Search PubMed⌕ Search

Biomedical subjects

R Bluestone

Publications and source records attributed to R Bluestone.

At least 37 records · Page 2Linked to original sources

Adjuvant polyarthritis. VI. Effect of oxonate-induced hyperuricemia on the development of acute inflammation, immune response and adjuvant arthritis.

In humans, there is a negative correlation between gout and rheumatoid arthritis. Similarly, rats rendered hyperuricemic by an oxonate diet appeared resistant to develop adjuvant arthritis. These animals exhibited a normal inflammatory response to a subplantar injection of carrageenin and normal humoral and cell-mediated immune responses to a sensitizing dose of EL4 cells. However, unlike that of normal animals, the cell-mediated immune system of the oxonate-treated rats was found to be unable to respond to adjuvant stimulation, which may be the basis for their resistance to develop adjuvant disease.

Animals↗

Bone disease associated with total parenteral nutrition.

An unusual metabolic bone disease which developed in 11 adults receiving total parenteral nutrition (TPN) for more than 3 months was characterised by the insidious onset of bone pain which became very severe and caused considerable disability. Serum levels of calcium, phosphorus, 25-hydroxy-vitamin D, and serum immunoreactive parathyroid hormone were normal. Patchy osteomalacia with impaired mineralisation and decreased bone turnover were seen on histomorphometric analysis of bone biopsy specimens. All patients receiving long-term TPN had hypercalciuria, but no biochemical features that distinguished patients with symptoms from those without. Skeletal symptoms generally resolved 1-2 months after stoppage of the TPN infusions, despite nutritional deterioration. The pathogenesis of this syndrome remains unknown.

Adult↗

Advances in the use of therapeutic pheresis for the management of rheumatic diseases.

Twenty-two patients with rheumatoid arthritis, 3 with seronegative juvenile rheumatoid arthritis, 4 with systemic lupus erythematosus, and 4 with psoriatic arthritis have undergone therapeutic pheresis at our institution over the last 3 yr. Lymphoplasmapheresis appears to be the most effective form of pheresis in treating rheumatoid arthritis. After achieving a remission with 20 treatments performed in 11 wk, a flare may be preventable by pheresing patients 3 times a week every 6 wk provided the patient is on a concomitant, long-acting agent. Therapeutic pheresis has been disappointing in seronegative juvenile rheumatoid arthritis. Life-threatening complications of systemic lupus erythematosus may respond dramatically to pheresis. In treating less severe disease on a long-term basis, pheresis has demonstrated excellent steroid sparing properties. Nonspondylytic psoriatic arthritis responds slowly to pheresis, but arthritic remissions may be prolonged, even though skin response is variable. Experience in the use of pheresis for treating these diseases has allowed for the development of criteria for deciding whether to institute such therapy as an adjunct to more standard modes of treatment for individual patients. Also, a variety of "technical" factors can influence the outcome of therapy, and these must be managed appropriately. Therapeutic pheresis is a promising tool for investigating and treating rheumatic diseases.

Adolescent↗

Abnormalities in synovial fluid of patients with septic arthritis detected by gas-liquid chromatography.

Gas liquid chromatography was performed on synovial fluid of 94 patients with exudative arthritis. A relatively constant pattern of peaks was obtained in all synovial fluid samples. Lactic acid was increased in synovial fluid of patients with septic arthritis excluding gonococcal arthritis. In addition 2 constant peaks with retention time of 546 and 848 seconds in the chromatogram usually showed a significant increase in the synovial fluids of patients with septic arthritis (including gonococcal arthritis) but not in those from patients with sterile inflammatory or degenerative arthritis. In 1 patient with pseudomonas arthritis an increase in the peaks was noted with clinical and bacteriological relapse and subsequently there was a gradual return to normal levels during clinical improvement. Increase in synovial fluid lactic acid is useful in the diagnosis of septic arthritis. Identification of the compounds represented by the 2 peaks, which presumptively correspond to n-valeric and n-hexanoic acid, may provide further information on diagnosis, prognosis and pathogenesis of arthritis and may help in the differentiation between gonococcal and nongonococcal arthritis.

Adolescent↗

Case report 84.

Explore the source record for details and available documents.

Aged↗

HLA-D locus typing in ankylosing spondylitis and Reiter's syndrome.

HLA-D typing of 44 patients with ankylosing spondylitis (AS) and 31 patients with Reiter's syndrome (RS) did not show increased frequency of any particular Dw allele in either population of patients as compared to controls. Such studies also allowed each patient's general response to be compared with other general responses within each experiment. Contrary to reports of diminished lymphocyte responses in AS patients, hyperresponsiveness in both AS and RS patients was found.

Alleles↗

Plasmapheresis and lymphoplasmapheresis in the management of rheumatoid arthritis.

We have demonstrated the efficacy of therapeutic pheresis in a number of rheumatic diseases, especially rheumatoid arthritis (RA). Ten of 12 patients with RA went into remissions averaging 4 months. These patients were pheresed 20 times over 11 weeks in a tapering fashion on a Haemonetics Model 30 Blood Processor. Clinical remissions were sustained even though serologies, immunoglobulins, immune functions, sedimentation rates, and circulating immune complexes returned to their pre-pheresis baseline by pheresis number 20. All these patients were taking gold or D-penicillamine concurrently, but neither of the 2 patients who failed to respond was on these agents. Plasmapheresis was just as effective as lymphoplasmapheresis. It is theorized that removal of a plasma factor that modulates lymphocyte or neutrophil function produces remissions in RA and that long-acting drugs (e.g., gold or penicillamine) are able to prevent its continued production and produce a sustained remission.

Adult↗

Diagnosis of rheumatic disease. 1. Radiographs.

Radiographs are a clinician's most valuable tool in differential diagnosis of rheumatic disease and in assessment of its severity. The patterns of joint involvement and the specific bony changes characteristic of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, Reiter's syndrome and psoriatic arthritis, gout, and systemic lupus erythematosus are discussed here.

Adolescent↗

Diagnosis of rheumatic disease. 2. Laboratory tests.

Part 1, which begins on page 64, discusses diagnosis of rheumatic disease by radiography. The most popular laboratory tests in rheumatic disease are nonspecific and include those based on the formation of autoantibodies. Rheumatoid factor assays actually are of little diagnostic help in rheumatoid arthritis, but antinuclear antibody tests have become mandatory for identification of systemic lupus erythematosus. Studies based on immune complexes and cell immunity are valuable in specific clinical situations.

Antibodies, Antinuclear↗

Susceptibility of isolates of Bacteroides to the bactericidal activity of normal human serum.

Seventy-one strains of species from the Bacteroides fragilis group, including 46 isolates of B. fragilis, were tested for susceptibility to the bactericidal effect of serum from healthy subjects. Twenty-seven (38%) of the isolates were killed by serum. Isolates from feces were significantly more sensitive to serum than were isolates from patients with clinical infections. Killing of bacteria required heat-labile serum components and was an exponential function of serum concentration. Among the various species tested, B. fragilis was clearly the most resistant to bactericidal activity of serum. These observations may be important to the understanding of infections caused by the B. fragilis group, which contains the anaerobes of greatest clinical importance.

Bacteroides fragilis↗