Seronegative arthritis: psoriatic arthritis.
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Arthritis↗
Biomedical subjects
M E Suarez-Almazor
Publications and source records attributed to M E Suarez-Almazor.
Ankylosing spondylitis in families with two distinct B27 haplotypes: a selective association.
Five families whose members had 2 distinct B27 haplotypes, and in which numerous members had ankylosing spondylitis (AS), were studied to see whether, in each family, both B27 haplotypes were associated with similar risks for the development of AS. In 4 of the 5 families, all family members with AS (4, 2, 3, and 2 individuals, respectively) shared the same B27 haplotype; however, 1 was homozygous for HLA-B27 and carried both haplotypes. By statistical analysis, we showed that the B27 haplotype carried by the eldest member with AS in each family was more likely to be associated with disease. If additional genetic factors play a role in the development of AS, these preliminary findings suggest that they are probably located around the major histocompatibility complex.
Female↗
Auranofin in juvenile rheumatoid arthritis. An open label, non-controlled study.
An open label, non-controlled trial of six-month duration was designed to determine the safety and efficacy of auranofin in the treatment of 13 children with polyarticular JRA. Adverse reactions were observed in 5 of the 13 patients (38%) but only in one was it serious enough to discontinue treatment. None of the patients developed diarrhea or hematologic abnormalities. Therapeutic response was evaluated in the 11 patients who completed the six-month treatment. According to the final overall assessment 9 of the 11 children had improved, one remained unchanged and one worsened. After four months of treatment serum gold levels in 11 patients ranged between 28 and 59 micrograms/dl, with a mean value of 34 micrograms/dl. There was no correlation between serum gold levels and the frequency and severity of side effects.
Adolescent↗
Lack of congruence in the ratings of patients' health status by patients and their physicians.
PURPOSE: The purpose of this study was to examine if physician assessments of their patients' health status after the medical encounter are comparable to their patients' self-assessment of their own health. METHODS: Consecutive patients with musculoskeletal diseases were recruited when they attended 1 of the rheumatology outpatient clinics selected for the study. Five physicians participated in the study, 4 based at an academic center and 1 in the community. Patients were interviewed after seeing the physician; they completed health status questionnaires (mHAQ and SF-12) and rated their pain, worry about disease, and overall health status on visual analog scales. Standard gamble techniques were used to obtain patient utilities in relation to their health status, "gambling" on the probability of obtaining perfect health from an intervention with varying risks of death. After the medical encounter, physicians were asked to rate their patients' health status with similar instruments and with standard gamble elicitation techniques, blinded to the patients' responses. RESULTS: A total of 105 patients participated in the study; 70% were female; mean age was 54+/-16 years; 64% had a connective tissue disease, most commonly rheumatoid arthritis; and the other diseases in this group included soft tissue rheumatism, osteoarthritis, or low back pain. Statistically significant differences were observed between patient and physician ratings for pain, overall health, and standard gamble. On average, physicians rated their patients' health status higher than the patients themselves and were less willing to gamble on the risk of death versus perfect health. Intraclass correlation coefficients (ICC) were low: 0.42 for pain, 0.11 for worry, 0.11 for overall health, and 0.04 for standard gamble utilities. Similar findings were observed when subgroup analysis was performed for individual physicians and for patients with connective tissue diseases. No specific patient characteristic consistently related to increased divergence in the ratings. CONCLUSIONS: These findings suggest that the communication between physicians and their patients at the time of the medical encounter needs to be enhanced. An understanding of their patients' health perceptions may assist physicians in suggesting appropriate interventions, taking into account their patients' benefit-risk preferences.
Attitude of Health Personnel↗
Parenteral methotrexate or gold for rheumatoid arthritis: a follow up.
The forty participants in a double blind controlled trial of parenteral methotrexate or gold for RA were followed up two years later. Fifty percent had remained on the original medication, 13/20 on MTX and 7/20 on gold. Only 5 and 3 of them respectively had no active joint swelling. No major differences between the two groups were seen.
Arthritis, Rheumatoid↗