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PMID	Title	PublicationDate	abstract
7006069	Diclofenac sodium (Voltaren) and ibuprofen in rheumatoid arthritis. A randomized double-bl	1980	A double-blind, cross-over trial compared the antiinflammatory and analgesic effects as well as tolerability of diclofenac sodium (Voltaren) and ibuprofen. Twenty-four outpatients with rheumatoid arthritis were included. A single-blind placebo period was inserted between the two active treatments. The daily dose of diclofenac sodium was 50 mg bid and that of ibuprofen 400 mg tid. The duration of each treatment period was 14 days. The efficacy was measured by the following criteria: Articular index (Lansbury), morning stiffness, fatigue, pain (measured on a visual analogue scale), consumption of rescue-analgesics, status of the arthritic condition, and patient preference. No significant differences were found between diclofenac sodium and ibuprofen, but regarding consumption of analgesic, global evaluation, rheumatic activity, and activity index, a slight trend towards a better effect of diclofenac sodium was found. The study had an adequate sensitivity as it could distinguish placebo from the active treatments for all parameters evaluated. No patient was withdrawn for unwanted effects. None of the laboratory data showed abnormalities of clinical relevance.
6775079	Fulminant colitis complicating gold therapy.	1980 Jul	Enterocolitis is lesser known complication of gold therapy. Two cases of fulminant colitis, complicating chrysotherapy for rheumatoid arthritis are described. One patient required colectomy, whereas the other responded to intensive medical treatment. Colonic biopsies demonstrated extensive ulcerations, diffuse edema, multiple hemorrhages and a dense mononuclear cell infiltrate. Our experience emphasizes the paramount importance of early recognition and treatment of this serious complication.
238274	A study of the influence of various antirheumatic drug regimens on serum acute-phase prote	1975 May	In patients with rheumatoid arthritis neither indomethacin nor aspirin influenced the levels of the erythrocyte sedimentation rate (e.s.r) or serum acute-phase proteins fibrinogen, haptoglobin, C-reactive protein and alphaI acid-glycoprotein). Treatment with D-penicillamine, sodium aurothiomalate, or alclofenac produced a significant reduction both in acute-phase protein levels and in e.s.r. Each of the drugs displaced L-tryptophan from plasma proteins in vivo but withdrawal of indomethacin and aspirin was followed immediatley by excessive binding of this amino acid to circulating proteins:this phenomenon was not observed when alclofenac, sodium aurothiomalate or D-penicillamine were withdrawn. It has been demonstrated that disease activity in rheumatoid arthritis is reflected in acute-phase protein concentrations and in the extent to which L-tryptophan is bount to plasma protein. It is suggested that drugs which profoundly affect these parameters provide not only symptomatic relieft but also possible beneficial effects upon the disease process itself.
6226096	Effect of nonsteroidal antiinflammatory drugs on immune function.	1983 Aug	Nonsteroidal antiinflammatory drugs (NSAID) have been thought to act by inhibiting the production of prostaglandins. Until recently, prostaglandins have been considered to be mainly proinflammatory compounds, responsible for pain, increased blood flow, and edema. It has more lately been realized that prostaglandins, particularly PGE2, have important immunoregulatory properties. Thus NSAID, by inhibiting PGE2 production, modulate immune responses in vitro and in vivo. One or more of these immunomodulating effects of NSAID may play a role in their efficacy as arthritis medications. The purpose of this paper is to review the immunologic role of PGE2 and the immunologic effects of NSAID.
487644	Inhibition of neutrophil migration by sera from patients with rheumatoid arthritis.	1979 Jun	Sera from patients with rheumatoid arthritis inhibited the migration of human neutrophils in 63% (twenty-two out of thirty-five) of the cases tested. The inhibition was not due to a toxic effect of the serum as it was reversed by a chemotactic stimulus. There was a strong correlation between the degree of inhibition of neutrophil migration and the amount of immune complexes present in the sera as determined by the C1q binding activity. It is suggested that the inhibition of neutrophil migration is due to the presence of circulating immune complexes, and that the capacity of immune complexes to inhibit neutrophil migration in vitro may also contribute to the accumulation of neutrophils at sites of immune complex formation in vivo.
6512790	Acute leukemia in rheumatoid arthritis treated with cytotoxic agents.	1984 Oct	Acute leukemia is described in two patients treated with cytotoxic agents for a destructive, seropositive rheumatoid arthritis. Both patients had received longterm azathioprine therapy. In addition, one patient had been treated with cyclophosphamide, the other with melphalan. Chromosomal abnormalities were noted in both patients. Studies in one patient included colony forming units, ferrokinetics, electron microscopy of bone marrow, and autopsy examination. All reports of acute leukemia associated with cytostatic drugs in the literature to date are reviewed and the possible mechanisms discussed. It is suggested that patients with rheumatoid arthritis treated with azathioprine and alkylating agents may have an increased risk of developing a therapy-related acute leukemia.
4007643	[Is resection-interposition arthroplasty in chronic polyarthritis an alternative to alloar	1985 May	Rheumatoid arthritis involving the wrist joint frequently causes destruction and subsequent dislocation of the radio-carpal joint. The resultant loss of function requires a stabilisation procedure to correct it. In order to preserve function, various types of prosthesis for the wrist joint have been developed and their values are discussed. The resection interposition arthroplasty described here not only improves stability but also appearance and function. The operative procedure and results are presented.
1224926	[The drug spectrum in rheumatoid arthritis therapy].	1975	The possibilities of medicamental antirheumatic treatment, are reviewed. Drugs are divided in nonsteroidal antirheumatic drugs, corticoids and combined drugs, so called basic treatment, and locally administered drugs. Mechanisms of action, indication, and effects of those groups are discussed and literature is briefly reviewed.
6499310	A synopsis of surgery for rheumatoid arthritis (excluding the hand).	1984 Dec	Over the years, orthopedic surgery has become more involved in the care of the rheumatoid patient. A more active and aggressive attitude by orthopedic surgeons has thrown new light on the handling of the rheumatoid patient. Currently, the surgical treatment of rheumatoid arthritis is evaluated not only by the outcome of a procedure on a single skeletal part but also by the generalized effects of the disease on the activity of the patient and the function of neighboring joints. Soft-tissue procedures, such as synovectomy and release operations, have been beneficial. Prosthetic surgery yields satisfactory results, and every effort should be made to give the rheumatoid patient as long a period as possible with relief of pain and increased mobility.
932086	Excision arthroplasty of the elbow in rheumatoid disease.	1976 May	The results of ten excision arthroplasties of the elbow for rheumatoid disease are described. The operation may afford good relief of pain and a useful increase both of hinge motion and of forearm rotation. Instability is not a serious problem unless the patient has to bear weight on crutches. To increase stability after arthroplasty it appears that Kirschner wire fixation is advisable as well as a plaster cast. For advanced rheumatoid disease unilateral excision arthroplasty has a definite value, especially for patients confined to a wheelchair.
6857168	Metatarsal head resection in the treatment of the rheumatoid forefoot.	1983	When conservative treatment in the management of the painful rheumatoid forefoot fails, surgery should be advocated. The aim is to relieve the sole from pressure on the metatarsal heads, which causes callosities on and pain in the forefoot. Various surgical procedures have been described, but they have in common to replace or remove the fat pad under the metatarsal phalangeal joints, to resect the metatarsal heads and, in doing this, restore the metatarsal ends to a flat arc. For if the intermediate metatarsals are left too long, new pressure points may develop, with ensuing pain. In this investigation a 4 1/2-year follow-up is presented of 32 patients operated on with metatarsal head resection in 59 feet. Twenty-two patients representing 39 feet were very satisfied, whereas 8 patients representing 15 feet were dissatisfied. Walking ability improved considerably; standing on toes improved; muscle power of toes improved. Despite attempting to maintain the metatarsal arc as a flat curve, this proved to be uneven in 25 feet, but did not jeopardize the results. The complications were minor and did not influence the final results. These, however, were decidedly influenced by the functional class of the patient at the time for investigation. Surgical management of the painful rheumatoid forefoot appears to be a recommendable procedure.
911360	Interaction of D-penicillamine with gold salts: in vivo studies on gold chelation and in v	1977 Sep	Serum and urinary gold levels were monitored in 18 patients previously treated with gold salts for rheumatoid arthritis and the effects of D-penicillamine studied. There was no statistically significant change in urinary gold levels on D-penicillamine therapy although there were some individual variations. Serum gold levels fell during D-penicillamine therapy but the rates of fall did not differ from those seen in patients not treated. In vitro studies on protein binding of gold salts suggest that a high affinity exists between gold salts and albumin with low levels of unbound gold even at concentrations far exceeding those seen in vivo. These preliminary results suggest that at therapeutic levels only small amounts of gold are available for chelation by penicillamine. It is concluded that penicillamine at low dosage is an unreliable chelator of gold salts in vivo and its use in the management of gold toxicity remains speculative.
329401	[Value of the detection and characterization of circulating immune complexes in rheumatoid	1977 May	The authors analyse the value of research into and identification of immune complexes (IC) in chronic inflammatory rheumatisms (CIR) and in rheumatoid polyarthritis (RP) in 93 patients hospitalise in a Rheumatology Department. Comparative levels of ICs were established simple and quick technique of measuring the 50% haemolytic complement (HC 50) used up by the ICs. The rheumatoid factor (RF) is identified at the PEG IC precipitates with the Waaler-Rose test. The existence of raised levels of IC containing RF in both seropositive and seronegative PRs and to a similar degree in a non-negligable percentage of clinically non-classable RICs conforms the diagnostic value of this research. On the other hand there is no relationship between the levels of ICs and either clinical signs or age of the illness. In RPs other than CIR circulating ICs are found whose nature is still unknown.
1085375	Classification criteria for systemic lupus erythematosus. Frequency in normal patients.	1976 Sep 27	One hundred healthy women were examined prospectively during their annual physical examination for any of the preliminary criteria of systemic lupus erythematosus (SLE). No patient had more than three of the criteria; 50 (50%) had none. The preliminary criteria were effective in excluding normal patients. Three of 19 patients taking oral contraceptives had serum antinuclear antibody (ANA), whereas only one of 81 non-pill users had serum ANA (P less than .05). None of these patients with positive ANA had clinical evidence of SLE.
7384724	[Tiopronine, new anti-rheumatic drug, has slow action in rheumatoid arthritis].	1980 Mar	2 mercapto propionyl glycine (tiopronine) has, like D-penicillamine, a thiol radicle; it is a powerful chelating agent of heavy metals. This analogy suggests that it may be used in rheumatoid arthritis. A preliminary double blind study lasting four months comparing 1g./day in 20 patients and a placebo in 10 patients showed slight (non significant) efficacy concerning all parameters. An open study using 1.5 g. daily is being carried out in 32 patients, and we note a beneficial effect on the morning stiffness, the joint index, the functional index, the prehension strength, the E.S.R., and the joint swelling. The side effects are similar to those of D-penicillamine: loss of taste, proteinuria, mucous ulceration, which required stopping treatment. The therapeutic effect within 4 months and was maintained for 18 months in the 15 patients under treatment. A new double blind trial comparing placebo and tiopronine at a dose of 1.5 g. daily is in progress.
3920842	[Indications for rheumatoid orthopedic interventions and priorities in the long-term treat	1985 Jan	The treatment of the polyarthritic patient has to consider the whole personality in order to be effective. This difficult task calls for a well functioning team. In this team the Rheuma-surgeon plays a decisive role. He will only be able to satisfy all the expectations if he masters, by virtue of his training and experience, the art of setting up a treatment plan with priorities. In order to outline a list of priorities, he has to answer the questions: What are the patient's needs, desires and expectations? What are the predictable end results of the measures envisaged and what are the remaining possibilities in case of surgical failure or when abstaining from surgery? Three categories of operation are outlined according to the expected success rate. Of particular importance is the patient's motivation.
266602	"Sausage-like" toes (dactylitis) and HLA B27.	1977	When "sausage-like" swelling of the toes occurs in the absence of clinical Reiter's disease or psoriasis, definite classification is hardly possible. Nine patients with isolated "sausage toes" (dactylitis) and minor involvement of other joints are described. The relationship between this syndrome and HLA B27 permits better classification and more rational treatment.
4015199	Routine quantification of rheumatoid factor by rate nephelometry.	1985 Jun	In a cross-sectional study of over 3000 consecutive serum specimens the levels of rheumatoid factor (RF) measured by rate nephelometry (Beckman ICS II) were compared with values obtained by the more traditional methods of sheep cell agglutination (Rose-Waaler) and latex agglutination. Similar values for sensitivity and specificity were found for all three methods for rheumatoid arthritis, with nephelometry giving slightly higher levels of sensitivity for other rheumatic disorders. A significant correlation (r = 0.46, p less than 0.01) was found between the nephelometric and Rose-Waaler method for 147 consecutive seropositive specimens. Of interest, however, several disparate results were observed, and explanations for these were sought. Longitudinal studies of RF were performed in 49 seropositive patients over a two-year period. The nephelometric method was considered superior compared with the other techniques because of its ability to detect changes in absolute levels at earlier stages and its low interassay coefficient of variance (11%). We conclude that the nephelometric technique appears suitable for routine diagnostic use, offers several advantages compared with more traditional methods, and is no more expensive per test specimen than the Rose-Waaler technique.
6751197	Perichondrial wrist arthroplasty--a follow-up study in 17 rheumatoid patients.	1982 Aug	The author analyzes the long-term results of a new method of arthroplasty in the rheumatoid wrist. The new method, performed in 17 patients over four years, consists of reconstruction of the joint surfaces with perichondrial grafts. The functional and clinical results are analyzed. All patients showed overall subjective and objective improvement. Moreover, the new functional stability of the wrist remained constant throughout the follow-up period. No recurrence of joint deformity or synovitis was observed. The method is recommended for patients with painful, unstable, or dislocated wrists and in those with ankylosis in the nonfunctional wrist.
6606514	Anti-globulins and circulating complexes in early rheumatoid arthritis.	1983 Dec	The importance of immunological parameters such as anti-globulins, anti-RANA and circulating immune complexes in rheumatoid arthritis (RA) has been studied by examining patients with early disease who are attending general practitioner clinics with joint pains for the first time. Anti-RANA, and IgG and IgM anti-globulins were detectable in the serum at the earliest time we were able to examine the patients. The anti-globulins had specificity for both rabbit and human IgG from the outset. Immune complexes were similarly raised in early disease. From these patients with early joint pains we were able to predict, by means of multivariant discriminant analysis of the laboratory data obtained from the first serum sample, between those who would develop into patients with classical or definite RA at 1 year and those who would have non-inflammatory joint disease.