Disease relevance of Mediastinitis

• Low-osmolality, water-soluble contrast agents are a safe alternative for patients in whom barium esophagography poses a risk of mediastinitis and esophagography with diatrizoate meglumine and diatrizoate sodium (Gastrografin) poses a risk of pulmonary edema [1].
• Poststernotomy mediastinitis due to Staphylococcus aureus: comparison of methicillin-resistant and methicillin-susceptible cases [2].
• Four (4%) wound infections, including one mediastinitis, occurred in the ceftriaxone group and five (5%) in the vancomycin group, with no statistically significant difference [3].
• Of three patients with Enterobacter mediastinitis treated with cefamandole, two failed initial treatment due to emergence of strains resistant to cefamandole and third generation cephalosporins [4].
• Other infections included skin and soft tissue infections, complicated urinary tract infections, bacteraemia and a case of meningitis treated with meropenem and one of mediastinitis treated with imipenem/cilastatin [5].

High impact information on Mediastinitis

• Two surviving patients (with a recurrent thymoma and fibrosing mediastinitis) were free of symptoms when followed up at eight and nine months respectively [6].
• In a case-control study examining patients exposed to the resident, a prolonged duration of surgery (P less than .05) and a preoperative albumin level of less than 3.0 g/dl (P less than .009) were associated with mediastinitis with this MRSA [7].
• Detection of mediastinitis after heart transplantation by gallium-67 scintigraphy [8].
• CONCLUSIONS: Simple primary closure is an effective means to treat selected cases of postoperative mediastinitis in children [9].
• CONCLUSIONS: During mediastinitis, the complement is activated and the cytokines and chemokines, interleukin-6, interleukin-8, and stromal cell-derived factor-1alpha are released [10].

Chemical compound and disease context of Mediastinitis

• Continuous povidone-iodine irrigation is frequently used to treat mediastinitis after median sternotomy and has been considered safe and effective [11].
• A gastrografin swallow subsequently demonstrated an oesophageal perforation and mediastinitis was diagnosed at surgical exploration [12].
• Multivariate analysis revealed that a glucose level of 126 mg/dL or greater was associated with a significantly increased risk of mediastinitis (OR, 5.25; P = .002) [13].
• Sternal segments with good vascularity and in bacteriologic balance were anatomically reduced and rigidly fixed to each other with titanium miniplates in 24 patients with postoperative mediastinitis [14].
• Successful treatment of sclerosing cervicitis and fibrosing mediastinitis with tamoxifen [15].

Anatomical context of Mediastinitis

• Acute mediastinitis secondary to leakage of parenteral nutrition from a migrated central venous catheter in a patient undergoing autologous bone marrow transplant [16].
• After arterial switch, 9 patients underwent 11 reoperations for residual coarctation (3), residual pulmonary artery stenosis (2), aortic valve replacement, aortic valvuloplasty, unrecognized VSD, mitral valvuloplasty, mediastinitis, and pacemaker insertion [17].
• This report shows that steroid therapy is a treatment option for hoarseness caused by recurrent laryngeal nerve involvement of fibrosing mediastinitis, if administered under close observation [18].
• Gram-positive organisms were identified in cultures of the exudate in all three patients, as Staphylococcus epidermidis in two and Methicillin-resistant Staphylococcus aureus in one, and concomitant mediastinitis was demonstrated by computed tomography in two cases [19].
• Successful treatment of MRSA mediastinitis after aortic arch replacement [20].

Gene context of Mediastinitis

• Interleukin-1beta, interleukin-10, and monocyte chemoattractant protein-1 concentrations were slightly higher in the mediastinitis group, and no differences were seen for the tumor necrosis factor-alpha [10].
• Interleukin-8, stromal cell-derived factor-1alpha and IL-6 concentrations were also significantly higher in the mediastinitis group than in the control group (p < 0.001), but with considerable overlap between the groups [10].
• Complications included fibrosing mediastinitis with superior vena cava obstruction, esophageal compression, and major upper airway compression [21].
• Is mediastinitis a preventable complication? A 10-year review [22].
• By logistic regression analysis, three of these factors were found to be associated independently with increased odds of developing mediastinitis: duration of surgery, history of COPD, and prolonged postoperative mechanical ventilation [23].

Analytical, diagnostic and therapeutic context of Mediastinitis

• Relief of superior vena cava syndrome due to fibrosing mediastinitis using the Palmaz stent [24].
• RESULTS: Three of five patients were diagnosed with cryptococcal mediastinitis within a median time of 90 days (range, 60-150) after commencing HAART and fluconazole prophylaxis [25].
• Sclerosing mediastinitis: findings on fluorine-18 fluorodeoxyglucose positron emission tomography [26].

References