Abstract:
:Weekly low dose methotrexate is an established treatment for rheumatoid arthritis, but its use in elderly people has not been adequately examined. The aim of this study was to evaluate its safety in elderly patients with rheumatoid arthritis. A retrospective review of the clinical records of rheumatoid arthritis patients over the age of 65 attending a rheumatology unit was conducted. Eligible patients were followed for at least two years and treated with methotrexate in a dose of 7.5 mg/week while being maintained on concurrent treatment. Thirty three patients were studied. Their mean age was 78.8 years; 32 were female and one was male. Treatment was discontinued in four patients, two because of raised serum liver enzymes and two because of gastrointestinal irritation. No serious adverse events were reported. After two years, haemoglobin levels increased from a mean (SD) of 12.4 (1.3) g/dl to 13.0 (1.1) g/dl (r = 0.226, p < 0.005). The white blood count was significantly reduced from 7.9 (1.8) x 10(9)/l to 6.8 (1.7) x 10(9)/l (r = 0.184, p < 0.05). No episodes of neutropenia or agranulocytosis were observed. There was a non-significant decrease in platelet count. The erythrocyte sedimentation rate decreased from 56.8 (30.8) to 35.2 (24.6) mm/h (r = 0.246, p < 0.01). In conclusion, low methotrexate treatment in elderly patients appears to be safe. Routine determination of serum liver enzymes and renal function may reduce individual risk.
journal_name
Postgrad Med Jjournal_title
Postgraduate medical journalauthors
Hirshberg B,Muszkat M,Schlesinger O,Rubinow Adoi
10.1136/pmj.76.902.787subject
Has Abstractpub_date
2000-12-01 00:00:00pages
787-9issue
902eissn
0032-5473issn
1469-0756journal_volume
76pub_type
杂志文章abstract:BACKGROUND:Post-radiation large vessel injury has not received as much attention as microvascular irradiation injury. A few studies have shown that common carotid intima-media thickness (IMT) is increased after radiotherapy to the head and neck. However, in most of these studies, the irradiated subjects also had other ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.2008.068569
更新日期:2008-11-01 00:00:00
abstract::The gross and microscopic features of an unusual case of neurocutaneous melanosis are described. This is an example of the rare association between a primary central nervous system malignant melanoma and a giant congenital melanocytic naevus of 'bathing trunk' distribution. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.65.764.387
更新日期:1989-06-01 00:00:00
abstract::Thiazide diuretics used alone to treat hypertension can cause hypokalaemia in a substantial proportion of patients. The possibility exists that any benefit of reducing high blood pressure by such treatment may be offset by an increased mortality due to arrhythmias initiated by hypokalaemia. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1983-01-01 00:00:00
abstract::Altogether 42 million people worldwide have been infected with HIV, and 12 million have died over the last 20 years. Effective antiretroviral therapy has lead to sustained HIV viral suppression and immunological recovery in patients who have been infected with the virus. The incidence of AIDS has declined in the Weste...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pmj.79.927.36
更新日期:2003-01-01 00:00:00
abstract::Venepuncture is commonly regarded as a trivial procedure allocated to the most junior medical staff. The result of this policy is that junior doctors are required to perform a minimally invasive procedure on consenting patients without any structured venepuncture training or assessment. Consequently, inexperienced doc...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.72.843.23
更新日期:1996-01-01 00:00:00
abstract::Essential tremor is the most common cause of tremor involving upper limbs, head and voice. The first line of treatment for limb tremor is pharmacotherapy with propranolol or primidone. However, these two drugs reduce the tremor severity by only half. In medication refractory and functionally disabling tremor, alternat...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/postgradmedj-2019-136647
更新日期:2020-02-01 00:00:00
abstract::In 40 hypertensive patients continuous ECG recording was done before and after 30 days treatment with indapamide 2.5 mg. There was no change in heart rate. In addition, the incidence of extrasystoles was not changed in patients in whom the ECG was normal before treatment (30 cases) or in 8 of the 10 patients who had a...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1981-01-01 00:00:00
abstract::The incidence, predisposing factors, management and outcome of toxic megacolon (TM) has been reviewed in 65 cases of severe ulcerative colitis (UC) and compared in 2 successive 6-year periods before and after January, 1973. Nineteen episodes of TM occurred in 18 patients. Despite a conscious aim towards earlier surger...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.57.666.223
更新日期:1981-04-01 00:00:00
abstract::A rare case of mediastinal carcinoid tumour with superior vena cava obstruction, and osteolytic as well as osteoblastic secondaries in the bones is described. The relevant literature is reviewed. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.65.763.327
更新日期:1989-05-01 00:00:00
abstract:INTRODUCTION:Rapid response systems (RRSs) have been introduced to facilitate effective 'rescue' of seriously ill patients on hospital wards. While research has demonstrated some benefit, uncertainty remains regarding impact on patient outcomes. Little is known about the relationship between social contexts and the app...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj-2011-000147rep
更新日期:2012-05-01 00:00:00
abstract::The anaesthetic properties of propofol ('Diprivan') have been described previously. This report summarizes additional studies designed to investigate some aspects of the general pharmacology of propofol. Following recovery from anaesthesia with propofol there was no evidence of any central anticholinergic or anticonvu...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:
更新日期:1985-01-01 00:00:00
abstract::The clinical features of acute chlorine gas inhalation, and its management are reviewed. Current medical views on the chronic effects of an acute overwhelming exposure on lung function (reactive airways dysfunction syndrome), and the more controversial field of lung disease secondary to repeated inhalations of lower c...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.73.865.697
更新日期:1997-11-01 00:00:00
abstract::This purports to be the first recorded case of carcinoma of the pancreas presenting as a mechanical obstruction of the colon. The literature relating to some other rare modes of presentation is reviewed, and a comment made on the desirability of routine post-mortem studies. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.57.663.66
更新日期:1981-01-01 00:00:00
abstract::Pneumoconiosis is still a health problem in Turkey and has a relatively high incidence. Retired underground miners were investigated to document alveolitis, and to observe the difference in the cellular profiles of bronchoalveolar lavage (BAL) fluid with or without pneumoconiosis. Twenty nine retired male miners and 1...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pmj.79.935.527
更新日期:2003-09-01 00:00:00
abstract::Three patients are described in whom one or more carotid territory transient ischaemic attacks (TIAs) were preceded by sneezing, straining, or bending over. It is argued that the mechanism involved dislodgment of embolic material from the site of carotid atheroma. This mechanism should be considered as an alternative ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.75.881.145
更新日期:1999-03-01 00:00:00
abstract:BACKGROUND:Medical views about the clinical value and potential detrimental effect on quality of life of postoperative follow up are divided. There is no literature on the views of British patients with colorectal cancer towards the follow up process. AIM:To investigate patients' views and experiences of follow up of ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pmj.79.933.403
更新日期:2003-07-01 00:00:00
abstract::Primary choriocarcinoma of the ovary arising, presumably, from a germ cell is extremely rare. The patient, a 16 year old girl who presented with dysuria and frequency of micturition developed fatal haemoperitoneum due to rupture of a pure primary nongestational ovarian choriocarcinoma. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.61.718.757
更新日期:1985-08-01 00:00:00
abstract:BACKGROUND:Primary percutaneous coronary intervention (PPCI) programmes vary in admission criteria from open referral to acceptance of electrocardiogram (ECG) protocol positive patients only. Rigid criteria may result in some patients with acutely occluded coronary arteries not receiving timely reperfusion therapy. OB...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2012-130818
更新日期:2013-07-01 00:00:00
abstract::The risk of developing an overt malignancy after an isolated deep venous thrombosis (DVT) is poorly documented. We therefore reviewed a series of patients in whom a solitary idiopathic DVT had been proven by venography at least 12 months earlier. No patient had developed a malignancy at follow-up. However, decreased f...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.60.702.275
更新日期:1984-04-01 00:00:00
abstract::Sudden cardiac death is the leading cause of mortality among young athletes with an incidence of 1-2 per 100,000 athletes per annum. It is described as 'an event that is non-traumatic, non-violent, unexpected, and resulting from sudden cardiac arrest within six hours of previously witnessed normal health'. Most predis...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/postgradmedj-2011-130215
更新日期:2012-07-01 00:00:00
abstract::Little is known about orthostatic blood pressure regulation in acute stroke. We determined postural haemodynamic responses in 40 patients with acute stroke (mild or moderate severity) and 40 non-stroke control in-patients, at two days ('Day 1') and one week ('Week 1') post-admission. Following a 10-minute supine rest ...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章
doi:10.1136/pgmj.75.882.213
更新日期:1999-04-01 00:00:00
abstract::Both acute myocardial infarction and reperfusion therapy with thrombolytic agents may be associated with bradyarrhythmias, and there may be a case for 'prophylactic' insertion of a temporary pacing wire in selected patients. We describe 4 patients in whom clinical decisions had to be made concerning the appropriatenes...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.67.789.649
更新日期:1991-07-01 00:00:00
abstract::In a cross-over study, 10 healthy adult volunteers received 1 g cefaclor and 1 g cephalexin orally 1 hour after a standard breakfast. Serum levels of cefaclor rose somewhat faster and were higher than those of cephalexin in the first 60 minutes. At the end of the second hour the serum concentration of cephalexin was 5...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章
doi:
更新日期:1979-01-01 00:00:00
abstract::The present report is the first description to our knowledge of a clinical case of bacterial calcification in human infective endocarditic vegetations. Partial calcification of bacteria within vegetations may be a further mechanism of bacterial protection from host defences and antibiotics. Similar calcification has r...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.65.767.665
更新日期:1989-09-01 00:00:00
abstract::Evidence is now accumulating on both clinical and experimental grounds that the retina is an a priori source of inflammatory activity. Reactive inflammation in the retina may produce many of the clinical signs previously ascribed to uveal inflammation. Autoimmune mechanisms are probably responsible for the majority of...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.64.753.488
更新日期:1988-07-01 00:00:00
abstract::We present a 78-year-old woman with clinical acute hypopituitarism in whom pathologic findings showed lymphocytic hypophysitis and retroperitoneal fibrosis. Lymphocytic hypophysitis should be included in the differential diagnosis of hypopituitarism at any age. The association with idiopathic retroperitoneal fibrosis ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.73.865.732
更新日期:1997-11-01 00:00:00
abstract::We describe two patients with associations of hereditary neuropathies and heritable skeletal disorders not previously reported. The first patient had Marfan's syndrome and hereditary motor and sensory neuropathy Type 1. The second patient had Ehlers-Danlos syndrome, Klippel-Feil syndrome and tomaculous neuropathy. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.71.834.245
更新日期:1995-04-01 00:00:00
abstract::The Chancellor of the Exchequer's recent announcements to devolve decision making power from Whitehall to 30 English regions provide a challenge to use devolution to deliver more favourable health outcomes. However evaluation of devolved health models internationally is scarce, because it is rarely considered. Evidenc...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/postgradmedj-2015-133894
更新日期:2016-05-01 00:00:00
abstract::A case is reported where the use of i.v. disopyramide for a supraventricular tachycardia resulted in a more serious ventricular dysrhythmia giving hypotension and this probably contributed to the development of a myocardial infarction. Attention is drawn to the possible risk. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.55.646.570
更新日期:1979-09-01 00:00:00
abstract::Two different doses of cefaclor advanced formulation (AF), a new sustained-release formulation of cefaclor, were compared with the regular formulation of cefaclor for efficacy and safety in the treatment of uncomplicated cystitis and asymptomatic bacteriuria. A 7-day course of treatment was used, and the trials were d...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:
更新日期:1992-01-01 00:00:00