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Biomedical subjects

J C Jacobs

Publications and source records attributed to J C Jacobs.

At least 55 records · Page 3Linked to original sources
PubMed1982

HLA-B27-associated spondyloarthritis and enthesopathy in childhood: clinical, pathologic, and radiographic observations in 58 patients.

HLA-B27 typing of all arthritic children helped to identify and focus attention on a subset whose disease was pathogenetically related to and demonstrated clinical features of ankylosing spondylitis and Reiter syndrome, but only rarely fulfilled current diagnostic criteria for those disorders (spondyloarthritis). In contrast to other forms of childhood arthritis, enthesopathy (inflammation at the sites of attachment of ligaments and tendons to bone) was a prominent feature in 75%; a family history of similar arthritis was obtained from 60%; boys were more frequently affected (2:1); urethritis, acute iritis, conjunctivitis, or keratoderma blennorrhagicum occurred at some time in 42%; and the initial attack followed an unexplained febrile illness, known dysentery or urethritis, or severe musculoskeletal trauma in 41%. The arthritis was generally pauciarticular, asymmetric, and primarily in the feet and large joints of the lower extremities. Distinctive radiographic features included periostitis, severe osteopenia, calcaneal erosions, and heel spurs; three of 58 had rapid destruction of a single joint. Only ten patients (all boys) were found to have radiographic sacroiliitis after an average of five years of disease, and only three had the Reiter triad. The lifetime risk of sacroiliitis and spinal ankylosis can only be determined by long-term follow-up of such prospectively identified groups of spondyloarthritic children.

Adolescent↗
PubMed1979

Salicylate treatment of epidemic Kawasaki disease in New York City.

Kawasaki disease, mucocutaneous lymph node syndrome, thought to be rare in the continental United States, occurred in epidemic form in New York City and adjacent New York and New Jersey in November-December, 1977. Aspirin and corticosteroids, reported to be ineffective treatment, were found to completely control the illness in affected children, provided adequate doses to achieve therapeutic blood levels were administered. Patients were found to malabsorb aspirin (and perhaps also to destroy it) and so required extraordinarily high doses during the acute phase; during recovery, doses had to be lowered to the usual range to avoid toxicity. The need for hospitalization and morbidity were reduced and, hopefully, mortality will also be reduced. The importance of not judging a drug ineffective in a disease without demonstrating adequate serum levels was again shown.

Aging↗
PubMed1977

A familial defect of neutrophil chemotaxis with asthma, eczema, and recurrent skin infections.

A defect in chemotaxis of peripheral blood polymorphonuclear leukocytes (PMN's) was demonstrated in both parents and three of four children in a single family afflicted with varying degrees of respiratory allergy, unusual onset of severe eczema in the first month of life, and recurrent bacterial skin infections. Of great interest was the identification of HLA-B12 at the B locus in all affected members but not in the unaffected child. The two children known since infancy to be most severely affected with eczema and recurrent infections are HLA identical and homozygous for HLA-B12. The child without eczema and infections had an intermediate cellular chemotactic defect most apparent on kinetic studies.

Adolescent↗
PubMed1977

Methotrexate and azathioprine treatment of childhood dermatomyositis.

Modern treatment of childhood dermatomyositis with corticosteroids has resulted in greatly improved prognosis and style of life. The immunosuppressive drugs methotrexate and azathioprine have been utilized as ancillary agents in life-threatening disease and in children whose disease could not be adequately controlled with prednisone alone. Two patients are completely well without medication two and seven years after onset; two have received no medications for more than two years and have only subtle signs of any residual illness although they had been profoundly ill for two to three years after the onset of dermatomyositis. A fifth patient, completing the third year of disease, remains ill and continues to require medications but has improved sufficiently to return to regular class in school.

Azathioprine↗
PubMed1977

Cricoarytenoid arthritis and airway obstruction in juvenile rheumatoid arthritis.

Laryngeal arthritis is a rare manifestation of JRA. The difficulty of indirect laryngoscopy in small children has precluded the type of study which has demonstrated this manifestation in up to one quarter of arthritic adults. Recognition of cricoarytenoid arthritis in the patient reported might have prevented the need for tracheostomy, and eventually led to satisfactory reduction of corticosteroid medication and healing of the tracheostomy stoma.

Airway Obstruction↗
PubMed1976

Needle biopsy of the synovium of children.

While the diagnosis of juvenile rheumatoid arthritis is based on clinical criteria and does not require confirmation by synovial biopsy, biopsy is occasionally desired to exclude other diagnoses. Needle synovial biopsy of the knee may be performed on young children as an office procedure and generally provides adequate tissue for examination. In the author's clinic this procedure has replaced open biopsy of the knee of children.

Adolescent↗
PubMed1975

Yersinia enterocolitica arthritis.

Human infections with Yersinia were first recognized and reported in upper New York State almost 40 years ago. Recently, there have been increasing numbers of reports from Scandinavia of episodes of polyarthritis associated with Yersinia infections. A 6-month-old girl from upstate New York had a fever of 40 C for two weeks and green watery diarrhea, and irritability was noted when she was handled. An evanescent rash was most apparent at times of temperature elevations. Her mother and father had had diarrhea during the month preceding the child's illness. Stool cultures were grown in an effort to identify Yersinia enterocolitica if it was present, and the organism was found. A rise in serum agglutination titer against polyvalent Y. enterocolitica was demonstrated from zero to 1:256 dilutions. Y. enterocolitica is probably a cause of arthritis, mesenteric adenitis, and erythema nodosum in the United States.

Antibodies, Bacterial↗
PubMed1975

"Streaking leukocyte factor," arthritis, and pyoderma gangrenosum.

A 14-year-old boy with a 12-year history of episodes of sterile pyarthrosis and cutaneous inflammation and ulceration was found to possess a serum factor which enhanced the random migration of leukocytes in vitro. The serum factor was isolated by Sephadex G-200 gel filtration and found to have a molecular weight of approximately 160,000. This partially purified principle enhanced the random migration of purified normal human neutrophils or mononuclear leukocytes by up to 200% without influencing chemotaxis. Trauma or other stimuli may lead to an accumulation of this serum factor in some tissues of the patient with resultant excessive leukocyte influx and heightened local activity of the leukocytes in the inflammatory exudate.

Adolescent↗