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Biomedical subjects

V Wright

Publications and source records attributed to V Wright.

At least 19 recordsLinked to original sources
PubMed1992

The effect of non-steroidal anti-inflammatory drugs on faecal flora and bacterial antibody levels in rheumatoid arthritis.

The faecal flora and bacterial antibody levels of 22 patients with active rheumatoid arthritis (RA) were compared with those of 26 patients with osteoarthritis (OA) undergoing comparable treatment with non-steroidal anti-inflammatory drugs (NSAIDs), and a further 22 patients with OA who were not receiving NSAIDs. Faecal counts of Clostridium perfringens were significantly higher in the RA patient group and in those OA patients receiving NSAIDs, compared with those OA patients not taking NSAIDs (P = 0.032, P = 0.0004 respectively). Total aerobic and anaerobic counts were, however, identical in all three groups. Levels of serum IgA antibody to the alpha toxin of Cl. perfringens were higher in the RA group and in the OA group taking NSAIDs than in OA patients not taking NSAIDs (P = 0.011, P = 0.055). Serum IgG antibody to alpha toxin was higher in the RA group than in OA patients both on and off NSAIDs (P = 0.019, P = 0.0072) and also a group of normal controls (P = 0.032). These results suggest that the increased faecal counts of Cl. perfringens together with the associated increased antibody levels seen in this and previous studies are more likely to result from NSAID therapy used to treat the disease than from a disease specific change in bowel flora.

Adult↗
PubMed1992

Growth deficits in children treated with desipramine: a controlled study.

Using multiple assessment methods, growth deficits in weight and height were examined in a clinical sample of children and adolescents with attention deficit hyperactivity disorder treated chronically (mean 14 months) with desipramine (DMI) and two comparison samples of children treated chronically with methylphenidate (MPH) and a not-treated group. Although there were statistically significant weight deficits in children treated with both DMI and MPH compared with normal controls, only those treated with MPH sustained height deficits that attained statistical significance. It appears that DMI may be an appropriate alternative for patients with stimulant-associated severe suppression of growth in height.

Adolescent↗
PubMed1992

Work related upper limb disorder: the relationship between pain, cumulative load, disability, and psychological factors.

Repetitive strain injury, or work related upper limb disorder, provides an interesting paradigm for the study of the relative contribution of physical and psychological factors to the resulting pain and disability. Sixty three subjects were studied, comprising the work-force of a subsection of a large local industrial company, in whom pain in the arm related to work was known to be common. Ergonomic data were obtained by estimating the cumulative daily load on the wrist joint for each of four identified tasks. Data on the occurrence of pain, treatment sought, and disability were obtained by a structured self administered questionnaire. Psychological data were obtained by administering the Hospital Anxiety and Depression (HAD) scale, a self reported measure of anxiety and depression, and the Bradford Somatic Inventory (BSI), an inventory of somatic symptoms associated with anxiety and depression. The employment specific period prevalence of work related upper limb disorder was 81%, with 30% of the subjects having pain at the time of the study. Domestic disability was minimal in all but two subjects, though the use of devices such as jar openers at home was common (12 of 51 subjects). Medical advice was seldom sought. Twenty per cent of subjects had received anti-inflammatory drugs, 10% had received physiotherapy, and 47% had wrist splints. Pain was related to the tasks with the highest estimated daily loads, but a history of pain and current pain were associated with higher scores on the HAD and BSI scales, suggesting an interaction between physical and psychological factors.

Adolescent↗
PubMed1992

Survey of satisfaction with care in a rheumatology outpatient clinic.

Consumer satisfaction is increasingly recognised by hospital administrators and health care providers as an important aspect of health care. A study was undertaken to investigate the satisfaction with care among patients with rheumatoid arthritis (RA) attending a rheumatology outpatient clinic at Leeds General Infirmary. The Leeds satisfaction questionnaire was developed and rigorously tested for reliability (Cronbachs alpha) and stability (test/retest). The Leeds satisfaction questionnaire was then completed by 70 patients with RA who had attended the Leeds General Infirmary on at least three previous occasions. The results showed that patients were, in general, satisfied with the care they received. The highest satisfaction scores were obtained on the scale for technical quality and competence of health professionals. The least satisfaction was accredited to the difficulty of unscheduled access to the clinic and the lack of continuity with the providers of care. The time spent in the waiting area before consultation was highlighted as the one aspect which caused the greatest dissatisfaction.

Adult↗
PubMed1992

Gait analysis in ankylosing spondylitis.

A study was conducted to compare the gait pattern of 12 patients with ankylosing spondylitis with axial disease only with that of 11 healthy controls using a telemeterised electrogoniometer gait analysis system. The reproducibility of the gait variables was found to be acceptable. Angles for movement at the hip and knee were less in patients with ankylosing spondylitis, but hip/knee angle ratios did not differ between the two groups. The stride length was shorter in the patients with ankylosing spondylitis. These findings are due to the increased rigidity of the spine, which results in decreased shock absorption and consequently a more cautious gait pattern in the absence of clinically and radiologically detectable peripheral joint disease.

Adult↗
PubMed1992

Endocrine disorders.

The effect of thyroxine replacement therapy on bone mass continues to attract attention. Although the advice of the American Thyroid Association to normalize serum thyroxine and thyroid-stimulating hormone concentrations is recommended, even physiologic doses of thyroxine may have an adverse effect on bone mass. The diagnosis and treatment of osteomyelitis in the diabetic foot is aided by magnetic resonance imaging, and long-term review of cases of diabetic femoral neuropathy emphasizes the good prognosis. Adrenal insufficiency as a complication of antiphospholipid syndrome is reviewed, and a useful physical sign, the acromegalic rosary, rediscovered. The association of sex steroids, oral contraception, and parity with rheumatoid arthritis is discussed. The outcome of pregnancy in women with juvenile rheumatoid arthritis is good, and quiescent disease does not appear to be permanently reactivated. Calcium deficiency, rather than vitamin D deficiency, is a cause of rickets in some Nigerian children.

Adrenal Gland Diseases↗
PubMed1992

From aspirin to biologics: therapeutic implications for rheumatoid arthritis.

As effective antiinflammatory agents have been added to our armamentarium, 2 major treatment strategies for the treatment of rheumatoid arthritis have developed. The traditional pyramid strategy is based on initial, conservative measures, followed by more aggressive therapy as the disease progresses. The step-down bridge approach is an alternative, more aggressive strategy that favors earlier use of more potent agents. The longterm effects of disease modifying antirheumatic drugs (DMARD) and combination second line therapy on disease progression remain unclear. Advances in the development of more specific DMARD and in human recombinant proteins offer promising future therapies.

Adrenal Cortex Hormones↗
PubMed1979

What shall we teach undergraduates?

The opinions of 600 randomly selected doctors on what should be taught to undergraduates in clinical years were analysed. The respondents gave a high priority to general medicine, paediatrics, general surgery, casualty, and gynaecology, but a low priority to forensic medicine, plastic surgery, radiotherapy, anaesthetics, radiology, and rehabilitation medicine. Doctors thought that these should be taught to postgraduates. The two major groupings of doctors--general practitioners and consultants--gave essentially the same priorities. Undergraduate curricula cannot include all major specialities, so the results of this analysis may provide a useful basis for selecting the most suitable subjects. Criteria for including other specialties might be the ability and enthusiasm of the teachers and well-thought-out and academically sound teaching programmes.

Attitude of Health Personnel↗
PubMed1979

A simple goniometer for measuring hip function.

A goniometer was designed and developed in an attempt to find an objective method of measuring hip flexion and extension in walking as as indication of hip function. Existing goniometers were found to be inadequate for clinical and research use because either they did not provide sufficient information or the information they provided was more than necessary, requiring bulky and time-consuming power devices. The present goniometer is a compromise, providing a quick and easy-to-use clinical and research tool which measures total flexion and extension in walking.

Adolescent↗
PubMed1979

Quantification of joint laxity.

We have compared the finger hyperextensometer (Jobbins et al., 1978) and the scoring system of Carter and Wilkinson (1964), modified by Beighton et al. (1973), in the quantification of joint laxity in a population selected to demonstrate a wide range of joint movement. Both systems correlated well (P less than 0.001) with a 'global index' of joint laxity derived by adding the arcs of movement recorded at most joints in the body by the method of the American Academy of Orthopaedic Surgeons (1965). The Carter and Wilkinson system produced better correlations and is the method of choice for assessing generalized joint laxity.

Humans↗
PubMed1979

Joint laxity leading to osteoarthrosis.

Joint laxity was compared in 50 females with symptomatic osteoarthrosis and an age-matched control group without osteoarthrosis. Generalized joint laxity measured by the scoring system of Cater and Wilkinson (1964) modified by Beighton (1973) was significantly higher in the osteoarthritic group (X2 = 10.00, P less than 0.05). In osteoarthritics the pattern of clinical joint involvement varied with the degree of generalized joint laxity.

Humans↗
PubMed1979

A note on indomethacin suppositories in rheumatic conditions.

The effect of indomethacin suppositories was observed in 102 patients. Some patients had rectal irritation (9%), and a few had difficulty in inserting the suppository. Most patients tolerated the medication well with relief of joint symptoms (the major reason for prescription) and usually with alleviation of dyspepsia (the second commonest reason for giving the drug in this way).

Humans↗