Rothia prosthetic knee joint infection

Rothia species — Gram-positive pleomorphic bacteria that are part of the normal oral and respiratory flora — are commonly associated with dental cavities and periodontal disease although systemic infections have been described. We describe a 53-year-old female with rheumatoid arthritis complicated by prosthetic knee joint infection due to Rothia species, which was successfully treated by surgical removal of prosthesis and prolonged antimicrobial therapy. The issue of antibiotic prophylaxis before dental procedures among patients with prosthetic joint replacements is discussed

A new encryption technique for the secured transmission and storage of text information with medical images

Modern day hospital management systems rely heavily on electronic data processing to maintain patient records. These electronic medical records (EMRs) must be maintained in an unaltered form by the creator. The need for a secure data handling method for the transmission and storage of text and digital media, comprising patient’s diagnostic history, imaging, scans, etc., is indispensible. This paper presents a novel method of text encryption by means of symmetric key encryption technique, using variable length key derived from the encrypted text itself

Pseudomembranous Tracheitis Caused by Aspergillus Fumigatus in the Setting of High Grade T-Cell Lymphoma

Pseudomembranous tracheitis (PMT) is a rare condition most commonly caused by fungal or bacterial infection that is characterized by a pseudomembrane that partially or completely covers the tracheobronchial tree. PMT is most commonly found in immunocompromised patient populations, such as post-chemotherapy, AIDS, post-transplant and hematological malignancies. Due to its rarity, PMT is often not included in the differential diagnosis. This case describes a 65 year old male with persistent fever and refractory cough despite high dose empiric antibiotics. Subsequent bronchoscopy with biopsy revealed pseudomembranous tracheitis due to Aspergillus fumigatus in the setting of T-cell lymphoma. PMT should be considered in the differential diagnosis of refractory cough in the immunocompromised population. However, it has been described in patients with nonspecific respiratory symptoms such as dyspnea, cough, and other airway issues

Endoscopic Management of Pediatric Airway and Esophageal Foreign Bodies

The use of endoscopy is critical to the management of pediatric tracheobronchial and esophageal foreign bodies. Children may present with nonspecific symptoms, and the diagnosis can be difficult when the ingestion or aspiration events go unwitnessed. Advances in endoscopic techniques and the use of optical graspers in the removal of foreign bodies in children have helped decrease morbidity and mortality. In this chapter, the history, clinical presentations, workup, and management for pediatric aerodigestive foreign bodies are discussed

Cytoview: development of a cell modelling framework

The biological cell, a natural self-contained unit of prime biological importance, is an enormously complex machine that can be understood at many levels. A higher-level perspective of the entire cell requires integration of various features into coherent, biologically meaningful descriptions. There are some efforts to model cells based on their genome, proteome or metabolome descriptions. However, there are no established methods as yet to describe cell morphologies, capture similarities and differences between different cells or between healthy and disease states. Here we report a framework to model various aspects of a cell and integrate knowledge encoded at different levels of abstraction, with cell morphologies at one end to atomic structures at the other. The different issues that have been addressed are ontologies, feature description and model building. The framework describes dotted representations and tree data structures to integrate diverse pieces of data and parametric models enabling size, shape and location descriptions. The framework serves as a first step in integrating different levels of data available for a biological cell and has the potential to lead to development of computational models in our pursuit to model cell structure and function, from which several applications can flow out

Computational fluid dynamics as surgical planning tool: a pilot study on middle turbinate resection.

Controversies exist regarding the resection or preservation of the middle turbinate (MT) during functional endoscopic sinus surgery. Any MT resection will perturb nasal airflow and may affect the mucociliary dynamics of the osteomeatal complex. Neither rhinometry nor computed tomography (CT) can adequately quantify nasal airflow pattern changes following surgery. This study explores the feasibility of assessing changes in nasal airflow dynamics following partial MT resection using computational fluid dynamics (CFD) techniques. We retrospectively converted the pre- and postoperative CT scans of a patient who underwent isolated partial MT concha bullosa resection into anatomically accurate three-dimensional numerical nasal models. Pre- and postsurgery nasal airflow simulations showed that the partial MT resection resulted in a shift of regional airflow towards the area of MT removal with a resultant decreased airflow velocity, decreased wall shear stress and increased local air pressure. However, the resection did not strongly affect the overall nasal airflow patterns, flow distributions in other areas of the nose, nor the odorant uptake rate to the olfactory cleft mucosa. Moreover, CFD predicted the patient\u27s failure to perceive an improvement in his unilateral nasal obstruction following surgery. Accordingly, CFD techniques can be used to predict changes in nasal airflow dynamics following partial MT resection. However, the functional implications of this analysis await further clinical studies. Nevertheless, such techniques may potentially provide a quantitative evaluation of surgical effectiveness and may prove useful in preoperatively modeling the effects of surgical interventions

Repair of Nasal Septal Perforation with Porcine Small Intestinal Submucosa Xenograft

Background: Numerous techniques have been described for nasal septal perforation repair, with various degrees of success in achieving closure. Evidence supports the use of bilateral mucoperichondrial advancement flaps with interpositional grafting for greatest success. Many surgeons use autografts such as fascia, cartilage, bone, and pericranium, however, extracellular matrices have also become popular. Objective: We analyze factors determining the success of nasal septal perforations repaired using using an acellular, freeze-dried interpositional xenograft derived from Porcine Small Intestinal Submucosa (PSIS). Methods: Patients with septal perforation repaired by the senior author from 1998 to 2006 were examined in a retrospective chart review with regard to perforation size, etiology, pre- and postoperative symptoms, follow-up, outcomes and complications. Results: Forty-seven PSIS repairs were performed on 46 patients. Two procedures were planned staged procedures. Of the total 47 procedures, 41 (87.2%) continued to be closed at the site of repair during the follow up period. Follow up ranged from 6 months to 4.9 years with a mean of 18.3 months. Two patients (4.3%) were found to have perforations at the site of closure in the immediate post-operative period. One patient (2.1%) perforated at the site of closure after the immediate post-operative period. Subjective symptom scores demonstrated improvement in crusting, epistaxis and obstruction postoperatively. Larger perforations correlated with poorer outcomes. Conclusions: The authors conclude that closure of nasal septal perforation with an interpositional xenograft derived from PSIS compares favorably to published results for autografts with advantages including absence of donor site morbidity, easy graft modification and manipulation, and shorter operative time

Increased Plasma Levels of the TH2 chemokine CCL18 associated with low CD4+ T cell counts in HIV-1-infected Patients with a Suppressed Viral Load

The chemokine (C-C motif) chemokine ligand 18 (CCL18) is a structural homolog of CCL3 primarily produced by monocyte-derived cells with an M2 phenotype. Elevated levels of CCL18 have been observed in several diseases associated with malignancies and chronic inflammation. The role of CCL18 in Human Immunodeficiency Virus (HIV-1) infection remains unknown. We analyzed expression levels of T helper cell-mediated (TH2) chemokines CCL18, CCL17, and CCL22 by ELISA in plasma collected from HIV-1-infected and healthy donors. In HIV-1-infected individuals, plasma viral loads were monitored by NucliSense HIV-1 QT assay and T cell counts and expression of the activation marker CD38 were determined by flow cytometry. Our data showed a significant increase in plasma levels of CCL18 in HIV-1-infected individuals compared to uninfected controls (p \u3c 0.001) and a significant correlation between CCL18 levels and viral load in untreated patients. No significant difference of CCL18 levels was detected among the HIV-1-infected patients treated with combined antiretroviral therapy (cART) and HIV-1-untreated patients.CCL18 values are negatively correlated with CD4+CD38+ cell numbers and total CD4+ T cell counts in patients with a suppressed viral load. Notably, plasma levels of the TH2 chemokines CCL17 and CCL22 are also elevated during HIV-1 infection. However, no correlation of CCL17 and CCL22 production with CD4+ T cell counts was detected. Presented data shows that the chemokines, CCL17, CCL18, and CCL22 are increased during HIV-1 infection. However, only increased levels of CCL18, a marker of M2 macrophages, correlate with low CD4+ T cell counts in patients with suppressed viral load, raising the possibility that CCL18 and/or CCL18-producing cells may interfere with their reconstitution in HIV-1-infected patients on cART