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Biomedical subjects

J T Gran

Publications and source records attributed to J T Gran.

At least 73 records · Page 4Linked to original sources
PubMed1993

The epidemiology of ankylosing spondylitis.

This review focuses on various epidemiological aspects of ankylosing spondylitis (AS). Diagnostic criteria currently available are described, and their use in scientific studies as opposed to everyday clinical practice is discussed. Present knowledge of the prevalence of AS is addressed in detail with particular emphasis on discrepancies caused by variations in population frequencies of HLA B27 and those caused by differences in study designs.

Adolescent↗
PubMed1993

Chronic idiopathic mediastinal fibrosis presenting with malaise, pleuritis and thoracic back pain.

A patient with chronic idiopathic mediastinal fibrosis (MF) without concomitant retroperitoneal fibrosis is reported. He presented with pleuritis, malaise and pain and stiffness in the thoracic spine. During the 3.5 years of observation no clinical signs of obstruction of adjacent visceral structures in the chest cavity have developed. The diagnosis was made by CT, X-rays of the chest remained normal throughout the observation period, except for thickening of the involved pleura. The administration of high doses of oral corticosteroids did not appear to influence either clinical symptoms or the manifestations of MF as seen by CT.

Adult↗
PubMed1993

Adult idiopathic polymyositis without elevation of creatine kinase. Case report and review of the literature.

A patient fulfilling diagnostic criteria for definite polymyositis, but with normal levels of creatine kinase (CK) is reported. Review of the literature reveals significant variations regarding the frequencies of normal CK reported among cases with myositis. The discrepancies may be partly explained by inclusion of both probable and possible polymyositis, administration of steroid therapy prior to estimations of CK, and possible differences in CK levels between polymyositis and dermatomyositis. The patient reported did not suffer from neither lung disease nor concomitant malignancy. Thus, the alleged association between low levels of CK and poor prognosis in myositis could not be supported by the present case report.

Creatine Kinase↗
PubMed1993

Toxicity of sulphasalazine in rheumatoid arthritis. Possible protective effect of rheumatoid factors and corticosteroids.

Adverse reactions to sulphasalazine were seen in 35 of 100 patients with rheumatoid arthritis. Gastrointestinal side effects, skin reactions and increases of serum liver enzymes were most frequently noted. Serious or fatal adverse reactions were not observed. The frequency of toxicity to sulphasalazine was significantly lower among patients treated concurrently with small doses of oral corticosteroids, and also among cases seropositive for rheumatoid factors. Of the 14 seropositive patients also treated with corticosteroids, none developed side effects to sulphasalazine.

Adolescent↗
PubMed1992

Joint manifestations in gastrointestinal diseases. 1. Pathophysiological aspects, ulcerative colitis and Crohn's disease.

The many unique structural and functional features of the intestine may offer explanations to the well-established association between arthritis and inflammatory bowel diseases (IBD). In ulcerative colitis (UC) and Crohn's disease (CD) some 6-8% of cases develop peripheral joint disease which frequently correlates with the activity and extent of the underlying bowel disorder. Ankylosing spondylitis is also found rather frequently in UC and CD, but is apparently not related to the severity of colitis. The occurrence of rheumatic manifestations in these two IBD is reviewed in detail.

Colitis, Ulcerative↗
PubMed1992

Joint manifestations in gastrointestinal diseases. 2. Whipple's disease, enteric infections, intestinal bypass operations, gluten-sensitive enteropathy, pseudomembranous colitis and collagenous colitis.

This review addresses the clinical picture of rheumatic diseases seen in Whipple's disease, gluten-sensitive enteropathy, pseudomembranous colitis, collagenous colitis and that developing after enteric infections and intestinal bypass operations for morbid obesity. These disorders exemplify the interplay between antigen entrance through the gastrointestinal canal, specific bacterial properties and genetic host factors such as HLA B27. In most cases such as interplay results in formation of circulating immune complexes causing the development of peripheral joint disease.

Bacterial Infections↗
PubMed1992

Ankylosing spondylitis. Current drug treatment.

The administration of drugs constitutes an important component of the therapeutic programme in ankylosing spondylitis (AS). The main objective of initiating such therapy is to reduce pain, stiffness and discomfort. There are at present 3 groups of drugs available for the management of AS. The first group is represented by drugs thought to influence the disease process itself. In this group, sulfasalazine is the only drug which is controlled trials has been shown to suppress disease activity in AS. We recommend the use of sulfasalazine in patients with high disease activity, with peripheral arthritis and in those with AS of short duration. The second group of drugs includes nonsteroidal anti-inflammatory drugs (NSAIDs), which suppress inflammation without influencing the disease process. These drugs should be administered selectively during periods of high disease activity. Moreover, 1 drug should be used in appropriate dosage before it is assumed to be inefficient. High doses of NSAIDs may be prescribed before bedtime in patients suffering from severe pain and stiffness during the night. The toxicity profile of NSAIDs includes gastrointestinal and renal side effects. The third group comprises analgesics and muscle relaxants. Such drugs should be used rather frequently in patients with longstanding AS refractory to treatment with NSAIDs. Peripheral arthritis and enthesopathy are generally managed by local injections of corticosteroids, while AS complicated by psoriasis or inflammatory bowel disease is treated as primary AS. AS occurring in juveniles is best treated with aspirin and an NSAID, although careful observation is necessary for the development of Reye's syndrome (with aspirin) and gastric irritation (with NSAIDs). When patients with AS undergo surgery, the possibility of silent gastrointestinal bleeding due to the use of NSAIDs and salicylates should not be ignored. Patients treated with oral corticosteroids should receive a bolus injection of soluble corticosteroid prior to surgical intervention. NSAIDs may be administered pre- and postoperatively to relieve stiffness induced by immobility. Rapid treatment of intervening infections and use of NSAIDs is recommended in AS complicated by renal amyloidosis. During pregnancy and lactation, ibuprofen may be the preferred drug in AS.

Adrenal Cortex Hormones↗
PubMed1992

The prevalence of fibromyalgia among women aged 20-49 years in Arendal, Norway.

In an epidemiological survey of females aged 20-49 years in Arendal, Norway, a prevalence of fibromyalgia according to the ACR criteria of 1990 of 10.5% was found. Thirty-four out of 40 women with fibromyalgia (85.0%) had, prior to the present population study, consulted a physician because of widespread pain and/or stiffness. Of these 34 women, 14 cases (41.2%) had been given a diagnosis of fibromyalgia. It is concluded that fibromyalgia represents one of the major causes of pain in the locomotor system, and unfortunately, the condition often remains undiagnosed for long periods.

Adult↗
PubMed1992

The prevalence of ankylosing spondylitis among Norwegian Samis (Lapps).

A population survey of the Sami (Lapp) population of the municipalities Karasjok and Kautokeino in north Norway revealed a prevalence of ankylosing spondylitis (AS) according to the New York criteria of 1.8%. Eleven cases of AS were found, 7 men and 4 women. Only 4 of the 11 observed cases of AS were aware of the diagnosis of AS prior to the survey. Ten of 11 patients with AS possessed HLA-B27 (91%) which is found in 24% of the general Sami population in this area. It was calculated that 6.8% of B27 positive persons had AS.

Adult↗
PubMed1990

[Clinical manifestations of primary Sjogren's syndrome].

The article reviews the symptoms and signs of primary Sjögren's syndrome. It describes the clinical and laboratory investigations of such patients, and briefly discusses the occurrence of malignancy in Sjögren's syndrome.

Eye Manifestations↗
PubMed1990

[Visceral manifestations of primary Sjogren's syndrome].

The author briefly surveys the visceral manifestations of primary Sjögren's syndrome. Two patients are described where the clinical picture was dominated by symptoms from lungs and kidneys respectively.

Acidosis, Renal Tubular↗
PubMed1990

[Reactive arthritis following Yersinia pseudotuberculosis infection].

A patient developed reactive arthritis due to Yersinia pseudotuberculosis. Five months after the primary infection, the patient still suffered from severe oligoarthritis. The administration of steroids and sulphasalazine had very little effect upon the development of the disease.

Adrenal Cortex Hormones↗
PubMed1988

Epidemiological and genetic aspects of IgM rheumatoid factors.

The occurrence of IgM rheumatoid factors (RF) was studied in a random sample of 8807 persons aged between 20 and 50 years in Tromsø, North Norway. Seropositivity for IgM RF was defined as a Waaler titre of 40 or more. A total prevalence of IgM RF of 1.36% was found, and a prevalence between 0.48-0.94% was found among the healthy persons, with no sex difference. Approximately 50% of IgM Rf positives are thus healthy. Only 11% of those with IgM RF suffered from rheumatoid arthritis. The majority of RF positive sera from healthy persons were low titred, and 81% of them converted to seronegativity in the course of 3.5 years. A low titred IgM RF appears rather harmless, while a high titre indicates a specific disease process. No association between IgM RF and DR4 could be found in healthy persons. The frequencies of Gm-allotypes a, b, e, f-n and x in healthy, RF positive individuals did not differ from the RF positive patients with RA, suggesting that the Gm-allotypes are not involved in the genetic pre-disposition for RA.

Adult↗
PubMed1988

What is seronegative rheumatoid arthritis?

Between classical, erosive, seropositive rheumatoid arthritis (RA) on one hand, and typical, axial ankylosing spondylitis (AS) on the other, there is a variety of seronegative polyarthritides, which are often difficult to diagnose, classify and also to distinguish from each other. During our studies of HLA antigens and their associations with rheumatic diseases, and particularly that of DR4 with RA, we became increasingly concerned with the problem of defining properly patients with seronegative RA. Both the statement of seronegativity with regard to rheumatoid factors (RF), the diagnosis of RA, and particularly the exclusion of cases of seronegative arthritis other than RA were difficult. We felt that such problems might explain the conflicting opinions as to the association between RF and HLA-DR4 in patients with RA. As a basis for discussing these problems, a set of criteria for RF seronegative RA are presented.

Arthritis↗