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Search for: rheumatoid arthritis    methotrexate    autoimmune disease    biomarker    gene expression    GWAS    HLA genes    non-HLA genes   

ID PMID Title PublicationDate abstract
1581141 Health status instruments and physical examination techniques in clinical measurement meth 1992 Apr Chronic rheumatic diseases can severely compromise a patient's functional ability. These limitations are often better appreciated through a patient's self-report and a physician examination than through laboratory and radiographic assessments. Researchers are adapting the established health status questionnaires for non-English-speaking patients and for other rheumatic conditions besides rheumatoid arthritis. Rather than tailoring existing instruments for other diseases, some clinician investigators are developing entirely new disease-specific self-assessment questionnaires. Physicians are also addressing the subjectivity of their physical examination techniques. They are devising consistent and sensitive parameters that can be combined with health status questionnaires to monitor disease activity, gauge therapeutics, predict health services utilization, and predict work disability.
8737727 Iatrogenically induced vertebral osteomyelitis due to Pseudomonas aeruginosa. 1996 Mar We report three cases of iatrogenically induced vertebral osteomyelitis due to Pseudomonas aeruginosa. One case was a post-nucleotomy and post-operative complication of herniated disk treatment, one was related to infection of an epidural catheter in a patient suffering from rheumatoid arthritis and the third followed urinary investigation in a patient with prostate cancer. Infection was cured in all patients with antibiotic treatment. These case reports shed light on the possibility of infections with pseudomonas aeruginosa, in addition to the more common infections such as by staphylococci, especially following iatrogenic maneuvers.
8366212 Primary cutaneous phaeohyphomycosis: report of seven cases. 1993 Jun We report seven cases of primary cutaneous phaeohyphomycosis. There were five males and two females, ranging in age from 42-65 years (mean 57.7 years). Two patients were otherwise healthy, but five were immunocompromised. One patient had rheumatoid arthritis and was on oral prednisone; two were renal transplant recipients, one was a heart transplant recipient, and the fifth had dermatomyositis. No history of trauma was elicited from any of the patients, but in two cases, foreign material was seen in the tissue sections. All lesions were on the extremities. In two cases, tissues were cultured, and these grew Exophiala jeanselmei. The others were not cultured because fungal infection was not clinically suspected. No systemic disease developed in any of the cases, and all were cured by the simple, complete excision of the lesions.
8492438 [Eosinophil-derived collagenase (metalloproteinase)]. 1993 Mar Collagenase is a highly specific neutral protease which acts by cleaving the collagen molecule into fragments, at a site three-quarters of the distance from the amino terminus. Collagenase has been assumed to be connected with the destruction of the pathological connective tissue which accompanies inflammatory conditions such as rheumatoid arthritis and interstitial lung disease. Despite the association of eosinophils with wound-healing and fibrotic processes, their collagenolytic ability has been poorly defined and it was not until 1984 that human eosinophils were shown to contain an enzymatic activity which degrades collagen. Eosinophils contain a metalloprotein that degrades types I and III collagens and no collagenolytic activity against types IV and V collagens is detected. Some experiments suggested that the eosinophil collagenase was different from neutrophil collagenase which cleaves type I collagen preferentially. Eosinophils may play a role in the alterations in connective-tissue matrices seen in physiological and pathological states.
8445041 Mechanisms of autoimmunity in type I diabetes. 1993 Jan The work presented in this review suggests that in human and murine type I diabetes, defective MHC class I expression on APC is linked to autoimmunity. The defect in self-antigen presentation is present on prediabetic and diabetic APC, and this presumably delivers abnormal or lack of signals to T cells to allow self tolerance. Since most autoimmune diseases have strong genetic linkage to MHC class II region, our recent results additionally demonstrating low MHC class I expression on lymphoid cells in a diversity of autoimmune diseases (hypothyroidism, rheumatoid arthritis, lupus, etc.) suggest that this pathway of abnormal class I presentation of self epitopes may be important for tolerance to many tissue-specific antigens (40). Certainly, the unanswered genetic questions will address the role of the specific genes controlling self-antigen presentation through MHC class I followed by T-cell education to self.
1637694 Minimizing the risk of post-operative pyoderma gangrenosum. 1992 Jul A 61-year-old woman with seropositive rheumatoid arthritis developed numerous ulcers due to pyoderma gangrenosum at suture entry/exit sites following an arthroplasty of the right hip when interrupted silk sutures were used to close the skin. When a subsequent arthroplasty was performed on the left hip and subcuticular Dexon sutures were used to close the skin only two small ulcers developed. Sixteen cases of pyoderma gangrenosum developing in surgical wounds have previously been reported. We recommend that surgery in patients with a history of pyoderma gangrenosum is performed when the pyoderma is clinically quiescent, and that subcuticular sutures are used for skin closure, thus avoiding puncturing the skin surface.
1433925 [Malignant lymphoma occurring subsequent to autoimmune disease]. 1992 Jun The authors report six cases of non-Hodgkin's lymphoma (NHL) (3B-cell type, one T-cell type, one non-T non-B cell type, one unclassified type) occurring subsequently to autoimmune diseases. The patients were females aged 43 to 70 (median 61). Rheumatoid arthritis was most frequent as the preceding autoimmune disease, and the intervals from the onset of an autoimmune disease to that of NHL were 10 to 36 years (median 20). Polyclonal hypergammaglobulinemia was seen in 4 cases, lymphocytopenia in 3 cases, and conversion to negative PPD reaction in 2 cases. Only one patient had been given corticosteroids, and immunosuppressive agents may not contribute much to the development of lymphoma in patients with autoimmune diseases.
9119517 Systemic manifestations of Takayasu arteritis: the expanding spectrum. 1996 Aug Takayasu arteritis (TA) is a chronic inflammatory and obliterative disease of large vessels particularly the aorta and its major branches. Recently, the disease has been shown to involve the parenchyma of various organs. Specific glomerular lesions reported in patients with TA are mesangial proliferative, membrano-proliferative, crescentic glomerulonephritis and amyloidosis. Dermatological manifestations of this disease are erythema nodosum, facial lupus rash and erythema induratum. Dilated cardiomyopathy, myocarditis and pericarditis have been reported in TA. Rarely, interstitial lung disease, pneumonic consolidation, idiopathic ulcerative colitis, rheumatoid arthritis and polymyositis have been described in association with TA. In this report, five patients of TA with primary parenchymatous involvement of kidneys, skin, heart and gastrointestinal tract have been described. An association of primary parenchymatous organ involvement and TA suggests an autosensitization to an unidentified antigen in the pathogenesis of TA.
8572833 Restless legs syndrome. A review. 1996 Feb 12 Restless legs syndrome is characterized by unpleasant, deep-seated paresthesias in the legs and sometimes the arms. These sensations occur at rest and are relieved by movement. Sleep disturbance is common. Many patients also have periodic movements of sleep. Mild symptoms of restless legs occur in up to 5% of the population. Restless legs syndrome is idiopathic in most patients, but it may be the presenting feature of iron deficiency and is also common in uremia, pregnancy, diabetes mellitus, rheumatoid arthritis, and polyneuropathy. Treatment of the underlying cause, when possible, usually relieves the symptoms. For patients with severe symptoms, levodopa, bromocriptine mesylate, opioids, carbamazepine, clonazepam, and clonidine hydrochloride have proved to be effective.
8624463 Chronic natural killer cell lymphocytosis. 1996 Jan Chronic proliferations of natural killer (NK) cells (CD3- CD16+) are identified initially by detecting large granular lymphocyte (LGL) excess in a peripheral blood smear and subsequent lymphocyte immunophenotyping by flow cytometry. A related disease, T-LGL leukemia, has an indolent clinical course with chronic neutropenia and a close association with rheumatoid arthritis. Herein are described the clinical presentation and long-term clinical course of patients with chronic NK cell lymphocytosis (CNKL). The majority of the 14 patients followed up for a median of 4 years presented with severe cytopenias or vasculitic syndromes that were responsive to immunosuppressive therapy. Other manifestations included fever and arthralgias. In general, the disease was nonprogressive and had a course similar to that of T-LGL leukemia.
7967067 [Osteoporosis--concept, classification and epidemiology]. 1994 Sep Though vertebral fractures were required to make the diagnosis of osteoporosis prior to the advent of methods for accurate bone measurement, osteopenia is readily defined by a decrease of bone mineral density by 2 to 2.5 SD from the peak bone density. After excluding other metabolic bone diseases such as primary hyperparathyroidism, osteomalacia, renal osteodystrophy, multiple myeloma and tumor metastases by means of X-ray studies and biochemical studies on serum and urine, by far the largest proportion of patients with osteopenia are usually found to have osteoporosis. Primary osteoporosis is found in males and females after middle age, and secondary osteoporosis at any age with definite causes such as corticosteroid excess, immobilization, rheumatoid arthritis or vitamin C deficiency. Estrogen withdrawal in young women is classified as secondary osteoporosis, but postmenopausal osteoporosis with similar cause is usually classified into primary osteoporosis, creating a confusion. Rapid bone loss occurring only during a few years after menopause should be clearly distinguished from the life-long process of bone loss common to males and females and should not be classified as a "type" of osteoporosis.
8140252 Dietary lipids and immune function. 1993 Oct Interest in the use of alternative dietary lipids to prevent or control human disease has gained scientific support from numerous studies which have uncovered beneficial effects of increased amounts of polyunsaturated fish and plant oils upon such diverse disease processes as atherosclerosis and coronary heart disease, rheumatoid arthritis, post-operative and post-traumatic recovery, and sepsis. The immunologic processes which underly these pathologic states, and the possible ways in which dietary lipids may influence immunologic function are areas of active research. This review aims to summarize the current views of understanding how immune-mediated processes and inflammatory states may be altered by the content and types of lipids in the diet.
8391361 The increasing recognition of medullary lysis, cortical osteophytic proliferation, and fra 1993 Mar During the past 20 years in the United States more than 2 million hinged, spacing implants, intended to replace degenerated bone and to allow improved motion in cases of hallux rigidus, hallux limitus, rheumatoid arthritis, trauma, and hallux valgus have been implanted in first and lesser metatarsophalangeal joints. In addition, implants made of similar material have been implanted in the fingers, hands, wrists, and elsewhere. Most of these materials have been constructed of silicone rubber or SILASTIC. Adverse effects such as implant fracture, implant particulization, and loss of cortical and intramedullary bone are now being seen with increasing frequency. Salvage surgical procedures are now being developed.
8435294 Endocrine disease. 1993 Jan The effects of endocrine disease on bone mass continue to attract attention. Investigations include the effects on the skeleton of thyroid disease, primary hyperparathyroidism, and their treatment. The effect of growth hormone replacement in adults with panhypopituitarism has also been investigated; children with treated growth hormone deficiency appear to reach adulthood with low bone mass. The indications for surgery in asymptomatic primary hyperparathyroidism have recently been reviewed. The associations between autoimmune thyroid disease and connective tissue disease have been investigated. Although patients with Graves' disease are frequently positive for antinuclear antibodies, there appears to be no increased risk of systemic autoimmune disease. The possible pathogenesis of diabetic bone disease via calcium malabsorption, hypercalciuria, reduced bone formation, and collagen abnormalities has been reviewed. A long-term study has clarified the links among diabetic control, limited joint mobility, nephropathy, and retinopathy. The possible mechanisms by which pregnancy may induce remission in rheumatoid arthritis have been discussed.
1381425 Lymphocytes in pseudomembranes of late prosthetic joint failure. 1992 Mar The pseudomembrane formed in association with late aseptic prosthesis failure contains a mixed giant cell and histiocytic infiltrate with variable numbers of lymphocytes. Immunolabelling with a panel of antibodies on paraffin sections was undertaken to define the nature of the lymphoid infiltrate in 19 cases. In all cases, the predominant lymphoid cell was a memory (CD45RO+, CD45RA-) T-cell. B-cells were rare. Tissue from patients with rheumatoid arthritis (RA) contained greater numbers of T-cells when compared with patients with osteoarthritis (OA), suggesting that the intensity of the lymphoid infiltrates reflects the underlying joint disease rather than necessarily being part of a hypersensitivity response to wear debris.
22822772 Sandimmun(®) (ciclosporin, Cyclosporin A) Past experience and present uses in autoimmune 1993 Sandimmun (cyclosporin) is the established therapy to prevent graft rejection of all transplanted organs. The drug is also effective in several autoimmune diseases. Uveitis was the first clinical indication tested with Sandimmun systematically in the early eighties. Its use has been widely accepted particularly for the treatment of Behçet uveitis. However, in long-term use at high doses, biopsy-proven kidney deterioration in some patients led to a reduction in recommended doses. With close monitoring of renal dysfunction and a starting dose not exceeding 5 mg/kg, Sandimmun has since been shown to be effective in controlled trials in severe rheumatoid arthritis, severe psoriasis and treatment-resistant atopic dermatitis. Sandimmun has also been shown to be of benefit in patients with nephrotic syndrome, SLE and primary biliary cirrhosis among other indications. Based on extended clinical trials and numerous publications, it can be concluded that the use of Sandimmun in selected autoimmune diseases is of benefit to patients if the risks are adequately controlled by following established safety monitoring rules.
8973729 Utility and safety of parotid gland biopsy in Sjögren's syndrome. 1996 Nov Parotid gland biopsy was performed in 32 female patients affected by suspected Sjögren's syndrome. In all cases histologic findings were in agreement with this diagnosis and in two subjects led us to detect the malignant transformation into lymphoma. None of the patients developed relevant complications. Our study indicates that parotid gland biopsy in Sjögren's syndrome is a safe procedure and may be useful in performing diagnosis.
8948194 Diagnosis and management of the dry mouth: Part 1. 1996 Mar Dry mouth is a relatively common problem, often neglected by patients and dentists alike. This article reviews the symptoms, causes and treatment of xerostomia and provides guidelines for recognizing the condition at an early stage.
8029168 Hashimoto's thyroiditis, Sjogren's syndrome and orbital lymphoma. 1994 Jun A 69 year old Chinese housewife presented with periorbital puffiness, and dry eyes and mouth. Subsequent investigations confirmed the presence of Hashimoto's thyroiditis, Sjogren's syndrome and orbital lymphoma. This unusual combination is discussed with reference to previous publications.
7517901 Sialogogic activities of SNI-2011 compared with those of pilocarpine and McN-A-343 in rat 1994 Jan 1. We examined the sialogogic activities in rat major salivary glands of SNI-2011, in comparison with those of pilocarpine and McN-A-343, and we characterized the subtypes of muscarine receptors that are involved in the sialogogic responses to SNI-2011 and McN-A-343. 2. SNI-2011 at doses ranging from 1 to 10 mg/kg (i.v.) increased the secretion of saliva in a dose-dependent manner. The dose-response curves for SNI-2011 were approximately parallel to curves for pilocarpine but the potency of SNI-2011 was about 25-fold lower than that of pilocarpine. 3. The total volume of saliva secreted in response to McN-A-343 was very much less than that secreted in response to SNI-2011. 4. The salivation induced by SNI-2011 and by McN-A-343 was inhibited by various antagonists with the following rank order of potency: 4-DAMP >> pirenzepine >> AF-DX 116. 5. Our results suggest that the sialogogic effects of SNI-2011 and McN-A-343 are mediated by direct stimulation of M3 receptors in salivary glands and that SNI-2011 may prove useful in the management of xerostomia in patients with Sjögren's syndrome.