scholarly journals Transient synovitis of the hip : is systematic radiological screening necessary for the detection of Perthes disease?

2021 ◽  
Vol 87 (2) ◽  
pp. 263-268
Author(s):  
Charles Edouard Heylen ◽  
Pierre-Louis Docquier ◽  
Dana Dumitriu
Keyword(s):  
Clinical Symptoms ◽  
Perthes Disease ◽  
X Rays ◽  
Single Center ◽  
Transient Synovitis ◽  
X Ray ◽  
Single Center Study ◽  
Center Study

Current imaging guidelines in Belgium advise a systematic X-ray screening of the hips after an episode of transient synovitis of the hip, in order to detect Perthes disease. The aim of this study was to analyze whether systematic radiological screening is necessary for all children or whether the X-ray indication could be guided by clinical symptoms. A retrospective single center study including all children with the diagnosis of transient synovitis of the hip between 2013 and 2018 was performed. 242 patients with the diagnosis of one or more transient synovitis episodes were included, 102 of whom underwent a follow up X-ray. Persistence or recurrence of symptoms were recorded for all patients, as well as the results of follow-up hip X-rays. 12 children did not remain symptom-free after the episode of transient synovitis. Of these patients 10 had a normal follow-up X-ray and 3 were diagnosed with Perthes disease. 1 patient of those 3 had a normal X-ray but was diagnosed with Perthes disease on MRI. Of the children which remained symptom-free after the episode of transient synovitis, none were diagnosed with Perthes disease afterwards. A follow-up X-ray to exclude Perthes disease after a diagnosis of transient hip synovitis appears to be necessary only in patients with persistent or recurrent symptomatology.

scholarly journals Proteinuria in COVID-19: prevalence, characterization and prognostic role

2021 ◽  
Author(s):  
Justine Huart ◽  
Antoine Bouquegneau ◽  
Laurence Lutteri ◽  
Pauline Erpicum ◽  
Stéphanie Grosch ◽  
...  
Keyword(s):  
Urinary Catheter ◽  
Single Center ◽  
Tubular Injury ◽  
Tubular Proteinuria ◽  
Prognostic Role ◽  
Urine Creatinine ◽  
Single Center Study ◽  
Center Study

Abstract Background Proteinuria has been commonly reported in patients with COVID-19. However, only dipstick tests have been frequently used thus far. Here, the quantification and characterization of proteinuria were investigated and their association with mortality was assessed. Methods This retrospective, observational, single center study included 153 patients, hospitalized with COVID-19 between March 28th and April 30th, 2020, in whom total proteinuria and urinary α1-microglobulin (a marker of tubular injury) were measured. Association with mortality was evaluated, with a follow-up until May 7th, 2020. Results According to the Kidney Disease Improving Global Outcomes staging, 14% (n = 21) of the patients had category 1 proteinuria (< 150 mg/g of urine creatinine), 42% (n = 64) had category 2 (between 150 and 500 mg/g) and 44% (n = 68) had category 3 proteinuria (over 500 mg/g). Urine α1-microglobulin concentration was higher than 15 mg/g in 89% of patients. After a median follow-up of 27 [14;30] days, the mortality rate reached 18%. Total proteinuria and urinary α1-microglobulin were associated with mortality in unadjusted and adjusted models. This association was stronger in subgroups of patients with normal renal function and without a urinary catheter. Conclusions Proteinuria is frequent in patients with COVID-19. Its characterization suggests a tubular origin, with increased urinary α1-microglobulin. Tubular proteinuria was associated with mortality in COVID-19 in our restropective, observational study.

scholarly journals Predictors of Impaired Postpartum Renal Function in Women after Preeclampsia: Results of a Prospective Single Center Study

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
T. Kaleta ◽  
A. Stock ◽  
D. Panayotopoulos ◽  
O. Vonend ◽  
D. Niederacher ◽  
...  
Keyword(s):  
Renal Function ◽  
Impaired Renal Function ◽  
Significant Proportion ◽  
Placental Growth Factor ◽  
Single Center ◽  
Singleton Pregnancy ◽  
Persistent Proteinuria ◽  
Single Center Study ◽  
Center Study

Objective. The purpose of this prospective study was to investigate the predictive value of single prepartum findings combined with serum biomarkers sFlt-1 (soluble fms-like tyrosine kinase-1) and PlGF (placental growth factor) indicating severity of preeclampsia (PE) for occurrence and extent of impaired postpartum kidney function.Study Design. In this prospective, single center study 44 PE patients were compared to 39 healthy controls (similar in age and gestational age with singleton pregnancy) evaluated at time of delivery and at 6 months and 12 months postpartum.pvalues below 0.05 are considered statistically significant.Results. The majority of the PE patients had persistence of proteinuria (>120 mg/L after delivery) 6 months (p=0.02) and 12 months postpartum (p<0.0001) compared to controls. Also reduced GFR (glomerular filtration rate) persisted up to 6 months postpartum in PE patients compared to controls (p<0.001). Prepartum sFlt-1 levels indeed correlated with impaired renal function parameters.Conclusion. A significant proportion of our PE patients had lower GFR levels and persistent proteinuria up to 12 months postpartum. Prepartum sFlt-1 is a trend-setting marker for impaired renal function postpartum, but it is not sufficient enough to predict renal impairment after PE. An evaluation of 24-month follow-up data is scheduled.

scholarly journals Pulsed Radiofrequency Application on Femoral and Obturator Nerves for Hip Joint Pain: Retrospective Analysis with 12-Month Follow-up Results

2018 ◽  
Vol 1 (21;1) ◽  
pp. 407-414 ◽  
Author(s):  
Andrea Tinnirello
Keyword(s):  
Retrospective Analysis ◽  
Hip Joint ◽  
Joint Pain ◽  
Pulsed Radiofrequency ◽  
Single Center ◽  
Medium Term ◽  
Post Procedure ◽  
Single Center Study ◽  
Center Study

Background: Osteoarthritis of the hip joint is a common cause of pain and disability. Patients not responding to conservative management often cannot undergo joint replacement due to the presence of multiple comorbidities, while some other patients prefer to postpone surgery as long as possible. Radiofrequency denervation of articular branches of the femoral and obturator nerves, which supply innervation of the joint, is a novel technique to reduce hip joint pain. Previous studies reported positive results after application of continuous radiofrequency to the target nerves; however, this approach carries the potential risk of neuritis and neuroma formation. Pulsed radiofrequency (PRF) is a safer alternative to continuous radiofrequency not creating necrosis but a complex neuromodulatory effect on target nerves. There is no published evidence of PRF efficacy after 3 month follow-up. Objectives: This single-center study objective was to evaluate the short and medium term effectiveness of PRF on the femoral articular branches and obturator nerves in patients with chronic hip pain. Study Design: Retrospective single-center study. Setting: Italian National Health Service Public Hospital. Methods: Retrospective analysis of 14 patients treated with PRF for severe hip joint pain (mean numeric rating scale (NRS) 7.7 ± 1.2 mean Oxford Hip Score (OHS) 20 ± 8.4). Mean pain and disability scores were evaluated with NRS and OHS respectively at 1, 3, 6, and 12-month follow-up. All patients were treated with pulsed radiofrequency applied under fluoroscopy on the articular branches of the femoral and obturator nerves for 300 seconds each. Results: Eight patients out of 14 (57%) reported an NRS reduction > 50% at 1 month post procedure. Overall, both pain and disability scores were significantly (P < 0.01) lower at all follow-up until 6 months, mean NRS at 1, 3, and 6 months was 3.6 ± 3; 4.1 ± 3.3; 4.8 ± 2.9 while OHS was 37.6 ± 17.7; 35.8 ± 17.7; 35.8 ± 14 respectively. At 12 months, NRS was 5.8 ± 2.4 while OHS 23.3 ± 12.7, it must be pointed out that even if both scores are significantly (P < 0.01) lower than basal, only 3 patients out of 14 (21%) maintained a NRS reduction > 50% from basal at 12 months post procedure. We reported 2 femoral artery punctures without any significant complication. Limitations: Retrospective study, small sample size. Conclusions: Pulsed radiofrequency is a safe and effective modality to treat hip joint pain in the short and medium term. Definition of positive outcome predictors is required to reserve radiofrequency treatment only for those patients who can benefit from this procedure. Key words: Hip joint pain, pulsed radiofrequency, obturator nerve, femoral nerve, interventional pain management, radiofrequency

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