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Biomedical subjects

G Bálint

Publications and source records attributed to G Bálint.

At least 19 recordsLinked to original sources
PubMed2001

[HLA genomic tissue typing in myasthenic patients with rheumatoid arthritis].

In a 36 years old male and a 56 years old female myasthenic patient thymectomy was performed several years ago. In the male patient 5, and in the female patient 7 years after the operation rheumatoid arthritis developed. The rheumatoid arthritis in the male patient was seropositive with marginal erosions in the carpometacarpal and in the tarsometatarsal joints. The female patient had no joint destruction and was seronegative as well. The female patient had also an abnormal ratio between the separated CD4 and CD8 T-cells. The major histocompatibility complex determined by the serological methods revealed a haplotype of HLA-A1-B8-D3-DQ2, which is typically due to the myasthenic disease. In the female patient the molecular analysis of the HLA-D region showed a HLA-DRB1* 0401 allele, which is frequently associated with rheumatoid arthritis. The male patient had no allelic variant which could be related to his chronic disabilitating joint disease.

Adolescent↗
PubMed2001

Etofenamate levels in human serum and synovial fluid following iontophoresis.

The absorption of etofenamate (CAS 30544-47-9, Rheumon gel) by iontophoresis in 11 patients with low back pain and in 13 patients with synovitis of the knee was evaluated. During the 5-day treatment period, the test gel in a quantity corresponding to 100 mg etofenamate was applied to affected body regions every day by 20-min iontophoresis sessions. Two hours after the fifth application, the concentration of etofenamate in serum and synovial fluid (in patients who had knee joint iontophoresis) were measured by HPLC. Iontophoresis of etofenamate into the lumbar region as well as to the knee joint resulted in consistent serum levels: 219 +/- 136.3 micrograms/l and 191 +/- 84.6 micrograms/l, respectively. In patients with synovitis of the knee, the synovial level of etofenamate (368 +/- 109.2 micrograms/l) was almost twice as high than the serum concentration. The authors conclude that with topical application of etofenamate by iontophoresis the drug appears not only in the serum but also--with higher levels--in the synovial fluid.

Administration, Topical↗
PubMed2000

Hereditary disorders mimicking and/or causing premature osteoarthritis.

Osteoarthritis is the most common joint disease, causing considerable disability and impairment of quality of life. Hereditary osteochondrodysplasias and some inborn errors of metabolism may mimic or cause premature osteoarthritis. Osteochondrodysplasias usually cause joint deformities, such as coxa vara or genu varum, which can cause abnormal biomechanics. In most of these disorders, the articular cartilage is originally defective as a result of genetically determined collagen or matrix protein abnormalities, or the deposition of mucopolysaccharides. In the case of inborn errors of metabolism, the pathological process affects healthy articular structures, causing secondary osteoarthritis. In alkaptonuria, the pathological deposition of polymerized homogenistic acid causes defective changes in cartilage, articular capsule and tendons. In Wilson's disease, the premature osteoarthritis might be caused by the copper deposition. It is worth paying attention to these rare disorders, even when they are mild or incomplete, because early diagnosis can lead to prevention and effective treatment. In addition, research is discovering the specific gene defects and molecular abnormalities that are responsible for disease expression. This may in turn lead to opportunities for prenatal diagnosis; thus, genetic counselling and gene replacement therapy may be a realistic possibility in the near future.

Adolescent↗
PubMed1999

[Caudal epidural injection in the management of lumbosacral nerve pain syndromes].

The effect of epidural steroid injections was assessed in 39 patients with lumbar nerve root compression syndromes in a double-blind controlled trial, the patients were allocated at random to 3 groups. In group A (n = 13) the patients received a caudal epidural injection of 1 ml (7 mg) bethametason (Diprophos) in 10 ml normal saline and 20 ml local anesthetic (Lignocaine 1%). The second group B (n = 13) received a caudal epidural injection of 20 ml local anaesthetic (Lignocaine 1%) and 10 ml normal saline. The third group C (n = 13) received a superficial injection of 1 ml (7 mg) bethametason around of the sacral hiatus. All injections were performed by the same experienced anaesthesiologist. An independent physician, who was not aware which type of injection had been given, carried out the clinical measurements and the evaluation. Taking of analgesic drug Tramadol was permitted. The symptoms were assessed by visual analogue scale (VAS 100 mm), lumbar flexion (Schober and finger-floor distance), the angle of raised leg sign (RLS degrees), and by complete neurological examination, the investigation was made 5 times (1 hour, 24 hours, 48 hours, 1 week, and 4 weeks after epidural injections). The results between 0-1 week and 0-4 week were statistically analysed by Student-, Wilcoxon-, and Mann-Whitney test and analysis of variance (ANOVA). The mean VAS values decreased in time in all patient groups. There was no difference between the three treatment groups either after one or after 4 weeks by ANOVA. The mobility of the lumbar spine improved in all patient groups, but there was no significant difference between the three treatment groups. The raised led sign--values improved in all patient groups. There was a significant difference between the three treatment groups by ANOVA after one week, due to the difference between group A and C. After four weeks there was no significant difference. No major complications or side effects were seen in our trial. The raised leg sign due to epidural steroid injection showed better results in comparison to steroid injection around of the sacral hiatus were seen.

Adrenal Cortex Hormones↗
PubMed1999

Cyclosporin and sulfasalazine combination in the treatment of early rheumatoid arthritis.

The aim of the study was to assess the efficacy of a new formulation of cyclosporin-A (CyA) and sulfasalazine (SASP) combination treatment in preventing disability and reducing inflammatory disease activity in patients with early rheumatoid arthritis, as well as to assess the tolerability, safety, and suitability for long-term treatment. Forty five patients with early, active rheumatoid arthritis, (RA) were treated with CyA and SASP combination therapy for 12 months. The patients were evaluated by disease activity and radiologic measurements. The combined CyA and SASP therapy seems to be effective. Disease activity parameters improved within 3 months. The individual treatment response rate according to EULAR response criteria was 78% after a one year treatment period. Five patients were withdrawn due to gastrointestinal side effect and two patients because of lack of efficacy. CyA and SASP combination treatment seems to be effective in early severe RA, and with careful monitoring, side effects can be kept under control.

Adult↗
PubMed1997

[Systemic mastocytosis].

The systemic mastocytosis is a rare disorder, however, the authors recently diagnosed two cases causing diagnostic problems. The diagnosis was proved by bone marrow biopsy in both patients. The authors review the diagnostic pathway considering the pitfalls. According to their conclusion, the most important factor in the diagnosis of systemic mastocytosis is to think of the possibility of systemic mastocytosis.

Aged↗
PubMed1997

Non-pharmacological therapies in osteoarthritis.

Non-pharmacological therapies are very important in osteoarthritis. Each form of this treatment should be individually devised, taking into account the anatomical distribution, the phase and the progression rate of the disease. Indications, contraindications, dosage and precautions are as important in non-pharmacological therapy as they are in drug treatment. Therapeutic exercises decrease pain, increase muscle strength and range of joint motion as well as improve endurance and aerobic capacity. Exercise programmes should be designed, conducted and regularly supervised by professionally trained physiotherapists. Weight reduction is of proven benefit in obese patients with osteoarthritis of the knee. Walking aids, crutches, shoe insoles, braces and patellar taping are useful tools in some form of osteoarthritis. Patient education and the management of the psychosocial consequences are priority tasks. Therapeutic heat and cold, electrotherapy, ultrasound, acupuncture, hydrotherapy and spa treatment are widely used, although the effects and benefits have not been fully established. Non-pharmacological therapies should undergo rigorous randomized controlled trials in a similar manner to pharmacological studies.

Aged↗
PubMed1996

Diagnosis of osteoarthritis. Guidelines and current pitfalls.

Diagnostic and classification guidelines for osteoarthritis based on clinical and radiographic signs for the most frequently involved joints (knee, hip and hand) have been developed by the American College of Rheumatology. Excellent, new 'high tech' biochemical and imaging methods and guidelines for clinical evaluation of the condition and its therapy have recently been developed and validated. Accordingly, we have consistent and reliable methods for assessing the established condition, but they provide little help in making an early and correct diagnosis for the different forms of osteoarthritis. Both the diagnostic process and the differential diagnosis consist of careful history taking and detailed analysis of the complaints (especially pain), with proper physical examination including a search for the source of pain and tenderness. Not all deformities and pain in and around the joints are signs and symptoms of osteoarthritis, even if the patient is of 'osteoarthritis age' and the joint shows 'osteoarthritis signs' on the x-ray. On the other hand, even if the underlying disease is osteoarthritis, the symptoms and signs may be due to disorders secondary to the basic disease (e.g. enthesopathy or tendinopathy) and the patient's complaints can be helped more easily by physiotherapy and local injections. The course of the disease and close follow-up yield diagnostic clues in cases where the cross-sectional diagnostic measures fail to provide them. Analysis of serum, joint fluid and x-ray films can be of diagnostic value, and other imaging methods (ultrasound, radioisotope scanning, computerised tomography, magnetic resonance imaging, arthroscopy) are also useful tools. Differential diagnosis is not only of theoretical value; misdiagnosis of osteoarthritis leads to either omitted or unnecessary treatment, and causes psychological stress to the patient.

Diagnosis, Differential↗
PubMed1996

Clinical immunotoxicity of antirheumatic drugs.

Non-steroidal antiinflammatory drugs (NSAIDs), corticosteroids and disease modifying antirheumatic drugs are commonly used for the treatment of the inflammatory rheumatic diseases. In addition to their antiinflammatory effects, many of these drugs influence an otherwise impaired immune system, which may result clinically in decreased resistance to infection and/or increased incidence of malignancies, in stimulation of the immune response and autoimmune diseases, or in allergy or hypersensitivity. Only corticosteroids increase considerably the risk of infections, immunosuppressive agents-at the low doses used in rheumatology-do not have this effect. Although the data are conflicting, neoplasms, especially leukaemias and lymphomas seem to develop more frequently during immunosuppressive treatment. Methotrexate, most commonly used nowadays in the early stage of joint disease, does not seem to increase the risk of malignancies. Although several drugs may induce autoimmune diseases, d-penicillamine is the commonest inducer. NSAIDs have the greatest propensity to produce allergy or hypersensitivity, causing various cutaneous, renal, and bronchial symptoms, and rarely vasculitis. Methods for the measurement of their plasma concentrations are available for most of the drugs, although not routinely used. Clinical vigilance, regular check-ups and full knowledge of side effects are crucial in the diagnosis of drug-induced immunotoxicity, especially because the symptoms and signs of immunotoxicity may mimic the naturally occurring features of the underlying disease.

Adrenal Cortex Hormones↗
PubMed1995

Ultrasound-guided aspiration in suspected sepsis of resection arthroplasty of the hip joint.

The authors described 17 patients who had had resection arthroplasty of the hip and who were suspected of having an infection. The resection arthroplasties had been performed for previous infection. All the patients were studied by ultrasonography to detect effusion in the pseudoarticular space. Thirteen of the 17 patients were found to have an effusion by ultrasonography. Fluid was obtained in 9 of the 13 patients by ultrasonographic-guided aspiration. The mean aspirated volume was 3 ml (range 1-25 ml). Five of the 9 aspirates proved to be septic. The echopattern in all but one of those five with sepsis was nonechofree. Of four other patients in whom it was not possible to aspirate fluid lavage of the pseudoarticular space one yielded a positive culture. The role of ultrasonography in the diagnosis and management of patients who have undergone resection arthroplasty of the hip and who are suspected of having an infected pseudoarticular space is discussed.

Aged↗