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Biomedical subjects

B Pal

Publications and source records attributed to B Pal.

At least 19 recordsLinked to original sources
PubMed1991

Primary Sjögren's syndrome in north east England--a longitudinal study.

We have documented the initial clinical features of 100 patients with primary Sjögren's syndrome (SS) together with the results of their baseline investigations. The evolution of the disease in these patients has been followed for a median of 34 months (range 3-84 months). The majority of patients were females aged 40-60 years, and common clinical features included eye symptoms (100%), xerostomia (100%), polyarthralgia (94%), Raynaud's phenomenon (81%) and salivary gland swelling (47%). Thyroid disease was relatively common (14%) while other endocrine disease was rare. Four patients died during follow-up, and three cases of lymphoma were detected. Other serious complications included pericarditis (10%), pleuroparenchymal lung disease (9%), renal tubular acidosis (3%) and cerebrovascular accidents (2%). The presence of anti-Ro antibodies identifies patients with more severe systemic disease. Spontaneous improvement occurred in 12 patients, while steroids were required for specific complications in 18. Overall, although lymphoma was found to excess in our group, the high mortality reported with primary SS elsewhere was not seen.

Adolescent↗
PubMed1991

Lung function in primary Sjögren's syndrome: a cross sectional and longitudinal study.

Clinical and radiological assessment of 100 patients (97 female) with primary Sjögren's syndrome was performed within six months of diagnosis in conjunction with spirometry and measurement of transfer factor for carbon monoxide (TLCO). This was repeated in an unselected subgroup of 30 patients after a mean interval of four years. On initial assessment, 43 patients had symptoms of lung disease and 10 had related physical signs; the chest radiograph was abnormal in five. There was a significant reduction (more than 2 standardised residuals) in forced expiratory volume in one second (FEV1), vital capacity (VC), and TLCO in 14, 12, and 10 patients, 24 patients overall having a significant reduction in one or more of these measures. There was a strong relation between reduction in lung function and both pulmonary symptoms and a lip biopsy specimen positive for Sjögren's syndrome. Lung function at the initial assessment in the 30 patients who were restudied was almost identical to that of the group as a whole. Seventeen now had symptoms and nine had related physical signs. The chest radiograph was abnormal in four patients. More patients had a significant reduction in FEV1, VC, and TLCO. Lung disease is sometimes an early feature of primary Sjögren's syndrome and may progress over a relatively short period.

Adolescent↗
PubMed1989

Stimulated eccrine gland function in primary Sjögren's syndrome.

Sweat secretion rate, stimulated by iontophoresis of pilocarpine, was measured in 22 patients with primary Sjögren's syndrome and 22 age- and sex-matched normal control subjects. There was no significant difference in measured sweat rates (P = 0.45). We conclude that the complaint of dryness of the skin in patients with Sjögren's syndrome is not due to decreased eccrine gland secretion.

Adult↗
PubMed1989

Alpha 1 antitrypsin (PI) phenotypes in two rheumatic diseases: a reappraisal of the association of PI subtypes in rheumatoid arthritis.

alpha 1 Antitrypsin phenotypes were determined by isoelectric focusing in 225 adult white patients with rheumatoid arthritis (RA), 60 patients with severe rheumatoid arthritis (grade III and IV), 17 sibling pairs--HLA identical but discordant for rheumatoid arthritis, and 122 random patients with Sjögren's syndrome. No significant increase in non-M phenotypes was found in either of the groups of patients with RA, but the association between M subvariants was striking. There was a significant increase in M1M2 phenotype and M2 allotype in both the RA and severe RA groups. This increase in M1M2 was also supported by DR4 positive patients with RA compared with DR4 positive siblings without RA. No apparent association of variant phenotype was found in four subgroups of patients with Sjögren's syndrome.

Alleles↗
PubMed1989

A study of headaches and migraine in Sjögren's syndrome and other rheumatic disorders.

Migraine occurs with increased frequency in patients with systemic lupus erythematosus and in subjects suffering from Raynaud's phenomenon without any underlying connective tissue disorders. A possible link between migraine and Raynaud's phenomenon has been suggested. Two rheumatic conditions where Raynaud's phenomenon occurs very commonly are scleroderma and primary Sjögren's syndrome. It is possible that migraine is also common in these disorders but has been unrecognised. Therefore, the prevalence of migraine was assessed by a questionnaire in 191 subjects suffering from various connective tissue disorders and control subjects. Migraine was diagnosed in 16/35 (46%) patients with primary Sjögren's syndrome, 31/97 (32%) patients with scleroderma, 4/33 (12%) patients with rheumatoid arthritis/Sjögren's syndrome compared with 3/26 (11%) control subjects. A family history of headaches was more common in the patient groups than controls. There was a significant association between occurrence of Raynaud's phenomenon and migraine. Small vessel pathology may underlie both migraine and Raynaud's phenomenon in these connective tissue disorders--as has been suggested in systemic lupus erythematosus. The findings stress the need to ask specifically about complaints of headaches/migraines in patients with scleroderma and primary Sjögren's syndrome for the appropriate total management of these patients.

Female↗
PubMed1988

Genetic markers in Sjögren's syndrome: the question of its genetic heterogeneity.

Genetic factors may be implicated in the causation of Sjögren's syndrome (SS) as shown by familial clustering of the disease and certain HLA associations. Non-HLA genetic markers in SS have not previously been studied in detail. In this study of 122 unrelated patients with various categories of SS and 104 control subjects, 29 genetic markers were studied (11 blood groups, 5 serum proteins and 13 red-cell enzymes). Almost all systems showed a considerable range of gene frequency among the various subgroups of patients with SS but only a few attained statistical significance (C3 and GPT). Multivariate (kinship) analysis, however, showed clear distinction between the subgroups of SS, suggesting that they are genetically distinct entities.

Alleles↗
PubMed1988

Multicentre double-blind comparison of sustained action formulations of tiaprofenic acid and indomethacin in osteoarthritis.

In a randomised double-blind, multicentre, crossover study, the short term efficacy and tolerance of a sustained action preparation of tiaprofenic acid 600 mg once daily was compared with sustained release indomethacin 75 mg once daily in 98 patients with osteoarthritis. After a minimum washout period of 3 days, patients were randomly allocated to receive each treatment in turn for a period of 4 weeks. There were no significant differences between the 2 treatments in the clinical assessments of pain level, duration of morning stiffness, articular index and functional impairment performed at the end of each treatment period. High pain levels on movement were reduced by both treatments, and reduction was also seen in night pain, where initial levels were lower. There was no significant difference between the number of patients who reported side effects on the 2 treatments. 37 patients (39%) reported 49 side effects while taking sustained release tiaprofenic acid, and 35 patients (37%) reported 53 side effects while taking sustained release indomethacin. Daily diary cards showed that both treatments provided improvements in duration of morning stiffness and in pain relief. Thus sustained action tiaprofenic acid and sustained release indomethacin were shown to be equally well tolerated and efficacious.

Adult↗
PubMed1987

Use of simple analgesics in the treatment of ankylosing spondylitis.

The role played by simple analgesics in the treatment of ankylosing spondylitis (AS) is not clear. A questionnaire survey of AS patients and rheumatologists revealed that a majority (78%) of patients took NSAIDs and a substantial proportion (34%) took simple analgesics. A majority of rheumatologists (65%) considered simple analgesics worth prescribing for AS patients. Rheumatologists tended to prescribe NSAIDs more often initially than simple analgesics while the reverse was true for general practitioners. Over half the patients (57%) considered pain relief as their first priority for drug treatment. Other objectives such as prevention of deformities and relief of stiffness were less important. A sizeable proportion of patients (15%) bought over-the-counter drugs. Prescribing habits of doctors can be improved by listing over-the-counter drugs in the British National Formulary and Data Sheet Compendium.

Analgesics↗
PubMed1987

Bf and C3 polymorphisms in rheumatoid arthritis.

Properdin factor B (Bf) and complement C3 polymorphisms were studied in 225 unrelated rheumatoid arthritis (RA) patients from North-East England. Patients were subdivided on the presence or absence of significant titres of rheumatoid factor and antinuclear factor. No association with the C3 system was detected. For the Bf system, a significant excess of Bf SS and deficiency of Bf FS phenotypes was observed in seropositive RA patients lacking antinuclear antibodies. This finding suggests that auto-antibody-defined subgroups of RA may be genetically heterogeneous with respect to Bf and confirms the status of Bf SS phenotype as a marker for RA susceptibility and/or severity.

Antibodies, Antinuclear↗
PubMed1987

Salivary amylase and pancreatic enzymes in Sjögren's syndrome.

Concentrations of immunoreactive trypsin (IRT) and pancreatic and salivary amylase activities were measured in 22 patients with primary Sjögren's syndrome (SS) and in 13 patients with secondary SS. Nineteen of the 22 patients with primary SS had above-normal IRT, and six had above-normal pancreatic isoamylase activity. Six of the 13 patients with secondary SS had above-normal IRT; none had above-normal isoamylase activities. Serum IRT and pancreatic isoamylase were correlated significantly (r = 0.7; p less than 0.0001). Above-normal values for IRT and pancreatic isoamylase were more frequent in patients who had SS for longer than 10 years, but were not related to the presence of salivary gland autoantibodies or to salivary isoamylase activity. We conclude that the concentration and activity of pancreatic enzymes are frequently abnormal in SS; that the abnormality is greater and more frequent in patients with primary SS; and that it increases with the duration of the disease.

Adolescent↗
PubMed1987

Association of limited joint mobility with Dupuytren's contracture in diabetes mellitus.

Limited joint mobility is a relatively recent addition to the list of other well known rheumatic disorders that may be associated with diabetes mellitus. In our study of 109 patients with diabetes, a higher prevalence of Dupuytren's contracture was found compared to nondiabetic subjects, but the difference was not statistically significant (p less than 0.1). An association between limited joint mobility and Dupuytren's contracture was shown. Patients with diabetes with Dupuytren's contracture showed no difference compared to those without Dupuytren's contracture with regard to sex, insulin dosage, metabolic control and presence of shoulder capsulitis. Limited joint mobility and Dupuytren's contracture may be associated with retinopathy.

Adolescent↗