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<art>
   <ui>cc5987</ui>
   <ji>CCJ</ji>
   <fm>
      <dochead>Poster presentation</dochead>
      <bibl>
         <title>
            <p>System approach to the diagnosis and treatment of septic arthritis in newborns</p>
         </title>
         <aug>
            <au id="A1">
               <snm>Khanes</snm>
               <fnm>Gennadiy</fnm>
               <insr iid="I1"/>
            </au>
            <au id="A2">
               <snm>Bidnenko</snm>
               <fnm>Svitlana</fnm>
               <insr iid="I2"/>
            </au>
            <au id="A3">
               <snm>Grygorovskyy</snm>
               <fnm>Volodymyr</fnm>
               <insr iid="I3"/>
            </au>
            <au id="A4">
               <snm>Maksakova</snm>
               <fnm>Iryna</fnm>
               <insr iid="I1"/>
            </au>
            <au id="A5">
               <snm>Romashko</snm>
               <fnm>Valeriy</fnm>
               <insr iid="I4"/>
            </au>
         </aug>
         <insg>
            <ins id="I1">
               <p>Neonatal Surgery Department, Ukrainian Specialized Pediatric Hospital OkhMatDyt, Kyiv, Ukraine</p>
            </ins>
            <ins id="I2">
               <p>Bacteriologic Laboratory of Scientific Research Institute of Traumatology and Orthopedics of the Academy of Medical Sciences of Ukraine, Kyiv, Ukraine</p>
            </ins>
            <ins id="I3">
               <p>Morphologic Laboratory of Scientific Research Institute of Traumatology and Orthopedics of the Academy of Medical Sciences of Ukraine, Kyiv, Ukraine</p>
            </ins>
            <ins id="I4">
               <p>Immunologic Laboratory, Ukraine Specialized Pediatric Hospital OkhMatDyt, Kyiv, Ukraine</p>
            </ins>
         </insg>
         <source>Critical Care</source>
         <supplement>
            <title>
               <p>Sepsis 2007</p>
            </title>
            <editor>John Marshall, Toronto, Canada and Thierry Calandra, Lausanne, Switzerland</editor>
            <note>Meeting abstracts</note>
         </supplement>
         <conference>
            <title>
               <p>Sepsis 2007</p>
            </title>
            <location>Paris, France</location>
            <date-range>26&#8211;29 September 2007</date-range>
            <url>http://www.sepsisforum.org</url>
         </conference>
         <issn>1364-8535</issn>
         <pubdate>2007</pubdate>
         <volume>11</volume>
         <issue>Suppl 4</issue>
         <fpage>P8</fpage>
         <url>http://ccforum.com/content/11/S4/P8</url>
         <xrefbib>
            <pubid idtype="doi">10.1186/cc5987</pubid>
         </xrefbib>
      </bibl>
      <history>
         <pub>
            <date>
               <day>26</day>
               <month>9</month>
               <year>2007</year>
            </date>
         </pub>
      </history>
      <cpyrt>
         <year>2007</year>
         <collab>BioMed Central Ltd</collab>
      </cpyrt>
   </fm>
   <bdy>
      <sec>
         <st>
            <p>Background</p>
         </st>
         <p>Bone and joint sepsis occurs in 20% of newborns having perinatal sepsis. The feature of septic arthritis against the background of age-specific functional immunodeficiency gives us a reason to consider this decease as the manifestation of immunodeficiency. Septic arthritis in newborns is lethal in 10% of cases and gives orthopedic complications in 20% of cases. The starting moments of septic arthritis development are: mother's intrauterine infection and nosocomial infecting in maternity hospitals and intensive care departments, and purulent omphalitis.</p>
      </sec>
      <sec>
         <st>
            <p>Materials and methods</p>
         </st>
         <p>We present the experience of diagnostics and treatment of 180 newborns aged 3 days and older having septic affection of the hip, knee, shoulder and other joints. The crucial role in diagnostics of septic arthritis is played by: cytology of smear, ultrasonic examination of a joint, X-ray examination of a joint, bacteriological, serological, PCR and PCT-Q. The bacteriological monitoring in 30% of newborns among the pathogens showed CoMRSA, often mixed with fungi and <it>Pseudomonas aerogenes </it>or <it>Klebsiella pneumonia</it>, and in 10% there was PCR of <it>Toxoplasma gondi</it>, <it>Chlamidia trachomatis </it>or cytomegalovirus. Immunological monitoring allowed one to determine the patients who needed substitute therapy by immunoglobulin and a number of immunomodulators. The degree of infection process severity and the adequacy of antibacterial therapy are determined by serologic investigations, PCR and PCT-Q. The treating complex included joint lavage, antibiotics, anticytokine, antifungal agents, probiotics, and magnetic-laser therapy.</p>
      </sec>
      <sec>
         <st>
            <p>Results</p>
         </st>
         <p>The lethality was reduced to zero, transition into the chronic form was up to 2.5%, and orthopedic complications were presented in 10% of cases.</p>
      </sec>
      <sec>
         <st>
            <p>Conclusion</p>
         </st>
         <p>The after-history of treatment was researched and showed that when the diagnosis was made in less than 3 days, complications occurred in 3.3% of cases, and after 6&#8211;7 days the complications occurred in 22.4% of patients.</p>
      </sec>
   </bdy>
</art>
