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ID PMID Title PublicationDate abstract
12703120 [Selective cyclooxygenase-2 inhibitors and the digestive tract]. 2002 Aug The use of non steroidal anti-inflammatory drugs (NSAIDs) is tempered by the development of side effects primarily in the gastro-intestinal tract. These effects result mainly from inhibition of the enzyme cyclo-oxygenase (COX)-1. Two NSAIDs (celecoxib and rofecoxib) COX-2 specific inhibitors had considerably lower ulcerogenic rates and lower serious gastro-intestinal side effects when compared with other NSAIDs used in rheumatoid arthritis and osteoarthritis. However, the exact place of COX-2 specific inhibitors remain to be determined as compared with the association of other NSAIDs and proton-pump inhibitors in the elderly. The efficacy of COX-2 specific inhibitors in digestive tumors is still unclear.
12572753 Pose estimation of artificial hip joint using a single radiographic projection. 2003 Jan Total hip joint arthroplasty is commonly used in cases of osteoarthritis and rheumatoid arthritis. A hip joint prosthesis consists of a cup and a stem. The relative pose (position and orientation) of the prosthesis, when the patient is standing naturally, is planned pre-operatively; however, there is no guarantee that the pre-operatively planned pose will be accurate. Prosthesis component malposition, which is inadequate positioning of the acetabular or femoral component, results in limited joint movement and a large prosthetic joint contact area, and this can cause dislocation of the femoral head from the cap. Because the range of motion after total hip joint arthroplasty is determined by the relative pose of the cup and the stem, it is important to know the relative pose after hip arthroplasty. Several pose estimation methods using single-plane fluoroscopy or conventional roentgenography have been proposed. Because a conventional radiograph system is commonly used at small cost, a method using conventional radiograms is desirable for use in a clinical setting. In this study, a pose estimation method using conventional radiography is proposed, and an in vitro experiment is performed to evaluate its accuracy. The rotational errors of the relative pose of the cup with respect to the stem were smaller than 2.3 degrees.
12554524 Malignant melanoma of the soft parts showing calciphylaxis. 2003 Mar Calciphylaxis is a poorly understood and highly morbid syndrome of vascular calcification and skin necrosis. Hypercalcemia, hyperphosphatemia, and secondary hyperparathyroidism are the factors implicated in the pathogenesis of calciphylaxis, which is generally identified in patients with hyperparathyroidism secondary to end-stage renal disease. It has also been observed in primary hyperparathyroidism, end-stage liver disease, and rheumatoid arthritis, in the absence of renal disease. There are few case reports of calciphylaxis occurring in hypercalcemia of malignancy. An unusual case is reported of calciphylaxis associated with malignant melanoma of the soft parts in the absence of renal or parathyroid disease. This is the first reported case of this soft tissue sarcoma showing calciphylactic changes.
12435385 Interleukin-10 expression after intramuscular DNA electrotransfer: kinetic studies. 2002 Nov 22 Transfected muscle can be used as a secreting tissue for therapeutic proteins. Skeletal muscle transfection is increased by suitable electric pulse application (electrotransfer). We and others had shown that electrotransfer of interleukin-10 encoding plasmid is an effective strategy in animal models of chronic diseases such as myocarditis, atherosclerosis, or rheumatoid arthritis. In the present work, we have studied murine interleukin-10 production and secretion after i.m. electrotransfer. In immunocompetent mice, serum and muscle mIL-10 levels were enhanced by electrotransfer. Serum mIL-10 concentration reached rapidly a peak level 2 days after electrotransfer. It then decreased to background at day 14. Muscle mIL-10 mRNA and protein remained more stable, being detectable up to 84 days after electrotransfer. A boost reinjection led to similar high level of circulating mIL-10. The fast decrease of serum mIL-10 was not observed in SCID mice.
12387520 Type 1 diabetes mellitus in a 3 1/2 year-old girl with Turner's syndrome. 2002 Sep Turner's syndrome is associated with autoimmune disorders. Autoimmune endocrinopathy in Turner's syndrome seems to be limited to autoimmune thyroiditis. A small number of patients with Turner's syndrome has also been associated with celiac disease, inflammatory bowel disease and juvenile rheumatoid arthritis. Type 1 diabetes mellitus in Turner's syndrome has been rarely reported. We present here the youngest patient with Turner's syndrome who developed type 1 diabetes mellitus. At the age of 3.5 years she was hospitalized with diabetic ketoacidosis. Anti-islet cell and anti-insulin antibodies were positive and C-peptide level was low. When she was investigated for recurrent urinary tract infections, horseshoe kidney was detected by ultrasonography. Karyotype analysis revealed 45,XO. She has been followed for 2 years with an insulin dose of 0.9 U/kg per day. The prevalence of type 1 diabetes mellitus associated with Turner's syndrome is still unknown.
12216038 Dissecting popliteal cyst resulting from a fragmented, dislodged metal part of the patella 2002 Sep Dissecting popliteal cyst is an uncommon complication after total knee arthroplasty, occurring mainly as a result of either rheumatoid arthritis or a malfunctioning knee prosthesis. Its association with a failed metal-backed patellar component has not been reported since the introduction of the resurfacing of the patella with this kind of design in 1980. We present a case of a late fracture-dislocation of the metal part of the patellar component that migrated to the posterior popliteal fossa, resulting in a cystic mass formation caused by a foreign body granuloma. The patient was treated successfully with a 2-stage operation: first, revision of the total knee arthroplasty and, second, excision of the cyst. The patient had a pain-free functional knee 7 years after surgery, with no recurrence of the symptoms or the popliteal cyst.
15624438 Inflammatory triggers of lymphangiogenesis. 2003 Inflammation is the common denominator to the postnatal events that overlap with lymphatic vessel growth, or lymphangiogenesis. Undoubtedly, inflammation and accompanying fluid overload are cardinal factors in wound healing, lymphedema, the pathogenesis of some forms of lymphangiomatosis, and solid tumor lymphangiogenesis. The assertion that inflammation actually triggers lymphangiogenesis lies in the evidence set forth below that inflammation is the usual precursor to tissue repair and regeneration. Moreover, the panel of pro-inflammatory and anti-inflammatory molecules that orchestrates the inflammatory response abounds with cytokines and chemokines that foster survival, migration, and proliferation of lymphatic endothelial cells. Finally, both interstitial fluid overload and increased demand for removal of leukocytes can benefit from lymphangiogenesis, although the mechanisms controlling the exit of leukocytes from tissues via the lymphatics are practically unknown. The pertinent question actually is how and why inflammation presents with formation of new lymph vessels in liver fibrosis but not in rheumatoid arthritis. One possible explanation is that organ-specific histological and functional properties of the lymphatic endothelium gauge their response to death, survival, and proliferative factors. Alternatively, the decision to remain quiescent, proliferate or regress resides within the stroma microenvironment.
15370743 Identification of relevant ICF categories in patients with chronic health conditions: a De 2004 Jul OBJECTIVES: To identify the most typical and relevant categories of the International Classification of Functioning, Disability and Health (ICF) for patients with low back pain, osteoporosis, rheumatoid arthritis, osteoarthritis, chronic generalized pain, stroke, depression, obesity, chronic ischaemic heart disease, obstructive pulmonary disease, diabetes mellitus, and breast cancer. METHODS: An international expert survey using the Delphi technique was conducted. Data were collected in 3 rounds. Answers were linked to the ICF and analysed for the degree of consensus. RESULTS: Between 21 (osteoporosis, chronic ischaemic heart disease, and obstructive pulmonary disease) and 43 (stroke) experts responded in each of the conditions. In all conditions, with the exception of depression, there were categories in all ICF components that were considered typical and/or relevant by at least 80% of the responders. While all conditions had a distinct typical spectrum of relevant ICF categories, there were also some common relevant categories throughout the majority of conditions. CONCLUSION: Lists of ICF categories that are considered relevant and typical for specific conditions by international experts could be created. This is an important step towards identifying ICF Core Sets for chronic conditions.
15295313 Tuberculosis associated with blocking agents against tumor necrosis factor-alpha--Californ 2004 Aug 6 The Food and Drug Administration (FDA) has determined that tuberculosis (TB) disease is a potential adverse reaction from treatment with the tumor necrosis factor-alpha (TNF-alpha) antagonists infliximab (Remicade), etanercept (Enbrel), and adalimumab (Humira); the three products are labeled accordingly. These products work by blocking TNF-alpha, an inflammatory cytokine, and are approved for treating rheumatoid arthritis and other selected autoimmune diseases. TNF-alpha is associated with the immunology and pathophysiology of certain infectious diseases, notably TB; blocking TNF-alphacan allow TB disease to emerge from latent Mycobacterium tuberculosis infection. In 2002, a California county health department reported three cases of TB disease occurring in association with infliximab therapy. This report summarizes those cases and nine subsequently reported cases and provides interim recommendations for TB prevention and management in recipients of these blocking agents. Health-care providers should take steps to prevent TB in immunocompromised patients and remain vigilant for TB as a cause of unexplained febrile illness.
15009836 The use of rituximab, anti-CD20 monoclonal antibody, in pediatric transplantation. 2004 Feb Rituximab, chimeric anti-human CD-20, is approved for treatment of B-cell lymphoma in adults. It is being used experimentally in other various immune-related disease such as immune thrombocytopenic purpura, myasthenia gravis, and rheumatoid arthritis. In transplant recipients it is used for treatment of post-transplant lymphoproliferative disease, and prevention and treatment of acute rejection. There are few data on its use in children. This paper reviews the use of rituximab in these disease states and provides hypotheses for its mode of action.
15003184 Treatment of refractory autoimmune diseases with ablative immunotherapy. 2004 Feb Immunological manipulations are the basis of modern therapy for refractory autoimmune diseases (AID). Ablative chemotherapy with stem cell support (autotransplant) as well as targeted immunotherapy using specific monoclonal antibodies, such as rituximab and campath 1-H have become acceptable second line therapy for severe refractory AID. Until now, more than 500 autotransplants have been performed worldwide for various autoimmune disorders, including multiple sclerosis (MS), systemic sclerosis (SSc), systemic lupus erythematosis (SLE) and rheumatoid arthritis (RA) with encouraging results, although transplant related mortality (TRM) in the range between 2 and 17% still remains one of the major limitations of the procedure. Immunotherapy is a relatively safe approach associating with sustained remissions in a considerable proportion of treated patients. Better selection of patients and earlier immunotherapy, preceded an irreversible organ damage might further improve the clinical outcome of patients with AID.
14622739 The active metabolite of leflunomide, an immunosuppressive agent, reduces mechanical sensi 2002 Oct Recent work has supported a key role for spinal cytokines and glial activation in the development and maintenance of persistent neuropathic pain after peripheral nerve injury. This study was undertaken to determine whether the active metabolite of leflunomide (A77 1726), an anti-inflammatory and immunosuppressive agent, could attenuate persistent mechanical allodynia in a rodent L5 spinal nerve transection model. A77 1726 was administered daily intraperitoneally (0.01 to 10 mg/kg) beginning 1 day before nerve transection. In a separate experiment, A77 1726 was administered daily intrathecally (0.001 to 10 microg in 40 microL) beginning 1 hour before nerve transection. Both systemic and centrally administered A77 1726 significantly reduced mechanical allodynia across the time course of the study (P < .05). A77 1726 attenuated glial activation on day 10 after transection at doses that reduced mechanical sensitivity. In addition, central A77 1726 administration decreased spinal expression of major histocompatibility complex class II. Spinal interleukin-6 levels were unaffected by A77 1726 treatment. This study provides further evidence implicating a contribution of spinal glial activation in the development and maintenance of persistent neuropathic pain. Furthermore, this study reports that systemic and central administration of the active metabolite of leflunomide, an immunosuppressive agent used for the treatment of rheumatoid arthritis, produces an antiallodynic action in a rodent mononeuropathy model.
19667687 Practical diagnostic strategies and tools for insomnia. 2004 Dec Despite the high prevalence of insomnia in the primary care setting, only a small proportion of patients report sleep problems to their physician. Evidence shows that treatment of insomnia can ameliorate the high socioeconomic burden associated with the disorder, as well as improve patient outcomes in coexistent diseases such as depression, bipolar disorder, rheumatoid arthritis, and fibromyalgia. The first strategy for improving diagnosis of insomnia is heightened awareness of the condition. As the first point of contact for most patients, primary care physicians are in a unique position to improve rates of detection and treatment. All patients should be screened for sleep disorders with such questions as "How is your sleep?" "Do you have trouble getting to sleep or staying asleep?" and "Do you get drowsy during the day or at inappropriate times?" Medical history and physical examination may also reveal possible coexistent psychiatric and medical illnesses that put patients at higher risk for insomnia, as well as suggest involvement of prescription and nonprescription medications and environmental factors that contribute to insomnia. Diagnostic tools such as the Epworth Sleepiness Scale and the Sleep Hygiene Self-Test can aid patients and physicians in recognizing sleep problems, assessing their severity, and measuring improvement after treatment.
15799190 Complications of fixation to the occiput-anatomical and design implications. 2004 Dec Internal fixation provides an increased immediate stability for the craniovertebral junction; however, there is no current consensus on the optimal method of occipitocervical (OC) fusion. In this report, we present 25 cases of craniovertebral instability treated with OC fusion by plates and screws instrumentation. The 25 cases comprised 12 men and 13 women, whose ages ranged 20 to 78 years. The principal aetiologies that lead to the OC instability of the patients in this series included trauma, rheumatoid arthritis, neoplasm and congenital abnormality. The fusion levels ranged from occiput-C3 to occiput-C6. Two mortalities occurred. The other patients showed satisfactory union after a follow-up of eight to 24 months. OC fusion using a plates and screws system is a safe and highly effective method for providing immediate internal stability to the OC junction. The internal occipital anatomy, which cannot be seen at surgery, is important when dealing with this taxing and potentially dangerous aspect of surgery.
15636327 Medical arthroscopy--emerging era of rheumatological intervention. 2004 Apr OBJECTIVE: To evaluate the safety and diagnostic value of arthroscopy performed by a rheumatologist. METHODS: Decisions for performing arthroscopy were taken when detailed clinical history-and relevant rheumatological investigations failed to arrive at a definite diagnosis. Arthroscopies were performed under local anesthesia as a daycare procedure. Synovial biopsies taken during procedures were subjected to histopathological examination (HPE). RESULTS: Of the 50 patients enrolled, 39 were males while 11 were females with mean age of 35.5 years. In lower limb oligoarthritis group of patients, three had macroscopic picture of crystal arthropathy, rest of the 29 patients revealed gross picture indicative of non-specific synovitis. While in polyarticular group of eight patients, three had macroscopic picture suggestive of crystal arthropathy (probably polyarticlar gout) while five were indicative of rheumatoid arthritis. In monoarticular disease pattern (n= 10) macroscopic picture findings were as follows- crystal arthropathy-two, tubercular-three, synovial chondromatosis-one and non-specific synovitis-two. HPE of synovium did not correlate in many cases. CONCLUSION: Arthroscopy using a 4 mm scope under local anesthesia in the hands of rheumatologists is a safe daycare procedure. In few cases arthroscopy helped in arriving at a final diagnosis but many patients remained undiagnosed. Both the rheumatologists and the pathologists require further experience in this field.
15507338 A cyclooxygenase (COX) inhibitory biflavonoid from the seeds of Semecarpus anacardium. 2004 Dec Semecarpus anacardium Linn., Anacardiaceae, is being most commonly used in India for the treatment of rheumatoid arthritis and other inflammatory disorders. Bioactivity guided fractionation of ethyl acetate extract led to the isolation of major active principle, tetrahydroamentoflavone (THA), a biflavonoid. The in vitro cyclooxygenase (COX-1) catalyzed prostaglandin biosynthesis assay of THA gave an IC(50) value of 29.5 microM (COX-1) and 40.5% inhibition at 100 microg/mL (COX-2). The in vivo carrageenan induced paw edema assay resulted in dose dependent anti-inflammatory effect of THA and the activity was comparable to that of ibuprofen, one of the well known NSAIDs.
15370744 Identification of the most common patient problems in patients with chronic conditions usi 2004 Jul OBJECTIVE: To identify the most common patient problems in patients with 12 different chronic conditions using the ICF checklist. METHODS: A multi-centre, cross-sectional study with convenient samples of patients who had received a clinical diagnosis of any of 12 different chronic conditions undergoing inpatient or outpatient rehabilitation. To describe the population, age, gender, and the SF-36 were recorded. Data for 917 patients from 33 rehabilitation centres were analysed. RESULTS: Most of the ICF-checklist categories were common to at least 1 condition. Pain was the sole category of 125 ICF-checklist categories that was common to all chronic conditions. Patients with low back pain, rheumatoid arthritis, and diabetes mellitus did not often experience the problems listed in the ICF-checklist. CONCLUSION: The main finding, that in most conditions categories from each component were common, underscores the need to address all components when assessing functioning and health in patients with chronic conditions.
15370742 Development of ICF Core Sets for patients with chronic conditions. 2004 Jul OBJECTIVE: The objective of the ICF Core Sets project is the development of internationally agreed Brief ICF Core Sets and Comprehensive ICF Core Sets. METHODS: The methods to develop both ICF Core Sets, the Comprehensive ICF Core Set and the Brief ICF Core Set, involved a formal decision-making and consensus process integrating evidence gathered from preliminary studies and expert opinion. RESULTS: The results regarding the development of the ICF Core Sets for 12 health conditions (chronic widespread pain, low back pain, osteoarthritis, osteoporosis, rheumatoid arthritis, chronic ischemic heart disease, diabetes mellitus, obesity, obstructive pulmonary diseases, breast cancer, depression, and stroke) are presented in this supplement. CONCLUSION: Both, the Brief ICF Core Sets and the Comprehensive ICF Core Sets are preliminary and need to be tested in the coming years based on a standardized protocol in close cooperation with the ICF research branch of the WHO FIC CC (DIMDI) in Munich and the CAS team at WHO. The final goals are valid and globally agreed tools to be used in clinical practice, research and health statistics.
14599838 Chondrosarcoma of small bones of the hand. 2003 Dec A clinicopathological review of 23 patients (mean age, 67 years; range, 42-85 years) with chondrosarcoma of the bones of the hand was done. The mean follow up was 8.5 years. Eleven patients presented with a progressive painless swelling, 26% having had symptoms for over 10 years. The proximal phalanx was the commonest site. Initial clinical misdiagnosis as ganglion, bursa, gout, rheumatoid arthritis and a cyst occurred in five patients. Radiologically most lesions showed bone expansion, cortical destruction and soft-tissue extension. The majority was of high histologic grade (Evan's grade 2 & 3) with extensive myxoid areas. Five out of eight patients who were originally treated by curettage or excision had local recurrences compared to none treated by ray resection or amputation of phalanx (P=0.002). None had metastases. The low risk of metastases despite the high histologic grade indicates that chondrosarcomas of the hand behave differently from chondrosarcomas elsewhere.
14572201 Immunoassay for soluble RANKL (receptor activator of NF-kappaB ligand) in serum. 2003 This paper describes a method for the direct measurement of human sRANKL (receptor activator of NF-kappaB ligand), a cytokine of the tumor necrosis factor superfamily, which is a key player in bone metabolism. Its role in the regulation of osteogenic disorders such as osteoporosis, Paget's disease and rheumatoid arthritis is being extensively discussed in the literature at present. We developed a highly specific, simple and reliable ELISA which allows the direct measurement of uncomplexed sRANKL in human serum. Assay characteristics such as analytical precision, sensitivity, interfering factors, sample stability and dilution linearity are shown. Reference values from healthy volunteers (n=57) were found to be between 0 and 2.7 pmol/l (10th-90th percentile) with a mean serum value of 1.3 pmol/l (median 0.9 pmol/l).