Conventional and complementary treatment for cancer.
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Biomedical subjects
Publications and source records attributed to J Cosh.
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We report 8 cases of complete heart block (CHB) occurring in patients with rheumatoid arthritis and review 20 similar patients previously reported. Complete heart block occurs generally in patients with established erosive nodular rheumatoid disease. It usually appears to be sudden and permanent, but progression from minor conduction delays is not uncommon. The characteristic histopathological finding is a rheumatoid granuloma in or near the AV node or bundle of His. If syncope or Stokes-Adams attacks occur, the treatment of choice is the insertion of a permanent pacemaker. The prognosis is good provided no other cardiac lesions occur, whether pericardial, valvular, or myocardial.
A double-blind, placebo controlled, crossover trial of 20 and 40 mg of xipamid once daily in the treatment of mild to moderate hypertension is reported and some of the difficulties and pitfalls of multicentre trials of this type are described. 2 Both doses were significantly more effective in reducing the blood pressure than the placebo and neither was superior to the other. Both produced some potassium loss. Xipamid acted for at least 22 h and was effective in up to 83% of the patients. 3 Further trials are suggested to investigate the activity of a lower dose than 20 mg.
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The proteinase cathepsin D which degrades proteoglycan was never demonstrated in extracellular sites in tissues from patients with traumatized meniscoid cartilage, either before or after culture with an antiserum to human cathepsin D. In contrast, in synovia (but not usually cartilage) from the knees of 6 of 11 rheumatoid patients, extracellular cathepsin D was commonly detected by culturing tissues with an antiserum to this enzyme.