ABSTRACT
Resumen: Introducción: ante una herida crónica a nivel digital se plantea el diagnóstico diferencial entre osteomielitis o tumor primario. No es infrecuente la coexistencia entre osteomielitis y quiste óseo epidermoide. Material y métodos: en este artículo describimos dos casos de quistes epidermoides en falange distal de la mano asociados a osteomielitis y se presenta una revisión de la literatura. Resultados: tanto la osteomielitis como el quiste óseo epidermoide se han relacionado con la presencia de un traumatismo previo en el sitio de la lesión, alteraciones ungueales y signos flogóticos crónicos, por lo que es importante llegar a un diagnóstico certero mediante un estudio anatomopatológico y realizar un buen desbridamiento quirúrgico que asegure la curación de ambas entidades. Conclusiones: el desbridamiento quirúrgico asociado a curetaje y relleno del defecto óseo con sustituto óseo por medio de antibiótico es una buena opción terapéutica en el tratamiento de estas lesiones.
Abstract: Introduction: when faced with a chronic digital injury, the differential diagnosis between osteomyelitis or primary tumor is raised. Coexistence between osteomyelitis and epidermoid bone cyst is not uncommon. Material and methods: in this article, we describe two cases of epidermoid cysts in distal phalanx of the hand associated with osteomyelitis and a review of the literature is presented. Results: both osteomyelitis and epidermoid bone cyst have been related to the presence of previous trauma at the site of the lesion, nail alterations and chronic phlogotic signs, so it is important to reach a diagnosis of certainty through an anatomopathological study and to perform a good surgical debridement to ensure the healing of both entities. Conclusions: surgical debridement associated with curettage and filling of the bone defect with bone substitute with antibiotic is a good therapeutic option in the treatment of these lesions.
ABSTRACT
INTRODUCTION: when faced with a chronic digital injury, the differential diagnosis between osteomyelitis or primary tumor is raised. Coexistence between osteomyelitis and epidermoid bone cyst is not uncommon. MATERIAL AND METHODS: in this article, we describe two cases of epidermoid cysts in distal phalanx of the hand associated with osteomyelitis and a review of the literature is presented. RESULTS: both osteomyelitis and epidermoid bone cyst have been related to the presence of previous trauma at the site of the lesion, nail alterations and chronic phlogotic signs, so it is important to reach a diagnosis of certainty through an anatomopathological study and to perform a good surgical debridement to ensure the healing of both entities. CONCLUSIONS: surgical debridement associated with curettage and filling of the bone defect with bone substitute with antibiotic is a good therapeutic option in the treatment of these lesions.
INTRODUCCIÓN: ante una herida crónica a nivel digital se plantea el diagnóstico diferencial entre osteomielitis o tumor primario. No es infrecuente la coexistencia entre osteomielitis y quiste óseo epidermoide. MATERIAL Y MÉTODOS: en este artículo describimos dos casos de quistes epidermoides en falange distal de la mano asociados a osteomielitis y se presenta una revisión de la literatura. RESULTADOS: tanto la osteomielitis como el quiste óseo epidermoide se han relacionado con la presencia de un traumatismo previo en el sitio de la lesión, alteraciones ungueales y signos flogóticos crónicos, por lo que es importante llegar a un diagnóstico certero mediante un estudio anatomopatológico y realizar un buen desbridamiento quirúrgico que asegure la curación de ambas entidades. CONCLUSIONES: el desbridamiento quirúrgico asociado a curetaje y relleno del defecto óseo con sustituto óseo por medio de antibiótico es una buena opción terapéutica en el tratamiento de estas lesiones.
Subject(s)
Bone Cysts , Epidermal Cyst , Finger Phalanges , Osteomyelitis , Humans , Epidermal Cyst/complications , Epidermal Cyst/diagnosis , Epidermal Cyst/surgery , Osteomyelitis/diagnosis , Osteomyelitis/therapy , Anti-Bacterial Agents/therapeutic use , Bone Cysts/diagnosis , Bone Cysts/drug therapyABSTRACT
RATIONALE: Among the most frequently encountered pathologies examined by the ophthalmologist is dry eye syndrome (DE), which can be discovered particularly in the elderly. The initial diagnosis of DE is of high importance, but also challenging. This is because the biochemical changes in the tear film often develop before any detectable signs. OBJECTIVE: In this study, the possible relationship between ocular symptomatology, tear volume and tear break-up time (TBUT) and lipocalin, lactoferrin and lysozyme concentrations in the tear film were explored in a group of symptomatic dry-eyed postmenopausal (PM) women compared to age-matched controls. PATIENTS AND METHODS: Sixty-six healthy PM females with ages of at least 50 years were grouped in two homogeneous lots (by age, post-menopause, co-morbidities) of 33 females each, one lot presenting mild or moderate dry eye syndrome (DE) and one asymptomatic non-dry eye (NDE), based on their feedback to the Ocular Surface Disease Index (OSDI) questionnaire and noninvasive TBUT and Schirmer test results. Tears were collected via capillary tubes and an eye wash method. Tear lysozyme, lactoferrin and lipocalin concentrations were determined via electrophoresis. RESULTS: OSDI responses revealed 3 mild DE, 30 moderate DE and 33 NDE. The OSDI total score and sub scores for the DE group were significantly greater than for the NDE group (p < 0.001). The mild and moderate DE group exhibited significantly shorter TBUTs compared to NDE (p < 0.001). No difference in tear lysozyme or lipocalin concentrations was found between DE and NDE groups, irrespective of the tear collection method, but a significant difference was found in lactoferrin concentration (p<0.001). No significant correlations were found between symptoms or signs of DE compared to either lipocalin, lysozyme or lactoferrin concentrations. DISCUSSION: In a PM population, lipocalin and lysozyme are invariable, irrespective of the presence and severity of DE symptoms. However, lactoferrin shows a significant decrease. This is a comprehensive study of lipocalin, lactoferrin and lysozyme in dry-eyed PM women and our results suggested that lactoferrin could be used as a biomarker of DE in postmenopausal women. ABBREVIATIONS: PM = postmenopausal; DE = dry eye disease; NDE = non-dry eye; ELISA = Enzyme-linked immunosorbent assay.
Subject(s)
Lactoferrin/metabolism , Lipocalin 1/metabolism , Muramidase/metabolism , Postmenopause/metabolism , Tears/metabolism , Dry Eye Syndromes/diagnosis , Dry Eye Syndromes/metabolism , Female , Humans , Middle AgedABSTRACT
RATIONALE: Common ophthalmological problems are found in patients with eyelid tumors and include ocular surface diseases, such as dry eyes, eyelid disorders, excessive tearing and ocular inflammation. OBJECTIVE: The potential correlation between the symptomatology, tear break-up time (TBUT) and lipocalin, lactoferrin and lysozyme concentrations in the tear film were investigated in a group of symptomatic dry-eyed postmenopausal (PM) women compared to age-matched controls, considering the patients with eyelid tumors. METHODS AND RESULTS: 66 females were divided into two groups of 33 females each, one group having dry eye (DE) and one asymptomatic group (non-dry eye) (NDE), based on their responses to the OSDI questionnaire, TBUT and Schirmer test evaluation. Tears were collected via capillary tubes. Tear lysozyme, lactoferrin and lipocalin concentrations were determined via electrophoresis and the results for patients with or without eyelid tumors were compared. The results revealed significant differences in lysozyme concentration between patients with or without eyelid tumors in the DE group (p = 0.004). Lower levels for TBUT and lactoferrin in the DE group were also found, compared to the NDE group for eyelid tumors patients. Tear lipocalins were in the same range in both groups. DISCUSSION: Within a PM population, some components of the tear film were found to be at lower levels in patients with eyelid tumors, compared to patients without this pathology, which resulted in the development of DE or in the enhancement of the symptoms of an existing DE.
Subject(s)
Lactoferrin/metabolism , Lipocalin 1/metabolism , Muramidase/metabolism , Postmenopause/metabolism , Tears/metabolism , Aged , Dry Eye Syndromes/metabolism , Eye Neoplasms , Female , Humans , Surveys and QuestionnairesABSTRACT
RATIONALE: Prevention of wear-mediated osteolysis, the most common complication in total joint arthroplasty, is a great challenge for orthopedic surgery. Despite the diversity of current biomarkers of periprosthetic osteolysis (products of wear, bone turnover and inflammatory biomarkers), the major interferences and the great amount of sample necessary for analysis limit their use in clinical practice. OBJECTIVE: The aim of this paper is to present three new electrophoretic methods using Hyrys-Hydrasys SEBIA system that have been used for the first time in Electrophoresis Laboratory of our hospital in the analysis of joint fluid for the prevention of periprosthetic osteolysis in revision arthroplasty. METHODS AND RESULTS: Analytical aspects of agarose gel electrophoresis of joint fluid proteins and lipoproteins as well as SDS-agarose gel electrophoresis of joint fluid proteins, their performances and clinical value are presented. The decreased level of albumin and increased level of alpha1 and alpha2 globulins were frequent changes detected on SEBIA electropherograms and good indicator for the presence of an inflammatory reaction generated by particle debris. In addition, a slightly increase of LDL mobility could provide good information about a high oxidative stress. Moreover, the Ig G assessed by using SDS-agarose gel electrophoresis could be a potential biomarker for an immunological reaction towards orthopedic implants. DISCUSSION: Electrophoresis of joint fluid using Hyrys-Hydrasys SEBIA France system is a new analytical technique able to remove the most of current biomarkers disadvantages due to the determination of particular proteins (acute phase proteins, albumin, lipoproteins, and immunoglobulins) by using minimal amounts of joint fluid with minor interferences, minimal cost and rapid results.