Implications of antirheumatic drug therapy in elderly patients with osteoarthritis.

The choice and dosage regimen of analgesic and NSAID for the elderly patient with osteoarthritis have to be made carefully with particular reference to hepatic and renal function, concomitant drug therapy, and concomitant disease.

Gold induced thrombocytopenia: 12 cases and a review of the literature.

Gold induced thrombocytopenia is immune mediated, with the production of platelet associated IgG leading to peripheral platelet destruction. An association with HLA-DR3 has been demonstrated. Corticosteroid therapy is effective in treatment, although other modes of therapy may be as efficacious.

Variation in physical and biological properties of solid gold sodium thiomalate on dissolution: an electron microscopic and energy dispersive spectroscopic study.

The dissolution of solid gold sodium thiomalate (GSTM) in water results in loss of yellow color. We studied the initial reaction on dissolution. It was associated with the disappearance of 2 absorption peaks on ultraviolet spectrum, one a well defined peak at 335 nm and the other a shoulder at 370 nm.

Punched-card aid in rheumatological diagnosis.

A punched-card diagnostic system is described for use in rheumatological practice. The system is based on pattern recognition and provides a list of both common and rare possible diseases. The system is simple and can be manufactured cheaply, and may be of particular use to family doctors in remote areas of practice.

The pharmacokinetics of isoxicam in elderly patients with rheumatoid arthritis.

Nineteen patients, aged 60 years and over, with rheumatoid arthritis participated in a clinical trial to investigate the pharmacokinetics of isoxicam (a new non-steroidal anti-inflammatory drug) in this age group. The purpose of the study was to determine if the pharmacokinetics are different compared to a younger healthy population. The half-lives were independent of dosage, indicating linearity of pharmacokinetics.

Lowering of plasma isoxicam concentrations with acetylsalicylic acid.

The pharmacokinetics of isoxicam 200 mg administered orally in 10 healthy male volunteers was studied before and during administration of acetylsalicylic acid 3.9 g daily by mouth starting 5 days after isoxicam. There was a statistically significant decrease in plasma isoxicam concentrations, but no significant change in time to reach maximum plasma concentration or disappearance time.

Diagnosis of rheumatic disease: a plea for contemplation of the future.

In clinical practice the definition of diagnosis is far from clear, since different levels of diagnosis are employed from the symptomatic to the pathological and aetiological. The recent development of computer data bases has important implications for the future, but will require a great deal of thought regarding the nature and quality of the data to be used. Evolution of diagnosis has occurred gradually during the history of medicine.

A preliminary evaluation of the dimensionality and clinical importance of pain and disability in osteoarthritis of the hip and knee.

Current methods of clinical assessment in osteoarthritis show a high degree of variability. By contrast, patients with rheumatoid arthritis may be evaluated using a number of standardised and validated indices. One hundred patients with primary osteoarthritis of the hip and knee were interviewed in order to determine the dimensionality of their discomfort and disability and to define the clinical importance of each component item.

European experience with flurbiprofen. A new analgesic/anti-inflammatory agent.

Numerous European clinical trials begun more than 12 years ago have clearly demonstrated flurbiprofen's safety and efficacy as an analgesic, anti-inflammatory, and antipyretic agent. In preclinical studies, flurbiprofen was at least as potent as indomethacin, and approximately 200 times more potent than aspirin. For patients with rheumatoid arthritis, a review of several trials found flurbiprofen often superior to aspirin and naproxen, and equivalent to indomethacin and ibuprofen in efficacy.

Double-blind randomized controlled trial of isoxicam vs piroxicam in elderly patients with osteoarthritis of the hip and knee.

1 Fifty-seven elderly patients with primary osteoarthritis of the hip and knee were entered into a double-blind, randomized, controlled parallel group trail to compare the efficacy and tolerability of isoxicam (maximum = 200 mg day-1) and piroxicam (maximum = 20 mg day-1). 2 Clinical assessments were made following a 1 week NSAID-free washout period and at biweekly intervals during the next 6 weeks of active treatment. 3 The majority of patients in both groups experienced a clinically important and statistically significant therapeutic response.

Fibroblast growth factors in scleroderma.

Sera from patients with progressive systemic sclerosis (PSS), compared to normal sera, contained increased fibroblast growth promoting factor(s) (FGPF) for autologous and heterologous PSS skin fibroblasts and fibroblasts from normal donors. The relative stimulatory effect of FGPF was unaltered by dilution, mixing with normal serum, or media refeeding. The mean value of 42 PSS sera tested showed growth promoting activity significantly greater than the mean level of activity obtained with 42 sex matched normals (p less than 0.

Pharmacokinetics of isoxicam in the elderly.

Several studies are under way to determine the pharmacokinetics of isoxicam in the elderly; this report presents preliminary results of these studies. Data have been collected from: eight healthy subjects older than 65 years old receiving single oral doses of 200 mg; eight patients with rheumatoid arthritis, 61 to 69 years old, receiving oral doses of 400 mg per day; and the same eight patients with arthritis receiving 100 mg per day (four patients), 200 mg per day (one patient), or 300 mg per day (three patients). The plasma levels of isoxicam were determined in the subjects for 96 hours following administration.

Statistical reappraisal of the clinical significance of nail beading in rheumatoid arthritis.

Nail beading has previously been reported as an accompaniment of rheumatoid arthritis. In order to assess the clinical significance of this form of nychodystrophy the fingernails and toenails of 119 patients with rheumatoid arthritis and an equal number of control subjects were studied. Analysis of data based on 4642 nails indicates that the presence of a global pattern of beading (i.

Grading of tenderness as a source of interrater error in the Ritchie articular index.

To assess the effect of grading of tenderness on the interrater reliability of the Ritchie articular index (RAI), 3 physicians recorded independent joint scores on each of 18 patients, examined in random order. Our results indicate that close agreement (Intraclass Correlation Coefficient = 0.85) can be achieved on global RAI scores, and that raters can achieve reasonable agreement (kappa = 0.

Solid base working cast.

A technique is presented to facilitate the fabrication of single or multiple restoration die working casts. The technique allows a full remount potential for use especially in multiple centric relation record verification techniques. A die removal technique that will not damage the brass dowel pin is suggested.

Controlled, double-blind, randomized trial of amitriptyline in relieving articular pain and tenderness in patients with rheumatoid arthritis.

Thirty-six patients with definite or classical rheumatoid arthritis participated in a double-blind, randomized, placebo-controlled trial to assess the effectiveness of adding amitriptyline to the treatment regimen for the relief of pain not adequately controlled by non-steroidal anti-inflammatory drugs. Dosage of amitriptyline was increased gradually up to 25 mg 3-times daily and patients were followed up for 12 weeks. Assessments were made of joint pain and tenderness every 4 weeks.