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Biomedical subjects

W W Buchanan

Publications and source records attributed to W W Buchanan.

At least 163 records · Page 9Linked to original sources
PubMed1983

Observations on written communications between physicians regarding patients' drug treatment compared with patients' recall.

The authors reviewed the quality of information shared by referring doctors with hospital consultants, in regard to past drug treatment in the cases of 95 consecutive patients with rheumatoid arthritis. Information contained in referral letters was compared with information obtained from patient interviews. It was found that the referral letters often contained little information on drug use and included no information on adverse reactions to drug therapy.

Arthritis, Rheumatoid↗
PubMed1983

Clinical therapeutic trial of sodium meclofenamate and naproxen in rheumatoid arthritis, with comments on the use of placebos in clinical trials.

Forty patients with active rheumatoid arthritis were entered into a single-blind study of 12-weeks' duration to compare the efficacy and tolerance of 100 mg sodium meclofenamate 3-times daily and 250 mg naproxen twice daily. Disease activity was defined by the presence of a Ritchie Articular Index score of greater than 15. Patients were assessed at 4-week intervals. Analysis of variance of the data from those patients who completed 12 weeks in the trial showed that in the sodium meclofenamate group there was a significant improvement in articular index, left grip strength, pain severity and patients' global assessment over the course of the study. In the naproxen group, there was a significant improvement in articular index, grip strength and pain severity over the study. Pairwise comparisons showed that morning stiffness improved significantly from baseline to 12 weeks only, in both treatment groups. There were no significant differences between the two treatment groups for any of the measurements at any time period during the study. In the sodium meclofenamate group, there were 4 drop-outs due to inadequate efficacy and 6 in the naproxen group. Four patients in the sodium meclofenamate group and 2 patients in the naproxen group dropped out of the study because of side-effects, primarily nausea. These results suggest that sodium meclofenamate was equally well tolerated and as effective as naproxen in the treatment of rheumatoid arthritis in this group of patients.

Adult↗
PubMed1983

Detection of kallikrein-like activity in inflamed synovial tissue.

The synovial tissue kallikrein of rheumatoid patients, arthritic dogs and normal dogs has been partially characterized and estimated. Both human and dog synovial tissue kinin-forming enzyme appears to be distinct from plasmin, plasma kallikrein and pancreatic kallikrein. In three rheumatoid arthritic patients, the mean synovial tissue kallikrein level was found to be 106 +/- 13.5 ng bradykinin equivalents (BK Equiv) per g per min. In nine arthritic dogs the mean synovial tissue kallikrein level, 60.5 +/- 4.5 ng BK Equiv per g per min, was found to be greater (p less than 0.05) than that of five normal dogs (21.6 +/- 5.3 ng BK Equiv per g per min). The possible significance of this finding is discussed.

Aged↗
PubMed1983

Judging "current disease activity" in rheumatoid arthritis--an international comparison.

Judgments of "current disease activity" made on "paper patients" (patient data presented on simple forms) reflect those made when seeing the real patients on whom the "paper patients" are based (R = 0.853) and furthermore are highly reproducible (R = 0.952). Judgments made on the same "paper patients" in a rheumatology department in the UK and one in Canada also correlate highly (R = 0.860) and this may reflect a common experience in the type of patients seen. Such general similarities between centers justify comparisons of more detailed analysis of clinical judgment using "paper patients."

Arthritis, Rheumatoid↗
PubMed1983

Observer differences in detecting erosions in radiographs of rheumatoid arthritis. A comparison of posteroanterior, Nørgaard and Brewerton views.

This study shows no significant advantage of Brewerton or Nørgaard radiographs in detection of erosions at metacarpophalangeal joints in patients with polyarthritis over the conventional posteroanterior view. The observer agreement for detection of exact number of erosions/pair of hands is uniformly low. Therefore, erosion index cannot be reliably used in epidemiologic surveys or therapeutic trials as an outcome measure unless steps are taken to improve the observer agreement.

Arthritis, Rheumatoid↗
PubMed1982

Some metabolic aspects of arthritis.

Arthritis commonly accompanies clinical disturbances of metabolism, while diseases which are primarily articular may cause major general metabolic abnormalities. The relationship between diet, nutrition and joint diseases is complex and varies from simple mechanical factors (as in obesity) to complex metabolic processes. Current knowledge of these processes is extensive in some areas, such as in gout and hyperuricaemia, whereas in others, such as the arthropathy encountered after intestinal bypass surgery, it is very scant indeed. Joint disorders in hyperlipoproteinaemia and diabetes mellitus are varied and the pathogenesis of these articular problems is as yet ill understood. In view of the frequency with which these metabolic problems occur, these disorders offer no opportunities for the clinical study of the processes involved in joint inflammation and damage. In contrast, metabolic abnormalities such as hypergastrinaemia and elevated ionized calcium in rheumatoid arthritis are worthy of study, as they may offer clues to the underlying aetiology of the joint disease. This latter abnormality is suggestive of hyperparathyroidism, a condition which may present with polyarthritis and in which joint changes may be severe, although they are usually obscured by the more obvious bony problems in this disease. An illustrative historical vignette is included.

Animals↗
PubMed1982

Prior gold therapy does not influence the adverse effects of D-penicillamine in rheumatoid arthritis.

One hundred fourteen patients with definite or classic rheumatoid arthritis were followed prospectively between January 1976 and April 1981 to monitor their toxicity pattern to D-penicillamine. The influence of previous sodium aurothiomalate therapy on the toxicity pattern of D-penicillamine is described. There was no significant difference in overall outcome of the patients treated with D-penicillamine with respect to adverse effects, whether they had previous gold toxicity, previous gold therapy but no toxicity, or no previous gold therapy. The time from gold toxicity to the start of D-penicillamine therapy was greater in those who did not develop D-penicillamine toxicity compared with those who did. This difference just reached statistical significance. Total gold salt received had no effect on eventual outcome of D-penicillamine treatment, and the toxicity pattern of D-penicillamine in those patients who had previous gold therapy was similar to those patients who had never received gold therapy.

Adolescent↗
PubMed1982

Robert Burns's illness revisited.

A careful review of Robert Burns's terminal illness, especially as documented in his correspondence, supports the widely held contention that death may have been due to subacute bacterial endocarditis secondary to chronic rheumatic heart disease. However, it is also possible that death have been caused by brucellosis or some non-infectious process such as malignant lymphoma. There is no evidence that Robert Burns suffered from either chronic alcoholism or venereal disease. The evidence that he may have died a doctor's martyr as a result of treatment with a mercury ointment is critically examined.

Endocarditis, Subacute Bacterial↗
PubMed1981

The detection of spinal pseudarthrosis in ankylosing spondylitis.

Spinal pseudarthrosis in ankylosing spondylitis can be difficult to detect radiologically. This paper assesses the value of bone radioscintigraphy in relation to radiological examination. The patterns of tracer uptake in the spine were recorded in 16 patients in whom established ankylosing spondylitis was complicated by pseudarthrosis. Twenty such lesions were identified in 16 patients, mostly occurring at one level in a junctional region of the spine. Four patients had two lesions. Standard radiography failed to demonstrate this abnormality in seven patients and in these, tomography was required to confirm the scintigraphic findings. On the other hand, bone scanning was much less accurate in detecting the minor forms of marginal vertebral end plate destruction (spondylo-discitis) than conventional radiology. This study suggests that 99TcmMDP scanning is a useful primary investigation for the detection of spinal pseudarthrosis in patients with chronic ankylosing spondylitis who suffer late onset back pain.

Adolescent↗
PubMed1980

Homoeopathic therapy in rheumatoid arthritis: evaluation by double-blind clinical therapeutic trial.

Twenty-three patients with rheumatoid arthritis on orthodox first-line anti-inflammatory treatment plus homeopathy were compared wtih a similar group of twenty-three patients on orthodox first-line treatment plus an inert preparation. There was a significant improvement in subjective pain, articular index, stiffness and grip strength in those patients receiving homoeopathic remedies whereas there was no significant change in the patients who received placebo. Two physicians were involved in prescribing for the patients and there were no significant differences in the results which they obtained. No side effects were observed with the homoeopathic remedies.

Adult↗
PubMed1980

The action of aspirin on plasma kininogen and other plasma proteins in rheumatoid patients: relationship to disease activity.

1. When six female seropositive rheumatoid patients were given placebo therapy for 48 h, their plasma kininogen level, 9.2 +/- 0.7 microgram bradykinin equivalents (bk eq) per ml, was found to be 59% greater than that of a group of eight healthy female volunteers (5.8 +/- 0.5 microgram/ml). 2. When the rheumatoid patients received aspirin therapy for 1 week, their mean plasma kininogen concentration fell by 31% to 6.3 +/- 0.8 microgram Bk eq/ml. This was accompanied by a 20.4% fall in mean plasma alpha 2-globulin level. Haematocrit and total plasma protein were not significantly altered (P > 0.05). 3. The fall in kininogen was very rapid, the main reduction occurring within the first hour. 4. Aspirin therapy greatly reduced the pain assessments but had no effect on plasma concentrations of IgG, IgA, IgM, complement component C3, nor on ESR, haemoglobin, leucocyte count, nor ring size. Left hand grip strength was increased while right hand grip strength was unchanged. 5. The action of aspirin on plasma kininogen and alpha 2-globulin was similar to that of indomethacin. Plasma kininogen has been considered to be an acute phase reactant. The possible diagnostic value of plasma kininogen estimation is discussed.

Adult↗