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Biomedical subjects

J S Marks

Publications and source records attributed to J S Marks.

17 recordsLinked to original sources
PubMed1979

Is chloroquine obsolete in treatment of rheumatic disease?

Retinal changes associated with chloroquine occurred in 22 out of 222 patients on long-term therapy for rheumatic diseases and were related to patient age, total dose, and duration of treatment. Ophthalmic review showed progression of the retinopathy with deterioration of visual acuity in only 1 case while the remainder retained normal vision. The results suggest that the risks of ocular toxicity related to chloroquine therapy are acceptably low.

Adult↗
PubMed1979

Primary osteoathrosis of the hip and Heberden's nodes.

One hundred patients with primary osteoarthrosis of the hip were examined for evidence of generalised arthrosis associated with Heberden's nodes, and in addition their hips were graded by the radiographic pattern of loss of joint space. Twenty-nine patients had bilateral concentric loss of joint space, and 18 in this group had Heberden's nodes. None of the 17 patients with bilateral upper pole changes had Heberden's nodes, and only 7 of the 31 patients with unilateral upper pole changes had Heberden's nodes. None of the 6 patients with medial loss of joint space had Heberden's nodes. This study has shown an association between Heberden's nodes had primary osteoarthrosis of the hip where this is characterised by concentric loss of joint space. The association is most marked where hip changes are bilateral, suggesting that hip involvement in generalised osteoarthrosis is part of a generalised disorder with possible genetic or biochemical abnormalities.

Aged↗
PubMed1979

Clinical and radiographic features of spondylitic hip disease.

The clinical and radiographic features of hip disease in 76 patients with definite ankylosing spondylitis have been studied. Symptomatic hip involvement occurred late in the course of the disease, with a mean delay after the onset of 12 years in males and 7 years in females. Patients with disease onset before the age of 20 developed hip symptoms at an earlier stage. Associated diseases included uveitis (13%), colitis (4%). Bilateral concentric loss of hip joint space with a relatively undeformed femoral head was the commonest radiological change (61%). Localised loss of joint space at the upper pole (16%) was associated with femoral head destruction and a greater degree of osteophytosis, suggesting coincidental or secondary osteoarthrosis. Bony ankylosis of the hips (10%) was present only in women, and the absence of osteophytes, cysts, and bone lesions of the iliac crests and ischial rami suggests that it is a distinct radiographic manifestation of female ankylosing spondylitis.

Adolescent↗
PubMed1979

Nosocomial Legionnaires' disease in Columbus, Ohio.

Three patients with severe pneumonia at a community hospital in Columbus, Ohio, were found to have Legionnaires' disease in late August 1977. A subsequent serologic survey of patients with pneumonia at this hospital identified three additional cases. Among patients with pneumonia, hospital exposure in the 2 weeks before onset of illness was significantly associated with Legionnaires' disease (P = 0.003). Serosurveys of hospital employees with a recent history of upper respiratory illness, healthy employees, and workers at the hospital construction site showed that one of 101, one of 107, and none of 114, respectively, has a single reciprocal titer of greater than or equal to 256 to the Legionnaires' disease (LD) bacterium. Serosurveys of patients with pneumonia at three control hospitals identified five additional patients with Legionnaires' disease, three of them with pneumonia that was apparently hospital acquired in a single renal transplant unit. A fourth patient from that unit without clinical illness had a fourfold rise in titer to LD bacterium.

Adult↗
PubMed1979

Risk factors associated with failure to receive vaccinations.

A major purpose of a state-wide survey to document the vaccination status of 1,003 2-year-old children was to identify factors associated with failure to receive the recommended vaccinations. With a basic series of immunization defined as three doses of diphtheria-tetanus-pertussis (DTP), three oral polio vaccine (OPV), one measles, and one rubella, 72.5% of the children had completed the series. When the completed series was redefined to include a fourth DTP and mumps vaccine the rate of completion dropped to 40.8%. However, 59.1% of the children who had not completed this optimal series could be brought up-to-date with a single visit to their provider of medical care. Demographic variables independently associated with completion of the basic series were increased paternal education (P less than .001), increased maternal education (P less than .02), smaller family size (P less than .01) and higher socioeconomic status, as determined by census tract or rural town of residence (P less than .02). Race was not found to be a factor associated with vaccination rates when socioeconomic status was controlled. Patients who received their vaccinations from private physicians had a better vaccination rate than those who attended health department clinics. This difference persisted even when socioeconomic status was controlled by residence (P less than .02). The simultaneous comparison of parental education and family size demonstrated that a child having one parent with less than 12 years education or having at least three siblings has a fourfold greater risk of failure to complete his immunization than children whose parents are both college graduates. By using paternal and maternal education level and family size as screening variables, children at high risk for failure to complete their immunizations could be identified prospectively and made the target of intervention programs to improve compliance.

Child↗
PubMed1978

Observer variation in examination of knee joints.

The knees of 20 patients with rheumatoid arthritis were each examined on two occasions on the same morning by three observers. Assessments were made of joint warmth, synovial thickening, effusion, instability, quadriceps power, bony enlargement, range of movement, and knee circumference, and were graded on a scale of 0-4. Analysis of the results shows close intraobserver agreement for all measurements but considerable interobserver variation for all subjective measurements.

Arthritis, Rheumatoid↗
PubMed1978

Measles vaccine efficacy in children previously vaccinated at 12 months of age.

During a large outbreak of measles in Ohio in 1976 it was possible to measure measles vaccine efficacy by age at time of vaccination and number of years since vaccination. Using a summed incidence method to control for the confounding variable introduced by mass immunization clinics held during the outbreak, vaccine efficacy was greater than 95% for children vaccinated at 12, 13, and 14 or more months of age. Vaccine efficacy for those vaccinated at 12 months of age was notably better than for those vaccinated at younger ages but not different from those vaccinated at older ages. Although recently administered vaccine appeared more efficacious than vaccine administered in the past, this difference was not significant when controlled for age at vaccination. Evaluation of the mass clinics held during the outbreak demonstrated that 59.6% of the inadequately immunized children attended the clinics, but this was not substantially different from the proportion of adequately immunized who attended (52.4%). Recommendations for measles revaccination need not include children previously vaccinated at 12 months of age or greater.

Adolescent↗
PubMed1977

Sarcoma complicating therapy with cyclophosphamide.

A patient is described who developed a poorly differentiated sarcoma after cyclophosphamide was used to treat his rheumatoid arthritis. This case emphasizes the importance ot considering neoplastic disease as a potential hazard associated with the use of immunosuppressive drugs.

Arthritis, Rheumatoid↗