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Biomedical subjects

M Weisman

Publications and source records attributed to M Weisman.

At least 37 records · Page 2Linked to original sources
PubMed1996

Quality-adjusted life years lost to arthritis: effects of gender, race,and social class.

OBJECTIVE: To estimate the public health impact of self-reported arthritis in terms of Quality-Adjusted Life Years. METHOD: The Quality of Well-being Scale (QWB) is a general measure of health-related quality of life that scores levels of wellness on a continuum between death (0.0) and optimum functioning (1.0). Values for the QWB were imputed for the National Health Interview Survey. These estimates were adjusted for mortality based on the life tables. Age-specific estimates were obtained for those reporting arthritis and compared to estimators for the population not reporting arthritis. These estimates were broken down by race (white versus nonwhite), gender and socioeconomic status. RESULTS: The expected life years lost because of arthritis were 1.86 (95% confidence interval 1.40-2.32 years). Arthritis was reported more often among those of lower income, those living in rural areas, those of lower educational attainment, and older respondents. Men and women did not differ in rates of reporting arthritis, but men with arthritis had lower QWB scores than women with arthritis. CONCLUSION: Arthritis has a significant public health impact.

Activities of Daily Living↗
PubMed1995

Predicting health care use among older osteoarthritis patients in an HMO.

OBJECTIVE: To determine factors that predict health care use among members of Health Maintenance Organizations (HMOs). Demographic, health, and psychological factors were examined simultaneously. METHODS: Participants were HMO members 60 years of age or older who had osteoarthritis (OA). All participants reported symptoms of OA, with 90% of the diagnoses confirmed by evaluation of physician records. RESULTS: Age, the presence of other medical conditions, quality of well-being, and the Health Worries subscale from the Arthritis Impact Measurement Scales accounted for 11.2% of the total variance in health care contacts. A model including prior health care use, age, quality of well-being, physical impairment, and pain accounted for 29.5% of the variance in utilization rates. CONCLUSION: The best single predictor of health care utilization was prior use of the system. Being older, more impaired, and having lower well-being scores were also predictors of health care use.

Age Factors↗
PubMed1995

Inter and intraobserver variability of total skin thickness score (modified Rodnan TSS) in systemic sclerosis.

OBJECTIVE: Assessment of the inter and intraobserver variability of the modified Rodnan (m-Rodnan) total skin thickness score by clinical palpation [a commonly used outcome measure in trials of systemic sclerosis (SSc)]. METHODS: Skin thickness was assessed by clinical palpation of 17 body areas on 0 to 3 scale (normal, mild, moderate, severe). The m-Rodnan total skin thickness score was derived by summation of the scores from all 17 body areas. Using the m-Rodnan, 6-7 investigators assessed skin thickness in 5-6 patients with SSc (22 patients and 23 examiners total) at each of 4 sessions for the determination of interobserver variability (accuracy). In addition 21 of the investigators then assessed m-Rodnan in 2-3 patients each (60 patients total) 3 times over a 2-8 week period to quantitate intraobserver variability (reliability). RESULTS: Interobserver and intraobserver mean +/- within patient standard deviations (SD) for the m-Rodnan were found to be 17.7 +/- 4.6 and 20.7 +/- 2.45, respectively. CONCLUSION: The m-Rodnan total skin thickness score is at least as reliable for measuring skin thickness in SSc as are the ARA and Ritchie joint tenderness counts for assessing joint disease in rheumatoid arthritis. These data are useful for the determination of sample size and for the definitions of clinically meaningful response. Assessment of skin score is sufficiently reproducible to include as a measure of disease outcome, especially if patients are serially evaluated by the same investigator.

Humans↗
PubMed1994

[Adamantinoma of the tibia].

Adamantinoma of the tibia is a rare, malignant growth originating in epithelial fetal cells. We present a 17-year-old girl who had prolonged pain in her right calf for 6 years. X-ray showed a growing malignant lesion whose nature was confirmed by biopsy. After planning the anatomical and functional aspects, the tibia was excised in its diaphyseal part, which included the growth with wide margins. Iliac bone was implanted in place of excised tibial bone. After 1 year the implant showed complete healing and had grown to impressive size, ensuring safe carrying of body weight, and the length and function of the limb were completely normal. 4 years postoperatively no pathologic lesion was noted on clinical examination, in X-rays nor in another biopsy of the implanted bone and the surrounding soft tissues.

Adolescent↗
PubMed1992

Responsiveness to 1,25-dihydroxyvitamin D3 is reduced in lymphocytes from osteoporotic women.

The purpose of this work was to test the hypothesis that reduced responsiveness of target organs to 1,25-dihydroxyvitamin D3 [1,25-(OH)2D3] is associated with osteoporosis. Peripheral blood mononuclear (PBM) cells have been previously shown to be a valid model for the action of 1,25(OH)2D3 on its classic target organs in various pathologic and physiologic situations. The responsiveness of lymphocytes to the hormone can be assessed by the extent of inhibition it exerts on the proliferative response to mitogenic lectins. A group of 39 postmenopausal women, at least 10 years after the menopause, participated in the study. Osteoporosis, defined as the presence of at least one nontraumatic vertebral crush fracture, was diagnosed in 19 subjects. Mitogenesis of PBM cells stimulated by phytohemagglutinin and cultured for 72 h in the presence or absence of 1,25-(OH)2D3 (0.03-1 nmol/liter) was assessed by [3H]thymidine incorporation during a 4 h pulse. The maximal inhibitory effect of 1,25-(OH)2D3 at saturating concentration (1 nM/liter) was 74.6 +/- 2.8% (mean +/- SEM) for normal compared to 65.3 +/- 2.9% for osteoporotic women (P = 0.015). The geometric mean of the ED50 values of 1,25-(OH)2D3 was 60% higher in the osteoporotic than in the normal group (P = 0.035). Our data are consistent with the notion that reduced responsiveness of target organs to 1,25-(OH)2D3 is associated with osteoporosis.

Aged↗
PubMed1988

Primary hypertrophic osteoarthropathy.

We describe seven patients with primary HOA and review 125 cases reported in the English, French, and German literature. The salient clinical features of primary HOA are: a bimodal distribution of disease onset with one peak during the first year of life and the other at age 15, a male predominance (nine to one), uncommon benign joint effusion, and a variety of skin abnormalities resulting from cutaneous hypertrophy or glandular dysfunction. We concluded that HOA is not a synovial disease. It is suggested that synovial effusions, when present, are perhaps a sympathetic reaction to the neighboring periostitis. Proposed diagnostic criteria for HOA, including digital clubbing and radiographic periostitis, appear 86% sensitive. The clinical features, age of onset, and sex distribution suggest that a genetically controlled growth promoting factor, different from growth hormone, plays a role in the pathogenesis of this syndrome.

Adolescent↗
PubMed1988

Neuroarthropathy associated with chronic alcoholism.

Neuroarthropathy involving the feet is seen most commonly in patients with diabetes mellitus. Chronic alcoholism has been implicated as a cause of neuroarthropathy, but many alcoholics have coexistent diabetes mellitus, which may not be detected by measuring blood glucose levels alone. We report five chronic alcoholic patients with neuroarthropathic alterations of the feet in whom coexistent diabetes mellitus was excluded by using laboratory methods that are more sensitive than those employed in previously reported series of alcoholic neuroarthropathy. The radiographic features of neuroarthropathy in our five cases consisted of hypertrophic changes at the tarsal joints in four, bony fragmentation at the tarsal and metatarsal regions in three, fracture dislocation at the tarsometatarsal joint in two, and multiple pathologic fractures in one. We conclude that alcoholism can result in neuroarthropathy in the absence of diabetes mellitus.

Adult↗
PubMed1987

Carpal alterations in adult-onset Still disease, juvenile chronic arthritis, and adult-onset rheumatoid arthritis: comparative study.

A specific pattern of pericapitate involvement of the wrist has been described in the rheumatologic literature as characteristic of adult-onset Still disease (AOSD), a relatively rare disorder that is often diagnosed by exclusion after extensive and frequently invasive tests. To evaluate the potential diagnostic value of carpal radiography in suspected cases of AOSD, a retrospective blinded analysis of 48 patients (16 each with AOSD, juvenile chronic arthritis, and adult-onset rheumatoid arthritis) was performed. Pericapitate articular alterations without radiocarpal involvement were found to be distinctly unusual among patients with rheumatoid arthritis but frequent in the setting of AOSD. In juvenile chronic arthritis severe pericapitate involvement also occurs frequently but is more likely to be associated with interosseous fusion and severe pancompartmental disease.

Adult↗
PubMed1979

Carpal involvement in inflammatory (erosive) osteoarthritis.

Inflammatory or erosive osteoarthritis, in addition to the classical digital distribution, may involve the carpus. Characteristic carpal changes are restricted to the radial aspect of the wrist and consist of narrowing, eburnation, osteophytosis, and mild subluxation of the first carpometacarpal and trapezio-scaphoid joints. Radiographic findings and differential diagnosis are discussed.

Arthritis, Rheumatoid↗
PubMed1978

Osteolysis with detritic synovitis. A new syndrome.

A new pattern of osteolysis accompanied by detritic synovitis occurred in a 71-year-old woman. The patient had a severe, destructive, and multilating arthropathy of her hands, with distal phalangeal deformity. Radiographs outlined bone resorption of the appendicular and axial skeleton, with involvement of phalanges, metacarpals, metatarsals, clavicles, long bones, and spine. There was no notable occupational history nor laboratory evidence of hyperparathyroidism. Pathological evaluation revealed synovial ulceration and necrosis, and necrotic bone embedded with fibrotic synovium. This patient's abnormalities appear to represent a new pattern of osteolysis that can be distinguished from other disorders.

Aged↗
PubMed1977

Extaarticular manifestations of septic arthritis of the glenohumeral joint.

Five patients with septic arthritis involving the glenohumeral joint are described. Although initial plain films were normal in all six involved joints, abnormalities were frequent on subsequent examinations, including demineralization (five joints), joint space narrowing (three joints), superior subluxation of the humeral head (three joints), osseous erosion (two joints), and inferior subluxation of the humeral head (one joint). Arthrography was helpful in documenting intraarticular placement of the needle for aspiration, synovial abnormalities, and extraarticular extension of disease. Particularly noteworthy was the occurrence of rotator cuff tears in four of six shoulders, suggesting a possible relationship between joint infection and disruption of the rotator cuff.

Aged↗
PubMed1975

Reaction of nitrite with ascorbate and its relation to nitrosamine formation.

In this study of the nitrosation of morpholine in the presence of ascorbic acid, the amount of ascorbate required to inhibit completely the formation of nitrosomorpholine depended on whether oxygen was present in the system. The nitric oxide (produced during the oxidation of ascorbate by nitrous acid) might have reacted with oxygen to yield additional oxidizing equivalents, or oxygen might have directly oxidized the ascorbate semiquinone intermediate produced in the initial step of oxidation reaction. A pH- dependent induction period observed during the nitrosation of morpholine in the presence of ascorbate and excess nitrite was accounted for by the kinetics of the reactions.

Ascorbic Acid↗
PubMed1975

Cryoimmunoglobulinemia in rheumatoid arthritis. Significance in serum of patients with rheumatoid vasculitis.

Cryogloculins were examined in a standardized manner in an unselected group of 35 patients with rheumatoid arthritis (RA) and 8 patients with RA complicated by cutaneous vasuclitis and neuropathy. Optimum conditions for detection and characterization of cryoglobulins were established; the proportion of resolubilized to total precipitable protein remained constant in an individual patient under these conditions. All 8 vascultis patients and 9 of 35 other patients with RA exhibited cryoglobulins; total protein and immunoglobin content were significantly higher in the cryoglobulins of patients with vasculitis. Immunoglobulins G and M constituted two-thirds and three-quarters of the total protein in the cryoglobulins from uncomplicated rheumatoid and vasculitis patients, respectively. Serum antiglobulin titers were higher, and serum C3 levels were lower, in vasculitis patients compared to rheumatoid patients without vasclitis. Anti-gamma globulin activity was detected in all cryoglobulins from vasculitis patients. Cryoglobulin IgG and IgM were polyclonal. Density gradient analyses demonstrated the majority of the cryoglobulin activity to reside in the 19S IgM fraction. There was no evidence of a light weight (8S) IgM. A monoclonal rheumatoid factor did not detect 7S-ANTI-7S complexes in the cryoprecipitates, but acid eluates from some cryoglobulins absorbed with insoluble IgG revealed an antiglobulin of the IgG class. Serial studies performed on vasculitis patients treated with cyclophosphamide disclosed a relationship between clinical evidence of vasculitis and the presence of cryoglobulins. The antigen (IgG) and antibody (largely IgM rheumatoid factor) nature of these cryglobulins is presented as evidence that the widespread vascular complications of RA are mediated, at least in part, by circulating immune complexes.

Aged↗