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ABSTRACT: Soft-tissue rheumatism (STR--tendinitis, bursitis, fasciitis and fibromyalgia) accounts for up to 25% of referrals to rheumatologists. The estimated prevalence of generalized hypermobility in the adult population is 5-15%. There have previously been suggestions that hypermobile individuals may be predisposed to soft-tissue trauma and subsequent musculoskeletal pain. This study was designed to examine the mobility status and physical activity level in consecutive rheumatology clinic attendees with a primary diagnosis of STR. Of 82 patients up to age 70 yr with STR, 29 (35%) met criteria for generalized hypermobility. Hypermobile compared to non-hypermobile individuals reported significantly more previous episodes of STR (90% vs 51%, P < 0.01), and more recurrent episodes of STR at a single site (69% vs 38%, P < 0.001). Although we were unable to show any difference in the time spent carrying out physical activity between the two groups, the hypermobile patients were performing significantly more repetitive activities. When specific anatomical sites of STR were analysed, small joints (elbows, hands and feet) currently affected with STR were more likely to show localized hypermobility than if those joints were asymptomatic. These findings suggest that hypermobility may be a factor in the development of STR. Repetitive activity may be a contributing factor towards STR in some hypermobile individuals.
British journal of rheumatology 05/1998; 37(4):382-6.
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Arthritis & Rheumatism 11/1997; 40(10):1907-8. · 7.87 Impact Factor
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ABSTRACT: The first case of primary antiphospholipid syndrome associated with recurrent life-threatening haemorrhages, due to the coexistence of acquired prothrombin deficiency, is described. Attention is drawn to the difficulty in diagnosing this situation, and therapeutic options are reviewed. Evidence is presented that implicates prothrombin as the protein cofactor for this lupus anticoagulant.
Lupus 02/1997; 6(1):68-71. · 2.34 Impact Factor
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ABSTRACT: Although we have considerable knowledge of the demographic characteristics of hypermobile individuals in population studies, we have little understanding of the implications of hypermobility. In this rheumatology clinic-based study we assessed the prevalence, diagnostic associations and clinical features of hypermobility in consecutive newly referred patients. Hypermobility was identified in 50 of 378 patients (13.2%). The most common clinical diagnosis in the hypermobile patients, compared with controls (those without hypermobility), was soft tissue rheumatism observed in 67% vs 25% (P<0.001). Fibromyalgia syndrome was the common specific rheumatological diagnosis in 30% vs 8% (P<0.001) and inflammatory arthritis the least common diagnosis in 4% vs 32% (P<0.001) of hypermobile versus non-hypermobile patients, respectively. Hypermobile patients complained of previous pain, including widespread or multiple localized sites of pain and spinal pain. Although clinic-based studies may not accurately reflect disease patterns as seen in the population, these results suggest an association between hypermobility and soft tissue rheumatic complaints and should be useful to the clinical rheumatologist.
British journal of rheumatology 12/1995; 34(12):1157-61.
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ABSTRACT: Human colonic tissue is exposed to a variety of toxic chemicals and potential carcinogens in the diet and the intestinal microenvironment. Colonic adenocarcinoma is commonly resistant to the cytotoxic effects of most chemotherapeutic drugs. We have examined drug metabolic and detoxification pathways in clinical specimens of colon carcinoma and normal adjacent mucosa from 17 patients. All elements of xenobiotic metabolism examined are present in these tissues, including cytochrome P-450-dependent enzymes, glutathione, and glutathione-utilizing enzymes. In comparison of tumor tissue to its respective normal mucosa specific alterations in the pathways affecting a number of chemotherapeutic agents were detected, including significantly higher glutathione, glutathione peroxidase, and anionic glutathione-S-transferase activity. These and other alterations found here could be the target of therapeutic maneuvers to enhance the efficacy of antineoplastic treatment of human colon cancer.
Cancer Research 10/1989; 49(17):4866-9. · 7.86 Impact Factor
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Biochemical Pharmacology 12/1988; 37(21):4241-3. · 4.70 Impact Factor
