225 research outputs found

    Nuclear imaging does not have clear added value in patients with low a priori chance of periprosthetic joint infection. A retrospective single-center experience

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    Background: A low-grade periprosthetic joint infection (PJI) may present without specific symptoms, and its diagnosis remains a challenge. Three-phase bone scintigraphy (TPBS) and white blood cell (WBC) scintigraphy are incorporated into recently introduced diagnostic criteria for PJI, but their exact value in diagnosing low-grade PJI in patients with nonspecific symptoms remains unclear. Methods: In this retrospective study, we evaluated patients with a prosthetic joint of the hip or knee who underwent TPBS and/or WBC scintigraphy between 2009 and 2016 because of nonspecific symptoms. We reviewed and calculated diagnostic accuracy of the TPBS and/or WBC scintigraphy to diagnose or exclude PJI. PJI was defined based on multiple cultures obtained during revision surgery. In patients who did not undergo revision surgery, PJI was ruled out by clinical follow-up of at least 2 years absent of clinical signs of infection based on MSIS 2011 criteria. Results: A total of 373 patients were evaluated, including 340 TPBSs and 142 WBC scintigraphies. Thirteen patients (3.5 %) were diagnosed with a PJI. TPBS sensitivity, specificity, and positive and negative predictive values (PPV, NPV) were 71 %, 65 %, 8 % and 98 %, respectively. Thirty-five percent of TPBS showed increased uptake. Stratification for time intervals between the index arthroplasty and the onset of symptoms did not alter its diagnostic accuracy. WBC scintigraphy sensitivity, specificity, PPV and NPV were 30 %, 90 %, 25 % and 94 %, respectively. Conclusion: Nuclear imaging does not have clear added value in patients with low a priori chance of periprosthetic joint infection

    F-18-FDG-PET uptake in non-infected total hip prostheses

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    Background and purpose - F-18-fluorodeoxyglucose positron emission tomography (FDG-PET) can be used in the diagnostic work-up of a patient with suspected periprosthetic joint infection (PJI) but, due to a lack of accurate interpretation criteria, this technique is not routinely applied. Since the physiological uptake pattern of FDG around a joint prosthesis is not fully elucidated, we determined the physiological FDG uptake in non-infected total hip prostheses. Patients and methods - Patients treated with primary total hip arthroplasty (1995-2016) who underwent a FDG-PET/CT for an indication other than a suspected PJI were retrospectively evaluated. Scans were both visually and quantitatively analyzed. Semi-quantitative analysis was performed by calculating maximum and peak standardized uptake values (SUVmax and SUVpeak) by volume of interests (VOIs) at 8 different locations around the prosthesis. Results - 58 scans from 30 patients were analyzed. In most hips, a diffuse heterogeneous uptake pattern around the prosthesis was observed (in 32/38 of the cemented prostheses, and in 16/20 of the uncemented prostheses) and most uptake was located around the neck of the prosthesis. The median SUVmax in the cemented group was 2.66 (95% CI 2.51-3.10) and in the uncemented group 2.87 (CI 2.65-4.63) (Median difference = -0.36 [CI -1.2 to 0.34]). In uncemented prostheses, there was a positive correlation in time between the age of the prosthesis and the FDG uptake (r(s) = 0.63 [CI 0.26-0.84]). Interpretation - Our study provides key data to develop accurate interpretation criteria to differentiate between physiological uptake and infection in patients with a prosthetic joint.</p

    VLBA polarimetric observations of the CSS quasar 3C147

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    Aims. We report new VLBA polarimetric observations of the compact steep-spectrum (CSS) quasar 3C147 (B0538+498) at 5 and 8.4GHz. Methods. By using multifrequency VLBA observations, we derived milliarcsecond-resolution images of the total intensity, polarisation, and rotation measure distributions, by combining our new observations with archival data. Results. The source shows a one-sided structure, with a compact region, and a component extending about 200 mas to the south-west. The compact region is resolved into two main components with polarised emission, a complex rotation measure distribution, and a magnetic field dominated by components perpendicular to the source axis. Conclusions. By considering all the available data, we examine the possible location of the core component, and discuss two possible interpretations of the observed structure of this source: core-jet and lobe-hot spot. Further observations to unambiguously determine the location of the core would help distinguish between the two possibilities discussed here.Comment: 11 pages, 12 figure

    HST/STIS low dispersion spectroscopy of three Compact Steep Spectrum sources Evidence for jet-cloud interaction

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    We present Hubble Space Telescope Imaging Spectrograph long-slit spectroscopy of the emission line nebulae in the compact steep spectrum radio sources 3C 67, 3C 277.1, and 3C 303.1. We derive BPT (Baldwin- Philips-Terlevich; Baldwin et al. 1981) diagnostic emission line ratios for the nebulae which are consistent with a mix of shock excitation and photoionization in the extended gas. In addition, line ratios indicative of lower ionization gas are found to be associated with higher gas velocities. The results are consistent with a picture in which these galaxy scale radio sources interact with dense clouds in the interstellar medium of the host galaxies, shocking the clouds thereby ionizing and accelerating them.Comment: Accepted for publication in A&A. 6 pages, 8 figure

    HI absorption in 3C 49 and 3C 268.3. Probing the environment of Compact Steep Spectrum and GHz Peaked Spectrum sources

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    We present and discuss European VLBI Network UHF band spectral line observations, made to localise the redshifted 21cm HI absorption known to occur in the subgalactic sized compact steep spectrum galaxies 3C 49 and 3C 268.3. We have detected HI absorption towards the western radio lobe of 3C 49 and the northern lobe of 3C 268.3. However, we cannot rule out the presence of similar amounts of HI towards the opposite and much fainter lobes. The radio lobes with detected HI absorption (1) are brighter and closer to the core than the opposite lobes; (2) are depolarized; and (3) are associated with optical emission line gas. The association between the HI absorption and the emission line gas, supports the hypothesis that the HI absorption is produced in the atomic cores of the emission line clouds. Our results are consistent with a picture in which compact steep spectrum sources interact with clouds of dense gas as they propagate through their host galaxy. We suggest that the asymmetries in the radio and optical emission can be due to interaction of a two sided radio source with an asymmetric distribution of dense clouds in their environment.Comment: 7 pages, 6 figures. Accepted in A&

    NCF1 gene and pseudogene pattern: association with parasitic infection and autoimmunity

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    <p>Abstract</p> <p>Background</p> <p>Neutrophil cytosolic factor 1, p47<sup>phox </sup>(NCF1) is a component of the leukocyte NADPH oxidase complex mediating formation of reactive oxygen intermediates (ROI) which play an important role in host defense and autoimmunity. An individual genomic pattern of <it>ncf1 </it>and its two types of pseudogenes (reflected by the ΔGT/GTGT ratio) may influence the individual capacity to produce ROI.</p> <p>Methods</p> <p>NCF1ΔGT/GTGT ratios were correlated with clinical parameters and ROI production during <it>Plasmodium falciparum </it>malaria and with susceptibility to the autoimmune disease multiple sclerosis (MS).</p> <p>Results</p> <p>Among Gabonese children with severe malaria, ROI production from peripheral blood tended to be higher in individuals with a ΔGT/GTGT ratio ≤ 1:1. ΔGT/GTGT ratios were not associated with susceptibility to MS, but to age-of-onset among MS patients.</p> <p>Conclusion</p> <p>The genomic pattern of <it>NCF1 </it>and its pseudogenes might influence ROI production but only marginally influence susceptibility to and outcome of malaria and MS.</p
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