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Biomedical subjects

M Harth

Publications and source records attributed to M Harth.

At least 73 records · Page 4Linked to original sources
PubMed1987

Pain perception and personality measures as discriminators in the classification of fibrositis.

Twenty patients with fibrositis were compared to age and sex matched groups of patients with rheumatoid arthritis (RA) and normal controls regarding personality variables measured by the Basic Personality Inventory (BPI) and responsiveness to experimentally induced pain. The group with fibrositis scored significantly higher than the normal group on 4 of the BPI scales and had lower pain threshold and tolerance than the normal group. The group with RA was found to be significantly different from the normal group on hypochondriasis and pain tolerance. Using only pain and personality measures, a statistical discriminant function that was developed resulted in a 72% classification accuracy for the 3 groups studied and 85% accuracy when only the 2 clinical groups were considered.

Adult↗
PubMed1985

Radiologic review: the rheumatoid cervical spine.

We have reviewed the multiplicity of lesions present in the cervical spine in the adult with RA. The clinicoradiographic correlations are presented, and the techniques available for appropriate investigation are suggested. Readily available, conventional radiology provides useful information for the majority of patients. A standardized system of weighting and grading roentgenographic changes would be a welcome area of future research. Myelography and angiography should be considered in every patient before cervical spine surgery. CT evaluation should be reserved for those without a readily appreciable cause for myelopathy and those undergoing cervical surgical procedures.

Angiography↗
PubMed1985

One-year comparative study of gold sodium thiomalate and auranofin in the treatment of rheumatoid arthritis.

The therapeutic benefits and toxicity profile of auranofin (AF) have been compared with that of gold sodium thiomalate (GSTM) over a one-year period in 120 patients with rheumatoid arthritis. A similar number of patients on both drugs remained in the study at one year (approximately 60%), and showed similar statistically significant improvement (p less than 0.01) in all clinical variables measured. At no time during the study was there a statistically significant difference in the clinical benefit obtained with either drug. Withdrawal from the study through lack of therapeutic benefit was twice as frequent with AF as with GSTM (11 compared to 6). Withdrawal due to a toxic reaction was twice as frequent and were potentially more serious with GSTM than with AF (15 compared to 9). We conclude that AF has a therapeutic potential similar to that of GSTM, however side effects were less prevalent and, when they did cause withdrawal of the drug, were potentially less serious.

Arthritis, Rheumatoid↗
PubMed1985

The effects of auranofin and gold sodium aurothiomalate on the chemiluminescent response of stimulated synovial tissue cells from patients with rheumatoid arthritis.

Mononuclear cells were obtained from synovial tissue of patients with rheumatoid arthritis. The cells were stimulated with opsonized zymosan and generation of reactive oxygen species (ROS) was assayed by chemiluminescence. The effects of gold sodium thiomalate (GSTM) and auranofin (AF) on the chemiluminescent response were observed. Synovial tissue cells showed a chemiluminescent response suggesting their ability to release ROS; this response was inhibited by AF but not by GSTM.

Adult↗
PubMed1985

An evaluation of rheumatology education at Canadian medical schools.

The present study uses data from a nationally administered multiple choice examination (MCE) to assess the performance of Canadian medical students in rheumatology. An average of 1722 medical students undertook to write the Medical Council of Canada (MCC) examination each year between 1978-82. Between 17 and 29 of the 516 MCE questions were of a rheumatological nature and the success rate of students from the 16 Canadian medical schools varied between 65.5 and 78.5% in any given year. No direct correlation was noted between the students' MCE performance and the amount of rheumatology education given at an individual university. Analysis of Arthritis Society Undergraduate Statistics indicated that the average medical student in Canada receives 17.5 h of didactic lectures, 10.4 h of clinical bedside demonstration and 8.9 h of direct supervision of rheumatologic patients by rheumatologists.

Canada↗
PubMed1984

Neurologic complications associated with gold therapy for rheumatoid arthritis.

Neurologic complications of gold are rare and include peripheral neuropathy, a Guillain-Barré-type syndrome, cranial nerve palsies and encephalopathy. Three cases of cranial neuropathy complicating chrysotherapy for rheumatoid arthritis are described. One also had a sensorimotor neuropathy associated with segmental demyelination and axonal degeneration, and another developed an encephalopathy which, on contrast enhanced computed tomographic scanning, showed reversible cerebral and cerebellar white matter lesions. Early recognition and prompt withdrawal of chrysotherapy are the mainstay of management of this lesser known complication.

Adult↗
PubMed1984

HLA antigens in systemic lupus erythematosus: relationship to disease severity, age at onset, and sex.

Sixty-two Caucasian patients with systemic lupus erythematosus (SLE) were studied to determine whether any significant clinical correlations existed with various HLA antigens. While HLA-B8 and DR3 were significantly increased among the SLE population in general, these or other HLA antigens did not correlate with the severity of renal disease. HLA-B8 was significantly higher only in SLE males compared to male controls. The age of onset of disease in females was clustered into 2 groups, one with early age of onset (mean = 21.6 years, range 12-32 years) and another with later age of onset (mean = 48 years; range 38-60 years). SLE females with later age of onset showed an increased frequency of HLA-DR3 compared to sex and age matched controls, while those with early onset SLE showed no significant increase in any HLA antigens. Therefore any risk conferred by the presence of genes associated with HLA-B8 or DR3 is significant only in SLE males and SLE females whose disease onset was over the age of 35. Despite the greater frequency of HLA-B8, DR3 in SLE females with later onset of disease, this group did not have a greater frequency of anti-Ro antibodies compared to females with early age onset of SLE.

Adolescent↗
PubMed1984

Pharmacokinetics of the major metabolites of D-penicillamine in patients with rheumatoid arthritis.

The pharmacokinetic disposition of D-penicillamine and its major metabolites, penicillamine cysteine disulfide ( PSSC ) and penicillamine disulfide ( PSSP ) has been studied in eight patients with rheumatoid arthritis. Plasma concentrations of D-penicillamine, PSSP and PSSC displayed similar characteristics in terms of times to maximum concentrations and biphasic elimination from plasma. Initial t1/2 (alpha) phase ranged from 0.86 to 4.41 h for parent drug and 0.81 to 4.41 h for metabolites. Final t1/2 (beta phase) ranged from 3.4 to 9.45 h for D-penicillamine and 5.62 to 21.7 h for the metabolites. Total drug and metabolites detected in urine accounted for 12.0 to 48.7% of oral drug.

Adult↗
PubMed1984

Effects of D-penicillamine on inflammatory and immune reactions.

The effects of D-penicillamine (D-Pen) in rheumatoid arthritis suggest that the drug may be anti-inflammatory and immunosuppressive. Paradoxically D-Pen therapy may also induce antibody formation, and autoimmune disease. D-Pen is not consistently effective in animal models of immune disease. It is weakly suppressive in cellular responses to mitogens, but has a more pronounced effect on macrophage-dependent mixed leukocyte responses. The drug has an inconsistent effect on various components of the inflammatory reaction but under certain circumstances inhibits oxygen radical generation by monocyte/macrophages.

Antibody Formation↗
PubMed1983

Conversion in vitro of urinary (+)-penicillamine to its major metabolites, PSSP and PSSC.

To investigate the discrepancy between the apparent pharmacokinetic disposition of (+)-penicillamine in plasma and urine, the spontaneous degradation of (+)-penicillamine was studied in acidified and non-acidified urine. Degradation was prevented by acidification. The oxidized metabolites were converted to reduced (+)-penicillamine by electrolysis.

Biotransformation↗
PubMed1983

Monocyte dependent excited oxygen radical generation in rheumatoid arthritis: inhibition by gold sodium thiomalate.

A chemiluminescent assay was used to measure generation of excited oxygen species by peripheral blood monocytes obtained from normal controls (NC) and patients with rheumatoid arthritis (RA). Whole peripheral blood mononuclear cells (PBMC) and adherent cells (AdhC) from RA patients showed a significantly higher chemiluminescent response to opsonized zymosan at certain observation times than cells from NC. There was no significant difference however in response to stimulation by calcium ionophore (CI). Gold sodium thiomalate (GSTM) significantly inhibited the peak response of fresh PBMC and AdhC (from both RA and NC) to zymosan and CI. GSTM inhibited only the peak response of fresh cells to zymosan; by contrast cells cultured with GSTM for 72 h showed inhibition at all time periods. The effect of GSTM was dependent on dosage and duration of incubation with cells. The addition of GSTM after zymosan stimulation did not inhibit chemiluminescence. GSTM appears to act upon cellular events following membrane activation which culminates in the generation of excited oxidative species. These results suggest a mechanism of action for GSTM in RA by inhibition of monocyte and macrophage dependent generation of oxy radicals and related excited oxygen species.

Arthritis, Rheumatoid↗
PubMed1983

The mucin clot test and the synovial fluid rheumatoid factor as diagnostic criteria in rheumatoid arthritis.

We evaluated the diagnostic usefulness of 2 synovial fluid (SF) tests viz the mucin clot test (MCT) and the rheumatoid factor (RF) test in rheumatoid arthritis (RA). SF was obtained from 140 patients, 60 with RA, 80 with other articular diseases. The sensitivity and specificity of the MCT in RA were 76% and 49%, respectively; the positive and negative predictive values (PPV, NPV) were 52% and 73%. The sensitivity and specificity of SF RF were 63% and 91% respectively compared with corresponding values of 75% and 87% for serum RF; PPV and NPV were 89% and 69%, and differed little from values obtained for serum RF. Our results suggest that RA diagnostic criteria should be revised to exclude the MCT, and that the detection of RF in SF in addition to its determination in serum is unnecessary in establishing a diagnosis of RA.

Adolescent↗
PubMed1981

HLA-Bw35 and prognosis in adult Still's disease.

Twenty-five patients with adult Still's disease were studied to determine clinical course and possible HLA associations. Two types of disease evolution were distinguishable clinically: a self-limited remitting disease with or without recurrent cyclic exacerbations was found in 11 patients, and a persistent disease with continuous activity for more than 1 year, generally accompanied by progressive joint disease, was determined in 8. Disease course could not be classified in 6 patients. The antigen frequencies of HLA-Bw35 (40%, P less than 0.05) and Cw4 (44%, P less than 0.05) were increased in adult Still's disease as compared to controls (18% and 20%, respectively). Because HLA-Bw35 was associated with self-limited remitting type disease (P less than 0.02), this antigen may be a favorable prognostic marker in adult Still's disease.

Adolescent↗
PubMed1981

Osteitis pubis: an unusual complication of herniorrhaphy.

Osteitis pubis is a well known complication of urologic and gynecologic procedures but its association with herniorrhaphy is poorly documented in the literature. A 55-year-old man underwent herniorrhaphy for a direct inguinal hernia, followed in 48 hours by herniorrhaphy for a femoral hernia. One week later he complained of pain in the pubic area and over the ischial tuberosities, had intermittent fever and an elevated erythrocyte sedimentation rate. Roentgenograms showed changes typical of osteitis pubis with widening of the symphysis pubis, loss of definition of the adjacent cortical surfaces and involvement of the ischial tuberosities. There ws no evidence of infection in the urinary tract or elsewhere. The patient was treated with indomethacin and showed clinical and radiologic improvement over the next 6 months. It is possible that in this case two operative interventions involving structures inserting into the pubic bones and performed within a short time of each other exposed this patient to an unusual complication.

Hernia, Inguinal↗
PubMed1979

Adult-onset Still's disease.

Four adults with an illness similar to the systemic variant of juvenile rheumatoid arthritis seen in children (Still's disease) are described. All four had fever, an erythematous maculopapular rash, splenomegaly and arthritis. The arthritis was asymmetric and involved only a few joints simultaneously. Erosive arthritis developed in one patient. Three patients had a sore throat, two had pleurisy and pericarditis, and one had transient abnormalities of liver function. The laboratory features included anemia, leukocytosis and high leukocyte counts in the synovial fluid. High titres of rubella hemagglutination-inhibiting antibody were detected in two patients, one of whom was found to have rubella virus in the urine. Only one patient responded well to therapy with acetylsalicylic acid; the other three were given prednisone therapy, and two continue to require it.

Adult↗