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Biomedical subjects

A Chalmers

Publications and source records attributed to A Chalmers.

At least 55 records · Page 3Linked to original sources
PubMed1988

Monitoring of nonsteroidal antiinflammatory drugs in populations. A clinician's point of view.

Nonsteroidal antiinflammatory drugs are widely used for increasingly broad indications. This article reviews the major issues encountered in the clinic in choosing and prescribing a specific agent to a given individual. A parallel view of the information available that would enable such decisions to be made logically reveals major gaps in the available database. The need for clinical consensus as to issues of priority for collaborative research is identified.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1988

An experiment in reducing interobserver variability of the examination for joint tenderness.

This experiment was designed to test the feasibility of reducing interobserver variability of the joint examination by agreement on a standard examination. Six rheumatologists independently examined 6 patients with rheumatoid arthritis (RA) in predetermined order, before and after a standardization of examination techniques. Results of an analysis of variance showed a reduction of the percent of variability due to observers from 13.8%, before standardization, to 3.2% after standardization, and an improvement in the percent variability related to patient differences from 70.7%, before standardization, to 86.3% after standardization. Such a reduction in observer variability has a potential for allowing a reduction in sample sizes required for RA clinical trials.

Analysis of Variance↗
PubMed1987

Evidence that the gene for tuberous sclerosis is on chromosome 9.

Linkage analysis was undertaken in nineteen families with tuberous sclerosis by use of 26 polymorphic markers. All affected members fulfilled strict diagnostic criteria and unaffected members were rigorously investigated to confirm their status. Maximum lod scores were 1.20 for adenylate kinase 1 (AK1) at zero recombination and 3.85 for the ABO blood group at zero recombination (confidence limits 0-0.10). These findings support the assignment of the gene for tuberous sclerosis to the distal long arm of chromosome 9.

Adenylate Kinase↗
PubMed1986

Retinopathy in systemic lupus erythematosus: relationship to disease activity.

Forty-three patients taking chloroquine for systemic lupus erythematosus were followed by one ophthalmologist over a 5-year period. Visual field testing, color vision testing, and fluorescein angiography were performed. Retinopathy was detected in 7 patients (16%), none of whom had hypertension or diabetes mellitus. Retinal abnormalities included cotton-wool spots in 4 patients, microaneurysms in 3, and vascular tortuosity in 4. In 4 patients, these abnormalities were associated with retinal dysfunction, measured in terms of abnormal hue discrimination. In 6 of the 7 patients, the finding of retinopathy coincided with a flare of lupus activity. In 5 patients, retinopathy improved when the disease was controlled.

Adult↗
PubMed1986

Auranofin therapy and quality of life in patients with rheumatoid arthritis. Results of a multicenter trial.

In a six-month, randomized, double-blind study at 14 centers, auranofin (3 mg twice daily) was compared with placebo in the treatment of patients with classic or definite rheumatoid arthritis. All patients had unremitting disease for at least the previous six months and at least three months of therapy with nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs, oral steroids, and analgesics were allowed throughout the trial. Efficacy was analyzed in 154 patients who received auranofin and 149 who received placebo. To reflect an expanded view of outcome assessment, the measures used included some 20 nontraditional measures of functional performance, pain, global impression, and utility (worth or value) in addition to five standard clinical measures of rheumatoid synovitis (e.g., number of tender joints). The nontraditional measures were mainly in the form of structured questionnaires administered by trained interviewers. To minimize the statistical problem of multiple comparisons, most of the measures were grouped into four composites--clinical (standard measures), functional, global, and pain--and the treatment effect for each composite was tested at the 0.0125 level of significance. Auranofin was superior to placebo in the clinical (p = 0.003), functional (p = 0.001), and global (p = 0.007) composites and trended similarly in the pain composite (p = 0.021). Individual measures within the composites consistently favored auranofin. Other measures, not part of the composites, also favored auranofin, including a patient utility measure designed for this study, the PUMS (p = 0.002). Results confirm the hypothesis that the favorable effect of auranofin on clinical synovitis is accompanied by improvements across a range of outcomes relevant to the patient's quality of life.

Adult↗
PubMed1986

Discordance between HLA-B27 and ankylosing spondylitis: a family investigation.

Forty-one members in 4 generations of a family were evaluated clinically for ankylosing spondylitis (AS). Thirty-five individuals were HLA typed. The propositus and 4 male siblings demonstrated AS. A sister had sacroiliitis. Three of the affected sibs shared the B27 containing haplotype, but the remaining 3 individuals lacked the B27 but shared the other maternal haplotype. Two other first degree relatives with B27 did not show evidence of either sacroiliitis or AS. Four members of the family had psoriasis, but did not all share a common haplotype. The lack of association of known HLA antigens with disease expression in this family suggests a role for a putative disease susceptibility gene for psoriasis in the development of B27 negative spondylitis and illustrates the difficulty with the diagnosis of B27 negative AS, since when the family was first studied, it presented as a family of "pure" AS and only after several years of followup did the first evidence of psoriasis appear.

Adolescent↗
PubMed1984

HL-A 27 and ankylosing spondylitis in B.C. Indians.

HL-A antigens were determined in Haida and Bella Coola native Indians, two communities known to have a high prevalence of ankylosing spondylitis. Tests were conducted on those with x-ray evidence of sacroiliitis and on a sample of the community at large. Sacroiliitis was found to prevail in approximately 10% of adult Haida males and in over 2% of Bella Coola adult males. Of 20 Haidas with sacroiliitis. 17 were HL-A 27 positive. Fifty percent of the Haida community at large were HL-A 27 positive. Three Bella Coolas known to have sacroiliitis were all HL-A 27 positive, while 25% of the community sampled at large were HL-A 27 positive. About one in five adult Haida males who were HL-A 27 positive showed evidence of sacroiliitis, a proportion close to that ascertained in Caucasian communities. It would appear, therefore that the risk of disease in HL-A 27 positive Bella Coola males is considerably lower.

British Columbia↗
PubMed1984

Selected adverse reactions of D-penicillamine.

Selected adverse reactions of penicillamine encountered in our clinic since 1975 are described. They include: proteinuria (26 cases), lupus erythematosus (six cases), myasthenia gravis (two cases), pemphigus (three cases), obliterative bronchiolitis (two cases) and obstructive jaundice (one case).

Adult↗
PubMed1984

Lichenoid lesions of the oral mucosa in rheumatoid arthritis patients treated with penicillamine.

Seven of 56 consecutive patients taking penicillamine for rheumatoid arthritis developed oral lesions that clinically and histologically resembled lichen planus. All 7 patients had rashes with prior gold therapy and 4 had rashes with penicillamine therapy. Lesions appeared between 3 and 12 months of therapy at an average dose of 400 mg/day and disappeared within 3 months of stopping the medication. Discontinuation of the drug for oral lichenoid lesions is not necessary. Topical steroids can be used for symptomatic relief.

Administration, Topical↗
PubMed1983

Osteomalacia in the elderly: the value of radio-isotope bone scanning in patients with equivocal biochemistry.

Radio-isotope bone scanning was used to detect osteomalacia in 17 elderly subjects who had equivocal biochemical evidence of this condition. The scan was positive in 10 of the 17 subjects. Bone biopsy confirmed osteomalacia in all 10, but also identified a further two cases. Isotope bone scanning is a practical and relatively non-invasive method of detecting osteomalacia in elderly subjects.

Aged↗
PubMed1982

Juvenile dermatomyositis: medical, social and economic status in adulthood.

Eighteen adults were studied an average of 18.5 years after the diagnosis of juvenile dermatomyositis had been made. Persistent weakness was found in six patients and recurrent rash in the classic distribution in seven. Other clinical features present were Raynaud's phenomenon, arthritis and subcutaneous nodules. Minor increases in the serum creatine phosphokinase level were noted in seven patients and did not correlate with the presence of weakness or rash. Educational achievement and employment status were better in this group than in a group of adults with juvenile rheumatoid arthritis or the general adult population of British Columbia. Significant residual disability related to calcinosis and flexion contractures was present in only three of the patients.

Adolescent↗
PubMed1982

Systemic lupus erythematosus during penicillamine therapy for rheumatoid arthritis.

Six patients with rheumatoid arthritis developed a syndrome resembling lupus erythematosus while being treated with penicillamine. All patients had previous mucocutaneous reactions to chrysotherapy. Manifestations included pleurisy in five of six patients, rashes in three, nephritis in two, and neurologic disturbances in two; lupus erythematosus cells were found in five patients, antinuclear antibodies in all six, antideoxyribonucleic acid in three, positive Coombs' test results for three patients, and low C4 complement in five of the six. Symptoms were slow to resolve after penicillamine treatment was discontinued, and four of the patients needed corticosteroid therapy. A higher frequency than expected of HLA A 11 in three patients and B 15 in five patients was seen.

Adult↗
PubMed1980

The arthropathy of maintenance intermittent peritoneal dialysis.

Among 61 patients undergoing maintenance peritoneal dialysis for an average of 20 months, 13 (21%) had a history of attacks of acute arthritis and 19 (31%) were found to have tender and often swollen joints. Deposits of calcium pyrophosphate dihydrate crystals in articular cartilage were identified in four patients and inflammation probably induced by hydroxyapatite crystals was noted in one. Periarticular calcification was observed in 12 patients and subperiosteal resorption of the phalanges in 20. The average calcium X phosphorus product was significantly higher (P < 0.025) in patients with a history of attacks of acute arthritis or with inflamed joints (58 +/- 12) than in those without (50 +/- 12). In the 19 patients whose treatment was changed to continuous ambulatory peritoneal dialysis there was a significant decrease (P < 0.025) in the calcium X phosphorus product but not in the proportion of patients with attacks of acute arthritis or with inflamed joints. The results indicate that articular complications are frequent among patients undergoing maintenance peritoneal dialysis and may be more common than with long-term hemodialysis.

Acute Disease↗