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Biomedical subjects

R M Bernstein

Publications and source records attributed to R M Bernstein.

At least 127 records · Page 7Linked to original sources
PubMed1983

Nuclear magnetic resonance (NMR) imaging of the brain in systemic lupus erythematosus.

Nuclear magnetic resonance (NMR) and X-ray computed tomographic (CT) imaging of the brain were performed on nine patients with clinical evidence of cerebral involvement by systemic lupus erythematosus (SLE). Focal lesions were demonstrated in eight patients by NMR and in six by CT. The examinations with both techniques were negative in one patient and showed essentially identical pathological conditions in three patients. In three patients NMR demonstrated more numerous lesions than CT. All lesions seen on CT were also seen on NMR, mostly with greater clarity and extent. In view of the limited number of patients, this study is preliminary, but it appears that NMR demonstrates more accurately the degree of brain involvement in SLE than CT.

Adult↗
PubMed1983

A comparison of low dose levamisole and penicillamine in rheumatoid arthritis.

Levamisole (150 mg once weekly) was compared with penicillamine (250 mg daily) in a single blind independent observer study in 28 patients with rheumatoid arthritis over twelve months. Fifty percent (8/16) of patients stopped levamisole, five within three months of starting, while only two of twelve stopped penicillamine. In those patients able to tolerate treatment for twelve months, both regimens produced a significant and comparable reduction in disease activity, with the onset of action of penicillamine occurring at three months compared with six to nine months for levamisole. Radiological progression of disease occurred in both groups. Levamisole in low dose may improve parameters of disease activity in rheumatoid arthritis but poor patient tolerance, slow onset of action and failure to prevent radiological progression limit its usefulness.

Arthritis, Rheumatoid↗
PubMed1983

Serological markers in progressive systemic sclerosis: clinical correlations.

The relation between clinical and serological findings was studied in 75 patients with definite progressive systemic sclerosis (PSS). Antinuclear antibodies were detected by indirect immunofluorescence in 95% of the patients by means of HEp-2 cells. The centromere pattern was observed in 50% of the patients with calcinosis, Raynaud's phenomenon, oesophageal dysmotility, sclerodactyly, and telangiectasia (CREST) and only 7% of the group with diffuse disease. Precipitating antibodies to nuclear and cytoplasmic antigens were detected by immunodiffusion in 53% of the patients and identified as anti Scl-70 in 16 (21%). We confirmed that autoantibodies are very frequent in PSS but varied in specificity. A combination of immunodiffusion and indirect immunofluorescence was useful in detecting antibodies characteristic of PSS (i.e., anti-Scl-70 and anticentromere) in 51% of these patients. Anticentromere antibody has a high specificity for CREST and identifies patients with less severe disease (i.e., more prolonged course and less involvement of internal organs). Anti-Scl-70 was associated with a high frequency of lung involvement.

Adult↗
PubMed1982

Hydralazine, antinuclear antibodies, and the lupus syndrome.

The incidence of patients with positive antinuclear antibody test results rose during three years of treatment with hydralazine. At the end of that period over half of the patients (both rapid and slow acetylators) had titres exceeding 1/20, but the rate of rise was faster in the slow acetylators than in the rapid. There was a significant relation between the cumulative dose of hydralazine and the proportion of patients found to have antinuclear factors. Fewer black patients had positive test results than white. Patients whose antinuclear antibody test results changed fron negative to positive during the study showed this change five to 26 months after beginning treatment. Some patients showed a substantial fall in antinuclear antibody titre even though hydralazine was continued. From these findings patients in whom test results for antinuclear antibody became positive during treatment with hydralazine need not have the drug stopped unless they have clinical features of the lupus syndrome.

Acetylation↗
PubMed1982

Glycosylated haemoglobin in rheumatoid arthritis.

Shortened red cell survival has a role in the anaemia of rheumatoid arthritis (RA), but direct measurement of it is difficult. Glycosylated haemoglobin (HbA1) provides an index of red cell life span in normoglycaemic patients, because glycosylation depends on both the concentration of blood glucose and the duration of erythrocyte survival. HbA1 was significantly lower in 30 patients with RA (5.6 +/- 0.7%, mean +/- SD) than in 15 healthy controls (7.3 +/- 0.7%) and 14 patients with osteoarthritis (7.4 +/- 0.7%, p less than 0.001). HbA1 was depressed less in active RA than during remission, which is consistent with diminished red cell production in active RA. These data on HbA1 confirm that shortened red cell survival is common in RA, and point to diminished red cell production in active disease. Determination of HbA1 should prove to be of clinical value in the assessment of normoglycaemic patients with RA but is an inadequate index of glucose homoeostasis in diabetics with RA.

Adolescent↗
PubMed1982

Anticentromere antibody in primary biliary cirrhosis.

An autoantibody specific for the centromere region of chromosomes and recently detected in the serum of patients with scleroderma was found in ther serum of 10 (9.1%) of 110 consecutive patients presenting with primary biliary cirrhosis. It was found exclusively among those with scleroderma, giving a prevalence of 50% in that group, and all patients with telangiectasia or calcinosis had the antibody. It was not found in 80 patients with chronic active hepatitis, including the 'autoimmune' variety. The pathogenetic significance of anticentromere antibody is not yet established, but this study confirms its specificity for scleroderma in the context of primary biliary cirrhosis.

Antibody Specificity↗
PubMed1982

Association of antinuclear and antinucleolar antibodies in progressive systemic sclerosis.

Antinuclear and/or antinucleolar antibodies were demonstrated in the sera of 74 of 76 patients (97%) with progressive systemic sclerosis, using tissue culture cells (HEp-2) as substrate in the indirect immunofluorescent method. Six patterns of nuclear staining and three nucleolar patterns were recognized. The nuclear patterns were centromere, fine speckles, coarse speckles, diffusely grainy, homogeneous and nuclear dots. The nucleolar patterns were speckled, homogeneous and clumpy. The results of digestion studies with ribonuclease, deoxyribonuclease and trypsin suggested that the nuclear antigens are proteins, some of which may be associated with chromatin. The nucleolar antigens appeared to be nucleic acid in nature. Certain characteristic serologic and clinical features associated with staining patterns were observed. The diffusely grainy pattern was seen only in sera containing antibody to Scl-70 antigen. Centromere staining was confirmed to be highly selective for the CREST (Calcinosis, Raynaud's phenomenon, esophageal involvement, sclerodactyly and telangiectasis) variant of progressive systemic sclerosis with rheumatoid factor titres higher in these patients with anti-centromere antibodies.

Adult↗
PubMed1981

Morphea-like reaction to D-penicillamine therapy.

We report the case of a 48-year-old woman who developed morphea-like plaques after 1 year of treatment with D-penicillamine at 250 mg daily for a seronegative erosive arthritis of rheumatoid type. The rash began as several red itchy patches on the trunk; these became thickened and shiny over about 3 months. The histological appearance was of increased dermal fibrosis with an inflammatory infiltrate round dermal capillaries. However, epidermal changes were not typical of morphea. New lesions ceased to appear within a few months of stopping penicillamine, and by 1 year all the plaques were pale and symptomless.

Adult↗
PubMed1978

Hepatic insulin responsiveness in patients with endogenous hypertriglyceridaemia.

Plasma insulin response to oral glucose, insulin resistance, and insulin suppression of hepatic glucose production were studied in 11 normal subjects and 11 hypertriglyceridaemic patients. Patients with hypertriglyceridaemia had a significantly higher insulin response to oral glucose. Insulin resistance was also significantly greater in hypertriglyceridaemic subjects as determined by measuring the steady-state plasma glucose response during a continuous infusion of epinephrine, propranolol, glucose, and exogenous insulin. Insulin suppression of hepatic glucose production was calculated from the results of two studies in which glucose turnover rate was measured by a continuous infusion of 3H-2-glucose. The first study was performed under conditions of basal insulin secretion, and the second carried out at steady state exogenous insulin levels of approximately 100 muU/ml. The results indicated that basal hepatic glucose production was the same in both groups, and was suppressed to an equal degree by physiological levels of insulin. These data demonstrate that hepatic glucose production can be suppressed to an equal degree in normal and hypertriglyceridaemic subjects at comparable circulating insulin levels, at the same time that resistance to insulin-stimulated glucose uptake is observed in the hypertriglyceridaemic individuals.

Adult↗
PubMed1978

Effect of obesity on the relationship between very low density lipoprotein production rate and plasma triglyceride concentration in normal and hypertriglyceridemic subjects.

The effect of obesity on the relationship between very low density lipoprotein (VLDL)-triglyceride (TG) production rate and concentration was studied in 80 subjects whose TG concentrations ranged from 41-1315 mg/100 ml and whose relative weight varied from 0.74-1.46. There was a positive correlation between VLDL-TG production rate and plasma TG concentration in all 80 patients (r = 0.78), which was highly statistically significant (p less than 0.001). Both male and female subjects were subdivided into quartiles on the basis of relative weight; the relationship between VLDL-TG production rate and plasma TG concentration was found to be comparable in all subgroups. These observations suggest that moderate degrees of obesity do not affect VLDL-TG kinetics in patients whose plasma TG levels vary over an extremely wide range.

Adult↗