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Biomedical subjects

R S Lever

Publications and source records attributed to R S Lever.

17 recordsLinked to original sources
PubMed1996

Patch testing in children.

92 children (45 girls, 47 boys), mean age 9.3 years (3-14.75), were referred to the Contact Dermatitis Investigation Unit, Belvidere Hospital, Glasgow, for patch testing during the period 1979-93 for the investigation of allergic contact dermatitis (ACD). The diagnoses at the time of referral were atopic dermatitis (45), non-atopic with localized dermatitis (26), juvenile plantar dermatosis (15), orofacial granulomatosis (2), vaccination reaction (2) and atypical psoriasis (2). In total, there were 55 positive reactions in 30 children. The commonest allergens were metals (18), fragrances (11) and rubber compounds (6). The patient groups with the highest yield of positive patch tests were those patients with atopic dermatitis who had a good history of a precipitating contact factor (4/5), and non-atopic patients with dermatitis of hand and/or feet (7/14). Our findings suggest that allergic contact dermatitis is more common in children than generally appreciated and that patch testing is a practicable and clinically worthwhile procedure in children.

Child↗
PubMed1994

Protein S deficiency in lupus erythematosus secondary to hereditary angio-oedema.

We report a child with lupus erythematosus secondary to type 2 hereditary angio-oedema (HAE). Reduced levels of free protein S were found. Total protein S, and C4 binding protein (C4bp) were normal, and there was no evidence of anticardiolipin antibodies or lupus anticoagulant. We postulate that reduced levels of C4, secondary to C1 inhibitor deficiency, resulted in increased binding of protein S to C4bp, leading to reduced levels of free protein S and thus functional deficiency of protein S.

Angioedema↗
PubMed1993

Epidermolysis bullosa acquisita occurring in association with systemic lupus erythematosus.

A 77-year-old retired male physician with a 6-year history of systemic lupus erythematosus (SLE) developed a mechanobullous eruption, the features of which were clinically and immunopathologically consistent with a diagnosis of 'classical' epidermolysis bullosa acquisita (EBA). As EBA shares immunopathological findings with a number of cases reported as the 'bullous eruption of SLE', the clinical findings commonly recognized as 'classical EBA' may, in patients with SLE, represent a specific subset of the bullous eruption of SLE rather than a separate diagnostic entity. There are few reports in the literature describing classical EBA in patients with SLE. Findings in this patient add further support to the suggestion that EBA occurring in association with SLE, represents a subset of the bullous eruption of SLE, the clinical features of which may be modified by genetic susceptibility or disease activity.

Aged↗
PubMed1989

A controlled trial of house dust mite eradication using natamycin in homes of patients with atopic dermatitis: effect on clinical status and mite populations.

In a controlled clinical trial, patients with atopic dermatitis carried out house dust mite eradication procedures on their mattresses, using natamycin or a matched placebo spray, with or without vacuum cleaning, for 4 months. For the two groups that used vacuum cleaning, mite numbers fell significantly both by comparison of mean initial and final numbers and by calculating mean rates of reduction from regression analyses (P less than 0.01 in all cases). There were no differences between the groups in the magnitude of the decreases. For the two groups that did not use vacuum cleaning, mite populations remained virtually unchanged. These results indicate vacuum cleaning not natamycin had the major effect on mite eradication. Mean symptom scores of patients in all four groups were slightly reduced by the end of the trial, but there was a greater reduction rate (P less than 0.01) in the combined scores of the groups that did not use vacuum cleaning, demonstrating a lack of correlation between improvement in clinical score and lowered mite numbers. No patients entered remission and the maximum improvement in clinical score was only 47%. Natamycin and vacuum cleaning neither alone nor in combination proved valuable in reducing mite numbers sufficiently to provide clinical benefit.

Adolescent↗
PubMed1989

The effect of topical steroid application on natural killer cell activity.

Peripheral blood natural killer (NK) cell activity of a group of 10 healthy non-atopic volunteers was reduced following the topical application of 15 g of 0.1% betamethasone valerate ointment to the skin nightly for 1 week. In contrast, no such effect was observed when the inactive base of the steroid ointment was used. NK cell activity dropped significantly by day 7 (P less than 0.05) and then recovered, although NK cell activity at day 22 was still lower than that observed at the start of the experiment. These findings suggest that topically applied steroid is absorbed in sufficient amounts to cause a systemic effect on NK cell function. This may have implications in a number of dermatological disorders, including atopic dermatitis, where topical steroids form the mainstay of treatment.

Administration, Topical↗
PubMed1985

The use of BELD combination chemotherapy (bleomycin, vindesine, CCNU, and DTIC) in advanced malignant melanoma.

Twenty-one patients with Stage III malignant melanoma have been treated with a 5-day quadruple chemotherapy regime (BELD) comprising bleomycin 15 mg subcutaneously on days 1 and 4, vindesine (Eldesine) 3 mg/m2 intravenously on days 1 and 5, CCNU (lomusine) 80 mg/m2 orally on day 1, and DTIC 200 mg/m2 intravenously on days 1 through 5. Twenty patients were evaluated after two cycles. Three (15%) are in complete remission 12, 16, and 53 weeks after therapy, respectively, and six (30%) experienced worthwhile partial remissions. This combined response rate of 45% is considerably better than that seen in single- or dual-agent chemotherapy. Toxicity was acceptable, and several patients received their therapy on an outpatient (ambulatory) basis. The one nonevaluable patient had radiotherapy for an isolated spinal metastasis and two courses of BELD. She is well and pain- and disease-free 56 weeks later. The median survival for all treated patients is 43 weeks, and the median follow-up time is now 63 weeks.

Adult↗
PubMed1985

Natural killer cell activity in atopic dermatitis: a sequential study.

It is well-recognized that patients with atopic dermatitis handle certain cutaneous viral infections poorly. As natural killer (NK) cell activity is considered to contribute to the immune response to viral infection, seven young adults with atopic dermatitis had their NK cell function assessed over a 12-month period. Natural killer cell activity was found to correlate inversely with disease activity. The more active the disease, the greater was the reduction in NK cell function (P less than 0.01. In addition, a strong correlation between clinical activity and IgE was shown (P less than 0.001).

Adult↗
PubMed1984

Natural-killer-cell activity in atopic dermatitis.

Natural-killer (NK)-cell activity was measured in the peripheral blood of twenty patients with atopic dermatitis and in a group of thirteen age-matched non-atopic controls (nine subjects on thirteen occasions). The method uses a chromium-release assay with the human leukaemia cell line, K562, labelled with 51Cr as the target cell. A highly significant reduction in NK-cell activity was found in the patients with atopic dermatitis.

Adolescent↗
PubMed1981

Low blood pressure in psychiatric inpatients.

Blood pressure recordings in 116 female psychiatric inpatients were analysed. Sixty-nine women had schizophrenia, the remainder a variety of psychiatric conditions. All had been in hospital continuously for more than one year, the average for 19 years continuously. An average of seven recordings of blood pressure per patient had been made during that time. The latest of these compared well with measurements made independently using a sphygmomanometer free from observer bias. On admission to hospital the blood pressure of these patients was close to that of two normal populations. Thereafter it failed to rise at the normal rate and after an average of 19 years, in the women having measurements made by special sphygmomanometer, systolic pressure was 28 mmHg lower than controls of the same age while diastolic pressure was 12.8 mmHg lower. Lower than control blood pressure was apparent in schizophrenic and non-schizophrenic women and in women taking no drugs, phenothiazines, and other drugs. Weight loss is an unlikely explanation: the mean weight of these women was 61.5 kg compared with 64.1 kg in a local control population of the same age. Some factor related to prolonged isolation in hospital seems more important.

Adult↗