A propósito de un caso: Pseudomonas stutzeri, una causa inusual de artritis séptica / A Case Report: Pseudomonas Stutzeri, An Unusual Cause Of Septic Arthritis

RESUMEN Se presenta un caso de artritis séptica de rodilla por Pseudomonas stutzeri, bacilo gramnegativo aerobio ampliamente distribuido en la naturaleza y que rara vez ocasiona infecciones graves en el ser humano. Se trata de una mujer de 84 arios, hemodializada, que desarrolla una artritis séptica de rodilla derecha tras una inflitración con ácido hialurónico y que evoluciona favorablemente tras terapia antibiótica. Se debe tener en cuenta esta etiología cuando hay antecedentes de invasión local de la articulación y en estados de inmunosupresión tal y como sucede en nuestra paciente.

A B S T R A C T A case is presented of septic knee arthritis caused by Pseudomonas stutzeri, which is an aerobic gram-negative bacillus widely distributed in nature and rarely causes serious infections in humans. The patient is an 84-year-old woman on haemodialysis, who developed a septic arthritis of the right knee after a hyaluronic acid injection. There was a favourable outcome after antibiotic therapy. This aetiology should be taken into account when there is a history of local invasion of the joint and in states of immunosuppression, as occurred in this patient.

Nitrogen Concentrations and Isotopic Compositions of Seafloor-Altered Terrestrial Basaltic Glass: Implications for Astrobiology.

Observed enrichments of N (and the δ15N of this N) in volcanic glasses altered on Earth's modern and ancient seafloor are relevant in considerations of modern global N subduction fluxes and ancient life on Earth, and similarly altered glasses on Mars and other extraterrestrial bodies could serve as valuable tracers of biogeochemical processes. Palagonitized glasses and whole-rock samples of volcanic rocks on the modern seafloor (ODP Site 1256D) contain 3-18 ppm N with δ15Nair values of up to +4.5‰. Variably altered glasses from Mesozoic ophiolites (Troodos, Cyprus; Stonyford volcanics, USA) contain 2-53 ppm N with δ15N of -6.3 to +7‰. All of the more altered glasses have N concentrations higher than those of fresh volcanic glass (for MORB, <2 ppm N), reflecting significant N enrichment, and most of the altered glasses have δ15N considerably higher than that of their unaltered glass equivalents (for MORB, -5 ± 2‰). Circulation of hydrothermal fluids, in part induced by nearby spreading-center magmatism, could have leached NH4+ from sediments then fixed this NH4+ in altering volcanic glasses. Glasses from each site contain possible textural evidence for microbial activity in the form of microtubules, but any role of microbes in producing the N enrichments and elevated δ15N remains uncertain. Petrographic analysis, and imaging and chemical analyses by scanning electron microscopy and scanning transmission electron microscopy, indicate the presence of phyllosilicates (smectite, illite) in both the palagonitized cracks and the microtubules. These phyllosilicates (particularly illite), and possibly also zeolites, are the likely hosts for N in these glasses. Key Words: Nitrogen-Nitrogen isotope-Palagonite-Volcanic glass-Mars. Astrobiology 18, 330-342.

Surgical repair for double outlet right ventricle and intact ventricular septum.

We report the case of a neonate with a complex cardiac anomaly that consisted of a double outlet right ventricle, intact ventricular septum, small left ventricle, and pulmonary stenosis who underwent surgical repair with a successful outcome. We have not previously found a case report of a patient with double outlet right ventricle and intact ventricular septum who is still alive and in good health at an intermediate postoperative follow-up.

[Pindolol in pediatrics. Evaluation of cardiac haemodinamics (author's transl)]. / Il pindololo in pediatria. Valutazione della dinamica cardiaca.

Pharmacological clinical studies about beta-blocking agents provide profound insights into the effects of these kinds of drugs in adults. Very little research on children has been done up to now. The hydroalcoholic solution of a beta-blocking agent (Visken Sandoz) facilitated this research on children. This paper investigates the effects of a beta-blocking agent in 19 healthy children aged between 5 and 13 years: arterial blood pressure, heart rate, systolic and diastolic parameters were controlled. The children were examined before and after a 10 day therapeutical cycle in which Pindolol 250 gamma/kg/die was administered. Statistically significant variations were obtained for TD, TT, TT/TET, QTc, but no variation for heart rate, TET, SM, QA2, diastolic parameters and arterial blood pressure. It is supposed that negative chronotropic effect and hypotensive activity were found only in patients with an altered cardiac rate and with an altered arterial blood pressure respectively. The kinetics of the drug is also described and its easy pediatric utilization is underlined.

Fat embolism as a cause of idiopathic necrosis of the head of the femur. Review of forty five cases of post traumatic fat embolism.

It has been postulated in recent years that idiopathic necrosis of the head of the femur may possibly be caused by arteriolar obstruction by fat emboli emanating from a fatty liver, which would act as a reservoir, due to various causes such as alcoholism and prolonged steroid therapy. A similar situation has been found in human pathology in post traumatic fat embolism. The writers have reviewed forty five cases of post traumatic fat embolism which had passed the pulmonary filter. All the cases were reviewed after a minimum of two years, since this is considered the minimum time within which necrosis can manifest itself radiologically. In none of these cases was there any evidence of necrosis of the head of the femur. These findings, supported by other critical considerations. do not lend support to the theory of fat embolism as a case of idiopathic bone necrosis.

Secondary treatment of fractures of the middle and lower third of the tibia unsuccessfully treated by primary internal fixation.

The authors present forty six cases, referred to us between 1969 and 1974, of fracture of the middle and lower thirds of the tibia, previously treated elsewhere by primary internal fixation using a plate and screws. The causes of failure are divided into defective indications and defective technique. The methods of treatment used in infected and non-infected lesions are described. They criticise the unnecessary use of plates and explain their reasons. They do not condemn the method outright, since in selected cases IT IS UNDOUBTEDLY A VALID METHod of treatment. They are opposed, however, to its indiscriminate use for lesions that may perfectly well be cured, with the minimum risk, either by conservative methods, or by intramedullary nailing.