Use of ultrafiltered dialysate was associated with improvements in some measures of morbidity, such as plasma beta(2)-microglubulin and nutrition. These changes occurred in spite of the presence of inflammatory stimuli, such as dialyser reuse, and with no measurable reduction in inflammation and oxidant stress.

A spine exposed to radiation can easily become compromised with of osteonecrosis and fracture due to hematogenous disorder and bone fragility. We report cases of 2 patients with pyogenic spondylodiscitis caused by mixed bacterial infection after radiation therapy and review the literature. The patients were a 67yearold woman case 1 who had undergone catheterization for acute myocardial infarction 7 years before the time of presentation and a 76yearold mancase 2who had undergone radiotherapy for pharyngeal cancer 4 years before the time of presentation. Patient 1 presented with fever, lumbago, and severe pain in the right lower limb. Patient 2 presented with fever and quadriplegia. Patients 1 and 2 were diagnosed with pyogenic spondylodisci-tis at L34 and C56, respectively. Computed tomographyguided puncture was performed in case 1, and decompression and fusion were performed via an anterior approach in case 2. The culture test revealed mixed bacterial infection in both cases. The infection was treated by using antibiotics and by administering hyperbaric oxygen therapy.

Objectives: Peritonsillar abscess (PTA) is the most common deep neck space infection and a frequent cause for otolaryngology consultation. Patients often undergo computed tomography (CT) scan for confirmation in addition to physical examination. Our aims were to determine whether patients unnecessarily undergo CT scans in the emergency department (ED) when presenting with sore throat and identify physical examination characteristics that predict PTA. Methods: The electronic medical records of all patients (>18 years) presenting to an ED between June 2014 and June 2015 with a primary diagnosis of acute pharyngitis, acute tonsillitis, or PTA were reviewed for presenting symptoms and diagnostic imaging use. Results: Four hundred eight patients met inclusion criteria; 21 were diagnosed with PTA, including 13 based on history and physical alone. A total of 21 CT scans were ordered, 11 (52.3%) of which did not demonstrate abscess. Soft palatal fullness, uvular deviation, drooling, and muffled voice were all significantly associated with increased CT usage (all P values <.02). Rising subjective pain scores were associated with increased use of CT imaging ( P = .029). Multivariable analyses revealed that soft palatal fullness, uvular deviation, and drooling were all significant predictors of PTA (all P values <.001). Conclusions: Patients with severe symptoms of PTA, including uvular deviation, drooling, and soft palatal fullness, were most likely to undergo CT imaging. Given the high likelihood of PTA, patients presenting with these symptoms could forego CT imaging, reducing exposure to ionizing radiation.

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