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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
11996442 Lipid profile in rheumatoid arthritis and its relation to disease activity. 2001 Dec AIM OF THE STUDY: To ascertain whether--1. Serum lipids are altered in rheumatoid arthritis (RA) patients and 2. Disease activity has any role in altering lipid profile. METHODOLOGY: Lipid profiles of 25 RA cases were compared with age and sex matched controls. RESULTS: Serum triglycerides (STG) and total cholesterol (TC) were found to be significantly lower in RA patients. In patients with very active disease, activity index (AI) > 80, STG, TC and low-density lipoprotein (LDL-C) were significantly lower as compared to controls. For TG 'r' value of -0.483 indicated negative correlation between disease activity and TG values, though the correlation is not significant (p > 0.05). For TC 'r' value (-0.0551) indicates negative correlation between disease activity and serum TC.
11500160 MR imaging for evaluation of early rheumatoid arthritis. 2001 Jun In rheumatoid arthritis (RA), due to its superior contrast resolution and tomographic nature, magnetic resonance (MR) imaging can depict soft tissue and joint involvement better than plain radiography. Active synovitis and pannus are shown by a wide variety of contrast on T1- and T2-weighted images. They are markedly enhanced by intravenous gadolinium-chelate injection. Fat-suppressed T1-weighted imaging with gadolinium enhancement is the most sensitive technique to demonstrate these tissues. Compared with plain radiography, MR imaging is more sensitive and equally specific in the diagnosis of early RA compared with plain radiography. MR imaging is useful in the diagnosis and treatment of patients who are suspected of having early RA.
9893700 [Rheumatoid polyarthritis: therapeutic management]. 1998 Dec 12 AN OPEN QUESTION: Developing a therapeutic strategy for rheumatoid arthritis is a difficult and much debated task. Recent clinical trials have confirmed the importance of initiating treatment at the onset of disease in all patients with rheumatoid arthritis in order to limit the degree of later progression. INDIVIDUALIZED REGIMENS: Treatment for patients with early-stage rheumatoid arthritis should be adapted individually taking into consideration the expected benefit and risks of drug therapy, the degree of joint inflammation and factors predictive of disease severity which are becoming more and more well understood. PATIENTS IN REMISSION: Treatment should be continued if well tolerated. Treatment should not be discontinued (and then only progressively) unless complete remission has been achieved for a long period. LONG-STANDING DISEASE: The precise therapeutic strategy in patients with long-standing disease remains a question of debate, but does require full-dose combination regimens.
11409668 Does satisfaction with abilities mediate the relationship between the impact of rheumatoid 2001 Jun OBJECTIVE: Both impact of rheumatoid arthritis (RA) on valued life activities and dissatisfaction with abilities have been linked to depression among individuals with RA. We integrated these concepts by examining the hypothesis that satisfaction with one's abilities may explain the mechanism by which the impact of RA on valued activities leads to depression. METHODS: Data were collected over 2 years (1997 and 1998) through interviews with the University of California, San Francisco, RA panel. Analyses examined whether activity impairment in 1997 predicted later (1998) dissatisfaction with abilities and depression. RESULTS: Greater impact on activities predicted dissatisfaction with abilities, which in turn was associated with higher depression scores. There was no direct relationship between activity impact and depression when satisfaction with abilities was considered. CONCLUSION: Satisfaction with abilities mediated the relationship between the impact of RA on valued activities and an increase in depressive symptoms, suggesting a need to assess not only physical decline but also individuals' interpretation of the decline.
10554438 Colchicine therapy for low-dose-methotrexate-induced accelerated nodulosis in a rheumatoid 1999 Oct Accelerated nodulosis developed on the fingers of a woman successfully treated with low dose methotrexate for rheumatoid arthritis. Colchicine therapy resulted in regression of these nodules for twelve months. To our knowledge, this is the first report in the dermatological literature on this relatively new entity in which the skin is also involved.
9825747 Diagnosis and course of early-onset arthritis: results of a special early arthritis clinic 1998 Oct OBJECTIVE: Early arthritis patients referred to an Early Arthritis Clinic (EAC) (n = 233) were compared to 241 patients from the routine out-patient clinic with respect to lag time between the onset of symptoms and the visit to the rheumatologist, clinical presentation and the consistency of the diagnosis after 1 yr. RESULTS: The reduction in median lag time for the EAC patients was at least 3 months. An insidious onset of symptoms was found more often in the rheumatoid arthritis (RA) patients in the routine clinic. In 70% of all cases, a diagnosis could be made after 2 weeks and, if the clinical diagnosis was definite RA, this hardly changed during the following year. Early erosions were seen in 25% of RA patients and were associated with a positive rheumatoid factor (OR 2.08, 95% CI 0.95 4.59). CONCLUSION: An early diagnosis of RA at the EAC is possible and reliable; the high frequency of erosions illustrates the need for early treatment.
9697143 [Cementless hip prosthesis in patients with rheumatoid arthritis]. 1998 Jun From 1986 to 1996, we implanted a total of 92 hip arthroplasties (86 cementless, 4 hybrid and 2 cemented) in 65 patients with rheumatoid arthritis. Of the 89 uncemented cups, 59 were threaded cups (Hofer-Imhof n = 45, Zweymüller n = 7, Mecring n = 5, PM n = 2) and 30 were hemispherical cups of the Harris Galante type I and II. 87 stems were implanted without cement (Zweymüller SL n = 58, Uni n = 16, Schenker n = 9, Zweymüller I n = 4) and 5 with cement. One patient died postoperatively and three (4 implants) within the first year. To date, one cup of each threaded type had to be revised because of loosening (revision rate approx. 6.8%); Up to now, three of 87 (approx. 3.4%) stem revisions (1 x Zweymüller I, 1 x Schenker, 1 x Zweymüller SL) have been undertaken. Ten patients with twelve hip arthroplasties did not return for follow-up; some of them had a poor general health status. The clinical and radiological results of the arthroplasties of 52 patients showed a Harris Hip Score averaging 72 after an average of 54 months (min. 12-max. 132). Ten patients had minor complaints in the hip region. 79% of the uncemented implants (70 out of 89 cups, 69 out of 87 stems) were assessed radiologically. Two threaded cups showed slight migration after cancellous bone grafting in the presence of acetabular protrusion that was present in a total of 13 hip joints. This subsided markedly after filling with cancellous bone and recentering of the hip joint. Homogeneous incorporation of the bone grafting und thus remodelling of the medial wall was achieved, with the bone graft exhibiting marked reduction. At final follow-up, approx. 75% of the cementless cups had complete bone ingrowth without any evidence of radiolucency (type I), approx. 19% had near-complete bone ingrowth with minimal radiolucencies in one zone or in a maximum of 50% of the bone contact area (type III) and approx. 6% had radiolucencies in more than 50% of the bone contact area (type II). The radiographic evaluation of the most frequently used stem (Zweymüller SL) showed approx. 47% with only slight remodelling of the calcar (type I), approx. 33% with moderate loss of femoral density (type II) and approx. 20% with severe bone loss and thinning of cortical bone (type III).
11242889 [Cholesterol pericarditis associated with rheumatoid arthritis]. 2001 Jan Cholesterol pericarditis (CP) is a rare and unusual disease characterized by chronic pericardial effusion with high cholesterol concentration. Precipitation of cholesterol crystals may occur and induce inflammation and constrictive pericarditis. CP may be idiopathic, but is usually associated with a systemic disease, such as tuberculosis, myxedema, or as in our case, rheumatoid arthritis (RA). We present a 78-year-old woman with RA, typical deformities of the metacarpo- and metatarso-phalangeal joints and subcutaneous rheumatoid nodules. She was hospitalized with increasing dyspnea and weakness and a 2-dimensional transthoracic echocardiogram showed a large pericardial effusion, without tamponade. Blood cholesterol was 208 mg/dl, triglycerides 169 mg/dl, LDH 37 u/L and rheumatoid factor 2560 u; glucose, kidney, and thyroid function tests were normal and PPD test negative. Pericardiocentesis yielded 800 ml of opaque, cloudy fluid, with glucose 19 mg/dl, cholesterol 264 mg/dl (normal 20-40 mg/dl), triglycerides 169 mg/dl, LDH 5820 u/L and rheumatoid factor 40 u; viral titers and cultures for bacterial, mycobacterial and fungal infections were negative. The pericardial fluid had a distinctive scintillating, gold-paint appearance and many cholesterol crystals were evident microscopically. The patient responded to treatment with methotrexate and steroids. Factors responsible for increase in pericardial fluid cholesterol may be its liberation from injured pericardial cells and rheumatoid nodules, lysis of red cells, or lymphatic obstruction and impairment of the absorptive capacity of the pericardium.
11469528 Anti-IL-1alpha autoantibodies in early rheumatoid arthritis. 2001 OBJECTIVE: To investigate the potential predictive value of autoantibodies against IL1-alpha (anti-IL-1alpha) in patients with early rheumatoid arthritis (RA). METHOD: Anti-IL-1alpha were assessed by radioimmunoassay in sera from 164 patients with early RA. RESULTS: At baseline, anti-IL-1alpha were detected in 52 (32%) of the patients. After 2 years, the entire patient material showed significant clinical improvement (DAS28, CRP, HAQ, and pain- VAS) while there was an overall radiological progression (Larsen score). The group of patients with anti-IL-1alpha and the group of patients without this antibody showed similar disease development in disease activity, function, and joint destruction and there were no statistically significant differences between the two groups, neither at baseline nor at end-point. CONCLUSION: The present data do not lend support to previous observations that anti-IL-1alpha may be a marker for less destructive RA. However, a predictive value of this antibody over longer time periods cannot be ruled out by this two year study.
9826417 The rotator cuff-deficient arthritic shoulder: diagnosis and surgical management. 1998 Nov The symptomatic rotator cuff-deficient, arthritic glenohumeral joint poses a complex problem for the orthopaedic surgeon. Surgical management can be facilitated by classifying the disorder in one of three diagnostic categories: (1) rotator cuff-tear arthropathy, (2) rheumatoid arthritic shoulder with cuff deficiency, or (3) degenerative arthritic (osteoarthritic) shoulder with cuff deficiency. If it is not possible to repair the cuff defect, surgical management may include prosthetic arthroplasty, with the recognition that only limited goals are attainable, particularly with respect to strength and active motion. Glenohumeral arthrodesis is a salvage procedure when other surgical measures have failed. Arthrodesis is also indicated in patients with deltoid muscle deficiency. Humeral hemiarthroplasty avoids the complications of glenoid loosening and is an attractive alternative to arthrodesis, resection arthroplasty, and total shoulder arthroplasty. The functionally intact coracoacromial arch should be preserved to reduce the risk of anterosuperior subluxation. Care should be taken not to "overstuff" the gleno-humeral joint with a prosthetic component. In cases of significant internal rotation contracture, subscapularis lengthening is necessary to restore anterior and posterior rotator cuff balance. If the less stringent criteria of Neer's "limited goals" rehabilitation are followed, approximately 80% to 90% of patients treated with humeral hemiarthroplasty can have satisfactory results.
10429571 [The interauricular laser therapy of rheumatoid arthritis]. 1999 May Investigations have proved the ability of interauricular low-intensity infrared laser therapy (0.89 nm, 7.6 J/cm) to produce anti-inflammatory, immunomodulating action in patients with rheumatoid arthritis. The method has selective, pathogenetically directed immunomodulating effect the mechanism of which is similar to that of basic antirheumatic drugs and of intravenous laser radiation of blood. This laser therapy can be used as an alternative to intravenous blood radiation being superior as a noninvasive method. Interauricular laser therapy can potentiate the effects of nonsteroid anti-inflammatory drugs, cytostatics and diminish their side effects.
10331123 Evaluation and surgical management of the arthritic midfoot secondary to rheumatic disease 1999 Apr RA is a common disorder that has significant destructive effects on the midfoot portion of the foot. When these degenerative joint changes occur, any motion at the involved joints causes severe pain and disability, and limits the patient in his or her attempt to perform daily activities. These changes have a significant social and economic impact, and cause unwanted lifestyle changes. Arthrodesis, when used judiciously, can offer pain relief and a restoration of normal activity for the patient with RA.
9235652 [Rheumatoid arthritis: an evaluation of treatment efficacy and some aspects of the physici 1997 The contribution of conventional therapeutic factors and such factors as psychotherapy, psychotropic drugs, psychological characteristics of the dyad "physician-patient" to overall treatment efficacy was measured in 111 patients with rheumatoid arthritis. Among non-traditional factors psychocorrection proved most effective. The skill of the physician to communicate with the patient, to inform him or her about the disease was found unsatisfactory. Special training in medical education to communicate with the patient is needed.
11094887 [The combined laser therapy of rheumatoid arthritis]. 2000 Mar Low-intensity infrared laser radiation to the tympanic vessels was studied as one of the hemophysiotherapeutic methods and as a component of combined treatment in which it accompanies local transcutaneous laser radiation of the affected joints. It is shown that immunomodulation is feasible under noninvasive interauricular laser effect on hemostasis. Indications for both laser regimens are formulated. Joint exposure to transcutaneous laser radiation is contraindicated if the affected joints have an exudative component of inflammation.
11438040 Bone loss. Therapeutic approaches for preventing bone loss in inflammatory arthritis. 2001 Inflammatory arthritides are commonly characterized by localized and generalized bone loss. Localized bone loss in the form of joint erosions and periarticular osteopenia is a hallmark of rheumatoid arthritis, the prototype of inflammatory arthritis. Recent studies have highlighted the importance of receptor activator of nuclear factor-kappa B ligand (RANKL)-dependent osteoclast activation by inflammatory cells and subsequent bone loss. In this article, we review the pathogenesis of inflammatory bone loss and explore the possible therapeutic interventions to prevent it.
11536074 [Association of disease severity in the early course of rheumatoid arthritis and locus of 2001 Aug This study examines the applicability of the questionnaire "Fragebogen zur Erhebung von Kontrollüberzeugungen zu Krankheit und Gesundheit - KKG" to patients with early course of rheumatoid arthritis (RA) or undifferentiated Arthritis (uA), and the relationship between the severity of the disease and locus of control by controlling for socio-demographic variables and personality characteristics. 326 patients with early RA or uA with a disease duration of less than 12 months (mean disease duration 6 months +/- 3.5, mean age 53 +/- 14) were assessed. Full clinical investigations were performed and patients questionnaires were administered at the outset of the study (T1), after 12 months (T2) and after 24 months (T3). The factor-solution of the KKG-questionnaire in patients with early course of RA/uA is not different from healthy controls. A marked influence on coping types can be demonstrated for the covariates sex, age, cognitive components of anxiety and the severity of RA. These results should be considered in education programs for RA applying special techniques of behaviour therapy. Such interventions in the early phase of RA might lead to a reduction of cognitive anxiety and thus to more active coping in patients with RA.
10380264 Cystic rheumatoid arthritis with Felty's syndrome and ankylosing spondylitis. 1999 May A 63-year-old man with strictly axial ankylosing spondylitis since the age of 28 years had a seven-year history of cystic seronegative rheumatoid arthritis with Felty's syndrome. Cysts were present in the hands, feet, wrists, shoulders, hips, one elbow, and one knee. There was no evidence of juxtaarticular demineralization, joint space loss, erosions, or joint destruction. Rheumatoid pannus was demonstrated within the cysts, particularly at the hip, ruling out cystic hip disease due to ankylosing spondylitis. HLA typing demonstrated the B27 and DR4 haplotypes. HLA B27 may be associated with a worse prognosis of rheumatoid hip involvement.
11281163 Mineral density and histomorphometric assessment of bone changes in the proximal tibia ear 2001 Bone changes in both actively growing (6-week-old) and mature (6-month-old) rats with collagen-induced arthritis (CIA) were investigated in order to clarify the mechanisms of osteoporosis near inflamed joints in patients with early rheumatoid arthritis (RA) and juvenile RA. In female Sprague-Dawley rats, the proximal tibiae from the CIA and control groups early after immunization, when any influence of immobilization due to joint pain and swelling is minimal, were studied using dual X-ray absorptiometry and histomorphometry after double-labeling with tetracycline. Arthritis developed within 10-14 days after immunization in both growing and mature rats. Physical activity, growth, and body weight continued to resemble that of the control group for at least 10 days. The bone mineral density in the proximal tibia did not differ significantly between the CIA and control groups. In growing rats, a highly significant increase in bone resorption, and decreases in bone formation and trabecular bone volume became evident histomorphometrically before visible signs of arthritis had developed. In mature rats, bone formation was markedly decreased without an increase in bone resorption. The differences in the reaction between growing and mature rats reflected a difference in the number of remodeling sites (units) and an uncoupling between osteoblasts and osteoclasts. We conclude that osteoporosis near inflamed joints results from an imbalance between bone resorption and formation caused by immune reactions in the CIA rats. Moreover, a decrease in bone formation may, in part, precede the clinical onset of arthritis.
10586595 [Multiple intrapulmonary rheumatoid nodules]. 1999 Oct A 66-year-old woman who had been treated at a nearby hospital since 1977 for rheumatoid arthritis complained of cough. Chest X-ray films disclosed multiple nodular shadows with cavitation in the fields of both lungs. The patient was admitted to our hospital and a thoracoscopic lung biopsy was performed. Histologically, the nodule consisted of necrotizing granuloma, indicating a necrobiotic nodule. Rheumatoid nodule was diagnosed because the patient exhibited rheumatoid arthritis. The chest X-ray shadow disappeared without medication. Rheumatoid nodules without coniosis are uncommon, but should be considered in the differential diagnosis of lung nodular lesions in patients with rheumatoid arthritis.
10750006 Arthroscopic synovectomy of the knee joint in early cases of rheumatoid arthritis: follow- 2000 Apr A retrospective multicenter study on a total of 93 knee joints in 81 patients with early forms of rheumatoid arthritis treated by arthroscopic synovectomy was carried out. During the average follow-up period of 33 months, the patients' clinical state showed appreciable improvement. The Lysholm score modified by Klein and Jensen increased from 43.2 points preoperatively to 78.1 points at follow-up. Also, the Insall score (knee score and functional score) showed a highly significant increase of 25.7 and 25.2 points to 71.2 and 80.2 points, respectively. Patients receiving additional radiation synovectomy showed a highly significantly better result than those receiving synovectomy alone. Among the individual variables investigated, pain, swelling, and walking distance in particular were improved. Only radiologically was a mild worsening observed (from Larsen stage 1.57 preoperatively to 1.95 at follow-up). The follow-up examination revealed no synovitis in 80.6% of the patients. Subjectively, 76.4% of the patients assessed the results to be good or very good, with only 7.5% remaining unsatisfied. 90.3% of the patients declared themselves in retrospect willing to undergo the operation again.