Ceftriaxone for the Treatment of Chronic Bacterial Prostatitis: A Case Series and Literature Review

Chronic bacterial prostatitis is increasingly difficult to treat due to rising antimicrobial resistance limiting oral treatment options. In this case series, 11 men with CBP (including patients with urological comorbidities) due to multi-resistant E. coli were treated with once-daily ceftriaxone intravenously for 6 weeks. Nine patients were clinically cured at 3 months follow up. No early withdrawal of medication due to side effects occurred. A literature review was conducted to describe the prostate pharmacokinetics of ceftriaxone and its use in prostatic infection. In conclusion, ceftriaxone can be considered an appropriate treatment of chronic bacterial prostatitis.

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AGGRESSIVE VERTEBRAL HEMANGIOMAS – CASE SERIES AND LITERATURE REVIEW

Coluna/Columna ◽

10.1590/s1808-185120201904223670 ◽

2020 ◽

Vol 19 (4) ◽

pp. 293-296

Author(s):

LUCAS XAVIER DA LUZ ◽

MARCELO SIMONI SIMÕES ◽

BRUNO DE AZEVEDO OLIVEIRA ◽

GUILHERME JOSÉ MIOTTO ◽

ERNANI VIANNA DE ABREU

Keyword(s):

Literature Review ◽

Treatment Options ◽

Case Series ◽

Neurological Deficits ◽

Subtotal Resection ◽

Decompression Surgery ◽

Management Options ◽

Level Of Evidence ◽

Vertebral Hemangiomas

ABSTRACT Objectives To present a series of aggressive hemangiomas of the institution, with a review of the management options described in the literature. Methods This is a retrospective survey of aggressive vertebral hemangiomas treated by the service in the last 10 years, with histological confirmation of the diagnosis and a minimum follow-up of 1 year. The case analysis and literature review were conducted with emphasis on treatment options for these injuries. Results Seven cases were found, three with pain and four with severe neurological deficits. Two patients were treated with open decompression, one with open decompression and cementation, one with open decompression and arthrodesis, one with biopsy and cementation, one with percutaneous biopsy, and one with open biopsy followed by decompression surgery. All patients underwent radiotherapy. There was a significant regression of presentation deficits, but one patient developed an irreversible deficit during treatment. There were no recurrences or late complications in the follow-up period. Conclusions Surgical decompression in patients with significant neurological deficit is a point of consensus in the literature. Subtotal resection followed by radiation therapy was effective in treating deficits and controlling pathology. Cases manifesting pain only can be managed with minimally invasive techniques, whether or not they are followed by radiotherapy. Level of evidence IV; Therapeutic study of case series.

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Highland Influence on Chronic-bacterial-prostatitis and Developing-reason of Prostate-cancer, KSA

Biotechnology and Bioprocessing ◽

10.31579/2766-2314/022 ◽

2021 ◽

Vol 2 (2) ◽

pp. 01-04

Author(s):

Sherifa Sabra

Keyword(s):

Prostate Cancer ◽

Pathogenic Bacteria ◽

Chronic Bacterial Prostatitis ◽

Location Factors ◽

Staph Aureus ◽

E Coli ◽

Bacterial Prostatitis ◽

Indirect Identification ◽

Vitek 2

This work was for "Highland (HL) Influence on Chronic-bacterial-prostatitis (CBP) and Developing-reason of Prostate-cancer (PCa), KSA"; the purpose was to determine CBP percentage at HL "Taif"; and influence of location factors on CBP percentage and indication of its developing-reason to causing PCa. It may negatively affected other body organs and may reach death of males' society, affected marital and community life. Used medical methods for cases taster (CsT) from patients were diagnosed as suffered from CBP. That were used direct and indirect identification by "CHROMagar Orientation Medium", and "VITEK 2 System (BioMerieux, France)". The pathogenic bacteria were found in more than a quarter of the CsT as (26 and 29%). That were Staphylococcous aureus (Staph. aureus), Escherichia coli (E. coli), Staphylococcous epidermidis (Staph. epidermidis) and Streptococcus species (Strept. Spp) in (36.2%, 9.5%, 5.7% and 4.3%) respectively. Pathogenic bacteria Staph. aureus represented more than third of CsT. E. coli represented tenth and it was dangerous for its transmission from UT and GT easily. Staph. epidermidis was present on the skin and represented normal flora can easily contaminated. Strept. Spp represented less than tenth, can transferred to prostate tissue and cause CBP leading to PCa. Concluded the CBP infection was present in HL and had developing-reason for PCa, the conditions must followed to reduce it to prevent condition of turning into PCa. Recommended best periodic follow-up to detect CBP infection presence to protect against infection and its PCa developing-reason. Cases CBP infection must treated and PCa cases should not neglected or tolerated.

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Midcarpal instability

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193415617756 ◽

2015 ◽

Vol 41 (1) ◽

pp. 86-93 ◽

Cited By ~ 10

Author(s):

D. G. Hargreaves

Keyword(s):

Surgical Treatment ◽

Treatment Options ◽

Case Series ◽

Definite Diagnosis ◽

Stress Tests ◽

Functional Instability ◽

Painful Wrist ◽

Relative Rarity ◽

Passive Stress

Midcarpal instability is a collective term for a number of conditions where the instability of the wrist is predominantly between the proximal and distal carpal rows. It has been regarded as relatively rare and infrequently requires surgical treatment. Palmar midcarpal instability is the most commonly found type of midcarpal instability and can be responsible for causing a clunking and painful wrist. The diagnosis is made on clinical grounds using the midcarpal instability provocative tests. Standard imaging and arthroscopic inspection do not usually confirm a definite diagnosis, but are important in excluding other pathologies. The classification and staging has been described using the extent of palmar translocation of the distal carpal row, which is elicited on passive stress tests. As this is a functional instability, it may be that a functional staging description might be better, and a proposed scheme is described. Treatment options including partial wrist fusions, tenodesis stabilizations and arthroscopic capsular shrinkage have been described in small case series with limited follow-up. There are no comparative series or randomized studies because of the relative rarity of this condition.

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Three Patients with CPT1A Deficiency: Literature Review and Case Series

World Journal of Peri & Neonatology ◽

10.18502/wjpn.v3i1.5064 ◽

2020 ◽

Author(s):

Naser Ali Mirhosseini ◽

Mahdieh Saatchi ◽

Sana Taghiyar

Keyword(s):

Genetic Disorder ◽

Case Series ◽

Autosomal Recessive Inheritance ◽

Abnormal Liver Function Test ◽

Medical Procedures ◽

Main Method ◽

Appropriate Treatment ◽

Liver And Kidney ◽

Renal Tubular

Background: Carnitine palmitoyltransferase 1A deficiency is a rare genetic disorder with autosomal recessive inheritance pattern of fatty acid metabolism secondary to CPT1A mutation. Several dozen infants and children have been described with a deficiency of the liver and kidney CPT1 isoenzyme (CPT1-A). Clinical manifestation includes fasting-induced hypoketotic hypoglycemia, occasionally with extremely abnormal liver function test (LFT) and rarely with renal tubular acidosis. Acyl carnitine analysis has been the main method for the diagnosis of CPT1A deficiency. Prompt treatment of hypoglycemia includes intravenous fluid containing 10% dextrose. To prevent hypoglycemia, infants should eat frequently during the day and have cornstarch continuously at night. Fasting should not last more than 12 hours during illness, surgery, or medical procedures. Case Presentation: We reported three patients with CPT1A deficiency presented with hypoglycemia and Reye like syndrome in early childhood that with early diagnosis and treatment they are well in follow-up. Conclusion: Prognosis of this genetic disorder will be good with appropriate treatment.

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Topical Treatment of Truncal Acne with Tretinoin Lotion 0.05% and Azelaic Acid Foam

Case Reports in Dermatological Medicine ◽

10.1155/2020/5217567 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Sharleen St. Surin-Lord ◽

Judi Miller

Keyword(s):

Azelaic Acid ◽

Oral Treatment ◽

Acne Vulgaris ◽

Topical Therapy ◽

Treatment Options ◽

Case Series ◽

Oral Antibiotics ◽

Gastrointestinal Microbiome ◽

The Face ◽

Extensive Body

Truncal acne is present in approximately half of all patients with facial acne but is also occasionally seen in isolation. Important considerations when selecting treatment options for adult female acne, whether on the face, back, chest, or shoulders, include patient compliance, treatment response time, tolerability of the treatment, and psychosocial impact of the disease. Oral antibiotics are widely prescribed for truncal acne due to the challenges of applying topical therapy to such an extensive body surface area. In cases of severe inflammatory and nodular acne vulgaris, this may be a reasonable consideration; however, oral antibiotics should only be used for short durations. Overprescription contributes to microbial resistance and may cause disruption of the gastrointestinal microbiome. In many cases of mild, moderate, or even severe truncal acne, combinations of topical therapies may be valid alternatives. The introduction of foam formulations with enhanced percutaneous absorption and tretinoin lotion formulations that incorporate moisturizing/hydrating agents challenges the previously held idea that effective and tolerable treatment of truncal acne requires oral treatment. This case series describes four female African-American patients with truncal acne successfully treated with a combination of tretinoin lotion 0.05% and azelaic acid 15% foam.

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Early Outcomes of 3D Printed Total Talus Arthroplasty

Foot & Ankle Specialist ◽

10.1177/1938640019873536 ◽

2019 ◽

Vol 13 (5) ◽

pp. 372-377 ◽

Cited By ~ 3

Author(s):

Daniel J. Scott ◽

John Steele ◽

Amanda Fletcher ◽

Selene G. Parekh

Keyword(s):

Treatment Option ◽

Treatment Options ◽

Case Series ◽

Level Of Evidence ◽

Ankle Motion ◽

Motion Data ◽

Number Of Patients ◽

3D Printed ◽

Radiographic Alignment

Background. Patients with talar avascular necrosis (AVN) have limited treatment options to manage their symptoms. Historically, surgical options have been limited and can leave patients with little ankle motion and have high failure rates. The use of custom 3D printed total talar replacements (TTRs) has arisen as a treatment option for these patients, possibly allowing better preservation of hindfoot motion. We hypothesized that patients undergoing TTR will demonstrate a statistically significant improvement in Foot and Ankle Outcome Score (FAOS) at 1 year after surgery. Methods. We retrospectively reviewed 15 patients who underwent a TTR over a 2-year period. Patient outcomes were reviewed, including age, sex, comorbidities, etiology of talar pathology, number and type of prior surgeries, radiographic alignment, FAOS and Visual Analog Scale (VAS) score, and range of motion. Data analysis was performed with Student t-tests and multivariate regression. Results. FAOSs and VAS scores showed statistically significant improvements postoperatively as compared with preoperative scores. There was a statistically significant decrease in VAS pain scores from 7.0 preoperatively to 3.6 (P < .001). Average follow-up was 12.8 months. With the number of patients available, there was no statistically significant change in radiographic alignment parameters postoperatively as compared with preoperatively (P values ranged from .225 to .617). Conclusion. Our hypothesis that these patients show statistically significant improvements in FAOSs at 1 year was confirmed. TTR represents an exciting treatment option for patients with talar AVN, though longer-term follow-up is needed. Level of Evidence: Level IV: Case series

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Long-term outcomes of acromegaly treated with fractionated stereotactic radiation: case series and literature review

Neuro-Oncology Practice ◽

10.1093/nop/npx002 ◽

2017 ◽

Vol 4 (4) ◽

pp. 255-262

Author(s):

Ryan Rhome ◽

Isabelle M Germano ◽

Ren-Dih Sheu ◽

Sheryl Green

Keyword(s):

Systematic Review ◽

Literature Review ◽

Case Series ◽

Tumor Control ◽

Pituitary Neoplasms ◽

Review Of The Literature ◽

Biochemical Control ◽

Low Incidence

Abstract Background Growth hormone (GH)-secreting pituitary adenomas represent an uncommon subset of pituitary neoplasms. Stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT) have been used as primary or adjuvant treatment. The purpose of this study is to report the long-term tumor control and toxicity from our institution and to perform a systematic literature review of acromegaly patients treated with FSRT. Methods We retrospectively reviewed all patients treated with FSRT (median dose 50.4 Gray [Gy], range 50.4–54 Gy) between 2005 and 2012 who had: 1) GH-secreting adenoma with persistently elevated insulin growth factor-1 (IGF-1) despite medical therapy and 2) clinical follow up >3 years after FSRT. Patients were treated with modern FSRT planning techniques. Biochemical control was defined as IGF-1 normalization. Systematic review of the literature was performed for FSRT in acromegaly. Results With a median follow-up of 80 months, radiographic control was achieved in all 11 patients and overall survival was 100%. Long-term biochemical control was achieved in 10 patients (90.9%) with either FSRT alone (36.4%) or FSRT with continued medical management (45.5%). No patient experienced new hypopituitarism, cranial nerve dysfunctions, or visual deficits. Our systematic review found published rates of biochemical control and hypopituitarism vary, with uniformly good radiographic control and low incidence of visual changes. Conclusions Adjuvant FSRT offered effective long-term biochemical control and radiographic control, and there was a lower rate of complications in this current series. Review of the literature shows variations in published rates of biochemical control after FSRT for acromegaly, but low incidence of serious toxicities.

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Oral Fosfomycin for the Treatment of Acute and Chronic Bacterial Prostatitis Caused by Multidrug-Resistant Escherichia coli

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2018/1404813 ◽

2018 ◽

Vol 2018 ◽

pp. 1-9 ◽

Cited By ~ 10

Author(s):

George G. Zhanel ◽

Michael A. Zhanel ◽

James A. Karlowsky

Keyword(s):

Escherichia Coli ◽

Chronic Prostatitis ◽

English Language ◽

Multidrug Resistant ◽

Chronic Bacterial Prostatitis ◽

E Coli ◽

Bacterial Prostatitis ◽

Total Treatment ◽

Cure Rates

Acute and chronic bacterial prostatitis in outpatients is commonly treated with oral fluoroquinolones; however, the worldwide dissemination of multidrug-resistant (MDR) Escherichia coli has resulted in therapeutic failures with fluoroquinolones. We reviewed the literature regarding the use of oral fosfomycin in the treatment of acute and chronic prostatitis caused by MDR E. coli. All English-language references on PubMed from 1986 to June 2017, inclusive, were reviewed from the search “fosfomycin prostatitis.” Fosfomycin demonstrates potent in vitro activity against a variety of antimicrobial-resistant E. coli genotypes/phenotypes including ciprofloxacin-resistant, trimethoprim-sulfamethoxazole-resistant, extended-spectrum β-lactamase- (ESBL-) producing, and MDR isolates. Fosfomycin attains therapeutic concentrations (≥4 μg/g) in uninflamed prostatic tissue and maintains a high prostate/plasma ratio up to 17 hours after oral administration. Oral fosfomycin’s clinical cure rates in the treatment of bacterial prostatitis caused by antimicrobial-resistant E. coli ranged from 50 to 77% with microbiological eradication rates of >50%. An oral regimen of fosfomycin tromethamine of 3 g·q 24 h for one week followed by 3 g·q 48 h for a total treatment duration of 6–12 weeks appeared to be effective. Oral fosfomycin may represent an efficacious and safe treatment for acute and chronic prostatitis caused by MDR E. coli.

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Case Series Regarding Parastomal Variceal Bleeding: Presentation and Management

Annals of Hepatology ◽

10.5604/01.3001.0012.2228 ◽

2018 ◽

Vol 17 (5) ◽

pp. 0-10

Author(s):

John Romano ◽

Charles V. Welden ◽

Jordan Orr ◽

Brendan McGuire ◽

Mohamed Shoreibah

Keyword(s):

Portal Hypertension ◽

High Risk ◽

Literature Review ◽

Variceal Bleeding ◽

Coil Embolization ◽

Case Series ◽

Treatment Modalities ◽

Post Procedure ◽

Lost To Follow Up

Parastomal variceal bleeding (PVB) is a serious complication occurring in up to 27% of patients with an ostomy and concurrent cirrhosis and portal hypertension. The management of PVB is difficult and there are no clear guidelines on this matter. TIPS, sclerotherapy, and /or coil embolization are all therapies that have been shown to successful manage PVB. We present a case series with five different patients who had a PVB at our institution. The aim of this case series is to report our experience on the management of this infrequently reported but serious condition. We also conducted a systemic literature review focusing on the treatment modalities of 163 patients with parastomal variceal bleeds. In our series, patient 1 had embolization and sclerotherapy without control of bleed and expired on the day of intervention due to hemorrhagic shock. Patient 2 had TIPS in conjunction with embolization and sclerotherapy and had no instance of rebleed 441 days after therapy. Patient 3 did not undergo any intervention due to high risk for morbidity and mortality, the bleed self-resolved and there was no further rebleed, this same patient died of sepsis 73 days later. Patient 4 had embolization and sclerotherapy and had no instance of rebleed 290 days after therapy. Patient 5 had TIPS procedure and was discharged five days post procedure without rebleed, patient has since been lost to follow-up.

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