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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Clinical rheumatology 7 (1988), S. 237-241 
    ISSN: 1434-9949
    Keywords: Keratoconjunctivitis Sicca ; Sjögren's Syndrome ; Rheumatoid Arthritis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The prevalence of keratoconjunctivitis sicca (KCS) was studied in a randomly selected group of 104 patients with rheumatoid arthritis (RA). Symptoms of KCS were noted in 33 patients (31.7%) and they were studied further. After rose bengal staining, 22 of these patients were found to have KCS which was diagnosed by the presence of corneal or conjunctival desiccation. The overall prevalence of KCS was 21.2%. Although an abnormal Schirmer's test was noted in 21 of the 22 patients with KCS, only 8 patients had values of 5 mm or less while the remainder had a mild abnormality ranging from 6 to 15 mm. A reduced marginal tear film was noted in 15 patients (68.2%) with KCS and 13 patients (59%) had a reduced tear break-up time. The Schirmer's test alone is inadequate to make a definite diagnosis of KCS and it is essential to perform slit lamp examination to detect epithelial staining with rose bengal.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Clinical rheumatology 14 (1995), S. 617-625 
    ISSN: 1434-9949
    Keywords: Osteoporosis ; Rheumatoid Arthritis ; Sensitivity ; Specificity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The aim of this study was to assess the prevalence of and diagnostic role of metacarpal osteopenia in rheumatoid arthritis (RA) and to evaluate its detectability using receiver operating characteristic (ROC) analysis. Metacarpal bone mineral density was measured in 98 patients with classical RA using a computer-assisted measure of 6 metacarpal diameters (radiogrammetry) in patients aged less than 50 years. Sensitivity and specificity of the technique in discriminating the RA patients from 85 normal controls and osteopenic RA subjects from their normopenic counterparts, was determined by standard statistical techniques. Clinical, laboratory and radiological variables were compared in their ability to explain the variance of metacarpal bone density. The prevalence of metacarpal osteopenia in RA was 55%. Prolonged disease and reduced function significantly differentiated osteopenic from non-osteopenic RA patients. Discriminant analysis of the RA and control groups showed that measurement of 6 metacarpals was more accurate than the 2nd metacarpal measurement alone in predicting the RA patients. The sum of 6 metacarpal combined cortical width (CCW) had a sensitivity of 61% and specificity of 68% in discriminating the RA patients from the controls. Receiver operating characteristic curves showed, not surprisingly, that objective measurement of bone diameters was superior to clinical or laboratory measures of disease activity in correctly classifying a randomly chosen RA patient as osteopenic or not. Metacarpal osteopenia is common in RA and it may be a useful measure of the disease in young patients.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Clinical rheumatology 11 (1992), S. 475-482 
    ISSN: 1434-9949
    Keywords: Osteoporosis ; Osteopenia ; Radiogrammetry ; Corticosteroid Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We report the prevalence of metacarpal cortical thinning in systemic lupus erythematosus (SLE). Fifty-eight ambulant female patients attending a lupus clinic (mean age 32.4 years), were found to have significant thinning of metacarpal cortices (p〈0.05) when compared with 63 normal females (mean age 34.1 years). However, metacarpal bone mass was within the normal range. Measurements were made at 6 metacarpals of the 2 hands using a computer-aided technique (digitized radiogrammetry). Femoral cortical width and Singh index at the left femur, as well as the vertebral index at L3 were also recorded. The trabecular indices were in the range of normality, but the SLE group had more patients in the immediately pre-osteopaenic range. Metacarpal bone loss was not related to disease duration or corticosteroid therapy. The prevalence of osteopenia in SLE is probably underestimated and the pathogenesis is likely to be multifactorial.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Digestive diseases and sciences 26 (1981), S. 1100-1103 
    ISSN: 1573-2568
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Rats develop hyperglucagonemia after end-to-side portacaval shunt and also after splenocaval shunt. In this study, animals with mesocaval shunt were shown not to develop hyperglobulinemia or increased titers of lipopolysaccharide antibodies. It is currently thought that the hyperglobulinemia of cirrhosis results from diversion of immunogens past the liver into the systemic circulation with stimulation of sites of globulin synthesis. Since all procedures result in development of immune complexes in the systemic circulation, an alternative hypothesis was sought. It is proposed that the liver may regulate antibody production by the spleen but that this mechanism only operates if splenic venous blood passes through the liver. Portacaval shunt and splenocaval shunt result in diversion of splenic venous blood past the liver and, consequently, failure of regulation, while after mesocaval shunt, splenic venous blood still enters the liver and thus the regulatory mechanism could operate.
    Type of Medium: Electronic Resource
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