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Biomedical subjects

D H Neustadt

Publications and source records attributed to D H Neustadt.

17 recordsLinked to original sources
PubMed1997

Double blind evaluation of the long-term effects of etodolac versus ibuprofen in patients with rheumatoid arthritis.

We compared the longterm efficacy and safety of 2 dosages of etodolac with that of ibuprofen in the treatment of active rheumatoid arthritis (RA). The ability of etodolac to retard, arrest, reverse, or heal joint damage due to RA was also evaluated. Patients in the early stages of RA were assigned randomly to 3 parallel groups for up to 3 years of therapy: etodolac at 150 mg bid, etodolac at 500 mg bid, and ibuprofen 600 mg qid. Concurrent disease modifying antirheumatic drugs were not permitted; established low dosage corticosteroid therapy could be continued. A total of 1446 patients was enrolled. About 50% of patients completed one year; dropout rates were comparable between groups. Both etodolac dosages provided comparable efficacy to that of ibuprofen during the first 2 months; longterm assessment showed that 1000 mg/day of etodolac produced superior improvement as assessed by patients' opinions and number of swollen joints. About 2% of patients in each group achieved remission, and radiographs showed no difference in disease progression between treatments. The incidences of adverse events were comparable, although dyspepsia and rash occurred less frequently with 300 mg/day of etodolac than with 2400 mg/day ibuprofen. A higher incidence of gastrointestinal ulcers and bleeding was seen with ibuprofen. Changes in hepatic and renal function were of minor clinical significance and were similar between the 3 groups. Both dosages of etodolac were comparable to 2400 mg/day ibuprofen in treating RA. All 3 treatment regimens were well tolerated.

Adult↗
PubMed1991

GM-CSF in the treatment of Felty syndrome.

Many therapeutic agents have been tried with variable success in the treatment of Felty neutropenia, but the reports are anecdotal. We now describe the second trial of recombinant granulocyte-macrophage colony-stimulating factor (GM-CSF), in a splenectomized, infected patient with Felty syndrome.

Felty Syndrome↗
PubMed1990

Dapsone is an effective therapy for the skin lesions of subacute cutaneous lupus erythematosus and urticarial vasculitis in a patient with C2 deficiency.

The deficiency of second component of complement (C2d) is the most common hereditary complement deficiency. Patients with C2 deficiency are frequently associated with an auto-immune disease process, in particular, systemic lupus erythematosus (LE)-like syndrome and/or vasculitic syndrome or bacterial infections. C2d has been associated with the LE subset of subacute cutaneous LE (SCLE), the presence of anti-Ro (SSA) antibodies, and the human leukocyte antigen (HLA) types A10, B18, DR2. We describe the clinical, serologic and immunogenetic data in a patient with manifestations of Sjögren's syndrome who developed urticarial vasculitis and photosensitive annular SCLE which were effectively treated with oral dapsone. Our case illustrates the dynamic nature of LE.

Administration, Oral↗
PubMed1977

Ankylosing spondylitis.

Ankylosing spondylitis occurs chiefly in young men and affects principally the sacroiliac, apophyseal, and costovertebral joints. Physical findings may be minimal, and special tests may be necessary to find objective evidence of the disease. HLA-B27 histocompatibility antigen is present in 90% to 95% of patients. The feature of highest diagnostic significance is the roentgenographic finding of syndesmophytes. The natural course of the disease is characterized by spontaneous remissions and exacerbations and by possible arrest at any stage. In general, the prognosis is good for maintenance of functional ability despite the development of severe back deformities. In management, emphasis must be given to maintaining normal posture and body habitus and to encouraging the patient to cope with individual needs and problems. If basic measures, including salicylate therapy, do not control the disease, additional drug therapy must be initiated. Surgical intervention is a last resort.

Adolescent↗
PubMedDate not supplied

Long-term efficacy and safety of intra-articular sodium hyaluronate (Hyalgan) in patients with osteoarthritis of the knee.

OBJECTIVE: This prospective cohort study evaluated the long-term efficacy and safety of 5 weekly intra-articular (i.a.) injections of sodium hyaluronate (Hyalgan) in 76 patients (92 knees) with moderate to severe osteoarthritis (OA) of the knee whose pain was not controlled by conventional measures. RESULTS: Thirteen patients had a repeat treatment course. A total of 72% of patients achieved > 50% improvement (defined by physical examination and assessment of pain using a visual analog scale [VAS]) for 1 year or longer; 9% of patients failed to achieve > 50% improvement for any period of time. The duration of response exceeded 2 years in some patients. Total knee replacement surgery was avoided or significantly delayed in 15 of 19 patients who were considering surgery prior to the injections. Ten of 15 (67%) knees improved after a repeat treatment course. Local adverse events were minor and infrequent. CONCLUSION: Intra-articular sodium hyaluronate was an effective and safe treatment for pain in difficult-to-treat patients with moderate to severe OA of the knee.

Activities of Daily Living↗