Retrospective study: The diagnostic accuracy of conventional forceps biopsy of gastric epithelial compared to endoscopic submucosal dissection (STROBE compliant).

Infectious Diseases Society of America.

Staphylococcus aureus is a major human pathogen that causes a wide range of clinical infections. It is a leading cause of bacteremia and infective endocarditis as well as osteoarticular, skin and soft tissue, pleuropulmonary, and device-related infections. This review comprehensively covers the epidemiology, pathophysiology, clinical manifestations, and management of each of these clinical entities. The past 2 decades have witnessed two clear shifts in the epidemiology of S. aureus infections: first, a growing number of health care-associated infections, particularly seen in infective endocarditis and prosthetic device infections, and second, an epidemic of community-associated skin and soft tissue infections driven by strains with certain virulence factors and resistance to β-lactam antibiotics. In reviewing the literature to support management strategies for these clinical manifestations, we also highlight the paucity of high-quality evidence for many key clinical questions.

Staphylococcus aureus Infections: Epidemiology, Pathophysiology, Clinical Manifestations, and Management

Modern techniques have reduced the frequency of infections that are associated with prosthetic joints, but such infections continue to pose difficult problems in clinical management. Advances in understanding biofilms and the pathogenesis of microbial interactions with the implant have led to more rational approaches to therapy. This review offers guidance in establishing the diagnosis correctly and an algorithm summarizing the appropriate medical and surgical options.

/pdf/prosthetic-joint-infections-qrunwr5dn0.pdf

Prosthetic-Joint Infections

http://academic.oup.com/milmed/article-pdf/146/7/506/24126715/milmed-146-7-506.pdf

Goodman and Gilman's The Pharmacological Basis of Therapeutics

The Fate of Acute MRSA Periprosthetic Infections Treated by Open Debridement and Retention of Components

Molecular pathology of total knee arthroplasty instability defined by RNA-seq

Background There are little data on the outcomes of primary total hip arthroplasties (THAs) in patients with a prior surgically treated hip or knee periprosthetic joint injection (PJI). The goal of this study was to compare the risk of infection in this population with matched controls. Methods We retrospectively reviewed 48 patients whom underwent 50 primary THAs from 2000 to 2014 with a history of a PJI in a total knee arthroplasty or contralateral THA. Thirteen patients (27%) were on chronic antibiotic suppression at the time of primary THA. Mean age was 67 years, and mean body mass index was 35 kg/m2. Mean follow-up was 6 years. We 1:3 matched (age, sex, body mass index, cemented vs cementless femoral fixation, and surgical year) these cases to 150 primary THAs. Competing risk analysis, with death as the competing risk, was performed. Results The cumulative incidence of PJI with death as a competing risk was 1.5-fold higher in the study cohort (2.0%) compared with matched controls (1.4%) (hazards ratio, 1.5; P = .75). The cumulative incidence of any infection with death as a competing risk was 2-fold higher in the study cohort (4.0%) compared with matched controls (2.1%) (hazards ratio, 2.0; P = .45). However, these were both statistically similar given the relatively small cohort. The overall complication rate, including infections and reoperations, was 17% in the study cohort. Conclusion Patients undergoing a clean primary THA with a history of a total knee arthroplasty or contralateral THA PJI in another joint have a 2% and 4% risk of PJI and any infection, respectively. Moreover, nearly 1 in 5 patients experience at least 1 complication.

Elevated Infection and Complication Rates in Patients Undergoing a Primary THA With a History of a PJI in a Prior Hip or Knee Arthroplasty: A Matched Cohort Study.

This supplemental issue of The Journal of Arthroplasty represents selected articles from the HealthStream-sponsored symposium entitled “Advances in Surgical Technology.” This is the second time the proceedings of this meeting have been published. This most recent meeting was held in New York City fromDecember 1 to 4, 2007. The goals of the meeting were to be a comprehensive update concerning the latest technology about total hip and knee arthroplasty. The meeting consisted of scientific lectures, panel discussions, case presentations, as well as multiple debates about important topics dealing with primary and revision total hip and knee arthroplasty. There were sessions on video techniques that were especially useful and another session included 9 lectures using evidence-based orthopedics. There were also 4 interactive live surgical demonstrations (direct anterior approach total hip arthroplasty, hip resurfacing, high effusion total knee arthroplasty, and revision total hip arthroplasty). There were many breakout sessions where surgeons were able to rotate through 4 timed sessions and learn through hands-on demonstrations of some of the latest issues in hip and knee arthroplasty (ie, hip resurfacing, joint preservation, knee revision). Many of the guest speakers contributed to the success of the symposium and have articles contained in this issue. The meeting

Introduction advances in surgical technology supplement.

We compared culture results to investigate the influence of antimicrobial-loaded cement on sonicate fluid culture positivity for the diagnosis of prosthetic joint infection. Fifty-four subjects were assessed. The sensitivities of sonicate fluid culture were 77.8% (14 of 18) in subjects with an antimicrobial-loaded cemented prosthesis and 58.3% (21 of 36) in subjects with an antimicrobial-free prosthesis.

Arlen D. Hanssen

Papers

The Fate of Acute MRSA Periprosthetic Infections Treated by Open Debridement and Retention of Components

Molecular pathology of total knee arthroplasty instability defined by RNA-seq

Elevated Infection and Complication Rates in Patients Undergoing a Primary THA With a History of a PJI in a Prior Hip or Knee Arthroplasty: A Matched Cohort Study.

Introduction advances in surgical technology supplement.

Antimicrobial-Loaded Bone Cement Does Not Negatively Influence Sonicate Fluid Culture Positivity for Diagnosis of Prosthetic Joint Infection.