Although the genus Prevotella is part of the general human flora, species of this anaerobic gram-negative bacteria have been described as cause of persisting nonpuerperal breast abscesses. Collecting ...punctate samples and testing these samples for anaerobic bacteria, is not part of the common diagnostic workflow in atypical breast abscesses. The causative anaerobic micro-organism can remain unclear and patients can be treated with multiple inadequate antibiotics and/or extensive surgical procedures. The aim of this cohort study of Prevotella induced breast abscesses is to gain more insights into the diagnostic procedures and treatment.
Medical charts of patients with a Prevotella induced breast abscess between 2015 and 2021, were retrospectively reviewed on patient characteristics, diagnostic procedures, treatment and outcome.
Twenty-one patients were included. Six subspecies of Prevotella were determined by culturing. High susceptibility was observed for amoxicillin/clavulanic acid (100%, n = 12). Nine patients (43%) were treated with antibiotics, eight patients (38%) with antibiotics and incision and drainage, and four patients (19%) with only incision and drainage. Recurrence was observed in nine patients (43%), of whom five patients were treated with antibiotics and three patients had surgery. The mean duration of antibiotic administration in patients with recurrence was significantly shorter compared to those without recurrence (5.6 days vs. 19.5 days, p = 0.039).
Specific anaerobic culturing should be common practice in atypical breast abscesses to confirm Prevotella species. The high recurrence rate emphasizes the need of further research for optimal treatment. Prolonged duration of antibiotics could be considered and amoxicillin/clavulanic acid seems to be the first choice.
Although the genus Prevotella is part of the general human microbiota, species of this anaerobic gram-negative bacterium have been described as causes of persisting nonpuerperal breast abscesses. ...Collecting punctate samples and testing these samples for anaerobic bacteria is not part of the common diagnostic workflow in atypical breast abscesses. The causative anaerobic micro-organism can remain unclear and patients can be treated with multiple inadequate antibiotics and/or extensive surgical procedures. The aim of this cohort study of Prevotella induced breast abscesses is to gain more insights into the diagnostic procedures and treatment.
Medical charts of patients with a Prevotella induced breast abscess between 2015 and 2021, were retrospectively reviewed on patient characteristics, diagnostic procedures, treatment and outcome.
Twenty-one patients were included. Six subspecies of Prevotella were determined by culturing. High susceptibility was observed for amoxicillin/clavulanic acid (100%, n = 12). Nine patients (43%) were treated with antibiotics, eight patients (38%) with antibiotics and incision and drainage, and four patients (19%) with only incision and drainage. Recurrence was observed in nine patients (43%), of whom five patients were treated with antibiotics and three patients had surgery. The mean duration of antibiotic administration in patients with recurrence was significantly shorter compared to those without recurrence (5.6 days vs. 19.5 days, p = 0.039).
Specific anaerobic culturing should be common practice in atypical breast abscesses to confirm Prevotella species. The high recurrence rate emphasizes the need of further research for optimal treatment. Prolonged duration of antibiotics could be considered and amoxicillin/clavulanic acid seems to be the first choice.
•Prevotella has been described as a cause of persisting nonpuerperal breast abscesses.•It is essential to exclude cancer as soon as possible in atypical breast abscesses.•The diagnostic process of Prevotella is challenging.•Anaerobic culturing with a punctate/aspirate should be added to the diagnostic process.•Prolonged duration of antimicrobial therapy could be considered.
Dacron
® velour is often used to anchor a percutaneous device, like the catheter used in peritoneal dialysis. However, exit-site infections complicate this method of dialysis and are supposed to be ...related to the design of the catheter. In animal experiments, a percutaneous device provided with a titanium fibre mesh to anchor the implant was not affected by infectious complications. The purpose of this study was to compare the differences in soft tissue reaction to Dacron velour and titanium fibre mesh under the same experimental conditions. Therefore, we placed implants, provided with either Dacron or titanium mesh, subcutaneously in the dorsum of goats. The implants were left
in situ for 4 months. Histological and histomorphological evaluations were performed. It was found that the soft tissue response inside the Dacron was mainly inflammatory, while the titanium mesh evoked good biocompatible behaviour. We concluded that the limited fibrous tissue ingrowth into the Dacron cuff has to be the reason for the observed high failure incidence of a percutaneous device.
In previous experiments a new type of percutaneous device for implantation in soft tissue was designed, containing a sintered titanium fibre mesh. The devices are inserted by a so-called ‘two-phase’ ...surgical technique with an intervening healing period of 3 months between insertion of the subcutaneous and percutaneous parts. From a clinical point of view, this time interval is too long. The aim of this study was to investigate whether it was possible to reduce the intervening healing period. The implants were inserted in the backs of nine goats. In each goat, six implants were placed with intervals of 1 week. Consequently, at the end of the experiment, in each goat six implants were present with implantation periods ranging from 1 to 6 weeks. After 6 weeks, the animals were killed and the implants with surrounding tissue were processed histologically. Analysis demonstrated that during the first 2 weeks an inflammatory response was present. Thereafter, no difference in tissue response was found between the various implantation periods. In conclusion, the experiment suggests that for titanium mesh percutaneous devices a 3-week healing period is sufficient between the installation of the subcutaneous and percutaneous parts.
We report the development of a new peritoneal dialysis catheter. The purpose of the current study was to evaluate tissue response to this catheter.
In our catheter design, the catheter's cuffs are ...made from sintered titanium fiber mesh instead of the common Dacron material. The catheters were implanted in goats. During the study period, the catheter exit sites were observed once every 2 weeks. After 14 weeks, the catheters and surrounding tissues were processed for histology and analyzed.
We observed that catheters with titanium cuffs performed significantly better, compared with a commercial catheter design. Histology showed that titanium fibers evoked a lesser inflammatory response compared with Dacron fibers. In addition, the capsule surrounding the titanium cuff was significantly thinner.
Supported by the obtained results, we conclude that the use of Dacron velour for anchorage of percutaneous catheters has to be reconsidered. Titanium fiber mesh has a great potential for application in percutaneous catheters.
Guided tissue regeneration (GTR) is a technique which is used for the treatment of bone defects associated with periodontal disease or enossal dental implants. In most experimental studies on GTR, ...non-degradable membranes are used. A drawback inherent to such devices is that at the end or in the course of the wound healing they have to be removed. Therefore, the aim of the present study was to investigate a new biodegradable membrane material for use in GTR, which also has excellent mechanical properties and is biocompatible. The material is a composite consisting of poly(ethyleneglycol terephthalate) and poly(butylene terephthalate) segmented copolymer (PEG/PBT), which for the experiments was used in pure form and also mixed with hydroxyapatite (HA) grains. Subcutaneous and subgingival implantation studies in goats were performed to determine the biocompatibility and biodegradability characteristics of several of these materials. Differences between materials were introduced in the production process,
PEG
PBT
ratio, material thickness and presence of HA. Implantation periods were 3, 6 and 12 wk. The histological results indicated that all investigated materials were biocompatible with the surrounding tissue. Degradation of the membranes was attended by a mild cellular reaction. The degradation process was mainly influenced by the
PEG
PBT
ratio. A higher PBT content resulted in a decreased degradation.
The tissue reaction to a percutaneous access device, applicable as a carrier for an implantable glucose sensor, was evaluated in goats. Titanium fibre mesh structures were used for anchorage of the ...device in superficial as well as deeper soft-tissue locations. The percutaneous part was subcutaneously anchored with a fibre mesh sheet. The distal part was placed intraperitoneally and anchored in deeper soft-tissue layers using a fibre mesh cuff. All implants showed good healing with the surrounding tissue. Histological evaluation showed that the subcutaneous fibre mesh sheets and peritoneal fibre mesh cuffs were filled with immature connective tissue, generally free of inflammation. Problems concerning disconnection of the silicone catheter from the titanium holding element and filling of part of the peritoneal fibre mesh cuff with silicone glue have to be overcome by more appropriate preclinical testing and improved implant design. Our results demonstrate that titanium fibre mesh structures can be used effectively for soft-tissue anchorage of percutaneous access devices. A sufficient ingrowth of connective tissue was obtained in superficial as well as in deeper soft-tissue layers. The access device could have application as a carrier for an implantable glucose sensor for glucose monitoring in different tissue compartments.
A percutaneous device, provided with a sintered titanium fiber web structure, was designed for implantation in soft tissue. The percutaneous device was inserted by a two stage surgical technique. ...Between the insertion of the subcutaneous and percutaneous part was an intervening healing period of 3 months. However, most clinicians prefer a one stage implant. Therefore, the authors wanted to investigate the soft tissue response to one stage and two stage percutaneous devices. The implants were inserted in the flanks of 12 goat. In each goat, one one stage and one two stage implant were placed and inspected on a regular base. It appeared that, during the experiments, significantly more one stage devices were extruded. Four months after the second surgical session, all successful implants with their surrounding tissues were retrieved for light microscopic and histomorphometric analysis. No difference in epidermal downgrowth and sulcus width was demonstrated between the implants. Furthermore, the fiber mesh was surrounded by a thin fibrous capsule free from inflammatory cells. Inside the fiber mesh structure, connective tissue was present with only scattered foci of inflammatory cells. An enhanced inflammatory tissue response was found inside the titanium mesh of one stage compared to two stage implants. This study showed that the two stage surgical procedure for implantation of a percutaneous device worked better than the one-stage surgical technique. ASAIO Journal 1996;42:961-967.
Planck pre-launch status: The optical system Tauber, J. A.; Norgaard-Nielsen, H. U.; Ade, P. A. R. ...
Astronomy and astrophysics (Berlin),
09/2010, Letnik:
520
Journal Article
Recenzirano
Odprti dostop
Planck is a scientific satellite that represents the next milestone in space-based research related to the cosmic microwave background, and in many other astrophysical fields. Planck was launched on ...14 May of 2009 and is now operational. The uncertainty in the optical response of its detectors is a key factor allowing Planck to achieve its scientific objectives. More than a decade of analysis and measurements have gone into achieving the required performances. In this paper, we describe the main aspects of the Planck optics that are relevant to science, and the estimated in-flight performance, based on the knowledge available at the time of launch. We also briefly describe the impact of the major systematic effects of optical origin, and the concept of in-flight optical calibration. Detailed discussions of related areas are provided in accompanying papers.
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