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ID PMID Title PublicationDate abstract
8471173 [Antiphospholipid syndrome: a new diagnostic option in rheumatology in children. Analysis 1993 Apr There are some patients with a clinical picture that suggests to be a rheumatological problem. However, it does not have all the criteria to be accepted such as specific problems like systemic lupus erythematosus, juvenile rheumatoid arthritis, etc. Now we know that a relation between high levels of antiphospholipid antibodies exist in these special patients and the name of the disease is antiphospholipid syndrome. This problem can be primary or secondary. This disease has been studied mainly in adults with SLE an there is not a description of this syndrome in national pediatric literature. For this reason we present three clinical cases that permit us to review both forms of the syndrome. In this way we alert want to the pediatric community about this topic, and if the number of cases increases, it will improve the knowledge and prognosis of the patients at this age.
8379159 [The spine in adulthood]. 1993 Back pain and low back pain can be caused by extravertebral diseases, functional disorders or morphologic changes of the spine. Diagnosis of back pain is mainly done by clinical examination. The examination of segmental mobility is necessary to make the diagnosis of functional disorders. X-ray and laboratory are mainly used to exclude morphologic changes of the spine. Functional disorders are best treated by chirotherapy completed by rehabilitation of the active motion apparatus. The most important morphologic diseases of the spine causing back pains are deformities, especially lumbar scoliosis, infectious diseases as pyogenous or specific spondylitis, rheumatic diseases as rheumatoid arthritis, mostly at the occipitocervical region, and Bechterew's disease, furthermore instability caused by spondylolisthesis or iatrogenic low back pain as the failed-backsyndrome and tumors, which are in the majority metastases. The role of degenerative changes as a cause of back pain is difficult to estimate. The operative treatment of spinal instability, which has changed in the last years is described, as modern treatment facilities of lumbar disc herniation as chemonucleolysis or percutaneous nucleotomy.
1448809 [Growth hormone therapy in dysmorphic syndromes and chronic disease]. 1992 Oct Many clinical syndromes are associated with short stature, which can be proportionate or disproportionate. In the first group of syndromes, such as Turner syndrome and its variants, Down syndrome, Prader-Willi-Labhart syndrome, Noonan syndrome, and Silver-Russell syndrome growth hormone therapy can lead to increased growth velocity, but so far only short-term results have been reported. Growth hormone is contraindicated in syndromes with an increased risk of chromosomal breakage, e.g. Bloom syndrome. In disproportionate syndromes, such as hypochondroplasia, pseudopseudohypoparathyroidism, spina bifida, and hypophosphataemic rickets, the results of growth hormone therapy are not encouraging. Growth hormone therapy in children with rheumatoid arthritis and thalassaemia appears little effective. Long-term clinical trials of reasonable size are needed before reliable conclusions can be drawn about the value of growth hormone therapy in these conditions.
1506969 Erosion and heterotopic bone formation after alloplastic temporomandibular joint reconstru 1992 Sep Twenty-three temporomandibular joint arthroplasties using metallic condylar prostheses were performed because of severe ankylosis (8 patients), segmental mandibular resections in tumor surgery (9 patients), and after extensive trauma (2 patients). A clinical and radiological follow-up study showed heterotopic bone formation in 52% of cases and glenoid fossa resorption in 43%. In one patient with rheumatoid arthritis the condyle eroded through the skull base 10 months after surgery. Seven prostheses (30%) were removed and/or exchanged during the average 27.6-month follow-up.
1386831 [Fc gamma receptors: structure, function, and clinical significance]. 1992 Jul Fc gamma receptors are a group of three different receptors with several subtypes. They are widely distributed on many cells of the immune system and contribute to the pathogenesis of immune complex- and autoantibody-mediated diseases such as vasculitis, rheumatoid arthritis, idiopathic thrombocytopenic purpura or autoimmune neutropenia. This review focuses on the structure, distribution and function in Fc gamma receptors and their subtypes.
1615334 The therapeutic role of recombinant erythropoietin in anemic patients with intact endogeno 1992 Jun Recombinant human erythropoietin (r-HuEPO) has been shown to be remarkably effective in raising the hemoglobin concentrations and improving the quality of life of patients with chronic renal disease. It is currently under investigation for treatment of patients with nonrenal anemias associated with cancer chemotherapy, acquired immunodeficiency syndrome, rheumatoid arthritis, and other chronic illnesses. To date, investigators have shown that patients with mild anemia and low endogenous erythropoietin (EPO) production may be good candidates for such treatment. Conversely, studies have shown that patients with severe anemia and serum EPO concentrations of above 500 mU/mL apparently do not respond to doses used for patients with mild anemia or chronic renal disease. Large doses of r-HuEPO may be of use in such patients, and clinical trials are in progress to determine if it is at least possible to make these patients transfusion-independent.
1606793 Bronchiolitis obliterans organizing pneumonia: the clinical and radiological features of s 1992 Jun The clinical and radiological features of seven cases of bronchiolitis obliterans organizing pneumonia (BOOP) are presented and the literature is reviewed. Six of these cases were idiopathic, one patient had rheumatoid arthritis. Detailed respiratory function tests were available in four cases and showed a restrictive defect with impaired gas transfer. The majority of chest radiographs showed consolidation with no zonal preponderance. One case with unilobar consolidation was mistaken for malignancy. Another case with interstitial shadowing was thought to have cryptogenic fibrosing alveolitis. In those cases with consolidation, it was mainly peripheral. Six of the cases showed good response to oral steroid therapy. Open lung biopsy was the principal means by which tissue was obtained for diagnosis. BOOP should be included in the differential diagnosis of multifocal consolidation. The condition is usually responsive to steroid therapy, so it is important to confirm the diagnosis histologically.
20470586 [Use of radiocolloids in orthopaedic practice.]. 1996 The authors submit in their paper the results of treatment with radiocolloids 198Au and Y90 in patients with chronic synovialitis associated with rheumatoid arthritis, degenerative diseases, haemophilia, posttraumatic conditions, arthropathy and gout. During the period between 1970 and 1995 they administered radiocolloid 1259 times to 865 patients. Up to 1986 they administered radiocolloid of gold 198, since 1986 to the present time only radiocolloid of yttrium 90. The authors compare the results obtained with the two preparations, the results being greatly in favour for yttrium. The evaluation was made 6 months before administration and 6 months following administration of radiocolloid. Following administration of gold 198 they recorded substantial improvement in one third of the patients and improvement in half the patients. After administration of yttrium 90 44% patients improved substantially and 49% of the patients improved. A long-term effect of treatment with radiocolloids after more than six months of treatment was found after gold 198 administration in 27% patients and after yttrium 90 in 78% patients. No therapeutic response was recorded after administration of gold 198 in 29% and after administration of yttrium 90 in 22% patients. Key words: chronic synovialitis, radiosynoviorthesis, radiocolloid 198Au and 90Y.
9010973 Parvovirus B19 infection and rheumatic diseases. 1996 Dec We reviewed the literature on relationships between human parvovirus B19 infection and rheumatic diseases. Parvovirus B19 causes erythema infectiosum in childhood, transient anemia in immunocompetent individuals, and potentially severe infections in fetuses; laboratory evidence that the virus is directly responsible for these disorders has been obtained. Acute arthropathy meeting American College of Rheumatology criteria for rheumatoid arthritis and disorders meeting some of the classification criteria for systemic lupus erythematosus are the most striking rheumatic manifestations of parvovirus B19 infection. Purpuric lesions have also been reported. Parvovirus B19 infection may be capable of inducing a number of manifestations that have not yet been described in the literature. Although the relationship between human parvovirus B19 infection and rheumatic diseases has been the focus of many studies, compelling evidence that the virus is directly involved in the pathogenesis of rheumatic diseases has not yet been obtained.
8948305 Injectable gold compounds: an overview. 1996 Nov Injectable gold compounds have enjoyed widespread, but occasionally controversial, use in rheumatoid arthritis since the 1920s. This overview examines the data from controlled trials and longer-term observational studies. We conclude that gold is equivalent to other widely used second-line agents in terms of efficacy. Toxicity profiles are similar, apart from methotrexate. It is most efficacious and toxic in the first 2 yr of treatment. There appears to be a dose-response relationship for both efficacy and toxicity. Gold is one of the few agents that decreases the rate of progression of erosions (RR 0.38, 95% CI 0.23-064). Gold compounds, therefore, have a definite place in the rheumatologist's armamentarium, but further research is required to determine optimal monitoring regimes as well as the role of maintenance therapy and combination therapy.
8902738 Central nervous system involvement in amyloid A type amyloidosis. 1996 Oct We report a 38-year-old male with recurrent cerebral infarction, who had a history of juvenile rheumatoid arthritis and suffered from ischemic necrosis of the jejunum at the age of 34 years. When the patient showed gastrointestinal symptoms, amyloid deposits were found with colon biopsy. The patient experienced recurrent episodes of headache and left homonymous lower quadrantanopsia at the age of 38 years. CT and MRI of the head revealed cerebral infarction in the right parieto-occipital region. At this time, amyloid deposits were detected in the mucosa of the stomach, duodenum, and rectum. Immunostaining revealed that amyloid fibrils were composed of amyloid A (AA) protein. It is possible that AA type amyloidosis may be of importance in the etiology of cerebral infarction in the young adult.
7996683 [Gut mucosal immunity and oral tolerance]. 1994 Nov The biological phenomenon that experimental animals become hyporesponsive to a particular protein antigen, when orally administered, is called oral tolerance. A breakdown of oral tolerance to dietary antigens may be related to food allergy. Conversely, the induction of oral tolerance by feeding autoantigens, such as myelin basic protein, protects animals from subsequent immunization by this antigen resulting in development of experimental autoimmune encephalomyelitis, which is a disease model of the human demyelinating disease, multiple sclerosis (MS). The mechanism of oral tolerance could be an induction of suppressor cells, which release inhibitory cytokines including transforming growth factor beta, when triggered antigen-specifically and/or clonal anergy to fed antigen. Against this background, patients with MS and rheumatoid arthritis are on a clinical trial with bovine myelin and type II collagen feeding, respectively. Oral tolerance could be a part of the mainstream in future treatment strategies for human diseases with autoimmune etiologies.
7996675 [The involvement of gamma delta T cells in neurological disorders]. 1994 Nov Several studies have demonstrated that gamma delta T cells increased during infections with various Pathogens. A significant fraction of these gamma delta T cells are specialized in recognizing mycobacterial antigen, in particular, 65 kda heat-shock protein (Hsp), which is highly conserved between bacteria and eukaryotes. The demonstrated immunogenicity of a number of hsp has led to their being implicated in diseases of possible autoimmune etiology. A possible role of gamma delta T cells in human autoimmune diseases such as rheumatoid arthritis, diabetes, polymyositis, sarcoidosis and acute or chronic multiple sclerosis has been previously proposed. In this brief review, we summarized the current understandings of the immunobiology of gamma delta T cells focusing on the involvement of autoimmune processes.
8025760 Opportunistic infection during treatment with low dose methotrexate. 1994 Jul Two patients receiving low dose methotrexate, one with rheumatoid arthritis and the other with pityriasis rubra pilaris, developed disseminated histoplasmosis and Mycobacterium avium intracellulare pneumonia, respectively. Twenty-three cases of opportunistic infection in patients receiving low dose methotrexate have been reported previously, with Pneumocystis carinii pneumonia being the most common infection (10 of 23, 43%). Patients receiving low dose methotrexate are at risk for opportunistic infection despite normal leukocyte counts.
23916131 Ground reaction force and its moment with respect to the knee joint centre in a total cond 1994 Mar In a group of patients with rheumatoid arthritis (n = 5)and osteoarthrosis (n =3) who had had had 12 total condylar knee arthroplasties a new technique for assessment of ground reaction forces was used. This technique graphically displays force vectors superimposed in real time on a video recording of the subject walking. We found that this new technique could assess reliably moments of the ground reaction force vectors with respect to the centre of the knee joint. Four patients had bilateral total condylar knee arthroplasty. All patients were subjectively satisfied with their operations and had neither radiographic nor clinical signs of loosening. Considerable moments were found in the dorsal part of the medial tibiofemoral compartment. These moments increased with extension deficits and varus angles. The size of these moments were consistent with earlier findings of increased bone strengths in the same compartment as the biological answer to stress demands and earlier studies of moment after total condylar knee arthroplasty.
8256631 Quality of life and daily management of children with rheumatic disease. 1993 Oct Appropriate management of the daily life of patients with rheumatic diseases is an important part of therapy for favorable results and a high quality of life. At home, gymnastic exercise, night splints and appropriate fun activities will help to preserve the function of affected joints of patients with juvenile rheumatoid arthritis (JRA). Improvement of home fixtures according to patient disability will provide a higher quality of life for the patients. The patient should be helped to perform as many school activities as would normally be possible. Instructional charts for management of school life for patients with JRA and systemic lupus erythematosus is shown in this article. Cooperation with school personnel is also crucial to support the patient emotionally and physiologically. For the best long-term treatment and a good relationship between patient and physician, comprehensive management is essential. Not only physicians, but also psychiatrists, occupational therapists, physical therapists and social workers should be involved in the treatment of children with rheumatic diseases.
8296655 Membrane surface proteinase 3 expression and intracytoplasmic immunoglobulin on neutrophil 1993 We studied the presence of proteinase 3 (PR3), myeloperoxidase (MPO) and elastase (HLE) on the plasma membrane of neutrophils in patients with biopsy-proven Wegener's disease (WG), pANCA-positive vasculitis, control patients (SLE, rheumatoid arthritis, ankylosing spondylitis), sepsis patients and healthy donors. We found an overexpression of PR3 on the cell surface of neutrophils in WG, ANCA-associated vasculitis and during infection (sepsis). Thus PR3 becomes accessible to ANCA. Furthermore we detected intracytoplasmic IgG antibodies in PMN from patients with WG by immunoelectron microscopy and direct immunofluorescence. Our findings support the pathophysiological role of ANCA.
8036589 [The role of sympathetic reactivity in the development of Raynaud's syndrome]. 1993 Finger skin blood flow was studied in 131 patients with Raynaud's syndrome using laser Doppler flowmetry. Scleroderma systematica, systemic lupus erythematosus, rheumatoid arthritis, Sjogren's disease, mixed connective tissue lesions, Raynaud's disease were diagnosed in 61, 17, 10, 10, 10 and 13 examinees, respectively. Control consisted of 20 healthy subjects. The response of the blood flow was registered in response to functional tests activating sympathetic nervous system: indirect cooling, emotional stress, deep inhalation, Valsalva's test. Hyper-response to the above sympathetic stimulation was noted in none of the groups studied. In scleroderma systematica the reactivity significantly decreased with longer disease duration. It is clear that the study did not confirm the leading role of sympathetic hyperactivity in Raynaud's syndrome pathogenesis.
1506703 [A successful case of thoracic aortic aneurysm with mixed cryoglobulinemia]. 1992 Jul Cold-reactive proteins, such as cold agglutinins, cryoglobulins, and cryofibrinogens, are reversibly precipitates, or gel, upon exposure to cold temperatures. Cryoglobulins are usually not of importance, but under special conditions, such as surgical hypothermia, hyperviscosity and damage in microcirculation may occur in patients with high plasma concentration of cryoglobulins. Several groups have reported their efforts to reduce further the risks of surgical hypothermia in patients with cold agglutinins, but rarely in patients with cryoglobulins. A 57-year-old woman with thoracic aneurysm, requiring replacement of the ascending aorta and the aortic arch, had mixed cryoglobulinemia (cryocrit 29%) associated with rheumatoid arthritis. Steroids therapy and preoperative plasmapheresis were performed, and cryocrit levels were decreased until 0% before operation. Systemic hypothermia (25 degrees C), hemodilution techniques during cardiopulmonary bypass, and cold crystalloid cardioplegia were successfully employed, and no clinical evidence of microcirculation damage was posed after operation.
1409097 Quantitative analysis of quadriceps muscle biopsy in systemic sclerosis. 1992 Jun The lesser diameter of the fibers, separately of type 1 and type 2 fibers, and the capillary density evaluated as number of capillaries/area and number of capillaries/fiber were quantitatively estimated in muscle biopsies from 12 patients with systemic sclerosis. Nine patients with polymyositis or rheumatoid arthritis and six patients with muscle dystrophy and neurogenic atrophy served as controls. The results showed that patients with systemic sclerosis had low values of the lesser diameter of the fibers. This reduction was most obvious in type 2 fibers. The capillaries were also significantly reduced when compared with the control groups. When considering the capillaries/fiber ratio, seven out of eight patients with values lower than 0.7 belonged to the systemic sclerosis group. In systemic sclerosis the capillary density values were not significantly correlated with those of the lesser diameters of the fibers.