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Biomedical subjects

J R Sewell

Publications and source records attributed to J R Sewell.

17 recordsLinked to original sources
PubMed1986

Polymyalgia rheumatica.

Early diagnosis of polymyalgia rheumatica is often difficult. A missed diagnosis and inadequate treatment can result in severe and prolonged disability and expose the patient to the hazards of temporal arteritis. Treatment is effective and relatively straightforward provided that good doctor-patient communication is maintained.

Aged↗
PubMed1983

Polymyositis.

Explore the source record for details and available documents.

Diagnosis, Differential↗
PubMed1980

Splenic function in non-renal systemic lupus erythematosus.

The reticuloendothelial clearance of autologous heat-damaged red blood cells was assessed in 10 patients with systemic lupus erythematosus (SLE) but without clinical nephritis. Although in nine patients the disease was clinically active at the time of the test, only one patient had a prolonged half-clearance time (T 1/2). One patient who had persistently high titers of circulating immune complexes, but whose disease was clinically inactive, had a normal T 1/2. There was no correlation between the patients' age, duration of disease, disease activity, therapy or titer of circulating immune complexes and the T 1/2. It appears that a general defect in splenic function is not a universal feature of SLE and that high titers of circulating immune complexes may be found in the presence of efficient reticuloendothelial phagocytic ability.

Adult↗
PubMed1980

Combined temporal arteriography and selective biopsy in suspected giant cell arteritis.

Superficial temporal arteriography was studied by selective biopsy of abnormal arterial segments and random biopsy of the main stem in 33 patients with clinically supected giant cell arteritis. Of the total of 33 temporal arteriograms 9 showed definite abnormalities (7 in the periphery and 2 in the main stem). Selective biopsy of the 7 peripheral abnormal segments showed arteritis in only 2, narrowing of the vessels in the remainder being due to atheroma (3) and fibrointimal thickening (2)--that is, 5 'false positives' for temporal arteritis on arteriography. Histological evidence of arteritis was found in 9 patients, only 5 of whom had clearly abnormal arteriograms--that is, 4 'false negatives'. Thus temporal arteriography appears to have low sensitivity for identifying arteritic lesions and also frequently gives 'false positive' results. It is concluded that temporal arteriography is not a satisfactory alternative to biopsy, and that its value as an adjunct to selective biopsy is limited because of its frequent failure to detect lesions found histologically.

Aged↗
PubMed1980

Quantitative scintigraphy in diagnosis and management of plantar fasciitis (calcaneal periostitis): concise communication.

We have found that Tc-99m methylene diphosphonate imaging of the heel is of diagnostic value in the "painful heel syndrome," permitting positive identification of the site of inflammation in cases where radiography is unhelpful. With this technique, tracer uptake in the heel is susceptible to quantification, allowing a serial and objective assessment of response to therapy.

Adult↗
PubMedDate not supplied

Chloroquine-induced cytosomes with curvilinear profiles in muscle.

A patient with systemic lupus erythematosus (SLE) was treated with chloroquine therapy for four years after the onset of her illness. Nine years after cessation of chloroquine, muscle weakness developed as part of the SLE. Four muscle biopsies performed for diagnostic purposes revealed varying degrees of inflammatory change as well as distinctive cytosomes with curvilinear profiles (CCPs). These CCPs were identical to those reported in Batten disease, a degenerative disorder of children which has a clinical course different from SLE. The CCPs seen in this case of SLE are thought to result from the effect of chloroquine on membrane systems within muscle cells. This report calls attention to the fact that CCPs are not unique to Batten disease bu may also occur in muscle of SLE patients treated with chloroquine.

Adult↗
PubMedDate not supplied

Children in homeless families in Melbourne: health status and use of health services.

OBJECTIVE: To determine the prevalence of health and behaviour problems in a sample of children in homeless families and of psychological problems in their parents, and to assess the use of health services by homeless families. DESIGN: A cross-sectional, questionnaire-based prevalence survey. SETTING: Supported accommodation provided by a welfare service in Melbourne between May 1994 and June 1995. SUBJECTS: 51 children from 31 families soon after housing crises. RESULTS: More than one-third of all children had total behaviour problems scores in the "deviant" range (i.e., requiring mental health referral). Intellectual disability/developmental delay, skin problems, vision problems, recurrent headache, and asthma or other breathing problems were more prevalent in these homeless children than in a large Australian normative population. Their mothers scored higher than a large normative sample on the mental health questionnaire, most markedly for "anxiety-insomnia", "severe depression" and total score. Cost of treatment and transport difficulties were seen as barriers to using health care services. RECOMMENDATIONS: Australian health-care practitioners should be aware of the health and health service access problems of children in homeless families, and work to minimise their physical, emotional, developmental and academic disadvantages. Psychological support services should be available for homeless families, particularly for mothers.

Adult↗