Shoulder Prosthetic Infection and Humerus Osteomyelitis From Cutibacterium Following Eden-Hybinette Procedure.

We describe the case of a patient who recently underwent a guided arthroscopic Eden-Hybinette procedure for the revision of a previous failed procedure of Latarjet and resurgence of shoulder instability. The subsequent development of painful infectious arthritis of the left shoulder complicated by osteomyelitis of the humerus, caused by , and accompanied by high fever was resolved only after the removal of synthetic screws and bone grafting and thanks to prolonged intravenous antibiotic treatment. The antibiotic regime was continued, both intramuscularly and orally, after discharge, allowing the full healing of the severe osteoarticular infection of the shoulder.

Performance of classical serum inflammatory markers in healed and unhealed treated patients with joint and prosthetic joint infections.

Background: Serum markers, such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and D-dimer, are currently used by clinicians and orthopedic surgeons in diagnosing and managing joint infections (JI), although conflicting results exist on their performance. The aim of this study was to evaluate their performance in assessing healing or unhealing of patients with JI or with prosthetic joint infection (PJI).

Methods: ESR, CRP and D-dimer serum levels were evaluated before, during and after antibiotic treatment in 61 patients (65.

Multiparametric ultrasound images of three different cases of schwannoma of the peripheral nervous system.

This case image illustrates the importance of new sonographic applications such as superb microvascular imaging and shear wave elastography; as showed, they improve the diagnostic recognition of peripheral nerve lesion thanks to a better definition of vascularity and measure of stiffness.

Human Monkeypox-A Global Public Health Emergency.

Monkeypox, a viral zoonosis caused by an Orthopoxvirus, is clinically characterized by fever, headache, lymphadenopathy, myalgia, rash and burdened by some complications that can be severe and life threatening. Monkeypox, endemic in some central and west African countries, in tropical areas near equator, rose to the headlines following its recent outbreak in non-endemic countries of Europe and the USA. Thus, the World Health Organization, worried about the growing dimension of the problem, declared monkeypox a global public health emergency.

Nosocomial Extracardiac Infections After Cardiac Surgery.

Purpose Of Review: Nosocomial extracardiac infections after cardiac surgery are a major public health issue affecting 3-8.2% of patients within 30-60 days following the intervention.

Recent Findings: Here, we have considered the most important postoperative infective complications that, in order of frequency, are pneumonia, surgical site infection, urinary tract infection, and bloodstream infection.

First case of aorto-bi-iliac endograft thrombotic infection by : A case report.

may cause serious vascular and graft infections. In the present case report, a 71-year-old man underwent partial prosthetic endograft replacement due to high-flow endoleak and limb occlusion. Following surgery, a multiple empiric antibiotic regime was initiated due to fever, malaise, abdominal tenderness and signs of an acute abdomen; however, in spite of this, the clinical condition of the patient worsened.

Fatal Clostridium Infection in a Leg-Amputated Patient after Unsuccessful Knee Arthroplasty.

Prosthetic joint infection (PJI) is a possible complication occurring after prosthesis implantation. We describe the case of a patient with early postoperative multidrug-resistant polymicrobial PJI and mixed infection of the surgical wound. Despite the removal of the prosthesis, the positioning of double-stage exchange, and dehiscence debridement of the surgical wound, the infection continued.

Prosthetic joint infection. A relevant public health issue.

Prosthetic joint infection (PJI) is a common complication of the knee and hip arthroplasty and represents a huge challenge for physicians. PJI raises serious social, economic and clinical concerns in the public health that need a comprehensive approach to better focus on proven strategies for disease prevention and treatment. History and clinical signs on joint site are useful means for suspecting PJI that need to be confirmed through major and minor diagnostic criteria.

Analogies and differences between cirrhotic cardiomyopathy and hepatopulmonary syndrome.

Cirrhotic cardiomyopathy and hepatopulmonary syndrome are two quite frequent clinical entities that may complicate the course of liver cirrhosis. The common pathophysiological origin and the same clinical presentation make them difficult to compare. Cirrhotic cardiomyopathy and hepatopulmonary syndrome may start with dyspnea and breathlessness but the former is characterized by a chronic cardiac dysfunction and the latter by a defect of oxygenation due to pulmonary shunts formation.

Reliability and Agreement of Point and 2-D Shear-Wave Elastography in Assessing the Sciatic Nerve Stiffness.

Information is lacking about the reliability and agreement of different shear-wave elastographic modes in the peripheral nervous system evaluation. The aim of this observational study was to evaluate reproducibility and agreement of two different shear-wave elastographic modes for measuring the sciatic nerve stiffness in patients affected by osteoarthrosis. Two sets of three measurements were conducted bilaterally on the sciatic nerve of 20 patients with point and 2-D shear-wave elastography by a unique expert sonographer.

Externally Supported Extra-anatomical Venous Bypass to Treat Upper Limb Ischemia with Shoulder Prosthetic Infection.

To report a case of acute arm ischemia and prosthetic shoulder infection treated by extra-anatomical great saphenous vein graft with external vascular scaffolding. A 65 year-old man with multiple surgical interventions for soft tissue sarcoma of the right shoulder, local radiotherapy with residual brachial plexus neuropraxia, was referred to our attention for signs of arm ischemia. Two weeks before, the patient was submitted to prosthetic shoulder replacement complicated with prosthetic infection.

Surgical wound dehiscence complicated by methicillin-resistant infection in a diabetic patient with femorotibial vascular bypass occlusion.

Diabetic patients with critical limb ischaemia may be affected by severe wound and skin ulcer infections. We report a case of a patient with bilateral femorotibial occlusion and methicillin-resistant infection. The patient was treated with femoroperoneal vascular bypass, debridement of wound dehiscence and targeted antimicrobial therapy for symptom resolution and healing of the wound.

Accuracy and performance of a new handheld ultrasound machine with wireless system.

We verified the accuracy and performance of a new handheld ultrasound machine, in comparison to a high-end sonographic machine. We performed bilateral measurements of the following tendon districts (supraspinatus, flexor of the middle finger, patellar and Achilles) and of the cross sectional area of the median nerve in 21 patients using a musculoskeletal ultrasound linear scanner of a handheld sonographic machine and a high-end sonographic machine. Two tail T test was used to evaluate whether there were differences in the measurements between the two sonographic machines.

Strain Ultrasound Elastography in the Achilles Tendon of Ankylosing Spondylitis Patients Treated With Anti-TNF-α: A Preliminary Study.

Background/aim: To compare patients affected by ankylosing spondylitis (AS) treated with anti-TNF-α for two years with controls in terms of Achilles tendon stiffness, ultrasound structure and thickness.

Patients And Methods: B-mode ultrasound evaluation and strain ultrasound elastography were performed in longitudinal and transverse planes on 22 Achilles tendons of 11 AS patients and 26 of 13 controls.

Results: There were no significant differences in thickness and stiffness of the Achilles tendon between AS patients and controls, except for an increased thickness in the middle third of the tendon in the AS patients (p=0.

Reliability of quantitative point shear-wave ultrasound elastography on vastus medialis muscle and quadriceps and patellar tendons.

Aim: The aim of this work was to evaluate the reliability of pSWE in assessing the stiffness of the vastus medialis muscle and of the quadriceps and patellar tendons.

Material And Methods: For this purpose, 18 subjects (9 males and 9 females of 57±22 years) in good clinical conditions were included in this study. pSWE examination was conducted by a unique expert operator with more than ten years of experience in musculoskeletal ultrasound.

Five-year-term results in cirrhotics without varices, either affected or not by portal hypertensive gastropathy.

Objectives: Information is lacking on the appearance of varices in cirrhotics, either affected or not by portal hypertensive gastropathy (PHG). We assessed whether the absence or presence and the grade of PHG influenced the development of varices in cirrhotics without varices over time.

Patients And Methods: Forty cirrhotics without varices affected or not by PHG at baseline underwent follow-up endoscopy after 5 years.

Differences in carotid atherosclerosis between patients with ankylosing spondylitis treated with tumor necrosis factor-α antagonists and healthy matched controls.

An increased vascular risk is present in patients with ankylosing spondylitis (AS). In this report, we evaluate the presence and grade of atherosclerosis in patients with AS, uninterruptedly treated with tumor necrosis factor-α (TNF-α) antagonists for 2 years, in comparison to that in a nontreated group of healthy controls.Fourteen patients with AS and 14 healthy controls underwent carotid sonography to measure intima-media thickness (IMT) and to evaluate the presence of plaque.

Diagnostic approach to neuropsychiatric lupus erythematosus: what should we do?

Neuropsychiatric systemic lupus erythematosus is a diagnostic challenge due to the multifarious neurological and psychiatric manifestations that define it but, when suspected, diagnostic imaging can give a fundamental help. The advancements and variety of neuroimaging techniques allow us to perform more and more accurate evaluations of structure, perfusion, and metabolism of the brain and to detect cerebral and spinal lesions. Moreover, vascular districts of the neck and the brain, as well as the electrical brain and peripheral muscle activity may be accurately investigated, thus giving us a wide panoramic view.

An ultrasound automated method for non-invasive assessment of carotid artery pulse wave velocity.

To validate the clinical applicability and feasibility of an automated ultrasound (US) method in measuring the arterial stiffness of patients with chronic inflammatory rheumatic diseases, comparing automated measurements performed by a rheumatologist without experience in vascular sonography with those obtained by a sonographer experienced in vascular US, using a standardized manual method. Twenty subjects affected by different chronic inflammatory rheumatic disorders were consecutively recruited. For each patient, the arterial stiffness of both common carotids was manually calculated.

Platypnoea-orthodeoxia syndrome in the elderly: A difficult-to-make diagnosis of intracardiac right-to-left shunt.

Introduction Platypnea-orthodeoxia syndrome is a combination of positional dyspnoea and hypoxemia; it is caused by several cardiac, pulmonary and hepatic diseases. Case presentation In this study, we describe a 77-year-old female affected by unexplained dizziness and hypoxia that exacerbated in upright position. After diagnosing platypnea-orthodeoxia syndrome and excluding all possible causes (liver cirrhosis, acute and chronic pulmonary diseases and arteriovenous malformations), the origin of the syndrome was individuated in the presence of a patent foramen ovale with right-to-left shunt.

Portopulmonary hypertension and hepatorenal syndrome. Two faces of the same coin.

Portopulmonary hypertension and hepatorenal syndrome are both severe local hypertensive complications of liver cirrhosis and portal hypertension. Both are characterized by vasoconstrictive manifestations regarding pulmonary and renal vascular network, respectively. This review addresses the mechanisms underlying the development of vasoconstriction that leads to local vascular hypertension in the lung and in the kidney with the result of organ dysfunction.