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Performance of alpha-defensin lateral flow test after synovial fluid centrifugation for diagnosis of periprosthetic knee infection

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World Journal of Orthopedics 2021年第8期12卷 565-574页

作者： Rodrigo Calil Teles Abdo riccardo gomes.gobbi Chilan Bou Ghosson Leite Sandra Gofinet Pasoto Elaine Pires Leon Ana Lucia Lei Munhoz Lima Eloisa Bonfa José Ricardo Pécora Marco Kawamura Demange Instituto de Ortopedia e Traumatologia Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloSao Paulo 05403-010Brazil Division of Rheumatology Faculdade de Medicina da Universidade de São PauloSao Paulo 01246-903Brazil

BACKGROUND The quantitative alpha-defensin enzyme-linked immunosorbent assay(ELISA)demands a prior synovial fluid centrifugation,whereas this processing is not routinely required prior to the alpha-defensin lateral flow *** To evaluate whether a prior synovial fluid centrifugation could lead the lateral flow performance to achieve comparable results to ELISA during periprosthetic joint infection(PJI)*** Fifty-three cases were included in this study:22 classified as PJI and 31 classified as aseptic cases,according to Musculoskeletal Infection Society 2013 *** fluid samples were submitted to centrifugation,and the supernatant was evaluated by ELISA and lateral flow *** sensitivity(SE),specificity(SP)and accuracy of each method were calculated as well as the agreement between those two *** In all of the 31 samples from aseptic patients,alpha-defensin ELISA and lateral flow tests showed negative results for *** the 22 infected patients,the lateral flow test was positive in 19 cases(86.4%)and the ELISA was positive in 21(95.5%).Sensibility,SP and accuracy were,respectively,86.4%(95%CI:65.1%-97.1%),100%(95%CI:88.8%-100%)and 93.2%(95%CI:82.8%-98.3%)for the lateral flow test and 95.5%(95%CI:77.2%-99.9%),100%(95%CI:88.8%-100%)and 98.1%(95%CI:89.9%-100%)for *** agreement of 96.2%between those methods were *** statistical difference was found between them(P=0.48).CONCLUSION Alpha-defensin lateral flow test showed high SE,SP and accuracy after a prior synovial fluid centrifugation,achieving comparable results to *** the lower complexity of the lateral flow and its equivalent performance obtained in this condition,a prior centrifugation might be added as a valuable step to enhance the PJI diagnosis.

关键词： Alpha-defensin Alpha-defensin lateral flow Periprosthetic joint infection

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Quantitative alpha-defensin testing: Is synovial fluid dilution important?

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World Journal of Orthopedics 2022年第8期13卷 760-767页

作者： Rodrigo Calil Teles Abdo riccardo gomes.gobbi Chilan Bou Ghosson Leite Sandra Gofinet Pasoto Elaine Pires Leon Ana Lucia Lei Munhoz Lima Eloisa Bonfa JoséRicardo Pécora Marco Kawamura Demange Instituto de Ortopedia e Traumatologia Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloSao Paulo 05403-010Brazil Orthopaedic Department HCor-Hospital do CoraçãoSao Paulo 04004-030Brazil Division of Rheumatology Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloSao Paulo 05403-010Brazil

BACKGROUND Alpha-defensin has been widely studied for the diagnosis of periprosthetic joint infection(PJI).However,there is a lack of detailed information regarding the proper laboratory technique of the enzyme-linked immunosorbent assay(ELISA)method,such as sample *** To assess the influence of dilution in the synovial fluid during ELISA for the diagnosis of knee PJI;and determine which dilution presents a better *** Forty samples of synovial fluid from arthroplasty knees were included,17 in the infected group and 23 in the aseptic group,according to Musculoskeletal Infection Society ***,five synovial fluid samples from each group were assessed for quantitative analysis of alpha-defensin using *** dilution ratios(1:10,1:100,1:500,1:1000 and 1:5000)were tested based on the predetermined cutoff value of 5.2 mg/*** dilutions that performed better were used to compare the results of all *** For infected cases,a gradual increase in the dilution of synovial fluid samples led to an equivalent increase in alpha-defensin *** same was not observed in the aseptic *** 1:1000 and 1:5000 dilutions presented satisfactory results to differentiate infected and aseptic *** analyses were performed using 1:1000 and 1:5000 for all 40 *** 1:1000 dilution resulted in a sensitivity of 88.2%(95%CI,66%-98%)and specificity of 95.7%(95%CI,79%-99%),whereas the 1:5000 dilution presented a sensitivity of 94.1%(95%CI,73%-99%)and a specificity of 100%(95%CI,86%-100%).CONCLUSION The synovial fluid dilution had an important influence on the alpha-defensin ELISA *** of 1:5000 showed the best performance for the diagnosis of knee *** results of this study set the basis for a more reliable and reproducible alpha-defensin ELISA during the investigation of PJI,contributing to the expansion of this technique in different treatment centers worldwide.

关键词： Alpha-defensin Enzyme-linked immunosorbent assay Periprosthetic joint infection Laboratory findings

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Biomechanical diagnostics of the cornea

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Eye and Vision 2020年第1期7卷 87-98页

作者： Louise Pellegrino gomes Esporcatte Marcella Q.Salomão Bernardo T.Lopes Paolo Vinciguerra riccardo Vinciguerra Cynthia Roberts Ahmed Elsheikh Daniel G.Dawson Renato Ambrósio Jr Rio de Janeiro Corneal Tomography and Biomechanics Study Group Rio de JaneiroBrazil Instituto de Olhos Renato Ambrósio Rua Conde de Bonfim 211/712Rio de JaneiroRJ 20520-050Brazil Department of Ophthalmology Hospital São Vicente de PauloRio de JaneiroBrazil Brazilian Study Group of Artificial Intelligence and Corneal Analysis–BrAIN Rio de Janeiro&MaceióBrazil Department of Ophthalmology Federal University of São PauloSão PauloBrazil Instituto Benjamin Constant Rio de JaneiroBrazil School of Engineering University of LiverpoolLiverpool L693GHUK Department of Biomedical Science Humanitas UniversityRozzanoItaly Eye Center Humanitas Clinical and Research CenterRozzanoItaly Department of Ophthalmology Humanitas San Pio X HospitalMilanItaly Department of Ophthalmology and Visual Science Department of Biomedical EngineeringThe Ohio State UniversityColumbusOHUSA School of Biological Science and Biomedical Engineering Beihang UniversityBeijingChina NIHR Biomedical Research Centre for Ophthalmology Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of OphthalmologyLondonUK The University of Florida Department of Ophthalmology GainesvilleFLUSA Department of Ophthalmology Federal University the State of Rio de Janeiro(UNIRIO)Rio de JaneiroBrazil

Corneal biomechanics has been a hot topic for research in contemporary ophthalmology due to its prospective applications in diagnosis,management,and treatment of several clinical conditions,including glaucoma,elective keratorefractive surgery,and different corneal *** clinical biomechanical investigation has become of great importance in the setting of refractive surgery to identify patients at higher risk of developing iatrogenic ectasia after laser vision *** review discusses the latest developments in the detection of corneal ectatic *** developments should be considered in conjunction with multimodal corneal and refractive imaging,including Placido-disk based corneal topography,Scheimpflug corneal tomography,anterior segment tomography,spectral-domain optical coherence tomography(SD-OCT),very-high-frequency ultrasound(VHF-US),ocular biometry,and ocular wavefront *** ocular response analyzer(ORA)and the Corvis ST are non-contact tonometry systems that provide a clinical corneal biomechanical *** recently,Brillouin optical microscopy has been demonstrated to provide in vivo biomechanical *** integration of tomographic and biomechanical data into artificial intelligence techniques has demonstrated the ability to increase the accuracy to detect ectatic disease and characterize the inherent susceptibility for biomechanical failure and ectasia progression,which is a severe complication after laser vision correction.

关键词： Corneal biomechanics Corneal ectasia Corneal imaging

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Transoral robotic surgery for obstructive sleep apnea syndrome: Principles and technique

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2017年第2期3卷 97-100页

作者： Claudio Vicini Filippo Montevecchi riccardo gobbi Andrea De Vito Giuseppe Meccariello Department of Head-Neck Surgery Otolaryngology Head-Neck and Oral Surgery UnitMorgagni Pierantoni Hospital Forli Italy

Objective:The present study is a review of transoral robotic surgery (TORS) for the treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS).Methods:The review presents the experience of the robotic center that developed the technique with regards to patient selection,surgical method,and post-operative *** addition,the review provides results of a systematic review and meta-analysis of the complications and clinical outcomes of TORS when applied in the management of ***:The rate of success,defined as 50％ reduction of pre-operative AHI and an overall AHI ＜20 events/h,is achieved in up to 76.6％ of patients with a range between 53.8％ and 83.3％.The safety of this approach is reasonable as the main complication (bleeding) affected 4.2％ of patients (range 4.2％-5.3％).However,transient dysphagia (7.2％;range 5％-14％) does compromise the quality of life and must be discussed with patients ***:TORS for the treatment of OSAHS appears to be a promising and safe procedure for patients seeking an alternative to traditional *** patient selection remains an important consideration for successful implementation of this novel surgical approach requiring further research.

关键词： Transoral robotic surgery TORS Partial glossectomy Midline glossectomy Posterior glossectomy Obstructive sleep apnea Sleep surgery

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