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Biomedical subjects

B M Rothschild

Publications and source records attributed to B M Rothschild.

At least 19 recordsLinked to original sources
PubMed2003

Frequency of pathology in a large natural sample from Natural Trap Cave with special remarks on erosive disease in the Pleistocene.

Population data are presented for erosive arthritis, osteoarthritis, diffuse idiopathic skeletal hyperostosis (DISH), joint eburnation and dental injury in a fauna from Natural Trap Cave, Wyoming, represented by over thirty thousand bones from twenty-four different species. Erosive arthritis is limited to the bovids, Bison, Ovis and Bootherium. Erosive arthritis is also present in bison from the late Pleistocene Twelve Mile Creek site in Kansas and from an early Holocene site in Wisconsin. The restriction of the known Pleistocene occurrences to bovids indicate the presence of a pathogen that predisposes bovids to erosive arthritis. The pathogen was identified as Mvcobacterium tuberculosis. Osteoarthritis and DISH are rare in the Natural Trap Cave, although Bison shows a relatively high occurrence of the former. Tooth breakage due to errors in bone manipulation was a problem for carnivores and one lion, Pantera atrox, was apparently reduced by joint disease to a scavenging lifestyle.

Animals↗
PubMed2001

Mycobacterium tuberculosis complex DNA from an extinct bison dated 17,000 years before the present.

In order to assess the presence of tuberculosis in Pleistocene bison and the origin of tuberculosis in North America, 2 separate DNA extractions were performed by 2 separate laboratories on samples from the metacarpal of an extinct long-horned bison that was radiocarbon dated at 17,870+/-230 years before present and that had pathological changes suggestive of tuberculosis. Polymerase chain reaction amplification isolated fragments of tuberculosis DNA, which were sequenced, and on which spoligotyping was also performed to help determine its relationship to the various members of the Mycobacterium tuberculosis complex. Extensive precautions against contamination with modern M. tuberculosis complex DNA were employed, including analysis of paleontologic and modern specimens in 2 geographically separate laboratories.

Animals↗
PubMed2001

Surgery and the patient with arthritis.

Patients with rheumatologic disease (e.g., arthritis) require special attention when surgery is considered. Proactive attention to medication usage, corticosteroid coverage, airway, respiratory, joint stability and fragility challenges, cold exposure, and coagulation risks facilitate surgical intervention for such individuals.

Anti-Inflammatory Agents↗
PubMed2001

Noninvasive measurement of acceleration at the knee joint in patients with rheumatoid arthritis and spondyloarthropathy of the knee.

Spondyloarthropathy represents a group of joint diseases with a tendency to reactive new bone formation. Spondyloarthropathy includes Reiter's syndrome, ankylosing spondylitis, and the arthropathy of inflammatory diseases (ulcerative colitis and Crohn's disease). Usually, an extensive investigation is required to distinguish spondyloarthropathy of the knee joint from rheumatoid arthritis. Recently, Reddy et al. (Ann. Biomed. Eng. 23:78-84, 1995) have developed the accelerometry technique to characterize various types of arthritis. The question remains if noninvasive acceleration measurements can be used to distinguish between spondyloarthropathy and rheumatoid arthritis. An ultraminiature accelerometer was placed on the patella, and the subject was asked to rhythmically rotate the knee from 90 flexion to full extension. Results have shown that the mean power of acceleration signal in the range of 100-500 Hz is significantly different (p<0.05) for spondyloarthropathy patients when compared to rheumatoid arthritis patients. The noninvasive accelerometry technique represents a potential tool for characterization of spondyloarthropathy patients.

Acceleration↗
PubMed2001

Inflammatory arthritis in canids: spondyloarthropathy.

Spondyloarthropathy was observed in 25 (2.8%) of 895 preserved canid museum specimens and was catalogued by species. The associated skeletal alterations in canids are indistinguishable grossly and physiologically from those in humans with spondyloarthropathy of the reactive type. Rate of affliction was independent of captive or wild-caught status or gender. In canids, spondyloarthropathy was much more common than osteoarthritis (0.3%), which predominantly is limited to captive animals. Animal well-being may be enhanced by recognition of the condition and initiation of specific treatment.

Animals↗
PubMed2001

Rheumatoid arthritis at a time of passage.

OBJECTIVE: To determine the relationship of what has been called pre-Columbian Old World rheumatoid arthritis (RA) to the RA identified in pre-Columbian North America. METHODS: All published claims of pre-Columbian Old World RA were reviewed against the established North American standard for its recognition in archeologic sites. Those characteristics included polyarticular symmetrical marginal erosions [in the absence of subchondral erosions, peripheral joint fusion, or axial skeletal involvement (C1-2 excepted)], but requiring the presence of perilesional osteopenia on radiographic examination. T test and Fisher's exact test were used to assess the significance of the extent of joint distribution and the presence of subchondral erosions, peripheral joint fusion, and axial disease in the Old World cases that some have claimed represent RA. RESULTS: Old World reports of alleged RA often describe isolated bones or isolated "finds" without epidemiologic consideration. Subchondral erosions were present in 95%. The 2 cases without subchondral erosions had peripheral joint fusion and axial joint disease. Peripheral joint fusion and axial joint involvement were present in almost all cases. Perilesional sclerosis was actually quite prominent, as was other evidence of reactive new bone formation, but not perilesional osteopenia. CONCLUSION: As the pre-Columbian Old World erosive arthritis is clearly a different phenomenon from what has been documented in the New World, the issue appears to relate to criteria for naming RA. There clearly are 2 distinct groups that some classify under the broad banner of RA. As the Old World variety is indistinguishable from spondyloarthropathy, it is suggested that the Old World cases should be recategorized with spondyloarthropathy and that only the variety reported in archeologic sites in North America be classified as RA.

Arthritis, Rheumatoid↗
PubMed2001

Medical care perceptions in elderly patients with musculoskeletal complaints.

BACKGROUND: Musculoskeletal complaints represent the second most common reason for visits to a physician, second only to the common cold. The limited capability of medical treatment for musculoskeletal disease requires modification of communication with patients by attending to their perception of the disease. OBJECTIVES: To assess patients' satisfaction with care provided by their primary physicians, and the relationship of patients' satisfaction to their expectations of that care, perceptions of physician performance, and perceived severity of musculoskeletal disease. METHODS: Questionnaires were administered to 90 community-dwelling elderly patients (mean age 76 +/- 8 years) presenting for follow-up appointments with their primary care physicians. Patients were asked to report on their satisfaction with the medical care provided by the primary physicians for musculoskeletal symptoms, their expectations of that care, their perceptions of their primary physicians' interaction (regarding competence, performance, and communication), and their perceptions of disease severity (based on the number of areas involved, pain frequency and intensity, and impact on daily activity). The effects on the degree of satisfaction were assessed with regard to demographic variables, co-morbidity, site involved, and response to recommended treatment. RESULTS: Most patients (> 85%) expressed overall satisfaction with their doctor's interpersonal skills. Fewer (76.9%) were satisfied with the amount of effort their doctors spend evaluating their musculoskeletal symptoms, the information received regarding their musculoskeletal symptoms (75%), the degree of pain relief (75%), and the degree of functional improvement (61.8%). Level of education and response to recommended treatment for musculoskeletal disease were the only parameters associated with degree of satisfaction (higher education P = 0.005, lower education P = 0.059, medication P = 0.008, rehabilitation P = 0.076). A high level of expectations (regarding physician's care and musculoskeletal disease treatment) was noted. CONCLUSIONS: The high level of patient satisfaction with their primary physicians' care for musculoskeletal symptoms may reflect the overall tendency of the elderly population to be satisfied with its primary care physicians. However, their high level of expectations (related to perceived efficacy of medical treatment) and their unrealistic perceptions of disease may lead to disappointment and non-compliance with their doctor's recommendations. Management of musculoskeletal disease in the elderly should address the patients' disease perceptions, as well as their therapeutic and functional needs.

Aged↗
PubMed2000

First European exposure to syphilis: the Dominican Republic at the time of Columbian contact.

Recognition of syphilis in Europe in the late 15th century and its prior absence suggest New World origin. Skeletal populations were examined from sites with documented Columbian contact in the Dominican Republic. Examination of 536 skeletal remains revealed periosteal reaction characteristic of treponemal disease in 6%-14% of the afflicted population. Findings were identical to that previously noted in confirmed syphilis-affected populations and distinctive from those associated with yaws and bejel: it was a low population frequency phenomenon, affecting an average of 1.7-2.6 bone groups, often asymmetric and sparing hands and feet, but associated with significant tibial remodeling. While findings diagnostic of syphilis have been reported in the New World, actual demonstration of syphilis in areas where Columbus actually had contact was missing, until now. The evidence is consistent with this site as the point of initial contact of syphilis and of its subsequent spread from the New World to the Old.

Bone and Bones↗
PubMed2000

Paget's disease of the elderly.

Paget's disease of bone affects 10% of those surviving to the eighth decade of life. Relatively easy to diagnose, treatment decisions are more complex. Surgery and immobilization present unique challenges often requiring prophylaxis to prevent activation/exacerbation of the disease.

Aged↗
PubMed2000

Management of reactive arthritis in a juvenile gorilla (Gorilla gorilla gorilla) with long-term sulfasalazine therapy.

A juvenile western lowland gorilla (Gorilla gorilla gorilla) experienced recurrent fever, lethargy, diarrhea, and/or arthritis starting at age 6 mo. During an episode at age 15 mo, Shigella sp. was isolated from diarrheic feces. At age 41 mo, reactive arthritis was diagnosed. In addition, the gorilla's growth was retarded. All arthritic attacks were managed symptomatically prior to age 4 yr, at which time a severe episode precipitated the implementation of therapy with sulfasalazine, an arthritis suppressive medication. Examination 27 mo later revealed cessation of progressive joint pathology although the animal exhibited decreased range of motion in most joints. The gorilla has been on sulfasalazine therapy for 4 yr without lameness. Growth has resumed, and there has been no radiographic evidence of progressive joint degeneration. Immunogenetic analysis of whole blood obtained at age 68 mo identified the gorilla major histocompatibility class I allele, Gogo-B*0101, which has limited nucleotide sequence similarity to HLA-B27, an allele associated with postinfection reactive arthritis in humans. Sulfasalazine therapy effectively managed reactive arthritis in this gorilla and should be considered for similarly frequently affected animals. Juvenile gorillas, in populations with a history of clinical shigellosis and/or postdiarrhea arthritis, may benefit from prophylactic sulfasalazine therapy after episodes of bacterial enterocolitis. Sulfasalazine therapy should be considered in all gorillas, juvenile and adult, experiencing confirmed Shigella sp.-associated enterocolitis.

Animals↗