Histocompatibility (HL-A) antigens were determined in 120 patients with systemic lupus erythematosus (SLE) and 120 matched controls. Increased frequencies of HL-A1 and HL-A8 were found. HL-A1 was more strongly associated with SLE in black patients (71 patients), whereas HL-A8 was more impressively associated with SLE in white patients (49 patients). In addition HL-A1 appeared more frequently in those with early onset of disease in both races; and HL-A1, HL-A8, and the HL-A1,8 phenotype seemed to be associated with severe SLE (renal and central nervous system involvement) in white patients. These data support the proposal that there are genetic influences in the pathogenesis and expression of SLE.

Adult↗

PubMedDate not supplied

Controlled trial of cyclophosphamide in rheumatoid arthritis.

Twenty-four patients with severe progressive rheumatoid arthritis were randomly assigned to cyclophosphamide or placebo in a double-blind crossover trial. Eleven patients who completed 9 months on cyclophosphamide (average dose: 1.8 mg/kg/day) demonstrated significant decrease in painful joints, swollen joints, and morning stiffness and increase in grip strength when compared to 11 patients on placebo. After crossover, significant improvement was observed in patients switched to cyclophosphamide, and deterioration within 2 months was observed in most patients changed from drug to placebo. Serum immunoglobulins and rheumatoid factor titers decreased with cyclophosphamide but antibody response to Vi antigen was unaffected. Primary delayed immune response to 2,4-dinitrochlorobenzene was markedly depressed. Adverse effects were troublesome--hemorrhagic cystitis affected 4 patients and amenorrhea occurred in 3. Despite striking beneficial effect, cyclophosphamide should be prescribed cautiously and only in severe resistant cases of rheumatoid arthritis.

Adult↗

PubMedDate not supplied

Competing on capabilities: the new rules of corporate strategy.

In the 1980s, companies discovered time as a new source of competitive advantage. In the 1990s, they will discover that time is only one piece of a more far-reaching transformation in the logic of competition. Using examples from Wal-Mart and other highly successful companies, Stalk, Evans, and Shulman of the Boston Consulting Group provide managers with a guide to the new world of "capabilities-based competition." In today's dynamic business environment, strategy too must become dynamic. Competition is a "war of movement" in which success depends on anticipation of market trends and quick response to changing customer needs. In such an environment, the essence of strategy is not the structure of a company's products and markets but the dynamics of its behavior. To succeed, a company must weave its key business processes into hard-to-imitate strategic capabilities that distinguish it from its competitors in the eyes of customers. A capability is a set of business processes strategically understood--for example, Wal-Mart's expertise in inventory replenishment, Honda's skill at dealer management, or Banc One's ability to "out-local the national banks and out-national the local banks." Such capabilities are collective and cross-functional--a small part of many people's jobs, not a large part of a few. Finally, competing on capabilities requires strategic investments in support systems that span traditional SBUs and functions and go far beyond what traditional cost-benefit metrics can justify. A CEO's success in building and managing a company's capabilities will be the chief test of management skill in the 1990s. The prize: companies that combine scale and flexibility to outperform the competition.

Decision Making, Organizational↗

PubMedDate not supplied

Proceedings: Serologic abnormalities and their significance in localized scleroderma.

Explore the source record for details and available documents.

Adolescent↗