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Biomedical subjects

R Bluestone

Publications and source records attributed to R Bluestone.

At least 19 recordsLinked to original sources
PubMed1992

Septic arthritis and bacteremia due to Mycoplasma resistant to antimicrobial therapy in a patient with systemic lupus erythematosus.

We report a case of septic arthritis caused by Mycoplasma hominis in a patient with systemic lupus erythematosus. The infection started as monarthritis but spread to at least four joints despite apparently suitable therapy with various antimicrobial agents, including doxycycline, clindamycin, and ciprofloxacin; subsequent bacteremia was documented. Control was ultimately achieved with use of the experimental fluoroquinolone temafloxacin in combination with doxycycline administration, arthroscopic drainage of a persistently infected joint, several intravenous infusions of immunoglobulins (which led to increases in levels of antibodies specific to M. hominis), and discontinuation of corticosteroid therapy. Antimicrobial susceptibility testing of various mycoplasmal isolates showed the presence of the tetM gene, disparity between susceptibility to tetracycline and doxycycline, and increasing resistance to most antimicrobial agents used (including to fluoroquinolones before clinical use), although the patient ultimately had a favorable clinical response to treatment with combined modalities.

Adult↗
PubMed1979

Case report 84.

Explore the source record for details and available documents.

Aged↗
PubMed1979

HLA-D locus typing in ankylosing spondylitis and Reiter's syndrome.

HLA-D typing of 44 patients with ankylosing spondylitis (AS) and 31 patients with Reiter's syndrome (RS) did not show increased frequency of any particular Dw allele in either population of patients as compared to controls. Such studies also allowed each patient's general response to be compared with other general responses within each experiment. Contrary to reports of diminished lymphocyte responses in AS patients, hyperresponsiveness in both AS and RS patients was found.

Alleles↗
PubMed1979

Plasmapheresis and lymphoplasmapheresis in the management of rheumatoid arthritis.

We have demonstrated the efficacy of therapeutic pheresis in a number of rheumatic diseases, especially rheumatoid arthritis (RA). Ten of 12 patients with RA went into remissions averaging 4 months. These patients were pheresed 20 times over 11 weeks in a tapering fashion on a Haemonetics Model 30 Blood Processor. Clinical remissions were sustained even though serologies, immunoglobulins, immune functions, sedimentation rates, and circulating immune complexes returned to their pre-pheresis baseline by pheresis number 20. All these patients were taking gold or D-penicillamine concurrently, but neither of the 2 patients who failed to respond was on these agents. Plasmapheresis was just as effective as lymphoplasmapheresis. It is theorized that removal of a plasma factor that modulates lymphocyte or neutrophil function produces remissions in RA and that long-acting drugs (e.g., gold or penicillamine) are able to prevent its continued production and produce a sustained remission.

Adult↗
PubMed1979

Diagnosis of rheumatic disease. 1. Radiographs.

Radiographs are a clinician's most valuable tool in differential diagnosis of rheumatic disease and in assessment of its severity. The patterns of joint involvement and the specific bony changes characteristic of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, Reiter's syndrome and psoriatic arthritis, gout, and systemic lupus erythematosus are discussed here.

Adolescent↗
PubMed1979

Diagnosis of rheumatic disease. 2. Laboratory tests.

Part 1, which begins on page 64, discusses diagnosis of rheumatic disease by radiography. The most popular laboratory tests in rheumatic disease are nonspecific and include those based on the formation of autoantibodies. Rheumatoid factor assays actually are of little diagnostic help in rheumatoid arthritis, but antinuclear antibody tests have become mandatory for identification of systemic lupus erythematosus. Studies based on immune complexes and cell immunity are valuable in specific clinical situations.

Antibodies, Antinuclear↗
PubMed1979

Susceptibility of isolates of Bacteroides to the bactericidal activity of normal human serum.

Seventy-one strains of species from the Bacteroides fragilis group, including 46 isolates of B. fragilis, were tested for susceptibility to the bactericidal effect of serum from healthy subjects. Twenty-seven (38%) of the isolates were killed by serum. Isolates from feces were significantly more sensitive to serum than were isolates from patients with clinical infections. Killing of bacteria required heat-labile serum components and was an exponential function of serum concentration. Among the various species tested, B. fragilis was clearly the most resistant to bactericidal activity of serum. These observations may be important to the understanding of infections caused by the B. fragilis group, which contains the anaerobes of greatest clinical importance.

Bacteroides fragilis↗
PubMed1979

The clinical spectrum of ankylosing spondylitis.

Ankylosing spondylitis is more common in young men than in young women and is insidious in onset. Typically, patients complain of pain and stiffness around the sacroiliac region. At the disease progresses, pain is often felt in the mid-lumbar, thoracic and cervical regions resulting in a significant reduction in the range of motion of the entire spine. About one fourth of the patients display involvement of proximal synovial joints. Acute anterior uveitis may precede AS or can occur when the disease is otherwise in apparent remission. Each patient with established disease should be carefully evaluated for cardiovascular, pulmonary, and neurologic complications. Early detection of AS is important, since proper management may well prevent the severe fixed deformities of the spine and root joints that is liable to occur in these patients.

Adult↗
PubMed1978

Ankylosing spondylitis and hyperparathyroidism.

An attempt was made to determine whether a relationship exists between ankylosing spondylitis (AS) and hyperparathyroidism (HP). Twenty patients with definite AS, studied for biochemical evidence of HP, did not show consistent abnormalities in serum calcium, phosphorus, alkalinephosphatase, or parathyroid hormone levels or in bone-density measurements. Reviewing roentgenograms of 39 patients with HP showed one patient with sacroiliitis, and one of the 28 hyperparathyroid patients tissue-typed as HLA B27-positive. Both AS and HP are independent entities that have no causative or pathological relationship to each other.

Alkaline Phosphatase↗