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PMID	Title	PublicationDate	abstract
3698477	Bone and joint surgery: rheumatoid arthritis--retrospective and contemporary techniques.	1986 Apr	A philosophy of treatment and surgical planning for the rheumatoid arthritis patient with hand deformities has been outlined. The surgeon should select procedures that are reliable and that will build confidence in the patient. The surgical goals are pain relief, improved function, prevention of further deformity, and cosmesis. The techniques of several surgical procedures advocated by the authors are described and they represent the continuum of bone and joint procedures from the past to the present.
2327849	Multiple rheumatoid nodules of the renal cortex.	1990 Apr	We report the findings of a large localized collection of rheumatoid nodules in the renal cortex of a male patient with long-standing seropositive rheumatoid arthritis. Rheumatoid nodules are a rare occurrence in the urinary tract, with only two previous reports of renal involvement, to our knowledge. A possible relationship, on the basis of immunologically mediated mechanisms, to accompanying chronic pyelonephritis is proposed.
2623407	[Percutaneous synovial biopsy in the diagnostic evaluation of the patient with rheumatic d	1989 Jul	Forty seven percutaneous synovial biopsies from 22 patients with rheumatoid arthritis, four of whom with the juvenile form, 13 with indetermined polyarthritis and 12 with monoarthritis, were evaluated. The histopathological examination confirmed the clinical diagnosis in 76% of cases with rheumatoide arthritis and juvenile rheumatoid arthritis, and it suggested the diagnosis of rheumatoid arthritis in 80% of cases with indetermined polyarthritis. In two cases of monoarthritis it reveled acid-fast bacilli, and a granulomatous process in one. These resuls suggest that the synovial biopsies can be useful for the establishment of diagnosis in patients suffering from indetermined poly or monoarthritis.
2487036	Destructive arthritis, rheumatoid factor, and HLA-DR4. Susceptibility versus severity, a c	1989 Oct	In response to the continuing debate as to whether seronegative rheumatoid arthritis (RA) and seropositive RA are part of the same disease spectrum or are distinct disorders, we evaluated 720 patients with definite and classic RA, of whom 53 subjects had definite persistently seronegative destructive disease. For all but 1 seronegative RA patient, a seropositive RA case control was identified and matched for age, disease duration, degree of destruction on hand radiographs, and disease-modifying drug therapy. DR typing was undertaken on these 105 patients, together with scoring of hand radiographs. The frequency of DR4 was 69% in seropositive RA patients and 60% in seronegative RA patients (P = 0.22), versus 36% in 318 healthy controls (P = 0.008 and P = 0.007 versus seropositive and seronegative RA, respectively). Patients were matched and rematched with different controls in a series of subanalyses in order to make comparisons of hand radiograph scores. We found that HLA-DR4 was associated with destructive RA in both seropositive and seronegative RA patients. In general, DR4+ patients had more severe disease by radiologic criteria than did DR4- patients. Thus, HLA-DR4 may be an additive factor to the serologic status and may be more closely related to disease severity than to disease susceptibility.
2009679	Diagnosis of rheumatoid arthritis. Medical and laboratory aspects.	1991 Apr	The diagnosis of rheumatoid arthritis (RA) is largely dependent on the existence of a characteristic pattern of clinical symptoms and signs that must be present for at least six weeks. Early morning joint stiffness and symmetric polyarticular inflammation, particularly in the metacarpophalangeal, proximal interphalangeal, wrist, and metatarsophalangeal joints, are typical of the disease. Extraarticular disease, including rheumatoid nodules, is usually associated with severe and well-established arthritis, and occular, pulmonary, cardiac, neurologic, and vasculitic involvement can be a considerable source of morbidity. Serologic testing for rheumatoid factor (RF) is helpful in confirming the diagnosis since 80% of patients are seropositive, but RFs are expressed in many other disease states. Expression of multiple RF isotypes differentiates RA from other populations. Erythrocyte sedimentation rates, C-reactive protein levels, circulating immune complexes, and platelet counts are often elevated in RA and serve as indicators of disease activity.
2213753	Suppressed serum erythropoietin response to anemia and the efficacy of recombinant erythro	1990 Jul	Serum erythropoietin (EPO) was measured by radioimmunoassay in 67 patients with rheumatoid arthritis (RA). Twenty of these patients judged to have iron deficiency anemia, based on reduced serum ferritin levels, had higher serum EPO levels than did the 24 other anemic patients with normal or elevated serum ferritin levels. A significant negative correlation between serum EPO and hemoglobin concentrations was noted in the former group, but not in the latter. Human recombinant erythropoietin (r-EPO) was administered to 6 anemic patients with RA, resulting in improvement of anemia in 4 patients, 2 of whom showed no change in RA activity. These findings suggest a suppressed serum EPO response ot anemia and the effectiveness of r-EPO in treating anemia associated with RA.
2290171	Lymphoma presenting as a popliteal mass in a patient with rheumatoid arthritis.	1990 Sep	A patient with HLA-B27 and rheumatoid factor positive rheumatoid arthritis presented with a painless swelling in his popliteal fossa. Clinical features were atypical for a Baker's cyst, and subsequent investigation showed this lesion to be a primary malignant lymphoma.
2684170	Immunohistologic demonstration of type II collagen in synovial fluid phagocytes of osteoar	1989 Nov	We were able to demonstrate type II collagen in synovial phagocytes of osteoarthritis (OA) and rheumatoid arthritis (RA) patients, using a monoclonal antibody to human type II collagen and immunoperoxidase staining. In addition, using immunoelectron microscopy, we demonstrated labeled fragments in synovial phagocytes of both RA and OA patients. This immunohistochemical assay may prove to be a sensitive indicator of cartilage erosion in patients with OA and RA.
3572939	The total assessment of rheumatoid polyarthritis--evaluation of a training program for phy	1987 Feb	We evaluated a training program for physiotherapists and occupational therapists in the total assessment of patients with rheumatoid polyarthritis. Close agreement was seen between the active joint counts of the rheumatologists and 36 therapists (p2 = 0.23). In the 7 quality variables for bedside case workups, a statistically significant learning effect was seen over the 6 week period (p2 = less than 0.005). In the 10 quality variables for the case presentations at Week 6, judged at the graduate medical trainee level, mean global scores achieved were 72.5%. Therapists reported a high level of satisfaction with all components of the program.
2254886	The temporomandibular joint in rheumatoid arthritis. Correlations between clinical and com	1990 Oct	Clinical and computed tomography (CT) examination of the temporomandibular joint (TMJ) was performed in 26 patients with rheumatoid arthritis (RA) and 26 control subjects. Each examination was scored. In the group with RA 61.2% had physical signs in the stomatognathic system compared to 42.3% in a control group (NS); 88.4% of the group with RA had erosive or cystic lesions of the TMJ compared to 57.6% of control subjects (p less than 0.05). The clinical dysfunction score did not correlate with the CT TMJ score in RA. It correlated with the number of slow acting antirheumatic drugs used, the rheumatoid factor titer and radiographic scores of the hands and cervical spine. In agreement with others, we believe that the only specific CT lesions of RA are erosions and cysts of the mandibular condyle, that there is no correlation between clinical and CT findings of TMJ in RA, and that the intensity of destructive lesions of TMJ on CT in RA is well correlated with the severity of the disease.
3490894	A family study of the prevalence of antibodies to the rheumatoid arthritis associated nucl	1986 Nov	Sera from families with at least two members suffering from seropositive rheumatoid arthritis (RA) were examined for the prevalence of antibodies to the RA associated nuclear antigen (RANA). It was found that consanguineous relatives of patients had a significantly increased prevalence of anti-RANA antibodies compared to sera from a control group of families. Anti-RANA antibodies were also significantly more prevalent in the sera of familial RA patients who possessed HLA-DR4. No correlation of anti-RANA antibodies with disease associated haplotypes was observed in these families.
2341208	Full flexion after total knee replacement in rheumatoid arthritis.	1990	The results of the Y-S total knee replacement are reported in 152 patients with rheumatoid arthritis (227 knees). The follow up was from 2 to 4 years (average 2.7 years). The good range of motion generally achieved was attributed to the use of a calibrated distractor for soft tissue balancing, a tibial prosthesis with a flattened plateau and extensive postoperative rehabilitation. Fourteen patients (27 knees) were able to squat fully after operation. A good range of motion before operation was related to a good range after operation. The range and overall results did not differ in patients with rheumatoid arthritis or osteoarthritis. The knees which recovered full flexion were no different from those with less than full flexion as far as stability and radiographic findings were concerned.
2065511	Knee arthritis revealing acute leukemia in a patient with rheumatoid arthritis.	1991 Mar	We report one case of leukemic synovitis in a patient with a 40-year history of rheumatoid arthritis. The synovial fluid sample and synovial biopsy specimen showed myeloblastic cells. So, leukemic synovitis can be suspected in a patient with inflammatory rheumatism and adequate diagnostic procedures should be carried out.
2878645	The abnormal cytotoxic T cell response to Epstein-Barr virus in rheumatoid arthritis is co	1986 Nov	The cytotoxic T cell response to Epstein-Barr virus as measured by the regression assay was found to be impaired in a group of patients with active rheumatoid arthritis (RA). When these patients responded clinically to treatment with sulphasalazine there was a concomitant increase in the strength of this virus specific T cell response. The suggestion of a correlation between disease activity and impairment in this immune response was borne out in studies of other groups of patients with RA. Thus six out of 10 hospitalised patients had abnormal regression compared with six out of 31 patients seen routinely as outpatients. Studies of patients with inflammatory arthropathies other than RA, however, also showed abnormal regression in four out of 16 patients. It is concluded that the impairment in the cytotoxic T cell response to Epstein-Barr virus in RA is influenced by disease activity, and that this abnormality is not a specific feature of rheumatoid disease.
1958102	Heat shock proteins: the missing link between hormonal and reproductive factors and rheuma	1991 Oct
3723499	Evaluation of an education program on the management of rheumatic diseases for physical th	1986 Apr	An educational program on the management of rheumatic diseases was developed for physical therapists. It was community based and designed to measure changes in patient care and physician behavior in the utilization of physical therapy services. Substantial changes in the utilization of physical therapy services were documented in 3 intervention communities, but not in control communities. In patients undergoing total hip arthroplasty, there was a 1.8 day reduction in the hospitalization, significant increases in the use of preoperative physical therapy and a shift in the use of walking aids. These data suggest that physical therapists can play an important role in physician and patient education, and this may result in lower costs and improved outcomes.
2138007	Azathioprine induced fever, chills, rash, and hepatotoxicity in rheumatoid arthritis.	1990 Jan	Within one year three of 25 patients with rheumatoid arthritis treated with azathioprine 100 mg daily developed the following adverse reactions less than two weeks after starting treatment: patient one showed fever with chills, rash, and severe liver function abnormalities suggestive of cholestasis; the second patient had fever, nausea, diarrhoea, and moderately raised liver enzymes; the third patient showed very high fever and severe chills. In two patients the drug was rechallenged, with more rapidly arising and more severe symptoms. In one case raised liver enzymes persisted until seven months after discontinuation of azathioprine. Hypersensitivity reactions and hepatotoxicity of azathioprine are discussed.
3050087	Concurrent use of folinic acid and methotrexate in rheumatoid arthritis.	1988 Jul	In a double blind placebo controlled crossover study, each arm of 4 weeks' duration, 20 mg of folinic acid/week or placebo were administered to 13 patients with rheumatoid arthritis. These individuals were receiving weekly intramuscular methotrexate (MTX) but were about to discontinue because of side effects. While there was considerable improvement in nausea during the study, the effect of folinic acid could not be differentiated from that of placebo. There was no adverse effect on control of disease activity. It therefore seems likely that polyglutamated tissue stores of MTX do not contribute to drug efficacy and in this format folinic acid could not be shown to be more useful than placebo in reducing drug induced nausea.
2873245	A study to determine the active moiety of sulphasalazine in rheumatoid arthritis.	1986 Apr	Thirty patients with active rheumatoid arthritis (RA) participated in an open study of 6 months' treatment with either 5-aminosalicylic acid (5-ASA) or sulphapyridine (SP), the two moieties of sulphasalazine (SASP). Patients were assessed at regular intervals using clinical and biochemical tests designed to detect specific antirheumatic activity. Patients taking SP showed significant improvement in disease activity, but those taking 5-ASA did not improve, despite the fact that high serum concentrations of 5-ASA and acetyl 5-ASA were achieved. These results suggest that SP is the active moiety of SASP. Its possible mode of action is discussed. Nausea was a frequent problem in patients taking SP. Unless this can be overcome, SP is unlikely to offer any therapeutic advantages over SASP in the treatment of RA.
1950638	HLA-B27 antigen and rheumatoid arthritis.	1991	The influence of HLA-B27 antigen on clinical, radiological and laboratory features of rheumatoid arthritis (RA) was studied. The group with B27 antigen comprised: 4 males and 20 females aged 28 to 71 and a group of patients free from B27 antigen consisted of 2 males and 21 females aged 26 to 69. RA patients possessing the B27 antigen did not differ regarding the age of the onset of disease, the distribution of affected joints during the follow-up (3-10 years), the development stages of the disease and the presence of rheumatoid factor when compared with B27 negative RA patients. The arthritis of the radiocarpal joints (p less than 0.01) was significantly more often the first sign of the disease in patients with B27 antigen. In these patients low back pain and morning stiffness in the low back were twice as frequent as they were in patients not possessing this antigen. The clinical pattern of the affected spine was also found more frequently in B27 carriers (p less than 0.05). B27 positive RA patients showed also the clinical pattern of sacroiliitis (SI) (p less than 0.05) and x-ray SI (p less than 0.01) significantly more often than the patients free from this antigen. In addition, symmetric arthritis of the peripheral joints was more often diagnosed in patients free from B27 antigen.