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Biomedical subjects

M J Goodfield

Publications and source records attributed to M J Goodfield.

At least 55 records · Page 3Linked to original sources
PubMed1988

C-reactive protein levels in venous ulceration: an indication of infection?

The role of bacteria in the pathogenesis of venous ulcers is unclear. It is difficult to be clinically certain of the presence of infection. Routine bacteriology is often unhelpful, and any simple investigation that improves diagnosis in this situation would be of value. C-reactive protein (CRP) levels are useful in detecting infection in other situations, and they may be of value in this context as well. C-reactive protein levels were measured in 50 patients with venous leg ulcers and in 20 patients with active venous eczema. There was no elevation of CRP levels in patients with eczema alone, nor in the majority of patients with ulcers. Sixteen patients had raised CRP levels: 7 had clinically obvious infection, and 9 had erythematous skin of uncertain cause surrounding their ulcers. All had positive bacterial cultures from the ulcer base, with beta-hemolytic streptococci the main contaminant. Treatment with an appropriate antibiotic reduced CRP levels to normal, cleared the bacteria from the ulcers, and was associated with resolution of erythema. CRP levels appear to distinguish between infectious and inflammatory causes of erythema in patients with gravitational disease.

Anti-Bacterial Agents↗
PubMed1988

The effect of simple warming procedures on finger blood flow in systemic sclerosis.

Finger blood flow was measured by laser Doppler flowmetry in 15 patients with Raynaud's phenomenon (RP) due to systemic sclerosis (SS), and 15 normal controls. Measurements were performed in a temperature controlled room at 28 degrees C. The blood flow in the patients was significantly lower than in the controls (P less than 0.001). After hand warming in water at 35 degrees C for 10 min, blood flow in the patients and controls did not differ significantly. Following this, the response to a standardized cold stress produced similar falls in both groups to levels that were not significantly different and these occurred over a similar time course. After cold stress ended, there was recovery of blood flow in both groups, and blood flow after 20 min was not significantly different between the two groups. The induced vasodilatation persisted, in those patients in whom it was remeasured, for at least 2 h. Repeating the experiments at a room temperature of 24 degrees C produced similar results. This indicates that considerable vasodilatation is possible in these patients, and can be produced by simple means. It also indicates that local and central thermoregulatory reflexes are intact. Cold induced symptoms in patients with SS are related to low resting blood flow, not to cold sensitivity, and simple warming may provide a useful treatment.

Adult↗
PubMed1988

Hand warming as a treatment for Raynaud's phenomenon in systemic sclerosis.

Twelve patients with Raynaud's phenomenon (RP) due to systemic sclerosis (SS) warmed their hands for 5 min in hand hot water every 4 h throughout the day during alternate weeks of a 6-week study. There was a statistically significant decrease in the number and duration of Raynaud's attacks in the weeks in which warming was performed compared with the intervening weeks. An increase in blood flow as measured by laser-Doppler flowmetry accompanied clinical improvement. Simple hand warming appears to be effective in the management of RP in patients with SS.

Hand↗
PubMed1988

Fragrance sensitivity in coal miners.

In a prospective study, we have examined the incidence of fragrance sensitivity in Nottinghamshire coal miners. Our results confirm previous reports of an increased incidence of such sensitivity in miners (45%) when compared with both male (20%) and female (13%) non-miners. This increased incidence is not related to an increased use of perfumed cosmetics, but may be related to the use of a highly perfumed body lotion in subjects who already have a high incidence of irritant hand eczema. There was no significant increase in the rate of positive reactions to other applied allergens.

Coal Mining↗
PubMed1988

Widespread cutaneous vasculitis associated with diltiazem.

Two cases of widespread cutaneous vasculitis are described in association with diltiazem, a recently introduced calcium antagonist. In both cases, spontaneous resolution occurred over several weeks following withdrawal of the drug.

Aged↗
PubMed1988

Systemic sclerosis in association with multiple primary pulmonary malignancy--a marker of internal malignancy?

Multiple pulmonary malignancy is uncommon and has not been reported in association with systemic sclerosis. We now report such a case in which it is likely that the connective tissue disease occurred as a marker of the internal malignancy. Systemic sclerosis is not generally a reliable indicator of malignant change, but it is possible that in patients who are immunosuppressed, either therapeutically or inherently, the onset of systemic sclerosis should prompt investigation for an underlying cause.

Carcinoma, Squamous Cell↗
PubMed1987

Experimental folliculitis with Pityrosporum orbiculare: the influence of host response.

The aetiology of the folliculitis associated with seborrhoeic eczema is unclear, though the yeast, Pityrosporum orbiculare has been implicated. P. orbiculare was applied under occlusion to normal forearm skin of patients with seborrhoeic eczema (SE), seborrhoeic eczema and folliculitis (SEF), and normal controls. There were significant differences in response to occlusion between the three groups. Those patients with previous clinical evidence of folliculitis (SEF) developed folliculitis at the site of occlusion more frequently than either of the other two groups (p less than 0.001), in whom only one patient developed skin changes. This difference was not explained by the response to occlusion alone, nor by natural carriage of yeasts. These results suggest that the yeast P. orbiculare is necessary for the development of folliculitis, but that the nature of the host response determines those patients prone to follicular inflammation.

Dermatitis, Seborrheic↗
PubMed1986

A relative thrombocytosis and elevated mean platelet volume are features of gravitational disease.

Platelet counts were obtained in 60 patients with gravitational ulceration (GU), 60 with gravitational eczema (GE), 56 with endogenous eczema (EE) and 60 normal controls. Mean platelet volume (MPV), a broad index of platelet size, was estimated in the last 40 patients in each group (29 with EE). Causes of a reactive thrombocytosis were excluded. Platelet counts were significantly higher in both gravitational groups than in the EE group or the normal controls (P = 0.001). Ulcer healing produced no significant changes in platelet count, and patients with non-gravitational ulcers had normal platelet counts. MPV was significantly higher in both gravitational groups than in controls after correction for platelet count, by analysis of co-variance (P = 0.01). These differences in platelet parameters in gravitational disease suggest a possible role for platelets in this disease, and platelet inhibiting therapy may be of value at an early stage in the development of the condition.

Adult↗
PubMed1986

Severe cutaneous reactions to captopril and enalapril; histological study and comparison with early mycosis fungoides.

A severe non-dose related skin eruption attributable to treatment with captopril was recently reported: this is distinct from the dose related rashes that have been widely described. Ultrastructural and immunohistochemical studies were carried out to determine in detail the histological features of this eruption: the histological appearances were similar to those found in early mycosis fungoides, so that this disease was erroneously diagnosed in one case. Unlike most other complications resulting from treatment with Captopril, an indistinguishable rash can result from treatment with enalapril, a newer angiotensin converting enzyme inhibitor.

Captopril↗