Extraction of Synovial Fluid from the Non-Effusive Pathologic Knee with Pneumatic Compression

Abstract

Objectives –Aspiration of synovial fluid from non-effusive joints is undertaken for the diagnosis of crystal-associated arthritis, biomarker analysis, and to confirm intraarticular positioning. We hypothesized that pneumatic compression of the non-effusive knee would mobilize occult synovial fluid and improve arthrocentesis success. Methods – The absence of a knee effusion was determined by physical examination, imaging, and exclusion of confounding disease. Conventional arthrocentesis was performed in 111 consecutive non-effusive knees and arthrocentesis volume (milliliters) determined. Pneumatic compression was then applied, and arthrocentesis was resumed. Results – Pneumatic compression improved fluid yield: conventional: 0.4±1.0 ml, compression: 1.8±2.5 ml (319% increase, 95% CI -1.9<-1.4<-0.9; p=0.0001). Pneumatic compression reduced arthrocentesis failure (< 0.1 ml) from 74.8% (83/111) to 41.4% (46/111) (p=0.0001) and improved successful arthrocentesis in terms of adequate synovial fluid yield: 1) ≥ 0.1 ml from 25.2% (28/111) to 58.5% (65/111) (+132%, p=0.0001), 2) ≥ 0.5 ml from 22.5% (25/111) to 57.7% (64/111) (+156%, p =0.0001), 3) ≥ 2.0 ml from 11.7% (13/111) to 47.7% (53/111) (+300%, p =0.0001), and 4) ≥ 3.0 ml from 5.4% (6/111) to 36.0% (40/111) (+319%, p =0.0001). Conclusions: Pneumatic compression of the non-effusive knee improves the extraction of synovial fluid of various requisite volumes for conventional and biomarker analysis.

Immune signature of patients with cardiovascular disease – in-depth immunophenotyping predicts increased risk for a severe course of COVID-19

“…To our knowledge, this is the first analysis to associate a specific immune signature of CVD patients with SARS-CoV-2 infection with the expected severity of COVID-19 during the disease. Here, we identified key immune system components critical to predicting a severe course of COVID-19 in our patient cohort through in-depth analyses of innate and adaptive immune cells 9,10 . Most other studies that have examined immune cell populations in the blood in SARS-CoV-2 infection have included an all-comers cohort of patients and have not stratified their analyses by concomitant comorbidities, such as diabetes, obesity, asthma, particularly the presence of CVD 4,5,8,[40][41][42][43][44][45] .…”

“…Common complications in hospitalized patients infected with SARS-CoV-2 include pneumonia, sepsis, acute respiratory distress syndrome (ARDS), and respiratory failure [9][10][11] .…”

Identification and Classification for Diagnosis of Malaria Disease using Blood Cell Images

“…These mezosites are known as Parasites. A Parasite includes the nucleus & cytoplasm employed in preliminary foundation for classifying a parasite to a non-parasite [7][8]. Single-photon emission computed tomography (SPECT)" As described above, malaria-effective people are not getting proper diagnosis/healthcare facilities worldwide.…”