Infections of Deep Hand and Wrist Compartments.

The human hand is the most exposed part of the body to highest risk for injuries, loss of the skin integrity, and to the inoculation of bacteria, most commonly Staphylococcus aureus, Streptococcus β-haemolytic, and gram-negative. In case of an infection, the mobile anatomical structures and the synovial membranes in close proximity to each other may spread the pus towards deep spaces and compartments. Mild early infections without an abscess formation may respond to antibiotics, but at more advanced stage, erythema, swelling, stiffness, and severe pain may ensue.

Risks in Antibiotic Substitution Following Medicine Shortage: A Health-Care Failure Mode and Effect Analysis of Six European Hospitals.

Medicine shortages result in great risk for the continuity of patient care especially for antimicrobial treatment, potentially enhancing resistance rates and having a higher economic impact. This study aims to identify, describe, assess, and assign risk priority levels to potential failures following substitution of antimicrobial treatment due to shortages among European hospitals. Furthermore, the study investigated the impact of corrective actions on risk reduction so as to provide guidance and improve future patient care.

An overview of management of intracranial hypertension in the intensive care unit.

Intracranial hypertension (IH) is a clinical condition commonly encountered in the intensive care unit, which requires immediate treatment. The maintenance of normal intracranial pressure (ICP) and cerebral perfusion pressure in order to prevent secondary brain injury (SBI) is the central focus of management. SBI can be detected through clinical examination and invasive and non-invasive ICP monitoring.

Radial Extracorporeal Shock Wave Therapy Against Implant-Associated Infections: An in Vitro Trial.

Background: Antibiotic management of low-virulent implant-associated infections induced by may be compromised by multi-drug resistance development, side effects, and increased cost. Therefore, we sought to assess the effects of shock wave therapy against the above pathogen using an in vitro model of infection.

Methods: We used a total of 120 roughened titanium alloy disks, simulating orthopedic biomaterials, to assess the results of radial extracorporeal shock wave therapy (rESWT) against (ATCC 11827) biofilms relative to untreated control.

Metabolic Syndrome in Patients with Coexistent Obstructive Sleep Apnea Syndrome and Chronic Obstructive Pulmonary Disease (Overlap Syndrome).

Evidence suggests that metabolic syndrome (MetS) is highly prevalent in patients with obstructive sleep apnea syndrome (OSAS) and chronic obstructive pulmonary disease (COPD). However, data on the prevalence of MetS in patients having both OSAS and COPD, or overlap syndrome (OS), are scarce. The aim of this study was to evaluate the prevalence and identify predictors of MetS in patients with OS.

Lambda sign on a gallium scan: not always sarcoidosis.

Sarcoidosis is a systemic disease of unknown origin. We describe a case of sputum smear-and culture-negative tuberculosis that was diagnosed with histological examination of a surgical lung biopsy, as other entities such as sarcoidosis could not be excluded after extended investigation. Even a typical lambda sign on gallium scintigraphy proved to be misleading.

Bronchial HPV; the good the bad and the unknown.

Background: Solitary tracheobronchial papilloma (STBP) is a rare benign tumor. Human papilloma virus (HPV) infection is associated with dysplasia and a high risk of carcinoma.

Case 1: Sixty five year old male with hemoptysis and with coilocytic atypia, indicating the presence of HPV.

Biomechanical comparison of six intramedullary nails, for the treatment of ex-tra-articular, proximal tibial fractures.

Background: Intramedullary nailing is the "gold standard" treatment modality of diaphyseal fractures of the tibia. However, when the same method is used for extra-articular fractures of the proximal tibia, various problems may occur, like malalignment, loss of reduction, and non-union. The objective of the present biomechanical study was to compare the stability of six tibial nails when these are used for the treatment of unstable, extra-articular, proximal tibial fractures.

Effect of monoclonal antibodies on olfactory dysfunction caused by chronic rhinosinusitis with nasal polyps: a systematic review and meta-analysis.

Background: Olfactory dysfunction is a common complaint in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). The purpose of this article is to critically review all published literature regarding the impact of monoclonal antibodies on CRSwNP-related olfactory dysfunction.

Methods: An electronic literature search was performed in MEDLINE, ScienceDirect, the Cochrane Library electronic databases, and multiple trial registries, followed by extensive hand-searching for the retrieval of relevant studies.

Fasting insulin levels correlate with the frequency of hypoglycemic events in people with type 2 diabetes on treatment with sulfonylureas: A pilot study.

Aims And Objectives: We aimed to explore whether fasting insulin levels correlate with the risk of hypoglycemia in people with Type 2 diabetes (T2D) receiving sulfonylureas (SUs).

Materials And Methods: Our study included 58 individuals with T2D who had been on treatment with SUs, but not insulin, for more than 2 years. Confirmed hypoglycemic episodes during the past year were self-reported by the patients, and a potential relationship of hypoglycemic event frequency with fasting insulin levels was investigated.

Dual photothermal MDSCs-targeted immunotherapy inhibits lung immunosuppressive metastasis by enhancing T-cell recruitment.

Immunosuppressive chemoresistance is a major barrier in lung cancer treatment. However, the immunosuppressive mechanisms responsible for lung cancer cell chemoresistance and tumor relapse are still unknown. In this study, we introduce a model of precise immunosuppressive-based nanotherapy by designing and delivering biocompatible MDSC-targeted nanocarriers (NCs) into the lung tumor microenvironment.

Burnout syndrome and its association with anxiety and fear of medical errors among intensive care unit physicians: A cross-sectional study.

Burnout is a work-specific syndrome with high incidence among intensive care unit personnel. Although several risk factors have been proposed, data regarding the association of anxiety and burnout among intensive care unit physicians are scarce. The aim of this study is to investigate the incidence of burnout and its association with state and trait anxiety and other sociodemographic, behavioural and occupational-related parameters, among intensivists.

Blood and fluid management during scoliosis surgery: a single-center retrospective analysis.

Aim: In the present retrospective study in scoliosis surgery, we hypothesized that application of a protocol for blood and fluid management, based on goal-directed fluid therapy, cell salvage and tranexamic acid, could lead to reduced allogeneic red blood cells transfusion.

Methods And Material: Thirty-five patients, with American Society of Anesthesiologists physical status I/III, between 14 and 18 years scheduled for elective orthopedic surgery of scoliosis, with a planned intensive care unit admission, were enrolled in a retrospective observational study. Patients were divided in two groups.

Bisphosphonate's Effect on Tongue Mucosa: An Experimental Electron Microscopy Study.

Background And Objectives: Bisphosphonates (BPs) are selective inhibitors of osteoclasts, used for the treatment of bone disorders. The objective of this study is to investigate the possible effects of BPs on the tongue's mucosa.

Materials And Methods: Specimens of the tongue of 20 female 12-month old Wistar rats were taken.

Late results of a randomized trial on the role of mild hypofractionated radiotherapy for the treatment of localized prostate cancer.

Prostate cancer is considered to be highly sensitive to changes in radiation therapy dose per fraction, specifically to hypofractionation. An increase in the fractionation dose could cause a higher increase to the prostate than to the normal tissues leading to better disease control with less toxicity. Here we present the results of a randomized trial comparing mild hypofractionation to conventional fractionation after a median of 3,6 years follow up.

Respiratory Involvement in Patients with Neuromuscular Diseases: A Narrative Review.

Respiratory muscle weakness is a major cause of morbidity and mortality in patients with neuromuscular diseases (NMDs). Respiratory involvement in NMDs can manifest broadly, ranging from milder insufficiency that may affect only sleep initially to severe insufficiency that can be life threatening. Patients with neuromuscular diseases exhibit very often sleep-disordered breathing, which is frequently overlooked until symptoms become more severe leading to irreversible respiratory failure necessitating noninvasive ventilation (NIV) or even tracheostomy.

Gender Differences in Obstructive Sleep Apnea: The Value of Sleep Questionnaires with a Separate Analysis of Cardiovascular Patients.

Background: Gender affects the clinical presentation of obstructive sleep apnea (OSA). The classic OSA symptoms, such as sleepiness, snoring, and apnea, are not so frequent in women.

Objectives: To evaluate possible gender differences in questionnaires used for OSA prediction, such as the Epworth Sleepiness Scale (ESS), STOP, STOP Bang (SB), Berlin Questionnaire (BQ), Athens Insomnia Scale (AIS), and Fatigue Scale (FS).

Inhibition of kras-derived exosomes downregulates immunosuppressive BACH2/GATA-3 expression via RIP-3 dependent necroptosis and miR-146/miR-210 modulation.

Immunosuppressive chemoresistance is a major challenge in lung cancer treatment. Exosomes present in the tumor microenviroment are implicated in chemoresistant-related immune suppression, and metastasis but the exact pathogenic role of lung-derived exosomes is still uncertain. Recent reports reveal that lung cancer pathogenesis is strictly associated with a exosomal tumor supportive status and a dysfunctional immune system.

Patients' and Clinicians' Preferences on Outcomes and Medication Attributes for Type 2 Diabetes: a Mixed-Methods Study.

Background: Patients' views on the relative importance of treatment outcomes and medication attributes for type 2 diabetes may differ from clinicians' perceptions.

Objective: To assess which treatment outcomes and medication attributes are considered important by patients and clinicians for therapeutic decisions in type 2 diabetes.

Design: Exploratory, sequential, mixed-methods design comprising a qualitative (focus groups) and a quantitative (survey) phase.

Is There an Independent Role of TERT and NF1 in High Grade Gliomas?

Background: High grade glioma molecular profiling is of particular interest in neurooncology. The role of telomerase reverse transcriptase (TERT) varies dependent upon other molecular parameters. We explored the role of TERT in 101 high-grade gliomas.

A phase 2 study of ibrutinib in combination with bortezomib and dexamethasone in patients with relapsed/refractory multiple myeloma.

Objective: We evaluated ibrutinib, a once-daily inhibitor of Bruton's tyrosine kinase, combined with bortezomib and dexamethasone in patients with relapsed or relapsed/refractory multiple myeloma who had received 1-3 prior therapies.

Methods: This was a phase 2, single-arm, open-label, multicentre study (NCT02902965). The primary endpoint was progression-free survival (PFS).

Lung cancer in patients with Idiopathic Pulmonary Fibrosis. A retrospective multicenter study in Greece.

Background: Abundant evidence supports an association between Idiopathic Pulmonary Fibrosis (IPF) and lung cancer development. Data on diagnosis and management of patients with IPF and lung cancer are still scarce.

Patients And Methods: This was a retrospective multicenter study, enrolling 1016 patients with IPF from eight different centers between 2011 and 2018 in Greece.