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J M Nolla

Publications and source records attributed to J M Nolla.

At least 55 records · Page 3Linked to original sources
PubMed1993

Brucellar sacroiliitis: findings in 63 episodes and current relevance.

Between 1974 and 1989 we prospectively observed 530 patients with brucellosis. The findings for 62 patients (42 males and 20 females; mean age, 34.7 years) with 63 episodes in which the sacroiliac joint was involved (the most frequent osteoarticular location [11.7%]) were analyzed. Ten of the older patients (mean age, 55.3 years) had concomitant spondylitis. Systemic symptoms were usually important, and characteristic pain and findings of sacroiliitis were observed in approximately 75% of cases. Blood cultures were positive for Brucella melitensis for 44 patients. The most frequent radiographic findings were blurring of articular margins (42 cases) and widening of the sacroiliac space (20 cases). No radiographic anomalies were detected in 13 cases. Results of 99mTc and gallium-67 bone scans were abnormal in approximately 90% of cases (abnormalities were often mild). Overall, clinical, radiographic, and isotopic bone scan findings were sensitive and useful, although they were occasionally minimal or difficult to evaluate, making diagnostic findings confusing or misleading. Brucellar sacroiliitis is a mild disease associated with a good outcome similar to that observed for patients with uncomplicated brucellosis.

Adolescent↗
PubMed1993

Bone mineral density in patients with temporal arteritis and polymyalgia rheumatica.

OBJECTIVE: To assess the influence of corticosteroids in the mineral content of patients with giant cell arteritis (GCA), 56 patients, 28 with polymyalgia rheumatica (PMR) and 28 with temporal arteritis (TA) were studied. METHODS: The bone mineral density (BMD) in the lumbar spine and the femoral neck was measured by dual photon X-ray absorptiometry. A control group (48 people) comparable in age and sex was also evaluated. RESULTS: Compared with the controls, the patients with GCA had lower values of BMD in the femoral neck (men: p < 0.03; women: p < 0.001). In the lumbar spine differences were significant in women (p < 0.05) but not in men (p < 0.1). Multiple regression analysis showed that the BMD at L2-L4 in men correlated with height and weight and was inversely related to the cumulative dose of corticosteroids and the duration of treatment. The BMD at L2-L4 in women correlated with height and weight, but not with corticosteroids. Multiple regression analysis in men showed that age and the total dose of corticosteroids were significant independent predictors of femoral BMD. In women BMD in the femoral neck was correlated with age and weight, but not with corticosteroid treatment. CONCLUSION: The total dose and duration of corticosteroid treatment have been shown to be determinant factors of bone mass in patients with GCA who received corticosteroids.

Absorptiometry, Photon↗
PubMed1993

[Pseudopodagra caused by hydroxyapatite. Report of 3 cases].

Calcium hydroxyapatite crystals deposit in periarticular soft tissues usually translates itself clinically through pain and mobility limitation of affected joint. Compromise of small joints in feet is infrequent, less than 1% of all cases. Recently pseudopodagra crises have been described due to the deposit of this material in soft tissues adjacent to metatarsal or phalangeal first joint. Its clinical expression is practically undistinguishable from gout crises. Three new cases of pseudopodagra due to hidroxyamatite are presented and some considerations are made concerning this clinical entity and its differential diagnosis in relation to gout.

Adolescent↗
PubMed1993

[A toxic syndrome and subcutaneous nodules as the only clinical manifestation of systemic sarcoidosis].

Sarcoidosis is a systemic disease with frequent cutaneous manifestations. Among these exists a predominance of the so-called unspecific lesions because of their histopathological features. Within the specific lesions, that is those which showed non-caseous granulomas, subcutaneous nodules are underlined, which have been associated with chronic sarcoidosis with a frequency of 1.4%-6%. These lesions appear during the evolution of the disease but rarely constitute an initial manifestation of it. The patient whose case is discussed had a debut with toxic syndrome and subcutaneous nodules. Histopathological study of these nodules showed the existence of non caseous granulomas formed by histiocytes, epithelioid cells, Langhans and foreign body giant cells. Lobulet hepatic granulomas were showed together with mediastinal pulmonary captation of gallium. We conclude that sarcoidosis must be considered when performing the differential diagnosis of the disease which debut with subcutaneous nodules.

Biopsy↗
PubMed1992

[Septic arthritis induced by pyogenic germs in patients without parenteral drug addiction. Analysis of 44 cases].

BACKGROUND: The aim of this study was to evaluate the clinical-microbiological characteristics presented in the area of influence of the Hospital de Bellvitge-Prínceps d'Espanya, of articular infection induced by pyogenic germs in patients without intravenous drug addiction. METHODS: All the cases of microbiologically confirmed articular infection in patients without intravenous drug addiction diagnosed during the period of 1981-1990 were evaluated by protocol. RESULTS: Five cases (11%) with gonococcal arthritis and 39 cases (89%) of non gonococcal arthritis were observed with Staphylococcus aureus being the causal germ in 27 cases. Sixty percent of the patients presented one or more predisposing factors for the appearance of infectious arthritis. Monoarticular involvement was seen in 84% of the cases. At the time of diagnosis fourteen patients presented radiological signs compatible with septic involvement, with the isotopic study with 99mTc being positive in the 27 cases in which it was carried out. Delay in diagnosis was of 20 +/- 25 days. Functional results were considered as satisfactory in 57% of the cases. CONCLUSION: In the area of influence of the Hospital de Bellvitge-Prínceps d'Espanya, the prevalence of gonococcal arthritis is low. Gram positive germ are the most frequent causal agents in all the age groups studied. Gammagraphy with 99mTc presented high profitability in the diagnosis of articular infections. The functional results observed were not optimal and improvement of the same probably requires a shortening in the time of delay in diagnosis.

Adolescent↗
PubMed1992

[Antiphospholipid syndrome in patients with ankylosing spondylitis. Presentation of 2 cases].

Antiphospholipid antibodies (APA) have been described not only in systemic lupus erythematosus but also in several inflammatory diseases of the connective tissue, some infections, neoplasms, in pregnancy and even in apparently healthy individuals. Arterial and venous thrombosis are some of the clinical manifestations most frequently associated with APA. Two patients with ankylosing spondylitis with antiphospholipid antibodies are presented. The first patient developed a infarct in the pons as a complication at 34 years of age, with high titres of anticardiolipin antibodies as the only factor predisposing a cerebral vascular accident. The second patient had deep vein thrombosis with the presence of circulating anticoagulant. These are the first cases of antiphospholipid syndrome associated to ankylosing spondylitis in the literature.

Adult↗
PubMed1991

[Uveitis: an etiological study of 200 cases following a protocol].

BACKGROUND: To evaluate the usefulness of a systematic study of patients with uveitis and to assess the associated systemic diseases. METHODS: 200 patients seen in an outpatient clinic for the evaluation of uveitis between 1981 and 1988 were included in the study. Patients with eye disease associated with drug abuse or human immunodeficiency virus were excluded. The study protocol included an initial clinical and ophthalmological evaluation followed by selected specific investigations. RESULTS: Anatomical localization: anterior uveitis 122 (61%), posterior 41 (20.5%), panuveitis 30 (15%) and intermediate 7 (3.5%). ETIOLOGY: 74 cases (37%) were secondary, 101 (50.5%) were idiopathic, and 25 (12.5%) were specific syndromes of uveitis of unknown cause. Toxoplasmosis was the most common cause of infective uveitis, and ankylosing spondylitis was the most common noninfective cause. Diagnostic process: group 1, diagnosed by the ophthalmological investigation (25 cases); group 2, diagnosed on the basis of the accompanying clinical features and/or specific investigations (66 cases); and group 3, diagnosed by wider detection methods (8 cases). CONCLUSIONS: There was a remarkably high rate uveitis without etiological diagnosis. The evaluation of patients with uveitis requires a careful evaluation of ocular and systemic features, followed by selected specific investigation. The indiscriminate use of diagnostic tests is not warranted.

Adolescent↗
PubMed1991

[Limitations of joint mobility in patients with type 1 diabetes mellitus].

BACKGROUND: To assess limitation of joint mobility in patients with type I diabetes mellitus and to evaluate its relation with retinopathy, joint mobility was prospectively assessed in 96 diabetic patients and 68 healthy controls. METHODS: Joint mobility was explored with the praying maneuver and the measurement in mobility degrees of the third and fifth metacarpophalangeal joints, wrists and elbows. The degree of metabolic control was assessed with the mean glycosylated hemoglobin in the last two years. Retinopathy was investigated with direct funduscopy. The results were statistically evaluated with chi-square and Student's t tests and the linear coefficient. RESULTS: A reduced joint mobility was found in 41 diabetics and 5 controls (p less than 0.0001). The reduction in joint mobility was related with the patients' age but not with the degree of metabolic control. 85% of diabetics with joint involvement had retinopathy of some degree. CONCLUSIONS: A limited joint mobility is a common complication of type I diabetes mellitus. The demonstration of this abnormality in diabetic patients might represent a first and simple marker of microangiopathy.

Adolescent↗