Cement loaded with high-dose gentamicin and clindamycin does not reduce the risk of subsequent infection after aseptic total hip or knee revision arthroplasty: a preliminary study.

Purpose: The aim of this study was to quantify the prophylactic effect of high-dose gentamicin and clindamycin antibiotic-loaded bone cement (ALBC) during revision total hip (rTHA) or knee (rTKA) arthroplasty for aseptic reasons. The hypothesis was that the raw surgical site infection (SSI) rate is lower when this particular cement is used in comparison with cement loaded with standard-dose gentamicin during rTHA or rTKA for aseptic reasons.

Methods: This retrospective study included 290 consecutive patients undergoing aseptic rTHA or rTKA.

Pituitary Abscess: A Challenging Preoperative Diagnosis-A Multicenter Study.

Pituitary abscess (PA) is a rare occurrence, representing less than 1% of pituitary lesions, and is defined by the presence of an infected purulent collection within the sella turcica. Pas can be classified as either primary, when the underlying pituitary is normal prior to infection, or secondary, when there is associated a pre-existing sellar pathology (i.e.

Cement Loaded With High-Dose Gentamicin and Clindamycin Reduces the Risk of Subsequent Infection After One-Stage Hip or Knee Arthroplasty Exchange for Periprosthetic Infection: A Preliminary Study.

Background: The use of antibiotic-loaded acrylic cement for treating periprosthetic joint infections remains controversial. We hypothesized that the raw rate of surgical site infection (SSI) is lower after using cement loaded with high-dose gentamicin and clindamycin than after using cement loaded with standard-dose gentamicin for implant fixation during 1-stage hip and knee revision arthroplasty for infection.

Methods: One hundred seventy-one continuous patients operated by 2 experienced surgeons during a 2-year period were included in the study.

Antibiotic prophylaxis in orthopedics-traumatology.

When all rules of hygiene have been scrupulously applied, antibiotic prophylaxis (ABP) is the one remaining means of further reducing surgical site infection risk. Its efficacy in major orthopedic surgical procedures is proven. Guidelines for indications and ABP systemic administration have been long established and are able to address many questions.

Subcutaneous teicoplanin in staphylococcal bone and joint infections.

Objective: We aimed to describe the use of subcutaneous teicoplanin as an alternative for the treatment of staphylococcal bone and joint infections.

Methods: A retrospective multicentric cohort (2002-2015) was conducted with patients receiving subcutaneous teicoplanin for a staphylococcal bone and joint infection.

Results: Forty patients were assessed.

Bone penetration of daptomycin in diabetic patients with bacterial foot infections.

Objectives: Daptomycin has shown clinical efficacy in diabetic foot infections (DFI). However, only limited data are available on its bone penetration in this particular population. The aim of this study was to determine daptomycin bone concentrations in patients with DFI undergoing surgery after multiple daptomycin infusions and to determine bone daptomycin inhibitory quotients (IQs) for the predominant gram-positive species involved in DFI.

Agreement between pre-operative and intra-operative bacteriological samples in 85 chronic peri-prosthetic infections.

Background: Whether pre-operative microbiological sampling contributes to the management of chronic peri-prosthetic infection remains controversial. We assessed agreement between the results of pre-operative and intra-operative samples in patients undergoing single-stage prosthesis exchange to treat chronic peri-prosthetic infection.

Hypothesis: Agreement between pre-operative and intra-operative samples exceeds 75% in patients undergoing single-stage exchange of a hip or knee prosthesis to treat chronic peri-prosthetic infection.

May one-stage exchange for Candida albicans peri-prosthetic infection be successful?

Unlabelled: Fungal infection of a total joint arthroplasty has a low incidence but is generally considered as more difficult to cure than bacterial infection. As for bacterial infection, two-stage exchange is considered as the gold standard of treatment. We report two cases of one-stage total joint exchange for fungal peri-prosthetic infection with Candida albicans, where the responsible pathogens was only identified on intraoperative samples.

Daptomycin for the treatment of osteomyelitis and orthopaedic device infections: real-world clinical experience from a European registry.

Osteomyelitis is a serious infection predominantly caused by Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA). Orthopaedic device-related infections are complex and require a careful combination of surgical intervention and antimicrobial therapy. Daptomycin, a cyclic lipopeptide, effectively penetrates soft tissue and bone and demonstrates rapid concentration-dependent bactericidal activity against Gram-positive pathogens.

[Feedback on the evaluation of clinical pharmacy activities developed in surgery].

Introduction: Our current development strategy integrates clinical pharmacy activities prioritized in surgical services. Patients in these services are typically risk patients: transfers, multiple prescribers, frequent medication change, pharmacotherapeutic risk classes.

Patients And Methods: Three clinical pharmacy activities (admission reconciliation, pharmaceutical analysis, participation doctors round) have been developed in orthopaedic surgery and neurosurgery.

Routine one-stage exchange for chronic infection after total hip replacement.

Purpose: We hypothesized that a routine one-stage exchange for treatment of chronically infected total hip replacement (THR) will lead to (1) a higher rate of infection recurrence and (2) a poorer hip outcome than the published rates after two-stage exchange.

Methods: Sixty-five cases have been treated consecutively with one-stage exchange. All patients have been followed for a period of three to six years or until death or infection recurrence.

[Clinical pharmacy and surgery: Review].

Clinical pharmacy has been developed and evaluated in various medical hospital activities. Reviews conducted in this area reported a higher value of this discipline. In surgical services, evenly adverse drug events may occur, so clinical pharmacy activities must also help to optimize the management of drug's patient.

Diagnostic accuracy of intra-articular C-reactive protein assay in periprosthetic knee joint infection--a preliminary study.

Background: Periprosthetic joint infection often raises diagnostic challenges, as the published criteria are heterogeneous. New markers for predicting periprosthetic infection have been evaluated. Here, we assessed one of these markers, C-reactive protein (CRP), in joint fluid.

Neuronal Nogo-A negatively regulates dendritic morphology and synaptic transmission in the cerebellum.

Neuronal signal integration as well as synaptic transmission and plasticity highly depend on the morphology of dendrites and their spines. Nogo-A is a membrane protein enriched in the adult central nervous system (CNS) myelin, where it restricts the capacity of axons to grow and regenerate after injury. Nogo-A is also expressed by certain neurons, in particular during development, but its physiological function in this cell type is less well understood.

Shared synaptic pathophysiology in syndromic and nonsyndromic rodent models of autism.

The genetic heterogeneity of autism poses a major challenge for identifying mechanism-based treatments. A number of rare mutations are associated with autism, and it is unclear whether these result in common neuronal alterations. Monogenic syndromes, such as fragile X, include autism as one of their multifaceted symptoms and have revealed specific defects in synaptic plasticity.

Opposite effects of ketamine and deep brain stimulation on rat thalamocortical information processing.

Sensory and cognitive deficits are common in schizophrenia. They are associated with abnormal brain rhythms, including disturbances in γ frequency (30-80 Hz) oscillations (GFO) in cortex-related networks. However, the underlying anatomofunctional mechanisms remain elusive.

High infection control rate and function after routine one-stage exchange for chronically infected TKA.

Background: Many surgeons consider two-stage exchange the gold standard for treating chronic infection after TKA. One-stage exchange is an alternative for infection control and might provide better knee function, but the rates of infection control and levels of function are unclear.

Questions/purposes: We asked whether a one-stage exchange protocol would lead to infection control rates and knee function similar to those after two-stage exchange.

Culture with BACTEC Peds Plus bottle compared with conventional media for the detection of bacteria in tissue samples from orthopedic surgery.

We evaluated the performance of the BACTEC Peds Plus bottles for the detection of bacteria in 186 tissue samples obtained from orthopedic infections. BACTEC Peds Plus bottles led to bacterial detection in 69% of these samples against less than 53% for each of the other types of conventional media (P < 0.05).

NMDA receptor hypofunction leads to generalized and persistent aberrant gamma oscillations independent of hyperlocomotion and the state of consciousness.

Background: The psychotomimetics ketamine and MK-801, non-competitive NMDA receptor (NMDAr) antagonists, induce cognitive impairment and aggravate schizophrenia symptoms. In conscious rats, they produce an abnormal behavior associated with a peculiar brain state characterized by increased synchronization in ongoing gamma (30-80 Hz) oscillations in the frontoparietal (sensorimotor) electrocorticogram (ECoG). This study investigated whether NMDAr antagonists-induced aberrant gamma oscillations are correlated with locomotion and dependent on hyperlocomotion-related sensorimotor processing.

[Knee septic arthritis].

The development of antibiotics and arthroscopic treatment have been two major turning points in the management of septic arthritis of the knee joint. We report a retrospective review of 78 patients managed in three surgery units and one rheumatology unit. Management practices varied between the units.

Results of treatment of septic knee arthritis: a retrospective series of 40 cases.

We studied a consecutive series of 40 patients presenting a septic knee arthritis, with a mean age of 49 +/- 20 (range 19-81) years. The aetiologies were: 18 postoperative arthritis, 12 haematogenous infections, 7 arthritis following aspiration or infiltration, and 3 articular wounds. The most common organisms were Staphylococcus aureus and epidermidis (23 cases).