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ID PMID Title PublicationDate abstract
9390346 Merkel cell carcinoma arising after therapeutic immunosuppression. 1997 Oct Azathioprine and cyclosporin have been used as immunosuppressants for many years, but long-term use has also been associated with neoplasia. We report three cases of rapidly fatal Merkel cell carcinoma in patients who had been treated with azathioprine for many years either for rheumatoid arthritis or following organ transplantation. Two of these patients had also received cyclosporin. We suggest that Merkel cell carcinoma may be seen more commonly in immunosuppressed patients than in the normal population and that the oncogenic potential of azathioprine and cyclosporin should be borne in mind when prescribing these drugs.
9331542 Pulmonary involvement in unusual multisystem disorders. 1997 Sep The clinical syndrome of interstitial lung disease encompasses a number of clinical disorders that affect the alveolar walls, interstitium, and vicinal structures including small airway and pulmonary vasculature. The syndrome has more than 200 causes including bacterial, viral, fungal, protozoal, and parasitic infections; collagen vascular disorders including systemic lupus erythematosus, rheumatoid arthritis, progressive systemic sclerosis, ankylosing spondylitis, mixed connective tissue disease, Sjögren's syndrome, and various vasculitides; hypersensitivity lung disease or extrinsic allergic alveolitis; inorganic neumoconioses including silicosis, asbestosis, and berylliosis; drug-induced and iatrogenic entities; and disorders of unknown origin including sarcoidosis, idiopathic pulmonary fibrosis, eosinophilic granulomatosis, lymphangioleiomyomatosis, and bronchiolitis obliterans-organizing pneumonitis. Apart from these, there are many uncommon metabolic and immune disorders that can involve pulmonary interstitium. Recently developed epidemiologic, immunologic, and molecular biology techniques undoubtedly will add to the list other entities that may produce interstitial lung disease.
9284400 [Pathophysiological roles of human chymase]. 1997 Aug Angiotensin (Ang) II plays an important role in cardiovascular homeostasis such as regulation of blood pressure and tissue remodeling. Alternative Ang II-forming pathways, independent of Ang I converting enzyme (ACE), have been reported. Several serine proteinases including kallikrein, cathepsin G and chymase appear to be involved in ACE-independent Ang II formation in vivo. Among them, biochemical analysis revealed that chymase is a highly efficient Ang II-forming enzyme with a high substrate specificity against Ang I and is rich in various human tissues. However, the pathophysiological roles of chymase have not yet been clarified. Recent reports from us and others indicated that chymase seems to be related to development of atherosclerosis, cardiomyopathy, remodeling of cardiovascular tissues, rheumatoid arthritis and etc. In this review article, the recent findings for chymase related to cardiovascular diseases are summarized.
9194526 The codependence of angiogenesis and chronic inflammation. 1997 May Angiogenesis is the growth of new blood vessels from existing ones. It is an important aspect of new tissue development, growth, and tissue repair. It is also a component of many diseases including cancer, blindness, and chronic inflammation such as rheumatoid arthritis (RA) and psoriasis. There is considerable evidence to suggest that angiogenesis and chronic inflammation are codependent; recent studies have begun to reveal the nature of this link, which involves both augmentation of cellular infiltration and proliferation and overlapping roles of regulatory growth factors and cytokines. Through these studies, we have begun to understand the codependence of chronic inflammation and angiogenesis, the potential benefits of targeting angiogenesis in the treatment of chronic inflammation, and of targeting chronic inflammation to affect angiogenesis.
19078158 Glucocorticoid-induced osteoporosis evaluation, prevention, and treatment. 1997 Apr Systemically administered glucocorticoids are widely used in rheumatology and have many serious side effects. Approximately 30-50% of patients chronically taking glucocorticoids develop osteoporosis. Studies looking at specific rheumatologic diseases, such as rheumatoid arthritis, suggest that subpopulations of rheumatology patients are particularly at risk for development of osteoporosis.Over the last few years, several studies have validated the role of routine administration of calcium and low dose vitamin D. Early limited studies suggest that hormonal replacement of testosterone and estrogen in selected patients may be of value, and newer therapies such as bisphosphonates and calcitonin have revolutionized the prevention and treatment of steroid-induced osteoporosis. These newer therapies, combined with the increased availability and accuracy of tests that measure bone mineral density, such as dual energy x-ray absorptiometry (DXA), make it important to use such tests and to individualize needed interventions for all patients requiring long-term systemic gluocorticoids.
9170209 The regulation of neovascularization of matrix metalloproteinases and their inhibitors. 1997 The process of new capillary formation from preexisting vessels, angiogenesis, is a complex physiological event which is strictly controlled, occurring only very rarely under normal conditions. In contrast, there are a number of serious diseases, among them solid tumor growth, rheumatoid arthritis and several eye diseases, which are characterized by unrestricted new capillary growth and which are described as "angiogenic diseases." One of the key events required for successful angiogenesis is extracellular proteolysis. Increased attention has been focused on matrix metalloproteinase (MMP) family of enzymes whose activity is a rate-limiting step in extracellular matrix remodeling. This review will present the accumulating body of evidence, from a number of laboratories, which documents the important role of MMP activity in the regulation of angiogenesis. Taken together, these data suggest that one strategy for controlling the deregulated angiogenesis characteristic of these serious angiogenic diseases may be one which is operative at the level of the control of MMP activity.
16121292 Novel therapeutic strategies. 1999 Sep Of the many sessions during the first day of the EPHAR meeting, several interesting topics emerged. Among these were a number of presentations investigating novel anti-inflammatory targets, including the search for a selective COX-2 inhibitor and the potential of cytokines/cytokine receptor targets (eg TNFalpha) as treatments for rheumatoid arthritis (RA) and other chronic inflammatory conditions. Recent advances in the understanding of the pathogenesis of diabetes and obesity have highlighted the need for a multi-therapeutic approach to treatment; several drugs in preclinical investigations were highlighted. Attention was drawn to the potential of AMPA/kainate receptors, historically investigated for the treatment of neurodegenerative disease, which are now showing promise as anti-ischemic therapeutics. Many novel therapeutics strategies were discussed in detail, including the CCK-B antagonists with considerable anxiolytic potential, mitochondrial mechanisms as targets for the treatment of brain injury and the use of stress-activated proteins in anti-ischemic research.
19078477 Molecular biology and immunology for clinicians, 12: T-cell co-stimulatory molecules. 2000 Aug T-cells are activated by their interaction with antigen-presenting cells. Antigen-presenting cells process and then express peptide fragments of the target protein in a complex with self-proteins known as major histocompatibility complex (MHC) proteins on the antigen-presenting cells' surface. However, the interaction of T-cell with antigen on the antigen-presenting cell is not sufficient to elicit T-cell activation. The T-cell must receive a second signal from the antigen-presenting cell. These "co-stimulatory signals" are mediated by other proteins on the antigen-presenting cell surface that interact with T-cell surface proteins other than the antigen receptor, the protein complex receiving the peptide fragment's specific antigen signal. Some of these co-stimulatory proteins are constitutively expressed, some are up-regulated during an immune response; some interactions stimulate activation, some suppress it. Thus, these receptor-ligand protein pairs represent new sites for blockade of immune responses in immunologically-mediated diseases, like rheumatoid arthritis, lupus, and transplant graft rejection.
9830972 Factors associated with the adaptation of parents with a chronically ill child. 1998 Jul The purpose of this paper is to describe the adaptation of parents who have a child with a chronic condition and some factors connected to it. Data were collected by a questionnaire from 189 parents who had a child with a chronic condition, such as diabetes, rheumatoid arthritis or asthma. Most (85%) of the responses were from mothers. The data were analysed using factor analysis. A four-factor model turned out to describe best the adaptation of the parents and their coping with the care of a chronically ill child. Two factors showed good adaptation and two poor adaptation. Emotional and instrumental support were connected to adaptation on each of the four factors. Support from health care staff and the parents' need to obtain more information were not connected to adaptation as clearly as emotional and instrumental support. Parents wished for support more in families where the child was under nine years old than in families where the child was over nine years old.
19078323 Meloxicam clinical data on a preferential cyclooxygenase-2 inhibitor. 1998 Oct Concomitant inhibition of both cyclooxygenase (COX) isoforms, COX-1 and COX-2, has been used to explain the therapeutic efficacy and gastrointestinal (GI) toxicity of nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment of rheumatic diseases. While COX-2 is induced during inflammatory responses, constitutively expressed COX-1 is cytoprotective in the GI tract. Newer inhibitors such as meloxicam, which have been shown to inhibit COX-2 preferentially in vitro, are expected to retain their efficacy while exhibiting decrease toxicity. Clinical trials have been performed with meloxicam to evaluate these parameters. Controlled trials showed that meloxicam is significantly more effective than the placebo for the treatment of both rheumatoid arthritis and osteoarthritis. In comparative studies with piroxicam, naproxen, and diclofenac, meloxicam was approximately as effective as the other drugs. Analysis of the safety profile of meloxicam indicated that the risk of GI adverse events, especially PUBs (perforation, ulceration, and bleeding) is significantly reduced with meloxicam compared with that of comparators. These data confirm that preferential COX-2 inhibitors such as meloxicam provide a significant advantage over standard NSAIDs in the treatment of rheumatic diseases.
9021738 Growth factors in angiogenesis: current interest and therapeutic potential. 1997 Jan Angiogenesis, the process of new blood vessel development, is an essential component of the body's physiology and contributes to the pathogenesis of a variety of diseases such as benign and malignant neoplasia and rheumatoid arthritis. Failure of this physiological response is also important in abnormalities of wound healing in diseases such as duodenal ulceration and diabetes. Angiogenesis is controlled by a variety of factors that initiate, control and terminate this complex, multi-stage process. This review covers those factors that are exciting much interest currently and have potential for incorporation into clinical medicine.
11789310 [Impaired daytime functions in children with sleep disorders]. 2001 Dec Sleep in adequate amount and quality is essential for normal child development. Sleep disorders may affect the childs daytime functions resulting in behavioral problems such as attention deficit, aggressiveness and hyperactivity. Recent reports have suggested that chronic sleep disturbance can cause neurocognitive deficits and impaired learning abilities. Obstructive sleep apnea syndrome, asthma, atopic dermatitis and juvenile rheumatoid arthritis--are common childhood diseases that can impair normal sleep. This article reviews the sleep characteristics in these diseases and the relation between sleep quality and the social and intellectual performance of the child during the day.
11442202 Antibody-Based targeting of angiogenesis. 2001 Angiogenesis-the sprouting of new blood vessels from pre-existing ones-is a characteristic feature of relevant diseases such as cancer, some blinding ocular disorders, rheumatoid arthritis, and psoriasis. This article reviews recent progress in the generation of monoclonal antibodies, which recognize and target new blood vessels in vivo, while sparing mature vessels and healthy tissues. The use of such antibodies as selective "molecular vehicles" is likely to open new important diagnostic and therapeutic opportunities.
11329733 [Free radicals in immunology and infectious diseases]. 2001 Apr Free radicals contribute significantly in modification of immune processes and inflammatory reactions. They are produced by activated phagocytes which use them for killing microorganisms. Free radicals facilitate production of cytokines, which are important as modifiers of inflammatory reactions. Formation of free radicals is influenced by antioxidants which can thus modify the intensity of inflammatory reaction and immune response. The authors describe in detail the contribution of free radicals in etiology and pathogenesis of autoimmune diseases including rheumatoid arthritis, multiple sclerosis or amyotrophic lateral sclerosis. The role of free radicals and modifying influence of antioxidants in viral, bacterial, parasitic and mycotic diseases is described in the second part of the review. Finally, influence of free radicals and antioxidants on immunity changes in patients with malignant tumours, during aging and physical exercise is discussed.
11261135 Compliance of adolescents with chronic disease. 2000 Jul The purpose of this paper is to describe the factors that affect compliance in adolescents with a chronic illness and to compare compliance and factors connected to compliance between adolescents with asthma, epilepsy, rheumatoid arthritis (JRA) and insulin dependent diabetes mellitus (IDDM). The data were collected by questionnaire. Altogether 1200 individuals were selected from the Finnish Social Insurance Institution's register. The response percentage was 88 (n = 1061). One-fifth (23%) of adolescents with chronic disease felt that they had complied fully with health regimens, while 60% placed themselves in the category of satisfactory compliance and the remaining 17% reported poor compliance. In each patient group compliance was promoted by good motivation, a strong sense of normality, a positive attitude towards the disease and treatment, energy and will-power, experience of results, support from the parents, nurses and physicians, and a feeling that the disease was not a threat to social well-being.
11204608 Persistent peripheral eosinophilia and cutaneous non-Hodgkin's lymphoma: a case report and 2001 Jan Peripheral eosinophilia can be the presenting sign in many cutaneous diseases but is often missed as a marker of a serious undiagnosed underlying disease such as atopic dermatitis, urticaria, drug eruption, bullous pemphigoid, inflammatory bowel disease, helminthic infection, Churg-Strauss syndrome, rheumatoid arthritis, or lymphoma. We report a case of non-Hodgkin's lymphoma presenting as persistent eosinophilia with a diffuse nodular cutaneous eruption.
11096203 Bullous pemphigoid associated with silicosis. 2000 Bullous pemphigoid (BP) has never before been reported to associate with silicosis, although there are numerous reports of silicosis accompanied by different autoimmune diseases, such as systemic sclerosis, systemic lupus erythematosus, dermatomyositis or rheumatoid arthritis. We report on a 63-year-old Japanese patient with silicosis who developed tensed bullae, erosions and macular pigmentation on the trunk and extremities. Indirect immunofluorescence revealed anti-basement-membrane-zone antibodies; immunoblotting analysis demonstrated that the patient's serum reacted with the 230-kD BP antigen in the epidermal extracts, as well as a recombinant protein of the NC16a domain of 180-kD BP antigen. Clinical symptoms improved after treatment with systemic steroids. To the best of our knowledge, this is the first reported case of BP associated with silicosis.
11092796 How important is patient education? 2000 Dec The prevalence and disability rate of rheumatic diseases are increasing. It seems that non-medical causes play an important role in the morbidity, disability and mortality of these patients. Efforts to reduce their impact are extremely important. Patient education is thought to be one way to limit disability in rheumatic diseases and to achieve an improvement in quality of life. In this chapter, we review the influence of non-medical causes of morbidity on disease outcome, some basic aspects of education and the evidence of the effectiveness of patient education in diseases such as ankylosing spondylitis, systemic lupus erythematosus, rheumatoid arthritis and fibromyalgia syndrome.
10562369 The differential diagnosis of generalized pain. 1999 Sep Patients whose symptoms include widespread, diffuse musculoskeletal pain are commonly referred for rheumatological evaluation, even when the underlying cause may lie out with the remit of rheumatology. A diagnosis of fibromyalgia may seem highly probable even from the referral letter, or after a few leading questions during the consultation. However, the lack of specificity of the many symptoms associated with widespread pain means that other diagnoses have to be considered. The history and examination must bear in mind alternative and concomitant musculoskeletal disorders, such as mild systemic lupus erythematosus, polyarticular osteoarthritis, rheumatoid arthritis, polymyalgia rheumatica, hypermobility syndromes and even osteomalacia. Non-rheumatological diseases may also have symptomatic similarities to fibromyalgia, including neoplastic and neurological diseases, hypothyroidism and other endocrine disorders, chronic infections, as well as a variety of psychiatric conditions. A rational approach to investigation will usually allow other diagnostic possibilities to be excluded without reinforcing the abnormal illness behaviour so common in chronic pain states.
9951694 Metastasis of bronchogenic carcinoma to the thumb. 1998 Dec Bone metastasis in the hand is rare. The etiology is quite different from that of metastasis to other bones; bronchogenic carcinoma is by far the most frequent case. Distal phalanges are mainly involved with irregular osteolysis and cortical destruction. Differential diagnosis of phalangeal metastasis includes osteomyelitis, rheumatoid arthritis and gout. The prognosis is always that of metastatic bronchial cancer with an average survival of three months. Treatment may involve distal digital amputation or antalgic radiotherapy. A case of bronchogenic carcinoma with metastasis to the thumb is presented. The metastasis was located in the distal phalanx of the left thumb. The primary tumor was located in the lung. Treatment consisted of amputation. The overall survival was five months.