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Biomedical subjects

M Petri

Publications and source records attributed to M Petri.

At least 163 records · Page 9Linked to original sources
PubMed1987

Randomized, double-blind, placebo-controlled study of the treatment of the painful shoulder.

The effect of triamcinolone subacromial bursa injection versus naproxen therapy was compared in a randomized, double-blind, placebo-controlled study of 100 patients who had painful shoulders. Outcome was compared using degree of active abduction, pain, limitation of function, and a clinical index that combined equally weighted measures of all of these. In a time-adjusted analysis, triamcinolone was superior to placebo in all clinical variables. Naproxen was superior to placebo in all variables except pain. Triamcinolone was superior to naproxen in the relief of pain (P = 0.04) and the clinical index (P = 0.04). Multiple linear regression analysis showed that naproxen and triamcinolone treatment accounted for only 16% of the variation in outcome, compared with 44% accounted for by the clinical index prior to treatment. Thus, patients with a poor pretreatment clinical index (those with the most room for improvement) were least likely to improve. We conclude that both triamcinolone (P = 0.00005) and naproxen (P = 0.02) are superior to placebo in the treatment of the painful shoulder.

Bursa, Synovial↗
PubMed1987

Fatal infections in systemic lupus erythematosus: the role of opportunistic organisms.

The causes of death were examined in patients with systemic lupus erythematosus (SLE) who were cared for at the University of California, San Francisco and who died after 1969. Of the 44 deaths analyzed, 33 patients had autopsies. Infections were common and often determined to be the cause of death. Overall, infections were present in 55 percent (22/44), and judged to be a cause of death in 30 percent (13/44) of all deaths. The infections could be divided into 2 groups: those due to common bacterial organisms and those due to opportunistic infections. These two types of infections occurred with similar frequency. When compared to common bacterial infections, however, the opportunistic infections were more likely to be first diagnosed at autopsy (p = .001). In only 3 of the 15 patients with an opportunistic infection was the diagnosis made antemortem. Failure to diagnose an opportunistic infection early occurred when the infection simulated active SLE, and when the possibility of an opportunistic infection was not aggressively investigated. The most common opportunistic infections were Candida albicans and Pneumocystis carinii. The most common site of opportunistic infection was the lung. Seventeen patients had 27 common bacterial infections, chiefly sepsis from Staphylococcus aureus and aerobic gram-negative organisms. Eight patients had both a common bacterial and an opportunistic infection. Stepwise linear regression analysis showed that death from infection correlated most strongly with prednisone and cytotoxic drug use in the 3 months before final admission. No measure of lupus activity was found to correlate with death from infection, except that hypocomplementemia correlated with death from bacterial infections.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Ultrastructure of the small intestinal mucosa in progressive systemic sclerosis (PSS).

The present study deals with ultrastructural changes of jejunal absorptive epithelium in mucosal biopsy specimens from eleven patients with progressive systemic sclerosis (PSS). Epithelial cells showed cytoplasmic condensations with cholesterol clefts and fat droplets. Intercellular spaces of the epithelium were dilated with deposits of fat droplets, while tight junctions and villi preserved their normal structures. Goblet cells and entero-endocrine cells showed no changes. In the lamina propria, fat droplets were observed as well. Vessels were strongly dilated and in 2 patients contained conglomerates of thrombocytes. Perivascular cell infiltrates consisted of lymphocytes, macrophages and mast cells, while plasma cells were scarcely seen; in 2 patients, plasma cells were abundant. Collagen fibrils, elastic fibres, and nerves showed no definite changes. The findings of epithelial cell degeneration and fat droplet deposits indicate dysfunction of jejunal absorptive epithelial cells in PSS.

Adult↗
PubMed1987

The frequency of lupus anticoagulant in systemic lupus erythematosus. A study of sixty consecutive patients by activated partial thromboplastin time, Russell viper venom time, and anticardiolipin antibody level.

Recent reviews have suggested a higher frequency of the lupus anticoagulant or related antiphospholipid antibodies in patients with systemic lupus erythematosus (21% to 65%) than was found in earlier studies (6% to 18%). In our study of 60 consecutive patients, we found the frequency of the lupus anticoagulant by Russell viper venom time was 6.7% (95% confidence interval, 16.2 to 1.8) and by anticardiolipin antibody assay was 25% (95% Cl, 37.0 to 15.7), compared with 0% (p = not significant) and 2.5% (p = 0.002), respectively, in the normal control population. The Russell viper venom time (p = 0.0001 by t-test) and anticardiolipin antibody levels (p = 0.01) were significantly associated with presumed thrombotic events (stroke, deep venous thrombosis, and digital gangrene). No association with miscarriage or pulmonary hypertension was detected. The Russell viper venom time was more specific than the anticardiolipin antibody level in the prediction of past presumed thrombotic events, miscarriage, or pulmonary hypertension (100% compared with 84%, p = 0.01).

Abortion, Spontaneous↗
PubMed1987

Chronic active hepatitis presenting with rheumatoid nodules and arthritis.

Chronic active hepatitis is often accompanied by extrahepatic rheumatic symptoms of mild or moderate severity. We report a 16-year-old girl with this disorder who presented with severe polyarthritis and rheumatoid nodules mimicking juvenile rheumatoid arthritis. Rheumatoid nodules have not previously been described in chronic active hepatitis, and the severity of the rheumatic symptoms in our patient led to a delay in the recognition of the underlying liver disease. Our report provides support for an autoimmune etiology in some patients with chronic active hepatitis, notes the occurrence of rheumatoid nodules in the disorder, and emphasizes that severe extrahepatic symptoms may obscure the diagnosis and institution of therapy in some individuals.

Adolescent↗
PubMed1986

The metabolic effects of thiazide therapy in the elderly: a population study.

The metabolic consequences of thiazide diuretics are well known. The elderly to whom these agents are widely prescribed may be particularly susceptible. To quantify this metabolic risk, plasma and intracellular electrolytes and plasma glucose were measured in the elderly population of a Somerset village. Highly significant reductions in both plasma and cellular magnesium and potassium were found in the 47 thiazide-treated people. Forty-eight per cent of the thiazide-treated group were hypomagnesaemic and 28% were hypokalaemic. Thus, magnesium and potassium depletion are commonly associated with thiazide therapy in the elderly. These metabolic effects should be considered carefully prior to the use of these agents.

Aged↗
PubMed1986

Enterocyte-labelling index in the duodenal mucosa of patients with progressive systemic sclerosis (PSS).

Ten patients with progressive systemic sclerosis (PSS), 4 patients with other gastro-intestinal diseases and 5 normal controls, underwent small intestinal biopsy procedure. The biopsy material was incubated with tritiated thymidine and processed for auto-radiography. The labelling index (LI) in the small intestinal mucosa was estimated. The LI in PSS patients with duodenal involvement was significantly higher than the LI in PSS patients without duodenal involvement. In the latter group, the LI was at the same level as in normal controls. The LI in patients with other gastro-intestinal diseases, with diarrhoea as a main symptom, was not significantly different from the LI found in duodenal PSS.

Adult↗
PubMed1986

Collagen components in the duodenal and rectal mucosa in progressive systemic sclerosis and other diseases.

Small intestinal mucosa from 14 patients suffering from progressive systemic sclerosis and 22 patients with various other diseases was analysed for collagen components. There was no significant difference in the concentration of hydroxyproline, hydroxylysine and proline between the two groups. Rectal mucosa from 11 progressive systemic sclerosis patients, 5 patients with ulcerative colitis and 7 patients with various other diseases was analysed for collagen components. No significant difference was demonstrated in the concentration of hydroxyproline, hydroxylysine and proline between progressive systemic sclerosis patients and patients with various other diseases, but in patients with ulcerative colitis the concentration of hydroxyproline, hydroxylysine and proline were found to be significantly lower than in the two other groups.

Adolescent↗
PubMed1985

Altered collagen in colonic polyps.

By biochemical analysis the molar ratio between hydroxyproline and hydroxylysine as indicator of collagen type were analyzed in normal colons, colonic polyps and carcinomas. Low ratios (type IV) were found in the polyps.

Collagen↗
PubMed1985

Myocardial infarct size and mortality in diabetic patients.

The mortality rate from myocardial infarction is disproportionately high in diabetic patients. One explanation for this may be that diabetic patients incur more extensive myocardial necrosis. This possibility was examined in a three part study. Firstly, peak serum aspartate aminotransferase concentrations of all diabetic and non-diabetic patients admitted with myocardial infarction over a 16 year period were compared retrospectively. Secondly, peak aspartate aminotransferase concentrations in a series of diabetic patients and controls matched by age and sex were examined retrospectively. Thirdly, creatine kinase MB release and electrocardiographic measures of infarct size were investigated prospectively in a case/control study. Although cardiac failure and death were more common in the diabetic groups, there were no significant differences in estimates of infarct size between diabetic and non-diabetic patients in any of the studies. Therefore, the high case fatality rate amongst diabetic patients is not caused by increased myocardial damage. Presumably survival is prejudiced by factors operating before the infarction.

Aspartate Aminotransferases↗
PubMed1985

Non-tropical sprue. Malignant diseases and mortality rate.

The complications of non-tropical sprue were registered in 100 patients seen during an 18-year period. The patients had a significantly higher mortality than the age- and sex-matched general population. They had an increased incidence of malignancies, predominantly malignant lymphomas and carcinomas of the gastrointestinal tract. The disease must be considered a premalignant condition.

Adolescent↗
PubMed1985

Digital necrosis: a paraneoplastic syndrome.

We describe a 62-year-old man who presented with digital necrosis as part of a clinical picture which resembled Wegener's granulomatosis. However, an open lung biopsy revealed adenocarcinoma of the lung. To our knowledge he is only the 5th reported patient with lung cancer presenting with digital necrosis. The unusual association of digital necrosis and internal malignancy is discussed.

Adenocarcinoma↗
PubMed1984

Effect of intravenous insulin infusion on mortality among diabetic patients after myocardial infarction.

A review of the records of 353 diabetic patients after a myocardial infarction confirmed the high mortality associated with the condition. The influence of improved diabetic control achieved by intravenous insulin was assessed in 64 patients and compared with earlier experience in a diabetic control group. The frequency of the major complications of myocardial infarction was unchanged and the death rate in both groups was identical (33%); even the patients with blood glucose concentrations greater than 20 mmol/l on admission failed to benefit. Thus careful control of blood glucose concentrations after myocardial infarction in diabetic patients fails to improve the outcome of this high risk group.

Aged↗
PubMed1984

Collagen in the esophageal mucosa of patients with progressive systemic sclerosis (PSS).

Eighteen consecutive patients with an established diagnosis of Progressive Systemic Sclerosis (PSS) underwent different investigative procedures to determine possible esophageal involvement. Esophageal sclerosis was demonstrated by X-ray and manometry in 13 patients. In all patients endoscopic biopsies of esophageal mucosa were obtained. In all biopsies the concentrations of hydroxyproline, hydroxylysine and proline were determined. Patients suffering from PSS involving the esophagus were found to have a significantly higher concentration of collagen specific amino acids (hydroxyproline and hydroxylysine) in the esophageal mucosa (endoscopic obtainable biopsies) than patients with PSS not affecting the esophagus.

Adult↗