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Biomedical subjects

R D Sturrock

Publications and source records attributed to R D Sturrock.

At least 73 records · Page 4Linked to original sources
PubMed1993

Duodenal histology, ulceration, and Helicobacter pylori in the presence or absence of non-steroidal anti-inflammatory drugs.

Duodenitis and gastric metaplasia, which is often colonised by Helicobacter pylori (H pylori), are increasingly recognised for their importance in the pathogenesis of duodenal ulcers. The situation is not clear in patients receiving non-steroidal anti-inflammatory drugs (NSAIDs), who have a higher risk of peptic ulceration. The aim of this study was to identify the duodenal histological abnormalities in the presence or absence of NSAIDs, H pylori, and duodenal ulceration. Endoscopic duodenal biopsy specimens were taken from healthy looking mucosa of 172 patients (74 took NSAIDs, and 98 did not). Duodenitis was graded according to the degree of neutrophilic and plasma cell infiltration, villus height, Brunner's gland prolapse, and gastric metaplasia. The activity of duodenitis was dependent on the neutrophilic infiltration. A global score covering all the above factors was constructed, and H pylori in both the stomach and duodenum, was also assessed. The results showed that duodenitis with varying degrees of neutrophilic infiltration and gastric metaplasia was found in 20 patients (27%) taking NSAIDs, compared with 56 patients (57%) not taking NSAIDs (chi 2 = 16.24, p < 0.001). This degree of duodenitis was also found in 20 of 25 patients (80%) with duodenal ulcers, regardless of NSAID intake (chi 2 = 15.38, p < 0.001). Gastric metaplasia was identified in 20 patients (27%) receiving NSAIDs and 38 (39%) not receiving NSAIDs. Duodenal H pylori was only seen in patients with gastric metaplasia 10 (50%) receiving NSAIDs, and 34 (89%) not receiving NSAIDs. H pylori positive gastritis, and the combination of active duodenitis and gastric metaplasia were independent predictors of duodenal ulceration. It is concluded that active duodenitis is less common in patients taking NSAIDs but is strongly associated with gastric metaplasia, H pylori positive gastritis, and duodenal ulceration. These findings are relevant to the pathogenesis and treatment of duodenal ulcers in patients taking NSAIDs.

Adult↗
PubMed1993

Cyclosporine A induced colitis and acquired selective IgA deficiency in a patient with juvenile chronic arthritis.

A 12-year-old girl with juvenile chronic arthritis was treated with cyclosporine A for recurrent uveitis. Two years later she presented with weight loss and diarrhea. Investigations suggested drug induced colitis. She improved after withdrawal of cyclosporine and her nonsteroidal antiinflammatory drug. Symptoms recurred on rechallenge with cyclosporine. She has developed a progressive selective IgA deficiency which persists despite cessation of cyclosporine.

Arthritis, Juvenile↗
PubMed1992

Studies of oxidative stress in cellular systems. The interaction of monocytes and erythrocytes.

1H spin echo NMR spectroscopy is used to follow the interaction of intact and viable erythrocytes and monocytes obtained from different sources in mixed cultures. After a lag time (270 min) erythrocyte glutathione is observed to become more oxidised. This result is believed to occur as a consequence of monocyte activation generating hydrogen peroxide or hypochlorous acid, which is targeted at the erythrocyte. The red cell in turn employs its sulphydryl system as an anti-oxidant defence.

Erythrocytes↗
PubMed1992

Clinical analysis by 1H spin-echo NMR. 2. Oxidation of intracellular glutathione as a consequence of penicillamine therapy in rheumatoid arthritis.

Spin echo NMR analysis is used to monitor the effect of penicillamine on intact erythrocytes obtained from patients suffering from rheumatoid arthritis during a 12-week period of therapy. The results are compared to the previously reported in vitro effects of the compound (McKay, C. N. N.; et al. Biochim. Biophys. Acta 1986, 888, 30-35). At clinical assessment at week 12, the 20 patients were divided into responder and nonresponder groups. The intracellular glutathione in the responder group is more oxidized (P less than 0.01) than in the nonresponder group. A retrospective analysis of the two patient groups at the initial assessment following the commencement of therapy indicated that in the nonresponder group intracellular glutathione was significantly more reduced (P less than 0.02) than in the responder group. It is postulated that penicillamine stimulates cellular defense against the oxidation of the cell membrane at the expense of cytosolic glutathione. This initial study suggests that spin-echo NMR analysis of erythrocyte glutathione can act as an early indicator of a clinical response to penicillamine therapy.

Arthritis, Rheumatoid↗
PubMed1992

Gold concentrations in blood fractions of patients with rheumatoid arthritis treated with Myocrisin.

Gold levels in the plasma and blood cells of patients treated with the gold drug Myocrisin (sodium aurothiomalate) were determined by atomic absorption spectrometry. There is a correlation between whole blood gold and plasma gold concentrations which is different for smokers and non-smokers. Most cellular gold is associated with the membrane and is present in concentrations approximately equivalent to the number of reactive sulphydryl groups on the exofacial surface of the cell. Since gold would be expected to react with SH groups and since these groups are vital for cellular function, a possible role for gold in modifying cellular metabolism is indicated.

Arthritis, Rheumatoid↗
PubMed1992

Age-dependent changes in position sense in human proximal interphalangeal joints.

Using a position matching paradigm, the ability of subjects to detect displacements at the proximal interphalangeal joint of the index finger was tested. These displacements were imposed at an angular velocity of 2 degrees per minute which is below the threshold for movement detection. An older group of subjects whose mean age (+/- s.e.m.) was 56.6 +/- 3.2 years showed significantly poorer performance in detecting the position of the index finger than a group of younger subjects (23.7 +/- 0.5 years). Analysis of the correlation between age and magnitude of matching error gave a positive correlation coefficient of 0.466 which was statistically significant. However, there was no systematic bias in judgements of finger position by the older group. These results indicate that the sense of position of the fingers decrements with age.

Adult↗
PubMed1992

A classification for dry eyes following comparison of tear thinning time with Schirmer tear test.

In a double-blind study a non-invasive method of examining the stability of the precorneal tear film was used to record tear thinning time on a population of 34 independently diagnosed dry eye patients. The results were compared with those for tear output, as inferred from the standard Schirmer tear test, and a correlation coefficient of 0.20 determined. The mean tear thinning time and Schirmer results for the population sample were 6.87 +/- 2.97 sec, and 5.62 +/- 5.69 mm wetting in 5 min, respectively. From a plot of tear thinning time against Schirmer a simple classification for dry eyes can be made. A Type A with normal tear stability and low output accounting for 14.70% of the dry eyes. A Type B with low tear stability and normal output, also accounting for 14.70% of the dry eyes. A Type C with low stability (less than 9.84 sec), and low output (less than 11.31 mm wetting in 5 min) accounting for 70.60% of the dry eyes.

Adult↗
PubMed1992

Position sense at the proximal interphalangeal joint is distorted in patients with rheumatoid arthritis of finger joints.

The results of this investigation demonstrate, using a position matching paradigm, that the ability of subjects to detect changes in the position of the proximal interphalangeal joint is impaired in patients with rheumatoid arthritis affecting this joint. In this group there is a systematic flexion bias in position judgements compared to an age- and sex-matched control group. This bias becomes progressively more pronounced at more extended positions. These results suggest that chronic inflammatory joint disease significantly alters proprioceptive sensations at finger joints and this may be due to the loss or distortion of afferent feedback from mechanoreceptors innervating the affected joint.

Adult↗
PubMed1992

A new method for the radiological assessment of vertebral squaring in ankylosing spondylitis.

A method has been developed for the objective assessment of vertebral 'squaring' based on quantitative morphometric analysis of vertebral 'concavity' in lateral radiographs of the lumbar spine. The reference range for vertebral concavity was defined as greater than 1.0-4.0 mm from measurements of 255 radiologically normal lumbar vertebrae in 51 patients with non-specific back pain. Evidence of vertebral squaring, as defined by concavity measurements of 1 mm or less, was found in 28% of vertebrae from 103 patients with ankylosing spondylitis and 8% of vertebrae from 10 patients with Reiter's syndrome. Assessment of vertebral squaring by the concavity measurement was more reproducible than subjective analysis in the diagnosis of vertebral squaring; in a subgroup of 30 patients with seronegative spondyloarthropathy, the interobserver agreement on the presence or absence of vertebral squaring as assessed by two independent clinicians was 84%, compared with 94% using the concavity measurement. Corresponding values for intraobserver agreement were 79% for subjective analysis and 84% for the concavity measurement. The vertebral concavity measurement is performed simply, rapidly (about three minutes for five lumbar vertebrae), and requires no special experience or equipment. As a result of this, the technique may be of value in the radiological diagnosis of ankylosing spondylitis and in assessing changes in vertebral squaring in individual patients with time.

Adult↗
PubMed1992

Chronic otitis media: a new extra-articular manifestation in ankylosing spondylitis?

Following a study reporting a fourfold increase in the occurrence of chronic otitis media in patients with ankylosing spondylitis, this prospective study examines this association with respect to severity, duration of disease, and acute phase in ankylosing spondylitis. Forty two consecutive patients with classical ankylosing spondylitis seen at the rheumatology clinic of a teaching hospital where the features of ankylosing spondylitis were recorded had an otological examination by an otolaryngologist. The occurrence of chronic otitis media (all categories) was 12/42 (29%). The acute phase serum markers (C reactive protein and IgG) were increased in patients with active or inactive chronic otitis media. Extra-articular manifestations were significantly more common in the chronic otitis media group than in those with no history of chronic otitis media. The results of this study suggest that chronic otitis media may be another extra-articular manifestation of ankylosing spondylitis. Alternative explanations, however, include similar aetiological factors for the two conditions or a previously unrecognised increased occurrence of HLA-B27 in patients with chronic otitis media.

Chronic Disease↗
PubMed1992

Action of sodium aurothiomalate on erythrocyte membrane.

The number of sulphydryl groups on the erythrocyte membrane has been assessed as a function of nutritional status for two groups of patients, one receiving non-steroidal anti-inflammatory drugs (NSAIDs) and the other receiving sodium aurothiomalate (Myocrisin). The patients receiving NSAIDs had a significantly higher number of sulphydryl groups in both the glucose depleted and glucose activated states than the patients receiving sodium aurothiomalate. The study focuses on the hexose transport protein where there is a specific binding site for gold using the two sulphydryl residues on helices 11 and 12 of the protein. The data suggest that the strong binding of gold to the erythrocyte membrane occurs via thiol pairs rather than by isolated sulphydryl groups and that there are possibly two further binding sites for gold on the membrane, the identities of which are still unclear.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1992

Chemical gastritis and Helicobacter pylori related gastritis in patients receiving non-steroidal anti-inflammatory drugs: comparison and correlation with peptic ulceration.

AIMS: To evaluate the prevalence and significance of chemical gastritis, in comparison with gastritis related to Helicobacter pylori in patients receiving non-steroidal anti inflammatory drugs (NSAIDs). METHODS: Two hundred and eighteen patients were studied, 174 of whom were taking NSAIDs. Chemical gastritis was defined as the presence of foveolar hyperplasia, muscle fibres in the lamina propria, oedema and vasodilation, in the absence of a chronic inflammatory cell infiltrate. RESULTS: Chemical gastritis was found in 46 (26%) patients taking NSAIDs, and three (7%) in subjects not taking these drugs (p less than 0.01). H pylori was detected in 56 (32%) subjects taking NSAIDs compared with 22 (50%) not taking these agents (p less than 0.02). Ulcers were found in 16 out of 72 patients (22%) taking NSAIDs and without H pylori infection or chemical gastritis compared with 27 out of 56 (48%) with H pylori related gastritis (p less than 0.01), and 25 out of 46 (54%) with chemical gastritis (p less than 0.01). CONCLUSIONS: Peptic ulcers associated with the use of NSAIDs seem to occur more commonly in patients with chemical gastritis or H pylori infection. Patients taking NSAIDs also seem to have a greater prevalence of chemical gastritis but a lower prevalence of H pylori than those not taking these drugs.

Adult↗
PubMed1992

Diagnostic tests for Helicobacter pylori: comparison and influence of non-steroidal anti-inflammatory drugs.

AIMS: To evaluate the efficacy of culture, histology, CLO-test, Helico-G and Pyloriset tests in diagnosing Helicobacter pylori in the presence or absence of non-steroidal anti-inflammatory drugs (NSAIDs). METHODS: Of 134 patients studied, 75 had taken NSAIDs. At endoscopy, biopsy specimens were taken for culture, histology, and CLO-test. Blood was also taken for enzyme linked immunosorbent assay (ELISA) (Helico-G) and latex agglutination (Pyloriset) tests. RESULTS: The sensitivity, specificity, and predictive values of histology and CLO-test, compared with culture, ranged from 90% to 97%, regardless of NSAID intake. In the 59 patients not taking NSAIDs Helico-G had a sensitivity of 75% (p < 0.05) and a specificity of 61%; Pyloriset's sensitivity and specificity were, respectively, 63% (p < 0.05) and 67%. In the 75 patients taking NSAIDs the sensitivity of Helico-G was 81% and its specificity 45% (p < 0.05); Pyloriset had a sensitivity of 61% (p < 0.05) and a specificity of 50% (p < 0.05). CONCLUSION: These findings suggest that H pylori is more reliably diagnosed by culture, histology, and CLO-test than by the serological tests used in this study, especially in patients treated with NSAIDs.

Adult↗
PubMed1992

Helicobacter pylori and peptic ulcers in rheumatoid arthritis patients receiving gold, sulfasalazine, and nonsteroidal anti-inflammatory drugs.

The conflicting reports on gold and Helicobacter pylori could be related to the use of serological tests of unproven value in NSAID patients, and to the lack of the appropriate control groups. More important is the fact that the endoscopic consequences of the possible effect of gold on H. pylori have not been investigated. We therefore decided to assess the prevalence of H. pylori and peptic ulcers in rheumatoid patients being treated with gold sodium thiomalate (GST) plus NSAID, sulfasalazine plus NSAID, or NSAID only. Eighty-five patients receiving treatment for at least 6 months were endoscoped, and H. pylori was studied in gastric antral biopsies by both culture and histology. Endoscopic abnormalities were classified into ulcers (measuring 5 mm in diameter or more) and erosions (smaller lesions). H. pylori (and ulcers) were found in 17 (12 ulcers) of 31 patients on NSAID only and 21 (9 ulcers) of 27 patients on sulfasalazine plus NSAID, compared with nine (3 ulcers) of 27 patients receiving GST plus NSAID, p < 0.05, analysis of variance. Patients treated with GST and NSAID had the lowest prevalence of detectable H. pylori. This could explain the apparent reduction in the prevalence of peptic ulcers in this group and, if confirmed in larger randomized studies, might have therapeutic implications.

Aged↗