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Biomedical subjects

M F Kahn

Publications and source records attributed to M F Kahn.

At least 163 records · Page 9Linked to original sources
PubMed1991

[Orthopedic surgery in rheumatoid polyarthritis].

The authors have determined the timing and details of the recourse to surgery in a cohort of 288 non-selected cases of rheumatoid arthritis. This was necessary in one third of the patients after a mean follow-up period of 10 years. The same was true for patients followed up as out-patients as for those hospitalized during the active progress of the disease. Fifteen percent of the patient in the cohort received total replacement of a large joint by a prosthesis. Orthopedic surgery makes a major contribution towards improving the functional prognosis in rheumatoid arthritis.

Arthritis, Rheumatoid↗
PubMed1990

[Sharp's syndrome].

The author presents the current concept of Sharp's syndrome and mixed connective tissue diseases, as well as the detailed composition, determined by modern immunological methods, of the U1-RNP antigen against which patients with this syndrome develop antibodies. A physiopathological concept of the syndrome is outlined.

Antibodies, Antinuclear↗
PubMed1990

[Does the general strategy for the treatment of rheumatoid polyarthritis need to be reviewed?].

At the start of the nineties, the therapeutic strategy for rheumatoid arthritis (RA) is still disappointing, and the natural history of this affection remains only slightly influenced by the treatments; a general re-assessment of the treatment seems therefore justified. Some new slow acting drugs are effective, but they cannot be considered as being therapeutic revolutions: gold salts per os, sulphasalazine, tiopronine whose efficacy is comparable to D-penicillamine without systematic cross interaction, methotrexate, cyclosporin which is difficult to manipulate. These observations encourage the search for new strategies, namely for the early treatment of the synovitis before the pannus and radiological signs appear. For this, the early and irrefutable diagnosis of RA must be made possible; and no completely reliable, early detection test is available yet. Though promising, the new therapeutic approaches, immunomanipulation or cell manipulation, do not revolutionize the evolution of this pathology. Other fields of research need to be developed, namely on the remission-inducing agents observed during pregnancy. It is still impossible to know which approach will provide the absolute weapon against RA.

Arthritis, Rheumatoid↗
PubMed1990

[Intra-articular injection of corticosteroids].

The corticosteroids administered by intra-articular injection are reviewed, together with their indications, contra-indications, precautions of use and side-effects. Emphasis is laid on some points of detail which may help the users.

Adrenal Cortex Hormones↗
PubMed1990

Handedness, immune disorders and information bias.

In order to investigate the relations between handedness and migraine or immune disorders, we performed a case control study comparing the handedness of patients suffering from systemic lupus erythematosus (SLE), type I diabetes, Graves' disease, or migraine to that of a random sample of controls from the general population. A handedness index was measured from a 10-item questionnaire. No significant difference was observed. But when the controls who denied having ever suffered from migraine or any allergic disease were set apart from those who gave at least one positive answer to the same questions, the former were found more right-handed, i.e. with a lower handedness index than the latter (P less than 0.05) and than the SLE patients (P less than 0.05). More generally, the mean observed handedness index of controls giving a positive answer to any question about their health was found repeatedly higher than that of controls giving a negative answer: this was observed for 27 of the 32 questions. These results are highly suggestive of an information bias, the subjects saying they use the right hand for each of the 10 activities considered in the questionnaire being more likely to deny having suffered from a given disease or used, more or less recently, some drug or medical service. Our conviction is that previous observations dealing with the same topic are also more easily explained by the presence of an information bias than by Geschwind's theory. The implications for the design of further epidemiologic studies are discussed.

Adult↗
PubMed1990

Comparison of long term evolution of adult onset and juvenile onset Still's disease, both followed up for more than 10 years.

Still's disease is a clinical entity of unknown origin, which can appear before 15 years of age (juvenile onset Still's disease) or later (adult onset Still's disease). There are few reported data about the long term prognosis of Still's disease and no study compares the long term evolution of adult onset and juvenile onset Still's disease. Eighteen patients fulfilling the American Rheumatism Association criteria for Still's disease were followed up for more than 10 years. Ten (group 1) had juvenile onset Still's disease and eight (group 2) adult onset Still's disease. A comparison of the groups showed no significant differences in the initial systemic manifestations of Still's disease, or in the joint lesions. Both groups had severe sequelae, which appeared between six and 10 years after the initial flare up of Still's disease. Nine patients had articular damage and nine had only arthritis without apparent x ray abnormalities. Nine patients had bilateral hip destruction in less than four years. Of these nine, seven required 13 total hip replacements before the age of 45. In the whole group of 18 patients bilateral involvement of the following joints was also seen: carpus (seven patients), knee (four), tarsus (four), ankle (three); three patients had ankylosis of the cervical spine. The occurrence of amyloidosis (three cases, two deaths) was restricted to group 2. This was the only difference between the groups, as the treatments were identical. It is concluded that the articular prognosis of Still's disease is poor, be it adult onset or juvenile onset, with severe joint destruction in half of the patients.

Adult↗
PubMed1990

Longitudinal immunoblotting variations of auto-antibody reactivity of patients with systemic lupus erythematosus.

The purpose of this study was to examine longitudinally the different patterns of nuclear and cytoplasmic antigen recognition by sera from patients with SLE during clinical flare and remission using immunoblotting (IB) techniques. Serum samples (n = 150) were obtained from 35 SLE patients during a follow-up period averaging 4.7 years. Three patients (10 sera) were in complete remission: the IB pattern of these 3 patients remained unchanged; 32 SLE patients experienced one or more clinical flares: in 5 cases (20 sera) the IB analysis showed no detectable antibody. The following dominant IB patterns were seen in the remaining 27 active SLE patients: anti-Sm (n = 7), anti-Sm/RNP (n = 7), anti-SS-B and/or anti-Ro (n = 6), anti-histones (n = 5), anti-70 Kd (unidentified) (n = 2). No IB pattern was able to differentiate mild forms of SLE from severe cases. In 9 of 21 clinical flares, the serum IB pattern was not different from that of the patient's serum drawn during remission (3 severe and 6 mild flares). Diversity of the antibodies increased in 7 cases (5 severe, 2 mild flares); and a shift from one pattern to another was observed 5 times (2 severe, 3 mild flares). Twenty three subsequent remissions were studied: in 14 cases the IB profile was unmodified (5 severe, 9 mild SLE), and the diversity of the antibody narrowed in 4 cases (2 severe, 2 mild SLE). The IB pattern shifted from one pattern to another (2 severe, 4 mild SLE) in 5 instances.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

Microheterogeneity of acute phase proteins in the differentiation of polymyalgia rheumatica from polymyositis.

We studied an alpha-1-acid glycoprotein (AGP) and an alpha-1-antichymotrypsin (ACHT) microheterogeneity in sera of patients with polymyalgia rheumatica (PMR), giant cell arteritis (GCA/PMR), polymyositis/dermatomyositis (PM/DM) and healthy individuals by affinity electrophoresis with concanavalin A (Con-A) as the ligand. Our results are expressed as reactivity coefficients. The mean of AGP reactivity coefficients (AG-RC +/- SD) in PMR (0.92 +/- 0.17) and GCA/PMR (0.91 +/- 0.12) were significantly lower compared with the mean AG-RC in patients with PM/DM (1.48 +/- 0.52) as well as in healthy individuals (1.34 +/- 0.9). Moreover, an additional microheterogeneous form of AGP was noted in patients with PM/DM. In parallel, we also found that the mean of ACHT reactivity coefficients (AC-RC +/- SD) were lower in patients with PMR (2.94 +/- 1.24) and GCA/PMR (1.66 +/- 0.16) compared with healthy individuals (3.92 +/- 1.17). The mean of AC-RC in patients with PM/DM (6.74 +/- 4.35) was significantly higher than in patients with PMR and GCA/PMR as well as in healthy individuals. Our results show that the changes in reactivity of AGP and ACHT with Con-A are useful diagnostic markers for the differentiation of PMR and GCA/PMR from PM/DM.

Acute-Phase Proteins↗
PubMed1990

[Profile of antinuclear antibodies in 14 cases of extinct systemic lupus erythematosus for more than 3 years].

In order to study the profile of antinuclear antibodies (ANA) and anticytoplasm in the clinical recovery period, we searched for ANA by 4 methods (indirect immunofluorescence on HEp-2 and Crithidia luciliae cells, double diffusion in agar against veal thymus and human spleen, immunoprint with a total extract of HeLa cells) in 14 patients with SLE extinct since more than 3 years. The population under study consisted of 12 women and 2 men, aged 43 years on average at the time of study (extremes: 28-64 years). The average lapse of time between the diagnosis of SLE and date of sampling is of 12.6 years (extremes: 3-22 years). The average remission/clinical recovery time during the study is of 8.9 years (extremes: 3-22 years). Seven patients were administered mild corticotherapy (average dose of prednisone: 4.7 mg/day). All the sera preserved ANA or anticytoplasm, distributed in the following way: presence of antinucleus: 10/14 (71.5%); average titre 40; speckled aspect: 10/10; presence of anti-DNA: 0/14; presence of anti-ECT: 2/14 (14.3%): anti-SSB 1 case, anti-RNP 1 case; positive immunoprint: 12/14 (85.7%): anti-Sm 5 cases (isolated or associated), isolated anti-SSB 2 cases; isolated anti-Ro 2 cases; various unidentified 3 cases. These results suggest that the production of ANA and anticytoplasm other than anti-DNA continues during the period of clinical extinction of SLE, underlining the rarity of a complete biological recovery and the necessity of long term clinical surveillance.

Adult↗
PubMed1990

Yersinia enterocolitica tenosynovitis. The first case.

We describe a case of tenosynovitis of tibialis posterior due to Yersinia enterocolitica occurring after injury by a plant thorn in a 55-year-old man. The illness was chronic with 2 recurrences in spite of antibiotic treatment. Full recovery was obtained only after surgical intervention. Our patient's chronic course was fostered by the persistence of thorn fragments in the infected area and the exceptionally pathogenic character of the isolated colony of Yersinia.

Doxycycline↗
PubMed1990

[Seronegative leukocytoclastic vasculitis preceding the onset of disseminated systemic lupus erythematosus].

We encountered 4 patients (3 women, 1 man) with cutaneous vasculitis: three have a delayed pressure urticaria, two a vascular purpura with which a mixt cryoglobulinemia. Histology show a leukocytoclastic vasculitis. Initially all studies for lupus erythematosus were negative. However, after 3 to 10 years of follow-up, the 4 patients developed clinical, serological and histological features of systemic lupus erythematosus meeting four or more criteria of the American Rheumatism Association for the diagnosis of SLE. In one case there is a moderate renal disease. In three others cases there are a severe visceral injury: one with aseptic valvula's injury treated by surgery, another who died from a septicemic incident. The last who died from a neurological complication of systemic lupus. During the isolated cutaneous vasculitis phasis antinuclear antibodies and antibodies to double stranded DNA were all negative. At the time of SLE's diagnosis anti-DNA antibodies were present with or without ANA. In all four cases hypocomplementaemia was not initially seen which distinguish these cases from others previously reported in the literature. The syndrome recognized in these patients may constitute an "ante" serological and clinical phasis of SLE.

Adult↗