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Biomedical subjects

A Kahan

Publications and source records attributed to A Kahan.

At least 91 records · Page 5Linked to original sources
PubMed1989

Lyme arthritis.

Evanescent arthralgias and myalgias are common early symptoms of Lyme disease. Transient, intermittent episodes of monoarticular, oligoarticular, or sometimes migratory polyarticular arthritis, lasting weeks to months, with disease-free intervals, are frequently observed in untreated patients with erythema chronicum migrans. A minority of patients develop chronic joint involvement, most commonly affecting the knee. Antibiotic therapy given during erythema chronicum migrans is often protective with regard to late joint manifestations. In chronic Lyme arthritis, however, the response to antibiotics is variable.

Anti-Bacterial Agents↗
PubMed1989

Lacrimal and salivary immunoglobulins in Sjögren's syndrome.

The diagnosis of Sjögren's syndrome is sometimes difficult. We have previously demonstrated the diagnostic value of salivary immunoglobulins IgG and IgM in Sjögren's syndrome. In the present study, we assessed both lacrimal immunoglobulins (1 Ig) and salivary Ig (s Ig) in Sjögren's syndrome. We studied 112 patients: 71 had rheumatoid arthritis (57 sero positive), 19 had connective tissue diseases or vasculitis (six Sjögren's syndrome alone, six systemic sclerosis, three mixed connective tissue diseases, three polyarteritis, one relapsing polychondritis), and 22 patients had other inflammatory, metabolic or degenerative joint diseases. Lacrimal Ig and salivary Ig were assessed by double immunodiffusion with antisera specific for IgG, IgM and IgA. Each Ig class was scored on a scale ranging from 0 to 3 plus without knowledge of the patient's diagnosis. The results of factorial analysis demonstrated a strong relationship between xerophtalmia, positive Schirmer's test, s IgG, s IgM, 1 IgG, and 1 IgM in patients with seropositive rheumatoid arthritis or other connective tissue diseases. Analysis of individual parameters showed a significant relationship between 1 IgG and ocular complaints (P less than 0.01), positive Schirmer's test (P less than 0.05), positive rose bengal dye test (P less than 0.05), 1 IgM (P less than 0.01), s IgG (P less than 0.01) and s IgM (P less than 0.05). A significant relationship was also found between s IgG and ocular complaints (P less than 0.02), positive rose bengal dye test (P less than 0.01), positive minor salivary gland biopsy (P less than 0.05), s IgM (P less than 0.01), and 1 IgM (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Recombinant interferon-gamma in the treatment of systemic sclerosis.

PURPOSE: Recombinant interferon-gamma (IFN-gamma) is a potent and selective inhibitor of collagen production by dermal fibroblasts in vitro and has numerous immunoregulatory activities. We assessed the effects of recombinant IFN-gamma in the treatment of patients with systemic sclerosis. PATIENTS AND METHODS: Ten patients entered the study and nine completed the six-month study period. Recombinant IFN-gamma was administered once daily for seven days per week by intramuscular injections: 10 micrograms/day for 10 days, 25 micrograms/day for 10 days, 50 micrograms/day for 10 days, and 100 micrograms/day for the next five months. RESULTS: After the six-month treatment period, a significant improvement, as compared with base-line values, was observed in total skin score, maximal oral opening, range of motion of wrists and elbows, grip strength, functional index, dysphagia, and creatinine clearance. No serious side effects were observed; however, a significant decrease in white blood cell counts and in peripheral blood lymphocytes was noted. CONCLUSION: These results suggest that recombinant IFN-gamma may be beneficial in the treatment of patients with systemic sclerosis.

Adult↗
PubMed1989

[Angina without involvement of large coronary trunks and precapillary pulmonary hypertension in a patient with periarteritis nodosa].

A patient affected with periarteritis nodosa and angina, presented a normal coronary angiography of the coronary trunks and an alteration of the left ventricular systolic function, improved by nicardipine, as well as a pre-capillary pulmonary hypertension with isolated, right cardiac repercussions, without pulmonary fibrosis nor thromboembolic disease. In addition, he presented three transient cerebral ischaemic accidents, with different localizations, which could not be related to a right aneurysm of the sylvian artery. Isolated precapillary pulmonary hypertension, without pulmonary fibrosis, which is not described in the course of periarteritis nodosa, seems related to an arteriolar involvement which is the known substratum of other visceral involvement in periarteritis nodosa. Improvement of the left ventricular function with nicardipine, administered acutely, suggest a partially reversible disorder of the coronary microcirculation.

Angina Pectoris↗
PubMed1989

[Neuro-rheumatologic manifestations in patients infected with the AIDS virus].

We are reporting 3 cases of lumbo-radiculalgia, simulating the usual picture of herniated disc, and revealing complications related to the virus of acquired human immunodeficiency (HIV). Rheumatologists must be aware of any atypical clinical signs in patients suffering from lumboradicular disease, and search for a HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1988

[Myocardial microvascularization in scleroderma].

Myocardial involvement in systemic sclerosis may be caused, at least in part, by myocardial ischemia due to functional or structural abnormalities of small coronary arteries or arterioles. Coronary reserve, assessed by dipyridamole-induced coronary vasodilatation, was strikingly impaired in patients with systemic sclerosis. Thallium scans have shown numerous myocardial perfusion defects in scleroderma patients. Two studies, using oral nifedipine and intravenous dipyridamole, demonstrated that these thallium-201 myocardial perfusion defects in patients with systemic sclerosis were partially reversible. Finally, the preliminary results of long-term studies suggest that some coronary vasodilators may be beneficial in the long-term treatment of myocardial perfusion abnormalities in systemic sclerosis.

Coronary Circulation↗
PubMed1988

Nicardipine improves myocardial perfusion in systemic sclerosis.

Primary scleroderma myocardial disease may be due in part to myocardial ischemia caused by a disturbance of the coronary microcirculation. We evaluated the effect of the calcium channel blocker nicardipine on myocardial perfusion assessed by thallium-201 scanning in 16 patients with systemic sclerosis. Thallium-201 single photon emission computerized tomography was performed at baseline and 90 min after 40 mg of oral nicardipine. The mean (+/- SD) number of left ventricular segments with perfusion defects significantly decreased from 6.0 +/- 2.0 at baseline to 4.1 +/- 2.3 after nicardipine (p less than 0.01). The mean global perfusion score significantly increased from 10.2 +/- 1.9 at baseline to 11.9 +/- 2.6 after nicardipine (p less than 0.02). Our study demonstrates short-term improvement in thallium-201 myocardial perfusion with nicardipine in patients with systemic sclerosis.

Adult↗
PubMed1987

Nicardipine in the treatment of Raynaud's phenomenon: a randomized double-blind trial.

The efficacy of the calcium-channel blocker nicardipine in the treatment of Raynaud's phenomenon was assessed in a prospective, double-blind, randomized, crossover trial in 20 patients. Each patient received nicardipine 20 mg or placebo three times a day for two weeks and then was crossed over for two weeks. Nicardipine significantly decreased the frequency and severity of Raynaud's phenomenon as compared with placebo. The authors conclude that nicardipine is effective in the treatment of Raynaud's phenomenon.

Adolescent↗
PubMed1987

Normal suppressive T cell function of Epstein-Barr virus-induced B cell activation in Graves' disease.

Several studies have demonstrated abnormalities of T cell regulation of Epstein-Barr virus (EBV)-induced B cell activation in systemic autoimmune diseases, such as rheumatoid arthritis, systemic lupus erythematosus, and systemic sclerosis. To investigate whether this abnormality is a common feature of other autoimmune diseases, we studied 10 EBV-immune normal subjects and 22 EBV-immune patients with Graves' disease (GD); 11 had newly diagnosed hyperthyroidism, and 11 had received carbimazole treatment for hyperthyroidism for at least 6 months. Peripheral B lymphocytes infected with EBV were cultured for 20 days in the presence or absence of autologous T cells at different ratios. Immunoglobulins M and G secretion into the supernatants was determined using an enzyme-linked immunosorbent assay. The extent of suppression when T cells were added, as measured by a suppression ratio, was not significantly different in normal subjects and newly diagnosed GD patients (0.65 vs. 0.63 on the 16th day and 0.77 vs. 0.72 on the 20th day of culture, respectively). In carbimazole-treated patients, the appearance of functional suppressor T cells was delayed slightly, but the overall suppression ratios on the 16th and 20th days were normal. Thus, a T cell regulation abnormality of EBV-induced B cell activation could not be demonstrated in patients with untreated hyperthyroid GD, suggesting that the autoimmune reactivity in such patients is probably dependent upon a specific thyroid suppression defect rather than a generalized suppression defect.

Adult↗
PubMed1987

[TaqI restriction polymorphism and the HLA-B27 allele in ankylosing spondylitis].

The restriction polymorphism Taq I of the 3.5 kb fragment of Class I HLA sequences is tested in patients suffering from ankylosing spondylarthritis, with or without antigen HLA B27. In a reference population, the frequency of this polymorphism is higher than that of allele B27. All B27 individuals, ill or not, present the polymorphic band, also present in some individuals B12. The distribution of this band is studied, in unrelated individuals serotyped for HLA B as well as members of families with spondylarthritis. The presence of the variable 3.5 kb band is not automatically correlated with the gene of the disease in corresponding individuals.

Alleles↗
PubMed1987

[Nicardipine in the treatment of Raynaud's phenomenon].

The efficacy of the calcium-channel blocker nicardipine in the treatment of Raynaud's phenomenon was assessed in a double-blind, randomised, crossover trial in 20 patients. Each patient received 2 weeks of nicardipine 20 mg three times daily and 2 weeks of placebo. Nicardipine significantly improved the frequency and severity of Raynaud's phenomenon. An open study during 2 months in 30 patients confirmed the effectiveness of nicardipine (20-40 mg 3 times daily). Side effects (headache, flushing, ankle oedema) were frequent but usually mild. We conclude that nicardipine is effective in the treatment of Raynaud's phenomenon.

Adult↗
PubMed1987

[Systematic ileocolonoscopy in seronegative spondylarthropathies].

An inflammation of the ileum was observed by Mielants and Veys in patients suffering from reactional arthritis associated to HLA B27 antigen. We thought it would be interesting to perform a systematic ileo-colonoscopy in patients suffering from seronegative spondylo-arthropathy, whether it was an axial or a peripheral form of the disease, or it was associated or not to HLA B27 antigen. The results observed in 30 patients who responded to the criteria of Wright and Moll for the diagnosis of seronegative spondylo-arthropathy, were compared to those of 18 patients suffering from various gastro-intestinal disorders. Macroscopically, a minimal abnormality (erythematous patches and/or micro-ulcerations) was observed in 10 out of 30 patients, and never in the reference group (p less than 0.02). The histological examination demonstrated, in patients suffering from spondylarthritis, a higher frequency of minimal signs of inflammation (lympho-plasmocytes infiltration) at the level of the ileum (in 18 out of 19 patients versus 11 out of 18 patients in the reference group, p less than 0.05) and at the level of the rectum (in 15 out of 19 patients, versus 8 out of 17 patients in the reference group, p less than 0.05). This study suggests therefore the presence of minimal ileorectal inflammation in patients with seronegative spondylo-arthritis, which could have an influence on the pathogenesis and/or the evolutive course of the disease.

Colonoscopy↗
PubMed1987

[Multicentric reticulohistiocytosis. A case with unusual clinical, radiologic and ultrastructural aspects].

We are reporting a case of multicentric reticulo-histiocytosis which is exceptional because of its gravity and the diversity of the clinical lesions: huge subcutaneous nodules, bone destruction in the spine responsible for spondylolisthesis, pulmonary fibrosis, acute pericarditis, laryngeal compression requiring a permanent tracheostomy. From ultrastructural observations, various hypotheses to explain the intra-macrophagic accumulation of membrane granules and lipids are discussed.

Arthritis↗