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D Carruthers

Publications and source records attributed to D Carruthers.

6 recordsLinked to original sources
PubMed2001

Activity, damage and outcome in systemic vasculitis.

Current therapy has transformed the prognosis of the systemic vasculitides from diseases that had a high acute mortality rate to chronic relapsing diseases with high rates of morbidity. This improved survival has highlighted the need for better methods of monitoring disease activity and recording the accumulation of organ damage that occurs during the course of the disease. Several clinical indices have been developed that record disease activity, damage and the extent of disease. These validated indices allow a detailed assessment of the patient's response to therapy and provide an essential tool for insuring uniformity of patient monitoring in multi-centre trials. In addition, more data are now available supporting the use of these assessment tools as prognostic and outcome criteria for clinical studies. The development, properties, application and inter-relationships of the available clinical assessment tools for patients with systemic vasculitis are reviewed in this chapter.

Humans↗
PubMed2001

New therapeutic aspects: haemopoietic stem cell transplantation.

Primary systemic vasculitis responds well to intensive immunosuppression, particularly with cyclophosphomide. Use of the latter is restricted by side-effects, particularly in relapsing disease. Techniques which allow more complete immunosuppression have an obvious attraction in autoimmune disease. They are particularly suitable for vasculitis which can go into long-lasting remission even with standard therapy in many cases. The conditioning used for stem cell transplantation allows more complete deletion of auto aggressive T-cell clones, with subsequently haemopoietic rescue by previously harvested stem cell precursors. The procedure also has immune potentiating effects, perhaps by promoting peripheral suppressor mechanisms. These may be important even though immune ablation is not achieved. With rigorous patient selection, experience with this technique in vasculitis may be broadened.

Hematopoietic Stem Cell Mobilization↗
PubMed2000

Lupus patients with fatigue-is there a link with fibromyalgia syndrome?

OBJECTIVE: To determine whether fibromyalgia syndrome (FMS) was more common in patients with lupus who were complaining of fatigue. METHODS: We interviewed 216 patients attending two lupus clinics, all of whom fulfilled the revised American College of Rheumatology (ACR) criteria for lupus. The patients completed a questionnaire and were examined to determine the presence of fatigue and whether they fulfilled the ACR criteria for FMS. Disease activity was measured using the British Isles Lupus Assessment Group (BILAG) index and the Systemic Lupus International Collaborating Clinics (SLICC)/ACR damage score. Measurements of erythrocyte sedimentation rate, complement C3, lymphocyte count and DNA titre were also performed. RESULTS: Fifty per cent of our patients complained of fatigue, but only 10% of these patients fulfilled criteria for FMS. FMS did not correlate with any measure of disease activity although patients with FMS had lower mean DNA antibody titres and mean SLICC/ACR damage scores. CONCLUSION: A minority of lupus patients with fatigue fulfil the ACR criteria for FMS. Other possible factors leading to fatigue should be considered.

Adult↗
PubMedDate not supplied

Serratia marcescens-a marker for an infection control program.

An infection control program was instituted at The Victoria General Hospital, an 800-bed acute care hospital, in July 1977. Serratia marcescens had infected or colonized (I/c) 225 to 232 patients yearly for each of the three previous years. Since this organism is usually acquired nosocomially, we decided to use Serratia I/C as a marker for our infection control program. During the years 1977 to 1980, we identified and eliminated several reservoirs of Serratia (contaminated urine measuring containers, urometers, diabetic urine testing equipment and in-use contamination of 2% Hibitane). Readmission of previously I/C patients proved to be an increasingly important reservoir. During 1980, only 120 patients were I/C, and gentamicin-resistant isolates of S.marcescens had dropped from 44% in 1977 to 4.4% in 1980. Use of Serratia as a marker enabled us to monitor the efficacy of our infection control program and allowed us to prove to our health care workers the usefulness of many of the measures we introduced.

Adolescent↗