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Biomedical subjects

M Yaron

Publications and source records attributed to M Yaron.

At least 73 records · Page 4Linked to original sources
PubMed1997

The absorption of low-dose methotrexate in patients with inflammatory bowel disease.

BACKGROUND: Recent clinical trials have demonstrated that methotrexate may have an important therapeutic role in the treatment of patients with inflammatory bowel disease, who are either refractory or intolerant to traditional medical therapy. The aim of this study was to evaluate the pharmacokinetics of low-dose oral methotrexate in patients with inflammatory bowel disease. METHODS: Methotrexate (12.5 mg) was given orally to nine patients with inflammatory bowel disease: five with Crohn's disease, and four with ulcerative colitis, and to six patients with rheumatoid arthritis who served as a control group. Blood samples were drawn at specific intervals to evaluate methotrexate plasma levels. RESULTS: Methotrexate was rapidly absorbed in all patients. Peak concentrations (Cmax) varied considerably, ranging from 0.25-0.87 micro M. The mean Cmax values were similar in all patient groups (0.59 +/- 0.12, 0.69 +/- 0.16 and 0.54 +/- 0.18 micro M, P not significant) for Crohn's disease, ulcerative colitis and rheumatoid arthritis, respectively. The mean area under curve in 120 min (AUC0-120) was also similar in all patient groups (32.9 + 11.3, 43.6 + 9.9 and 41.8 + 14.9 ng.min/mL, P not significant) for Crohn's disease, ulcerative colitis and rheumatoid arthritis, respectively. The mean time to reach Cmax, (tmax), varied between patient groups (84, 112 and 95 min, respectively, with a significant difference, P < 0.02, between the Crohn's disease and ulcerative colitis groups. A negative correlation was found between methotrexate dosage/kg and Cmax (r = -0.74) only in Crohn's disease patients but not in the other patient groups. CONCLUSIONS: Orally administered methotrexate is well absorbed in patients with inflammatory bowel disease including those with severe small bowel disease or resection. If methotrexate is proven to be effective in inflammatory bowel disease, it should be administered orally.

Adult↗
PubMed1997

Elevated levels of hyaluronic acid in the sera of women with fibromyalgia.

OBJECTIVE: To evaluate serum levels of hyaluronic acid (HA) in patients with fibromyalgia (FM). METHODS: HA serum levels were evaluated by a radiometric assay in 42 women with FM (ACR criteria), 27 female patients with rheumatoid arthritis (RA) and 36 healthy female controls matched for age. RESULTS: HA serum levels (mean microg/l +/- SEM) were 41 +/- 8.7 in healthy controls; 113 +/- 15.9 in RA: and 420 +/- 26 in FM. CONCLUSION: HA serum levels in women with FM were significantly elevated compared to healthy controls and patients with RA. This observation suggests that FM is associated with a biochemical abnormality and that serum HA could be a laboratory marker for its diagnosis.

Adult↗
PubMed1996

The lack of prognostic value of computerized tomography imaging examinations in patients with chronic non-progressive back pain.

The purpose of the present study was to evaluate the prognostic value of computerized tomography (CT) in the conservative treatment of patients with chronic non-progressive back pain. The study included 73 patients with chronic non-progressive back pain in the lumbar region of at least 3-months duration who were referred to the back clinic because of pain that was non-responsive to physical therapy and analgesics. All patients underwent clinical examination and spinal CT scan. The clinical examination and imaging procedures were followed by a 4-week rehabilitation programme based on a multidisciplinary approach that included a rheumatologist, a pain specialist, back school. "Alexander" technique, acupuncture, manipulation and psychological intervention. Patients were evaluated by the same physician at the end of the 4-week programme and after 6 months follow-up using parameters of pain rating, pain frequency and analgesic drug consumption. CT examinations were evaluated separately by two radiologists. The patients were divided into three groups according to the CT findings: group 1-normal imaging: 26 patients: group 2 -spinal stenosis: 20 patients; group 3 -posterior bulging, protrusion, extrusion or sequestration of disc: 27 patients. The clinical improvement was almost the same (approximately 50%) in the three different groups. In spite of the small number of cases, the results were statistically significant. We concluded that, in contrast to the importance of modern spinal-imaging procedures before the performance of surgery, the role of these procedures in the prognosis of the conservative treatment of patients with chronic non-progressive back pain does not seem to be important.

Adult↗
PubMed1996

Utility of the expiratory capnogram in the assessment of bronchospasm.

STUDY OBJECTIVE: To determine whether the plateau phase of the expiratory capnogram (dco2/dt) can detect bronchospasm in adult asthma patients in the emergency department and to assess the correlation between dco2/dt and the peak expiratory flow rate (PEFR) in spontaneously breathing patients with asthma and in normal, healthy volunteers. METHODS: We carried out a prospective, blinded study in a university hospital ED. Twenty adults (12 women) with acute asthma and 28 normal adult volunteers (15 women) breathed through the sampling probe of an end-tidal CO2 monitor, and the expired CO2 waveform was recorded. The dco2/dt of the plateau (alveolar) phase for five consecutive regular expirations was measured and a mean value calculated for each patient. The best of three PEFRs was determined. The PEFR and dco2/dt were also recorded after treatment of the asthmatic patients with inhaled beta-agonists. RESULTS: The mean +/- SD PEFR of the asthmatic subjects was 274 +/- 96 L/minute (57% of the predicted value), whereas that of the normal volunteers was 527 +/- 96 L/minute (103% of the predicted value) (P < .001). The mean dco2/dt of the asthmatic subjects (.26 +/- .06) was significantly steeper than that of the normal volunteers (.13 +/- .06) (P < .001). The dco2/dt was correlated with PEFR (r = .84, P < .001). In 18 asthmatic subjects the pretreatment and posttreatment percent predicted PEFRS were 58% +/- 17% and 74% +/- 17%, respectively (P < .001), whereas the dco2/dt values were .27 +/- .05 and .19 +/- .07, respectively (P < .005). CONCLUSION: The dco2/dt is an effort-independent, rapid noninvasive measure that indicates significant bronchospasm in ED adult patients with asthma. The dco2/dt value is correlated with PEFR, an effort-dependent measure of airway obstruction. The change in dco2/dt with inhaled beta-agonists may be useful in monitoring the therapy of acute asthma.

Adrenergic beta-Agonists↗
PubMed1996

Differential effects of 1,25-(OH)2D3 on acyl hydrolase and cyclooxygenase activities in interleukin 1 beta-stimulated human synovial fibroblast cultures.

Effects of proinflammatory cytokines on synovial fibroblasts are considered to play a role in the accumulation of prostaglandin E2 (PGE2) in the inflamed joint in rheumatoid arthritis. We have previously shown that interleukin 1 beta (IL-1 beta) induces PGE2 production in synovial fibroblast cultures and that this effect is suppressed by the active metabolite of vitamin D3, 1,25-(OH)2D3. To study the mechanism of the inhibitory action of 1,25-(OH)2D3, its effect on acyl hydrolase (arachidonic acid (AA) release) and cyclooxygenase (COX) activities were investigated. Our findings indicate that IL-1 beta caused an increase in AA release and COX activity and that in the presence of 1,25-(OH)2D3 AA release, but not COX activity, is suppressed. In comparison, dexamethasone, which also inhibits IL-1 beta induction of PGE2, had inhibitory effects on both parameters.

Arachidonic Acid↗
PubMed1996

Minocycline induced arthritis associated with fever, livedo reticularis, and pANCA.

OBJECTIVE: To describe a novel iatrogenic immunological reaction produced by minocycline. CASE REPORTS: The clinical course and laboratory results of three women who presented with similar rheumatological manifestations after a prolonged exposure to minocycline are described. All three presented a unique reaction manifested by fever, arthritis/arthralgia and livedo reticularis during treatment with minocycline for acne vulgaris. The clinical syndrome was associated with high titre of serum perinuclear anticytoplasmatic antibodies (p-ANCA) and antimyeloperoxidase antibody (anti-MPO). Symptoms resolved after stopping the drug and recurred promptly after rechallenge in all three patients. CONCLUSIONS: Minocycline, which is widely used in the treatment of acne, often without adequate supervision, may induce arthritis and livedo vasculitis associated with anti-MPO.

Acne Vulgaris↗
PubMed1996

Salivary eicosanoid concentration in patients with Sjögren's syndrome.

OBJECTIVE: To investigate eicosanoid concentrations in the saliva of patients with primary Sjögren's syndrome (SS). METHODS: Whole mixed saliva of 36 subjects was assayed for eicosanoid concentrations using a radioimmunoassay. Patients with primary SS having positive lip biopsy served as the study group; their results were compared with data from patients with dry mouth and negative lip biopsy (dry mouth group), and with a group of normal healthy controls. RESULTS: Concentrations of thromboxane B2 were significantly (p < 0.01) increased in 18 patients with primary SS compared with 10 patients with dry mouth and eight healthy normal controls (1.95 (SD 0.51) ng/ml saliva compared with 0.52 (0.1) ng/ml and 0.3 (0.1) ng/ml, respectively). Similarly, prostaglandin E2 concentrations were also significantly increased (p < 0.01) in 11 patients with primary SS compared with five patients with dry mouth and eight normal controls (3.75 (0.82) ng/ml saliva compared with 0.32 (0.1) ng/ml and 0.41 (0.1) ng/ml, respectively). CONCLUSION: Salivary concentrations of eicosanoids are significantly increased in patients with primary SS, and this may prove helpful in the diagnosis of this disease.

Biomarkers↗
PubMed1995

Spa therapy for gonarthrosis: a prospective study.

The objective of this study was to evaluate the effect of spa therapy on clinical parameters of patients with gonarthrosis. Patients with gonarthrosis (n = 33) underwent a 2-week spa therapy using three treatment regimes and a 20-week follow-up as follows: group I (n = 11) had mineral water baths and hot native mineral mud packs, group II (n = 12) had mineral water baths and rinsed mineral-free mud packs and group III (n = 10) had tap water baths and mineral-free mud packs. The patients and the assessing rheumatologist were blinded to the difference in the treatment protocols. A significant improvement in the index of severity of the knee (ISK), as well as night pain scores, was achieved in group I. Improvement in physical findings and a reduction in pain ratings on a visual analogue scale (VAS) did not reach statistical significance. Analgesic consumption was significantly decreased in both groups I and III for up to 12 weeks. Global improvement assessed by patients and physician was observed in all three groups up to 16 weeks but persisted to the end of the follow-up period in group I only. Patients with gonarthrosis seemed to benefit from spa therapy under all three regimes. However, for two parameters (night pain and ISK) the combination of mineral water baths and mud packs (group I) appeared to be superior.

Aged↗
PubMed1995

Effect of spa therapy in Tiberias on patients with ankylosing spondylitis.

Fourteen patients with ankylosing spondylitis (AS) were treated in a pilot study for two weeks at a Tiberias spa with a combination of hot mineral water baths and mud packs. A significant improvement was noticed in morning stiffness, finger to floor distance and the overall well-being assessment both by the patient and the physician. A significant reduction in the use of analgesics and NSAIDs was also noted in most of the patients. Improvement in all parameters began after one week of treatment and was still present at three months.

Adult↗
PubMed1995

Early immunization with inactivated poliovirus vaccine in premature infants.

The antibody titers of 41 premature infants receiving inactivated poliovirus vaccine at 2 months of age (control group) were compared with titers of 39 infants receiving an additional dose at 5 to 10 days of age (study group). At 1 month of age 97.4% of the study group but only 70.8% of the control group had protective antibodies against poliovirus 3 (p < 0.001).

Administration, Oral↗
PubMed1995

Efficacy of tissue glue for laceration repair in an animal model.

OBJECTIVE: To compare the efficacy of butyl-2-cyanoacrylate tissue glue (TG) for the repair of skin lacerations in rats with the efficacy of standard closure with sutures. METHODS: In a prospective study, eight rats were anesthetized and an 8-cm dorsal incision was made on each side of the midline. One wound was closed with a single layer of interrupted 5-0 Prolene suture and one by application of TG. The time required to close each wound was recorded. Sutures were removed at seven days; the TG was allowed to fall off spontaneously. The animals were sacrificed after 20 days and the wounds were judged for cosmetic outcome. Four I x 3-cm strips of skin were excised from each wound; one strip for histologic analysis and three for load extension testing using a tensiometer. Specimens were loaded to wound failure while displacement (D) and energy absorption (EA) were recorded. The paired t-test was used for comparisons and reported as mean +/- SE. No significant difference between TG and suture was found in D (6.5 +/- 0.4 vs 5.2 (1.4 mm), EA (0.18 +/- 0.01 vs 0.17 +/- 0.03 kg x mm/cm2), or histologic features. The closure time was significantly less using TG (66 +/- 5 vs 401 +/- 17 sec; p < 0.0001). CONCLUSIONS: 1) Sutures and TG in rat skin repair result in similar wound strengths (EA), amounts of stretch (D), and histologic feasures. 2) Wound closure is accomplished much more rapidly with TG.

Animals↗
PubMed1995

How well do older persons tolerate moderate altitude?

We studied the physiologic and clinical responses to moderate altitude in 97 older men and women (aged 59 to 83 years) over 5 days in Vail, Colorado, at an elevation of 2,500 m (8,200 ft). The incidence of acute mountain sickness was 16%, which is slightly lower than that reported for younger persons. The occurrence of symptoms of acute mountain sickness did not parallel arterial oxygen saturation or spirometric or blood pressure measurements. Chronic diseases were present in percentages typical for ambulatory elderly persons: 19 (20%) had coronary artery disease, 33 (34%) had hypertension, and 9 (9%) had lung disease. Despite this, no adverse signs or symptoms occurred in our subjects during their stay at this altitude. Our findings suggest that persons with preexisting, generally asymptomatic, cardiovascular or pulmonary disease can safely visit moderate altitudes.

Acute Disease↗
PubMed1994

Sjogren's syndrome in Israel: primary versus secondary disease.

Sixty Israeli patients, 30 with primary Sjögren's syndrome (SS) and 30 with rheumatoid arthritis (RA) and secondary SS, were evaluated. The Schirmer-1 test and a positive labial salivary gland biopsy were found to be the most helpful tools in assessing the diagnosis of SS. Extraglandular features such as Raynaud's phenomenon, lymphadenopathy and CNS involvement as well as parotid gland enlargement (p < 0.05) were more common in primary SS. Antinuclear antibodies, especially anti-Ro (SSA) and anti-La (SSB) were also more common in primary SS (p < 0.05). Our results are in accord with those of many European centers, despite the different genetic background.

Adult↗