P Davis's research while affiliated with University of Alberta and other places
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Publications (81)
This was a prospective cohort study of 145 seniors attending a senior's clinic and social day program using a self-administered questionnaire. Its objective was to evaluate the awareness, knowledge, risk factors and current treatment of osteoporosis in our two patient groups. A secondary objective was to determine differences between the two cohort...
To evaluate the feasibility and acceptability of providing telehealth consultations in rheumatology.
A prospective review of new consults from a rural area assessed by a rheumatologist in an urban area using telehealth. Patient demographics were recorded along with a self-administered questionnaire reporting assessment of the acceptability of the p...
To determine the utilisation and costs of investigations, and the accuracy of polymyalgia rheumatica (PMR) by family physicians, a retrospective chart review of 123 patients referred to a tertiary care rheumatology clinic was undertaken. The accuracy of diagnosis of PMR in the cohort was 24%. A variable number of investigations and costs occurred p...
To develop and evaluate a practice based small group (PBSG) learning intervention on osteoporosis for primary care physicians.
A needs assessment on osteoporosis was performed and objectives for a continuing medical education (CME) program developed by an interdisciplinary advisory committee. Nine clinical cases were developed for evaluation by CME...
To describe primary care patterns of referral and diagnoses of patients with rheumatic diseases referred to rheumatologists.
The medical records of all consecutive patients referred in 1994 by >300 primary care physicians to two rheumatologists at an academic centre were reviewed. The referring physician diagnosis was compared with the rheumatologi...
Antinuclear antibodies (ANA), rheumatoid factors (RF), and erythrocyte sedimentation rate (ESR) are among the most frequently requested tests in the diagnosis and investigation of connective tissue diseases (CTD). We evaluate the utilization patterns and predictive value of these tests in patients referred to rheumatologists by primary care physici...
To assess the clinical outcome of patients with polymyalgia rheumatica (PMR) and giant cell arteritis (GCA).
All charts of consecutive patients with a diagnosis of PMR and/or GCA attending a tertiary referral center from June 1989 to February 1996 were reviewed following a predetermined protocol. Subsequently, the majority of patients (90%) were as...
To determine the prevalence and association with various diseases of certain autoantibodies among elderly patients, in order to challenge the hypothesis that these autoantibodies are elevated generally in these patients as a result of immunosenescence.
Prospective prevalence study.
A total of 399 elderly patients: 63 aging successfully (without chr...
To determine treatment success rates and factors predicting successful outcome using yttrium-90 intraarticular injections for chronic knee synovitis refractory to other treatments.
A retrospective one year review of 133 treatment interventions with yttrium-90 (Y-90) with response recorded at 3, 6, 9, and 12 mo after injection.
An excellent, good, o...
To make recommendations for the long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) in primary care practice, particularly for patients at high risk for NSAID-induced complications.
The use of misoprostol to prevent gastrointestinal ulceration and other unwanted NSAIDs effects was considered. The role of cyclooxygenase-2 (COX-2) versus C...
Previous studies have reported that the prevalence of certain autoantibodies is nonspecifically elevated in elderly subjects due to immunoscenescence. This study was undertaken to assess the prevalence of anticardiolipin antibodies (aCL) in two elderly subpopulations: Two hundred and eighteen elderly were included in this study; 63 healthy elderly...
Fifty four coded sera, 38 from eight patients with systemic lupus erythematosus (SLE), four from one patient with systemic vasculitis, one from one patient with polyarthritis and 11 normal controls were tested for anti-dsDNA antibodies using seven commercial enzyme linked immunosorbent assays (ELISA) and the radioimmunoassay method (RIA) routinely...
To assess the needs and determine the effect of a Continuing Medical Education (CME) program designed for primary care physicians on the management of osteoarthritis (OA).
The needs of potential CME consumers were determined using a standardized case recall questionnaire on the management of OA. A CME program was designed to specifically address id...
We have evaluated the prevalence of selected autoantibodies commonly utilized in rheumatologic practice in different elderly
subpopulations grouped according to their clinical status. RF, ANA, double-stranded DNA antibodies, and antibodies to extractable
nuclear antigens (ENA) were measured in the serum of all participants using standardized labora...
We have reviewed 11 women post-augmentation mammoplasty who were referred to our clinic with diffuse rheumatic complaints. All patients had undergone mammoplasty with silicone gel-filled implants prior to the onset of their locomotor symptoms (mean latency time 7.8 years). One physician interviewed and examined each of these patients following a st...
Serum cytidine deaminase (CD) as a marker of disease activity was assessed in 100 patients with rheumatoid arthritis (RA) and in 102 assessments of 85 patients with systemic lupus erythematosus (SLE). In RA CD levels correlated well with clinical assessment of disease activity, but were not influenced by varying dosages of ibuprofen as therapy. In...
We have evaluated the autoantibody profiles in the sera of 117 patients with systemic lupus erythematosus (SLE) and compared and contrasted the clinical and laboratory features of the disease of patients segregated according to an autoantibody profile. Using this approach we are able to demonstrate that autoantibody profiles identified subsets of p...
The prevalence of antinuclear (ANA) and antineutrophil cytoplasmic antibodies (ANCA) has been studied in the sera of 62 patients with rheumatoid arthritis and 32 patients with Felty's syndrome. The presence of ANA was less in RA than Felty's syndrome (37% versus 69%). Specific autoantibody identification, where possible, was usually of SS-A or SS-B...
Eighty three patients with classical or definite rheumatoid arthritis taking non-steroidal anti-inflammatory drugs (NSAIDs) were studied in an attempt to determine whether a patient's personality and psychological profile might contribute to the development of NSAID induced gastrointestinal symptomatology. It was found that the personality profile...
We tested the hypothesis that the application of 5 laboratory generated serologic profiles facilitates the interpretation of individual autoantibodies in connective tissue diseases without loss of specificity, sensitivity or diagnostic predictive value. The predetermined laboratory generated autoantibody profiles were analyzed in 423 sera from pati...
Our clinical experience with patients in Zimbabwe suggests that an arthropathy may be a feature of HIV disease. This takes two forms: the first is a reactive arthropathy usually affecting the large, lower limb joints with no other clinical features of a connective tissue disease. The second form is seen in association with features of complete or i...
We have reviewed 10 cases of gold sodium aurothiomalate (GSTM) induced marrow suppression. All had biopsy proven marrow hypoplasia/aplasia. Anemia, neutropenia and thrombocytopenia were observed in 7 of the 10 patients. In 2 patients, hypoplastic marrow was associated with suppression of 2 of the formed elements of the blood, while in one patient,...
The generation of superoxide radicals by activated peripheral blood polymorphonuclear leukocytes from patients with rheumatoid arthritis (RA) has been measured and the in vivo effect of nonsteroidal anti-inflammatory drugs (NSAIDs) and disease remittive agents studied. Generation of superoxide radicals from RA patients was significantly decreased w...
An unusual case of thrombocytopenia as a manifestation of systemic lupus erythematosus is presented. Management was complicated by regeneration of splenic tissue resulting in recurrent thrombocytopenia and a need for repeated splenectomy.
Three patients who received antithymocyte globulin therapy for severe aplastic anemia due to gold therapy are described. In 2 patients the hemoglobin, white blood cell count and neutrophils were normal and platelet counts exceeded 100 X 10(9)/1 more than 2 years after treatment. The 3rd patient did not respond to antithymocyte globulin or to cyclos...
Six patients with Felty's syndrome were reevaluated after a course of chrysotherapy. In 5 patients, white cells and absolute neutrophil counts had returned to normal. In 4 of these, there was significant concomitant improvement in neutrophil function as assessed by the ability of cells to generate superoxide radicals.
Polymorphonuclear leukocytes (PMN) isolated from patients with Felty's syndrome (FS) generate fewer superoxide anions (O-2) upon stimulation with fmet-leu-phe than PMN from normal controls or patients with rheumatoid arthritis (RA). In this study, plasma samples were obtained from 12 patients with RA and 12 patients with FS. Incubation of normal PM...
Neutrophils of 31 patients with neutropenia and rheumatoid arthritis (RA) have been studied to assess their ability to generate superoxide radicals (O-2) on activation. Seventeen patients had classical Felty's syndrome and 14 presumed chrysotherapy related neutropenia. Results were compared with those from age and sex matched controls with uncompli...
We compared the effectiveness of Auranofin, and sodium aurothiomalate (SATM) given for 2 years to patients with rheumatoid arthritis. This was an open trial with randomized entry to 2 treatment groups of 60 patients each. Only 40% of patients completed 2 years of treatment but these showed significant improvement in their indices of disease activit...
The effect of sodium aurothiomalate and auranofin on the generation of superoxide anions (O
2
–
) by polymorphonuclear leukocytes (PMNLs) and adherent mononuclear phagocytic cells (AMNCs) has been investigated. Sodium aurothiomalate at final concentrations of 1, 10, and 100 g Au/ml and auranofin ranging from 0.1 to 2.0 g Au/ml were used in the reac...
The effects of auranofin (AF) and sodium aurothiomalate (GSTM) on the production of specific arachidonic acid metabolites by chemotactic tripeptide activated polymorphonuclear leukocytes has been investigated using radioimmunoassay techniques. AF insignificantly enhanced the production of leukotrienes B4 and C4 at a concentration of 0.5 microgram A...
The effect of three non-steroidal anti-inflammatory drugs, diclofenac, indomethacin and tolfenamic acid, on the production of superoxide (O2-), by normal human polymorphonuclear leukocytes (PMNL) was studied, in vitro. The cells were activated with N-formyl-methionyl-leucyl-phenylalanine (FMLP) and O2- production was measured as superoxide dismutas...
The records of 25 patients who developed neutropenia (granulocyte count less than or equal to 2500 mm3) while receiving intramuscular gold sodium aurothiomalate (GSTM) were reviewed. According to commonly used clinical criteria, 3 patients developed Felty's syndrome, 8 gold myelotoxicity, and 14 mild, chronic benign granulocytopenia. Myelotoxicity...
The therapeutic benefits and toxicity profile of auranofin (AF) have been compared with that of gold sodium thiomalate (GSTM) over a one-year period in 120 patients with rheumatoid arthritis. A similar number of patients on both drugs remained in the study at one year (approximately 60%), and showed similar statistically significant improvement (p...
The production of superoxide by N-formylmethionyl-leucyl-phenylalanine activated neutrophils was measured prospectively with a ferricytochrome C reduction assay in 33 normals, 33 patients with rheumatoid arthritis and 9 patients with Felty's syndrome. Both the rate and quantity of superoxide production were significantly lower in patients with Felt...
Although the presence of free DNA and antibodies to DNA in the sera of patients on maintenance hemodialysis has been reported, we found only a low incidence of antibodies to single-stranded DNA (ss-DNA) and native DNA (n-DNA) using an improved detection technique. In our search for evidence of the possible formation of DNA-anti-DNA circulating immu...
The effect of sodium aurothiomalate and triethylphosphine gold on the generation of superoxide radicals by chemotactic tripeptide-activated polymorphonuclear leukocytes has been investigated using a cytochrome C reduction technique. Neither gold compound inhibited the binding of the tripeptide to cells. Sodium aurothiomalate in concentrations rangi...
One hundred and twelve patients with classical or definite rheumatoid arthritis (RA) were randomly assigned to receive either sodium aurothiomalate (GSTM) or auranofin (AF). Monthly clinical assessments (morning stiffness, grip strength, articular index, pain, quality of life) and concurrent hematological, biochemical, and urine studies were perfor...
The effect of sodium aurothiomalate (GSTM) and auranofin (AF) on polymorphonuclear (PMN) leukocytes has been assessed using a Candida albicans phagocytosis method and by the generation of chemiluminescence of activated cells. Both compounds inhibited the phagocytosis of Candida albicans but at therapeutic concentrations this was only consistent and...
Therapeutic serum concentrations of auranofin, expressed as elemental gold, range from 0.25 - 1.0 micrograms/ml. Monocyte antibody dependent cellular cytotoxicity (ADCC) could be reduced by up to 50% at a gold concentration of 0.125 micrograms/ml. Lymphocyte ADCC was much less dramatically affected although 2.5 micrograms/ml produced virtually comp...
Plasma exchange (PE) has been used in the therapy of RA on the theoretical premise that clinical benefits may accrue from the removal of circulating immune complexes (CIC) and/or from a reversal of reticuloendothelial system (RES) blockade. The role of PE in the management of RA remains controversial. There is little doubt that this procedure can e...
Four tritiated thymidine-labeled DNA preparations known to contain areas of single strandedness were chromatographed on BNDC, HAP, and MAK. With an ethidium bromide fluorescence technique, the proportion of single-stranded regions in each of the stock preparations and DNA column eluates was evaluated. Although all column methods removed a significa...
Splenic reticuloendothelial function was assessed in 20 patients with active rheumatoid arthritis by measuring the clearance of autologous heat-damaged labeled erythrocytes from the circulation. Eight patients (40%) had delayed clearance but in contrast to previous reports, we found no correlation between disease activity, levels of circulating imm...
Sixty female patients with chronic low back pain have been studied clinically, radiographically, and by radionuclide bone scanning for evidence of sacroiliac disease. Twenty-four patients had quantitative sacroiliac scintigraphy (QSS) results suggesting sacroiliitis. In only one of these patients was the radiograph abnormal. Clinical and laboratory...
The assessment of anemia in patients with rheumatoid arthritis may be difficult, especially when iron deficiency and the anemia of chronic disease coexist. The development of a radioimmunoassay for serum ferritin concentration has aided the detection of reduced body iron stores in uncomplicated iron deficiency, but its use is compromised in clinica...
It has been suggested that antibodies to native DNA occur with some frequency in patients treated by hemodialysis. This has been attributed to the use of the technique. We have investigated 48 patients on maintenance dialysis for the presence of antibodies to single stranded DNA (ss-DNA) and native DNA (n-DNA) compared to a control group of 25 nond...
A patient with angioimmunoblastic lymphadenopathy with dysproteinaemia is described. The patient had a severe clinical illness with a pronounced haemolytic anaemia, which followed well-established polyarthritis and gold therapy. It was accompanied by in-vitro evidence of suppressed cell-mediated immune responses and by development of serum antismoo...
We have shown that the function of the effector cells in antibody mediated cell dependent cytotoxicity (ADCC) can be reduced by the use of a number of drugs and prostaglandins. Both polymorphonuclear leucocyte and mononuclear effector cells were studied. Aminophylline and isoproterenol markedly reduced this activity. All the prostaglandins tested--...
In vivo, gold salts have been shown to induce disease remission in rheumatoid arthritis. In some patients, this is associated with a return to normal of suppressed lymphocyte responses to mitogens and antigens. This study demonstrates that gold salts will suppress lymphocyte transformation in vitro but do not affect antibody dependent cell-mediated...
Adherent mononuclear cells from normals and patients with rheumatoid arthritis (RA) were isolated and effects of gold salts on cell cultures assessed in vitro. Phagocytic function of adherent mononuclear cells was assessed by the injestion of opsonized chicken red blood cells. Absolute numbers of phagocytic cells were higher in the RA patients than...
Forty-seven patients receiving gold therapy for rheumatoid arthritis were observed sequentially at 6-monthly intervals. When the disease was in remission, and remained so, the in vitro responses of lymphocytes to phylohemagglutinin stimulation tended to be normal. Improvement in the disease were associated with improvement in lymphocyte response an...
We have used a rapid, sensitive technique to assay penicillamine and its disulphide metabolites in body fluids. Penicillamine in serum is rapidly oxidized and the serum levels of the reduced material found in a pilot study of 10 patients ranged between 0.07 to 0.28 mg%. This technique may prove useful in allowing closer monitoring of therapy with t...
99M Tc stannous pyrophosphate bone scanning with quantitative sacroiliac scintigraphy (Q.S.S.) has been used in 50 females with low backache and in 66 symptomless female controls. Mean uptake of radionuclide at the sacroiliac joints was significantly increased in the patients when compared with controls. Q.S.S. gave objective evidence of unilateral...
In vivo and in vitro animal experiments have been performed to clarify the role of ultraviolet light denatured DNA (UV DNA) and ultraviolet light (UVL) in the pathogenesis of the dermal lesions of human SLE. Rabbits immunized with UV DNA show deposition of immunoglobulin at the dermal-epidermal junction following exposure to UVL. We have also shown...
The development of antinuclear antiboides, proteinuria and cumulative mortality has been studied in four groups of NZB/W mice. Two groups were exposed to different amounts of ultraviolet light [UVL] and one group were bred and raised in total darkness. The fourth group served as a control. No significant difference was noted bwtween the groups in t...
Sera were tested from 23 patients with systemic lupus erythematosus followed over a period of 1 to 5 years. Antibodies to native DNA were measured and correlated retrospectively with clinical evidence of disease activity. The overall degree of correlation between the presence of DNA antibodies and evidence of disease activity was good (P less than...
Antibodies to native DNA have been assessed by three separate radioimmunoassay methods: the Millipore filter technic, the Farr ammonium sulfate precipitation test, and a commercially available kit method. Although each method was found to be reliably reproducible, the different units by which results are expressed made comparison difficult because...
One hundred and six sera from patients with systemic lupus erythematosus (SLE), 20 from patients without SLE but with a positive FANA, and 50 controls were tested for the presence of antibodies to n-DNA, using an immunofluorescent technique with the kinetoplast of Crithidia luciliae as a substrate. A high degree of correlation existed between the r...
The value of an epidemiologic approach to the diagnosis of ankylosing spondylitis was assessed in a pilot study of an Amerind population. In 103 adult volunteers aged 20 to 42 years on a Cree reservation lumbar flexion and chest expansion were measured and HLA typing was performed on peripheral blood lymphocytes. Of the 14 subjects with HLA-B27, 2...
Sacroiliitis can be demonstrated radiologically in over one-third of patients with chronic Reiter's syndrome. We have used a bone scan technique with digital analysis which will quantitatively assess the sacroiliac joints, and have found abnormalities in 24 of 33 patients with active Reiter's syndrome. It seems likely therefore that sacroiliitis is...
Antibodies to ultraviolet light denatured DNA (UV DNA) have been measured in patients with systemic lupus erythematosus (SLE) and normal subjects, using a millipore filter radioimmunoassay. High levels of UV DNA binding were only found in patients with SLE. The presence of UV DNA antibodies correlated well with the presence of native DNA antibodies...
Citations
... The most recent studies involving AuNPs demonstrate the effects of gold sodium thiomalate on macrophage function, showing lysosomal enzyme inhibition and reducing phagocytosis (37). Similar effects were seen in macrophages of several origins, which, when stimulated with AuNPs, showed diminished bactericidal activity against Staphylococcus aureus (38) and low or absent cytokine production IL-6, IL-10, and TNF-α (39,40). Moreover, when splenocytes were stimulated with LPS, the addition of AuNP reduced IL-17 and TNF-α release (40). ...
... Antifosfolipidna antitela se mogu dokazati i kod malog procenta zdravih osoba, bez ikakvih kliničkih manifestacija antifosfolipidnog sindroma. Prema podacima iz literature, učestalost pozitivnih antikardiolipinskih antitela u zdravoj odrasloj populaciji je 1% -5%, a učestalost pozitivnog lupusnog antikoagulansa je 0% -4% [5]. Antifosfolipidna antitela se mogu javiti u okviru drugih autoimunih oboljenja, kao što su sistemske bolesti vezivnog tkiva, posebno često kod bolesnika sa sistemskim lupusnim eritematodesom (SLE). ...
... Idiopathic low back pain is a commonly overlooked, reversible, biomechanical, dysfunction of the sacral axis in anterior innominate rotation, usually bilateral and asymmetrical. [6][7][8][9]23,[27][28][29][30] Frequently caused by a shift in the line of gravity anterior to the acetabula, when lifting, bending, lowering, shoveling, sweeping, etc., the anterior innominate rotation loosens the sacrotuberous ligaments disturbing the ligamentous balance. The innominates sublux on an acetabular axis; shear cephalad and laterally on the sacrum at S3 and fixate in that position. ...
![[object Object]](https://i1.rgstatic.net/ii/profile.image/272368555786276-1441949132418_Q64/Brian-Lentle.jpg)
... A similar CD40-dependent mechanism allows CD4 ? T cells to facilitate antibody production by B cells [44,45]. ...
... No increase in mortality was seen in two other autoimmune strains, however: MRL/Mp lpr/lpr and (NZB Q NZW)F 1 mice. Furthermore, in another study using (NZB Q NZW)F 1 mice, chronic UVR did not affect survival, ANA titers, or proteinuria (Davis and Percy, 1978). In contrast, chronic radiation of NZB mice has been shown to signi®cantly suppress antissDNA levels, using a UV source that emitted equal amounts of UVA and UVB radiation (Strickland, 1984). ...
... A number of older studies have examined the relationship that exists between UVR exposure and systemic autoimmune abnormalities in murine models of SLE (22)(23)(24)(25)(26)(27)(28)(29). The results of these studies are difficult to compare because different light sources and exposure protocols were often used. ...
... The development of a standardised commercially available assay for quantitation of DNA antibodies, suitable for routine clinical application, would potentially be of value. We have had the opportunity to test one such commercially available assay provided by Amersham/Searlel and have demonstrated (Davis et al., 1977b) that a good degree of correlation occurs between the presence of antibodies to double-stranded DNA as detected by this method, and antibodies to double-stranded DNA as detected by the Millipore filter assay with the 3H-DNA procedure now used routinely in our laboratory. ...
... For example, the Farr radioimmunoassay detects highavidity antibodies believed to be more closely associated with SLE activity, while the Crithidia and enzyme-linked immunosorbent assays (ELISAs) detect both high-and low-avidity antibodies. Also, the Crithidia assay is considered to be the most specific of these 3 assays, since the test antigen includes only dsDNA, with no contamination by single-stranded DNA (15,16). Radioimmunoassay and ELISA measure levels of IgG anti-dsDNA, which are thought to be more important pathogenically than IgM, but some immunofluorescence tests may detect both isotypes. ...
... The recent development of a high performance liquid chromatographic (HPLC) method for the determination of penicillamine (20,21) has provided an assay method with the specificity and sensitivity necessary to conduct pharmacokinetic studies of unchanged penicillamine. We have modified this HPLC method and adapted it for use in our laboratory (22). ...
![[object Object]](https://i1.rgstatic.net/ii/profile.image/273597378895875-1442242108396_Q64/Dallas-Rabenstein.jpg)
... 49 Rheumatoid arthritis has also been reported occasionally with DH. 38 Moreover, serologic studies showing increased levels of rheumatoid factor in patients with DH may further support this association. 50 To our knowledge, only 11 cases of rheumatoid arthritis have been reported in association with DH. 29,39,[49][50][51][52] Rheumatoid factor values were mentioned in six of these 11 patients, and reported as positive in five. The incidence of rheumatoid arthritis in our study (3.7%; five patients each with positive and negative rheumatoid factor) is similar to the incidence of LE. ...
