Pseudomembranous colitis after COVID-19 antibacterial therapy

A new coronavirus infection poses a challenge to infectious disease specialists, health care administrators, and subspecialty physicians in the search for the most eff ective treatment options. The past year has allowed us to clarify the main aspects of pathogenesis with a focus on the most severe versions of the COVID-19 course. Most signifi cant is to understand that the severe course is associated with prolonged viremia and T-cell lymphocyte defi ciency leading to activation of innate immunity, manifested by a burst of macrophage activity known as the “cytokine storm”. This inadequate response is a major factor in both pulmonary and multiple organ failure. Fever, pulmonary infi ltrates with leukocytosis and neutrophilia are traditionally perceived by doctors as indications for antibiotic therapy, which is nevertheless erroneous in the absence of signs of bacterial infection. We present a case that illustrates the severe course of pseudomembranous colitis and secondary myocarditis in an elderly woman with comorbid pathology and massive antibiotic therapy received during hospitalization for COVID-19.

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Endovenous procedures in varicose veins

Phlebologie ◽

10.1055/s-0037-1622235 ◽

2008 ◽

Vol 37 (05) ◽

pp. 229-236

Author(s):

N. Cayne ◽

G. Jacobowitz ◽

P. Lamparello ◽

T. Maldonado ◽

C. Rockman ◽

...

Keyword(s):

Varicose Veins ◽

Treatment Options ◽

Postoperative Recovery ◽

Comparable Efficacy ◽

Intense Pulse Light ◽

Efficacy And Safety ◽

Endovenous Laser Ablation ◽

The Past ◽

Early Evidence ◽

Endovenous Treatment

SummaryOver the past ten years endoveous treatment options for varicose veins have evovled considerably, offering clinicians a multitude of options to meet the needs of their patients. The endothermal ablation procedures have moved to the forefront as the choice modality for treating truncal reflux. Both radiofrequency ablation and endovenous laser ablation are widely accepted and interchangeable, showing comparable efficacy and safety. Although numerous endovenous laser wavelengths exist, the data indicates that the differences do not affect the efficacy or postoperative recovery of the procedure. The endovenous laser innovation that has shown early evidence of improved patient outcome is the jacket-tip fiber. The versatility of sclerotherapy makes it a critical component in the endovenous treatment of varicosities. Although not approved by the Food and Drug Administration (USA), the use of a foamed sclerosing agent is the fastest growing segment of sclerotherapy and an important treatment modality in the future of varicose vein treatment. Cutaneous lasers and intense pulse light devices contribute a crucial element, enabling clinicians to treat minute veins that may be impossible to treat with other therapies.

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Review on Efficacy of Herbal Antiviral Drugs against COVID-19

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11ispl1.3552 ◽

2020 ◽

Vol 11 (SPL1) ◽

pp. 1116-1121

Author(s):

Pooja P. Thakre ◽

Vinod Ade ◽

Shweta Parwe

Keyword(s):

Physical Contact ◽

Research Articles ◽

Herbal Drugs ◽

Plant Origin ◽

Respiratory Pathway ◽

Traditional Medicines ◽

The Past ◽

Primary Health ◽

Coronavirus Infection ◽

Novel Coronavirus

Coronavirus disease (CoViD-19) is an infection of the respiratory system caused due to various viruses affects the respiratory pathway, and it can spread from one person to another by coughing, sneezing or physical contact. Commonly include cough, cold, fever are the symptoms. Viral diseases increase worldwide concern, including emerging and chronic viruses. The invention of new anti-viral drugs from plants has implicit in the past. The Coronavirus disease 19 (COVID-19) caused due to severe acute respiratory syndrome, which is a transmittable and pathogenic viral infection. Several traditional medicines of plant origin having antimicrobial and anti-inflammatory properties some have been studied for their anti-viral properties and immune-modulating effects. Herbal drugs are now in massive requirement in the developing countries for primary health care not because of their economical but also for better civilising adequacy, improved compatibility with the human body and significantly fewer side effects. This review gives an overview of some critical traditionally used medicinal herbs with anti-viral properties—the literature regarding the drugs of this group, collected from Ayurveda classics. Research articles are collected from published material and discussed per therapeutic actions. Most of the Herbs are with Katu Rasa (pungent) and Ushna Virya (hot potency). They are indicated in diseases, viz. Kasa (cough), Shwas (asthma), Krumi (worm/ infection). Krumihara property drugs which are correlated with anti-viral action helps to prevent against Novel coronavirus infection.

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Conventional versus Mindfulness-based Interventions for Anxiety and Worry: A Review and Recommendations

Current Psychiatry Research and Reviews ◽

10.2174/2666082216666200220121648 ◽

2020 ◽

Vol 16 (1) ◽

pp. 60-67

Author(s):

Deah Jo Abbott ◽

Caleb Wayne Lack

Keyword(s):

Treatment Options ◽

Additional Treatment ◽

Third Wave ◽

Stage Model ◽

Pharmacological Treatments ◽

The Past ◽

Behavioral Therapies ◽

Cognitive Behavioral Therapies ◽

Specific Disorders ◽

Psychiatric Problems

Anxiety disorders are among the most prevalent and most functionally impairing psychiatric problems experienced by the population. Both pharmacological and psychological evidencebased treatments exist for a number of specific disorders, but may fail to fully relieve symptoms, pointing to the need for additional treatment options. Often considered to be part of the “third wave” of cognitive-behavioral therapies, treatments incorporating mindfulness have emerged in the past two decades as increasingly popular with clinicians and frequently sought out by consumers. The present article reviews the extant literature regarding the efficacy and effectiveness of mindfulnessbased treatments for anxiety, worry, and related problems. Although they have not attained the solid empirical status of CBT or certain pharmacological treatments, the extant research shows mindfulness- based interventions appear to be a promising and useful treatment for people suffering from anxiety and worry. Further work should be done, levels 3-5 of the NIH stage model to determine whether or not they should be further implemented.

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The Role of Histones and Heparin in Sepsis: A Review

Journal of Intensive Care Medicine ◽

10.1177/0885066621992320 ◽

2021 ◽

pp. 088506662199232

Author(s):

Xiaojuan Zhang ◽

Xin Li

Keyword(s):

Septic Shock ◽

Multiple Organ ◽

Clinical Settings ◽

The Past ◽

Life Saving ◽

Extracellular Histones ◽

Sepsis And Septic Shock ◽

Development And Management ◽

Made In

Septic shock with multiple organ failure is a devastating situation in clinical settings. Through the past decades, much progress has been made in the management of sepsis and its underlying pathogenesis, but a highly effective therapeutic has not been developed. Recently, macromolecules such as histones have been targeted in the treatment of sepsis. Histones primarily function as chromosomal organizers to pack DNA and regulate its transcription through epigenetic mechanisms. However, a growing body of research has shown that histone family members can also exert cellular toxicity once they relocate from the nucleus into the extracellular space. Heparin, a commonly used anti-coagulant, has been shown to possess life-saving capabilities for septic patients, but the potential interplay between heparin and extracellular histones has not been investigated. In this review, we summarize the pathogenic roles of extracellular histones and the therapeutic roles of heparin in the development and management of sepsis and septic shock.

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Therapeutic Advances in Oncology

International Journal of Molecular Sciences ◽

10.3390/ijms22042008 ◽

2021 ◽

Vol 22 (4) ◽

pp. 2008

Author(s):

Jinsha Liu ◽

Priyanka Pandya ◽

Sepideh Afshar

Keyword(s):

Small Molecules ◽

New Technologies ◽

Treatment Options ◽

Current Treatment ◽

Bispecific Antibodies ◽

Gene Therapies ◽

Therapeutic Modalities ◽

The Past ◽

Drug Conjugates ◽

Novel Targets

Around 77 new oncology drugs were approved by the FDA in the past five years; however, most cancers remain untreated. Small molecules and antibodies are dominant therapeutic modalities in oncology. Antibody-drug conjugates, bispecific antibodies, peptides, cell, and gene-therapies are emerging to address the unmet patient need. Advancement in the discovery and development platforms, identification of novel targets, and emergence of new technologies have greatly expanded the treatment options for patients. Here, we provide an overview of various therapeutic modalities and the current treatment options in oncology, and an in-depth discussion of the therapeutics in the preclinical stage for the treatment of breast cancer, lung cancer, and multiple myeloma.

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Visceral Mycotic Aneurysm: Superior Mesenteric Artery Aneurysm Caused by K. pneumoniae

Dubai Medical Journal ◽

10.1159/000517222 ◽

2021 ◽

pp. 1-4

Author(s):

Reham Almasoud ◽

Alaaeddin Nwilati ◽

Saeb Bayazid ◽

Mamoun Shafaamri

Keyword(s):

Infectious Disease ◽

Antibiotic Therapy ◽

Superior Mesenteric Artery ◽

Mesenteric Artery ◽

Mycotic Aneurysm ◽

Artery Aneurysm ◽

Management Plan ◽

Resected Tissue ◽

Infectious Disease Specialists

We herein report a rare case of mycotic aneurysm of the superior mesenteric artery caused by <i>Klebsiella pneumoniae</i>. A 66-year-old man, a known case of hypertension and aorto-oesophageal fistula with stented aorta in 2010 and 2018, presented to the emergency department multiple times over 2 months with severe postprandial abdominal pain associated with vomiting and fever. On his last presentation, the obtained blood cultures grew ESBL positive <i>K. pneumoniae</i> and a repeated computed tomography (CT) showed a growing aneurysm at the origin of the ileocecal branch of the superior mesenteric artery measuring 17 × 10 mm (the aneurysm was 8 × 7.5 mm in the CT angiography on the previous admission). Extensive workup did not reveal the underlying cause of the mycotic aneurysm, thus we believe the cause to be the infected aortic stent, leading to bacteraemia and vegetations to the mesenteric artery causing the aneurysm. The management plan was placed by a multidisciplinary team consisting of vascular surgeons and infectious disease specialists along with review from a dietician to evaluate the patient’s nutritional status. The patient was started on total parenteral nutrition due to his postprandial pain and on antibiotic therapy according to the infectious disease team’s recommendation. He underwent surgical resection of the mycotic aneurysm, which showed a thrombosed aneurysm in the jejunoileal mesenteric area. The histopathology of the resected tissue demonstrated inflammatory aneurysm of the mesenteric artery. Following the surgery, the patient continued his antibiotic therapy and was discharged on the 13th post-operative day with follow-up appointments in the vascular surgery and infectious disease clinic.

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Advances in Surgical Approaches to Dural Fistulas

Neurosurgery ◽

10.1227/neu.0000000000000228 ◽

2014 ◽

Vol 74 (suppl_1) ◽

pp. S32-S41 ◽

Cited By ~ 19

Author(s):

Patrick P. Youssef ◽

Albert Jess Schuette ◽

C. Michael Cawley ◽

Daniel L. Barrow

Keyword(s):

Treatment Options ◽

Venous Drainage ◽

Venous Hypertension ◽

Surgical Approaches ◽

Dural Sinus ◽

Intraoperative Angiography ◽

Indocyanine Green Videoangiography ◽

Arteriovenous Fistulas ◽

The Past ◽

Dural Arteriovenous Fistulas

Abstract Dural arteriovenous fistulas are abnormal connections of dural arteries to dural veins or venous sinuses originating from within the dural leaflets. They are usually located near or within the wall of a dural venous sinus that is frequently obstructed or stenosed. The dural fistula sac is contained within the dural leaflets, and drainage can be via a dural sinus or retrograde through cortical veins (leptomeningeal drainage). Dural arteriovenous fistulas can occur at any dural sinus but are found most frequently at the cavernous or transverse sinus. Leptomeningeal venous drainage can lead to venous hypertension and intracranial hemorrhage. The various treatment options include transarterial and transvenous embolization, stereotactic radiosurgery, and open surgery. Although many of the advances in dural arteriovenous fistula treatment have occurred in the endovascular arena, open microsurgical advances in the past decade have primarily been in the tools available to the surgeon. Improvements in microsurgical and skull base approaches have allowed surgeons to approach and obliterate fistulas with little or no retraction of the brain. Image-guided systems have also allowed better localization and more efficient approaches. A better understanding of the need to simply obliterate the venous drainage at the site of the fistula has eliminated the riskier resections of the past. Finally, the use of intraoperative angiography or indocyanine green videoangiography confirms the complete disconnection of fistula while the patient is still on the operating room table, preventing reoperation for residual fistulas.

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Prostatic Abscess in a Patient with Chronic Granulomatous Disease: A Multi-Disciplinary Intervention

Urologia Journal ◽

10.5301/uro.5000216 ◽

2017 ◽

Vol 84 (4) ◽

pp. 267-269 ◽

Cited By ~ 2

Author(s):

Alberto Martini ◽

Ioannis Katafigiotis ◽

Sofia Kalantzi ◽

Ioannis Anastasiou ◽

Ioannis Adamakis ◽

...

Keyword(s):

Antibiotic Therapy ◽

Chronic Granulomatous Disease ◽

Urine Culture ◽

Underlying Disease ◽

Multidrug Resistant ◽

Granulomatous Disease ◽

Prostatic Abscess ◽

The Past ◽

First Case

Introduction Chronic granulomatous disease (CGD) is a rare pathology that increases patients’ susceptibility to infections, given the inability to generate oxygen radicals to fight microorganisms. In the context of CGD, primary prostatic involvement has been described only once in the past, in a pediatric patient. Case Report We report the case of a 35-year old patient with CGD presenting with persistent fever. After hospital admission, blood and urine were sent for culture and antibiotic therapy was initiated. Patient's conditions continued to deteriorate and an aggressive antibiotic therapy was administered to treat the septic scenario. Urine culture grew a multidrug-resistant Escherichia Coli. After patient's condition improved, a CT scan was performed. The depiction showed multiple abscesses within the prostate. A rectal approach was excluded given patient's underlying disease. A TURP was performed and prostatic pathology resolved. Patient was discharged on postoperative day 14. At 6-month follow-up he hasn't experienced major infections. To the best of our knowledge, this is the first case of septic shock originating from a prostatic abscess in an adult patient with CGD. Conclusions Aggressive medical therapy along with TURP resulted curative in our case. A multi-disciplinary approach was mandatory.

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Mycobacterium mageritense infection following mastectomy and breast reconstruction requiring triple antibiotic therapy and surgical debridement

BMJ Case Reports ◽

10.1136/bcr-2020-237618 ◽

2021 ◽

Vol 14 (2) ◽

pp. e237618 ◽

Cited By ~ 1

Author(s):

Christie Alyce Joya ◽

Cara Deegan ◽

Todd D Gleeson

Keyword(s):

Antibiotic Therapy ◽

Surgical Intervention ◽

Treatment Guidelines ◽

Perforator Flap ◽

Published Data ◽

Gastrointestinal Distress ◽

Deep Inferior Epigastric Perforator ◽

Infectious Disease Specialists ◽

Systemic Symptoms ◽

Early Surgical Intervention

A 40-year-old woman was referred to infectious disease specialists for a Mycobacterium mageritense skin infection following mastectomy and bilateral reconstruction with deep inferior epigastric perforator flap. Her case demonstrates the difficulty in treating non-tuberculosis mycobacterial infections, especially the rarely seen species. She failed to respond to dual antibiotic therapy containing imipenem-cilastin despite reported sensitivity. Additionally, her course was complicated by intolerance to various regimens, including gastrointestinal distress, a drug rash with eosinophilia and systemic symptoms, and tendinopathy. With few published data, no treatment guidelines, and limited medications from which to choose for M. mageritense, her treatment posed a challenge. She ultimately required aggressive surgical intervention and a triple therapy antibiotic regimen. The duration of our patient’s treatment and the extent of her complications suggest a potential need for early surgical intervention in postsurgical wounds infected with M. mageritense that do not respond to conventional treatment.

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