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Biomedical subjects

I D Griffiths

Publications and source records attributed to I D Griffiths.

At least 55 records · Page 3Linked to original sources

Linkage studies of HLA and rheumatoid arthritis in multicase families.

The linkage of rheumatoid arthritis (RA) to the HLA-DR locus was investigated in 17 families with multiple cases of RA. Log odds scores were computed using the Liped program; sibship associations were examined by 2 methods. The results showed a trend toward linkage which was short of significance. The results were similar for patients with classic or definite RA, with or without the inclusion of probable RA patients. The finding of strong association and weak linkage would suggest that it is DR4, itself, that is important in RA.

Arthritis, Rheumatoid↗

Classification of rheumatoid arthritis: the importance of including data from the siblings.

A discriminant analysis has been applied to physical and laboratory data on a series of 37 patients with rheumatoid arthritis (RA). Good discrimination was found between RA when it was associated with organ-specific autoimmune phenomena and when it was not. When data from other members of the families was included there was consistently better discrimination than when using data from the patients alone. The results suggest that future studies of classification of variable diseases should include study of relatives.

Adult↗

Costs of providing a rheumatological service.

As a result of a management budgeting exercise, the costs of rheumatology services in two hospitals in the Northern Region have been calculated. These comprehensive and itemized charges were derived by an external group of accountants. The data for a 1-year period from April 1985 are presented. Differences in both mean out-patient-visit and in-patient bed-day charges between hospitals were found. Factors contributing to these differences are discussed. The major costs, particularly of in-patient care, are not directly controllable by the clinician. Mean costs per out-patient visit were 26.00 pounds and 36.90 pounds at the two hospitals. Costs for in-patient care per bed-day were 49.00 pounds and 70.71 pounds, respectively. The calculated total cost of the rheumatology service in Newcastle was approximately 1.00 pound per capita catchment population per annum.

Costs and Cost Analysis↗

Cervical myelopathy, ossification of the posterior longitudinal ligament, and diffuse idiopathic skeletal hyperostosis: problems in investigation.

This report describes a patient presenting with a spastic quadriplegia who was found to have both diffuse idiopathic skeletal hyperostosis (DISH) and ossification of the posterior longitudinal ligament (OPLL) in the cervical spine. There was a dramatic worsening of his symptoms during a myelogram examination of the neck. It is suggested that computed tomographic imaging of the neck is the preferred investigative procedure if OPLL is suspected as a cause of cervical myelopathy.

Cervical Vertebrae↗

Salivary amylase and pancreatic enzymes in Sjögren's syndrome.

Concentrations of immunoreactive trypsin (IRT) and pancreatic and salivary amylase activities were measured in 22 patients with primary Sjögren's syndrome (SS) and in 13 patients with secondary SS. Nineteen of the 22 patients with primary SS had above-normal IRT, and six had above-normal pancreatic isoamylase activity. Six of the 13 patients with secondary SS had above-normal IRT; none had above-normal isoamylase activities. Serum IRT and pancreatic isoamylase were correlated significantly (r = 0.7; p less than 0.0001). Above-normal values for IRT and pancreatic isoamylase were more frequent in patients who had SS for longer than 10 years, but were not related to the presence of salivary gland autoantibodies or to salivary isoamylase activity. We conclude that the concentration and activity of pancreatic enzymes are frequently abnormal in SS; that the abnormality is greater and more frequent in patients with primary SS; and that it increases with the duration of the disease.

Adolescent↗

Association of limited joint mobility with Dupuytren's contracture in diabetes mellitus.

Limited joint mobility is a relatively recent addition to the list of other well known rheumatic disorders that may be associated with diabetes mellitus. In our study of 109 patients with diabetes, a higher prevalence of Dupuytren's contracture was found compared to nondiabetic subjects, but the difference was not statistically significant (p less than 0.1). An association between limited joint mobility and Dupuytren's contracture was shown. Patients with diabetes with Dupuytren's contracture showed no difference compared to those without Dupuytren's contracture with regard to sex, insulin dosage, metabolic control and presence of shoulder capsulitis. Limited joint mobility and Dupuytren's contracture may be associated with retinopathy.

Adolescent↗

Autoantibodies and antibodies to microorganisms in rheumatoid arthritis: comparison of histocompatible siblings.

A selection of antibodies to microorganisms were assayed on sera from a group of 12 pairs of HLA identical rheumatoid arthritis (RA) discordant siblings. Our results did not show any consistent quantitative or qualitative differences between RA and non-RA. However, autoantibodies were commoner and of higher titer in the subjects with RA. There was a difference in the antibodies to intrinsic antigens in RA which was not reflected in the antibodies to extrinsic antigens.

Antibodies, Bacterial↗

Limitation of joint mobility and shoulder capsulitis in insulin- and non-insulin-dependent diabetes mellitus.

Limited joint mobility and shoulder capsulitis were evaluated in 109 consecutive diabetic patients attending an out-patient diabetic clinic. Forty-nine had insulin-dependent diabetes mellitus (IDDM) and 60 had non-insulin-dependent diabetes mellitus (NIDDM). Seventy-five normal subjects were also examined. Limitation of joint mobility was detected in 24 (49%) patients with IDDM and in 31 (52%) patients with NIDDM but in only 17 (20%) normal subjects (p less than 0.001). There were no significant differences between diabetic patients with and without joint limitation with regard to age, sex, type of DM, mean daily insulin dosage and overall diabetic control as assessed by estimation of glycosylated haemoglobin concentration. However, patients with impaired joint mobility had a longer duration of diabetes (p = 0.01) and a significantly increased frequency of retinopathy compared to patients without joint limitation (p less than 0.05). Normal subjects with restricted joint mobility were older than those without restriction (p = 0.05). Shoulder capsulitis was present in 19% of patients with diabetes mellitus and 5% of normal subjects. However, there was no significant association between limited joint mobility and shoulder capsulitis in the diabetics.

Adolescent↗

Lack of effect of total body irradiation in rheumatoid arthritis.

We are reporting a pilot study of total body irradiation in six patients with progressive rheumatoid arthritis, who had previously received gold and penicillamine. Radiation (150 cGy) was administered in ten fractions over 5 weeks. There was a transient pancytopenia following radiotherapy and the total peripheral lymphocyte count remained below pre-treatment levels after 6 months. There were no serious short-term adverse effects. By 6 months, there was no evidence of any change in clinical and laboratory estimates of disease activity. We feel that further studies of this regimen in intractable rheumatoid arthritis are not justified.

Aged↗

Occurrence of autoimmune diseases and autoantibodies in multicase rheumatoid arthritis families.

The presence of autoimmune diseases and autoantibodies has been studied in 237 individuals from 17 families with two or more members affected by rheumatoid arthritis (RA). Hyperthyroidism occurred significantly more frequently than in a local control population (p less than 0.05), but if the RA cases were excluded this significance was lost. Thyroid cytoplasmic and microsomal antibodies were significantly more common (p less than 0.001), and this remained true if RA sufferers were excluded (p less than 0.01). The prevalence of both clinical thyroid disease and circulating thyroid autoantibodies was similar in the families where RA was associated with HLA-DR4 and in those where no DR4 association was observed. RA and immune thyroid disease may, therefore, share a common inherited factor, but this is unlikely to be at the HLA-DR locus. Antinuclear factor (ANF) was found in association with RA and with HLA-DR3 within the RA group (p less than 0.02). Relatives of RA sufferers did not show any excess of ANF positivity. The prevalence of pernicious anaemia (PA) and gastric parietal cell antibody did not differ from the expected.

Arthritis, Rheumatoid↗

Rheumatoid factor tests in the diagnosis and prediction of rheumatoid arthritis.

Four assays of rheumatoid factor (RF) have been measured on serum from 213 individuals from 13 families containing at least two sufferers from classical or definite rheumatoid arthritis (RA). Families were not uniformly RF positive or negative, and there was no evidence that non-RA RF positivity was inherited. Four individuals developed definite RA over a two year period, showing that the family members were at increased risk of RA. IgG RF and latex RF assays predicted the RA in the four cases. An association of RF positivity in RA with DR4 was observed, but this may be related to disease severity.

Arthritis, Rheumatoid↗

HLA associations are with severe rheumatoid arthritis.

Rheumatoid arthritis (RA) has been studied in 17 multicase families from the North East of England. The families comprised 281 individuals, 51 of whom had classical or definite RA, 18 had probable RA, and six were classified as previous RA. The association of classical and definite RA with HLA-DR4 was confirmed, and homozygosity for DR4 was more strongly associated than heterozygosity. There was a trend towards negative association with HLA-DR2 and DR7. Homozygosity for DR4 and possession of the haplotype most frequently inherited with RA in a particular family showed association with more severe disease. HLA-DR2 and DR7 tended to associate with less severe disease. It is therefore likely that HLA association is with the severity of disease rather than disease susceptibility.

Adolescent↗

Application of Bayes' theorem to the diagnosis of ankylosing spondylitis from radioisotope bone scans.

The ratio of the uptake of radioactivity in each sacroiliac joint to the uptake in the sacrum has been measured in 57 patients with early ankylosing spondylitis and in 51 control subjects. The distribution of ratios of uptake obtained in each of these two groups shows appreciable overlap, and it is shown that the specification of a 'normal range' in this sort of situation can be misleading in the interpretation of the uptake ratio obtained in a given subject. An alternative approach described here is to use Bayes' theorem, which combines a probability based on the numerical value of the measured ratio with the pretest clinical impression about the likelihood of ankylosing spondylitis to yield a post-test probability of the presence of the disease.

Adolescent↗

Association of MHC antigens with susceptibility to and severity of rheumatoid arthritis in multicase families.

A study of HLA association with rheumatoid arthritis (RA) in multicase families has been performed in north east England. Two hundred and nineteen individuals from 13 families were assessed for the presence of RA, and all were HLA typed. Thirty-nine were found to have classical or definite RA by American Rheumatism Association (ARA) criteria. Thirty-five (90%) of these possess HLA-DR4, confirming the previously reported association of RA with DR4. A further 19 individuals were found to have probable RA or gave a convincing history of previous inflammatory polyarthritis. Thirteen (68%) of these possess HLA-DR4, and this is not significantly different from non-affected family members of whom 63% possess DR4. These results suggest that HLA-DR4 is associated only with the more severe forms of RA. Homozygosity for HLA-DR4 was not associated with either earlier onset or more severe disease when compared with heterozygous DR4. Possession of the haplotype most commonly inherited with the RA in individual families was not associated with earlier onset but may be associated with more severe disease. The severity of RA appears to be influenced by the major histocompatibility complex (MHC) in these families.

Adult↗

Haematuria in rheumatoid arthritis: an association with mesangial glomerulonephritis.

Twenty-four patients with rheumatoid arthritis and isolated haematuria were investigated for the cause of their haematuria. In 3 patients local urological disorders were identified, including a pelvicaliceal carcinoma. Renal biopsies were performed on the remaining 21 patients, and the most common abnormality found was a mild mesangial glomerulonephritis (71%). Immunofluorescence and electron microscopy in these patients usually gave normal results. The lesions occurred independently of gold or D-penicillamine therapy and were not associated with impairment of glomerular function.

Adult↗