HealthNews

Lupus:

Sinai is the Standard

onsider a disease that af-
fects the skin, the joints
and, in severe cases, the
kidneys, heart and lungs
and blood. It often makes
its victims feel sick with
fatigue, fever, loss of ap-
petite, nausea, joint pain
and weight loss. They may
suffer neurological or psy-
chiatric problems.
The disease is lupus.
Sinai Hospital is one of the
nation's recognized lead-
ers in research and pa-
tient management of this
distressing autoimmune
disorder. Emphasis on
both patient and family
makes this lupus program
unique.
Sinai's Immunology
Lab is headed by Chaim
Brickman, M.D., who has
been honored as an in-

ductee into the Lupus
Hall of Fame. Dr. Brick-
man cannot promise a
cure, but he does offer
Sinai lupus patients the
most up-to-date technolo-
gies and treatments.
In addition, lupus suf-
ferers who consult Sinai
benefit from one of the
country's most experi-
enced and respected pro-
grams, emphasizing
patient and family coun-
seling, exercise guidance
and education for inde-
pendent living.
Much to Dr. Brickman's
delight, Sinai recently ac-
quired a state-of-the-art
flow cytometer that,
among other applications,
enhances the lab's abili-
ty to diagnose lupus and
to determine the most ef-
fective medication for each
individual.
Dr. Brickman is also
conducting the first study
ever that manipulates the
female hormone estrogen
in lupus patients. Because

the majority of lupus pa-
tients are women of child-
bearing age, he reasons
that estrogen could be a
culprit.
Patients involved in Dr.
Brickman's study range in
age from 22 to 46 and
have experienced some
benefits from estrogen
manipulation. Now his
study is expanding to in-
clude other medical cen-
ters.
Because Dr. Brickman
recognizes the importance
of understanding the
scope of symptoms and
characteristics of this elu-
sive disease, he has start-
ed a computerized system
at Sinai to link databases
at medical centers across
the country that treat lu-
pus patients.
"The more information
we have," Dr. Brickman
explains, "the more likely
we are to successfully in-
tervene and protect our
patients."

•

Sinai's Immunology Laboratory is responsible for groundbreaking research into lupus.

Getting It Right

A rthritis is one of this country's most com

..m.on disorders. So many people are affect-
ed that an internal medicine sub-specialty —
rheumatology — has evolved to treat compli
cated cases.
Some folks have osteoarthritis, a wear-and-
tear disorder, usually seen in aging adults where
the joint.s are sore. These are otherwise healthy
people who respond to aspirin or other anti-
inflammatory medications.
Some suffer the more serious rheumatoid
arthritis, which can appear in one's youth. This
disease can affect many of the body's organs and
needs to be treated aggressively.
Then there are over 100 different diseases
with arthritis as a component.
Because of its complex nature, Dr. Samuel In-
denbaum, Section Chief of Rheumatology at
Sinai, has one simple piece of advice: "If you
have persistent joint pain, get to a doctor." lie
adds, "This is very important: Don't be treat-
ed without a diainosis."
Dr. Indenbaiirn is optimistic about near-f i
ture treatments for the disease, especially those
that selectively change the immune system
which is responsible for arthritis. At Sinai,
board-certified rheumatologist,s are research-
ing new drugs as well as antibody clues that di-
rect amore precise diagnosis.
But, to the patient, perhaps the most signif-
icant element of Sinai's rheumatology program
is education. Physician seminars are held an-
nually to update family physicians on the dis-
ease. And free "town meetings" are held
regularly for the public.
6'47

In the recent past, these seminars have ex-
amined the topics: "What Is Arthritis?," 'The
Treatment of Arthritis" and "Unproven Reme-
dies."
"Patients are educated about their disease,
given materials about their particular condition
and medications, and invited to bring in ques-
tions," Dr. Indenbaum explains. They are also
counseled in exercise, nutrition and rest And,
for those who need rehabilitation, there is in-
struction about joint function, stress and rest.
One of the most critical undertakings in
arthritis treatment is achieving an accurate,
predictive diagnosis. New research indicates
that the most severe form of rhetunatoid arthri-
tis responds favorably to early, aggressive treat-
ment. So the opportunity should not be missed.
On the other hand, Dr. Indenbaum points out
these drugs are potent and should not be pre-
scribed unless there is every indication that the
disease is persistent and severe. In these cas-
es, a good rheumatology service and lab, such
as Sinai's are essential.