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Biomedical subjects

G R Struthers

Publications and source records attributed to G R Struthers.

At least 19 recordsLinked to original sources
PubMed1997

Do gold rings protect against articular erosion in rheumatoid arthritis?

OBJECTIVE: To examine the hypothesis that gold rings might delay articular erosion at the metacarpophalangeal (MCP) joint of the left ring finger in ring wearers with rheumatoid arthritis (RA). METHODS: Consecutive patients with RA were recruited. They were classified as ring wearers if they had worn a gold ring on the left ring finger throughout most of the time since disease onset, or as non-ring wearers if they had never worn a gold ring. Standard hand radiographs (with rings removed, where possible) were taken and articular erosion was quantified at the MCP and proximal interphalangeal joints. RESULTS: Thirty ring wearers (27 female) and 25 non-ring wearers (12 female) were included. The median (25th-75th centile) Larsen score in the left hand ring MCP joint of ring wearers was 1.0 (1.0-2.0), which was significantly less than in their equivalent right hand joint (1.0, 1.0-5.0, p = 0.01). It also tended to be less than the equivalent left hand joint of non-ring wearers (4.0, 1.0-5.0, p = 0.06), with a similar but significant difference observed at the adjacent middle finger MCP joint (p = 0.01). CONCLUSIONS: The results of this preliminary study suggest that there may be less articular erosion at the left hand ring, and perhaps adjacent, MCP joints observed in ring wearers with RA. These data support the hypothesis that gold could pass from a gold ring through skin and local lymphatics 'downstream' to nearby MCP joint in sufficient quantities to delay articular erosion.

Arthritis↗
PubMed1995

Use of interferon-2 alpha in the treatment of cryoglobulinaemic leg ulcers.

We report three cases of leg ulcers complicating cryoglobulinaemia which resisted conventional therapy but responded to interferon-2 alpha. All three cases improved with the complete resolution of painful vasculitic lesions and healing of deep ulcers. The dose of interferon to produce ulcer healing was determined by individual response with escalation of the daily dose to 4.5 x 10(6) units per day required in one case. A lower dose of maintenance interferon could be used to prevent subsequent relapses of disease.

Adult↗
PubMed1994

C3 nephritic factor and SLE: report of four cases and review of the literature.

We present four patients with C3 nephritic factor associated with partial lipodystrophy and/or mesangiocapillary glomerulonephritis type II. Each of these patients subsequently developed features of SLE, with an onset between 2 and 24 years after the development of the lipodystrophy or glomerulonephritis. All four patients had antinuclear antibodies and three of the four had anti-Ro antibodies. These patients bring to six the number of reported cases of this association. Possible explanations for the link between these two conditions are discussed.

Adult↗
PubMed1993

Gender, depression, and ankylosing spondylitis.

Depression has been established as a common reaction to rheumatoid arthritis but has rarely been investigated among people with other forms of arthritis. The present study examined the prevalence and determinants of depressive symptoms in people with ankylosing spondylitis, focusing on gender differences and set in the context of widely held medical views concerning the psychosocial nature of ankylosing spondylitis patients. Results showed that approximately one third of the ankylosing spondylitis patients reported a high level of depressive symptoms and that women reported more depression than men. No evidence was found to support the stereotype of the "typical" ankylosing spondylitis patient as being less depressed than people with other forms of arthritis. Pain was found to be a major determinant of depression for women, but was of lesser importance for men. The implications of these findings are discussed.

Adult↗
PubMed1993

Health locus of control, self-help and treatment adherence in relation to ankylosing spondylitis patients.

Ankylosing spondylitis (AS) is a form of arthritis characterised by an early onset and an active style of treatment involving regular exercise. Self-help groups for AS patients have developed in many countries as a means of promoting exercise treatment. The empirical section presents a comparative study of members and non-members of such groups along psychosocial dimensions including health locus of control, social support, and health behaviour. Self-help group members were distinguished by a combination of factors including a low reliance on powerful others health locus of control beliefs, greater satisfaction with available support, and increased frequency of exercise. A subsample showed improvements on physiological measurements over a 6-month period. The utility of including psychosocial variables in examination of rheumatic diseases is discussed and practical implications of these findings for health care professionals and future research are considered.

Adult↗
PubMed1989

IgA-alpha 1 antitrypsin complexes in ankylosing spondylitis.

A study of 95 serum samples from 61 patients with ankylosing spondylitis (AS) showed that 21 patients (34%) had raised levels of IgA-alpha 1 antitrypsin complexes. These were associated with active disease as measured by a clinical index and also with erythrocyte sedimentation rate, C reactive protein, and serum IgA. In particular, an association was noted between 'extraspinal' manifestations of AS such as synovitis, uveitis, and active inflammatory properties of these complexes. It is suggested that these complexes may have a role in the pathogenesis of such clinical manifestations.

Adult↗
PubMed1988

Parasymphyseal and associated insufficiency fractures of the pelvis and sacrum.

Eleven post-menopausal women presenting with a parasymphyseal insufficiency fracture of the pubis are reported. The plain radiographs showed delayed healing with a mixed lytic and sclerotic area developed at the fracture site simulating a malignant lesion. Aetiological factors included post-menopausal osteoporosis, rheumatoid arthritis and steroid therapy, previous hip replacement and pelvic radiotherapy. Ten patients had concomitant fractures of the pelvis, including nine with sacral fractures. These were all initially missed on presentation because of the subtle radiographic signs of a longitudinal band of sclerosis, usually bilaterally, in the sacral ala. Bone scanning was shown to be the most sensitive technique in detecting the sacral fractures by demonstrating increased uptake in the sacral ala as well as the other fractures of the pelvis. Computed tomography in three cases was helpful in confirming the presence of fractures and excluding the possibility of malignancy.

Aged↗
PubMed1985

Fenclofenac-induced selective IgA deficiency in rheumatoid arthritis.

A 35-year-old man with seropositive rheumatoid arthritis developed selective IgA deficiency during treatment with fenclofenac. His arthritis remained quiescent while taking the drug and following its withdrawal his condition relapsed and his serum IgA level returned to normal. This case demonstrates the association of selective IgA deficiency with remission in rheumatoid arthritis induced by fenclofenac as well as aurothiomalate and sulphasalazine. It also shows severe relapse after withdrawal of fenclofenac.

Adult↗
PubMed1985

Ultrastructural changes in the rectal mucosa of patients with rheumatoid arthritis.

The rectal mucosa from patients with severe rheumatoid arthritis has been examined by electron microscopy. Initially the patients were biopsied for investigation into the diagnosis of amyloidosis or vasculitis, which proved to be negative. A range of ultrastructural abnormalities was found which included proliferation of the rough endoplasmic reticulum, mitochondrial inclusions, association of the mitochondria with cytoplasmic filaments, and marked increase in the number of iron containing siderosomes. Most of these abnormalities have already been reported in rheumatoid synovial tissue, and attention is drawn to the similarity in findings between these two sites.

Adult↗
PubMed1984

Septic arthritis and thigh abscess after dilatation and curettage.

A previously fit 57-year old housewife who developed a septic arthritis of the right knee and abscess in the right thigh after dilatation and curettage is described. This is the first report of joint and soft tissue complications occurring together after this procedure. Despite antibiotic therapy which eradicated the joint infection, the abscess required surgical intervention. This illustrates the potential morbidity of septic complications after a minor surgical procedure.

Abscess↗