TY  - JOUR
A1  - Boelch, Sebastian Philipp
A1  - Rüeckl, Kilian
A1  - Streck, Laura Elisa
A1  - Szewczykowski, Viktoria
A1  - Weißenberger, Manuel
A1  - Jakuscheit, Axel
A1  - Rudert, Maximilian
T1  - Diagnosis of chronic infection at total hip arthroplasty revision is a question of definition
JF  - Biomed Research International
N2  - Purpose. Contradicting definitions of periprosthetic joint infection (PJI) are in use. Joint aspiration is performed before total hip arthroplasty (THA) revision. This study investigated the influence of PJI definition on PJI prevalence at THA revision. Test quality of prerevision aspiration was evaluated for the different PJI definitions. Methods. 256 THA revisions were retrospectively classified to be infected or not infected. Classification was performed according to the 4 different definitions proposed by the Musculoskeletal Infection Society (MSIS), the Infectious Diseases Society of America (IDSA), the International Consensus Meeting (ICM), and the European Bone and Joint Infection Society (EBJIS). Only chronic PJIs were included. Results. PJI prevalence at revision significantly correlated with the applied PJI definition (p=0.01, Cramer's V=0.093). PJI prevalence was 20.7% for the MSIS, 25.4% for the ICM, 28.1% for the IDSA, and 32.0% for the EBJIS definition. For synovial fluid white blood cell count, the best ROC-AUC for predicting PJI was 0.953 in combination with the MSIS definition. Conclusion. PJI definition significantly influences the rate of diagnosed PJIs at THA revision. Synovial fluid white blood cell count is a reliable means to rule out PJI. In cases with a borderline high synovial white blood cell count before THA revision as the only sign of chronic PJI, an extended diagnostic work-up should be considered.
KW  - periprosthetic joint infection
KW  - algorithm
KW  - consensus
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-265762
VL  - 2021
ER  - 
TY  - JOUR
A1  - Egenolf, Nadine
A1  - Altenschildesche, Caren Meyer zu
A1  - Kreß, Luisa
A1  - Eggermann, Katja
A1  - Namer, Barbara
A1  - Gross, Franziska
A1  - Klitsch, Alexander
A1  - Malzacher, Tobias
A1  - Kampik, Daniel
A1  - Malik, Rayaz A.
A1  - Kurth, Ingo
A1  - Sommer, Claudia
A1  - Üçeyler, Nurcan
T1  - Diagnosing small fiber neuropathy in clinical practice: a deep phenotyping study
JF  - Therapeutic Advances in Neurological Disorders
N2  - Background and aims:
Small fiber neuropathy (SFN) is increasingly suspected in patients with pain of uncertain origin, and making the diagnosis remains a challenge lacking a diagnostic gold standard.
	
Methods:
In this case–control study, we prospectively recruited 86 patients with a medical history and clinical phenotype suggestive of SFN. Patients underwent neurological examination, quantitative sensory testing (QST), and distal and proximal skin punch biopsy, and were tested for pain-associated gene loci. Fifty-five of these patients additionally underwent pain-related evoked potentials (PREP), corneal confocal microscopy (CCM), and a quantitative sudomotor axon reflex test (QSART).
	
	
Results:
Abnormal distal intraepidermal nerve fiber density (IENFD) (60/86, 70%) and neurological examination (53/86, 62%) most frequently reflected small fiber disease. Adding CCM and/or PREP further increased the number of patients with small fiber impairment to 47/55 (85%). Genetic testing revealed potentially pathogenic gene variants in 14/86 (16%) index patients. QST, QSART, and proximal IENFD were of lower impact.
	
Conclusion:
We propose to diagnose SFN primarily based on the results of neurological examination and distal IENFD, with more detailed phenotyping in specialized centers.
KW  - algorithm
KW  - diagnosis
KW  - neurological examination
KW  - skin punch biopsy
KW  - small fiber neuropathy
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-232019
SN  - 1756-2864
VL  - 14
ER  -