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Biomedical subjects

M Amit

Publications and source records attributed to M Amit.

13 recordsLinked to original sources

Seasonal variations in manifestations and activity of systemic lupus erythematosus.

The purpose of the present study was to investigate a possible seasonal pattern in various clinical and laboratory manifestations in a group of systemic lupus erythamatosus (SLE) patients. One hundred and five SLE patients were followed up during a 4 yr period. Data on each of the clinical and laboratory variables examined, as well as the results of the disease activity index (SLEDAI), were plotted against the month during which they were obtained. Photosensitivity was the only variable to show a seasonal pattern, having higher scores during the summer months (1.04 +/- 0.16 in July vs 0.58 +/- 0.12 in December). We were unable to show seasonal patterns in any of the other variables examined. As a group, SLE patients do not show any significant seasonal pattern in disease manifestations and activity, except for photosensitivity. However, such a pattern may exist for the individual patient.

Adolescent

Expression of rheumatoid arthritis in two ethnic Jewish Israeli groups.

OBJECTIVE: To investigate the expression of rheumatoid arthritis (RA) in Jewish Israeli patients according to ethnic origin. METHODS: RA patients who were seen in a primary public rheumatology clinic were divided into two groups according to ethnic origin (Sepharadic or Askenazi) and subjected to a cross sectional study. The two groups were compared for history, physical status, and radiographic and laboratory variables. The entire study population was again divided into two groups according to formal educational level, and these were also compared for the same variables as above. RESULTS: The patients of Sepharadic origin had significantly more pathological recordings of pain and fatigue, and greater Ritchie scores than those of Askenazi origin. The Sepharadic group patients were younger, had a lower educational level, and were predominantly female. The more educated group recorded significantly less pathological pain and fatigue, and had smaller Ritchie scores. Functional capacity and global disease severity, assessed by physician and patient, were also reduced in the more educated group. On multiple regression analysis, ethnic origin was found to be independently related to functional class. Education was found to be independently related to the Ritchie score. CONCLUSIONS: Disease manifestations in Jewish RA patients of Sepharadic origin are more serious compared with those in patients of Askenazi origin. In addition, low educational level is related to more severe disease manifestations in Israeli RA patients.

Adult

Bacteremia in patients without known underlying disorders.

Of 2030 consecutive patients with bacteremia, only 102 were free from underlying disorders. 43 were males, and the median age was 66 years. The sources of infection were the urinary tract (in 48%), lower respiratory tract (13%), endocarditis (7%), biliary tract (6%) and the meninges (5%). The most common pathogens were Escherichia coli (in 45% of patients), Streptococcus pneumoniae (21%), Staphylococcus aureus (9%) and hemolytic streptococci (9%). Overall mortality rate was 13%, 4% in patients with urinary tract infection and 19% in patients with other sources. Half of the deaths occurred within 2 days of hospitalization, and 75% of them within 4 days. All patients with septic shock and all patients with meningitis died. Other factors related to mortality were residence in a nursing home, low functional capacity, advanced age, high blood urea nitrogen and creatinine and low albumin, and infections caused by Staphylococcus aureus, Neisseria meningitidis and polymicrobial infections. A protective effect of appropriate antimicrobial antibiotic therapy could not be demonstrated. In conclusion, bacteremic patients with no known underlying disorder and source of their infection other than the urinary tract should be given maximum supportive treatment and should be closely watched.

Adult

Rash in systemic lupus erythematosus: prevalence and relation to cutaneous and non-cutaneous disease manifestations.

Rash is a common cutaneous sign in patients with systemic lupus erythematosus (SLE) but no data regarding its prevalence or relation to disease manifestations are known, possibly due to the fact that it is a common but non-specific sign. Rash was present in 48/81 (59%) patients with SLE. Patients with rash had more cutaneous symptoms and signs, lymphadenopathy, increased levels of antibodies to double stranded DNA and decreased complement levels. They were also receiving a higher dose of prednisone. There was no difference between patients with and without rash with respect to renal or central nervous system disease. Rash did not correlate with the disease activity index and clinical parameters of disease exacerbation.

Dermatitis

Disease patterns of patients with systemic lupus erythematosus as shown by application of factor analysis.

Clinical and laboratory test data of 77 patients with systemic lupus erythematosus (SLE) were evaluated by factor analysis. Six factors representing disease patterns were extracted: cutaneous symptoms of alopecia, malar rash, rash and photosensitivity; renal involvement; the anticoagulant syndrome of phlebitis and partial thromboplastic time inversely related to platelet count; lymphopenia; viral or fibromyalgia symptoms of headache, nervousness, joint and muscle pain; and serology of anti-DNA antibodies and complement inversely related. Application of factor analysis reveals various clinical presentations of SLE.

Adult

Alopecia in systemic lupus erythematosus. Relation to disease manifestations.

Alopecia was observed in 40/74 (54%) patients with systemic lupus erythematosus (SLE). Patients with alopecia had a significantly higher rating for cutaneous manifestations, Raynaud's phenomenon and muscle tenderness, and most of these signs correlated with the magnitude of alopecia. There was no difference between patients with or without alopecia for arthritis, nephritis or central nervous system manifestations. Alopecia correlated with disease activity index but did not correlate with various specific measurements of disease exacerbation.

Adult

Induction of suppressor cell activity by cyclosporin A and/or uremic serum in normal versus uremic peripheral blood mononuclear cells.

We investigated induction of suppressor cell activity in peripheral blood mononuclear cells (PBMC) from normal or uremic subjects. The cells were primed with cyclosporin A (CS-A), uremic serum, or both and subsequently cocultured with fresh phytohemagglutinin-stimulated normal allogeneic responders. CS-A-primed normal as well as uremic PBMC significantly suppressed responder cell thymidine incorporation. Uremic serum primed normal, but not the uremic, PBMC exerted a significant suppression on responder cell proliferation. No significant additive suppressive effect was detected following coculture of responders with PBMC primed by CS-A and uremic serum together. Exclusion of a distinct suppressor cell subset by panning, using anti-Leu-2b monoclonal antibody, did not result in blunting suppressive activity of the CS-A or uremic serum pretreated cells. On the other hand, adherent cell depletion of primed PBMC completely abolished their subsequent suppressive effect on responder cell proliferation.

Adult

Neonatal polycythemia causing multiple cerebral infarcts.

A child had neonatal polycythemia, severe seizures beginning at 6 weeks of age, and a computerized tomography scan showing multiple cerebral infarcts. Follow-up showed substantial developmental delay with spastic quadriplegia. This case illustrates that neonatal polycythemia is a rare but preventable cause of multiple cerebral infarctions, subsequent seizures, and developmental delay.

Cerebral Infarction

Effect of the timing of perphenazine administration on pregnancy in the rat.

Perphenazine in doses of 10--50 mg kg-1 day-1 given at the early stages of pregnancy delayed nidation up to day 8 of pregnancy. Once nidation had occurred the length of the rest of the gestation period was normal. Doses of up to 20 mg perphenazine kg-1 day-1, injected on days 1--7, prolonged gestation but the mothers and young were apparently normal; lower doses were effective only when treatment commenced soon after copulation. The delay in implantation of the ovum caused by perphenazine was corrected and and implantation was brought about immediately, by injection of 0.1 microgram oestradiol together with perphenazine. It is suggested that perphenazine delays and prevents implantation in rats by counteracting oestrogen release from the ovaries.

Animals

Experimental septic arthritis in rabbits treated by a combination of antibiotic and steroid drugs.

OBJECTIVES: Intraarticular steroid injection is traditionally contraindicated during acute septic arthritis. However, there is abundant evidence which proves that the damage to the joint is not only due to the direct effect of bacteria, but also to the local protective mechanisms evoked by the organism. There is, therefore, theoretical justification for a combined therapy of systemic antibiotics and intraarticular corticostertoids in septic arthritis. METHODS: Experimental arthritis was induced by the intraarticular injection of Staphylococcus epidermidis in rabbits. The experimental scheme included three groups of animals: animals that were infected but not treated (group 1); animals treated with systemic antibiotics (group 2); and animals treated with systemic antibiotics and intraarticular steroids (group 3). Nine days later the animals were sacrificed and joint histopathological-histochemical indices were calculated. RESULTS: Animals from groups 2 and 3 had a smaller pannus, reduced proteoglycan loss, no loss of cartilage height and diminished synovial inflammation in comparison to the animals from group 1. The animals from groups 2 and 3 were identical in terms of cartilage cellularity, surface erosion, chondrocyte cloning, pannus formation and proteoglycan loss. Synovial inflammation appeared to be less pronounced in group 3 animals when compared to animals of group 2. CONCLUSION: Concomitant antibiotic-steroid treatment of septic arthritis seems to be harmless in this experimental setting.

Animals