Pediatric Antibiotic-refractory Lyme Arthritis: A Multicenter Case-control Study.

CONCLUSION: Older children and those with prolonged arthritis, arthritis limited to the knees, or poor initial response to antibiotics are more likely to have antibiotic-refractory disease and treatment-associated toxicity. Children with severe symptoms of systemic inflammation have more favorable outcomes. For children with persistently active Lyme arthritis after 2 antibiotic courses, pediatricians should consider starting antiinflammatory treatment and referring to a pediatric rheumatologist. PMID: 30824653 [PubMed - as supplied by publisher]
Source: Journal of Rheumatology - Category: Rheumatology Tags: J Rheumatol Source Type: research

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This article reviews current and past practices of peripheral nerve stimulation and upcoming advancements in the field.
Source: Neurosurgery Clinics of North America - Category: Neurosurgery Authors: Source Type: research
Intrathecal drug delivery has been well established an effective and safe method for the treatment of pain, including palliative cancer-related and chronic nonmalignant pain. In this article, we discuss the role of intrathecal pain therapy in the management of chronic, refractory nonmalignant pain. Common indications, patient selection criteria, medication options, complications, and adverse events are discussed within the context of results from randomized controlled trials, clinical consensus guidelines, and best available literature to date.
Source: Neurosurgery Clinics of North America - Category: Neurosurgery Authors: Source Type: research
Purpose of review To review the clinical diagnosis, management and natural history of septic arthritis of the hip (SAH) in the pediatric patient, and to highlight new information that may improve the management of these patients. Recent findings The basics of management of possible pediatric SAH have remained largely unchanged for generations. New questions have been raised regarding the role and timing of advanced imaging (MRI) in the evaluation of patients with possible SAH. Published criteria have been derived to guide the need for MRI studies in these patients. Validation of these guidelines continues. Recent revi...
Source: Current Opinion in Pediatrics - Category: Pediatrics Tags: ORTHOPEDICS: Edited by Daniel W. Green Source Type: research
Background: Lyme arthritis (LA) of the hip can present similarly to septic arthritis (SA) and transient synovitis (TS). The primary purpose of this study was to determine clinical and laboratory parameters differentiating LA of the hip from SA or TS among children who had undergone hip aspiration during the evaluation of hip pain. Methods: This was a retrospective review of all patients who underwent hip aspiration for the evaluation of hip pain at a tertiary care children’s hospital in a Lyme endemic area. Clinical and laboratory data were reviewed and comparative analyses were performed between those diagnosed wit...
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Selected Topics Source Type: research
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Source: Science - The Huffington Post - Category: Science Source Type: news
Growing up a musically-obsessed child in the 80's, Daryl Hall was one of my biggest inspirations. A masterful, inventive songwriter with an ocean of soul, he set me on the path to being an artist, to never waste a word, and to sing because I mean it. With six number ones and five additional top ten hits throughout the 70's and 80's Daryl Hall and John Oates are the number one duo in music history. Still at the top of his game at 69 years old, Daryl has won legions of new fans with his hit MTV Live show Live From Daryl's House. In February of 2015, at my very sickest from chronic Lyme and Bartonella, after it was missed b...
Source: Science - The Huffington Post - Category: Science Source Type: news
Conclusions: Although septic arthritis of the knee and Lyme monoarthritis share common features that can make them difficult to distinguish clinically, the presence of pain with short arc motion, C-reactive protein of>4.0 mg/L, patient-reported history of fever, and age younger than 2 years were independent predictive factors of septic arthritis in pediatric patients. The more factors that are present, the higher the risk of having septic arthritis. Level of Evidence: Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Source: JBJS - Category: Orthopaedics Authors: Tags: Infection, Pediatrics Scientific Articles Source Type: research
Abstract Differentiating septic arthritis of the pediatric hip from other causes of hip pain and effusion continues to present a diagnostic challenge for the clinician. Although septic arthritis traditionally has been reported to have a synovial white blood cell count of 75,000 cells/mm3 or greater, lower counts can be seen in this condition. In cases where a synovial sample has been obtained and the cell count falls in the intermediate range between 25,000 and 75,000 cells/mm3, it is unclear what proportion of these cases may be truly septic hips. In this evidence-based review, we examine Heyworth et al...
Source: HSS Journal - Category: Orthopaedics Source Type: research
CONCLUSIONS: The reported incidence of LD in Poland, in our opinion, may be biased by overreporting and overdiagnosis. Nonspecific musculoskeletal and joint pain are the most frequent cause of LD suspicion and hospitalization. There is a necessity of better tests for active LD confirmation (especially in patients with musculoskeletal pain) as seroprevalence of anti Borrelia burgdorferi antibodies is high in endemic regions. PMID: 26641887 [PubMed - as supplied by publisher]
Source: Advances in Medical Sciences - Category: Biomedical Science Authors: Tags: Adv Med Sci Source Type: research
Conclusions The reported incidence of LD in Poland, in our opinion, may be biased by overreporting and overdiagnosis. Nonspecific musculoskeletal and joint pain are the most frequent cause of LD suspicion and hospitalization. There is a necessity of better tests for active LD confirmation (especially in patients with musculoskeletal pain) as seroprevalence of anti Borrelia burgdorferi antibodies is high in endemic regions.
Source: Advances in Medical Sciences - Category: Biomedical Science Source Type: research
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