What Are the Effects of Irreversible Electroporation on a Staphylococcus aureus Rabbit Model of Osteomyelitis?

What Are the Effects of Irreversible Electroporation on a Staphylococcus aureus Rabbit Model of Osteomyelitis? Clin Orthop Relat Res. 2019 Aug 05;: Authors: Muñoz NM, Minhaj AA, Dupuis CJ, Ensor JE, Golardi N, Jaso JM, Dixon KA, Figueira TA, Galloway-Peña JR, Hill L, Shelburne SA, Tam AL Abstract BACKGROUND: The treatment of osteomyelitis can be challenging because of poor antibiotic penetration into the infected bone and toxicities associated with prolonged antibiotic regimens to control infection. Irreversible electroporation (IRE), a percutaneous image-guided ablation technology in which the targeted delivery of high-voltage electrical pulses permanently damages the cell membrane, has been shown to effectively control bacterial growth in various settings. However, IRE for the management of bone infections has yet to be evaluated. QUESTIONS/PURPOSES: We aimed to evaluate IRE for treating osteomyelitis by assessing (1) the efficacy of IRE to suppress the in vitro growth of a clinical isolate of S. aureus, alone or combined with cefazolin; and (2) the effects of IRE on the in vivo treatment of a rabbit model of osteomyelitis. METHODS: S. aureus strain UAMS-1 expanded in vitro to the log phase was subjected to an electric field of 2700 V/cm, which was delivered in increasing numbers of pulses. Immediately after electroporation, bacteria were plated on agar plates with or without cefazolin. The number of colony-forming units (CFUs) ...
Source: Clinical Orthopaedics and Related Research - Category: Orthopaedics Authors: Tags: Clin Orthop Relat Res Source Type: research

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ConclusionWhile rib osteomyelitis is rare, imaging findings of lytic changes at the costochondral junction combined with a history of fever, elevated inflammatory markers or localized soft-tissue swelling in the chest should raise suspicion for this disease.
Source: Pediatric Radiology - Category: Radiology Source Type: research
ConclusionFlat bones are relatively rare locations of osteomyelitis. Standard radiography remains the first-line examination. Their treatment obeys the same rules as that of osteomyelitis of long bones. There is a successful outcome when the care is early and adequate.
Source: Journal of Clinical Orthopaedics and Trauma - Category: Orthopaedics Source Type: research
Conclusion: TROAI are relatively uncommon in children but cause significant morbidity. While MRSA contributes substantially to TROAI, the highly diverse microbiology emphasizes the importance of obtaining cultures for microbiologic diagnosis and management. Clinicians should be aware of the frequency of E. cloacae in TROAI and its high risk for sequelae.
Source: The Pediatric Infectious Disease Journal - Category: Infectious Diseases Tags: Original Studies Source Type: research
We describe such a patient who was successfully treated with a calcium-based resorbable bone substitute that preserved the first metatarsophalangeal joint. A 38-year-old female presented to our department with a foot infection. Examination revealed a methicillin-susceptible Staphylococcus aureus infection of the first metatarsophalangeal joint. The histopathologic findings confirmed active osteomyelitis of the first metatarsal head. The metatarsophalangeal joint was debrided with open synovectomy, the metatarsal head was curetted, and the bone defect was filled with 2 mL of a synthetic bone graft substitute. Two yea...
Source: The Journal of Foot and Ankle Surgery - Category: Orthopaedics Source Type: research
​BY GREGORY TAYLOR, DO, &ERIC MCDOWELL, DOA 47-year-old woman presented to the emergency department with a chief complaint of pain and swelling on her left index finger two days after she was bitten by her cat. Her vitals were within normal limits. Physical exam was notable for two puncture wounds to the left index finger along the radial aspect of the middle phalanx. Fusiform swelling was noted around the proximal phalanx to the level of the MCP joint, with erythema extending to the distal palmar crease. The index finger was held in slight flexion with pain during passive extension and pain with palpation of the ten...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
We report an 11-year old female who presented with acute complaints of high grade fever, pain in the left thigh and inability to walk and breathlessness since 6 days. On physical examination, there was a diffuse tender swelling of the left thigh, tachypnea, tachycardia with hyperdynamic precordium and bilateral basal crepitations. Ultrasonography and venous doppler of lower limbs showed mild effusion of left hip joint and thrombus in the left common femoral vein and left external iliac vein suggesting a diagnosis of septic arthritis with thrombophlebitis. The tachypnea and tachycardia which was out of proportion to fever a...
Source: Journal of Postgraduate Medicine - Category: Internal Medicine Authors: Source Type: research
Conclusions: Although rare, SD represents an important disease in children. In toddlers and preschool children, it can have a subacute or chronic course, in which only back pain, irritability, and walking difficulties are the signs and symptoms of the disease. MRI remains the best method for confirming the diagnosis and for evaluating therapy efficacy. Antibiotics are the drugs of choice. Although the duration has not been established, antibiotics should be administered for several weeks.
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Case Report Source Type: research
Conclusions: Contrary to trends identified in an earlier publication, the annual frequency of CA-MRSA infections has stabilized at roughly 40% of all cases. Our data suggest that MSSA infections have become more virulent because these patients now have similar rates of complications and operative interventions to patients with CA-MRSA infections. Level of Evidence: Prognostic level II study (retrospective).
Source: Current Orthopaedic Practice - Category: Orthopaedics Tags: SPECIAL FOCUS: Pediatric Orthopaedic Rotation Source Type: research
We describe such a patient who was successfully treated with a calcium-based resorbable bone substitute that preserved the first metatarsophalangeal joint. A 38-year-old female presented to our department with a foot infection. Examination revealed a methicillin-susceptible Staphylococcus aureus infection of the first metatarsophalangeal joint. The histopathologic findings confirmed active osteomyelitis of the first metatarsal head. The metatarsophalangeal joint was debrided with open synovectomy, the metatarsal head was curetted, and the bone defect was filled with 2 mL of a synthetic bone graft substitute. Two yea...
Source: The Journal of Foot and Ankle Surgery - Category: Orthopaedics Source Type: research
Authors: Aragón-Sánchez J, Lipsky BA Abstract Introduction Diabetic foot osteomyelitis (DFO) has long been considered a complex infection that is both difficult to diagnose and treat, and is associated with a high rate of relapse and limb loss. Areas covered DFO can usually be diagnosed by a combination of clinical evaluation, serum inflammatory markers and plain X-ray. When the results of these procedures are negative or contradictory, advanced imaging tests or bone biopsy may be necessary. Staphylococcus aureus remains the most frequent microorganism isolated from bone specimens, but infection is of...
Source: Expert Review of Anti-Infective Therapy - Category: Infectious Diseases Tags: Expert Rev Anti Infect Ther Source Type: research
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