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Biomedical subjects

G R Struthers

Publications and source records attributed to G R Struthers.

28 records · Page 2Linked to original sources
PubMed1984

Progression of radiological changes in rheumatoid arthritis.

A prospective study over one year of patients who had active rheumatoid arthritis discovered 64 who had received treatment for an adequate time with second-line drugs. In these patients there was evidence of continuing joint destruction as shown by radiological progression. During the year there were highly significant correlations between improvements in clinical and laboratory measurements, but neither group of tests was related to the degree of radiological change. However, in the second 6 months of treatment there was evidence that radiological progression was reduced. In a second prospective study of 88 patients with rheumatoid arthritis given prolonged, intensive therapy with second-line drugs and followed up for 10 years two-thirds showed radiological progression. However, the number of joints damaged per year fell significantly during the study period. There was a divergence between deterioration in radiological features and improvements in the ESR and functional capacity, though patients with a persistently low ESR had less radiological progression. These studies provide evidence that treatment may be associated with a reduced rate of radiological progression but suggest that changes in radiological progression and clinical and laboratory measurements may result from different mechanisms.

Adult↗
PubMed1984

Whipple's disease diagnosed at hip arthroplasty.

A patient is reported with a six-year history of seronegative inflammatory arthritis, lymphadenopathy, and a rash. Many investigations, including repeat jejunal and synovial needle biopsies, failed to establish the diagnosis. Eventually right hip destruction led to arthroplasty. Synovial membrane obtained at operation was examined by electron microscopy and organisms were found with the morphological characteristics of those in patients where the diagnosis was firmly established as Whipple's disease. We propose that Whipple's disease should be seriously considered as a rare but distinct and treatable possibility in the differential diagnosis of seronegative inflammatory arthritis.

Adult↗
PubMed1983

The assessment of radiological changes in the hands and wrists in rheumatoid arthritis.

Two methods of assessing changes in hand and wrist radiographs, the Larsen Index and Amos Index, were compared and contrasted in 48 patients with rheumatoid arthritis (RA). X-rays were taken before and after 1 year of treatment with remission-inducing drugs and scored independently by three observers using both methods. Single readings of radiographs using the Larsen Index were highly reproducible (intra- and inter-observer correlations greater than 0.90 on all occasions), but reproducibility fell when changes were determined from paired films (intra- and inter-observer correlations 0.47-0.82). Variability was greatest in the proximal interphalangeal and wrist joints. The Amos Index, which assesses erosive progression and not the appearance of single films, was more reproducible (intra- and inter-observer correlations 0.72-0.94); it would therefore be better able to detect small changes in groups of patients. The scoring systems were significantly correlated (r = 0.63; P less than 0.001), and with both different observers scored the films at the same "level'. The Amos Index is simple, reproducible, and does not require standard films. It is the assessment of choice.

Adult↗
PubMed1983

The use of 'alternative treatments' by patients with rheumatoid arthritis.

In a study of 199 patients with rheumatoid arthritis, 68% were found to have tried 'alternative treatments'. Some treatments (acupuncture and faith healing) gave subjective benefit in nearly half those who tried them and were considered to be better than others (such as copper bracelets). No adverse reactions were reported. 'Alternative treatments' play an important role as self prescribed therapy in rheumatoid arthritis and their use should not be ignored nor underestimated.

Acupuncture Therapy↗
PubMed1983

Musculoskeletal disorders in patients with hyperlipidaemia.

We have assessed the nature and significance of musculoskeletal disorders in 166 patients with the commonly encountered forms of hyperlipidaemia attending a lipid clinic. The incidence of musculoskeletal disorders was determined by questionnaire to the patients, inquiries to general practitioners, and a review of hospital records. To ensure the sensitivity of these methods a series of negatively responding cases were seen and examined; none had identifiable musculoskeletal disease. Eight males with type IV hyperlipidaemia had recurrent acute attacks of gout. The only other musculoskeletal disorder possibly attributable to an association with hyperlipidaemia was a transient polyarthritis in 3 patients. This was inflammatory, recurrent, but nondeforming, and involved the small joints of the hand. It did not require any specific therapy or lead to disability. We suggest that, while we have confirmed the association of type IV hyperlipidaemia and gout, there is little evidence for clinically significant arthritis being associated with other commonly presenting forms of hyperlipidaemia, although we accept that the rarely met homozygous familial hypercholesterolaemia may also be complicated by a crystal arthropathy due to the presence of crystalline cholesterol in joints.

Arthritis↗
PubMed1982

Basophils, histamine and gastric acid secretin in chronic myeloproliferative disorders.

Fourteen patients with polycythaemia rubra vera (PRV) and four with chronic granulocytic leukaemia (CGL) were studied to examine the relationship between basophil counts, blood histamine, gastric acid secretion and dyspepsia or peptic ulceration. Basophil counts and blood histamine were markedly raised in untreated CGL but only marginally increased in other cases. Blood histamine and basophil counts were well correlated. Gastric acid secretion was normal in 10 out of 11 cases, and did not correlate with blood histamine values. The previously reported high incidence of dyspepsia and peptic ulceration is examined and its mechanisms are discussed.

Basophils↗