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Biomedical subjects

B Bresnihan

Publications and source records attributed to B Bresnihan.

At least 145 records · Page 8Linked to original sources
PubMed1986

Lymphoid irradiation in intractable rheumatoid arthritis. A double-blind, randomized study comparing 750-rad treatment with 2,000-rad treatment.

Twenty patients with intractable rheumatoid arthritis were treated with 750-rad or 2,000-rad lymphoid irradiation in a randomized double-blind comparative study. Over a 12-month followup period, there was a significant improvement in 4 of 7 and 6 of 7 standard parameters of disease activity following treatment with 750 rads and 2,000 rads, respectively. Transient, short-term toxicity was less frequent with the lower dose. In both groups, there was a sustained peripheral blood lymphopenia, a selective depletion of T helper (Leu-3a+) lymphocytes, and reduced in vitro mitogen responses. These changes did not occur, however, in synovial fluid. These results suggest that 750-rad lymphoid irradiation is as effective as, but less toxic than, that with 2,000 rads in the management of patients with intractable rheumatoid arthritis.

Adult↗
PubMed1986

Effects of gold therapy on the synthesis and quantity of serum and synovial fluid IgM, IgG, and IgA rheumatoid factors in rheumatoid arthritis patients.

Eleven patients with active rheumatoid arthritis were monitored prospectively while receiving up to 1 gm of gold sodium thiomalate. There was a significant decrease in serum and synovial fluid IgG, IgA, and IgM rheumatoid factor (RF) levels over the period of study. Comparison of changes in serum RF and total immunoglobulin levels indicated a selective effect on RF production. These observations were supported by changes in the spontaneous in vitro production of IgM-RF and total IgM by peripheral blood mononuclear cells. Studies of synovial membrane synthesis showed a downward trend in immunoglobulin and RF production, but this did not reach statistical significance. A differential effect on the various RF classes was also noted. The most profound effect was on IgM-RF production; whereas, changes in IgG-RF production were least affected. These results suggest a selective and differential effect of gold salts on RF production.

Adult↗
PubMed1986

Reversible myocardial perfusion defects during cold challenge in scleroderma.

Myocardial perfusion was studied using 201thallium scintigraphy in patients with Raynaud's phenomenon undergoing cold challenge. Ten patients with systemic sclerosis and 10 with other systemic rheumatic diseases were selected. Patients with clinical features of cardiac disease were not included. Both groups of patients had similar cold-induced elevations of pulse rate and systolic and diastolic blood pressure. Reversible perfusion abnormalities suggesting cold-induced ischaemia were seen in four of the ten patients with systemic sclerosis, but in none of the patients with other rheumatic diseases. This study supports the suggestion that the vascular disorder in scleroderma differs from that seen in other rheumatic diseases which are associated with Raynaud's phenomenon.

Adolescent↗
PubMed1986

Peptic ulcer in rheumatoid arthritis--intrinsic or related to drug therapy?

The reported incidence of peptic ulcer disease (PUD) in patients with rheumatoid arthritis (RA) is higher than that of the general population. Unusual susceptibility to PUD in RA, independent of therapy, has been suggested. To compare RA patients with others who had similar drug exposure but no known predisposition to PUD, 120 patients hospitalized for treatment of severe arthritis (65 with RA, 55 with osteoarthritis) were assessed by questionnaire for PUD history, drug history and other relevant variables. The relationship of PUD to sex distribution, smoking, alcohol consumption and anti-inflammatory therapy followed expected patterns. We found high but similar PUD rates in RA and osteoarthritis (OA) patients (RA 15%, OA 18%). This suggests that a common factor (probably drugs) is responsible. We feel that the documented high incidence of PUD in RA is most probably related to drug therapy. Available methods cannot determine if PUD ever occurs as a primary manifestation of RA.

Aged↗
PubMed1986

The immunological consequences of gold therapy: a prospective study in patients with rheumatoid arthritis.

Gold sodium thiomalate (GST) is known to modify the disease process in patients with active rheumatoid arthritis (RA). To help understand the mechanism of action of GST, several immunological parameters were prospectively evaluated in 10 patients with active RA following the introduction of gold therapy. Before therapy, absolute numbers of peripheral blood T suppressor/cytotoxic lymphocytes were significantly depressed (P less than 0.01) and a raised T helper/T suppressor cell ratio was found. After 1 g of GST, an absolute reduction in total lymphocyte numbers including HLA/DR positive mononuclear cells, was evident (P less than 0.01). This lymphopenic effect was not selective for a single population since the proportions of T cells, T cell subsets and B cells remained unchanged. Lymphocyte function was also examined. Raised in vitro production of IgG (P less than 0.01) and IgA (P less than 0.05) was found before therapy. After GST, in vitro immunoglobulin synthesis was reduced and this was significant with respect to the IgM (P less than 0.001) and IgA (P less than 0.01) isotypes. Similarly, a parallel reduction in serum immunoglobulin levels developed. GST therapy was also associated with a reduced proliferative response to phytohaemagglutinin, concanavalin A and pokeweed mitogen in the initial phase of gold administration. The significant finding in this study suggest that the in vivo immunosuppressive effect of GST is explained not only by impaired mononuclear cell function but also by a significant reduction in T and B lymphocyte numbers.

Arthritis, Rheumatoid↗
PubMed1985

Effects of joint lavage on knee synovitis in rheumatoid arthritis.

Ten patients with rheumatoid arthritis and persistent knee synovitis had synovial fluid aspirated through a 14 gauge wide-bore needle followed by joint lavage and intra-articular triamcinolone. This resulted in the removal of variable quantities of intra-articular debris including rice bodies. When compared to a control group of patients, the addition of joint lavage to the standard procedure of aspiration and injection of corticosteroid resulted in more sustained resolution of synovitis after 12 weeks as judged by knee tenderness and circumference, recurrence of effusion, and synovial fluid leucocyte count. This study suggests that knee joint lavage may be a useful adjunct to therapy in rheumatoid arthritis patients having persistent knee synovitis.

Aged↗
PubMed1985

Reduction of peripheral blood lymphocytes in patients receiving gold therapy for rheumatoid arthritis.

Peripheral blood lymphocytes were monitored prospectively in 10 patients with rheumatoid arthritis (RA) receiving up to 1 g of sodium aurothiomalate. There was a significant fall in the absolute lymphocyte count from a mean +/- SEM of 1956 +/- 190/mm3 (1.956 +/- 0.19 X 10(9)/l) to 1232 +/- 210/mm3 (1.232 +/- 0.21 X 10(9)/l) (p less than 0.01). The number of of circulating lymphocytes fell in all patients by an amount which ranged between 108/mm3 (0.108 X 10(9)/l) and 1394/mm3 (1.394 X 10(9)/l), with a mean fall of 727/mm3 (0.727 X 10(9)/l). No significant change was noted in the total white cell count or total polymorphonuclear cell count over the same period. In contrast there was no change in the total lymphocyte count in an age and sex matched group of RA patients treated with penicillamine. This previously unreported observation may give new insight into the mechanism of action of gold salts in RA.

Arthritis, Rheumatoid↗
PubMed1985

Massive osteolysis in the hand and response to radiotherapy.

We report a case of severe bony and articular destruction in the hand of a 62-year-old woman, secondary to localized vascular proliferation. A short course of radiotherapy (total dose 3000 rad) resulted in rapid relief of symptoms and prevention of further osseous destruction over a 6-year followup period.

Bone Resorption↗
PubMed1985

Lymphoid irradiation in intractable rheumatoid arthritis: effects on the production of immunoglobulins and rheumatoid factors.

Changes in the production of immunoglobulins and rheumatoid factors (RF's) were studied in 20 patients with intractable rheumatoid arthritis (RA) following total doses of 750 rad or 2,000 rad lymphoid irradiation. Over a 12 month follow up period there was no consistent change in absolute serum or synovial fluid levels, or in synovial membrane production of either total IgG, IgA or IgM, or the corresponding RF fractions. The invitro production of immunoglobulins and IgM RF by peripheral blood mononuclear cells was also unaltered, except for one patient who had a dramatic rise in IgM RF production. Over the same period there was a significant overall reduction in disease activity following both doses of radiotherapy. It is concluded that the clinical response which occurs following lymphoid irradiation is not due to a reduction in RF production. Furthermore, the production of RF's appears to be unaffected by the changes in T cell immunity which occur following lymphoid irradiation.

Arthritis, Rheumatoid↗
PubMed1984

The frequent occurrence of neurological disease in patients with late-onset systemic lupus erythematosus.

Ten patients with systemic lupus erythematosus, whose first disease manifestation appeared after age 50 years, have been studied prospectively for up to five years. Neurological manifestations attributable to lupus occurred in nine patients and were multiple and varied. In all nine patients the neurological features appeared within one year of disease onset, and in four were present as an initial manifestation. Clinical recovery was generally satisfactory, and was complete in four. The apparent high incidence of neurological disease observed in late-onset lupus may help to elucidate causative mechanisms.

Adrenal Cortex Hormones↗