scholarly journals Recurrent pneumomediastinum in a patient with rheumatoid arthritis

2013 ◽  
Vol 79 (3-4) ◽  
Author(s):  
H. Bhardwaj ◽  
B. Bhardwaj ◽  
P.V. Carlile
Keyword(s):  
Rheumatoid Arthritis ◽  
Chest Pain ◽  
Connective Tissue ◽  
Subcutaneous Emphysema ◽  
Clinical Presentation ◽  
Rare Occurrence ◽  
Connective Tissue Disorders ◽  
Young Males ◽  
One Year ◽  
Extraluminal Air

Recurrent pneumomediastinum in a patient with rheumatoid arthritis. H. Bhardwaj, B. Bhardwaj, P.V. Carlile. Spontaneous pneumomediastinum (SPM); also known as mediastinal emphysema, is a rare and usually benign self-resolving appearance of extraluminal air in the mediastinum without any underlying trigger. This is an uncommon disorder mostly seen in the young males and classic clinical presentation is with chest pain, dyspnea, cough and appearance of subcutaneous emphysema. Although several connective tissue disorders have been reported in association with SPM, it is a rare occurrence in rheumatoid arthritis (RA) with only small number of cases reported in literature. We report a 69 years old male with RA who developed recurrent asymptomatic episodes of SPM detected over a period of one year. The recurrent but benign episodes of SPM in this patient reestablish the usual uncomplicated course of this unusual clinical entity even in the rare recurrent cases.

Corticosteroids v. corticotrophins with special reference to asthma and rheumatoid arthritis

1970 ◽  
Vol 8 (13) ◽  
pp. 49-51
Keyword(s):  
Rheumatoid Arthritis ◽  
Nephrotic Syndrome ◽  
Connective Tissue ◽  
Special Reference ◽  
Intravenous Injection ◽  
Skin Diseases ◽  
Oral Medication ◽  
Connective Tissue Disorders ◽  
Fibrosing Alveolitis

Either a corticosteroid or a corticotrophin may be used in the management of asthma and rheumatoid arthritis, and of a number of less common conditions including sarcoidosis, fibrosing alveolitis, the nephrotic syndrome, certain connective tissue disorders and certain skin diseases. The choice between them is influenced mainly by their unwanted effects and by the convenience of oral medication compared with injections. In emergencies of course only intravenous injection of a corticosteroid is appropriate.

scholarly journals Ocular trauma in patients presenting to Dhulikhel Hospital

2012 ◽  
Vol 9 (1) ◽  
pp. 54-57 ◽  
Author(s):  
P R Sthapit ◽  
S Marasini ◽  
U Khoju ◽  
G Thapa ◽  
B P Nepal
Keyword(s):  
Visual Acuity ◽  
Clinical Presentation ◽  
Ocular Trauma ◽  
Public Awareness ◽  
Prevalence Studies ◽  
Young Males ◽  
Common Location ◽  
One Year ◽  
Complete History ◽  
Better Than

Background Ocular trauma is an important cause of blindness and ocular morbidity throughout the world. Prevalence studies help to define the target group, plan strategies and thereby lessen trauma related blindness in the country. Objective To identify the risk factors for ocular trauma, those at risk, describe the visual acuity at time of clinical presentation, and assess the nature and severity of ocular trauma in patients presenting to Dhulikhel Hospital’s emergency department and eye OPD with ocular trauma. Methods It is a descriptive and prospective study of all the patients with ocular trauma presenting to Dhulikhel Hospital from December 2009 to December 2010. A complete history and detailed ophthalmologic evaluation was done and noted down. Results There were 112 subjects with ocular trauma. Mean age was 28.43±16.36 years with a range of one year to 74 years. Males predominated with 72.3% frequency (p<0.001). Incidence peaked in third decade of life (p<0.01). Ocular trauma peaked in months of September and October. Presenting visual acuity better than 6/12 was noted in 83.9% of cases whereas 2.7% of cases had visual acuity of <3/60. Household (56.3%, p<0.001) was the commonest place of injury with wooden objects (19.6%) being the commonest object of injury. Most of the injuries were mechanical (85.7%, p>0.001). ConclusionBlunt injuries were more common in young males. Household and workplace were common location of ocular injuries. Public awareness and strict legislation to use personal protective devices can help to reduce the occurrence of ocular injury.http://dx.doi.org/10.3126/kumj.v9i1.6264 Kathmandu Univ Med J 2011;9(1):54-7

Bone, joint, and connective tissue disorders

2018 ◽  
Author(s):  
Colin Berry
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Systemic Sclerosis ◽  
Ankylosing Spondylitis ◽  
Connective Tissue ◽  
Musculoskeletal Disorders ◽  
Lupus Erythematosus ◽  
Anaesthetic Management ◽  
Connective Tissue Disorders ◽  
Systemic Lupus

This chapter describes the anaesthetic management of the patient with those musculoskeletal disorders which are relevant to anaesthetic practice. Topics covered include rheumatoid arthritis, ankylosing spondylitis, systemic lupus erythematosus, systemic sclerosis, scoliosis, and achondroplasia. For each topic, preoperative investigation and optimization, treatment, and anaesthetic management are described.

scholarly journals A study on the safety and tolerability of mycophenolate mofetil in patients with connective tissue disease

2018 ◽  
Vol 7 (11) ◽  
pp. 2169
Author(s):  
Subham Das ◽  
Prasanta Padhan
Keyword(s):  
Clinical Trials ◽  
Mycophenolate Mofetil ◽  
Connective Tissue ◽  
Tissue Injury ◽  
Inclusion Criteria ◽  
Connective Tissue Disorders ◽  
Fibrotic Tissue ◽  
Safety Parameters ◽  
One Year

Background: Connective tissue disorders (CTD) are mostly due to inflammatory and fibrotic tissue injury. Glucocorticoids and immunomodulators though useful but are toxic. Mycophenolate mofetil (MMF) is now being used successfully in many autoimmune diseases, but the safety of MMF in CTD patients is yet to be conclusively established.Methods: The study was a retrospective record based observational one in patients of CTD satisfying the predetermined inclusion criteria. Various safety parameters were noted down from the observed records and analysed accordingly.Results: The 120 case records of CTD patients were analysed for a specific set of safety parameters over the preceding one year. Diarrhoeal attacks were the most commonly encountered side effect (38.3%) of long term patients who were on mycophenolate therapy followed by infection.Conclusions: Mycophenolate was found to be generally well tolerated in CTD patients with few reports of adverse events, but larger clinical trials are needed to conclusively establish its safety.

scholarly journals Sulla eredopatologia delle mesenchimopatie reattive (cosidette malattie del collageno). III. Sulla comune predisposizione genetica al reumatismo acuto primario e al reumatismo cronico primario

1957 ◽  
Vol 6 (1) ◽  
pp. 25-44
Author(s):  
G. G. Neri Serneri ◽  
V. Bartoli
Keyword(s):  
Rheumatoid Arthritis ◽  
Connective Tissue ◽  
Rheumatic Disease ◽  
Rheumatic Fever ◽  
Allergic Diseases ◽  
Principal Factor ◽  
Autosomal Gene ◽  
Connective Tissue Disorders ◽  
Modifying Factors ◽  
Reduced Penetrance

SUMMARYThis study is based on pedigrees of 479 patients with Primary Rheumatism (287 patients with Rheumatic Fever and 192 with Rheumatoid Arthritis) which are compared with pedigrees of 300 controls. The conclusion of this study is that the predisposition to Rheumatic Fever and to Rheumatoid Arthritis is trasmitted by a single principal autosomal gene wich is dominant and has reduced penetrance and variable expressivity.The appearance of the acute and the chronic forms of the disease is in function of accessory modifying factors, as genetic and acquired ones. These factors condition the variation of the organic reactive response into the ambit of «type of reactivity» trasmitted by the principal factor. The possible existence of accessory modifying factors, admitted because the way of appearance of the disease in the various generations of families, it occurs in similar situations of human and experimental genetics.The predisposition to primary rheumatic disease has no genetic relationship to the diathesis of allergic diseases and the diathesis of degenerative connective tissue disorders (mesenchymotic diathesis).

scholarly journals Prospective evaluation of clinical profile and treatment outcome of patients presenting with polyarthritis diagnosed as rheumatoid arthritis

2012 ◽  
Vol 10 (2) ◽  
pp. 22-28
Author(s):  
Arpana Neopane ◽  
Mona Sharma ◽  
Sumugdha Rayamajhi
Keyword(s):  
Rheumatoid Arthritis ◽  
Treatment Response ◽  
Clinical Presentation ◽  
Prospective Longitudinal Study ◽  
Early Presentation ◽  
Common Presentation ◽  
Characteristic Features ◽  
One Year ◽  
Prospective Longitudinal

Introduction: Polyarthritis is a common presentation of patients attending medicine outpatient department. Among various causes Rheumatoid arthritis is the commonest and a well established case has distinct characteristic features. However the early presentation of this disease has not been clear thus leading to delay in treatment. The objectives of this study was to identify the various causes of polyarthritis in our clinical practice, discuss the varied clinical presentation of rheumatoid arthritis including early Rheumatoid arthritis and to evaluate the treatment response during one year follow up. Methods: Prospective longitudinal study conducted in a teaching hospital over a two years period Results: Rheumatoid arthritis was the commonest cause of polyarthritis (77.8%) with a period prevalence of 0.7%. Early presentation included atypical features like asymmetry, unilateral presentation, manifesting within 2 months to 2 years of diagnosis. 43% (n=18) of the patients had swelling and tenderness in overused joints 1.5 years prior to full clinical manifestation. Flitting or migratory joint pain not considered to be a feature of rheumatoid arthritis was also present in 14.3% (n=6) patients with mean duration of 1.5 years prior to full blown presentation. MCPJ (metacarpophalyngeal joints) and PIP (proximal interphalyngeal joints) were involved in 90%. Treatment response with Methotrexate as a single DMARD was good as compared with DAS 28 ESR score. Conclusions: RA is a common arthritis with varied clinical presentation. Recognition of early symptoms is needed for early diagnosis and initiation of DMARD. Methotrexate as a DMARD is effective and should be initiated early. DOI: http://dx.doi.org/10.3126/mjsbh.v10i2.6459 Medical Journal of Shree Birendra Hospital July-Dec 2011 10(2) 22-28

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