Showing papers by "James F. Fries published in 1975"
TL;DR: Evaluation by postal questionnaires, pelvic radiography of 78 HL-A 27W-positive blood donors selected from a group of apparently healthy subjects revealed 14 who satisfied the criteria for definite ankylosing spondylitis, and the prevalence was similar in both sexes.
Abstract: Ankylosing spondylitis is diagnosed once or twice in each 1000 males and one tenth as frequently in females, but the true prevalence is unknown. Indentification of genetic marker, HL-A W27, for susceptible persons has provided a tool facilitating epidemiologic studies and allowing identification of "control" populations without the marker. Evaluation by postal questionnaires, and pelvic radiography of 78 HL-A 27W-positive blood donors selected from a group of apparently healthy subjects revealed 14 who satisfied the criteria for definite ankylosing spondylitis. The prevalence was similar in both sexes. One hundred and twenty-six W27-negative controls matched for race, sex, and age failed to yield a single case. For a person of either sex with HL-A W27, there appears to be about a 20 per cent chance that ankylosing spondylitis will develop, suggesting a prevalence of 10 to 15 per thousand. Hitherto accepted figures may underestimate the frequency by a factor of 10 to 20.
274 citations
19 May 1975
TL;DR: The practicing physician is faced with an information explosion of major dimensions and a gap between scientific knowledge in a basic form and its practical application at the bedside.
Abstract: The health care delivery system is under strong pressures from several sides. Many of these pressures derive from the demand for a more comprehensive range of health services and from the increased complexity of disease and treatment patterns. Since medical science has provided tools to manage many of the once common diseases, it now has to cope with problems of less well understood origin and course. The practicing physician is faced with an information explosion of major dimensions and a gap between scientific knowledge in a basic form and its practical application at the bedside.
68 citations
TL;DR: By increasing the information available to practicing physicians, medical speciality databanks may reinforce clinical practice sufficiently to allow modular expansion into a hospital network.
59 citations
Journal Article•
TL;DR: It is illustrated that chlorambucil therapy should not be continued after initial leukopenia, until peripheral counts or marrow cellularity has returned to normal, and Titration of drug dosage and leukocyte count, as frequently employed with cyclophosphamide and other alkylating agents, must be presumed hazardous.
Abstract: Two cases of irreversible bone marrow failure are described, one with rheumatoid disease and one with systemic lupus erythematosus. Each case was associated with prior chlorambucil administration, effective in controlling the clinical manifestations (total dosage 398 and 1,764 mg respectively). The irreversibility of the bone marrow depression in the two cases presented stands in contrast to published assurances that chlorambucil-associated leukopenia is dose-related and readily reversible. The cases illustrate that chlorambucil therapy should not be continued after initial leukopenia, until peripheral counts or marrow cellularity has returned to normal. Titration of drug dosage and leukocyte count, as frequently employed with cyclophosphamide and other alkylating agents, must be presumed hazardous. Additional studies are needed to determine if irreversible bone marrow depression is dose-related or idiosyncratic.
31 citations
16 citations