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  • 1
    Online Resource
    Online Resource
    Treatment Failure in Vertebral Osteomyelitis : Is it All About Staphylococcus aureus?
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Spine Vol. 47, No. 20 ( 2022-10-15), p. E607-E614
    Details
    In: Spine, Ovid Technologies (Wolters Kluwer Health), Vol. 47, No. 20 ( 2022-10-15), p. E607-E614
    Abstract: Retrospective cohort study. Objective. The aim was to compare the influence of 2 common vertebral osteomyelitis (VO) causing pathogens on treatment failure within the first year of diagnosis. Summary of Background Data. VO is mainly caused by Staphylococcus aureus (SA), while enterococci and streptococci (ENST) are also responsible for a significant proportion of VO, particularly in elderly patients. Data on VO caused by SA show a tendency for worse outcome, whereas data on VO caused by ENST are scarce. For this purpose, our study compares characteristics of patients with VO caused by SA or ENST in order to analyze risk factors for treatment failure. Methods. We conducted a retrospective monocentric study including VO patients from 2008 to 2020. Primary outcome was treatment failure defined as death or relapse within 1 year (T1). We compared patients diagnosed with VO caused by Staphylococcus aureus including MRSA to patients diagnosed with VO caused by Enterococcus and Streptococcus species, which were combined into one group. Polymicrobial infections were excluded. We employed multiple logistic regression analysis to adjust for confounding. To account for moderation, the model was repeated with an included interaction term. Results. Data of 130 VO patients (SA=95; ENST=35) were available at T1. Treatment failure occurred in 37% of SA patients and 23% of ENST patients. On multivariate analysis SA [odds ratio (OR): 3.12; 95% confidence interval (CI): 1.09–10.53; P =0.046], Charlson comorbidity index (OR: 1.31; 95% CI: 1.11–1.58; P =0.002) and infectious endocarditis (IE; OR: 4.29; 95% CI: 1.23–15.96; P =0.024) were identified as independent risk factors for treatment failure. Conclusion. In our cohort every third patient with VO caused by SA or ENST dies within 1 year. Our findings indicate that patients with VO caused by SA, concomitant IE and/or a high Charlson comorbidity index score may be at elevated risk for treatment failure. These findings can be used to individualize patient care and to direct clinical surveillance. This could include echocardiography evaluating for the presence of IE in patients with VO caused by gram-positive pathogens.
    Type of Medium: Online Resource
    ISSN: 0362-2436
    URL: Article
    DOI: 10.1097/BRS.0000000000004420
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2002195-1
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  • 2
    Online Resource
    Online Resource
    Feasibility and acceptance of simultaneous amyloid PET/MRI
    Springer Science and Business Media LLC ; 2016
    In:  European Journal of Nuclear Medicine and Molecular Imaging Vol. 43, No. 12 ( 2016-11), p. 2236-2243
    Details
    In: European Journal of Nuclear Medicine and Molecular Imaging, Springer Science and Business Media LLC, Vol. 43, No. 12 ( 2016-11), p. 2236-2243
    Type of Medium: Online Resource
    ISSN: 1619-7070 , 1619-7089
    URL: Article
    DOI: 10.1007/s00259-016-3462-x
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2016
    detail.hit.zdb_id: 2098375-X
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  • 3
    Online Resource
    Online Resource
    Simultaneous PET/Mri in Stroke: A Case Series
    SAGE Publications ; 2015
    In:  Journal of Cerebral Blood Flow & Metabolism Vol. 35, No. 9 ( 2015-09), p. 1421-1425
    Details
    In: Journal of Cerebral Blood Flow & Metabolism, SAGE Publications, Vol. 35, No. 9 ( 2015-09), p. 1421-1425
    Abstract: Prospective studies on magnetic resonance imaging (MRI)-guided systemic thrombolysis 44.5 hours after stroke onset did not reach their primary end points. It was discussed and observed in post hoc data re-assessment that this was partly because of limited MRI accuracy to measure critical hypoperfusion. We report the first cases of simultaneous [ 15 O]H 2 O-positron emission tomography (PET)/MRI in stroke patients and an ovine model. Discrepancies between simultaneously obtained PET and MRI readouts were observed that might explain the above current limitations of stroke MRI. By offering highly complementary information, [ 15 O]H 2 O-PET/MRI might help to identify critically hypoperfused tissue resulting in an improved patient stratification in thrombolysis trials.
    Type of Medium: Online Resource
    ISSN: 0271-678X , 1559-7016
    URL: Article
    DOI: 10.1038/jcbfm.2015.158
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2015
    detail.hit.zdb_id: 2039456-1
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  • 4
    Online Resource
    Online Resource
    Dual Time-Point [18F]Florbetaben PET Delivers Dual Biomarker Information in Mild Cognitive Impairment and Alzheimer’s Disease
    IOS Press ; 2018
    In:  Journal of Alzheimer's Disease Vol. 66, No. 3 ( 2018-11-23), p. 1105-1116
    Details
    In: Journal of Alzheimer's Disease, IOS Press, Vol. 66, No. 3 ( 2018-11-23), p. 1105-1116
    Type of Medium: Online Resource
    ISSN: 1387-2877 , 1875-8908
    URL: Article
    DOI: 10.3233/JAD-180522
    Language: Unknown
    Publisher: IOS Press
    Publication Date: 2018
    detail.hit.zdb_id: 2070772-1
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  • 5
    Online Resource
    Online Resource
    Regulatory T Cells from Patients with Rheumatoid Arthritis Are Characterized by Reduced Expression of Ikaros Zinc Finger Transcription Factors
    MDPI AG ; 2022
    In:  Cells Vol. 11, No. 14 ( 2022-07-11), p. 2171-
    Details
    In: Cells, MDPI AG, Vol. 11, No. 14 ( 2022-07-11), p. 2171-
    Abstract: Regulatory T (Treg) cells play an important role in immune tolerance and contribute to the prevention of autoimmune diseases, including rheumatoid arthritis (RA). The differentiation, function and stability of Treg cells is controlled by members of the Ikaros zinc finger transcription factor family. In this study, we aimed to reveal how the expression of Ikaros transcription factors is affected by disease activity in RA. Therefore, we analyzed the ex vivo expression of Ikaros, Helios, Aiolos and Eos in Treg cells, Th17 cells and Th1 cells from RA patients by flow cytometry. We found significantly reduced expression of Helios, Aiolos and Eos in Treg cells from RA patients as compared to healthy controls. Moreover, Helios and Aiolos levels correlated with disease activity, as assessed by DAS28-CRP. In addition, Ikaros, Helios and Aiolos were significantly downregulated in Th1 cells from RA patients, while no difference between healthy individuals and RA was observed in Th17 cells. In summary, Helios and Aiolos expression in Treg cells correlates with disease activity and the expression levels of Ikaros transcription factors are diminished in Treg cells from RA patients. This observation could explain the reduced stability of Treg cells in RA.
    Type of Medium: Online Resource
    ISSN: 2073-4409
    URL: Article
    DOI: 10.3390/cells11142171
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2661518-6
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  • 6
    Online Resource
    Online Resource
    Surgery for Vertebral Osteomyelitis Lowers 1-Year Mortality and Failure Rates Compared with Nonsurgical Treatment : A Propensity-Matched Analysis
    Ovid Technologies (Wolters Kluwer Health) ; 2024
    In:  Journal of Bone and Joint Surgery Vol. 106, No. 7 ( 2024-4-3), p. 575-581
    Details
    In: Journal of Bone and Joint Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 106, No. 7 ( 2024-4-3), p. 575-581
    Abstract: The aim of this study was to determine differences between patients who underwent surgical treatment and those who underwent nonsurgical treatment of vertebral osteomyelitis (VO) and to identify potential factors influencing treatment failure (death and/or recurrence within 1 year). Methods: We performed a retrospective analysis of clinical data prospectively collected from patients treated for VO between 2008 and 2020. The decision between surgical and nonsurgical treatment was made for each patient based on defined criteria. A 1:1 propensity score matching was performed to exclude confounders between the 2 treatments. Univariate and multivariable analyses were performed to identify potential risk factors for death and/or recurrence within the first year after VO diagnosis. Results: Forty-two patients (11.8%) were treated nonsurgically and 313 patients (88.2%) underwent surgery. A higher percentage of the surgically treated patients than the nonsurgically treated patients had an American Society of Anesthesiologists score of 〉 2 (69.0% versus 47.5%; p = 0.007), and the thoracic spine was affected more often in the surgical group (30.4% versus 11.9%; p = 0.013). Endocarditis was detected significantly more often in the nonsurgically treated patients (14.3% versus 4.2%; p = 0.018). The recurrence rate was 3 times higher in the nonsurgically treated patients (16.7% versus 5.4%; p = 0.017), but this difference was no longer detectable after propensity matching. After matching, the nonsurgically treated patients showed an almost 7-fold higher 1-year mortality rate (25.0% versus 3.7%; p = 0.018) and an almost 3-fold higher rate of treatment failure (42.9% versus 14.8%; p = 0.022). Multivariable analysis revealed nonsurgical treatment and bacteremia to be independent risk factors for treatment failure. Conclusions: In our matched cohort of patients with VO, surgical intervention resulted in a significantly lower rate of treatment failure (death and/or recurrence within 1 year) compared with nonsurgical intervention. Furthermore, nonsurgical treatment was an independent risk factor for treatment failure. Level of Evidence: Therapeutic Level III . See Instructions for Authors for a complete description of levels of evidence.
    Type of Medium: Online Resource
    ISSN: 0021-9355 , 1535-1386
    URL: Article
    DOI: 10.2106/JBJS.23.00283
    RVK:
    XA 52200.A
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2024
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  • 7
    Online Resource
    Online Resource
    Update Knocheninfektionen
    Georg Thieme Verlag KG ; 2023
    In:  DMW - Deutsche Medizinische Wochenschrift Vol. 148, No. 06 ( 2023-03), p. 313-317
    Details
    In: DMW - Deutsche Medizinische Wochenschrift, Georg Thieme Verlag KG, Vol. 148, No. 06 ( 2023-03), p. 313-317
    Abstract: Periprothetische Infektionen: Diagnostik, Prothesenerhalt und Therapielänge. Nach einer neuen Studie kann bei Vorliegen einer hämatogenen periprothetischen Infektion und weiteren einliegenden Gelenkprothesen, die in der klinischen Untersuchung unauffällig sind, auf weitere invasive oder bildgebende Diagnostik verzichtet werden. Periprothetische Infektionen, die spät auftreten ( 〉 3 Monate nach Implantation) haben ein schlechteres Outcome. Neue Studien versuchen Faktoren zu identifizieren, wann der Prothesenerhalt weiterhin eine Option ist. Eine neue randomisierte Landmarkstudie aus Frankreich konnte keine Nichtunterlegenheit für 6 versus 12 Wochen Therapielänge zeigen. Somit ist anzunehmen, dass dies aktuell der Standard für alle OP-Modalitäten (Erhalt oder Wechsel) wird. Wünschenswert wären weitere Studien zu dem Thema, die v.a. mehr Patienten mit spätem Prothesenwechsel betrachten. Spondylodiszitis: Inzidenz und Erregerprofil. Die Spondylodiszitis ist eine eher seltene Knocheninfektion, deren Inzidenz in den vergangenen Jahren aber weiter stark gestiegen ist (erneut fast verdoppelt in 10 Jahren). Betroffen sind weiterhin vor allem ältere Personen, Männer und komorbide Patienten. Eine retrospektive Studie aus Korea von Kim et al. gibt Aufschluss über die Erregerverteilung in verschiedenen Altersgruppen sowie mit verschiedenen Komorbiditäten. Damit hilft sie bei der Einschätzung des verursachenden Erregers und der Auswahl der empirischen Therapie, wenn die Erregeridentifizierung vor Therapiestart nicht gelingt. S. aureus ist am häufigsten über alle Altersgruppen, aber mit Zunahme von Enterokokken und v.a. gram-negativen Erregern bei Älteren. Diabetische Fußinfektion: Leitlinien, Diagnostik und Therapielänge. Die Leitlinien der „International Working Group on the Diabetic Foot“ (IWGDF) wurden mit leicht veränderter Klassifikation aktualisiert, außerdem hat die Deutsche Diabetes Gesellschaft neue Handlungsempfehlungen publiziert. Die empirische Therapie richtet sich weiterhin nach der Schwere der Infektion und weiteren Risikofaktoren (wie Vortherapien, Ischämie). Die mikrobiologische Diagnostik aus Gewebeproben wird gegenüber Abstrichen als überlegen beschrieben. Nach einer randomisierten Pilotstudie scheinen 3 Wochen Therapiedauer bei Osteomyelitis nach Debridement 6 Wochen nicht unterlegen zu sein. Größere randomisierte Studien zu dem Thema rekrutieren aktuell.
    Type of Medium: Online Resource
    ISSN: 0012-0472 , 1439-4413
    URL: Article
    DOI: 10.1055/a-1853-4777
    RVK:
    XA 39100
    RVK:
    XA 10000
    Language: German
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2023
    detail.hit.zdb_id: 2035474-5
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