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ID PMID Title PublicationDate abstract
23397163 A dancer with rheumatoid arthritis: a role for biologics. 2013 Apr A case study is presented in which a student dancer who developed rheumatoid arthritis during her degree course was able to complete her course with meticulous treatment including the use of biologics. She describes her own reactions to the disease occurring at this crucial phase in her career.
25468430 Social support needs of families: the context of rheumatoid arthritis. 2015 May AIM: The present study aimed to describe the experience of family members who provide social support to their relative with rheumatoid arthritis (RA), and explore the forms of support that they require. BACKGROUND: The psychosocial effects and changes that family members experience with their relative's illness can pose considerable challenge for the family unit. METHODS: The study used a descriptive qualitative design. A semi-structured interview guide was used to interview seven participants. Qualitative direct content analysis was used to analyze the data. RESULTS: Five themes emerged from the data analysis: effect of the disease; reshaping the relationship; provider of support; social support needs of family members; and, finding balance and coping. CONCLUSIONS: Family members of people with RA require social support to achieve balance and cope with the chronicity and disability of RA. Nurses should tailor nursing interventions to provide emotional support, informational support, and guidance to families.
23455663 Effectiveness of sensorimotor training in patients with rheumatoid arthritis: a randomized 2013 Sep The objective of this study was to evaluate the effectiveness of a sensorimotor training in patients with rheumatoid arthritis on the improvement of functional skills and quality of life, a double-blinded, prospective, randomized controlled trial. One hundred two participants with rheumatoid arthritis were selected. After the baseline evaluation, the participants were randomized to two different groups: sensorimotor group (2 sessions per week, 30-50 min each session, besides continuing taking the same drugs as the control group) and control group (control group was only submitted to the clinical drug treatment with Methotrexate, Leflunomide and/or Prednisone (5 mg), being then evaluated 4 months later). Functional capacity [Health Assessment Questionnaire (HAQ) and Timed Up & Go Test (TU>)], Balance and Gait (Berg Balance Scale (BBS) and Tinetti Test) and Quality of Life (Short Form Health Survey-SF-36). The study had been concluded with ninety-one participants, and a statistically significant improvement was found in all variables assessed: HAQ (P < .01), TU> (P < .01), BBS (P < .01), Tinetti Test (P < .01) and improvement in the subscales of SF-36 (P < .01) in the sensorimotor group in comparison with the baseline evaluation and control group. No significant difference was found related to the pre- and post-evaluation in the control group. Therefore, the sensorimotor training is effective in the improvement of the functional capacity and quality of life of patients with rheumatoid arthritis.
24556936 Discourse analysis of the written press reports regarding rheumatoid arthritis, psoriasis, 2014 Sep The management of rheumatoid arthritis (RA) and psoriasis/psoriatic arthritis (PS/PsA) has radically changed during the last decade modifying physicians' perception about those diseases. However, if communication and transfer of information, from doctors to patients, is not efficient, patients' perception could be influenced by other sources of information. The aim of this study is to analyze newspaper articles about RA or Ps/PsA published in the Argentinean written press between 1995 and 2010. Quantitative and qualitative analyses of all press articles that mentioned RA or Ps/PsA either on the headlines or in the text of the digital versions of the three main Argentinean newspapers from 1995 to 2010 were analyzed. A total of 166 press articles were analyzed; of these, 65.7 % of the articles were informative and the remaining were testimonials. Ninety-five articles were considered positives (57.2 %). Informative articles were positive with more frequency than the testimonials (64.2 vs. 43.9 %, p 0.02). Press articles that mentioned a new treatment were positive more frequently than those that did not mention it (78.3 vs. 49.2 %, p 0.001). Balanced articles included the opinion of, at least, one specialist in 84.2 versus the 48.1 % of the not balanced (p 0.02). Articles about RA and Ps/APs in Argentina tended to be positive all along the study period. A positive result was more frequent in those articles, which informed about a new treatment. The inclusion of the opinion of a professional is not associated with a positive result, although it is to a balanced article.
25388232 Using global illumination in volume visualization of rheumatoid arthritis CT data. 2014 Nov Proper lighting in rendering is essential for visualizing 3D objects, but most visualization software tools still employ simple lighting models. The advent of hardware-accelerated advanced lighting suggests that volume visualization can be truly usable for clinical work. Researchers studied how volume rendering incorporating global illumination impacted perception of bone surface features captured by x-ray computed-tomography scanners for clinical monitoring of rheumatoid arthritis patients. The results, evaluated by clinical researchers familiar with the disease and medical-image interpretation, indicate that interactive visualization with global illumination helped the researchers derive more accurate interpretations of the image data. With clinical needs and the recent advancement of volume visualization technology, this study is timely and points the way for further research.
22711333 The impact of appearance concerns on depression and anxiety in rheumatoid arthritis. 2013 Mar OBJECTIVES: Increased levels of anxiety and depression are commonly reported by patients with rheumatoid arthritis (RA) in comparison to the general population. Rather than the clinical features of the disease, this difference has been attributed to psychosocial factors. Patients with RA can develop joint swelling and disfigurement as a direct result of the disease, and experience concerns about their altered appearance. This study aimed to identify if appearance-specific issues contribute to our understanding of mood in RA, over and above demographic, functional and generalized psychosocial measures. METHODS: A total of 89 patients with RA completed a series of psychosocial questionnaires measuring demographics, physical function, general cognitive processes and a number of appearance-specific concepts, to determine the contribution of appearance concerns to mood. RESULTS: Hierarchical linear regression suggested that living status, optimism, social support and appearance-related social anxiety and avoidance are associated with levels of depression. The relationship between social support and depression was found to be mediated by appearance-related social anxiety and avoidance. Optimism remained the only variable significantly associated with anxiety. CONCLUSION: These findings confirm the role of optimistic cognitions and a supportive environment in determining the mood of patients with RA and also establishes a possible link between depression and appearance concerns in this population. Interventions targeting social support, optimism and social anxiety and avoidance in relation to appearance are key in the improvement of depression in this patient group.
23378466 Remission in rheumatoid arthritis: a comparison of the 2 newly proposed ACR/EULAR remissio 2013 Apr OBJECTIVE: We analyzed whether a patient self-report remission criterion, such as that according to the Rheumatoid Arthritis Disease Activity Index-5 (RADAI-5), meets the criteria of the 2011 proposed American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) definition of remission. METHODS: The 2 approaches of the ACR/EULAR proposal [Boolean- and Simplified Disease Activity Index (SDAI)-based] as well as the RADAI-5 were used to assess whether patients with RA are in remission. Sensitivity, specificity, positive and negative predictive values (PPV, NPV), and kappa analyses were performed to illustrate the relationship among the different approaches defining remission at a group level. RESULTS: In total, 705 patients' assessments were included. Eighty-nine patients were classified as being in remission according to the Boolean-based and 169 according to the SDAI-based definition of the ACR/EULAR proposals, and 154 according to the RADAI-5. Sixty-eight assessments were classified as being in remission according to all 3 definitions. In the case of RADAI-5 remission, sensitivity was 78%, specificity 86%, PPV 45%, and NPV 96%, indicating remission according to the Boolean-based definition; and 60%, 92%, 66%, and 90%, respectively, indicating remission according to the SDAI-based definition. In the case of remission according to the SDAI-based ACR/EULAR definition, sensitivity was 52%, specificity 100%, PPV 98%, and NPV 87%, also indicating remission according to the Boolean definition; while according to the Boolean definition the values were 98%, 87%, 52%, and 100%, respectively. Kappa statistics showed fair to good agreement for all 3 definitions. CONCLUSION: Nearly twice as many assessments were classified as being in remission using the SDAI-based or the RADAI-5 definitions when compared to the Boolean-based definition. Remission according to the RADAI-5 also was highly specific for both ACR/EULAR criteria. Sensitivity for the RADAI-5 criterion was even better for the Boolean-based definition than that for the SDAI-based definition.
23615628 MicroRNA-323-3p: a new biomarker and potential therapeutic target for rheumatoid arthritis 2014 May Increased expression of microRNA-323-3p (miR-323-3p) has been demonstrated in rheumatoid arthritis synovial fibroblast. The gene encoding miR-323-3p, which is a biomarker in immune and inflammatory responses, occurs in an miRNA cluster in chromosomal region 14q32.31.
24000386 The first 2 years of rheumatoid arthritis: the influence of acceptance on pain, physical l 2015 Jan The influence of acceptance in the progression of pain, physical limitation and depression was explored in the first 2 years of rheumatoid arthritis. Latent growth curve models showed significant increases in pain, physical limitation and depression. Besides that, the levels of pain and physical limitation at the baseline were associated with acceptance but not its progression across time. Therefore, patients with higher scores of acceptance reported less pain and physical limitation. The progression of depression was associated with acceptance; higher acceptance patients had slower growth rates of depression across time, even when pain and physical limitations increased. The inclusion of pain acceptance in clinical practice is discussed.
25455156 Current and future trends in biomarker discovery and development of companion diagnostics 2015 Feb Musculoskeletal diseases such as rheumatoid arthritis are complex multifactorial disorders that are chronic in nature and debilitating for patients. A number of drug families are available to clinicians to manage these disorders but few tests exist to target these to the most responsive patients. As a consequence, drug failure and switching to drugs with alternate modes of action is common. In parallel, a limited number of laboratory tests are available which measure biological indicators or 'biomarkers' of disease activity, autoimmune status, or joint damage. There is a growing awareness that assimilating the fields of drug selection and diagnostic tests into 'companion diagnostics' could greatly advance disease management and improve outcomes for patients. This review aims to highlight: the current applications of biomarkers in rheumatology with particular focus on companion diagnostics; developments in the fields of proteomics, genomics, microbiomics, imaging and bioinformatics and how integration of these technologies into clinical practice could support therapeutic decisions.
23974974 [Survey of quality of life of rheumatoid arthritis patients admitted to rehabilitation cen 2013 Sep 1 INTRODUCTION: There are limited data about the quality of life of rheumatoid arthritis patients admitted to rehabilitation centres in Hungary. AIM: The aim of the authors was to assess demographic data, social status, health related quality of life, and needs for assistance and disease-related information of 239 rheumatoid arthritis patients (169 women and 7 men) admitted to four rehabilitation centres in Hungary. METHOD: For the assessment of demographic, social and other data the authors developed questionnaires. The health related quality of life was evaluated using the validated Short Form 36 questionnaire. RESULTS: The authors found that rheumatoid arthritis patients require in-patient rehabilitation relatively early in their disease course. 80.4% of the patients were over 50 years of age, and their social status was low as compared to the average of the Hungarian population. The health related quality of life of patients was significantly lower than that of the average population, but it was similar to the quality of life of patients with osteoarthritis, osteoporosis and low back pain. Among domains of the quality of life, the scores for physical function and pain were the lowest. The most common accompanying diseases included hypertension and osteoporosis. In case of knee and hip surgeries, postoperative rehabilitation was performed in due time. Patients were not satisfied with disease-related information and education given by health care providers. CONCLUSIONS: There is poor quality of life of rheumatoid arthritis patients admitted to rehabilitation centres in Hungary. More efforts should be done to provide disease-related information and education for patients.
23588516 Clinical and laboratory features of patients with rheumatoid arthritis diagnosed at rheuma 2013 Feb INTRODUCTION: Brazilian epidemiological studies on rheumatoid arthritis are scarce, thus all data currently available originate from the international literature. OBJECTIVES: To determine the incidence and some clinical and laboratory characteristics of patients with rheumatoid arthritis in the municipality of Cascavel, state of Paraná, Brazil. PATIENTS AND METHODS: Data were collected between August 2010 and July 2011 in all health services of the municipality of Cascavel that provided health care in Rheumatology: a university-affiliated hospital, a public outpatient clinic and four private clinics. RESULTS: We identified 38 patients diagnosed with rheumatoid arthritis, resulting in an estimated incidence of 13.4 cases per 100,000 inhabitants/year. Thirty two patients were females, whose mean age was 47.6 years. The age group with the highest incidence was over 40 years. The mean time between first symptoms and diagnosis was 12.4 months. Rheumatoid factor was positive in 68.4% of the patients, and 18.4% already had radiological abnormalities at diagnosis. The pharmacological treatment of patients was also assessed and proved to be in accordance with those found in the literature. CONCLUSION: The incidence of rheumatoid arthritis obtained in the municipality of Cascavel was lower than those reported in international studies.
22955876 How much difference does the age at onset make in early arthritis patients? Comparison bet 2013 Nov The age at onset in early arthritis (EA) may influence the disease activity and its evolution. The aim of the current study is to identify possible differences regarding the "old" and the "new" classification criteria between patients with early-onset and late-onset early arthritis. The study included 64 patients. They were divided in two groups, according to the mean age: early-onset EA--less or equal than 45 years old (group A) and late-onset EA--over 45 years old (group B). The "old" criteria as well as the "new" ones were assessed for all patients, at the time of the first visit to the rheumatologist. The initiation of treatment with Methotrexate was used as "gold standard" to calculate the sensitivity and the specificity of both criteria. "New" criteria were fulfilled in 51% (A) and 72% of cases (B), while "old" criteria were fulfilled in 37% of patients (A) and 62% (B). Methotrexate was initiated in 82% of patients (B) and in 51% (A), p = 0.01. "New" criteria demonstrated a sensitivity of 77.7% (A) and 83.3% (B), while "old" criteria had a sensitivity of 50% (A) and 66.6% (B). Patients with late onset had significantly higher disease activity scores: 76% (B) versus 40% (A), p = 0.04. The sensitivity and the specificity of the "new" criteria for RA are comparable in patients with early-onset and late-onset EA, and the sensitivity of these criteria is increased compared to the "old" criteria. Patients with late onset fulfilling the "old" criteria had poor prognostic factors and higher disease activity at the time of diagnosis, which may have possible implications for the disease course.
25291016 Health-related quality of life and depression in a sample of Latin American adults with rh 2017 Nov OBJECTIVE: To compare the health related quality of life (HRQoL) and depression of individuals with rheumatoid arthritis (RA) to healthy controls in Colombia, as well as to examine the connections between these two variables in individuals with RA. METHOD: One hundred and three individuals with RA were recruited from ambulatory centers in Colombia. Seventy-three control participants were recruited from the local community. Both groups differed with respect to age, gender and marital status (P < 0.001), while education and socio-economic levels were similar. HRQoL was assessed using the Short Form-36 (SF-36) and depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). RESULTS: A multivariate analysis of covariance found that RA patients reported substantially higher depressive symptoms and lower HRQoL than healthy controls (P < 0.01 and P < 0.05, respectively). The effect sizes of the differences between patients and controls in HRQoL and depressive symptoms were all large. All SF-36 HRQoL variables were significantly correlated with depressive symptoms in patients and controls (P < 0.05). Social functioning and vitality were uniquely associated with depressive symptoms in the RA group (P < 0.01 and P < 0.05, respectively), whereas education and social functioning were uniquely associated with depressive symptoms in controls (P < 0.05 and P < 0.005, respectively). CONCLUSIONS: Research indicates that individuals with RA have deteriorated HRQoL, and this study extends these findings to a Colombian sample and highlights the importance of the independent relationship between depressive symptoms and vitality in this group of Colombians with RA.
23468964 On the origin of rheumatoid arthritis: the impact of environment and genes--a population b 2013 BACKGROUND: Rheumatoid arthritis (RA) is an autoimmune disease with a complex origin. Previous studies have reported heritability estimates on RA at about 60%. Only 16% of the genetic background of the disease has been disclosed so far. The purpose of the present investigation was to provide an optimized estimate on the heritability of RA and to study the recurrence risk in a nationwide Caucasian twin population. METHODS AND FINDINGS: In a mail survey addressed to 56.707 twin individuals, RA was reported by 479 individuals, mean age 52 (range 16-73). Respondents underwent an interview and clinical examination. Ascertainment probability was 80%. RA was confirmed in 162 twin individuals yielding a prevalence at 0.37% (95% CI 0.31-0.43). The mean discordance time was 19 years (range 0-57). The concordance was 9.1% (95% CI 1.9 to 24.3) in MZ, 6.4% (95% CI 2.1 to 14.3) in DZss. The increased relative risk of attracting RA conditioned on having an affected cotwin compared to the background population risk was 24.6 to 35.4 in MZ twins and 17.3 to 31.6 in DZss twins. The correlation coefficients were 0.60 (0.33 to 0.78) in monozygotic (MZ) and 0.55 (0.33 to 0.72) in dizygotic same sexed (DZss) pairs. Twelve percent (95% CI 0-76%) of the phenotypic variance in the liability to RA was due to additive genetic effects, 50% (95% CI 0-72%) to shared environmental effects and 38% (95% CI 17-61%) to non-shared environmental effects. CONCLUSIONS: This study emphasizes that family factors are important for the development of RA. Although genetic effectors are important, shared and non-shared environmental triggers and/or epigenetic stochastic events seem to be even more significant. However, it should be borne in mind that the genetic and non-genetic components may not be the same across disease subsets.
25437270 Social support and quality of life in patients with rheumatoid arthritis in Greece. 2015 Jan OBJECTIVES: Previous research suggests that social support has beneficial effects for rheumatoid arthritis (RA) patients. Yet, recent studies suggest that sociocultural differences have implications for whether or not the individuals use social support to cope with stressful events. Given the stressful nature of a chronic disabling disease, the purpose of the present study was to investigate the association of structural and functional facets of social support with quality of life (QoL) in Greek RA patients. METHODS: In a cross-sectional study, 127 Greek RA patients completed the Rheumatoid Arthritis Quality of Life questionnaire (RAQoL), the Patient Activity Scale-II (PAS-II), the Quality of Social Support Scale (QSSS), the Social Network Index (measuring social network size and number of social roles) and a visual analogue scale measuring reciprocity. RESULTS: Patients' age, social network size and reciprocity had no significant correlation with QoL. Family income, education level and male gender were positively correlated with QoL. Number of social roles was positively correlated with QoL, but not significantly when disease activity and demographic factors were controlled. Quality of social support was positively correlated with QoL, and the correlation remained statistically significant after controlling for disease activity, demographic variables and number of social roles. CONCLUSIONS: In Greek RA patients, quality of social support predicts quality of life above and beyond disease activity, demographic factors and social integration. Structural aspects of social support were not significant predictors of QoL, in line with previous research on cultural differences in how people utilise their social networks.
24229435 Total knee arthroplasty treatment of rheumatoid arthritis with severe versus moderate flex 2013 Nov 15 BACKGROUND: This study aims to explore the technique of soft tissue balance and joint tension maintenance in total knee arthroplasty (TKA) for the rheumatoid arthritis (RA) patients with flexion contracture of the knee. METHODS: This retrospective study reviewed flexion contracture deformity of RA patients who underwent primary TKA and ligament and soft tissue balancing. Based on the flexion contracture deformity, the remaining 76 patients available for analysis were divided into two groups, i.e., severe flexion group (SF) and moderate flexion group (MF). RESULTS: There were no intraoperative complications in this study. All patients had improved Knee Society Rating System scores and range of motion. The flexion contracture was completely corrected in MF and SF patients. There were no cases of patellar dislocation, but three cases had mild mediolateral instability in severe flexion group. Four knees (two knees in SF versus two knees in MF) had transient peroneal nerve palsy but recovered after conservative therapy. CONCLUSIONS: TKA can be performed successfully in the RA knees with severe flexion contracture. It is very important in TKA to maintain the joint stability in the condition of severe flexion contracture deformity of the RA knee.
24986683 Recommendations of the French Society for Rheumatology for managing rheumatoid arthritis. 2014 Jul INTRODUCTION: This article reports the latest recommendations of the French Society for Rheumatology (SFR) regarding the management of rheumatoid arthritis (RA). METHODS: New recommendations were developed by hospital- and community-based rheumatologists having extensive experience with RA and a patient self-help organization representative. They rest on the recently issued EULAR recommendations and a literature review. RESULTS: Points emphasized in the 15 recommendations include the need to share treatment decisions between the rheumatologist and the patient, the acquisition by patients of self-management skills, remission or minimal disease activity as the treatment target, the need for initiating disease-modifying drugs as early as possible, and the usefulness of regular disease activity assessments to allow rapid treatment adjustments if needed (i.e., tight disease control). First-line methotrexate monotherapy is recommended, with concomitant short-term glucocorticoid therapy if indicated by the risk/benefit ratio. Patients who fail this approach (no response after 3 months or target not achieved after 6 months) can be considered for another synthetic disease-modifying antirheumatic drug (DMARD: leflunomide or sulfasalazine), combined synthetic DMARD therapy, or methotrexate plus a biologic, depending on the prognostic factors and patient characteristics. If the first biologic fails, switching to a second biologic is recommended. In the event of a sustained remission, cautious dosage reduction of the biological and/after synthetic DMARDs is in order. CONCLUSION: These recommendations are designed to improve the management of patients with RA.
23588412 Level of knowledge and sources of information about the rheumatoid arthritis in Estonian p 2014 May The objective of this paper was to find out how many patients with rheumatoid arthritis (RA) know about several aspects of disease, to explain the associations between the level of self-rated knowledge and patients' background and health status and to compare the importance of the main sources of information. A random sample (n = 1,259) of adult Estonian RA patients was selected from the Estonian Health Insurance Fund Database. The patients completed a self-administered questionnaire, which included information about their socio-demographic and disease characteristics, use of health services, information about the disease, and sources of information. Regression analysis was used to calculate the associations between the independent variables and level of self-rated knowledge about several aspects of RA. The results of the study indicated that the self-reported ratings of knowledge about the disease in Estonian RA patients were rather low. Health professionals were mentioned as the primary sources of information, but the longer disease history and more frequent use of health services as considerable predictors of higher ratings of knowledge refer to role of personal experience in obtaining knowledge about the disease as well.
25065917 Efficacy of the clinical use of iguratimod therapy in patients with rheumatoid arthritis. 2015 Mar OBJECTIVE: Iguratimod (IGU) is a new synthetic disease-modifying antirheumatic drug intended to treat patients with rheumatoid arthritis (RA). We conducted a 24-week study on the efficacy of IGU in RA patients with daily clinical use. METHODS: Forty-one patients were enrolled in this study, and the improvement in RA was evaluated every 4 weeks during the 24 weeks. RESULTS: The patient's global assessment of the disease activity with a scale (Pt VAS) was significantly decreased beginning at week 4. The disease activity score (DAS) 28-erythrocyte sedimentation rate, DAS28-C-reactive protein (CRP), simplified disease activity index and clinical disease activity index all significantly decreased at week 24. The matrix metalloproteinase-3 level was significantly decreased by the combination treatment with methotrexate at week 24. According to a logistic regression analysis, the factor which was most associated with the achievement of low disease activity (DAS28-CRP < 2.7) at week 24 was the DAS28-CRP at week 0. CONCLUSIONS: IGU had significant clinical effects on the RA patients within 24 weeks. IGU might therefore represent a new practical choice to treat RA patients.