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Biomedical subjects

D Kredich

Publications and source records attributed to D Kredich.

8 recordsLinked to original sources
PubMed2001

Effects of inherited thrombophilic mutations in an adolescent with antiphospholipid syndrome and systemic lupus erythematosus.

Thrombophilia can result from either inherited or acquired conditions. We describe a teenager who developed extensive thrombosis requiring aggressive and prolonged anticoagulation. Laboratory evaluation revealed an acquired lupus anticoagulant, consistent with the antiphospholipid antibody syndrome (APS). DNA analysis revealed inherited thrombophilic mutations in the factor V and methylene tetrahydrofolate reductase genes. We believe that the combination of inherited and acquired hypercoagulable conditions affected her therapeutic response to anticoagulant therapy. Inherited thrombophilic DNA mutations may contribute to the hypercoagulability observed in patients with acquired thrombophilic conditions such as APS and systemic lupus erythematosus.

Adolescent↗
PubMed1998

The first certifying examination in pediatric rheumatology.

OBJECTIVE: On May 12, 1992, the first certifying examination in pediatric rheumatology was administered by the American Board of Pediatrics to 94 candidates. We describe the certifying process and the characteristics of the examinees. METHODS: The Sub-board of Pediatric Rheumatology developed an examination consisting of 235 multiple choice items covering a broad range of topics pertinent to the subspecialty. Applicants with a current certificate in general pediatrics and a current medical license were admitted through one of 3 pathways requiring 2 years of fellowship training or equivalent practice experience. RESULTS: Sixty-three percent of the candidates had completed at least 2 years of fellowship training. The total group average score was 76% correct. Eighty-five percent of the examinees passed the examination. CONCLUSION: The 80 candidates who were certified received time limited certificates that may be renewed by a recertification process to begin in 1999. A second certifying examination was offered in 1994 and a third in 1996. Requirements for future certifying examinations will include 3 years of full time fellowship training and verification of meaningful accomplishment in research.

Adult↗
PubMed1991

Disease experience and psychosocial adjustment in children with juvenile rheumatoid arthritis: children's versus mothers' reports.

Adjustment in children with juvenile rheumatoid arthritis (JRA) has been evaluated most frequently by parental or teacher reports and with reference to disease severity. In this study, 38 children, ages 7 to 13 with JRA, and their mothers were interviewed. Modest correlations were found between children and mothers in their assessments of children's perceived competence in several domains (i.e., athletic competence, social acceptance, physical attractiveness, and global self-worth) and in their perceptions of how JRA is experienced by children and families. Children's perceptions of the disease experience were significantly correlated with the four measures of perceived competence, even after controlling for disease severity. The results highlight the importance of cross-validating parental reports with children's self-reports, and demonstrate the need to consider variables other than disease severity--in particular how JRA is interpreted by children--in predicting their adjustment.

Adaptation, Psychological↗
PubMed1990

Pediatric spondyloarthropathies.

Seronegative spondyloarthropathies in childhood are often misdiagnosed as juvenile rheumatoid arthritis, but recognition of their distinct clinical manifestations and unique underlying pathophysiologies can aid in making a proper diagnosis. Ankylosing spondylitis, Reiter's syndrome, psoriatic arthritis, and the arthritis associated with inflammatory bowel disease are arthritides most often found in young adults, but they may also be present in children. Extraarticular manifestations include inflammation of the eyes, skin, gastrointestinal tract, and genitourinary tract associated with inflammation of the entheses. The proper diagnosis will allow for treatment regimens that differ from those usually used for juvenile rheumatoid arthritis. Early diagnosis and treatment often lead to an early recovery and a return to normal daily activities.

Adolescent↗
PubMed1986

Flurbiprofen in the treatment of juvenile rheumatoid arthritis.

Thirty-four patients with juvenile rheumatoid arthritis, who were treated with flurbiprofen at a maximum dose of 4 mg/kg/day, had statistically significant decreases from baseline in 6 arthritis indices after 12 weeks of treatment. Improvements were seen in the number of tender joints, the severity of swelling and tenderness, the time of walk 50 feet, the duration of morning stiffness and the circumference of the left knee. The most frequently observed side effect was fecal occult blood (25% of patients); however, there was no other evidence of gastrointestinal (GI) bleeding in these patients. One patient was prematurely discontinued from the study for severe headache and abdominal pain. Most side effects were mild and related to the GI tract.

Abdomen↗