Search PubMed⌕ Search

Biomedical subjects

B M Ansell

Publications and source records attributed to B M Ansell.

At least 37 records · Page 2Linked to original sources
PubMed1991

Juvenile chronic arthritis: classification, differential diagnosis and prognosis.

Although the nomenclature and classification of juvenile chronic polyarthritis is not uniform, the division into systemic, polyarticular and pauciarticular forms is generally accepted. The characteristic symptoms, the division into subgroups according to age, clinical course and serology as well as the differential diagnostic considerations pertaining to each form are described. Most of the children with the pauciarticular form have a good prognosis; however, in 15% of these cases the disease changes into polyarticular JCA. The systemic form has the least favorable prognosis, while the prognosis of polyarthritic JCA depends upon the presence of the IgM-Rheuma factor. In seronegative patients the prognosis also depends on the age at onset of the disease and on the quality of the treatment of the joints during the acute phases.

Adolescent↗
PubMed1991

The wrist in juvenile arthritis.

Patients with juvenile arthritis affecting the wrist have been reviewed six months or more after treatment, which has included steroid injection, synovectomy, arthroplasty, arthrodesis and distraction lengthening of the ulna. The pattern of wrist involvement is described, the general management reviewed, and the indications, techniques and results of these various procedures are presented.

Arthritis, Juvenile↗
PubMed1991

Juvenile chronic arthritis and juvenile spondyloarthropathy.

Clinically recognized subgroups of juvenile chronic arthritis and the juvenile spondyloarthropathies are gradually being shown to be immunogenetically distinct; greater subdivision may ultimately be required. Mechanisms by which the association of certain genes work await further elucidation. Meanwhile, therapy such as intravenous gamma globulin may be most effective in systemic disease. Sulfasalazine is recommended for patients with later-onset pauciarticular disease, particularly HLA-B27 patients. Methotrexate should probably be reserved for severe unresponsive disease, particularly polyarthritis, until side effect profiles are better evaluated.

Arthritis↗
PubMed1991

Panniculitis: a report of four cases and literature review.

Panniculitis is a disease with many causes and associations. The classification of clinical subtypes is unsatisfactory and hampered by the use of eponyms. Four children with recurring panniculitis are described and their histology presented. Three had subcutaneous fat atrophy with lobular panniculitis on biopsy; all responded well to corticosteroids. The fourth child had a septal panniculitis with no atrophy of subcutaneous tissues and only a partial response to treatment with corticosteroids. A widely accepted precise histological classification of panniculitis is needed to enable accurate predictions of the outcome of this serious disorder.

Adipose Tissue↗
PubMed1991

Total hip replacement for juvenile chronic arthritis.

We review the results of 96 primary total hip replacements in 54 patients with juvenile chronic arthritis at five years or longer after surgery. The mean age at operation was 16.7 years (range 11.25 to 26.6); the follow-up period averaged 11.5 years. The clinical results in terms of pain, range of movement, mobility and function are presented. A revision procedure was required in 24 hips (25%) in 18 patients at an average of 9.5 years after the primary operation. A further 17 hips had radiographic signs of loosening. The factors thought to contribute to this relatively high failure rate in patients with juvenile chronic arthritis are discussed.

Adolescent↗
PubMed1991

Juvenile dermatomyositis.

Juvenile dermatomyositis is a multisystem disease characterized by muscular inflammation affecting primarily the skin and muscle; it presents as a nonsuppurative myositis causing symmetrical weakness and typical skin rashes that affect the face and hands in particular, but can occur at any site. In the last few years, a number of reviews have been published, this article only highlights some points of interest.

Adolescent↗
PubMed1991

Still's disease.

Explore the source record for details and available documents.

Arthritis, Juvenile↗
PubMed1991

Randomized, double-blind trial of deflazacort versus prednisone in juvenile chronic (or rheumatoid) arthritis: a relatively bone-sparing effect of deflazacort.

Thirty-four children with juvenile chronic (rheumatoid) arthritis were recruited to a randomized, double-blind study of deflazacort (an oxazolone derivative of prednisone) vs prednisone. All had been receiving glucocorticoid therapy for at least 1 year and required at least 5 mg/d of prednisolone (usually as 10 mg every 2 days). Thirty-one children completed the study. Bone density trends were measured in the spine by dual photon absorptiometry and in the forearm by single photon quantitative computed tomography at 3-monthly intervals. Trends (velocities) in bone and soft tissue growth were calculated. In the spine, bone growth correlated well with indices of soft tissue growth, but covariance analysis showed a significant advantage (P less than .007) of deflazacort when spinal bone mineral growth was compared to body surface area and weight. In part this was due to a temporary interruption in weight by children receiving deflazacort, whose gain in height was comparable with that of the prednisone group. Some children in both groups improved clinically and showed catch-up growth; in these children relative spinal bone mineral growth velocities were about twice those observed for height and weight. It is concluded that during the first year of deflazacort, their spinal bone mineral content at a level that was appropriate for their height and weight. Further observations are required to establish whether this advantage can be maintained subsequently. The anti-inflammatory effects of the two glucocorticoids appeared similar.

Adolescent↗
PubMed1990

Rapid periarticular bone loss in rheumatoid arthritis. Possible promotion by normal circulating concentrations of parathyroid hormone or calcitriol (1,25-dihydroxyvitamin D3).

For approximately 2 years, bone loss was measured in women with early stages of rheumatoid arthritis (RA) and in control subjects, using serial computed tomography and dual photon absorptiometry. Rapid trabecular bone loss from the distal radius was observed in the RA patients but not the controls. The bone loss correlated with initial plasma levels of parathyroid hormone and 1,25-dihydroxyvitamin D3 (calcitriol) concentrations. It has been suggested that these humoral factors may interact with cytokines or other mediators produced in the adjacent wrist joint. Losses of the cortical bone of the radial midshaft and the lumbar spine were modest and were comparable in the 2 groups. Indices relating to both bone formation and bone resorption predicted bone loss at these 2 sites, but changes in the parathyroid hormone and calcitriol concentrations did not.

Absorptiometry, Photon↗
PubMed1990

Tarsometatarsal involvement in juvenile spondyloarthropathy.

Patients with juvenile spondyloarthropathy who carry HLA B27 antigen or have a family history of ankylosing spondylitis may have marked tarsometatarsal arthritis. This may be associated with hindfoot involvement and result in a supination deformity. Spontaneous fusion with complete obliteration of the tarsometatarsal joints may occur.

Adolescent↗
PubMed1989

Recurrent acute proptosis in atypical systemic lupus erythematosus.

A patient is described who developed acute proptosis, a rare complication of systemic lupus erythematosus, 16 years after the onset of the disease. Treatment with intravenous methylprednisolone produced rapid improvement, but swelling recurred a few days later. Intravenous corticosteroid was again effective and was continued orally without further episodes of proptosis. This patient is unusual in the long period of mild disease before the development of systemic complications, and in having antibodies to nuclear ribonucleoprotein but persistently normal titres of DNA-binding antibodies in her serum.

Acute Disease↗
PubMed1989

HLA and complement C4 antigens in polyarticular onset seronegative juvenile chronic arthritis: association of early onset with HLA-DRw8.

HLA-A,B,C,DR and DQ antigens were tested in 53 British Caucasian patients with polyarticular onset seronegative juvenile chronic arthritis (JCA); C4 allotypes were also tested in 46. A strong association with HLA-DRw8 was found (RR = 6.1, Fp = 7.6 x 10(-5)), with increased -B5(51) and C4A QO, and decreased -DR7 frequencies. DRw8 incidence correlated with an onset under 5 years, 9 of 12 DRw8+ cases being in this subgroup (Fp = less than 0.06), whereas B5 and C4A QO were prevalent in late onset (greater than or equal to 5 years). Erosions after 5 years associated with HLA-DRw6, and their absence with -Cw1 and -DR5. Genetic susceptibility factors and a further subdivision by onset age are thus demonstrated in this disease. Comparative data suggest that the genetic basis of susceptibility to early onset disease is similar to that of pauciarticular JCA.

Adolescent↗
PubMed1988

Galactosylation of IgG associated oligosaccharides: reduction in patients with adult and juvenile onset rheumatoid arthritis and relation to disease activity.

The prevalence of agalactosyl N-linked oligosaccharides on serum IgG was determined for patients with juvenile onset and with adult rheumatoid arthritis. A significant difference in the prevalence of these structures from age matched controls was found in both types of arthritis. In patients with adult onset rheumatoid arthritis, the results showed a strong correlation between the prevalence of IgG-associated agalactosyl oligosaccharides and disease activity. A correlation between disease activity and agalactosyl structures was also seen in a retrospective analysis of serial IgG samples from patients with juvenile onset disease. The finding that childhood onset arthritis and adult rheumatoid arthritis share a defect of glycosylation of serum IgG suggests that there may be a greater similarity between these two varieties of rheumatoid arthritis than has been hitherto considered. The observation that the incidence of agalactosyl oligosaccharides on IgG fluctuates with disease activity provides indirect evidence for a seminal role for this change of glycosylation in the inflammatory process which, in rheumatoid arthritis, is focused on the synovial tissues and results in bone erosions and joint destruction.

Adolescent↗
PubMed1988

A review of the diagnoses of hip pain presentation in the adolescent.

This paper describes 26 adolescents presenting with hip pain. Monarticular hip arthritis can be the onset of juvenile spondylitis or even juvenile rheumatoid arthritis, whilst occasionally it persists as localized disease which becomes destructive; however, in this small series, the two commonest diagnoses were idiopathic protrusio acetabuli and idiopathic chondrolysis. Initial diagnosis may be difficult despite adequate investigation and exclusion of infection. In such cases long-term follow-up with appropriate orthopaedic advice is essential.

Acetabulum↗