Efficacy of intravenous immunoglobulins in the prophylaxis of neonatal sepsis
Published on: 14th April, 2021
OCLC Number/Unique Identifier: 9006870046
Despite critical care advances, robust antibiotic therapy and improved strategies in early detection and prevention of infection, the incidence of morbidity and mortality from neonatal sepsis worldwide in preterm and low birth weight neonates remains overwhelmingly high. Neonatal sepsis is characterised by a clinical syndrome of systemic signs of infection and bloodstream bacteraemia in newborns within the first months of life. The risk of sepsis in neonates is inversely proportional to gestational age and birth weight due to deficiency in humoral immunity and the need for more invasive supportive neonatal intensive care unit interventions. Adverse effects such as necrotising enterocolitis associated with antimicrobial therapy are serious enough to warrant exploration of alternative therapeutic strategies. Immunoglobulin replacement therapy offers hope of enhancing immune competence and reducing infection rates in vulnerable populations. It is evident from the relevant studies to date that the benefits offered by intravenous immunoglobulin prophylaxis may not be significant enough for routine hospital implementation. Further research to better understand the mechanisms underlying immunodeficiency will lead to the realisation of alternative therapeutic and prophylactic interventions.
Revisiting childhood pneumonia in low-recourse setting hospitals
Published on: 12th July, 2021
OCLC Number/Unique Identifier: 9137597336
Introduction: Pneumonia, defined as infection of lung parenchyma, is associated with severe complications especially in the very young and old patients. It is the world’s leading cause of childhood mortality. The World Health Organization (WHO) classification and guidelines are commonly used in Sudan in the diagnosis and management of pneumonia patients. This review was the outcome of some researches done in Sudan by the author and his colleagues. Management Systems were evaluated to give complete end to end solutions for serving patients along with their records in hospitals and clinics in Sudan. The objective of the study was: To reflect author experience in management of childhood pneumonia in Sudan and to determine feasible, affordable approach to pneumonia in Sudan.
Methodology: Searching through PubMed for the author publication and review of publication by author in Sudan regarding management of pneumonia.
Conclusion: Simple tests like chest X-ray, high WBC high-reactive protein, together with high temperature can predict the need for urgent blood culture. Antibiotic treatment for childhood pneumonia weather that recommended by WHO, b-lactam inhibitors or 3rd generation cephalosporin has the same outcome.
Linear IgA bullous dermatosis in a child successfully responding to oral antibiotics
Published on: 6th December, 2018
OCLC Number/Unique Identifier: 7949734217
Linear IgA bullous dermatosis (LABD) is a rare, chronic, autoimmune bullous dermatosis affecting young children and adults. The exact pathogenesis of this disease is still unknown, although both humoral and cellular immune response are involved. Clinically, it may show heterogeneous skin manifestations. However, it is characterized histologically by linear immunoglobulin A (IgA) deposits over the basal membrane, causing subepidermal blisters. Studies on LABD are relatively sparse and most of the publications are small series or single case reports. Several treatments are reported in literature, however, they should be used with care due to the risk of side effects. We report a case of linear IgA dermatosis with generalized lesions in a 7 year old child, with good outcome under dermocorticoids and antibiotics.
Granulomatosis with polyangiitis (GPA) in a 76-year old woman presenting with pulmonary nodule and accelerating acute kidney injury
Published on: 20th January, 2020
OCLC Number/Unique Identifier: 8516756417
Granulomatosis with polyangiitis (GPA), a form of ANCA-associated vasculitis (AAV), is a rare disease with an often-occult presentation. It is more common in 4th and 5th decades of life but can be seen in all ages.
This case report details a 76-year-old female presenting with abdominal pain, generalized weakness, and malaise, who was found to have pulmonary nodules on chest imaging. Biopsy of the lung nodule showed organizing pneumonia. Initially, antibiotics were used to treat the patient. However, she developed acute renal failure a few days after presentation and found to have positive serum C-ANCA as well as elevated ANCA-PR3 serologies. A subsequent kidney biopsy demonstrated pauci-immune necrotizing and crescentic glomerulonephritis that was consistent with GPA and the patient was started immediately on combination immunosuppressive therapy, plasmapheresis, and hemodialysis.
GPA’s clinical and radiological presentation can mimic other common conditions such as pneumonia, malignancy, bacterial sinusitis, pulmonary tuberculosis, sarcoidosis, and urinary tract infection. Because of this, a high level of suspicion is required for early diagnosis and treatment to alter the high mortality rate in this disease entity. All forms of ANCA-associated vasculitis (AAV) should be in the differential diagnosis for all patients presenting with multiorgan system involvement particularly in individuals with pulmonary and renal manifesations.
A study on pacemaker pocket infection
Published on: 25th March, 2020
OCLC Number/Unique Identifier: 8576354340
Objective: Cardiac implantable electronic device (CIED) infections now constitute ∼ 10% of all endocarditis cases. The incidence of CIED infection is usually < 2%. Our objective was to study pacemaker pocket infection rate and different risk factors in our institution.
Methods: This observational study was conducted over a period of five years from January 2011 to December 2016 and it included 1096 patients. Common risk factors like patients with diabetes, repeat procedure, chronic renal failure, chronic obstructive airway disease, immunosuppressive agents were studied in our patients.
Results: Our study consisted of 1096 patients. Pacemaker pocket infection occurred in sixteen patients (1.5%). Chronic renal failure patients were one hundred thirty in our study (11.86%). There were three hundred fifty six diabetic patients (32.48%). Repeat procedure was done in ninety five patients (8.6%).
Results: Our study consisted of 1096 patients. Pacemaker pocket infection occurred in sixteen patients (1.5%). Chronic renal failure patients were one hundred thirty in our study (11.86%). There were three hundred fifty six diabetic patients (32.48%). Repeat procedure was done in ninety five patients (8.6%)
Eighty six patients were suffering from chronic obstructive airway (7.8%). Patients on immunosuppressive therapy were fourteen in our study (1.2%).
Conclusion: Pacemaker pocket infections is a dreaded complication after pacemaker implantation. During implantation, there is a risk of device contamination with the patient’s own skin flora and it can be prevented by ideal surgical asepsis technique, pre and perioperative use of antibiotics.
Metabolic profiling and antibacterial activity of Eryngium pristis Cham. & Schltdl. - prospecting for its use in the treatment of bacterial infections
Published on: 3rd November, 2021
OCLC Number/Unique Identifier: 9331573236
Morbidity and mortality of the infected patients by multidrug-resistant bacteria have increased, emphasizing the urgency of fight for the discovery of new innovative antibiotics. In this sense, natural products emerge as valuable sources of bioactive compounds. Among the biodiversity, Eryngium pristis Cham. & Schltdl. (Apiaceae Lindl.) is traditionally used to treat thrush and ulcers of throat and mouth, as diuretic and emmenagogue, but scarcely known as an antimicrobial agent. With this context in mind, the goals of this study were to investigate the metabolic profile and the antibacterial activity of ethanolic extract (EE-Ep) and hexane (HF-Ep), dichloromethane (DF-Ep), ethyl acetate (EAF-Ep) and butanol (BF-Ep) fractions from E. pristis leaves. Gas Chromatography-Mass Spectrometry (GC-MS) was performed to stablish the metabolic profile and revealed the presence of 12 and 14 compounds in EAF-Ep and HF-Ep, respectively. β-selinene, spathulenol, globulol, 2-methoxy-4-vinylphenol, α-amyrin, β-amyrin, and lupeol derivative were some of phytochemicals identified. The antibacterial activity was determined by Minimal Inhibitory Concentration (MIC) using the broth micro-dilution against eight ATCC® and five methicillin-resistant Staphylococcus aureus (MRSA) clinical strains. HF-Ep was the most effective (MIC ≤ 5,000 µg/µL), being active against the largest part of tested Gram-positive and Gram-negative bacterial strains, including MRSA, with exception of Escherichia coli (ATCC 25922) and Pseudomonas aeruginosa (ATCC 9027) and (ATCC 27853). These results suggest that E. pristis is a natural source of bioactive compounds for the search of new antibiotics which can be an interesting therapeutic approach to recover patients mainly infected by MRSA strains.
Spontaneous pneumomediastinum: case report
Published on: 28th January, 2022
OCLC Number/Unique Identifier: 9406533532
Pneumomediastinum is the presence of free air within the mediastinum. As a general rule, it occurs in the presence of underlying lung disease and if it does not exist, it is called spontaneous pneumomediastinum. We present a case of a 53 years old asthmatic patient which further investigation revealed to be consistent with spontaneous pneumomediastinum. He underwent medical treatment with relative rest, oxygen therapy, and prophylactic antibiotic therapy, in addition to his usual asthma treatment. There was a clinical and radiological improvement with complete passive reabsorption of air and the patient was discharged on the 4th day and referred to the pulmonology department for consultation. During 2 months follow-up period, there were no signs of recurrence.
Treatment of perianal fistulae in crohn's disease with mesenchymal stem cells
Published on: 4th May, 2022
Crohn's disease is a chronic syndrome of the gastrointestinal tract that produces idiopathic inflammation. Approximately half of the patients develop abscesses and/or fistulas throughout their history that are located, mainly, in the perianal region. Current treatments are based on individualized plans that generally use combined pharmacology for symptomatic relief based on glucocorticoids, immunosuppressants or immunomodulators, antibiotics, anti-inflammatories, probiotics, and antibodies, or surgical therapies such as intestinal resections or ostomizations (colostomy and ileostomy) that tend to cause notable side effects in a considerable percentage of patients and a significant decrease in their quality of life.Perianal fistulas consist of abnormal tracts, inflammatory tunnels, or chronic tracts of granular tissue that connect two surfaces lined with epithelium, have an external hole in the skin that borders the anus, and an internal hole located inside it around the anal canal, rectus and sphincters. Treatment is a complex process that requires a multidisciplinary approach and the combination of several treatments. In the short term, the goal is to drain abscesses, reduce inflammatory and infectious processes, guard the fistulous tract with seton or lax lines, facilitate patency, and hinder new formations. In the long term, a total cure and the avoidance of complications that require surgery or the creation of intestinal stomas are pursued.For this reason, new effective remedies with fewer adverse effects continue to be investigated, one of the most promising being the use of mesenchymal stem cells for the regeneration and cure of perianal fistulas and the remission of symptoms. The present bibliographic review delves into this new therapy and analyzes the current state of the situation regarding its efficacy and safety.
Treatment of antibiotic-resistant bacteria by nanoparticles: Current approaches and prospects
Published on: 8th June, 2022
Antibiotic-resistant bacteria are emerging pathogens whose resistance profiles generate a serious health crisis by holding their impact on human health. Misuse of antibiotics has directed the emergence of microbes immune to presently accessible drugs. Pathogenic bacteria become resistant by employing various mechanisms, such as; antibiotic modification, target site alteration, and biofilm formation, increasing the time they spend in the intracellular environment where antibiotics are unable to succeed at therapeutic levels. Due to this, attempts are being made to develop new alternative nanoantibiotics as a promising approach to treat multidrug resistance disease-causing bacteria. Accordingly, there is considerable contemporary attention to the use of nanoparticles (NPs) as antibacterial agents against different pathogens and as target drug delivery toward specific tissues therefore microbes are eliminated by the biocidal properties of nanoantibiotics. Additionally, the utilization of nanoencapsulation systems can help to beat the issues of, those with toxicity natures, and target drug delivery problems. This review encompasses the antibiotic resistance prevalence, mechanisms, and therefore the use of nanoparticles as antibacterial and drug delivery systems to overcome the antibiotic resistance challenges of bacteria. Overall, this review paper provides a conceptual framework for understanding the complexity of the matter of emergence of antibiotic resistance bacteria even for brand spanking new synthesized antibiotics. Therefore the availability of such knowledge will allow researchers to supply detailed studies about the applications of nanoparticles in the treatment of multidrug-resistant bacteria.
A case report of hepatic actinomycosis: A rare form of presentation
Published on: 20th September, 2022
Hepatic Actinomycosis (HA) is a very rare abdominal actinomycosis that can be confused with hepatic involvement due to a tumor. Liver involvement can occur from an abdominal focus or by blood dissemination from another focus. This disease is much more common in men between 50 - 70 years and in a situation of immunosuppression. Symptoms are nonspecific and diagnosis includes histopathology, cultures, and imaging test. Treatment includes prolonged antibiotic therapy with antibiotics such as penicillin and drainage of abscesses.We present a case of a 54-year-old man patient with a record of three years of chronic pancreatitis of probably alcoholic origin, who developed hepatic actinomycosis, requiring drainage of liver abscesses and directed antibiotic treatment.
A case of coexistent acute severe alcoholic and Q fever hepatitis: The useful contribution of repeated liver biopsies
Published on: 23rd September, 2022
Acute Q fever is a worldwide zoonotic infection due to C. burnetii that may be associated with hepatitis. Nonspecific clinical and biological manifestations may accompany liver involvement, including hepatomegaly and elevated liver biological tests. However, the presence of jaundice is rare. Therefore, making a diagnosis of Q fever hepatitis may be difficult in an afebrile patient with jaundice of recent onset, altered liver function tests, excessive alcohol intake and no reported contact with animals. We report here the diagnostic work-up and complex clinical management of a patient presenting with acute hepatitis resulting from both C. burnetii infection and severe alcoholic steatohepatitis. Positive serology together with a detailed examination of the liver biopsy was able to reveal the coexistence of both Q fever hepatitis with typical fibrin-ring granulomas as well as florid lesions of alcoholic steatohepatitis. A combination of antibiotics, hydroxychloroquine and steroids, guided by the helpful description of changes in histological alterations on repeated liver biopsies during the course of the disease contributed to the slow but favorable outcome.
The thoracoscopic approach in the management of parapneumonic pleural effusion in children
Published on: 23rd December, 2022
Background: Parapneumonic pleural effusion is a relatively common entity and continues to be a major cause of morbidity in children. However, managing this disease is still a matter of controversy between surgical and non-surgical options. With the advancement of mini-invasive surgery, video-assisted thoracoscopic surgery (VATS) has become a mainstay in the treatment of parapneumonic effusion in children. This study aimed to evaluate the clinical characteristics and pathological features of parapneumonic pleural effusion in children and to explore the feasibility and safety of the thoracoscopic approach in the pediatric population.Methods: The clinical data of all patients who underwent VATS for parapneumonic effusion between 2007 and 2021 were analyzed retrospectively. Factors that were documented included demographic criteria, clinical manifestations, preoperative examinations, therapeutic procedures, intraoperative findings, postoperative complications, and outcomes.Results: Totally, 35 patients with a mean age of 5.14 ± 3.9 years were operated on thoracoscopically. The mean duration of evolution before VATS was 9 days ± 4. All children were hospitalized in a Pediatric Continuing Care Unit. Antibiotic therapy was administrated in combination in all cases. Corticosteroid therapy was used in 2 patients. Thoracentesis was performed in 6 patients. Thoracostomy tube drainage was placed before surgery in 11 patients. The average duration of drainage before VATS was 6 days ± 4. VATS decortication and/or debridement was indicated as second-line in 23 patients. The average duration of the surgery was 51 minutes (20 min - 115 min). There is no conversion to open surgery and no intraoperative procedure-dependent complication. 4 children have early complications after the VATS and one patient had a late postoperative complication. There were no deaths during the hospital stay or follow-up. Conclusion: In skilled hands, VATS is safe, feasible, and effective in the management of parapneumonic pleural effusion in children with excellent outcomes.
Fluctuation of serum creatinine: preoperative and postoperative evaluation of chronic kidney disease patients
Published on: 8th February, 2023
Renal impairment is one of the most severe non-communicable diseases around the world. Especially patients with diagnosed/newly diagnosed renal impairment who needed surgery are more focused on preoperative and postoperative preparation. Serum creatinine is the prime biochemical marker for assessing renal function and the level of impairment is widely measured by this marker as well as Glomerular Filtration Rate (GFR). Objective: Factors responsible for fluctuating serum creatinine during preoperative and postoperative periods and minimizing the process of serum creatinine is the ultimate goal of this study. Method: 37 patients participated in this cross-sectional study who were previously diagnosed/newly diagnosed. They were admitted to different tertiary-level hospitals for emergency or elective surgery. 15 patients were admitted in the renal function impairment stage and 22 were admitted as normal patients’. Values of creatinine at the pre-admission stage and 2nd/3rd post-admission follow-up were compared. Results: 0.41 was the average of 22 patients’ creatinine between pre-admission and 2nd/3rd follow-up. The responsible factor like prolonged staying, immobilization, co-morbidities, different preoperative antibiotics and NSAIDs were also inducers for creatinine elevation. After postoperative hemodialysis rapid decrease of creatinine is seen in normal patients but this decrease is very much minor in CKD-diagnosed patients.
Hospital-acquired infections and antibiotic use in a geriatric hospital: a point prevalence study
Published on: 3rd March, 2023
Background: Healthcare-Associated Infections (HAIs) are the most common healthcare-associated complications, particularly in elderly patients. The aim of this study is to describe the prevalence of HAIs and associated risk factors in the IRCCS INRCA of Ancona.Methods: A cross-sectional study has been carried out. Data has been collected in accordance with the European Centre for Disease Prevention and Control (ECDC) Point Prevalence Survey 2022-2023 (PPS3) protocol in the IRCCS INRCA of Ancona in November 2022.Results: Out of the 128 patients included in our study, 75.0% were over 78 years old and 9.1% presented an active HAI on the day of the survey. The prevalence of HAIs varied based on the length of the hospital stay (OR 1.1, CI 95% 1.05 - 1.17, p < 0.001) and hospitalization > 7 days (OR 5.9, CI 95% 1.2 - 28.7, p = 0.02).Conclusion: It is clear from our findings that HAIs are associated with advanced patient age, prolonged hospital stay, and use of medical devices, especially in those patients that, due to their clinical situation, are more vulnerable. Although some of these infections can easily be treated, it is important to develop effective infection control strategies thanks to antimicrobial stewardship programs.
Detection of extended-spectrum betalactamase and carbapenemase-producing Enterobacteriaceae in Tunisia
Published on: 15th March, 2023
The emergence of dramatic urinary tract infections (UTIs) caused by the members of the Enterobacteriales is an important public health problem in the community as well as in Tunisian hospitals. This study aims to investigate the prevalence of extended-spectrum β-lactamase (ESBL) and carbapenemase-producing uropathogenic isolates of Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae). Based on decreased susceptibility to β-lactams antibiotics and analyzed for the presence of ESBL and carbapenemase genes by Real Time- polymerase chain reaction (RT-PCR), 56 uropathogenic isolates of E. coli (n = 36) and K. pneumoniae (n = 20) were confirmed positive for ESBLs. The CTX-M-type β-lactamases were mostly detected in E. coli isolates (21 strains, 58.33% [95% CI 38.09% - 72.06%]) followed by blaSHV-like (18 strains, 50% [95% CI 32.92% - 67.07%]), blaTEM-like and blaCMY-2-like simultaneously (15 strains, 41.67% [95% CI 25.51% - 59.24%]). Furthermore, the RT-PCR system on the K. pneumoniae strains demonstrated that blaSHV-12-like was the most predominant (16 strains, 80% [95% CI 56.33% - 94.26%]) followed by blaTEM-like (14 strains, 70% [95% CI 45.72% - 88.10%]), blaCTX-M belonging to groups 9 and 1 (11 strains, 55% [95% CI 31.52% - 76.94%]) and finally blaCMY-2-like (10 strains, 50% [95% CI 27.19% - 72.80%]). In addition, E. coli and K. pneumoniae strains harbored a carbapenemase gene blaOXA-48-like with 22.2% [95% CI 10.11% - 39.15%]; 20% [95% CI 12.83% - 43.66%], respectively.Our results confirm the need to monitor the resistance to extended-spectrum β-lactams and to carbapenems among enterobacteria in Tunisia.
Hypochlorous acid has emerged as a potential alternative to conventional antibiotics due to its broad-spectrum antimicrobial activity
Published on: 30th March, 2023
Hypochlorous acid (HOCl) is a potent antimicrobial agent that has recently gained attention as a potential alternative to conventional antibiotics. HOCl is produced by the human immune system in response to infection and is known for its broad-spectrum antimicrobial activity. It is effective against a wide range of microorganisms, including bacteria, viruses, and fungi, and has been shown to be more effective than many conventional antibiotics. One of the key advantages of HOCl is its ability to kill bacteria without promoting the development of antibiotic resistance. Unlike conventional antibiotics, which target specific bacterial structures or processes, HOCl acts by disrupting multiple cellular components, making it much more difficult for bacteria to develop resistance. Another advantage of HOCl is its safety profile. Unlike many conventional antibiotics, HOCl is not toxic to human cells and does not cause side effects such as gastrointestinal upset or allergic reactions. Overall, HOCl shows great promise as a potential alternative to conventional antibiotics, particularly in the face of rising antibiotic resistance. With further research, it may become an important tool in the fight against infectious diseases. Herein, we discuss the mechanisms of HOCl antimicrobial action, its potential clinical applications, and future directions for research. This review aims to provide an overview of the use of hypochlorous acid (HOCl) as an antibiotic agent.
Dalbavancin and moleculight in the COVID-19 pandemic
Published on: 11th April, 2023
The COVID-19 Pandemic, which began in March 2020, and its associated surges, had an immense impact on our medical staff and their ability to perform their daily duties.The COVID-19 Pandemic necessitated hospital modifications, including the expansion of the Emergency Department, ICU, and Isolation units. The overwhelmed staff and overburdened ER and ICU required adjustments to deal with the Inpatient impasse. For example, temporary patient care rooms needed to be set up for the overflow of patients. The tsunami of the Pandemic almost overwhelmed our hospital.With the challenges presented to our hospital during the Pandemic, we needed a fresh perspective to our multi-disciplinary approach. Thus, we fathomed that the use and cost-effectiveness of both Dalbavancin, a long-acting lipoglycopeptide antibiotic combined with the diagnostic Moleculight Imaging Device would be a sound decision.We hypothesized that with the use of this cost-effective antibiotic in conjunction with the use of the Moleculight Imaging Device, with its fluorescent imaging, we could detect the presence of bacteria and assist our wound treatment and decision-making.A shift in patients from the Emergency Room/Inpatient Department to the Outpatient Department/Wound Care Center was made possible with the use of these two novel products.
The effect of respira inhalation on the oxygen saturation of a patient’s blood (SpO2): A Case Report
Published on: 7th April, 2023
Introduction: Infection and the accompanying inflammation of the upper and lower respiratory tract, influenza and COVID-19, are among the deadliest diseases in human life in the world. Due to the high emergence of bacterial resistance to antibiotics, we strive to find alternatives to contribute to the treatment by using a new formulation of a mixture of six essential oils in the form of a drop called Respira drops for a therapeutic approach to the upper or lower parts of the respiratory system infection, either by inhalation or sniffing, or by touching it with the body in the form of a skin patch on the head, neck, or chest. The present study suggested that natural essential oils may act as a prophylactic and therapeutic agent in respiratory tract hypoxia, inflammation, and bacterial and viral infection (influenza and COVID-19).Case presentation: A 62-year-old Yemeni man was suffering from acute pneumonia and had used antibiotics his condition improved, but he was suffering from difficulty breathing and stayed on the use of oxygen at home for more than three months, and his SpO2 ranged between 75 to 85 and he also suffered from an abdominal hernia, and he went for a procedure Surgery, and when the SpO2 was measured at 86, the surgery was not completed as a result, so he used Respira drops by inhalation and by steam for twenty-four hours and the next day he went to the hospital and the SpO2 was measured 96 and the operation was performed and he continued using Respira for two weeks three times per day and his condition improved completely.Conclusion: The present case study shows the excellent therapeutic response for Respira drops as inhalation and smiling three times per day increased SpO2 levels which reflect the anti-inflammatory, antimicrobial and anti-viral effects (influenza and COVID-19).
Pneumopericardium: A Rare Complication of Antireflux Surgery
Published on: 23rd August, 2023
Pneumopericardium is a rare clinical entity, occurring in the setting of thoracic trauma, malignancies, or mechanical ventilation. Very few cases report pneumopericardium as a complication of gastrointestinal tract surgery. Signs and symptoms may be frustrating, ranging from asymptomatic to chest pain, sepsis, hemodynamic instability, pericarditis, or even cardiac tamponade. Clinical pathognomonic signs of pneumopericardium include pericardial metallic tinkling friction rub and mill wheel murmur. Diagnostic work-up includes electrocardiogram, chest radiography, and, computed tomography imaging. A gastro pericardial fistula should be considered a rare differential diagnosis for acute chest pain in patients with a history of gastroesophageal surgery. Rapid recognition and treatment avoid life-threatening complications. The successful outcome of gastro pericardial fistula treatment depends on both emergency and definitive surgical management. The survival rate with conservative management is poor.We present the case of a 78-year-old patient suffering from pneumopericardium and pericardial infusion, due to a fibrotic fistula between the Nissen’s valve, occurring 10 years after redo antireflux surgery. Treatment included broad-spectrum antibiotics, and emergency surgery for pericardial drainage, biopsy of the valve’s defect, suture, and omentoplasty.
Laser Doppler Flowmeter as a Periodontal Evaluation Method: A Clinical Pilot Study
Published on: 9th October, 2023
Background and objectives: Periodontal disease, as an inflammatory pathology, induces hemodynamic changes that can be evaluated by different unbiased methods such as laser Doppler flowmetry. This clinical investigation assesses laser Doppler as a non-invasive procedure to monitor gingival vascularization and its potential relationship with the response to treatment of periodontal disease.Materials & methods: 45 sites of white Spanish patients with active periodontitis undertake a complete periodontal analysis. This included periodontal pathogens identification along with the monitoring of the gingival margin microvascularization using a Doppler laser at the points exhibiting the most periodontal damage. All assessments were performed before and after periodontal combined treatment PCT (scaling, root planing, and antibiotic therapy prescription) (n = 45 sites).Results: Parameters of periodontal disease showed a positive correlation with pathogen levels. Blood flow readings decreased significantly after PCT (p < 0,05), although this parameter was not statistically correlated with periodontal nor microbial assessments in a significant range.Conclusion: Laser Doppler is a complementary method of monitoring periodontal inflammation to traditional techniques of clinical periodontal evaluation. Further studies are necessary to determine its usefulness as a predictive method of periodontal disease evolution.
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