A new method of monitoring osteomyelitis.

Chronic infections of bone such as osteomyelitis are frequent events, especially in immunocompromised or diabetic patients, and costly on a national level. Incorrect treatment or delayed diagnosis may lead to loss of the affected extremity or mandible. The aim of this study was to assess the possible value of urinary lysylpyridinoline (LP) and hydroxylysylpyridinoline (HP) concentrations in the monitoring of mandibular osteomyelitis. Patients were assigned to the following groups: group 1 (n=85), control; group 2a (n=38), patients with active disease; group 2b (n=25), patients of group 2a 6 months after successful treatment; group 2c (n=7), patients of group 2a with ongoing osteomyelitis 6 months after treatment. The range and upper limit of normal values (HP(max) and LP(max)) were determined in group 1. Levels of LP and HP were measured by high-performance liquid chromatography and fluorescence detection. There was a significant decrease (mean 45.43% for HP and 32.12% for LP) in samples of group 2b compared to 2a (P<0.001 for HP and LP). There was a significant increase in HP values in samples from group 2c compared to 2a (P=0.018). The urinary concentrations of HP and LP appear to act as a marker of disease activity, with a decrease reflecting treatment success and an increase or stable values indicating persistent disease. An inexpensive tool (US$5 per analysis) for the monitoring of osteomyelitis is described.

[Chromatographic analysis of urinary amino acids in Paget's disease. II : clinical study]. / Analyse chromatographique des acides aminés urinaires au cours de la maladie de Paget Partie II : étude clinique

The authors demonstrated in the urine of certain patients a peptide form of hydroxyproline and of glutamic acid. This peptide was found in patients with Paget's disease who presented clinical and laboratory signs of an evolutive episode and in other patients who presented restructuration of bone of a radiologicaly type. This peptide was one of the factors determining the increase in the total hydroxyprolinuria. The demonstration of the peptide provokes discussion as to its origin, and also of the possibility of using it as a biochemical parameter.