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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
10224703 Rheumatoid pannus of the cervical spine: a case report of an unusual cause of dysphagia. 1999 Apr Dysphagia as an initial complaint in rheumatoid arthritis is rare. We describe the case of a 69-year-old woman with rheumatoid arthritis who presented with a 2-day history of acute dysphagia. Our evaluation revealed the cause of the dysphagia was the presence of rheumatoid pannus that involved the anterior cervical spine and compressed the esophagus. Although the otolaryngologic manifestations of rheumatoid arthritis usually relate to synovial involvement of the temporomandibular and cricoarytenoid joints, our case establishes that a rheumatoid pannus on the anterior cervical spine can cause dysphagia. We believe that this may be the first reported case of this clinical entity.
11505513 [Effect of actarit combination therapy in patients with active rheumatoid arthritis resist 2001 Jun We investigated the utility of combination therapy of actarit with gold agents in patients with active rheumatoid arthritis resistant to gold agents even after the administration of gold agents for longer than 24 weeks in principle. 1. In the final global improvement rate by the combination therapy of actarit with gold agents, the ratio of "improved" and/or better was 30.8% (12/39). 2. The clinical evaluation items which showed significant improvement were grip strength, ESR, number of painful joints, number of swollen joints, active joint count, duration of morning stiffness and Lansbury's activity index. 3. ADRs were observed in 6 patients per 75 patients (8.0%), but there was no serious ADR.
9663474 Clinical and radiographic outcomes of rheumatoid arthritis patients not treated with disea 1998 Jul OBJECTIVE: To compare the radiographic and clinical features of rheumatoid arthritis (RA) patients who were not given disease-modifying antirheumatic drugs (DMARDs) with those of RA patients who were followed up and treated with DMARDs at a rheumatology clinic. METHODS: The population of this case-control study includes a series of RA patients who immigrated to Israel from the previous Union of Soviet Socialist Republics and who were treated only with nonsteroidal antiinflammatory drugs. Control patients who were followed up and treated with DMARDs at our rheumatology clinic were matched by sex, disease duration, number of actively inflamed joints, and the presence of serum rheumatoid factor. The outcome measures were the number of deformed and radiographically damaged joints. Radiographic damage was evaluated by the methods of Steinbrocker and Sharp. RESULTS: The study population consisted of 22 RA patients (15 women, 7 men) who were not treated with DMARDs and 22 patients (15 women, 7 men) who were treated with DMARDs. The mean disease duration was 16.2 years for the study patients and 14.3 years for the controls. Compared with the matched controls, RA patients who were not treated with DMARDs were found to have a significantly higher mean number of deformed joints (13.8 versus 7.2), a higher mean number of damaged joints (24.4 versus 15.5), and a higher overall damage score by the Sharp criteria (146.1 versus 65.7). CONCLUSION: RA patients who were not given DMARDs had a 1.57-fold increased number of radiographically damaged joints and a 2.22-fold increased overall Sharp damage score compared with patients who were treated with second-line agents.
9844770 Rheumatoid vasculitis presenting as appendicitis. 1998 Nov Appendicitis was diagnosed in a 38-year-old patient with seropositive rheumatoid arthritis. Despite appendectomy the patient's clinical condition deteriorated. Thorough microscopical evaluation of the pathological anatomical specimens from the appendix made possible a diagnosis of necrotizing vasculitis. The systemic nature of the vasculitis was confirmed with a muscle biopsy. A complete remission was induced with immunosuppressive treatment. The case exemplifies a rare but serious manifestation of rheumatoid vasculitis.
11006812 The Joint Protection Behavior Assessment: a reliability study. 2000 Sep OBJECTIVE: Of the various measures developed for studying persons with rheumatoid arthritis, only one that focuses on joint protection has undergone extensive testing, the Joint Protection Behavior Assessment (JPBA). The purpose of the present study was to examine the interrater and intrarater reliability of the JPBA. METHOD: Six healthy participants performed the JPBA under three test conditions (uninformed, informed, completely guided joint protection behavior). The 18 test performances were videotaped and scored by nine independent raters. RESULTS: Analysis of these data showed that interrater reliability (intraclass correlation coefficient [ICC]) was .90 or higher, and intrarater reliability was .95 or higher (ICC). The correlation between the JPBA and its two shortened versions was .95 or higher (ICC). Internal consistency was also high, with a coefficient alpha of 0.95 for the complete JPBA. Kappa values showed that for most subtasks, there was fair to excellent agreement between raters and consistency of raters over time. CONCLUSION: Our data suggest that the complete JPBA has excellent clinimetric properties and that the shortened versions are adequate for clinical situations. Some improvements in the test manual suggested by the present study may further improve the measure. A repeat of this study under real-world circumstances would provide an estimate of JPBA reliability in clinical practice.
9501616 [Diagnosis of early rheumatoid polyarthritis]. 1997 Nov 15 The diagnosis of rheumatoid arthritis is mainly based on the clinical findings showing in typical cases a bilateral symmetrical polysynovitis predominantly on the small hand and feet joints, without any other extra-rheumatological feature. Even this clinical presentation is very suggestive of the diagnosis, other diagnoses of diseases life and or function threatening (septic arthritis, viral arthritis, arthritis related to hemopathy, systemic vasculitis ...) have to be systematically evocated. The interest of an early diagnosis of rheumatoid arthritis is to facilitate the treatment and the monitoring of the patients since such treatment seems to be more efficient when initiated at an early stage of the disease.
10685832 Evidence from rheumatoid arthritis trials for approval: what does it mean? With special re 2000 Feb Since medicine remains largely empirical, clinical knowledge about therapy is derived primarily from experiments designed to control confounders that use inferential techniques applied to the null hypothesis model. On a public health scale, health agencies need to assess the evidentiary weight supplied for new therapies to make approval decisions. In the field of rheumatoid arthritis (RA), there are additional analytic challenges such as designation of endpoints or missing data. The intellectual architecture that underpins these exercises continues to evolve, and recently the US Food and Drug Administration released an RA Guidance Document to describe some aspects of these exercises. This article focuses on the use of measurements of radiographic endpoints in particular as an element in the evidentiary portrayal of therapeutic efficacy in RA.
11865243 Psychological wellbeing of patients with rheumatoid arthritis. 2001 Nov 22 The impetus for this multiphased project was the realization that rheumatoid arthritis (RA) is not only physically debilitating, but also a cause of severe psychological distress which is often unacknowledged. A small sample of patients (n=15) was interviewed to identify their main area of psychological distress caused by RA, and data were analysed thematically. These themes formed the basis of a questionnaire that was distributed to a random sample of inpatients and outpatients with RA. This larger sample (n=140) prioritised the areas of distress that were identified by the interviewed sample of patients. This led to the development of an education programme for nurses. The authors describe the impetus for the project, the activities and processes associated with data collection, and the development and evaluation of the education programme.
9436333 [Analysis of pulmonary manifestations in patients with rheumatoid arthritis]. 1997 Nov We studied chest X rays of 911 patients with rheumatoid arthritis (RA). The findings showed interstitial shadow in 28 patients (3.1%), pleuritis in 13 patients (1.4%) and nodular shadow in 3 patients (0.3%). RA patients with interstitial pneumonia were commonly male and older. And they had significantly high levels of rheumatoid factor (RF), RAPA and IgG-RF in serum, but they were not associated with high score of Lansbary index. All patients with more than 1500 IU/ml in RF value had a complication of interstitial pneumonia. These results suggest the importance of chest X-ray in the management of RA patients with high titer in RF.
10556257 The peripheral benzodiazepine receptor ligand PK 11195 inhibits arthritis in the MRL-lpr m 1999 Nov OBJECTIVE: Mice of the MRL-lpr strain develop a severe autoimmune arthritic condition when primed with complete Freund's adjuvant. The pathology is similar to that seen in human rheumatoid arthritis. We investigated whether PK 11195, a powerful ligand for peripheral benzodiazepine receptors, would have preventative or therapeutic effects in this model. METHODS: MRL-lpr mice were primed with complete Freund's adjuvant at 13-14 weeks of age. Daily PK 11195 injections were started on the same day as priming to test for preventative effects. Daily PK 11195 injections were started 10 days after priming to test therapeutic effects. RESULTS: PK 11195 showed both preventative and therapeutic effects. At 1 mg/kg/day, it inhibited disease onset. At 3 mg/kg/day, it inhibited established disease progression. CONCLUSION: The evidence suggests that PK 11195 may be the prototype of a new class of anti-inflammatory agents.
9830343 [Surgical treatment of the rheumatic neck]. 1998 Oct 20 This paper reviews rheumatoid cervical spine disease with emphasis on surgical management. The rheumatoid process in the cervical spine is outlined, and the different clinical syndromes are explained according to the underlying pathology. Guidelines for the management of patients with this disease are suggested, and the indications for surgery are discussed. The different surgical approaches and techniques are briefly summarised.
17939239 [Functional outcome in rheumatoid arthritis patients]. 1998 The Stanford Health Assessment (HAQ) was implemented to Croatian population in order to assess disability in the patients with rheumatoid arthritis (RA). 101 patients with RA were in the study (9 males, 92 females). The mean age was 52 years and mean disease duration was 9 years. 51 patients completed HAQ with no prior instructions and were then interviewed by a rheumatologist. 50 patients completed HAQ in inverse manner. Ten patients were tested by a physiotherapist in order to confirm the facts given from the interview. Our patients showed a mean score of 1.89 on the scale of 0 to 3 which is statistically significant lower than those given by the rheumatologist--1.99. Also we recorded higher score related to age and disease duration. All 101 patients were able to complete HAQ with or without some terminology difficulties. We consider HAQ is easy to use, simple to scoring and no time consumption questionnaire. It can be used in our RA population with small terminology modifications for better understanding of some questions. We registered some difficulties in discrimination between score 1 and 2, so we added a new formulation to score 1--still satisfied to improve that part of the questionnaire.
10697372 [Pain sensitivity in patients with rheumatoid arthritis]. 2000 The paper deals with specific characteristics of pain sensitivity, types of anxiety disorders in patients with rheumatoid arthritis and their correlation.
11480530 A comparison of two methods of assessing disease activity in the joints. 2001 Jul BACKGROUND: Considerable debate has occurred concerning the utility of different methods of obtaining joint counts and their usefulness in predicting outcomes in persons with rheumatoid arthritis. OBJECTIVE: The purpose of this study was to compare two methods of assessing disease activity in the joints (clinician joint count, self-reported joint count), and to compare their relative utility in predicting two methods of assessing outcomes (self-reported ratings of impairment and pain, objective performance index) with and without controlling for negative affectivity. METHOD: Data for this study were obtained during home visits from 185 persons diagnosed with rheumatoid arthritis. Individuals completed a series of self-report measures including the joint count. Trained research assistants completed a 28-joint count and timed participants on a series of measured performance activities (e.g., grip strength, pinch strength, walk time). RESULTS: The self-report joint count was highly correlated with the clinician joint count and also accounted for as much, if not more, variance in the subjective outcome measures than did clinician assessments. Both types of indicators predicted unique variance in the objective performance index. CONCLUSIONS: For most research purposes, measures such as self-report joint counts have sufficient validity to be used in place of more costly clinician assessment of joint counts.
9232261 Allogeneic bone marrow transplantation from a donor with severe active rheumatoid arthriti 1997 Jul We report a patient who underwent allogeneic bone marrow transplantation from a sibling with longstanding untreated severe active rheumatoid arthritis. After 4 years of follow-up there is no evidence of adoptive transfer of rheumatoid arthritis to the recipient. This case, along with another recently reported case, provides reassurance that haemopoietic stem cell transplantation from a donor with systemic autoimmune disease may not necessarily result in adoptive transfer of the disease. All previous reports of transfer of autoimmunity in humans have been of organ-specific autoimmune diseases and we speculate that pathophysiological differences might account for why systemic autoimmune disease is not transferred.
9697139 [Review of the results of the ARO multicenter study]. 1998 Jun The ARO multicenter study intended to show clinical and radiological differences with regard to different systems of fixation and designs of the prothesis in total hip replacement in patients with hip dysplasia, osteoarthritis and rheumatoid arthritis. In 1987 and 1988 5255 total hip prothesis were implanted by the 24 hospitals which took part in the study. 3133 prothesis (95.6%) were clinically and radiologically examined. The follow-up period averaged 6.9 years. The results of the Aro multicenter-study showed that despite difficult preoperative conditions especially in cases of rheumatoid arthritis the satisfaction rate improved remarkably. During the operation less complications arose in comparison to patients with hip dysplasia and osteoarthritis. Regarding the rate of infection after operation there were no differences between the 3 groups. Only the rate of post-operative luxation concerning rheumatoid patients turned out to be twice the number of the others. In our opinion this is due to the fact that these rheumatics were operated by posterior approach. Patients with rheumatoid arthritis were satisfied most with their surgeries. Results of rheumatic patients according to Harris hip score were slightly worse than the results of the two other groups. This was due to systemic involvement and bad preoperative function of the hip. As a result of the study there were no differences in using cemented or cementless techniques for rheumatic hip replacement. The decision for the method of fixation should depend on the patient's ability to relief the prothesis after operation. The study has shown that cementless implantation can also be used for young rheumatics provided that a suitable design of prothesis will be selected.
11327265 Treatment of Felty's syndrome with leflunomide. 2001 Apr Felty's syndrome (FS) is a rare manifestation of severe rheumatoid arthritis (RA). It is an immune mediated inflammatory process, usually treated with standard disease modifying antirheumatic drugs. We describe a case of severe FS that developed in a patient receiving methotrexate therapy for RA. Treatment with etanercept resulted in severe allergic cutaneous reactions. The patient subsequently responded to treatment with leflunomide. The response included dramatic improvement of leukopenia and neutropenia as well as excellent control of his arthritis. Leflunomide has recently been used effectively for the treatment of RA and may be useful for the management of patients with FS.
11469524 Long-term results of wrist arthrodeses fixed with self-reinforced polylevolactic acid impl 2001 OBJECTIVE: Implants made of self-reinforcing polylevolactic acid (SR-PLLA) have been successfully used in arthrodeses of patients with rheumatoid arthritis. No lone-term evaluation on bioabsorbable fixation in patients with rheumatoid arthritis has been published so far. METHODS: In this study 21 wrist fusions were performed on 18 patients with rheumatoid arthritis by using SR-PLLA rods as fixation devices. The follow-up time was 3-8 years (mean 5.4 years). RESULTS: The results showed one non-union but no infections or problems associated with the bioabsorbable implants used. CONCLUSION: According to this study, fixation of wrist arthrodesis in patients with rheumatoid arthritis can be performed by using SR-PLLA implants with favourable results. The benefit of this method is the avoidance of the removal operation of fixation devices.
11806220 [Hematosalivary mechanisms of regulation in rheumatoid arthritis]. 2001 AIM: To study biochemical indicators of the hematosalivary barrier operation in varying activity of articular inflammation and their correlations. MATERIAL AND METHODS: Biochemical indices of mixed saliva and peripheral blood were studied in 38 healthy subjects and 99 patients with rheumatoid arthritis (RA). RESULTS: Optimal composition of the saliva was abnormal. It lost its buffer function. In RA, permeability of the hematosalivary barrier for cholesterol, calcium, phosphorus, magnesium declines with growing activity of the process with resultant lowering of their content in the saliva, their blood levels being unchanged. CONCLUSION: Decreased permeability of the hematosalivary barrier results from growing sympathetic influence on the salivary glands reflecting the presence of the autonomic dysfunction in RA. It is pathogenetically related to the process activity.
9204256 Cellular pathways of joint destruction. 1997 May In the past year, evaluation of cellular pathways of rheumatoid synovial fibroblasts has been the focus of several laboratories investigating the molecular and cellular mechanisms operating in the pathogenesis of rheumatoid arthritis. Major topics that have been reported on include the adhesion and interaction of synovial fibroblasts with cartilaginous matrix and other synovial cells, intracellular signaling, and activation of gene transcription. Novel approaches to inhibiting cartilage destruction have also been described. In the latter case, thorough multicenter characterization of the interleukin-1/interleukin-1 receptor antagonist pathways resulted in the first gene therapy trials in animals and humans.