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American Family Physician Dec 2021Septic arthritis must be considered and promptly diagnosed in any patient presenting with acute atraumatic joint pain, swelling, and fever. Risk factors for septic...
Septic arthritis must be considered and promptly diagnosed in any patient presenting with acute atraumatic joint pain, swelling, and fever. Risk factors for septic arthritis include age older than 80 years, diabetes mellitus, rheumatoid arthritis, recent joint surgery, hip or knee prosthesis, skin infection, and immunosuppressive medication use. A delay in diagnosis and treatment can result in permanent morbidity and mortality. Physical examination findings and serum markers, including erythrocyte sedimentation rate and C-reactive protein, are helpful in the diagnosis but are nonspecific. Synovial fluid studies are required to confirm the diagnosis. History and Gram stain aid in determining initial antibiotic selection. Staphylococcus aureus is the most common pathogen isolated in septic arthritis; however, other bacteria, viruses, fungi, and mycobacterium can cause the disease. After synovial fluid has been obtained, empiric antibiotic therapy should be initiated if there is clinical concern for septic arthritis. Oral antibiotics can be given in most cases because they are not inferior to intravenous therapy. Total duration of therapy ranges from two to six weeks; however, certain infections require longer courses. Consideration for microorganisms such as Neisseria gonorrhoeae, Borrelia burgdorferi, and fungal infections should be based on history findings and laboratory results.
Topics: Anti-Bacterial Agents; Arthralgia; Arthritis, Infectious; Blood Sedimentation; Borrelia burgdorferi; Fever; Humans; Neisseria gonorrhoeae; Staphylococcus aureus; Synovial Fluid
PubMed: 34913662
DOI: No ID Found -
WMJ : Official Publication of the State... Dec 2016Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are widely used laboratory markers of systemic inflammation. (Review)
Review
INTRODUCTION
Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are widely used laboratory markers of systemic inflammation.
OBJECTIVE
A thorough understanding of the similarities and differences between these two serological markers, including factors that affect measurements, is necessary for the proper utilization and interpretation of ESR and CRP.
METHODS
This review summarizes the current published literature (searched on MEDLINE through February 2016) surrounding the history and utilization of ESR and CRP, and examines factors that affect ESR and CRP measurements and discordance amongst these two inflammatory markers.
RESULTS
As ESR and CRP lack sensitivity or specificity, these tests should be used only in combination with clinical history and physical exam for diagnosis and monitoring of pathological conditions. The clinical application of these tests in diagnosis is best applied to conditions in which there is high or low clinical probability of disease. Importantly, discrepancies between ESR and CRP measurements commonly have been reported in both inpatient and outpatient settings and this problem may be particularly prevalent in chronic inflammatory diseases. Numerous physiological factors, including noninfectious conditions and resolution of inflammation can contribute to abnormally high ESR/low CRP readings or vice versa.
CONCLUSIONS
Although discordance may be encountered in certain settings, proper utilization of ESR and CRP measurements continues to play an important role in clinical management of many inflammatory and other conditions.
Topics: Biomarkers; Blood Sedimentation; C-Reactive Protein; Decision Making; Humans; Inflammation; Predictive Value of Tests
PubMed: 29094869
DOI: No ID Found -
Scientific Reports Jan 2021Aggregation of human red blood cells (RBC) is central to various pathological conditions from bacterial infections to cancer. When left at low shear conditions or at...
Aggregation of human red blood cells (RBC) is central to various pathological conditions from bacterial infections to cancer. When left at low shear conditions or at hemostasis, RBCs form aggregates, which resemble stacks of coins, known as 'rouleaux'. We experimentally examined the interfacial dielectric dispersion of aggregating RBCs. Hetastarch, an RBC aggregation agent, is used to mimic conditions leading to aggregation. Hetastrach concentration is incrementally increased in blood from healthy donors to measure the sensitivity of the technique. Time lapse electrical impedance measurements were conducted as red blood cells form rouleaux and sediment in a PDMS chamber. Theoretical modeling was used for obtaining complex permittivity of an effective single red blood cell aggregate at various concentrations of hetastarch. Time response of red blood cells' impedance was also studied to parametrize the time evolution of impedance data. Single aggregate permittivity at the onset of aggregation, evolution of interfacial dispersion parameters, and sedimentation kinetics allowed us to distinguish differential aggregation in blood.
Topics: Blood Sedimentation; Erythrocyte Aggregation; Erythrocytes; Hemorheology; Hemostasis; Humans; Hydroxyethyl Starch Derivatives; Kinetics; Models, Theoretical; Physical Phenomena
PubMed: 33514847
DOI: 10.1038/s41598-021-82171-x -
PloS One 2015The erythrocyte sedimentation rate (ESR) test has been used for over a century. The Westergren method is routinely used in a variety of clinics. However, the mechanism...
The erythrocyte sedimentation rate (ESR) test has been used for over a century. The Westergren method is routinely used in a variety of clinics. However, the mechanism of erythrocyte sedimentation remains unclear, and the 60 min required for the test seems excessive. We investigated the effects of cell aggregation during blood sedimentation and electrical conductivity at different hematocrits. A sample of blood was drop cast into a small chamber with two planar electrodes placed on the bottom. The measured blood conductivity increased slightly during the first minute and decreased thereafter. We explored various methods of enhancing or retarding the erythrocyte aggregation. Using experimental measurements and theoretical calculations, we show that the initial increase in blood conductivity was indeed caused by aggregation, while the subsequent decrease in conductivity resulted from the deposition of erythrocytes. We present a method for calculating blood conductivity based on effective medium theory. Erythrocytes are modeled as conducting spheroids surrounded by a thin insulating membrane. A digital camera was used to investigate the erythrocyte sedimentation behavior and the distribution of the cell volume fraction in a capillary tube. Experimental observations and theoretical estimations of the settling velocity are provided. We experimentally demonstrate that the disaggregated cells settle much slower than the aggregated cells. We show that our method of measuring the electrical conductivity credibly reflected the ESR. The method was very sensitive to the initial stage of aggregation and sedimentation, while the sedimentation curve for the Westergren ESR test has a very mild slope in the initial time. We tested our method for rapid estimation of the Westergren ESR. We show a correlation between our method of measuring changes in blood conductivity and standard Westergren ESR method. In the future, our method could be examined as a potential means of accelerating ESR tests in clinical practice.
Topics: Algorithms; Blood Sedimentation; Blood Specimen Collection; Clinical Laboratory Techniques; Electric Conductivity; Erythrocyte Aggregation; Erythrocytes; Hematocrit; Humans; Models, Theoretical
PubMed: 26047511
DOI: 10.1371/journal.pone.0129337 -
Biosensors Jul 2022Red blood cell sedimentation has been used as a promising indicator of hematological diseases and disorders. However, to address several issues (i.e., syringe...
Red blood cell sedimentation has been used as a promising indicator of hematological diseases and disorders. However, to address several issues (i.e., syringe installation direction, blood on-off flow control, image-based quantification, and hemodilution) raised by the previous methods, it is necessary to devise a new method for the effective quantification of red blood cell sedimentation under a constant blood flow. In this study, the shear stress of a blood flow is estimated by analyzing an interface in a co-flowing channel to quantify the red blood cell sedimentation in blood syringes filled with blood (hematocrit = 50%). A red blood cell sedimentation index is newly suggested by analyzing the temporal variations in the shear stress. According to the experimental investigation, the sedimentation index tends to decrease at a higher flow rate. A higher level of hematocrit has a negative influence on the sedimentation index. As a performance demonstration of the present method, the red blood cell sedimentation processes of various test bloods were quantitatively compared in terms of the shear stress, image intensity, and sedimentation velocity. It was found that the proposed index provided a more than 10-fold increase in sensitivity over the previous method (i.e., image intensity). Additionally, it provided more consistent results than another conventional sedimentation method (sedimentation velocity). In conclusion, the present index can be effectively adopted to monitor the red blood cell sedimentation in a 10-min blood delivery.
Topics: Blood Sedimentation; Erythrocytes; Hematocrit; Microfluidics; Stress, Mechanical
PubMed: 35884350
DOI: 10.3390/bios12070547 -
Translational Research : the Journal of... Apr 2018Malaria remains a major burden on global health, with roughly 200 million cases worldwide and more than 400,000 deaths per year. Besides biomedical research and... (Review)
Review
Malaria remains a major burden on global health, with roughly 200 million cases worldwide and more than 400,000 deaths per year. Besides biomedical research and political efforts, modern information technology is playing a key role in many attempts at fighting the disease. One of the barriers toward a successful mortality reduction has been inadequate malaria diagnosis in particular. To improve diagnosis, image analysis software and machine learning methods have been used to quantify parasitemia in microscopic blood slides. This article gives an overview of these techniques and discusses the current developments in image analysis and machine learning for microscopic malaria diagnosis. We organize the different approaches published in the literature according to the techniques used for imaging, image preprocessing, parasite detection and cell segmentation, feature computation, and automatic cell classification. Readers will find the different techniques listed in tables, with the relevant articles cited next to them, for both thin and thick blood smear images. We also discussed the latest developments in sections devoted to deep learning and smartphone technology for future malaria diagnosis.
Topics: Blood Sedimentation; Humans; Machine Learning; Malaria; Smartphone; Staining and Labeling
PubMed: 29360430
DOI: 10.1016/j.trsl.2017.12.004 -
Revista Medica de Chile Mar 2020Biomarkers in inflammatory bowel disease are an essential tool in clinical practice. They allow a non-invasive evaluation of patients and thus guide decision-making at... (Review)
Review
Biomarkers in inflammatory bowel disease are an essential tool in clinical practice. They allow a non-invasive evaluation of patients and thus guide decision-making at different stages of the disease, including diagnostic suspicion, severity assessment, relapse prediction, and treatment response. Although biomarkers in blood such as erythrocyte sedimentation rate and C-reactive protein, are the most commonly used biomarkers, because their low cost and accessibility, they lack specificity. Currently, fecal biomarkers offer greater reliability, applicability, and specificity. Fecal calprotectin is the most commonly used marker. This review discusses the advantages and disadvantages of biomarkers in inflammatory bowel disease, as well as their clinical applications and new biomarkers currently under research.
Topics: Biomarkers; Blood Sedimentation; Feces; Humans; Inflammatory Bowel Diseases; Leukocyte L1 Antigen Complex; Reproducibility of Results
PubMed: 32730381
DOI: 10.4067/S0034-98872020000300362 -
Australian Family Physician Jun 2014Polymyalgia rheumatica is a relatively common inflammatory rheumatic disease. There are no validated international guidelines available for the diagnosis and treatment... (Review)
Review
BACKGROUND
Polymyalgia rheumatica is a relatively common inflammatory rheumatic disease. There are no validated international guidelines available for the diagnosis and treatment of PMR; however, diagnostic and classification criteria are currently being developed.
OBJECTIVE
The aim of this article is to summarise the main management options suggested by American College of Rheumatology and discusses the role of the general practitioner in the diagnosis and early management of PMR.
DISCUSSION
Diagnosis is made on the basis of a combination of clinical and laboratory findings. Patients typically present with shoulder and hip girdle pain with pronounced stiffness. Inflammatory markers are usually elevated and an ultrasound and MRI of the shoulder and hip can be done to localise inflamed tissues. Response to steroids should not be used as a defining feature of PMR but treatment with low dose prednisone should be considered. PMR has an excellent prognosis if diagnosis is prompt and therapy adequate.
Topics: Anti-Inflammatory Agents; Biomarkers; Blood Sedimentation; C-Reactive Protein; Humans; Polymyalgia Rheumatica
PubMed: 24897986
DOI: No ID Found -
Journal of Clinical Pathology May 1980
Review
Topics: Anticoagulants; Blood Sedimentation; Blood Viscosity; Capillaries; Erythrocyte Membrane; Hematocrit; Hematologic Diseases; Hemodilution; Humans; Plasmapheresis; Rheology; Temperature; Vascular Diseases
PubMed: 6995492
DOI: 10.1136/jcp.33.5.417 -
Zeitschrift Fur Rheumatologie Jun 2023Polymyalgia rheumatica (PMR) is the second most frequent inflammatory rheumatic disease in old age. Remission and recurrence are frequently used as endpoints in clinical... (Review)
Review
Polymyalgia rheumatica (PMR) is the second most frequent inflammatory rheumatic disease in old age. Remission and recurrence are frequently used as endpoints in clinical trials; however, there is as yet no international consensus on the definition of these states, which limits the comparability of published studies. The PMR activity score (PMR-AS) is the only composite score specifically developed for PMR, which together with remission is used to define low, middle and high disease activity. In recent studies the PMR-AS was often used and low disease activity was established as endpoint. The most important limitation of the PMR-AS is the potential influence of the individual variables by comorbidities. The value of C‑reactive protein (CRP) and the erythrocyte sedimentation rate (ESR) are of restricted value in studies using drugs that influence the interleukin 6 (IL-6) axis. In these cases, calprotectin and osteopontin are promising alternative biomarkers, as they have already been shown to reflect disease activity independently of CRP in rheumatoid arthritis. Furthermore, imaging modalities including sonography, magnetic resonance imaging and fluorodeoxyglucose (FDG) positron emission tomography could also be helpful in monitoring disease activity; however, these techniques must first be validated in further studies. The PMR impact scale (PMR-IS) is a composite score to assess the impact of PMR on the patients; however, it has not yet been used in clinical studies. The development of additional patient reported outcomes (PRO) for PMR and the definition of standardized criteria for documentation of remission and recurrence are important questions in the future research agenda for PMR.
Topics: Humans; Polymyalgia Rheumatica; Giant Cell Arteritis; Biomarkers; Blood Sedimentation; C-Reactive Protein
PubMed: 37184675
DOI: 10.1007/s00393-023-01358-x