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Biomedical subjects

J R Ward

Publications and source records attributed to J R Ward.

171 records · Page 10Linked to original sources
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Acute hematogenous osteomyelitis progressing to septic synovitis and eventual pyarthrosis. The vascular pathway.

A case suggesting sequential infection of bone, synovial membranes, and finally synovial fluid is presented. Hematogenous osteomyelitis manifests itself differently in children than in adults. In children, the avascular epiphyseal cartilage in the growing long bone is an effective barrier to the spread of bone infection to the joint. After obliteration of the growth plate, vascular anastomoses form between metaphysis and epiphysis, and at maturity the entire bone shares a common blood supply with the capsule and synovium of the adjacent joint. In the adult with acute osteomyelitis, contiguous joint infection should be anticipated. In septic arthritis, unless caused by penetrating trauma, the synovium must be infected before the joint fluid. Even when bacterial joint infection is present, repeated arthrocenteses may be required over several days to confirm the diagnosis.

Adult↗
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Pharmacology, clinical efficacy, and adverse effects of piroxicam, a new nonsteroidal anti-inflammatory agent.

Piroxicam, a new non-steroidal anti-inflammatory drug, possesses analgesic, antipyretic, and anti-inflammatory properties and inhibits platelet aggregation in animal models. Its elimination half-life is 38 hours, and hepatic metabolism to inactive metabolites is the primary route of elimination. Less than 10% of a dose appears unchanged in the urine. Clinical studies demonstrate that piroxicam's analgesic and anti-inflammatory properties are useful in the management of rheumatoid arthritis and osteoarthritis. Limited clinical studies suggest that piroxicam may be useful in the management of acute gouty arthritis, ankylosing spondylitis, acute musculoskeletal disorders, and as an analgesic. The gastrointestinal system is the major site of adverse effects. Piroxicam is currently marketed in 20 mg capsules and once daily dosing has proven effective for many patients.

Animals↗
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Pharmacology, clinical efficacy, and adverse effects of the nonsteroidal anti-inflammatory agent benoxaprofen.

Benoxaprofen is a nonsteroidal anti-inflammatory agent that belongs to the arylalkanoic acid class of antirheumatic drugs. Animal studies have demonstrated that it has analgesic, antipyretic, and anti-inflammatory properties. Although benoxaprofen is a relatively weak inhibitor of cyclo-oxygenase in in vitro systems, inhibits lipoxygenase in other systems, and inhibits monocyte migration in some animal models of inflammation, it has not been established that it is unique with regard to these actions. Benoxaprofen undergoes hepatic metabolism via glucuronidation as the primary route of elimination and has a half-life of 28-35 hr. Clinical trials have demonstrated that its analgesic and anti-inflammatory properties are useful in the management of the signs and symptoms of rheumatoid arthritis and osteoarthritis. Once daily dosing of 300-600 mg is effective for many patients. In addition to gastrointestinal intolerance, photosensitivity and onycholysis are the most frequent adverse effects encountered. Recent reports of fatal cholestatic jaundice often associated with nephrotoxicity led to the withdrawal of benoxaprofen from world markets. It is uncertain whether it will once again be available for clinical use.

Animals↗
PubMedDate not supplied

The effect of cimetidine on serum concentrations of piroxicam.

To evaluate the effect of cimetidine on serum concentrations of piroxicam, we administered a single 20-mg oral dose of piroxicam to 10 healthy male volunteers on 2 occasions. The first was given on day 1 of the study and the second on day 15, 7 days after starting cimetidine 300 mg orally 4 times a day. Nineteen blood samples were drawn for 7 days after each piroxicam dose to characterize its pharmacokinetics. Piroxicam was analyzed by high-performance liquid chromatography. The mean piroxicam elimination rate constants (Kel), elimination half-lives, and area under the serum concentration-time curves (AUC) were as follows (mean +/- standard deviation): (formula; see text) Data were analyzed with a Wilcoxon matched-pairs, signed-ranks, two-tailed statistical test. Although the increase in AUC was statistically significant, it was of low amplitude (mean 15%) and is probably not clinically significant. The results of this study suggest that cimetidine does not significantly alter the elimination kinetics of a single dose of piroxicam in young healthy males. Additional investigation is needed to confirm these findings in other patient populations.

Adult↗
PubMedDate not supplied

Chronic arthritis of rabbits induced by mycoplasmas. IV. Protective effect of immunization and prior infection.

Rabbits exposed to Mycoplasma arthritidis either by active immunization with killed mycoplasmas or by primary infection in the right knee were protected against intra-articular challenge with viable M. arthritidis in the left knee. This protection extended to the challenged knees of preinfected rabbits even while highly active inflammation persisted in the initially injected joints. We propose that the protection is mediated by antibody, probably metabolic-inhibiting antibody, present in the joint at the time of challenge.

Animals↗
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Acute joint pain.

Explore the source record for details and available documents.

Acute Disease↗
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Normal erythrocyte sedimentation rate with hyperfibrinogenemia in 6-sulfanilamidoindazole arthritis.

The erythrocyte sedimentation rate (ESR) is the most frequently employed laboratory indicator of inflammatory activity. The plasma fibrinogen concentration is usually increased in inflammatory disorders and is thought to contribute to the ESR elevation, 6-sulfanilamidoindazole induced arthritis in rats produces very high plasma fibrinogen concentrations and increased blood viscosity but no change in ESR.

Animals↗
PubMedDate not supplied

Articular complications of jejunoileal bypass surgery.

Articular complications are now frequently recognized with jejunoileal-bypass surgery for morbid obesity. We have evaluated 6 referred patients with these problems and 50 consecutive patients who had this procedure. The arthritis is variable but usually affects multiple joints. Four patients were seen during acute attacks of arthritis and all had cryoprecipitable material in their sera and plasma. Three of these 4 patients had evidence of Group D streptococcal antigen present while their joint disease was active, suggesting a possible role for bacterial antigens in the pathogenesis of the arthritis of jejunoileal bypass.

Adult↗