Recent molecular evidence has implicated canine distemper virus (CDV) as a possible aetiologic agent in Paget's disease. However, previous serological studies have shown no differences in levels of anti-CDV antibodies between Paget's patients and controls. In this study, the technique of enzyme linked immunosorbent assay was used to measure anti-CDV antibodies in a group of Paget's patients from the North West of England. Some patients were undergoing treatment with 3-amino-hydroxypropylidene (APD), and the pre-treatment levels of antibody were compared with those following treatment. With several patients, it was also possible to compare the antibody levels with results from in situ hybridisation studies. No significant difference was found between the levels of anti-CDV antibodies in patients and controls. However, several patients and some of the controls did have markedly elevated levels of anti-CDV antibody. Antibody levels remained fairly constant following treatment with APD, except for two patients who showed marked changes. The patients positive for CDV by in situ hybridisation had significantly lower levels of anti-CDV antibodies when compared with those that were negative by in situ hybridisation. These results suggest that if CDV does cause Paget's disease, anti-CDV antibodies play little or no part in the disease pathogenesis. High levels of anti-CDV antibodies in both Paget's patients and controls suggest that a canine virus can infect humans. The fact that those patients that had CDV transcripts detectable in their bone cells had low levels of anti-CDV antibodies might suggest failure to clear the virus during an initial infection.(ABSTRACT TRUNCATED AT 250 WORDS)
The characteristic bone deformities associated with advanced Paget’s disease of bone may result in abnormal gait and plantar foot pressures, which contribute to the development of pressure-related skin problems. This study aimed to characterize the foot problems and foot-care needs in this patient group and to investigate the effect of disease distribution on the occurrence of foot pathology. One hundred thirty-four patients with Paget’s disease were assessed clinically, and the Foot Structure Index was completed for each patient. Patients completed self-administered questionnaires concerning foot function (Foot Function Index) and quality of life (12-Item Short Form). The results of this study suggest that foot-health and footwear problems are common in patients with Paget’s disease. Forty percent of the patients required professional foot care in addition to those already receiving it. The site of pagetic involvement did not affect the occurrence of foot pathology. Further research is required on the impact of the extent of any femoral or tibial deformity on foot symptoms and pathology. Biomechanical studies of the forces and motion in the foot related to different degrees of femoral and tibial deformity might also help determine the impact of deformity on foot pathology. (J Am Podiatr Med Assoc 96(3): 226–231, 2006)
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