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Biomedical subjects

M Camerlain

Publications and source records attributed to M Camerlain.

30 records · Page 2Linked to original sources

A double-blind cross-over evaluation of ketoprofen and aspirin in rheumatoid arthritis.

Thirty rheumatoid patients participated in a 6-week double-blind cross-over assessment of ketoprofen (200 mg daily) and aspirin (3.6 g daily). Regular clinical and laboratory assessments were conducted and revealed that at the dosages employed, the two drugs exerted a statistically comparable therapeutic effect. Side-effects were more frequent with aspirin. Ketoprofen was preferred more often by the patients while the investigator found it acceptable as often as aspirin.

Adult

Naproxen: long-term study in rheumatoid arthritis and "placebo pulse".

Naproxen is by now a relatively well-known antirheumatic drug, and many short-term studies have shown its efficacy and relatively good tolerance. We have observed 64 patients with definite or classical rheumatoid disease, 27 of whom have been followed for well over two years on daily doses of naproxen to ascertain the persistence of drug efficacy and safety. In this part of our study, patients were subjected to complete clinical and biochemical evaluations at two-monthly intervals. Naproxen was well tolerated, and the few side effects reported were transient and mild in nature. Sequential laboratory studies revealed no significant anomaly. Clinical evaluation showed no pattern suggestive of decreasing antirheumatic activity. A question frequently encountered in the treatment of certain diseases such as rheumatoid arthritis is whether long-term improvement is due to efficacious suppressive therapy or spontaneous abatement of disease activity. We devised a double-blind placebo pulse phase in which 19 of our 28 long-term patients participated in a study within a study lasting four weeks. They were divided into two groups. The first group took their usual dose of naproxen during the first two weeks and a corresponding number of placebo tablets in the next two weeks. The procedure was reversed in the other group. We conclude that naproxen remains efficacious.

Adult

Inorganic pyrophosphate pool size and turnover rate in arthritic joints.

Recent studies have shown elevated inorganic pyrophosphate (PPi) levels in most knee joint fluid supernates from patients with pseudogout (PG) or osteoarthritis (OA) and more modestly elevated levels in some supernates from patients with gout or rheumatoid arthritis (RA) relative to PPi levels found in the venous blood plasma of normal or arthritic subjects. We measured the intraarticular PPi pool and its rate of turnover to better understand the significance of the joint fluid-plasma PPi gradient. Preliminary studies in rabbits showed that (32-P)PPi passed from joint space to blood and vice versa without detectable hydrolysis. Incubation of natural or synthetic calcium pyrophosphate dihydrate (CPPD) microcrystals with synovial fluid in vitro in the presence of (32P)PPi tracer showed no change in PPi specific activity in the supernate over a 19-h period so that exchange of PPi in solution with that in CPPD microcrystals could be ignored. Clearance rates of (32P)PPi and of (33P)Pi, as determined by serially sampling the catheterized knee joints of volunteers with various types of arthritis over a 3-h period, were nearly identical. The (32P)PPi/(32P)Pi was determined in each sample. A mixture of a large excess of cold PPi did not influence the clearance rate of either nuclide. The quantity of PPi turned over per hous was calculated from the pool size as determined by isotope dilution and the turnover rate. The residual joint fluid nuclide was shown to be (32P)PPi. The PPi pool was generally smaller and the rate of turnover was greater in clinically inflamed joints. The mean plus or minus SEM pool size (mu-moles) and turnover rate (percent/hour) in PG knees was 0.23 plus or minus 0.07 and 117 plus or minus 11.9, hydrolysis rate (%/h) to Pi was 27.7 plus or minus 13.2; in OA knees: 0.45 plus or minus 0.26 and 72 plus or minus 9.2, hydrolysis 6.9 plus or minus 0.9; in gouty knees: 0.8 plus or minus 0.41 and 50 plus or minus 11.6, hydrolysis 9.8 plus or minus 2.8; and in RA knees: 0.14 plus or minus 0.14 and 114 plus or minus 35.8, hydrolysis 236 plus or minus 116. PPi turnover (mumoles/hour) correlated with the degree of OA change present in the joint as graded by radiologic criteria irrespective of the clinical diagnosis. Mean PPi turnover in joints with advanced OA was greater than in those with mild or moderate changes (P smaller than 0.001), but the mild and moderate groups showed no significant difference. We conclude that synovial PPi turnover and elevated PPi fluid concentrations are not specific for PG patients, and that these factors alone cannot be the only determinants of CPPD crystal deposition.

Adult

Variation in plasma and urinary inorganic phosphate and pyrophosphate in normal subjects and in patients with acromegaly or osteoarthritis.

Plasma inorganic pyrophosphate (PPi) and inorganic orthophosphate (Pi) levels, urinary PPi and Pi excretion were measured every 2 h for a day in 4 normal subjects on a normal diet and again while fasting; 5 patients with osteoarthritis and 4 patients with acromegaly were also studied. Plasma Pi values were elevated at night in all subjects and were highest in the acromegalic patients. Mean plasma PPi was lower during fasting and correlated with Pi levels in all non-fasting subjects. Urinary Pi and PPi were strongly correlated; both were lower in fasting subjects. Food intake and the time of blood sampling are important biological variables that must be considered when interpreting plasma PPi levels.

Acromegaly