Tag Archives: infection

Morpho-Pathological Review on the Healing of Synthetic Vascular Grafts

DOI: 10.1515/amma-2015-0098

Objective: Tissue integration of vascular grafts partially depends on the host response to injury, which immediately begins after implantation and restoration of the circulation. In an infected environment, the inflammation changes the incorporation patterns. The aim of the study was to observe the tissue incorporation process, in a normal and an infected environment. Methods: We have created an experimental model by performing subfascial implantation of four types of vascular grafts, in rats (woven Dacron®, knitted Dacron®, silver coated Dacron® and expanded Polytetrafloroethylene – ePTFE) and by infecting some of them with three different bacterial strains. We have retrieved the non-infected grafts at two and four weeks after implantation, whilst the infected ones at one, two and three weeks.
Results: Detailed microscopic appearences were analysed. The control and infected groups were compared. Statistical significance was calculated for various corelations. Conclusions: The morphopathological findings showed that the ePTFE graft’s structure was best preserved. Statistical significance existed between the bacterial strain and the degree of inflammation. The silver coated Dacron® was not shown to be superior to the knitted Dacron®. The poorest incorporation was the one of the woven Dacron®.

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Cytological, Histological Correlations and Human Papillomavirus Testing in the Diagnosis of Cervical Intraepithelial Neoplasia

Introduction: Persistent infection with high risk Papillomavirus (HR HPV) is the main risk factor for cervical cancer. Usually there is a period of approximately 10 years since someone gets infected with HPV till the incidence of an invasive cancer. The slow evolution of precancerous lesions allows their detection before the invasive stage. The objective of this study is to evaluate correlations among cytology, colposcopically guided biopsy and HPV testing, HR HPV prevalence and the reliability of cervical-uterine smears as screening method.
Material and method: The study comprises a number of 64 patients who underwent colposcopy, cytodiagnosis and biopsy examinations during January 2010 – December 2011 at Saint Die Hospital (France). Testing for HR HPV was performed especially in case of ASCUS Pap smears.
Results: ASCUS results of cervical-uterine smears corresponded to histological diagnosis of normal aspect and benign lesions in 60% of the cases, in 26.66% of cases with low grade malignant lesions and in 13.33% of the cases with high grade malignant lesions. HR HPV testing was positive especially in patients younger than 30 years (93.33% of patients who performed the HR HPV test), for patients between 30 and 50 years HR HPV was present in 80% of tested patients and for patients over 50 years was present only in 20% of the cases. Neither of the patients who tested negative for HR HPV presented high grade malignant lesions as a result of the biopsy test.
Conclusions: There is a direct correlation between the presence of HPV and grade of malignancy, thus all patients presenting high grade malignant lesions tested positive for HR HPV. HPV testing should not be performed in patients with LSIL results when sampling cervical-uterine smears, because the HPV prevalence is highly increased and a positive HR HPV test result would only create panic in young patients.

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Personalized Cement Spacer Manufacturing Using Computer Assisted Design for the Treatment of Osteoarticular Infections

Background: Infection is the most feared complication in every aspect of bone surgery. Antibiotic impregnated cement spacers and cement beads are widely used since 1972 for treating prosthetic infection. The delivery of a high concentration of antibiotics in a localized area is thought to be safer than systemic administration of intravenous antibiotics in such doses.
Materials and methods: Our clinic has more than 10 years of experience in using preformed and manufactured spacers, mostly hand made. A new method developed by us puts the designing in the preoperative planning phase. Antibiotics are chosen based on the antibiogramm the cement is chemically “configured”. 3D design based on the previous implant or on the bony structure is done; negative molds are manufactured with CNC mill the manufacturing kit is sterilized with ethylene oxide. Intraoperatively the spacer is molded and implanted.
Results and Conclusions: We consider that our method meets almost all the conditions proposed by us. Problems were found with the inconsistent mechanical behavior. More studies are required regarding the mechanical properties of the bone cement in function of antibiotic concentrations and preparation methods.

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