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PMID	Title	PublicationDate	abstract
4063625	Evaluating self-care activities: comparison of a self-reported questionnaire with an occup	1985 Nov	Accurately evaluating a patient's ability to perform self-care activities is important for clinical and research purposes. We compared assessments of self-care activities obtained from a patient self-administered questionnaire and an occupational therapist interview. Forty-five rheumatoid arthritis patients admitted to a multidisciplinary rheumatology rehabilitation unit were evaluated by both methods for their ability to bathe, dress, perform toileting and general hand activities. Patients reported requiring more assistance with self-care activities in a self-administered questionnaire than they did in an occupational therapist interview. For example, 78% of patients reported requiring no assistance with bathing in the therapist's interview, whereas 31% reported no assistance on the questionnaire. Patients appear more willing to admit difficulties with self-care activities in a self-administered questionnaire than in a personal interview.
6476914	Microvascular filtration in subjects with connective tissue disorders.	1984 Aug	A simple non-invasive method for studying microvascular filtration in the non-articular tissues of the forearm is described. Rates of filtration under a standard hydrostatic pressure were measured in 20 normal female subjects and 44 female subjects with connective tissue disorders. An increased mean filtration rate was found in 14 subjects with rheumatoid arthritis. In 20 subjects with systemic lupus erythematosus and 10 subjects with scleroderma no such generalised increase in filtration rates was seen, but isolated cases had very high filtration rates, suggesting a more heterogeneous physiological disturbance. Increased filtration was not associated with the presence of oedema. This confirms doubts raised by other workers about the importance of filtration in the genesis of clinical oedema.
7205931	The inhibitory effect of pregnancy serum on polymorphonuclear leukocyte chemotaxis.	1980 Mar	The influence of pregnancy serum on the directional migration of normal human polymorphonuclear leukocytes (PMN) in response to a standard chemotactic attractant was studied. Using the Boyden chamber method for quantitating directional migration, both gestational and control sera in the unmodified state were found to have comparable actions on neutrophil chemokinesis and chemotaxis. Activation of these sera with endotoxin generated equivalent amounts of chemotactic factors. However, pregnancy serum in direct contact with normal PMN, inhibited their response to a standard chemoattractant (p less than 0.001). The suppressive effect was present in sera obtained during the third trimester of gestation. Sera obtained one month post partum contained less of the inhibitor of PMN directional migration. Since neutrophils are essential to the development of rheumatoid arthritis and certain other inflammatory diseases, the subsidence of these disorders during gestation and their exacerbation post partum could be related to the inhibitory effects of pregnancy serum on leukocyte functions.
1171083	Therapeutic effectiveness of paracetamol in rheumatoid arthritis.	1975 Jan	A single-blind, non-crossover study of the effectiveness of paracetamol, compared with aspirin and indomethacin has been carried out in 143 patients suffering from rheumatoid arthritis. Subjective indices have been employed, and the validity of the present method is discussed. The results of the trial have also been compared with those of a previous study (of prednisone, aspirin and placebo). Paracetamol was not significantly different from placebo, either in terms of pain relief or patient satisfaction rating. Prednisone and indomethacin were significantly better than paracetamol in respect to both parameters, but aspirin was not. On the basis of these results, the frequent prescription of paracetamol as the main therapeutic agent in the treatment of rheumatoid arthritis is not justified.
132816	[Long-term therapy of rheumatoid arthritis with perclusone].	1975 May	124 patients afflicted with rheumatoid arthritis were being treated with gold salts or antimalarial preparations with the addition of corticoids as well as other antirheumatic preparations. If the Lansbury-Index fell under 30% of the initial value, the therapy was interrupted, and that in 84 patients. One half of these patients were then given Perclusone (Clofezone) in the dose of 600 mg daily for 4 years. The other half of patients -- as control group-- were given various non-steroid antirheumatics, mostly acetylsalicylic acid, phenylbutazon or indomethacin in normal doses. The course of the disease of both groups was followed up clinically and the Lansbury-Index as well as the number and duration of reactivations were determined. In the group treated with Perclusone, the previously obtained remissions remained substantially more stable, only rarely reactivations ensued and their duration was then also remarkably shorter. Tolerance of Perclusone was very good, no side-effects whatsoever have been ascertained. In the group treated with other antirheumatics distinctly more frequent and longer-lasting reactivations were ascertained. Tolerance of these drugs was generally worse and they had to be changed more frequently. Perclusone has thus proved efficient as a very good stabilizing drug in patients suffering from rheumatoid arthritis.
7205823	Connective tissue activation XIX. Plasma levels of the CTAP-III platelet antigen in rheuma	1980 Nov	Plasma levels of platelet granule proteins CTAP-III and beta-thromboglobulin (beta-TG) were measured by radioimmunoassay of their common antigen (CTAP-Ag). Healthy adults had 29.4 +r5.8 ng CTAP-Ag/ml plasma while patients with rheumatoid arthritis (RA) had higher levels of the CTAP-Ag (range 23-260 ng/ml, median 43 ng/ml, p less than .006). RA patients with CTAP-Ag levels greater than 50 ng/ml (mean 104.8 ng/ml) were compared to patients having lower CTAP-Ag levels. Patients in the group with elevated plasma CTAP-Ag levels had higher sedimentation rates (p less than .005), and higher platelet counts (p less than .05). Anemia was more common in patients with abnormal CTAP-Ag levels.
6428946	Initial experience with oral gold salts in the treatment of rheumatoid arthritis in patien	1984	Fifteen patients, eight males and seven females, suffering from classic or definite rheumatoid arthritis were treated for 1 year with Auranofin, a new gold salt active by the oral route, different from parenteral gold as far as dosage, mechanism of action and toxicity are concerned. Patients received a dosage of 3 mg twice daily, equivalent to 0.85 mg of elemental gold, in order to evaluate the therapeutic efficacy and tolerability of this new compound. Subjective and objective parameters were monitored during the trial and serum gold levels were assayed every 2 months by atomic absorption spectrophotometry. Our study, which is on-going, shows the therapeutic efficacy of Auranofin which seems better tolerated than parenteral gold salts and will probably become a widely used drug in the long-term treatment of rheumatoid arthritis.
7026817	Nonsteroidal anti-inflammatory agents in rheumatoid arthritis and ankylosing spondylitis.	1981 Nov 13	The relative effectiveness of six nonsteroidal anti-inflammatory agents was studied in 33 patients with rheumatoid arthritis and 32 patients with ankylosing spondylitis in a double-blind, randomized, prospective study employing a six-way multiple crossover design with six-week trials of each agent. In ankylosing spondylitis, naproxen, indomethacin, and fenoprofen calcium were the most effective agents. In rheumatoid arthritis, relatively little mean difference between drugs was found. Most of this difference could be attributed to compliance factors, which favored drugs that required only a small number of pills daily. Despite the small differences in effect, patients had strong preferences. More than 85% of patients were still taking their preferred medication after a mean follow-up period of one year.
309327	Rheumatic disease: exercise or immobilization?	1978 Aug	Though it may be true that, in the absence of a dependable cause, there is no single cure for inflammatory diseases of the locomotor system, nevertheless there is no reason for therapeutic nihilism. Much can be done to induce a remission in the disease while at the same time suppressing inflammation, relieving pain, preventing or correcting deformities, easing stiffness and increasing muscular control of the joints. However, no drug regime can be expected to achieve this, and reliance on drugs alone invariably leads to disappointing results, both for the doctor and patient. Hence every patient also should have a properly organized and supervised regime of physical methods of treatment. The relative value of rest or exercise remains controversial, and different considerations play a role in some of the disease processes. Thus in patients with active rheumatoid synovitis there seems no doubt that at first, extra rest to the inflamed joints is essential, but as the disease process is brought under control, the patient can be mobilized and made more active. In patients with ankylosing spondylitis, the emphasis should be placed on activity and exercise.
6662727	[Subungual calcinosis in the normal nailbed of the fingers].	1983 Dec	Subungual calcifications in the normal nail bed of the digits are occasionally to be seen in elderly adults, especially women. The frequency is decreasing from the second to the fifth digit. In about 10% the subungual calcifications are combined with the same subungual calcifications of the toes.
472861	Subcutaneous inflammation (infection?) after synovial rupture: a complication of a complic	1979 Sep	Six weeks after presumptive acute synovial rupture at the knee, a patient was admitted with cutaneous induration over the medial calf. Roentgenograms showed gas shadows within the involved area. A fluctuant area at the center of the indurated mass yielded a Corynebacterium species.
975665	Results of knee replacement with the Walldius prosthesis: an interim report.	1976 Oct	Fourty-two knees replaced with the Walldius prosthesis have been followed for an average of almost 6 years. The rating of the average knee on a 100 point clinical scale improved 29 points as a result of the procedure. Complications were carefully documented and were numerous, although relatively few affected the end result.
64413	[Effect of gold therapy in rheumatoid arthritis on leukopoiesis and granulocyte phagocytos	1976	In 12 patients with rheumatoid arthritis the investigations of leukopoiesis and granulocytic phagocytosis were carried out before and after a gold therapy. A marked reduction of granulocytic phagocytosis could be observed here which decreased after the gold therapy, yet remained below the values of a normal collective. Partly contrary informations are discussed. The disturbance of the phagocytosis capacity of granulocytes may possibly be due to a rheumatic factor.
6332367	[Anti-B-lymphocyte antibodies in rheumatoid polyarthritis. I.--1st findings in 22 patients	1984 Jun	Anti B and T lymphocyte antibodies were sought in the serum of 22 rheumatoid arthritis patients from the Marseille area. No immunization against T lymphocytes was found. In contrast anti B lymphocyte activity was demonstrated in every diluted serum tested against a panel of 21 cells. In these sera, the complement dependent cytotoxicity was of medium intensity (lysis - 50 to 90 percent), antibody titers were high (medium 1/512) and a zone phenomenon was observed in 14 out of 22 non-diluted sera. As a rule, serum reactivity was slightly higher at 4 degrees C than at 22 degrees or 37 degrees C but at the latter temperature, it seemed to be more related to the target cells than to the serum tested. These anti B lymphocyte antibodies were predominantly IgMs and were not autoantibodies. Their specificity is still under study but already appears to be wide and not HLA related. These antibodies reacted with 9 to 100 percent of the panel cells and 85 percent of the sera recognized over 50 percent of the cells. Thus the antigenic determinants were probably allotypes or idiotypes of Fab fragments from surface immunoglobulins of a B lymphocyte subpopulation. Thus far, no relationship has been demonstrated between the presence or the titer of these antibodies and clinical, biological or genetic features of rheumatoid arthritis. In the future, this method should simplify the detection of Ig seric groups. It already allows detection of antiglobulin factors which could play an immunoregulatory role in rheumatoid arthritis.
7347330	Total knee prosthesis. Evolution of the principles and technique and initial results obtai	1981 Aug	The principles and details of the surgical technique for the insertion of total knee prostheses are presented, in particular the methods of dealing with the soft tissues, the correction of deformities, and the sequence and details of making the bone sections. The authors deal in detail with the technical characteristics of their modification of the Total-Condylar prosthesis "with posterior stability" and discuss its advantages over the traditional design. The main advantages are increased range of movement and better functional capacity, stability, and distribution of load on the tibial component. No disadvantages have yet been encountered, so the authors recommend the use of this prosthesis in all cases, rather than only in selected cases.
6369924	Immunosuppressant therapy.	1984	In this chapter, an attempt has been made to discuss the major immunosuppressant agents in use today as well as some of those whose future is as yet undecided. Obviously, not every immunosuppressive modality could be included in this limited space. However, we have endeavored to include agents of practical and theoretical importance to the practicing physician. The therapies discussed here are all hampered by significant degrees of toxicity, which compromises their usefulness and limits their potential. The decision to begin therapy with these agents must be made carefully, and it is incumbent upon the physician to include the patient and patient's family in this process. In many cases, these choices can be based on well-controlled trials in which efficacy has been established. Unfortunately, for many immunologically mediated processes no such studies are available, or those that have been reported are flawed. In such cases, decisions become increasingly difficult. One must then weigh the potential adverse effects of the agent against the possible long-term consequences of witholding such treatment. We can only hope that the continued study of these diseases and the immunosuppressant agents in concert with the development of new, less toxic therapies will make these choices less difficult in the future.
4048874	Effects on bone marrow cells of oral treatment with podophyllotoxin derivatives in rheumat	1985	SPG 827, a mixture of podophyllotoxin derivatives, has been thought to alleviate the symptoms of rheumatoid arthritis (RA) by arresting cell division in metaphase (i.e. resulting in an increase of the mitotic index) of rapidly proliferating cells of the immune apparatus. In contrast, the present study produced evidence that peroral SPG treatment of RA patients reduced the mitotic index of bone marrow cells, mainly in erythropoiesis. At the same time, slight megaloblastic changes appeared in the erythroblasts. These observations suggest that SPG treatment induced an interphase block in the G2 phase of the cell cycle, analogous to the cell action of the newer podophyllotoxin derivatives teniposide and etoposide. It may be that part of the clinical effect of SPG in rheumatoid arthritis is due to the described interphase-blocking activity.
7029742	Diflunisal in rheumatoid arthritis. A controlled trial.	1981 Dec 12	Diflunisal (Dolobid; Frosst-MSD) is an acetylsalicylic acid (ASA) derivative and has potential advantages over ASA, e.g. a longer half-life, higher potency and better tolerance. It has been shown to be effective as an analgesic in a variety of conditions. In a 12-week double-blind controlled trial diflunisal was compared with naproxen (Naprosyn; Syntex) in patients with rheumatoid arthritis. Suitable efficacy data were only available at week 4 owing to a number of withdrawals from the naproxen group. Both drugs, however, produced improvement in all the indices measured. At week 12 the initial improvement in the diflunisal group was maintained. Side-effects from diflunisal were mainly related to the gastro-intestinal tract but were not of serious nature; tinnitus and deafness did not occur. Diflunisal is an effective analgesic and also has anit-inflammatory action. It is a useful addition to the range of aspirin derivatives available for the treatment of rheumatoid arthritis.
7042367	Indoprofen compared with naproxen and placebo in rheumatoid arthritis.	1981	Thirty-six patients suffering from rheumatoid arthritis took part in a double-blind controlled cross-over trial, in which they received either indoprofen 800 mg daily, naproxen 500 mg daily, or a matching placebo. Each treatment was administered for two weeks. Indoprofen was shown to be significantly superior as an analgesic and in improving grip strength, and was the drug the patients preferred. Adverse effects were comparable, although indigestion was seen slightly more often during indoprofen treatment. Indoprofen is therefore at least as effective as existing anti-inflammatory drugs in rheumatoid arthritis and should be used as an alternative.
10268832	The genesis of chronic illness: narrative re-construction.	1984 Jul	In this paper I demonstrate the way in which people's beliefs about the aetiology of their particular affliction (arthritis) need to be understood as part of a more comprehensive imaginative enterprise which I refer to as narrative reconstruction. The intrinsically teleological form of this enterprise means that identified 'causes' represent only putative efficient connexions between the disease and antecedent factors but also narrative reference points between the individual and society in an unfolding process which has become profoundly disrupted. Through the presentation of case material taken from lengthy interviews I illustrate the way in which my question to the subjects about the cause of their disease: 'Why do you think you got arthritis?' was translated by them into a narrative reconstruction of their changing relationship to the world in which they live and the genesis of illness within it.