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Biomedical subjects

D H Bossingham

Publications and source records attributed to D H Bossingham.

14 recordsLinked to original sources
PubMed1991

Intra-articular distension and steroids in the management of capsulitis of the shoulder.

OBJECTIVE: To determine whether there is any synergistic effect in the administration of intraarticular steroids with distension in the management of early capsulitis of the shoulder. DESIGN: Prospective randomised trial of three treatments--namely distension only, steroid only, and steroid with distension. SETTING: Academic department of orthopaedic and accident surgery at Queen's Medical Centre, Nottingham. SUBJECTS: 47 patients (30 women) with capsulitis affecting 50 shoulders. INTERVENTIONS: Three intra-articular injections into the shoulder given at six week intervals by the same technique. MAIN OUTCOME MEASURES: Passive range of abduction, forward flexion, and external rotation; results of shoulder dynamometry measuring work done and torque produced; pain levels at rest and with resisted movement. RESULTS: All patients reported improvement during the study. Analysis of the mean improvements in abduction and forward flexion showed these to be significantly greater in the steroid with distension and steroid only groups than in the distension only group (mean improvements in abduction (degrees/week (95% confidence interval)) 4.3 (3.4 to 5.2), 3.4 (2.4 to 4.5), and 1.0 (-0.8 to 2.8) in the three groups respectively; mean improvements in flexion (degrees/week (95% confidence interval)) 3.6 (3.2 to 4.0), 3.3 (2.3 to 4.3), and 1.5 (0.5 to 2.5) respectively). Shoulder dynamometry failed to show a significant difference among the treatment groups. No severe complications occurred as a result of the injections, but two patients reported facial flushing related to the use of steroids. CONCLUSION: Intra-articular steroid injections have a useful role in the outpatient management of early capsulitis.

Air↗
PubMed1990

A comparison of two formulations of indomethacin ('Flexin Continus' tablets and 'Indocid' capsules) in the treatment of osteoarthritis.

The efficacy and side-effect profiles of two formulations of indomethacin were compared in a multi-centre, double-blind, crossover study in 77 patients with osteoarthritis. Patients were allocated at random to receive 75 mg indomethacin per day either as 1 controlled-release tablet at night or as 1 immediate-release capsule given 3-times daily for a period of 4 weeks, after which patients were crossed over to receive the alternative treatment for a further 4 weeks. Pain scores, daily symptomatology and the requirement for escape analgesia recorded by the investigator and patient indicate that controlled-release indomethacin tablets, 75 mg given at night, were as efficacious as immediate-release indomethacin capsules, 25 mg given 3-times daily, in the treatment of osteoarthritis. The side-effect profiles of the two formulations were similar.

Administration, Oral↗
PubMed1985

Class specific rheumatoid factors in rheumatoid arthritis: response to chrysotherapy and relationship to disease activity.

IgG rheumatoid factors (RF) may play an important role in the pathogenesis of rheumatoid arthritis (RA). Our study investigates the relationship between class specific RF levels measured by radioimmunoassay and disease activity in patients with RA undergoing chrysotherapy. Nineteen patients were treated with 20 mg disodium aurothiomalate weekly for 6 months. Rheumatoid disease activity was assessed before and after 6 months' treatment and the level of IgG, IgA and IgM RF measured. There were significant falls in disease activity (p less than 0.005), IgA RF (p less than 0.005) IgG RF (p less than 0.005) and SCAT (p less than 0.025), but not IgM RF, over the 6 month treatment period. No correlation was found between absolute levels of IgA, IgG or IgM RF and disease activity before or after 6 months' therapy but there was a highly significant linear correlation between reduction in IgG RF levels and fall in disease activity (r = 0.642, p less than 0.005) with treatment.

Adult↗
PubMed1985

An improved assay for IgG rheumatoid factor: its value in the diagnosis of rheumatoid arthritis.

A simple radioimmunoassay suitable for the routine estimation of IgG rheumatoid factors (IgG RF) has been developed. This involves determination of the amount of IgG RF binding to highly purified human IgG Fc on microtiter plates using a radiolabelled F(ab')2 preparation of an antihuman IgG Fd antiserum. A correction for nonspecific binding is made by subtracting sample reactivity with bovine serum albumin. Significantly elevated IgG RF levels were found only in patients with symmetrical peripheral erosive polyarthritis and in some patients with "mixed connective tissue disease."

Adult↗
PubMed1981

Knee function after intra-articular hydrocortisone.

The effect of intra-articular hydrocortisone on knees affected by rheumatoid synovitis has been assessed objectively by the use of an electrogoniometer. The range of flexion during walking has been shown to improve, in some cases into the normal range, and this effect was maintained to a significant degree for eight weeks in a group of 12 patients. Function was shown to improve more slowly than pain and this may have an important bearing on future assessment of anti-inflammatory drugs.ion during walking has been shown to improve, in some cases into the normal range, and this effect was maintained to a significant degree for eight weeks in a group of 12 patients. Function was shown to improve more slowly than pain and this may have an important bearing on future assessment of anti-inflammatory drugs.ion during walking has been shown to improve, in some cases into the normal range, and this effect was maintained to a significant degree for eight weeks in a group of 12 patients. Function was shown to improve more slowly than pain and this may have an important bearing on future assessment of anti-inflammatory drugs. The benefits of hydrocortisone have been measured against intra-articular saline in a single-blind study and shown to be significant both symptomatically and functionally.

Adult↗
PubMed1980

Medicine in orthopaedics: a role for the rheumatologist?

In a seven-month period 102 patients admitted for elective orthopaedic surgery (total hip replacement for more than 50%) were referred for a medical opinion, and more than 70% were seen preoperatively. Twenty-nine patients were considered unfit for operation for a variety of different reasons, but after suitable treatment surgery was possible for most of this group. General practitioners and surgeons alike provided insufficient information prior to admission, and this resulted in postponement of operations. A wide variety of conditions was seen pre- and post-operatively, and a very high level of diagnostic criticism was maintained by orthopaedic junior staff but management of certain metabolic conditions was poor. As the number of elderly patients requiring joint replacement surgery increases, great care must be exercised in preoperative assessment in order to maintain an economic service. Combined orthopaedic and rheumatology consultation might be advantageous.

Adolescent↗
PubMed1979

Yellow nail syndrome in rheumatoid arthritis: report of three cases.

We report the occurrence of the yellow nail syndrome in 3 patients with rheumatoid arthritis. In 2 patients the development of the syndrome was related to severe chest infections, and there was evidence of immunodeficiency, consisting in 1 case of a persistently low serum IgA level and in the other of a generalised marrow suppression. The third patient gave a history of recurrent sinusitis and showed evidence of previous chest infections and pulmonary fibrosis, but has no gross evidence of immunodeficiency. We have found only 1 previous brief mention of a patient with the yellow nail syndrome and rheumatoid arthritis.

Adult↗