Clinical and cost effectiveness of post-acute neurobehavioural rehabilitation.

The value of post-acute, community based social and behavioural rehabilitation for people with serious neurobehavioural disability has been the subject of a dispute for a number of years. Some authorities doubt that major changes in social adaptability and independence is possible several years post-injury. This paper attempts to assess both the clinical and cost effectiveness of such rehabilitation on a group who have suffered serious brain injury and display behaviour problems and cognitive deficits which prevent them living as independent members of the community.

A case of Sjögren's syndrome, sarcoidosis, previous ulcerative colitis and gastric autoantibodies.

We describe a patient with sicca syndrome, Raynaud's phenomenon and fixed waxy skin lesions. Investigations confirmed both Sjögren's syndrome and sarcoidosis. The patient had previously had ulcerative colitis and other antibody evidence of autoimmunity.

A controlled evaluation of diagnostic criteria in the development of a rheumatology expert system.

As an intermediate stage in the development of an expert system to support undergraduate teaching in rheumatology, a decision tree incorporating the diagnostic criteria to be used in the expert system was produced by a team of rheumatologists. In a controlled trial, 119 final-year medical students each diagnosed 10 rheumatology cases, drawn from a pool of 96 cases, with or without the aid of the decision tree. Students who used the decision tree correctly diagnosed the following conditions more frequently than the control group: polymyalgia rheumatica (p less than 0.

Vibration arthrography as a diagnostic aid in diseases of the knee. A preliminary report.

The detection and recording of vibration emission from human joints, a technique which we have termed "vibration arthrography", is a sensitive, non-invasive method for the objective study of the locomotor system. Using vibration sensors attached to bony prominences around the knee, we studied the joints of both normal and symptomatic subjects. Normal subjects produced three signal types--physiological patellofemoral crepitus, patellar clicks, and the lateral band signal.

Clinical and laboratory characteristics of patients with speckled pattern antinuclear antibodies.

Fifty patients whose sera contained a speckled antinuclear antibody (ANA) were interviewed and examined to determine if there was any relationship between their clinical manifestations and the presence of certain serological markers. The results suggest that speckled ANA is usually found in patients with definite connective tissue diseases, but a significant minority have incomplete or early stages of these diseases. Characterisation of the antibody to extractable nuclear antigen (ENA) and other serological markers does not normally assist in making a clinical diagnosis, but the detection of a speckled ANA should prompt further investigation and careful follow-up.

Growth of human B cell colonies from peripheral blood of patients with systemic lupus erythematosus.

Human B cell colonies were grown from peripheral blood of 12 patients with systemic lupus erythematosus (SLE) and from 12 healthy control subjects. The SLE group showed a large increase (p less than 0.001) in the number of colony forming cells (CFC) present in peripheral blood as compared with controls.

A comparison of plasma and synovial fluid profiles of standard and controlled-release formulations of ketoprofen in patients with rheumatoid arthritis.

The plasma and synovial fluid profiles of standard and controlled-release formulations of ketoprofen were compared in 8 patients with rheumatoid arthritis. During chronic dosing with both forms of ketoprofen, peak drug concentrations were lower and occurred later in the synovial fluid than in the plasma. These findings were more pronounced in the case of the controlled-release formulation.

Measurement of anti-cardiolipin antibodies by an enzyme-linked immunosorbent assay (ELISA): standardization and quantitation of results.

We describe the development of a simple and highly sensitive double antibody sandwich enzyme-linked immunosorbent assay (ELISA) for measuring IgG and IgM anticardiolipin antibodies (ACA). Microtitre plates were coated with cardiolipin at a concentration of 45 micrograms/ml by evaporation under nitrogen. Non-specific binding of diluted sera was eliminated by blocking of plates with 10% fetal calf serum in phosphate buffered saline (PBS/FCS) for 2 h.

Detection and partial characterization of human B cell colony stimulating activity in synovial fluids of patients with rheumatoid arthritis.

The joint fluids of 37 patients with rheumatoid arthritis, eight patients with traumatic injuries to their joints, two patients with Reiter's syndrome and three patients with psoriatic arthritis were tested for the presence of B cell colony stimulating activity (B cell CSA). B cell CSA was found in all of the joint fluids from the patients with rheumatoid arthritis but in none of the joint fluids from patients with traumatic injuries to their joints or in the joint fluids from the patients with Reiter's syndrome. A trace of B cell CSA was found in the joint fluid of one of the three patients with psoriatic arthritis.

[Vibration arthrography in the diagnosis of knee joint diseases].

In this paper, the principles of vibration arthrography are briefly described and the analysis of the resulting signals is explained. Using such a system, localisation of signals from within the joint is possible. Finally, the development of a vibration-based arthrographic system is proposed as a safe, relatively inexpensive, and totally non-invasive aid to the diagnosis of internal disease of the knee.

[Current trends in phonoarthrography].

The detection of sounds from the human body for diagnostic purposes has a long history. In the respiratory and circulatory systems such auscultation is a precise science yielding much useful information. The detection and interpretation of joint sounds, however, has been much less successful in its development.