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Biomedical subjects

B L Kidd

Publications and source records attributed to B L Kidd.

48 records · Page 3Linked to original sources
PubMed1989

A neurogenic mechanism for symmetrical arthritis.

Human synovium is richly innervated by autonomic and sensory nerve fibres, many of which contain neuropeptides. The hypothesis is that, in addition to a sensory role, some of these fibres modulate the response of the synovial membrane to a variety of noxious stimuli by releasing these peptides. Synovial damage results in acute inflammation in the damaged joint and a neurogenically mediated infiltrate of inflammatory cells in the contralateral joint. These cells might protect the contralateral synovium from injury similar to that in the damaged joint. An increased response would lead to synovitis and symmetrical disease.

Arthritis↗
PubMed1989

Hypoxic-reperfusion injury in the inflamed human joint.

A series of experiments showed that, on exercise of the inflamed human knee, intra-articular pressure rises above synovial capillary perfusion pressure, causing intra-articular hypoxia; and that, on cessation of exercise, there is oxidative damage to lipids and IgG within the joint. These findings are consistent with the hypothesis that persistence of synovial inflammation can be due to exercise-induced hypoxic-reperfusion injury mediated by reactive oxygen species.

Adult↗
PubMed1989

Immunohistological features of synovitis in ankylosing spondylitis: a comparison with rheumatoid arthritis.

The immunohistological features of the synovial membrane in ankylosing spondylitis, HLA-B27 associated oligoarthritis, and rheumatoid arthritis wer examined with particular reference to T lymphocyte subsets. T helper (CD4+) cells clearly outnumbered T suppressor/cytotoxic (CD8+) cells in rheumatoid arthritis, whereas both cell types were present in equal numbers in ankylosing spondylitis. A reduction of CD4+/CD45R+ suppressor/inducer cells relative to CD4+/UCHL1+ helper/inducer cells was apparent in all diagnostic groups. The observations were suggestive of disease specific inflammatory responses within synovial membrane.

Adult↗
PubMed1989

Use of laser Doppler flowmetry and transcutaneous oxygen tension electrodes to assess local autonomic dysfunction in patients with frozen shoulder.

The laser Doppler flowmeter (LDF), which measures changes in cutaneous blood flow, and the transcutaneous oxygen electrode which measures cutaneous perfusion, were used to study reflex changes in the microcirculation of the shoulder in 38 patients with frozen shoulder and 10 normal controls. In all controls and 22 patients with frozen shoulder, a normal LDF response to inspiration/expiration was observed. In 16 patients with frozen shoulder, LDF responses were either unilaterally or bilaterally absent. Comparison between the two patient groups showed a significant association (chi 2 = 6.43, P less than 0.02) between abnormality of response and the persistence of pain. TcPO2 was in the normal range in all patients and controls. These findings suggest that the LDF together with the TcPO2 may be a useful method of studying the skin microcirculation over the shoulder.

Adult↗
PubMed1988

Delay in diagnosis of spondarthritis.

A survey was made of referral patterns and investigative procedures in 125 patients with HLA-B27 related spondarthritic diseases reviewed in the rheumatology department of a district general hospital. At the time of referral a large proportion of the patients had already been seen by other hospital departments for the same complaint although in many cases such referrals did not result in a correct diagnosis. Multiple referrals had often resulted in prolonged diagnostic delay during which time unnecessary and invasive investigations were performed. The data indicate the need for improved diagnostic awareness of common rheumatic conditions by all clinicians dealing with musculoskeletal disease.

Diagnostic Errors↗
PubMed1988

Mechanisms of persistent synovitis.

Rheumatoid arthritis is characterised by persistent and symmetrical synovitis. In this article we propose two linked hypotheses to explain these observations. A mechanism to explain symmetry of synovitis is described whereby fine afferent nerve fibres from joints become bilaterally sensitized to movement with resultant release of neuropeptides promoting an inflammatory response. Clinical and experimental evidence is reviewed and shows that movement and resulting hypoxic reperfusion injury leads to a persistent synovitis.

Animals↗
PubMed1986

Admission thyroid function testing in elderly patients.

The free thyroxine index (FTI) was measured in 307 elderly patients admitted to two geriatric units. The initial FTI was abnormal in 41 (13.3%), being raised in 27 and low in 14 patients. On further testing, these abnormalities were found to be either transient or of no clinical significance in 36 of the 41 patients (88%). Only five of the 307 patients (1.6%) were finally treated for previously undiagnosed thyroid disease and of these three improved (1%). Thyroid disease identified by routine screening, and not suspected from the history and clinical findings, was present in only two patients (0.7%). In view of these findings we suggest that thyroid screening is no more justified in the elderly than in younger hospitalised patients.

Aged↗
PubMed1985

Clinical features of meningococcal arthritis: a report of four cases.

Four patients with Neisseria meningitidis infection complicated by arthritis are described. Three patients had an acute polyarthritis which responded quickly to antimicrobial therapy. A fourth patient developed a prolonged arthritis which occurred after the initial infection had been successfully treated. Tenosynovitis occurred as a complication in one case. Attention is drawn to possible confusion with gonococcal infection, and postulated pathological mechanisms are discussed.

Acute Disease↗
PubMed1984

Employment in ankylosing spondylitis.

All patients with ankylosing spondylitis attending our rheumatology clinics were reviewed to assess the effect of their disease on employment. Back movement was measured in three planes, chest expansion determined, and peripheral joint involvement was noted to see whether these correlated with work capability. Sixty patients were reviewed (47 men, 13 women; mean disease duration 24.3 years). Nine were unemployed, but only four of these attributed this condition to ankylosing spondylitis. Although all four had severe neck, back, and hip involvement, this did not differentiate them from other patients who were fully employed. There was no relationship between disease duration and employment. The prospect for continued employment in ankylosing spondylitis is good even when the disease is long standing and severe.

Adult↗
PubMedDate not supplied

The functional significance of sacroiliitis and ankylosing spondylitis in Reiter's syndrome.

The frequent development of sacroiliitis and ankylosing spondylitis (AS) in patients suffering from Reiter's Syndrome (RS) has been stressed by a number of authors. This study was designed to ascertain the frequency of these problems in our RS patients, whether they were related to other clinical features of RS and what was the extent of the resulting disability. Fifty-five patients (50 men and 5 women) with RS with a mean duration of 9.3 years were assessed radiologically to determine the prevalence of sacroiliitis and thoracolumbar syndesmophyte formation. These radiological findings were correlated with HLA-B27, clinical features and functional status. Sacroiliitis was found in 22 patients (40%) but was mild in severity, frequently asymmetrical and very rarely associated with syndesmophyte formation. Sacroiliitis occurred significantly more commonly in patients with iritis and/or a prolonged disease duration (p less than 0.05) but although it was also found more frequently in HLA-B27 positive patients this was not significant (0.1 greater than p greater than 0.05). Some restriction in back movement was observed in 31 patients (56.3%) but only two patients satisfied New York criteria for AS and just one was functionally impaired by his back disease. Although the frequent finding of sacroiliitis in RS may provide an interesting insight into the interrelationship between RS and AS, our study shows that this sacroiliitis is commonly asymptomatic and does not provide a problem in management.

Adolescent↗