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ID PMID Title PublicationDate abstract
12476750 [Evaluation of a 3-week hospital rehabilitation of patients with rheumatoid arthritis]. 2002 Essential for evaluation of disease activity and functional disability in rheumatoid arthritis is to monitor the disease course by the outcome measures, which show quality of care i.e. efficacy of drugs, physical therapy and rehabilitation. To assess disease activity in 21 days hospital rehabilitation we chose Disease Activity Score (DAS). Functional disability was measured by Health Assessment Questionnary (HAQ). The measures were noted at arrival and admission and we found statistically significant decrease in values of DAS (t = 5,836; p < 0.01) and HAQ (h = 16.26; p < 0.05), but without clinically valid criteria for improvement. The conclusions are: these measures are not appropriate for assessment of efficacy for a short therm hospital rehabilitation, because DAS is measure which primary shows activity of inflammatory process, and HAQ as a long term measure is not sensitive enough for the assessment of short term rehabilitation.
12079905 Laboratory and imaging studies used by French rheumatologists to determine the cause of re 2002 Jul BACKGROUND: The cause of recent onset polyarthritis can be difficult to identify. OBJECTIVE: To determine which laboratory and imaging studies French rheumatologists recommend, not taking cost into account, for the diagnosis of recent onset polyarthritis without extra-articular manifestations. METHODS: From the list of the French Society for Rheumatology, a random sample of 210 rheumatologists was selected, who were asked to complete a questionnaire on the laboratory and imaging studies they would recommend in two fictional cases of recent onset polyarthritis (possible rheumatoid arthritis (RA)-case 1 and probable RA-case 2). RESULTS: In case 1, the following were recommended by over 75% of respondents: hand radiographs, rheumatoid factors (RFs), and antinuclear antibodies (ANA) (92%, 98%, and 98%, respectively). 50-74% of respondents recommended radiographs of the feet, knees, and chest (50%, 57%, and 66%, respectively); blood cell counts, erythrocyte sedimentation rate (ESR), serum assays of C reactive protein (CRP), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) (65%, 74%, 67%, and 62%, respectively). 25-49% recommended determination of creatinine and proteinuria, HLA-B27, antikeratin antibody, radiographs of the pelvis, and synovial fluid analysis. Several investigations were recommended less often in case 2 than in case 1. Nevertheless, some laboratory and imaging studies (radiographs of hand, feet, knees, chest x rays, blood cell counts, ANA, RF, antikeratin antibody, CRP, ESR, creatinine, AST and ALT, proteinuria, and joint aspiration) were recommended by more than 25% of respondents in both cases. CONCLUSION: Wide variations were found among rheumatologists, indicating a need for standardisation. Some laboratory and imaging studies are recommended by at least 25% of respondents in recent onset polyarthritis with or without clues suggesting RA. In contrast, many tests were considered useful by fewer than 25% of the respondents in both cases.
12195628 Simple function tests, but not the modified HAQ, correlate with radiological joint damage 2002 OBJECTIVE: To test the validity of the Modified Stanford Health Assessment Questionnaire (MHAQ) for assessment of physical disability in rheumatoid arthritis (RA). METHODS: Sixty-one RA patients with mean age of 61 years and median disease duration of four years were included in this cross sectional study. The patients completed the MHAQ. Four simple function tests were performed (walk test, chair test, upper extremity mobility test, and grip strength) and a modified Larsen score was established. Pain score (VAS) and laboratory variables for inflammation were recorded. RESULTS: MHAQ, function tests, pain, and C reactive protein (CRP) showed highly significant mutual correlations (p < 0.01). However, MHAQ did not correlate with Larsen score (R = 0.06; NS), while most function tests did (walk test, R = 0.29; p < 0.05; chair test, R = 0.21; NS; mobility test, R = 0.36; p < 0.01 and grip strength, R = -0.35 p < 0.01). The superiority of function tests was even more pronounced after four years (walk test, R = 0.31; p < 0.05; chair test, R = 0.50; p < 0.01; mobility test, R = 0.49; p < 0.01; grip strength, R = -0.52; p < 0.01; MHAQ, R = 0.34; NS). CONCLUSION: Objective function tests are preferable to MHAQ in the assessment of physical disability in RA.
12030042 [A case of multiple bone and joint tuberculosis which had been misdiagnosed as the rheumat 2002 Apr A 34-year-old man had a multiple arthralgia for about eleven months. The swelling of his right wrist and foot had appeared in the dorsal side, and he had been misdiagnosed as the rheumatoid arthritis. He was treated with prednisolone in the dosages of 2.5 mg per day for one month, and 10 mg per day for ten months. When he admitted to our hospital, the bone X-ray examinations of the wrist and foot revealed the marked atrophy and destruction of the carpal and tarsal bones. The aspiration fluid from the swelling around his wrist and foot was positive for acid-fast bacilli on smear and Mycobacterium tuberculosis was found on culture. He was treated with isoniazid, rifampicin, ethambutol and pyrazinamide, however, these medication was not adequately effective to his complications of tuberculous arthritis. Curettage, irrigation and synovectomy of his right carpal and tarsal bone were performed in order to control his bone and joint infection. He recovered from his arthritis and tenosynovitis after these operations. The clinical practitioners should not omit tuberculosis from the differential diagnosis of persistent osteoarthralgia.
12066333 The technological edge. 2002 May New bench-top instrumentation and novel spin-trapping assays open up the way to diagnosing and monitoring a range of conditions associated with rheumatoid arthritis and renal disease.
12563372 [Power Doppler e mezzi di contrasto nello studio della membrana sinoviale reumatoide]. 2002 Oct Pannus formation is a fundamental event in the pathogenesis of rheumatoid arthritis and its hypervascularisation seems to be crucial to the development of joint damage. High-resolution greyscale ultrasonography is a safe, quick, and inexpensive imaging tool that allows an accurate detection of even minimal morphostructural changes in patients with rheumatoid arthritis, including joint effusion, thickening of synovial membrane and bone erosions. More recently, power Doppler sonography has proved to be a reliable tool for semiquantitative assessment of the vascularity of the synovial tissue. The contrast-enhanced power Doppler sonography seems to be a helpful adjunct in assessing synovitis and the therapeutic response to the different therapies in patients with rheumatoid arthritis. The aim of this radiological vignette was to show a representative example of use of power Doppler sonography with contrast agent in assessing rheumatoid synovitis.
12849951 The rheumatoid wrist in black South African patients. 2003 Aug The wrist and hand X-rays of 75 black patients with rheumatoid arthritis were scored according to the Larsen criteria. The mean Larsen score for left hands was 9.6 (range 0-100) and for the right hands was 10:3 (range 0-100), whereas the score for the wrists were 2.5 (range 0-5) for the left and 2.7 (range 0-5) for the right. Our conclusion is that rheumatoid wrist involvement in black patients was more or less the same as reported in other series, but finger joint involvement was considerably less. This finding must influence surgical decision-making and also the interpretation of results of drug trials, whenever black patients are involved.
11879532 Ex vivo gene transfer in the years to come. 2002 Synovial fibroblasts (SFs) have become a major target for ex vivo gene transfer in rheumatoid arthritis (RA), but efficient transduction of RA-SFs still is a major problem. The low proliferation rate and heterogeneity of RA-SFs, together with their lack of highly specific surface receptors, have hampered a more extensive application of this technique. Improving transduction protocols with conventional viral vectors, therefore, as well as developing novel strategies, such as alternative target cells, and novel delivery systems constitute a major challenge. Recent progress in this field will lead to the achievement of high transgene expression, and will facilitate the use of gene transfer in human trials.
12087910 [The role of suprasegmental and segmental autonomic disorders in the development of muscul 2002 AID: To investigate the role of suprasegmental (anxious disorders) and segmental vegetative disorders (dysfunction of neuromuscular transmission and cutaneous microcirculation) in pathogenesis of muscular syndrome of rheumatoid arthritis (RA). MATERIAL AND METHODS: MMPI, Beck's questionnaire, Spilberger's test were used in experimental-psychological assessment of RA patients' personality profile. A total of 60 healthy subjects and 340 RA patients were examined. Segmental vegetative disorders were studied by excitability of hand muscles (Prognoz-6 device) and cutaneous microcirculation (doppler flowmetry). RESULTS: RA patients showed suprasegmental disorders manifesting as frequent anxious disturbances (95%). Dysfunction of the segmental part of the autonomic nervous system was represented by various changes in excitability of hand muscles in response to weak currents, by abnormal regulation of cutaneous microcirculation. CONCLUSION: Neuromuscular and microcirculation disturbances participate in development of RA muscular syndrome. This is confirmed by a positive correlation coefficient. There was also a negative correlation between suprasegmental and segmental disorders.
11954885 Immunohistological indication for arthroscopic synovectomy in rheumatoid knees: analysis o 2002 Feb To determine the histological indication for arthroscopic synovectomy in rheumatoid knees, 23 patients underwent lavage and biopsy by needle arthroscopy. Eighty-one patients were treated with arthroscopic knee synovectomy after needle arthroscopy, and 51 of these patients underwent only arthroscopic synovectomy. Thirty patients who showed no improvement following arthroscopic synovectomy underwent open surgical synovectomy. Intra-articular lavage of knee joints by needle arthroscopy did not result in any clinical improvements. In the patients who underwent only arthroscopic synovectomy, two groups (only macrophages, no macrophages or B cells) showed clinical improvement (symptoms of the knee, ESR, RF). Patients in whom open surgical synovectomy was performed because of the failure of arthroscopic synovectomy showed clinical improvement. However, there was a significant loss of movement in the knee joint and more severe radiological deterioration in patients who underwent open surgical synovectomy than in those who underwent only arthroscopic synovectomy. Arthroscopic synovectomy should be used for rheumatoid patients with synovial tissue containing only macrophages or none of these two cells.
12510354 [Cell transplantation therapy for the treatment of articular cartilage defect]. 2002 Dec Articular cartilage destruction is a major problem in rheumatoid arthritis patients. However, there is no treatment that is widely accepted to regeneratively repair the lesion. When the joint cartilage is destructed progressively and activity of daily life is worsened, joint arthroplasty is the most common treatment to relieve joint pain though it has limited survivorship and sometimes severe complications. Recently in order to repair cartilage defect, new method with cell transplantation; autologous cultured chondrocyte transplantation has been put into clinical practice. And we also have reported autologous cultured-expanded bone marrow mesenchymal cell transplantation. These methods have possibility to repair cartilage defect with good quality histologically, biochemically and biomechanically.
14508646 [Surgical replacement of the thumb saddle joint with the GUEPAR prosthesis]. 2003 Sep Primary arthritis of the thumb saddle joint is very common. Among the different treatment options, the implantation of a total joint arthroplasty is an alternative. The GUEPAR prosthesis, developed by a group of French surgeons, is mainly used in elderly patients and only in cases with preserved trapezial height. This study reports the mid-term results of the second generation of this implant. The clinical results show good pain relief and good mobility of the thumb. There were a few patients with radiological signs of implant loosening, but none of them had clinical problems. The advantage of a total replacement of the saddle joint, compared to the standard resection arthroplasty, is faster rehabilitation and preservation of the length of the thumb. The new generation of the GUEPAR prosthesis has a more anatomical metacarpal stem and a modularity which allows the fit of the implants according to the anatomical situation.
12794372 [Correlation of power Doppler sonography with vascularity of the synovial tissue]. 2003 The purpose of this study was to investigate the intra-articular vascularization of the synovium with power Doppler sonography and correlate these findings with histopathologic al findings of synovial vascularity. Before arthroplasty or arthroscopy with synovectomy the knee joints of 20 patients with osteoarthritis or rheumatoid arthritis were examined with power Doppler sonography. Vascularity of the synovial membrane was classified semi quantitatively. The degree of the synovial vascularity was graded quantitatively using histological method. The strong correlation was found between qualitative power Doppler sonography results with histological findings of vascularity (Spearman's correlation coefficient was 0.85, p=0.0005). Power Doppler sonography may be a valuable tool to detect synovial vascularity and to assist clinicians in distinguishing between inflammatory and non-inflammatory synovium.
14551709 [Rheumatology 2003-part I: research news concerning pathogenesis, epidemiology, diagnosis, 2003 Sep 15 Due to the partial elucidation of the immunopathogenesis of chronic inflammatory diseases during the last years, clinical rheumatology has made a rapid development, which by the consequent use of immunomodulatory therapies including recombinant proteins (biologicals) led to a significantly ameliorated prognosis of these diseases. On this basis, new research projects are continuously performed in the fields of pathogenesis, new drug development, outcome and therapy studies. New developments of imaging techniques and serologic testing facilitate a better classification and definition of disease activity and remission criteria. The current state of research in the field of rheumatoid arthritis and spondylarthropathies with its clinical consequences is reviewed in this article on the basis of the most recent data available.
12537263 Hip involvement in patients with familial Mediterranean fever. A review of ten cases. 2002 Dec Hip involvement is uncommon in familial Mediterranean fever (FMF) and can result either from a process specific to this disease or from a coexisting chronic inflammatory joint disease, usually suggestive of ankylosing spondylitis (AS). We report ten cases of FMF with radiologically-documented inflammatory hip disease. Five patients had AS and one had juvenile idiopathic arthritis. There were six men and four women, with a mean age of 34.4 years +/- 17.6 (range, 15-70 years). Onset of the inflammatory hip disease occurred after bouts of acute hip symptoms in one of the patients with isolated FMF and after protracted hip arthritis in another; the two other patients had no history of hip symptoms. The HLA-B27 antigen was looked for in two of the five patients with FMF and AS, with negative results in both; another patient in this subgroup had severe ulcerative colitis. Total hip replacement or replacement of the acetabulum was required in six patients, including two with isolated FMF. Chronic joint disease has been estimated to contribute fewer than 5% of the joint manifestations in FMF. In previous studies, the hips and knees were affected in 75% of patients with chronic joint disease related to FMF. The association of FMF and AS (usually without the HLA-B27 antigen) has been well documented, although the pathogenic mechanisms that link these two conditions remain unknown.
15488873 Effect of anti TNFalpha therapy on arterial diameter and wall shear stress and HDL cholest 2004 Nov It has been recently hypothesized that both TNFalpha and anti TNFalpha treatment have a stimulating effect on nitric oxide synthesis and release. Moreover, an in vitro experiment has demonstrated that HDL-cholesterol binds TNFalpha. Aims of our study were to investigate wall shear stress of peripheral arteries and endothelial function of brachial artery in subjects with Rheumatoid Arthritis (RA) at baseline and after infliximab. Moreover, we evaluated the effect of anti TNFalpha therapy on lipid profile. Ten patients with RA received infliximab therapy at weeks 0, 2 and 6. Lipids and vascular parameters were measured before and the day after each infusion. After the first treatment, FMD increased (3.7 +/- 1.9% versus 17.5 +/- 2.9%, P <0.01) and common carotid and brachial artery diameters decreased (5.9 +/- 0.2 mm versus 5.5 +/- 0.2 mm; 3.5 +/- 0.4 mm versus 3.1 +/- 0.4 mm, respectively, P <0.005). Common carotid and brachial artery wall shear stress increased (21.1 +/- 1.1 dynes/cm2 versus 23.9 +/- 1.4 dynes/cm2; 42.0 +/- 4.7 dynes/cm2 versus 51.6 +/- 5.7 dynes/cm2, P <0.01). Similar results were observed after the second and third infusion. All these parameters returned to pre-treatment level at the following infusion. HDL-cholesterol and apolipoprotein AI significantly decreased after each treatment (1st treatment: 1.4 +/- 0.05 mmol/L versus 1.2 +/- 0.06 mmol/L, P <0.01; 1.73 +/- 0.05 g/L versus 1.57 +/- 0.02 g/L, P <0.03). The present data show vasoconstriction and an increase of wall shear stress in studied arteries after infliximab. HDL cholesterol is reduced by treatment and does not seem to influence FMD.
11863302 Effusive constrictive pericarditis due to rheumatoid arthritis revealed by pericardiocente 2002 Jan A 59-year-old man had a history of rheumatoid arthritis. He presented with incurable pericardial effusion. He was repeatedly treated with pericardiocentesis with only transient attenuation of his symptoms because the underlying pericardial constriction had been overlooked. This time the authors diagnosed effusive constrictive pericarditis due to rheumatoid arthritis using the hemodynamic findings observed before and after pericardiocentesis.
12740668 Functional outcome and subset identification in RA patients from meridional Europe: analys 2003 May The aim of this study was to study the short-term functional and anatomical prognosis of rheumatoid arthritis (RA) in a series of Spanish patients and to identify different subsets of patients as well as possible baseline factors associated with specific outcomes. All patients seen in our division who met the ACR criteria for RA and with disease duration between 2 and 7 years were eligible for the study. Available patients were further evaluated at the clinic for disease activity using biological tests and joint indices as joint counts and Thompson's index, functional capacity using the ACR functional classification (ACR-FC) and the modified Health Assessment Questionnaire (M-HAQ) and radiologic damage by the Sharp's radiologic scoring method. Cluster analysis was used to identify different clinical subsets of patients. One hundred and sixty-three patients were eligible for the study, 13 could not be located or refused to participate and 12 had died. Mean (+/-SD) age at disease onset and mean disease duration were, respectively, 56(+/-14) years and (55+/-20) months. Median (interquartile range) of M-HAQ was 0.4 (0.1-1.1) and 41% of patients were in III or IV ACR-FC. The majority of patients (93%) showed radiologic lesions and 65% had erosions. Cluster analysis identified three subsets: cluster I (70% of patients) was characterised by a good prognosis, cluster II (13%) by a high level of disease activity, and cluster III (17%) by a greater anatomic damage and longer disease duration. No baseline predictive markers were found for these different outcomes. We concluded that RA portends an overall poor short-term prognosis in a relative large percentage of our patients with significant anatomic and functional sequelae. Aggressive management is specially indicated in this subgroup of patients, although definitive prognostic markers for its early identification are still lacking.
15628320 Mucinous nodules on the skin overlying a rheumatoid arthritic joint. 2004 Sep A rare case of mucinous nodules on the skin overlying rheumatoid synovitis in a 79-year-old man is described. The patient had a five year history of RA. The patient had complained of arthralgia in the left elbow joint, and X-ray demonstrated narrowing of thejoint space along with bone destruction. He underwent an intraarticular injection of dexamethazone and lidocaine. Three weeks later, he noticed two dome-shaped nodules about 5 mm in size developing on the elbow. Histopathological examination demonstrated poorly defined mucinous nodules in the upper dermis. The mucinous material positively stained with alcian blue and colloid iron, and was metachromatic with toluidine blue. These positive stainings disappeared after hyaluronidase digestion. Five to six weeks after being resected, both nodules recurred. Lesional injections of triamcinolone were effective. The intraarticular injections preceding the appearance of the nodules might have created channels from the joint space to the skin. Leakage of activated synovial cells, which produced hyaluronic acid, through the channels might have caused the mucinous stroma of the nodules.
12360615 [Borderline nervous mental disorders in patients with chronic joint diseases]. 2002 Nervous-psychic status by criteria of the V. P. Serbsky Center of Mental Health (Moscow) was assessed in 107 patients with rheumatoid arthritis (n = 54), osteoarthritis deformans (n = 35), gout (n = 11), ankylosing spondyloarthritis (n = 7). Autonomic and psychosomatic, asthenic, affective, hypochondriac, phobic, hysteric disorders were detected in 24.3, 15.9, 8.4, 7.5, 4.6 and 2.8% of examinees, respectively. These disorders correlated with the form and duration of the underlying disease, age of the patients, severity of anemia and joint dysfunction. Such social factors as invalidity, family and financial problems, frequent pregnancies and labor also contributed to development of nervous-psychic disorders.