Rheumatica Acta: Open Access最新文献

{"title":"Are Leukocyte Esterase (LE) strip and Alpha-Defensin kit reliable enough to diagnose peri-prosthetic joint infection, intra-operatively?","authors":"Gill Usman Nazir, Hamid Adeel, Uddin Shuja, Shair Naveed Ali, Qasim Muhammad, Mian Muhammad Hanif, Mehboob Irfan","doi":"10.17352/raoa.000014","DOIUrl":"https://doi.org/10.17352/raoa.000014","url":null,"abstract":"Background: Despite improvement in sterilization techniques, peri-prosthetic joint infection (PJI) is the most fearsome complication after hip and knee arthroplasties. Various strategies have been devised from time to time to diagnose and treat PJI. Recently, Leukocyte esterase and alpha-defensin are identified as markers of active infection in synovial fluid. Therefore, kits are designed to detect these two markers during surgery. If found reliable, these tests will increase the confidence of surgeons in situations, where the diagnosis of PJI is not established. Material and methods: This study was conducted on 132 patients in Lahore General Hospital; from August 2020 to December 2021. Leukocyte Esterase strip and Alpha-Defensin kit were used to detect infection in synovial samples taken just before performing arthrotomy, intra-operatively. Patients were divided into 2 groups, Group-A had 31 patients with peri-prosthetic joint infection (PJI) diagnosed as per Musculoskeletal Infection Society (MSIS) criteria, whereas in Group B 101 patients were present in whom PJI was not present. Synovial tissue and fluid samples were also sent to a laboratory for culture and histopathology; so that sensitivity and specificity of LE strips and Alpha-Defensin Kits could find out. Results: The mean age of patients in our study was 59.6 SD 11.90 years with a male to female ratio of 85:47. 31 patients were diagnosed as PJI after primary hip or knee arthroplasty based on serological investigations and culture of joint aspiration. The sensitivity and specificity of LE strips were 90.32% and 95.04%, whereas that of Alpha defensin was 93.54% and 100% respectively. The correlation coefficient between the LE strip test and synovial fluid polymorphonuclear neutrophils (PMN) counts was 0.811 and it was even higher when the Alpha-Defensin kit was used (0.845). Conclusion: Both LE and Alpha-Defensin kits are highly specific and sensitive in diagnosing PJI. Though Alpha-defensin is more accurate the cost-effectiveness of the LE strip makes it a more feasible option in diagnosing PJI, intra-operatively.","PeriodicalId":381426,"journal":{"name":"Rheumatica Acta: Open Access","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126377363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Usefulness of PCR for diagnosing Meningococcal Septic Arthritis","authors":"Sylvain Raoul Simeni Njonnou, M. Soyfoo, F. Vandergheynst","doi":"10.17352/raoa.000010","DOIUrl":"https://doi.org/10.17352/raoa.000010","url":null,"abstract":"We report the case of a 60-year-old female patient who presented meningoencephalitis due to Neisseria meningitidis serogroup B in November 2018. She was admitted at the emergency department for febrile confusion lasting two days associated with one episode of vomiting.","PeriodicalId":381426,"journal":{"name":"Rheumatica Acta: Open Access","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128298930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can NMR (Nuclear Magnetic Resonance) spectroscopy serve as a diagnostic tool for Rheumatoid Arthritis?","authors":"N. Srivastava","doi":"10.17352/RAOA.000009","DOIUrl":"https://doi.org/10.17352/RAOA.000009","url":null,"abstract":"Rheumatoid arthritis (RA) is a general, chronic, systemic and autoimmune inflammatory disease. This disease represents the inflammatory response of the synovium resulting to hyperplasia of synovial cells along with associated destruction of cartilage, bone and ligaments, eventually leading to deformity of the joints. There is a considerable alteration observed in the metabolism. Chronic inflammation is responsible for altering the metabolism and also the metabolic profile of an individual patient with early inflammatory arthritis expects the following route of disease. These metabolic changes would identify biomarkers, which may be useful for the diagnostic purposes. NMR (nuclear magnetic resonance) spectroscopy based metabolomics studies of serum, urine and synovial fluid of RA were performed. These studies reflected the possibility of the development of metabolomics based diagnostic methods for RA. So, our question “Can NMR (Nuclear Magnetic Resonance) spectroscopy serve as a diagnostic tool for rheumatoid arthritis?” will definitely get an answer with the development of NMR based diagnostic method for RA.","PeriodicalId":381426,"journal":{"name":"Rheumatica Acta: Open Access","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130433619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}