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Biomedical subjects

B Kirkham

Publications and source records attributed to B Kirkham.

26 records · Page 2Linked to original sources
PubMed1990

New approaches for antirheumatic therapy.

New approaches for antirheumatic therapy are firmly based on current knowledge of immunopathogenic processes. Specific immunotherapy is directed at the treatment of the disease per se and not the production of generalized immunosuppression with its unwanted side-effects. The three targets against which specific immunotherapy is directed are the T cell receptor, the HLA antigen linked to the disease and the antigenic peptide involved in the initiation and/or persistence of the disease. Therapies directed against lymphokines, monokines and cytokines produced during the chronic immune-mediated inflammation are also being developed but they may be unsuccessful not only because of the great redundancy inbuilt into the inflammatory response but also because they would produce too general a response with possibilities of harmful side-effects. Specific immunotherapy at present is largely through the use of monoclonal antibodies directed against a variety of T cell membrane antigens such as CD4, CD7 and the interleukin 2 receptor. A possible therapy is monoclonal antibodies, directed against the HLA molecule involved in the aetiopathogenesis of disease. The use of disease-causing T cell lines or clones as vaccines or therapeutic agents has solid experimental support and studies are in progress in patients with rheumatoid arthritis using T cell lines grown from synovial fluid aspirates. If successful, such therapy could be modified to the use of short peptide fragments from the relevant T cell receptor. T cells recognize antigenic peptides presented on the surface of antigen-presenting cells within a groove formed by the HLA molecule. Displacement of disease-inducing antigenic peptides by engineered 'neutral' peptides could offer a very precise form of immunotherapy. Many of these approaches are based on the hypothesis that transient but effective switching-off of the disease process may allow immunoregulatory circuits, as yet poorly defined, to come into play to permanently cure the disease. Many such therapies are in the offing. It may be that they have to be used in various combinations in order to achieve cure. For this complex and time-consuming task to attain that desired consummation, co-operative interaction between many clinicians, basic scientists and patients will be required. It is to that cooperation that we dedicate this chapter on new approaches for antirheumatic therapy.

Animals↗
PubMed1988

Discovertebral destruction in ankylosing spondylitis complicated by spinal cord compression.

A 56 year old man with ankylosing spondylitis and discovertebral destruction presented with signs of spinal cord compression that was the result of the soft tissue reaction occurring at the level of the discovertebral destruction. This case emphasises the importance of early recognition, use of appropriate imaging techniques (computed tomographic myelography or magnetic resonance), and operative intervention in the management of this rare complication of ankylosing spondylitis.

Humans↗
PubMed1987

Severe hypokalaemia from kaolin and morphine abuse.

A 34 year old man, registered disabled as a result of muscle weakness, was admitted to hospital because of increasing weakness. He had profound hypokalaemia and admitted to taking up to 1400 ml of kaolin and morphine mixture daily. After considerable potassium replacement muscle power recovered completely. The hypokalaemia is likely to have been caused by the combination of liquorice extract and sodium bicarbonate in kaolin and morphine.

Adult↗
PubMed1979

Screening for nutritional deficiencies in the elderly following gastric surgery.

Following gastric resection a slightly reduced haemoglobin is common. The use of erythrocyte morphology as a screening test for deficient absorption of haematinics is unsatisfactory; false positive (42.8%) and false negative (41.6%) results are encountered too frequently to recommend its use. The elderly postgastrectomy patient with mild anaemia may have biochemical evidence of iron, folic acid, or vitamin B12 deficiency with normal erythrocyte morphology.

Aged↗