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Biomedical subjects

N L Gottlieb

Publications and source records attributed to N L Gottlieb.

At least 37 records · Page 2Linked to original sources
PubMed1979

Gold excretion and retention during auranofin treatment: a preliminary report.

Auranofin, an oral gold compound, was administered to 12 patients with rheumatoid arthritis using 2 dosage schedules (3 mg or 1 mg twice daily for 8 weeks, and then once daily for 18 weeks). In addition to outpatient clinic monitoring, all patients were admitted to a metabolic ward for 3 days for collection of 24 hr daily urine and feces. Gold content of excreta was determined by atomic absorption spectroscopy. Seventy-three per cent of the administered gold was recovered in the urine and feces of patients receiving 3 mg b.i.d., and all the gold was recovered in those taking 1 mg b.i.d. Ninety-five per cent of the recovered gold was in the feces and 5% was in the urine. These findings contrast with those observed during intramuscular (gold sodium thiomalate) chrysotherapy: 40% of the injected dose was recovered, 70% in urine, 30% in feces. Less tissue gold retention occurred with oral gold than with parenteral therapy. Following 20 weeks of auranofin (6 mg/day) chrysotherapy approximately 66 mg of gold was retained. By comparison, 300 mg of gold was retained after injectable gold sodium thiomalate treatment. The significance of these findings is discussed.

Adult↗
PubMed1977

Allopurinol-associated hand and foot deformities in chronic tophaceous gout.

Telescoped digits of the hands and feet developed in a 69-year-old male with severe chronic tophaceous gout during allopurinol treatment. Extensive osseous tophi, resorbed rapidly during therapy with this xanthine oxidase inhibitor and not replaced by new bone matrix, were responsible for the deformity. Several hypotheses are advanced to explain the failure of bone erosions to heal.

Aged↗
PubMed1977

Hand flexor tenosynovitis in rheumatoid arthritis. Prevalence, distribution, and associated rheumatic features.

Tenosynovitis of one or more flexor tendons of the hand (mean 3.1 tendons per patient) was noted in 55% of 100 patients with rheumatoid arthritis (RA) examined periodically during a mean period of 5 years. The third flexor tendon was involved most frequently (71% of patients), followed by the second (62%), fourth (53%), fifth (27%), and first (13%). Patients with flexor tendonitis (FT) had a significantly higher prevalence of rheumatoid nodules (56% vs 33%), carpal tunnel syndrome (47% vs 13%), wrist extensor tenosynovitis (47% vs 9%), and elbow epicondylitis (22% vs 7%) than patients without FT. Dupuytren's contracture, DeQuervain's tenovaginitis, flexor carpi radialis and ulnaris tendonitis, and Achilles tendonitis were found exclusively in patients with FT. A control group of 50 non-RA patients with FT had statistically fewer diseased tendons per patient (mean 1.5) and a different digital distribution, the thumb being affected more frequently (P less than 0.05) than in RA patients.

Achilles Tendon↗
PubMed1977

Acute myocardial infarction following gold sodium thiomalate induced vasomotor (nitritoid) reaction.

A vasomotor (nitritoid) reaction occurred following an initial injection of gold sodium thiomalate (GST; Myochrysine) in a 69-year-old man with rheumatoid arthritis (RA). An acute anterior wall myocardial infarction, documented by serial electrocardiographic and serum enzyme changes, developed immediately thereafter. A second patient, a 49-year-old man with RA and a history of GST-associated vasomotor reactions, was monitored clinically and electrocardiographically after GST administration. Sinus tachycardia developed and peripheral blood pressure fell within 2 minutes of injection, simultaneous with the onset of vasomotor symptoms. Vasomotor reactions from GST may compromise myocardial perfusion by their action on arteriolar smooth muscle, and thus result in peripheral vasodilatation, or they may act by adrenergic discharge initiated by such a reaction, and thus increase myocardial work and oxygen demand. Aurothioglucose (Solganal), rarely produces vasomotor reactions, and may be preferred to GST in elderly RA patients with concomitant cardiovascular disease or atherosclerosis.

Aged↗
PubMed1977

Gold compounds in rheumatoid arthritis. Report of a symposium.

A vast accumulation of clinical experience and controlled studies justifies the use of gold compounds in selected cases of rheumatoid arthritis. The striking therapeutical efficacy observed in some patients has stimulated active research to clarify the pharmacokinetics and mechanisms of action of gold compounds. Based on this knowledge, the possibility of selecting gold-responsive patients may be enhanced, and the frequency of adverse reactions decreased. Liberal indications and inexperience in administration and control have given gold therapy mixed reputation. A symposium in Umeå, Sweden, summarized present knowledge and current concepts among Scandinavian rheumatologists on the rational use of gold compounds.

Arthritis, Rheumatoid↗
PubMed1976

Aberrant serum enzyme patterns in dermatomyositis associated with hepatoma.

A Caucasian male developed florid dermatomyositis documented by serum enzyme elevation, electromyography, and histology of skin and muscle. Serum enzymes, including creatine phosphokinase (CPK), aldolase, glutamic oxaloacetic transaminase (SGOT), and lactic dehydrogenase (LDH), decreased initially during high dose systemic corticosteroid therapy, although profound muscle weakness persisted. Subsequent elevation of serum LDH and SGOT levels during treatment provided a clue to underlying neoplasia. Primary hepatoma with widespread metastases was found at necropsy.

Adult↗
PubMed1975

The quantitative distribution of gold in skin during chrysotherapy.

Gold concentrations in epidermis, dermis, and whole skin were measured by neutron activation analysis after formation of suction bullae in 8 patients who had received protracted cyrysotherapy. Epidermis contained 3% (median) of the gold content of whole skin. A direct correlation between cumulative gold dose and skin gold level was noted. These findings suggest that apparent gold concentrations in skin are influenced by the depth of the biopsy, that keratinous tissues have little affinity for gold, and that the gold storage capability of skin is not saturated by large cumulative doses of gold. The beneficial effect of gold in pemphigus may not be mediated at the site of blister formation.

Adult↗
PubMed1975

Pulmonary manifestations of ankylosing spondylitis.

Chest radiographs of 39 patients with ankylosing spondylitis were studied. Three showed apical pulmonary fibrosis, two with cavitary lesions. Other known causes of lung disease were excluded. Symptoms and roentgenographic evidence of spondylitis were present for many years prior to the onset of pulmonary symptoms, which variably included shortness of breath, cough, hemoptysis, pleuritic chest pain, fever, and chills. Apical pulmonary lesions of unknown cause were absent in 53 age, sex, and racematched osteoarthritis control patients. The findings suggest that apical pulmonary fibrosis may be an extra-skeletal manifestation of ankylosing spondylitis, the frequency of which approaches that of spondylitic heart disease.

Adult↗
PubMed1975

The influence of chrysotherapy on serum protein and immunoglobulin levels, rheumatoid factor, and antiepithelial antibody titers.

Serum protein and immunoglobulin concentrations, rheumatoid factor (RF) titers, and erythrocyte sedimentation rates (ESR) from 18 patients with active rheumatoid arthritis (RA) who were being treated with gold sodium thiomalate (Myochrysine) and monitored clinically were measured serially. Serum antiepithelial antibody (AEA) titers from 10 patients with pemphigus who were similarly treated were measured at frequent intervals. Statistically significant reductions of alpha2, gamma, and total globulins, IgG, IgA, and IgM, ESR, and RF, and AEA titers were found after 3 to 6 months of gold treatment. Serum albumin levels rose significantly, but alpha1, beta-globulin, and total protein did not change. A temporal relationship between the alteration of these serological tests and the clinical response to treatment was noted, but the magnitude of protein change did not correlate with the degree of clinical improvement within a given patient. These findings indicate that gold treatment influences serum protein and antibody concentrations in two diseases having diverse target organs and different etiologies. The question of whether gold compounds exert an immunosuppressive action, or whether the serologic changes are a secondary phenomenon reflecting amelioration of disease activity, is unresolved.

Aged↗