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E F Morand

Publications and source records attributed to E F Morand.

43 records · Page 3Linked to original sources
PubMed1993

Idiopathic polymyositis complicated by arthritis and mesangial proliferative glomerulonephritis: case report and review of the literature.

A 56-yr-old male developed a systemic illness while receiving cyclical oral etidronate therapy for idiopathic osteoporosis. The illness, characterized by fever, proximal myopathy and inflammatory synovitis, was associated with interstitial lung disease and mesangial proliferative glomerulonephritis. Elevated plasma creatine phosphokinase level and inflammatory muscle biopsy findings confirmed a diagnosis of polymyositis (PM). Antibodies to Jo-1 were also detected. A review of the literature reveals that mesangial proliferation is the commonest glomerular lesion and suggests a possible association between arthritis and glomerulonephritis in PM. The prognosis of this renal lesion appears to be good, although only limited data is available.

Arthritis↗
PubMed1993

Connective tissue disease: an approach.

The connective tissue diseases are a poorly defined group of conditions characterised by abnormal activity of the immune system. This article will not detail the features of any one condition, but rather attempt to provide a system for the evaluation and classification overall and thus hopefully enable the reader to approach these complex conditions with greater confidence.

Connective Tissue Diseases↗
PubMed1992

Continuation of long term treatment with hydroxychloroquine in systemic lupus erythematosus and rheumatoid arthritis.

BACKGROUND: Hydroxychloroquine is used for the treatment of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Long term studies have shown a high rate of termination of hydroxychloroquine treatment in patients with RA. Although it has been shown that discontinuation of treatment with hydroxychloroquine is associated with exacerbation of SLE, long term maintenance rates of treatment with hydroxychloroquine in patients with SLE have not been investigated. METHODS: Hydroxychloroquine use in patients with RA and SLE in a group of patients in a single community rheumatology practice was studied. Information was drawn from a computer drug use database containing details of the beginning and end of treatment. Data were analysed using life table methods. RESULTS: Four hundred and three treatment episodes (366 patients with RA, 37 patients with SLE) were observed over eight years. In patients with RA, the cumulative probability of discontinuing treatment was 37% at 12 months and 54% at 24 months. In contrast, hydroxychloroquine treatment of patients with SLE continued over significantly longer periods of time (p < 0.001); the discontinuation probabilities at 12 and 24 months were 8 and 24% respectively. Treatment terminations were predominantly for inefficacy; terminations for toxicity were limited to the first 19 months of treatment. No ocular toxicity was observed. CONCLUSIONS: Treatment of patients with RA in a community rheumatology practice with hydroxychloroquine has a low probability of long term continuation, mostly because of inadequate control of disease manifestations rather than toxicity. In patients with SLE, treatment with hydroxychloroquine has a significantly higher probability of long term continuation.

Adult↗
PubMed1992

Life table analysis of 879 treatment episodes with slow acting antirheumatic drugs in community rheumatology practice.

In 596 patients with RA managed over a decade in a community practice setting, 879 slow acting antirheumatic drug (SAARD) treatment episodes were analyzed using 5-year life tables. The probability of continuation of therapy was 50% by 9-24 months for all drugs except for methotrexate (MTX), which was 62% by 5 years [corrected]. MTX treatments were of significantly longer duration than those of all other SAARD (p less than 0.001); terminations for both inefficacy (p less than 0.001) and toxicity (NS) were less likely. These findings concur with recent evidence suggesting that MTX is a superior SAARD in this setting.

Adult↗
PubMed1990

Medical problems in joint replacement patients: a retrospective study of 243 total hip arthroplasties.

Two hundred and forty-three total hip arthroplasties were performed in 217 patients over a five-year period in one institution. Seventy-one per cent had one or more significant preoperative medical problems, 22% being referred for preoperative management to a specialist physician. Thirty per cent of patients experienced re-activity of medical problems after operation; in 41% of patients a physician review was sought while in a further 40% the problems were apparently unnoticed or not acted upon. There was a positive correlation between preoperative and postoperative medical problems (P less than 0.001). Fifteen per cent of patients developed complications and one patient died. There was a highly significant trend towards longer hospital stay in patients with medical problems and complications (P less than 0.001). It is concluded that there is a high incidence of medical problems in joint replacement patients, that these problems have an influence on the morbidity and cost of the procedure, and that management of these problems can be improved.

Acute Kidney Injury↗