By Linda on Sep 9, 2010 in Infections | comments(0)
Excerpt:
March 15, 2010 (New Orleans, Louisiana) — Almost half of children with fluid in the knee in the Northeastern United States are likely to have Lyme arthritis, according to a new study presented here at the American Association of Orthopaedic Surgeons 2010 Annual Meeting.
“In a pediatric population, Lyme arthritis is probably the first diagnosis to consider if you are in an endemic area,” Matthew D. Milewski, MD, from Yale–New Haven Children’s Hospital in Connecticut, told meeting attendees.
Connecticut has the highest rate of Lyme disease, but other areas of the United States are considered endemic, including the northeast from Maine to the mid-Atlantic states, Minnesota, Wisconsin and other Midwestern states, and Northern California.
Lyme arthritis is on the rise, increasing almost 100% in the past 15 years, according to data from the Centers of Disease Control and Prevention.
Children are nearly twice as likely to develop arthritis with Lyme disease than adults, and also to have it as the initial manifestation. Distinguishing children who have Lyme arthritis from those who have septic arthritis can be a challenge in the emergency department (ED), but doing so is essential because their treatment is so different, Dr. Milewski said.
By Linda on Aug 29, 2010 in Interesting Stories | comments(0)
Excerpt:
OBJECTIVES/HYPOTHESIS:: The purpose of this study is to critically evaluate the typical cost of asymmetrical sensorineural hearing loss (ASNHL) work-up, and to compare the positive predictive value from this common presenting symptom. STUDY DESIGN:: Retrospective chart review from two major otolaryngology centers. METHODS:: We reviewed charts from patients presenting to New York Eye and Ear Infirmary between January 1, 2006 and December 31, 2006, and the University of Minnesota between December 1, 2002 and November 30, 2007 with ASNHL. Diagnostic information included magnetic resonance imaging (MRI) and serum laboratory values (antinuclear antibodies, erythrocyte sedimentation rate, Lyme, rapid plasma reagin, and thyroid-stimulating hormone). We calculated positive rate according to each item of diagnosis. To estimate cost-benefit, we further calculated the average cost for identifying a patient with a positive result.
CONCLUSIONS:: A comprehensive ASNHL work-up may not be applicable to all patients. Laboratory serologic tests are highly cost effective in diagnosing treatable causes of ASNHL, such as syphilis and Lyme. Although radiographic imaging with MRI is not as cost effective, its value in detecting for acoustic neuroma is undeniable. Laryngoscope, 2010.
By Linda on Nov 16, 2009 in F.I.G.H.T. | comments(0)
Low White Blood Cell Count Distinguishes Lyme Arthritis From Septic Arthritis
Crina Frincu-Mallos, PhD
November 13, 2009 (Washington, DC) — The odds that a child living in a Lyme-endemic area of the United States who presents with a joint effusion will be diagnosed as having Lyme arthritis is 29%. The odds are even higher (44%) if the affected joint is the knee. The leukocyte count is useful in distinguishing between septic and Lyme arthritis, researchers announced here. Continued
