RESUMO
Although uncommon, spontaneous and postoperative pyogenic spondylodiscitis entail major morbidity and may be associated with serious long-term sequelae. A review of the literature was done to advance our understanding of the diagnosis, treatment, and outcome of these infections. The principles of conservative treatment are to establish an accurate microbiological diagnosis, treat with appropriate antibiotics, immobilize the spine, and closely monitor for spinal instability and neurological deterioration. The purpose of surgical treatment is to obtain multiple intraoperative cultures of bone and soft tissue, perform a thorough debridement of infected tissue and decompression of neural structures, and reconstruct the unstable spinal column with bone graft with or without concomitant instrumentation. Appropriate management requires aggressive medical treatment and, at times, surgical interventions. If recognized early and treated appropriately, a full recovery can often be expected. Therefore, clinicians should be aware of the clinical presentation of such infections to improve patient outcome.
Assuntos
Dor nas Costas/etiologia , Infecções Bacterianas/diagnóstico , Discite/microbiologia , Coluna Vertebral/cirurgia , Anti-Infecciosos/uso terapêutico , Dor nas Costas/microbiologia , Dor nas Costas/terapia , Infecções Bacterianas/tratamento farmacológico , Desbridamento , Descompressão Cirúrgica , Diagnóstico Diferencial , Discite/diagnóstico , Discite/terapia , Humanos , Complicações Pós-Operatórias , Resultado do TratamentoAssuntos
Resistência à Proteína C Ativada/genética , Anticoncepcionais Orais/efeitos adversos , Fator V/genética , Veia Femoral , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Trombose Venosa/etiologia , Resistência à Proteína C Ativada/diagnóstico , Resistência à Proteína C Ativada/epidemiologia , Adulto , Anticoagulantes/uso terapêutico , Feminino , Triagem de Portadores Genéticos , Testes Genéticos , Homozigoto , Humanos , Líbano/epidemiologia , Linhagem , Mutação Puntual/genética , Fatores de Risco , Ultrassonografia Doppler , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/tratamento farmacológicoAssuntos
Trombofilia , Anticoncepcionais Orais , Tromboembolia Venosa , Conscientização , Medição de Risco , Fator VRESUMO
The objective was to study the gene frequencies of HPA-1 in the Lebanese population for the first time. The aims of this study were to assess the prevalence of 1a and 1b HPA-1 alleles in healthy Lebanese individuals and compare with the international literature. Human platelet antigen (HPA) systems are involved in alloimmunization, organ transplantation rejection and the development of cardiovascular disease. Of several classified HPA systems, HPA-1 specifically has been considered to be the most important antigenic system implicated in the Caucasian population. This specific gene has never been investigated in our population. DNA was extracted from specimens collected from 205 healthy unrelated Lebanese individuals and tested, using a reverse hybridization polymerase chain reaction (PCR) assay, for the prevalence of 1a and 1b HPA-1 alleles. Genotypes 1a/1a, 1a/1b, and 1b/1b were assigned accordingly. We observed that the 1a/1a genotype was the most prevalent (65.85%) followed by 1a/1b (30.24%) and 1b/1b (3.91%) with allelic frequencies for 1a and 1b of 0.81 and 0.19, respectively. As compared with other ethnic groups, the Lebanese population was found to have a relatively high prevalence of the HPA-1b, which may predispose to a higher risk of alloimmunization. This report is the first to study the prevalence of the HPA-1 system in the Lebanese population and serves as a template for future clinical research involving platelet disorders and cardiovascular diseases.
