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Biomedical subjects

R L Kaye

Publications and source records attributed to R L Kaye.

16 recordsLinked to original sources

Rheumatoid nodules. Review of the spectrum of associated conditions and proposal of a new classification, with a report of four seronegative cases.

The literature relating to prevalence, characteristics, differential diagnosis, histologic features, pathogenesis, complications, and prognosis of rheumatoid nodules is tabulated and reviewed. The broad spectrum of conditions associated with rheumatoid nodules is discussed. A new classification of these clinical entities, reflecting disease characteristics and prognosis, is proposed. This classification is based on age, association or lack thereof with rheumatoid arthritis or rheumatic features, the presence or absence of rheumatoid factors, and the location of the rheumatoid nodules. Four cases of rheumatoid nodules in patients without rheumatoid factor are presented. Three patients had classic or definite rheumatoid arthritis, and one had palindromic rheumatism. In follow-ups lasting one to 15 years, significant permanent joint deformities, bony erosions, or extra-articular manifestations of rheumatoid arthritis have not developed in any of the patients. All have experienced significant periods of remission.

Adult↗

Injectable collagen: a clinical overview.

Injectable bovine collagen is extremely effective in the correction of contour defects of the skin due to scarring and age-induced rhytides and folds. The rate of adverse reactions is low. Of 5,109 patients treated in clinical trials, 1.3 percent experienced temporary local inflammation at the site of injection. Techniques of injection and proper patient selection are presented. Repeat implantations at intervals of six to twenty-four months are often required to maintain full correction of cutaneous contour defects.

Cicatrix↗

Nonsteroidal anti-inflammatory agents in rheumatoid arthritis and ankylosing spondylitis.

The relative effectiveness of six nonsteroidal anti-inflammatory agents was studied in 33 patients with rheumatoid arthritis and 32 patients with ankylosing spondylitis in a double-blind, randomized, prospective study employing a six-way multiple crossover design with six-week trials of each agent. In ankylosing spondylitis, naproxen, indomethacin, and fenoprofen calcium were the most effective agents. In rheumatoid arthritis, relatively little mean difference between drugs was found. Most of this difference could be attributed to compliance factors, which favored drugs that required only a small number of pills daily. Despite the small differences in effect, patients had strong preferences. More than 85% of patients were still taking their preferred medication after a mean follow-up period of one year.

Anti-Inflammatory Agents↗

Understanding rheumatoid arthritis. Evaluation of a patient education program.

We evaluated a patient education program on understanding rheumatoid arthritis; 94% of those responding to our questionnaire considered the program helpful in increasing their understanding of their condition, and 93% said it enhanced their communication with their family. A total of 85% reported one or more behavioral changes, such as not abusing joints (63%), getting more rest (56%), and using medications more meticulously (48%) after participating in the program. We recommend patient education as an effective means of helping patients understand and hence comply with physicians' instructions as well as helping patients to assume greater responsibility for their own health care.

Arthritis, Rheumatoid↗

Rheumatoid hand deformities: pathophysiology and treatment.

Rheumatoid disease, as it affects the hand, is a disease of the synovium lining the joints and sheaths of the tendon. The proliferating synovium destroys the articular surfaces of the joint, interferes with the gliding mechanism of the tendons and weakens the supporting ligaments of the joints. The degree and variety of deformities is multifold. Treatment of the rheumatoid hand is aimed at conservation and restoration of hand function, as well as prevention of future deformities. Rheumatologists, physical therapists and hand surgeons carry out important functions in the well-planned, integrated regimen. Surgical treatment of the rheumatoid hand deformity may alleviate pain, lessen deformity and improve function in selected cases. It should be integrated in the general medical management of a patient. Treatment of tendon ruptures includes tenorrhaphy, tendon grafting and arthrodesis in the case of mallet finger deformity. The wrist joint is improved by synovectomy and carpal tunnel release is accomplished by median nerve decompression. Metacarpal phalangeal joint deformities may be treated by synovectomy or silastic joint replacement when there is destruction of the articular joint surface, severe subluxation, or persistent painful motion.

Arthritis, Rheumatoid↗

Treatment of rheumatoid arthritis: a review including newer and experimental anti-inflammatory agents.

Treatment of rheumatoid arthritis is often frustrating for patient and physician alike because of its chronic nature and our lack of knowledge about precise cause. It can be confused by the vast array of anti-inflammatory drugs now available, with new agents being added all the time. We present here an outline for a systematic treatment program that must be tailored to each patient's needs. It emphasizes a broad approach on the part of the physician and indicates that drugs comprise only one part of treatment. We review the drugs currently used in the treatment of rheumatoid arthritis and include discussion of those newer antiinflammatory agents that should be available shortly. A rational scheme for the use of these drugs is proposed.

Activities of Daily Living↗

Reiter's syndrome following epidemic shigellosis.

To define the epidemiology of post-dysenteric Reiter's syndrome (RS), 1,162 persons were questioned about compatible symptoms soon after 3 separate outbreaks of shigellosis. We diagnosed RS for 3 women of 204 persons ill during an outbreak of Shigella flexneri 1b, for 3 women of 206 ill during an outbreak of S. flexneri 2a, and for none of 85 ill during an outbreak of S. sonnei. We found no RS among 667 persons without diarrhea. Prospective controlled investigations in defined populations documented that RS follows S. flexneri 1b as well as 2a infections in about 1.5% of white adults with dysentery and indicated that women develop post-dysenteric RS as often as men.

Adolescent↗