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Biomedical subjects

E G Bywaters

Publications and source records attributed to E G Bywaters.

At least 19 recordsLinked to original sources
PubMed1995

Commented glossary for rheumatic spinal diseases, based on pathology.

OBJECTIVES: To redefine and comment on terms on a pathological basis, in order to avoid the confusion due to the use of terms with different meanings, to standardise usage among clinicians, radiologists and pathologists, and to facilitate literature searches. METHODS: Within the Committee of Pathology of the European League against Rheumatism, a study group was set up to analyse the medical literature and common practice concerning the nomenclature of rheumatic spinal diseases. The group tried to amalgamate the main trends in the field, to reconcile etymology, historical background, morphology, and common practice. RESULTS: The group warns against use of the terms 'acquired hyperostosis syndrome', '(von) Bechterew's disease', 'Kümmel's disease', 'pseudospondylolisthesis', 'rheumatoid spondylitis', 'spondylarthropathy' in the sense of spondarthritis, and 'spondylosis'. It recommends intercorporal or interapophyseal rather than intervertebral (osteo) chondrosis, zygapophyseal diverticulum rather than cyst, disc hernia rather than prolapse, spondyloarthritis rather than spondyloarthropathy, marginal rather than anterior spondylitis, and discarthrosis. It proposes 'zygarthrosis' to designate zygapophyseal osteoarthrosis. CONCLUSIONS: Knowledge of the pathological basis of diseases and an understanding of the original definitions given by those who coined new terms make it possible to avoid most of the confusion arising from improper use of spinal terms.

Humans↗
PubMed1988

Historical aspects of the aetiology of rheumatoid arthritis.

Since the first description of the disease in the early part of the nineteenth century, the aetiology of rheumatoid arthritis has been associated with the interacting concepts of diathesis or internal factors and environment or external factors.

Arthritis, Rheumatoid↗
PubMed1985

Illustrated glossary for spinal anatomy. With explanations and a French and German translation.

The authors define, explain, and illustrate a number of concepts pertaining to normal spinal anatomy that are of practical use but omitted in standard anatomical sources or are the subject of conflicting views: bony and cartilaginous end-plate, marginal ring, cortex of the vertebral body, isthmus, neurocentral junction, uncus, uncovertebral joint, zygapophyseal joint, annulus fibrosus, shorter and longer perivertebral ligaments, interspinous bursa, mamillo-accessory ligament. A French and German translation of recommended terms is provided as well.

Humans↗
PubMed1983

Historical perspectives in the aetiology of ankylosing spondylitis.

A brief historical review of the aetiology of ankylosing spondylitis is presented. A recurrent theme has been diathesis and infection. Diathesis has now been pinpointed to the 6th chromosome in the form of HLA-B27, but, as yet, we know little of any infective aetiology for ankylosing spondylitis itself.

England↗
PubMed1982

Adult-onset Still's disease. Twenty-year followup and further studies of patients with active disease.

Eleven female patients with adult-onset Still's disease were followed for 7-36 years (mean 20.2 years) after the onset of their illness. Ten of these patients had a chronic course characterized by remissions and exacerbations of arthritis associated with fever and rash. Five patients had terminal interphalangeal involvement, and carpal ankylosis was demonstrated on x-ray film in 10. Two patients developed a widespread polyarthritis, and renal amyloidosis was diagnosed 10 years after disease onset in the most severely affected patient. In 4 patients studied during an exacerbation of the disease, circulating immune complexes were detected by the staphylococcal A binding assay, but not by the C1q binding assay. Synovial fluid analysis in 1 patient revealed a low C3 level and total hemolytic complement (CH50) together with immune complexes and IgG rheumatoid factor. Immune complexes were not identified in the characteristic Still's rash by immunofluorescence or electron microscopy, although mast cell degranulation, neutrophil lysis, and perivascular fibrin deposition were reminiscent of immune complex--mediated vascular injury. The clinical and laboratory features as well as the long-term course of adult- and juvenile-onset systemic Still's disease are similar, but further studies of genetic markers and immunopathology are required to establish a common pathophysiology.

Adult↗
PubMed1982

The lumbar interspinous bursae and Baastrup's syndrome. An autopsy study.

This study describes the prevalence, distribution, pathology and pathogenesis of lumbar interspinous bursitis (described as a clinical syndrome by Baastrup in 1933). It is based on an anatomic study of 152 lumbar spines derived from routine and random postmortem material, together with selected specimens from autopsies on patients with various rheumatic diseases. From a statistical study of 50 randomly chosen spines, bursae are found when the interspinous distance is small compared with the total height of the lumbar spine ('bursal index'): nearly all bursal spaces show some sign of inflammation and a few show severe bony erosion. Crystal deposits therein are also described.

Arthritis, Juvenile↗
PubMed1982

Rheumatoid and other diseases of the cervical interspinous bursae, and changes in the spinous processes.

Bursal spaces between the cervical interspinous processes were found at necropsy in 14 out of 27 "normal' adult necks, especially when the spines were close together. In this random series they were the seat of crystallopathic disease in 2 instances out of 14 cases. In spines from 9 cases of adult-onset rheumatoid arthritis, rheumatoid bursitis was seen in 2 and banal bursitis in 2. In juvenile-onset chronic arthritis inflammatory bursal changes of rheumatoid nature were found in 2 out of 5 cases, and are compared with the "normal'. A third case showed crystallopathic destruction. In one instance of adult RA very severe changes were seen, with destruction of the spinous processes, and this was associated with hypermobile segments dependent on discal destruction starting in the oncovertebral joints. An association is described between discal lesions, spinous erosion, enthesopathy, and interspinous bursitis.

Adult↗
PubMed1981

Thoracic intervertebral discitis in rheumatoid arthritis due to costovertebral joint involvement.

Discitis (with intervertebral disc destruction), found pathologically in the thoracic region of 8 out of 114 rheumatoid patients, is shown to derive and spread from primary rheumatoid involvement of the costovertebral joints. Erosion and destruction of bone may occur, followed by healing, visible radiologically as disc narrowing and posterolateral bony sclerosis and sometimes with ankylosis. There are few clinical symptoms, since most of these patients have limited locomotor function.

Adult↗
PubMed1981

Observations on chronic polyarthritis in monkeys.

Erosion and inflammatory changes in the carpus, fingers and toes of a rhesus monkey, Macaca mulatta, are described; this was one of 152 animals in each of which four fixed limbs were available for examination. The histological changes resembled closely those found in adult human rheumatoid arthritis. The limited literature is reviewed (including cases with amyloid disease).

Animals↗
PubMed1978

The selection of patients for controlled trials.

The selection of patients for testing drugs is a very complicated process even overtly; subconscious bias must be avoided and our social conscience respected. It is of prime importance to define in advance exactly what you want to test and this may include not only the therapeutic and pharmacological effects and side-effects, the long-term neoplastic potential, the mutagenic effects and the effects on the foetus, but also mundane effects like credibility, acceptance, and even taste! Patient selection is not just "Attention there Volunteers nos. 1,3,5,7,9,....step forward smartly from the left". It is a complicated process in which there is inevitably some bias and our job is to see that any biases which are included do not bias the results, and that the results are understood to apply to this particular selection of patients and not to any other. Too many explicit exclusions therefore make results less useful because less widely relevant.

Clinical Trials as Topic↗
PubMed1978

A family with primary protrusio acetabuli.

The family of a child who developed symptoms and flexion contractures with protrusio acetabuli rapidly between the age of 8 and 11 was examined. The mother and one sib showed limitation of hip movements, while radiological criteria for protrusio were found in the mother and 4 of the proband's 8 sibs; only one had complained of pain. At the age of 16 the proband underwent bilateral total replacement arthroplasty; histologically the changes were those of fibrocartilaginous replacement and osteophyte formation.

Acetabulum↗