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Article: Pyogenic spinal infections warrant a total spine MRI.

Balcescu, Cristian / Odeh, Khalid / Rosinski, Alexander / Nudelman, Brandon / Schlauch, Adam / Shah, Ishan / Ungurean, Victor / Prasad, Priya / Leasure, Jeremi / Stepansky, Flora / Piple, Amit / Kondrashov, Dimitriy

Journal of bone and joint infection

2023 Volume 8, Issue 1, Page(s) 1–9

Abstract: ... Study ... ...

Abstract	Study design
Language	English
Publishing date	2023-01-03
Publishing country	Germany
Document type	Journal Article
ISSN	2206-3552
ISSN	2206-3552
DOI	10.5194/jbji-8-1-2023
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Book ; Online: Pyogenic spinal infections warrant a total spine MRI

Balcescu, Cristian / Odeh, Khalid / Rosinski, Alexander / Nudelman, Brandon / Schlauch, Adam / Shah, Ishan / Ungurean Jr., Victor / Prasad, Priya / Leasure, Jeremi / Stepansky, Flora / Piple, Amit / Kondrashov, Dimitriy

eISSN: 2206-3552

2023

Abstract: Study design : retrospective case series. Objective : the presenting clinical symptoms of spinal infections are often nonspecific and a delay in diagnosis can lead to adverse patient outcomes. The morbidity and mortality of patients with multifocal ... ...

Abstract	Study design : retrospective case series. Objective : the presenting clinical symptoms of spinal infections are often nonspecific and a delay in diagnosis can lead to adverse patient outcomes. The morbidity and mortality of patients with multifocal spinal infections is significantly higher compared to unifocal infections. The purpose of the current study was to analyse the risk factors for multifocal spinal infections. Methods : we conducted a retrospective review of all pyogenic non-tuberculous spinal infections treated surgically at a single tertiary care medical center from 2006–2020. The medical records, imaging studies, and laboratory data of 43 patients during this time period were reviewed and analysed after receiving Institutional Review Board approval. Univariate and multivariate analyses were performed to identify factors associated with a multifocal spinal infection. Results : 15 patients (35 %) had multifocal infections. In univariate analysis, there was a significant association with chronic kidney disease ( p =0.040 ), gender ( p =0.003 ), a white blood cell count ( p =0.011 ), and cervical ( p <0.001 ) or thoracic ( p <0 .001) involvement. In multivariate analysis, both cervical and thoracic involvement remained statistically significant ( p =0.001 and p <0.001 , respectively). Conclusions : patients with infections in the thoracic or cervical region are more likely to have a multifocal infection. Multifocal pyogenic spinal infections remain a common entity and a total spine MRI should be performed to aid in prompt diagnosis.
Subject code	610
Language	English
Publishing date	2023-01-03
Publishing country	de
Document type	Book ; Online
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Article ; Online: Antagonistic activity of autosimbionts А. viridans, B. subtilis and their probiotic association to conditionally microflora

Stepansky D.A.

Medičnì Perspektivi, Vol 20, Iss 1, Pp 14-

2015 Volume 21

Abstract: ... strain B. subtilis 3 towards pathogenic and opportunistic pathogenic microflora isolated from oropharynx ... opportunistic pathogenic microflora was shown. Common antagonist activity of A. viridans (k) N 1 and B. subtilis ... on development of probiotic associations, that contain representatives of normal microflora - bioassociants ...

Abstract	In this research the data on examination of antagonist qualities of bioassotiantes A. viridans and strain B. subtilis 3 towards pathogenic and opportunistic pathogenic microflora isolated from oropharynx and nasopharynx of children who were in contact with patients with pulmonary tuberculosis (MBT +) are submitted. The expressed antagonist activity of autosimbionts A. viridans towards pathogenic and opportunistic pathogenic microflora was shown. Common antagonist activity of A. viridans (k) N 1 and B. subtilis 3 towards diverse strains of test-cultures is 1,5-2 times higher, than separate antagonist activity of A. viridans (k) №1 and B. subtilis 3. Received research data showed the possibility of continuing work on development of probiotic associations, that contain representatives of normal microflora - bioassociants A. viridans and probiotic strains B. subtilis 3 with broadspectrum of antagonistic activity in relation to the various groups of bacterium.
Keywords	autosimbionts ; antagonist activity ; Aerococcus ; Medicine ; R
Language	English
Publishing date	2015-03-01T00:00:00Z
Publisher	Dnipro State Medical University
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Antagonistic activity of autosimbionts А. viridans, B. subtilis and their probiotic association to conditionally microflora.

D. A. Stepansky

Medičnì Perspektivi, Vol 20, Iss 1, Pp 14-

2015 Volume 21

Abstract	In this research the data on examination of antagonist qualities of bioassotiantes A. viridans and strain B. subtilis 3 towards pathogenic and opportunistic pathogenic microflora isolated from oropharynx and nasopharynx of children who were in contact with patients with pulmonary tuberculosis (MBT +) are submitted. The expressed antagonist activity of autosimbionts A. viridans towards pathogenic and opportunistic pathogenic microflora was shown. Common antagonist activity of A. viridans (k) N 1 and B. subtilis 3 towards diverse strains of test-cultures is 1,5-2 times higher, than separate antagonist activity of A. viridans (k) №1 and B. subtilis 3. Received research data showed the possibility of continuing work on development of probiotic associations, that contain representatives of normal microflora - bioassociants A. viridans and probiotic strains B. subtilis 3 with broadspectrum of antagonistic activity in relation to the various groups of bacterium.
Keywords	autosimbionts ; antagonist activity ; Aerococcus ; Medicine ; R
Language	English
Publishing date	2015-03-01T00:00:00Z
Publisher	Dnipro State Medical University
Document type	Article ; Online
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Article ; Online: ANTAGONISM OF A. VIRIDANS TO CONDITIONALLY - PATHOGENIC MICROFLORA OF THE NOSE AND OROPHARYNX OF CHILDREN WITH CARDIAC PATOLOGY

Stepansky D.O.

Annals of Mechnikov's Institute, Vol 4, Pp 90-

2015 Volume 93

Abstract: ... of particular interest, as it is representative of the normal microflora of human with broad spectrum ... autostrains of aerococcuses, isolated at patients, to conditionally - pathogenic microflora of the nose and ... oropharynx of children with cardiac patology. At the first stage of the study the microflora ...

Abstract	Introduction. Search for harmless and simultaneously effective probiotics, which could be successfully used for treatment and prevention of infectious deseases, is currently important. A. viridans is of particular interest, as it is representative of the normal microflora of human with broad spectrum of antibacterial action. The use of this microorganism has a number of advantages: the absence of side effects on the body; high adhesive abilities; resistance to lysozyme in saliva; the ability of use in patients, sensitized to antibiotics and chemotherapeutic drugs; stimulation effects on the human immune system. Material and methods. The purpose of the study was to investigate the antagonism of A. viridans № 167 and autostrains of aerococcuses, isolated at patients, to conditionally - pathogenic microflora of the nose and oropharynx of children with cardiac patology. At the first stage of the study the microflora of the of the nose and oropharynx of 2 investigated categories was examined – 40 children 4-14 years with cardiac patology and 40 healthy children 4-5 years old. The second stage of work was to study the effect of A. viridans on the explored strains. Results and discussion. A. viridans manifests the antagonism to all studied strains of gram-positive and gram-negative microorganisms, except C. albisans. A. viridans antagonistic activity to staphylococci (10 + 3 mm) and streptococci (10 + 2mm) is at the approximately same level. It is interesting to compare the antagonism of aerococcuses to clinical isolates of S. pyogenes and similar strains from carriers (healthy children category). Impact of aerococcuses on P. mirabilis strain appeared at the highest level. Autosimbionts of A. viridans, isolated from healthy children, are more antagonistic to CPM strains, isolated from these children, than autostrains of A. viridans, isolated from children with with cardiac patology, and higher than the museum strain of A. viridans № 167 antagonism, and do not affect the growth of microorganisms of Candida kind. Severe antagonistic activity of the A. viridans № 167 strain and autostrains of A. viridans to isolated conditionally patogenetic strains was discovered: S. pyogenes, S. pneumoniae, S. aureus, K. pneumoniae, P. mirabilis. Antagonism of A. viridans № 167 to C. albicans was not found. Conclusion. The recieved data can serve as a basis for further study of the strain of A. viridans № 167 and aerococcuses’ autostrains usage for correction of fauces and nasopharynx microbiocenosis and also for the complex treatment and preventive actions in case of cardiac pathology.
Keywords	Aerococcus viridans ; probiotics ; autostrains of aerococcuses ; children. ; Medicine (General) ; R5-920 ; Medicine ; R
Subject code	610
Language	Ukrainian
Publishing date	2015-12-01T00:00:00Z
Publisher	Annals of Mechnicov's Institute
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Dynamic MR angiography of upper extremity vascular disease: pictorial review.

Stepansky, Flora / Hecht, Elizabeth M / Rivera, Rafael / Hirsh, Laurie E / Taouli, Bachir / Kaur, Manmeen / Lee, Vivian S

Radiographics : a review publication of the Radiological Society of North America, Inc

2008 Volume 28, Issue 1, Page(s) e28

Abstract: Unlike peripheral lower extremity vascular disease, upper extremity vascular disease is relatively uncommon. While atherosclerosis and embolic disease are the most common causes of upper extremity ischemia, a wide variety of systemic diseases and ... ...

Abstract	Unlike peripheral lower extremity vascular disease, upper extremity vascular disease is relatively uncommon. While atherosclerosis and embolic disease are the most common causes of upper extremity ischemia, a wide variety of systemic diseases and anatomic abnormalities can affect the upper extremity. Upper extremity ischemia poses a significant diagnostic and therapeutic challenge for both clinicians and radiologists. Although history and physical examination remain the mainstays of diagnosis, imaging can be vital in confirming suspected disease and guiding treatment planning. Digital subtraction angiography is often the preferred method for detection of upper extremity vascular disease, particularly for characterization of complex arteriovenous anatomy such as in vascular malformations and for evaluation of dialysis fistulas and grafts. However, this modality is invasive, requires iodinated contrast agents and radiation, and may fail to demonstrate significant extraluminal disease. More recently, magnetic resonance (MR) angiography techniques have made important advances, permitting higher temporal and spatial resolution that is preferable for diagnosing upper extremity vascular disorders. In this review, the authors present an overview of upper extremity MR angiography techniques and protocols, revisit the often variable vascular anatomy of the arm and hand, and offer examples of various pathologic entities diagnosed with MR angiography. Finally, several imaging pitfalls that one must be aware of for accurate diagnosis are illustrated and reviewed.
MeSH term(s)	Humans ; Image Enhancement/methods ; Ischemia/diagnosis ; Magnetic Resonance Angiography/methods ; Peripheral Vascular Diseases/diagnosis ; Practice Guidelines as Topic ; Practice Patterns, Physicians' ; Upper Extremity/blood supply ; Upper Extremity/pathology
Language	English
Publishing date	2008-01
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	603172-9
ISSN	1527-1323 ; 0271-5333
ISSN (online)	1527-1323
ISSN	0271-5333
DOI	10.1148/radiol.e28
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Article ; Online: Homo- and heteroadhesion activity of autosymbionts of Aerococcus Viridans strains.

D. A. Stepansky / G. N. Kremenchutsky / I. P. Koshevaya / Ye. A. Velychko

Medičnì Perspektivi, Vol 21, Iss 4, Pp 67-

2016 Volume 71

Abstract: ... with the help of which microflora colonizes different biotypes of macroorganism, thus providing colonization ...

Abstract	Adhesion is the major stage of interaction of microorganisms with macroorganism, important factor with the help of which microflora colonizes different biotypes of macroorganism, thus providing colonization resistance, preventing adhesion and pathogenic invasion. In our study data about adhesive features of Aerococcus viridans autophytes of rats, mice and human are presented. Aerococcus viridans autosymbionts have higher performances of adhesion in the condition of heteroadhesion. Among performance of homoadhesionthe highest microorganisms adhesive index (MAI) was in human autosymbionts – 5,78±0,04, in rats – 4,49±0,06 and mice – 4,29±0,04. On the account of greater adhesive features, using of autosymbionts of Aerococcus viridans theoretically can be justified for correction of disbiotic conditions of a human and animals, this requires further study.
Keywords	autosymbionts ; Aerococcus viridans ; adhesion ; Medicine ; R
Language	English
Publishing date	2016-12-01T00:00:00Z
Publisher	Dnipro State Medical University
Document type	Article ; Online
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Article ; Online: Homo- and heteroadhesion activity of autosymbionts of Aerococcus Viridans strains

Stepansky D.A. / Kremenchutsky G.N. / Koshevaya I.P. / Velychko Ye.A.

Medičnì Perspektivi, Vol 21, Iss 4, Pp 67-

2016 Volume 71

Abstract: ... with the help of which microflora colonizes different biotypes of macroorganism, thus providing colonization ...

Abstract	Adhesion is the major stage of interaction of microorganisms with macroorganism, important factor with the help of which microflora colonizes different biotypes of macroorganism, thus providing colonization resistance, preventing adhesion and pathogenic invasion. In our study data about adhesive features of Aerococcus viridans autophytes of rats, mice and human are presented. Aerococcus viridans autosymbionts have higher performances of adhesion in the condition of heteroadhesion. Among performance of homoadhesion the highest microorganisms adhesive index (MAI) was in human autosymbionts – 5,78±0,04, in rats – 4,49±0,06 and mice – 4,29±0,04. On the account of greater adhesive features, using of autosymbionts of Aerococcus viridans theoretically can be justified for correction of disbiotic conditions of a human and animals, this requires further study.
Keywords	autosymbionts ; Aerococcus viridans ; adhesion ; Medicine ; R
Language	English
Publishing date	2016-12-01T00:00:00Z
Publisher	Dnipro State Medical University
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Dual-energy CT in patients suspected of having renal masses: can virtual nonenhanced images replace true nonenhanced images?

Graser, Anno / Johnson, Thorsten R C / Hecht, Elizabeth M / Becker, Christoph R / Leidecker, Christianne / Staehler, Michael / Stief, Christian G / Hildebrandt, Henriette / Godoy, Myrna C B / Finn, Myra E / Stepansky, Flora / Reiser, Maximilian F / Macari, Michael

Radiology

2009 Volume 252, Issue 2, Page(s) 433–440

Abstract: Purpose: To qualitatively and quantitatively compare virtual nonenhanced (VNE) data sets derived from dual-energy (DE) computed tomography (CT) with true nonenhanced (TNE) data sets in the same patients and to calculate potential radiation dose ... ...

Abstract	Purpose: To qualitatively and quantitatively compare virtual nonenhanced (VNE) data sets derived from dual-energy (DE) computed tomography (CT) with true nonenhanced (TNE) data sets in the same patients and to calculate potential radiation dose reductions for a dual-phase renal multidetector CT compared with a standard triple-phase protocol. Materials and methods: This prospective study was approved by the institutional review board; all patients provided written informed consent. Seventy one men (age range, 30-88 years) and 39 women (age range, 22-87 years) underwent preoperative DE CT that included unenhanced, DE nephrographic, and delayed phases. DE CT parameters were 80 and 140 kV, 96 mAs (effective). Collimation was 14 x 1.2 mm. CT numbers were measured in renal parenchyma and tumor, liver, aorta, and psoas muscle. Image noise was measured on TNE and VNE images. Exclusion of relevant anatomy with the 26-cm field of view detector was quantified with a five-point scale (0 = none, 4 = >75%). Image quality and noise (1 = none, 5 = severe) and acceptability for VNE and TNE images were rated. Effective radiation doses for DE CT and TNE images were calculated. Differences were tested with a Student t test for paired samples. Results: Mean CT numbers (+/- standard deviation) on TNE and VNE images, respectively, for renal parenchyma were 30.8 HU +/- 4.0 and 31.6 HU +/- 7.1, P = .29; liver, 55.8 HU +/- 8.6 and 57.8 HU +/- 10.1, P = .11; aorta, 42.1 HU +/- 4.1 and 43.0 HU +/- 8.8, P = .16; psoas, 47.3 HU +/- 5.6 and 48.1 HU +/- 9.3 HU, P = .38. No exclusion of the contralateral kidney was seen in 50 patients, less than 25% was seen in 43, 25%-50% was seen in 13, and 50%-75% was seen in four. Mean image noise was 1.71 +/- 0.71 for VNE and 1.22 +/- 0.45 for TNE (P < .001); image quality was 1.70 HU +/- 0.72 for VNE and 1.15 HU +/- 0.36 for TNE (P < .0001). In all but three patients radiologists accepted VNE images as replacement for TNE images. Mean effective dose for DE CT scans of the abdomen was 5.21 mSv +/- 1.86 and that for nonenhanced scans was 4.97 mSv +/- 1.43. Mean dose reduction by omitting the TNE scan was 35.05%. Conclusion: In patients with renal masses, DE CT can provide high-quality VNE data sets, which are a reasonable approximation of TNE data sets. Integration of DE scanning into a renal mass protocol will lower radiation exposure by 35%.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Body Burden ; Female ; Humans ; Kidney Neoplasms/diagnostic imaging ; Male ; Middle Aged ; Radiation Dosage ; Radiographic Image Enhancement ; Radiographic Image Interpretation, Computer-Assisted/methods ; Reproducibility of Results ; Sensitivity and Specificity ; Tomography, X-Ray Computed/methods ; Young Adult
Language	English
Publishing date	2009-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	80324-8
ISSN	1527-1315 ; 0033-8419
ISSN (online)	1527-1315
ISSN	0033-8419
DOI	10.1148/radiol.2522080557
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