Article
Critical Care Medicine
Christian A. Gonzalez, Noelle L. Van Rysselberghe, Clayton Maschhoff, Michael J. Gardner
Summary: This study utilized a large national database to investigate the incidence and risk factors of Clostridium difficile (C. diff) infection in patients with lower extremity fractures. The results showed that C. diff infection was associated with increased mortality, readmission, and length of hospital stay compared to patients without C. diff infection.
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED
(2022)
Article
Medicine, General & Internal
Kosei Nagata, Koji Yamada, Tomohiro Shinozaki, Tsuyoshi Miyazaki, Fumiaki Tokimura, Yasuhito Tajiri, Takuya Matsumoto, Kiyofumi Yamakawa, Hiroyuki Oka, Akiro Higashikawa, Toshihide Sato, Kenichi Kawano, Tatsuro Karita, Takuya Koyama, Takahiro Hozumi, Hiroaki Abe, Makoto Hodohara, Kazuhiro Kohata, Masato Toyonaga, Yasushi Oshima, Sakae Tanaka, Hiroshi Okazaki
Summary: This study aimed to examine whether a shorter duration of antimicrobial prophylaxis after surgery is not inferior to a longer duration in preventing healthcare-associated infections in orthopedic surgery. The clinical trial found that a shorter duration of antimicrobial prophylaxis was noninferior in preventing healthcare-associated infections without an increase in antibiotic resistance risk.
Article
Biotechnology & Applied Microbiology
Jianfeng Wang, Chu Yang, Chao Zhang, Xiaoyan Mao, An Lizhe
Summary: In this study, the genome of Clostridium difficile was studied using metagenomic technology, revealing its gene sequence information and potential toxicological genes. Through gene function analysis and pathogenicity analysis, the metabolism activity, catalytic activity, carbohydrate-active enzyme genes and other aspects of the bacterium were understood, and an assessment was made on its virulence genes.
Review
Microbiology
Marta Mattana, Riccardo Tomasello, Claudia Cammarata, Paola Di Carlo, Teresa Fasciana, Giulio Giordano, Alessandro Lucchesi, Sergio Siragusa, Mariasanta Napolitano
Summary: This review analyzed the correlation between coagulation complications related to C. difficile infection and inflammasome activation, particularly the pyrin-dependent one. The evidence suggests that inflammasome activation increases the risk of venous thromboembolism, and inhibition of molecules involved in coagulation activation could block this process. It may be possible to reduce complications and mortality associated with C. difficile infection by reducing inflammatory activity and preventing thromboembolic complications.
Review
Medicine, General & Internal
Ibrahim A. Al-Zahrani
Summary: Clostridioides difficile (C. difficile) infection is a global threat to many healthcare settings. Excessive use of antimicrobials, lack of optimal antibiotic policies, and suboptimal infection control practices have fueled the development of this health issue. Prudent use of antimicrobials and simple infection control measures can significantly reduce infection rates.
SAUDI MEDICAL JOURNAL
(2023)
Article
Pharmacology & Pharmacy
Ann L. Arulappen, Monica Danial, Norliza Haron, Lim Choo Hau, Amer Hayat Khan
Summary: This study demonstrates the positive impact of antimicrobial stewardship programs on the prescribing patterns of surgeons for perioperative antimicrobial prophylaxis, leading to reductions in drug usage, improvements in guideline compliance, decreased surgical site infection rates, and cost savings. It highlights the importance of maintaining high standards of perioperative antimicrobial prophylaxis in healthcare settings for optimal outcomes.
FRONTIERS IN PHARMACOLOGY
(2021)
Article
Multidisciplinary Sciences
Srijita Basak, Debashrito Deb, Utkarsh Narsaria, Tamalika Kar, Filippo Castiglione, Indraneel Sanyal, Pratap D. Bade, Anurag P. Srivastava
Summary: Clostridium difficile infection is a major health-associated infection with high incidence and mortality rates. A chimeric vaccine candidate was designed using immunoinformatics, which showed stability and reliability in silico and molecular dynamics simulations. Docking studies demonstrated stable interactions with immune receptors, and in silico modeling indicated competent expression in E. coli system for potential immune response.
SCIENTIFIC REPORTS
(2021)
Article
Infectious Diseases
Anita Hasler, Ines Unterfrauner, Maurits G. L. Olthof, Peter Jans, Michael Betz, Yvonne Achermann, Ilker Uckay
Summary: The systemic doubling of perioperative antibiotic prophylaxis in obese patients did not reduce the overall risk of deep surgical site infections, according to a study with nearly 17,000 orthopedic surgeries in adult patients.
INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES
(2021)
Article
Biotechnology & Applied Microbiology
Peng An Khun, Long Duc Phi, Huong Thi Thu Bui, Nguyen Thi Bui, Quyen Thi Huyen Vu, Luong Duy Trinh, Deirdre A. Collins, Thomas Riley
Summary: This study investigated the prevalence, molecular type, and antimicrobial susceptibility of Clostridioides difficile in the environment in Vietnam. It found that the overall contamination rate of C. difficile was 24.5%, with the highest prevalence in pig farm and hospital soils. C. difficile was also found in pig feces and potato surfaces. These findings highlight the importance of environmental sources in the epidemiology of C. difficile infection in Vietnam.
JOURNAL OF APPLIED MICROBIOLOGY
(2023)
Article
Nanoscience & Nanotechnology
Jiuxing Li, Jimmy Gu, Hongfen Zhang, Rudi Liu, Wenqing Zhang, Mostafa Mohammed-Elsabagh, Jianrun Xia, Devon Morrison, Sandy Zakaria, Dingran Chang, Amjad Arrabi, Yingfu Li
Summary: A highly specific DNA aptamer for RNase H2 from Clostridium difficile was developed through SELEX, demonstrating its potential for diagnostic tests and drug development.
ACS APPLIED MATERIALS & INTERFACES
(2021)
Article
Orthopedics
Pelle Hanberg, Mats Bue, Jesper Kabel, Andrea Rene Jorgensen, Christian Jessen, Kjeld Soballe, Maiken Stilling
Summary: The study evaluated the impact of tourniquet on cefuroxime concentrations, finding that the antibiotic concentration remained within effective levels throughout the surgery. Intravenous administration of cefuroxime (1.5 g) 15 minutes before surgery ensured tissue concentrations met therapeutic standards.
Article
Infectious Diseases
Dolors Rodriguez-Pardo, Laura Escola-Verge, Julia Sellares-Nadal, Pablo S. Corona, Benito Almirante, Carles Pigrau
Summary: In patients with proximal femoral fractures, there is a lack of specific guidelines for preventing periprosthetic joint infections after hip hemiarthroplasty surgery. General prophylaxis guidelines, such as the use of cefazolin, are commonly applied. Personalized antibiotic schemes may be considered for patients suspected of colonization by multidrug-resistant microorganisms.
Article
Biotechnology & Applied Microbiology
Meng Wang, Zifeng Deng, Yanmei Li, Yi Ma, Jufang Wang
Summary: A novel lytic protein Cw1-CWB2 with high binding specificity and strong lytic activity has been designed in this study for combating C. difficile.
APPLIED MICROBIOLOGY AND BIOTECHNOLOGY
(2022)
Article
Multidisciplinary Sciences
Ashleigh S. Paparella, Briana L. Aboulache, Rajesh K. Harijan, Kathryn S. Potts, Peter C. Tyler, Vern L. Schramm
Summary: Clostridium difficile produces toxins TcdA and TcdB causing diarrhea by affecting host cell functions using UDP-glucose, leading to disease onset. Researchers identified potential therapeutic approach using transition state analogue iminosugars.
NATURE COMMUNICATIONS
(2021)
Article
Pediatrics
Ryan M. Hanson, Amy J. Wagner
Summary: Severe, complicated Clostridium difficile colitis is rare in pediatric patients and little is known about its medical and surgical management in this population. A case report of a 15-year-old female patient with severe, complicated C difficile colitis successfully treated with diverting loop ileostomy and colonic lavage is presented. This approach, instead of subtotal colectomy and end ileostomy, should be considered as an alternative for pediatric patients with severe, complicated C difficile colitis.
Article
Surgery
Filippo Migliorini, Nicola Maffulli, Joerg Eschweiler, Hanno Schenker, Markus Tingart, Marcel Betsch
Summary: This meta-analysis compares the clinical outcomes of all-arthroscopic rotator cuff repair and mini-open surgery. The results show no significant differences in surgical duration, clinical scores, and functional outcomes between the two techniques. Male gender and older age are associated with higher rates of rotator cuff re-tears, while longer surgical duration is associated with a higher rate of adhesive capsulitis.
SURGEON-JOURNAL OF THE ROYAL COLLEGES OF SURGEONS OF EDINBURGH AND IRELAND
(2023)
Review
Surgery
Filippo Migliorini, Nicola Maffulli, Alice Baroncini, Jorg Eschweiler, Markus Tingart, Marcel Betsch
Summary: This study identified prognostic factors associated with treatment failure and conversion to total hip arthroplasty in the management of osteonecrosis of the femoral head. The results showed that male gender, longer symptom duration before treatment, higher VAS scores, and lower HHS scores were negative prognostic factors after treatment for osteonecrosis of the femoral head.
SURGEON-JOURNAL OF THE ROYAL COLLEGES OF SURGEONS OF EDINBURGH AND IRELAND
(2023)
Review
Orthopedics
Ahmed Khalil Attia, Greg A. J. Robertson, John McKinley, Pieter P. d'Hooghe, Nicola Maffulli
Summary: This study aimed to determine the effect of orthobiologic augmentation on the outcome of surgically managed Jones fractures in athletes. The findings suggest that biologically augmented fixation can increase the fracture union rate, but has similar rates of return to play and time to return to play compared to fixation alone.
AMERICAN JOURNAL OF SPORTS MEDICINE
(2023)
Review
Surgery
Marco Quaranta, Nicola Poeta, Francesco Oliva, Nicola Maffulli
Summary: This study aims to evaluate the outcomes of conservative and surgical management for muscle herniae and determine the most appropriate management based on the etiology and size of the fascial defect. The findings suggest that fasciotomy should be considered for congenital muscle herniae to prevent complications, while direct suture repair can be used for small fascial defects in post-traumatic muscle herniae, and mesh repair and autologous graft repair are recommended to avoid severe complications.
SURGEON-JOURNAL OF THE ROYAL COLLEGES OF SURGEONS OF EDINBURGH AND IRELAND
(2023)
Article
Surgery
Nikolaos Malliaropoulos, Georgios Bikos, Ioannis Tsifountoudis, Dimosthenis Alaseirlis, Dimitrios Christodoulou, Nat Padhiar, Nicola Maffulli
Summary: This study used therapeutic ultrasound (TUS) as a primary diagnostic tool to assess tibial stress injuries and compared its sensitivity with magnetic resonance imaging (MRI). The results showed that TUS has a sensitivity of 79.2% related to MRI, making it a useful tool for clinicians to initially assess suspected tibial stress injuries in high-level track and field athletes.
SURGEON-JOURNAL OF THE ROYAL COLLEGES OF SURGEONS OF EDINBURGH AND IRELAND
(2023)
Article
Orthopedics
Lorenzo Giordano, Nicola Maffulli, Giulia Carimati, Emanuela Morenghi, Piero Volpi
Summary: This study aimed to assess the incidence of meniscal tears in ACL-deficient knees in a large sample of female patients and to evaluate the effects of surgery timing, age, and BMI on the rate of meniscal repair or meniscectomy. The results showed that a delay in surgery greater than 12 months increased the risk of nonrepairable medial meniscal tear, especially between 24 and 60 months after injury. Increasing age up to 30-50 years was associated with a greater prevalence of meniscal tears, while BMI had no clear association with associated lesions. The findings highlight the importance of timely ACL reconstruction for female patients to reduce the risk of meniscal tears.
ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY
(2023)
Review
Medicine, General & Internal
Filippo Migliorini, Francesco Oliva, Joerg Eschweiler, Ernesto Torsiello, Frank Hildebrand, Nicola Maffulli
Summary: Patients with ACL rupture can choose conservative management or reconstruction surgery. However, surgical management may increase the risk of early-onset knee osteoarthritis.
BRITISH MEDICAL BULLETIN
(2023)
Review
Medicine, General & Internal
Filippo Migliorini, Gianluca Vecchio, Riccardo Giorgino, Joerg Eschweiler, Frank Hildebrand, Nicola Maffulli
Summary: Micro RNAs (miRNAs), short non-coding RNAs, play a primary role in posttranscriptional gene silencing and have attracted increasing interest in musculoskeletal conditions. Recent studies have postulated the potential of miRNAs as biomarkers for the diagnosis and treatment of meniscal injuries. However, the evaluation of miRNAs in patients with meniscal tears remains controversial. A systematic review was conducted to explore the potential of miRNAs in the diagnosis and management of meniscal damage.
BRITISH MEDICAL BULLETIN
(2023)
Letter
Orthopedics
Nicola Maffulli
JOURNAL OF FOOT & ANKLE SURGERY
(2023)
Editorial Material
Orthopedics
Nicola Maffulli, Katarina Nilsson Helander, Filippo Migliorini
Summary: In both tendon repair and tendinopathy, symptoms may not align with the appearance of the affected tendon on imaging, suggesting a dissociation between morphology and symptoms. Asymptomatic abnormal findings have limited predictive value, and interventions based on imaging are inappropriate. Patient education and clinical monitoring are recommended. Planning interventions based on sonographic abnormalities in symptomatic tendinopathy may not be warranted. Current evidence is limited and caution is needed when interpreting incidental findings in athletes.
KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY
(2023)
Article
Orthopedics
Shi-Ming Feng, Qing-Qing Sun, Jie Chen, Shun-Hong Gao, Francesco Oliva, Nicola Maffulli
Summary: A retrospective cohort study found that there were no significant differences in functional outcomes between the use of one or two double-loaded anchors in all-inside anterior talofibular ligament (ATFL) repair for chronic lateral ankle instability (CLAI).
KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY
(2023)
Review
Orthopedics
Nicola Maffulli, Alessandro Bartoli, Giuliano Sammaria, Filippo Migliorini, Jon Karlsson, Francesco Oliva
Summary: This study systematically evaluated the use of free tendon grafts in the treatment of chronic Achilles tendon tears. The results showed that free tendon grafts can restore functional outcomes and allow patients to return to sports, especially when the gap between the torn ends is at least 6 cm.
KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY
(2023)
Article
Medicine, General & Internal
Attilio Basile, Riccardo Maria Lanzetti, Alessio Giai Via, Teresa Venditto, Marco Spoliti, Pasquale Sessa, Mauro Tortora, Nicola Maffulli
Summary: The study aimed to assess the effect of delaying operative fixation through the sinus tarsi approach on wound complications and the quality of reduction in subjects with displaced intra-articular calcaneus fractures. Two groups were compared: Group A, treated within 21 days after injury; Group B, treated more than 21 days after injury. The study found no significant differences between the groups in terms of wound complications or quality of reduction.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Medicine, General & Internal
Daryl Poku, Rifat Hassan, Filippo Migliorini, Nicola Maffulli
Summary: This systematic review evaluates the efficacy of hydrodilatation for the management of frozen shoulder compared with other conservative management modalities. The study found that hydrodilatation leads to more marked short-term improvements in shoulder disability and passive external rotation compared with intra-articular corticosteroid injections. However, the clinical relevance of hydrodilatation remains unclear, and further research is necessary to establish its role in the management of frozen shoulder.
BRITISH MEDICAL BULLETIN
(2023)
Review
Medicine, General & Internal
Giuseppe Gargano, Giovanni Asparago, Filippo Spiezia, Francesco Oliva, Nicola Maffulli
Summary: Small interfering RNAs (siRNAs) have potential therapeutic applications in osteoporosis and can be used to study metabolic processes and identify new drug targets. However, it is challenging to predict the in vivo response of siRNAs and drugs based on in vitro studies.
BRITISH MEDICAL BULLETIN
(2023)
