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Biomedical subjects

M Leirisalo

Publications and source records attributed to M Leirisalo.

30 records · Page 2Linked to original sources

Electrocardiographic findings in patients with connective tissue disease.

ECG changes in 49 patients with rheumatoid arthritis, 18 with ankylosing spondylitis, 47 with systemic lupus erythematosus, 17 with dermatomyositis, 21 with scleroderma and 7 with polyarteritis nodosa were compared with ECG changes in 106 control subjects. The classification of ECG findings was based mainly on the Minnesota Code. Compared with control subjects, pathological Q--QS, ST segment and T wave patterns were more common in all patient groups--including dermatomyositis, in which cardiac involvement has rarely been reported. P terminal force (PTF) was higher in the patient group. Conduction defects were probably more common in connective tissue diseases, whereas differences in ectopic beats, arrhythmias, QRS duration and QRS axis and R wave amplitude were not significant. The only significant difference between the steroid-treated patients and those without such treatment was the higher frequency of ST changes in the steroid-treated group. The results imply that heart affection is common in all connective tissue diseases. The several mechanisms underlying the cardiac involvement are reflected in many ways in the electrocardiograms of these patients, including an increased frequency of ECG changes mimicking those met in coronary heart disease.

Adult↗

Relation between HLA-B27 and clinical features in patients with yersinia arthritis.

A study of 74 yersinia arthritis patients implied that the clinical picture of the disease may be modified by genetic background associated with the histocompatibility antigen B27 (HLA-B27). Sixty-six percent of patients were B27 positive. Joint symptoms were somewhat more severe in B27+ patients. Iritis, conjunctivitis, carditis, signs of urologic inflammation, and complete Reiter's triad occurred only in the B27 + group, whereas erythema nodosum was more common in B27 - group. Several B27 + patients also had "B27 + rheumatic diseases," such as ankylosing spondylitis or Reiter's disease, in their history.

Adult↗

HLA phenotypes in patients with rheumatic fever, rheumatic heart disease, and Yersinia arthritis.

HLA phenotypes were determined in 109 patients with rheumatic fever (RF), 48 patients with Yersinia arthritis (YA), 86 patients with chronic rheumatic heart disease (RHD), and 326 controls. There was an increased frequency of Bw35 in RF as compared to controls (Pc less than 0.01), while B18 was more common in patients with acute carditis than in those without (P less than 0.02). HLA frequencies in RHD did not differ significantly from those in controls. A significant correlation between B27 and YA was observed (Pc less than 0.001). Carditis or iritis occurred in 10 of 31 B27 positive YA patients but in none of 17 B27 negative patients. Eleven of 31 B27 carriers had signs of urological inflammation vs one of 17 B27 negative patients. In the B27 positive YA group, there were three men with previous ankylosing spondylitis and one with Reiter's syndrome (RS). Also, four patients developed RS during Yersinia infection. This simultaneous occurrence of three B27 positive rheumatic diseases suggests that a patient with one "B27 positive rheumatic disease" is more susceptible to other diseases or symptoms known to be associated with the B27 antigen.

Adult↗

The efficacy of single dose of pindolol in hypertension.

The effect of pindolol was studied in 32 patients suffering from hypertension of WHO grad I or II. 25 of these patients respondered to pindolol administered three times daily, and were thereafter treated with a single 20-40 mg dose of pindolol. Normotension was achieved in 15 patients and a satisfactory result in five patients but three patients did not respond to the single dose and two had to interrupt their treatment because of side effects. The side effects were generally mild. As a significant observation NaCl retention was found. It may be due to the preceeding diuretic treatment in most patients, but nevertheless needs further investigations.

Clinical Trials as Topic↗

Rheumatic fever and Yersinia arthritis. Criteria and diagnostic problems in a changing disease pattern.

A study of rheumatic fever (RF) in Finland and Sweden was carried out by examining (a) the patients with RF in two hospitals in Helsinki, Finland during the years 1969-72, (b) the case reports of RF patients in Uppsals hospital region (UHR) in Sweden during the years 1968-69. In Helsinki there were 22 and 2n UHR 16 patients with an acceptably certain diagnosis of RF. Of the five "major manifestations" according to Jones' revised criteria (Circulation, 32: 664, 1965), carditis and polyarthritis were the most valuable diagnostic criteria, whereas only 8 cases of the whole material had erythema marginatum. The two remaining criteria, chorea and subcutaneous nodules, have lost their diagnostic value, since they are extremely rare nowadays. The diagnosis of RF was substantially influenced by arthritis associated with Yersinia enterocolitica infection. Some of the patients with YA met completely the Jones revised criteria for the diagnosis of RF. The symptomatology of Yersinia arthritis (YA) and that of RF are similar in some cases it is impossible to separate then even on the basis of serological tests. Diagnostic criteria should therefore be viewed against the geographical distribution of the disease. In addition to the required Jones' criteria, we concluded that at least in Sweden and Finland, in order to be categorized under RF, a patient must demonstrate clinical and serological evidence of acute streptococcal infection and, furthermore, Yersinia infection must be excluded.

Adolescent↗

Rheumatic fever in adult patients.

A study of rheumatic fever in adult patients (diagnosed according to the Jones revised criteria; Circulation 36: 664, 1965) was performed by examining 26 patients during the acute phase of the disease, and by re-examining 22 of them from 6 months to 64 months later (mean 33 months). Polyarthritis and carditis were the most common major manifestations. 23 patients had polyarthritis and 3 monoarthritis. 18 patients had signs of acute cardiac involvement. Carditis appeared to be rather benign: at the acute stage no patient developed congestive heart failure or any other serious complication. Five patients had erythema marginatum, but we saw no chorea or subcutaneous nodules. Of the 22 patients examined in the follow-up study, 4 had persistent signs of cardiac involvement and 15 showed chronic joint manifestations. Yersinia enterocolitica infection was by far the most difficult differential diagnostic problem, since polyarthritis and carditis associated with this enteric infection were very similar to those in patients with rheumatic fever. Current literature on rheumatic fever and the results of this series suggest that the diagnostic criteria of rheumatic fever (Jones) should be re-evaluated, at least in industrial countries.

Acute Disease↗

Rheumatic fever and its sequels in children. A follow-up study with HLA analysis.

An analysis of 170 attacks (in 158 children) treated with a diagnosis of rheumatic fever (RF) in 1956-1961 or 1970-1974 showed that the Jones revised criteria of RF were fulfilled in about 1/2 of the attacks. Arthritis occurred in 72%, carditis in 39%, chorea in 18%, and erythema marginatum in 1% of the attacks with confirmed diagnosis. No chorea was observed in 1970-1974. Follow-up of the patients showed favorable prognosis and low frequency of recurrences of RF. HLA analysis showed frequencies of A and B loci were similar, whereas "blank" finding in locus C was rarer in RF patients than in controls.

Adolescent↗