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ID PMID Title PublicationDate abstract
7794978 The sense of coherence scale in patients with rheumatoid arthritis. 1995 Mar OBJECTIVE: To analyze Antonovsky's Sense of Coherence (SOC) Scale, in 828 patients with rheumatoid arthritis (RA) from 15 private rheumatology practices. This scale is designed to evaluate strengths within individuals that allow them to select appropriate strategies to deal with stressors; both the total 29-item (SOC-29) total scale and a 13-item (SOC-13) short form of the 29-item scale were analyzed. METHODS: Data were collected through mailed self-report questionnaires as a component of a long-term monitoring program. Internal consistency was evaluated according to Cronbach's alpha. Split-halves reliability was estimated according to the Spearman-Brown prophecy formula. Associations of the SOC-29 and the SOC-13 scale scores with demographic, clinical, and psychological variables were analyzed according to Pearson product moment correlations. RESULTS: Lower SOC-29 and SOC-13 scale scores were correlated significantly with higher scores for difficulty in performing activities of daily living (ADL), a visual analog pain scale score, global health status, and perceived learned helplessness. The levels of correlation for these variables suggest that each measure represents a construct that differs from the SOC. Lower scale scores were also correlated significantly with fewer years of formal education, adjusted for age, sex, and disease duration. CONCLUSIONS: The SOC-29 and SOC-13 scales are reliable and valid in patients with RA. The SOC scale explained in part variation in clinical status in patients with RA. The SOC-13 provides utility comparable to the SOC-29 in patients with RA.
8147132 [Expression of TNF receptors in rheumatoid arthritis and ankylosing spondylitis]. 1993 Nov Tumor necrosis factor is an important mediator of the pathophysiologic events in synovitis. The expression of the p75 and p55-TNF-receptors in rheumatic diseases was investigated. Synovial mononuclear cells (SMNC) of patients with rheumatoid arthritis and spondylarthropathies express p75 TNF receptors in all cases, whereas SMNC of patients with traumatic synovitis do not. In 4/9 patients with rheumatoid arthritis and in 6/11 patients with spondylarthropathies SMNC also expressed the p55 TNF receptor. Differential analysis of lymphocytes and monocytes/macrophages revealed that both predominantly expressed the p75 TNF receptor. The highest concentrations of both soluble TNF receptors which may act as TNF antagonists were found in synovial fluids of rheumatoid arthritis patients.
7864689 Outcome of second line therapy in rheumatoid arthritis. 1994 Dec OBJECTIVES: To study the functional outcome in patients with rheumatoid arthritis (RA) who tolerate second line drug therapy for five years. METHODS: We enrolled into prospective controlled trials, 190 patients with rheumatoid arthritis who tolerated 'disease modifying' antirheumatic drug therapy for five years. Demographic data were recorded. Disease activity was measured every six months for two years and annually thereafter, using clinical and laboratory variables. Patient function was measured using the modified Health Assessment Questionnaire. The change in each variable was analysed using paired Wilcoxon tests. RESULTS: Patient function improved significantly compared with baseline. The improvement was maximal after one to two years, and thereafter function started to decline slowly. After five years of treatment the patients' function was still significantly better than before treatment had started. There were highly significant improvements in all variables measured to assess disease activity, which remained well controlled throughout the five year period. CONCLUSION: Good control of disease activity and improved function can be achieved long term in approximately 30% of RA patients treated with injectable gold, sulphasalazine or penicillamine.
8992006 Problems in evaluating radiographic findings in rheumatoid arthritis using different metho 1995 Oct Radiographic scoring is generally accepted as the "gold standard" to follow the course of rheumatoid arthritis (RA). Several methods have been developed to quantify radiographic changes due to RA. The most widely used methods have been proposed by Larsen and Sharp. Problems of the interpretation of the radiograph and the design of the scoring methods are not resolved. The design of established scoring methods lacks correct correlation to the amount of change on radiographs, leading to confounding of the results of the radiographic analysis. Concerns arise about the correct interpretation of findings on plain radiographs that are caused by having a 2-dimensional picture of a 3 dimensional object. There is no agreement which of the different changes caused by RA on the radiograph have to be considered and which can be neglected. Examples for these problems are given. We compared the established scoring methods of Larsen and Sharp on the same set of radiographs with longterm followup using the correct data analysis to provide the information needed to design an improved scoring method. Details of the study design are reported.
1336964 Comparison of Indium-111-labeled leukocyte scintigraphy and Technetium-99m joint scintigra 1992 Nov This study was undertaken to evaluate the use of Indium-111-labeled leukocyte (111In-WBC) imaging compared with Technetium-99m pertechnetate (99mTcO4-) imaging in 19 patients with rheumatoid arthritis (RA) and 8 with osteoarthritis. Knee and wrist joints were evaluated for both radionuclides. The results indicated a good correlation of the clinical assessment of pain and swelling with joint uptake ratio (JUR) between 111In-WBC and 99mTcO4- in RA and osteoarthritis patients. We observed a discrepancy in both imagings in "burned out" cases. It was concluded that a JUR of 111In-WBC could distinguish active RA from inactive RA or osteoarthritis at a value of 1.15 and that the use of 111In-WBC was a more reliable procedure than 99mTcO4-.
8371222 Acute leukemia after low dose methotrexate therapy in a patient with rheumatoid arthritis. 1993 Jul An 83-year-old woman with seropositive rheumatoid arthritis (RA) developed acute myeloid leukemia after receiving weekly methotrexate (MTX) for 33 months (total dose 690 mg). Although cytogenetic abnormalities typical of damage by cytotoxic agents were not documented, our case may be the first report of acute myeloid leukemia in RA with MTX. We estimate that 6 similar cases should have been observed in France by chance alone. The absence of other reports suggests either that MTX possesses a paradoxical protective effect or that it is not considered a risk factor for malignancy by rheumatologists. Since the number of patients with RA taking MTX can be estimated with reasonable accuracy, the reporting of all suspected cases could help to assess the safety of the drug in rheumatology.
8448644 Cyclosporin A in rheumatoid arthritis--future perspectives. 1993 Mar The new programme for the use of cyclosporin A (CyA) in RA is based on the hypothesis that the drug is more efficacious and better tolerated in early RA and that it can be used as part of therapy with a rational combination of drugs. This paper gives some examples of the ongoing and planned studies that have been set up to test that hypothesis. The development of CyA therapy of RA is a stepwise process. The next steps depend on the outcome of current trials and also on our ability to identify progressive RA at a very early stage.
7974027 [Relationship between apneic episodes and destruction of temporomandibular joints in patie 1994 Aug There have been only a few investigational reports of sleep apnea syndrome (SAS) in patients with rheumatoid arthritis (RA), although it may not be a rare condition and may be life-threatening occasionally. The factor precipitating SAS in such patients is thought to be destruction of the temporomandibular joints (TMJs) from RA processes. To assess the relationship of the degree of destruction of the TMJs to the frequency of apnea, we examined them in 10 RA patients who complained of snoring. Those patients were classified as classical RA according to the criteria of American Rheumatism Association. They consisted of 3 males and 7 females with a mean age of 57.8 + 11.0 years and a mean disease duration of 15.9 +/- 9.4 years. In order to numerically evaluate the degree of destruction of the mandibular rami, we quoted a method from the literature (Redlund-Johnell I, Scand J Rheumatol 16:355, 1987) and measured the vertical distance (= ramal height) from the mandibular angle to the palato-occipital line on the lateral view film of the cervical spine in each patient. The mean values of ramal height (RH) of the normal material (we studied in Japanese) are 46.0 mm in males and 38.3 mm in females. There were 8 cases of SAS out of the 10 RA patients studied. Their mean total apneic episode (TAE) was 289.9 mm with a range of 0-611. The mean ratio (%) of RH to mean value of the normal material (%RH) was 68.8 +/- 22.2% for all. There was a significant statistic correlation between TAE and %RH (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
8534873 [Quality of life, subjective health status and health and life satisfaction in rheumatoid 1995 Sep A Japanese version of Arthritis Impact Measurement Scales (AIMS) was developed after the original AIMS Version 2 and utilized for Quality of Life (QOL) measurement in 691 patients with Rheumatoid Arthritis (RA). Various medical (physical and laboratory) examinations, which are widely used in the clinical settings for the assessment of RA activity and severity, were also performed by physicians. Interrelationships between QOL, patient subjective health status, and health and life satisfaction were analyzed with the following results: 1: The effect of QOL impairment by RA upon patients' subjective health rating and health satisfaction were not constant over the range of severity of disease status. Pain was found to lower overall subjective health and health satisfaction regardless of RA class. On the other hand, while the deterioration of mobility aspects of QOL had negative effects upon patients' subjective health status and satisfaction among less-disabled RA patients, any of physical aspects of QOL, including the degree of mobility impairment, showed no significant association with patients' subjective health status and satisfaction in the more disabled. 2: Psychological aspects of QOL (mood and tension) had significant associations with patients' subjective health status and satisfaction. In the less severe group, mood impairment had a significant effect on subjective health and satisfaction, while in the more severe group tension showed a significant association. It was indicated that management of psychological aspects of QOL is important in RA patients to improve and advance their subjective health status and satisfaction. 3: Although social aspects of QOL, i.e. social support, social life and job status, showed no significant relationship to subjective health rating and health satisfaction, those with less disease severity who lacked social support and who had a jobless state were likely to have lower disease acceptance and life satisfaction, while those with more severe disease who had less social interaction manifested lower life satisfaction. These results suggested that social aspects of QOL, while not directly associated with subjective health rating, could be important factors affecting disease acceptance and life satisfaction.
1318290 Role of bradykinin in inflammatory arthritis: identification and functional analysis of br 1992 Mar Receptor type and function of bradykinin (BK) receptors on human synovial fibroblasts (HSF) was determined. Scatchard analysis of [3H]BK saturation binding to intact synovial cells revealed a single binding site, with a Kd of 3.8 +/- 0.6 nM. HSF express approximately 50,000 BK sites/cell. Specificity of [3H]BK binding was confirmed by the ability of several BK peptide agonists and antagonists to inhibit binding in a dose dependent manner. The rank order of potency for agonist inhibition of [3H]BK and the inability of selective antagonists of the B1-type to displace binding suggest that the BK receptor on HSF is a B2 subtype receptor. The addition of BK to HSF caused a time and concentration dependent increase in PGE2 production. This BK induced PGE2 production was blocked by specific B2 type BK antagonists and not by B1 antagonists. The results of this study identify B2 type BK receptors on synovial fibroblasts and suggest that BK may be a primary mediator in inflammatory arthritis.
8493584 [Effect of arthroplasty of the first metatarsophalangeal joint and shortening valgus osteo 1993 Feb Results of forefoot surgery with rheumatoid arthritis were evaluated in 19 feet of 11 patients. Clayton's operation was performed on 12 feet of 7 patients. The follow-up averaged 3 years and 10 months (range, 2 years and 1 month to 8 years). 1 foot (8.3%) recurred hallux valgus deformity and 3 feet (25%) recurred hammer toe deformity. But all patients complained of difficulties to push off action on the forefoot. Interpositional arthroplasty of the first metatarsophalangeal joint with shortening-valgus osteotomy through the first metatarsal base was done on 7 feet of 4 patients. The follow-up averaged 1 years and 8 months (range, 8 months to 2 years and 2 months). 2 feet recurred hammer toe deformity. But, this group had no problem to push off action on the forefoot compared with Clayton's operation. As regard the relief of pain, all patients had satisfactory results from both methods. These results clarified that the preservation for the first metatarsophalangeal joint function was superior for push off action on the forefoot.
8849537 Collagenase (MMP-1) and TIMP-1 in destructive corneal disease associated with rheumatoid a 1995 The aim of the study was to immunolocalise interstitial collagenase (MMP-1) and the tissue inhibitor of metalloproteinases (TIMP-1) in ulcerating corneas from patients with rheumatoid arthritis, to determine whether changes in expression are associated with destructive corneal disease. Collagenase was expressed by stromal cells in 8 of 8 ulcerating corneas but was not seen in normal tissue (n = 3). TIMP-1 was abundant throughout the normal stroma, but was much reduced or absent from diseased corneas. Collagenase staining was frequently more intense near the epithelial surface and associated with a cellular infiltrate consisting of activated antigen-presenting cells (HLA-DR+), many of which were macrophages (CD68+) and derived from the epithelium or limbus (S100+). Interstitial collagenase produced by infiltrating macrophages and/or stimulated corneal fibrocytes is probably a major mediator of collagen degradation in rheumatoid corneal ulceration. In addition, reduced levels of TIMP-1 expression are consistent with collagenase activity and tissue destruction. Epithelial-stromal cell interactions and the production of local inflammatory mediators are of major importance in the pathogenesis of corneal destruction, although the precise nature of the antigenic stimulation and/or cellular interactions remains to be elucidated.
1611751 Rupture of the Achilles tendon in rheumatoid arthritis with histologic evidence of enthesi 1992 Jul Spontaneous Achilles tendon rupture occurred in a 60-year-old man with a two-year history of sero-positive rheumatoid arthritis (RA). Histologic section of the ruptured Achilles tendon revealed the existence of rheumatoid granulation that consisted of lymphocytes, histiocytes, and small vascular proliferation within the tendon tissue. The enthesis of the tendon to the calcaneus also revealed lymphocyte infiltration in the bone marrow and rheumatoid granulation within the tendon. Throughout the course of his disease, the patient had not been treated with corticosteroids. These facts suggested that enthesis (attachment of tendon to bone) was one of the extraarticular sites of the rheumatoid inflammation and that enthesitis was a possible cause of Achilles tendon rupture in this RA patient.
8809437 Middle ear function in rheumatoid arthritis: a multiple frequency tympanometric study. 1996 May OBJECTIVE: To evaluate the modifications in the mechanical properties of the middle ear in rheumatoid arthritis by assessing its resonance frequency. METHODS: Thirty patients with rheumatoid arthritis (RA) aged 20 to 68 years (mean age 45.8 +/- 12.4 yrs) were investigated by multiple frequency tympanometry and their data were compared with those obtained in a control group of 48 subjects aged from 19 to 65 years. RESULTS: Normal values, calculated at the 95th percentile from the control group, ranged from 800 to 1250 Hz. Eleven RA patients (36.6%) displayed abnormal resonance values. These findings were monolateral in 9 patients and bilateral in 2 (in all a total of 13 ears). Nine out of 13 ears with abnormal multiple frequency tympanometry data were characterized by an increase in resonance and 4 by a decrease. CONCLUSION: These findings were attributed to abnormal acoustic impedence of the middle ear and indicate a possible involvement of the ossicular diarthroses in RA. Our study suggests that RA may involve the incudo-malleolar and incudo-stapedial joints, altering the ossicular mechanisms in response to static air pressure modifications.
7603918 Tricon hybrid total knee arthroplasty: a review of 81 knees followed for 2 to 4 years. 1995 Apr The authors discuss the results of 81 total knee arthroplasties in 65 patients performed between April 1987 and April 1989 using a Tricon hybrid system, consisting of the Tricon M bio-ingrowth femoral prosthesis and the Tricon C cemented tibial component. The Tricon metal-backed patella was used until February 29, 1988, when the all-plastic Tricon C patella was introduced. With an average follow up of 24 months (range: 12 to 48), 38 arthroplasties using this hybrid system were rated as excellent (47%) and 38 were rated as good (47%). The Hospital for Special Surgery scores, which averaged 53 preoperatively, averaged 80 at the most recent follow-up assessment. At the most recent follow-up assessment, 79% of osteoarthritis patients and 56% of rheumatoid arthritis patients have no pain at rest, while 19% of osteoarthritis patients and 44% of rheumatoid arthritis patients have mild pain at rest. Sixty-four percent of osteoarthritis patients and 33% of rheumatoid arthritis patients have no pain while walking, whereas 26% of osteoarthritis patients and 56% of rheumatoid arthritis patients have mild pain while walking. Postoperative complications included fragmentation of the patella in five patients, all occurring with the metal-backed patella. Five patients also experienced petellar subluxation (two metal-backed and three all-polyethylene). One patient had deep venous thrombosis which was treated successfully by re-hospitalization and heparin therapy; one patient with chronic heart disease expired 4 days postoperatively. Use of the Tricon hybrid system has resulted in 94% of all patients having a good or excellent result an average of 24 months postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)
8846648 B lymphocytes and humoral immune responses in rheumatoid arthritis. 1995 Sep Although the etiology of rheumatoid arthritis (RA) remains unknown at present, major evidence implicates humoral immune mechanisms in the pathophysiology of this disease. The primary lesions occur in the synovium and are characterized by immunological activation and chronic inflammation. Activated B cells and plasma cells secrete antibodies including rheumatoid factors and anticollagen antibodies. These antibodies give rise to immune complex formation and activation of the inflammatory cascade. There is no evidence that rheumatoid factor secreting B cells act as antigen presenting cells and present immune complex to T cells, leading to perpetuation of the inflammatory response.
8273547 Immunomodulatory activity of recombinant IL-1 receptor (IL-1-R) on models of experimental 1993 Given the role of IL-1 in inflammation and in autoimmune diseases, studies were designed to examine the ability of IL-1 receptor (IL-1-R) to suppress inflammation in a model of chronic degenerative joint disease of adjuvant arthritis (AA) in Lewis rats and to suppress the development of a systemic lupus erythematosus (SLE)-like disease in MRL/lpr mice. IL-1-R was able to prevent the onset of the AA and, even if therapy started after the establishment of AA, the cytokine receptor was still able to reduce the degree of chronic inflammation and arrested its progress. Treating MRL/lpr mice with IL-1-R resulted in a decrease in the amount of autoantibodies and inhibited joint inflammation. Even in the established disease IL-1-R could reduce rheumatoid factors (RF) and autoantibodies, and the signs of a polyarthritis were inhibited.
7837140 Direct degradation of articular cartilage by rheumatoid synovial fluid: contribution of pr 1994 Oct OBJECTIVE: To test the effects of synovial fluids (SF) on human cartilage in an in vitro model. METHODS: Freshly collected SF were incubated with cryostat sections of articular cartilage, and glycosaminoglycan (GAG) loss determined by microdensitometry after alcian blue staining. RESULTS: Of 20 rheumatoid SF, 11 induced significant GAG loss compared with only 3 out of 15 osteoarthritic SF. The effect of rheumatoid fluids appeared to be related to disease activity. GAG loss was partially prevented by a broad spectrum serine protease inhibitor and a specific elastase inhibitor. Cartilage degrading activity was lost on storage which may explain why it has not been widely reported before. CONCLUSION: Rheumatoid SF can directly degrade cartilage through the action of proteases. There is an involvement of serine proteases, elastase in particular.
8295189 Ultrasonography of the subtalar and midtarsal joints. 1993 Oct An ultrasonographic method for detecting intraarticular effusion in subtalar and midtarsal joints was developed. An unechogenic zone in these joints is a sign of intraarticular effusion or synovitis. It is also possible to inject glucocorticoid into these small joints with the guidance of ultrasonography.
7615698 [Macrophage colony-stimulating factor in patients with rheumatoid arthritis]. 1995 Jun Macrophage colony-stimulating factor (M-CSF) is a cytokine involved in the development and proliferation of the monocyte/macrophage lineage cells. M-CSF has also been reported to participate in the induction of osteoclasts, and may be important in the destruction of bone and cartilage and the periarticular osteoporotic changes seen in patients with rheumatoid arthritis (RA). We developed a new ELISA technique to measure M-CSF levels in synovial fluid with high sensitivity and reproducibility. The mean M-CSF level in the synovial fluid of patients with RA was 1.38 +/- 0.56 ng/ml, and that of patients with osteoarthritis (OA) was 0.67 +/- 0.13 ng/ml. In contrast, serum levels of M-CSF in patients with RA and in normal controls were 1.32 +/- 0.50 ng/ml and 0.90 +/- 0.09 ng/ml, respectively. These differences were both statistically significant. Since serum M-CSF levels correlate with inflammatory signs obtained from examination of blood, they indicate the general condition of patients with RA. Synovial fluid M-CSF levels increase even in the early phase of RA and remain high despite drug therapy, which suggests that they reflect the condition of affected joints including joint spaces and inflamed synovia more directly than do the levels of serum M-CSF. Measurement of the M-CSF level in the synovial fluid may be useful in the diagnosis, clinical evaluation, and assessment of the effects of treatment in patients with RA.