PubMed Health⌕ Search

Biomedical subjects

B F Mandell

Publications and source records attributed to B F Mandell.

At least 19 recordsLinked to original sources
PubMed2001

Trends in rheumatic disease: update on new diagnostic and treatment strategies.

Advances in our understanding of the pathophysiology of rheumatic and immunologic diseases have led to improved therapies, such as tumor necrosis factor inhibitors and bisphosphonates. These drugs can not only alleviate symptoms but also alter the course of the disease. However, they also have significant potential side effects, which mandate, more than ever, correct diagnosis and vigilant monitoring for toxicity.

Adult↗
PubMed2000

Alveolar hemorrhage in systemic lupus erythematosus: presentation and management.

AIM: To describe our experience with alveolar hemorrhage (AH) in systemic lupus erythematosus (SLE). METHODS: Review of medical records and pertinent medical literature using MEDLINE and reference lists from retrieved publications. PATIENTS: Seven patients with SLE admitted with episodes of AH (n = 11). RESULTS: Six patients were female, and one was male. Mean age at the time of AH was 31.1 years. Mean duration of SLE was 4.5 years. AH occurred within 3 weeks of SLE onset in two patients. Recurrent AH was observed in four patients. Six patients were already receiving treatment for SLE at the time of AH. All patients presented with dyspnea and new pulmonary infiltrates. Hemoptysis occurred in only 54%. All patients had BAL within 48 h of presentation. Temperature > or =39 degrees C (102.2 degrees F) accompanied 82% of episodes. Glomerulonephritis was the most common nonpulmonary SLE manifestation (74%). Treatment with empiric IV antibiotics was initiated in 10 episodes. Initial treatment included high-dose corticosteroids (prednisone, 1 to 3 mg/kg/d [n = 2]; or IV methylprednisolone, 1 g/d [n = 9], with or without oral cyclophosphamide, 2 to 3 mg/kg/d [n = 7]). Plasmapheresis (three to four sessions) was added in five episodes for persistent AH. All patients survived. CONCLUSIONS: AH may mimic pneumonia. Hemoptysis may not be evident. Infection must be aggressively excluded, especially since many patients with AH are already receiving immunosuppressive therapy. AH frequently recurs despite ongoing immunosuppression. Although high mortality rates have been reported with AH in SLE, we observed 100% survival.

Adult↗
PubMed1999

General tolerability and use of nonsteroidal anti-inflammatory drugs.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are generally well tolerated medications but are associated with several adverse effects that may occur as a result of the physiologic effects of inhibition of cyclooxygenase (COX) or for idiosyncratic reasons. Selective COX-1-sparing NSAIDs may be associated with fewer COX-related complications, such as primary gastric injury and bleeding. Adverse effects in other organ systems including liver, skin, and bone may not be diminished with the use of selective COX inhibitors. Prevention of colonic polyps and adenocarcinoma of the colon seems to be mediated by inhibition of the COX-2 isoenzyme.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1999

Perioperative management of selected problems in patients with rheumatic diseases.

Patients undergoing surgery are subject to multiple perioperative problems. This article reviews several issues that occur in surgical patients with rheumatic diseases, including management of medications, diagnosis of fat embolism syndrome, prophylaxis against endocarditis, postoperative fever, and perioperative myocardial infarction.

Embolism, Fat↗
PubMed1999

COX 2-selective NSAIDs: biology, promises, and concerns.

Celecoxib (Celebrex) is the first of a new family of nonsteroidal anti-inflammatory drugs (NSAIDs) that selectively inhibit cyclooxygenase 2 (COX 2) while sparing COX 1. Clinical trials indicate that it is approximately as effective in relieving the pain of osteoarthritis and the pain and inflammation of rheumatoid arthritis as nonselective NSAIDs, but causes less gastrointestinal ulceration and bleeding. This paper reviews the pharmacology and possible clinical role of celecoxib and other COX 2-selective NSAIDs.

Adolescent↗
PubMed1998

Infections and systemic vasculitis.

Bacterial infections can clinically mimic a primary vasculitic syndrome and can directly cause a vasculitis that may respond to prompt recognition and treatment of the infection. Increasing direct and indirect evidence is establishing links between certain infections and vasculopathies, including aortitis, atherosclerosis, and Wegener's granulomatosis. The literature on the hepatitis viruses, particularly hepatitis C, and various vasculitic syndromes continues to grow. The spectrum of clinical syndromes, including "essential" cryoglobulinemia (elicited by the hepatitis viruses) and HIV, continues to broaden. Clinical trials have begun to demonstrate the therapeutic value of antiviral therapy in patients with these conditions.

Bacterial Infections↗
PubMed1997

Septic arthritis.

Septic arthritis is a medical emergency that can lead to significant morbidity and mortality. Prompt recognition and treatment are critical to ensuring a good prognosis. Thus, this article reviews the clinical presentation, microbiology, diagnostic workup, and outcome of nonprosthetic joint infections.

Aged↗
PubMed1995

Refractory osteoarthritis. Differential diagnosis and therapy.

The patient with osteoarthritis and severe or resistant pain should be evaluated for coexistent mechanical problems or distinct diseases. Treatment remains symptomatic and empiric. The value of many frequently used invasive therapies remains unproven given the large placebo response rate in osteoarthritis. In this article, the many new agents in development that may prove to be chondroprotective are discussed.

Diagnosis, Differential↗
PubMed1994

Differentiating the vasculitides.

The vasculitides represent a heterogeneous set of disorders that differ in prognosis and response to therapy. The initial approach to diagnosis should include distinguishing primary vasculitis from nonvasculitis disease and vasculitis associated with a separate underlying process. Subsequently, an attempt should be made to recognize the specific vasculitic disorder and initiate appropriate therapy. Diagnosis should be primarily made on the basis of the clinical pattern of disease and supported by tissue pathology, angiography, or appropriate laboratory tests.

Adult↗