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Biomedical subjects

A Calin

Publications and source records attributed to A Calin.

At least 145 records · Page 8Linked to original sources
PubMed1984

Familial aggregation of Reiter's syndrome and ankylosing spondylitis: a comparative study.

To determine the nature and prevalence of spondyloarthropathy (SpA) among the 1st degree relatives of probands with either Reiter's syndrome (RS) or ankylosing spondylitis (AS), 599 relatives of 223 consecutive probands (110 RS and 113 AS) were blindly evaluated in a controlled study. Analysis was by questionnaire, radiographic examination without knowledge of proband or relative status and, where relevant, by chart review. No cases of RS were found among the 277 relatives of probands with AS. In contrast, 11 of 322 relatives of probands with RS did have RS which was neither temporally related in onset nor due to a common epidemic source (p less than 0.01). There were 18 cases of AS among the relatives of the probands with AS compared to only 7 cases among the relatives of the patients with RS (p less than 0.05). Two probands with AS each had 2 relatives with AS. Thus, the degree of familial aggregation in RS (11/110; 10%) approaches that seen in AS (16/113; 14%) and the 2 diseases tend to breed true within families. These data suggest that there may be different genetic backgrounds in patients with RS and AS, despite the fact that both conditions are typically associated with HLA-B27.

Adult↗
PubMed1983

Sustained improvement of intractable rheumatoid arthritis after total lymphoid irradiation.

Total lymphoid irradiation (TLI) was administered to 11 patients who had intractable rheumatoid arthritis that was unresponsive to conventional medical therapy, including aspirin, multiple nonsteroidal antiinflammatory drugs, gold salts, and D-penicillamine. Total lymphoid irradiation was given as an alternative to cytotoxic drugs such as azathioprine and cyclophosphamide. After radiotherapy, 9 of the 11 patients showed a marked improvement in clinical disease activity as measured by morning stiffness, joint tenderness, joint swelling, and overall functional abilities. The mean improvement of disease activity in all patients ranged from 40-70 percent and has persisted throughout a 13-28 month followup period. This improvement permitted the mean daily steroid dose to be reduced by 54%. Complications included severe fatigue and other constitutional symptoms during radiotherapy, development of Felty's syndrome in 1 patient, and an exacerbation of rheumatoid lung disease in another. After therapy, all patients exhibited a profound T lymphocytopenia, and a reversal in their T suppressor/cytotoxic cell to helper cell ratio. The proliferative responses of peripheral blood mononuclear cells to phytohemagglutinin, concanavalin A, and allogeneic leukocytes (mixed leukocyte reaction) were markedly reduced, as was in vitro immunoglobulin synthesis after stimulation with pokeweed mitogen. Alterations in T cell numbers and function persisted during the entire followup period, except that the mixed leukocyte reaction showed a tendency to return to normal values.

Adult↗
PubMed1983

Genetic differences between B27 positive patients with ankylosing spondylitis and B27 positive healthy controls.

In a controlled study of the 499 available first degree relatives of 79 consecutive HLA-B27 positive patients with ankylosing spondylitis and 69 HLA-B27 positive healthy blood donors, 19 cases of ankylosing spondylitis were found: 16 (15 B27 positive) among the 282 relatives of the patients with ankylosing spondylitis, and 3 (1 B27 positive, 1 B27 negative, 1 unknown) among the 217 relatives of healthy donors (chi c2 = 5.11; P less than 0.025). However, if all cases of possible spondylarthritis are included, 48 cases of ankylosing spondylitis were found: 37 of 282 relatives of patients with ankylosing spondylitis and 11 of 217 relatives of healthy donors (chi c2 = 8.29; P less than 0.01). Assuming that 50% of relatives of B27 positive individuals carry this antigen, 15 of 142 (10.6%) B27 positive relatives of patients and 2 of 108 (1.9%) B27 positive relatives of healthy subjects (chi c2 = 5.91; P less than 0.025) have ankylosing spondylitis. The relative risk of spondylarthropathy for B27 positive relatives of B27 positive patients compared with relatives of B27 positive healthy subjects is 5.6. Assuming all subjects were evaluated in a similar manner, analysis of these data suggests genetic differences between B27 positive diseased individuals and B27 positive healthy subjects.

Adult↗
PubMed1983

Clinical use of tolmetin sodium in patients with ankylosing spondylitis: a review.

The efficacy and safety of tolmetin sodium in the management of ankylosing spondylitis are presented in a review of published and unpublished data. In both open and controlled clinical studies, tolmetin was superior to placebo and equal to indomethacin in its capacity to relieve pain, inflammation, and other symptoms of ankylosing spondylitis (AS). Objective and subjective assessments showed that both tolmetin sodium and indomethacin provided significant therapeutic benefits to patients with AS. In AS, the two drugs showed similar adverse reaction profiles. Adverse reactions with both drugs were minimal and predominantly affected the gastrointestinal tract; in most cases these symptoms cleared spontaneously without discontinuing the drugs.

Clinical Trials as Topic↗
PubMed1983

The hand radiograph as a diagnostic discriminant between seropositive and seronegative 'rheumatoid arthritis': a controlled study.

Although traditional teaching emphasises that 70-80% of patients with rheumatoid arthritis have positive serological tests for rheumatoid factor, a review of the evidence suggests that the seronegative group has distinctive characteristics. In a blinded and controlled evaluation of hand and wrist films we correctly identified the serological status of 43 out of 46 patients satisfying the ARA criteria for 'definite RA'. The radiographic appearances of the seronegative group differed significantly from those of the seropositive group in (1) degree of juxtalesional osteosclerosis (p less than 0.001); (2) the relative absence of classical subchondral erosions (p less than 0.001); (3) presence of new bone formation (p less than 0.001); (4) more fusion (p less than 0.001); (5) more asymmetrical joint involvement (p less than 0.001); and (6) predominant carpal involvement (p less than 0.001). The nature of the destructive process, as defined radiologically, may be different in patients with seropositive rheumatoid arthritis from that seen in individuals with so-called 'seronegative rheumatoid arthritis'.

Adult↗
PubMed1983

Efficacy and tolerance of a novel precision-dose formulation of indomethacin: double-blind trials in rheumatoid arthritis and osteoarthritis.

Two short-term, double-blind, multi-centre studies, one in rheumatoid arthritis and the other in osteoarthritis, were carried out to investigate the efficacy and tolerance of two formulations of the new osmotic delivery system containing sodium indomethacin trihydrate ('Osmosin') compared with conventional indomethacin capsules and placebo. Both formulations contained the equivalent of 85 mg indomethacin. 'Osmosin' was designed to deliver drug in solution at a constant rate of 7 mg per hour, the other formulation at 9 mg per hour. The results indicated that 'Osmosin' administered once or twice daily was at least as effective in reducing disease symptoms as 25 mg indomethacin capsules 3-times daily. In addition, the combined incidence of gastro-intestinal side-effects reported in the two studies was significantly lower with 'Osmosin' than with the other active drug groups. The possible contribution of this novel drug delivery system towards patient compliance as a result of less frequent administration and fewer digestive system side-effects is discussed.

Administration, Oral↗
PubMed1983

Observer variation in grading sacroiliac radiographs in HLA-B27 positive individuals.

This study attempts to reconcile the apparent differences in the reported frequency of ankylosing spondylitis and radiological sacroiliitis in HLA-B27 positive individuals. Pelvic radiographs from 125 Busselton subjects were mixed with 81 other films selected to illustrate the possible range of sacroiliac changes and were graded by observers who were involved in 2 of the conflicting studies and by a 3rd independent observer. Concordance was high for advanced bilateral disease but not for unilateral and milder changes. Variation between observers and the interpretation of sacroiliac radiographs is sufficiently large to account for much of the disagreement between frequency estimates.

Arthritis↗
PubMed1983

Spondyloarthropathy in Caucasians and non-Caucasians.

The striking association between the spondyloarthropathies and HLA-B27 transcends all ethnic and geographical boundaries. The relationship between the various entities is well defined for many conditions, but others such as pustulotic arthroosteitis, undifferentiated spondyloarthropathy, and seronegative enthesopathic arthropathy of childhood are less clear. The association between B-27 and disease is less dramatic in non-Caucasians where cross-reacting antigens and other genetic determinants may be more important. Worldwide, some 20% of individuals develop sacroiliitis or Reiter's syndrome following an unknown or specific infective agent, respectively. The debate continues as to whether B27 itself is operative or whether additional gene or genes are required. Detailed epidemiological and molecular analysis is required.

Arthritis, Reactive↗
PubMed1983

Analysis of HLA-B27 antigen with monoclonal antibodies.

To explore the possibility that the HLA-B27 antigen may exist in more than one form, murine monoclonal antibodies were produced to B27 molecules. The first such antibody, anti-B27M1, reacts with 100% of B27 + cells and, therefore, does not distinguish B27 + healthy individuals from those with spondyloarthropathies. A second antibody, anti-B27M2, recognizes a variant of the B27 molecule that is present in most but not all Caucasian B27 + individuals. The frequency of B27M2(+) variants also appears to differ among different ethnic groups. Preliminary studies suggest that B27 + patients with ankylosing spondylitis are less likely than B27 + healthy individuals to express the B27M2 variant.

Animals↗
PubMed1983

Ankylosing spondylitis in women and men: a case-control study.

During an ongoing survey of 161 patients with ankylosing spondylitis (AS), 25 females were identified and retrospectively studied in detail. For each, a case-control male subject with similar age of onset of illness (mean, 23.0 years for women, 22.2 years for men) and duration of followup (mean, 20.7 years for women, 17.0 years for men) was selected. The diagnosis of AS was delayed an average of 12.8 years for females and 10.3 years for males. Extraspinal arthropathy occurred in 18 women (72%) and 8 men (32%) (p less than 0.05). Cervical spine disease and shoulder arthritis each occurred in 10 women (40%) and 4 men (16%) (NS). Hip disease affected 10 females and 6 males (NS). Peripheral joint disease occurred in 12 women (48%) and 9 men (36%); the knees were most commonly involved. Recurrent uveitis affected 10 females and 1 male (p less than 0.01). Anemia was detected in 8 women and 2 men (p less than 0.05). Sixty percent of the women had relatives with spondylarthritis, compared to 35% of the men (p less than 0.05). This last finding suggests that, in addition to possible hormonal and anatomic influences on the expression of disease, there may be some sex-linked, genetic factors.

Adolescent↗
PubMed1982

Aortitis in ankylosing spondylitis: early detection of aortic root abnormalities with two dimensional echocardiography.

Mild aortic root dilatation, cusp thickening and subvalvular fibrous ridges have been reported as characteristic in patients with ankylosing spondylitis and aortic regurgitation. Thirty-five patients with ankylosing spondylitis (10 also had Reiter's syndrome) without clinically apparent cardiac involvement were studied using phased array two dimensional and sector-directed M mode echocardiography to determine the prevalence of aortic abnormalities. Aortic root dimensions were measured at the aortic anulus, at the tip of the cusps and 0.5 to 1.5 cm above the cusps. The two dimensional echocardiographic study was also analyzed for qualitative abnormalities. The dimensions were compared with those in 20 normal men and among patient subgroups separated according to age, duration and severity of ankylosing spondylitis and presence of qualitative abnormalities. With one exception, no abnormally increased aortic dimensions suggestive of aortic dilatation were found in any group. However, two patients had aortic dimensions greater than 4.2 cm at the valve (normal 4.0 cm or less). Also, six patients had discrete areas of increased bright echoes below the left or noncoronary cusps suggestive of a subaortic "bump" and two of the six patients had increased aortic cusp echoes suggestive of thickening or fibrosis, or both. These changes tended to occur more commonly in older patients and those with more severe disease. It is concluded that aortic root changes suggestive of inflammation or fibrosis, or both, occur in asymptomatic patients with ankylosing spondylitis and are detectable on two dimensional echocardiography. Dilatation usually does not occur without aortic regurgitation.

Adult↗