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Biomedical subjects

K Eberhardt

Publications and source records attributed to K Eberhardt.

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

Early rheumatoid arthritis--some social, economical, and psychological aspects.

Physical, psychological, and social features were assessed with standardized methods in 84 early RA patients followed prospectively for 2 years. During this time disease activity decreased, and disability evaluated by HAQ remained small. Psychological distress measured by SCL-90 (Symptom Check List) was in general not very pronounced and fairly stable over time. A high pain level at baseline provided a 4 times higher risk for a high level of psychological distress after 2 years. The prevalence of early retirement was 37% at the end of the study. Physical demanding work and a high initial HAQ score were the best predictors of work disability, increasing the risk of not working 10.7 and 5.5 times, respectively. At least 28% of patients had lower annual income compared to the year before disease onset. The ability to do shopping, home work, leisure time activities and social activities were negatively influenced by the disease in more than half of the patients. The social and economical consequences were thus considerable in the early stages of RA.

Activities of Daily Living↗
PubMed1993

HLA-DR antigens, Gm allotypes and antiallotypes in early rheumatoid arthritis--their relation to disease progression.

OBJECTIVE: Evaluation of the prognostic value of immunogenetic markers in early rheumatoid arthritis (RA). METHODS: Ninety-nine patients with definite RA and disease duration 24 months or less were followed with standardized assessment. Disability was assessed by the HAQ index and radiographic changes in hands and feet by the Larsen method. The frequencies of HLA-DR genes were determined by serological typing, Gm allotype distribution by classical hemagglutination inhibition test, and occurrence of anti-Gm allotypes by use of anti-Rh coats. The immunogenetic findings were related to disease severity after 2 years' followup. RESULTS: Functional capacity was well preserved, disease activity was less, but radiographic changes in hands and feet had increased considerably at study finish. A group of 13 patients had developed rapidly progressive changes of hip and/or shoulder joints, all requiring arthroplasty. There was a significantly increased frequency of HLA-DR4. Twenty-seven of the 68 HLA-DR4 positive patients were putatively homozygous. HLA-DR4 was not related to disability or to severe small joint destruction. However, progressive large joint damage was significantly more prevalent in homozygous patients (p < 0.01). Gm allotype distribution was normal and not related to clinical findings. Anti-Gm antibodies were common and frequently specific for nonhost Gm allotype. Fifty-six patients carried anti-G1m(a), and occurrence of this antibody was significantly associated with radiographic progression of small joints (p = 0.01), presence of nodules (p < 0.01) and number of active joints (p = 0.001). CONCLUSION: Immunogenetic markers aided in identifying patients with early RA with more severe disease.

Adult↗
PubMed1992

The usefulness of nocturnal resting splints in the treatment of ulnar deviation of the rheumatoid hand.

Seven patients with definite RA and bilateral ulnar deviation of Fearnley grade I were included in a study of the usefulness of nocturnal resting splints. Each patient used the splint on average 17 months on one hand, randomly chosen, with the free hand as control. Joint mobility, grip strength, pain and radiographic findings were recorded at start and finish of the study. Splint treatment influenced grip strength positively, and most patients stated pain relief during the night. However, all but one patient showed progression of ulnar deviation in both hands, and there was no significant difference in progression between treated and nontreated hands. This study thus supported the use of resting splints at night for pain relief but not for prevention of ulnar deviation.

Aged↗
PubMed1992

Increased serum concentrations of cartilage oligomeric matrix protein. A prognostic marker in early rheumatoid arthritis.

Two cartilage specific macromolecules, cartilage oligomeric matrix protein (COMP) and proteoglycan, were quantified by immunoassay in sera of two groups of patients with rheumatoid arthritis (RA) of recent onset to evaluate the prognostic value of such measurements. Patients with rapidly progressive joint destruction had increased COMP concentrations initially, which subsequently decreased. A group with more benign disease, and less extensive joint damage, had normal COMP levels throughout the study period. Serum concentrations of proteoglycan were normal in both groups. Thus measurement of COMP in serum early in the course of RA holds promise as a prognostic marker for development of joint destruction in this disease.

Adult↗
PubMed1992

[Lymphangioleiomyomatosis].

A female patient is presented with a history of asthma, recurrent pneumothoraces and chylothoraces. A CT of the chest revealed typical thin-walled cysts of lymphangioleiomyomatosis. The suggested diagnosis was confirmed histologically. CT is exceptionally suited to narrow down the scope of differential diagnosis of interstitial lung diseases.

Adult↗
PubMed1991

The occurrence and significance of hand deformities in early rheumatoid arthritis.

One hundred rheumatoid arthritis patients (38 men, 62 women), with mean age of 53 years and mean disease duration of 11.5 months, were followed. Standardized clinical, biochemical, and radiographic evaluation was performed regularly. After 2 years the prevalence of ulnar deviation, buttonhole deformity, and swan neck deformity was 13%, 16%, and 8%, respectively. Altogether, 31 patients had developed one or more deformities. There was no difference in age or gender distribution and no predominance of the dominant hand. Each patient with a deformity was matched according to age, sex, and disease duration with another early RA patient without deformity. The deformity group had more active disease, less grip strength, more disability, and markedly more severe radiographic changes. When studied retrospectively at a time point 3 months prior to the detection of deformity, synovitis of relevant joints was as common in the group who developed deformities as in the control group. This suggests that joint inflammation may contribute to the genesis of deformity but additional factors are needed. Hand deformities were found to be common in early RA.

Adult↗
PubMed1991

Autologous blood stem cell (ABSCT) versus purged bone marrow transplantation (pABMT) in standard risk AML: influence of source and cell composition of the autograft on hemopoietic reconstitution and disease-free survival.

Complete and sustained hemopoietic function following myeloablative therapy can be successfully achieved by autologous transfusion of blood derived hemopoietic stem cells. It was the purpose of this study to compare autologous blood stem cell transplantation (ABSCT) in 20 patients with autologous transplantation of a mafosfamide purged marrow (pABMT) in 23 patients; all were transplanted in first complete remission (CR) of acute myelogenous leukemia (AML) using the same pretransplant regimen (14.4 Gy total body irradiation and 200 mg/kg cyclophosphamide). The autografts, mostly differing in source of hemopoietic stem cells, cell composition and CFU-GM number, were evaluated for their ability to reconstitute hemopoiesis and induce long-term disease-free survival (DFS). Prior to harvest, hemopoietic stem cells were mobilized by inducing transient myelosuppression (ara-C 100 mg/m2 every 12 h s.c. days 1-5 and daunorubicin 45 mg/m2, days 3 and 4) followed by an overshooting of peripheral stem cell concentration.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Alloimmunization to human immunoglobulin genetic markers is frequent in early rheumatoid arthritis.

HLA and Gm allotypes of 99 consecutive Swedish patients with rheumatoid arthritis were determined. Ninety-two of the 198 haplotypes contained DR4, a significant increase. The patients' sera from 3 different occasions were studied for anti-immunoglobulin profile as judged by 6 selected anti-Rh coats, 4 of them being monoclonal anti-Ds restricted as to allotype. Ninety-two of the patients were reactive with a polyclonal anti-Rh Ri as against 10 with the monoclonal carrying the G1m(f) allotype. Antibodies to Ig coats carrying defined allotypes were more frequently observed in patients not carrying the allotype in question than in those individuals possessing it. The difference was significant or highly significant as regards presence/absence of G1m(a), G3m(b) and G3m(g), respectively. Anti-G1m(a) and anti-G3m(g) cooccurred in 17 of the patients. Results consistent with presence/absence of particular anti-immunoglobulins at the 3 examinations were observed in 74 of the patients. Gm allotypes or antiallotypes were not statistically related with DR4 status. In conclusion, alloimmunization to Gm markers frequently occurs in early rheumatoid arthritis.

Adult↗
PubMed1990

HC-IgA antibodies of different specificities are normally present in serum: quantitation by ELISA and relationship to the major Ig classes.

Enzyme-linked immunosorbent assays (ELISA) were developed for direct measurement of protein HC-IgA complexes (HC-IgA) in serum with antibody specificity for rabbit IgG (rheumatoid factor (RF) activity), lipopolysaccharide from Yersinia enterocolitica serotype O:3 (Y3) and tetanus toxoid (TT). About 80% of patients with rheumatoid arthritis had increased concentrations of HC-IgA-RF. The values were correlated with the concentrations of IgA-RF and IgM-RF. HC-IgA anti-Y3 was measured in 45 sera with anti-Y3 antibodies of IgM, IgG and IgA class. The HC-IgA anti-Y3 levels were correlated with those of anti-Y3 of IgG and IgM class, but not of IgA class. For HC-IgA anti-Y3, the closest correlation was that with the specific IgM antibody concentration, rs = 0.63 (p less than 0.001). In 25 normal sera, significant correlations were observed between HC-IgA anti-TT and specific antibodies of IgG and IgA class, but not of IgM class. In 107 sera containing IgA M-components, the total concentration of HC-IgA correlated poorly with both protein HC and with IgA concentrations. It was concluded that specific HC-IgA antibodies are normal constituents of serum, and that their concentrations are not directly related to the serum content of specific IgA antibodies.

Alpha-Globulins↗
PubMed1990

[Short- and long-term results of tuberculosis therapy with a fixed combination of isoniazide, prothionamide and diaminodiphenylsulfone combined with rifampicin].

This is a report on 912 patients treated during 1973 to 1979 for pulmonary tuberculosis and/or extrapulmonary organ involvement. These patients had been treated with a fixed tablet combination of isoniacide, prothionamide and diaphenyl sulfone in association with rifampicin and partly other substances. It was the aim of our study to examine this form of therapy in respect of side effects and effectivity. 535 of these 912 patients were followed up for as long as 13 years (maximum follow-up period). According to the criteria of the American Tuberculosis and Respiratory Diseases Association the patients were suffering from 182 cases of pulmonary tuberculosis of only slight extension, 490 of moderate extension and 130 of large extension, as well as 55 cases of pleuritis, 67 extrapulmonary organ tuberculoses and 1 tuberculosis of the bronchial mucosa. Allergic skin reactions occurred in 0.7% of the cases, and in 0.9% there were neurological disturbances such as vertigo, paroxysms and polyneuropathies. In 7.4% of the patients there was an increase in serum enzyme activities of SGOT, SGPT, Y-GT as a sign of hepatotoxicity. In 5.5% of the patients there were several gastrointestinal concomitant phenomena such as sensation of fullness, nausea, and vomiting. Under IPD therapy the hemoglobin valuedropped on the average by 12% up to the 5th or 6th week of treatment and rose subsequently to almost normal levels. No permanent damage was seen in any of the patients under observation. In the moderately extended tuberculosis cases disinfection occurred on the average between the 6th and 8th week of treatment, in the greatly extended cases on the average in the 9th to 13th week.(ABSTRACT TRUNCATED AT 250 WORDS)

Dapsone↗
PubMed1990

[TMJ morphology after condylar dislocation fractures in childhood].

In a CT- and NMR-study, condylar remodeling after conservative treatment of condylar dislocation fractures in growing individuals was evaluated. The regenerated condyles displayed great similarities. Two condylar parts could be differentiated--one with and one without muscular attachment. The medial part represents the former small fragment and the lateral part a bony outgrowth. One of the patients studied demonstrated a bifid condyle. NMR-records were remarkable in that each of the three patients presented a lateral pterygoid muscle with the two heads oriented one above the other rather than side by side. This does not seem to support the observation made in experiments, that the disc remains fixed to the caput in low condylar fractures.

Adolescent↗
PubMed1990

[Remodeling after condylar dislocation fractures in growing individuals].

A longitudinal study of the remodelling process in three growing individuals who had suffered low condylar fractures with luxation was made utilizing computerized tomography. The small fragment of the condyle is partially resorbed during the remodeling process, while new bone is formed on the lateral aspect. Below the fracture site in the ascending ramus bone apposition was observed. Each of these remodeling responses was more vigorous in the one child examined than in the two adolescents.

Adolescent↗
PubMed1990

[CT morphology and function of the temporomandibular joint following conservative functional treatment of temporomandibular joint fractures].

In 8 adult and 13 adolescent individuals who had undergone conservative treatment for condylar fractures 4.2 and 4.5 years earlier, respectively computed tomography was performed. In addition, joint mobility was examined clinically in 18 of these patients. The results of the radiological examination allow discrimination between high-grade and low-grade remodeling and excessive bone formation. With one exception, high-grade remodeling was invariably observed after childhood fractures. In the adult patients new bone formation was rarely observed. Correlation between the morphologic appearance and joint mobility was detectable only in cases of severely limited function. In the presence of less severe functional lesions, the size of the insertion area of the lateral pterygoid muscle might indicate the degree of functional rehabilitation. The radiological procedure is discussed.

Adolescent↗
PubMed1988

Detection of suspected inflammatory joint disease with a new simple self-administered hand test.

A self-administered hand test was used to screen 5262 persons aged 40-70 living in a rural district in southern Sweden. It revealed evidence of hand impairment in 13%. The prevalence of RA was 1.1%. At the screening procedure a subgroup of 48 previously unrecognized individuals with inflammatory joint disease was identified. They were assessed by a rheumatologist, who established the following diagnoses: four definite RA, eight probable RA, three psoriatic arthritis, one unclassifiable arthritis, 10 osteoarthritis and 22 non-specific arthralgia. No advanced RA was detected. Two were seropositive and another was erosive. One with RA, one with psoriatic arthritis and three with arthralgic symptoms were unable to work. Most had only a minor need for further medical aid. The test was thus able to identify persons with hand impairment. Follow-up studies will address the practical implications of the screening procedure.

Activities of Daily Living↗
PubMed1988

Assessing disability in patients with rheumatoid arthritis. Use of a Swedish version of the Stanford Health Assessment Questionnaire.

The validity and reliability under Swedish conditions of a translated and slightly modified version of the Stanford Health Assessment Questionnaire (HAQ), referred to here as the ADL questionnaire, was studied. Sixty-four patients with definite/classical rheumatoid arthritis (RA) participated in the major part of the investigation. In addition, inter-observer reliability was studied in the testing of 15 other patients with RA. The questionnaire was filled in by the patients twice (ADL Tests 1 and 2) with a one-week interval between. A physiotherapist or occupational therapist also assessed each of the patients on a sample of ADL functions (ADL Test 3). Joint mobility, grip-strength, pain, Ritchie index and ESR were likewise checked. Results indicated inter-observer reliability to be high for the ADL (r(S) = 0.98), for joint mobility (r(S) = 0.86), and for the Ritchie index (r(S) = 0.83). The test-retest reliability for the ADL questionnaire which the patients filled in (Tests 1 and 2) was high r(S) = 0.91. Results of the ADL questionnaires the patients completed were found to correlate fairly closely with the observations of the therapists, r(S) = 0.71. The validity of the scoring system was found to be sufficient, using Ward's cluster analysis for comparing the original HAQ scores with scores on all the questions included in the questionnaire. Thus, the translated and somewhat modified version of the ADL questionnaire studied here appears to possess a high degree of reliability and validity in assessing patients with RA.

Activities of Daily Living↗
PubMed1983

Prognosis in juvenile rheumatoid arthritis with systemic onset. A follow-up study.

Thirty-three patients with systemic onset JRA were followed up for 4 to 24 years (median 10 years). None had positive RF or ANA. Most patients developed polyarthritis. Cardiac involvement occurred in 14 patients (42%). Cardiac prognosis was good for pericarditis but seemed to be worse for myocarditis or perimyocarditis. Three patients contracted renal amyloidosis (9%). Severe growth retardation was observed in 39 per cent. Half of the patients had low activity or were in remission after in average 5.9 years' duration of the disease. Seventy per cent of the patients were in a good functional state. Patients with less than average radiological progression during the first 5 years of disease and those with onset of disease after the age of 5, seemed to have a better functional prognosis.

Amyloidosis↗
PubMed1981

Follow-up study of 6 children presenting with a MCTD-like syndrome.

Since 1974 we have observed 6 children presenting with symptoms, signs and serology consistent with a MCTD-like syndrome. During this observation period (3-6 years) 3 children developed a severe disease, 2 of them contracted glomerulonephritis and one digital vasculitis. On the basis of the presenting symptoms the course of the disease was not predictable. The prognostic implications of the MCTD syndrome might therefore be questioned.

Adolescent↗