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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
14608733 [Radiologic progression of rheumatoid arthritis lesions treated with methotrexate]. 2003 Aug Methotrexate is the treatment of reference in rheumatoid arthritis (RA) because it has proved effective in this pathology. Its clinical efficacy is largely admitted but its radiological efficacy is still in certain. The other aim is to look for other clinical and radiological indices that influence these score evolution in patients treated by Methotrexate. Our study is an open prospective study about thirty RA defined about ACR criterions that don't receive other treatment followed up for 6 months. The methotrexate is administered at least 12 months (12 to 72 months) we evaluate its efficacy by Larsen score and Cohin indices. Remission has been reported in 80% of patients according to Larsen score and in 63.3% of patients according to Cohin indices. Its more efficace if admitted as a first treatment and for at least 12 months in young patients (under 40 years) with an arthritis evolution below 10 years and is at stage 0 or 1 of steinbroker but these data are not statistically significant first for patient age and ancientness of RA.
12531670 Preliminary results of total wrist arthroplasty using the RWS Prosthesis. 2003 Feb Twenty-nine wrist prostheses were implanted and followed-up for a mean of 4 (range, 2-8) years. Twenty-four of these patients had rheumatoid arthritis. Pain and range of motion improved significantly. Sixteen patients were graded as excellent, six as good, two as fair and three as poor according to Meuli's wrist score. There were three frank radiological failures and one revision in this study. Eleven prostheses showed signs of possible loosening without progression or clinical instability. The management of the distal ulna during this procedure and the long-term fixation of the carpal component were problematic.
12141211 Mechanical wearing down of flexor tendons in rheumatoid arthritis as a result of extreme v 2002 We report the case of a 72-year-old patient with rheumatoid arthritis complicated by spontaneous ruptures of the flexor digitorum superficialis and profundus tendons of the left index finger. Extreme volar-flexed intercalated segment instability resulted in protrusion of the head of the capitate bone into the carpal tunnel and rupture of both tendons caused by wear. Reconstruction of the flexor digitorum profundus tendon, interposition of a tendon graft, and radiolunate arthrodesis restored function.
15339306 Bayesian variable selection in multinomial probit models to identify molecular signatures 2004 Sep Here we focus on discrimination problems where the number of predictors substantially exceeds the sample size and we propose a Bayesian variable selection approach to multinomial probit models. Our method makes use of mixture priors and Markov chain Monte Carlo techniques to select sets of variables that differ among the classes. We apply our methodology to a problem in functional genomics using gene expression profiling data. The aim of the analysis is to identify molecular signatures that characterize two different stages of rheumatoid arthritis.
14969407 Identification of auto-antibodies in the sera of patients with rheumatoid arthritis. 2003 Dec Serological analysis of a recombinant cDNA expression library was carried out and a number of auto-antibodies were found that were highly prevalent in the sera of such patients.
15273761 Absorption and digestion of phagocytized objects by mononuclear phagocytes during rheumato 2004 Feb Radioisotope study of mononuclear phagocytes from patients with rheumatoid arthritis showed impaired ingestion of bacteria in the presence of pronounced digestive activity. Excessive accumulation methylumbelliferyl phosphate beta-glucuronide (product of hydrolysis catalyzed by glucuronidase released from cells) into the incubation medium was observed. This was probably related to the predominance of extracellular digestion.
12707479 Testing for the integrity of blinding in clinical trials: how valid are forced choice para 2003 May BACKGROUND: In randomised controlled trials, an increasingly used test of the 'blindness' of assessors is to have them guess the group to which each participant has been allocated. Because assessors are usually aware of the trial hypotheses, we predicted that trial participants who showed the greatest improvement would be assumed by an assessor to have been in the 'preferred intervention' group. METHODS: Data were derived from a trial in recent-onset rheumatoid arthritis comparing cognitive behavioural therapy plus routine care with routine care alone. RESULTS: Although in this trial assessor blindness was demonstrated, patients 'guessed' by the assessor to be in the cognitive therapy group showed significantly greater improvements than those predicted to have received routine care alone in variables predicted to change in the study protocol. CONCLUSIONS: These results indicate that even if an assessor's guesses about patient group allocations are more accurate than expected by chance, this would not necessarily demonstrate failure of blinding. This casts further doubt on the validity of forced choice paradigms in testing the integrity of blinding in clinical trials.
12175115 16-year remission of rheumatoid arthritis after unusually vigorous treatment of closed den 2002 Jul This report describes a remission of rheumatoid arthritis (RA) of 16 years duration, apparently caused by the extraction of endodontically well-treated, healthy looking teeth. The only clue that the teeth were contributing to the disease pathogenesis in this case of RA was that the patient was able to reproducibly induce severe attacks of arthritis after prolonged, heavy pressure on some of his teeth treated with root canal fillings. After extraction, a small pus layer was found to cover the apices of the clinically healthy looking teeth. The rheumatoid factor (RF) became negative and the patient remained symptom free for the next 16 years. The possible connections between micro-organisms in closed dental foci under constant pressure and the chronicity and exacerbations of RA are discussed.
12621840 [Radiologic progression of rheumatoid arthritis in early basic drug therapy]. 2002 For therapy and follow-up control in early disease modifying antirheumatic drug (DMARD) treated rheumatoid arthritis (RA), objective quantification is still lacking. Therefore, radiological analyses are considered the most appropriate method. One aim of this study was to retrospectively determine the time-dependent progression of joint damage in RA patients on DMARDs. Outpatient records and radiographs from hands and feet of 54 RA patients on DMARDs were evaluated. Radiographs were quantified by using the original Larsen score and a newly developed computer-assisted quantification software. Our observations showed that radiologically-detectable damage in all patients, regardless of their treatment, is most pronounced during the first year of disease, being mitigated and generally progressing linearly in the subsequent years. Cumulative ESR correlated with RA progression, and its reduction with therapeutic efficacy.
11934959 Erosions in inflammatory polyarthritis are symmetrical regardless of rheumatoid factor sta 2002 Mar BACKGROUND AND AIMS: Symmetry is considered an important criterion for the differentiation of rheumatoid arthritis (RA) from other forms of inflammatory polyarthritis (IP), particularly those that are seronegative. Because of the inclusion of symmetry in the diagnostic and classification process, however, its true occurrence in RA cannot be assessed. As a surrogate, peripheral inflammatory arthropathies associated with rheumatoid factor production may be more likely to be symmetrical. We examined the degree of symmetry of erosions in an unselected cohort of patients with IP and tested the hypothesis that the presence of rheumatoid factor (RF) is associated with greater symmetry. METHODS: All patients registered with The Norfolk Arthritis Register (NOAR; a UK primary-care based cohort of patients with IP with annual follow-up) and who had radiographs performed at the fifth anniversary from notification were included in the analysis. Radiographs of the hands and feet were read using the Larsen method; a score of 2 or more in any particular joint indicated an erosion. Log-linear modelling was used to determine the symmetry of erosions between right and left for the following joint groups: wrists, metacarpophalangeal joints, proximal interphalangeal joints and metatarsophalangeal joints. Log-linear modelling was also used to determine the influence of RF on symmetry. RESULTS: Five hundred and thirty-seven patients contributed to the analysis. The median time to performing radiographs was 69 months (interquartile range 65.5-74.8) from the onset of symptoms. A total of 212 (39%) patients had erosive disease. Overall, IP was found to be a symmetrical disease. Despite there being more erosions in RF-positive patients, there was no greater excess of symmetry in RF-positive compared with RF-negative patients. CONCLUSION: Radiographically, IP is a symmetrical disease irrespective of RF status. The use of symmetry as an important feature in identifying subgroups of patients with IP, such as RA, is challenged.
14660739 Complement system on the attack in autoimmunity. 2003 Dec The antiphospholipid syndrome is characterized clinically by fetal loss and thrombosis and serologically by the presence of autoantibodies to lipid-binding proteins. In a model of this procoagulant condition in which these antibodies are injected into pregnant mice, fetal loss was prevented by blocking of complement activation. Specifically, interaction of complement component 5a (C5a) with its receptor is necessary for thrombosis of placental vasculature. Inhibition of complement activation may have a therapeutic role in this disease.
15646736 [Clinical case of the month. Acute rheumatic arthritis disclosed by purpura]. 2004 Nov We report the case of an adult who presented cutaneous manifestations of rheumatic fever. The lesions are rarely diagnosed. However, they represent a clue inciting a specific diagnostic search for identifying the disease.
12058893 Long-term follow-up of systemic reactive AA amyloidosis secondary to rheumatoid arthritis: 2002 May Reactive AA amyloidosis frequently develops in patients with a long history of rheumatoid arthritis (RA), usually resulting in an unfavorable outcome due to dysfunction of the vital organs. We report a 56-year-old woman with this form of amyloidosis secondary to RA who has been successfully treated with intermediate-dose prednisolone for two and a half years since diagnosis. Because prednisolone is superior to other drugs used for amyloidosis with respect to possible harmful effects on vital organs, we can safely try this drug as an alternative therapy to improve the prognosis even in patients with severe organ dysfunction.
14618801 [Changes in topography of the popliteal artery in patients with rheumatoid arthritis depen 2003 Jul The paper is devoted to the first results of studies on abnormalities in the topography of vessels of the knee joint in rheumatoid arthritis (RA) and to potentialities of digital subtraction angiography (DSA) in differential diagnosis of degree of severity of the vascular system in the joint. Knowing the arrangement of arteries (their positions) we can prevent complications like vascular traumata, loss of blood in surgical treatment of contractures, what is of particular importance in hormone-dependent patients presenting with hypervascularization of the knee joint. DSA is an objective method of diagnosis of abnormalities in the topography of vessels of knee joints in RA patients, permitting the different diagnosis to be established concerning degrees of severity of the vascular system in the joint.
12632736 [Temporomandibular joint dysfunction in patients with rheumatoid arthritis]. 2002 Clinical and instrumental examinations of 120 patients with rheumatoid arthritis (RA) detected a direct correlation between RA stage and severity of dysfunctions and an inverse correlation between the disease stage and angle of the sagittal articular route of the temporomandibular joint.
14769517 Shared-epitope HLA-DRB1 alleles and sex ratio in Italian patients with rheumatoid arthriti 2004 Jan OBJECTIVE: To investigate the association between the HLA-DRB1 alleles sharing the epitope (Q/R)(K/R)RAA and rheumatoid arthritis (RA) in a large sample of Italian patients (N = 264) recruited from a single centre over the last 5 years. METHODS: Patients' classification according to the ACR criteria. DNA typing of HLA-DRB1 alleles by conventional polymerase chain reaction sequence specific oligonucleotide probing techniques. RESULTS: Low-resolution DRB1 "generic" typing showed a significantly higher frequency of DR4+ RA patients as compared to normal controls. Both DR1 and DR10 specificities were over-represented in our patients, but neither reached the statistically significant P level of 0.05 after Bonferroni's correction. However, direct search of Q(K/R)RAA epitopes, which are present in most DR4+ and DRl+ samples, demonstrated that these motifs were found at increased frequencies in RA patients. Stratification according to gender did not show differences in the proportion of disease-associated HLA alleles. CONCLUSIONS: Our study confirms the association of HLA-DR4, and -DR1 alleles, and more generally speaking of the shared epitopes Q(K/R)RAA, with disease susceptibility in Italian patients.
11850999 [The discharge from hospital record of the patient with rheumatoid arthritis]. 2002 Jan Rheumatoid arthritis is a chronic inflammatory disease characterised by diarthrodial joint involvement, where bone erosions are the first signs. Early diagnosis, polyarticular exacerbation, treatment unefficacy, concomitant disease or intollerance to therapy represent the reasons that often require hospital admission. The discharges's report is divided into sections. The reason of admission, clinical and laboratory findings, result of aimed tests performed, the treatment administrated, the conclusions in diagnosis favour and the suggested therapy are precised. The discharge's report represents an health iter conclusion, in which the medical services and certificative functions of charitable institutions are combined.
12435167 Longterm maintenance therapy with disease modifying antirheumatic drugs. 2002 Nov Longterm safety and efficacy of disease modifying antirheumatic drugs (DMARD) have been challenging to assess. There are few studies that have evaluated patient outcome beyond 5 years. As patients may receive several DMARD over the course of their disease a long with nonsteroidal antiinflammatory drugs, corticosteroids, and other drugs for comorbidities, it is difficult to design and implement a trial to define a specific drug's longterm effect. Based on the findings of several key studies, however, it does appear that DMARD are safe when taken longterm, and that they are more likely to be discontinued because of inefficacy than toxicity. Although DMARD are often discontinued because of lack of efficacy, 12 year data suggest that DMARD can provide benefit over this period. The toxicity profiles vary significantly between DMARD. In addition, the time during therapy when the majority of these adverse effects most frequently appear is DMARD-specific. Prospective studies are needed to further clarify longterm safety and efficacy of the newer DMARD.
12730509 Association of polymorphisms of the tumour necrosis factor receptors I and II and rheumato 2003 Aug OBJECTIVE: To assess the role of polymorphisms of the tumour necrosis factor (TNF) receptors, TNF-RI (p55) and TNF-RII (p75) in the susceptibility to and severity of rheumatoid arthritis (RA) in Dutch patients. METHODS: A total of 319 consecutive RA patients, and a cohort of 90 female RA patients with detailed 12-yr follow-up were genotyped for the TNF-RI exon 1 (+36 A to G) and TNF-RII 3' UTR (+1690 T to C) polymorphisms. RESULTS: The frequencies of the TNF-RI and TNF-RII polymorphisms were determined in both patient groups and healthy controls, but no significant differences were found. To determine the relationship of these polymorphisms to disease severity, the extent of joint damage in the cohort of 90 female RA patients was analysed. No differences in severity were observed. CONCLUSION: These TNF-RI and TNF-RII polymorphisms were not found to be associated with susceptibility to or severity of RA in the Dutch population.
12069760 Evaluation of two different models of semi-automatic knowledge acquisition for the medical 2002 Jul As part of a plan to promote semi-automatic knowledge acquisition for the medical consultant system CADIAG-II/RHEUMA, this study sought to explore and cope with the variability of results that may be anticipated when performing knowledge acquisition with patient data from different patient settings. Patient data were drawn both from a published study for the classification of rheumatoid arthritis (RA) and from a large database of rheumatological patient charts developed for the CADIAG-II/RHEUMA system. An analysis of the relationships between RA and selected CADIAG-II/RHEUMA symptoms was done using two models. In one of them, we controlled for the differences in baseline frequencies of symptoms and diseases in the two study populations as an important factor influencing the results of the calculations. Other factors that were identified included inconsistent definitions of symptoms and diseases, and the different composition of study groups in the two study populations. By eliminating differences in baseline frequencies as the most important bias, the results obtained from the two different knowledge sources became more consistent. All remaining inconsistencies and uncertainties about the contribution and relative importance of the factors were formalized using fuzzy intervals.