ISSN:1076-1608    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Isolated antinuclear antibodies were neither very sensitive or specific for scleroderma in this study.This study was designed to determine the prevalence and positive predictive value of isolated antinucleolar antibody (ANA) in scleroderma patients. We identified 73 rheumatology clinic patients with isolated ANAs. ANA titers greater than 1:160 were considered positive.The overall prevalence of isolated ANAs was 2.9%.The prevalence of isolated ANAs in scleroderma, systemic lupus erythematosus (SLE), and rheumatoid arthritis were 20.3%, 2.68%, and 3.3%, respectively. Scleroderma and SLE were present in 12 patients (16.4%) each. Other rheumatologic disorders identified in these patients were RA (12.3%), undifferentiated connective tissue disease (8.2%), mixed connective tissue disease (4.1%), vasculitis (6.8%), fibromyalgia (8.2%), osteoarthritis (5.4%), crystal-related arthropathy (6.8%), seronegative arthritis (2.7%), sarcoidosis (4.1%), and others (8.2%).There were no statistically significant differences in the median ANA titers in scleroderma versus systemic lupus (P= 0.16) or undifferentiated connective tissue disease (P= 0.18). The median titers were higher in scleroderma in comparison with rheumatoid arthritis (P= 0.01), osteoarthritis (P= 0.007), fibromyalgia (P= 0.001), and crystal-related arthropathy (P= 0.009).Isolated ANAs have poor sensitivity (20.3%) and the positive predictive value for this test is only 16.4% for scleroderma.

ISSN:1076-1608    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Rheumatoid nodulosis is an entity that describes a particular variant of polyarthritis associated with early manifestations of palindromic rheumatism, radiologic subchondral bone cysts, and subcutaneous rheumatoid nodules. This study describes the clinical, radiologic, histologic, crystallographic, and laboratory findings, as well as the outcome in a group of 16 patients with rheumatoid nodulosis that were followed for a period of 1–12 years. Six of these patients had an aggressive course and developed classic erosive polyarticular rheumatoid arthritis, while the others continued having episodic arthritis without erosive disease. Seven patients had cholesterol crystals in olecranon bursae containing nodules.Second-line drugs used to control the articular manifestations did not improve the nodulosis, erosive, or cystic subchondral bone changes. Rheumatoid nodulosis mimics several other rheumatic diseases, and in about 40%, classic erosive rheumatoid arthritis develops. The presence of cholesterol crystals in rheumatoid nodules or affected bursae can increase the confusion with other crystal-induced arthritis, in particular, tophaceous monosodium urate gout or xanthomatosis.

ISSN:1076-1608    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

IV corticosteroids should be considered as a cause of hiccups.Singulata, commonly known as hiccups, have many causes and are most often idiopathic and short-lived. Occasionally, hiccups can be persistent and becoming quite bothersome, distracting, and even disabling. Many medications have been implicated as a cause of hiccups. Although uncommon, corticosteroids and benzodiazepines are 2 classes of drugs most frequently associated with the development of hiccups. The following case series describes 5 patients with intravenous corticosteroid-associated hiccups reported to our adverse drug reaction reporting system between January 1998 and December 2000. Physicians using intravenous corticosteroids should be aware of this potential complication.

ISSN:1076-1608    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

The cutaneous manifestations of autoimmune diseases, including systemic lupus erythematosus, are common and often recalcitrant to treatment. Unfortunately, therapy for lupus and other autoimmune skin diseases has not advanced and relies heavily on the use of oral and topical corticosteroids. Frequently, treatments prove less than ideal, either from toxicity or lack of efficacy. A topical form of the immunomodulating transplant medication, tacrolimus (FK-506, Protopic®), has recently been developed and approved for use in treating atopic dermatitis. Its mechanism of action and local route of administration render tacrolimus a potentially attractive novel therapeutic alternative for the treatment of various autoimmune dermatologic conditions. We report our successful experience using this drug in 3 patients with autoimmune dermatologic disease who were referred to a tertiary care subspecialty clinic.

ISSN:1076-1608    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Cardiac involvement occurs in less than 5% of Behçet patients, and coincidence of regurgitation of the aortic and mitral valves and myocardial infarctions is rare. This report describes a 49-year-old Turkish man with Behçet disease (BD) of 6 years’ duration who presented with reduced left ventricular function. Both aortic and mitral valves had to be replaced. Five months later, the patient presented with non-ST segment elevation myocardial infarction. Only 1 month later, the patient was successfully resuscitated after an acute ST segment elevation inferior myocardial infarction. Coronary arteries were normal in appearance at angiography before valvular replacement and at autopsy 2 years later.This report should increase awareness of cardiac involvement in BD and its potential danger. Even in BD patients without atherothrombotic plaques, myocardial infarctions can happen. Early and adequate immunosuppressive treatment might have reduced cardiac morbidity in this patient.

ISSN:1076-1608    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:1076-1608    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Although sarcoidosis frequently involves bone, it rarely presents as isolated osseous disease. We present a case in which sarcoidosis is limited to the sacrum and pelvis, a case that underscores the potential importance of both magnetic resonance imaging (MRI) and bone marrow biopsy in establishing the diagnosis. Additionally, we report the interval resolution of bony disease by MRI following glucocorticoid treatment.

ISSN:1076-1608    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

This system determines Medicare reimbursement in the USA but also may provide information to help analyze your practice.Since being implemented in 1992, the Resource- Based Relative Value Scale (RBRVS) has been the basis of all physician reimbursement from Medicare and increasingly is being used by other third-party payers to determine physician payments. The development of the RBRVS dates back to the 1980s and has evolved to the current system. Besides its use in physician reimbursement, by virtue of its nationwide usage, RBRVS has become a tool by which physicians can compare practice volume and efficiency, both with respect to other practices and within a single practice, to compare individual physicians. Although seemingly complex, the RBRVS provides a useful tool for physicians to understand their productivity, contracting, and reimbursement.

ISSN:1076-1608    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:1076-1608    

出版商:OVID    

年代:2003

数据来源: OVID