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ID PMID Title PublicationDate abstract
1633722 Efficacy and tolerability of enteric-coated naproxen in the treatment of osteoarthritis an 1992 One hundred and twenty-three patients with osteoarthritis (n = 50) or rheumatoid arthritis (n = 73) were enrolled in a 6-week, double-blind, randomized, controlled, parallel trial comparing enteric-coated naproxen with standard naproxen. Ninety-eight patients subsequently entered a 20-week, open-label trial of enteric-coated naproxen. The study demonstrated that naproxen in both its standard formulation and its new enteric-coated formulation is a highly effective form of therapy for osteoarthritis and rheumatoid arthritis. The tolerability profiles of the two formulations were similar in terms of the types of complaints reported. It is concluded that enteric-coated naproxen is an efficacious and well-tolerated formulation for the treatment of osteoarthritis and rheumatoid arthritis.
8299259 Influence of disease activity on steroid hormone levels in peripheral blood of patients wi 1993 Nov The steroid hormone status of 27 female patients (15 premenopausal and 12 postmenopausal) and 11 male patients with rheumatoid arthritis (RA) was investigated before and after a clinically significant deterioration in disease activity. In postmenopausal patients the serum level of cortisol decreased significantly with the progression of disease activity. No significant change in the serum levels of oestrone, oestradiol, androstenedione, dehydroepiandrosterone, dehydroepiandrosterone sulfate or prolactin was found within the groups. In premenopausal patients serum cortisol levels also decreased, with progression of disease activity, but this difference did not reach statistical significance. In male patients with RA none of the measured steroid hormone levels changed significantly after exacerbation of disease activity. Our data indicate that the synthesis and/or utilization of cortisol might be abnormal in female patients with active rheumatoid arthritis.
8124918 Marked thrombocytosis with chromosomal abnormalities in a patient with rheumatoid arthriti 1993 Dec An 80 year-old Japanese woman with rheumatoid arthritis (RA), complicated with thrombocytosis is described. Mild to moderate thrombocytosis is commonly observed in patients with RA, but she had marked thrombocytosis of over 1000 x 10(3)/mm3 and monosomy 22 with marker chromosome. This case suggests that thrombocytosis unusual with disease activity of RA might occur, and that careful evaluation of the thrombocytosis is required.
8783415 Cytokines affecting megakaryocytopoiesis in rheumatoid arthritis with thrombocytosis. 1996 Particular interleukins, namely interleukin (IL)-6, IL-4 and IL-1, with pro-inflammatory mediator activities have also been shown to be involved in the regulation of megakaryocytopoiesis. As rheumatoid arthritis (RA) is not uncommonly associated with reactive thrombocytosis, we investigated serum IL-1 alpha, IL-1 beta, IL-4 and IL-6 concentrations in RA patients with marked thrombocytosis, and compared them to the levels in RA patients with normal platelet counts and healthy volunteers. IL-1 beta. IL-4 and IL-6 concentrations were found to be correlated with the disease activity in both groups of RA patients, with higher serum levels of each cytokine in the thrombocythaemic group. Significant positive correlations of IL-1 beta and IL-4 with the platelet counts were documented only in patients with thrombocytosis. According to our results. IL-6 and IL-1 beta were found to be good indicators of disease activity in RA, while IL-1 beta and IL-4 seemed to be related more with the process of reactive thrombocytosis secondary to rheumatoid inflammation.
1408372 Total elbow replacement. 1992 Sep Elbow joint replacement is performed primarily in patients with severe elbow pain and elbow joint destruction caused by rheumatoid arthritis. The capitellocondylar implant is the prototype of the nonconstrained elbow resurfacing implant. Successful total elbow joint replacement can result in pain relief and improve rotation and flexion of the arm. Outpatient and inpatient nursing intervention in coordination with occupational therapy promotes optimum function.
8573930 Multiple bursitis--a case with an unusual skin manifestation. 1995 Bursitis is a periarticular rheumatism which occurs as a result of trauma, infection, metabolic disease or rheumatoid arthritis. The disease is usually manifested as a solitary lesion except in a few reported cases of multiple lesions. We describe here a case of bursitis in a 58-year-old woman with multifocal cystic lesions containing sterile bloody or yellowish fluid in the four extremities. Serological abnormalities were also noted, suggesting the presence of rheumatoid arthritis or another autoimmune connective tissue disease.
8761191 A stiff collar for the treatment of rheumatoid atlantoaxial subluxation. 1996 Aug Conservative treatment of atlantoaxial subluxation (AAS) has tended to be rather passive, since there has been a lack of effective tools. The stabilizing effect of a stiff collar in the treatment of AAS was evaluated. Fifty successive rheumatoid patients with unstable AAS were interviewed and examined clinically. Lateral view radiographs of the cervical spine were taken in neutral position, during flexion and extension without a collar, and during flexion with a stiff collar. Seventeen patients did not have cervical symptoms. A stiff collar was able to significantly stabilize AAS in more than half of the cases, the effect being predictable from neutral-position radiographs. The improvement in bearing enhanced the effect of the collar. The means and strategy of conservative treatment of AAS are discussed.
1298591 [A multi-center double blind prospective study of ridaura in the treatment of rheumatoid a 1992 Jul 223 cases of definite rheumatoid arthritis were studied which were divided into ridaura treatment group and placebo group. Observations were made double-blind and prospectively. Judging from the comparison of therapeutic results of each treatment group on each clinical and laboratory parameters and of effective rate of each treatment group on the parameters and by comparing the physicians' and patients' assessments to the ridaura or placebo treatment, it was evident that the ridaura was much superior than placebo, possessing statistical significance. In physicians' assessment 14.2% failed to improve in the ridaura group but being 52% in the placebo group. Ridaura was a slow-acting drug, the earliest time for it to show clinical improvements being 2-4 months after medication. Adverse effects of ridaura were limited; incidence of loose bowel movements was much lower than that reported in the western countries. Among the 148 cases of the ridaura group, only two cases failed to complete the six months treatment course because of untoward reactions.
8835297 Value of 99mTc-IgG scintigraphy in the prediction of joint destruction in patients with rh 1995 The ability of technetium-99m-labelled polyclonal human immunoglobulin G (99mTc-IgG) scintigraphy to predict joint destruction in patients with rheumatoid arthritis (RA) was investigated in this study. The progression of radiographically determined joint destruction in wrists, hands and feet was compared with the results of physical and laboratory examination, as well as 99mTc-IgG scintigraphy, measured at the beginning of a year-long study on 30 patients with RA of recent onset. The sensitivity of joint swelling in predicting the progression of radiographically determined joint destruction ranged between 57% and 74%. The sensitivity of 99mTc-IgG scintigraphy ranged between 71% and 100%. The specificity and positive predictive value both of joint swelling and 99mTc-IgG scintigraphy were low. Multiple regression analysis showed that for the total joint score, and for the metacarpophalangeal and forefeet joints, progression of radiographically determined joint destruction was primarily predicted by 99mTc-IgG scintigraphy. Joint swelling, ESR and IgM rheumatoid factor did not contribute to this prediction. We concluded that 99mTc-IgG scintigraphy is superior to conventional clinical and laboratory measurements in RA with respect to prediction of joint destruction.
1356177 Humanised monoclonal antibody therapy for rheumatoid arthritis. 1992 Sep 26 Monoclonal antibodies that target T cells have shown some benefit in rheumatoid arthritis although responses have not been long lasting. This is partly due to insufficient therapy consequent upon antibody immunogenicity. Use of humanised antibodies, which are expected to be less foreign to man than conventional rodent antibodies, might overcome this problem. We therefore assessed in a phase 1 open study the potential of a "lymphocyte depleting" regimen of the humanised monoclonal antibody CAMPATH-1H in 8 patients with refractory rheumatoid arthritis. Apart from symptoms associated with first infusions of antibody, adverse effects were negligible. Significant clinical benefit was seen in 7 patients, lasting for eight months in 1. After one course of therapy, there was no measurable antiglobulin response, although 3 out of 4 patients have become sensitised on retreatment. Humanisation reduces the immunogenicity of rodent antibodies but anti-idiotype responses may still be seen on repeated therapy, even in patients sharing immunoglobulin allotype with the humanised antibody.
1290348 [Evaluation of immunological studies in patients with rheumatoid arthritis]. 1992 Immunological studies are widely applicable at a clinic in rheumatoid patients, despite the fact that their clinical value is still a disputable subject. Many authors are of opinion that the determination of individual immunological tests does not provide the estimation of immunological state in patients, and should be evaluated critically. The aim of the actual paper was to evaluate the immunological state of patients with rheumatoid arthritis by means of immunological profile index, which consists in performing concurrently many immunological tests involving both humoral immunology and cellular one. The results were referred to the duration of the disease, pathological process activity, the presence of rheumatoid factor, the advancement of osseous changes. The studies were carried out in patients, aged 16-69 years, 63 of them had RA and 9 were affected by ankylosing spondylitis. The control group comprised 16 normal subjects aged 28-61 years. It has been disclosed that the values of the immunological profile index in patients were statistically significantly lower than in the control group. The lowest values of immunological profile index were recorded in patients with extra-articular symptoms with recurrent infections of urinary and respiratory tracts, as well as in patients with active form of RA, and the presence of rheumatois factor. The patients with ankylosing spondylitis were found to reveal immunological disorders, but they were expressed less markedly than in RA patients. With the help of immunological profile it was possible to show that multifunctional immunological disorders appeared in patients with rheumatoid arthritis. The most sensitive immunological tests were: levels of immunoglobulins in blood serum, and the count of lymphocytes T and B. The immunological profile study in patients with rheumatoid inflammation of joints is an objective method of evaluating their immunological state.
10147571 Survivorship and clinical evaluation of cementless, meniscal-bearing total ankle replaceme 1992 Jan A porous-coated, cementless, congruent-contact, meniscal-bearing total ankle replacement with a centrally placed trochlear groove and a cylindrical articulating axis representing the lateral talar curvature was developed and used clinically over a 10-year period. An initial clinical series of 40 ankle replacements involved the use of cobalt-chromium-molybdenum tibial and talar components with sintered-bead porous coating of 275-mum pore size and a shallow-sulcus trochlear groove with a central fixation fin for the talar onlay component. The congruent meniscal bearing, made of ultrahigh molecular-weight polyethylene (UHMWPe), was flat superiorly and matched the shallow-sulcus and cylindrical geometry inferiorly. Two bearings in two patients subluxed laterally and required revision within 2 years. The overall cumulative survival at the 10-year interval for this group using revision as an end point was 94.75%. The clinical results, using a strict ankle evaluation scoring scale, demonstrated 85% overall good to excellent results. Three patients required further treatment for intermalleolar exostoses, one patient required a debridement for infection, two ankles had medially subluxed bearings, eight ankles developed talar component subsidence, and two patients suffered from chronic reflex-sympathetic dystrophy. A second clinical series of 14 ankle replacements involved the use of polished titanium-nitride-coated titanium-6 aluminum-4 vanadium tibial and talar components with sintered-bead porous coating of 350-mum pore size and a deep-sulcus trochlear groove with two lateral fixation fins for the talar onlay component. The bearing element was similar to the initial series except that it had a deeper engagement in the trochlear groove to prevent subluxation.(ABSTRACT TRUNCATED AT 250 WORDS)
1632661 Predictive value of synovial fluid analysis in estimating the efficacy of intra-articular 1992 Jul The predictive relevance of synovial fluid analysis and some other variables for the efficacy of intra-articular corticosteroid injections in 30 patients with rheumatoid arthritis and hydropsy in a knee joint was evaluated in a prospective study. At the onset of the study, the knee joints were aspirated and 30 mg triamcinolone hexacetonide injected intra-articularly. The circumferences and the tenderness scores of the knee joints were measured at onset, after two months, and at the end of the six months' follow up. Of the variables studied, synovial fluid C4, percentage of synovial fluid polymorphonuclear leucocytes, blood haemoglobin, and serum C3 correlated significantly with the decrease in knee joint circumference after two months, whereas only the percentage of synovial fluid polymorphonuclear leucocytes correlated significantly after six months. Between the patients with and without improvement in the tenderness scores of the knee joints, only serum IgM differed at the examination after two months; this was higher in patients whose scores showed no improvement.
8921923 Perceived control: a comparison of women with fibromyalgia, rheumatoid arthritis, and syst 1996 This study compared the attitudes of women with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), or fibromyalgia (FM) regarding their perceptions of control and ability to cope with their disease. We also report the validation of a Swedish version of the Rheumatology Attitudes Index (RAI). One hundred thirty-nine women participated in the study by completing the RAI two or three times along with several other self-report and disease severity measures. The Swedish version RAI was found to have acceptable reliability, evidence of validity, sensitivity to change, and two distinct factors of internality and helplessness. In general, patients with RA or SLE perceived higher control over their symptoms than those with FM. FM patients who participated in a self-management experimental program significantly changed their scores on the RAI in a positive direction.
7932414 Functional disability in early rheumatoid arthritis: description and risk factors. 1994 Jun OBJECTIVE: To provide a description and identify risk factors for functional disability in early rheumatoid arthritis (RA). METHODS: A cohort of 337 patients with early RA with disease duration under 5 years was constituted in 2 areas in France and The Netherlands. Examination included the Ritchie index, the presence of nodes and other extraarticular manifestations, and the erythrocyte sedimentation rate (ESR). The Health Assessment Questionnaire, adapted and validated in the French and Dutch languages, was used to assess functional disability. RESULTS: The results allowed for the cross sectional description of a marked early functional disability, with a score of 1 (adjusted for disease activity variables) from the first year of the disease. Functional disability was increasing nonlinearly with the disease duration in a quadratic model. Disease activity variables, namely ESR and Ritchie index, were identified as other important components of functional disability. CONCLUSION: Consequences for the early management of RA are underlined.
8921924 Low dose cyclosporine in early rheumatoid arthritis: effective and safe after two years of 1996 Forty-four patients with early RA who had participated in a six months double-blind trial, comparing cyclosporine A (CsA) (n = 22) with chloroquine (Chl) (n = 22), were followed for a further 18 months irrespective of their treatment status. At two years follow up, the mean CsA dose was 2.7 +/- 1.1 mg/kg/day (n = 15) and the dose of Chl (n = 11) was 100 mg/day in every patient. Maximal difference in efficacy (represented by the percentage of patients who fulfilled the Paulus 50% response) was reached at one year (CsA group: 68% and Chl group: 36%; p = 0.07). At two years, the differences in efficacy and toxicity between the two groups had diminished. The conclusions of this follow-up study are: 1. maximal efficacy of low dose CsA in early RA patients is reached after one year of therapy. 2. CsA can maintain clinical efficacy and safety comparable to Chl for a period of at least two years.
8690921 T cells bound by vascular cell adhesion molecule-1/CD106 in synovial fluid in rheumatoid a 1996 Mar 15 Elevated levels of soluble vascular cell adhesion molecule-1 (sVCAM-1)/CD106 have been reported in synovial fluid (SF) from patients with rheumatoid arthritis (RA). In the present study, VCAM-1-positive lymphocytes were found in SF from RA patients. The data strongly suggest that sVCAM-1 might be bound to lymphocytes in SF. rsVCAM-1 in the fluid phase can bind to both SF lymphocytes and IL-2-dependent T cell lines with up-regulated expression and binding activity of VLA-4. Furthermore, proliferative responses of SF mononuclear cells (SFMC) with PHA, immobilized anti-CD3, or anti-CD2 and PMA were inhibited to various extents in the presence of rsVCAM-1, but only PMA-induced proliferative response of PBMC from normal individuals was inhibited notably in the presence of rsVCAM-1. rsVCAM-1 also drastically reduced IL-2 production of Jurkat leukemic T cells possessing high affinity VLA-4 with the stimulation of anti-CD3 and PMA, suggesting that the T cell hyporesponsiveness induced by rsVCAM-1 might stem from impairment of IL-2 production. These results indicate that sVCAM-1 provides a negative signal to T cell activation, probably by affecting the pathway of protein kinase C activation. Thus, binding of sVCAM-1 to SF lymphocytes might partly explain the anergic state of these lymphocytes.
7481899 C1-2 arthrography. 1995 Aug OBJECTIVE: To describe the technique of C1-2 arthrography and recommend it as a suitable treatment for pain due to C1-2 abnormalities. MATERIALS AND METHODS: One hundred patients with the following conditions were studied: cervical pain or neuralgia without radiographic changes (group 1, n = 23), osteoarthritis (group 2, n = 37), rheumatoid arthritis (group 3, n = 23), ankylosing spondylarthritis (group 4, n = 5) and diverse conditions (group 5, n = 12). The technique consists of lateral puncture of the posterior aspect of the C1-2 joint with a 20-gauge needle under fluoroscopic control, arthrography using 1 ml contrast medium, and a 1-ml long-acting steroid injection subsequently. RESULTS: The articular cavity has an anterior and a posterior recess. Sometimes the posterior recess is large. In 18% of cases the contralateral joint also opacifies. CONCLUSIONS: C1-2 arthrography appears to be an efficient and safe technique for the treatment of upper cervical pain due to C1-2 articular disorders.
8480142 Proresid therapy in rheumatoid arthritis. A comparison with injectable gold using life-tab 1993 Proresid, mainly consisting of podophyllotoxin derivatives and two glycosides thereof, has been used as a disease-modifying antirheumatic drug in Sweden since the late 1960s. A life-table analysis of Proresid treatment averaging 41 months (range 4-144) in 79 rheumatoid arthritis patients showed a termination rate of 40, 56, 75 and 85% after 1/2, 1, 2 and 4 years, respectively. Dominant reasons for discontinuing therapy were inefficacy (37%) and gastrointestinal symptoms (35%). The risk of discontinuation of therapy due to inefficacy was constant over time, while the risk due to other causes, including side effects, gradually decreased. A comparison with injectable gold therapy showed, after adjusting for confounding factors, that the total termination incidence was higher (p < 0.05) in the Proresid-treated patients. A comparison with the regional cancer register of 334 patients exposed to Proresid for a mean time of 2.2 years showed no increased cancer risk after a mean observation time of 6.1 years.
8235495 Ultrasound examination of metacarpophalangeal joints in rheumatoid arthritis. 1993 To evaluate the ability of ultrasonography with high frequency transducer (13-MHz) in detecting metacarpophalangeal (MCP) joint abnormalities, 20 patients with rheumatoid arthritis (RA) and a symptomatic involvement of MCP joints were studied. Twenty healthy subjects served as controls. In all RA patients, ultrasonography clearly demonstrated one or more soft tissue and/or bone abnormalities. Sixteen patients (80%) had joint cavity widening because of effusion (1 case), synovial thickening (7 cases), and joint effusion with synovial thickening (8 cases). Loss of definition of the metacarpal articular cartilage was observed in 17 cases (85%). Sixteen (80%) had bone erosions and 9 (45%) showed a definite widening of the flexor tendons sheath. Margin irregularities of the extensor and flexor tendons were respectively visualized in 7 (35%) and in 8 (40%) cases. An extensor tendon rupture was observed in 2 cases (10%). Ultrasound examination by 13-MHz transducer appears to increase the accuracy of MCP joints evaluation in RA with respect to conventional radiography. It can be recommended as the first investigation in the assessment of soft tissue involvement in RA patients.