RESUMO
Although low-sensitivity CRP (Ls-CRP) is an important tool for evaluating infected orthopedic prostheses, no clinical studies have evaluated whether Hs-CRP is a suitable surrogate for Ls-CRP or other traditional infection biomarkers. The laboratory data of 98 arthroplasty patients with suspected prosthetic infection were reviewed. Hs-CRP was highly correlated with Ls-CRP (R = 0.93). ROC analysis generated 100% sensitivity and 97% specificity for both Hs-CRP and Ls-CRP at optimal cutoffs of 28.6 and 2.6 mg/dL, respectively. Both CRP tests were more accurate than serum erythrocyte sedimentation rate, neutrophil differential, and white blood cell count. Hs-CRP was no different from Ls-CRP after unit conversion, and regression analyses suggested conversion factors that approximated 10. Hs-CRP and Ls-CRP have equivalent utility in the diagnosis of infected joint arthroplasty.
Assuntos
Proteína C-Reativa/análise , Infecções Relacionadas à Prótese/sangue , Infecções Relacionadas à Prótese/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Sedimentação Sanguínea , Feminino , Humanos , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Curva ROC , Sensibilidade e EspecificidadeRESUMO
The physis, or growth plate, is relatively weaker than the surrounding bone; as a result, individuals with immature skeletons are at risk for growth plate injury from forces that would not harm an adult. Based on the knowledge that immature growth plates are weaker than adult growth plates, it is not known with certainty whether or not adolescents can participate safely in resistance training programs. Because medical literature does not definitively answer if it is safe for adolescents to pursue strength-training programs, we previously surveyed 500 experts in sports medicine to determine whether they agreed with the statement "resistance training ('weight lifting') should be avoided until physeal closure." Overall, respondents answered that "this statement is very likely false." In this article, we interpret the experts' survey responses by reviewing the basic and clinical sciences implicit in the question, as well as the literature regarding adolescent outcomes. Although the avoidance of resistance training by adolescents is theoretically appealing, we found that the data indicate properly supervised weight programs are not associated with increased risk of acute injury. However, the literature offers no insight about the long-term implications of weight lifting on growth plates. In sum, the expert consensus from our survey that strength training is safe for individuals with immature skeletons is consistent with data from medical literature.