Granulocyte colony stimulating factor in drug-induced agranulocytosis.
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Biomedical subjects
Publications and source records attributed to P L Boardman.
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Whipple's disease is a rare multisystem disorder which may affect the lungs and pleurae. Four men with Whipple's disease are described. All developed dyspnoea and pleuritic chest pain and three had a chronic cough. Lung function tests in three patients showed reduced lung volumes. Chest radiographic changes included pleural adhesions, small lung volumes and nodular shadowing. In three patients treatment of the Whipple's disease resulted in resulted in resolution of the disabling breathlessness, thus underlining the importance of recognising this feature of the disease. Although intestinal and joint manifestations of Whipple's disease are attributed to intracellular infection, the respiratory manifestations may be due to an inflammatory reaction to locally deposited immune complexes containing bacterial antigens.
A double-blind trial compared diclofenac with placebo in 44 outpatients. On from each group dropped out with dyspepsia, and one (placebo group) with ineffective treatment. Twenty completers received diclofenac. Dosage was one tablet (25 mg diclofenac) three times daily during the first week. In the second (final) week, most patients had four or six tablets. Diclofenac had significantly greater effect on pain, grip, morning stiffness, joint tenderness and swelling, and in comparison to previous treatments, even though the placebo group required significantly more rescue anaglesic. A few patients in each group had slight dyspepsia. One in the active and six in the placebo group complained of minor central nervous system symptoms. There were no serious side-effects. Haematological, biochemical and urinary analyses showed no clinically important changes. It is concluded that, in the short term, diclofenac (Voltarol) is effective in relieving the symptoms of inflammatory polyarthritis. It is well tolerated as placebo medication, and had no detrimental haematological or biochemical effects.
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Five patients with fascioliasis presented with malaise, pruritus, and pain in the right hypochondrium. Eosinophilia, increase in serum gamma globulin, and pyrexia were other features. Four patients treated with oral bithionol recovered completely and it is suggested that this is an effective form of therapy. The double diffusion precipitin test, being speedy and simple, was used as a screening procedure for diagnosis. The source of infection was wild watercress growing in a farm ditch.
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