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Spondylodiscitis is a infective processes of the spinal column, that can affect the vertebrae in isolation (spondylitis), the discs (discitis) or both (spondylodiscitis). Three infection pathways are described from a pathogenetic perspective: endogenous, exogenous, and per continuitatem. The hematogenic form is the most common (about 60%), but cases of direct inoculation following surgical procedures on the spine (15%) or contamination by contiguity (12%) are not rare. Diagnosis is based on clinical, laboratory, radiological, microbiological and histopathological data, where the magnetic resonance imaging is the technique of choice for the diagnosis. Treatment may be medical using antibiotics to eliminate the infection or surgery using spinal fixation to prevent spinal instability and ample debridement of infected tissue. We report on a patient who had spondylodiscitis due to a sigmo-rettal fistula caused by a intrarectal penetration of a toothpick which was accidentally swallowed by the patient; which was successfully treated with targeted antibiotic therapy and immobilization.

In this paper, we consider a Hepatitis C model characterized by acute and chronic infections, treatment as a health-protective measure for the chronically infected is proposed, and its effect on the population is further highlighted. The model is perturbed by white noise and we incorporate Lévy jumps as means to depict abrupt fluctuations. We demonstrate the solution’s existence and uniqueness and deduce adequate criteria for the disease’s extinction and persistence. The importance of treatment as a protective strategy is manifested in its ability to eradicate or mitigate the propagation of the disease. We present numerical simulations to demonstrate the theoretical findings we have obtained.

Investigations of the levels of nine elements (P, S, Cl, K, Ca, Fe, Cu, Zn, Br) in plasma collected continuously from eels infected with atypical A. salmonicida by PIXE analysis were performed. The PIXE technique proved to be a powerful tool for performing multielement analysis in a small amount of blood collected by an intra-vascular cannulation technique. Decreases in Hb and plasma protein, P, Cl, Ca, Fe and Cu, and increase in plasma K were observed with the infection. On day 3, the reduction in plasma Zn were found in the control and the deseased groups. At the moribund stage, increased ammonia and decreased Br in plasma were observed. The decrease in Fe of the diseased eels was remarkable. No significant change in plasma S was found.

This paper describes an evolutionary model based on sexual Penna model and shape space model with infection and immunity. Each individual is represented by Penna model with an immune system. In order to study how the infection and immunity influence the survival process, we modify the Verhulst factor. Then, we present the results of our simulations, and discuss the evolution of population and the effect of immunity respectively. In addition, we study the effect of the memory of the immune system and the effect of vaccination under different conditions.

In this paper, the individual is represented by a Bit-String based on the Penna model. The infection information is also denoted by a Bit-String including 0 and 1. The degree of getting an infection is rested with the matching degree between the Bit-String of the individual and the Bit-String of infection information. Thus, we define the Hamming Distance with age. The infection rules among individuals is described by Cellular Automata on the lattice with L * L. We discuss the existence and extinction for a certain infection on the process of evolution.

Shiunko is a traditional botanic formula (ointment) which is used clinically for the treatment of wounded skin caused by cuts, abrasions, frost or burn. The aim of this study was to evaluate the effect of Shiunko on epithelization of wounded skin. Experimental cutting wounds on the back skin of Sprague-Dawley rats were induced. Different bacterial inoculations (Pseudomonus aeruginosa and Staphylococcus aureus) and treatment (Shiunko, Povidone-iodine and saline) were arranged herein. The incidences of infection and the speed of epithelization were evaluated. We observed that the incidences of wound infection following Pseudomonas aeruginosa inoculation were lower on both the Shiunko-treated group (0%, p<0.01) and Povidine-iodine-treated group (5%, p<0.05), than the saline-treated group (40%). The Shiunko-treated group reported higher percentages of complete epithelization not only on the sterilized wounds (100%) but also on the contaminated wounds (90%) when compared to the saline-treated group (60% sterilized wounds, 40% and 50% contaminated wounds) on day 7 (p<0.01). Povidone-iodine did not promote epithelization of wounded skin, whereas Shiunko did.

The objective of this review was to summarize and critically evaluate the clinical evidence of the effect of qigong exercise on immunity and its efficacy in the prevention or treatment of infectious diseases. Thirteen databases were searched from their respective inceptions through January 2011, and all controlled clinical trials of qigong exercise on immunity and infections were included. Quality and validity of the included studies were evaluated using standard scales. Seven studies including two randomized controlled trials (RCTs), two controlled clinical trials (CCTs) and three retrospective observational studies (ROSs) met the inclusion criteria. One study focused on functional measures of immunity (antigen-induced immunity) and six studies on enumerative parameters of immunity. No study on clinical symptoms relevant to infectious diseases could be identified. Overall, the included studies suggested favorable effects of qigong exercise on immunity, but the quality of research for most of the studies examined in this review was poor. Further rigorously designed studies are required, which should adhere to accepted standards of methodology for clinical trials.

We investigate the switching feeding behavior of predators in the context of one single prey population, which is disease affected. We consider the case of hunting indiscriminately both types of prey, when the infected prey causes no harm to their predators, but assume also in another model that feeding on the infected individuals has a negative return on the predators. Some counterintuitive results are obtained and discussed.

For 30 years, silicone oil has been used for the management and rehabilitation of the injured hand. Its benefits accrue from its providing a non-irritant, bland, air-free medium in which the hand can undergo early movement, which prevents drying out of the tissues and helps in the separation of necrotic and infected tissue. It has been reported, however, that the silicone oil might act as a reservoir for nosocomial infection after two patients developed epidemic methicillin-resistant Staphylococcus aureus (EMRSA) infections.

Since no firm guidelines exist with regard to open and/or infected wounds and the continued use of the same oil, a prospective study was set up to study the bacterial colonisation of the silicone oil. Thirty-five consecutive patients were entered into the study. The oil for each patient was changed each week but if any wound became clinically infected the oil was changed earlier. Treatment was continued until the wound was healed or until the treatment was stopped by the referring doctor.

Bacteriology swabs taken from the wound and the oil before each treatment and from the oil after each treatment were analysed for bacterial colonisation. The results indicated that while bacteria were transferred into the oil from the wound, the inoculum was small and had no effect on wound healing. There was no evidence that wounds were being re-infected from the oil. The conclusion was that silicone oil remains a safe medium in which to exercise injured hands.

Acute carpal tunnel syndrome is an orthopaedic emergency that requires prompt surgical treatment. We describe two rare cases of this condition, one secondary to pyogenic infection and one secondary to prolonged pressure on the upper limb brought on by overdose.

Vibrio vulnificus may cause severe soft tissue infections of the upper extremity. This pathogen usually gains access to soft tissues either by direct inoculation through a penetrating injury by an infected marine animal or by exposing abraded skin to contaminated water. We report five patients with Vibrio vulnificus hand infections following superficial hand injuries incurred within 24 hours after uneventful handling of fish. This clinical observation, together with the fact that the physiologic characteristics of human sweat simulate the natural environment of the Vibrio vulnificus, support the assumption that human skin may serve as a reservoir for Vibrios. The anamnesis in patients presenting with hand infection should essentially include an inquiry regarding recent, albeit uneventful, fish handling.

When tendons, bones or joints are exposed in infected digits, functional and cosmetic sequelae are frequent. We propose continuous negative pressure therapy with irrigation (NPI) for an infected digit with an open wound. Continuous NPI was evaluated in vitro and subsequently applied to a clinical case. Acceptable functional and cosmetic results were obtained without any problems when continuous NPI was performed in the clinical case. Continuous NPI may be a useful alternative for treatment of an infected digit with an open wound.

Os acromiale is an unfused epiphysis of the anterior part of the acromion occurring in approximately 8% of the population. Infection of this joint has not been previously described in the literature. We report such a case in a 59-year-old woman presenting with shoulder pain. A high index of clinical suspicion, with early imaging of the shoulder leading to prompt and definitive diagnosis, can lead to appropriate treatment and produce a favorable outcome.

A case of a 35-year-old male with necrotizing fasciitis of the hand is presented. Clinical manifestations of necrotizing fasciitis are discussed and intraoperative findings are highlighted to illustrate the disease process that initially affects the deep layer of the superficial fascia.

Penetrating sea urchin spine injuries, can lead to devastating, irreversible consequences. Persistent inflammation, cutaneous granuloma, neuroma, tenosynovitis, arthritis and destructive arthritis, leading to permanent loss of function and digit amputation, can occur. We present a case of a patient who developed sea urchin spine arthritis of the proximal interphalangeal joint. Only 17 cases of sea urchin spine arthritis of the hand have been documented in the medical literature. However, in this case, the article also includes sequential radiographs, histopathological slides, and intra-operative photographs.

We present a rare case of primary tuberculous tenosynovitis in a young patient with an acute history of non-penetrating traumatic injury. The patient had recently visited Pakistan and presented with sudden onset pain at the base of their right fifth digit after trying to catch a cricket ball. A provisional diagnosis of haematoma was made; however, ultrasonography revealed a mass attached to the A2 pulley. Surgical excision followed by histological examination and culture identified Mycobacterium Tuberculosis infection. This case serves to raise clinical awareness of this rare condition and highlight the importance of obtaining a travel history.

Purpose: To determine the rate of antibiotic elution from tobramycin-impregnated ProOsteon (Interpore) and Collagraft (Zimmer). Methods: Five samples of Collagraft and ProOsteon were impregnated with a solution containing 1.2 g of tobramycin and 10 ml of sterile water. The samples were then allowed to dry overnight. These samples were stored at 37°C in separate test tubes containing phosphate buffered saline (PBS). The solution in each test tube was removed with a pipette at hours 3, 6, 9 and 12 and days 1, 2, 3, 5, 7, 9, 11 and 13. The PBS was then replaced. The pipetted solution was sent for laboratory quantification and also used in a bioassay to determine antibiotic level. To serve as a control, two additional samples of each bone graft that were not impregnated with antibiotic were placed in separate test tubes and subjected to the same protocol. Results: The antibiotic elution rate for both ProOsteon and Collagraft was high at 3 hours [5362 and 4875 μg/ml on day 3 (3.1 μg/ml) for the Collagraft and day 7 (3.7 μg/ml) for the ProOsteon]. Effective intravenous tobramycin level is considered to be 4–6 μg/ml. Conclusion: Bone graft substitute can be used as a delivery vehicle for tobramycin. In addition, antibiotic-impregnated synthetic bone graft may potentially fill a dead space or cavitary defect without the need for large autologous grafts and does not require later removal.

Elite athletics requires maximum effort by the pursuer, exposing the tendons, ligaments and muscles, including the heart muscle, to intense and frequent mechanical and metabolic demands, which may increase the susceptibility to, and severity of, infections in these tissues. Furthermore, intense and frequent exercise with insufficient resting periods can compromise the immune system. Muscles and tendons are more vulnerable to overuse injuries in the recovery period following various infections. Although the etiology and pathogenesis of a substantial proportion of cases of tendinitis and tendinosis are still largely unknown, gram-positive cocci prevail as the most common etiologies in soft tissue infections. The recent identification of binding sites of staphylococci to intercellular tissue matrix components have opened up the possibility of selectively blocking such binding by prior vaccination. New molecular biological methods, enabling the identification of slow-growing bacteria that are difficult to culture, including Bartonella and Rickettsia, have created the possibility of studying the potential role also of such organisms in soft tissue conditions, including myocarditis. Acute myocarditis remains the most frequent form of myocarditis, commonly emerging in the course of an acute respiratory infection. Since myocarditis episodes are frequently subclinical and self-healing, athletes (and others) should generally be recommended rest during infections, especially during the early phase of the infection.

Infections following limb-saving surgeries still happen frequently and are refractory to treatment, even though the treatment of massive bone defects caused by bone resection of bone tumors has improved gradually. Once infections become intractable, they generally result in amputations in spite of all kinds of treatment. We report the case of a patient who developed an intractable infection after limb-saving surgery utilizing a massive frozen autograft and a tumor prosthesis, but whose limb was finally successfully salvaged by multiple surgical interventions. We conclude that continued perseverance in treatment after infections may enable preservation of the limb and restoration of good function.

Korean and American Research Institutes Combine Approaches in Analysis of Viral Infectivity