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Biomedical subjects

G E Ehrlich

Publications and source records attributed to G E Ehrlich.

At least 37 records · Page 2Linked to original sources
PubMed1997

Vasculitis in Behçet's disease.

Vasculitis underlies most of the characteristic lesions of Behçet's disease and is obligatory for the diagnosis in populations at risk. Sporadic cases and similar presentations in non-Silk-Route patients should be labelled as Behçet's syndrome and carry different prognosis because of differences in underlying pathologic changes and pathogenesis. Ethnicity and vasculitis should be included in diagnostic criteria. Large vessel involvement is characteristic if less common.

Behcet Syndrome↗
PubMed1996

On the difficulties of disability and its determination.

The World Health Organization (WHO) model for the cascade of disease to impairment to disability to handicap does not adequately model pain and psychological dysfunction. The work disability of the legal system comprises WHO disability and handicap. But the physician usually cannot determine handicap. The process by which work disability is determined, imposing a judgment role on the physician, compromises the physician-patient relationship and the physician's primary responsibility: enablement of the patient. Physicians should report patient data, but ordinarily should not judge work disability.

Confidentiality↗
PubMed1992

Racemic mixtures: harmless or potentially toxic?

Issues involved in the development and evaluation of racemic drug mixtures are described. Administration of a racemic drug mixture is in reality administration of two drugs with distinct pharmacokinetic and pharmacodynamic properties. Compared with the active enantiomer, the inactive enantiomer in a racemic mixture often has different rates of absorption, metabolism, and excretion, as well as different affinities for tissue receptor and protein receptor binding sites. It may be an agonist or antagonist, produce adverse effects, increase efficacy, or place an undue burden on clearance mechanisms. Thus, the pharmacokinetic and pharmacodynamic properties, pharmacologic activity, and toxicity of each enantiomer in a racemic drug mixture need to be determined. When pharmacokinetics of enantiomers differ, the contribution of each enantiomer to effectiveness and toxicity and whether the mixture may be more beneficial than a single enantiomer will need to be considered before racemic mixtures are marketed.

Animals↗
PubMed1988

The quality of life.

Explore the source record for details and available documents.

Arthritis, Rheumatoid↗
PubMed1987

The subclinical phase of osteoarthritis.

The clinical diagnosis of osteoarthritis (OA) generally requires x-ray confirmation, fastening upon features such as narrowing of the joint and proliferative changes at the joint margins. In the formative phases, because of simple structural reasons, the joint may well not be narrowed and the proliferative changes and geodes may not as yet be apparent. Even symptomatic joint disease at this time may fail of diagnosis because the customary criteria have not yet been met. I submit that all OA is secondary, the inception being remote in time and, unless dramatic, being forgotten or never even noticed. An understanding of some of the mechanical features that characterize the progression to OA and the mechanism of pathogenesis should lead to earlier diagnosis and possible application of preventive measures.

Cartilage, Articular↗
PubMed1985

Basis and current scope of rational anti-inflammatory therapy.

With the increased understanding of inflammation today, it is clear that those therapeutic agents that control noxious effects of inflammation without blocking the protective aspects are more desirable. In the past 30 years, numerous new classes of anti-inflammatory agents have emerged, having first passed stringent clinical pharmacologic testing. Of the available nonsteroidal anti-inflammatory agents, most act through blockade of the cyclo-oxygenase pathway, and some through specific effects on the lipoxygenase pathway. Each of the major categories of nonsteroidal anti-inflammatory agents is discussed briefly with regard to these actions and their clinical effects. The use of nonsteroidal anti-inflammatory agents is also discussed in the context of the elderly patient in whom physiologic aspects of aging must be considered.

Absorption↗
PubMed1984

Other NSAIDs of choice for rheumatoid arthritis.

Aspirin is an effective antiinflammatory and analgesic agent. Pain relief is achieved with relatively modest doses, far below those necessary for inflammation control. The patient reacts to the need for pain relief and will take fewer aspirin than prescribed because the lower dosage is better tolerated and less expensive. This often obviates the wanted effects. This pain-inflammation gap does not exist for most nonsteroidal antiinflammatory drugs (NSAIDs), in which analgesic and antiinflammatory doses approximate each other. The range of toxic effects from aspirin is larger than that for nonsteroidal drugs. Gastric erosions and bleeding are far more prevalent with aspirin. Other organ systems are involved more by aspirin than by other drugs, and, in osteoarthritis, aspirin actually may militate against recovery by interfering with glycosaminoglycan synthesis.

Anti-Inflammatory Agents↗
PubMed1984

Systemic lupus erythematosus and pulmonary vascular hypertension.

Although pulmonary involvement commonly occurs in systemic lupus erythematosus (SLE), pulmonary vascular hypertension has rarely been reported. Two patients with SLE had pulmonary hypertension without underlying pulmonary parenchymal or cardiac disease. The first patient's condition was initially diagnosed as primary pulmonary hypertension (PPH), and full-blown SLE subsequently developed. The second patient had well-established SLE when respiratory symptoms secondary to underlying pulmonary hypertension developed. There is a possible relationship between connective tissue diseases and PPH.

Adolescent↗
PubMed1983

Social, economic, psychologic, and sexual outcomes in rheumatoid arthritis.

Rheumatoid arthritis takes an economic toll in a variety of ways--the actual costs of treatment for the individual patient and society are only a fraction thereof. Other costs derive from the legal definition of disability, from a lack of employment opportunities, from premature retirement from work, and from the social and familial consequences of these events. Depression is a major feature of chronic disease and colors both behavior by the patient and the doctor-patient relationship. Self-image suffers in this potentially deforming disease, with consequences in sexual and social behavior. Ignorance and a confusion between disability and handicap lead to more disablement than do the physical changes of rheumatoid arthritis.

Architectural Accessibility↗
PubMed1983

Long-term therapy with tolmetin in rheumatoid arthritis.

Data from over 1000 patients with rheumatoid arthritis who received tolmetin sodium in double-blind and open studies have been pooled to assess long-term efficacy and safety. Duration of the studies was 12 weeks to 48 months. Mean age of patients was 54 years; ratio of males to females was 1:3. The results showed that tolmetin provided rapid onset of action and continuous progressive decrease in symptoms in all measurements of inflammation. Mean number of painful joints was reduced from 22 at baseline to 16 at one month, to 9 at one year, and to 6 at two years. Duration of morning stiffness was 155 minutes at baseline, 123 minutes at one month, 74 minutes at one year, and 78 minutes at two years. The final global evaluation by the investigators showed that 61 per cent of patients had a marked or moderate response. Mean erythrocyte sedimentation rates did not increase during therapy with tolmetin. Initial dose of tolmetin in the patients pooled for this analysis was generally 600 to 800 mg/day, and the mean dose throughout the study was 1256 mg/day. The drug was well tolerated overall. As anticipated, gastrointestinal symptoms were the most frequently reported; nausea was experienced by 13 per cent of the patients at some time during therapy, and gastrointestinal distress, dyspepsia, or abdominal pain was reported by approximately 8.6 per cent each. Only 12.7 per cent of patients discontinued tolmetin because of untoward reactions; 15.9 per cent of patients discontinued because of insufficient therapeutic response. The results of these long-term studies of patients with rheumatoid arthritis demonstrated that tolmetin is an effective antiinflammatory agent with an acceptable record of safety.

Adolescent↗