molar. The sequence of treatment, clinical management and rehabilitation is presented.


Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Osteíte/diagnóstico , Osteíte/patologia , Osteíte/terapia , Doenças Periapicais/classificação , Tratamento do Canal Radicular/métodos , Osteosclerose/diagnóstico , Osteomielite/diagnóstico , Osteíte/diagnóstico por imagem , Coroas , Diagnóstico Diferencial , México
12.
Odontostomatol Trop ; 39(155): 20-6, 2016 Sep.
Artigo em Francês | MEDLINE | ID: mdl-30239180

RESUMO

Introduction: Osteitis is an inflammatory disease of bone tissue. Its clinical presentation varies according to the site, presence or absence of pus, duration and etiology. It represents one of the endo-periodontal diseases complication. We report the case of a mandibular osteitis having led to confusion with an ostesarcoma. Observation: A 13-year-old boy was referred to our department for a right low swelling with suspicion of mandible osteosarcoma. The lesion's evolution was 6 weeks. With the local aggressiveness and the speed evolution, the first diagnosis proposed was a mandibular osteosarcoma. Based on the clinical and radiological data established, the diagnosis of mandibular osteitis on a periapical granuloma was made and the treatment consisted on the causal tooth extraction with curettage of the periapical lesion associated to the prescription of macrolide (ERY®). The clinical follow-up was 6 weeks, a recovery with cessation of clinical signs were noticed. Discussion: The differential diagnosis facing the clinical context is an osteitis on a periapical inflammatory cyst and especially mandibular osteosarcoma. For the therapy, it's a 3 components treatment (etiology, medical and surgical) to obtain a recovery.


Assuntos
Doenças Mandibulares/diagnóstico , Doenças Mandibulares/terapia , Osteíte/diagnóstico , Osteíte/terapia , Granuloma Periapical/diagnóstico , Granuloma Periapical/terapia , Adolescente , Terapia Combinada , Curetagem , Diagnóstico Diferencial , Humanos , Macrolídeos/uso terapêutico , Masculino , Osteossarcoma/diagnóstico , Extração Dentária
13.
Crit Rev Microbiol ; 42(1): 158-71, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-24809926

RESUMO

Mucorales, Scedosporium and Fusarium species are rarely considered as cause for bone and joint infections. However, these moulds are emerging as important fungal pathogens in immunocompromised and immunocompetent patients. Typical pre-disposing host conditions are immunosuppression and diabetes. Most common causative pathogens are Mucorales followed by Scedosporium and Fusarium. Acremonium and Phialemonium species are rare but some case reports exist. MRI is the gold standard imaging technique. Tissue specimens obtained as aspirates, imaging guided biopsy or open surgery need mycological and histopathological work-up for genus and species identification. Multimodal treatment strategies combine surgical debridement, drainage of joints or abscesses, removal of infected prosthetic joints and systemic antifungals. The treatment of mucormycosis is polyene based and may be combined with either posaconazole or - in rare cases - caspofungin. As Scedosporium species are intrinsically resistant to polyenes and azoles show absence of in vitro activity, voriconazole plus synergistic treatment regimens become the therapeutic standard. In fusariosis, fungal susceptibility is virtually impossible to predict, so that combination treatment of voriconazole and lipid-based amphotericin B should be the first-line strategy while susceptibility results are pending. In the absence of randomized controlled trials, infections due to the above moulds should be registered, e.g. in the registries of the European Confederation of Medical Mycology (ECMM).


Assuntos
Artrite/microbiologia , Fusarium/fisiologia , Mucorales/fisiologia , Osteíte/microbiologia , Scedosporium/fisiologia , Artrite/diagnóstico , Artrite/epidemiologia , Artrite/terapia , Diagnóstico por Imagem , Gerenciamento Clínico , Fusariose/diagnóstico , Fusariose/epidemiologia , Fusariose/microbiologia , Fusariose/terapia , Humanos , Hospedeiro Imunocomprometido , Incidência , Técnicas de Diagnóstico Molecular , Mucormicose/diagnóstico , Mucormicose/epidemiologia , Mucormicose/microbiologia , Mucormicose/terapia , Osteíte/diagnóstico , Osteíte/epidemiologia , Osteíte/terapia
14.
J Pediatr Orthop ; 36(2): 152-7, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25985369

RESUMO

BACKGROUND: Calcaneal apophysitis is a frequent cause of heel pain in children and is known to have a significant negative effect on the quality of life in affected children. The most effective treatment is currently unknown. The purpose of this study is to evaluate 3 frequently used conventional treatment modalities for calcaneal apophysitis. METHODS: Three treatment modalities were evaluated and compared in a prospective randomized single-blind setting: a pragmatic wait and see protocol versus a heel raise inlay (ViscoHeel; Bauerfeind) versus an eccentric exercise regime under physiotherapeutic supervision. Treatment duration was 10 weeks. INCLUSION CRITERIA: age between 8 and 15 years old, at least 4 weeks of heel pain complaints due to calcaneal apophysitis based, with a minimal Faces Pain Scale-Revised of 3 points. Primary exclusion criteria included other causes of heel pain and previous similar treatment. Primary outcome was Faces Pain Scale-Revised at 3 months. Secondary outcomes included patient satisfaction and Oxford Ankle and Foot Questionnaire (OAFQ). Points of measure were at baseline, 6 weeks, and 3 months. Analysis was performed according to the intention-to-treat principles. RESULTS: A total of 101 subjects were included. Three subjects were lost to follow-up. At 6 weeks, the heel raise subjects were more satisfied compared with both other groups (P<0.01); the heel raise group improved significantly compared with the wait and see group for OAFQ Children (P<0.01); the physical therapy group showed significant improvement compared with the wait and see group for OAFQ Parents (P<0.01). Each treatment modality showed significant improvement of all outcome measures during follow-up (P<0.005). No clinical relevant differences were found between the respective treatment modalities at final follow-up. CONCLUSIONS: Treatment with wait and see, a heel raise inlay, or physical therapy each resulted in a clinical relevant and statistical significant reduction of heel pain due to calcaneal apophysitis. No significant difference in heel pain reduction was found between individual treatment regimes. Calcaneal apophysitis is effectively treated by the evaluated regimes. Physicians should deliberate with patients and parents regarding the preferred treatment.


Assuntos
Calcâneo , Osteíte/terapia , Adolescente , Criança , Pré-Escolar , Terapia por Exercício , Feminino , Órtoses do Pé , Humanos , Masculino , Satisfação do Paciente , Estudos Prospectivos , Método Simples-Cego , Conduta Expectante
15.
Bull Hosp Jt Dis (2013) ; 73(2): 90-9, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26517161

RESUMO

Groin pain is a common complaint in athletes that use the musculature of the lower abdomen and proximal thigh. The complex anatomy of the groin region and broad differential diagnosis presents the sports medicine specialist with unique diagnostic and treatment challenges. Sports hernia, osteitis pubis, and adductor dysfunction are common extra-articular musculoskeletal causes of groin pain in athletes. The current paper reviews the pathogenesis, history and physical examination, imaging, non-operative treatment, surgical techniques, and outcomes for these conditions. Treatment algorithms are presented for management of patients with sports hernia, osteitis pubis, and adductor dysfunction.


Assuntos
Traumatismos em Atletas/complicações , Hérnia Inguinal/complicações , Dor Musculoesquelética/etiologia , Osteíte/complicações , Algoritmos , Traumatismos em Atletas/diagnóstico , Traumatismos em Atletas/fisiopatologia , Traumatismos em Atletas/terapia , Procedimentos Clínicos , Diagnóstico por Imagem , Virilha , Hérnia Inguinal/diagnóstico , Hérnia Inguinal/fisiopatologia , Hérnia Inguinal/terapia , Humanos , Dor Musculoesquelética/diagnóstico , Dor Musculoesquelética/fisiopatologia , Dor Musculoesquelética/terapia , Osteíte/diagnóstico , Osteíte/fisiopatologia , Osteíte/terapia , Exame Físico , Valor Preditivo dos Testes , Fatores de Risco , Resultado do Tratamento
16.
Khirurgiia (Mosk) ; (8): 14-17, 2015.
Artigo em Russo | MEDLINE | ID: mdl-26356053

RESUMO

AIM: To estimate the results of sternomediastinitis management using vacuum-therapy compared with conventional treatment of such wounds. MATERIAL AND METHODS: We have retrospectively analyzed data for the period from January 2007 to October 2014. The study enrolled 79 patients with infectious complication after cardiac surgery. All patients underwent coronary artery bypass grafting. The first group included 40 patients who received conventional therapy. The second group enrolled 39 patients in whom vacuum-therapy was applied. Patients were comparable in main characteristics. RESULTS: Mortality rate was significantly lower in vacuum-therapy group (2.5% vs. 15%, p=0.05). Similarly duration of hospital-stay in the 2nd group was 29±10 days, in the 1st group - 47±11 days (p<0.01). Incidence of sepsis and other complications was significantly higher in group of conventional treatment. CONCLUSION: Vacuum-therapy for infectious complications after cardiac surgery provided good results including decrease of hospital-stay duration and mortality rate in comparison with conventional management of wounds.


Assuntos
Ponte de Artéria Coronária/efeitos adversos , Mediastinite/terapia , Tratamento de Ferimentos com Pressão Negativa/métodos , Osteíte/terapia , Infecção da Ferida Cirúrgica/terapia , Feminino , Seguimentos , Mortalidade Hospitalar/tendências , Humanos , Incidência , Masculino , Mediastinite/epidemiologia , Mediastinite/etiologia , Pessoa de Meia-Idade , Osteíte/epidemiologia , Osteíte/etiologia , Estudos Retrospectivos , Sibéria/epidemiologia , Esterno , Infecção da Ferida Cirúrgica/epidemiologia , Infecção da Ferida Cirúrgica/etiologia , Resultado do Tratamento
18.
Eur Arch Otorhinolaryngol ; 272(4): 821-826, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24771214

RESUMO

Rhinosinusitis is a disease of multifactorial aetiology. As a profession our insight into this pathological process has progressed enormously over the last few decades. The contribution from environmental, host immunity, microbiology and anatomical factors is well recognised, if not completely understood. The involvement of underlying bone in rhinosinusitis was first recognised experimentally in animals and has subsequently been highlighted as a potentially significant finding in humans with CRS. In this review, the role of bone in chronic rhinosinusitis and the evidence behind that role are discussed. Both histological and radiological findings are presented and the subsequent potential clinical impact and relevance of osteitis in rhinosinusitis patients. Future pathways for research to add to the current knowledge of the impact of bony involvement are also discussed.


Assuntos
Osso Nasal/diagnóstico por imagem , Osteíte , Rinite , Sinusite , Animais , Doença Crônica , Gerenciamento Clínico , Modelos Animais de Doenças , Humanos , Osteíte/complicações , Osteíte/patologia , Osteíte/terapia , Radiografia , Rinite/etiologia , Rinite/fisiopatologia , Sinusite/etiologia , Sinusite/fisiopatologia
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