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Biomedical subjects

J C Gerster

Publications and source records attributed to J C Gerster.

At least 37 records · Page 2Linked to original sources
PubMed2000

[Takayasu's arteritis--case report and review of the literature].

A 26 year old Albanian woman presented with intermittent claudication of upper limbs in association with alleviation of radial pulses, reduction of arterial pressures, bilateral axillary bruits and subocclusive lesions of proximal part of both humeral arteries on arteriography and MRI. Takayasu's arteritis was diagnosed according to ACR criteria. A treatment of prednisone was started together with methotrexate. The response was favourable and symptoms like claudication and malaise vanished. Takayasu's arteritis is a vasculitis which affects large vessels such as aorta and its main branches. This disease involves mainly premenopausal women; it is very rare in Europe. Diagnosis is lying on clinical features and arteriography results. Treatment of choice is corticosteroids, and immunosuppressors; sometimes a surgical procedure is necessary if stenosis is fixed.

Adult↗
PubMed1999

[Spondylodiscitis due to Propionibacterium acnes. Case report and review of the literature].

Propionibacterium acnes, a gram positive anaerobic organism, is a component of normal skin flora. It can exceptionally be a source of osteoarticular infection (osteitis, arthritis, spondylodiscitis). We report a case of Propionibacterium acnes spondylodiscitis following lumbar puncture. This observation should alert the clinician to the fact that Propionibacterium acnes may rarely cause spondylodiscitis and lumbar pain, and should be considered a causative agent of bone infections after local procedures.

Clindamycin↗
PubMed1999

Serum MMP-3 in rheumatoid arthritis: correlation with systemic inflammation but not with erosive status.

OBJECTIVE: Metalloproteinases (MMP) play an important role in the remodelling of the extracellular matrix. However, evidence that they are responsible for tissue damage in pathological situations remains circumstantial. Stromelysin (MMP-3) production is increased in rheumatoid arthritis (RA), and has been proposed as a marker of joint damage. The relevance of serum levels of MMP-3 to erosions in RA was studied. METHODS: Fifty-three patients with active RA of > 5 yr duration and with available X-rays were stratified according to disease duration. Hand X-rays were scored for erosions. Patients were then classified into upper and lower quartiles. Serum MMP-3 levels were compared between these two groups. RESULTS: No significant differences in serum MMP-3 were seen between high and low eroders. A statistically significant correlation was observed between sMMP-3 and erthyrocyte sedimentation rate and C-reactive protein. CONCLUSIONS: Serum MMP-3 is not an independent marker of joint damage, but is correlated with systemic inflammation. Its precise role in joint damage in RA remains to be elucidated.

Adult↗
PubMed1999

Bone non-union after osteotomy in patients treated with methotrexate.

We describe 2 men with seronegative rheumatoid arthritis who presented non-union of bone after osteotomy of the tibia in one case and of a metatarsal bone in the second. Both patients were still being treated with oral low doses of methotrexate (MTX). After MTX was stopped, a prompt healing of the bone occurred. These observations suggest that MTX should be stopped temporarily in cases with delayed bone healing after surgery.

Antirheumatic Agents↗
PubMed1998

[Systemic corticosteroid therapy in rheumatology, advantages and risks].

Apart from the therapy of autoimmune diseases, corticosteroids have an important position in the treatment of rheumatoid arthritis. Corticosteroids are used after the failure of non-steroidal antiinflammatory agents or of the basis therapies to control the illness. When the rheumatoid arthritis is accompanied by a systemic disease, they will be used earlier and in higher dosages. For polymyalgia rheumatica, independently of an association with temporal arteritis, corticosteroids are the therapy of choice. Risks of long-time corticosteroid therapy are a higher incidence of infection and bone demineralisation, especially in postmenopausal women. A careful prevention with Calcium and Vitamin D must be carried out systematically. The demineralisation can be limited by the use of Deflazacort, a corticosteroid, which decreases the loss of calcium.

Adolescent↗
PubMed1998

[General practice of lumbosacral peridural infiltrations in rheumatology: considerations based on a review of the literature].

Recommendations about the practice of epidural steroid injections for low back pain and sciatica are formulated based on an extensive review of the published literature. These infiltrations should be reserved to trained physicians observing strictly aseptic conditions. Their indications are limited to the few special situations where classical treatments have failed, and only after exclusion of an infectious or tumoral process. To the present time no conclusive data have been published to prove that these procedures reduced the need for surgery in the case of herniated nucleus pulposus or spinal stenosis. Their efficacy on the intensity of pain is also controversial. Some improvement on pain and functional scores may be observed for a few weeks but this positive effect disappears 2 or 3 months post-injection.

Adrenal Cortex Hormones↗
PubMed1998

Medial meniscal cyst imitating a tumor, with compression of the saphenous nerve.

We report a case of large medial meniscal cyst responsible for symptomatic saphenous nerve compression in a 49-year-old male with a history of mild trauma to the affected knee. We are not aware of any similar cases in the literature. The lesion was delineated by ultrasonography and even more clearly by magnetic resonance imaging. At surgery, the saphenous nerve was seen to be displaced by the cyst. Cystectomy and partial meniscectomy were performed. The outcome was favorable.

Bone Neoplasms↗
PubMed1998

Rheumatic manifestations related to acrodermatitis chronica atrophicans. A review of four cases.

BACKGROUND: Acrodermatitis chronica atrophicans is a delayed manifestation of Lyme disease caused by a Borrelia burgdorferi subspecies, B. afzelii. Although rheumatic manifestations are rare, they can result in deformities of the fingers and toes if they are not treated promptly. METHODS: We report four cases of acrodermatitis chronica atrophicans seen over a 15-year period. RESULTS: Two patients had a noninflammatory unilateral knee effusion and one had swelling of the dorsum of one hand. Antimicrobial therapy was followed by a full recovery in the three patients who received an early diagnosis. The remaining patient, a 63-year-old woman, had swelling and dysesthesia in the fingers of both hands. She developed finger deformities over a period of two years. Although the swelling resolved under antimicrobial therapy, she had persistent reducible deformities of the fingers consistent with Jaccoud's arthropathy. CONCLUSION: The diagnosis of acrodermatitis chronica atrophicans rests on a history of a tick bite, a suggestive skin biopsy histology and a positive Western blot for B. afzelii. A positive response to antimicrobial therapy is also required. Acrodermatitis chronica atrophicans, a common condition in central and northern Europe, can cause joint manifestations and persistent finger deformities in the absence of early treatment.

Acrodermatitis↗
PubMed1997

[Thromboangiitis obliterans (Buerger disease) discovered by symptoms of arthralgia in a young woman].

Thromboangiitis obliterans (TAO) or Buerger's disease is an inflammatory disease that affects the small and medium caliber arteries and veins. It affects predominantly young, smoking males. The clinical manifestations are usually ischemic lesions of the extremities or limb claudication. The physiopathology is yet unknown. However, several hypotheses involving a dysregulation of the immune response are discussed. Here, we report a case of a young woman, smoker, that presented with diffuse arthralgia of the lower extremities. We were able to diagnose a thromboangiitis obliterans using criteria established by Papa et al. They include anamnestic, clinical and angiographic data. The pharmacological treatment of TAO is disappointing. The only way to prevent the extension of the disease is to stop smoking cigarettes.

Adult↗
PubMed1997

Destructive pneumococcal septic arthritis in end-stage renal disease.

Pneumococcal arthritis generally presents as non-destructive monoarthritis, although some underlying metabolic disorders such as liver failure and diabetes have been suggested to represent a risk factor for severe joint disease. Here we report a case of destructive pneumococcal arthritis of the left hip joint in a patient suffering from chronic renal failure treated with hemodialysis for ten years. Inspite of effective anti-pneumococcal antibiotic treatment, the patient with preexisting renal osteopathy and a mild osteoarthritis continued to suffer from severe and disabling pain of the left hip. This case demonstrates that pneumococcal joint infection in patients with underlying uremic bone disease can lead to quick deterioration of the affected joint.

Aged↗