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Biomedical subjects

Jean-Charles Gerster

Publications and source records attributed to Jean-Charles Gerster.

8 recordsLinked to original sources
PubMed2004

Return-to-work status 1 year after muscle reconditioning in chronic low back pain patients.

OBJECTIVE: To evaluate return-to-work status 1 year after a physical deconditioning program in manual laborers with chronic low back pain. METHODS: In this open prospective study, a questionnaire was sent to 125 patients and their physicians (115 men and 10 women, mean age 40 years). Mean sick leave duration at program initiation was 4 months. All participants had followed a physical reconditioning program 12 months earlier. The program for the present study included 6 h of physical and occupational therapy each day, 5 d a week for 3 weeks. RESULTS: One hundred and nine questionnaires were evaluable. Fifty-seven patients (52.3%) were working, 39 (35.8%) full time and 18 (16.5%) part time. The remaining 52 patients were on disability leave. Among the study variables, only a favorable subjective evaluation by the patient at completion of the program and absence of clinical evidence of nonorganic pain at study inclusion significantly predicted return-to-work within 1 year. CONCLUSION: This intensive reconditioning program for low back pain patients had positive effects on return-to-work status after 1 year.

Adult↗
PubMed2004

Good outcomes of Lyme arthritis in 24 patients in an endemic area of Switzerland.

OBJECTIVE: To describe outcomes of treated Lyme arthritis in an endemic area of western Switzerland, where some of the first cases of Lyme disease outside the United States were reported. PATIENTS AND METHODS: We retrospectively studied 24 patients (15 males and nine females, mean age 38.7 years) managed by rheumatologists between 1994 and 1999 for Borrelia burgdorferi arthritis manifesting as monoarthritis (n = 20), oligoarthritis (n = 3), or polyarthritis (n = 1). The knee was affected in 20 (85%) patients. Nine patients reported a history of tick bite and four of erythema chronicum migrans. All the patients but one had a high titer of antibodies to B. burgdorferi by ELISA and all but two had a positive immunoblot test (22 positive for all three types of B. burgdorferi found in Switzerland and one positive only for B. burgdorferi sensu stricto). Joint fluid PCR for B. burgdorferi was done in nine patients and was positive in six. RESULTS: All 24 patients received antibiotic therapy, orally (n = 10) or parenterally (n = 14). A second course of antibiotic therapy was used in four patients with persistent arthritis. A rapid response was noted in 13 patients. Intraarticular glucocorticoid therapy or a synoviorthesis was required in nine patients. After a mean follow-up of 40 months (range, 6-84 months), none of the patients had chronic arthritis but two reported persistent muscle or joint pain. CONCLUSION: Recurrent or chronic arthritis, which has been reported in treated patients in the United States, did not occur in our series. This may be ascribable to differences in B. burgdorferi subtypes, as in the United States only B. burgdorferi sensu stricto is found.

Adolescent↗
PubMed2004

The cervical spine in calcium pyrophosphate dihydrate deposition disease. A prevalent case-control study.

OBJECTIVE: To test the hypothesis that calcium pyrophosphate dihydrate (CPPD) deposition disease is a risk factor for neck pain. METHODS: A prevalent case-control study was conducted to assess cervical calcifications and neck pain between patients with and without known peripheral CPPD deposition disease. CPPD cases were included if diagnosed with CPPD deposition disease of peripheral joints, and excluded if their chief complaint was neck pain. Controls were randomly selected among consecutive patients, hospitalized for conditions unrelated to CPPD deposition disease or neck pain, and matched to CPPD cases by age and sex. Cervical calcifications were assessed by lateral cervical radiographs and computed tomography scans of the upper cervical spine; neck pain and cervical function were appraised by a validated questionnaire. RESULTS: Cervical calcifications were found in 24 out of 35 patients (69%) in the CPPD group compared to 4 out of 35 patients (11%) in the control group (p < 0.001). Patients with CPPD deposition disease reported significantly more neck pain and discomfort than controls (p < 0.001), and were 5 times more likely to report any neck pain (odds ratio 5.5; 95% confidence interval: 1.9, 21.9). Among male patients, more extensive cervical calcified deposits correlated with more severe neck pain (rs = 0.58, p = 0.03). CONCLUSION: These results suggest that CPPD deposition disease frequently involves the cervical spine and may be associated with the development of neck pain.

Aged↗
PubMed2004

[Chondrocalcinosis: a disease frequently occurring in the second half of life].

Articular chondrocalcinosis (ACC) is a metabolic arthropathy caused by calcium pyrophosphate crystal deposits. It is frequent in the second half of the life (6% of the population aged between 60 and 70 years, 30% of the elderly after 80 years). Both males and females, are involved in the same proportion. Clinical manifestations include pseudogout attacks, mainly of the knee and wrist joints, secondary osteoarthritis and destructive arthropathy (mainly of the knee and hip joints). There is no basis therapy. The pyrophosphate calcium deposits do not disappear during the evolution of the disease. Symptomatic therapy with NSAIDS, analgesic drugs or intra-articular corticosteroids may be very useful. Orthopaedic surgery is necessary in cases with severe destructive arthropathy.

Chondrocalcinosis↗
PubMed2004

[Slow-acting anti-rheumatic agents: recent developments].

Until recently, treatment of osteoarthritis targeted the pain and the disability of the involved joints. It consisted in a mix of analgesics, anti-inflammatory drugs, steroid infiltrations and physical therapies. Usefulness of slow but long acting substances is increasing not only by their action on the symptoms but also because they positively influence the evolution of the disease. Some of them seem to induce a structural effect on the cartilage confirmed by a slow down of the joint space narrowing on successive radiographs of the knees. Presently, only basic matricial precursors such as chondroitin sulfate, glucosamine sulfate and hyaluronic acid are available in the clinic. They act by reducing cartilage destruction and enhancing chondrocyte anabolism. These preliminary results should be confirmed by further studies based on magnetic resonance imaging and surrogate markers of the cartilage matrix. Recent developments in the understanding of the physiopathology of osteoarthritis, including the key role of some cytokines, should allow new therapic ways, individually or in combination.

Antirheumatic Agents↗
PubMed2002

Contribution of digit joint aspiration to the diagnosis of rheumatic diseases.

OBJECTIVES: To assess the diagnostic usefulness of digit joint aspiration in patients with involvement of one or more digit joints. PATIENTS AND METHODS: All patients who underwent digit joint aspiration during a rheumatology outpatient visit between 1994 and 1998 were included. Fine needles (25 or 28 G) were used, and the aspirate was immediately examined under the microscope to determine the leukocyte count and to look for crystals under polarized light. RESULTS: Digit aspiration yielded a diagnosis of crystal deposition arthropathy in 20 (29%) of the 71 patients (gout, N = 14; calcium pyrophosphate dihydrate crystal deposition disease, N = 6). In 28 patients, the amount of fluid was too small to allow analysis. The leukocyte count indicated inflammatory disease in eight of the remaining 23 patients and mechanical disease in 15. CONCLUSION: Fine-needle aspiration of symptomatic digit joints provided the diagnosis in two-thirds of patients.

Adult↗