BackgroundThus far, studies on Klebsiella pneumoniae carbapenemase (KPC)-producing organisms have only been reported in those with a history of foreign travel, and a specific Japanese KPC-producing isolate has not yet been reported.Case presentationWe describe a Japanese patient, with no history of travel to foreign countries, admitted due to aspiration pneumonia, and a KPC-producing isolate detected in his sputum. Fortunately, his pneumonia resolved. His close contacts did not have a history of foreign travel, and the isolate was not detected in other patients.ConclusionsThe potential for KPC-producing organisms to become endemic in Japan is currently of great concern.
Major lung resection for lung cancer in patients with coronary artery disease is feasible. Our study suggests that discontinuation of antiplatelet therapy may not increase postoperative complications in patients with coronary artery disease.
Background: Many studies have reported lead migration and breakage as complications
of epidural spinal cord stimulation. In cases where rapid changes in physique such as those
caused by pregnancy are expected, it is unclear whether extra consideration regarding
possible adjustments and care to avoid complications such as lead breakage are required.
Objective: This article presents a case in which spinal cord stimulation was used to
manage these complications in a woman during the perinatal period.
Design: Case report
Setting: Pain management clinic
Methods: The patient was a 36-year-old female, approximate weight of 100 pounds,
and 5-foot 1 inch in height, whose chief complaint was lower back and bilateral leg pain.
The pain could not be alleviated by conservative therapies such as nerve blockade, oral
medications with non-steroidal anti-inflammatory drugs, antidepressants, anticonvulsants
or physical therapy. A spinal cord stimulator was implanted at another facility, which relieved
the pain. The patient subsequently had 2 vaginal births without any problems relating to
the stimulation sites, and both infants were healthy. She experienced lead breakage after
the third vaginal birth that led to the subsequent reimplantation procedure.
Results: The patient had 2 subsequent vaginal births following the initial implantation
with no problems related to the stimulation sites, and both infants were healthy. At age
34, following her third vaginal birth, the stimulator became ineffective and was removed.
The withdrawn lead wire was found to be broken in 2 places.
Limitations: A case report.
Conclusion: Pregnancy following implantation of a spinal cord stimulator might result in
lead breakage as abdominal girth increases. The present case exemplifies how pregnancy
following implantation of a spinal cord stimulator might cause lead breakage as abdominal
girth increases. Extra care is required to prevent lead breakage when anchors are fixed.
Key words: spinal cord stimulator, reimplantation, lead breakage, pregnancy
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.