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Biomedical subjects

E C Huskisson

Publications and source records attributed to E C Huskisson.

At least 19 recordsLinked to original sources
PubMed1992

The response of 99Tcm-methylene diphosphonate and 99Tcm-hexametazime-labelled neutrophils to intra-articular steroid injection in rheumatoid arthritis.

The synovial and bone uptake of tracer in the knees of patients with rheumatoid arthritis (RA) was quantified using 99Tcm-hexamethyl propylene amine oxime-labelled leucocytes and 99Tcm-methylene diphosphonate (MDP), respectively. Significant neutrophil migration and MDP uptake occurred in the knees of patients with RA irrespective of the disease duration. In all but one patient neutrophil migration was reduced after intra-articular steroid injection. The change in MDP uptake after steroid injection was variable. There was a significant correlation between the percentage reduction in neutrophil migration and pain score, while the latter correlated poorly with the change in MDP uptake. The quantification of the neutrophil component of the inflammatory process is a sensitive index for monitoring RA activity and response to pharmacological interventions, while quantitative bone scintigraphy should not be employed to monitor changes in joint inflammation in patients with RA.

Aged↗
PubMed1992

Radiological progression of osteoarthritis: an 11 year follow up study of the knee.

A follow up study was carried out in 1990 on 169 well documented patients initially presenting with osteoarthritis of the hands or knees between 1975 and 1977. Radiographic change in the knee was used as the outcome measure. Sixty three subjects had paired knee radiographs a mean of 11 years apart and were 69 (range 52-87) years old at follow up. Thirty subjects were known to have died, 28 were untraceable, and 48 were traced but did not have paired films available. The films were read independently and blind to time sequence by two observers using five different radiological scoring methods. Most of the knees did not increase in Kellgren and Lawrence grade, with only 33% deteriorating over the time period. The results were similar when a subject was categorised by their worst knee. When a more sensitive global score on paired films was used 50% of knees showed a slight deterioration and 10% improved. Visual analogue pain scores remained unchanged. Those with knee pain at baseline had a greater chance of progressing, as did those with existing osteoarthritis in the contralateral knee. These results suggest that most patients with osteoarthritis attending rheumatology clinics do not deteriorate radiographically or symptomatically over an 11 year period. More work is needed in the selection and early detection of subjects with a poor prognosis and in focusing early intervention on this high risk group.

Aged↗
PubMed1992

Enteric coated naproxen; a double blind trial comparing the tolerance of enteric coated and standard formulations.

Enteric coated naproxen (Nycopren) was compared with standard naproxen in a double blind comparative trial of 348 patients with either rheumatoid or osteoarthritis. There were slightly fewer gastric side effects and slightly fewer withdrawals because of side effects in the enteric coated naproxen group but the differences did not reach statistical significance. There was no significant difference in the efficacy of the two formulations. A satisfaction index was used to assess the therapeutic ratio with visual analogue scales assigned to both efficacy and side effects. The scale performed as intended and is worthy of further exploration.

Adult↗
PubMed1992

Radioleucoscintigraphy in osteoarthritis. Is there an inflammatory component?

The possible contribution of an inflammatory component in osteoarthritis was investigated. There was no correlation between the percentage uptakes of 99Tcm-hexamethylpropyleneamine oxime (HMPAO)-labelled white blood cells and 99Tcm-methylene diphosphonate (MDP) and between the former and pain scores. A significant correlation was found between the percentage uptake of 99Tcm-MDP and pain scores (0.002 > P > 0.01). In osteoarthritis, 99Tcm-HMPAO-labelled white cell imaging may or may not show a positive localization in the synovial membrane. Positive white cell localization appears to be limited to the area that corresponds to the radiological evidence of the condition and the positive uptake of the skeletal imaging agent.

Adult↗
PubMed1991

Rheumatoid nodules do not predict response to treatment with slow-acting anti-rheumatic drugs.

Rheumatoid nodules have been associated with a poor long-term prognosis. We investigated whether they predict a poor response to treatment with slow-acting anti-rheumatic drugs (SAARDs). Two hundred and twenty-eight patients with rheumatoid arthritis (RA) were treated for six months with a SAARD. Clinical and laboratory assessments of disease activity were made initially and after 6 months' treatment. Patients were divided into two groups according to the presence or absence of nodules at entry. Twenty-one % had nodules before treatment but their response was no different to patients without nodules (79%), both groups showing improvements in all variables. Males were more likely to develop nodules and had a relative risk of 1.7. High titres of rheumatoid factor correlated with nodules and no sero-negative patients had nodules. We conclude that nodules are not predictive of poor response to treatment with a SAARD, despite their presence being associated with a poor long-term prognosis. One possible implication is that SAARDs themselves, despite an early response, may not effect long-term outcome.

Anti-Inflammatory Agents↗
PubMed1991

Joint space in radiologically normal knees.

Joint space loss is a characteristic feature of rheumatoid arthritis and osteoarthritis. It cannot be fully evaluated, however, without knowledge of the normal variability of joint space size. We have measured joint space size using digital image analysis in a population of radiologically normal individuals. Anteroposterior films of the knee were studied from 685 consecutive patients attending Casualty with unexplained knee pain or following trauma, but with no clinical or radiological evidence of arthritis. Results show that in a radiologically normal population, men have larger joint spaces than women and there is a steady decline in joint space size with age. We found no significant difference in joint space size between weight bearing and non-weight bearing women. There was also no difference in patients presenting with pain and those presenting following an injury. Normal joint space size was not related to height, weight or body mass index in a subgroup of 213 patients. We suggest that patients lose joint space with increasing age and eventually reach a 'pain threshold' at which symptoms of osteoarthritis occur. This explains the increase in joint symptoms in those who begin with smaller joint spaces; that is in women and in the elderly.

Adolescent↗
PubMed1991

A clinical comparison of two leading non-steroidal anti-inflammatory drugs.

One hundred patients with rheumatoid arthritis were entered into a randomised, double-blind, cross-over study of naproxen (500 mg b.d.) and diclofenac (50 mg t.i.d.). Each treatment period lasted four weeks with a wash-out period of up to one week on admission and again between periods of active therapy. Compared with baseline, both treatments significantly reduced the duration of morning stiffness, Ritchie Articular Index, daytime and night-time pain and produced a significant improvement in the disease status. Forty-two non-serious presumed side-effects were reported in 21 patients (21%). All were characterised by common everyday signs and symptoms. These largely related to the upper gastrointestinal tract and typical of those commonly reported for non-steroidal anti-inflammatory agents. There were no statistically significant differences between the two treatments for any of the efficacy parameters or in the incidence of side-effects. Patients also expressed an equal preference for the two drugs.

Adult↗
PubMed1991

Four commonly prescribed non-steroidal anti-inflammatory drugs for rheumatoid arthritis.

A four-way single-blind crossover study was used to compare the efficacy and tolerance of four non-steroidal anti-inflammatory drugs. In addition, pain intensity was compared during the day, at night, at rest, on walking, in the most painful joint, and with the patients most painful activity. Ninety-six patients with rheumatoid arthritis took single daily doses of controlled release naproxen (N), diclofenac S.R. (D), indomethacin S.R. (I) and standard piroxicam (P). The greatest changes from baseline after treatment were seen in those patients with the highest initial pain measurement scores. Assessments of pain in the morning, in the most painful joint and the most painful activity were more discriminating than those at noon or at rest. Of the treatments, 'N' and 'P' were the most effective in reducing pain, with statistically significant differences from baseline. 'I' was the most effective in reducing morning stiffness. Adverse experiences were generally mild, occurring more frequently on 'I' than on other treatments.

Administration, Oral↗
PubMed1979

Osteoarthritis. Changing concepts in pathogenesis and treatment.

The clinical features of osteoarthritis provide little support for the traditional view of the disease as a wear-and-tear phenomenon of aging. In many cases osteoarthritis consists of a polyarthritis with mildly inflammatory features, such as stiffness, effusions, and hot Heberden's nodes. The finding of biochemical abnormalities of cartilage throws new light on this enormously important disease and suggests the possibility of more effective therapy.

Humans↗
PubMed1979

Treatment of rheumatoid arthritis with a single daily dose of benoxaprofen.

A single daily dose of 600 mg of henoxaprofen has been shown to be more effective than a previously reported dosage regime in patients with rheumatoid arthritis. Increased total daily dosage was not associated with a greater incidence of side-effects. The drug worked slowly reaching a plateau after eight days of treatment. It was usually well tolerated especially by the gastro-intestinal tract.

Adult↗
PubMed1979

D-penicillamine and immune complex deposition.

Dense, granular immunoglobulin deposits have been identified at the epidermo-dermal junction in 4 out of 10 patients who developed toxic reactions to D-penicillamine therapy for rheumatoid arthritis. Three of 4 patients developing a lupus-like syndrome while on penicillamine had similar findings on skin biopsy. Serum immunoglobulin and complement levels decreased significantly in patients treated with penicillamine. It is suggested that, in addition to penicillamine nephropathy, other side effects of this drug may be related to widespread deposition of immune complexes.

Adult↗
PubMed1979

Another look at osteoarthritis.

One hundred consecutive cases of osteoarthritis seen in a medical clinic have been reviewed and contrasted with 100 patients with rheumatoid disease. Osteoarthritis was usually a polyarticular disease and as symmetrical in distribution as rheumatoid; the knees and hands were the most commonly involved sites. Evidence of inflammation was often found in patients with osteoarthritis and included morning stiffness, redness of distal interphalangeal joints, warmth, and effusions in the knees. In many cases there was either radiological or electron microscopical evidence of deposition of calcium salts. These findings do not support the concept of osteoarthritis as a mechanical, noninflammatory 'wear and tear' condition. An active metabolic abnormality of articular cartilage resulting in cartilage destruction, calcification, and inflammation is suggested as being more compatible with the findings.

Arthritis, Rheumatoid↗