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Biomedical subjects

L Fernandes

Publications and source records attributed to L Fernandes.

At least 19 recordsLinked to original sources
PubMed1991

Treatment of polymyalgia rheumatica with intramuscular injections of depot methylprednisolone.

Although the treatment of patients with polymyalgia rheumatica by corticosteroids given by mouth is effective, it is often accompanied by multiple side effects. Various studies have shown that the steroid related complications are proportional to the cumulative dose of steroids administered. In a prospective study of 16 patients with polymyalgia rheumatica the effects of regular intramuscular injections of methylprednisolone over 12 months were evaluated. Remission of disease was achieved with injections of 120 mg of methylprednisolone every three weeks for 12 weeks. Subsequent disease remission was maintained by monthly injections of methylprednisolone on a reducing schedule of dose. The treatment was efficacious, safe, well tolerated over one year, and showed no suppression of the hypothalamic pituitary adrenal axis at 12 weeks after initiation of treatment. Such a mode of steroid treatment results in a considerably lower cumulative steroid dose than with conventional doses of prednisolone given by mouth. These results will be further evaluated in a controlled trial using intramuscular injections of methylprednisolone and prednisolone given by mouth for the treatment of polymyalgia rheumatica.

Delayed-Action Preparations↗
PubMed1989

IgA rheumatoid factor and IgG dietary protein antibodies are associated in rheumatoid arthritis.

This study sought to determine whether patients with rheumatoid arthritis (RA) were immunologically sensitised to dietary protein (DP). Using an enzyme linked immunosorbent assay (ELISA), antibodies to milk and wheat proteins were measured in 93 unselected out-patients with classical or definite RA. Of these 93, 53 had raised levels of IgG antibodies to one or both dietary proteins (DP). In the DP antibody positive group, 48 patients (90%) also had raised levels of IgA rheumatoid factor (measured by ELISA) while only 7 (17%) of the 40 DP antibody negative patients had detectable IgA RF; P less than 0.02. There was no association between IgM rheumatoid factor and dietary protein antibodies. These results demonstrate that in RA, raised levels of IgA RF are associated with an increased IgG response to antigens which enter the body through the gastrointestinal tract. A breakdown in gastrointestinal tolerance to dietary antigens may play a role in the immunopathogenesis of RA in these patients who might therefore benefit from dietary manipulation.

Adult↗
PubMed1988

Association between villous atrophy in rheumatoid arthritis and a rheumatoid factor and gliadin-specific IgG.

93 patients with rheumatoid arthritis (RA) were examined for histological or other evidence of gut abnormalities. 44 had raised levels of IgG to gliadin, and of these 38 (86%) were also positive for IgA rheumatoid factor (RF). 24 patients (15 with raised levels of IgA RF and wheat protein IgG [AB+] and 9 with normal levels of both antibodies [AB-]) underwent jejunal biopsy. 6 of the AB+ and 1 of the AB- patients had villous atrophy. The AB+ group had lower villous surface/volume ratio and small intestinal lactase concentrations than did the AB- group or age-matched controls. There was no significant difference between the two groups of RA patients in disease severity or treatment regimen. The findings suggest that the gut may play a more important part in the immunopathogenesis of some cases of RA than in others, and that the former may be identified by raised levels of IgA RF and wheat protein IgG.

Adolescent↗
PubMed1988

A study of the hypouricaemic effect of tiaprofenic acid.

Tiaprofenic acid is a non-steroidal anti-inflammatory drug which also has hypouriceamic effect. Studies involving 10 healthy volunteers were designed to investigate the mode of this effect. We postulate that the site of action of tiaprofenic acid is at the cell membrane, the mechanism being an interference with the transport of uric acid from intra- to extra-cellular fluid thus limiting its passage into the plasma. The same mechanism acting on renal tubular cells impedes reabsorption thereby increasing uric acid clearance.

Adult↗
PubMed1986

The TRH test in rats with chronic Chagas disease.

TRH was studied in rats with chronic Chagas disease. It was found an increased secretion of TSH 60 minutes after intraperitoneal injection of the hypothalamic hormone. T3 and T4 were also decreased in basal conditions. This may indicate a primary hypothyroidism.

Animals↗
PubMed1979

Studies on the frequency and pathogenesis of liver involvement in rheumatoid arthritis.

A systematic prospective survey of 100 outpatients with rheumatoid arthritis revealed that 45 had biochemical evidence of liver disease. In most cases this was due to increases in total serum alkaline phosphatase (ALP) and/or gammaglutamyl transpeptidase (GGT). Examination of serum ALP isoenzyme profiles in 50 of the patients showed that the liver isoenzyme was the sole or major component in 44 patients, including many with normal total ALP levels. 18% had raised serum liver ALP together with raised GGT, suggestive of an underlying hepatobiliary lesion. No correlation could be detected between raised serum levels of liver enzymes and the age or sex of the patient, duration or severity of arthritis, and drug or alcohol history. However, there was a significant correlation between raised serum ALP and lacrimal or salivary gland dysfunction. It is suggested that immunological mechanisms may be involved in the development of hepatic abnormalities in rheumatoid arthritis.

Adult↗
PubMed1978

Indoprofen and naproxen in the treatment of rheumatoid arthritis: a clinical trial.

Thirty-six patients suffering from rheumatoid arthritis took part in a double-blind crossover trial, in which they received either indoprofen 800 mg/day, naproxen 500 mg/day, or a matching placebo. Indoprofen was shown to be significantly superior as an analgesic and in improving grip strength and the patients preferred it. Adverse effects were comparable, although indigestion was seen slightly more often during indoprofen treatment. Indoprofen is therefore at least as effective as existing anti-inflammatory drugs in rheumatoid arthritis and seems to be better tolerated.

Adult↗
PubMed1978

Local anaesthetic nerve block in the treatment of intractable pain from osteoarthritis of the hip.

Previous workers have advocated hip nerve block, with local anaesthetic, in the treatment of intractable pain from osteoarthritis of the hip. In a pilot study we obtained some degree of pain relief in only six of 13 patients. A further double-blind, controlled, randomized trial was undertaken in 31 patients, comparing 0.5% Marcain and normal saline. There was no significant improvement in pain or hip movements in either group over a six-week period.

Aged↗
PubMed1978

Alclofenac and D-penicillamine. Comparative trial in rheumatoid arthritis.

Forty-six patients with rheumatoid arthritis, 22 receiving D-penicillamine and 2j alclofenac, took part in a 6-month single-bind external observer trial to compare the efficacy and toxicity of these drugs in the treatment of severe rheumatoid arthritis. Both drugs were active and similar in their efficacy at 6 months as judged by clinical and laboratory measurements. Penicillamine was active therapeutically by 3 months, one month before alclofenac. 9 patients, 8 on alclofenac and one on D-penicillamine, had to stop treatment because of lack of effect or toxic effects. Skin rashes within the first week of treatment were a major problem with alclofenac and led to 6 withdrawals.

Arthritis, Rheumatoid↗
PubMed1978

Impairment of lachrymal and salivary secretion and cellular immune responses to salivary antigens in rheumatoid arthritis.

During a systematic investigation of 100 unselected outpatients with rheumatoid arthritis, 58 were found to have reduced lachrymal or salivary secretion. No correlation could be detected between the presence or absence of secretory abnormalities and the age or sex of the patient, the presence of nodules or salivary duct antibody, or the occurrence of vasculitis. However, there was a significant correlation between diminished salivary of lachrymal flow and the occurrence of cellular immune responses to a protein fraction of normal human saliva, sensitisation being found in 94% of those with impairment of salivary and lachrymal secretion as compared with 33% of those without.

Aged↗
PubMed1977

Dermatomyositis complicating penicillamine treatment.

A case of dermatomyositis developing during the course of treatment with D-penicillamine in a patient with rheumatoid arthritis is described. Complete remission occurred on withdrawal of the drug. Possible alternative diagnoses are discussed.

Arthritis, Rheumatoid↗
PubMed1977

Plasmalogens in arterial wall.

Plasmalogens have been determined in blood plasma, arterial and myocardial tissue of rats intubated with an atherogenic diet (vitamin D2 + cholesterol). These lipids are significantly decreased in arterial tissue after the administration of these substances for 5 consecutive days. Folic acid involved in the synthesis of plasmalogens and a powerful inhibitor of xanthine oxidase, on the contrary, increases enormously the concentration of plasmalogens in arterial tissue even with an atherogenic diet.

Animals↗