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Biomedical subjects

P A Frith

Publications and source records attributed to P A Frith.

At least 37 records · Page 2Linked to original sources
PubMed1989

Intraocular nocardiosis: a further case and review.

A case is presented of bilateral intraocular nocardial infection associated with lung and liver foci and responding to treatment. Difficulties in diagnosis and treatment are discussed. It is suggested that unusual infections such as this should be considered in the differential diagnosis of chorioretinitis, and should be carefully sought, especially in immunocompromised patients. However, our patient is unusual in having no evidence of immunosuppression predisposing to ocular involvement in his nocardial infection.

Biopsy↗
PubMed1989

Mucosal involvement in systemic and chronic cutaneous lupus erythematosus.

The prevalence and pattern of mucosal involvement in 121 patients with lupus erythematosus (LE) was investigated. Fifty-three patients had systemic LE (SLE) and 68 patients had chronic cutaneous LE (CCLE). Twenty-one per cent (11/53) of patients with SLE and 24% (16/68) of patients with CCLE had signs of mucosal involvement, but the pattern of involvement differed in the two groups. Nasal mucosal lesions were a feature in 2% (I/53) of patients with SLE and 9% (6/68) of patients with CCLE. Hyperkeratotic lichen planus-like plaques on buccal mucosa and the palate occurred in 9% (6/68) of patients with CCLE and 4% (2/53) of patients with SLE. Episcleritis occurred in 9% (5/53) of patients with SLE and not seen in CCLE. Erythematous plaques on the lower eyelids were present in 6% (4/68) of patients with CCLE and these were associated with conjunctival scarring in two patients. Vulval lesions were present in 5% (2/42) of female patients with CCLE. Oral plaques may occur when the disease is relatively quiescent elsewhere. The prevalence of mucosal involvement in lupus is underestimated as the lesions may be asymptomatic.

Adult↗
PubMed1989

The lupus band test in oral mucosa, conjunctiva and skin.

The prevalence and clinical significance of subepithelial immunoglobulin and complement deposition (the lupus band) were examined in the uninvolved sun-protected skin of the forearm, the uninvolved sun-protected lip mucosa and sun-protected bulbar conjunctival mucosa in systemic lupus erythematosus (SLE) and chronic cutaneous lupus erythematosus (CCLE). In SLE, linear deposition of an immunoreactant at the BMZ was detected in 32% (6/19) of skin biopsies; 21% (4/19) of lip mucosal biopsies and 42% (5/12) of conjunctival biopsies. There was no significant difference in the sensitivity of the test at different sites in SLE and no correlation between a positive test in skin, lip or conjunctiva and clinical mucosal involvement. In CCLE, linear deposition of an immunoreactant at the BMZ was found in 3% (1/32) of skin biopsies; 3% (1/29) of lip mucosal biopsies and 50% (10/20) of conjunctiva and clinical mucosal involvement. In the conjunctiva, IgG was present in all but one of the biopsies and was the only immunoreactant in 90% (9/10) of positive CCLE biopsies and 60% (3/5) of positive SLE biopsies. In lupus erythematosus immunoreactants may be deposited in the basement membrane zone beneath non-keratinizing mucosal surfaces of the lip and the eye as well as the skin. In CCLE, the test may be positive in conjunctiva when skin and lip are negative.

Adolescent↗
PubMed1989

Conjunctival involvement in cicatricial and bullous pemphigoid: a clinical and immunopathological study.

Patients with bullous pemphigoid were found to have significant ocular abnormalities. In a group of 18 patients one had conjunctival shrinkage, and 11 of 15 (73%) had positive linear direct immunofluorescence on conjunctival biopsy from a clinically uninvolved site. Our ocular findings in a group of 14 with cicatricial pemphigoid are also reported and compared with those from a control group of 20. Our findings suggest there is overlap between the pemphigoid groups and raise further questions about the pathogenicity of immunoreactants within the basement membrane zone. Bulbar conjunctival biopsy was simple and well tolerated, and the rate of immunofluorescence positivity of conjunctiva was twice that of skin in both pemphigoid groups.

Aged↗
PubMed1988

A study of bleeding time in 120 long-term aspirin trial patients.

The bleeding time was measured in 120 patients participating in a longterm randomised double-blind trial of aspirin in thromboembolic prophylaxis (UK-TIA aspirin Study). In 70 patients taking aspirin 300 mg or 1,200 mg daily for a mean duration of 35 months the bleeding time averaged 228 seconds. In comparison with 30 patients randomised to placebo and not taking aspirin whose bleeding time averaged 217 seconds, there was no significant difference. Stratification of bleeding time estimation by duration of treatment suggested no significant trend in either placebo or aspirin groups over several years. These results suggest that the longterm trials of aspirin should be looked at again from the point of view of efficacy of treatment by time from randomisation.

Aged↗
PubMed1988

Mucosal involvement in bullous and cicatricial pemphigoid. A clinical and immunopathological study.

Thirty-six patients with bullous pemphigoid (BP) and 15 with cicatricial pemphigoid (CP) were studied for evidence of mucosal involvement both clinically and by direct immunofluorescence. Twenty-one patients with BP and all those with CP had lesions of the mucous membranes. Eighteen patients with BP and 14 patients with CP had involvement of the oral mucosa. Lesions of the eyes, nose, pharynx, vulva and urethra also occurred in both groups. The lesions tended to be more widespread in CP patients. Twenty-one patients with BP and 14 with CP were examined by an ophthalmologist. Fine scarring of the tarsal conjunctiva was found in both groups, but also in elderly controls. However, symblepharon occurred in one patient with BP as well as in three patients with CP, but was not seen in a group of 20 controls. Direct immunofluorescence (IF) studies showed linear deposition of IgG or C3 or both in the basement membrane zone of the skin, oral mucosa and conjunctival mucosa in both groups. The frequency of positive immunofluorescence was higher in the conjunctiva than in the lip mucosa or skin in both BP and CP patients. The significance of these findings and the relationship between BP and CP is discussed.

Aged↗
PubMed1988

A clinicopathological study of mucosal involvement in linear IgA disease.

Mucosal involvement in linear IgA disease was assessed clinically and immunologically using direct and indirect immunofluorescence (IF) techniques. There was clinical evidence of oral mucosal involvement in all 10 patients examined and conjunctival diseases in six. Direct IF findings correlated well with clinical oral disease, with all patients demonstrating linear IgA deposits in the basement membrane zone of oral mucosa. However, this was not true of conjunctiva where no linear IgA could be demonstrated. Conjunctiva did provide a good substrate for indirect immunofluorescence using patients' sera, and showed that five of the 10 patients had circulating anti-basement membrane zone IgA.

Adolescent↗
PubMed1986

Effects of inhaled oxitropium and fenoterol, alone and in combination, in chronic airflow obstruction.

Twenty-four elderly male patients with moderate-to-severe chronic airway obstruction took part in a double-blind, placebo-controlled, randomized dose-response and response-duration comparison of a new inhaled anticholinergic bronchodilator oxitropium bromide and the inhaled beta-agonist bronchodilator fenoterol hydrobromide. On 6 separate days lung function changes and side effects were monitored for 8 h after either placebo, oxitropium 100, 200 and 300 micrograms, fenoterol 400 micrograms, or oxitropium 200 micrograms plus fenoterol 400 micrograms. Fenoterol alone and in combination with oxitropium produced a rapid peak effect (mean delta FEV1 = 41.6 and 39.5%, respectively at 30 min). Oxitropium alone had a slow onset of action (peak delta FEV1 seen at 120 min: 100 micrograms = 22.7%, 200 micrograms = 29.9%, 300 micrograms = 28.2%). However, mean FEV1 remained within 5% of peak for 60 min after fenoterol, but for 180 min after each dose of oxitropium and after fenoterol plus oxitropium. No differences between oxitropium 200 and 300 micrograms were seen; however, these doses produced more prolonged bronchodilatation than did oxitropium 100 micrograms. The fenoterol-plus-oxitropium combination produced even more prolonged bronchodilatation. The only side effect, seen with each inhaler was a mildly unpleasant taste. No anticholinergic effects were seen. We conclude that oxitropium is an effective bronchodilator with slow onset but prolonged duration of action. In combination with fenoterol it produced both rapid and prolonged bronchodilatation in patients with chronic airflow obstruction.

Administration, Inhalation↗
PubMed1986

Oxitropium bromide. Dose-response and time-response study of a new anticholinergic bronchodilator drug.

The efficacy and side effects of oxitropium bromide, a new anticholinergic bronchodilator drug, were tested in a double-blind placebo-control study. Twenty-four men, aged 58 to 72 years, with chronic partially reversible obstruction of the airways were used as subjects. Three doses of oxitropium were tested (100 micrograms, 200 micrograms, and 300 micrograms) to determine the optimum dose by metered-dose inhaler. A comparison was also made between oxitropium, fenoterol (400 micrograms), and a combination of oxitropium (200 micrograms) and fenoterol (400 micrograms). Fenoterol produced a greater degree of maximal bronchodilatation than each of the three doses of oxitropium, and its effect was more rapid in onset (30 vs 120 minutes to peak effect); however, the duration of action of oxitropium was greater than that of fenoterol (ie, the forced expiratory volume in one second [FEV1] remained within 5 percent of peak FEV1 for three hours, compared to one hour). Oxitropium in the 100 micrograms dose was inferior to 200 micrograms and 300 micrograms in subjective efficacy scores, peak percent change in FEV1, forced vital capacity, (FVC), mean forced expiratory flow over the middle half of the FVC, and duration of action; there was no difference between 200 micrograms and 300 micrograms. The oxitropium-fenoterol combination had a rapid onset of action, and a greater peak effect was achieved than for oxitropium alone. The main unwanted effect was a mildly unpleasant taste. Anticholinergic effects were not seen in this group of elderly men. Oxitropium bromide therefore is an effective bronchodilator with slow onset but prolonged activity and few side effects when used in patients with moderately severe obstruction of the airways. An appropriate dose appears to be 200 micrograms. Addition of oxitropium to fenoterol appears to offer even greater efficacy.

Aged↗
PubMed1984

Ultrastructural changes in the oviductal epithelium of Merino ewes during the estrous cycle.

Isthmic and ampullary oviductal epithelia sampled from Merino ewes at days -1, 1, 3, and 10 of the estrous cycle (estrus = day 0) were studied by scanning and transmission electron microscopy after fixation by vascular perfusion. Secretory cells, ciliated cells, and lymphocytelike basal cells were observed in both isthmic and ampullary epithelium at all stages of the estrous cycle studied and their ultrastructural features were analyzed. Synthesis of lamellated secretory granules occurred in the ampullary secretory cells during the follicular and early luteal phases, and their contents were released by exocytosis into the oviductal lumen during the luteal phase. Granule release was associated with nucleated apical protrusion of these cells into the oviductal lumen. No such secretory activity was displayed by isthmic secretory cells even though a few cells contained nonlamellated granules. Apocrine release of apical vesicles and accompanying cytoplasmic material from apical protrusions of ciliated cells occurred in the isthmus around estrus but not in the ampulla. This unexpected feature has not previously been reported in any other mammal. Dendritic basal cells were distinguished in the lower part of the epithelium by their heterochromatic nuclei, electron-lucent cytoplasm, and lack of attachment zones. No migration of basal cells was observed, and their ultrastructural features were similar in the ampulla and isthmus and at all stages of the estrous cycle examined. The function of these lymphocytelike cells in the epithelium is uncertain, but the presence of phagocytic bodies and lysosomes in 20% of them may indicate a phagocytic role.

Animals↗
PubMed1982

Long-term stability of bronchial responsiveness to histamine.

Bronchial responsiveness to histamine was measured in 35 adult asthmatics whose symptoms were controlled on a minimum of medication. The tests were carried out on two occasions separated by 10-30 months. On each occasion the subjects had no symptoms of respiratory infection and no exposure to relevant allergens for at least six weeks. Bronchial responsiveness did not change in those who required no medication or inhaled salbutamol only to control their symptoms, but was significantly improved in those who required continuous treatment with both beclomethasone and salbutamol (p = 0.03). The results suggest that non-specific bronchial responsiveness remains similar over long periods when exacerbating factors are not present and that treatment with beclomethasone may reduce hyperresponsiveness.

Adult↗
PubMed1981

Compliance with aerosol therapy in chronic obstructive lung disease.

The compliance of 114 patients with chronic airways disease to therapy with aerosol salbutamol and beclomethasone dipropionate was examined over two consecutive periods of approximately four weeks. Values ranging from 90-110 percent compliance were recorded for the two agents and a further increase in compliance was noted with both aerosols during the second month of surveillance. Over-use of salbutamol occurred in those patients who had been recently discharged from hospital. It was concluded that the high level of compliance was due to the symptomatic nature of the illness and the over-use of the bronchodilator was attributed to the usually prompt relief it provided.

Adolescent↗