Search PubMed⌕ Search

Biomedical subjects

B Amor

Publications and source records attributed to B Amor.

At least 55 records · Page 3Linked to original sources
PubMed1994

Diacerhein in the treatment of osteoarthritis of the hip.

OBJECTIVE: To determine the efficacy and safety of diacerhein, a potential new therapeutic agent with properties differing from those of existing nonsteroidal anti-inflammatory drugs (NSAIDs), and of a combination of diacerhein and an NSAID (tenoxicam) in the treatment of osteoarthritis (OA) of the hip. METHODS: Two hundred eighty-eight patients with painful OA of the hip were enrolled in an 8-week randomized, double-blind, placebo-controlled, 2 x 2 factorial design study. Four treatment groups were defined: 1) diacerhein placebo and tenoxicam placebo, 2) tenoxicam and diacerhein placebo, 3) diacerhein and tenoxicam placebo, and 4) diacerhein and tenoxicam. The daily dosages of diacerhein and tenoxicam were 100 mg and 20 mg, respectively. RESULTS: Analyses of efficacy showed no interaction between diacerhein and tenoxicam in terms of efficacy, a clinically significant rapid (< or = 2 weeks) and persisting effect of tenoxicam during the 8 weeks of the study, and a slow-acting (6 weeks) effect of diacerhein. Moderate, transient diarrhea was the most frequent side effect observed in the diacerhein group (37%) compared with the placebo group (4%). CONCLUSION: Both tenoxicam and diacerhein appear to be superior to placebo, and neither agent appears to significantly enhance or detract from the efficacy of the other when they are administered concomitantly. The onset of action of diacerhein appears to be delayed (> or = 4 weeks).

Aged↗
PubMed1994

Efficacy and tolerability of a new formulation of oral tiludronate (tablet) in the treatment of Paget's disease of bone.

We sought to assess efficacy and safety of a new oral formulation (tablet) of tiludronate in Paget's disease of bone. We studied 128 patients with Paget's disease in an open-label uncontrolled trial. Patients received a daily dose of 400 mg oral tiludronate (two tablets). Treatment was for 6 months. Serum alkaline phosphatase activity (SAP) and fasting urinary excretion of hydroxyproline/creatine (OH/Cr) were measured every 3 months, as were biochemical parameters reflecting renal, hepatic, and hematologic functions. Analgesic efficacy was self-evaluated from a visual analog scale (VAS). Statistical analysis revealed a significant reduction from baseline in SAP and OH/Cr levels, as well as VAS scores. In the whole population with evaluation under treatment, there was a reduction in initial SAP activity after 3 months (47.2 +/- 2.2%, mean +/- SEM) and 6 months (58.3 +/- 2.3%). In the population with SAP levels above twice the upper limit at inclusion and with evaluation at month 3 and month 6 (n = 96), the reduction in SAP levels was 49.3 +/- 2.4% after 3 months and of 59.5 +/- 2.6% after 6 months (ANOVA time effect, p = 0.0001). Aside from mild gastrointestinal disturbances, as experienced with other oral bisphosphonates, clinical tolerance was good. Exhaustive biochemical investigation failed to reveal significant toxicity of tiludronate tablets at the dose of 400 mg/day. The dose of 400 mg daily of this new formulation appears to be a satisfactory tiludronate regimen for the treatment of Paget's disease of bone.

Aged↗
PubMed1994

Predictive factors for the longterm outcome of spondyloarthropathies.

OBJECTIVE: To determine the predictive factors of outcome in patients with spondyloarthropathy (European Spondyloarthropathy Study Group or Amor criteria) monitored by a single investigator. METHODS: Classification of longterm outcome on a 3-grade scale. Candidate predictive factors: presence or not of 12 clinical or biological variables during the first 2 years of the disease, collected by history at the time of the first visit. Univariate analysis to pick up the factors statistically correlated with severity and then odds ratio and 95% confidence interval (CI) for each variable were calculated. RESULTS: Of the 328 patients with spondyloarthropathy, 151 had a followup of > or = 10 years and minor disease (81), severe (28), or moderate disease (42). Seven variables at entry were correlated with disease severity (odds ratio; CI 95%); hip arthritis (22.85; 4.43-118); erythrocyte sedimentation rate > 30 mm/h (7; 4.84-9.50); poor efficacy of nonsteroidal antiinflammatory drugs (8.33; 2.56-27.10); limitation of lumbar spine (7; 2-25); sausage-like finger or toe (8.45; 1.48-9); oligoarthritis (4.25; 1.38-13.10); onset < or = 16 years (3.47; 1.06-12.75). If none of these factors is present at entry a mild outcome can be predicted (sensitivity: 92.5%; specificity: 78%). If a hip is involved or if 3 factors are present, a severe outcome is predictable (sensitivity: 50%) and a mild disease practically excluded (specificity: 97.5%). CONCLUSION: Predictive factors of poor or benign longterm outcome could be defined very early after onset of spondyloarthropathy in a set of patients monitored by one observer.

Adolescent↗
PubMed1994

[The carpus-metacarpus-index distance: a measurement for quantifying radiological lesions in rheumatoid polyarthritis. Comparison with Larsen's scores and Steinbrocker's index].

The carpus-to-digits distance measured on a posteroanterior roentgenogram of the hands and wrists takes into account 18 different joints. This study demonstrates that the carpus-to-digit distance is a simple, reproducible score which reliably reflects progression of roentgenological rheumatoid arthritis lesions and is correlated with Larsen's lesion score and with Steinbrocker's index, but not with Larsen's erosion score during the first two years after onset of the disease. Larsen's erosion score and similar parameters should be preferred for clinical studies of recent-onset rheumatoid arthritis. The carpus-to-digit distance, which requires neither a reference film not observer training, is appropriate for long-term clinical studies.

Arthritis, Rheumatoid↗
PubMed1993

Chondroscopy: a new method for scoring chondropathy.

The purpose of this study was to evaluate the performance (simplicity, reproducibility, relevance) of chondroscopy as a method for evaluating cartilage damage. Chondroscopy consisted in endoscopic evaluation of the knee using a 2.7-mm Storz arthroscope under local anesthesia and recorded on videotape. Scoring of chondropathy was based on physician's overall assessment using a 100-mm-length visual analogue scale (VAS) and size and grade of cartilage lesions. Reproducibility was evaluated by variability (coefficient of variation [CV]) in the reading of chondroscopic evaluations of five patients five times by one physician and one time each by four different physicians. The correlations between scoring of chondropathy (VAS) and radiological articular joint space narrowing, demographic data (sex, age, weight), and disease characteristics (localization, etiology, activity) were studied in 84 outpatients fulfilling the American College of Rheumatology criteria for the diagnosis of osteoarthritis of the knee. The grade and size of the lesions were both correlated with the physician's overall assessment (r = 0.713 and r = 0.816, respectively). These two variables accounted for 72% of the variance of the VAS (multiple regression analysis). Intraobserver reproducibility was better than interobserver reproducibility (CV, 9% and 37%, respectively). There was a strong correlation between the scoring of chondropathy (VAS) and radiological joint space narrowing (r = .646, P < .0001). Moreover, in 17 of 33 patients without radiological joint space narrowing, VAS was > 20 mm. At variance, the body mass index was the single clinical variable found to correlate with the scoring of chondropathy (r = .282, P < .001).(ABSTRACT TRUNCATED AT 250 WORDS)

Arthroscopy↗
PubMed1993

High molecular weight sodium hyaluronate (hyalectin) in osteoarthritis of the knee: a 1 year placebo-controlled trial.

Hyaluronic acid is a natural component of cartilage and is considered not only as a lubricant in joints but also as playing a physiological role in the trophic status of cartilage. Hyalectin, a selected fraction of hyaluronic acid extracted from cocks' combs, has exhibited efficacy in animal models of osteoarthritis. To assess the efficacy and tolerability of intra-articular injections of hyalectin, we conducted a prospective, randomized, placebo-controlled trial of 1 years' duration in 110 patients with painful hydarthrodial osteoarthritis of the knee. At entry and once a week for 3 weeks, aspiration of the knee effusion and intra-articular injections of either hyalectin 20 mg (H) or its vehicle (C) were performed. The vehicle acted as the control treatment. Four weeks after the last injection, the improvement was greater in the H group compared with the C group (pain: -35.5 +/- 26.4 mm vs -25.8 +/- 21.4, P = 0.03, Lequesne's functional index: -3.8 +/- 4.3 vs -2.3 +/- 3.3, P = 0.03). During the 1 year follow-up, the need to perform supplementary local therapies (joint fluid aspiration because of painful hydarthrodial episodes and/or local corticosteroid injections) was more frequent in group C (44% vs 30%, P = 0.03). Moreover, at the final visit, the physician's overall assessment of efficacy was in favor of H (77% vs 54%, P = 0.01) and the improvement in the functional index was greater in group H (-4.4 +/- 5.1 vs -2.7 +/- 4.1, P = 0.05). This study suggests that intra-articular injections of hyalectin may (1) improve clinical condition and (2) have a long-term beneficial effect in patients with osteoarthritis of the knee.

Aged↗
PubMed1993

[Ultrasound attenuation in calcaneus and bone density].

Broadband ultrasound attenuation (BUA) is a new technique for investigating bone status. We evaluated its use in osteoporosis. To assess in vivo reproducibility, we determined the coefficient of variation (cv) on the basis of five measurements (with repositioning) of the same foot in 50 women. The cv was 2.8 +/- 1.7%. BUA values were similar in the right feet and left foot and were correlated with bone density in the calcaneal area investigated (r = 0.8, p < 10(-4). BUA of the calcaneus was correlated with bone density in the lumbar spine, femur, and forearm in 240 healthy postmenopausal women (correlation coefficients 0.36 to 0.55; p < 10(-4)). BUA decreased with age, with a sharper drop during the first years following menopause. Mean broadband ultrasonic attenuation in 37 females with osteoporosis (58.92 +/- 11.59 dB/MHz) is lower than controls (66.10 +/- 15.29 dB/MHz, p = 0.04). Areas under receiver operating characteristic curves, used to evaluate the discriminating value of BUA in osteoporosis and osteopenia, were 0.79 and 0.72, respectively. The kappa coefficient of concordance between BUA and spinal density was 0.59. These data demonstrate that BUA cannot replace bone density measurements. Prospective studies are needed to investigate the potential role of this technique for identifying women at high risk for osteoporotic fractures.

Adult↗
PubMed1993

[Evaluation of a quality of life scale (AIMS2) in rheumatology].

OBJECTIVES: To evaluate the feasibility, relevance, and sensitivity of the French version of the revised Arthritis Impact Measurement Scale (AIMS2) in patients with rheumatoid arthritis or osteoarthritis of the hip. METHODS: translation of the English-language AIMS2 into French using the back-to-back technique; evaluation of feasibility on the basis of a) time needed to complete the AIMS2; b) percentage of questionnaires with at least one missing answer or one answer indicating that the question was misunderstood; evaluation of relevance on the basis of correlations between AIMS2 scores and conventional parameters for evaluating the activity of rheumatoid arthritis (85 patients); evaluation of sensitivity on the basis of total hip replacement-induced improvements in AIMS2 scores versus other conventional scores used to evaluate activity of osteoarthritis of the hip (48 patients). RESULTS: feasibility, mean time needed to complete the AIMS2 was 23 minutes in rheumatoid arthritis patients and 26 minutes in osteoarthritis patients. Forty per cent of patients failed to answer at least one question and 21% misunderstood at least one question; relevance: conventional parameters used in rheumatoid arthritis accounted for 51% of AIMS2 score variance, suggesting that the AIMS2 provided information not supplied by conventional parameters. SENSITIVITY: after total hip replacement for osteoarthritis, there were statistically significant decreases in all AIMS2 scores (with the exception of function and work). CONCLUSION: These data suggest that the AIMS2 score is not an easy evaluation tool but is both relevant and sensitive. These findings require confirmation by longitudinal studies.

Activities of Daily Living↗
PubMed1993

[Comparison of patients evaluated for spondylarthropathy in France and Morocco].

The authors compared demographic and clinical data in patients with spondylarthropathy residing in Morocco or in France and searched for factors associated with increased disease severity, with special attention to course of the disease, life style, clinical findings and roentgenographic changes. They carried out univariate analyses (chi-square test, Student's t test) to look for factors associated with hip involvement. Evaluation of the relative risk associated with each factor by determination of the odds ratio and corresponding 95% confidence interval. Statistically significant differences were found between the two groups concerning socioeconomic status and disease characteristics. Patients seen in Morocco had more severe disease, with roentgenographic hip involvement in 48% of cases versus only 16% of patients seen in France (p < 0.0001). Several factors were associated with the presence of hip disease, including residence in Morocco, Maghrebine ethnic origin, patient characteristics (male sex, low body mass index), disease characteristics (high erythrocyte sedimentation rate, young age at onset), and environmental factors (no running water in the home). Patients with spondylarthropathy residing in Morocco had more severe disease than their counterparts living in France; both genetic and environmental factors may explain this difference.

Adolescent↗
PubMed1993

[Hyperparathyroidism disclosed by forward sagging of the head].

An unusual clinical presentation of hyperparathyroidism is reported. The 73-year-old patient was unable to maintain her head upright after ten minutes of walking or standing. Parathyroid adenoma was diagnosed on the basis of ultrasound and pathological findings and parathyroid hormone assays. Following surgery the forward sagging of the head no longer occurred and serum levels of calcium and phosphorus returned to normal. Pathophysiological hypotheses are discussed. No similar cases with isolated weakness of the cervical and dorsal paravertebral muscles has been reported to date.

Adenoma↗
PubMed1993

[Measurements in rheumatology].

Measuring a phenomenon is the first step of the scientific approach. Use of quantitative measurements to evaluate clinical and roentgenological data improves patient follow-up, increases the validity of collected data, encourages critical evaluation of measurement tools, use of reproducible roentgenographic views, and careful planning of investigations with the aim of achieving a predefined goal, and allows more objective assessment of treatment efficacy. Use of quantitative parameters can be expected to improve the quality of care and to reduce health care costs.

Absorptiometry, Photon↗
PubMed1993

[Criteria for classification of spondylarthropathies in children].

BACKGROUND: The term spondylarthropathy is used for several different entities including undifferentiated forms. The latter are particularly frequent in children and often not recognized. Two sets of criteria, the Amor and the European Spondylarthropathy Study Group (ESSG) criteria, primarily devised for adults, were evaluated in a pediatric population. METHODS: Three hundred and ten consecutive patients referred to one pediatric rheumatology center over 6 months were prospectively assessed, whatever the rheumatic complaint. Twenty two items were analysed for each patient and compared with the criteria proposed by Amor (17 items) and the ESSG (12 items). RESULTS: The Amor criteria performed better than the ESSG criteria. The sensitivity was 84 and 69.7%, and the specificity 96.1 and 92.2% for the Amor and the ESSG criteria, respectively. The sensitivity for pauci-arthritis was much higher in children, but the specificity was lower than in adults. The sensitivity of spinal involvement was very low in children. The undifferentiated type accounted for 81% of all definite spondylarthropathies. Definite and possible spondylarthropathies were 17% of the total referral over the 6 months, i.e. one patient in 6. CONCLUSIONS: These two sets of criteria, particularly the Amor criteria, can help pediatricians to recognize the undifferentiated type of spondylarthropathy, in the absence of spinal or any other characteristic manifestation.

Adolescent↗
PubMed1992

[Comparative efficacy of ketoprofen related to the route of administration (intramuscular or per os). A double-blind study versus placebo in rheumatoid arthritis].

Evidence of the analgesic effects of nonsteroidal antiinflammatory drugs in human diseases is easy to collect. However, demonstration of differences in the activity of NSAIDs according to the route of administration is considerably more difficult. Forty patients with rheumatoid arthritis were given either one intramuscular injection of 100 mg ketoprofen with two placebo capsules or one intramuscular injection of placebo with two 50 mg ketoprofen capsules. Analysis of changes in pain severity over the six-hour study period failed to disclose any statistically significant differences between the two groups. However, time to peak effectiveness (Tmax) was significantly shorter with the intramuscular route (194 +/- 118 minutes) than with the oral route (276 +/- 111 minutes) (p = 0.029). Although intramuscular NSAID therapy is rarely warranted in RA patients, these findings suggest that RA may serve as a clinical model for evaluating the effectiveness of a NSAID according to the route of administration.

Administration, Oral↗
PubMed1992

[Sciatica or herniated disk].

Lumbar radiculalgia may be due, beside the disc-nerve root conflict, to stenosis of osteoarticular canals, wide dural sac, epidural lipomatosis, segmental arachnoiditis, malignant or benign tumours and meningoradiculitis. Extraspinal truncular or radicular sciatica is usually due to compression by an expansive process. Some types of pain referred from articular structures may mimic sciatica.

Back Pain↗