Rheumatic manifestations associated with human immunodeficiency virus infection.
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Acquired Immunodeficiency Syndrome↗
Biomedical subjects
A Berman
Publications and source records attributed to A Berman.
Structural and stereochemical relations between acidic macromolecules of organic matrices and crystals.
Detailed studies of the molecular organization of various mineralized tissues highlight the role played by acidic glycoproteins in controlling crystal formation. In vitro experiments show that these macromolecules are able to interact with specific faces of different crystals, influencing both nucleation and crystal growth. Significantly a common stereochemical motif can be recognized in all the interacting faces studies to date.
Animals↗
Psoriatic arthritis and acquired immunodeficiency syndrome.
We describe 2 patients who developed psoriatic arthritis during the course of acquired immunodeficiency syndrome. Both patients developed skin and articular involvement characteristic of psoriatic arthritis; these manifestations were refractory to conventional therapy. Our findings suggest that psoriatic arthritis should be added to the expanding spectrum of musculoskeletal manifestations of the acquired immunodeficiency syndrome.
Acquired Immunodeficiency Syndrome↗
Rheumatic manifestations of human immunodeficiency virus infection.
PURPOSE: The prevalence and characteristics of the rheumatic and extra-rheumatic manifestations of human immunodeficiency virus (HIV) infection were determined in a prospective manner. PATIENTS AND METHODS: One hundred one patients with HIV infection were consecutively interviewed and examined. The prevalence of autoantibodies and their association with rheumatologic symptoms were also determined. RESULTS: The musculoskeletal system was involved in 72 patients. Thirty-five patients had arthralgias, 10 had Reiter's syndrome, two had psoriatic arthritis, two had myositis, and one had vasculitis. Also found were two previously unreported syndromes. The first, occurring in 10 patients, consisted of severe intermittent pain involving less than four joints, without evidence of synovitis, of short duration (two to 24 hours), and requiring therapy (ranging from nonsteroidal antiinflammatory drugs to narcotics). The second, occurring in 12 patients, consisted of arthritis (oligoarticular in six patients, monoarticular in three patients, and polyarticular in three patients) involving the lower extremities and lasting from one week to six months. The synovial fluid of five patients (three with arthritis, one with Reiter's syndrome, and one with psoriatic arthritis) was sterile and inflammatory. CONCLUSION: Musculoskeletal complications are common in advanced stages of HIV infection. Persons in a high-risk group for HIV infection who manifest oligoarthritis with or without any other extra-articular manifestation suggestive of Reiter's syndrome or other form of spondyloarthropathy should be tested for HIV.
Acquired Immunodeficiency Syndrome↗
Autoimmune phenomena in human immunodeficiency virus infection.
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Acquired Immunodeficiency Syndrome↗
Atrophoderma (Pasini-Pierini). Findings on direct immunofluorescent, monoclonal antibody, and ultrastructural studies.
A patient with atrophoderma (Pasini-Pierini) was studied. Microscopic examination showed small collections of mononuclear cells around dermal blood vessels. Electron microscopic study demonstrated macrophages and lymphocytes around vessels and between fibers in the dermis; the epidermis, dermis, collagen, and elastic fibers appeared normal. Monoclonal antibody studies of the cells in the perivascular infiltrate demonstrated cells reacting with anti-Leu-1 (pan-T-cell antibody), anti-Leu-3a (the helper/inducer T-cell antibody), and OKM 1 antibody-reacting cells (macrophages). Direct immunofluorescent studies showed IgM and C3 staining in the small blood vessels of the papillary dermis, scattered IgM cytoids at the basement membrane, and focal fibrinogen in the mid-dermis. Mononuclear cells in the perivascular infiltrate, similar in type and percentage concentration, have been demonstrated also in patients with anetoderma, another rare atrophic cutaneous disorder. Macrophages and T lymphocytes around papillary dermal blood vessels may play a role in the pathogenesis of atrophoderma and anetoderma.
Adolescent↗
Dry period heat stress relief effects on prepartum progesterone, calf birth weight, and milk production.
Effects of cooling high producing dairy cows during the dry period were examined in 84 pluriparous Israeli-Holstein cows. Cooling was by a combination of wetting and forced ventilation from 0600 to 1800 h until parturition and common management afterwards for both groups. Cooling maintained diurnal increase in rectal temperature within .2 degrees C as compared with .5 degrees C in control cows in warmer months, Mean rectal temperatures at 1400 h in control cows were moderate, within 39.2 degrees C. Cooling did not affect prepartum or postpartum body condition score or mean blood progesterone during the dry period. Results suggested a possible increase in blood progesterone in later pregnancy by cooling during hot weather. Cooling increased mean 150-d milk production by 3.6 kg/d (3.1 kg FCM/d). Prepartum cooling negatively affected first lactation month yield in cows calving in early summer. Prepartum cooling might prevent adaptation to heat and impair subsequent postpartum performance. Prepartum progesterone was not related to milk yield. Calves' birth weight increased by cooling, but the effect was mostly in older cows. Birth weight was related to milk yield, independently of cooling effect, mostly in older cows. Cooling during the dry period might increase milk yield as it does during lactation. Results indicate possible benefit of cooling dry cows even under mild heat stress.
Animals↗
Thermal, productive, and reproductive responses of high yielding cows exposed to short-term cooling in summer.
Effect of cooling on body temperature, milk production, estrous behavior, and reproductive performance was examined in 66 estrous-synchronized, Israeli-Holstein dairy cows. Cooling was by an automated system, which actuated sprinkling (30 s) followed by forced ventilation (4.5 min) for 30-min periods. Cows were cooled 9 times/d between 0500 and 2100 h over 10 d, starting 1 d before expected estrus until d 8 post estrus. Cooling reduced typical diurnal rise of body temperature in summer heat-stressed cows by .5 to .9 degrees C, and body temperature was maintained close to normothermic temperature (38.6 degrees C). Milk production of cooled cows was 2.6 kg/d (+8%) above control at end of the cooling period. More cooled cows than noncooled exhibited standing estrous behavior; in noncooled cows, silent ovulations or anestrus were more frequent. Conception rate of cooled cows did not differ from control, suggesting need for a longer than a 10-d cooling period for improvement of fertility. The cooling system has potential to alleviate heat stress in dairy cows and to improve their thermal balance, productive, and reproductive performances.
Animals↗
Hyperthermia and body energy store effects on estrous behavior, conception rate, and corpus luteum function in dairy cows.
The reproductive performance of 74 Israeli Holstein dairy cows was examined during summer. Cows were fed prepartum to reach high (3.8) and low (2.6) body condition scores by 1 mo prepartum. After calving, half of each group were cooled seven times a day for 30 min by sprinkling and ventilation. Cows were inseminated starting 60 d postpartum. Daily mean body temperatures of cooled and noncooled cows were 38.6 and 39.2 degrees C, respectively, with differences between them reaching 1 degree C and more during the hot hours. Body condition affected only the time taken postpartum to the start of ovarian activity (26 d for high and 32 d for low body condition groups). Estrous behavior lasted longer in cooled (16 h) than in noncooled (11.5 h) cows of the low body condition group only. Conception rate was higher in cooled than in noncooled cows (59 vs. 17%). Pregnancy rate at 90 d postpartum was higher in cooled (44%) than in noncooled cows (14%). Progesterone concentrations were higher in inseminated nonpregnant and in noninseminated cyclic cooled cows than in noncooled cows and were similar in pregnant cows of both cooled and non-cooled groups. The present cooling method appears to have a high potential for improvement of summer fertility.
Animals↗
Classification systems for human immunodeficiency virus (HIV) infection.
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Acquired Immunodeficiency Syndrome↗
New concepts in viral wart infection.
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Carcinoma, Squamous Cell↗
High-dose oral and intravenous metoclopramide in doxorubicin/cyclophosphamide-induced emesis. A randomized double-blind study.
Emesis remains a major side effect of cancer chemotherapy. High-dose intravenous metoclopramide has proved to be effective antiemetic therapy for cisplatinum induced emesis. It has not been rigorously tested in nonplatinum chemotherapy. This double-blind, noncrossover, randomized trial compared high-dose oral and intravenous metoclopramide to standard oral prochlorperazine in emesis caused by doxorubicin [70 mg/m2 body surface area (BSA)] and cyclophosphamide (700 mg/m2 BSA). Prochlorperazine (10 mg/dose), oral metoclopramide, and intravenous metoclopramide (2 mg/kg/dose each) were given 30 min before chemotherapy and then every 4 h for 24 h. Ten patients were randomized to prochlorperazine therapy, 10 to oral metoclopramide, and 9 to i.v. metoclopramide. Median number of emeses for the first chemotherapy cycle was 3, 3, and 7 for prochlorperazine, oral, and i.v. metoclopramide, respectively. Statistical analysis showed no significant advantage of any regimen (p greater than 0.4). For patients who continued the antiemetic study, frequency of emesis increased with each successive cycle of chemotherapy. Six of 19 patients treated with metoclopramide developed dystonic reactions compared with zero of 10 on prochlorperazine. High plasma metoclopramide levels were achieved with both metoclopramide regimens and did not correlate with frequency of emesis. High-dose oral and i.v. metoclopramide in an every 4 h regimen did not show any advantage over standard antiemetic therapy for doxorubicin/cyclophosphamide-induced emesis and were associated with significant toxicity.
Administration, Oral↗
Cooling dairy cattle by a combination of sprinkling and forced ventilation and its implementation in the shelter system.
A method for cooling dairy cattle based on repeated wetting to attain maximal water trapping in the coat, followed by its rapid evaporation by using forced ventilation has been examined. Effects examined include duration of wetting, duration of cooling, and density of the animals in the holding area. The coat was wetted by inverted static sprinklers. Also examined was the extent to which the diurnal increase in rectal temperature can be prevented. The maximal decrement of temperature was attained at 30 min after cessation of cooling in all trials. Wetting the coat for 10 s was less effective than for 20 or 30 s; the latter did not differ in their effects. Cooling animals for 15, 30, and 45 min produced decrements in temperature of .6, .7, and 1.0 degrees C, respectively. Maintaining animals at a density of 1.9 m2/cow in the holding area reduced to about half the decrement as compared with a density of 3.5 m2/cow. When cows were cooled 5 times per day for 30 min, temperatures were maintained within 38.2 to 38.9 degrees C during the day, which were significantly lower than for those not cooled.
Animals↗
Upper critical temperatures and forced ventilation effects for high-yielding dairy cows in a subtropical climate.
Upper limit of thermal stability and subsequent rise of thermoregulatory functions as affected by forced ventilation were examined. Rectal temperature, respiratory frequency, ear skin temperature, body weight, and milk yield were recorded biweekly July to March over 2 yr for 170 Israeli-Holstein cows (305-day milk yield 9000 kg/cow) at air temperatures 10 to 36 degrees C. Cows were in an open shelter. One side was force ventilated over 2.5 m along the stanchions (air velocity 1.5 to 3 m/s) from 0500 to 2200 h. Control side mean air velocity was .5 m/s. Within the 10 to 24 degrees C range, rectal temperature was not affected by air temperature or forced ventilation but increased by .02 degrees C/kg fat-corrected milk in animals producing above 24 kg/day. Between 26 and 36 degrees C rectal temperature increased with air temperature in both groups; rate of rise was halved by forced ventilation. In this range of air temperature, rectal temperature increased with rising milk yield, as in the lower air temperature range, in both high-producing and lower-producing cows in forced ventilation. Body weight or parity did not have significant effects. Mean ear skin temperature was higher for control animals, but its rate of increase with air temperature was similar in both groups. Forced ventilation reduced mean respiratory rate. An upper critical temperature is 25 to 26 degrees C and is independent of milk yield or acclimatizational state of cows exposed to the natural sequence of climate.
Animals↗
Patterns of peripheral vasomotor function in near-natural conditions in the calf (Bos taurus).
Patterns of ear temperatures were examined in 2- to 45-day-old calves. At variable heat loads, peripheral temperature levels varied with the heat load with little fluctuations. When 2 to 3 days old, high ear temperatures were maintained for 10-14 hr/day at 10-15 degrees C ambient temperatures in 5 of 8 calves. In near-natural conditions, fluctuating ear temperatures were the rule in the vasodilated, intermediate and vasoconstricted states; fluctuations were symmetrical in the two ears in the vasodilated and intermediate states only. The possible occurrence of cold-induced vasodilation at 10-20 degrees C ambient temperature is discussed.
Aging↗
Effects of different forms of central nervous system prophylaxis on neuropsychologic function in childhood leukemia.
A comparison of the late effects on intellectual and neuropsychologic function of three different CNS "prophylaxis" regimens was conducted in 104 patients treated for childhood acute lymphocytic leukemia. Of the children studied, 33 were randomized to treatment with intrathecal (IT) methotrexate alone, 36 to IT methotrexate plus 2,400 rad cranial irradiation, and 35 to IT methotrexate plus intravenous intermediate dose methotrexate. All patients were in their first (complete) continuous remission, were a minimum of one year post-CNS prophylaxis and had no evidence of CNS disease at the time of evaluation. In contrast to the other two treatment groups, children whose CNS prophylaxis included cranial irradiation attained significantly lower mean Full Scale IQs (P less than .001), performed more poorly on the Wide Range Achievement Test, a measure of school abilities, and exhibited a greater number of difficulties on a variety of other neuropsychologic measures. The poorer performance of the irradiated group was independent of sex of the patient, time since treatment and age at diagnosis. These data suggest that the addition of 2,400 rad cranial irradiation to CNS prophylaxis in ALL puts these children at greater risk for mild global loss in intellectual and neuropsychologic ability.
Adolescent↗
Seborrheic keratoses: appearance in course of exfoliative erythroderma and regression associated with histologic mononuclear cell inflammation.
We observed a patient in whom large numbers of seborrheic keratoses developed in the course of a generalized dermatitis that progressed into an exfoliative erythroderma. A renal mass was finally discovered and was surgically excised. On microscopic examination, the kidney tumor proved to be a benign fibrous-walled, multilocular cyst. After removal of the renal cyst, the erythroderma and exfoliation subsided. A few months later, the seborrheic keratoses were noted to have become smaller, flatter, and fewer in number. Microscopic examination of five such involuting lesions showed, in each instance, mononuclear cell infiltration of the seborrheic keratoses. Our findings confirm earlier reports that seborrheic keratosis-like lesions developing during the course of widespread inflammatory cutaneous disorders may regress after control of the dermatosis and suggest that mononuclear cell inflammation may be the mechanism by which regression of these lesions is accomplished.
Aged↗
Blood flow distribution during artificially induced respiratory hypocapnic alkalosis in the fowl.
In birds, hyperthermia is normally associated with panting and progressive respiratory alkalosis. The effect of respiratory alkalosis on capillary blood flow distribution was examined by artificially hyperventilating normothermic fowls, thereby dissociating it of the normally occurring concomitant hyperthermia. In contrast with mammals, in which hyperventilation associated with hypocapnia reduced blood flow to the brain, uterus and other organs, in the hen blood flow distribution in most organs remained unaltered. This indicates that the potential change in acid-base balance which develops in the hyperthermic birds during panting is not likely to affect the regulation of blood flow. The comb and wattles were the only affected organs, in which capillary blood flow diminished to about 45% of normal values. This reduction did not prevent a vasodilatation in those organs in hyperthermic fowls, though it probably limited its full expression.
Alkalosis, Respiratory↗