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Biomedical subjects

J W Goldberg

Publications and source records attributed to J W Goldberg.

7 recordsLinked to original sources
PubMed1992

A study of adverse effects of high-dose intravenous (pulse) methylprednisolone therapy in patients with rheumatic disease.

OBJECTIVE: To determine the frequency of significant adverse effects associated with high-dose intravenous methylprednisolone therapy (HIVMP) given as methylprednisolone 1 g/d for three consecutive days. DESIGN: Retrospective study of consecutive patients. SETTING: Department of Veterans Affairs Medical Center (VAMC), university teaching hospital, and private outpatient clinic. PATIENTS: Eighty-four patients given HIVMP for systemic rheumatic disease. MEASUREMENTS: Subjective complaints were elicited via a standardized questionnaire that identified adverse effects through organ system review. Medical records were reviewed for adverse effects occurring within two weeks of HIVMP therapy. RESULTS: Two hundred seventy-five HIVMP treatments were examined by either patient questionnaire (76 patients) and/or chart review (78 patients). Sixty-five patients described symptoms after HIVMP treatment. Most symptoms were transient in duration, mild in severity, and required no medical treatment. Chart review found 42 possible complications occurring within two weeks of HIVMP therapy. In 18 instances medical intervention was required for problems that included hypertension, seizures, gastric erosions, sepsis, and other infections. It is impossible to attribute all of the complications to HIVMP alone because of underlying disease, use of other medications at the time of therapy, or both. CONCLUSIONS: HIVMP has an acceptably low risk of significant adverse effects.

Adult↗
PubMed1988

The use of methotrexate in steroid-resistant systemic lupus erythematosus.

Although the use of methotrexate (MTX) is gaining acceptance in the treatment of several connective tissue diseases, there is little evidence of its therapeutic value in systemic lupus erythematosus (SLE). We examined the response to MTX in patients with steroid-resistant SLE in an open, unblinded study. Of 10 SLE patients treated with MTX (7.5 mg/weekly), 7 showed improvement. The other 3 stopped therapy because of lack of response or because of side effects. Improvements were noted within 3 months in responding patients. These promising observations suggest that controlled studies of MTX for the treatment of SLE are justified.

Adolescent↗
PubMed1988

Cerebral vasculitis in relapsing polychondritis.

Recurrent inflammation of cartilage in multiple sites is a hallmark of relapsing polychondritis (RP). Neurologic complications of this disease have begun to attract increasing attention, but the neuropathologic basis of these complications has not been described. We report a patient with RP whose autopsy showed extensive cerebral and systemic vasculitis.

Cerebrovascular Disorders↗
PubMed1987

Giant cell arteritis of the skin simulating erythema nodosum.

Cutaneous involvement in giant cell arteritis is quite uncommon. A patient is described who presented with pretibial skin lesions clinically indistinguishable from erythema nodosum which, on biopsy, showed subcutaneous pannicular giant cell vasculitis. Cutaneous manifestations of giant cell arteritis are subsequently reviewed.

Diagnosis, Differential↗
PubMed1986

Early rheumatoid arthritis. Approach to diagnosis and treatment.

Early rheumatoid arthritis is a diagnosis most often made by history and physical examination and is frequently a diagnosis of exclusion. Differential diagnosis can be difficult because of the wide variation in age, sex, constitutional symptoms, physical findings, and joint distribution. Early, aggressive therapy should include patient education, rest, graded exercise, counseling, and appropriate medication. Absence of subcutaneous nodules and joint erosion may indicate a better prognosis in rheumatoid arthritis. Presence of rheumatoid factor, eosinophilia, thrombocytosis, and/or vasculitis suggests a less favorable course.

Adult↗
PubMed1985

Cyclophosphamide-associated hepatotoxicity.

Cyclophosphamide, a potent alkylating agent, is effective therapy for some rheumatic diseases. Despite primary hepatic activation of the drug, hepatic toxicity has been reported only in one case. We have reported two episodes of hepatic dysfunction associated with oral cyclophosphamide administration in patients with systemic rheumatic diseases.

Adult↗