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1.
Ter Arkh ; 92(4): 57-63, 2020 May 19.
Artículo en Ruso | MEDLINE | ID: mdl-32598699

RESUMEN

AIM: To evaluate the efficacy of mechanical bacterial lysate on the prevention of infectious exacerbations of chronic obstructive pulmonary disease in patients with frequent exacerbations. MATERIALS AND METHODS: The study included patients (n=60) with frequent exacerbations of COPD (groups C and D according to the GOLD classification). All COPD patients were divided into two groups by blind method. The first group (n=30) received conventional therapy for COPD plus MBL (the course included 3 cycles of 10 days therapy with 20-day intervals between them). The second group of patients (control, n=30) received conventional therapy for COPD without MBL.We evaluated the severity of symptoms, frequency of recurrence of COPD exacerbations, readmissions, need for emergency care and changes in basic therapy of COPD. Evaluations were done on 10 days, 1, 3 and 6 months from the start of the study. RESULTS: Adding of MBL to the therapy list of COPD resulted in a significant decrease of biomarkers of systemic inflammation and sputum purulence during compared to the control group. After 6 months of observation MBL group demonstrated statistically significant improvement of respiratory function, decrease in frequency of COPD exacerbations, needs for emergency medical service, reduced changes in basic therapy and hospitalization for exacerbation of COPD. Therapy with MBL showed a high degree of safety and low incidence of adverse events. CONCLUSION: The results of the study indicate that MBL may be used for the prevention of severe infectious exacerbations of COPD.


Asunto(s)
Antibacterianos/uso terapéutico , Enfermedad Pulmonar Obstructiva Crónica/tratamiento farmacológico , Extractos Celulares , Progresión de la Enfermedad , Humanos , Resultado del Tratamiento
2.
Rev Med Suisse ; 9(377): 569-70, 572, 574-5, 2013 Mar 13.
Artículo en Francés | MEDLINE | ID: mdl-23534244

RESUMEN

Erosive hand osteoarthritis is common and debilitating. Diagnosis is based on the presence of bone erosions which can appear late. Ultrasonography allows earlier diagnosis. The presence of apatite deposits could be of poor prognosis. Non pharmacological treatment includes the explanation of the inflammatory phenomena involved and the use of splints and physical therapy. Drug therapy includes analgesics, NSAIDs and infiltration of a steroid. Chondroitin sulfates have an analgesic and functional effect proven. DMARDs such as hydroxychloroquine and methotrexate have been used successfully. Some patients also benefited from isotope synoviortheses. New therapeutic ways, based on the pathophysiology of the disease, are new under evaluation.


Asunto(s)
Antirreumáticos/uso terapéutico , Apatitas/metabolismo , Osteoartritis/terapia , Analgésicos/uso terapéutico , Antiinflamatorios no Esteroideos/uso terapéutico , Sulfatos de Condroitina/uso terapéutico , Glucocorticoides/uso terapéutico , Mano , Humanos , Hidroxicloroquina/uso terapéutico , Metotrexato/uso terapéutico , Osteoartritis/diagnóstico , Osteoartritis/fisiopatología , Pronóstico
3.
J Exp Med ; 172(4): 1011-7, 1990 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-1976733

RESUMEN

C3 exhibits two common allotypic variants that may be separated by gel electrophoresis and are called C3 fast (C3 F) and C3 slow (C3 S). C3 F, the less common variant, occurs at appreciable frequencies only in Caucasoid populations (gene frequency = 0.20). An increased prevalence of the C3 F allele has been reported in patients with partial lipodystrophy, IgA nephropathy, and Indian childhood hepatic cirrhosis. Studies of the genomic organization of the human C3 gene led to the identification of a single change (C to G) between C3 S and C3 F at nucleotide 364 in exon 3. This leads, at the translation level, to the substitution of an arginine residue (positively charged) in C3 S for a glycine residue (neutral) in C3 F. This substitution results in a polymorphic restriction site for the enzyme HhaI. The resulting restriction fragment length polymorphism (RFLP) was investigated using genomic DNA, amplified using the polymerase chain reaction; there was absolute concordance between the genomic polymorphism and the distribution of C3 S and C3 F in 50 normal subjects. The molecular basis of a second structural polymorphism, defined by the monoclonal antibody HAV 4-1, was also characterized. The polymorphic determinant was identified at codon 314 in the exon 9 of the beta chain where a leucine residue (HAV 4-1+) is substituted for a proline residue (HAV 4-1-). Identification of the amino acid sequences of these polymorphic variants will facilitate characterization of possible functional differences between different allotypes of C3. Three RFLPs (BamHI, EcoRI, and SstI) were located to introns in the C3 gene. There was no allelic association between these three RFLPs, or between the RFLPs and the C3 F/S polymorphic site. Genetic equilibration of these polymorphisms has occurred within a gene of 41 kb.


Asunto(s)
Complemento C3/genética , Polimorfismo Genético , Anticuerpos Monoclonales , Secuencia de Bases , Complemento C3/química , Sondas de ADN , Humanos , Datos de Secuencia Molecular , Polimorfismo de Longitud del Fragmento de Restricción , Relación Estructura-Actividad
4.
Ann Rheum Dis ; 69(3): 483-9, 2010 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-19762361

RESUMEN

OBJECTIVE: To develop evidence-based recommendations for the diagnosis of knee osteoarthritis (OA). METHODS: The multidisciplinary guideline development group, representing 12 European countries, generated 10 key propositions regarding diagnosis using a Delphi consensus approach. For each recommendation, research evidence was searched systematically. Whenever possible, the sensitivity, specificity and likelihood ratio were calculated for individual diagnostic indicators and a diagnostic ladder was developed using Bayes' method. Secondary analyses were undertaken to test directly the recommendations using multiple predictive models in two populations from the UK and the Netherlands. Strength of recommendation was assessed by the EULAR visual analogue scale. RESULTS: Recommendations covered the definition of knee OA and its risk factors, subsets, typical symptoms and signs, the use of imaging and laboratory tests and differential diagnosis. Three symptoms (persistent knee pain, limited morning stiffness and reduced function) and three signs (crepitus, restricted movement and bony enlargement) appeared to be the most useful. Assuming a 12.5% background prevalence of knee OA in adults aged > or =45 years, the estimated probability of having radiographic knee OA increased with increasing number of positive features, to 99% when all six symptoms and signs were present. The performance of the recommendations in the study populations varied according to the definition of knee OA, background risk and number of tests applied. CONCLUSION: 10 key recommendations for diagnosis of knee OA were developed using both research evidence and expert consensus. Although there is no agreed reference standard, thorough clinical assessment alone can provide a confident rule-in diagnosis.


Asunto(s)
Osteoartritis de la Rodilla/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Diagnóstico Diferencial , Métodos Epidemiológicos , Medicina Basada en la Evidencia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Guías de Práctica Clínica como Asunto , Adulto Joven
5.
J Comp Neurol ; 504(5): 570-82, 2007 Oct 10.
Artículo en Inglés | MEDLINE | ID: mdl-17701979

RESUMEN

The ability to identify and respond to food is essential for survival, yet little is known about the neural substrates that regulate natural variation in food-related traits. The foraging (for) gene in Drosophila melanogaster encodes a cGMP-dependent protein kinase (PKG) and has been shown to function in food-related traits. To investigate the tissue distribution of FOR protein, we generated an antibody against a common region of the FOR isoforms. In the adult brain we localized FOR to neuronal clusters and projections including neurons that project to the central complex, a cluster within the dorsoposterior region of the brain hemispheres, a separate cluster medial to optic lobes and lateral to brain hemispheres, a broadly distributed frontal-brain cluster, axon bundles of the antennal nerve and of certain subesophageal-ganglion nerves, and the medulla optic lobe. These newly described tissue distribution patterns of FOR protein provide candidate neural clusters and brain regions for investigation of neural networks that govern foraging-related traits. To determine whether FOR has a behavioral function in neurons we expressed UAS-for in neurons using an elav-gal4 driver and measured the effect on adult sucrose responsiveness (SR), known to be higher in rovers than sitters, the two natural variants of foraging. We found that pan-neuronal expression of for caused an increase in the SR of sitters, demonstrating a neural function for PKG in this food-related behavior.


Asunto(s)
Proteínas Quinasas Dependientes de GMP Cíclico/fisiología , Proteínas de Drosophila/fisiología , Conducta Alimentaria/efectos de los fármacos , Expresión Génica/efectos de los fármacos , Sacarosa/farmacología , Edulcorantes/farmacología , Animales , Conducta Animal/efectos de los fármacos , Conducta Animal/fisiología , Encéfalo/citología , Encéfalo/efectos de los fármacos , Encéfalo/metabolismo , Drosophila melanogaster , Expresión Génica/genética , Cuerpos Pedunculados , Neuronas/metabolismo
6.
J Clin Invest ; 86(4): 1158-63, 1990 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-2212005

RESUMEN

Hereditary deficiency of complement component C3 in a 10-yr-old boy was studied. C3 could not be detected by RIA of serum from the patient. Segregation of C3 S and C3 F allotypes within the family confirmed the presence of a null gene for C3, for which the patient was homozygous. 30 exons have been characterized, spanning the entire beta chain of C3 and the alpha chain as far as the C3d region. Sequence analysis of the exons derived from the C3 null gene showed no abnormalities in the coding sequences. A GT-AT mutation at the 5' donor splice site of the intervening sequence 18 was found in the C3 null gene. Exons 17-21 were amplified by the polymerase chain reaction (PCR) from first-strand cDNA synthesized from mRNA obtained from peripheral blood monocytes stimulated with LPS. This revealed a 61-bp deletion in exon 18, resulting from splicing of a cryptic 5' donor splice site in exon 18 with the normal 3' splice site in exon 19. This deletion leads to a disturbance of the reading frame of the mRNA with a stop codon 17 bp downstream from the abnormal splice in exon 18. His parents had both the normal and abnormal C3 mRNA and were shown to be heterozygous for this mutation by sequence analysis of genomic DNA amplified by PCR. Similar splice mutants have previously been reported in the beta-globin, phenylalanine hydroxylase, and porphobilinogen deaminase genes. This mutation is sufficient to cause the deficiency of C3 in the patient.


Asunto(s)
Complemento C3/deficiencia , Secuencia de Bases , Niño , Complemento C3/análisis , Complemento C3/genética , ADN/análisis , Exones , Femenino , Humanos , Masculino , Mutación , Reacción en Cadena de la Polimerasa , Empalme del ARN
7.
Clin Rheumatol ; 25(4): 468-9, 2006 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-16365684

RESUMEN

The aim of this study was to assess the frequency and the outcome of patients suffering from rheumatoid arthritis in which calcium pyrophosphate dihydrate (CPPD) crystal deposits were found to coexist in synovial fluid analysis. Such association was more frequent than previously believed with CPPD crystals found in 25.8% of 93 patients with rheumatoid arthritis. As a group, a trend toward a worse outcome was suggested by more frequent prostheses of the lower limb.


Asunto(s)
Artritis Reumatoide/fisiopatología , Pirofosfato de Calcio/análisis , Líquido Sinovial/química , Adulto , Anciano , Anciano de 80 o más Años , Miembros Artificiales , Progresión de la Enfermedad , Femenino , Humanos , Pierna/patología , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Estudios Retrospectivos
8.
Rev Med Suisse ; 2(65): 1268-70, 1272-4, 2006 May 10.
Artículo en Francés | MEDLINE | ID: mdl-16767883

RESUMEN

Low back pain is a major burden for health care. According to the International Classification of Function, it is a disability of complex origin. Risk factors for chronification are of psychosocial and not physical nature. Primary targets of treatment should be physical fitness and the self-management of problem by the patient. Awareness of the psychosocial factors (yellow, blue and black flags) which can disturb occupational reintegration should be developed. Rehabilitation is based on measures to modify patient's beliefs and fitness. The prescribed treatment should aim to relieve pain, correct disability, prevent relapses, inform and educate the patient. Every low back pain sufferer which does not improve in 1 month should be sent to a team skilled in handling this kind of problem.


Asunto(s)
Dolor de la Región Lumbar/diagnóstico , Dolor de la Región Lumbar/terapia , Humanos , Dolor de la Región Lumbar/fisiopatología , Factores de Riesgo
9.
Medicine (Baltimore) ; 71(6): 327-36, 1992 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-1435228

RESUMEN

The clinical and laboratory features of 32 patients with anti-PM-Scl were studied. Patients with this rare autoantibody suffered from a homogenous overlap connective tissue disease defined by Raynaud phenomenon (32/32), features of scleroderma (31/32), arthritis (31/32, erosive in 9/32), myositis (28/32), lung restriction (25/32), calcinosis (15/32), and sicca (11/32). Significant renal and neurologic involvement was uncommon. All patients examined (22/22) had HLA-DR3, and 50% of these patients were homozygous. Our patients responded favorably to moderate immunosuppression and, with therapy, the disease generally has a good prognosis; over 50% of our series (17/32) remained well on minimal or no immunosuppression after a median follow-up of 8 years.


Asunto(s)
Autoanticuerpos/inmunología , Autoantígenos/inmunología , Enfermedades del Tejido Conjuntivo/inmunología , Adolescente , Adulto , Anciano , Artritis/inmunología , Niño , Enfermedades del Tejido Conjuntivo/genética , Dermatomiositis/inmunología , Exorribonucleasas , Complejo Multienzimático de Ribonucleasas del Exosoma , Femenino , Antígeno HLA-DR3/genética , Humanos , Enfermedades Renales/inmunología , Enfermedades Pulmonares/inmunología , Lupus Eritematoso Sistémico/inmunología , Masculino , Persona de Mediana Edad , Polimiositis/inmunología , Enfermedad de Raynaud/inmunología , Esclerodermia Sistémica/inmunología
10.
J Thromb Haemost ; 1(12): 2510-5, 2003 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-14675085

RESUMEN

BACKGROUND: Activation of coagulation and fibrinolysis play a role in the pathophysiology of experimental arthritis. OBJECTIVE: To determine the extent of activation of the coagulation and fibrinolytic pathways in different joint diseases in humans and to ascertain the factors that may influence fibrin deposition within the joint. METHODS: Plasma from normal subjects (controls, n= 21) and plasma and synovial fluid samples from patients with rheumatoid arthritis (RA; n = 64), osteoarthritis (OA; n = 29), spondyloarthropathy (SpA; n = 22) and crystal arthritis (CA; n = 25) were analyzed for the levels of TF (tissue factor) and tissue factor pathway inhibitor (TFPI) activities, thrombin-antithrombin III (TAT) complexes, and F1 + 2 (thrombin fragment), fibrin d-dimer and thrombin-activated fibrinolysis inhibitor (TAFI) antigenic levels. The measurements were analyzed by pairwise correlation with each other as well as with standard parameters of inflammation [C-reactive protein (CRP), joint leukocyte count]. Inter-group comparisons were performed to look for disease-specific differences. RESULTS: Compared with healthy controls, patients with joint diseases had higher levels of TAT, F1 + 2 and d-dimers in their plasma. In the synovial fluid, TF activity, TAT, d-dimers, and TAFI were significantly higher in inflammatory arthritides than in OA. The levels were highest in RA patients. In the plasma, TF activity was correlated with TAT and d-dimer levels with CRP, TFPI, and TAT. In the synovial fluid, TF activity correlated with plasma CRP levels, synovial fluid leukocyte count, and synovial TAT and TAFI levels. In addition, synovial d-dimers correlated with CRP, and synovial TAFI levels were correlated with synovial F1 + 2 and TAT. CONCLUSIONS: Activation of the coagulation and fibrinolytic cascades in the joint and in the circulation is evident in both inflammatory and degenerative joint diseases. Within the joint, inflammatory mechanisms leading to TF-mediated activation of the coagulation pathway and subsequent fibrin deposition is the most likely explanation for the observed findings. In the plasma, the link between inflammation (CRP increase) and TF activation is weak, and a non-TF-mediated mechanism of coagulation activation could explain these findings. RA is characterized by significantly higher levels of TAT in the synovial fluid and plasma than other arthritides. Although fibrinolytic activity is linked to inflammation, the increased amounts of TAFI in the joint, particularly in RA, may explain why fibrin formation is so prominent in this condition compared with other joint diseases.


Asunto(s)
Artritis/fisiopatología , Coagulación Sanguínea/fisiología , Fibrinólisis/fisiología , Adulto , Anciano , Artritis/etiología , Artritis Reumatoide/etiología , Artritis Reumatoide/fisiopatología , Biomarcadores/análisis , Biomarcadores/sangre , Carboxipeptidasa B2/análisis , Estudios de Casos y Controles , Femenino , Fibrina/metabolismo , Humanos , Inflamación/fisiopatología , Modelos Lineales , Masculino , Persona de Mediana Edad , Osteoartritis/etiología , Osteoartritis/fisiopatología , Espondilitis Anquilosante/etiología , Espondilitis Anquilosante/fisiopatología , Líquido Sinovial/química
11.
Hum Immunol ; 20(2): 167-73, 1987 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-2890606

RESUMEN

T-cell receptor alpha- and beta-chain polymorphisms have been investigated in patients with autoimmune thyroid disease. Using a cDNA probe for the T-cell receptor alpha chain, a 1.4-kb V alpha Taq I restriction fragment was found in 25 of 33 patients with autoimmune hypothyroidism compared to 33 of 61 control subjects (p less than 0.05) and 16 of 43 patients with Graves' disease (p less than 0.001 compared to patients with autoimmune hypothyroidism). Moreover, when Graves' patients were divided according to HLA-DR3 status, there was a significantly reduced frequency of the 1.4-kb V alpha fragment in HLA-DR3-negative patients (p less than 0.05 compared to controls). There was no significant association of either thyroid disorder with polymorphisms of the T-cell receptor alpha- or beta-chain-constant region genes, after Taq I and Bgl II digestion, respectively. These results show that inherited variation in T-cell receptor genes, recognizable before any somatic event has taken place, may play a role in susceptibility to autoimmune disease.


Asunto(s)
Enfermedades Autoinmunes/genética , Enfermedad de Graves/genética , Hipotiroidismo/genética , Receptores de Antígenos de Linfocitos T/genética , Humanos , Polimorfismo de Longitud del Fragmento de Restricción
12.
QJM ; 90(5): 347-52, 1997 May.
Artículo en Inglés | MEDLINE | ID: mdl-9205670

RESUMEN

Anti-PL 4 is an autoantibody which binds to a 150 kDa polypeptide and is found in approximately 1% of SLE sera. The clinical and laboratory features of 16 patients who have had anti-PL 4 detected in their serum are presented. Anti-PL 4 is highly specific for SLE (100%) and identifies a population of patients who typically develop severe renal (75%) and haematological disease (100%).


Asunto(s)
Autoanticuerpos/análisis , Lupus Eritematoso Sistémico/inmunología , Especificidad de Anticuerpos , Biomarcadores/análisis , Antígenos HLA-DP/inmunología , Enfermedades Hematológicas/diagnóstico , Humanos , Enfermedades Renales/diagnóstico , Enfermedades Renales/inmunología , Lupus Eritematoso Sistémico/complicaciones , Pruebas de Precipitina
13.
Cancer Genet Cytogenet ; 81(1): 42-5, 1995 May.
Artículo en Inglés | MEDLINE | ID: mdl-7773959

RESUMEN

The pathogenesis of nasopharyngeal carcinoma (NPC) is multifactorial. Associations have been reported between HLA and NPC. We studied the HLA-DR and -DQ regions on the molecular level in 136 persons (51 NPC patients and 85 healthy controls) from southern China, a particularly high-prevalence area for NPC. Restriction fragment-length polymorphism (RFLP) was used to genotype the MHC class II DR beta, DQ alpha, and DQ beta regions of the subjects. Polymerase chain reaction (PCR) using sequence-specific primer (SSP) for DQ beta genes was also performed. By RFLP, no significant difference was observed with respect to DRB, DQA, and DQB genes. By PCR SSP typing, we confirmed that there was no significant difference between NPC patients and controls with respect to DQ beta alleles. Our study suggests that HLA-DQ and -DR genes are not associated with NPC in southern Chinese and there may be other gene loci that predispose them to have such a high prevalence of the disease.


Asunto(s)
Antígenos HLA-DQ/genética , Antígenos HLA-DR/genética , Neoplasias Nasofaríngeas/genética , Adolescente , Adulto , Alelos , China , ADN de Neoplasias/análisis , Femenino , Genotipo , Humanos , Masculino , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa , Polimorfismo de Longitud del Fragmento de Restricción
14.
Clin Exp Rheumatol ; 20(3): 427-30, 2002.
Artículo en Inglés | MEDLINE | ID: mdl-12102485

RESUMEN

OBJECTIVES: To determine if adolescent onset systemic juvenile idiopathic arthritis (JIA) and adult onset Still's disease (AOSD) represent the same clinical continuum of disease. METHODS: Retrospective review of available clinical data on all pediatric and adult patients diagnosed with Still's disease within the last 10 years at a university hospital. Assessment of functional outcomes at last visit by clinical evaluation and HAQ or c-HAQ. RESULTS: Nine patients were identified as adolescent onset systemic JIA and were compared with 10 patients with AOSD (onset > 18 years old). No statistically significant differences were found between the two groups in terms of clinical presentation at onset and outcome at follow up. CONCLUSION: Adolescent patients presenting with systemic JIA have a disease onset and course undistinguishable from that of AOSD patients, suggesting that they represent a continuum of a single disease entity.


Asunto(s)
Artritis Juvenil/clasificación , Artritis Juvenil/diagnóstico , Enfermedad de Still del Adulto/clasificación , Enfermedad de Still del Adulto/diagnóstico , Adolescente , Adulto , Edad de Inicio , Artritis Juvenil/terapia , Niño , Estudios de Seguimiento , Humanos , Estudios Retrospectivos , Enfermedad de Still del Adulto/terapia , Resultado del Tratamiento
15.
Clin Rheumatol ; 22(1): 67-9, 2003 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-12605323

RESUMEN

Intraspinal synovial cysts presenting with lower back pain and radiculopathy are well known but rare. They are associated with facet joint arthopathy, generally degenerative in nature. Spinal synovial cysts have not been described in spondyloarthropathies (SpA). We report a case of a 66-year-old man with a chronic undifferentiated SpA who presented with severe weakness of both legs. A centrally located spinal cyst was encountered on MRI and led to excision of a highly inflammatory synovial cyst. This association may not be fortuitous and be related to inflammation of the facet joint in SpA.


Asunto(s)
Enfermedades de la Columna Vertebral/complicaciones , Espondiloartropatías/etiología , Quiste Sinovial/complicaciones , Anciano , Enfermedad Crónica , Humanos , Pierna , Región Lumbosacra , Imagen por Resonancia Magnética , Masculino , Debilidad Muscular/etiología , Enfermedades de la Columna Vertebral/diagnóstico , Enfermedades de la Columna Vertebral/patología , Quiste Sinovial/diagnóstico , Quiste Sinovial/patología
16.
Joint Bone Spine ; 67(2): 129-33, 2000.
Artículo en Inglés | MEDLINE | ID: mdl-10769106

RESUMEN

STUDY OBJECTIVE: To report two cases of amyloidosis secondary to ankylosing spondylitis. PATIENTS AND RESULTS: Of the 47 ankylosing spondylitis patients who have received follow-up at our department over the last few years, two have developed AA amyloidosis. Both have extremely severe, long-standing joint disease, with virtually complete spinal ankylosis and destructive peripheral arthritis of the hips and wrists; one also has tarsal joint destruction. Renal dysfunction was the first manifestation of amyloidosis in both cases. One patient required chronic hemodialysis and developed peritonitis due to colonic perforation, probably at a site of amyloid deposition. CONCLUSIONS: Secondary amyloidosis is a rare complication of ankylosing spondylitis that can cause severe renal and gastrointestinal complications. No treatment capable of clearing established amyloid deposits is available to date.


Asunto(s)
Amiloidosis/etiología , Espondilitis Anquilosante/complicaciones , Adulto , Humanos , Masculino , Persona de Mediana Edad
17.
J Radiol ; 80(4): 373-7, 1999 Apr.
Artículo en Francés | MEDLINE | ID: mdl-10337576

RESUMEN

PURPOSE: The appearance of scintigraphic and magnetic resonance imaging during the evolution of reflex sympathetic dystrophy of the foot is not well known and subject to controversies. The purpose of this preliminary study is to compare these two types of investigation during the first 6 months of evolution. METHODS: 4 non-selected patients with a diagnosis of acute reflex sympathetic dystrophy of the foot (no more than 2 months of evolution and more than 3 out of 6 clinical criteria suggesting a "warm" phase) were studied prospectively. A clinical evaluation, scintigraphy and magnetic resonance imaging (MRI) were performed at diagnosis and after 3 and 6 months. All available examinations (n = 22) were analyzed independently by independent observers. RESULTS: Clinically 3 of 4 patients developed or previously had another site of sympathetic dystrophy confirmed by total body scintigraphy. After 6 months 2 of 4 patients still have a "warm" dystrophy. Bone scanning showed localized or diffuse tracer uptake and MRI showed bone and soft tissue edema when the sympathetic dystrophy was and/or remained clinically "warm". MRI bone edema moved from one location to another in 3 of 4 patients during the follow-up. There was a good correlation between bone scan and MRI images. In "warm" dystrophy, MRI was positive 5 out of 7 times and scintigraphy in all cases. Bone edema and tracer uptake faded simultaneously although the latter was more diffuse and more persistent than the former. CONCLUSION: MRI as well as bone scintigraphy are suitable for the diagnosis of warm dystrophy of the foot. Both exams remain positive when the dystrophy is still "warm" after 6 months. The radiographic evolution after 6 months still has to be evaluated.


Asunto(s)
Enfermedades del Pie/diagnóstico por imagen , Imagen por Resonancia Magnética , Distrofia Simpática Refleja/diagnóstico por imagen , Enfermedades Óseas/diagnóstico por imagen , Enfermedades Óseas/patología , Medios de Contraste , Difosfonatos , Progresión de la Enfermedad , Edema/diagnóstico por imagen , Edema/patología , Estudios de Seguimiento , Pie/diagnóstico por imagen , Pie/patología , Huesos del Pie/diagnóstico por imagen , Huesos del Pie/patología , Enfermedades del Pie/diagnóstico , Enfermedades del Pie/fisiopatología , Gadolinio , Humanos , Variaciones Dependientes del Observador , Compuestos de Organotecnecio , Pronóstico , Estudios Prospectivos , Cintigrafía , Radiofármacos , Distrofia Simpática Refleja/diagnóstico , Distrofia Simpática Refleja/fisiopatología , Irradiación Corporal Total
18.
Praxis (Bern 1994) ; 97(21): 1133-6, 2008 Oct 22.
Artículo en Francés | MEDLINE | ID: mdl-18951353

RESUMEN

Pulmonary involvement is the most frequent extra-articular manifestation of rheumatoid arthritis. The occurrence of a chronic hydro-pneumo-thorax associated with pulmonary nodules is rare. Cavitation of the most superficial nodules and their rupture into the pleural cavity are most likely involved in this complication. The presence of broncho-pleural fistulae may be responsible for the persistence of the phenomenon in our patient.


Asunto(s)
Artritis Reumatoide/complicaciones , Hidroneumotórax , Humanos , Hidroneumotórax/complicaciones , Hidroneumotórax/diagnóstico , Hidroneumotórax/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Radiografía Torácica , Nódulo Reumatoide/diagnóstico , Toracoscopía , Tomografía Computarizada por Rayos X
19.
Skeletal Radiol ; 36 Suppl 1: S116-9, 2007 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-16715241

RESUMEN

INTRODUCTION: Epidural calcification is a rare cause of back pain, and spontaneous epidural calcification has not been reported previously. CASE REPORT: We describe a patient with acute low back pain and signs of lumbar nerve root compression due to epidural calcification, as demonstrated by CT-scan and MRI. Radiological signs of spondylodiscitis led to a search for an infectious cause, which was negative, and her symptoms responded rapidly to NSAID treatment alone. Her symptoms recurred 18 months later, and further imaging studies again revealed epidural calcification, but with a changed distribution. Her symptoms were relieved once more by NSAID treatment alone. DISCUSSION: We propose that epidural calcification secondary to aseptic spondylodiscitis is the main cause of acute back pain in this patient. A possible mechanism may be the pro-inflammatory effects of calcium pyrophosphate or hydroxyapatite crystal deposition within the epidural space.


Asunto(s)
Calcinosis/complicaciones , Calcinosis/diagnóstico , Discitis/complicaciones , Discitis/diagnóstico , Dolor de la Región Lumbar/etiología , Compresión de la Médula Espinal/diagnóstico , Compresión de la Médula Espinal/etiología , Enfermedad Aguda , Anciano , Antiinflamatorios no Esteroideos/uso terapéutico , Diagnóstico Diferencial , Discitis/tratamiento farmacológico , Femenino , Humanos , Dolor de la Región Lumbar/tratamiento farmacológico , Vértebras Lumbares/patología , Imagen por Resonancia Magnética , Recurrencia , Tomografía Computarizada por Rayos X
20.
Curr Opin Rheumatol ; 10(3): 207-11, 1998 May.
Artículo en Inglés | MEDLINE | ID: mdl-9608323

RESUMEN

T cells play a critical role in rheumatoid arthritis. They are probably continuously involved in pathogenesis, from the initiation to the chronic stage. As recent studies have demonstrated, the part they play in rheumatoid arthritis is closely linked to the roles of macrophages and mesenchymal cells, because they all interact through autocrine, paracrine, and cell-contact pathways. This paper reviews recent work and research regarding the specific role of T cells in the pathogenesis of rheumatoid arthritis.


Asunto(s)
Artritis Reumatoide/etiología , Artritis Reumatoide/inmunología , Citocinas/inmunología , Linfocitos T/inmunología , Animales , Apoptosis/inmunología , Autoantígenos , Humanos , Activación de Linfocitos , Autotolerancia , Superantígenos , Células TH1/inmunología , Células Th2/inmunología
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