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Symptoms and signs of septic arthritis are an important medical emergency, with high morbidity and mortality. We review the changing epidemiology of septic arthritis of native joints in adults, encompassing the increasing frequency of the disorder and its evolving antibiotic resistance. We discuss various risk factors for development of septic arthritis and(More)
OBJECTIVE To compare joint and soft tissue aspiration using a conventional technique with an ultrasound (US) guided technique. METHODS In the conventional group, 32 joints in 30 consecutive patients referred for joint aspiration and injection to an experienced consultant rheumatologist were aspirated. In the US guided group, 31 consecutive patients were(More)
OBJECTIVE To evaluate the effect of disease-modifying antirheumatic drugs (DMARDs) on the likelihood of patients with rheumatoid arthritis (RA) developing septic arthritis (SA). METHODS The United Kingdom General Practice Research Database (GPRD) was used to identify adults with RA, and age-, sex-, and practice-matched control subjects. Subjects were(More)
BACKGROUND This study evaluates whether peer-assisted learning (PAL) can be used to improve students' clinical examination skills. METHODS Four year 4 students trained in PAL techniques and musculoskeletal (MSS) examination used the Gait, Arms, Legs and Spine (GALS) system in a five-week student selected module. These students then recruited and trained(More)
OBJECTIVES There is a need to improve competence of musculoskeletal system (MSS) examination in medical students and junior doctors. Peer-assisted learning (PAL) is a technique whereby students learn from and with each other. This study aimed to determine whether PAL can be integrated into standard undergraduate medical curricula to improve MSS examination(More)
OBJECTIVE This study aimed to determine whether peer-assisted learning (PAL) can enhance clinical examination skills training. METHODS Three student trainers studied small-group theory and clinical examination and provided PAL as extra tuition for 86 trainees. Trainees watched an examination video, were videotaped practising the examination and, after(More)
 We examined the distribution of polymorphic elements within the tumor necrosis factor (TNF) gene cluster in 105 unrelated individuals and determined their relationship to class I and class II major histocompatibility complex (MHC) antigens, and to the highly polymorphic microsatellites TNFa and TNFb. The data demonstrate the contribution of elements within(More)
Alpha-1-acid glycoprotein (AGP) is a plasma glycoprotein produced by the liver that undergoes increased production and altered glycosylation in several physiological and pathological conditions including rheumatoid arthritis. To date, although present in the synovial fluid of rheumatoid arthritis patients, there has been no evidence for the separate(More)
In systemic lupus erythematosus (SLE) it has been hypothesized that self-reactive B cells arise from virgin B cells that express low-affinity, nonpathogenic germline V genes that are cross-reactive for self and microbial antigens, which convert to high-affinity autoantibodies via somatic hypermutation. The aim of the present study was to determine whether(More)
The context in which learning takes place exerts a powerful effect on the approach learners take to their work. In some instances learners will be forced by the nature of a task to adopt a less-favoured approach. In this study, we used a combination of qualitative and quantitative methods to compare the effect of context on learning at different UK medical(More)