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Biomedical subjects

M Doherty

Publications and source records attributed to M Doherty.

At least 253 records · Page 14Linked to original sources
PubMed1982

Localised chondrocalcinosis in post-meniscectomy knees.

100 patients who had had unilateral meniscectomy were examined some years (mean 24.8) after operation to compare the condition of their operated knees with that of their unoperated knees. Chondrocalcinosis (CC) was detected by X-ray in 20% of operated knees and in 4% of unoperated knees. In 16 patients CC was confined to the operated knee. The frequency of CC increased with age, rising in operated knees from 16.7% (less than 50 years) to 31.6% (greater than 65 years). Inflammatory features (stiffness [p less than 0.01], effusion [p less than 0.01], acute attacks [p less than 0.01]) and more severe X-ray changes of osteoarthritis were more common when CC was present. Wrist CC was present in 4 patients, and in 2 of these there had been previous trauma. CC was observed in only 3 knee radiographs from 100 age and sex matched controls. This study supports the hypothesis that calcium salts may be deposited locally in altered or damaged cartilage and may then cause further inflammation and joint damage via an amplification loop mechanism.

Acute Disease↗
PubMed1982

Inflammatory responses to intradermal crystals in healthy volunteers and patients with rheumatic diseases.

The inflammatory response to intradermal injections of urate, pyrophosphate and hydroxyapatite crystals in human forearm skin is described. Patients with rheumatoid arthritis responded normally to urate crystals, and patients with osteoarthritis or pyrophosphate arthropathy responded normally to hydroxyapatite and pyrophosphate crystals respectively. These results suggest that variation in host response to crystals cannot explain the different patterns of crystal-induced disease seen in man. The model, however, is recommended as a safe, simple ethical and reproducible test of inflammation in human subjects.

Arthritis, Rheumatoid↗
PubMed1982

Pyrophosphate arthropathy: a clinical and radiological study of 105 cases.

105 consecutive patients who presented to a rheumatologist because of joint disease and who also had evidence of deposition of calcium pyrophosphate dihydrate (CPD) were studied clinically and radiologically. There were 76 women (mean age 73) and 29 men (mean age 62). Of only 18 patients below the age of 60 at presentation 12 were men. The majority of the younger male group suffered from acute attacks of synovitis, and had no clinical or radiological evidence of joint damage. In contrast the older female group had widespread destructive changes. Associated joint disease included generalised osteoarthritis (45), rheumatoid arthritis (8), joint hypermobility (13), previous knee surgery (8), and gout 92). Sixteen patients had received long-term steroid therapy. Severe destructive joint changes were seen in 16 patients. The radiological features in those with rheumatoid arthritis by ARA criteria were atypical. The relationship between CPD deposition and arthritis is discussed in the light of these findings.

Acute Disease↗
PubMed1982

Pyrophosphate arthropathy: a study of metabolic associations and laboratory data.

105 consecutive patients with pyrophosphate arthropathy have been studied. Disease associations and metabolic abnormalities were compared with those of an age and sex matched group of 105 acute medical admissions, and with 48 patients presenting with uncomplicated osteoarthritis. Patients with pyrophosphate arthropathy had a higher incidence of hypothyroidism (10, hyperparathyroidism 92), and chronic steroid therapy (15) than did those in the comparative groups. Laboratory data showed abnormalities suggesting chronic inflammatory disease in many patients, but no other unexpected metabolic findings. Metabolic abnormalities were uncommon in pyrophosphate arthropathy, and extensive metabolic screening of patients was unrewarding.

Adrenal Cortex Hormones↗
PubMed1981

Effect of intra-articular yttrium-90 on chronic pyrophosphate arthropathy of the knee.

Fifteen patients with bilateral, symmetrical, chronic pyrophosphate arthropathy of the knee were given intra-articular injections of yttrium-90 (5 mCi) plus steroid (triamcinolone hexacetonide, 20 mg) into one knee, and saline plus steroid into the other (control) knee. Allocation of the 90Y injection was random and double blind. After 6 months there was significantly less pain, inactivity stiffness, joint-line tenderness, and effusion in the 90Y-injected knees than in the controls (p less than 0.01). There were also significant differences between 90Y-injected and control knees in the changes in range of movement (p less than 0.01) and joint circumference (p less than 0.05) caused partly by progression of disease in the control knees. No significant differences in joint deformity, instability, X-ray appearance, or synovial-fluid analysis were seen. In all cases patient and observer assessment favoured the treated side (p less than 0.01). These findings indicate that intra-articular 90Y may be of benefit in chronic pyrophosphate arthropathy, a disease for which there is no treatment. The predilection of this condition to affect the knees of the elderly makes such treatment highly suitable because the joint lends itself readily to injection and the procedure carries very few actual or potential risks in this age group.

Aged↗
PubMed1981

Gluten-induced mucosal changes in subjects without overt small-bowel disease.

Five normal volunteers, six normal first degree relatives of coeliac patients, and four patients with altered immunity (two primary biliary cirrhosis, one common variable immune deficiency, one immunoglobulin A deficiency) were studied both before and after a six week period during which their normal diet was supplemented by 40 g of gluten per day. Administration of the high gluten diet produced significant architectural changes in the jejunal mucosa of both the normal relatives of coeliac patients and the patients with altered immunity (p less than 0.01). In some cases changes amounted to severe partial villous atrophy. A significant increase in intraepithelial lymphocytes was also observed in the normal relatives of coeliac patients and in the normal volunteers (p less than 0.05); patients with altered immunity had high intraepithelial lymphocyte counts both before and after the high gluten diet. A significant decrease in xylose absorption occurred in the relatives of coeliac patients and in the normal volunteers (p less than 0.05). Two normal relatives and one patient with altered immunity had diarrhoea, which ceased on return to a normal diet. These findings indicate that excessive gluten intake can induce changes in the jejunal mucosal architecture in susceptible individuals who do not have overt coeliac disease.

Adolescent↗
PubMed1981

Polyarteritis nodosa associated with acute cytomegalovirus infection.

A case of polyarteritis nodosa is described in which the onset of the disease was associated with acute infection by cytomegalovirus. Peripheral neuropathy was the predominant clinical feature, and death occurred 4 years after the onset. This is the first recorded case of polyarteritis in which cytomegalovirus is of possible aetiological significance.

Acute Disease↗
PubMed1977

Disopyramide phosphate: tissue uptake and relationship between drug concentrations in the plasma and myocardium of rats.

Tissue uptake of total-14C and disopyramide (DP) was examined in rats following 5 to 100 mg/kg doses of [14C]-disopyramide phosphate [14C-DPP]. Disopyramide was the major 14C constituent in the plasma or tissues. The gastrointestinal absorption of [14C]-DPP was 86% as determined from the areas under the plasma total-14C concentration-time curves following 10 mg/kg oral or i.v. administration. Total-14C was widely distributed in tissues, and at 2 hr the highest uptake occurred in the fat, liver and spleen giving concentrations ranging from 7 to 15 times that in plasma. In the thymus, adrenals, lungs, salivary glands, testes and muscle the concentrations were about twice that in plasma, in the heart and eyes similar to that in plasma, and in the brain less than one-third that in plasma. The uptake and elimination characteristics of total-14C or DP in plasma and myocardium were similar. The two-hour plasma or myocardium DP concentrations were linearly related to the oral dose in the 5 to 50 mg/kg range. In three days about 30% (oral) and 39% (i.v.) of the 14C dose (10 mg/kg) was excreted in the urine, 64% (oral) and 54% (i.v.) in the feces, and less than 2.1% remained in the carcass. The composition of the urinary and fecal metabolites was similar after oral or i.v. administration of the drug.

Administration, Oral↗