In reference to targeted imaging modality selection for bacterial biofilms in chronic rhinosinusitis and different biofilms, different disease? a clinical outcomes study

2011 ◽  
Vol 121 (9) ◽  
pp. 2043-2044
Author(s):  
Thomas Lawson ◽  
Russell Connally ◽  
Subramanyam Vemulpad ◽  
James Piper ◽  
Jonathan Iredell
2009 ◽  
Vol 120 (2) ◽  
pp. 427-431 ◽  
Author(s):  
Andrew Foreman ◽  
Deepti Singhal ◽  
Alkis J. Psaltis ◽  
Peter-John Wormald

2005 ◽  
Vol 19 (5) ◽  
pp. 452-457 ◽  
Author(s):  
Berrylin J. Ferguson ◽  
Donna B. Stolz

Background Bacterial biofilms may explain why some patients with bacterial chronic rhinosinusitis (CRS) improve while on antibiotics but relapse after completion of the antibiotic. In the human host, biofilms exist as a community of bacteria surrounded by a glycocalyx that is adherent to a foreign body or a mucosal surface with impaired host defense. Biofilms generate planktonic, nonadherent bacterial forms that may metastasize infection and generate systemic illness. These planktonic bacteria are susceptible to antibiotics, unlike the adherent biofilm. Methods We reviewed four cases of CRS using transmission electron microscopy (TEM) to assay for typical colony architecture of biofilms. Bacterial communities surrounded by a glycocalyx of inert cellular membrane materials consistent with a biofilm were shown in two patients. Results In the two patients without biofilm, a nonbacterial etiology was discovered (allergic fungal sinusitis) in one and in the other there was scant anaerobic growth on culture and the Gram stain was negative. Culture of the material from the biofilm grew Pseudomonas aeruginosa in both patients. Pseudomonas from the biofilm showed a glycocalyx, not present in Pseudomonas cultured for 72 hours on culture media. Both patients’ symptoms with bacterial biofilms were refractory to culture-directed antibiotics, topical steroids, and nasal lavages. Surgery resulted in cure or significant improvement. Conclusion Biofilms are refractory to antibiotics and often only cured by mechanical debridement. We believe this is the first TEM documentation of bacterial biofilms in CRS in humans.


10.14444/2039 ◽  
2015 ◽  
Vol 9 ◽  
pp. 39 ◽  
Author(s):  
Paul D. Lane ◽  
Jacob L. Cox ◽  
Roger B. Gaskins ◽  
Brandon G. Santoni ◽  
James B. Billys ◽  
...  

HPB Surgery ◽  
2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Christine S. M. Lau ◽  
Krishnaraj Mahendraraj ◽  
Ronald S. Chamberlain

Introduction. Hepatocellular carcinoma (HCC) is a rare pediatric cancer accounting for 0.5% of all pediatric malignancies. This study examines a large cohort of HCC patients in an effort to define the factors impacting clinical outcomes in pediatric HCC patients compared to adults. Methods. Demographic and clinical data on 63,771 HCC patients (257 pediatric patients ≤ 19 and 63,514 adult patients age ≥ 20) were abstracted from the SEER database (1973–2011). Results. HCC was more common among males (59.5% pediatric and 75.1% adults) and Caucasians (50.4% and 50.5%), p<0.05. Children more often presented with fibrolamellar variant HCC (24.1% versus 0.3%, p=0.71) and advanced HCC, including distant disease (33.1% versus 20.8%, p<0.001), and tumors > 4 cm in size (79.6% versus 62.0%, p=0.02). Pediatric HCC patients undergoing surgery (13.107 versus 8.324 years, p<0.001) had longer survival than adult HCC patients. Overall mortality was lower (65.8% versus 82.0%, p<0.001) in the pediatric HCC group. Conclusion. HCC is a rare pediatric malignancy that presents most often as an advanced tumor, >4 cm in Caucasian males. Children with HCC achieve significantly longer mean overall survival compared to adults with HCC, primarily attributable to the more favorable fibrolamellar histologic variant, and more aggressive surgical intervention, which significantly improves survival.


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