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J J Biundo

Publications and source records attributed to J J Biundo.

9 recordsLinked to original sources

Suprascapular neuropathy during progressive resistive exercises in a cardiac rehabilitation program.

A 56-year-old man developed left shoulder pain three weeks after starting a cardiac rehabilitation program, which consisted of submaximal aerobic and progressive resistive exercises. Pain in the left shoulder intensified and weakness developed one week later. He sought medical attention ten weeks after the onset. Physical examination showed only weakness of left shoulder abduction and external rotation with mild atrophy of the left supraspinatus and infraspinatus muscles. Electrodiagnostic study showed fibrillation potentials and positive sharp waves in the left supraspinatus and infraspinatus muscles with delayed conduction to the supraspinatus. The left suprascapular notch was injected with local steroid. Within one week, improvement occurred, and one month later the patient was pain free and stronger. The motor latency returned to normal, and no fibrillations nor positive waves were seen. The patient returned to his previous functional level. Suprascapular neuropathy should be considered as a cause of shoulder pain and weakness in a person involved in any strengthening exercise program. A steroid injection of the suprascapular notch performed early may avoid the need for surgery.

Angioplasty, Balloon, Laser-Assisted

The rarity of Felty's syndrome in blacks.

Evidence is presented that Felty's syndrome (FS) is rare among black patients with rheumatoid arthritis (RA). All of 12 patients with FS seen at Parkland Memorial Hospital, Dallas, Texas betwen 1964 and 1978 were white. During this period 52% of patients admitted to the Parkland medical service were black and 31% of patients dischargd with a diagnosis of RA were black. The number of expected black cases of FS on the basis of the racial distribution of hospitalized patients with RA was 3.7 (P is less than 0.02 when the zero incidence in blacks was compared with the expected incidence). All 7 cases of FS observed at Charity Hospital, New Orleans, Louisiana between 1968 and 1978 were also white. During this period, 65% of patients discharged with a diagnosis of RA were black, and the number of expected black cases of FS was 4.5 (P is less than 0.001). These findings suggest a genetic basis for the development of leukopenia and splenomegaly in RA patients.

Adult

Aortic insufficiency with mild ankylosing spondylitis in black men.

Two black male patients with aortic insufficiency were later found to have mild, asymptomatic ankylosing spondylitis, evident from roentgenograms and from the presence of HLA-B27 antigen. The two cases emphasize the even "subclinical" ankylosing spondylitis may have aortic insufficiency, and that the uncommon occurrence of ankylosing spondylitis in black patients may also be associated with this extra-articular manifestation.

Aged

Rheumatic diseases. 1. Differential diagnosis.

In a case of rheumatic disease, the patient's history and a careful physical examination should yield most of the information needed to identify the specific disorder present. A convenient classification is based on four differentiating features: number of joints affected, acuteness or chronicity of disease, absence of joint involvement, and anatomic distribution.

Arteritis

Rheumatic diseases. 2. Therapeutic considerations.

In the management of rheumatic diseases, the use of corticosteroids should be reserved for active arthritis. Phenylbutazone (Butazolidin) is probably the drug of choice for acute gout and is also effective in ankylosing spondylitis, Reiter's syndrome, and psoriatic arthritis. Indomethacin (Indocin) also is useful in these conditions. Ibuprofen (Motrin) is only slightly more efficacious than aspirin. Aspirin is still the preferred treatment for rheumatoid arthritis and should be tried before ibuprofen. Osteoarthritis of the cervical or lumbar spine calls for a full program of physical therapy. Experimental procedures for total replacement of joints other than hip and knee show promise.

Adrenal Cortex Hormones

Incidence of serum anti-DNA precipitins in patients with systemic lupus erythematosus by counterimmunoelectrophoresis.

The technique of counterimmunoelectrophoresis (CIE) has been adapted for detection of serum precipitins to calf thymus (CT) DNA in patients with SLE, discoid LE, miscellaneous connective tissue and infectious diseases, and control populations. Of seventy-eight LE patients, 58% demonstrated anti-ss DNA precipitins, and 20% exhibited anti-ds DNA precipitins. Good correlation was noted between the presence of ss DNA precipitins and ss DNA binding values determined by the more sensitive ammonium sulphate precipitation assay. Depressed total serum haemolytic complement activity in CH50 mu/ml was noted in 64% of sera exhibiting ss DNA precipitins and 38% of those with negative ss DNA precipitins. There was a strong association, however, between ds DNA precipitins and depressed serum complement levels. Although less sensitive than primary binding assays, CIE can be used as a rapid and simple screening test for detection of circulating anti-native and denatured CT DNA precipitins. CT DNA serum precipitins are present in a significantly higher percentage of SLE patients when compared with other disease states and normal control populations.

Ammonium Sulfate

Results of a one-year trial of tolmetin in patients with rheumatoid arthritis.

The safety and effectiveness of tolmetin was assessed in ten patients with active rheumatoid arthritis for 12 months. All patients met the requirements of the American Rheumatism Association's diagnostic criteria for definite rheumatoid arthritis. None of the patients had received gold, antimalarials, or glucocorticoids. All had been stabilized, more or less, with aspirin. Monthly measurements were made of grip strength, duration of morning stiffness, time to the onset of fatigue, Westergren sedimentation rates, the number of swollen joints, number of hot joints, the time to walk 50 feet, and the circumference of proximal interphalangeal (PIP) joints (measured in millimeters with a plastic-loop arthrocircameter). The initial dosage of tolmetin in all patients was 600 mg a day, given orally in three divided doses. Upon completion of the study, the average daily oral dosage was 1400 mg tolmetin. No other antiinflammatory drugs were allowed. The results indicate that tolmetin affords symptomatic relief of rheumatoid arthritis; its use results in global improvement in 80 per cent of the patients, and a net improvement in one or more of the parameters used to assess disease activity in 100 per cent of the patients; it seems to be sufficiently safe to administer to patients over a long period of time; there was no evidence of severe toxicity of any kind; gastrointestinal side effects were uncommon, and epigastric distress, in particular, was not observed.

Adult