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PMID	Title	PublicationDate	abstract
443249	Differences in the clinical manifestations of sicca syndrome in the presence and absence o	1979 May	In this restrospective study we review the clinical features of patients with the sicca syndrome in the presence and absence of rheumatoid arthritis. All patients were followed at the National Institutes of Health for at least five years after the diagnosis of sicca syndrome was established. Twenty-two patients had sicca syndrome alone, and 21 patients had definite rheumatoid arthritis and the sicca syndrome. Rheumatoid arthritis tended to precede the developement of sicca syndrome. The mean age at diagnosis of sicca syndrome is the same in both groups. No significant differences in serum innumoglobulins, the third component of complement (C3), rheumatoid factor titer and salivary histopathology were found. However, the clinical features were quite distinct. Patients with sicca syndrome alone had a significantly greater frequency of recurrent parotitis, Raynaud's phenomenon, purpura, lymphadenopathy, myositis and renal involvement. The clinical characteristics of these two groups coupled with the known serologic and genetic differences suggest that sicca syndrome alone is a distinct pathologic entity.
1251103	Inhibition of secondary osteophyte formation in rheumatoid arthritis.	1976 Feb	Using radiographically demonstrated joint narrowing as an index of joint damage, a reduced incidence of osteophyte size and number as a measure of osteoarthritic change in the PIP and knee joints of patients with RA as compared to DJD has been demonstrated. The possible pathogenetic factors discussed include reduced joint use in RA, increased resilience of juxta-articular bone associated with osteoporosis in RA and the possibility that products of inflammation in the RA joint act locally or via juxta-articular vascular mechanisms to inhibit the secondary changes of DJD. Further study of the possible pathogenic mechanisms including the roles of joint stress, juxta-articular osteoporosis, and possible effects of the inflammatory reaction of the rheumatoid joint on intra-articular structures and juxta-articular vascular phenomena are needed.
935467	Resorption of the undersurface of the distal clavicle in rheumatoid arthritis.	1976 Jul	An elongated erosion on the undersurface of the distal clavicle, adjacent to the coracoid process, may be seen in the shoulder of a patient with rheumatoid arthritis. This finding is apparently related to inflammatory changes in the coracoclavicular ligament. Such an erosion may occur with or without additional radiographic alterations and, although not entirely specific, suggests rheumatoid arthritis.
661557	Membranous nephropathy in patients with rheumatoid arthritis: relationship to gold therapy	1978 Jul	Of 90 patients with membranous nephropathy proved by biopsy, 8 (8.9%) had pre-existing rheumatoid arthirtis. Four of these eight patients received systemic treatment with gold. Two others received only token amounts of gold. In two patients who received gold, the renal lesions did not occur until months after discontinuance of gold therapy. We found that clinically significant renal lesions (lesions associated with proteinuria) in patients with rheumatoid arthritis were more likely to be membranous nephropathy than occult amyloidosis or adult lipoid nephrosis. The membranous lesion in patients with rheumatoid arthritis may be difficult to identify by light microscopy, and, although special strains can be helpful, the pathology is frequently sufficiently subtle to require immunofluorescence and electron microscopy for definitive diagnosis. We postulate that chrysotherapy may not be the cause of membranous nephropathy in patients with classic rheumatoid arthritis in whom gold has been used. Whether it merely exacerbates a lesion already present in these patients, or whether it plays little or no role in the development of membranous nephropathy is an unsettled question. Our data lead to think that RA can induce MN and that gold is not the primary inciting agent.
512310	Rheumatoid synovitis of the volar compartment of the wrist joint: its radiological signs a	1979 Nov	The radiological signs that suggest involvement of the volar compartments of the wrist include grooving of the scaphoid, pseudocysts of the distal radius, and scaphoid-lunate dissociation. These indicate involvement of the radiocarpal ligamentous support. This leads to loss of stability of the scaphoid, which then goes into a volar-flexed position, contributing to shortening the radial carpal height and favoring rotation of the carpus into supination, radial deviation of the metacarpals, and ulnar drift of the fingers.
686860	Rheumatoid polyarthritis after rubella.	1978 Jun	A 21-year-old woman developed persistent polyarthritis indistinguishable from rheumatoid arthritis after rubella. The arthritis persisted for approximately 30 months and was associated with high levels of antibody to rubella virus and with rheumatoid factor. The antibody titres declined pari passu with clinical improvement which progressed to complete resolution. Fractionation of serial serum specimens showed a substantial and persistent IgM antibody response to rubella virus. Rubella antigen was not demonstrated in the synovial exudate.
6356905	Approaches to rheumatoid arthritis and osteoarthritis: an overview.	1983 Oct 31	The diagnosis of rheumatoid arthritis and osteoarthritis remains primarily clinical. Available diagnostic criteria represent minimum requirements and cannot adequately describe the broad areas of variability in clinical manifestations, natural history, and severity, nor the probable heterogeneity in etiology and pathogenesis. Host factors that determine clinical course and response to treatment are poorly defined and often not considered in therapeutic trials. Traditionally, treatments have developed empirically, and only later have efforts been made to account for mechanisms of action. The modern approach, however, involves the screening of a large number of promising agents and their analogues, using both animal models and in vitro systems. In osteoarthritis, pain relief has been the primary target; additional measures have aimed at reducing the impact of mechanical stress. The increasing realization that inflammation may contribute to the disruption of cartilage in osteoarthritis has raised questions about the importance of anti-inflammatory activity in therapeutic agents. These effects are also important in rheumatoid arthritis, but the extraordinary complexity of its pathogenesis confounds therapeutic efforts since it is unclear which facet or aspect of the process is most relevant. Thus, the approaches to therapy include classic anti-inflammatory agents, pheresis, chemical and radioactive cytotoxicity, and immunomodulation. The risks and benefits of these efforts are demonstrable in relatively short-term trials, but the ultimate goal of disease modification over a period of years is still elusive and difficult to document.
422635	Decompression of the extensor tendons at the wrist in rheumatoid arthritis.	1979 Feb	Simple decompression of the extensor tendons at the wrist was carried out on fifty-four wrists in a total of forty-one patients with rheumatoid disease. This procedure was combined with excision of the ulnar head in forty-five wrists. Complete resolution of the synovitis occurred in 81.5 per cent of the wrists. In two patients the tendons ruptured soon after operation and in both cases this was due to prolapse of the ulnar stump after an associated Darrach procedure. The clinical results of decompression compare favourably with those of the widely accepted operation of dorsal tenosynovectomy.
6544383	Subaxial caudal dislocation of the cervical spine in rheumatoid arthritis.	1984	Subaxial (below the C 2) caudal dislocation is in the present study defined as a complete or partial dislocation caudally of a vertebral body (C 3 or below) into the plane of a lower vertebral body. In rheumatoid arthritis this dislocation is combined with erosive lesions of the vertebral bodies. In the present retrospective study seven such cases are presented. All were middle-aged or elderly women with a long history of disease and all also had a horizontal dislocation at the same level. Two patients had this dislocation at more than one level of the cervical spine and in two patients there was encroachment on the spinal canal. Most patients also had dislocations at the atlanto-axial level. Neurologic sequelae were rare.
6524529	Clinical pharmacology of GP53,633--a new non-steroidal anti-inflammatory drug--in patients	1984 Oct	GP53,633 is a new basic non-steroidal anti-inflammatory drug showing analgesic and anti-inflammatory activity in animal models. Pharmacokinetic studies in 6 patients with rheumatoid arthritis show it to be rapidly absorbed with a short half life (approximately 2 hours). No change in pharmacokinetics is seen over a two week treatment period. Clinical parameters of inflammation were reduced and no adverse reactions were seen.
4085160	The M.D.R. index of function in rheumatoid arthritis.	1985 Oct	The M.D.R. index is a new instrument which has been designed to give a measurement of physical function in inflammatory joint disease. It is very easy to apply and is not time-consuming. In preliminary assessment, the index has proven to be highly reliable. It has also been sufficiently sensitive to detect short-term changes in functional capacity which were unrelated to changes in the severity of joint inflammation. The application of the index is inexpensive and does not require extensive training of personnel for its accurate use. It is expected that the M.D.R. index will prove to be suitable for widespread use as a clinical assessment of physical function.
7156467	[Analysis and evaluation of the rehabilitation measures in a 5-year prospective study of c	1982 Nov	328 patients with a definite or classical adult rheumatoid arthritis were studied over a five-year treatment period. Two groups of patients were established from this total population. One group was treated primarily on an outpatient basis, with the treatment consisting always in medical care given by the general practitioner or a hospital outpatient department. The other group received inpatient treatment in a special rehabilitation centre once or twice a year, or according to necessity. During these measures the whole range of medical, vocational and social care was provided, as appropriate to the clients' needs. On evaluation of this five-year period, it is found that the patient group who had undergone periodical rehabilitative treatment every year demonstrated markedly better functional results than did the group which had almost exclusively received medication.
799987	Imipramine and rheumatoid factor.	1976	It has been reported that imipramine reduces the titre of rheumatoid factor in schizophrenic patients. Twenty out-patients suffering from classical rheumatoid arthritis and having rheumatoid factor titre equal to, or greater than 1:64, were treated in a double-blind trial with imipramine 75 mg or matching placebo. In this study the dose of imipramine used failed to affect the levels of rheumatoid factor.
666994	The estimation of whole-body zinc and Zn turnover in rheumatoid and osteoarthritis using 6	1978 Jul	1. A method of estimating whole-body zinc, and Zn balances using a two-compartment model in combination with whole-body counting of 65Zn, is described. The method is applied to patients with rheumatoid and osteoarthritis. 2. The results suggested that there was not a wide variation in whole-body Zn and Zn turnover in individuals with these two diseases and no clearcut difference between patients with one or the other.
665477	Rheumatoid arthritis.	1978 Jul	Management should help relieve symptoms, increase or maintain function, produce few side effects and keep the cost to a minimum. Aspirin remains the first-line drug; other nonsteroidal anti-inflammatory drugs may be useful when aspirin cannot be tolerated. Symptoms and signs of rheumatoid disease may be suppressed by corticosteroids, but only gold compounds, penicillamine and cytotoxic therapy have been shown to decrease disease activity and lessen permanent joint damage.
303393	Subpopulations of B- and T-Lymphocytes in Peripheral Blood of Rheumatoid Patients.	1977 Aug	Using the immunofluorescent staining for detection of surface membrane immunoglobulin and the spontaneous rosette formation with sheep erythrocytes, B- and T-lymphocytes were identified in lymphocyte populations obtained from the peripheral blood of 36 patients with classical or definite rheumatoid arthritis and 13 normal adults. In all of three immunoglobulin subclasses, the mean percentage of B-lymphocytes in the peripheral blood of the patients was significantly higher than that of the normal subjects. On the other hand, the mean percentage of blood T-lymphocytes in the patients was remarkably low as compared with that of the normal controls.
241600	Double-blind comparison of alclofenac and aspirin in the treatment of rheumatoid arthritis	1975	A double-blind trial was carried out in 76 patients with active rheumatoid arthritis to compare the analgesic and anti-inflammatory activity of 3 g. alclofenac with 4.8 g. aspirin daily over a 6-week period. All patients selected showed reversible inflammatory swelling of the finger joints. Of the 60 patients successfully completing the trial, 30 were treated as out-patients and 30 patients received in-patient treatment for approximately the first 2 weeks. Both groups were analysed separately. Treatment was randomised and patients received the drugs in identical tablet form except for the last 16 patients who were transferred to capsules. Results showed that though the activity potential, morning stiffness, grip strength, joint pain and tenderness improved significantly at the end of the 6-week period, there was no statistical difference between the two drugs. However, functional capacity indicated slight superiority of alclofenac over aspirin at a low level of significance. P.I.P. joint swelling showed that both in-patients and out-patients on alclofenac improved significantly (p less than .001)compared to patients in the aspirin group. Laboratory investigations showed no difference between the two drugs as far as changes in serum proteins, serum transaminase, haemoglobin and E.S.R. levels were concerned. However, serum uric acid levels dropped significantly (.05 greater than p greater than .01) with aspirin. The incidence of side-effects was slightly higher in the aspirin group but a high incidence of skin rash (30% approx.) was recorded with alclofenac tablets. No incidence of skin rash was recorded in patients taking alclofenac capsules, but the number of patients taking capsules was too small to make any prediction. It appears from this study that in active rheumatoid arthritis the analgesic and anti-inflammatory activity of 3 g. alclofenac is equivalent to 4.8 g. aspirin, and alclofenac is superior to aspirin in reducing the inflammatory swelling of rheumatoid joints.
6977346	Circulating immune complexes in rheumatoid arthritis. Selective removal by cryogelation wi	1982 Feb	We have developed a system of extracorporeal circulation that removes proteins of the molecular weight of the circulating immune complexes of rheumatoid arthritis by cryogelation with hollow-fiber membrane filtration. A 52-year-old woman with a 36-year history of severe, unremitting, high-titer, seropositive rheumatoid arthritis who had failed to respond to anti-inflammatory, antirheumatic, and cytotoxic drugs was chosen for a trial of this system. A rapid and sustained decrease in circulating immune complexes as measured by C1q binding occurred, accompanied by a much slower improvement in clinical factors of disease activity. Rheumatoid factor changed very little and loss of other serum proteins by the procedure was relatively modest. This new procedure was successful in removing circulating immune complexes in a patient with rheumatoid arthritis, and in inducing a remission in one who has not had such in 36 years, while sparing volume and other plasma proteins.
7153608	[Bone atrophy in rheumatoid arthritis--a morphological and histometrical study of proximal	1982 Aug	A qualitative and quantitative histological study of the proximal tibial condyles was performed to elucidate the features of the bone atrophy in rheumatoid arthritis. Undecalcified, methyl-methacrylate embedded sections were prepared from 21 cases of rheumatoid arthritis, 3 cases of osteoarthritis and 3 cases of non-arthritic subjects. The rheumatoid bone marrow was classified into three layers according to its morphological features. The first layer was pannus, the second was fibrofatty bone marrow and the third was fatty bone marrow. This third layer was used for this study. The characteristic finding in the rheumatoid bone marrow was their inflammatory changes observed in arterioles and venulocapillary beds. The trabecular bones were sparse and thin, and resorption surfaces associated with osteoclasts were increased, whereas osteoblastic activity on osteoid surfaces seemed to be inhibited. These findings may have consequently resulted from the inflammatory changes of vessels around the trabeculae. Inflammatory exudates from venulocapillary beds may stimulate the production of osteoclasts, while stenotic vascular change caused by arteriolitis may reduce the intramedullary blood flow, so that inhibition of osteoblastic activity and retardation of mineralizing process at osteoid surfaces may occur in rheumatoid bone.
236805	Long-term study of indomethacin and alclofenac in treatment of rheumatoid arthritis.	1975 Apr 5	Indomethacin and alclofenac were compared for 13 months under double-blind conditions in 109 patients with active, classical, or definite rheumatoid arthritis at a relatively early stage of the disease. Both indomethacin and alclofenac were clearly effective: most patients either improved or remained as well controlled as on entry. Alclofenac proved the more effective drug, however, producing a significantly greater reduction in morning stiffness, articular index, and erythrocyte sedimentation rate, and only in the alclofenac-treated group did functional capacity improve and latex-agglutination titres diminish. Comprehensive laborabory tests showed no significant deviation from normal which could have been attributed to either drug.