PubMed · 4428887
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S D Graham, G T Golden. 1974. Splenic abscess.. https://pubmed.ncbi.nlm.nih.gov/4428887/
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INTRODUCTION: Surgical voice rehabilitation after total laryngectomy is still only a partially solved problem. Because of easy handling and rare complications, the Provox voice prosthesis has become common in voice rehabilitation. CASE REPORT: The 69 year old patient underwent laryngectomy, selective bilateral neck dissection and the implantation of a Provox voice prosthesis because of a glottic squamous cell carcinoma (pT(4), pN(0), M(0)). Postoperative healing ensued without any complications. During adjuvant radiochemotherapy, the patient developed distinctive cervical edema which led to a tilting of the Provox prosthesis. Due to a perforation of the posterior esophageal wall, the patient developed a pronounced mediastinal abscess which was relieved through a transcervical mediastinotomy. Antibiotic therapy led to a partial remission of the symptoms. CONCLUSION: Severe complications may not only occur during the early phase of surgical voice rehabilitation, but also at a much later stage, after completion of the healing process. A voice prosthesis which is too long or generates pressure from a radiogenic edema, cannula and finger pressure used to close the tracheostoma is transmitted through the prosthesis and may lead to a perforation of the posterior esophageal wall. In particular, when the tissue is injured during the course of radiotherapy, this type of complication should be taken into consideration.
In 82 patients with infective endocarditis, including 11 with a perivalvular abscess detected by transesophageal echocardiography, age was a significant predictor of in-hospital mortality (p <0.001). At 3.8-year follow-up, 5 of 7 patients with an abscess who had valve replacement and 2 of 4 patients with an abscess who did not have surgery survived (p = NS); 13 of 22 patients (59%) with no abscess who had valve replacement and 20 of 49 patients (41%) with no abscess who did not have surgery survived (p = NS).
OBJECTIVES: The efficacy of prophylactic treatment with human lactoferrin 1-11 (hLF1-11), a broad-spectrum antimicrobial peptide, was studied in a rabbit model of femur infection. METHODS: Calcium phosphate cement with 50 mg/g hLF1-11 or gentamicin was injected into the femoral canal, after inoculation with Staphylococcus aureus. Three weeks later, slices of the proximal femora were sawn for quantitative bacterial culture and histology. RESULTS: Treatment with hLF1-11 (P<0.038) or gentamicin (P<0.008) caused a reduction of cfu compared with the untreated control rabbits. The number of sterile cultures was higher in hLF1-11- (3/7) and gentamicin- (5/6) treated animals than in controls (1/7). Radiological and histological analysis showed early bone ingrowth into the cement cracks, and only moderate pathological changes in rabbits with positive cultures. CONCLUSIONS: Local prophylaxis with hLF1-11 effectively reduced development of osteomyelitis in a rabbit model, but gentamicin resulted in a larger number of sterile femora.