Intraspinal Anomalies in Individuals with Scheuermann’s Kyphosis: Is the Routine Use of Magnetic Resonance Imaging Necessary for Preoperative Evaluation?

Study Design Retrospective study. Purpose This study aimed to determine the incidence of intraspinal pathologies (ISPs) in individuals with Scheuermann’s kyphosis (SK) and to validate whether the routine use of magnetic resonance imaging (MRI) is necessary for preoperative evaluation. Overview of Literature There are several studies on the necessity of routine MRI screening and prevalence of ISPs related to different types of scoliosis have been conducted. However, despite the well-established association between ISPs and a higher risk for neurological complications there is no any study on the scientific literature concerning the prevalence of ISPs in patients with SK has been conducted. Methods The database of the institution was retrospectively reviewed to identify all patients diagnosed with SK who underwent surgery between 2012 and 2015. Patients were excluded from the study if their hospital database records did not include spinal images, which are routinely collected before surgery. The presence or absence of ISPs, as indicated on magnetic resonance images, was evaluated by a radiologist. Results Of the 138 potential participants, 120 were included in the study. Of these, seven patients (5.8%) had ISPs, and all the cases involved syringomyelia. None of the seven patients with ISPs required additional neurosurgical procedures before corrective surgery. No complications were reported during the perioperative period, and none of the patients developed postoperative neurological deficits. Conclusions According to this study, the incidence rate of ISPs in patients with SK was 5.8%, and we recommend that all patients with SK should be evaluated using MRI of the spine before corrective surgery

Hydatid cyst of biceps brachii associated with peripheral neuropathy

AbstractIntroductionHydatidosis represents the most significant parasitic disorder in the Mediterranean countries and leads to major problems through unfavorable effects on the public health and national economy. Localization of the primary cyst hydatid infection in the extremity is rare and biceps brachii localization is also rarely reported in the literature.Presentation of caseA 43-year-old woman, who presented with the complaints of mass and pain in the left arm and numbness of the hand. Laboratory investigations, X-ray and magnetic resonance (MRI) findings revealed hydatid cyst of the biceps brachi muscle. The mass was totally excised and the diagnosis was confirmed by the macroscopic images of the mass and the pathologic results. After the surgery, the patient had an improvement in the nerve compression findings including numbness of the hand and the upper extremity and pain.DiscussionLocalization of a primary cyst hydatid infection in the upper extremity is rare and there are no reports of peripheral neuropathy secondary to mass effect. Even if the pre-surgical electromyelography performed for the nerve conduction study reveals a normal result, the potential for the hydatid cysts to cause nerve compression should be taken into consideration in such patients.ConclusionCases of concomitant neurologic findings and complaints secondary to peripheral nerve compression are very rare. The clinical findings should not be ruled out even if the EMG result is negative

Causative pathogens and antibiotic resistance in diabetic foot infections: A prospective multi-center study

WOS: 000378759700027PubMed ID: 26965794Aim: Clinical practice guidelines for the management of diabetic foot infections developed by the Infectious Diseases Society of America (IDSA) are commonly used worldwide. The issue of whether or not these guidelines need to be adjusted for local circumstances, however, has seldom been assessed in large prospective trials. Methods: The Turk-DAY trial was a prospective, multi-center study in which infectious disease specialists from centers across Turkey were invited to participate (NCT02026830). Results: A total of 35 centers throughout Turkey enrolled patients in the trial. Overall, investigators collected a total of 522 specimens from infected diabetic foot wounds for culture from 447 individual patients. Among all isolates, 36.4% were gram-positive organisms, with Staphylococcus aureus the most common among these (11.4%). Gram-negative organisms constituted 60.2% of all the isolates, and the most commonly isolated gram-negative was Escherichia coli (15%). The sensitivity rates of the isolated species were remarkably low for several antimicrobials used in the mild infection group. Conclusions: Based on our findings, several of the antimicrobials frequently used for empirical treatment, including some also recommended in the IDSA guidelines, would not be optimal for treating diabetic foot infections in Turkey. Although the IDSA guideline recommendations may be helpful to guide empiric antimicrobial therapy of DFIs, they should be adjusted to local conditions. (C) 2016 Elsevier Inc. All rights reserved