The Experts below are selected from a list of 7953 Experts worldwide ranked by ideXlab platform
Kengo Yamamoto - One of the best experts on this subject based on the ideXlab platform.
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bacille calmette guerin bcg spondylitis with adjacent mycotic aortic aneurysm after intravesical bcg therapy a case report and literature review
BMC Infectious Diseases, 2018Co-Authors: Takuya Kusakabe, Kenji Endo, Itaru Nakamura, Hidekazu Suzuki, Hirosuke Nishimura, Shinji Fukushima, Kengo YamamotoAbstract:Although intravesical bacille Calmette-Guerin (BCG) therapy is accepted as an effective treatment for bladder cancer, serious complications may occur in rare cases. To date, only 4 cases have been reported in which the patient developed a combination of mycotic aortic aneurysm and BCG spondylitis. Accurate diagnosis of BCG spondylitis is important because it is an Iatrogenic Disease, and its treatment is different from usual tuberculous spondylitis. However, distinguishing BCG spondylitis from usual tuberculous spondylitis is very difficult and takes a long time. In this study, we were able to suspect BCG spondylitis at an early stage from the result of the interferon-gamma release assay (IGRA). We encountered a case of BCG spondylitis with adjacent mycotic aortic aneurysm after intravesical BCG therapy in a 76-year-old man. We performed a 2-stage operation to obtain spine stabilization and replace the aneurysm with a synthetic graft. We started multidrug therapy with antituberculosis medication, excluding pyrazinamide, because the patient’s history of BCG therapy, negative IGRA, and positive of tuberculosis-polymerase chain reaction (Tb-PCR) suggested that the pathogenic bacteria of the spondylitis was BCG. Eventually the bacterial strain was identified as BCG by PCR-based genomic deletion analysis. BCG infection should be considered in patients who have been treated with BCG therapy, even if the treatment was performed several months to several years previously. In the case of a patient with a history of BCG therapy, a positive Tb-PCR result and negative IGRA result probably suggest BCG infections, if the possibility of false-negative IGRA result can be excluded.
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Bacille Calmette-Guérin (BCG) spondylitis with adjacent mycotic aortic aneurysm after intravesical BCG therapy: a case report and literature review
BMC, 2018Co-Authors: Takuya Kusakabe, Kenji Endo, Itaru Nakamura, Hidekazu Suzuki, Hirosuke Nishimura, Shinji Fukushima, Kengo YamamotoAbstract:Abstract Background Although intravesical bacille Calmette-Guérin (BCG) therapy is accepted as an effective treatment for bladder cancer, serious complications may occur in rare cases. To date, only 4 cases have been reported in which the patient developed a combination of mycotic aortic aneurysm and BCG spondylitis. Accurate diagnosis of BCG spondylitis is important because it is an Iatrogenic Disease, and its treatment is different from usual tuberculous spondylitis. However, distinguishing BCG spondylitis from usual tuberculous spondylitis is very difficult and takes a long time. In this study, we were able to suspect BCG spondylitis at an early stage from the result of the interferon-gamma release assay (IGRA). Case presentation We encountered a case of BCG spondylitis with adjacent mycotic aortic aneurysm after intravesical BCG therapy in a 76-year-old man. We performed a 2-stage operation to obtain spine stabilization and replace the aneurysm with a synthetic graft. We started multidrug therapy with antituberculosis medication, excluding pyrazinamide, because the patient’s history of BCG therapy, negative IGRA, and positive of tuberculosis-polymerase chain reaction (Tb-PCR) suggested that the pathogenic bacteria of the spondylitis was BCG. Eventually the bacterial strain was identified as BCG by PCR-based genomic deletion analysis. Conclusions BCG infection should be considered in patients who have been treated with BCG therapy, even if the treatment was performed several months to several years previously. In the case of a patient with a history of BCG therapy, a positive Tb-PCR result and negative IGRA result probably suggest BCG infections, if the possibility of false-negative IGRA result can be excluded
Arthur P. Grollman - One of the best experts on this subject based on the ideXlab platform.
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Aristolochia Herbs and Iatrogenic Disease: The Case of Portland's Powders.
The Yale journal of biology and medicine, 2020Co-Authors: Tristan Tomlinson, Andrea Fernandes, Arthur P. GrollmanAbstract:Aristolochia herbals have a 2500-year history of medicinal use. We focused this article on Portland's Powders, an 18th-century British gout medicine containing Aristolochia herbs. The powders constitute an 18th-century iteration of an herbal remedy, which was used, with variations, since at least the fifth century BCE. The use of Portland's Powders in Great Britain may appear to be an unusual choice for investigating a public health problem currently widespread in Asia. Yet it exemplifies long-term medicinal use of Aristolochia herbs, reflecting our argument that aristolochic acid nephropathy (AAN) is a historically persistent Iatrogenic Disease. Moreover, we provide compelling evidence that individuals taking Portland's Powders for gout would have ingested toxic quantities of aristolochic acid, which causes AAN and cancer. Several factors, including long history of use, latency of toxic effects, and lack of effective regulation, perpetuate usage of Aristolochia herbals to the present day.
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Aristolochic acid nephropathy: Harbinger of a global Iatrogenic Disease.
Environmental and molecular mutagenesis, 2012Co-Authors: Arthur P. GrollmanAbstract:This review constitutes an overview of our investigations of aristolochic acid nephropathy, a chronic kidney Disease associated with carcinomas of the upper urinary tract. Our studies began by confirming the hypothesis that chronic dietary poisoning by aristolochic acid was responsible for endemic (Balkan) nephropathy. A unique TP53 mutational signature in urothelial tumors and the presence of aristolactam-DNA adducts in the renal cortex, defined in the course of this research, proved to be robust biomarkers of exposure to this potent nephrotoxin and human carcinogen. Armed with this information, we used molecular epidemiologic approaches and novel mechanistic information to establish the causative role of aristolochic acid in upper urinary tract carcinoma in Taiwan, where one-third of the population had been prescribed herbal remedies containing Aristolochia, and the recorded incidence of upper urinary tract cancers is the highest in the world. As traditional Chinese medicine is practiced similarly in Taiwan and China, it is likely that upper urinary tract carcinomas and their attendant aristolochic acid nephropathy are prevalent in China and other Asian countries where Aristolochia herbs have been used for centuries in the treatment and prevention of Disease, creating a potential public health problem of considerable magnitude.
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chapter 7 aristolochic acid nephropathy an environmental and Iatrogenic Disease
Advances in Molecular Toxicology, 2009Co-Authors: Arthur P. Grollman, John Scarborough, Bojan JelakovicAbstract:Publisher Summary This chapter reviews the molecular and clinical toxicology of aristolochic acid (AA), nephrotoxic chemical carcinogen. Recently, AA, a principal component of all Aristolochia sp., is shown to be the toxin responsible for the clinical syndromes known as Chinese herb nephropathy (CHN) and endemic (Balkan) nephropathy (EN). The epidemiology and pathophysiology of CHN and EN are reviewed extensively and the association of these Diseases with human cancer is the subject of several comprehensive reports. Both disorders are associated with a high incidence of urothelial (transitional cell) cancer and appear to constitute a single Disease entity, designated aristolochic acid nephropathy (AAN). The dramatic revelation that AA is a powerful nephrotoxin and carcinogen for humans drew attention to the worldwide distribution and extensive use of Aristolochia sp. as herbal remedies. The subsequent reports described almost 200 patients outside of Belgium in whom chronic renal failure followed ingestion of Aristolochia herbs. In addition based on the traditional use of Aristolochia in herbal remedies, the chapter posits that AAN represents a long-overlooked Iatrogenic Disease and an international public health problem of considerable magnitude.
Takuya Kusakabe - One of the best experts on this subject based on the ideXlab platform.
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bacille calmette guerin bcg spondylitis with adjacent mycotic aortic aneurysm after intravesical bcg therapy a case report and literature review
BMC Infectious Diseases, 2018Co-Authors: Takuya Kusakabe, Kenji Endo, Itaru Nakamura, Hidekazu Suzuki, Hirosuke Nishimura, Shinji Fukushima, Kengo YamamotoAbstract:Although intravesical bacille Calmette-Guerin (BCG) therapy is accepted as an effective treatment for bladder cancer, serious complications may occur in rare cases. To date, only 4 cases have been reported in which the patient developed a combination of mycotic aortic aneurysm and BCG spondylitis. Accurate diagnosis of BCG spondylitis is important because it is an Iatrogenic Disease, and its treatment is different from usual tuberculous spondylitis. However, distinguishing BCG spondylitis from usual tuberculous spondylitis is very difficult and takes a long time. In this study, we were able to suspect BCG spondylitis at an early stage from the result of the interferon-gamma release assay (IGRA). We encountered a case of BCG spondylitis with adjacent mycotic aortic aneurysm after intravesical BCG therapy in a 76-year-old man. We performed a 2-stage operation to obtain spine stabilization and replace the aneurysm with a synthetic graft. We started multidrug therapy with antituberculosis medication, excluding pyrazinamide, because the patient’s history of BCG therapy, negative IGRA, and positive of tuberculosis-polymerase chain reaction (Tb-PCR) suggested that the pathogenic bacteria of the spondylitis was BCG. Eventually the bacterial strain was identified as BCG by PCR-based genomic deletion analysis. BCG infection should be considered in patients who have been treated with BCG therapy, even if the treatment was performed several months to several years previously. In the case of a patient with a history of BCG therapy, a positive Tb-PCR result and negative IGRA result probably suggest BCG infections, if the possibility of false-negative IGRA result can be excluded.
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Bacille Calmette-Guérin (BCG) spondylitis with adjacent mycotic aortic aneurysm after intravesical BCG therapy: a case report and literature review
BMC, 2018Co-Authors: Takuya Kusakabe, Kenji Endo, Itaru Nakamura, Hidekazu Suzuki, Hirosuke Nishimura, Shinji Fukushima, Kengo YamamotoAbstract:Abstract Background Although intravesical bacille Calmette-Guérin (BCG) therapy is accepted as an effective treatment for bladder cancer, serious complications may occur in rare cases. To date, only 4 cases have been reported in which the patient developed a combination of mycotic aortic aneurysm and BCG spondylitis. Accurate diagnosis of BCG spondylitis is important because it is an Iatrogenic Disease, and its treatment is different from usual tuberculous spondylitis. However, distinguishing BCG spondylitis from usual tuberculous spondylitis is very difficult and takes a long time. In this study, we were able to suspect BCG spondylitis at an early stage from the result of the interferon-gamma release assay (IGRA). Case presentation We encountered a case of BCG spondylitis with adjacent mycotic aortic aneurysm after intravesical BCG therapy in a 76-year-old man. We performed a 2-stage operation to obtain spine stabilization and replace the aneurysm with a synthetic graft. We started multidrug therapy with antituberculosis medication, excluding pyrazinamide, because the patient’s history of BCG therapy, negative IGRA, and positive of tuberculosis-polymerase chain reaction (Tb-PCR) suggested that the pathogenic bacteria of the spondylitis was BCG. Eventually the bacterial strain was identified as BCG by PCR-based genomic deletion analysis. Conclusions BCG infection should be considered in patients who have been treated with BCG therapy, even if the treatment was performed several months to several years previously. In the case of a patient with a history of BCG therapy, a positive Tb-PCR result and negative IGRA result probably suggest BCG infections, if the possibility of false-negative IGRA result can be excluded
Karen E Deveney - One of the best experts on this subject based on the ideXlab platform.
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clostridium difficile colitis an increasingly aggressive Iatrogenic Disease
Archives of Surgery, 2002Co-Authors: Arden M Morris, Blair A Jobe, Mark Stoney, Brett C Sheppard, Clifford W Deveney, Karen E DeveneyAbstract:these, 2 (4%) of 51 required surgical intervention and 10 (20%) of 51 died. An additional 18.5% of patients had diabetes, renal failure, or both. Of these, 2 (7%) of 30 required surgery and 4 (13%) of 30 died. Only 9.5% of patients had prophylactic perioperative antibiotics as a sole risk factor; 2 (13%) of 15 required surgery and 3 (20%) of 15 died. The overall mortality rate was 15.3%, increased from 3.5% in our previous series. Neither need for surgery nor mortality differed among these patient groups. Conclusions: The frequency of C difficile colitis remains high and seems to be associated with increasing mortality. Among patients with positive C difficile toxin assay results, immunocompromise and delayed diagnosis no longer seem to be associated with higher risk for death. All patients taking antibiotics are at risk and require early recognition and aggressive medical intervention.
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clostridium difficile colitis an increasingly aggressive Iatrogenic Disease
Annual Meeting of the American Society of Colon and Rectal Surgeons, 2002Co-Authors: Arden M Morris, Blair A Jobe, Mark Stoney, Brett C Sheppard, Clifford W Deveney, Karen E DeveneyAbstract:Hypothesis: The diagnosis of Clostridium difficile colitis is increasing in frequency, with worsening patient outcomes. Design: Retrospective cohort study. Setting: University hospital. Patients: One hundred fifty-seven patients diagnosed with C difficile colitis between 1994-2000. Main Outcome Measures: Resolution of Disease, operative intervention, and death. Results: Compared with our previous 10-year experience, overall cases of C difficile colitis have risen by more than 30%, and immunocompromised patients comprise a larger proportion of those affected. One third of patients were receiving posttransplantation medication, chemotherapy, or had human immunodeficiency virus. Of these, 2 (4%) of 51 required surgical intervention and 10 (20%) of 51 died. An additional 18.5% of patients had diabetes, renal failure, or both. Of these, 2 (7%) of 30 required surgery and 4 (13%) of 30 died. Only 9.5% of patients had prophylactic perioperative antibiotics as a sole risk factor; 2 (13%) of 15 required surgery and 3 (20%) of 15 died. The overall mortality rate was 15.3%, increased from 3.5% in our previous series. Neither need for surgery nor mortality differed among these patient groups. Conclusions: The frequency of C difficile colitis remains high and seems to be associated with increasing mortality. Among patients with positive C difficile toxin assay results, immunocompromise and delayed diagnosis no longer seem to be associated with higher risk for death. All patients taking antibiotics are at risk and require early recognition and aggressive medical intervention.
T. Sato - One of the best experts on this subject based on the ideXlab platform.
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Iatrogenic creutzfeldt jakob Disease final assessment
Emerging Infectious Diseases, 2012Co-Authors: Paul Brown, R G Will, J. Mackenzie, T. Sato, Maurizio Pocchiari, Jean Philippe Brandel, Yosikazu Nakamura, Anna Ladogana, Ellen W Leschek, Lawrence B SchonbergerAbstract:The era of Iatrogenic Creutzfeldt-Jakob Disease (CJD) has nearly closed; only occasional cases with exceptionally long incubation periods are still appearing. The principal sources of these outbreaks are contaminated growth hormone (226 cases) and dura mater grafts (228 cases) derived from human cadavers with undiagnosed CJD infections; a small number of additional cases are caused by neurosurgical instrument contamination, corneal grafts, gonadotrophic hormone, and secondary infection with variant CJD transmitted by transfusion of blood products. No new sources of Disease have been identified, and current practices, which combine improved recognition of potentially infected persons with new disinfection methods for fragile surgical instruments and biological products, should continue to minimize the risk for Iatrogenic Disease until a blood screening test for the detection of preclinical infection is validated for human use.
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Iatrogenic Creutzfeldt-Jakob Disease: the waning of an era
Neurology, 2006Co-Authors: T. SatoAbstract:The outbreaks of Iatrogenic Creutzfeldt-Jakob Disease (CJD) from cadaveric human growth hormone and dura mater are winding down and, like the only other environmentally acquired form of CJD (variant CJD due to infection with the agent of bovine spongiform encephalopathy), Iatrogenic Disease seems to have reached its high water mark during the 1990s. The total number of cases has reached 405, and the diminishing number of new cases is due to extremely long incubation periods from infections acquired before 1985 (up to 23 years for dura mater and 36 years for growth hormone). Although no cases associated with surgical or other invasive procedures have been identified during the past several decades, the recent discovery of three transfusion-associated variant CJD infections has provoked new concerns about the possibility of further secondary transmissions from operative procedures as well as blood and tissue donations. Therefore, at least in those countries in which variant CJD has occurred, precautionary measures must continue for the indefinite future
