Biomedical subjects
E C Huskisson
Publications and source records attributed to E C Huskisson.
The value of radiography in the management of rheumatoid arthritis.
All radiographs of joints requested on 50 consecutive clinic patients with rheumatoid arthritis were reviewed; 1094 films were available. With few minor exceptions, all information relevant to diagnosis and medical management was provided by one view of each joint: postero-anterior hands, dorsi-planar feet, antero-posterior (AP) elbow, AP shoulder, AP pelvis and lateral flexion cervical spine. Norgaard's 'ballcatcher's' projection of the hands provided no extra information. Radiographs of the hands were consistently more sensitive in showing progression of erosion than those of the feet. Radiography of both hands and feet was required to avoid missing earliest erosions. Radiographs requested at times when drug treatment was under review did not consistently affect decisions, which were largely dependent on clinical findings.
Pityriasis rosea-like rashes complicating drug therapy for rheumatoid arthritis.
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Measurement of patient outcome.
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Thymopoietin and levamisole in chronic granulomatous inflammation.
Two animal models were used to investigate the mode of action of levamisole and thymopoietin. Neither compound influenced the subcutaneous carrageenan air pouch. While thymopoietin inhibited the formation of cotton pellet granulomas, levamisole enhanced it. This supports the conclusions of clinical studies reported elsewhere that levamisole and thymopoietin do not act in the same way in rheumatoid arthritis.
Diclofenac sodium in the treatment of painful stiff shoulder.
A double-blind controlled, between-patient trial was carried out in 40 patients with painful stiff shoulder to compare the effect of treatment with either 50 mg diclofenac sodium or 400 mg ibuprofen given 3-times daily for 2 weeks. The results of assessments made before and after treatment showed that although both drugs produced some improvement no statistically significant differences between the two groups in terms of pain relief or the range of movement were evident. The incidence of side-effects was also similar.
Naproxen and piroxicam. A comparative trial in rheumatoid arthritis.
A single-blind crossover trial in 60 patients with rheumatoid arthritis showed that piroxicam, 20 mg daily and naproxen, 500 mg twice daily were comparable in both efficacy and tolerance.
What piroxicam does and why.
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Current practice in rheumatology.
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Once-a-day treatment for arthritis. A comparison.
The three currently available once-a-day treatments for osteoarthritis were compared in a double blind crossover trial. 90 patients received benoxaprofen 600 mg daily, slow-release indomethacin (Indocid-R) 75 mg daily and piroxicam 20 mg daily for three weeks each. The three compounds were comparable in efficacy. Benoxaprofen caused more side effects than the other two drugs and slow-release indomethacin caused slightly more than piroxicam. Despite the greater incidence of side effects, a number of patients still preferred benoxaprofen and elected to continue taking it. Individual preference remains the most important factor in choosing an anti-inflammatory drug for osteoarthritis.
Misleading symptoms and signs of cervical spine subluxation in rheumatoid arthritis.
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Intra-articular drug therapy in rheumatoid arthritis. A study with indoprofen.
Six patients (4 men, 2 women) with moderate/large knee effusions due to rheumatoid arthritis (RA) were studied after receiving indoprofen, 25 mg intra-articularly and then 200 mg orally 1 week later. There was significant improvement in pain (t = 3.74, P less than 0.05), morning stiffness (t = 2.91, P less than 0.05) and range of movement (t = 2.52, P less than 0.05) for at least 1 week following the intra-articular injection. The terminal phase plasma half-life after the 200 mg oral dose was 6.4 +/- 0.7 h (mean +/- SEM) and was significantly longer than the often quoted plasma half-life of 2-3 h from previous studies, but much less than the pharmacodynamic half-life. Synovial fluid concentration were not significantly different from those in plasma in the post-distribution phase. Intra-articular indoprofen may be a useful addition to the treatment of RA.
Analgesic action of isoxepac.
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Thymopoietin in rheumatoid arthritis.
In a controlled study involving 36 patients, thymopoietin was shown to be more effective than levamisole and as effective as penicillamine in improving the clinical status of patients with rheumatoid arthritis. There were small reductions in erythrocyte sedimentation rate and IgG which did not achieve statistical significance. Rheumatoid factor titre did not change. Although its mechanism of action is almost certainly related to its immunomodulatory properties it does not seem to be the same as that of levamisole.
Diclofenac sodium, diflunisal and naproxen: patient preferences for anti-inflammatory drugs in rheumatoid arthritis.
Ninety patients with active rheumatoid arthritis took part in a cross-over trial comparing diclofenac sodium, diflunisal and naproxen. The efficacy of the three drugs was similar though there were trends in favour of diclofenac sodium in some measurements. The incidence of side-effects was similar with the three drugs and each was chosen by a significant group of patients as continuation therapy at the end of the study.
Clinical response to therapy with thymopoietin pentapeptide (TP-5) in rheumatoid arthritis.
The effect of thymopoietin pentapeptide (TP-5) was evaluated in patients with rheumatoid arthritis (RA). Ninety-two patients were divided into 3 groups, namely, placebo, TP-5 intramuscularly (IM) 1 mg, TP-5 intravenously (IV) 50 mg, and were evaluated for 6 measures of disease activity at the beginning of the study and at 3 and 6 months. No difference was observed between the placebo group and the group treated with TP-5 IM 1 mg. However, in the group treated with TP-5 IV 50 mg a statistically significant improvement of all parameters except the ESR was observed.
Short-term efficacy and tolerance of tiaprofenic acid ('Surgam') in rheumatoid arthritis and osteoarthritis: multi-centre, placebo-controlled trials.
Two multi-centre, placebo-controlled, crossover trials of tiaprofenic acid were conducted to an identical design: one in 80 patients suffering from rheumatoid arthritis, the other in 60 patients suffering from osteoarthritis. After a washout period, each patient received 600 mg tiaprofenic acid daily and placebo each for 1 week. The results were similar for both trials. Tiaprofenic acid was more effective than placebo in both rheumatoid arthritis and osteoarthritis and differences in all the assessments of efficacy used were statistically significant. This significance was attained from the first day in rheumatoid arthritis and from the second day in osteoarthritis. Tiaprofenic acid was as well tolerated as placebo. Routine laboratory tests revealed no adverse effects. Possible side-effects, which were predominantly mild and related to the gastro-intestinal system, were reported by 23% patients with tiaprofenic acid and 21% patients with placebo. The 2 patients withdrawn for possible side-effects were both receiving placebo.
Crystal arthropathies in osteo-arthritis--clinical aspects and laboratory techniques for crystal identification.
Crystal arthropathies are frequent findings in patients with radiographical osteo-arthritis (OA). The associations between cartilage degeneration and crystal deposition of hydroxy-apatite or calcium pyrophosphate dihydrate are not yet understood. However, from the clinical point of view it is important to differentiate synovitis caused by micro-crystals from other symptoms in OA since symptomatic relief is readily obtained with the use of antiphlogistic drugs. Methods to screen synovial fluids for crystals should be introduced in routine clinical practice.