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Biomedical subjects

S Sam Lim

Publications and source records attributed to S Sam Lim.

3 recordsLinked to original sources

Bisphosphonate-associated arthritis.

We present a case of arthritis apparently induced by the administration of intravenous bisphosphonates in a 51-year-old white woman with metastatic breast carcinoma. She presented with bilateral knee pain and effusions on 2 separate occasions after receiving aminobisphosphonates. Synovial fluid analysis was negative for infection, metastasis, or crystals. Her symptoms resolved after the medication was discontinued and recurred after the patient was rechallenged with a medication from the same drug class. The administration of aminobisphosphonates has been associated with an acute-phase response in several in vivo studies. The mechanism of action is thought to be that aminobisphosphonates transiently stimulate the production of proinflammatory cytokines such as interleukin-1, interleukin-6, and tumor necrosis factor-alpha. Rheumatologists should be aware of this possible cause of arthropathy.

Arthritis↗

Factors affecting physical activity behavior in urban adults with arthritis who are predominantly African-American and female.

BACKGROUND AND PURPOSE: Physical activity and exercise play a critical role in the management of arthritis. Understanding the factors affecting physical activity and exercise behavior is a necessary first step toward identifying the needs of, and intervention strategies for, people with arthritis. The purpose of this study was to identify factors affecting physical activity and exercise behavior in urban subjects with osteoarthritis (OA) and rheumatoid arthritis (RA). SUBJECTS: Seventy-two consecutive subjects were recruited from the rheumatology clinic at a large urban public hospital. The sample was predominantly African American (92%), female (87%), and not working (90%). The subjects' average age was 60.9 years (SD=13.9, range=30-90). METHODS: Time per day spent sitting or lying down and time per week spent in exercise, leisure, and household activities were determined by individual interview. Self-efficacy, outcome expectations, disability, pain, body mass index, and social support were measured as possible explanatory factors. RESULTS: The average daily total activity time was 3.1 hours. Household and leisure activities accounted for 85% of that time. Explanatory factors for physical activity behavior were not the same for subjects with OA and RA, despite similar between-group characteristics. Self-efficacy was present in all of the significant explanatory models. DISCUSSION AND CONCLUSION: The results indicate that factors that affect physical activity behavior among urban and predominantly African-American adults are dependent upon the type of physical activity and are different for people with OA and RA. Self-efficacy was the most consistent explanatory factor.

Adult↗

New role for an old friend: prednisone is a disease-modifying agent in early rheumatoid arthritis.

There has been a renewed interest in the use of low doses of prednisone in the treatment of early rheumatoid arthritis. This is because it has been conclusively shown that low doses of prednisone retard bone damage, and physicians use prednisone because it helps control tender and swollen joints. Two studies appeared in 2002, one by van Everdingen et al. and one by Landewe et al. demonstrating the reduction of bone damage in early RA with the use of prednisone. Van Everdingen used 10 mg/day of prednisone and Landewe used an initial high dose of 60 mg/day of prednisone for a week, tapering off by 6 months. The bone sparing effect was still evident at 5 years. Low doses of prednisone are well tolerated, with documented side effects including weight gain, ecchymosis, and osteopenia.

Anti-Inflammatory Agents↗