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ID PMID Title PublicationDate abstract
7966065 Quality of life in rheumatoid arthritis: validation of a Spanish version of the Arthritis 1994 Jul OBJECTIVE: To translate and validate The Arthritis Impact Measurement Scales (AIMS) to be used by Spanish speaking populations. METHODS: We administered the questionnaire to 97 outpatients with rheumatoid arthritis (RA) during routine patient care, in most cases with a trained interviewer. Reliability was assessed in stable patients using test-retest at a one-month interval. Internal consistency was evaluated with the coefficient of reliability. Convergent and construct validation was tested using ARA functional class, disease severity, disease activity, patient global assessment, and pain scores. Responsiveness was evaluated with one-tailed Student's t test and percentage of change. RESULTS: Test-retest reliability was statistically significant for all scales except Activities of Daily Living and Anxiety. The coefficient of reliability was > 0.7 for all scales. Convergent and construct validity was detected with the constructs employed (Pearson's r > 0.4). Four/nine scales detected improvement (p < 0.05) in those patients in whom clinical change was recorded. CONCLUSION: The Spanish-AIMS retained the methodological properties of the original version and can be used as an outcome measure in Spanish speaking patients with RA.
8033718 [Previously deposited autologous blood for rheumatic patient in surgical field]. 1993 Sep From June 1991 to February 1992, an autologous blood transfusion program was employed for 26 rheumatic patients in this hospital. Among them, 16 were diagnosed as rheumatoid arthritis (RA), 6 osteoarthritis (OA) and 4 ankylosing spondylitis (AS). Knee synovectomy was performed for 7 patients and total hip or knee arthroplasty for the other 19 patients. The total amount of blood autotransfused was 15,200 ml, which accounted for 89.4% of the total blood transfusion during the operation. Twenty-one patients (80.7%) received only autologous blood, while the other 5 (19.3%) required additional homologous blood. Only one adverse reaction occurred in one patient who received homologous blood. By the observation of a series of clinical and immunological indices, no aggravation was seen. Therefore we believe a program of prior deposit and storage of autologous blood for rheumatic patients, who need surgical treatment, is both cost-effective and safe.
1626282 Dietary fish oil and rheumatic diseases. 1992 Jun Dietary fish oil supplementation can induce several metabolic changes relevant to rheumatic diseases. Both experimental and clinical evidence show that dietary fish oil supplementation modulates inflammatory and immune responses. Many studies have shown beneficial, albeit modest, effects in the treatment of rheumatoid arthritis. Studies in murine models of systemic lupus erythematosus have been encouraging, but few studies have been performed to assess the effects of dietary fish oil in the human disease or in other systemic rheumatic diseases. Further study on the efficacy of dietary fish oil supplementation in the treatment of specific rheumatic diseases is warranted.
8081672 Psoas abscess in rheumatoid arthritis--an inperspicuous diagnosis. 1994 Sep Primary or secondary psoas abscess is infrequently seen but should not be forgotten. We report on two patients with RA who presented predominantly with back pain and who subsequently developed pyrexia. The correct diagnosis of psoas abscess was not immediately apparent. These cases and the discussion and comments which follow illustrate the difficulties that may be encountered and remind readers of this inperspicuous diagnosis.
8970269 Health status response of rheumatoid arthritis to treatment with DAB486IL-2. 1996 Apr OBJECTIVE: To examine and compare health status and disease activity changes in patients with rheumatoid arthritis (RA) in a clinical trial of the biologic agent DAB486IL-2. METHODS: Data on 45 patients with RA who were enrolled in a multicourse, double-blind trial, consisting of a first, placebo-controlled, course followed by open-label treatment with the active agent to a total of 3 active courses, were examined for evidence of improvement in health status (measured using the 5 components of the Arthritis Impact Measurement Scales 2 [AIMS2]) and disease activity (measured using standard clinical measures and erythrocyte sedimentation rate). RESULTS: Over a single course of treatment, DAB486IL-2-treated patients showed significant improvement relative to placebo-treated patients on the symptom and social components of AIMS2 and in patient's assessment of disease activity. With subsequent open-label courses of treatment with DAB486IL-2, all 5 AIMS2 health status components and the disease activity measures of tender and swollen joint counts, grip strength, and the observer and patient assessments showed steady and generally parallel improvement. CONCLUSION: Short-term health status effects of this biologic agent were detected using the AIMS2.
7835010 Involvement of atlanto-axial joint in rheumatoid arthritis: rare or frequent? 1994 Sep The authors studied the incidence of atlanto-axial joint involvement by conventional radiography and CT in 183 patients with classical or definite rheumatoid arthritis (RA). In determining lesions the significance of factors such as age, sex, duration and severity of the disease was evaluated. Atlanto-axial subluxations turned out to be quite frequent (30%) in the series of patients examined and were directly correlated with age, duration and stage of the disease, and extraarticular manifestations. Clinical symptoms were evident in only 70.9% of cases, confirming the correlation reported by other authors between clinical manifestations and radiologically observed lesions. Traditional radiography performed in the dynamic position revealed a prevalence of anterior subluxation, whereas CT gave a precise indication of the entity and type of atlanto-axial lesion. In conclusion, the authors confirm the importance of such investigations in all patients with RA, even those without evident clinical manifestations. They also emphasize the necessity of periodic monitoring in view of the possible risk of mortality in these patients.
8186407 Comparisons of the oscillatory shear viscoelasticity and composition of pathological synov 1993 Sep Rheological and compositional properties of pathological synovial fluids were measured and compared in order to reveal differences between disease states. The cases include degenerative joint disease, rheumatoid arthritis, mixed connective tissue disease, and pseudogout. Using an oscillatory flow capillary instrument, measurements were made of both the frequency and shear rate dependence of the complex viscoelasticity. The fluid types differ most in their elasticity, with the degenerative joint disease fluids having the greatest average viscosity, elasticity and intrinsic viscosity, followed by the rheumatoid arthritis fluids, and the fluids from cases of mixed connective tissue disease. Differences in the hyaluronate and protein concentrations are not as great as those between rheological variables. The viscoelasticity of synovial fluid appears more strongly dependent on the degree of polymerization of hyaluronate than on its concentration. These synovial fluids conform well to a model of relaxation process truncation. Distinct types of elastic stress-strain behavior reveal the nature of the dynamic fluid structure.
1633723 Open-label tolerability study of enteric-coated naproxen in the treatment of osteoarthriti 1992 Two hundred and ninety-six patients were enrolled in a 6-month, open-label tolerability study of enteric-coated naproxen in patients with rheumatoid arthritis (n = 174) and osteoarthritis (n = 122). Thirty percent of the patients were greater than 65 years of age. Under standard clinical prescribing conditions, enteric-coated naproxen 500 mg twice daily and 375 mg twice daily demonstrated an acceptable tolerability profile that was not different from what one would expect with standard naproxen.
7921756 A comparative study of the safety and efficacy of dysprosium-165 hydroxide macro-aggregate 1994 Oct The aim of our study was to compare the safety and efficacy of a new preparation, Dysprosium-165 Hydroxide Macroaggregate (165Dy) with Yttrium-90 Silicate (90Y) for radiation synovectomy of the knee in patients with RA and OA. A multicentre double blind clinical trial with subjects randomized to receive 165Dy or 90Y was undertaken in Sydney, Melbourne and Perth. Seventy knees of 59 patients were studied, using as clinical end point measurements, pain in the knee on walking, pain in the knee at rest and stiffness in the knee after rest. Cytogenetic damage, knee retention and extra-articular spread of the radionuclide to regional lymph nodes, liver, urine and blood were evaluated. There was no significant difference in clinical response in the two treatment groups for either RA or OA. Chromosomal changes occurred with equal frequency and the knee retention and extra-articular leakage of radiocolloids to regional lymph nodes and liver were comparable in the two groups. For radiation synovectomy of the knee, 165Dy is at least as safe and as effective as 90Y and has the advantage of a short half-life (2.334 h) and hence requires a shorter period of post-injection immobilization and hospitalization.
1506621 A case of rheumatoid arthritis associated with silent thyroiditis. 1992 May A 41-year-old female with rheumatoid arthritis had nontender enlarged thyroid gland. Thyroid function tests revealed increased concentrations of serum free T3 (FT3, 10.8 pmol/L) and free T4 (FT4, 31.1 pmol/L) with suppressed concentration of thyrotropin (TSH, lower than 0.1 mU/L) and low 24-hour thyroidal radioactive iodine uptake (1.6%). Serum thyrotropin receptor antibody (TRAb) was negative (0%) and she had positive anti-thyroglobulin and anti-microsomal antibodies. A diagnosis of silent thyroiditis was made based on laboratory findings. Serum concentrations of FT3 and FT4 normalized one month later without treatment. The causal relationship between the two diseases is discussed.
7553042 [A case of Sjögren's syndrome with rheumatoid arthritis manifesting transverse myelitis w 1995 Feb We report a sixty-year-old woman with transverse myelitis who had suffered from rheumatoid arthritis since age of 52. She was admitted to our department because of muscle weakness and painful tonic spasm in the bilateral lower extremities, sensory disturbance below the mamillary level and bladder disturbance. She had sicca symptoms. As a result of sialography, Sjögren's syndrome was diagnosed. Antineuronal antibody was found in the sera of the patient. She had no symptom of systemic vasculitis. Lupus anticoagulant and anticaldiolipin antibody were negative. The pathogenesis of transverse myelitis in rheumatic disease is still uncertain. Vasculitis and the immunological reaction of antineuronal antibody have been suggested as possible causes. This report suggests the influence of direct immunological reaction on the central nervous system.
1464075 [Use of pulsed steroid therapy in active rheumatoid arthritis]. 1992 Oct 9 The authors implemented a prospective double blind, controlled study where they administered to a group of 34 patients with active rheumatoid arthritis either three pulses a 1000 mg methyl prednisolone in a small infusion or an infusion with placebo. They proved a very favourable effect--after five days a marked diminution of morning stiffness was recorded, as well as a diminution of pain during locomotion and rest and general improvement of the patient's condition. After two weeks the effect declines but even after 8 weeks the difference, as compared with the initial value, was still significant, while this was not the case after placebo. The sedimentation rate increased after the initial decline to the baseline level. A number of immunological indicators (decline of immunoglobulins, IgG rheumatoid factor, rise of C3 and C4 complement levels and rise of T lymphocytes) suggest an anti-inflammatory and immunosuppressive action persisting for several weeks although the mentioned results were not statistically significant (the majority at the very borderline of significance, probably significant in a larger number of patients). The authors confirm the reactive safety of this treatment, emphasize the necessity to investigate contraindications of treatment (diabetes mellitus) and the necessity to follow up patients in inpatient facilities.
10155563 Extracorporeal photochemotherapy: evaluation of two techniques and use in connective tissu 1994 Dec Extracorporeal photochemotherapy (ECP) consists of collection of mononuclear cells, their irradiation with UV-A light in the presence of a photoactivable molecule--8-methoxy-psoralen (8-MOP) being the most widely used--and their reinjection into a patient. Two technical approaches have been developed. The photopheresis procedure involves four steps: (i) 8-MOP is given to the patient orally, 2 h before collection of white blood cells; (ii) a discontinuous flow cell separator (UVAR, Therakos, West Chester, PA, U.S.A.) is used for cell collection. The final product (740 mL) has a hematocrit of 4.5 +/- 1.7%); (iii) irradiation, performed with the same UVAR apparatus, begins before all the cells are collected, and lasts for 180 min after collection; and (iv) after irradiation, the buffy-coat is reinjected into the patient. We developed a technique summarized as follows: (i) mononuclear cell collection is performed using the Spectra (Cobe, Denver, CO, U.S.A.) cell separator, which provides a highly enriched mononuclear cell concentrate (always > 90% purity), in a small volume < 150 mL, subsequently adjusted to 300 mL for irradiation. Hematocrit of the final product is always < 2%. (ii) Soluble 8-MOP is added to the mononuclear cell concentrate at a final concentration of 200 ng/mL. (iii) Mononuclear cell concentrate is transferred in an EVA plastic bag (Macopharma, Tourcoing, France) to ensure an efficient irradiation with a UV irradiator (Vilber Lourmat, Marne-la-Vallée, France). (iv) After irradiation at 2 J/cm2 (time < 20 min), the cells are reinfused into the patient. Experimental and clinical data suggest that ECP has potential applications in the treatment of connective tissue disorders, such as systemic sclerosis and rheumatoid arthritis. Although encouraging data have been obtained, further clinical trials are warranted to establish the role of this therapy in these indications.
8698995 Fever in rheumatic and autoimmune disease. 1996 Mar This article reviews the most common clinical conditions presenting with fever and musculoskeletal symptoms and attempts to categorize these disorders according to general etiologic categories as an aid to differential diagnosis. Although a substantial armamentarium of serologic, immunologic, and molecular laboratory studies have been developed and are available to the clinician, the most important data are obtained from a careful history and physical examination with emphasis on the musculoskeletal system.
8976644 Quantitation of IL-2Rp75 (CD122) expression on mononuclear cells in rheumatic disease. 1996 Nov OBJECTIVE: To compare expression of the p75 chain of the interleukin-2 receptor (IL-2Rp75, CD122) on peripheral and synovial mononuclear cells in rheumatoid and non-rheumatoid inflammatory arthritis. METHODS: Peripheral blood (PBMC) and synovial (SFMC) mononuclear cells were isolated from subjects with rheumatoid arthritis (n = 16) and non-rheumatoid inflammatory arthritis (n = 12). PBMC were isolated from six healthy controls. Expression of CD122 was examined using indirect immunofluorescence and quantitative flow cytometry. RESULTS: There was no difference in IL-2Rp75 expression on PBMC from rheumatoid arthritis patients, non-rheumatoid arthritis patients, and controls. In subjects with rheumatoid arthritis there was no difference in IL-2Rp75 expression on PBMC and SFMC. However, in the non-rheumatoid arthritis group there was an increase in IL-2Rp75 expression on SFMC compared with PBMC (P = 0.0032). On SFMC there was a greater expression of IL-2Rp75 in non-rheumatoid arthritis than in rheumatoid arthritis (P = 0.0007). Expression was greater on CD8 positive cells and in subjects with shorter duration of disease. CONCLUSIONS: The p75 chain of the IL-2 receptor, an important T cell activation antigen, is not upregulated in synovial fluid. This appears to be a disease specific defect and provides further support for the concept of "frustrated" or incomplete T cell activation in this disease.
7912505 Lack of association of T cell receptor V beta 8 polymorphism with rheumatoid arthritis in 1994 May OBJECTIVES: To study if the reported association of a BamH I 2kb RFLP of the T cell receptor V beta 8 gene with DR4+ rheumatoid arthritis patients is found in non-American white populations. METHODS: The frequency of this RFLP in two different populations was analysed. Eighty one northern Italians were studied for HLA-DR genotypes and V beta 8 polymorphism, and 29 DR4+ British white patients were studied for V beta 8 polymorphism. RESULTS: No association between the V beta 8 RFLP and DR4 was found with rheumatoid arthritis in both groups. CONCLUSION: The reported V beta 8-DR4 association is not generally applicable. The lack of association in our populations may be due to genetic differences, or to differences in factors which shaped the T cell repertoire.
7836026 The purine nucleotide content of lymphocytes from patients with rheumatoid arthritis. 1994 A procedure has been described for the preparation of T and non-T lymphocyte populations. The purine nucleotide contents were analyzed by high-performance liquid chromatography. In healthy subjects the pattern was shown to be different in the two cell populations. In patients with rheumatoid arthritis the findings as compared with the healthy subjects were as follows; in T cells the RA patients showed a slight decrease in di- and tri-phosphates, a more significant decrease of NAD and an increase of AMP. The changes in non-T cells of the RA patients were highly significant and can be summarized as a generalized reduction of all nucleotides, except IMP which tends to increase, and GMP which remains constant. The variations observed in nucleotide content do not involve alterations of some parameters, such as the adenylates/guanylates, the ATP/ADP and GTP/GDP ratios and the energy charges for adenylates and guanylates, regarded as an index of cell energy and viability. It is possible that disturbances of purine metabolism, revealed through the determination of purine contents of lymphocytes, precede immunological events and could be useful in the study of immunologic disorders such as rheumatoid arthritis.
8867431 [Use of gadoteridol in MR diagnosis of rheumatoid changes in the joints]. 1996 Feb PURPOSE: To investigate the diagnostic and clinical usefulness of a new non-ionic, hydrophilic gadolinium (III) chelate [Gd(HP-DO3A), gadoteridol, ProHance] and to compare it with Gd-DTPA (gadopentetate dimeglumine, Magnevist). METHODS: In a Phase III clinical trial, 20 patients with rheumatic joint disease were examined before and after intravenous administration of gadoteridol in two different doses (0.1 and 0.3 mmol/kg bodyweight). Magnetic resonance imaging (MRI) was performed at 1.5 T with T1-weighted FLASH and T2-weighted spin echo sequences. Fourteen patients were examined with gadopentetate dimeglumine for comparison. Dynamic changes of signal intensity in the joints and muscle tissue were determined quantitatively. RESULTS: No significant changes in cardiovascular data and no adverse effects occurred after injection of gadoteridol. The 0.3 mmol/kg dose showed no advantage in diagnostic contrast over the 0.1 mmol/kg dose. No significant differences (p > 0.01) were noted between gadoteridol and gadopentetate dimeglumine in patients with early rheumatoid arthritis. CONCLUSION: Gadoteridol proved useful in the detection of early rheumatoid arthritis. No significant differences were observed between the two gadoteridol doses. There were no diagnostically relevant differences between gadoteridol and gadopentetate dimeglumine.
8801222 A one-day double-labelling technique for tissue specimens: immunogold-silver staining for 1996 Feb An improved technique is described that addresses the problems of sensitivity, specificity, the use of hazardous radioactive equipment and time consumption in immunohistochemical labelling and double labelling of in situ hybridization of tissue specimens. It consists of a two-step protocol in which digoxigenin-uridine triphosphate (UTP) labelled riboprobes in the in situ hybridization step are visualized by the immunogold-silver staining method, and double labelling of tissue antigens is achieved by the application of an alkaline phosphatase-anti-alkaline phosphatase staining step. We tested this protocol using snap-frozen tissue sections of synovial tissue from patients with rheumatoid arthritis. The target mRNA was detected by perforin or cathepsin D riboprobes, the double labelling was performed using anti-collagen type IV and alpha-smooth muscle actin antibodies. It is concluded that, in comparison with an established three- to four-day double-labelling protocol used in many laboratories, this one-day combination is currently the most rapid assay of reliable quality for double labelling of in situ hybridization products and tissue antigens.
7678505 Streptokinase and human fibronectin share a common epitope: implications for regulation of 1993 Jan 22 Rheumatoid arthritis is a disease characterized by a destructive inflammatory process in joints. Fibronectin (FN) is present at a high concentration in rheumatoid synovial tissue and it is a chemoattractant for inflammatory cells. FN fragments also play significant and specific roles in promoting inflammation. In the present study, we demonstrate that FN and the streptococcal plasminogen activator streptokinase (SK) share a common epitope which is recognized by both a rabbit anti-SK IgG and a human anti-SK IgG isolated from the serum of a rheumatoid arthritis patient. This cross-reactive antibody was present in the plasma of 40 patients with rheumatoid arthritis. The region of homology is present in a 90-kDa FN fragment generated by plasmin (Pm) digestion of FN. Amino terminal sequence analysis of this fragment demonstrates that it contains the cell binding domain of FN and the domain responsible for plasminogen binding. The epitope common to SK and FN is not reactive in native FN and it is exposed as a consequence of Pm digestion. It is, however, exposed in native SK. Examination of the sequences of FN and SK indicates a region of homology containing the sequence LTSRPA. This sequence, moreover, is present in the 90-kDa FN fragment generated by Pm digestion. The sequence is present in the amino terminal domain of SK which is essential for its ability to serve as a plasminogen activator. LTSPRA coupled to a carrier protein also reacts with anti-SK antibodies obtained from rabbit or the plasma of patients with rheumatoid arthritis. These studies suggest that the Pm-generated FN 90-kDa fragment may react with circulating antibodies originally elicited by streptococcal infections. These immune complexes may play a role in the etiology of rheumatoid arthritis.