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Biomedical subjects

A D White

Publications and source records attributed to A D White.

18 recordsLinked to original sources
PubMed1992

The use of corticosteroids in dermatological practice.

OBJECTIVE: To discuss the various uses of corticosteroids in patients with skin diseases. DATA SOURCES: All relevant literature published since 1950 was reviewed and 33 studies were selected. CONCLUSIONS: Systemic and topical corticosteroid preparations are used commonly in patients with skin diseases. Oral administration of steroids is particularly useful in acute hypersensitivity diseases, connective tissue diseases, immunological blistering diseases, and the commoner dermatoses when they are very severe and widespread. Topical steroid preparations are mainly used in the different forms of dermatitis, but are also useful in psoriasis and a number of other skin diseases. If potent topical steroid preparations are used for too long, or in excessive quantities, side effects will be encountered as a direct effect on the skin, for example atrophy, and as a result of systemic absorption, for example, hypothalamic-pituitary-adrenal suppression and Cushing's syndrome.

Administration, Oral↗
PubMed1992

Cell-cycle progression rates and sister chromatid exchange frequencies in the bone marrow of patients with myelodysplastic syndrome and acute myeloid leukemia.

The proliferation characteristics of leukemic cells may be a determining factor in disease course and response to therapy. The present study compares the rate of cell-cycle progression in the bone marrow of 16 hematologically normal subjects, 19 patients with acute myeloid leukemia (AML), and 23 patients with myelodysplastic syndrome (MDS). The frequency of sister chromatid exchanges (SCE) in bone marrow cells is also compared. MDS and AML patients showed a reduction in the rate of cell-cycle progression compared with normal subjects. Patients with 'high risk' MDS (RAEB/RAEB-t) did not differ significantly from patients with AML but had a significantly slower rate of cell-cycle progression than patients with 'low-risk' MDS (PASA/RA). There was no correlation between the rate of cell-cycle progression and clonal karyotype status or the percentage of blast cells in either MDS or AML. There were no significant differences in SCE frequency between normal subjects and MDS or AML patients.

Acute Disease↗
PubMed1992

Isochromosome (6p) in Waldenstrom's macroglobulinemia.

Cytogenetic data on two cases of previously treated Waldenstrom's macroglobulinemia (WM) are presented. An i(6p) was identified in 60 and 56% of bone marrow (BM) metaphases from each patient, respectively. In both cases, i(6p) occurred as part of a complex karyotype but was also observed as the sole abnormality in a proportion of metaphases. The literature on the cytogenetics of WM and the relevance of i(6p) is discussed.

Chromosome Aberrations↗
PubMed1992

Peripheral blood chromosome aberrations in MDS.

The frequency of non-clonal structural and numerical chromosome aberrations in peripheral blood lymphocytes of 51 patients with MDS and 37 age-matched hematologically normal subjects is assessed. The frequency of aneuploid cells (p less than 0.001) and of structural aberrations (p less than 0.005) was significantly higher in MDS patients than in normal subjects, but showed no relationship with FAB type or with the presence of clonal karyotype abnormalities in the bone marrow. Exchange configurations were only observed in MDS patients (27.5%). The data also suggest that there may be an association between high peripheral blood aberration levels and rapidly progressive disease. This may indicate increased mutagen sensitivity and have implications for treatment.

Adult↗
PubMed1992

Chromosome aberrations following cytotoxic therapy in patients in complete remission from lymphoma.

The frequency of chromosome aberrations in the peripheral blood of patients successfully treated for Hodgkin's disease (HD) and non-Hodgkin's lymphoma is compared with that seen in age-matched haematologically normal subjects. Findings are considered in relation to risk factors associated with the development of secondary myelodysplastic syndrome (MDS) or acute myeloid leukaemia (AML). Overall aberration frequencies were not significantly increased in patients compared with normal subjects. However, there were differences in aberration type. The frequency of exchanges was significantly higher among patients (P less than 0.01) and the frequency of gaps lower (P less than 0.0005). The mean frequency of exchanges was also greater in patients receiving multiple compared to single courses of therapy (P less than 0.0005) and in patients receiving radiotherapy or combined modality therapy compared to chemotherapy alone (P less than 0.005 and P less than 0.0005). Four patients had aberration frequencies greater than 2 SD above the patient mean. One of these was also found to have a mutation of the ras oncogene. None of the patients has yet developed secondary MDS/AML.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

Extended cytogenetic follow-up of patients with myelodysplastic syndrome (MDS).

The prognostic significance of clonal karyotype status in myelodysplastic syndrome (MDS) is assessed after an extended follow-up period of 5 years. There are three karyotype, single abnormalities or multiple abnormalities at the time of referral. However, there is no correlation between the size of the abnormal clone and prognosis. Karyotype status has independent prognostic significance in 'high risk' MDS so that patients with a refractory anaemia with excess of blasts (RAEB)/RAEB in transformation (RAEB-t) and a normal karyotype survive significantly longer than those with an abnormal karyotype (P < 0.001) and do not differ significantly from patients with refractory anaemia (RA). Significant differences in survival according to karyotype status are also seen in patients with chronic myelomonocytic leukaemia (P < 0.001) but not in those with primary acquired sideroblastic anaemia and RA. Among patients studied sequentially, those who retained a normal karyotype survived significantly longer than those who developed an abnormality on follow-up (P < 0.001). The risk of leukaemic transformation was also increased in patients who presented with or subsequently developed a clonal karyotype abnormality compared with those who remained normal (P < 0.05).

Aged↗
PubMed1991

Chilblains.

Explore the source record for details and available documents.

Acute Disease↗
PubMed1991

Therapeutic potential of ACAT inhibitors as lipid lowering and anti-atherosclerotic agents.

Hypercholesterolemia is one of the few independent risk factors definitively linked to increased morbidity and mortality due to myocardial infarction. One possible therapy of current interest is the prevention of the absorption of dietary cholesterol by inhibiting the enzyme, acyl-CoA: cholesterol acyltransferase (ACAT), which catalyses the intracellular formation of cholesterol esters. Evidence is now accumulating that suggests that ACAT inhibition may not only lower plasma cholesterol levels, but may also have a direct effect at the artery wall, where ACAT has been shown to be responsible for the accumulation of cholesterol esters in arterial lesions. Drago Sliskovic and Andrew White discuss the importance of ACAT in the lipid transport system and the consequences of its inhibition in a variety of tissues, with emphasis on both lipid-lowering and anti-atherosclerotic effects.

Animals↗
PubMed1990

Pancreatitis and palindromic arthropathy with effusions associated with sodium stibogluconate treatment in a renal transplant recipient.

We report the occurrence of two side effects, pancreatitis and palindromic arthropathy with effusions, associated with injections of sodium stibogluconate used in the treatment of kala-azar. No clear mechanism to account for the problems was identified despite extensive investigation. We suggest that when abdominal pain is experienced during treatment with antimonial drugs pancreatitis should be borne in mind as a possible cause.

Adult↗
PubMed1990

Features of multiple sclerosis in older patients in South Wales.

Multiple sclerosis (MS) may occur outside the commonly accepted age range. Data relating to features of MS in a population in South Wales have been analysed to find features which characterise older patients. The older patients are more severely disabled due to the accumulation of visual defects and motor signs and symptoms. The course of the disease is marked by single localised attacks with long remissions. Those with onset over 50 years deteriorate more rapidly, but in those who were over 50 at the time of interview, this did not occur. It is suggested that there is no essential difference in MS in older patients, but there may be features which reflect normal ageing and diseases commoner in old age.

Adolescent↗
PubMed1977

Photochemotherapy of psoriasis using methoxsalen and sunlight. A controlled study.

Fifty-one patients with psoriasis were treated with oral methoxsalen and sunlight exposure. Twelve of these patients received either methoxsalen or placebo prior to whole-body exposure. The remainder were treated with methoxsalen and sunlight to one side of the body and sunlight alone to the other. The conventional dose of methoxsalen (0.6 mg/kg) was compared with a low dose (0.3 mg/kg). Oral methoxsalen when used in the higher dose followed by sun exposure is an effective treatment for psoriasis. Accurate ultraviolet dosimetry is essential to avoid phototoxic burns. The advantages and disadvantages of solar photochemotherapy are discussed.

Clinical Trials as Topic↗
PubMedDate not supplied

Serum cholesterol and 20-year mortality in black and white men and women aged 65 and older in the Evans County Heart Study.

Serum cholesterol and 20-year mortality rates were studied in 396 Evans County black and white men and women who were 65 years and older and free of prevalent coronary heart disease (CHD) at baseline examination in 1960 to 1962. Previous reports on Evans County men and women younger than 65 found cholesterol levels to be significantly associated with all-cause and CHD mortality in white men, with CHD mortality in black men, and with cardiovascular disease mortality in white women. The independent role of total serum cholesterol as a predictor of CHD and all-cause mortality in the 65-and-older age group was evaluated using Cox proportional hazards models. Among white men, serum cholesterol level was positively associated with CHD mortality (relative risk of 1.54, P < 0.05 for an increment of 40 mg/dL [1.03 mmol/L], or one standard deviation in cholesterol). A significant J-shaped relationship of cholesterol with all-cause mortality was found among white men. Among black women, cholesterol was negatively associated with all-cause mortality. Neither all-cause nor CHD mortality was related to serum cholesterol among black men or white women. Although based on small numbers, the results of this study suggest that in Evans County, total serum cholesterol is an independent predictor of mortality in white men aged 65 and over, while these results should not be generalized to other race-gender groups in this cohort.

Black or African American↗