Giles G. Bole

FAMILY SUPPORT, HEALTH BELIEFS, AND THERAPEUTIC COMPLIANCE IN PATIENTS WITH RHEUMATOID ARTHRITIS

Abstract Compliance with recommendations about aspirin, exercise, and splints was evaluated in 40 patients with rheumatoid arthritis to determine the relationship of compliance to two variables: family support and belief in benefit. Interventions to enhance family support were effective in two cases, but belief in the benefit of the recommendation was the critical variable in all types of compliance.

Drug-sensitive ecto-ATPase in human leukocytes

An ecto-ATPase has been described in human leukocytes. The enzyme is present in both granulocytes and lymphocytes, exhibiting higher activity and substrate affinity in the latter cells, I

CHARACTERIZATION OF LIPID CONSTITUENTS OF HUMAN "FIBROBLASTS" CULTIVATED IN VITRO.

,, values ranged from 0.06 mM in lymphocytes to 0.3 mM in the unresolved leukocyte fraction. Enzymatic activity had a pH optimum in the physiological range, required MgZc, and was insensitive toward ouabain and Ca2*. Potent inhibitors of ecto-ATPase were tricyclic antidepressants and substituted phenothiazines, to which the enzyme in lymphocytes was most susceptible. These drugs also decreased the phagocytic ability of leukocytes. However, while drug inhibition of the enzyme was reversible by washing, the effect dn phagocytosis was not. We have described previously an ecto-ATPase in rat leukocytes and reported the potent inhibition of the enzymatic activity by tricyclic antidepressants and substituted phenothiazines (l, 21. These drugs also markedly inhibited phagocytosis (3). The inhibitory effects were not reproduced by a variety of drugs of different structures, investigated at identical con- centrations. In human platelets, inhibition of ecto- ATPase has been linked to the loss of aggregating ability (4). Our preliminary work provided evidence for the existence of ecto-ATPase in human leuko- cytes (S). In view of the unknown function of this enzyme, and considering its potent inhibition by a number of drugs of wide ciinical use, it was of interest to investigate further the properties of the ecto- ATPase in human leukocytes, including granulocytes and lymphocytes, and to characterize its interaction with drugs.

Pseudoseptic Arthritis Due to Acute Lipoarthrosis in a Systemic Lupus Erythematosus Patient With Osteonecrosis

Summary Lipids from connective tissue cells cultivated in vitro were identified by silicic acid column and paper chromatography, and by Dawsons hydrolysis procedures. Phospholipids constituted 64–84% of the total lipid with the remainder approximately equally distributed between cholesterol and the glycerides. Total lipid concentration ranged from 9.1 to 17.2 mg per 100 mg of dry cell solids. Phosphatidyl choline,-ethanol-amine,-myoinositol, sphingomyelin, and plasmalogens were identified in all cells examined. Phosphatidyl serine was undetected in one, and “phosphatidic acid” undetected in several of the cell lines. No unusual intracellular concentration of lipid or definite correlation with mucopolysaccharide production was demonstrated.

Appointment-keeping behavior and patient satisfaction: implications for health professionals.

Acute unexplained monarthritis from which purulent-ap-pearing but sterile synovial fluid is obtained has beendubbed pseudoseptic arthritis (1). A number of entitieshave been described that can present in this manner. Em-pirical therapy for septic arthritis is still indicated in thesepresentations, but can be discontinued when an alterna-tive explanation for the acute condition is identified. Weencountered a patient with acute knee monarthritis fromwhich we obtained seemingly purulent synovial fluid, butin whom we ultimately demonstrated a process illustrat-ing an unusual mechanism by which such a presentationmight develop.

Development of criteria for the classification and reporting of osteoarthritis: Classification of osteoarthritis of the knee

This study examines patient satisfaction with care received in a subspecialty clinic, appointment-keeping behavior in that clinic, and the interrelationships between satisfaction and appointment-keeping compliance. The implications for health education and patient counselling are also discussed. The setting is an outpatient clinic of a large university hospital that serves both an urban and rural population. A mailed questionnaire was returned by 150/270 (56%) patients. While satisfaction and compliance were not significantly related, satisfaction was significantly related to the patients perception of benefit received as a result of care provided by the clinic.