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Biomedical subjects

B M Ansell

Publications and source records attributed to B M Ansell.

At least 91 records · Page 5Linked to original sources
PubMed1985

Bone turnover in early rheumatoid arthritis. 1. Biochemical and kinetic indexes.

Biochemical, hormonal, and kinetic indexes of bone turnover were measured in 17 ambulant female patients with rheumatoid arthritis (RA) of recent onset (mean disease duration 14.2 months) and 19 controls. Mean serum osteocalcin concentration and 85Sr accretion rates were reduced and mean urinary hydroxyproline-creatinine ratios were increased in RA, but these differences were not significant compared with control values. Mean total body potassium (TBK), an index of skeletal muscle mass, was significantly reduced in RA, and the ratio of observed to predicted TBK correlated with indexes of bone formation. No abnormality of skeletal metabolism could be shown in early RA, but reduced rates of bone formation associated with diminished muscle mass may influence the development of osteopenia later in the disease.

Adult↗
PubMed1985

Bone turnover in early rheumatoid arthritis. 2. Longitudinal bone density studies.

Serial measurements of bone mineral in 17 ambulant female patients with rheumatoid arthritis (RA) of recent onset and 19 age matched female controls were made in the radius by computed tomography and in the vertebrae by dual photon absorptiometry. Loss of trabecular bone from the distal radius was more rapid in RA (p = 0.0014), but there was no difference in the rate of loss of bone mineral from the radial midshaft or lumbar spine compared with the controls. This study is consistent with the hypothesis that the predominant form of bone loss early in the disease is the vicinity of affected joints.

Arthritis, Rheumatoid↗
PubMed1985

Calcium absorption in rheumatoid arthritis.

Calcium absorption, assessed by a double isotope method, was found to be impaired in postmenopausal women with rheumatoid arthritis of recent onset (mean 14.2 months) compared with controls. Circulating levels of 1,25-dihydroxyvitamin D (calcitriol) were higher than in controls, suggesting a primary malabsorption of calcium in these patients. The reduction in calcium absorption correlated with several measures of disease activity, suggesting that the disease process was responsible for the intestinal defect, but an effect from non-steroidal anti-inflammatory agents cannot be excluded. A primary reduction in calcium absorption may increase the risk of osteoporosis in women with rheumatoid arthritis.

Adult↗
PubMed1985

IgG-anti-IgG antibodies in juvenile chronic arthritis.

IgG antiglobulins were measured in 117 children with seronegative juvenile chronic arthritis (JCA). 100 had active disease, and these had significantly higher levels of IgG antiglobulins (mean 0.45 +/- 0.16 micrograms/ml) than the control group (mean 0.25 +/- 0.16 micrograms/ml (p less than 0.01]. The inactive group of patients had a mean of 0.14 +/- 0.06 micrograms/ml, comparable to a group of cord bloods from normal births (mean 0.14 +/- 0.05 micrograms/ml). In the active patients there was no difference when subdivision was made according to their mode of onset into pauciarticular, polyarticular, or systemic.

Adrenal Cortex Hormones↗
PubMed1985

Sibling pairs affected by chronic arthritis of childhood: evidence for a genetic predisposition.

Twelve families with a sibling pair affected by seronegative juvenile chronic arthritis (JCA) were studied. The ratio of HLA haplotype sharing was significantly different from that expected. No common haplotype was found. All 10 sibling pairs concordant for pauciarticular disease shared 2 haplotypes and the other 2 pairs shared one haplotype. These findings are evidence of a genetic predisposition to develop pauciarticular onset JCA in the families studied and suggest the presence of a disease susceptibility gene or genes within the major histocompatability complex.

Antibodies, Antinuclear↗
PubMed1984

Infection and interferon production in systemic juvenile chronic arthritis: a prospective study.

Twenty-four episodes of disease exacerbation in 19 children suffering from systemic juvenile chronic arthritis were studied. Sixteen of these were preceded by an infection (chi 2 = 20.14, p less than 0.001), mostly of the upper respiratory tract. In the 10 cases seen during an infection causative agents were identified in 5 (herpes simplex, rhinovirus, and on 3 occasions streptococcus). The total number of infections was not increased when compared with infection rates predicted by several reported studies. In the absence of clinical infection, specific antibody titres to a panel of microbial antigens were similar to those of a control group but with a trend toward higher titres in patients with hypergammaglobulinaemia. Interferon (IFN) responses were not defective, though sequential in-vitro IFN production from peripheral blood mononuclear cells (PBM) fluctuated considerably in the same patients, occasionally being absent with no obvious clinical correlate. IFN-alpha was induced by stimulation with Newcastle disease virus (NDV), and the mean responses of the patients were significantly greater than those of controls. IFN-gamma production on phytohaemagglutinin (PHA) stimulation was similar in patients and control groups. IFN was not detected in any of the sera from patients or controls.

Adolescent↗
PubMed1984

Developmental aspects of the hip in juvenile chronic arthritis. A radiological assessment.

The aim of this study in sero-negative juvenile chronic arthritis was to examine the radiological changes in the hip joints in relation to age and mode of onset of disease. Particular attention was paid to periods of complete immobilization or reduction in weightbearing, irrespective of clinical hip involvement. Twenty-two children with an early onset of disease (i.e. less than 5 years) with clinical hip involvement were compared with 12 similarly aged children without clinical hip involvement, and 22 children with a later onset but with clinical hip involvement. In all the children with an early onset of disease the initial radiographic findings were developmental rather than destructive. In those with clinical hip involvement, destructive changes supervened, while those with later onset had destruction as the first feature, often followed by the development of protrusio acetabula. The 12 children without clinical hip involvement who had prolonged periods of non-weightbearing in early life, usually because of knee involvement, showed developmental abnormalities. These findings suggest that weightbearing should be encouraged, to promote the normal development of the hips.

Acetabulum↗
PubMed1984

Management of polymyositis and dermatomyositis.

The overall prognosis for polymyositis and dermatomyositis has improved with the judicious use of corticosteroids, while azathioprine and other cytotoxic agents are of value in improving functional ability and decreasing the total steroid requirement. However, the duration of therapy and the relative risks of it must be under constant surveillance. Problems such as respiratory or cardiac failure in the course of the disease are of serious importance and require particular care in management . Finally, the possibility of neoplasm underlying the disease or occurring as a sequel to cytotoxic therapy should always be borne in mind.

Adolescent↗
PubMed1983

Disseminated intravascular coagulation complicating systemic juvenile chronic arthritis ("Still's disease").

Two children suffering from systemic juvenile chronic arthritis (JCA) complicated by acute disseminated intravascular coagulation (DIC) are described. One had a fatal outcome with acute renal failure and cerebral haemorrhage; the other recovered. Early recognition and treatment of the underlying cause - usually an infection - as well as replacement of clotting factors are important in management.

Arthritis, Juvenile↗
PubMed1983

A comparison of low dose levamisole and penicillamine in rheumatoid arthritis.

Levamisole (150 mg once weekly) was compared with penicillamine (250 mg daily) in a single blind independent observer study in 28 patients with rheumatoid arthritis over twelve months. Fifty percent (8/16) of patients stopped levamisole, five within three months of starting, while only two of twelve stopped penicillamine. In those patients able to tolerate treatment for twelve months, both regimens produced a significant and comparable reduction in disease activity, with the onset of action of penicillamine occurring at three months compared with six to nine months for levamisole. Radiological progression of disease occurred in both groups. Levamisole in low dose may improve parameters of disease activity in rheumatoid arthritis but poor patient tolerance, slow onset of action and failure to prevent radiological progression limit its usefulness.

Arthritis, Rheumatoid↗
PubMed1983

Articular hypermobility simulating chronic rheumatic disease.

A retrospective survey of 54 children with symptoms associated with articular hypermobility showed only occasional recognition of the syndrome before referral; some patients had been treated for inflammatory arthritis. Of the patients, 78% were girls; their mean age at onset of symptoms (11 years) was 3 years older than the mean age of the boys. Hypermobility was localised rather than generalised in most patients, and this may be an important reason for the apparent under recognition of the syndrome.

Adolescent↗
PubMed1983

HLA studies in IgM rheumatoid-factor-positive arthritis of childhood.

The clinical course of children with IgM rheumatoid-factor-positive chronic arthritis closely resembles that of seropositive rheumatoid disease in adults. The frequency of HLA DR4 is known to be increased in adults with seropositive rheumatoid arthritis, but the first major report on childhood arthritis did not suggest a correlation, though only 8 seropositive cases were included. Fifty-two children with polyarthritis beginning before the age of 16 who persistently carried IgM rheumatoid factor were studied. HLA DR4 was present in 60% of these children but was found in only 29% of 93 patients with seronegative juvenile arthritis and 27% of a normal adult population. These results suggest immunogenetic similarities in patients with seropositive arthritis irrespective of age of onset.

Adolescent↗
PubMed1983

Effect of different corticosteroid regimens on hypothalamic-pituitary-adrenal axis and growth in juvenile chronic arthritis.

Linear growth was recorded in 36 children with juvenile chronic arthritis. In 20, the hypothalamic-pituitary-adrenal axis (HPA axis) was assessed by insulin-induced hypoglycaemia, the results of which correlated well with resting cortisol levels. Three groups were identified according to type of corticosteroid regimen administered. Group 1 (6 children), receiving daily corticosteroid therapy, were clearly suppressed and failing to grow. Group 2 (13 children) had received an alternate-day regimen from the initiation of corticosteroid therapy; they were not suppressed and growth was satisfactory in 11. Group 3 (17 children) were receiving alternate-day therapy, but had had daily corticosteroid in the past; they showed no clear pattern of suppression or growth. Factors influencing the recovery of the HPA axis and resumption of growth were assessed. No difference was found in the individual growth of 7 children who commenced alternate-day therapy before the age of 5, compared with matched controls. It is suggested that daily divided doses of corticosteroid should not be used. Ideally, a single morning dose (up to 2 mg/kg) alternate-day regimen should be employed, as this regimen has minimal effects on HPA function and growth, even in young children. For very severe systemic features, it may be necessary to add a small single dose on the alternate day.

Adolescent↗