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  • 1
    ISSN: 1432-2161
    Keywords: Key words Rheumatoid arthritis ; Cervical spine ; Cervical myelopathy ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. Comparison of clinically observed neurologic long tract signs in a heterogeneous group of patients with rheumatoid arthritis (RA), with morphologic abnormalities of the cervical spine as depicted on radiographs and magnetic resonance (MR) images. Design. The patients were prospectively assigned to one of three classes on the basis of their neurologic status. Lateral cervical spine radiographs and sagittal T1-weighted and gradient echo images were performed. The qualitative MR features evaluated were erosion of the dens and atlas, brain stem compression, subarachnoid space encroachment, pannus around the dens, appearance of the fat body caudal to the clivus, and the signal intensity of the pannus. The quantitative imaging parameters were the cervicomedullary angle and the distance of the dens to the line of McRae. Patients. Sixty-three consecutive patients with RA and subjective symptoms, especially neck or occipital pain, and/or clinical objective signs consistent with a compromised cervical cord were included in this study. Results and conclusions. Damage documented with radiographs and MR imaging in patients with RA is often severe, even in those without neurologic signs (class 1). None of the abnormalities confined to the atlantoaxial level correlated significantly with neurologic classification. Subarachnoid space encroachment anywhere in the entire cervical spine did correlate significantly with neurologic classification.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1573-2568
    Keywords: pepsinogens ; achlorhydria ; ulcer disease ; nonsteroidal antiinflammatory drugs
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract It is widely accepted that the absence of acid-peptic activity excludes the presence of a benign upper gastrointestinal ulcer. We assessed the frequency of a history of benign upper gastrointestinal ulcer disease in patients with and without serological evidence of achlorhydria with reference to the use of nonsteroidal antiinflammatory drugs (NSAIDs). In total 857 patients were interviewed, using a standard questionnaire with emphasis on demographic data, chronic use of NSAID, and history of upper gastrointestinal ulcers. The frequency of achlorhydria was determined by extremely low serum levels of pepsinogen A (PgA〈17 µg/liter). Of the total group of patients, 36 patients (4.2%; 95% CI 2.9–5.5) had a PgA lower than 17 µg/liter. A history of benign upper gastrointestinal ulcer was found in 57/827 (6.9%) of patients with serum PgA higher than 17 µg/liter and in 3/36 (8.3%) of patients with serum PgA lower than 17 µg/liter (NS). The three patients with upper gastrointestinal ulcer and PgA lower than 17 µg/liter were known to have pernicious anemia (PA) before (two patients) or simultaneously (one patient) with the diagnosis of the upper gastrointestinal ulcer and were using NSAIDs at that time. The presence of gastric acid is not obligatory for the development of ulcers during NSAID use.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-0991
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Abstract The efficacy of rifamycin SV and vancomycin againstBacteroides fragilis was compared with that of metronidazole in vitro and in vivo. The in vitro comparison was based on the MIC and on short-term growth curves, the in vivo comparison on a mixed infection withB. fragilis andEscherichia coli in a thigh infection model in mice. Rifamycin SV was about 11 times less effective than metronidazole in vivo, according to dose, and about 30 times less effective according to the mean plasma concentration. This lower efficacy could have been anticipated on the basis of the effect on in vitro grwoth curves, but not from the MIC. Vancomycin was about nine times less effective than metronidazole in vivo according to dose and about 18 times less effective according to the mean plasma concentration. The latter difference was less than would have been predicted from the results obtained in vitro, i.e., from both the effect on the growth curves and the MIC.
    Type of Medium: Electronic Resource
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