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Biomedical subjects

D Buskila

Publications and source records attributed to D Buskila.

At least 19 recordsLinked to original sources
PubMed1992

Mud pack therapy in rheumatoid arthritis.

Twenty-eight patients with classical or definite rheumatoid arthritis were randomly divided into two groups of fourteen patients each. All patients were treated once a day with mud packs derived from the Dead Sea heated to 40 degrees C and applied over the four extremities, neck and back for 20 minutes. Group 1 was treated with the true mud packs and Group 2 with washed out and less concentrated mud packs. The study was double blind and of two weeks duration. All patients were evaluated by one rheumatologist both before treatment and two weeks later at the end of the treatment period. Follow-up evaluations were made one and three months after conclusion of the treatment. The clinical indices evaluated included duration of morning stiffness, hand-grip strength, activities of daily living, patient's own assessment of disease activity, number of active joints and the Ritchie index. A statistically significant improvement (p less than 0.01 or p less than 0.05) was observed in Group 1 only in most of the clinical indices, lasting between 1 to 3 months.

Arthritis, Rheumatoid↗
PubMed1992

Polyarthritis associated with hydatid disease (echinococcosis) of the liver.

A 36-year-old male developed asymmetric polyarthritis during the course of hydatid disease of the liver. Excision of the hydatid cyst was accompanied by full remission of the arthritis without recurrence during the 7-year follow-up period. This sequence of clinical events suggests an eventual cause and effect relationship. A "reactive" immune mechanism, triggered by a parasite located at a distant site, appears to be responsible for this type of arthritis.

Adult↗
PubMed1992

HLA alleles in systemic sclerosis: association with pulmonary hypertension and outcome.

HLA antigen distribution was studied in 126 patients with systemic sclerosis (SSc) followed prospectively and compared to that of 325 healthy controls. The frequencies of HLA antigens DR3, DR5 and DRw52 were increased in patients with diffuse skin involvement (P = 0.02, 0.05, 0.03). The presence of DRw52 (relative risk [RR] much much greater than 1) and DRw6 (RR = 54.5) was associated with significantly increased risks of a fatal disease outcome with pulmonary hypertension (PHT). In the absence of PHT, DRw252 was inversely associated with the risk of death. These findings indicate an adverse prognosis in SSc when PHT is present in association with DRw52.

HLA Antigens↗
PubMed1992

Followup in psoriatic arthritis: relationship to disease characteristics.

We investigated whether patient disease characteristics can explain differences in patients registered at the psoriatic arthritis clinic before 1987 who were seen regularly (139, "regular") to those who had not been seen for 2 years before 1989 (165, "inactive"). Despite a higher percentage of women in the regular group (p = 0.0058), logistic regression analysis identified no significant differences in disease severity or treatment at the first or last assessment before 1987. A followup study in 1989 revealed that of the 165 inactive patients, 20 had died and 64 had moved away. Of the 81 remaining patients, 18 were not interested, 18 were seeing other physicians, and 45 returned for followup. The latter 45 patients were compared to 85 of the regular patients who were seen during the same period. Both groups demonstrated similar disease attributes at first and last assessments before 1987. At their 1989 assessments, the same degree of disease progression was noted in both groups. Thus, loss to to followup appears to be random, and should not influence further studies of these patients.

Adult↗
PubMed1992

The utility of the arthritis impact measurement scales for patients with psoriatic arthritis.

The Arthritis Impact Measurement Scales (AIMS) consists of 9 scales that measure physical function, pain and psychosocial function. It has been validated for use in various forms of arthritis, but not in psoriatic arthritis (PsA). The AIMS was administered to 145 patients attending our PsA clinic. We carried out simultaneous assessment of clinical measures of function, measures of disease activity, and measures of disease severity. Most scales of physical function were moderately to highly correlated with clinical measures of function (r = 0.33-0.57; p = 0.0001), measures of disease activity (r = 0.24-0.53, p = 0.003-0.0001), and measures of disease severity (r = 0.23-0.6; p = 0.02-0.0001). The pain scale was highly correlated with clinical measures of function and measures of disease activity (r = 0.38-0.58; p = 0.0001) but not with measures of disease severity. Of the psychosocial scales, the depression scale was moderately correlated with clinical measures of function (r = 0.27-0.3; p = 0.001-0.0001). Our data suggest that the physical function and pain scales are good indicators of overall function and disease activity and are valid for use in PsA.

Activities of Daily Living↗
PubMed1992

Patients with rheumatoid arthritis are more tender than those with psoriatic arthritis.

Articular and nonarticular tenderness was examined in 51 patients with rheumatoid arthritis (RA) and 50 patients with psoriatic arthritis (PsA) by scored palpation and dolorimeter readings. Fifty-seven percent of patients with RA had 10 or more tender fibrositic points vs 24% of patients with PsA (p = 0.0008). Thresholds of tenderness measured by dolorimetry of 6 fibrositic point sites were 3.97 (1.99) [mean (SD)] for RA vs 5.95 (2.28) for PsA (p less than 0.0001). Thresholds over actively inflamed joints were 4.19 (1.53) for RA vs 6.78 (2.55) for PsA (p less than 0.0001). In both RA and PsA, fibrositic sites were more tender than actively inflamed joints (p less than 0.0001). Nonarticular control sites were also more tender in subjects with RA with dolorimeter thresholds at 5.99 (1.96) in RA vs 7.58 (1.60) in PsA (p less than 0.0001). These data demonstrate that actively inflamed joints, fibrositic and control nonarticular sites were all more tender in patients with RA than PsA. Both groups were similar in their disease duration and clinical assessments of joint inflammation and damage. We suggest that there may be a disease specific diffuse increase in tenderness in patients with RA, which is not related to joint inflammation. Similarly, the severity of articular inflammation may be underestimated in subjects with PsA.

Adult↗
PubMed1992

Psoriatic spondyloarthropathy in men and women: a clinical, radiographic, and HLA study.

Psoriatic spondyloarthropathy as defined by the presence of inflammatory back pain and stiffness, sacroiliitis on physical examination, radiographic evidence of grade greater than or equal to 2 sacroiliitis, and classical or paramarginal syndesmophytes on spinal radiographs was identified in 82 women and 112 men followed at the Psoriatic Arthritis Clinic according to a standard protocol. A logistic regression analysis was performed to look for variables which discriminate between men and women with this condition. No differences in type of peripheral arthritis, degree of damage, or medication were noted between the two groups. However, there was some evidence for more advanced spondyloarthropathy in men. There were no differences in the frequency of HLA B27 or any of the psoriatic arthritis-related HLA antigens. Thus, there may be gender-related differences in the expression of psoriatic spondyloarthropathy, which are unrelated to HLA antigens.

Adult↗
PubMed1992

Control and "fibrositic" tenderness: comparison of two dolorimeters.

It can be as important to quantify lack of tenderness, as tenderness. Palpation detects tenderness only; dolorimeters with a limited scale restrict ability to assess variations in thresholds at clinically nontender sites. Such variations must be measured if we are to evaluate generally acting factors affecting tenderness. We measured thresholds at "fibrositic" and control sites in 8 subjects, using 2 observers and 2 different dolorimeters. The traditional Chatillon dolorimeter yielded twice as many readings off the 9 kg scale (17 of 96 versus 8 of 96) as the Fischer instrument, with a scale of 11 kg [continuity corrected (chi 2 = 3.725, p = 0.086)/bd. The Fischer instrument also used a footplate with a smaller diameter, and results using the 2 instruments were not parallel. Median values were the same (5.1 kg), but the Fischer instrument gave lower readings at tender sites (10th percentile 2.4 versus 2.9 kg) and higher values at nontender sites. Thresholds at fibrositic and control sites were significantly correlated, reinforcing evidence of generally acting factors affecting tenderness.

Analysis of Variance↗
PubMed1992

Mortality in systemic sclerosis (scleroderma).

Two hundred and thirty-seven patients with systemic sclerosis were followed prospectively in a scleroderma clinic. The overall 3, 6, and 9-year survival rates were 86, 76 and 61 per cent respectively. Renal, cardiac and pulmonary disease, and older age at enrollment were adverse prognostic factors associated with reduced survival. There were no significant differences in survival between males and females or in patients with restricted compared to those with diffuse skin thickening. Death from systemic sclerosis was most frequently due to pulmonary hypertension, with fewer than expected deaths from renal or cardiac causes. Twenty-eight per cent of deaths were due to causes unrelated to systemic sclerosis, most commonly cancer and ischaemic heart disease, and in older patients.

Coronary Disease↗
PubMed1992

The detection of anti-Ro/SS-A and anti-La/SS-B activity of human serum monoclonal immunoglobulins (monoclonal gammopathies).

The sera of 340 patients with monoclonal gammopathies were examined for the presence of anti-Ro/SS-A and anti-La/SS-B activity. An enzyme-linked immunosorbent assay (ELISA) technique was employed. Forty-six sera (13.5%) bound to Ro/SS-A, while 79 sera (23.2%) bound to La/SS-B. The anti-Ro/SS-A and anti-La/SS-B antibodies were found in sera of patients with IgG, IgM, and IgA gammopathies. Forty-two of the 46 sera (91.3%) with positive anti-Ro/SS-A activity were found to bind La/SS-B as well, while only 53.2% (42 out of 79) of the sera that had anti-La/SS-B activity also bound Ro/SS-A. The activity against Ro/SS-A and La/SS-B was further confirmed by immunoblotting with purified immunoglobulins. Antibodies to Ro/SS-A and La/SS-B are common in systemic lupus erythematosus, Sjögren's syndrome, and other rheumatic disorders. Yet none of the patients whose serum was found to contain high titres of anti-Ro/SS-A or anti-La/SS-B human monoclonal antibodies presented with symptoms related to such autoimmune diseases. Our results of a high incidence of anti-Ro/SS-A or anti-La/SS-B activity in the sera of patients with monoclonal gammopathies support previous reports of autoantibody properties characteristic of these immunoglobulins.

Antibodies, Antinuclear↗