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Biomedical subjects

R Luqmani

Publications and source records attributed to R Luqmani.

12 recordsLinked to original sources
PubMed2000

Medical student appraisal of interactive computer-assisted learning programs embedded in a general pathology course.

Computer-assisted learning programs (CALs) were embedded in a course on general pathology for medical students at the University of Edinburgh Medical School. Students' reactions to the programs were evaluated. Students completed written questionnaires and were interviewed and observed as they used the CALs. Students liked the CALs and felt that they were integrated with other parts of their teaching and aided them in understanding the subject material. Different question styles were variably appreciated. The most useful aspects of the CALs were the interactive parts (questions and answers), summaries, pictures, learning at the individual's own pace, and question practice, especially with MCQs. Students found the CALs an effective learning tool, particularly when linked with other course components as a complement to, rather than a replacement for, other learning methods.

Computer-Assisted Instruction↗
PubMed1994

Clinical pharmacology and modification of autoimmunity and inflammation in rheumatoid disease.

The increased understanding of the mechanisms which underlie rheumatoid disease has been accompanied by a more appropriate use of the limited repertoire of therapeutic agents. Conventional second-line drugs still have a role in everyday practice. The efficacy of these agents in reducing the severity of clinical signs of joint inflammation, whilst at the same time causing significant reductions in the laboratory measures of the acute phase response is undoubtedly confirmed by meta-analysis of several therapeutic trials of these agents. Whether or not these agents can influence outcome, usually assessed in terms of radiological progression, is more contentious. Furthermore, their toxicity in long term use is not inconsiderable. However, newer agents may play a more important part in therapy in the future. Such therapy can be designed to specifically interfere with the abnormalities of the immune system which characterise rheumatoid arthritis. Many of the agents reviewed have been successfully applied to animal models of arthritis but we still await large randomised controlled studies in humans to determine their clinical efficacy and toxicity. In view of the complexity of the immunological abnormalities in rheumatoid arthritis, it may be necessary to consider using a number of such agents in any particular patient. This should result in more rational therapy in rheumatoid arthritis.

Animals↗
PubMed1993

The validity of surrogate markers in rheumatic disease.

Although RA is an inflammatory disease primarily affecting the synovial joints it also has marked systemic consequences. Pro-inflammatory systemically active cytokines are produced within the joint, found in the serum and are capable of inducing the hepatic synthesis of acute-phase proteins. Initially it was believed that the acute-phase response was elicited by the cytokine, interleukin-1 alone. However, it is now clear that there is a complex interaction between the cytokines with interleukin-6 predominant, but also involving interleukin-1, tumour necrosis factor and a group of recently described cytokines including interleukin-11, leukaemia inhibitory factor and oncostatin M all of which influence the levels of acute-phase proteins. In clinical practice CRP is frequently used as a marker of the acute-phase response. It has a short half-life and consequently is a sensitive measure of cytokine-induced protein synthesis. The rate of appearance of bony erosions early in disease correlates with the mean serum concentration of CRP in some studies. It has been suggested that a weak correlation probably reflects the fact that joints in which erosions most frequently occur, namely the small joints of the hand, produce smaller amounts of cytokine than the large joints such as the knee. A recent study examining the rate of spinal trabecular bone loss in the first year of rheumatoid disease found a strong correlation between bone loss and serum CRP concentrations. It appears that CRP concentrations reflect the level of 'systemic osteoclast-activating factor' and are, therefore, a good measure of the general catabolic state of the patient.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute-Phase Proteins↗
PubMed1991

Inner ear deafness in Wegener's granulomatosis.

Autoimmune deafness represents a heterogeneous group of disorders in which there is though to be inner ear and/or middle ear damage mediated by various immunological abnormalities. We describe a patient with Wegener's granulomatosis in whom there was evidence of significant inner ear damage caused by vasculitis, which was completely reversed by cyclophosphamide and prednisolone. We propose that Wegener's granulomatosis is a cause of autoimmune deafness.

Adult↗
PubMedDate not supplied

Pseudoporphyria and nonsteroidal antiinflammatory agents in children with juvenile idiopathic arthritis.

Pseudoporphyria is characterized by erythema, blistering, and scarring on sun-exposed skin. Nonsteroidal antiinflammatory drugs (NSAIDs) are implicated in the etiology of this condition. In a 1-year prospective study of children attending the pediatric rheumatology clinic in Edinburgh we found a prevalence of pseudoporphyria of 10.9% in children taking NSAIDs for juvenile idiopathic arthritis. Naproxen was the most commonly implicated NSAID, independent of dosage. Blue/gray eye color was an independent risk factor for the development of pseudoporphyria. We would advise caution in prescribing naproxen in these children to prevent disfiguring facial scarring.

Adolescent↗
PubMedDate not supplied

Systemic cytokine measurements: their role in monitoring the response to therapy in patients with rheumatoid arthritis.

OBJECTIVE: To determine the value of serial measurements of circulating cytokines in patients with rheumatoid arthritis in response to the introduction of disease modifying anti-rheumatic drugs (DMARDs). METHODS: A prospective 12-week study of 98 patients starting second line therapy with serial measurements of IL1 beta, IL2 receptor, IL6, TNF, and urinary neopterins as well as ESR, CRP and rheumatoid factor. RESULTS: The markers of the acute phase response fell significantly with treatment as did the rheumatoid factor. IL-6 fell in certain sub-groups (significantly so after sulphasalazine SZP) of treated patients, but no other consistent change in circulating cytokine levels was demonstrated. Urinary neopterins rose with therapy. CONCLUSIONS: The measurement of circulating cytokine levels in patients with rheumatoid arthritis is of limited benefit; macrophage function (as measured by urinary neopterins) is initially enhanced by DMARDs in patients with rheumatoid arthritis.

Adult↗
PubMedDate not supplied

Disease-modifying antirheumatic drugs in rheumatoid arthritis: current concepts.

Disease-modifying antirheumatic drugs are used in virtually all patients with established rheumatoid arthritis. An increasingly large number of new drugs is now available. Furthermore, old therapies are being used in novel ways. Treatment is now begun earlier and patients are rarely left untreated. This report summarises recent developments regarding the drugs currently in use and those that may be available in the near future.

Anti-Inflammatory Agents↗