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Biomedical subjects

M Yaron

Publications and source records attributed to M Yaron.

At least 91 records · Page 5Linked to original sources
PubMed1994

Anti-Ro(SSA) antibodies in patients with rheumatoid arthritis--a possible marker for gold induced side effects.

OBJECTIVE: To determine whether anti-Ro antibodies are associated with gold induced side effects. METHODS: A retrospective chart review of 208 patients with rheumatoid arthritis (RA) and examination of sera for the presence of anti-Ro antibodies by enzyme linked immunosorbent assay. RESULTS: Anti-Ro antibodies were detected in 44 (21%) of our patients with RA and their presence correlated with positive rheumatoid factor, antinuclear antibody, and secondary Sjögren's syndrome. Thirty-three out of 48 patients with gold induced side effects (69%) were anti-Ro positive in contrast to 11 patients (7.5%) with positive antibodies with no side effects (p < 0.001). Mucocutaneous reactions had the only significant correlation (p < 0.01) with the presence of anti-Ro antibodies. CONCLUSION: Patients with RA with anti-Ro antibodies are prone to develop mucocutaneous side effects to gold salts.

Antibodies, Antinuclear↗
PubMed1993

Long-term experience with low dose methotrexate in rheumatoid arthritis.

One hundred twenty-six patients with rheumatoid arthritis (RA) were treated with weekly low doses of methotrexate (MTX) for a mean period of 36.8 months (range 13-110 months). The overall probability of continuing with MTX therapy was 72% at 2 and 3 years, 67% at 4 years and 65% at 5-7 years. Seronegative patients had a higher probability of continuing therapy than seropositive patients (P < 0.05). Out of the whole group, 8% showed no improvement, 16% showed mild improvement, 30% showed moderate improvement, and 45% experienced marked improvement. Eight patients (6%) of the latter group achieved complete clinical remission. In the course of the follow-up period there was a significant decrease in the mean daily dosage of prednisone and NSAIDs. Minor side effects were common (68%), but therapy was discontinued in only 27 patients (21%) because of major complications. In most of them (25 out of 27) these occurred within the first 24 months of therapy. Although malignancy was revealed in 5 patients during the follow-up period, its occurrence did not differ from expected rates.

Aged↗
PubMed1993

Response of neonates to vibroacoustic stimulation.

The response to vibroacoustic stimulation was evaluated in 30 healthy full-term newborns and in five newborns with severe neurologic deficits. The stimulus was applied during a period of quite sleep and a subsequent period of quiet sleep served as the control. All 30 healthy newborns reacted by changing from a state of quite sleep to an active sleep state as determined by heart rate acceleration, irregular respiration, and the appearance of limb movements. Heart rate increased by 19.5 +/- 9.7 beats/min (mean +/- SD) for a mean duration of 21.4 +/- 11.9 seconds. The five newborns with severe neurologic deficits did not show any response to vibroacoustic stimulation, and auditory brainstem evoked responses were also absent. We conclude that this technique may be useful as a screening procedure in the evaluation of the neurologic integrity of newborn infants.

Acoustic Stimulation↗
PubMed1993

SAPHO syndrome.

Four women with pustulosis palmoplantaris (PPP) and associated sternocostoclavicular hyperostosis are described. The connection between the two diseases is not coincidental: it is encountered in 9.4% of PPP patients, and was reported in the French literature as part of the SAPHO (synovitis acne pustulosis hyperostosis osteomyelitis) syndrome. This syndrome is linked to the spondyloarthropathies, having an increased prevalence of HLA B27 and occurrence of sacroiliitis. None of our patients had HLA B27, but HLA A26 was found in the 3 patients examined. No conclusion can be drawn from this finding, however, since this antigen is found in 21.7% of Ashkenazi Jews. Recognition of this syndrome by dermatologists will improve diagnosis and treatment.

Acne Vulgaris↗
PubMed1993

Effect of 1,25-dihydroxyvitamin D3 on interleukin 1 beta actions and cell growth in human synovial fibroblast cultures.

OBJECTIVE: To investigate the effects of vitamin D3 [1,25-(OH)2D3] metabolites on interleukin 1 beta (IL-1 beta) stimulated secretory activities and on the proliferation of human synovial fibroblasts in culture. METHODS: Dose dependent effects on IL-1 beta actions were determined in nonproliferating cultures containing 1% fetal calf serum (FCS) in the culture medium. Production of prostaglandin E (PGE), collagenase and hyaluronic acid (HA) was measured respectively by radioimmunoassay, enzymatic degradation of radiolabelled collagen gels after collagenase activation and 14C-glucosamine incorporation. Effects on cell growth in 10% FCS were monitored colorimetrically, by staining cells with crystal violet. RESULTS: 1,25-(OH)2D3 inhibited the effects of IL-1 beta on PGE production by up to 90%, with half maximal inhibition at 2.0 x 10(-10) M. Inhibitory effects on stimulated collagenase and HA production and cell growth were also found but were less marked. At 10(-7) M 1,25-(OH)2D3 inhibition was 50, 21 and 50%, respectively. 24,25-dihydroxyvitamin D3 was a less potent inhibitor than 1,25-(OH)2D3. Neither metabolite influenced IL-1 beta effects on PGE or sulfated glycosaminoglycan production in human articular cartilage in tissue culture. CONCLUSION: Our results suggest that the active metabolites of vitamin D3 may modulate the behavior of synovial fibroblasts in articular inflammatory processes.

24,25-Dihydroxyvitamin D 3↗
PubMed1993

Methotrexate inhibits proliferation but not interleukin 1 stimulated secretory activities of cultured human synovial fibroblasts.

The effect of methotrexate (MTX) on proliferation and on interleukin 1 stimulated secretory activities of human synovial fibroblasts in culture was investigated. MTX caused a dose dependent inhibition of growth over the concentration range 0.07-2.2 microM with a half-maximal effect at 0.37 microM. INhibition was competitively relieved by coaddition of leucovorin. Cell growth was fully restored after MTX pretreatment of 24 h but not after 48 h, even on subsequent leucovorin addition. Cell viability was unaffected by MTX treatment. MTX had no effect on interleukin 1 stimulated production of prostaglandin E, hyaluronic acid and collagenase. Our results raise the possibility that one of the mechanisms contributing to the therapeutic effects of MTX in patients with rheumatoid arthritis may involve modulation of synovial fibroblast growth.

Arthritis, Rheumatoid↗
PubMed1992

A prospective analysis of liver biopsies in rheumatoid arthritis patients receiving long term methotrexate therapy.

Baseline and sequential liver biopsies were performed in ten patients with rheumatoid arthritis (RA) treated with methotrexate (MTX) for more than 4 years. Liver biopsies were performed in all patients before the initiation of MTX therapy and were repeated after reaching a cumulative dose of 1500 mg or more. In four patients a third biopsy was performed 3 years after the first one. No significant worsening of hepatic architecture was found in any of our patients after 4 to 7 1/2 years of MTX therapy. No correlations between histologic findings and various clinical or pharmacological variables could be found. Our results suggested that prolonged MTX administration in RA patients did not cause severe hepatic abnormalities.

Adult↗
PubMed1992

Ulnar translation of the scaphoid: an early X-ray sign of rheumatoid arthritis.

The distance between the os trapezium and radius (which we called scaphoid distance) became shorter during the course of rheumatoid arthritis (RA). Measurement of this distance was performed in 600 hands (300 patients), using standard position of patient's hand in supination with permanent angle (15-20%) between the axis of the radius and the axis of the third metacarpal bone (scaphoid distance). This provided a stable distance between the most distal point of the radial styloid process and most proximal point of the os trapezium. The patients were divided into two groups: a control group consisting of 100 patients with no inflammatory joint disease, and a group of 200 patients suffering from RA. Patients suffering from RA with bone erosions had smaller scaphoid distance than those suffering from RA without bone erosions. The ratio between the distance from the distal radius to the most distal point of the third metacarpal bone and scaphoid index was called carpo-metacarpo-scaphoid index. It excluded the constitutional influence on the scaphoid distance. The shorter the scaphoid distance, the bigger the carpo-metacarpo-scaphoid index. The average indexes were: in the control group 7.8 (+/- 0.4), in group 2A with advanced RA 21.1 (+/- 4.1), and in group 2B with early RA without bone changes 12.0 (+/- 1.6). The results were statistically significant. The measurements are easy to perform and may be helpful in the early X-ray diagnosis of RA, when there are no bone erosions, or narrowing of articular spaces.

Adolescent↗
PubMed1992

The ring of C2 and evaluation of the cross-table lateral view of the cervical spine.

The cross-table lateral view is essential in the initial workup of a trauma patient with a suspected cervical-spine injury. The identification of the radiographic "ring" of C2 on the cross-table lateral view is discussed. When a type III odontoid fracture is present, the ring of C2 is disrupted. We propose that "identification of the ring of C2" should be added to the emergency physicians' systematic checklist when clearing a cross-table lateral view of the cervical spine.

Axis, Cervical Vertebra↗
PubMed1992

Methotrexate treatment of rheumatoid arthritis: is a fortnightly maintenance schedule enough?

In 15 patients with rheumatoid arthritis who were in clinical remission the weekly regimen of methotrexate treatment was changed to fortnightly without a change in dose. A total of 13 patients completed a 12 month trial. No change in clinical or laboratory parameters occurred. There was no change in the use of analgesics or non-steroidal anti-inflammatory drugs and the patients remained in remission. Two patients had to be withdrawn after two and four months respectively because of a flare in disease activity. It is suggested that in most patients with rheumatoid arthritis who are treated with methotrexate and whose disease activity is stable a fortnightly regimen can be permitted without affecting drug efficacy.

Arthritis, Rheumatoid↗
PubMed1992

Sulphasalazine induced hepatitis in juvenile rheumatoid arthritis.

Two 19 year old patients with juvenile chronic arthritis developed liver toxicity during treatment with sulphasalazine. A significant increase in the levels of liver enzymes in serum samples was noticed in relation to the initiation of treatment in one patient and to the increase in dose in the second. The enzymes returned to normal levels 14 days after the drug had been stopped. A rechallenge in one of the patients caused re-exacerbation. This is the first report of liver toxicity induced by sulphasalazine in juvenile chronic arthritis. As spontaneous liver involvement in juvenile chronic arthritis is not rare, the possibility of drug induced hepatitis should be recognised in these patients.

Adolescent↗
PubMed1992

Increased incidence of urinary tract infection in patients with rheumatoid arthritis and secondary Sjögren's syndrome.

The incidence of lower urinary tract infection in 120 women with rheumatoid arthritis and secondary Sjögren's syndrome was evaluated retrospectively. Thirty one patients (26%) had secondary Sjögren's syndrome. Recurrent urinary tract infection was significantly more common in these patients (11/31) than in patients without Sjögren's syndrome (4/89). Habitual leucocyturia was also more common in patients with secondary Sjögren's syndrome (18/31) than in patients with rheumatoid arthritis without Sjögren's syndrome (8/89). Of seven patients with vaginal sicca symptoms, six had recurrent urinary tract infection. Urinary 24 hour mucopolysaccharide excretion in 20 patients with Sjögren's syndrome was similar to the excretion in 10 patients without Sjögren's syndrome. These results show that recurrent urinary tract infection is significantly more common in women with rheumatoid arthritis and secondary Sjögren's syndrome. A local deficit in protective urinary mucosal secretion or other immune mechanisms may be responsible for this susceptibility.

Adult↗
PubMed1992

Genetic studies of anti-Ro (SSA) antibodies in families with rheumatoid arthritis.

Forty-nine members of 4 families with multiple cases of rheumatoid arthritis (RA) were investigated. Nine patients with RA, one patient with primary Sjögren's syndrome (SS) and one patient with systemic lupus erythematosus (SLE) were detected among them. Anti-Ro (SSA) antibodies were found in 11 members (22%) of the investigated group; 6 suffered from RA, SLE or primary SS, and 5 were healthy first degree relatives. Anti-La (SSB) antibodies were detected in only one family member with primary SS. Secondary SS was evident in 5 patients with RA, 3 of whom had anti-Ro antibodies; HLA-DR4 was present in 7 of 9 patients with RA (78%) but in only 7 of 26 asymptomatic relatives (27%) (p less than 0.05). All patients with RA and their relatives who had anti-Ro antibodies were found to have HLA-DR4. Our results demonstrate that anti-Ro antibodies are present in relatives of patients with RA and are strongly associated with HLA-DR4.

Antibodies, Antinuclear↗
PubMed1991

Familial erythema nodosum.

Erythema nodosum (EN) is a hypersensitivity reaction associated with many diseases. We describe a family in which 4 sisters had acute or recurrent EN. HLA typing showed a common haplotype in the affected members of the family. A review of familial EN and HLA distribution in EN is presented.

Acute Disease↗
PubMed1991

Treatment of acute mountain sickness: hyperbaric versus oxygen therapy.

STUDY OBJECTIVES: To compare the benefits of simulated descent in a hyperbaric chamber with those of supplementary oxygen for the treatment of acute mountain sickness. DESIGN: A prospective study. SETTING: The Snake River Health Clinic in Keystone, Colorado, which has an altitude of 2,850 m (9,300 ft). TYPE OF PARTICIPANTS: Twenty-four patients who presented with acute mountain sickness. INTERVENTIONS: A simulated descent of 1,432 m (4,600 ft) was attained by placing the patients in a fabric hyperbaric chamber and pressurizing the chamber to 120 mm Hg (2.3 PSI) above ambient pressure. Patients were randomly assigned to either the hyperbaric treatment or treatment with 4 L of oxygen given by facemask; both treatments lasted for two hours. MEASUREMENTS AND MAIN RESULTS: Mean arterial oxygen saturation (SaO2) increased 7% (84 +/- 2% to 91 +/- 1%) with pressurization and 14% (83 +/- 4% to 96 +/- 1%) with oxygen during treatment over pretreatment levels. Symptoms of acute mountain sickness decreased as rapidly with pressurization as with oxygen treatment, despite significantly higher SaO2 in the oxygen-treated group during treatment. Symptomatic improvement was retained in both groups at least one hour after treatment. CONCLUSION: Simulated descent in a fabric hyperbaric chamber is as effective as oxygen therapy for the immediate relief of acute mountain sickness.

Acute Disease↗