5 Bacterial antigens in reactive arthritis and spondarthritis. Rational use of laboratory testing in diagnosis and follow-up

1998 ◽  
Vol 12 (4) ◽  
pp. 627-647 ◽  
Author(s):  
Jürgen Wollenhaupt ◽  
Sebastian Schnarr ◽  
Jens G. Kuipers
Keyword(s):  
Reactive Arthritis ◽  
Laboratory Testing ◽  
Rational Use ◽  
Bacterial Antigens

Assessing Sexual Dysfunction, Part 1: Male Sexual Dysfunction

2016 ◽  
Vol 21 (2) ◽  
pp. 3-8
Author(s):  
Seth D. Cohen ◽  
Steven Mandel ◽  
David B. Samadi
Keyword(s):  
Sexual Dysfunction ◽  
Health Care Professionals ◽  
Laboratory Testing ◽  
Aging Male ◽  
Testosterone Deficiency ◽  
Subjective Complaint ◽  
Validated Questionnaire ◽  
Male Sexual Dysfunction ◽  
Multiple Health

Abstract To properly assess men and women with sexual dysfunction, evaluators should take a biopsychosocial approach that may require consultation with multiple health care professionals from various fields in order to get to the root of the sexual dysfunction; this multidisciplinary methodology offers the best chance of successful treatment. For males, this article focuses on erectile dysfunction (ED) and hypogonadism. The initial evaluation of ED involves a thorough case history, preferably taken from the patient and partner, physical examination, and proper laboratory and diagnostic tests, including an acknowledgment of the subjective complaint. The diagnosis is established on the basis of an individual's report of the consistent inability to attain and maintain an erection sufficient to permit satisfactory sexual intercourse. Initial workups for ED should entail a detailed history that can be obtained from a validated questionnaire such as the International Index of Erectile Function and the Sexual Health Inventory for Men. Hypogonadism is evaluated using the validated Androgen Deficiency in the Aging Male questionnaire and laboratory testing for testosterone deficiency. Treatments logically can begin with the least invasive and then progress to more invasive strategies after appropriate counseling. The last and most important treatment component when caring for men with sexual dysfunction—and, arguably, the least practiced—is close follow-up.

Blood Pressure

PEDIATRICS ◽  
1987 ◽  
Vol 80 (3) ◽  
pp. 459-460
Author(s):  
MYUNG K. PARK
Keyword(s):  
Blood Pressure ◽  
Laboratory Testing ◽  
Normative Data ◽  
Task Force ◽  
Pressure Control ◽  
Proper Treatment ◽  
Blood Institute ◽  
National Heart Lung ◽  
Standards And Guidelines

To the Editor.— Recently the National Heart, Lung, and Blood Institute Task Force on Blood Pressure Control in Children published revised normal BP standards and guidelines for children.1 I welcome this effort, as reliable normative data have been unavailable but are prerequisite for the early detection of hypertension and its proper treatment. The guidelines published by the Task Force for the detection of hypertension, the diagnostic evaluation, follow-up laboratory testing, and treatment are, in my opinion, excellent.

Rhabdomyolysis in a Female Caucasian Adolescent Distance Runner: A Case Report

2016 ◽  
Vol 21 (6) ◽  
pp. 26-32 ◽  
Author(s):  
R. Mitchell Todd ◽  
Michelle Cleary ◽  
J. Susan Griffith
Keyword(s):  
Case Report ◽  
Laboratory Testing ◽  
Heat Stroke ◽  
Distance Runner ◽  
Heat Illness ◽  
Adolescent Female ◽  
Systemic Symptoms ◽  
Return To Competition

We present the case of an adolescent female collegiate distance runner competing in her first 6K race. She presented with multiple systemic symptoms of dizziness, nausea, confusion, muscle cramping, and syncope. The patient was immediately treated for heat stroke and, on follow-up, reported to the AT with a headache, lack of appetite, muscle aches, and dark-colored urine. Rhabdomyolysis should be considered following a heat illness event with necessary treatments performed immediately. Symptomatic patients must be referred to a physician for evaluation and laboratory testing. We present recommendations for a supervised return-to-participation protocol and acclimatization to safely return to competition readiness.

scholarly journals Reactive Arthritis Secondary to Cauda Equina Injury following Spine Fracture: A Case Report

2011 ◽  
Vol 2011 ◽  
pp. 1-3
Author(s):  
Xiao Li ◽  
Shaoling Wu ◽  
Chao Ma
Keyword(s):  
Urinary Tract Infection ◽  
Reactive Arthritis ◽  
Early Recognition ◽  
Burst Fracture ◽  
Cauda Equina ◽  
Spine Fracture ◽  
Appropriate Treatment ◽  
Delayed Initiation ◽  
History Of

A 38-year-old man presented with a one-month history of muscle weakness and dysesthesia in the lower extremities, urinary retention, and urinary tract infection after lumbar burst fracture resulted from high fall. During the rehabilitation in our hospital, he had arthritis in both the ankle and knee. However, the patient was treated as gouty arthropathy initially. The arthritis was completely remitted in a few days after the patient was diagnosed as reactive arthritis and started with sulfasalazine therapy and there was no recurrence during 4 months of follow-up. Based on this case, early recognition of reactive arthritis is of major importance to avoid delayed initiation of appropriate treatment in the patients with polyarthritis secondary to neurogenic bladder following cauda equina injury after spine fracture.

scholarly journals Reactive arthritis and other musculoskeletal symptoms associated with acquisition of diarrhoeagenic Escherichia coli (DEC)

2020 ◽  
Vol 79 (5) ◽  
pp. 605-611
Author(s):  
Riitta Tuompo ◽  
Tinja Lääveri ◽  
Timo Hannu ◽  
Sari H Pakkanen ◽  
Juha Kirveskari ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Multivariate Analysis ◽  
Antibiotic Treatment ◽  
Reactive Arthritis ◽  
Musculoskeletal Symptoms ◽  
E Coli ◽  
Increased Risk ◽  
Stool Samples ◽  
Study Participants

ObjectivesUsing a prospective research design, we evaluated the association between acquisition of diarrhoeagenic Escherichia coli (DEC) and development of reactive arthritis (ReA) and other reactive musculoskeletal (MSK) symptoms among international travellers.MethodsA total of 526 study participants were asked to provide pretravel and post-travel stool samples and fill in questionnaires (pretravel, post-travel and 3-week follow-up). A multiplex quantitative PCR assay was deployed to detect five DEC comprising enteroaggregative E. coli, enteropathogenic E. coli, enterotoxigenic E. coli, enterohaemorrhagic E. coli and enteroinvasive E. coli and Salmonella, Shigella, Campylobacter, Yersinia, and Vibrio cholerae. Multivariate analysis was employed to identify factors predisposing to MSK symptoms. New post-travel MSK symptoms reported by participants with DEC were assessed by phone interviews and, if needed, clinically confirmed.ResultsFrom among the total of 224 volunteers who returned all questionnaires and stool specimens, 38 (17.0%) reported MSK symptoms. Multivariate analysis revealed that acquisition of DEC was associated with MSK symptoms (OR 3.9; 95% CI 1.2 to 13.3). Of the 151 with only-DEC, four (2.6%) had ReA, two (1.3%) reactive tendinitis and three (2.0%) reactive arthralgia. ReA was mostly mild, and all patients with ReA were negative for human leucocyte antigen B27. Antibiotic treatment of travellers’ diarrhoea did not prevent development of MSK symptoms.ConclusionA total of 17% of volunteers reported post-travel MSK symptoms. DEC acquisition was associated with an increased risk of developing them, yet the ReA incidence remained low and the clinical picture mild. Antibiotic treatment did not protect against development of MSK symptoms.

scholarly journals Impact of optimal follow-up of monoclonal gammopathy of undetermined significance on early diagnosis and prevention of myeloma-related complications

Blood ◽  
2010 ◽  
Vol 116 (12) ◽  
pp. 2019-2025 ◽  
Author(s):  
Giada Bianchi ◽  
Robert A. Kyle ◽  
Colin L. Colby ◽  
Dirk R. Larson ◽  
Shaji Kumar ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Laboratory Testing ◽  
Monoclonal Gammopathy ◽  
Incidental Finding ◽  
Optimal Frequency ◽  
Future Studies ◽  
Risk Of Progression ◽  
Undetermined Significance

Abstract Monoclonal gammopathy of undetermined significance (MGUS) is associated with a long-term risk of progression to multiple myeloma (MM) or related malignancy. To prevent serious myeloma-related complications, lifelong annual follow-up has been recommended, but its value is unknown. We reviewed all patients from southeastern Minnesota seen at Mayo Clinic between 1973 and 2004 with MGUS who subsequently progressed to MM. Of 116 patients, 69% had optimal follow-up of MGUS. Among these, abnormalities on serial follow-up laboratory testing led to the diagnosis of MM in 16%, whereas MM was diagnosed only after serious MM-related complications in 45%. In the remaining, workup of less serious symptoms (25%), incidental finding during workup of unrelated medical conditions (11%), and unknown (3%) were the mechanisms leading to MM diagnosis. High-risk MGUS patients (≥ 1.5 g/dL and/or non-IgG MGUS) were more likely to be optimally followed (81% vs 64%), and be diagnosed with MM secondary to serial follow-up testing (21% vs 7%). This retrospective study suggests that routine annual follow-up of MGUS may not be required in low-risk MGUS. Future studies are needed to replicate and expand our findings and to determine the optimal frequency of monitoring in higher-risk MGUS patients.

Early treatment of reactive arthritis with etanercept and 2 years follow-up

2017 ◽  
Vol 84 (3) ◽  
pp. 367 ◽  
Author(s):  
Audrey Courcoul ◽  
Olivier Muis Pistor ◽  
Jacques G. Tebib ◽  
Fabienne Coury
Keyword(s):  
Early Treatment ◽  
Reactive Arthritis

Improving follow-up testing in children with Shiga toxin-producing Escherichia coli through provision of a provider information sheet

2020 ◽  
Vol 26 (6) ◽  
pp. 479
Author(s):  
Jack X. Pang ◽  
Jaskaran Singh ◽  
Stephen B. Freedman ◽  
Jianling Xie ◽  
Jia Hu
Keyword(s):  
Escherichia Coli ◽  
Shiga Toxin ◽  
Laboratory Testing ◽  
Laboratory Tests ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Information Sheet ◽  
Positive Stool ◽  
Intervention Zone

The aim of this study was to improve follow-up laboratory testing for children infected by Shiga toxin-producing Escherichia coli (STEC) through the provision of an information sheet to healthcare providers in the province of Alberta, Canada. An information sheet recommending the performance of laboratory tests, every 24–48h until 3 days after diarrhoea resolves or the platelet count stabilises or begins to rise, was sent to all physicians who ordered a STEC-positive stool test as of 1 November 2016. The information sheet was only distributed to physicians in one of the province’s five healthcare delivery zones (i.e. intervention zone). Medical records for children aged <18 years with laboratory confirmed STEC-positive stool samples between November 2014 and November 2018 were reviewed to determine the performance of recommended laboratory tests. Post-intervention, follow-up testing in all categories increased significantly for cases that occurred in the intervention zone, with odds ratios (OR) ranging from 3.02 (95% CI: 1.35–6.78) to 3.94 (95% CI: 1.70–9.16) when compared with pre-intervention. No increase in any of the laboratory testing categories was detected outside of the intervention zone. The provision of a targeted information sheet to healthcare providers improved the monitoring of STEC-infected children.

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