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Biomedical subjects

N R Rowell

Publications and source records attributed to N R Rowell.

At least 37 records · Page 2Linked to original sources

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↗

Anticardiolipin antibodies in systemic sclerosis: immunological and clinical associations.

Anticardiolipin antibodies of IgG/IgM class were detected in seven of 28 patients with systemic sclerosis including five of 16 patients severely affected by extensive visceral disease. This severely affected sub-group also showed significant elevations of plasma levels of von Willebrand factor antigen in 10 cases and serum C1q binding activity in seven cases respectively. This triple association raises the possibility that multiple immunological mechanisms are involved in the pathogenesis of systemic sclerosis and its vascular lesions.

Adult↗

Comparison of Grenz rays versus placebo in the treatment of chronic hand eczema.

A double-blind trial was performed on 30 patients with bilateral symmetrical constitutional hand eczema, resistant to previous treatment. There was no difference in efficacy between Grenz rays in a total dose of 900 rad (9 Gy) given in three equal doses at 21-day intervals, and placebo therapy given in a similar treatment schedule.

Chronic Disease↗

Cimetidine and chlorpheniramine in the treatment of chronic idiopathic urticaria: a multi-centre randomized double-blind study.

One hundred and twenty patients with chronic idiopathic urticaria, who entered a study at five centres (Sheffield, London, Bristol, Cardiff and Leeds) were treated with therapeutic doses of the H1 antagonist chlorpheniramine for 6 weeks. Histamine H1 non-responders (40 patients) were entered into a double-blind study and received chlorpheniramine plus cimetidine 400 mg q.d.s. (21 patients) or chlorpheniramine plus placebo (19 patients) for a further 8 weeks. The most important response measure was the change from baseline of the total symptom score: an assessment of the number and duration of new weals and degree of itching. There was a statistically significant difference between the average response in the two treatment groups in favour of chlorpheniramine plus cimetidine after 4 and 8 weeks' treatment (P less than 0.05 and P less than 0.01, respectively). No significant side-effects related to treatment were noted.

Chlorpheniramine↗

Antinuclear antibodies in the relatives and spouses of patients with systemic sclerosis.

The families of 65 patients with systemic sclerosis were examined clinically and serum samples from each subject were tested for antinuclear antibodies (ANA) by immunofluorescence on HEp2 cells and for precipitating antibodies to soluble cellular antigens including Scl-70. Of 217 blood relatives, 58 (27%) had ANA (42 speckled, 13 nucleolar, one centromere, two homogeneous); 22 (10%) had precipitins, one anti-Scl-70, one anti-PM-Scl, one anti-nRNP, two anti-Ro(SSA), the remainder unidentified). Family members tended to share ANA patterns. Of 38 spouses, nine (24%) had ANA (all speckled) and two showed unidentified precipitins. This compares with an incidence of ANA and precipitins in a control population of 8% and 1% respectively. Antibodies were more common in female than male relatives (particularly in mothers and sisters of probands). Twenty one of the 58 family members with ANA had clinical features of connective tissue disease; the remainder were asymptomatic. The presence of genetic factors influencing autoimmunity is suggested by the incidence of autoantibodies in first degree relatives. Similar observations in spouses, however, indicate that environmental factors may also have a role in these immune abnormalities.

Antibodies, Antinuclear↗

Quantification of the nail fold capillary abnormalities in systemic sclerosis and Raynaud's syndrome.

Measurements were made of capillary luminal diameters and capillary numbers in four groups: 19 normal controls 10 patients with 'idiopathic' Raynaud's disease, 12 patients with Raynaud's phenomenon with an underlying connective tissue disease other than systemic sclerosis, and 18 patients with systemic sclerosis. There was a significant reduction of capillary numbers in all three patient groups compared with the normal controls. Both the afferent and efferent luminal diameters were also increased in each patient group. Patients with Raynaud's phenomenon, either on its own or associated with connective tissue disease, gave results intermediate between normal controls and patients with systemic sclerosis. There were no significant correlations between either the reduction in capillary numbers or increase in luminal diameter with disease severity or duration in systemic sclerosis. It is unlikely that capillary microscopy will provide useful prognostic information for an individual patient with systemic sclerosis; its predictive value in Raynaud's disease must await the outcome of long term follow-up studies.

Adult↗

Serum immune complexes in systemic sclerosis: relationship with precipitating nuclear antibodies.

In a comparative study of antinuclear antibodies (ANA) and immune complexes in the serum of 43 patients with systemic sclerosis (SS) ANA were detected by indirect immunofluorescence on Hep 2 cells and/or double immunodiffusion in 90% of patients, while immune complex assays were positive in 32% of patients. The immune complex assays were positive only in sera containing antibodies to Scl 70, n-RNP, Ro, and La. The presence of immune complexes in SS sera is therefore related to ANA specificity. This might explain the variable findings of several previous studies of immune complexes in SS.

Adult↗

Antibody-dependent cellular cytotoxicity of human vascular endothelium in systemic lupus erythematosus.

Sera from 35 patients with systemic lupus erythematosus were examined for a cytotoxic effect on human umbilical vein endothelium. Although none of these sera produced direct cytotoxicity of 51Cr-labelled endothelial cells, even with added complement, 3 sera regularly produced increased 51Cr release when co-cultured with endothelial cells and normal human peripheral blood mononuclear cells. The effector cells involved in this cytotoxicity possessed Fc-receptors but were non-T and non-adherent while fractionation studies indicated that the responsible serum factor(s) was IgG, probably in the form of immune complexes of small size. Control studies, using sera from both 27 normal controls and 19 patients with either diabetes or extensive atherosclerotic vascular disease failed to reveal any similar cytotoxicity. Two of the 3 patients, whose sera produced this antibody-dependent cellular cytotoxicity, had had clinical episodes of major vascular thrombosis, raising the possibility that the cytotoxicity might provide an additional pathogenic mechanism in certain patients with systemic lupus erythematosus.

Adult↗

Short-contact dithranol therapy--a comparison with the Ingram regime.

We have compared a short-contact dithranol regime with the traditional Ingram regime in the treatment of forty-three patients with plaque psoriasis. The Ingram regime produced a significantly faster rate of improvement of the psoriasis than the short-contact regime. The degree of relapse 12 weeks after stopping treatment was identical for both regimes. The irritant effect was more troublesome with short-contact dithranol therapy. Nevertheless, short-contact dithranol regimes may have a place in home treatment.

Administration, Topical↗