Follow-up of Osteomyelitis of Infants with Systemic Serum Parameters and Bone Scintigraphy

Summary Aim: To prevent orthopedic sequelae in acute hematogenous pyogenic osteomyelitis (AHPO) of infants early diagnosis, recognition of recurrence and effective therapy is needed. This retrospective study of 47 infants with bacteriologically confirmed AHPO concerned with an analysis of the diagnostic value of systemic serum parameters compared to bone scintigraphy (BSC). Methods: AHPO was characterized initially and during the course of disease by clinical findings, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), total and differential white blood cell (WBC) count, BSC, and plain radiography. Results: CRP was the most effective serum parameter for follow- up of disease. The first sign of BSC to signal adequate response to antibiotic treatment was the decrease or normalization of hyperperfusion. Escape from therapy or poor prognosis, even when the serum parameters were normalized, was signaled by the recurrence of focal hyperperfusion and the persistent or increasing local uptake ratios on the 3-h-image over 6 weeks during a course of antibiotic treatment. Conclusion: Antibiotic treatment masks the clinical presentation, and the radiographic findings, causes non-characteristic laboratory findings, but do not prevent the scintigraphic visualization; BSC and serum parameters used in the right completion are the most successful and efficient modalities for follow-up of AHPO. Maintenance of antibiotic therapy should be done until BSC findings have reverted to normal.

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Clinical and laboratory findings in the diagnosis of right lower quadrant abdominal pain: outcome analysis of the APPAC trial

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2015-0981 ◽

2016 ◽

Vol 54 (10) ◽

Cited By ~ 5

Author(s):

Elina Lietzén ◽

Imre Ilves ◽

Paulina Salminen ◽

Hannu Paajanen ◽

Tero Rautio ◽

...

Keyword(s):

Acute Appendicitis ◽

Antibiotic Treatment ◽

Roc Curves ◽

Multicenter Trial ◽

Clinical Findings ◽

Outcome Analysis ◽

Laboratory Findings ◽

Duration Of Symptoms ◽

Lower Quadrant ◽

Wbc Count

AbstractBackground:The current research on acute appendicitis aims to improve the diagnostics and to clarify to whom antibiotic treatment might be the treatment of choice.Methods:The present study is a retrospective analysis of a prospectively collected data in our randomized multicenter trial comparing surgery and antibiotic treatment for acute uncomplicated appendicitis (APPAC trial, NCTO1022567). We evaluated 1321 patients with a clinical suspicion of acute appendicitis, who underwent computed tomography (CT). Age, gender, body temperature, pain scores, the duration of symptoms, white blood cell count (WBC) and C-reactive protein (CRP) were recorded on admission.Results:CT confirmed the diagnosis of acute appendicitis in 73% (n=970) and in 27% (n=351) it revealed no or other diagnosis. Acute appendicitis patients had significantly higher WBC levels than patients without appendicitis (median 12.2 and 10.0, respectively, p<0.0001), whereas CRP levels did not differ between the two groups. Ideal cut-off points were assessed with receiver operating characteristic (ROC) curves, but neither these markers or neither their combination nor any clinical characteristic could accurately differentiate between patients with acute appendicitis and those without. The proportion of patients with normal WBC count and CRP was significantly (p=0.0007) lower in patients with acute appendicitis than in patients without appendicitis.Conclusions:Both clinical findings and laboratory tests are unable to reliably distinguish between patients with acute appendicitis and those without. If both WBC count and CRP are normal, acute appendicitis is very unlikely. The current results emphasize the role of CT imaging in patients with suspected acute appendicitis.

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Diagnostic Tests and Clinical, Laboratory and Radiological Charactersitics of COVID-19 in Pregnant Women: A Review

The Journal of Qazvin University of Medical Sciences ◽

10.32598/jqums.24.2.2392.1 ◽

2020 ◽

Vol 24 (2) ◽

pp. 146-157

Author(s):

Sedigheh Hasani Moghadam ◽

◽

Abbas Alipour ◽

Saeid Abedian Kenari ◽

Soghra Khani ◽

...

Keyword(s):

Pregnant Women ◽

Clinical Laboratory ◽

Ground Glass Opacity ◽

Clinical Findings ◽

Diagnostic Methods ◽

Laboratory Findings ◽

Radiographic Findings ◽

Controllable Factors ◽

Second Category ◽

Do So

The emerging Coronavirus (COVID-19) is a new infectious disease and the definitive gold standard for its diagnosis in pregnancy has not yet been established. Therefore, this study was conducted with the aim of reviewing the diagnostic methods and clinical, laboratory and radiological symptoms of COVID-19 disease in pregnant women. The present study is a Narrative review. To do so, the keywords were searched in the Scopus, Google scholar, PubMed, Embase, Science Direct, WHO databases from April 1, 2020 to May 9, 2020. 34 articles were obtained and finally 6 articles were used to write this study. Evidence related to the purpose of this study was identified in three categories. The first category examines clinical findings (fever and cough), the second category examines laboratory findings (leukocytosis and lymphopenia), and a third category examines chest radiographic findings (Pure ground-glass opacity). Since infection is one of the most important causes of death in pregnant women and is one of the preventable and controllable factors, so by identifying the correct diagnostic methods of this infection, at-risk pregnant women will be identified and Prevent the consequences of this infection.

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RARE-38. CNS LYMPHOMA INVOLVING HYPOTHALAMIC-PITUITARY AXIS

Neuro-Oncology ◽

10.1093/neuonc/noz175.961 ◽

2019 ◽

Vol 21 (Supplement_6) ◽

pp. vi229-vi229

Author(s):

Dong-Won Shin ◽

Hee Jun Yoo ◽

Jeong Hoon Kim

Keyword(s):

B Cell Lymphoma ◽

Visual Disturbance ◽

Clinical Findings ◽

Endoscopic Biopsy ◽

Cns Lymphoma ◽

Laboratory Findings ◽

Radiographic Findings ◽

Female Ratio ◽

Perilesional Edema ◽

Hypothalamic Pituitary Axis

Abstract BACKGROUND It is rare for CNS lymphoma which involves the hypothalamic-pituitary axis. It could result in misdiagnoses such as pituitary adenoma, craniopharyngioma, or glioma. We report clinical findings of eight cases of either primary or secondary lymphoma involving the hypothalamic-pituitary axis(H-P axis). METHODS We retrospectively reviewed 488 patients who were diagnosed as CNS lymphoma from 2000 to 2017 in our institute. There were eight patients (8/488, 1.6%) who had H-P axis involvement in radiographic findings while six patients received chemotherapy. We analyzed patient characteristics, pathologies, clinical features, laboratory findings, imaging, and treatment outcome. RESULTS The mean age was 48-year-old (range 18~80) and male to female ratio was 5:3. We performed endonasal TSA for four patients, endoscopic biopsy for two patients, and stereotactic biopsy for two patients. There were six patients of diffuse large B-cell lymphoma and two patients of MALT lymphoma. Seven patients were PCNSL and one patient was metastasized lymphoma. All patients had hormone imbalance whereas three patients had visual disturbance and one patient had diabetes insipidus. Initial serum LDH was 337±167IU/L(range 169~567 except one patient). MRI finding was different from the usual pattern which was low SI in T1 and high SI with perilesional edema in T2, on the other hands, our patients group revealed that five patients(62.5%) had iso SI in both T1 and T2, and only two patients(25%) showed perilesional edema in T2. Median OS and PFS of six patients who received chemotherapy were 34.8 months(range 0.9~93.7) and 33.0 months(range 0.9~93.4), respectively. Two patients(25%) died in 26 days and 51 days after diagnosis because of pneumonia and cardiac arrest, respectively. And one patient lost to follow up after diagnosis. CONCLUSION CNS lymphoma involving H-P axis is rare, however, we need to understand its unique characteristic.

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Is less more? Assessing the utility of early clinical and radiographic follow-up for operative supracondylar humerus fractures

Journal of Children s Orthopaedics ◽

10.1302/1863-2548.12.180054 ◽

2018 ◽

Vol 12 (5) ◽

pp. 502-508 ◽

Cited By ~ 1

Author(s):

R. M. Thompson ◽

E. W. Hubbard ◽

M. Elliott ◽

A. I. Riccio ◽

D. J. Sucato

Keyword(s):

Postoperative Complications ◽

Clinical Findings ◽

Late Complications ◽

Percutaneous Pinning ◽

Level Of Evidence ◽

Radiographic Findings ◽

Clinic Appointment ◽

Supracondylar Humerus Fractures ◽

Humerus Fractures

PurposePostoperative protocols following surgical management of supracondylar humerus fractures (SCFs) are often based upon surgeon preference rather than clinical merit. The purpose of this study is to determine the utility of early clinical and radiographic follow-up.MethodsA retrospective review of patients who underwent closed reduction and percutaneous pinning (CRPP) for SCF between 2009 and 2015 was performed using a database of prospectively-collected consecutive patient data. Previously undiagnosed neuropathies documented at the first postoperative visit were identified. Unscheduled visits and postoperative complications were compared between patients who were seen at one week and those with delayed first clinic visits.ResultsOf 873 patients, 823 (94.3%) were seen within ten days of surgery (early follow-up) and 50 (5.7%) had a delayed first clinic appointment. Among patients seen for early follow-up, 12 (1.5%) had a previously undocumented neuropathy diagnosed but only eight (1%) had an alteration of management secondary to clinical findings. Greater than 90% of patients seen for early follow-up had radiographs performed, but only one had an alteration in management due to radiographic findings. Patients seen for early follow-up had the same rate of unscheduled visits (2.9% versus 4%, p = 0.66) and postoperative complications (1.6% versus 0%, p > 0.99) as those with delayed first appointments. Radiographic parameters were comparable at final follow-up (Baumann’s angle 74.5° versus 73.7°, p = 0.40; lateral humeral condylar angle 40.2° versus 41.2°, p = 0.53).ConclusionThe early follow-up visit after CRPP of SCF rarely leads to alterations in care and does not reduce unscheduled visits or late complications.Level of EvidenceLevel IV

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Interpretation of Clinical and Laboratory Findings of Patients with Lupus Nephritis According to the Results of Biopsy

Zahedan Journal of Research in Medical Sciences ◽

10.5812/zjrms.86588 ◽

2021 ◽

Vol In Press (In Press) ◽

Author(s):

Parviz Soufivand ◽

Abdolrahman Rostamian ◽

Mohammad Reza Abbasi ◽

Fatemeh Shahbazi

Keyword(s):

Lupus Nephritis ◽

Clinical Manifestations ◽

Study Groups ◽

Diagnostic Value ◽

Clinical Findings ◽

Laboratory Findings ◽

Exact Test ◽

Limb Edema ◽

Severity Of The Disease ◽

Compare Study

Background: There are controversies regarding the diagnosis of lupus nephritis. Also, its clinical manifestations and severity are different from one patient to another. Objectives: The current study aimed to interpret clinical and laboratory features of lupus nephritis according to the results of the biopsy. Methods: Following a retrospective design, 30 patients with lupus, who were candidates for renal biopsy and undergoing kidney biopsy, were studied. Clinical findings (blood pressure and limb edema) and laboratory findings (Cr, ESR, CRP, BUN, C3, C4, CH50, Anti-ds DNA, and hematuria) were gathered. Finally, the diagnostic value of clinical and laboratory findings was interpreted according to the biopsies and the staging of samples in the pathology. Data were analyzed using SPSS. Quantitative variables are displayed using mean and quartiles. Fisher’s exact test was used to compare study groups. Also, independent samples t-test and Levene’s test were used to evaluate variances of quantitative variables. Results: Of 30 cases, 5 had a biopsy of 3 and FSGN. Also, 8 cases were on stages 3 and 4, 9 had a stage of 4 biopsy, and 8 cases were on stage 4 - 5, 5, and 5 - 6. The association between age, Limp edema, ESR, and biopsy was statistically significant (P < 0.05). Conclusions: This study demonstrated the usefulness of clinical and laboratory findings to determine the severity of the disease in the shortest time, mainly due to its easy, non-invasive access and early preparation of the results, which will facilitate the initiation of treatment.

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Prematur e Ejaculation and Chronic Bacterial Prostatitis

Medicine Today ◽

10.3329/medtoday.v29i2.34621 ◽

2017 ◽

Vol 29 (2) ◽

pp. 21-25

Author(s):

Md Shafiqul Islam

Keyword(s):

General Hospital ◽

Antibiotic Treatment ◽

Chronic Prostatitis ◽

Premature Ejaculation ◽

Control Group ◽

Latency Time ◽

Chronic Bacterial Prostatitis ◽

Bacterial Prostatitis ◽

Wbc Count

Premature ejaculation (PE) is regarded as the most common male sexual disorder. Previous studies reported that prostatic inflammation was highly prevalent in PE. However, the effect of antibiotic treatment of cases with PE and chronic prostatitis has not been extensively investigated. To examine the effect of antibiotic treatment in delaying ejaculation in patients with PE and chronic prostatitis. The study was carried out in my private chamber and at General Hospital N.Gong from June 2014 to December 2016. The study was performed with prior permission and the confidentiality was maintained. A total of 135 consecutive men attending of secondary premature ejaculation (SPE) were included in this study. Sequential microbiologic specimens were obtained from urine and prostatic fluids. Antibiotics were given for one month according to the results of their culture and sensitivity test. All patients were instructed to follow up in General Hospital N.Gong/Private chamber monthly for at least 4 months. At the end of the 4-month follow-up, another prostatic secretion analysis was performed. Based on expressed prostatic secretion culture and white blood cell (WBC) count, 84 (62.2%) were having chronic bacterial prostatitis. The remaining 51 (37.8%) patients had negative WBC count. Of the 84 patients with secondary premature ejaculation (SPE) and chronic bacterial prostatitis, 20 patients were left untreated and considered as a control group. All 64 patients with PE and chronic prostatitis continued the 1- month treatment duration. Following 1-month antibiotic treatment, all 64 patients with initially positive cultures had sterile final cultures (P < 0.05). Fifty one (79.68%) patients showed increases in their ejaculatory latency time and reported good control of their ejaculation and were considered treatment responsive. None of the control group patients experienced any improvement either in their prostatic infection condition or in their ejaculation time. The follow-up of treatment-responsive patients (N = 51) revealed no recurrence of PE with negative prostatic culture. Successful eradication of causative organisms in patients with PE and chronic prostatitis may lead to marked improvement in intravaginal ejaculatory latency time and ejaculatory control.Medicine Today 2017 Vol.29(2): 21-25

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Clinical Management of Endo-Perio Lesion Through Guided Tissue Regeneration: a 5 Year Follow-Up

Odovtos - International Journal of Dental Sciences ◽

10.15517/ijds.2021.46204 ◽

2021 ◽

pp. 151-156

Author(s):

Munis Mukhtar ◽

Maaz Asad ◽

Asaad Javaid Mirza

Keyword(s):

Tissue Regeneration ◽

Bone Allograft ◽

Clinical Findings ◽

Guided Tissue Regeneration ◽

Collagen Membrane ◽

Pocket Depth ◽

Radiographic Findings ◽

Freeze Dried ◽

Distal Surface

Progressive periodontal disease causes loss of supporting structures of teeth resulting in deep bony defects. In this case a report of 22-year old female patient is being presented with clinical findings of vertical bone loss in two adjacent teeth, on distal surface of 2nd upper right premolar and mesial surface of upper right 1st molar. Root canal treatment, non-surgical periodontal therapy followed by guided tissue regeneration was carried out using decalcified freeze-dried bone allograft (DFDBA) and collagen membrane. Analysis of clinical and radiographic findings showed marked reduction in pocket depth up to 12mm with hard tissue repair on 3-month, 2-year and 5- year follow ups.

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Clinicoepidemiological Profile and Short term Outcome of Abdominal Tuberculosis in Western Region of Bangladesh

Journal of Bangladesh College of Physicians and Surgeons ◽

10.3329/jbcps.v37i1.39288 ◽

2018 ◽

Vol 37 (1) ◽

pp. 25-29

Author(s):

Madhusudan Saha ◽

SAHM Mesbahul Islam ◽

Irin Perveen ◽

Nasrin Aktar ◽

Kabir Ahmed ◽

...

Keyword(s):

Clinical Laboratory ◽

Clinical Symptoms ◽

Intestinal Tuberculosis ◽

Abdominal Tuberculosis ◽

Clinical Findings ◽

Response To Therapy ◽

Laboratory Findings ◽

Term Outcome ◽

Gold Standard Method

Introduction: Abdominal tuberculosis is not uncommon in daily medical practice. This study was done focusing variable presentations of abdominal tuberculosis Material and methods: Data of consecutive patients diagnosed as abdominal tuberculosis were analyzed. Their epidemiological features, presentations, laboratory findings, and response to therapy were analysed. Result: Total 69 cases (male 43, 62.3%,and female 26, 37.7%), age ranging from 15 to 85 years (mean 36.23) were enrolled. Rural (55, 79.7%), poor (49,71%) and housewives (24, 34.8%) and people of 21-30 years age group (27, 39.1%) were more affected. Diagnosis was based on combinations of clinical, laboratory findings and therapeutic response. In this series 30 (43.5%), 23 (33.4%) and 12 (17.3%) were diagnosed as intestinal, peritoneal and disseminated tuberculosis respectively. Of them68 patients recovered with treatment. Five patients developed intestinal obstruction and one developed hepatitis and lost from follow up. Conclusion: Diagnosis of abdominal tuberculosis is by combinations of clinical findings, without gold standard method. In our series intestinal tuberculosis and peritoneal tuberculosis were common clinical types with weight loss and abdominal pain as common clinical symptoms. And outcome of Treatment of TB was excellent J Bangladesh Coll Phys Surg 2019; 37(1): 25-29

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Follow-up Brucellacapt and Rose Bengal Tests in 110 Children with Brucellosis

Journal of Pediatric Infectious Diseases ◽

10.1055/s-0040-1718882 ◽

2020 ◽

Author(s):

Sevliya Öcal Demir ◽

Fatma Bacalan

Keyword(s):

Rose Bengal ◽

Clinical Findings ◽

Study Data ◽

Favorable Outcome ◽

Response To Treatment ◽

Serological Tests ◽

Laboratory Findings ◽

Loss To Follow Up ◽

Significant Difference

Abstract Objective The interpretation of serologic tests in brucellosis can be difficult because of nonspecific symptoms and vague signs of disease, and limitations of serological tests to distinguish persistent and cleared infection. Here, we evaluated the role of Brucellacapt test in conjunction with Rose Bengal test (RBT) in the follow-up of children treated for brucellosis. Methods A total of 174 children diagnosed with brucellosis were included in the study. Data about demographic characteristics of patients, clinical and laboratory findings including Brucellacapt and RBT results, therapeutic approach, and response to treatment were collected from medical records. Results Of the 174 cases, 109 (62.6%) were boys and 65 (37.4%) were girls. The mean age of children at the diagnosis was 122 ± 54 months. Sixty-four cases were excluded from the study for loss to follow-up. The follow-up period for the remained 110 cases was 4.3 ± 2.9 months. Eleven cases (10%) had persistent illness, 7 (6.4%) had recurrence/relapse, and 92 had favorable outcome. During the follow-up, Brucellacapt titers did not drop under 1/320 in cases with persistent illness, and it increased again to 1/320 in cases with relapses at average 6.1 months after treatment. In 48 of cases with favorable outcome, Brucellacapt titers decreased to 1/160 in average 3.3 ± 1.8 months; in 35 cases, RBT became negative in average 3.8 ± 2.5 months, and there was no statistically significant difference between them (p = 0.241). In cases with higher Brucellacapt titers on admission, decrement of titers took longer time. Conclusion Persistent serological titers without clinical findings of brucellosis should not lead physician to prolong or repeat treatment because the decline in Brucellacapt titers and RBT negativity may be delayed in contrast to clinical recovery.

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