Therapy control in a patient with an inflammatory abdominal aneurysm: potential pitfalls in PET/CT imaging

We present a case of inflammatory abdominal arterial aneurysms, which demonstrates the potential usefulness of PET/CT with F-FDG in long-term monitoring of this disease, but also demonstrates potential pitfalls in abdominal arterial aneurysm imaging with PET/CT. Imaging may be challenged as the initial presentation prior to therapy may mimic an infected aneurysm. Follow-up images may be mistaken for vascular graft infection or persistent disease

Morbidity and Aging in HIV-Infected Persons: The Swiss HIV Cohort Study

Comorbid diseases, such as myocardial infarction, stroke, diabetes mellitus, bone fractures without adequate trauma, osteoporosis, and non-AIDS-defining malignancies, among HIV-infected individuals are age-related. Consequently, multimorbidity will become an important issue in care of the aging HIV-infected populatio

Vascular graft infections

Vascular graft infections are rare complications after surgical and endovascular treatment of aortic diseases. This condition is characterized by complexity in diagnosis and medico-surgical management. Moreover, even if properly treated, morbidity and mortality rates are high. Although several advances have been made over the years and guidelines of treatment have been published, there is still debate on the optimal care for this disease. With local microbiological patterns and multiresistant strains conditioning antimicrobial treatment as well as several surgical debridement techniques in the armamentarium, it is difficult to offer recommendations that can be generalized for every single case. In this review, we aim at describing thoracic and abdominal vascular graft infections and providing current information on diagnosis, medical treatment, and surgical management

Neutrophil extracellular trap formation is elicited in response to cold physical plasma

Cold physical plasma is an ionized gas with a multitude of components, including hydrogen peroxide and other reactive oxygen and nitrogen species. Recent studies suggest that exposure of wounds to cold plasma may accelerate healing. Upon wounding, neutrophils are the first line of defense against invading microorganisms but have also been identified to play a role in delayed healing. In this study, we examined how plasma treatment affects the functions of peripheral blood neutrophils. Plasma treatment induced oxidative stress, as assessed by the oxidation of intracellular fluorescent redox probes; reduced metabolic activity; but did not induce early apoptosis. Neutrophil oxidative burst was only modestly affected after plasma treatment, and the killing of Pseudomonas aeruginosa and Staphylococcus aureus was not significantly affected. Intriguingly, we found that plasma induced profound extracellular trap formation. This was inhibited by the presence of catalase during plasma treatment but was not replicated by adding an equivalent concentration of hydrogen peroxide. Plasma-induced neutrophil extracellular trap formation was not dependent on the activity of myeloperoxidase or NADPH oxidase 2 but seemed to involve short-lived molecules. The amount of DNA release and the time course after plasma treatment were similar to that with the common neutrophil extracellular trap inducer PMA. After neutrophil extracellular traps had formed, concentrations of IL-8 were also significantly increased in supernatants of plasma-treated neutrophils. Both neutrophil extracellular traps and IL-8 release may aid antimicrobial activity and spur inflammation at the wound site. Whether this aids or exacerbates wound healing needs to be tested

Longitudinal increase in the detection rate of Mycobacterium chimaera in heater-cooler device-derived water samples

Colonization with Mycobacterium chimaera and other nontuberculous mycobacteria (NTM) has been reported for heater-cooler devices (HCD) produced by several manufacturers. Up to now, exclusively LivaNova (London, UK) HCDs have been associated with M. chimaera infections after cardiac surgery. The vast majority of studies on HCD colonization were cross-sectional. We were interested in longitudinal dynamics of mycobacterial growth in HCD water samples and analyzed data of a prospective mycobacterial surveillance of five LivaNova 3T HCDs. Nontuberculous mycobacteria were isolated in 319 (48.0%, 21 water samples grew more than one mycobacterial species) of a total of 665 water samples. The most frequently detected species were M. chimaera (N= 247/319, 77.4%), Mycobacterium gordonae (46/319, 14.4%) and Mycobacterium paragordonae (34/319, 10.7%). Detection rates increased longitudinally for any NTM (odds ratio (OR) per year in use: 1.60, 95% CI 1.17-2.24, P<0.001) and for M. chimaera (OR per year in use: 1.67, 95% CI 1.11-2.57, P<0.01)