Arthro-osteitis--a clinical spectrum.

Arthro-osteitis is an uncommon condition which can be associated with palmoplantar pustulosis. It forms part of a group of conditions which include the synovitis, acne, pustulosis, hyperostosis, osteitis syndrome (SAPHO) and sternocostoclavicular hyperostosis. We report four cases illustrating the clinical spectrum of this condition which occurred in the absence of concomitant skin lesions. One patient had extensive aortic calcification a feature not previously reported in this condition, which may represent a low grade inflammatory aortitis.

A multicentre double-blind comparison of auranofin, intramuscular gold thiomalate and placebo in patients with psoriatic arthritis.

The efficacy and safety of the oral gold compound auranofin and intramuscular gold thiomalate have been compared in a placebo-controlled, double-blind, four-centre trial in 82 patients with psoriatic arthritis requiring remittive drug therapy. There were statistically significant falls in Ritchie articular index, visual analogue pain score and ESR at 12 and 24 weeks following i.m. gold but no significant changes in the auranofin group. Intramuscular gold was safe and more effective than auranofin as a second-line, suppressive antirheumatic agent for patients with psoriatic arthritis when followed for 6 months.

Alterations in appendicular skeletal mass in patients with rheumatoid, psoriatic, and osteoarthropathy.

Appendicular bone mass was measured in a series of 50 patients with non-steroid treated rheumatoid arthritis, 20 with polyarticular seronegative psoriatic arthritis, and 30 with osteoarthrosis, and compared with that of 40 controls of similar age and sex. Distal forearm bone mineral content was reduced in patients with rheumatoid and psoriatic arthritis and increased in those with osteoarthrosis. The increase in bone mass in patients with osteoarthrosis was confined to those with isolated large joint disease and was not found in those with primary generalised osteoarthrosis.

Tunable diode laser measurements of formaldehyde foreigngas broadening parameters and line strengths in the 9-11 microm region.

A tunable diode laser spectrometer has been used to determine pressure broadening coefficients due to collision with the foreign gases air, H(2), O(2), and N(2) in the nu(4) and nu(6) bands of H(2)CO between 9 and 11 microm. Absolute line strengths for twenty-eight transitions have also been determined. The broadening coefficients are very similar to theoretical literature values in the cases of air, N(2), and O(2). The H(2)-H(2)CO values are in good agreement with earlier experimental millimeter wave results.

Spontaneous fusion of atlanto-axial dislocation in psoriatic spondylitis.

A 36-year-old man, suffering from psoriatic arthritis from the age of 17 years, was found to have developed atlanto-axial dislocation at the age of 30. Spontaneous fusion took place over the next two years. An explanation for this finding is based upon a review of the literature regarding the nature of spinal involvement in psoriatic arthritis.

Ulcerative vulvitis in Reiter's syndrome. A case report.

In a case of acute Reiter's syndrome with severe vulvitis the diagnosis was based on the presence of a vaginal discharge and dysuria, arthritis, conjunctivitis, buccal ulceration, keratodermia blenorrhagica, and HLA B27 tissue-typing antigen. The vulval lesions were similar in appearance to those of circinate vulvitis. The acute histological change were confined to shallow ulceration with an inflammatory infiltration of the subjacent dermis. Coincidential lichen sclerosus et atrophicus was present, which could have been masked by the acute lesions.

In vivo platelet activation following myocardial infarction and acute coronary ischaemia.

Forty-seven patients presenting with acute chest pain had in vivo platelet activity assessed by measuring plasma levels of the platelet-specific protein beta thromboglobulin (BTG), and by screening for the presence of circulating platelet aggregates. Nineteen patients with transmural myocardial infarction (MI), 21 patients with acute coronary ischaemia (CI), and 7 patients with non-cardiac chest pain (NCCP) were investigated in a serial study and compared with a normal control group. The means of all BTG determinations in the MI (34, +/- SD = 21-57) and CI (33, +/- SD = 19-57) groups were significantly higher than those in the NCCP group (24, +/- SD equal 17-34; p less than 0.01) and normal subjects (22,5 +/- SD = 14-37; p less than 0.001). There was no difference in BTG between those with MI or CI, nor between the NCCP group and normal subjects. Raised numbers of circulating platelet aggregates could not be detected in either MI or CI. The mean BTG levels in both MI and CI patients were significantly raised, compared to normal subjects, on the first day of admission to hospital and remained so on each of the subsequent nine days. Neither heparin plus warfarin nor sulphinpyrazone had any significant effect in lowering BTG levels. 15/40 patients (37.5%) following MI and CI had repeatedly raised BTG levels throughout the study period, and it is suggested that these patients represent an "at risk" group that may benefit from anti-platelet therapy in secondary prevention studies.