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[The comparative efficacy of slow-acting (basic) preparations in psoriatic arthritis].

Overall 126 patients with verified and clinically active psoriatic arthritis (PA) were subjected to a randomized study of the efficacy of chrisanolum (Chr), sulfasalicylic drugs (SSD) (sulfasalazine and salazopyridazine) and methotrexate (MT) as compared to nonsteroidal anti-inflammatory drugs (NSAID). The treatment that lasted for a year was completed by 77 patients: in the group on NSAID, by 31, on Chr by 15, on SSD by 15, and on MT by 16. In the remainder, the treatment was discontinued because of side effects. The best clinical effect was recorded in patients on Chr. The improvement was observed in 73% of the patients, with a significant effect being attained in 60%. In the groups on SSD and MT, the improvement was observed in 80 and 69%, respectively. However, noticeable improvement was only recorded in 20 and 19%. SSD turned out more effective than MT. in the group on NAID, the improvement was ascertained but in 35% of the patients, with noticeable one being attained in 6%. According to Pearson's criterion chi 2, the results of the treatment with NAID alone were less potent than in the group given Chr (p < 0.001) and SSD (p < 0.05). The differences between the effect of the treatment with NAID and MT appeared nonsignificant (p > 0.1). Therefore, according to the diminution of the clinical efficacy in PA, the basic drugs may be distributed in the following way: Chr, SSD, MT. The side-effects in the group on NAID were. recorded in 37% of cases, in the group on Chr in 53%, on SSD in 33%, and on MT in 55%. This means that SSD were tolerated best of all.

Anti-Inflammatory Agents, Non-Steroidal↗

[The "Emmerich Arthritis Record", function and acceptance within the scope of an integrated treatment concept].

For a comprehensive model of rheumatoid arthritis treatment, we designed an arthritis manual for continuous treatment of chronic illness. One goal of introducing the manual to the patients was the improvement of communication between patient and different doctors and therapists. The first part includes of a doctor's documentation sheet and a patient calendar (6 months each) for daily self-documentation of drug compliance. The second part is a daily pain-rating scale. The 3-year evaluation of 655 patient manuals for 286 patients was analyzed to estimate the compliance in using the manual. Overall, 87% of diagnoses, 83% of disease-modifying anti-rheumatic drugs (DMARDs), 87% of non-steroidal anti-rheumatic drugs (NSAIDs) had been documented in the manual. Data indicates that the general practitioner and the rheumatologist accepted the manual form. In addition, 85% of the documented patients used the DMARDs, 74% used the daily pain score, and 43% the daily physiotherapy. Subgroup data (n = 130 RA patients) suggest additional results: 1) there was no difference in sociodemographic data between the patient manual user group and the non-user group; 2) the user group consisted of patients with higher disease activity (ARA-criteria), higher pain score, and negative mood pattern. Furthermore, the user group was more active in daily physiotherapy, ergotherapy, and balneotherapy.

Anti-Inflammatory Agents, Non-Steroidal↗

Ocular side effects of selected systemic drugs.

Numerous systemic drugs produce adverse effects that involve the eye. Pigmentary inclusions of the lids or conjunctivae or both may be caused by a variety of drugs, including amiodarone, chlorpromazine, and gold salts, while conjunctivitis and blepharoconjunctivitis have been associated with isotretinoin, sulfonamides, salicylates, and antineoplastic agents. Dry eye complaints may be caused by antihistamines, beta-receptor blocking agents prescribed for cardiovascular problems, antianxiety agents, and tricyclic antidepressants. Several drugs have been well documented as causes of keratopathies and/or lenticular deposits, including chloroquine and hydroxychloroquine, chlorpromazine, gold salts, systemic corticosteroids, nonsteroidal antiinflammatory drugs, and the antiarrhythmic agent amiodarone. Visual acuity may be decreased by transient changes in refractive error caused by sulfonamides, the antifungal agent metronidazole, thiazide diuretics, and carbonic anhydrase inhibitors. Dilation of the pupil may be caused by anticholinergic drugs, antihistamines, antidepressant agents, and central nervous system stimulants such as cocaine, methylphenidate, and amphetamines. Nystagmus, diplopia, and extraocular muscle palsies have been associated with central nervous system depressants, antihistamines, barbiturates, and elevated blood ethanol concentrations. Intraocular pressure can be elevated in susceptible individuals by long-term use of topical or systemic corticosteroids. Numerous drugs have been associated with retinal toxicity, including chloroquine and hydroxychloroquine, thioridazine, tamoxifen, and talc, which may embolize to the retinal circulation when administered by long-term drug abusers. The antituberculosis agents ethambutol and isoniazid have been implicated as causes of reduced acuity, visual field defects, and disturbances of color vision. Optic neuritis and retrobulbar neuritis may result from the use of chloramphenicol. This paper describes these and other adverse ocular effects that may be encountered when examining patients who are taking systemic drugs.

Amiodarone↗

[Rheumatoid arthritis in Morocco. Apropos of 404 observations].

A retrospective study of 404 cases of rheumatoid arthritis seen in a department of internal medicine in Casablanca highlights a number of specific features of the disease in Morocco. Onset occurred early and mean age of patients was 34.4 years. Analysis of joint manifestations showed that the disease tended to be mild in the hips and perhaps in the cervical spine. Thirty-five percent of patients were Steinbrocker's class II and 25.5% had carpal bone fusion. Only 20 patients had severely erosive disease, which manifested as giant geodes in 8 cases and as main en lorgnette deformity in one case. Subcutaneous nodules (7.9%) and systemic visceral disorders were fairly infrequent. Only three cases of malignant rheumatoid arthritis were found. Gougerot-Sjögren syndrome was present in 13.6% of patients. Among comorbid conditions, thyroid gland diseases and tuberculosis were fairly common. Serologic tests were positive in 61.14% of cases, often in low titres. Gold salt therapy was well tolerated. No patients in this group had surgical treatment. These data suggest that in Morocco rheumatoid arthritis may be less aggressive than in Europe.

Adolescent↗

Functional and morphological studies of mitochondria exposed to undecagold clusters: biologic surfaces labeling with gold clusters.

This study reports morphological and functional alterations observed in respiring isolated mitochondria when they are exposed to nonpenetrating, positive electrostatically charged synthetic undecagold clusters. Modification of the undecagold clusters positive charges change or prevent the functional effects and the binding to the outside surface of the mitochondria. The mitochondrial functional alterations are dependent on the oxidative phosphorylation capacity of the isolated organelles. The results of these experiments indicate that artificial undecagold may be useful to explore the molecular mechanisms of biological energy transducers which require electric charges separation, ionic fluxes, and electric surface properties.

Animals↗