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Biomedical subjects

P Revell

Publications and source records attributed to P Revell.

34 records · Page 2Linked to original sources
PubMed1989

Effect of non-steroidal anti-inflammatory drugs on the course of osteoarthritis.

To test the hypothesis that non-steroidal anti-inflammatory drugs (NSAIDs) accelerate the progression of osteoarthritis by reducing synthesis of vasodilator prostaglandins, thereby diminishing joint perfusion, 105 osteoarthritis patients awaiting hip arthroplasty were treated prospectively with a strong or weak prostaglandin synthesis inhibitor, indomethacin or azapropazone, respectively. Pain and radiological joint space were monitored during the period up to arthroplasty and the condition of the excised femoral head was determined. As judged by radiological and histopathological data, the two treatment groups were at a similar pathophysiological end-point when they came to arthroplasty. In the indomethacin group the affected hips lost joint space more rapidly than did the contralateral hips, a difference not seen in the azapropazone group. The patients receiving azapropazone, who had higher concentrations of synovial vasodilator prostaglandins, took longer than the indomethacin group to reach the arthroplasty end-point. Potent inhibitors of prostaglandin synthesis may be inappropriate in the management of osteoarthritis of the hip.

Aged↗
PubMed1989

Thrombophilia.

Disorders of coagulation and fibrinolysis which increase the tendency to clot are far more common than the well-known conditions which predispose to bleeding. An increased understanding of these processes will improve the management of patients with thrombosis.

Anticoagulants↗
PubMed1988

Safe application of a 13-Gy split dose total body irradiation schedule prior to bone marrow transplantation.

Two conditioning regimens for bone marrow transplantation for patients with acute lymphoblastic leukaemia were compared. Both regimens (VVRAPID and VVRAPID-X) incorporated the same cytotoxic chemotherapy but differed in the radiation dose; VVRAPID employed a single fraction of 10.5 Gy and VVRAPID-X employed 10.5 Gy followed 4 days later by a further dose of 2.5 Gy. The 13-Gy split-fraction schedule was well tolerated with no significant increase in infection or requirement for blood products. An increase in gastrointestinal toxicity occurred but responded to increased oral anti-diarrhoeal agents. Overall survival and relapse rates did not differ significantly between the two groups. There was a trend for the 13-Gy schedule to reduce the graft failure rate following T cell-depleted bone marrow transplants.

Adolescent↗
PubMed1984

Pseudo-malignant osseous tumour of soft tissue.

A case of pseudo-malignant osseous tumour of soft tissue in the hand is described. The history was over two years with intractable pain becoming the dominant symptom. There was no history of trauma or infection initiating the condition. Local amputation provided complete relief of symptoms and there has been no recurrence in two years.

Adult↗
PubMed1984

Synovial infection with Mycobacterium kansasii.

Atypical mycobacteria have been recognised as saprophytic organisms for many years, but it was only with the development of better microbiological culture techniques that they became recognised as potentially pathogenic to man. Infections of tendon sheaths and joints by these organisms may present diagnostic problems, and we report here 3 cases in which Mycobacterium kansasii was responsible for disease at the hand and wrist.

Adult↗
PubMed1983

Controlled trial of calcitriol in the prevention of bone disease in haemodialysed patients.

Seventy-six patients receiving regular haemodialysis, without biochemical or radiological evidence of renal osteodystrophy, entered a five-year double-blind placebo-controlled trial of calcitriol (1,25-dihydroxycholecalciferol) in the prevention of bone disease. Significantly more patients on placebo developed bone disease as judged by a sustained elevation of plasma alkaline phosphatase or the development of sub-periosteal erosions on hand radiographs. Serum parathyroid hormone fell significantly in the patients receiving calcitriol and was significantly lower than in patients receiving placebo. It is concluded that calcitriol delays and may prevent the development of metabolic bone disease in patients receiving regular haemodialysis therapy.

Adolescent↗
PubMed1982

Calcium oxalate deposition in growing bone: anatomical and radiological study in a case of primary oxalosis.

A combined radiological, histological, and crystallographical study of bone, primarily the inferior femur, taken at autopsy from a 9 year old female with primary oxalosis, is reported. The essential feature is the deposition of calcium oxalate monohydrate (whewellite) crystals, inducing a foreign body reaction and bone remodelling. Synovial and cartilage surfaces are not involved. The changes occur primarily at sites of previous or present growth and seem to be related to the reaction of tissue to the deposition of blood-borne crystals. The radiological changes may be explained in part by the deposition of crystals at Harris' lines of growth arrest. Cancellous bone also shows changes similar to those observed in renal osteodystrophy.

Blood Vessels↗
PubMed1982

Metal concentration in synovial fluids of patients with prosthetic knee arthroplasty.

Significant levels of the major components of metal prostheses in total knee arthroplasty were measured in the synovial fluids from patients with these implants. Cobalt (Co), Chromium (Cr), and Nickel (Ni) concentrations were determined by atomic absorption spectrophotometry on 26 synovial fluid samples from 18 patients with hinged (metal-on-metal) prostheses and eight patients with nonhinged (metal-on-polyethylene) prostheses. Concentrations of Co, Cr, and Ni were significantly higher in synovial fluids from hinged knees, as were Ni concentrations in fluids from nonhinged knees. Of the three metals, Ni showed some evidence of increases solubility. The metal debris did not appear to provoke a leukocyte response, insofar as surprisingly low numbers of neutrophils were present in these fluids, all of which were obtained from nonseptic knees. However, significant numbers of lymphocytes and large mononuclear cells were present in the fluids.

Arthritis, Rheumatoid↗
PubMedDate not supplied

High Seas, high drama.

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Emergency Nursing↗