Sensitive and specific tests for the diagnosis of prosthetic joint infection (PJI) are lacking. The aim of this study was to report clinical and microbiological findings of consecutive patients diagnosed with PJI at the University Hospital of Perugia, Perugia, Italy, and to validate these diagnoses utilizing the European Bone and Joint Infection Society (EBJIS) three-level diagnostic approach from 2021. Patients with a PJI diagnosis were included in this study and examined retrospectively. Overall, 133 patients were diagnosed with PJI: mean age 72 years, 54.9% female, and 55.6% with more than one comorbidity. The most frequent involved joints were hip 47% and knee 42%. Aetiology was identified in 88/133 (66.2%): staphylococci resulted the most frequent microorganisms and over 80% (45/54) resulted rifampin susceptible. Applying the EBJIS approach, PJI diagnosis resulted: confirmed in 101 (75.9%), likely in 25 (18.8%), and unlikely in 7 (5.3%). Likely PJIs aetiology was Staphylococcus aureus 11/25, coagulase-negative staphylococci 8/25, Streptococcus agalactiae 3/25, viridans group streptococci 2/25, and Pseudomonas aeruginosa 1/25. No statistically significant differences were detected among the three diagnosis groups with regard to clinical characteristics with the exception of a higher number of confirmed PJIs occurring < 3 months after implantation. The logistic regression analysis did not disclose any independent predictor of confirmed PJIs. We recommend using all the diagnostic tests available to approach PJI diagnosis, and suggest caution before rejecting PJI diagnosis in the presence of highly virulent microorganisms from a single sample, in patients without sinus tract, and in those receiving antimicrobial at the time microbiologic samples are collected. Study approved by Umbrian Regional Ethical Committee, Perugia, Italy, Prot. N. 23,124/21/ON of 10.27.2021.
Obesity is a widespread and broadly consequential health condition associated with numerous medical complications that could increase mortality rates. As personality concerned individual’s patterns of feeling, behavior, and thinking, it may help in understanding how people with obesity differ from people with normal-weight status in their typical weight-relevant behavior. So far, studies about personality and BMI associations have mainly focused on broad personality traits. The main purpose of this study was to explore the personality and health associations among a clinical group composed of 46 outpatients with overweight/obesity (mean age = 55.83; SD = 12.84) in comparison to a healthy control group that included 46 subjects (mean age = 54.96; SD = 12.60). Both the clinical and control groups were composed of 14 males and 32 females. Several personality and psychopathological aspects were assessed with the Personality Assessment Inventory (PAI). The results of the analysis of variance of aligned rank transformed (ART) showed that patients with overweight/obesity reported higher scores for Somatic Complaints, Depression, and Borderline Features than the control group. Logistic regression highlighted specifically that the subscales of the Borderline Features assessing the Negative Relationship contributed to the increased risk of belonging to the clinical group. For the purpose of this study, the role of gender was considered. The present findings highlight the importance of focusing on assessing personality functioning in the health context and on specific characteristics of interpersonal relationships to promote more tailored treatments.
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