[Quinines--past and present].

Quinines are known to mankind and have been in medical use against malaria for over 350 years. The revelation of quinines' activity against malaria in the 17th century brought a revolution to the medical world and had dramatic implications on the political arena of Europe at that time. The source of these materials is the bark of the Cinchona trees indigenous to remote mountain areas of Latin America.

Use of complementary and alternative medicine among patients attending rheumatology clinics in Israel.

Background: Complementary and alternative medicine has recently attracted attention due to its widespread use. In a recent study in Israel, almost a half of CAM users in the general population used it for joint diseases or back pain.

Objective: To evaluate the prevalence of CAM use among patients with defined rheumatic diseases, and analyze the demographic features of CAM users, their reasons for using CAM and the use of specific CAM methods.

Desensitization to hydroxychloroquine--experience of 4 patients.

Hydroxychloroquine (HCQ) is an antimalarial agent with immunomodulatory effects. It is widely used in rheumatologic diseases, and has a very high efficacy/toxicity ratio. It is particularly important in the treatment of systemic lupus erythematosus (SLE) since it reduces new organ involvement and disease flares, and relieves skin and joint symptoms.

Transient severe eosinophilia precipitating massive venous thrombosis in a patient with hereditary thrombophilia.

We describe a patient homozygous for both the prothrombin G20210A and methylenetetrahydrofolate reductase C667T mutations who was symptom-free for 40 years and developed near-catastrophic thrombotic complications following transient, severe eosinophilia. This course of events raises the possibility of an increased risk of thrombosis associated with transient eosinophilia in the presence of hereditary thrombophilia and supports the concept of multifactorial etiology of venous thrombosis. Our experience suggests that in patients with severe eosinophilia, evaluation for known causes of hereditary or acquired thrombophilia may be useful for identifying subjects at increased risk of thrombosis.

Rofecoxib, a COX-2 inhibitor, lowers C-reactive protein and interleukin-6 levels in patients with acute coronary syndromes.

Background: Patients with acute coronary syndromes (ACS) have high levels of inflammatory mediators such as C-reactive protein (CRP) and interleukin (IL)-6.

Aim: To evaluate whether patients with ACS treated with rofecoxib, a COX-2 inhibitor, will have reduced CRP, IL-6, and soluble tumor necrotic factor receptor-1 (sTNF-R1) levels and improved endothelial function.

Methods And Results: Thirty-four patients hospitalized with ACS were randomized to receive rofecoxib, 25 mg/d plus aspirin 100 mg/d, or placebo plus aspirin, 100 mg/d, for a period of 3 months.

Low-dose aspirin and prevention of cranial ischemic complications in giant cell arteritis.

Objective: Cranial ischemic complications such as cerebrovascular accidents (CVAs) and acute visual loss are among the leading causes of giant cell arteritis (GCA)-related morbidity. In this retrospective study, we evaluated the effect of treatment with low-dose aspirin on the incidence of cranial ischemic complications in GCA.

Methods: Charts of 175 consecutive patients in whom GCA was diagnosed between 1980 and 2000 were reviewed for medical data.

Risk factors for cranial ischemic complications in giant cell arteritis.

Cranial ischemic complications (CICs) are among the presenting manifestations of giant cell arteritis (GCA). Yet patients with GCA may develop CICs at a later stage, despite steroid therapy. In the current report we delineate risk factors for CICs, both at presentation and during follow-up, and review the relevant literature.

The predictive value of the halo sign in color Doppler ultrasonography of the temporal arteries for diagnosing giant cell arteritis.

Objective: The diagnosis of giant cell arteritis (GCA) usually requires a temporal artery biopsy. Recently it has been reported that a periluminal dark halo, detected by color Doppler ultrasonography (US) of the temporal arteries, is a characteristic sign of GCA. We evaluated the predictive value of this dark halo sign in diagnosing GCA.