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PMID	Title	PublicationDate	abstract
668197	Complement-fixing material in ther sera of patients with rheumatoid arthritis.	1978 May	We investigated the properties of the complement-fixing material in samples of sera from fifteen patients with rheumatoid arthritis having low levels of C4, in order to determine its possible relationship to the immune complexes and rheumatoid factors. The complement-fixing material in most sera was of high molecular weight, 19s or greater, but in two sera it was also present in an intermediate zone (about 12s--15s). Cryoprecipitation did not remove the complement-fixing material except from serum with a elevated content of cryoglobulin. Analysis of the sera by analytical ultracentrifugation for the content of rheumatoid factor IgG complexes did not show a close relationship between the content of these complexes and the amount of complement-fixing material present in the sera. The responsible material could be absorbed by IgG-Sepharose together with the removal of rheumatoid factor. It was, however, possible to absorb the complement-fixing material from most sera with unconjugated Sepharose without significantly affecting the rheumatoid factor titres. Thus the complement-fixing material in the rheumatoid sera closely resembles an immune complex. It very likely contains rheumatoid factor, but it is not certain whether the material consists entirely of rheumatoid factors complexed to IgG or whether other antigen-antibody systems may also be present.
6373620	Leukocyte sensitization against synovial components in rheumatoid arthritis: blocking by p	1984	The leukocyte adherence inhibition (LAI) test in arthritis can serve as an in vitro model for investigating cellular cooperation between mononuclear cells sensitized by cytophilic IgG rheumatoid factor(s) present in rheumatoid arthritis (RA) serum, normal synovial components, and polymorphonuclear cells. Since inflammatory and immunologic responses are altered during pregnancy, we studied the effect of pregnancy serum on the LAI. The adherence of normal leukocytes once sensitized in RA serum is inhibited by a synovial extract, but when these leukocytes are exposed to pregnancy serum prior to sensitization with RA serum, the cells are unresponsive to subsequent stimulation by the synovial extract (p less than 0.01). This blocking effect on sensitization is only present in serum obtained after the first trimester of pregnancy and can be detected even at serum dilutions of 1:100. Leukocytes obtained directly from pregnant subjects, washed, and then incubated with RA serum failed to react. Since pregnancy serum has been shown to mask certain cell membrane receptors, it is possible that our results are due to the blocking of IgG rheumatoid factor binding to mononuclear cells. This finding could contribute to the subsidence during pregnancy of some disorders such as rheumatoid arthritis.
7288780	Uncemented total hip replacement.	1981 Oct	During the last 20 years almost 3000 uncemented total hip replacements have been used in the treatment of osteoarthritis and rheumatoid arthritis. The development of an axially located prosthesis is outlined, and the causes of failure indicated. Uncemented prostheses have the advantage of a relatively low mortality and morbidity and the rate of infection in particular is low. Interface pain, with or without frank prosthetic loosening, is the commonest cause of failure, but revisional surgery is relatively easy, and usually successful. Loss of function without significant pain may occur after many years from distal migration of the femoral component. The development of an uncemented metal-on-plastic joint has produced better short-term results than the metal-on-metal articulation, probably because of its lower frictional coefficient and the use of a wider range of pelvic and femoral components.
6660243	Practices, strategies, and motivations in treatment of rheumatoid arthritis.	1983 Dec 30	National Analysts conducted primary research with rheumatologists--specifically, two panel discussions, 25 in-depth telephone interviews, and a mail survey of conference (Auranofin Symposium and Workshop) participants--to examine current treatment practices and to probe the rationale and motivations underlying treatment strategies in rheumatoid arthritis. The research identified important areas of consensus in drug perceptions, therapeutic approaches, and disagreements. Physicians differ regarding the minimum time they wait after diagnosing rheumatoid arthritis before initiating remittive therapy, some beginning immediately and others waiting six months or longer. Younger physicians are quicker to initiate remittive treatment than their older colleagues, but both younger and older practitioners are initiating remittive therapy earlier than in the past. Some noteworthy differences between hospital-based and office-based practitioners were discerned with respect to factors that figure in their decisions to initiate remittive therapy. Differences were also found among physicians in the way they pose drug options to their patients; "authoritarian," "libertarian," and "guided democracy" were names given to the three styles identified. In general, however, physicians report that patients are more directly involved in treatment selection than previously, a trend that may in part be due to the use of more aggressive treatment strategies than in the past and a desire to share the psychologic burden of those decisions. Findings suggest that gold compounds will continue to be a mainstay first-line disease-modifying agent in the treatment of rheumatoid arthritis but that there may be less reluctance to use other agents as physicians become increasingly familiar and comfortable with alternative options, especially penicillamine and immunosuppressive agents.
308748	[Protein synthesis in lymphocytes of patients with various stages of chronic polyarthritis	1978 Jul	Protein synthesis in lymphocytes of patients suffering from rheumatoid arthritis shows various levels according to the stage of the disease. Incorporation of 3H-isoleucine is markedly increased in progredient cases (compared to normal subjects + 75%). Additional treatment of these patients with corticosteroids has no effect on the protein synthesis in the lymphocytes. This seems to be in contrast to investigations using in vitro incubation of lymphocytes in media containing steroids. Because of completely different conditions in these investigations exact comparison of the results is not possible. Protein synthesis in lymphocytes from patients with early stages of rheumatoid arthritis or ankylosing spondylitis shows no statistically significant difference to normal controls.
6652388	Hip arthroplasty: patient satisfaction.	1983 Nov	A total of 1074 patients, the survivors of a multicentre sample of 1085 who, 9-15 months earlier, had undergone total hip replacement, were asked to complete a questionnaire about their satisfaction with the outcome of surgery. Of 1027 (96%) who responded, 90% were satisfied, 5% were unsure and 3% were dissatisfied with the result--2% failed to answer the question about satisfaction. The highest satisfaction rate was found amongst patients who had undergone bilateral hip replacement (96%) and those with a diagnosis of rheumatoid arthritis (94%). Dissatisfaction was associated with previous surgery to the index hip and additional surgery following total hip replacement. In all but five of the 98 patients who did not express satisfaction an adequate reason could be found either in the case notes or from questionnaire responses.
6773487	Factor VIII antibodies in rheumatoid arthritis. Effect of cyclophosphamide.	1980 Sep	Three patients with rheumatoid arthritis had bleeding and bruising and were found to have circulating antibodies specifically directed against factor VIII. Review of the literature indicates that this is an unusual but serious complication of rheumatoid arthritis. In two of our three cases, disappearance of the factor VIII antibody coincided with the oral administration of cyclophosphamide; in the third patient, antibody titers declined several weeks after cyclophosphamide therapy was discontinued. Our collected experience involving 11 nonhemophilic patients with factor VIII antibodies indicates that a good response to cyclophosphamide therapy may be expected if the antibody titer is less than 10 Bethesda units at the initiation of treatment. While optimum treatment of these patients is not yet established, we suggest an initial trial of prednisone and, if there is no response, then therapy with cyclophosphamide.
1019188	The discriminability of apsirin in arthritic and nonarthritic rats.	1976 Nov	Aspirin, 56 mg/kg IP, was shown to be mildly, but significantly discriminable from saline in a group of 12 nonarthritic rats exposed to a 2-lever fixed ratio 10 drug discrimination protocol for 56 trials. In a concurrently-tested group of 12 rats made arthritic by injection of Mycobacterium butyricum into a hind paw, the discrimination of aspirin from saline was enhanced. The results exemplify how drug discriminability may vary depending on the pathological state of the subjects exposed to drug-discrimination training.
6226245	Functional defects of monocyte C3b receptor-mediated phagocytosis in rheumatoid arthritis	1983 Oct	We have previously described a selective defect of monocyte C3b receptor-mediated phagocytosis in patients with rheumatoid cutaneous vasculitis. We have studied a further 15 rheumatoid arthritis patients with other associated diseases and complications and have identified 4 further patients with a similar defect. Serological and cytochemical studies suggest that the defect in phagocytosis is due to the appearance of increased numbers of large nonspecific esterase-negative mononuclear phagocytes with defective C3b receptor phagocytic function rather than to receptor blockade by immune complexes.
6491310	Centrifugation of normal and rheumatoid arthritis blood on Ficoll-Hypaque and Ficoll-Nycod	1984 Oct 26	Attempts to use the rapid single-step Ficoll-Hypaque centrifugation procedure for the purification of mononuclear and polymorphonuclear leucocytes from the blood of normal individuals and rheumatoid arthritis patients have sometimes been unsuccessful, largely because the erythrocytes would not sediment through the centrifugation medium. Re-evaluation of the factors (e.g. Ficoll concentration, temperature, and ratio of the diatrizoate salts) which affect these separations showed that under our conditions it was advantageous to use a medium with a lower viscosity (Ficoll concentration) and/or a higher osmotic strength (increased sodium diatrizoate: meglumine diatrizoate) than had been recommended previously (Ferrante and Thong, 1978; 1980; Ferrante et al., 1982). Higher osmotic strength media must be used for separating the components of blood from rheumatoid arthritis patients than from normal individuals because rheumatoid arthritis erythrocytes have a lower buoyant density than normal erythrocytes.
6340183	A double blind crossover study of carprofen and indomethacin in patients with rheumatoid a	1983	Twenty-eight patients with definite or classic rheumatoid arthritis were studied in a four-month double blind crossover trial. Patients were randomly divided into two groups, and received either carprofen, 300 mg/day, or indomethacin, 75 mg/day, for a period of two months, and then the other medication for a further two months. The classic procedures and measurements for evaluation of activity of rheumatoid arthritis were used. Laboratory tests were also carried out to assess toxicity. Both drugs were effective for the long term treatment of rheumatoid arthritis, and there were no statistically significant differences between the carprofen and indomethacin periods, or between groups. Although the incidence of adverse reactions was similar for both drugs, cutaneous symptoms were more frequent with carprofen than with indomethacin, whereas gastrointestinal and central nervous system reactions were found more often with indomethacin.
4052121	Low synovial clearance of iodide provides evidence of hypoperfusion in chronic rheumatoid	1985 Oct	Iodide clearance was measured in the chronic knee effusions of 11 patients with rheumatoid arthritis and 9 patients with osteoarthritis. The mean (+/- SE) iodide clearance of 1.92 +/- 0.30 ml/minute in rheumatoid arthritis effusions did not differ significantly from the 2.19 +/- 0.52 ml/minute found in osteoarthritis effusions. Clearance values in rheumatoid arthritis patients ranged widely (0.79-3.22 ml/minute). Iodide clearance in these patients correlated directly with synovial fluid (SF) pH (r = 0.731, P = 0.005), SF glucose:serum glucose ratio (r = 0.746, P = 0.004), and SF temperature (r = 0.878, P = 0.001), and directly with SF lactate (r = -0.782, P = 0.002) and percentage of SF neutrophils (r = -0.581, P = 0.03). These relationships support the hypothesis that rheumatoid synovitis is often marked by tissue hypoperfusion, and that the "sickest" rheumatoid joints (as defined by physiologic indices) are the most ischemic.
6116452	[Polyarthrosis of the hand (author's transl)].	1981 Jul	The polyarthrosis of the hand is a typical disease of the old age. Its banal form is more frequent in women, its erosive type in men. It can be demonstrated not only on the interphalangeal joints but on the metacarpophalangeal joints as well. The degenerative process of the basal-joints of the first ray of the hand is often seen in polyarthrosis. Most frequently diagnostic problems are caused by the erosive arthrosis however first of all polyarthrosis has to be differentiated from the p.c.p.
810649	[The significance of gold serum level determinations during chrysotherapy in rheumatoid ar	1975 Sep 19	The determinations of gold levels in serum of patients with rheumatoid arthritis allow an exact monitoring of chrysotherapy. The atomic absorption spectrophotometry turned out to be superior for clinical use when compared with the neutron activation analysis. Under the conventional gold therapy serum levels increase with repetitive application achieving on maintenance therapy levels, which are in some cases under the recommended levels for effective therapy. The comparison of the clinical response of prolonged gold applications and serum levels revealed for instance that recurrent acute episodes of arthritis are more often with levels of 0.5 ppm or less, than with levels of 1.0 ppm or more. To what extent high dose therapy can increase the efficiency of chrysotherapy should still be determined, it should however be considered that with increased gold levels also more adverse reactions are to be expected. The predominant indication to determine serum gold level in the case of rheumatoid arthritis is the lack of any response to gold application. The serum gold level determination allows to differentiate between insufficient dosage and total ineffectivity of gold.
4063003	Effective patient education. A quasi-experiment comparing an individualized strategy with	1985 Nov	A quasi-experiment was conducted on 127 hospitalized rheumatoid arthritis patients to determine the relative success of 3 patient teaching strategies--an individualized program, a routinized program, and a no-planned-instruction program--on patients' knowledge of their disease and treatment. Data analysis revealed that the individualized program produced a 100% greater learning gain than the routinized program in patients who had low pretest scores. The results suggest that maximum patient learning occurs when the teaching process accommodates important patient differences.
3889563	Multifactorial pathogenesis: ought we to classify disease or treat the individual's causes	1985 Mar	Added to the uniqueness of most of us imparted by HLA, our individual differences in the expression of other genetic traits, foetal period steroid imprints on brain and other functions, and regulators shared by body and mind indicate that each one of us (except most monozygotic twins) is born as a unique individual whole (I). Mechanisms suspected to be contributing ones in classified synovitides appear to correspond to individually exaggerated or depressed modes of response by physiological mechanisms linked to our unique individual wholes (II). If we upgrade the importance of influences of combinations of 'contributing' mechanisms, the importance of the alleged unknown fundamental causes of these diseases diminishes (III). This broad interpretation of 'multifactorial pathogenesis' can probably be applied to many common types of disease (IV), implying that disease classifications may poorly reflect the individual's causes of disease (V). There is reason to challenge modern concepts about disease (VI).
6641051	Utilization of the extensor retinaculum in the radiocarpal joint of rheumatoid wrists.	1983 Dec	Synovectomy and debridement were combined with use of pedicled flaps of the extensor retinaculum as interposition material in the radiocarpal joint to cover the eroded articular surfaces of the radius and ulna in rheumatoid wrists. The technique was devised for the purpose of preventing postoperative osseous ankylosis of the radiocarpal joint. Results were satisfactory in 13 of 17 wrists operated on during the period from 1974 to 1979 and followed up for 38 to 84 months (average, 61 months).
4017312	Mineral metabolism and bone mineral content in rheumatoid arthritis. Effect of corticoster	1985 Apr	An evaluation of mineral metabolism was performed in 41 patients with RA and the pertinent data were compared to bone mineral content in patients either untreated or treated with different doses of corticosteroids. Our study confirms that osteoporosis is a common finding even in rheumatoid patients never treated with corticosteroids. Moreover, in patients treated with such drug the loss of bone mineral content was related to the dosage rather than to the length of treatment. In all cases no overt biochemical derangement was observed. According to our study, parathyroid hormone does not seem to influence the development of osteoporosis in rheumatoid arthritis, while a relative deficiency of calcitonin along with an inadequate vitamin D metabolism could play some role.
7108318	[A study on the lipid peroxide and its scavenging enzymes in rheumatoid arthritis (author'	1982 May	Superoxide free radical (O2.-) produced by leukocytes, found in a rheumatoid joint, degrade various high molecular polymers in the synovial fluid and thus may play an important role in initiating an inflammatory response. The present work is an attempt to measure the lipid peroxide value as a parameter of peroxidation by O2.- and to measure the activities of superoxide dismutase, catalase and glutathione peroxidase as scavenging enzymes in the serum and the synovial fluid of patients with rheumatoid arthritis and osteoarthritis. The following results were obtained: 1) The lipid peroxide value of the synovial fluid from the rheumatoid arthritic group was found to be higher than that from osteoarthritic group, whereas in the serum no significant difference was found between these two groups. 2) The superoxide dismutase activity of the synovial fluid from the rheumatoid arthritic group was found to be remarkably higher than that from the osteoarthritic group. A significant correlation was also found between the superoxide dismutase activity and the inflammatory indexes, such as C-reactive protein, erythrocyte sedimentation rate, and the number of nucleated cells in the synovial fluid. 3) The catalase activity of the synovial fluid from the rheumatoid arthritic group was increased. 4) No significant difference was found in the glutathione peroxidase activities of the serum and the synovial fluid between the two groups. 5) A positive correlation was found between the lipid peroxide value and the superoxide dismutase activity in the synovial fluid of patients with rheumatoid arthritis. These observations suggest that superoxide free radical may play an important role as a chemical mediator on the inflammatory response of rheumatoid arthritis.
281059	[Psychosomatic and somatopsychic aspects of progressive chronic polyarthritis (author's tr	1978	By means of psychiatric depth-psychological investigations in more than 100 patients with PCP the somatopsychic aspect of the disease is described, which manifests itself in two thirds of the patients as an inhibited to agitated humble-depressive psychosyndrome. On the basis of family anamneses and analytical inquiries the somatopsychic aspects of the disease is described in more the half of the patients as consistent continuation of a specific way of life, so that psychosomatic and somatopsychic aspects of the disease are mentioned as one strategy persuing the same fictitious goal. Both aspects appear as functions of a seemingly threatened psychic-physical motivity.