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Biomedical subjects

A Kraus

Publications and source records attributed to A Kraus.

At least 19 recordsLinked to original sources
PubMed1995

Autoimmune thyroid disease in primary Sjögren's syndrome.

PURPOSE: To evaluate the prevalence of autoimmune thyroid disease and thyroid dysfunction in patients with primary Sjögren's syndrome. PATIENTS AND METHODS: Thyroid function of 33 patients with primary Sjögren's syndrome was clinically and biochemically evaluated. Thyroid hormones and autoantibodies against thyroid peroxidase, thyroglobulin, and thyroid hormones were measured. RESULTS: Autoimmune thyroid disease and thyroid dysfunction were found in 15 cases (45%): autoimmune thyroiditis in 8 (24%); autoimmune hyperthyroidism in 2 (6%); and reversible iodine-induced hypothyroidism in the remaining 5 (15%). One or more of the evaluated autoantibodies were detected in 8 euthyroid patients (24%). Overall, the prevalence of autoantibodies against thyroid peroxidase, thyroglobulin, thyroxine, and triiodothyronine was 45%, 18%, 42%, and 36%, respectively. CONCLUSIONS: The high prevalence of autoimmune thyroid disease and thyroid dysfunction found in primary Sjögren's syndrome, using sensitive immunologic and thyroid function tests, suggest that both diseases are more frequently associated than it was previously thought, and should be sought clinically and by laboratory tests in all patients with primary Sjögren's syndrome.

Adult↗
PubMed1995

Cloning, expression and functional analyses of the catabolite control protein CcpA from Bacillus megaterium.

A mutant of Bacillus megaterium relieved from catabolite repression has been used to clone ccpA from B. megaterium by complementation. ccpA is the first gene of a presumed operon, in which it is followed by the motA homologue ORF1 and the motB homologue ORF2. The mutation maps in the 3'-terminal region of ccpA, where an in-frame duplication of 84 nucleotides located between two 9 bp direct repeats leads to an insertion of 28 amino acids near the C-terminus of CcpA. An in-frame deletion of 501 bp in ccpA exhibits the same phenotype as the 84 bp duplication. Deletion of ORF1 and ORF2 does not yield an apparent phenotype. A single-copy ccpA::lacZ transcriptional fusion is constitutively expressed, independent of whether the growth medium triggers catabolite repression or not. The ccpA mutation leads to relief of catabolite repression exerted by glucose, fructose, mannitol, glucitol and glycerol, whereas only smaller effects were found with ribose, citrate and glutamate. The respective growth rates on these carbon sources are uniformly reduced to a generation time of about 90 min in the ccpA mutant. Catabolite repression of a plasmid-encoded xylA::ccpA fusion is less efficient than that of a xylA::lacZ fusion in the same vector. Furthermore, overproduction of CcpA decreases catabolite repression of a single-copy xylA::lacZ fusion approximately twofold. Thus, overexpression of CcpA may be counterproductive for catabolite repression, supporting the hypothesis that CcpA by itself may not bind sufficiently strongly to the cis-active catabolite-responsive element to exert catabolite repression.

Bacillus megaterium↗
PubMed1995

Psychotherapy based on identity problems of depressives.

I present here what I call my identity-theoretical concept of depression, discussing both bipolar disorders and major depressive disorders. The method is phenomenological in that through interviews with depressives we become aware of their being-in-the-world, their social roles and the various identities they form through identification and under the pressure of their environment. In contrast to the normal individual, whose identity is autonomous, flexible, and continuously changes throughout the life cycle, depressives have what I call an "overidentifying" identity formation. That is to say, they cannot stand back and be autonomous, they must overidentify or throw themselves excessively into whatever particular social expectations they encounter. This leads to an "overadjustment" to the norms of society, a rigidity, and an excessive dependence on others. Patients in the manic phase may show the opposite extreme in their effort to avoid the overidentification tendency. Furthermore, depressives cannot tolerate ambiguity, they cannot deal with the positive and negative characteristics in one or the same object or person. Depressive or manic episodes are precipitated by situations where ambiguity cannot be avoided, or where conflicting identities are demanded at the same time, for example when a high quantity of high quality work is demanded in too short a time for this to be possible. Any sort of changes or role losses that demand flexibility of one's identity or the capacity to step back a bit and suspend one's characteristic habits or identity manifestations will precipitate manic or depressive episodes in such predisposed melancholics. On the basis of my identity-theoretical concept certain guidelines for psychotherapy suggest themselves, and these are presented. I call this "identity therapy," and I distinguish it from cognitive therapy because it is not the cognitive schemes that are disturbed in these patients but rather their identity structure. I discuss separately the guidelines for treatment in the acute and in the rehabilitation phase of the illness. In the former I suggest helping the depressive accept the role of patient in order to relieve the pressure of sociologic conflicting expectations on the patient's brittle identity concept. It is important for the patient to be able to resume social roles and routine activities, beginning in an anxiety-free setting where ego-satisfying achievements are encouraged. In the rehabilitation phase self-reflection is more encouraged, with the patient achieving an understanding of what has precipitated the episode of the illness in terms of the overwhelming of the patient's identity concept.(ABSTRACT TRUNCATED AT 400 WORDS)

Bipolar Disorder↗
PubMed1995

Visceral larva migrans mimicking rheumatic diseases.

OBJECTIVE: To report rheumatologic or rheumatologic-like manifestations of the visceral larva migrans (VLM) syndrome. METHODS: We carried out a prospective study of patients with VLM seen in a private practice setting in Mexico City between 1990 and 1993. RESULTS: From a population of 600 patients we identified 6 patients (5 women) with VLM. Three patients complained of arthralgia; in 4 a history of migratory cutaneous lesions was elicited, and in one monoarthritis of the right knee was found. One patient had deep edema that suggested thrombophlebitis of the right arm; the man in our series had right testicular swelling during followup. In 2 cases, panniculitis was documented by biopsy and in one, small vessel vasculitis. Four patients had frequent contact with dogs and one with cats; 4 patients frequently ate raw fish. The diagnosis of VLM was confirmed either by the clinical picture, biopsy, or ELISA: CONCLUSION: The spectrum of rheumatological manifestations in VLM may be wider than previously thought.

Adult↗
PubMed1993

[Morphological classification and comparison of the different types of stromal nodules in benign prostatic hyperplasia].

The expression of immunohistochemical markers for cytoskeletal differentiation and that of neuroendocrine- and immunological cells showed in general the same tendency in the 4 types of prostatic stromal nodules: missing or low expression in immature-mesenchymal-, distinct augmentation in fibroblastic-, a maximum in fibro-muscular- and a slight decline in smooth-muscular nodules. These results are in agreement with developmental sequences, revealed by immunohistochemical investigations of fetal prostates, and seem to confirm the hypothesis that the four types of stromal nodules represent successive degrees of maturation, recapitulating ontogenetic processes.

Biomarkers↗
PubMed1992

Raynaud's phenomenon in primary Sjögren's syndrome. Association with other extraglandular manifestations.

One hundred and four patients with primary Sjögren's syndrome (SS) were evaluated for the presence (29%) or absence of Raynaud's phenomenon (RP). The clinical course of RP was, in general, benign and caused no vascular sequelae. In patients with primary SS having RP, nonerosive arthritis, vasculitis and pulmonary fibrosis were significantly more frequent than in those without RP. Myositis also appeared more frequently associated with RP, but the difference reached statistical significance only when combined in meta-analysis with 2 other comparable series. There were no differences in the autoantibody profiles of the 2 groups.

Adult↗
PubMed1991

Defects of the retinal pigment epithelium in scleroderma.

We completed ocular examination, including retinal fluoroangiography, in 19 unselected patients with diffuse systemic sclerosis (scleroderma) and compared the findings with those made in 50 consecutive patients with systemic lupus erythematosus, 18 with primary Sjögren's syndrome, 20 with mixed connective tissue disease, and 20 healthy women. Five of 19 scleroderma patients had atrophy of the retinal pigment epithelium (26.3%) while none of the controls and only four of the 88 (4.5%) patients with other connective tissue diseases (P less than 0.01) had this anomaly. Atrophy of the pigmented epithelium of the retina may occur in scleroderma as a result of damage of the choroidal plexus.

Adult↗
PubMed1991

Salmonella arizona arthritis and septicemia associated with rattlesnake ingestion by patients with connective tissue diseases. A dangerous complication of folk medicine.

Snakes constitute the main reservoir of Salmonella arizona, which are opportunistic pathogens in patients with serious underlying diseases. The 2 may meet when such patients ingest uncooked snake flesh, most often as a folk remedy for arthritis or other conditions. We have seen 11 patients in whom Salmonella arizona infection was documented. Six had systemic lupus erythematosus and another had dermatomyositis and are described in detail. All 7 had received prednisone, which was combined with azathioprine in 3. Five developed septic arthritis, including the site of a hip prosthesis in one patient. A history of dessicated rattlesnake ingestion as a "natural" remedy in either capsule or powder form was obtained in all but one of the 7 patients. Patients often think that if natural or folk remedies are not helpful they also are not harmful and, therefore, safe and worth trying. We disprove that belief and call attention to the perils of one such remedy: dessicated rattlesnake, particularly when ingested by patients with connective tissue diseases who may be immunocompromised.

Adolescent↗
PubMed1991

Diabetes insipidus secondary to Wegener's granulomatosis: report and review of the literature.

We describe a 51-year-old woman with Wegener's granulomatosis who developed diabetes insipidus 7 months after the onset of her granulomatous disease and despite apparently good clinical response to prednisone and trimethoprim-sulphametoxazole treatment. A brain computerized tomographic scan taken soon after the onset of polyuria disclosed an enlarged pituitary gland that completely returned to its normal size after 5 months of cyclophosphamide therapy. We review 6 other published cases of diabetes insipidus secondary to Wegener's granulomatosis and discuss the potential pathogenetic mechanisms of this rare combination.

Diabetes Insipidus↗
PubMed1991

Air esophagogram and intestinal pseudoocclusion in a patient with scleroderma.

Air in the esophagus is unusual because it is collapsible. Its finding on a chest roentgenogram, particularly when not associated with a fluid level indicative of stricture, should strongly suggest systemic sclerosis (scleroderma). We describe a patient with scleroderma with intestinal pseudoocclusion and an air esophagogram. Study of chest roentgenograms of 83 patients with scleroderma, including those of 7 with pseudoocclusion, revealed no other instance of air esophagogram. This radiological sign, although rare, should suggest scleroderma and may be particularly useful in patients with "systemic sclerosis sine scleroderma."

Air↗
PubMed1991

Fever in adult onset Still's disease. Response to methotrexate.

Four patients who fulfilled criteria for adult onset Still's disease were treated sequentially with increasing doses of acetylsalicylic acid, nonsteroidal antiinflammatory drugs (NSAID) and prednisone to control their fever and systemic manifestations. Persistence of the fever led us to treat them with small doses of methotrexate (MTX) with excellent response. Low dose MTX should be considered in patients unresponsive to antiinflammatory drugs before using high doses of prednisone.

Adolescent↗