Prospective Study of Bone, lndium-111-Labeled White Blood Cell, and Gallium-67 Scanning for the Evaluation of Osteomyelitis in the Diabetic Foot

1996 ◽  
Vol 17 (1) ◽  
pp. 10-16 ◽  
Author(s):  
Jeffrey E. Johnson ◽  
E. Jeff Kennedy ◽  
Michael J. Shereff ◽  
Neetin C. Patel ◽  
B. David Collier
Keyword(s):  
Blood Cell ◽  
White Blood Cell ◽  
Diagnostic Value ◽  
Clinical Suspicion ◽  
Cell Uptake ◽  
Diabetic Patients ◽  
Bone Scanning ◽  
Diagnostic Efficacy ◽  
Radiographic Findings ◽  
Gallium 67

Twenty-two adult diabetic patients with clinical suspicion of foot and/or ankle infection were prospectively evaluated using radiography, technetium-99m methylene diphosphonate bone scanning (99Tc), indium-111-labeled leukocyte scanning (111In), and gallium-67 scanning (67Ga) to determine the presence of clinically suspected osteomyelitis. Biopsy for culture and histology was performed in 16 patients. The diagnosis of osteomyelitis was confirmed by biopsy in 12 patients. The remaining 10 patients had no evidence of osteomyelitis with long-term follow-up. 99mTc was snown to be of limited valued when used alone in these patients with peripheral neuropathy. 67Ga, either alone or in combination with 99mTc bone scanning, was of little diagnostic value and gave no additional information that was not available from 111In. The combination of three-phase 99mTc and 111In had the highest diagnostic efficacy (100% sensitivity, 80% specificity, and 91% accuracy), followed closely by 111In alone (100% sensitivity, 70% specificity, and 86% accuracy). We conclude that for adult diabetic patients with clinical suspicion of osteomyelitis but no radiographic findings of that disease, 111In alone is an appropriate nuclear medicine evaluation for ruling out infection if it is negative. However, if an area of 111In white blood cell uptake is present, a “simultaneous” 99mTc is often helpful in providing the anatomic correlation to differentiate osteomyelitis from infection that is limited to soft tissue.

Carotid artery intima-media thickness is associated with insulin-mediated glucose disposal in nondiabetic normotensive offspring of type 2 diabetic patients

2007 ◽  
Vol 292 (1) ◽  
pp. E347-E352 ◽  
Author(s):  
Marina Cardellini ◽  
Maria Adelaide Marini ◽  
Simona Frontoni ◽  
Marta Letizia Hribal ◽  
Francesco Andreozzi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Cell ◽  
White Blood Cell Count ◽  
White Blood Cell ◽  
Glucose Disposal ◽  
Diabetic Patients ◽  
Blood Cell Count ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetic

The aim of this study was to investigate whether insulin resistance is independently associated with early manifestations of atherosclerosis. To this end, 176 normotensive offspring of type 2 diabetic patients were subjected to euglycemic hyperinsulinemic clamp to assess insulin sensitivity. Early atherosclerosis was studied by ultrasonography of the common carotid artery. Of the total 176 subjects, 145 were glucose tolerant, 18 had impaired fasting glucose, and 13 had impaired glucose tolerance. Univariate correlations showed that age, body mass index, waist, blood pressure, 2-h postchallenge glucose, fasting insulin, triglycerides, interleukin-6, fibrinogen, and white blood cell count were significantly correlated with carotid intima-media thickness (IMT), whereas HDL cholesterol and glucose disposal showed a negative correlation. A stepwise multivariate regression analysis including sex, age, waist circumference, smoking status, systolic blood pressure, diastolic blood pressure, triglyceride, HDL cholesterol, 2-h postchallenge glucose, plasma IL-6, fibrinogen, white blood cell count, insulin-stimulated glucose disposal, and fasting insulin showed that the four variables that remained significantly associated with carotid IMT were waist circumference, insulin-stimulated glucose disposal, white blood cell count, and diastolic blood pressure, accounting for 33.7% of its variation. These findings support the concept that insulin sensitivity, rather than plasma insulin levels, is associated with early atherosclerosis in nondiabetic normotensive offspring of type 2 diabetic patients.

Symptom Duration and CT Findings in Pediatric Neck Infection

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P69-P69
Author(s):  
Abby C Meyer ◽  
Tyler G Kimbrough ◽  
Marsha Finkelstein ◽  
James D Sidman
Keyword(s):  
Blood Cell ◽  
Ct Scan ◽  
White Blood Cell ◽  
Peritonsillar Abscess ◽  
Symptom Duration ◽  
Duration Of Symptoms ◽  
Radiographic Findings ◽  
Neck Infection ◽  
Cell Counts ◽  
Significant Difference

Objective To test the hypothesis that children with less than 48 hours of localized symptoms of deep space neck infections are less likely to have an abscess on CT than children with at least 48 hours of localized symptoms. Methods Children seen in a tertiary hospital between 2000 and 2007 with infections of the head and neck region, excluding peritonsillar abscess, were identified. Data regarding presentation, physical exam findings, radiographic findings, and treatment were extracted. Results Of 179 children identified, 167 (93.3%) underwent a CT scan of the neck, of which 102 (61.1%) were positive for abscess. The median duration of symptoms in children with and without abscess on CT were the same (48 hours). There was no significant difference in the rate of abscess on CT between children with less than 48 hours of localizing symptoms and 48 or more hours of symptoms at 58.1% and 57.7% respectively (p=0.96). Furthermore, there were no significant difference in gender, C-reactive protein levels, or disease location between children with and without abscess on CT. White blood cell counts were significantly higher in the abscess group (p=0.01), however the median white blood cell count in both groups was above normal. Conclusions Because duration of symptoms does not predict finding of abscess on CT scan in pediatric deep neck space infections, it is appropriate to obtain a CT scan upon presentation in all children with symptoms concerning for deep neck space abscess.

scholarly journals Correlation Between Ultrawide-Field Fluorescence Contrast Results and White Blood Cell Indexes in Diabetic Retinopathy

2021 ◽  
Author(s):  
Lili Huang ◽  
Lele Li ◽  
Min Wang ◽  
Dongmei Zhang ◽  
Yu Song
Keyword(s):  
Diabetic Retinopathy ◽  
Blood Cell ◽  
White Blood Cell ◽  
Microvascular Complications ◽  
White Blood Cells ◽  
Diabetic Patients ◽  
Microvascular Leakage ◽  
Department Of Ophthalmology ◽  
Liver And Kidney ◽  
Fluorescence Contrast

Abstract Background: Diabetic retinopathy (DR) is one of the most common microvascular complications of diabetes. DR involves a state of systemic inflammation, and chronic inflammation can promote microvascular and macrovascular diseases in diabetic patients and accelerate disease progression. Ultrawide-field FFA (UWFA) systems are increasingly being used to examine a wider retina. To explore the correlation between the different manifestations of retinopathy under UWFA and the systemic indicators of white blood cells in patients with diabetic retinopathy .Methods: This retrospective study included the hospitalized DR patients in the Department of Ophthalmology and Endocrinology of the Affiliated Hospital 2 of Nantong University between January 2016 and March 2019. This study examined the correlations between the UWFA examination results and glycated hemoglobin (HbA1c), routine blood tests, blood coagulation function, liver and kidney function, and the neutrophil-to-lymphocyte ratio of patients with clinically diagnosed DR during hospitalization.Results: A total of 115 patients with DR (53 females and 62 males) were included (199 eyes: 102 right eyes and 97 left eyes). UWFA revealed that most eyes (77.4%) had grade 4 microvascular leakage, 52.8% had grade 0 capillary non-perfusion area, 59.3% had grade 0 neovascularization, and 92.0% had grade 0 fibrous proliferative membranes. Microvascular leakage was correlated with the NLR (r=0.186, P=0.027). Capillary non-perfusion area was correlated with the monocyte ratio (r=0.144, P=0.042) and the eosinophil ratio (r=0.123, P=0.044). Neovascularization was correlated to the monocyte ratio (r=0.324, P=0.018). Finally, the fibrous proliferative membrane was correlated to the monocyte ratio (r=0.418, P=0.002). Only the eosinophil ratio was independently associated with proliferative DR (odds ratio=1.25, 95% confidence interval: 1.04-1.51, P=0.018).Conclusion: The results of UWFA imaging in patients with DR are correlated with white blood cell population indexes. The eosinophil ratio was independently associated with proliferative DR.

Sign in / Sign up

Export Citation Format

Share Document