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https://www.readbyqxmd.com/read/28321490/c-reactive-protein-may-misdiagnose-prosthetic-joint-infections-particularly-chronic-and-low-grade-infections
#1
Daniel Pérez-Prieto, María E Portillo, Lluís Puig-Verdié, Albert Alier, Santos Martínez, Lluisa Sorlí, Juan P Horcajada, Joan C Monllau
BACKGROUND: Periprosthetic tissue cultures, sonication and synovial fluid cultures remain the gold standard for prosthetic joint infection (PJI) diagnosis. However, some 15-20% culture-negative PJI are still reported. Therefore, there is the need for other diagnostic criteria. One point of concern relative to the different definitions of PJI is as to the inclusion of the c-reactive protein (CRP) and the erythrocyte sedimentation rate (ESR) as diagnostic criteria for PJI despite them being non-specific inflammatory blood tests...
March 21, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28274250/prosthetic-joint-infection-development-of-an-evidence-based-diagnostic-algorithm
#2
Heinrich M L Mühlhofer, Florian Pohlig, Karl-Georg Kanz, Ulrich Lenze, Florian Lenze, Andreas Toepfer, Sarah Kelch, Norbert Harrasser, Rüdiger von Eisenhart-Rothe, Johannes Schauwecker
BACKGROUND: Increasing rates of prosthetic joint infection (PJI) have presented challenges for general practitioners, orthopedic surgeons and the health care system in the recent years. The diagnosis of PJI is complex; multiple diagnostic tools are used in the attempt to correctly diagnose PJI. Evidence-based algorithms can help to identify PJI using standardized diagnostic steps. METHODS: We reviewed relevant publications between 1990 and 2015 using a systematic literature search in MEDLINE and PUBMED...
March 9, 2017: European Journal of Medical Research
https://www.readbyqxmd.com/read/28259167/diagnostic-accuracy-of-arthroscopic-biopsy-in-periprosthetic-infections-of-the-hip
#3
Florian Pohlig, Heinrich M L Mühlhofer, Ulrich Lenze, Florian W Lenze, Christian Suren, Norbert Harrasser, Rüdiger von Eisenhart-Rothe, Johannes Schauwecker
BACKGROUND: Diagnosis of a low-grade periprosthetic joint infection (PJI) prior to revision surgery can be challenging, despite paramount importance for further treatment. Arthroscopic biopsy of synovial and periprosthetic tissue with subsequent microbiological and histological examination can be beneficial but its specific diagnostic value has not been clearly defined. METHODS: 20 consecutive patients who underwent percutaneous synovial fluid aspiration as well as arthroscopic biopsy due to suspected PJI of the hip and subsequent one- or two-stage revision surgery at our institution between January 2012 and May 2015 were enrolled...
March 4, 2017: European Journal of Medical Research
https://www.readbyqxmd.com/read/28255205/the-autophagy-level-is-increased-in-the-synovial-tissues-of-patients-with-active-rheumatoid-arthritis-and-is-correlated-with-disease-severity
#4
Li Zhu, Huaizhou Wang, Yu Wu, Zhengwen He, Yanghua Qin, Qian Shen
Rheumatoid arthritis (RA) is a complex and not fully understood autoimmune disease associated with multijoint damage. The main effector cells, the synovial fibroblasts, are apoptosis resistant and hyperplastic which indicate that autophagy level is high in synovial tissue. Real-time PCR, immunocytochemistry, and western blotting were used in this paper to study the autophagy status of the synovial tissues obtained from RA and OA patients at the time of joint replacement surgery. We further evaluated the correlation between autophagy levels with RA activity-associated serum markers with SPSS...
2017: Mediators of Inflammation
https://www.readbyqxmd.com/read/28249975/improving-the-accuracy-of-synovial-fluid-analysis-in-the-diagnosis-of-prosthetic-joint-infection-with-simple-and-inexpensive-biomarkers-c-reactive-protein-and-adenosine-deaminase
#5
R Sousa, P Serrano, J Gomes Dias, J C Oliveira, A Oliveira
AIMS: The aims of this study were to increase the diagnostic accuracy of the analysis of synovial fluid in the differentiation of prosthetic joint infection (PJI) by the addition of inexpensive biomarkers such as the levels of C-reactive protein (CRP), adenosine deaminase (ADA), alpha-2-macrogloblulin (α2M) and procalcitonin. PATIENTS AND METHODS: Between January 2013 and December 2015, synovial fluid and removed implants were requested from 143 revision total joint arthroplasties...
March 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28243953/the-role-of-biomarkers-for-the-diagnosis-of-implant-related-infections-in-orthopaedics-and-trauma
#6
Abtin Alvand, Maryam Rezapoor, Javad Parvizi
Diagnosis of implant-related (periprosthetic joint) infections poses a major challenge to infection disease physicians and orthopaedic surgeons. Conventional diagnostic tests continue to suffer from issues of accuracy and feasibility. Biomarkers are used throughout medicine for diagnostic and prognostic purposes, as they are able to objectively determine the presence of a disease or a biological state. There is increasing evidence to support the measurement of specific biomarkers in serum and/or synovial fluid of patients with suspected periprosthetic joint infections...
February 28, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28212115/predictor-of-hand-radiological-progression-in-patients-with-rheumatoid-arthritis-receiving-tnf-antagonist-therapy-by-change-in-grayscale-synovitis-a-preliminary-study
#7
Ying-Chou Chen, Fu-Mei Su, Shih-Wei Hsu, Jia-Feng Chen, Tien-Tsai Cheng, Han-Ming Lai, Wen-Chan Chiu
OBJECTIVES: This prospective study aimed to compare synovial ultrasound scores to conventional measures (DAS28, CRP levels) in predicting radiographic progression in patients with rheumatoid arthritis under TNF antagonist therapy. METHODS: Patients with RA who received TNF antagonist therapy were enrolled, all of whom underwent clinical, laboratory, and ultrasonographic assessments with grayscale and power Doppler assessments of bilateral elbows (anterior and posterior recess), wrists (dorsal, palmar, and ulnar aspects), second and third MCP joints (dorsal and palmar recess), and PIP II and III (dorsal and palmar) at baseline and at 1, 3 months...
March 2017: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
https://www.readbyqxmd.com/read/28149700/retrospective-study-of-prognostic-factors-in-pediatric-invasive-pneumococcal-disease
#8
Nan-Chang Chiu, Hsin Chi, Chun-Chih Peng, Hung-Yang Chang, Daniel Tsung-Ning Huang, Lung Chang, Wei-Te Lei, Chien-Yu Lin
Streptococcus pneumoniae remains the leading causative pathogen in pediatric pneumonia and bacteremia throughout the world. The invasive pneumococcal disease (IPD) is known as isolation of S. pneumoniae from a normally sterile site (e.g., blood, cerebrospinal fluid, synovial fluid, pericardial fluid, pleural fluid, or peritoneal fluid). The aim of this study is to survey the clinical manifestations and laboratory results of IPD and identify the prognostic factors of mortality. From January 2001 to December 2006, a retrospective review of chart was performed in a teaching hospital in Taipei...
2017: PeerJ
https://www.readbyqxmd.com/read/28134047/effectiveness-of-leucocyte-esterase-as-a-diagnostic-test-for-acute-septic-arthritis
#9
V K Gautam, Rishabh Saini, Siddharth Sharma
BACKGROUND: We hypothesized that leucocyte esterase strip test can aid in diagnosing septic arthritis in native synovial fluid because leucocyte esterase concentrations would be elevated at the infection site because of secretion by recruited neutrophils. METHOD: The cohort included 27 patients (suspected septic arthritis and normal subjects). A standard chemical test strip (graded as negative, trace, +, ++ or +++) was used to detect the presence of leucocyte esterase...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28108745/leukocyte-esterase-as-a-biomarker-in-the-diagnosis-of-periprosthetic-joint-infection
#10
Chi Wang, Rui Li, Qi Wang, Jinyan Duan, Chengbin Wang
BACKGROUND Total joint arthroplasty (TJA) has been one of the most rewarding interventions for treating patients suffering from joint disorders. However, periprosthetic joint infection (PJI) is a serious complication that frequently accompanies TJA. Our study aimed to investigate the application of the leukocyte esterase (LE) strip in the diagnosis of PJI. MATERIAL AND METHODS From October 2014 to July 2015, 72 patients who had undergone joint puncture after arthroplasty in our hospital were enrolled in this trial...
January 21, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27987492/-significance-and-diagnostic-value-of-synovial-fluid-anti-cyclic-citrullinated-peptide-antibody-and-anti-mutated-citrullinated-vimentin-antibodies-in-patients-with-serum-negative-rheumatoid-arthritis
#11
S J Qu, H Ye, R L Jia, Z G Li
OBJECTIVE: To explore the significance of synovial fluid (SF) anti-cyclic citrullinated peptide (CCP) antibodies and anti-mutated citrullinated vimentin (MCV) antibodies in the diagnosis of serum negative rheumatoid arthritis (SNRA). METHODS: Enzyme linked immunosorbent assay (ELISA) method was apllied in the detection of two groups of patients with knee joint fluid resistance against CCP antibody and antibody of MCV, the experimental group to SNRA patients, a total of 29 cases, and the control for patients with osteoarthritis (OA), a total of 28 cases, and clinical manifestations and laboratory parameters of the two groups were collected...
December 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/27979408/aseptic-lymphocytic-dominated-vasculitis-associated-lesions-scores-do-not-correlate-with-metal-ion-levels-or-unreadable-synovial-fluid-white-blood-cell-counts
#12
Darren R Plummer, Paul H Yi, Joshua J Jacobs, Robert M Urban, Mario M Moric, Craig J Della Valle
BACKGROUND: Failed metal-on-metal (MoM) bearings are being increasingly encountered with little information to guide evaluation for aseptic lymphocytic-dominated vasculitis-associated lesions (ALVAL). It is often assumed that elevated metal ion levels correlate with the occurrence of ALVAL. Our purpose was to determine the utility of the erythrocyte sedimentation rate, C-reactive protein, synovial white blood cell count, differential (%PMN), and serum metal ion levels in diagnosing ALVAL...
November 22, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27965310/rare-cause-of-back-pain-staphylococcus-aureus-vertebral-osteomyelitis-complicated-by-recurrent-epidural-abscess-and-severe-sepsis
#13
Louise Dunphy, Shabnam Iyer, Christopher Brown
An epidural abscess represents a rare acute medical emergency, with a reported incidence of 2.5/10 000 hospital admissions annually. The clinical features include fever, spinal pain, radiating nerve root pain and leg weakness. When sepsis is present, prompt recognition is required to initiate appropriate antimicrobial therapy and surgical decompression. We present the case of a man aged 68 years presenting to the emergency department with a 3-day history of fever, low back, right hip and leg pain. He was hypoxic, tachycardic and hypotensive...
December 13, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27941198/-clinical-and-ultrasound-assessment-of-the-disease-activity-in-patients-with-rheumatoid-arthritis
#14
Bożena Targońska-Stępniak, Mariusz Piotrowski, Robert Zwolak, Maria Majdan
INTRODUCTION: Rheumatoid arthritis (RA) is a chronic, systemic, inflammatory disease, leading to irreversible joint destruction and deformities. The adequate assessment of the disease activity enables the correct choice of therapy and evaluation of the treatment efficacy. The aim of the study was to compare different methods of assessment of the disease activity, using clinical data and ultrasonography (US) of joints, in patients with RA, in daily clinical practice. MATERIAL AND METHODS: The study group consisted of 68 patients with RA...
2016: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/27894951/a-pilot-study-of-cxcl8-levels-in-crystal-proven-gout-patients-during-allopurinol-treatment-and-their-association-with-cardiovascular-disease
#15
Laura Kienhorst, Hein Janssens, Timothy Radstake, Piet van Riel, Johannes Jacobs, Elly van Koolwijk, Ellen van Lochem, Matthijs Janssen
OBJECTIVES: Gout is associated with cardiovascular diseases, and systemic inflammation has a role in this. CXCL8 (interleukin-8) levels were increased in synovial fluid of gout patients, and in serum in gout patients irrespective of their disease activity. We hypothesized that the well-known cardiovascular protective effects of allopurinol could be related to effects of this drug on CXCL8 levels. METHODS: Patients with a crystal proven gout diagnosis, who newly started allopurinol treatment, were included in this prospective cohort study...
November 25, 2016: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/27878500/anti-inflammatory-and-antioxidant-effect-of-kerabala-a-value-added-ayurvedic-formulation-from-virgin-coconut-oil-inhibits-pathogenesis-in-adjuvant-induced-arthritis
#16
M Ratheesh, S Sandya, C Pramod, S Asha, Jose P Svenia, S Premlal, B GrishKumar
Kerabala (CB) is a novel ayurvedic formulation used for treating various inflammatory diseases. This formulation was made from virgin coconut oil and it comprises extracts of Sida cordifolia, coconut milk and sesame oil. The current study was performed to evaluate the anti-inflammatory action of CB on carrageenan-induced acute and adjuvant-induced chronic experimental models. 5 mg/kg bwt was found to be potent dose from carrageenan model and evaluated its effect in adjuvant-induced chronic arthritic model...
February 2017: Inflammopharmacology
https://www.readbyqxmd.com/read/27852377/-predictive-value-of-dynamic-enhanced-mr-synovial-wash-in-rate-in-progression-to-rheumatoid-arthritis-in-patients-with-undifferentiated-arthritis
#17
H X Li, J Qu, Y Zhan, X W Lei
Objective: To investigate the predictive value of dynamic enhanced MR synovial wash in rate (WASHIN) in progression to rheumatoid arthritis (RA) in patients with undifferentiated arthritis (UA). Methods: The data of dynamic enhanced MR synovial WASHIN and C- reactive protein (CRP) of 33 patients with UA were analyzed between October 2014 and January 2016 from Tianjin First Center Hospital, so as to evaluate the correlation between the two indicators. According to the value of CRP, the patients were divided into two groups, the CRP>8 mg/L for CRP positive group (18 cases), CRP≤8 mg/L for CRP negative group (15 cases)...
November 8, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27832086/serum-calprotectin-discriminates-subclinical-disease-activity-from-ultrasound-defined-remission-in-patients-with-rheumatoid-arthritis-in-clinical-remission
#18
Jana Hurnakova, Hana Hulejova, Jakub Zavada, Martin Komarc, Petra Hanova, Martin Klein, Herman Mann, Olga Sleglova, Marta Olejarova, Sarka Forejtova, Olga Ruzickova, Jiri Vencovsky, Karel Pavelka, Ladislav Senolt
OBJECTIVE: Clinical remission in some patients with rheumatoid arthritis (RA) may be associated with ongoing synovial inflammation that is not always detectable on clinical examination or reflected by laboratory tests but can be visualized by musculoskeletal ultrasound. The goal of our study was to determine the levels of serum calprotectin, a major leukocyte protein, in patients with RA in clinical remission and to investigate the ability of serum calprotectin levels to distinguish patients in ultrasound-defined remission from those with residual ultrasound subclinical inflammation...
2016: PloS One
https://www.readbyqxmd.com/read/27826220/chitinase-3-like-1-is-produced-by-human-th17-cells-and-correlates-with-the-level-of-inflammation-in-juvenile-idiopathic-arthritis-patients
#19
Manuela Capone, Laura Maggi, Veronica Santarlasci, Maria Caterina Rossi, Alessio Mazzoni, Gianni Montaini, Rolando Cimaz, Matteo Ramazzotti, Marie Pierre Piccinni, Giusi Barra, Raffaele De Palma, Francesco Liotta, Enrico Maggi, Sergio Romagnani, Francesco Annunziato, Lorenzo Cosmi
BACKGROUND: CHI3L1 is a chitinase-like protein without enzymatic activity, produced by activated macrophages, chondrocytes, neutrophils. Recent studies on arthritis, asthma, and inflammatory bowel diseases suggest that chitinases are important in inflammatory processes and tissue remodeling, but their production by human T cells, has never been reported. METHODS: A microarray analysis of gene expression profile was performed on Th17 and classic Th1 cell clones and CHI3L1 was found among the up-regulated genes on Th17 cells...
2016: Clinical and Molecular Allergy: CMA
https://www.readbyqxmd.com/read/27793205/measurement-of-serum-c-reactive-protein-concentration-for-discriminating-between-suppurative-arthritis-and-osteoarthritis-in-dogs
#20
Anna Hillström, Jonas Bylin, Ragnvi Hagman, Karin Björhall, Harold Tvedten, Kristian Königsson, Tove Fall, Mads Kjelgaard-Hansen
BACKGROUND: In a dog with joint pain, it is important to determine whether it has suppurative joint disease, characterized by exudation of neutrophils in the synovial fluid, or not, as this affects choice of diagnostic tests and treatments. The aim of this study was to evaluate whether measurement of serum C-reactive protein (CRP) concentration could be used to discriminate between dogs with suppurative arthritis and osteoarthritis (OA). Furthermore, the concentrations of serum and synovial fluid interleukin (IL) 6 concentrations were measured in dogs with joint disease and in healthy dogs, and were correlated to serum CRP concentrations...
October 28, 2016: BMC Veterinary Research
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