Scleroderma and breast carcinoma.
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Biomedical subjects
Publications and source records attributed to C J Goodwill.
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We report a 31 year old Arab female patient with Behçet's disease and erosive arthritis of both wrists and intercarpal joints.
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Twenty-one patients with rheumatoid arthritis took part in a comparison of three toothbrushes, each used for one month in a randomized trial. The three toothbrushes were a conventional toothbrush with modified handle to allow ease of gripping, an electric toothbrush, and thirdly a finger-stall attached to a normal toothbrush. There was no change in the patients' rheumatoid status during the trial. The patients were scored for plaque and gingival changes but no difference was found between the three toothbrushes. We recommend a standard toothbrush with a modified grip for the rheumatoid hand; the extra expense of an electric toothbrush cannot be justified.
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Fifteen cases of herpes zoster with lower motor neurone paresis involving the upper and lower limbs are reviewed. Five patients had an underlying disease--three had rheumatoid arthritis, two of whom were on prednisolone; one had chronic lymphatic leukaemia and one lymphosarcoma. Details are given of the time relationship between onset of pain, the appearance of the skin eruption and the later muscle weakness. Electromyographic evidence was available in 12 patients. The difficulty of assessing the muscle power in the presence of severe pain is discussed. Prognosis was generally very good; 11 patients recovered fully, three improved and one was unchanged after 5 months, when he died of lymphosarcoma. One patient was lost to follow-up at 5 months but was improving at the time.
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Previous workers have advocated hip nerve block, with local anaesthetic, in the treatment of intractable pain from osteoarthritis of the hip. In a pilot study we obtained some degree of pain relief in only six of 13 patients. A further double-blind, controlled, randomized trial was undertaken in 31 patients, comparing 0.5% Marcain and normal saline. There was no significant improvement in pain or hip movements in either group over a six-week period.
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Two patients with the aortic arch syndrome and biopsy-proved but asymptomatic temporal giant cell arteritis are described. Corticosteroid treatment was followed by the return of peripheral pulsation in these two patients after an interval of a few months. A review of the literature suggests that of patients where giant cell arteritis causes subclavin obstruction there is an undue predominance of women, compared to the sex ratio found in giant cell arteritis overall.
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