scholarly journals The importance of eliminating microcirculatory disorders in the complex treatment of common soft tissue phlegmon

2021 ◽  
Vol 6 (5) ◽  
pp. 212-221
Author(s):  
E. A. Tseimakh ◽  
V. Yu. Zinchenko
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
Multiple Organ ◽  
Purulent Discharge ◽  
Enzyme Therapy ◽  
Complex Treatment ◽  
Inflammatory Processes ◽  
Microcirculatory Disorders ◽  
New Treatment ◽  
Thrombohemorrhagic Syndrome

Background. The treatment of purulent-inflammatory processes of soft tissues remains today an area of surgery that is not given enough attention by specialists of both inpatient and outpatient levels, with many unresolved problems. Of particular importance in the pathogenesis of purulent-septic processes are the emerging microcirculation disorders due to the formation of micro-clots. An important point that aggravates the course of the disease is the development of thrombohemorrhagic syndrome. As a result, even with a variety of antibacterial drugs and the ыavailability of  new treatment methods, it is often not possible to achieve positive results in the treatment of this heavy contingent of patients.Aim: to improve the effectiveness of complex therapy of patients with extensive soft tissue phlegmon by relieving thrombohemorrhagic syndrome.Materials and methods. Cryoplasma-anti-enzyme therapy in the composition of complex treatment was received by 59 (48.8 %) patients of the main group, 62 (51.2 %) patients of the comparison group received only the generally accepted treatment. In each group, there are three variants of the course of the disease – moderate, severe and septic.Results. The analysis of the clinical course of the disease showed that in patients of the first group, wounds were cleared of necrotic masses and purulent discharge with filling them with healthy granulation tissue 5.3 days faster than in the second group (p˂0.001). The number of deaths decreased – 11.9 % in the first group against 27.4 % in the second group (p˂ 0.001). The number of deaths decreased – 11.9 % in the first group against 27.4 % in the second group (p˂ 0.001). The proportion of thrombotic and thromboembolic causes of death in the first group (14.3 %) was lower than in the second (17.7 %) (p˂ 0.05).Conclusion. The use of cryoplasma-anti-enzyme therapy as part of complex treatment contributed to the effective relief of thrombohemorrhagic syndrome, the  elimination of microcirculatory disorders, which allowed performing plastic closure of  a  wound defect 1.6  times faster, prevented the progression of multiple organ failure, and contributed to a reduction in mortality. 

scholarly journals Efficacy of Miramistin-Metronidazole Combination in the Treatment of Purulent-Inflammatory Processes of Soft Tissues

2020 ◽  
Vol 13 (4) ◽  
pp. 312-318
Author(s):  
Boris S Sukovatych ◽  
Yuri Yu Blinkov ◽  
Sergey I Tiganov ◽  
Arsen Yu Grigoryan ◽  
Alexander I Bezhin ◽  
...  
Keyword(s):  
Sodium Salt ◽  
Soft Tissues ◽  
Inflammatory Diseases ◽  
Local Treatment ◽  
Purulent Discharge ◽  
Inpatient Stay ◽  
Wound Area ◽  
Common Category ◽  
Inflammatory Processes ◽  
Wound Discharge

Importance of the topic. The patients with purulent-inflammatory processes of soft tissues are the most common category of surgical patients, since the effectiveness of their treatment decreases due to the development of microorganism resistance to antibiotics and antiseptics. The aim of research was to study the clinical efficacy of topical application of miramistin-metronidazole combination immobilized on sodium salt of carboxymethyl cellulose in the treatment of purulent-inflammatory processes of soft tissues.Materials and methods. The study included 60 patients with purulent-inflammatory diseases of soft tissues. They were divided into 2 groups, 30 people in each group. All patients were exposed to partial surgical treatment of the purulent focus. In the first group, the treatment consisted of local application of dioxomethyltetrahydropyrimidine ointment with the antibiotic chloramphenicol, and in the second group with miramistin-metronidazole combination immobilized on the sodium salt of carboxymethylcellulose. The course of the wound process was assessed by the dynamics of the local wound temperature, the percentage of reduction of the wound size and volume and the rate of its healing; the terms of edema and purulent discharge elimination, the onset of the appearance of mature granulations and epithelialization of wounds, the cessation of the microflora growth in wounds, the average number of inpatient days were also registered. Results. Measurements of the local wound temperature demonstrated that the inflammatory process in patients of the first group lasted for 10 days, and in patients of the second group for 5-6 days. Prior to discharge from the hospital, the wound area was 16.1% and the volume of wounds was 14% less in patients of the second group compared with similar findings in patients of the first group. The edema of the tissues surrounding the wound eliminated within 1.5 days, and the exudation from the wound stopped 2 days earlier in patients of the second group. Granulation in the wound appeared 2 days, and marginal epithelialization 1 day earlier in patients of the second group. With bacterial culturing of the wound discharge, the growth ceased 1 day earlier in patients of the second group compared to patients in the first group. Such dynamics of the course of the wound process led to a 3 bed-day decrease in the hospital stay of patients of the second group.Conclusion. Local treatment of purulent-inflammatory diseases of soft tissues with miramistin-metronidazole combination allowed optimizing the course of the wound process, reducing duration of inpatient stay.

scholarly journals Osseous Metaplasia of the Cervix: A Rare Transformation Can Mimic a Tumor—Literature Review

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Ameerah Alsaqobi ◽  
Nabeel Al-Brahim
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
Rare Condition ◽  
Punch Biopsy ◽  
Purulent Discharge ◽  
Osseous Metaplasia ◽  
Case Summary ◽  
Clinical Presentations ◽  
Central Nervous Systems ◽  
Bone Fragments

Background. The transformation of nonosseous soft tissue into bone is known as osseous metaplasia (OM). This condition most commonly affects the musculoskeletal and central nervous systems and it is a well-known phenomenon in different soft tissue organs. Rarely, OM can affect the uterus, which can extend into the cervix. OM affecting the cervix alone is a more rare condition that has multiple different clinical presentations. The presentation can be similar to that of a tumor in extremely rare cases. Case Summary. A 23-year-old nulligravida was complaining of irregular vaginal bleeding for one-month duration. Speculum examination revealed a foul-smelling bloody purulent discharge, tender cervix, and a brownish growth located at the posterior cervical lip. A punch biopsy of the growth was performed. Histological examination of the tissue revealed multiple bone fragments with necrosis and an inflammatory exudate. Because of the unusual findings, a repeat biopsy was performed. The biopsy yielded the same findings, which confirmed the diagnosis of osseous metaplasia of the cervix. Conclusion. Although osseous metaplasia is a known phenomenon in different soft tissues, it is extremely rare in the uterine cervix and can mimic malignancy. Therefore, clinicians should be aware of it.

Analysis of the monitoring study of the antibiotic-resistance of the agents of purulent-inflammatory processes of soft tissue

2018 ◽  
Vol 22 (2) ◽  
pp. 285-288
Author(s):  
A.P. Prevar ◽  
A.V. Kryzshanovskaya ◽  
V.A. Radionov ◽  
V.M. Mrug
Keyword(s):  
Soft Tissues ◽  
High Sensitivity ◽  
Biochemical Properties ◽  
Antimicrobial Drugs ◽  
Strict Adherence ◽  
E Coli ◽  
Monitoring Study ◽  
Treatment Measures ◽  
Inflammatory Processes ◽  
Main Factor

The main factor in the treatment of suppurative and inflammatory processes is the timely optimization of treatment measures taking into account the nature of the microflora and its susceptibility to antimicrobial drugs. The purpose of the study is to monitor the spectrum of microorganisms – pathogens of purulent-inflammatory processes of soft tissues in surgical patients; study of the sensitivity of isolated strains to antibiotics. The material was collected in accordance with aseptic rules. The identification of a pure culture of bacteria was carried out according to morphological, culture, biochemical properties, and the presence of virulence enzymes. Sensitivity of bacteria to antibiotics was determined by the standard disks method (by Kirby-Bauer’s). 255 patients with purulent-inflammatory processes of soft tissues were examined for the period from 2014 to 2017. 229 strains of isolated bacteria were included to Escherichia coli, Citrobacer freundii, Enterobacter cloacae, E.aerogenes, Proteus vulgaris, Staphylococcus aureus, S.epidermidis, Streptococcus pyogenes, S.viridians, S.agalactiae, Pseudomonas aeruginosa. The main cause of purulent-inflammatory processes of soft tissues is Staphylococci (67,2%). Compared to previous studies, the number of P.aeruginosa isolated cultures increased (7.9%). In monoculture and in association with other microorganisms, E. coli (9.6% of cases), E.cloacae et aerogenes (3.9% of cases), P.vulgaris (3.9% of cases), C.freundi (2.5% of cases), S.agalactiae, S.pyogenes, S.viridans (3.5%). The number of associated sows reaches 12%. Clinical strains of microorganisms remain most sensitive to fluoroquinolones, cephalosporins, and also retains high sensitivity to gentamicin, lincomycin, rifampicin, which is important for empirical antibiotic therapy. To increase the effectiveness of antibacterial therapy, strict adherence to the mode of appointment of antibiotics, justification of indications, a combination of antibiotics of different spectrum of action, mandatory correction after determining the sensitivity of the pathogen.

Imaging Features of Primary Tumors of the Hand

2020 ◽  
Vol 16 ◽  
Author(s):  
Filippo Boriani ◽  
Edoardo Raposio ◽  
Costantino Errani
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
Epithelioid Sarcoma ◽  
Case Series ◽  
Malignant Neoplasm ◽  
Benign Tumors ◽  
Imaging Features ◽  
Primary Tumors ◽  
Therapeutic Decisions ◽  
Tumors Of The Hand

: Musculoskeletal tumors of the hand are a rare entity and are divided into skeletal and soft tissue tumors. Either category comprises benign and malignant or even intermediate tumors. Basic radiology allows an optimal resolution of bone and related soft tissue areas, ultrasound and more sophisticated radiologic tools such as scintigraphy, CT and MRI allow a more accurate evaluation of tumor extent. Enchondroma is the most common benign tumor affecting bone, whereas chondrosarcoma is the most commonly represented malignant neoplasm localized to hand bones. In the soft tissues ganglions are the most common benign tumors and epithelioid sarcoma is the most frequently represented malignant tumor targeting hand soft tissues. The knowledge regarding diagnostic and therapeutic management of these tumors is often deriving from small case series, retrospective studies or even case reports. Evidences from prospective studies or controlled trials are limited and for this lack of clear and supported evidences data from the medical literature on the topic are controversial, in terms of demographics, clinical presentation, diagnosis prognosis and therapy.The correct recognition of the specific subtype and extension of the tumor through first line and second line radiology is essential for the surgeon, in order to effectively direct the therapeutic decisions.

scholarly journals Developing a Quantifying Device for Soft Tissue Material Prop-Erties around Lumbar Spines

Biosensors ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 67
Author(s):  
Song Joo Lee ◽  
Yong-Eun Cho ◽  
Kyung-Hyun Kim ◽  
Deukhee Lee
Keyword(s):  
Lumbar Spine ◽  
Soft Tissue ◽  
Young’S Modulus ◽  
Viscoelastic Properties ◽  
Soft Tissues ◽  
Young's Modulus ◽  
Strain Curve ◽  
Stress And Strain ◽  
Commercial Device ◽  
Tissue Material

Knowing the material properties of the musculoskeletal soft tissue could be important to develop rehabilitation therapy and surgical procedures. However, there is a lack of devices and information on the viscoelastic properties of soft tissues around the lumbar spine. The goal of this study was to develop a portable quantifying device for providing strain and stress curves of muscles and ligaments around the lumbar spine at various stretching speeds. Each sample was conditioned and applied for 20 repeatable cyclic 5 mm stretch-and-relax trials in the direction and perpendicular direction of the fiber at 2, 3 and 5 mm/s. Our device successfully provided the stress and strain curve of the samples and our results showed that there were significant effects of speed on the young’s modulus of the samples (p < 0.05). Compared to the expensive commercial device, our lower-cost device provided comparable stress and strain curves of the sample. Based on our device and findings, various sizes of samples can be measured and viscoelastic properties of the soft tissues can be obtained. Our portable device and approach can help to investigate young’s modulus of musculoskeletal soft tissues conveniently, and can be a basis for developing a material testing device in a surgical room or various lab environments.

scholarly journals Quantification of assembly forces during creation of head-neck taper junction considering soft tissue bearing: a biomechanical study

Arthroplasty ◽  
2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Toni Wendler ◽  
Torsten Prietzel ◽  
Robert Möbius ◽  
Jean-Pierre Fischer ◽  
Andreas Roth ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Work Experience ◽  
Soft Tissues ◽  
Force Sensor ◽  
Biomechanical Study ◽  
Measuring System ◽  
Wide Range ◽  
Head Neck

Abstract Background All current total hip arthroplasty (THA) systems are modular in design. Only during the operation femoral head and stem get connected by a Morse taper junction. The junction is realized by hammer blows from the surgeon. Decisive for the junction strength is the maximum force acting once in the direction of the neck axis, which is mainly influenced by the applied impulse and surrounding soft tissues. This leads to large differences in assembly forces between the surgeries. This study aimed to quantify the assembly forces of different surgeons under influence of surrounding soft tissue. Methods First, a measuring system, consisting of a prosthesis and a hammer, was developed. Both components are equipped with a piezoelectric force sensor. Initially, in situ experiments on human cadavers were carried out using this system in order to determine the actual assembly forces and to characterize the influence of human soft tissues. Afterwards, an in vitro model in the form of an artificial femur (Sawbones Europe AB, Malmo, Sweden) with implanted measuring stem embedded in gelatine was developed. The gelatine mixture was chosen in such a way that assembly forces applied to the model corresponded to those in situ. A study involving 31 surgeons was carried out on the aforementioned in vitro model, in which the assembly forces were determined. Results A model was developed, with the influence of human soft tissues being taken into account. The assembly forces measured on the in vitro model were, on average, 2037.2 N ± 724.9 N, ranging from 822.5 N to 3835.2 N. The comparison among the surgeons showed no significant differences in sex (P = 0.09), work experience (P = 0.71) and number of THAs performed per year (P = 0.69). Conclusions All measured assembly forces were below 4 kN, which is recommended in the literature. This could lead to increased corrosion following fretting in the head-neck interface. In addition, there was a very wide range of assembly forces among the surgeons, although other influencing factors such as different implant sizes or materials were not taken into account. To ensure optimal assembly force, the impaction should be standardized, e.g., by using an appropriate surgical instrument.

scholarly journals High-dose diquat poisoning: a case report

2021 ◽  
Vol 49 (6) ◽  
pp. 030006052110261
Author(s):  
Yanxia Huang ◽  
Renjing Zhang ◽  
Mei Meng ◽  
Dechang Chen ◽  
Yunxin Deng
Keyword(s):  
Renal Failure ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Multiple Organ ◽  
High Dose ◽  
Severe Respiratory Failure ◽  
Aggressive Treatment ◽  
Lung Lesions ◽  
Pulmonary Lesions ◽  
New Treatment

Diquat is a widely used herbicide that is substituted for paraquat. With paraquat off the market, cases of diquat poisoning have been gradually increasing. The kidney is the most frequently impaired organ in diquat poisoning. Few cases of multiple organ failure caused by diquat have been reported. We herein describe a 30-year-old man who orally ingested about 160 mL of enriched diquat. Despite aggressive treatment, the patient’s condition progressed to multiple organ failure and death. The pulmonary lesions in this patient were different from those previously reported. This patient did not die of renal failure but of severe respiratory failure. He exhibited three different stages of pulmonary disease. The lung lesions in this case were unique. We hope that doctors will pay more attention to the lung lesions in patients with diquat poisoning in future and find new treatment methods to save the lives of such patients.

scholarly journals Imaging of Joint and Soft Tissue Involvement in Systemic Lupus Erythematosus

2021 ◽  
Vol 23 (9) ◽  
Author(s):  
Andrea Di Matteo ◽  
Gianluca Smerilli ◽  
Edoardo Cipolletta ◽  
Fausto Salaffi ◽  
Rossella De Angelis ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Soft Tissue ◽  
Lupus Erythematosus ◽  
Structural Damage ◽  
Structural Changes ◽  
Soft Tissues ◽  
Imaging Techniques ◽  
Joint Involvement ◽  
Systemic Lupus ◽  
Muscle Involvement

Abstract Purpose of Review To highlight the potential uses and applications of imaging in the assessment of the most common and relevant musculoskeletal (MSK) manifestations in systemic lupus erythematosus (SLE). Recent Findings Ultrasound (US) and magnetic resonance imaging (MRI) are accurate and sensitive in the assessment of inflammation and structural damage at the joint and soft tissue structures in patients with SLE. The US is particularly helpful for the detection of joint and/or tendon inflammation in patients with arthralgia but without clinical synovitis, and for the early identification of bone erosions. MRI plays a key role in the early diagnosis of osteonecrosis and in the assessment of muscle involvement (i.e., myositis and myopathy). Conventional radiography (CR) remains the traditional gold standard for the evaluation of structural damage in patients with joint involvement, and for the study of bone pathology. The diagnostic value of CR is affected by the poor sensitivity in demonstrating early structural changes at joint and soft tissue level. Computed tomography allows a detailed evaluation of bone damage. However, the inability to distinguish different soft tissues and the need for ionizing radiation limit its use to selected clinical circumstances. Nuclear imaging techniques are valuable resources in patients with suspected bone infection (i.e., osteomyelitis), especially when MRI is contraindicated. Finally, dual energy X-ray absorptiometry represents the imaging mainstay for the assessment and monitoring of bone status in patients with or at-risk of osteoporosis. Summary Imaging provides relevant and valuable information in the assessment of MSK involvement in SLE.

scholarly journals Inflammatory Mechanisms Underlying Nonalcoholic Steatohepatitis and the Transition to Hepatocellular Carcinoma

Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 730
Author(s):  
Moritz Peiseler ◽  
Frank Tacke
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Disease ◽  
Disease Progression ◽  
Immune Cells ◽  
Nonalcoholic Steatohepatitis ◽  
Adaptive Immune System ◽  
Nonalcoholic Fatty Liver ◽  
Inflammatory Processes ◽  
New Treatment ◽  
End Stage

Nonalcoholic fatty liver disease (NAFLD) is a rising chronic liver disease and comprises a spectrum from simple steatosis to nonalcoholic steatohepatitis (NASH) to end-stage cirrhosis and risk of hepatocellular carcinoma (HCC). The pathogenesis of NAFLD is multifactorial, but inflammation is considered the key element of disease progression. The liver harbors an abundance of resident immune cells, that in concert with recruited immune cells, orchestrate steatohepatitis. While inflammatory processes drive fibrosis and disease progression in NASH, fueling the ground for HCC development, immunity also exerts antitumor activities. Furthermore, immunotherapy is a promising new treatment of HCC, warranting a more detailed understanding of inflammatory mechanisms underlying the progression of NASH and transition to HCC. Novel methodologies such as single-cell sequencing, genetic fate mapping, and intravital microscopy have unraveled complex mechanisms behind immune-mediated liver injury. In this review, we highlight some of the emerging paradigms, including macrophage heterogeneity, contributions of nonclassical immune cells, the role of the adaptive immune system, interorgan crosstalk with adipose tissue and gut microbiota. Furthermore, we summarize recent advances in preclinical and clinical studies aimed at modulating the inflammatory cascade and discuss how these novel therapeutic avenues may help in preventing or combating NAFLD-associated HCC.

scholarly journals Micro-CT imaging of Thiel-embalmed and iodine-stained human temporal bone for 3D modeling

2021 ◽  
Vol 50 (1) ◽  
Author(s):  
Sebastian Halm ◽  
David Haberthür ◽  
Elisabeth Eppler ◽  
Valentin Djonov ◽  
Andreas Arnold
Keyword(s):  
Soft Tissue ◽  
Temporal Bone ◽  
Middle Ear ◽  
3D Modeling ◽  
Soft Tissues ◽  
Ct Imaging ◽  
Micro Ct ◽  
Data Set ◽  
Iodine Staining ◽  
Tissue Structures

Abstract Introduction This pilot study explores whether a human Thiel-embalmed temporal bone is suitable for generating an accurate and complete data set with micro-computed tomography (micro-CT) and whether solid iodine-staining improves visualization and facilitates segmentation of middle ear structures. Methods A temporal bone was used to verify the accuracy of the imaging by first digitally measuring the stapes on the tomography images and then physically under the microscope after removal from the temporal bone. All measurements were compared with literature values. The contralateral temporal bone was used to evaluate segmentation and three-dimensional (3D) modeling after iodine staining and micro-CT scanning. Results The digital and physical stapes measurements differed by 0.01–0.17 mm or 1–19%, respectively, but correlated well with the literature values. Soft tissue structures were visible in the unstained scan. However, iodine staining increased the contrast-to-noise ratio by a factor of 3.7 on average. The 3D model depicts all ossicles and soft tissue structures in detail, including the chorda tympani, which was not visible in the unstained scan. Conclusions Micro-CT imaging of a Thiel-embalmed temporal bone accurately represented the entire anatomy. Iodine staining considerably increased the contrast of soft tissues, simplified segmentation and enabled detailed 3D modeling of the middle ear.

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