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Biomedical subjects

C A Agudelo

Publications and source records attributed to C A Agudelo.

At least 55 records · Page 3Linked to original sources
PubMed1986

Coexistence of rheumatoid nodulosis and gout.

The case of a 42-year-old white male with a 7-year history of multiple subcutaneous nodules and intermittent episodes of acute arthritis is presented. The patient was found to have monosodium urate crystals on joint aspiration and rheumatoid nodules on biopsy. Our patient, the first reported case of coexistent rheumatoid nodulosis and gout, emphasizes the importance of a thorough evaluation and the need to account for all available clinical and laboratory data. The classification system, differential diagnosis and clinical manifestations of patients presenting with rheumatoid nodules are briefly reviewed.

Adult↗
PubMed1984

Does hyperuricemia protect from rheumatoid inflammation? A clinical study.

The negative association between gout and rheumatoid arthritis is well accepted. The reason for this mutual exclusion is not clear; a protective immunosuppressive effect of hyperuricemia has been included among possible explanations. To test this hypothesis, we reviewed the charts of 160 rheumatoid arthritis patients on whom clinical information and followup for at least a year were available. We selected those patients with persistent hyperuricemia as defined by serum urate levels averaging above 7.5 mg% for at least 6 months. We found 12 patients fulfilling such criteria, and 11 of these were judged to have quiescent, minimally active, or inactive disease during hyperuricemic periods. In 2 patients, flares of the rheumatoid process coincided with normalization of serum urate levels. We propose that persistent hyperuricemia may protect against or decrease the expression of rheumatoid inflammation.

Arthritis, Rheumatoid↗
PubMed1984

Increased incidence of recurrent hematuria in ankylosing spondylitis: a possible association with IgA nephropathy.

A retrospective analysis of our patients with ankylosing spondylitis revealed a 17.8% incidence of recurrent hematuria. Two of the five patients with recurrent hematuria had previously undergone renal biopsies showing a focal proliferative glomerulonephritis. The only specimen examined by immunofluorescent staining showed the typical changes of IgA nephropathy. A control group of patients with rheumatoid arthritis did not show recurrent hematuria. Recurrent hematuria may be a frequent occurrence in ankylosing spondylitis and may signify the presence of one of the glomerulonephritides such as IgA nephropathy.

Adult↗
PubMed1984

Psychological approaches to the management of arthritis pain.

The present review examines the literature regarding the efficacy of cognitive-behavioral and other self-control interventions in helping arthritis patients reduce their pain and functional disabilities. The evidence indicates that self-control interventions have produced significant and positive changes in the pain and functional disabilities of patients with rheumatoid arthritis and arthritis secondary to hemophilia. However, the literature suffers from deficiencies with regard to the use of small subject samples; inadequate control procedures and follow-up assessments; failure to demonstrate that positive outcomes are related to changes in subjects' covert experiences or control of physiological variables; and reliance upon self-report measures of outcome. The review is followed by a description of a multidisciplinary study of the efficacy of a biofeedback-assisted, cognitive-behavioral group therapy program for rheumatoid arthritis patients that features several methodological improvements relative to previous investigations. The preliminary outcome data show that the cognitive-behavioral intervention is associated with reductions in pain behavior and self-reports of pain and disability. It is concluded that, although the self-control interventions have shown promising results, psychologists must demonstrate positive and reliable outcomes among large numbers of arthritis patients over extended periods of time if the interventions are to be viewed as credible by rheumatologists.

Arthritis↗
PubMed1983

Uric acid effects on in vitro models of rheumatoid inflammatory and autoimmune processes.

A neutrophil monolayer system was used to study the effects of uric acid on neutrophil-aggregate interactions important in rheumatoid inflammation. No effect on immunoglobulin G aggregate phagocytosis was seen, but hyperuricaemic levels of uric acid were associated with an enhancement of phagocytosis-induced release of the azurophilic granular enzyme beta-glucuronidase. A trinitrophenyl-coupled mononuclear leucocyte rheumatoid factor plaque-forming assay was utilised to study uric acid effects on polyclonal activation of immunocompetent cells. Low levels of uric acid enhanced and high levels suppressed this system. Hyperuricaemia may enhance some aspects of rheumatoid inflammation, while uric acid may modulate an important component of rheumatoid autoimmunity.

Arthritis, Rheumatoid↗
PubMed1981

Rheumatoid factor and monosodium urate crystal-neutrophil interactions in gouty inflammation.

A monolayer system was designed to study the interactions between human neutrophils and monosodium urate crystals important in gouty inflammation. The effects of rheumatoid factor on gouty inflammation were then examined in this system and in patients with acute gouty arthritis. Monosodium urate crystal phagocytosis was apparent at 30 min, and this phagocytosis was accompanied by lysosomal enzyme release and decreased neutrophil adherence to plastic petri dishes. Rheumatoid factor did not affect phagocytosis, adherence, or lactic dehydrogenase release and appeared to variably enhance lysosomal enzyme release. Two of 19 acute gouty patients were found to have low titers of rheumatoid factor and, of these, one exhibited mild disease and the other tophaceous destructive disease.

Adult↗
PubMed1981

Vasculitis involving muscle associated with Crohn's colitis.

A case of Crohn's colitis is described in a patient who demonstrated multiple extraintestinal complications, including erythema nodosum, pyoderma gangrenosum, and aphthous oral ulcerations. Our patient simultaneously developed an unusual vasculitis in muscle. Small vessels were affected by necrosis, and polymorphonuclear leukocyte infiltration was appreciated. Leukocytoclastic was suggested by these features and the additional finding of small amounts of nuclear debris. A strong immunofluorescence to antihuman C3 was demonstrated in the affected vessel walls. We did not find circulating IgG immune complexes in serum with the Raji cell assay. The implication of the finding of leukocytoclastic vasculitis in muscle, associated with Crohn's colitis, is discussed.

Adult↗
PubMed1972

Intravascular degranulation of neutrophils: an important factor in inflammation?

Polymorphonuclear leukocytes are degranulated in the lumens of vessels in synovial membrane in humans with various types of inflammatory arthritis and in dogs with synovitis induced by urate crystals. This degranulation, accompanied by the release of lysosomal enzymes and vasoactive materials, may be an important part of the mechanism resulting in vascular injury.

Animals↗