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PMID	Title	PublicationDate	abstract
443885	Serum copper and its relationship to clinical symptoms in rheumatoid arthritis.	1979 Apr	Total serum copper and ultrafilterable copper levels in patients with rheumatoid arthritis were determined and related to articular index, erythrocyte sedimentation rate (ESR), and serum iron concentration. Relationships were found between serum copper and ESR, and between ultrafilterable copper and articular index. The relationship between serum copper and serum iron was found to be a drug-dependent.
6360511	Radiographic evaluation of the course of articular disease.	1983 Dec	Radiological analysis is the single most attractive objective method for assessing the long-term anatomical effects of rheumatoid arthritis. Measurement of x-ray changes has given us our most important clues on the effectiveness of disease-modifying drugs. Although no single system has been adopted by all investigators to quantify radiological changes, most investigators have used joint counts or scores which have many properties of an interval scale to measure erosions and, at times, joint space narrowing. More extensive use of radiological analysis in therapeutic trials, if based on a thorough understanding of the natural history of radiological progression in rheumatoid arthritis, should provide a more accurate appraisal of our ability to modify the course of the disease.
7323782	The effect of plasma exchange on synovitis in rheumatoid arthritis.	1981	Eight patients with a severe exacerbation of rheumatoid arthritis were treated by twice weekly plasma-exchange for 3 weeks in order to evaluate the effect of plasma-exchange on synovitis. During the plasma-exchange period, patients remained on the drug regimen they were on at admission to the hospital. Plasma was replaced isovolemically with human, purified plasma protein fraction. Improvement in clinical parameters of synovitis and serological parameters of inflammation occurred in almost all patients. After 6 months the clinical remissions were sustained. Three patients experienced a rebound synovitis and one patient a rebound vasculitis at the end of or just after the plasma-exchange period. The rebound phenomena were moderate and of short duration. Plasma-exchange may exert its beneficial effects by depleting important mediators of injury such a complement fibrinogen and circulating immune complexes, by improving reticuloendothelial function, and by increasing the drug response of the inflammatory target tissue. The role of depletion of circulating immune complexes was not so clear in this study. It is concluded that limited plasma-exchange is an effective means to induce a symptomatic improvement in an acute exacerbation of polyarthritis, without changing the basic therapy and thus avoiding corticosteroid dependency.
7365934	Pulmonary involvement in rheumatoid arthritis.	1980 May 2	Diffuse pulmonary affection in rheumatoid arthritis remains a controversial subject that requires further and more accurate investigation. All patients with rheumatoid arthritis attending a general hospital during a six-year period underwent clinical, radiological, and functional pulmonary evaluation and serological investigation. Twenty-five had an open lung biopsy for microscopic examination and immunofluorescence. The histopathological findings in this group were correlated with the clinical, radiological, functional, and serological altercations and with the clinical course of the rheumatoid process as well. Pulmonary affection in this series was a common finding, showing definite histopathological patterns and particular clinical features.
3914703	The efficacy of piroxicam in comparison with sulindac in the treatment of rheumatoid arthr	1985 Feb	The efficacy of piroxicam 20 mg/qd was compared with that of sulindac 200 mg twice a day in 49 patients with rheumatoid arthritis. Both nonsteroidal anti-inflammatory agents showed statistically significant improvement in efficacy variables including duration of morning stiffness, disease activity as judged by the examiner and by the patient, patient assessment of feeling, total joint pain, total joint swelling, and performance of daily activities. The overall frequency of adverse reactions was similar with both treatment regimens, and required discontinuance in three patients in each treatment group. However, the number of moderate/severe adverse reactions in the sulindac-treated patients was greater than that in the piroxicam-treated patients, and there was a trend toward the differences between the two groups being statistically significant (P = .06). Both drugs were effective in the treatment of rheumatoid arthritis and resulted in comparable improvement in efficacy variables.
3970042	Cancer in rheumatoid arthritis: a prospective long-term study of mortality.	1985 Jan 21	Eight hundred and five consecutive patients with definite or classic rheumatoid arthritis, representative of a general population, were followed prospectively over an average of 12 years with 94 percent follow-up, during which time 233 patients died. Mortality rates were increased in rheumatoid arthritis by approximately 50 percent compared with population controls. "Excess deaths" (78) were due, in part, to disease-related causes, infections, and gastrointestinal problems secondary to therapy. Thirty-one deaths (14.1 percent) were due to malignancy, compared with 22.8 percent in non-age-adjusted population controls. Frequency of malignancy type (colon seven, lung four, breast three, prostate three, leukemia three, ovary three, stomach two, and lymphoma zero) did not differ significantly from the general population. Age-adjusted figures showed lower malignancy rates for patients with rheumatoid arthritis except after age 80. Two treatments were suitable for analysis. Gold-treated patients trended toward lower malignancy rates (11 versus 17 percent) than did those not treated with gold, and prednisone-treated patients had less malignancy (11 versus 20 percent) than did those not treated with prednisone. These data indicate that there is not an important increase in deaths due to malignancy in rheumatoid arthritis, and that at least two treatments, gold and prednisone, are not associated with higher risk of malignancy.
6670523	Synovectomy of the elbow in rheumatoid arthritis.	1983 Dec	The results of 39 synovectomies of the elbow performed during the period 1976-1980 were evaluated, and the factors which may have influenced the success of synovectomy analysed. Synovectomy results were satisfactory in 27 of the cases. Success of synovectomy seems to be related to the operative approach used and not to the radiographic grade of destruction of the elbow or to the duration of the follow-up.
997658	[Early diagnosis of rheumatoid arthritis].	1976 Aug 15	On the basis of own observations of courses the author adopts a definite attitude to the early symptomatology of the rheumatoid arthritis. During the first weeks of the rheumatoid arthritis the following symptoms are found: articular syndromes, more frequently in form of obstinate polyarthralgias, mono-oligoarthritis, accompanied by morning rigidity and accelerated BSR as well as impairment of the general condition. In the majority of the patients only the tentative diagnosis rheumatoid arthritis may be made. After a one to three months' course of the disease the diagnosis becomes more probable. It is above all based on constancy and symmetry, characteristic localisation of the articular process, morning rigidity, radiologically paraarticular loosening of the structure and morphological symptoms of an acute and subacute synovialitis. 6 to 12 months after the beginning of the disease a clinical picture forms which allows to make the diagnosis of a certain or classical rheumatoid arthritis in accordance with the criteria of the ARA. The occurrence of a high activity of multiple affection of the joints (permanent symmetrical polyarthritis including the small joints of the hands and feet), distinctive morning rigidity, high fever and much accelerated BSR, beginning with the first weeks of the disease, speaks for the possibility of the development of an arthrovisceral form of the course of rheumatoid arthritis.
1128884	The rheumatoid shoulder.	1975 Apr	The rheumatoid shoulder is a frequent manifestation in the rheumatoid patient. Most of the symptoms are of a mild to moderate degree and can usually be ameliorated by heat, massage, and gently exercise. Local injection therapy may be of value in selected cases. Strenuous exercise or manipulation is contraindicated. Tendon ruptures and rotator cuff tears are not amenable to surgical reconstruction and are adequately treated with a conservative regimen. Prophylactic synovectomy is not performed as a routine, because the majority of patients do not develop disabling symptoms. This procedure is usually restricted to the few patients who exhibit uncontrollable proliferative synovitis. Prosthetic replacement is employed for intractable pain with full anticipation of limitied mobility. Various designs of a "total shoulder" are undergoing clinical evaluation, but their application has not been defined.
7465640	[Venous participation in gonarthrosis, rheumatoid arthritis, and gout].	1981 Jan	The authors describe three major rheumatological classifications together with an account of the phlebological aspects of these phenomena. They deal with gonarthrocace, which is predominantly stasis; rheumatoid arthritis, which may be induced by inflammatory injuries to the vein wall, by endothelitis of the venulo-capillary segments, or racemose lividity; and gout which mainly involves turgescence, and mural phlebitis. This is not forgetting the secondary classifications, associated with polyglobulism, anemia, and foranioplasia.
6838343	Cubital tunnel syndrome in rheumatoid arthritis.	1983 Apr	There has been an increase in reported cases of peripheral neuropathy and nerve entrapment syndromes in rheumatoid arthritis. (RA). To date, only a few incomplete studies on the prevalence of cubital tunnel syndrome (CuTS) in patients with RA have been reported. We investigated the prevalence of electrodiagnostic findings of CuTS in patients with RA and correlated them with the clinical findings. Forty-nine patients with the diagnosis of classic RA were evaluated clinically and by electrodiagnostic studies performed on the ulnar nerve, bilaterally, across the elbow. The study found 1 patient with slowing of both sensory and motor nerve conduction velocity (NCV), 8 patients with slowing of sensory NCV only, and 1 patient with slowing of motor NCV only. However, the correlation was poor between clinical and electrodiagnostic findings.
729236	Knee synovectomy for rheumatoid arthritis.	1978 Jul	Twenty-one patients with rheumatoid arthritis had 33 knees treated with synovectomy. They were followed for an average of 5 2/3 years postoperatively. At follow-up, patients with 58% of the knees had less pain, 15% more pain, 54% were satisfied, 39% had palpable synovitis, but all had lesser synovitis postoperatively, and 53% showed radiographic progression of disease. Motion was not lost. There were no significant complications. Better results can be anticipated in those patients whose knees show little or no destruction radiographically and no significant deformity at the time of operation. However, beneficial results can occur even in those with more advanced changes. Even though quality of results tends to diminish with time, the procedure offers sufficient benefits to continue its use.
747510	[Proliferation of synovial fluid cells (author's transl)].	1978	Investigations with labelled thymidine indicated that the mononuclear cells of the synovial fluid only rarely proliferateunder physiological conditions. Even in cases of rheumatoid arthritis no elevated proliferation rate was found. Cytophotometric investigations on Feulgen-stained nuclei is another way to determine cellular proliferation. To answer the question if the relative content of neutrophilic granulocytes in synovial fluids influences the proliferation of mononuclear cells, the DNA content of these cells was determined after Feulgen-staining with respect to the number of neutrophilic granulocytes. It was observed that nearly all mononuclear round cells exhibit diploid nuclear DNA content. No effect of the intensity of inflammation (as expressed by the content of neutrophilic granulocytes) was observed. From these results it is concluded that mononuclear cell proliferation is not influenced by the intensity of the inflammation. On the other hand it can be assumed that there is no immunological stimulus for an increassed proliferation of the synovial fluid in rheumatoid arthritis.
443884	Acetylator phenotype in spontaneous SLE and rheumatoid arthritis.	1979 Apr	Acetylator phenotype was determined in 22 patients with spontaneous systemic lupus erythematosus and the proportion of 'slow' acetylators compared with that obtained in a group of patients with rheumatoid arthritis and a group of healthy controls. 73% of the SLE group were designated 'slow' compared with 72% of the rheumatoid group and 64% of the control group. These differences were not significant.
463211	[Tenosynovectomy in rheumatoid arthritis (author's transl)].	1979 Apr	Tenosynovitis is much more frequent in RA than supposed. A comparative statistic of joint- and tenosynovectomy of the Clinic Wilhelm Schulthess is presented. It also proves the importance of flexor tendon involvement. From the patient's point of view the result is good in more than 95% 6 years in average after synovectomy. Recurrent synovitis is very rare in the extensor tendon. It may occur in the extensor carpi ulnaris. In the flexor compartement the symptoms disappear also in most instance. The reasons are discussed and figures given of our statistic.
139090	[Studies with the NBT test in various clinical forms of juvenile rheumatoid arthritis].	1976	Fifty-six healthy neonates and children as well as 33 patients with juvenile rheumatoid arthritis and other diseases of the locomotor system were examined using a modification of the NBT test. In healthy newborn infants there was observed an increase in the number of NBT-positive cells between the first and tenth days. The test results obtained for the 33 patients with juvenile rheumatoid arthritis were positive in 73%, with positive results being obtained especially in those patients where the disease was in its second stage of activity. Highest values were obtained in patients with a predominantly articular manifestation of the disease. Stimulative effects produced by immune complexes are considered to be chiefly responsible for this. However, this method of examination is of small practical value from a differential diagnosis point of view.
962974	Carpo:metacarpal ratio. A new quantitative measure of radiologic progression of wrist invo	1976 Sep	Analysis of 878 hand films shows the carpo : metacarpal ratio to be a sensitive quantitative index of progression of carpal involvement in rheumatoid arthritis. This index, easily calculated by dividing the lengths of the carpus by the third metacarpal, showed marked consistency in the ratio regardless of age, race, or sex in normal adults. A decreased ratio correlated highly with recognized radiographic stages of rheumatoid arthritis and thus suggested utility in longitudinal studies of patients with this disease.
6386698	Apheresis in rheumatoid arthritis.	1984 Jul	Plasmapheresis was first introduced as a means of treating the rheumatic diseases in 1976. The rationale of its use was the removal of circulating immune complexes, thus preventing their deposition in the tissue. In rheumatoid arthritis circulating immune complexes do indeed occur and are responsible for some of the serious complications such as vasculitis. Since the T cells are implicated in tissue damage, lymphapheresis and lymphoplasmapheresis were introduced with various success rates. Controlled trials in rheumatoid arthritis have found no value for intensive plasmapheresis, limited value for lymphapheresis and possible, though suspect, value for lymphoplasmapheresis.
4050151	[Effectiveness of D-penicillamine therapy in chronic polyarthritis].	1985 Jul	In 52 patients with severe rheumatoid arthritis the therapeutic efficacy of 600 mg/die of D-penicillamine was evaluated for two years in a prospective trial. Patients were included in the study only if the duration of their disease exceeded 6 months (upper limit 12 months), and there was involvement of 6 or more joints and an elevated erythrocyte sedimentation rate (1 hour values greater than or equal to 25 mm). In 26 patients (50%) a decline in the activity index could be observed, but 18 of these subjects had a deterioration of findings as assessed by X-ray. The increase of the activity index indicated no therapeutic benefit in 26 patients (50%), which could be confirmed in 23 subjects by X-rays.
656284	A thermographic assessment of three intra-articular prednisolone analogues given in rheuma	1978 May	1 Three intra-articular prednisolone analogues have been studied in a group of forty-six rheumatoid arthritic subjects. Each compound was tested at 50 mg and 100 mg dose over 3 weeks. 2 The anti-inflammatory effect was assessed by quantitative thermography. Systemic escape of the drug was monitored by plasma prednisolone and cortisol levels. 3 Both the systemic escape from the joint and the duration of effect on injected and uninjected knees were related to drug solubility. 4 Depression of plasma cortisol occurred with all three preparations and was most prolonged with the long-acting preparation. 5 Increasing the dose from 50 mg to 100 mg increased the antiflammatory effect only with the soluble acetate preparation.