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Biomedical subjects

P Hickling

Publications and source records attributed to P Hickling.

16 recordsLinked to original sources

Myocardial dysfunction in ankylosing spondylitis.

Echocardiographic evidence has suggested abnormalities of the myocardial function in patients with ankylosing spondylitis. In this work the cardiac function in patients with ankylosing spondylitis and in normal volunteers was evaluated. Twenty four normal volunteers and 21 patients with ankylosing spondylitis aged 18-45 were studied. None had overt cardiac disease. Cardiac function was assessed at rest with echocardiography, at rest and during supine bicycle exercise using radionuclide angiography in the left anterior oblique position following equilibration with 740 MBq of technetium-99. The subjects undertook supine bicycle exercise with 30 W increments every three minutes to the point of fatigue. Comparison of data from normal volunteers and patients with ankylosing spondylitis were made using Student's t test for independent samples or the Mann-Whitney non-parametric technique, as appropriate. Subjects were matched for age, sex, height, and weight. There were no echocardiographic differences; however, global nuclide left ventricular function showed several differences between normal volunteers and patients with ankylosing spondylitis. The peak filling rate during exercise was significantly lower in patients with ankylosing spondylitis: normal volunteers 6.5 (SD 1.2); patients with ankylosing spondylitis 5.7 (1.2). The time to reach peak filling during exercise was significantly lower in patients with ankylosing spondylitis: normal volunteers 102 (22); patients with ankylosing spondylitis 120 (23). Regional analysis also showed differences between patients with ankylosing spondylitis and normal volunteers both at rest and during exercise. In the anteroseptal region the filling fraction and peak filling rate were significantly lower in patients with ankylosing spondylitis. Most of the differences (although not all) were in the variables of diastolic function. This study shows that there are subtle abnormalities in cardiac function in patients with ankylosing spondylitis. The major abnormalities are in the diastolic function, suggesting a decrease in left ventricular compliance.

Adult

A comparison of glutathione reductase and glutathione peroxidase activities in patients with rheumatoid arthritis and healthy adults.

A 30% increase in erythrocyte glutathione peroxidase (GP) activity was found in patients with rheumatoid arthritis when compared with healthy controls (p = 0.001) whereas the increase in glutathione reductase (GR) was statistically insignificant. No correlation was found between the activities of the enzymes and the erythrocyte sedimentation rate (ESR). The enzyme activities were independent of age, sex, or type of drug treatment of the patients. A possible interpretation of the results is presented.

Adult

Prospective comparison of laser nephelometry with standard agglutination techniques for detection of rheumatoid factor.

IgM rheumatoid factor was assayed by three routine methods: latex fixation; haemagglutination; and end point laser nephelometry in 69 patients with definite or classical rheumatoid arthritis and 58 patients with other non-rheumatoid arthropathies, selected prospectively according to the American Rheumatism Association clinical criteria. The operators of the assays were unaware of the clinical diagnoses. In the group with rheumatoid arthritis 75.4% were positive by latex fixation, 73.9% by haemagglutination, and 55.1% by nephelometry. In the group with non-rheumatoid arthropathies 10.4% were positive by latex fixation, 8.6% by haemagglutination, and 10.4% by nephelometry. Thus the simple and inexpensive latex fixation test was as good as the haemagglutination test, and both were significantly better than nephelometry in the laboratory confirmation of the clinical diagnosis of definite or classic rheumatoid arthritis (chi 2 = 5.40 and 4.56, and p less than 0.025 and less than 0.05, respectively). None of these tests was significantly better or worse than the others in producing positive results in the group with non-rheumatoid arthropathies.

Adolescent

Effect of treatment on erythrocyte phosphoribosyl pyrophosphate synthetase and glutathione reductase activity in patients with primary gout.

The activities of erythrocyte phosphoribosyl pyrophosphate (PRPP) synthetase and glutathione reductase (GTR) were studied in 26 patients with primary gout who were receiving no treatment or treatment with either allopurinol or azapropazone, and compared with the activity in a group of healthy controls. The activity of PRPP synthetase was significantly higher in the gout group and was not influenced by either drug. No significant difference in the activity of GTR was observed. The failure of either drug to suppress the increased activity of PRPP synthetase associated with gout is discussed.

Adult

Ankylosing spondylitis and trauma: the medicolegal implications. A comparative study of patients with non-specific back pain.

Ankylosing spondylitis (AS) arising as a result of injury was reported by five of 113 hospital patients who completed questionnaires on the historical and symptomatic features of their disease. Identical questionnaires were given to a group of 51 patients with non-specific back pain (NSBP) attending an orthopaedic clinic. Five of these patients developed their first symptoms after trauma. A further four patients with ankylosing spondylitis believed that their disease was initiated by injury, however, x-ray photographs showed that they had already developed AS at the time of their injuries. It is suggested that injury does not cause AS but brings it to the patient's attention, possibly through immobilisation, in 7% of hospital cases.

Accidents

Takayasu's disease and bilateral sacroiliitis.

A young woman, with HLA B27 negative bilateral sacroiliitis and subsequent Takayasu's disease is described. It has been previously suggested that there is an association between Takayasu's disease and ankylosing spondylitis. We discuss and dispute this association.

Adult