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Biomedical subjects

G Littlejohn

Publications and source records attributed to G Littlejohn.

16 recordsLinked to original sources
PubMed1995

Fibromyalgia and disability. Report of the Moss International Working Group on medico-legal aspects of chronic widespread musculoskeletal pain complaints and fibromyalgia.

The present article is the result of a working group conference held in Moss, Norway, in June 1993, financed by the Royal Norwegian Ministry of Health and Social Affairs. Its purpose was to review and focus upon problems and needs related to the medico-legal aspects of fibromyalgia and chronic widespread musculoskeletal complaints: thus to define directions for future work on issues which have generally not been addressed within the medical community. Our report describes specific problems in this area in regard to definition, evaluation and recommendation, and in currently available work and disability statistics. We have recommended international efforts to establish research programs through organizations such as the International Social Security Association and the World Health Organization. While our recommendations call for research into medico-legal interactions, causes and pathogenic mechanisms, prevention and treatment are also key and relevant concerns in the medico-legal setting.

Chronic Disease↗
PubMed1990

The radiographic changes of scleroderma in the hands.

Hand radiographs from 160 patients with scleroderma were reviewed. The presence of calcinosis distal to the metacarpophalangeal joints was significantly associated with the female sex, disease duration over 10 years, digital ulceration, telangiectasia, tuft erosion and the presence of anticentromere antibodies. The presence of calcinosis proximal to the metacarpophalangeal joints was significantly associated with tuft erosions and erosions involving all joints. The lack of distal calcinosis was significantly associated with anti Scl 70 and antinucleolar antibodies. The prevalence of other radiological manifestations of scleroderma such as osteoarthritis, erosions and dorsal tuft modelling was documented. Specific radiological findings correlate with certain clinical and serological characteristics in scleroderma.

Calcinosis↗
PubMed1990

Identifying subclasses of patients with rheumatoid arthritis through cluster analysis.

Nonhierarchical cluster analysis was used to classify 92 patients with rheumatoid arthritis drawn from a community rheumatology practice into 5 groups on the basis of biochemical measures and disease indices. The major differentiating variables were the number of active joints, number of damaged joints, overall disease activity, extraarticular complications, and history of joint surgery. Although the 5 subclasses were equivalent on measures of psychological functioning, they differed systematically on such health outcome measures as mobility, physical activity, and dexterity. Relationships between the taxonomy produced through cluster analysis and conventional classifications are discussed, and directions for further investigation are noted.

Adult↗
PubMed1989

Medicolegal aspects of fibrositis syndrome.

The recent Australian epidemic of localized fibrositis syndrome is used to highlight the role of compensation and medicolegal systems on the clinical features and outcome of fibrositis syndrome. It is suggested that psychological factors are of great importance when this syndrome occurs after minor injury or de novo in the workplace. Current compensation and medicolegal systems usually negate appropriate management plans and thus lead to perseveration of fibrositis syndrome. It is suggested that public health policies in regard to fibrositis syndrome in this context need reappraisal.

Australia↗
PubMed1988

Local radiotherapy for pedal manifestations of HLA-B27-related arthropathy.

Four males with characteristic foot manifestations of HLA-B27-related arthropathy are reported. The severity of this problem and its recalcitrance to standard therapies led to the use of local radiotherapy. The beneficial outcome and minimal short-term side effects of this treatment are discussed in relation to previous experience with radiotherapy in ankylosing spondylitis.

Adolescent↗
PubMed1986

Bilateral internuclear ophthalmoplegia in systemic lupus erythematosus.

The case of a 25-year-old female with bilateral internuclear ophthalmoplegia as a presenting feature of systemic lupus erythematosus (SLE) is described. It is important to recognize that bilateral internuclear ophthalmoplegia may be an early manifestation of cerebral involvement in SLE in addition to its occurrence in multiple sclerosis.

Adult↗
PubMed1985

The use of unproven remedies for rheumatoid arthritis in Australia.

It is important for a medical practitioner to be aware of his or her patient's use of non-prescribed, unproven remedies. This is especially so in a chronic relapsing disease of unknown cause such as rheumatoid arthritis. We selected 90 consecutive patients with classic or definite rheumatoid arthritis who attended the rheumatology clinic of a teaching hospital in 1982. The patients were asked about their previous or current use of an unproven remedy; 82% had used more than one unproven remedy since the diagnosis was made and 52% were currently using an unproven remedy. In all, 352 separate unproven remedies were used, with a mean of 4 +/- 0.3 remedies per patient. Avoidance of a particular food substance or use of a copper bracelet were the most common of such remedies. Fourteen per cent of remedies were deemed to be useful and 3% were felt to have resulted in an adverse effect.

Adolescent↗
PubMed1983

Spinal entheseal new bone formation: the early changes of spinal diffuse idiopathic skeletal hyperostosis.

Diffuse idiopathic skeletal hyperostosis is characterized by new bone growth at the point of insertion of ligaments and tendons to bone. We examined retrospectively the anatomical morphologic changes discernible at the insertion of spinal longitudinal ligamentous fibrous tissue to vertebral bodies. The earliest evidence of bone formation was in the "waist" of the vertebral body away from the intervertebral disc area. New bone arose along the insertion of the fibrous tissue to the anterior cortical surface of the vertebral body and progressed along the fibres at an angle to the cortical surface distinct from it until the advanced stages. With disc degeneration the 2 processes were distinct and separate. Degenerative disc disease occurred at the margin of the endplate of the vertebral body with associated changes in the disc itself. Entheseal ossification occurred remote from the margin of the intervertebral disc and remained distinct from the subjacent vertebral body as it followed the ligamentous tissue; fusion with the cortical surface of the subjacent vertebral body was only seen in the most advanced cases of disseminated idiopathic systemic hyperostosis.

Adult↗
PubMed1982

Steady-state plasma levels of salicylate in patients with rheumatoid arthritis: effects of dosing interval and tablet strength.

Forty patients who were admitted to hospital with rheumatoid arthritis received a total of 3.9 g/d of enteric-coated acetylsalicylic acid (ASA) (Entrophen) according to one of four dosing schedules: group 1 (n = 13), three 325-mg tablets four times daily; group 2 (n = 11), two 650-mg tablets three times daily; group 3 (n = 10), three 650-mg tablets twice daily; and group 4 (n = 6), two 975-mg tablets twice daily. Five to seven days after the start of therapy, when steady-state plasma salicylate levels had been achieved, 10 blood samples, 1 per hour, were collected. Three healthy volunteers who received plain ASA formed a control group. There was little fluctuation in the salicylate levels over the sampling period, regardless of the dosing interval, and no significant difference in the fluctuations between the five groups. Likewise, there was no significant difference in the mean salicylate levels at each sampling time, regardless of the dosing interval or tablet strength. These results suggest that different tablet strengths of enteric-coated ASA and different dosing intervals produce comparable plasma salicylate levels. Less frequent dosing may improve patient acceptance of salicylate therapy in the treatment of arthritis.

Adult↗