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Biomedical subjects

J Dudler

Publications and source records attributed to J Dudler.

At least 19 recordsLinked to original sources
PubMed2006

[Gout].

Gout must be regarded as a systemic and chronic disease with potentially serious sequelae. Hyperuricemia is probably an independent risk factor for cardiovascular diseases, at least in high-risk individuals. Nevertheless, current data do not justify for the moment the treatment of asymptomatic hyperuricemia. Finally, if allopurinol remains the only available agent in Switzerland for the treatment of chronic gout, new molecules, like febuxostat and pegylated uricase, are currently being evaluated.

Acute Disease↗
PubMed2005

CPPD crystal deposition disease in patients with rheumatoid arthritis.

The aim of this study was to assess the frequency and the outcome of patients suffering from rheumatoid arthritis in which calcium pyrophosphate dihydrate (CPPD) crystal deposits were found to coexist in synovial fluid analysis. Such association was more frequent than previously believed with CPPD crystals found in 25.8% of 93 patients with rheumatoid arthritis. As a group, a trend toward a worse outcome was suggested by more frequent prostheses of the lower limb.

Adult↗
PubMed2005

[Clinical evaluation of rheumatoid arthritis in practice].

Clinical evaluation is an integral part of medical practice. However, recent data have demonstrated that a systematic and standardized evaluation modifies the prognosis of our rheumatoid arthritis patients. The systematic use of activity indexes allows us to better appreciate the needs of our patients and the necessity to optimize and intensifie treatment. Likewise, auto-evaluations tools bring useful information to patient management.

Arthritis, Rheumatoid↗
PubMed2005

[Interest of magnetic resonance imaging in rheumatoid arthritis].

Magnetic Resonance Imaging (MRI) is the best imaging method in early detection and management of rheumatoid arthritis (RA). There are other imaging methods available as ultrasound, scintigraphy, computed tomography and plain radiography for imaging RA but MRI provides the best sensitivity in detecting inflammatory changes in the joints. MRI shows the best intra and interobserver reliability and low variation between repetitive examinations. MRI has shown the best visualisation and the greater sensitivity to detect erosion in early RA, compared to standard radiography. The use of a contrast agent further increases the sensitivity in detecting erosions and differentiate synovial proliferation from fluid collections. Otherwise, intraossous cyst, tenosynovitis, bone marrow edema, that are concomitant manifestations of the disease, are best imaged by MRI. MRI assists in the early detection of rheumatoid arthritis, which allows earlier initiation of treatment.

Arthritis, Rheumatoid↗
PubMed2005

[Rheumatoid arthritis and pregnancy].

Rheumatoid arthritis occurs frequently in women in childbearing years. With the improvement of the treatments, more patients with rheumatoid arthritis consider a pregnancy. Close co-operation between the physician and the obstetrician caring for the mother and the foetus is necessary. The disease should be well controlled at the time of the conception, although an amelioration of rheumatoid arthritis occurs in about 75% of pregnancies, in the first trimester. Some medications can be used during pregnancy and lactation. There is no indication of any adverse effects of rheumatoid arthritis on pregnancy outcome. The mother needs to be followed up regularly after delivery because of the high risk of post-partum flare.

Arthritis, Rheumatoid↗
PubMed2003

Rat bite fever without fever.

Rat bite fever is a rarely reported acute febrile bacterial illness caused by Streptobacillus moniliformis or Spirillum minus following a rat bite. It is classically characterised by abrupt onset of fever with rigors, myalgias, headache, and the appearance of a generalised maculopapular petechial skin rash. Polyarthritis complicates the course of the disease in up to 50% of infected patients, and numerous hurdles can make the diagnosis particularly difficult in the absence of fever or rash, as in the present case. A high degree of awareness is necessary to make the correct diagnosis in such cases. Diagnosis has important prognostic implications as the disease is potentially lethal, but easily treatable.

Aged↗
PubMed2001

Plasma apolipoprotein(a) co-deposits with fibrin in inflammatory arthritic joints.

Extravascular coagulation and diminished fibrinolysis are processes that contribute to the pathology of both inflammatory arthritis and atherosclerosis. We hypothesized that, given its homology with plasminogen, apolipoprotein (apo) (a), the distinctive glycoprotein of the atherogenic lipoprotein (Lp) (a), may be equally implicated in inflammatory arthritis. We detected the presence of apo(a) as part of Lp(a) in human arthritic synovial fluid. The abundance of apo(a) in synovial fluid rose in proportion to plasma apo(a) levels and was higher in inflammatory arthritides than in osteoarthritis. In addition, apo(a) immunoreactive material, but not apo(a) transcripts, was detected in inflammatory arthritic synovial tissues. These data indicated that synovial fluid apo(a) originates from circulating Lp(a) and that diffusion of Lp(a) through synovial tissue is facilitated in inflammatory types of arthritis. In synovial tissues, apo(a) co-localized with fibrin. These observations could be reproduced in a model of antigen-induced arthritis, using transgenic mice expressing human Lp(a). Although in this mouse model the presence of apo(a) did not change the severity of arthritis, the co-localization of apo(a) with fibrin in synovial tissue suggests that, in humans, apo(a) may modulate locally the fibrinolytic activity and may thus contribute to the persistence of intra-articular fibrin in inflammatory arthritis.

Animals↗
PubMed2000

Effect of interleukin 17 on proteoglycan degradation in murine knee joints.

OBJECTIVE: To evaluate the effect of murine interleukin 17 (IL17) on cartilage catabolism and joint inflammation by direct intra-articular injection of the cytokine into murine knee joints. METHODS: Knees of normal C57 Bl mice were injected once or repeatedly with recombinant IL17 or IL1beta. Inflammation was estimated by technetium-99m pertechnetate ((99)Tc) uptake and histological scoring of tissue sections. Proteoglycan depletion was evaluated by histological scoring of safranin O stained sections. Effects on proteoglycan synthesis were studied by (35)SO(4) incorporation. RESULTS: A single intra-articular injection of IL17 (10 ng/knee) produced effects very similar to those of IL1beta (10 ng/knee). No inflammation was detected at six or 24 hours by (99)Tc uptake. However, safranin O staining showed depletion of proteoglycan at 48 hours. Repeated injections of IL17 induced joint inflammation and cartilage proteoglycan depletion as shown by histological scoring. Unlike IL1beta, proteoglycan depletion induced by IL17 seemed to be the result of increased degradation only, as no suppression of (35)SO(4) incorporation was seen. CONCLUSION: These findings confirm, in vivo, the catabolic effects of IL17 on cartilage. IL17 is thus the first T cell cytokine showing a direct catabolic effect on cartilage in addition to stimulatory effects on macrophages and synoviocytes, making it a potentially important cytokine in the pathogenesis of arthritis.

Animals↗
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

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

T cells and related cytokines.

T cells play a critical role in rheumatoid arthritis. They are probably continuously involved in pathogenesis, from the initiation to the chronic stage. As recent studies have demonstrated, the part they play in rheumatoid arthritis is closely linked to the roles of macrophages and mesenchymal cells, because they all interact through autocrine, paracrine, and cell-contact pathways. This paper reviews recent work and research regarding the specific role of T cells in the pathogenesis of rheumatoid arthritis.

Animals↗