Various procedures for these fistulae such as simple closure,
muscle flap interposition, esophageal diversion and jejunal interposition are reported. Some authors also advise removal of prosthetic plates and posterior stabilization, besides the repair of fistulae in a staged manner (Orlando et al. in Spine 28(15):E290-E295, 2003).
Two similar cases of pharyngeal fistulae with similar etiology and clinical scenario are presented here, which were managed successfully with initial control of sepsis followed by delayed definitive repair with sternocleidomastoid muscle flap interposition and cricopharyngeus myotomy without removal of prosthetic plates.
Postoperatively, both patients showed no evidence of any wound complications or collections until the seventh day. A contrast swallow study on seventh Epacadostat in vitro day showed no leak following which soft diet was started. Both patients were not having any difficulty in swallowing or aspiration. On 1-year follow-up, both patients were having no difficulty in swallowing, no episodes of aspiration and no recurrence of fistula.
This case series highlights
Tozasertib the importance of cricopharyngeus myotomy for treating PEF and the improved results with the prosthesis kept undisturbed.”
“Purpose of review
An important effort is being made among the transplant community investigating novel biological markers at different biological levels that enable transplant clinicians to identify patients at risk for allograft rejection or, conversely, patients in whom immunosuppression could be safely minimized. Here, we review recent important biomarkers
that have shown relevant impact on renal graft outcome.
Recent findings
Important Selleckchem SC79 collaborative studies have allowed the identification of biomarkers or biological signatures indicative of organ tolerance or rejection in different transplant settings (mainly kidney and liver transplantation). This has required novel and highly specific technological assays focused at different biological levels, employing peripheral blood, urine and grafts tissue. Noteworthy, standardization and methodical validation of reliable tests or biomarkers is being a crucial task since the start of this challenge. These endeavours include detailed characterizations of serum alloantibody levels, measurements of individual soluble or cell-surface markers in peripheral blood, urine or both; profiling gene expression, proteome expression patterns or both and evaluations of peripheral cellular alloimmunity, among others.
Summary
Despite the important advances achieved so far in the identification of several potentially useful biomarkers of tolerance, rejection or both, validation and demonstration of their clinical utility still needs to be tested.