Biomedical subjects

S Goemaere

Publications and source records attributed to S Goemaere.

46 records · Page 3Linked to original sources

PubMed1991

Sulfasalazine treatment in juvenile chronic arthritis: an open study.

In an open study, the effect of sulfasalazine was evaluated in the treatment of juvenile chronic arthritis (JCA). Forty-one patients, i.e., 27 boys and 14 girls with JCA under 16 years of age, were included in the study. In all of them, treatment with nonsteroidal antiinflammatory drugs (NSAID) had been unable to control the disease. The patients were divided in 4 subgroups depending on the mode of onset and evolution (Type I = systemic onset, Type II = polyarticular form. Type IIIa and Type IIIb = pauciarticular form). Remission was achieved in 21 patients, significant improvement in 12. Status was unchanged in 4 patients and worsened in 3. In 5 patients side effects were observed, which forced interruption of treatment in 4. Sulfasalazine was stopped in 7 patients: for toxicity in 4 and for inefficacy in 3. In 7 other patients the treatment was terminated after a prolonged remission. These promising results must be confirmed in a double blind versus placebo study, preferably restricted to type III JCA.

Adolescent↗

PubMed1991

Gut inflammation in the spondyloarthropathies: clinical, radiologic, biologic and genetic features in relation to the type of histology. A prospective study.

Ileocolonoscopy was performed on 354 patients with spondyloarthropathies. Histologically, the population could be divided into 145 patients with normal gut histology, 88 patients with acute inflammatory lesions and 121 patients with chronic inflammatory lesions. A number of clinical, biologic, radiologic and genetic variables were determined before ileocolonoscopy. Chronic gut lesions were associated with a family history of ankylosing spondylitis (AS) and Crohn's disease, several episodes of diarrhea, an increased stool frequency, elevated inflammatory serum variables, reduced axial mobility, the presence of sacroiliitis, bamboo spine, destructive joint lesions, a diagnosis of AS and HLA-Bw62 positivity. As the frequency of HLA-Bw62 is also increased in proven Crohn's disease, this would suggest that chronic gut lesions are related to this disease. Acute inflammatory lesions were related to a higher fecal carriage of specific bacteria and to the diagnosis of undifferentiated spondyloarthropathy, especially the enterogenic forms of reactive arthritis. Consequently, these lesions also appear to be related to a bacterially induced gut inflammation. Gut histology was normal in urogenital inflammation and urogenital reactive arthritis, suggesting a different portal of entry for antigens. The 3 histologic pictures of the gut (normal, acute and chronic) inflammation seem to correlate with different clinical, biologic and radiologic manifestations of the disease concept of spondyloarthropathies.

Adolescent↗

PubMed1991

Intestinal mucosal permeability in inflammatory rheumatic diseases. I. Role of antiinflammatory drugs.

Using the 51Cr-EDTA resorption test, gut permeability was measured in 129 patients with inflammatory joint diseases and in 97 control patients (42 patients with no inflammatory rheumatic disorders taking antiinflammatory medication and 55 healthy controls). Thirty-two patients (30 arthritis and 2 control patients) taking nonsteroidal antiinflammatory drugs (NSAID) as well as corticosteroids were excluded from statistical analysis. The intake of NSAID significantly increased gut permeability in controls but not in the arthritis groups. The same applied to corticosteroid intake. This could be due to the restricted number of arthritis patients who had never taken antiinflammatory drugs or to a disease related increased permeability. There was no statistically significant difference in altered gut permeability between patients taking NSAID and patients taking corticosteroids. Our findings suggest that drug induced alteration of gut permeability may not only be accounted for by an inhibition of mucosal cyclooxygenase activity, but that other enzymatic pathways in the arachidonic cascade might be implicated.

Adrenal Cortex Hormones↗

PubMed1991

Intestinal mucosal permeability in inflammatory rheumatic diseases. II. Role of disease.

Gut permeability as measured by the 51Cr-EDTA resorption test was determined in 56 patients with rheumatoid arthritis (RA), 73 patients with spondyloarthropathies (SpA), 18 patients with inflammatory bowel disease (IBD) and 97 controls (42 patients with no inflammatory rheumatic diseases and 55 healthy controls). Gut permeability was found to be increased in the 3 patient groups, partially due to the intake of antiinflammatory drugs. When only patients not taking these drugs were considered, an increased gut permeability was found in patients with SpA and IBD. In patients with RA gut permeability could not be evaluated as they were all taking antiinflammatory medication. Ileocolonoscopy with biopsies of the gut was performed in 62 of the 73 patients with SpA and disclosed subclinical gut inflammation in 21. No difference in gut permeability was found between patients with or without gut inflammation. However, when the type of gut inflammation was considered, a significant increase of gut permeability was found in patients with chronic gut inflammation compared with patients presenting acute lesions. Our findings again suggest that the chronic gut inflammation seen in SpA is fundamentally different from acute gut inflammation and possibly related to the gut inflammation of IBD.

Adult↗

PubMed1991

The efficacy and toxicity of a constant low dose of methotrexate as a treatment for intractable rheumatoid arthritis: an open prospective study.

Ninety-two patients with intractable rheumatoid arthritis (RA) participated in an open prospective study of the longterm efficacy and toxicity of methotrexate (MTX), administered orally at a constant dosage of 7.5 mg/week. Twenty-four patients (25%) had to be withdrawn from the study within the first 12 months because of inefficacy or adverse reactions with a fatal outcome in 2 patients. In the remaining 68 patients, the mean duration of therapy was 19 months. Sixty-three of 92 patients (68%) experienced significant clinical improvement after one year, 23 (25%) were in clinical remission. Twenty-three of these patients initially responded well but relapsed after a median of 15 months of therapy. In 5 patients (5%) the disease activity remained status quo. Toxicity was noted at some time in 51 patients (54%), consisting of clinical side effects in 37 patients (40%) and biological abnormalities in 36 patients (39%), including 9 patients (10%) with blood and bone marrow toxicity, in whom renal function at start was normal. Two of these latter 9 patients had a fatal outcome because of an unexpected renal deterioration due to intercurrent disease. Thus, MTX at this constant low dose appears to be a temporarily valuable therapy for intractable RA. Careful monitoring is necessary in view of the potentially dangerous side effects.

Adult↗

PubMed1990

Onset of symptoms of rheumatoid arthritis in relation to age, sex and menopausal transition.

In a population of 564 patients with rheumatoid arthritis (RA), the onset of symptoms has been studied in relation to age, sex and last menstrual period for women. Median age of menopause was 49 years (3rd percentile: 32 years and 97th percentile: 56 years). Median age of first symptoms was 45 years in women and 50 in men. The individual interval between menopause and first symptoms has a Gaussian distribution with mean at time 0, implying that the average woman develops the first symptoms at the time of her menopause. The F:M ratio of all patients was 2.3; with increasing age the F:M ratio decreased from 3.7 before 30 years of age to 1 after the 6th decade of life, with a peak at the age of 40-44 years. A possible effect of age related changes in sex hormone levels on the pathogenesis of RA is suggested.

Adult↗

PubMed1990

Destructive hip lesions in seronegative spondyloarthropathies: relation to gut inflammation.

In the seronegative spondyloarthropathies the hip lesions can be subdivided into a concentric type progressing to ankylosis and an eccentric type leading to joint destruction. Radiologic examination of the hips was performed in 177 of 211 patients suffering from seronegative spondyloarthropathies on whom ileocolonoscopy with biopsies of ileum and colon was performed; in 27 of these 177 patients, hip lesions were demonstrated. The concentric form seems to be radiologically, clinically and genetically more related to axial involvement; moreover, the frequency of subclinical gut inflammation was the same as in the group of patients with ankylosing spondylitis (AS) without peripheral arthritis, and thus significantly lower than in patients with AS with peripheral arthritis. Eccentric, destructive hip lesions seem to be unrelated to axial involvement, but they are associated with the presence of HLA-Bw62 and gut inflammation (100%), mainly of the chronic, Crohn disease-like type.

Biopsy↗

PubMedDate not supplied

Churg-Strauss syndrome presenting as polymyositis.

Churg-Strauss syndrome is a vasculitis-based pathology, predominantly characterized by asthma and eosinophilia. Histopathologically, the vessel wall infiltration contains a substantial proportion of eosinophils and extravascular granulomata can be demonstrated. We report a case of Churg-Strauss syndrome presenting as polymyositis.

Blood Vessels↗

PubMedDate not supplied

Prevalence of inflammatory rheumatic diseases in an adolescent urban student population, age 12 to 18, in Belgium.

In order to determine the prevalence of inflammatory rheumatic diseases in an urban secondary school student population, a questionnaire dealing with past or present joint, tendon, axial, gastrointestinal, ocular and dermatological symptoms was completed by 2,990 students of secondary schools in Antwerp and Ghent. The parents were asked to complete a questionnaire regarding the family medical history. From these 2,990 students, 524 were selected for further investigation by a rheumatology resident, who checked the answers to the first questionnaire and performed a clinical examination. Forty-one adolescents with a presumptive history or present symptoms of inflammatory rheumatic diseases were retained. These students were examined by the medial staff of the rheumatology department; if necessary, a complementary biochemical and radiological examination was performed. Five cases of definite juvenile chronic arthritis (JCA) (with polyarticular onset in 1 case and late pauciarticular onset in 4 cases) and 4 cases of presumptive late pauciarticular onset JCA were detected, resulting in a prevalence of 167 per 100,000 for definite JCA and of 301 per 100,000 for possible JCA. This prevalence rate is higher than that generally described. This method of investigation effectively allows the detection of milder and spontaneously remitting cases of JCA. It further enabled us to definite case and 4 presumptive cases of various previously undiagnosed forms of JCA.

Adolescent↗

PubMedDate not supplied

A double-blind study to determine the duration of action of flurbiprofen in a sustained release preparation.

This double-blind, placebo-controlled, parallel-group study proves that the duration of activity of a sustained-release preparation of flurbiprofen 200 mg covers a full 24 hour period. In a group of 24 patients with clinically active rheumatoid arthritis a statistically significant increase of pain was noted 37 hours after the last active dose. The increase in disease symptoms was inversely related to the plasma flurbiprofen levels and was rapidly reversed with one active dose of sustained release flurbiprofen.

Adult↗