Culturomics Approaches Expand the Diagnostic Accuracy for Sexually Transmitted Infections.

Sexually transmitted infections (STIs) are a major health concern with clinical manifestations being acknowledged to cause severe reproductive impairment. Research in infectious diseases has been centered around the known major pathogens for decades. However, we have just begun to understand that the microbiota of the female genital tract is of particular importance for disease initiation, infection progression, and pathological outcome.

Recurrent Urinary Tract Infections: Unraveling the Complicated Environment of Uncomplicated rUTIs.

Urinary tract infections (UTIs) are frequent in humans, affecting the upper and lower urinary tract. Present diagnosis relies on the positive culture of uropathogenic bacteria from urine and clinical markers of inflammation of the urinary tract. The bladder is constantly challenged by adverse environmental stimuli which influence urinary tract physiology, contributing to a dysbiotic environment.

Minimum effective volume of local anesthetic for shoulder analgesia by ultrasound-guided block at root C7 with assessment of pulmonary function.

Background And Objectives: This study was performed to determine the minimum effective volume of ropivacaine 0.75% required to produce effective shoulder analgesia for an ultrasound (US)-guided block at the C7 root level with assessment of pulmonary function.

Methods: Using the Dixon and Massey up-and-down method study design, 20 patients scheduled for elective open shoulder surgery under combined general anesthesia and continuous interscalene brachial plexus block were included.

Ultrasound-guided continuous phrenic nerve block for persistent hiccups.

Background: Phrenic nerve block can be performed and repeated if necessary for persistent hiccups, when conservative and pharmacological treatment is unsuccessful. We report the first description of an in-plane ultrasound (US)-guided phrenic nerve block (PhNB) with a catheter, after US investigation of the bilateral diaphragm, to treat hiccups while avoiding repeated PhNBs.

Case: A 36-year-old man had persistent postoperative hiccups not responding to conservative and pharmacological treatment.

Ultrasound-guided low-dose interscalene brachial plexus block reduces the incidence of hemidiaphragmatic paresis.

Background And Objectives: Interscalene brachial plexus block is associated with 100% incidence of hemidiaphragmatic paresis as a result of phrenic nerve block. We examined whether an ultrasound (US)-guided interscalene brachial plexus block performed at the level of root C7 versus a nerve stimulation interscalene brachial plexus block, both using 10 mL of ropivacaine 0.75%, resulted in a lower incidence of hemidiaphragmatic paresis.

Hemidiaphragmatic paresis can be avoided in ultrasound-guided supraclavicular brachial plexus block.

Background And Objectives: Supraclavicular brachial plexus block is associated with 50% to 67% incidence of hemidiaphragmatic paresis as a result of phrenic nerve block. We examined whether ultrasound-guided compared with nerve stimulation supraclavicular brachial plexus block using 0.75% ropivacaine results in a lower incidence of hemidiaphragmatic paresis.

Ultrasound-guided training in the performance of brachial plexus block by the posterior approach: an observational study.

The application of ultrasonography in guiding and controlling the path of the stimulating needle to the brachial plexus via the posterior approach (Pippa technique) was studied. In 21 ASA physical status 1 and 2 patients, scheduled for surgery of the shoulder or upper arm, needle insertion was monitored by ultrasonography and the interaction between needle, surrounding structures and brachial plexus was followed. During injection, the spread of local anaesthetic was visualised and a prediction of block success was made.

The pharmacokinetics of ropivacaine after four different techniques of brachial plexus blockade.

Arterial plasma concentrations of ropivacaine were measured after brachial plexus blockade using four different approaches: lateral interscalene (Winnie), posterior interscalene (Pippa), axillary and vertical infraclavicular. Four groups of 10 patients were given a single 3.75 mg.

A comparison of the lateral and posterior approach for brachial plexus block.

Background: Brachial plexus block by the posterior approach described by Pippa is not widely used in contrast to the lateral approach of Winnie. We compared the clinical efficacy of both approaches in a randomized prospective study.

Methods: Eighty patients, American Society of Anesthesiologists physical status I or II, scheduled for surgery of the shoulder or upper arm were randomized in 2 groups: lateral (Winnie, n = 40) or posterior approach (Pippa, n = 40).

Vertical infraclavicular block of the brachial plexus: effects on hemidiaphragmatic movement and ventilatory function.

Background And Objectives: Several case reports have suggested that block of the brachial plexus by the vertical infraclavicular approach influences hemidiaphragmatic movement and ventilatory function. These effects have not been evaluated in a prospective study.

Methods: Thirty-five consecutive patients scheduled for elective surgery under brachial plexus anesthesia were included.

A comparison of the vertical infraclavicular and axillary approaches for brachial plexus anaesthesia.

Background: This prospective, randomized study compared the efficacy of the vertical infraclavicular and axillary approaches using a single injection blockade of the brachial plexus. The primary endpoint was complete blockade in dermatomes C5-Th1, while secondary endpoints included onset time, motor block, block performance time, surgical success rate, patient satisfaction, and side-effects/complications.

Methods: Sixty patients, American Society of Anesthesiologists physical status I or II, scheduled for surgery of the forearm or hand received either a vertical infraclavicular (n = 30) or an axillary block (n = 30).

Effects of hypnotics on sleep and psychomotor performance. A double-blind randomised study of lormetazepam, midazolam and zopiclone.

Lormetazepam, midazolam and zopiclone were compared as night medication in patients scheduled for elective surgery the next morning. Sixty patients divided at random into three groups, received double-blind lormetazepam 1 mg, midazolam 15 mg or zopiclone 7.5 mg, by mouth at 2200 hours.

[Vascular pedicled iliac bone graft in therapy of femur head necrosis in the adult. Clinical and angiographic results].

23 hip joints with hip head necrosis in 22 patients were provided with a pedicle bone-graft perfused by the art. circumflexa ilium profunda. I two cases it was necessary to remove the bone-graft contralaterally because bone had already been removed from the side with the necrosis at an earlier date.

[Growth disorders of the para-articular end of the femur following surgical treatment of pediatric femoral fractures].

In pediatric traumatology, conservative treatment takes precedence over surgery. Since the skeleton is capable of spontaneous correction even after malpositioning, surgical intervention to treat fractures is only justified within very narrowly defined limits. Where osteosynthesis material is used, not only the vascular supply, but also the development and functionality of growth joints must be taken into account.

[20 years of subcapital osteotomy of slipped upper femoral epiphysis. Indications and results].

Between 1945 and 1985, 570 patients with a slipped upper femoral epiphysis were treated at our hospital. During the last two decades a subcapital osteotomy was performed if the degree of slip exceeded 50 degrees. Twenty two such operations were carried out in 21 patients.

[Shaft fractures in the growth stage--surgical indications or conservative therapy].

The treatment of fractures in growing children, especially shaft fractures, is subject to special rules compared to the treatment of such injuries in adult persons. Osteosynthesis is only rarely indicated. Marrow nailing involves great risks at the point where the nail is driven in.

[Arthrolysis of the knee joint].

The surgical treatment of the extensor rigidity of the knee joint described by Payr was performed in fourteen cases at the Orthopedic University Hospital of Giessen. A flexion of more than 90 degrees was achieved in all patients. In case of correct indication, this method has still its value in orthopedia even regarding the changed patient categories.

[Femoral fractures near the knee in the growth period].

Fractures of the distal part of the femur in children are difficult to classify as suggested by Aitken, Harris and Salter if the epiphyseal cartilage is injured. Such injuries are rare if seen in relation to the grand total of paediatric lesions. There are late complications, however.

[Liability problems in endoprosthetics].

The alloarthroplasty is a successful operation in coxarthrosis. It is a procedure not including alone the possibility of alternative treatment but also many certain and uncertain risks. Patients wishes are not always to realise so increased number of demands are in this way to expect.