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Biomedical subjects

J Kirwan

Publications and source records attributed to J Kirwan.

48 records · Page 3Linked to original sources
PubMed1993

The course of established ankylosing spondylitis and the effects of sulphasalazine over 3 years.

A 3-year placebo-controlled trial of sulphasalazine (SASP) in 89 patients with established AS (including radiological sacroiliitis) showed a reduced frequency of peripheral arthritis in the treated group but did not show any definite benefit in the maintenance of spinal mobility. Adverse effects causing treatment withdrawal occurred in five placebo-treated patients and eight SASP-treated patients, but 22 patients preferred to stop taking daily medication of unproven benefit for the full 3 years. The natural history of established AS suggested two groups of patients: the majority with principally spinal symptoms and infrequent peripheral arthritis or iritis, and a minority who tend to have recurrent extra-spinal problems.

Adult↗
PubMed1993

Prediction of the progression of joint space narrowing in osteoarthritis of the knee by bone scintigraphy.

OBJECTIVES: To test the hypothesis that bone scintigraphy will predict the outcome of osteoarthritis (OA) of the knee joint. METHODS: Ninety four patients (65 women, 29 men; mean age 64.2 years) with established OA of one or both knee joints were examined in 1986, when radiographs and bone scan images (early and late phase) were also obtained. The patients were recalled, re-examined, and had further radiographs taken in 1991. Paired entry and outcome radiographs were read by a single observer, blinded to date order and other data. Scan findings and other entry variables were related to outcome. Progression of OA of the knee was defined as an operation on the knee or a decrease in the tibiofemoral joint space of 2 mm or more. RESULTS: Over the five year study period 10 patients died and nine were lost to follow up. Fifteen had an operation on one or both knees (22 knees). Of the remaining 120 knees (60 patients) analysed radiographically, 14 (12%) had progressed in the manner defined. Of 32 knees with severe scan abnormalities, 28 (88%) showed progression, whereas none of the 55 knees with no scan abnormality at entry progressed. The strong negative predictive power of scintigraphy could not be accounted for by disease severity or any combination of entry variables. Pain severity predicted a subsequent operation, but age, sex, symptom duration, and obesity had no predictive value. CONCLUSIONS: Scintigraphy predicts subsequent loss of joint space in patients with established OA of the knee joint. This is the first description of a powerful predictor of change in this disease. The finding suggests that the activity of the subchondral bone may determine loss of cartilage.

Female↗
PubMed1992

Seronegative systemic lupus erythematosus.

We have presented a patient with severe clinical SLE but negative serological tests. This diagnostic difficulty, together with a presentation limited to the skin and an initial response to high dose steroids probably lead to a delay in starting immunosuppression. The finding of a retinopathy was important in deciding on therapy. An excellent response to immunosuppression was seen, with full recovery.

Adult↗
PubMed1992

Increasing age at presentation for patients with ankylosing spondylitis.

An analysis of the age at first presentation was undertaken in patients with ankylosing spondylitis and mechanical back pain seen at the London Hospital department of rheumatology between 1952 and 1983. There was a significant positive correlation with the calendar year of presentation in the patients with ankylosing spondylitis but a negative correlation in those with mechanical back pain. An increasing age at presentation in ankylosing spondylitis is likely to be due to an increasing age at disease onset--all anticipated biases would act in the opposite direction. This observation in a prospective study supports the findings of other studies using different epidemiological techniques.

Adult↗
PubMed1990

Clinical assessment of osteoarthritis of the knee.

The repeatability of physical signs used to assess osteoarthritis of the knee has not been systematically examined. The within and between observer variation of 10 commonly used physical signs to determine osteoarthritis of the knee has been assessed here. The results obtained show variation in the repeatability of these signs. For those examining the tibiofemoral joints the repeatability was greater than for those examining the patellofemoral joint. It would therefore seem vital to take note of the repeatability of physical signs in determining the number of subjects to be studied in epidemiological studies and therapeutic studies in osteoarthritis.

Female↗
PubMed1987

Muscle fiber composition and enzyme activities in elite female distance runners.

This study has attempted to describe the fiber composition and respiratory potential in the leg (gastrocnemius) muscle of highly trained, elite female distance runners. As noted, many of these women were competing successfully in middle-distance (1500-3000 m) rather than long distance (10 km and marathon) events. This fact appears to explain many of the differences observed between these "elite female runners" and the "elite male runners" studied in the 1975 Dallas study (6). With the exception of differences in muscle fiber areas, the female runners appear to show the same enzyme adaptations to endurance training that have been reported for male runners. The most notable finding of this study was the remarkable similarity of muscle fiber composition and enzyme activity for male and female runners when matched according to their preferred competitive distance.

Capillaries↗
PubMed1985

Serum creatine kinase activity following forearm flexion isometric exercise.

The purpose of this study was to compare serum creatine kinase (CK) activity following two forearm flexion isometric exercise regimens differing in work to rest ratio, and examine the CK response to a repeated bout of isometric exercise. Eleven males were tested on two sessions (bouts) spaced 1 week apart. For bout 1, five subjects (group A) performed a forearm flexion isometric exercise consisting of 40 10-s maximal contractions with 20-s inter-trial rests (10:20), while six (group B) performed 40 maximal 10-s contractions with 5-s inter-trial rests (10:5). The increase in serum CK activity following the 10:20 exercise (143%) was significantly greater than that following the 10:5 exercise (52%). The 10:20 exercise was also associated with greater tension generation over trials. One week later, both groups performed a bout of 10:20 exercise. A substantial reduction in the serum CK response was found following this second bout. The data suggest that for bout 1 the isometric exercise associated with the greater overall tension levels resulted in the greater CK response. However, when the 10:20 exercise was repeated 1 week later, a substantial reduction in the CK response was found which was unrelated to the tension generated.

Adult↗
PubMed1985

Energy expenditure during front crawl swimming: predicting success in middle-distance events.

Male (n = 25) and female (n = 14) competitive swimmers were studied during tethered (breaststroke) and free (front crawl) swimming to determine the validity of calculating exercise oxygen uptake (VO2) from expired gas samples taken immediately after the activity. Based on a single 20-s recovery VO2, the swimmers' VO2 max was correlated with performance in a 400-yd (365.8-m) front crawl swim. The best predictors of VO2 max for trained swimmers were lean body weight and stroke index (r = 0.97). The single best predictor of performance in the 365.8-m front crawl swim was the distance per stroke (r = 0.88), whereas the combination of distance per stroke and VO2 max (ml/kg LBW/min) correlated 0.97 with performance in the swim. This study demonstrates that it is possible to accurately determine the VO2 during maximal and submaximal swimming using a single, 20-s expired gas collection taken immediately after a 4-7 min swim. These findings demonstrate the importance of stroke technique on the energy cost and variations in performance during competitive swimming.

Adolescent↗
PubMed1981

Prolonged reduction in polymorphonuclear adhesion following oral colchicine.

Polymorphonuclear leucocyte (PMN) function was studied in 7 healthy subjects before and after 5 mg of colchicine taken in divided doses over 24 hours. Mean adherence to nylon fibre colums fell from a pretreatment level of 51% to 33.6% by day 1, remained low (31.8%) at day 5, and returned to pretreatment levels only by about day 9. Random motility (agarose plate method) fell from 932 micrometers to 688 micrometers by day 1, but had returned to normal by day 5. Directed migration and the phagocytic index (opsonised Candida albicans method) were not affected by colchicine treatment. In this marked and prolonged reduction in PMN adhesion implies an influence on maturing PMN precursors in bone marrow. Adherence to nylon fibres may reflect in-vivo properties of PMN which are important in the pathogenesis of acute gouty arthritis.

Administration, Oral↗