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Biomedical subjects

L Fernandes

Publications and source records attributed to L Fernandes.

At least 55 records · Page 3Linked to original sources
PubMed1981

Dental study in patients with rheumatoid arthritis.

Twenty-one patients with rheumatoid arthritis took part in a comparison of three toothbrushes, each used for one month in a randomized trial. The three toothbrushes were a conventional toothbrush with modified handle to allow ease of gripping, an electric toothbrush, and thirdly a finger-stall attached to a normal toothbrush. There was no change in the patients' rheumatoid status during the trial. The patients were scored for plaque and gingival changes but no difference was found between the three toothbrushes. We recommend a standard toothbrush with a modified grip for the rheumatoid hand; the extra expense of an electric toothbrush cannot be justified.

Arthritis, Rheumatoid↗
PubMed1981

Indoprofen compared with naproxen and placebo in rheumatoid arthritis.

Thirty-six patients suffering from rheumatoid arthritis took part in a double-blind controlled cross-over trial, in which they received either indoprofen 800 mg daily, naproxen 500 mg daily, or a matching placebo. Each treatment was administered for two weeks. Indoprofen was shown to be significantly superior as an analgesic and in improving grip strength, and was the drug the patients preferred. Adverse effects were comparable, although indigestion was seen slightly more often during indoprofen treatment. Indoprofen is therefore at least as effective as existing anti-inflammatory drugs in rheumatoid arthritis and should be used as an alternative.

Adult↗
PubMed1980

Expectation and patient preference -- does it matter?

Admission to clinical trials is often based on the assumption of homogeneity of the population. A group of 60 patients, all with pain in the neck or shoulder of at least 3 months duration, were studied. Expectation was graded before treatments were started by sharing out 100 points between freedom from side effects, pain relief, depression relief, improved mobility, improved sleep and speed of action. A double-blind crossover study of two established anti-inflammatory analgesics and placebo was carried out. Using analogue scales, patients were asked to grade their response. Side effects were recorded, and preference was established at the end of the study.Although all the patients were in sufficient pain to require medical attention, some rated relief of depression, improvement in sleep or lack of side effects as more important than pain relief. Differences between drug and placebo were most clearly demonstrated in those patients whose main concern was improved mobility. In our view it is important to select patients who are in need of a dominant property of a drug for a trial of this property and this may have ramifications across the medical spectrum.

Apazone↗
PubMed1980

Clinical study comparing acupuncture, physiotherapy, injection and oral anti-inflammatory therapy in shoulder-cuff lesions.

In a single-blind trial, five treatments for painful stiff shoulder were compared for a 4-week assessment period in 60 patients. The treatments were acupuncture, steroid injection with placebo and with active tolmetin sodium, physiotherapy in the form of ultrasound and 'placebo' physiotherapy with placebo tolmetin sodium. Objective assessment was gained by use of goniometer readings to monitor shoulder abduction. Pain was measured by visual analogue scales and by a 4-point scale. Comparative assessment was also recorded and at the end of the study a success or failure was recorded for each patient's treatment. With very few exceptions all patients improved markedly, both in terms of the subjective and objective parameters. No differences between the treatments were detected. The incidence and severity of side-effects was low. It is suggested that the results show that the painful stiff shoulder may be a self-limiting condition and that any beneficial effect was really due to natural recovery. This is an important consideration because patients do not always receive immediate attention when referred to an out-patient department and the use of physiotherapy and acupuncture in such cases, perhaps, should be critically examined.

Acupuncture Therapy↗
PubMed1979

Studies on the frequency and pathogenesis of liver involvement in rheumatoid arthritis.

A systematic prospective survey of 100 outpatients with rheumatoid arthritis revealed that 45 had biochemical evidence of liver disease. In most cases this was due to increases in total serum alkaline phosphatase (ALP) and/or gammaglutamyl transpeptidase (GGT). Examination of serum ALP isoenzyme profiles in 50 of the patients showed that the liver isoenzyme was the sole or major component in 44 patients, including many with normal total ALP levels. 18% had raised serum liver ALP together with raised GGT, suggestive of an underlying hepatobiliary lesion. No correlation could be detected between raised serum levels of liver enzymes and the age or sex of the patient, duration or severity of arthritis, and drug or alcohol history. However, there was a significant correlation between raised serum ALP and lacrimal or salivary gland dysfunction. It is suggested that immunological mechanisms may be involved in the development of hepatic abnormalities in rheumatoid arthritis.

Adult↗
PubMed1978

Indoprofen and naproxen in the treatment of rheumatoid arthritis: a clinical trial.

Thirty-six patients suffering from rheumatoid arthritis took part in a double-blind crossover trial, in which they received either indoprofen 800 mg/day, naproxen 500 mg/day, or a matching placebo. Indoprofen was shown to be significantly superior as an analgesic and in improving grip strength and the patients preferred it. Adverse effects were comparable, although indigestion was seen slightly more often during indoprofen treatment. Indoprofen is therefore at least as effective as existing anti-inflammatory drugs in rheumatoid arthritis and seems to be better tolerated.

Adult↗
PubMed1978

Local anaesthetic nerve block in the treatment of intractable pain from osteoarthritis of the hip.

Previous workers have advocated hip nerve block, with local anaesthetic, in the treatment of intractable pain from osteoarthritis of the hip. In a pilot study we obtained some degree of pain relief in only six of 13 patients. A further double-blind, controlled, randomized trial was undertaken in 31 patients, comparing 0.5% Marcain and normal saline. There was no significant improvement in pain or hip movements in either group over a six-week period.

Aged↗
PubMed1978

Alclofenac and D-penicillamine. Comparative trial in rheumatoid arthritis.

Forty-six patients with rheumatoid arthritis, 22 receiving D-penicillamine and 2j alclofenac, took part in a 6-month single-bind external observer trial to compare the efficacy and toxicity of these drugs in the treatment of severe rheumatoid arthritis. Both drugs were active and similar in their efficacy at 6 months as judged by clinical and laboratory measurements. Penicillamine was active therapeutically by 3 months, one month before alclofenac. 9 patients, 8 on alclofenac and one on D-penicillamine, had to stop treatment because of lack of effect or toxic effects. Skin rashes within the first week of treatment were a major problem with alclofenac and led to 6 withdrawals.

Arthritis, Rheumatoid↗
PubMed1978

Impairment of lachrymal and salivary secretion and cellular immune responses to salivary antigens in rheumatoid arthritis.

During a systematic investigation of 100 unselected outpatients with rheumatoid arthritis, 58 were found to have reduced lachrymal or salivary secretion. No correlation could be detected between the presence or absence of secretory abnormalities and the age or sex of the patient, the presence of nodules or salivary duct antibody, or the occurrence of vasculitis. However, there was a significant correlation between diminished salivary of lachrymal flow and the occurrence of cellular immune responses to a protein fraction of normal human saliva, sensitisation being found in 94% of those with impairment of salivary and lachrymal secretion as compared with 33% of those without.

Aged↗
PubMed1977

Dermatomyositis complicating penicillamine treatment.

A case of dermatomyositis developing during the course of treatment with D-penicillamine in a patient with rheumatoid arthritis is described. Complete remission occurred on withdrawal of the drug. Possible alternative diagnoses are discussed.

Arthritis, Rheumatoid↗
PubMed1977

Plasmalogens in arterial wall.

Plasmalogens have been determined in blood plasma, arterial and myocardial tissue of rats intubated with an atherogenic diet (vitamin D2 + cholesterol). These lipids are significantly decreased in arterial tissue after the administration of these substances for 5 consecutive days. Folic acid involved in the synthesis of plasmalogens and a powerful inhibitor of xanthine oxidase, on the contrary, increases enormously the concentration of plasmalogens in arterial tissue even with an atherogenic diet.

Animals↗