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Biomedical subjects

D Barraclough

Publications and source records attributed to D Barraclough.

16 recordsLinked to original sources
PubMed1989

Gastrointestinal blood loss from a new buffered aspirin (Ostoprin): measurement by radiochromium and Hemoquant techniques.

Occult gastrointestinal blood loss induced by a new buffered aspirin preparation (Ostoprin, 4.0 g per day) was compared with that from an enteric-coated aspirin (Ecotrin, 3.9 g per day) in 40 patients with osteoarthritis. Blood loss was measured by the radiochromium method and compared with the HemoQuant assay of fecal heme and heme-derived porphyrins. By radiochromium, mean daily blood loss during the first week of treatment with Ostoprin increased 1.6 ml above basal compared to 0.8 ml above basal with Ecotrin (p = 0.06). When aspirin was ceased, blood loss returned more rapidly towards normal in the Ostoprin group (p less than 0.01). By HemoQuant, mean fecal hemeporphyrin excretion rose 0.63 mg hemoglobin equivalent per g feces during the first week of treatment by Ostoprin compared with 0.40 mg/g for Ecotrin (p = 0.06). There was a significant linear relationship between the two methods (r = 0.65, p less than 0.001). Serum salicylate levels achieved with both preparations were almost identical and encompassed the therapeutic range. HemoQuant is sufficiently sensitive to detect low-level aspirin-induced bleeding. Ostoprin appears to be a safe alternative to Ecotrin and has similar bioavailability.

Adolescent↗
PubMed1989

Pulmonary involvement in Behçet's syndrome.

We present a case of Behcet's syndrome with unusual pulmonary manifestations. A woman presented five years previously with oral, genital and ocular lesions found on biopsy to be consistent with Behcet's syndrome. While on prednisolone, she complained of nonpleuritic chest pain. Clinical features of active Behcet's syndrome were absent. A previously normal chest x-ray film showed multiple intrapulmonary lesions. Laboratory abnormalities were consistent with findings seen in phases of disease activity. Bronchoscopy showed ulceration of the bronchial mucosa, but no evidence of opportunistic infection or neoplasia. Pulmonary angiography excluded vaso-occlusive abnormalities. A provisional diagnosis of pulmonary involvement with Behcet's syndrome was made and the patient responded to further immunosuppressive therapy.

Behcet Syndrome↗
PubMed1985

Cryptococcal sacroiliitis.

Disseminated cryptococcal disease is known to occur in patients with altered immune status. We have reported an unusual case of cryptococcal disease manifested solely by sacroiliitis, which occurred in a patient on chronic steroid therapy for autoimmune haemolytic anaemia. This case stresses the importance of considering unusual organisms as a cause of sepsis in patients with altered immune status.

Adult↗
PubMed1979

Difficulties in the use of D-penicillamine in the treatment of rheumatoid arthritis.

The difficulties encountered in administering D-penicillamine to 40 patients with rheumatoid arthritis (RA) over a six to 24 month period are recorded. Side-effects were frequent. Proteinuria occurred in 13 patients (33%) mainly in the fourth to the sixth month. Renal biopsies were performed in six patients and all showed light microscopy abnormalities. Electron microscopy performed in five patients revealed subepithelial deposits in all and in addition some had mesangial and subendothelial deposits. Seven patients (17.5%) developed eight episodes of thrombocytopaenia which was quickly reversed on cessation of treatment or reduction in dosage. On the positive side, there was significant improvement in most parameters of disease activity at six, 12 and 18 months compared to the pretreatment levels, but the results at two years were less impressive. Reduction in steroid dosage was considerable and was greater than half the mean pretreatment dose after two years but the absence of a control group makes the full significance of these uncertain. Patients on high and low dosage regimens were compared over a 12 month period of treatment. Although the differences were not statistically significant, withdrawals and side-effects were less frequent in the low dose group.

Adolescent↗
PubMed1978

Laboratory diagnosis of rheumatic diseases.

Laboratory investigations have been perhaps the most important factor in the development of our understanding and classification of rheumatic diseases. Provided they are used and interpreted appropriately, they can assist considerably in the diagnosis and management of these diseases. They are an important adjunct to clinical findings, but not a substitute for them.

Adolescent↗
PubMed1977

Diagnosis and follow-up of children referred to a rheumatic disease unit.

Juvenile rheumatoid arthritis (JRA) has become the predominant rheumatic disease of childhood. In a survey of 292 children referred to a rheumatic disease unit over a 5-year period, 94 had JRA and only three had rheumatic fever. At follow-up, of the children with JRA, 70% were found to be in remission with little or no functional disability. Febrile onset of JRA or onset before six years of age were worse prognostic features than pauciarticular or polyarticular onset of occurrence after six years of age. Of 28 children who had either growing pains or psychogenic rheumatism, two were subsequently found to have chondromalacia patellae. None of the other children in this group for whom follow-up information was available had developed organic disease.

Adolescent↗
PubMed1977

Some atypical features of Still's disease.

Still's disease can no longer be considered a rare disorder. Although the onset usually follows one of several definable patterns, some patients may present with features at variance with classical descriptions of the disease. Four such patients are described to illustrate some of the diagnostic problems which may arise.

Arthritis, Infectious↗
PubMed1977

Psoriatic spondylitis: a clinical, radiological, and scintiscan survey.

Thirty-three per cent of patients with psoriatic spondyloarthropathy referred to a rheumatic disease unit were found to have radiological sacroiliitis. The majority of these patients had definite or probable spondylitis according to the New York criteria. Abnormal sacroiliac uptake of 99mTcPP on bone scan correlated well with the radiological finding of sacroiliitis. In addtion, eight patients with normal radiographs had an abnormal uptake of radionuclide over the sacroiliac joints, indicating sacroiliitis. Patients with sacroiliitis tended to have more severe psoriasis. Sacroiliitis occurred in association with all of the patterns of peripheral joint involvement which may occur in psoriatic arthritis. Although the HLA antigen B27 was present in only 21 percent of the total group and in 33 percent of those with sacroiliitis, 8 out of 10 with this antigen had sacroiliitis.

Adult↗
PubMed1975

Effect of penicillamine therapy on circulating immune complexes in rheumatoid arthritis.

The sera of 40 patients with severe progressive rheumatoid arthritis were examined for the presence of soluble immune complexes before penicillamine therapy was started, and again after treatment for a mean period of 14-4 months. The methods used were radiobioassay (macrophage uptake), C1q-binding capacity, and precipitation by 4% polyethylene glycol. Before treatment the sera of 37 patients showed significantly enhanced uptake of 125I-labelled aggregated human IgG by guinea pig macrophages. Treatment produced significant falls in mean erythrocyte sedimentation rate, differential agglutination titre, and serum IgG and IgM levels, and enhancing complexes (EC) decreased or disappeared in 20 patients. In 9 patients EC changed to inhibiting complexes, and in 8 EC levels were unchanged. In 6 of 8 patients with cutaneous vasculitis initially, both lesions and EC disappeared. The total protein and the IgG and IgM precipitated from patients' sera by 4% polyethylene glycol fell significantly on treatment. Antinuclear antibody titres were unchanged by penicillamine, and 3 patients acquired these antibodies during treatment. These findings suggest that penicillamine treatment in rheumatoid arthritis reduces the level of circulating soluble immune complexes in which IgM rheumatoid factor is a component.

Adult↗
PubMedDate not supplied

Interaction of D-penicillamine with gold salts: in vivo studies on gold chelation and in vitro studies on protein binding.

Serum and urinary gold levels were monitored in 18 patients previously treated with gold salts for rheumatoid arthritis and the effects of D-penicillamine studied. There was no statistically significant change in urinary gold levels on D-penicillamine therapy although there were some individual variations. Serum gold levels fell during D-penicillamine therapy but the rates of fall did not differ from those seen in patients not treated. In vitro studies on protein binding of gold salts suggest that a high affinity exists between gold salts and albumin with low levels of unbound gold even at concentrations far exceeding those seen in vivo. These preliminary results suggest that at therapeutic levels only small amounts of gold are available for chelation by penicillamine. It is concluded that penicillamine at low dosage is an unreliable chelator of gold salts in vivo and its use in the management of gold toxicity remains speculative.

Arthritis, Rheumatoid↗