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Biomedical subjects

B S Gottlieb

Publications and source records attributed to B S Gottlieb.

4 recordsLinked to original sources

Discontinuation of methotrexate treatment in juvenile rheumatoid arthritis.

OBJECTIVE: Children with juvenile rheumatoid arthritis (JRA) treated with methotrexate (MTX) were examined for their course after the discontinuation of the drug to define the relapse and remission rates and to identify predictors of relapse. METHODOLOGY: A retrospective chart review of all patients with JRA was conducted in two pediatric rheumatology centers. A total of 101 patients being treated with MTX were identified. Dose, response to the drug, and length of time until reaching a state of complete control were noted. The outcome of patients with a complete response in whom the drug was discontinued was examined with regards to length of time to relapse or continued remission. RESULTS: In 25 patients, MTX was discontinued after reaching complete control of the disease. There were no statistically significant predictors of response to MTX identified. Of 25 whose MTX was discontinued, relapse occurred in 13 (52%) after a mean of 11 months after discontinuation. There was no significant difference among patients who relapsed or those who remained in remission as to sex, subtype of JRA, number of months to complete control, or number of months in complete control until discontinuing MTX. Patients younger than 41/2 years at diagnosis were found to be more likely to relapse than patients diagnosed at a later age. In 10 of the patients who relapsed, complete control was induced within a mean of 7 months after restarting MTX. CONCLUSION: The optimal time for discontinuing MTX in children with JRA who have achieved complete control is unknown. Relapse occurred in approximately half of the patients in whom MTX was discontinued. Because response to reinstitution of the drug is good, it is reasonable to discontinue MTX after prolonged complete control. It remains to be seen whether the relapse rate can be improved by waiting for longer periods of time in complete control before its discontinuation.

Adolescent↗

Methotrexate treatment of Wegener granulomatosis in children.

Wegener granulomatosis traditionally has been treated with glucocorticoids and cyclophosphamide. Both the disease and its treatments are associated with significant morbidity and mortality rates. There has been an effort to find effective but less toxic alternative treatments. We describe three children with Wegener granulomatosis who responded well to treatment with glucocorticoids and methotrexate, similar to a regimen used in adults.

Adolescent↗

Alleviation of autotransfusion-induced haematological damage by corticosteroids.

Thrombocytopenia and haemolysis in intraoperative autotransfusion result mainly from extravascular tissue contact and therefore are not correctable by mechanical improvements in the autotransfusion apparatus. Instead, attention must be directed towards prevention of blood 'recognition' of extravascular tissue or stabilization of blood components against this damage. Methylprednisolone is shown to be effective in alleviating red cell and platelet damage induced by intraoperative autotransfusion in the canine model.

Animals↗

A comparison of response exaggeration techniques.

Compared the effectiveness of several response exaggeration techniques. Socially anxious college males (N = 34) were instructed to exaggerate some component of social anxiety onset. One group exaggerated their attending to manifestations of their anxiety, two groups exaggerated either a relevant or irrelevant anxiety response, a fourth group imagined an exaggerated consequence of their anxiety, and a fifth group served as a placebo control. All groups reported a greater willingness to initiate and maintain an interaction with a female and displayed less anxiety in a role-playing situation; no differential treatment effects were found. These findings fail to support results from other studies that attested to the efficacy of response exaggeration techniques.

Anxiety↗