scholarly journals The Promising Role of Dynamic 18F-NaF PET-CT in Diagnosing Symptomatic Joint Prosthesis

2015 ◽  
Vol 1 (2) ◽  
Author(s):  
Olu Adesanya ◽  
Pedro Foguet ◽  
Charles Hutchinson
Keyword(s):  
Cell Count ◽  
White Cell Count ◽  
Joint Prosthesis ◽  
C Reactive Protein ◽  
Septic Loosening ◽  
Reactive Protein ◽  
Pet Ct

Our purpose was to establish proof of principle case study for the use of dynamic 18F-NaF PET-CT in the assessment of knee and hip prostheses. Approval was granted by the research ethics committee and informed<br />consent was obtained. This is a case study investigating the role of dynamic 18F NaF PET-CT in a patient with ilateral knee prostheses (1 symptomatic/painful and 1 asymptomatic). Both knees were studied with dynamic 18F-NaF PET-CT technique to demonstrate the different pattern of uptake in normal/asymptomatic joint as well as painful joints with aseptic loosening. In addition, a knee aspirate was obtained from the symptomatic knee and serum C-reactive protein and erythrocyte sediment rate levels as well as a peripheral white cell count were<br />obtained in addition to 12 month clinical follow up. Images were obtained with multi-sequential dynamic image acquisition in list mode using GE Healthcare® volume imaging protocol (ViP) after an intravenous injection of 250 MBq 18F-NaF. The images were interpreted as normal, loosening or septic loosening based on the graphical pattern of tracer uptake produced at the bone-prosthesis interface. A final diagnosis was made by a combination of joint aspiration microbiology and clinical follow-up for 1 year; in addition to C-reactive protein and erythrocyte sediment rate levels as well as peripheral white cell count. NaF PET results were compared with 3-phase dynamic bone scan results and plain radiographs. The degree of uptake in the symptomatic joint exceeded background<br />levels and also levels of uptake in the asymptomatic knee. The pattern of uptake and curve slope in both the asymptomatic and symptomatic joints matched the pattern of uptake in our hypothesis. Dynamic 18F-NaF PET-CT is a useful imaging modality for assessing painful joint prosthesis. It can differentiate between asymptomatic joints and aseptic loosening. However, more work is required for the detection of septic loosening.

scholarly journals Patients with Clinical Acute Appendicitis Should have Pre-operative Full Blood Count and C-Reactive Protein Assays

2006 ◽  
Vol 88 (1) ◽  
pp. 27-32 ◽  
Author(s):  
D Birchley
Keyword(s):  
Acute Appendicitis ◽  
Cell Count ◽  
Neutrophil Count ◽  
White Cell Count ◽  
White Cell ◽  
Full Blood Count ◽  
Categorical Variables ◽  
C Reactive Protein ◽  
Reactive Protein

INTRODUCTION The role of inflammatory markers in the diagnosis of acute appendicitis has not been clearly defined. The aims of this prospective audit were to define the role of the serum markers of inflammation total white cell count, neutrophil count and C-reactive protein in the diagnosis of acute appendicitis with particular reference to the discrimination between uncomplicated and complicated appendicitis, and the prediction of abscess. PATIENTS AND METHODS The author compiled a prospective database over a 13-month period of all appendicectomies performed. After five exclusions (three having no notes for review and two having confounding second morbidity in the presence of a normal appendix), the data relating to 75 patients were analysed. RESULTS In patients judged on clinical grounds to require laparotomy for suspected acute appendicitis, white cell count and neutrophil count distinguish acute appendicitis from normal appendices when used as categorical variables, though they do not reflect the presence of abscess. C-reactive protein neither distinguishes appendicitis from normal, nor predicts abscess when used as a categorical variable, though higher levels suggest abscess. CONCLUSIONS Laboratory tests of the white cell count, neutrophil count and C-reactive protein are more effective in supporting a clinical diagnosis of acute appendicitis in patients with typical clinical features than in excluding the diagnosis.

scholarly journals The Predictive Role of Tooth Extractions, Oral Infections, and hs-C-Reactive Protein for Mortality in Individuals with and without Diabetes: A Prospective Cohort Study of a 12 1/2-Year Follow-Up

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Lise Lund Håheim ◽  
Kjersti S. Rønningen ◽  
Morten Enersen ◽  
Ingar Olsen
Keyword(s):  
Blood Pressure ◽  
Cohort Study ◽  
C Reactive Protein ◽  
Oral Infections ◽  
Reactive Protein ◽  
Predictive Role ◽  
Hs Crp ◽  
Tooth Extractions

The predictive role of high-sensitivity C-reactive protein (hs-CRP), number of tooth extractions, and oral infections for mortality in people with and without diabetes is unclear. This prospective cohort study is a 12 1/2-year follow-up of the Oslo II study, a health survey in 2000. In all, 12,764 men were invited. Health information was retrieved from 6434 elderly men through questionnaire information, serum measurements, and anthropometric and blood pressure measurements. Diabetes was reported by 425 men. Distinct differences were observed in baseline characteristics in individuals with and without diabetes. In the diabetes group, age and hs-CRP were statistically significant whereas in the nondiabetes group, age, hs-CRP, number of tooth extractions, tooth extractions for infections and oral infections combined, nonfasting glucose, systolic blood pressure, total cholesterol, regular alcohol drinking, daily smoking, and level of education were independent risk factors. The number of tooth extractions <5 was inversely related whereas more extractions increased the risk. Multivariate analyses showed that hs-CRP was a significant predictor in persons with diabetes and tooth extractions and oral infections combined; the number of teeth extracted and hs-CRP were for persons without diabetes. Infection and inflammation were associated with mortality in individuals both with and without diabetes.

scholarly journals The diagnostic value of white cell count, C-reactive protein and bilirubin in acute appendicitis and its complications

2013 ◽  
Vol 95 (3) ◽  
pp. 215-221 ◽  
Author(s):  
I G Panagiotopoulou ◽  
D Parashar ◽  
R Lin ◽  
S Antonowicz ◽  
AD Wells ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Cell Count ◽  
Inflammatory Markers ◽  
White Cell Count ◽  
Perforated Appendicitis ◽  
Diagnostic Value ◽  
White Cell ◽  
C Reactive Protein ◽  
Reactive Protein

Introduction Inflammatory markers such as white cell count (WCC) and C-reactive protein (CRP) and, more recently, bilirubin have been used as adjuncts in the diagnosis of appendicitis. The aim of this study was to determine the diagnostic accuracy of the above markers in acute and perforated appendicitis as well as their value in excluding the condition. Methods A retrospective analysis of 1,169 appendicectomies was performed. Patients were grouped according to histological examination of appendicectomy specimens (normal appendix = NA, acute appendicitis = AA, perforated appendicitis = PA) and preoperative laboratory test results were correlated. Receiver operating characteristic (ROC) curve area analysis (area under the curve [AUC]) was performed to examine diagnostic accuracy. Results ROC analysis of all laboratory variables showed that no independent variable was diagnostic for AA. Good diagnostic accuracy was seen for AA when all variables were combined (WCC/CRP/bilirubin combined AUC: 0.8173). In PA, the median CRP level was significantly higher than that of AA (158mg/l vs 30mg, p<0.0001). CRP also showed the highest sensitivity (100%) and negative predictive value (100%) for PA. CRP had the highest diagnostic accuracy in PA (AUC: 0.9322) and this was increased when it was combined with WCC (AUC: 0.9388). Bilirubin added no diagnostic value in PA. Normal levels of WCC, CRP and bilirubin could not rule out appendicitis. Conclusions CRP provides the highest diagnostic accuracy for PA. Bilirubin did not provide any discriminatory value for AA and its complications. Normal inflammatory markers cannot exclude appendicitis, which remains a clinical diagnosis.

scholarly journals Multimorbidity, inflammation, and disability: a longitudinal mediational analysis

2018 ◽  
Vol 10 ◽  
pp. 204062231880684 ◽  
Author(s):  
Elliot M. Friedman ◽  
Daniel K. Mroczek ◽  
Sharon L. Christ
Keyword(s):  
Chronic Conditions ◽  
Structural Equation ◽  
Structural Equation Models ◽  
Functional Limitations ◽  
The United States ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Mediational Analysis

Background: Using longitudinal data from the Survey of Mid-Life Development in the United States, this study examined the role of systemic inflammation in mediating the link between multimorbidity and increases in and onset of functional limitations over a 17–19 year follow-up period. Methods: Participants completed questionnaire assessments of chronic conditions and functional limitations. Interleukin-6, C-reactive protein, and fibrinogen were assayed in serum. Structural equation models were used to predict increases in and onset of functional limitations associated with baseline multimorbidity status; mediation by inflammation was also determined. Results: Multimorbidity ( versus 0–1 conditions) predicted more functional limitations and greater odds of onset of limitations over time. Significant indirect effects showed that inflammation partially mediated the link between multimorbidity and changes in, but not onset of, limitations. Discussion: These results show that inflammation, a nonspecific marker of multiple disease conditions, explains in part the degree to which multimorbidity is disabling.

scholarly journals Serum C - Reactive Protein, White Cell Counts and Neutrophil Percentage are Predictors For Distal Ureteric Calculus Expulsion Rate: A Prospective Study

2019 ◽  
Vol 8 (1) ◽  
pp. 58-62
Author(s):  
Ram Sagar Shah ◽  
Kaushal Sigdel
Keyword(s):  
Cell Count ◽  
White Cell Count ◽  
White Cell ◽  
C Reactive Protein ◽  
Expulsion Rate ◽  
Reactive Protein ◽  
Ureteric Calculus ◽  
Cell Counts ◽  
Neutrophil Percentage ◽  
Wbc Count

Background: To determine the relationship between expulsion rate of distal ureteric calculus less than orequal to 10mm in size and C reactive protein (CRP) level, white cell count and neutrophil percentage. Materials and Methods: A total of 186 patients with distal ureteric calculus of ≤10mm were evaluated for stone expulsion rate and its correlation with serum CRP, white cell count and neutrophil percentage. All patients received tablet Tamsulosin 0.4mg for 4 weeks or till the expulsion of stone. Patients were called weekly till 4 weeks, or early if there was history of stone expulsion. Patients were divided in two groups according to normal and elevated CRP levels, white cell count and neutrophil percent age at baseline for statistical analysis. Results: The patients had an average age of 35.6 } 13.9 years. 52.2% were male. Ratio of right to left was1.58:1. Majority of the patients with distal ureteric calculus ≤ 10mm passed their stone (74.7 %) with medical expulsion therapy. Expulsion of stone less than 5mm was statistically significant (p0.017). Patients with normal neutrophil percentage and normal CRP level had higher stone expulsion rate than elevated neutrophil or CRP (85.2% vs. 40.9, 91.8% vs. 30.8% respectively).In patients with normal white cell count, 86.4% passed their stone while in elevated white cellcount group 39.1% passed their stone. Conclusion: This study showed patients with distal ureteric calculus of ≤10mmwith normal CRP level and normal neutrophil count had higher expulsion rate while WBC count showed no statistically significant association.

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