Achieving consensus on an algorithm for the treatment of rheumatoid arthritis with methotrexate.
Explore the source record for details and available documents.
Algorithms↗
Biomedical subjects
L G Kendall
Publications and source records attributed to L G Kendall.
Rheumatology algorithms for primary care physicians.
Primary care physicians were trained on three rheumatology topics to assess the effectiveness of an educational strategy for continuing medical education. Algorithm training was shown to be at least as effective as that based on standard prose monographs. Both training groups improved their knowledge of patient management skills but there were no statistically significant differences between groups in the amount learned. When algorithms were used to design text materials, the designed texts required less study time than did the annotated clinical algorithms alone. That difference was significant for the shoulder pain materials (P less than 0.05) but not for the osteoporosis materials. The ratio of knowledge gained to study time was significantly higher for the algorithm group on the low back pain topic (P less than 0.05) but not for the other topics. Taped interview problems tests were studied as a method for assessing patient management skills related to problem-specific indicator conditions and were found to produce interrater reliability greater than 0.80 on five of the six tests.
Clinical Protocols↗
Cryptococcosis associated with low-dose methotrexate for arthritis.
One patient with psoriatic arthritis and a second with rheumatoid arthritis were each treated with low-dose methotrexate (10 to 15 mg per week, orally) for more than a year before pulmonary cryptococcosis developed. These are the first case reports of opportunistic fungal disease during this treatment. Low-dose methotrexate may be more immunosuppressive than has been appreciated. Patients demonstrating pneumonitis while receiving this therapy should be carefully evaluated to rule out an infectious cause.
Arthritis↗
Delayed appearance of vancomycin-induced neutropenia in a patient with chronic renal failure.
A patient receiving hemodialysis for chronic renal failure had neutropenia six weeks after administration of his last dose of intravenous vancomycin and in the absence of other drug therapy. This case provides confirmation that neutropenia can be seen with vancomycin therapy; suggests an immunologic basis for the reaction, since the patient exhibited a concomitant hypersensitivity rash; and points out that delayed clearance of vancomycin in patients with chronic renal failure can produce late onset of side effects in such patients.
Agranulocytosis↗
The effects of fentanyl and thiopental on breathing in man.
Explore the source record for details and available documents.
Abdominal Muscles↗