Mark de Boer’s Post

Actinomycosis is a rare, granulomatous infection of the skin characterized by the formation of multiple pus-filled abscesses (or bumps) in different body regions. The abscesses can become large and induce localized swelling. They also often form sinus tracts that drain yellowish pus, known as sulfur granules (typical of actinomyces infection). The pus is composed of clumps of dead bacteria and combating immune cells (neutrophils), which impart the yellow color.... https://lnkd.in/dHUNHcFW

This meta-analysis of 1.9 million total knee arthroplasties from 10 registries found no difference in risk of revision due to infection in antibiotic-loaded- vs plain bone cement. https://ja.ma/4azWa8a

🦴Are you involved in arthroplasty surgery or bone and joint infection management? 🦴Would you like to help shape development of an ex vivo model to validate a novel technology to prevent peri-prosthetic joint infection? I am a PhD researcher at Sheffield Hallam University working with a hybrid silica based sol-gel device coating for local antimicrobial delivery to prevent periprosthetic joint infections in cementless arthroplasty surgeries. In addition to antimicrobial efficacy, cytotoxicity and biocompatibility testing, including in an ex vivo bone model, I believe it is very important to consider the viewpoints of clinicians who may be future users of this new technology! I am very interested in your opinion regarding your preferred antimicrobials in bone cement or antibiotic loaded spacers to inform my decision making and research which will lead to publication. Your valuable input will help shape my choices regarding the antibiotic (s) to incorporate into the sol-gel coating, and would greatly appreciate it if you could find time to fill out my short (8 question) survey: INFORMATION SHEET AND CONSENT FORM LINK: https://lnkd.in/emysMhm2 To maintain anonymity, the survey link will be emailed to you after your completion of our participant consent form. If you are interested in sharing your thoughts, please could you complete the consent form and send it to me by email at sarah.boyce@shu.ac.uk? Any help will be greatly appreciated! If you are interested in further information on our research, here is the most recent research paper: The antimicrobial activity and biocompatibility of a controlled gentamicin-releasing single-layer sol-gel coating on hydroxyapatite-coated titanium | Bone & Joint (boneandjoint.org.uk), and Professor Tom Smith’s (part of my fantastic supervisory team)recent REF report: Our research into antibiotics is helping surgeons carry out life-changing work | Sheffield Hallam University (shu.ac.uk)

Factors that Delay Implant Treatment ⬇️ While most patients are keen to complete their treatment in a timely fashion, there are several factors which can delay or slow treatment... 👉 Treatment of an infected failing tooth: If you have a failing tooth with an associated infection, it usually needs to be treated and allowed to heal prior to placing the implant, as pre-existing infection will increase the risk of the bone not healing around the implant. Once signs of healing are present, we can place our implant. 👉 Additional bone is required: We may need to increase the amount of bone present before placing an implant, as this is fundamental for the long-term success of the treatment. While small amounts can sometimes be added when the implant is placed, if we need to add a larger volume of bone, it might need to be done as a prior procedure, which usually delay implant placement by 4-9 months. 👉 An increase in gum is required: We need thick, fibrous gum around both teeth and implants and sometimes this is absent. It's necessary to increase this gum as it provides a bacterial seal and helps prolong the life of implants. This will require a procedure that is often performed after implant placement and before the teeth are added to the implant(s). Generally, a minimum of 3 months are required for healing before completing treatment. Find out more and enquire > https://bit.ly/48JDTV2

UTI - Inpatient vs Outpatient care Urinary tract infections (UTIs) are commonly treated on an outpatient basis with oral antibiotics. However, there are situations where UTIs should be treated as an inpatient acute care admission. Here are some scenarios in which hospitalization for UTI may be necessary: 1. Severe Symptoms: If the patient exhibits severe symptoms such as high fever, chills, severe pain, and vomiting, hospitalization may be necessary for closer monitoring and more intensive treatment. In the worst-case scenario, if the UTI has progressed to sepsis (UTI with organ dysfunction/s due to an extreme immune response), sepsis from the UTI becomes the reason for the acute inpatient admission and becomes the principal diagnosis. 2. Complicated UTI: In cases where the UTI is considered complicated, such as in individuals with anatomical abnormalities, urinary retention, or underlying medical conditions like diabetes or kidney disease, inpatient treatment may be necessary to ensure appropriate management. 3. Recurrent UTIs: If the patient has a history of recurrent UTIs that have not responded to outpatient treatment or if the infection is caused by multidrug-resistant bacteria, hospitalization for intravenous antibiotics and further evaluation may be needed. 4. Compromised Immune System: Individuals with a weakened immune system, such as those undergoing chemotherapy, organ transplant recipients, or HIV/AIDS patients, are at higher risk of developing severe complications from UTIs and may require inpatient treatment. 5. Pregnancy: Pregnant women with UTIs, especially those at risk of complications such as pyelonephritis, should receive prompt and thorough treatment, which may involve hospitalization to prevent adverse outcomes for the mother and the fetus. In these circumstances, healthcare providers may opt for inpatient acute care admission to ensure the appropriate management of the UTI and prevent potential complications. #MedicalNecessity #InpatientvsObservation #UtilizationManagement #CDI #AHIMA #ACDIS #PhysicianAdvisors

If you are attending the Advanced Wound Care Summit USA, come see Karim Lalji, Microbion CEO, present on topical pravibismane's promising clinical safety and efficacy results treating moderate to severe Diabetic Foot Ulcer Infections.  Presentation takes place Wednesday, April 17 at 9:30am in the Grand Ballroom at the Boston Marriot Long Wharf. We hope to see you there! #diabeticfoot #chronicwounds #antibioticresistance #mrsa #woundhealing #woundcare #chronicinflammation #antibiotics #infectioncontrol #drugresistance #infectiousdisease

Plaque rupture, plaque erosion, and COVID-19 infection can cause acute coronary syndromes (ACS). We illustrate case examples demonstrating the distinctive and characteristic pathologic findings underlying each of these various causes of acute...

#IHIT #HeartSurgery #Surgical site infections #Mediastinitus #CABG #InfectionPREVENTION The“I Hate Infections Team”(IHIT) WakeMed, Raleigh NC has achieved zero deep sternal wounds per STS criteria for 3  1/2 years now!!!! https://lnkd.in/gJbH-tB4 This is fascinating information about where surgical site infections come. I would argue that while we may identify which “bug” might be the cause of any one SSI, there are many variables that lead to that infection. Therefore, optimizing or mitigating all risk factors matters in the prevention of a surgical site infection! https://lnkd.in/gB6yrdPe

Acute Pancreatitis Crash Course # 6 Complications of acute pancreatitis Scenario 1: My patient has developed a very large pseudocyst. It is not causing any symptoms, and there is no concern about infection. What should I do? Answer: Leave it alone. Nothing to do Scenario 2: My patient has developed a pseudocyst. It is causing symptoms, but there is no concern about infection. What should I do? Answer: Drain the pseudocyst Scenario 3: My patient has developed a pseudocyst. It is causing symptoms, and there is concern about infection. What should I do? Answer: Drain the pseudocyst, provide antibiotic therapy Scenario 4: My patient has developed pancreatic necrosis. There is no concern about infection. What should I do? Answer: Get surgery evaluation Scenario 5: My patient has developed pancreatic necrosis. There is also concern about infection. What should I do? Answer: Get surgery evaluation, provide antibiotic therapy Key point: Patients with gallstone biliary pancreatitis need a cholecystectomy prior to discharge from the hospital. If you find this video helpful, please support my work by liking, sharing, reposting to your network, and following me for more. I would appreciate it. MedEd University Piracha Consulting LLC

At last, evidence for the connected interplay between elevated microclots and elevated NET formation, both observed in the blood during severe acute COVID-19 infection and then remaining persistently elevated in those suffering from chronic LC PASC is being reported in May at the ATS 2024 conference by an MGH-Boston clinical research team. This is something I have been hypothesizing for quite some time. Now we need a safe and effective timely therapy to help patients remove these microthrombi when they are persistently elevated to prevent the development of larger plasmin-resistant intravascular thrombi and atheromas that can cause life-threatening ischemia. I continue to recommend we prognostically track them and try removing them using covalently immobilized heparin whole blood purification to see if there is significant patient relief of LC symptoms. The "Seraph 100" https://lnkd.in/gg4dzRB6.