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Biomedical subjects

K Chakravarty

Publications and source records attributed to K Chakravarty.

At least 37 records · Page 2Linked to original sources
PubMed1996

A simple algorithm to predict the development of radiological erosions in patients with early rheumatoid arthritis: prospective cohort study.

OBJECTIVE: To produce a practical algorithm to predict which patients with early rheumatoid arthritis will develop radiological erosions. DESIGN: Primary care based prospective cohort study. SETTING: All general practices in the Norwich Health Authority, Norfolk. SUBJECTS: 175 patients notified to the Norfolk Arthritis Register were visited by a metrologist soon after they had presented to their general practitioners with inflammatory polyarthritis, and again after a further 12 months. All the patients satisfied the American Rheumatism Association's 1987 criteria for rheumatoid arthritis and were seen by a metrologist within six months of the onset of symptoms. The study population was randomly split into a prediction sample (n = 105) for generating the algorithm and a validation sample (n = 70) for testing it. MAIN OUTCOME MEASURES: Predictor variables measured at baseline included rheumatoid factor status, swelling of specific joint areas, duration of morning stiffness, nodules, disability score, age, sex, and disease duration when the patient first presented. The outcome variable was the presence of radiological erosions in the hands or feet, or both, after 12 months. RESULTS: A simple algorithm based on a combination of three variables--a positive rheumatoid factor test, swelling of at least two large joints, and a disease duration of more than three months--was best able to predict erosions. When the accuracy of this algorithm was tested with the validation sample, the erosion status of 79% of patients was predicted correctly. CONCLUSIONS: A simple algorithm based on three easily measured items of information can predict which patients are at high risk and which are at low risk of developing radiological erosions.

Adult↗
PubMed1996

Monoclonal antibody therapy of diffuse cutaneous scleroderma with CAMPATH-1H.

A worker in a polyvinyl chloride factory with rapidly progressive diffuse cutaneous scleroderma was treated with the humanized monoclonal antibody (Mab) CAMPATH-1H. Treatment was followed by rapid and substantial improvement in skin score, which was maintained during followup without additional therapy. The mode of action of CAMPATH-1H and its relationship to clinical improvement are discussed.

Adult↗
PubMed1995

Activity and stability of Bacillus cereus penicillinase entrapped in aerosol OT reverse micelles.

The kinetics of enzyme catalyzed hydrolysis of penicillin G and stability of the enzyme alpha-penicillinase, entrapped in aerosol OT reverse micellar droplets have been investigated spectrophotometrically. Various physical parameters, such as, water pool size (related to Wo), pH and temperature, were optimized for maximum activity of penicillinase in water/aerosol OT/isooctane reverse micelles. The enzyme showed maximum activity of Wo - 14 and pH, 7.0. At any temperature the enzyme was to be more active in reverse micelles than in aqueous solution. At optimum conditions of Wo, pH and temperature the enzyme was 100% more active in reverse micelles than its maximum activity in aqueous solution. In both the systems, the activity starts falling at and above 25 degrees C. CD Spectral studies showed that the enzyme in reverse micelles possesses more helical structure than it has in aqueous solution and at the optimum conditions in which it showed maximum activity, the alpha-helicity was also maximum. The enzyme was very stable in reverse micelles at and above room temperature compared to the same in aqueous solution.

Bacillus cereus↗
PubMed1995

A longitudinal study of anticardiolipin antibody in polymyalgia rheumatica and giant cell arteritis.

OBJECTIVE: To determine the incidence of elevated levels of anticardiolipin antibody (aCL) in patients with newly diagnosed polymyalgia rheumatica (PMR) and/or giant cell arteritis (GCA); and to determine the relationship between these antibodies at diagnosis and subsequent course of the disease over a period of 2 yrs. METHODS: Ninety-eight consecutive patients with PMR and/or GCA were examined for the presence of aCL, at presentation and every 6 mo for 2 yrs. Sixty-four patients had PMR alone, 22 had coexistent PMR and GCA, and 12 presented with pure GCA. Patients presenting with suspected clinical diagnosis, overt or covert, of GCA were subjected to temporal artery biopsy from the symptomatic side within 3 days of presentation. Appropriate serological, biochemical, and hematological investigations were undertaken at presentation and subsequently at times of periodic assessments. One hundred healthy age and sex matched elderly subjects were also screened for the presence of aCL as a control group. RESULTS: Elevated levels of aCL were detected in 20 patients at presentation. These included 9 patients with PMR/GCA and 11 patients with pure PMR. During followup, 10 patients with pure PMR at presentation developed GCA. These comprised 5 of the 11 patients with high aCL at presentation and 5 of the 53 patients with normal levels of aCL at presentation. This was statistically significant with relative risk (4.82, 95% CI, 1.72-13.51) of developing GCA in the presence of PMR and a high aCL at presentation. Furthermore, 3 of the 5 patients with pure GCA and high aCL at presentation progressed to severe vascular complications (stroke, 2; anterior ischemic optic neuritis, 1) compared to none of the other patients in the study. Elevated levels of antineutrophilic cytoplasmic antibody were also analyzed and detected in only 4 patients, 3 with pure PMR and one with biopsy proven GCA. CONCLUSION: This prospective study suggests that a significant number of patients with PMR and/or GCA with elevated levels of aCL at presentation have increased risk of developing GCA or other major vascular complications. It is possible that aCL may be an independent prognostic marker for future vascular complications in patients with PMR and/or GCA.

Aged↗
PubMed1994

A district audit on the management of polymyalgia rheumatica and giant cell arteritis.

Twenty-one hospital consultants, representing 20% of the hospital specialists and 54 general practitioners representing 22% of the general practitioners in the Norwich Health District were circulated a questionnaire on the management of polymyalgia rheumatica and giant cell arteritis, as part of a departmental audit. The wide variations in the diagnosis and treatment of these two common conditions are shown in this study. Appropriate recommendations have been made for these two common conditions in the hope of providing a useful guideline for more uniform and effective therapy. We intend to repeat this study at a later date to assess if any of the recommendations have been undertaken successfully.

Family Practice↗
PubMed1994

A randomized controlled study of post-injection rest following intra-articular steroid therapy for knee synovitis.

In order to assess the effect of 24 h observed bed rest following intra-articular steroid injection of the knee joint in patients with an inflammatory arthritis such as RA, AS or colitic arthropathy, 91 patients with inflammatory arthritis of one knee joint were randomized to receive 24 h bed rest in hospital following intra-articular steroid injection or were injected in outpatients. The clinical and laboratory assessments such as pain and stiffness on a 10-cm visual analogue scale, knee circumference (cm), 50 ft walking time (s), CRP and ESR were measured before receiving the steroid injection and at 3, 6, 12 and 24 weeks. Both groups of patients improved clinically and serologically at 3 weeks. By 12 weeks the degree of improvement in the pain score, stiffness score, knee circumference, 50 ft walking time and CRP was better in the rest group and these differences persisted to 24 weeks. For each outcome variable the summary measure of response was significantly better in the rest group compared to the no rest group. Intra-articular steroid injection of the knee joint followed by strict i inpatient bed rest for 24 h results in a greater degree of clinical and serological improvement, compared to routine outpatient injections for up to 6 months. It is therefore possible that 24-h post-injection rest will result in a prolonged duration of clinical response and reduce the need for frequent steroid injections and the risk of complications.

Adult↗
PubMed1994

A single infusion of bisphosphonate AHPrBP in the treatment of Paget's disease of bone.

OBJECTIVE: To assess the efficacy of single infusion of bisphosphonate AHPrPB (APD) (60 mg) in active Paget's disease of bone. METHODS: Twenty-six patients with symptomatic Paget's disease of bone were treated with a single infusion of APD (60 mg) over 12 h and were assessed for clinical as well as biochemical improvement for a mean period of 2 years. Treatments were repeated if relapse occurred during followup. RESULTS: Bone pain improved in 92% of patients within one month and over 76% of patients had no pain at 6 months. Serum alkaline phosphatase fell to normal level in 78% of patients at 6 months and about 77% at one year. Further treatment with intravenous (iv) APD (60 mg) was given for relapse in 7 patients at one year, 13 at 18 months and 2 at 24 months. CONCLUSION: Our prospective study demonstrates that 60 mg APD given iv is an effective, simple, safe and less expensive treatment for active Paget's disease of bone and this therapy may well be given in a daycare unit or an outpatient setting.

Aged↗
PubMed1993

Three flavone glycosides from Gelonium multiflorum.

Two new flavone diglycosides along with 7,4'-O-dimethylscuttelarein 6-O-beta-D-glucopyranoside, a known glycoside, were isolated from the seeds of Gelonium multiflorum and their structures were elucidated as 7,4'-O-dimethylscuttelarein 6-O-alpha-L-rhamnopyranosyl(1-->2)-beta-D-glucopyranoside and 6-O-beta-D-xylopyranosyl(1-->2)-beta-D-glucopyranoside.

Carbohydrate Sequence↗
PubMed1993

Cervical spondylotic myelopathy with occult foramen magnum meningioma--a case for MRI?

A fatal case of occult foramen magnum meningioma is described which presented with features of cervical myelopathy confirmed by cervical myelogram. Surgical decompression led to initial improvement followed by progressive deterioration and death. Postmortem examination revealed a 4 cm diameter foramen magnum meningioma. The dangers of using only standard radiographic investigations of the cervical cord are discussed.

Aged↗