Search for: rheumatoid arthritis    methotrexate    autoimmune disease    biomarker    gene expression    GWAS    HLA genes    non-HLA genes   

ID PMID Title PublicationDate abstract
2612114 Treatment of articular effusions with local deep microwave hyperthermia. 1989 Dec Local deep microwave hyperthermia (LDMWH) may be considered as a therapeutic tool for joint diseases because it has the advantage of heating the target organ e.g. synovium, while sparing the adjacent tissues, as demonstrated in animals. The effect of this new microwave device has been evaluated on seven rheumatoid arthritis patients with knee effusion. The hyperthermia apparatus consists of a 915 MHz power source with a cooling system to the skin. LDMWH was operated for one hour, twice a week for two weeks. Intra-articular knee temperature reached the level of 40.6 +/- 1.1 degrees C within 15 minutes, raised to 41.2 +/- 0.7 degrees C after 30 minutes and to 41.3 +/- 0.9 degrees C at one hour. The skin temperature over the heated knee joints remained at 24.3 +/- 1.1 degrees C during treatment. All patients noted a sensation of warmth in the treated knee. Aspiration of synovial fluid was performed before and immediately after each treatment. Walking time was improved (p = 0.04) and significant decrease in pain (p = 0.01) was noted following treatment. Synovial fluid leukocyte count and prostaglandin E2 level, knee circumference and range of motion did not change. Severity of pain, walking time, knee circumference and range of motion remained stable in the six weeks following the last hyperthermia application. No adverse reaction could be observed. These results suggest LDMWH to be safe and successful as an adjuvant treatment of chronic inflammatory joint effusions.
2343338 Autoimmune hemolytic anemia and rheumatoid arthritis. 1990 May The incidence of AIHA in patients with rheumatoid arthritis has not been shown to exceed that in the general population. The prevalence of rheumatoid arthritis in patients with AIHA approximates that in the general population. On the basis of these data, it is extremely difficult to establish a relationship between AIHA and rheumatoid arthritis. The patient we have described had the unusual presentation of AIHA with rheumatoid arthritis. We believe the two remain distinct entities.
3959321 Treatment of intractable rheumatoid arthritis with combined cyclophosphamide, azathioprine 1986 May 2 Cyclophosphamide, azathioprine, and hydroxychloroquine sulfate were prescribed for 31 patients (26 women and five men) with rheumatoid arthritis refractory to conventional therapy. Maintenance drug dosages (mean +/- SD) were as follows: cyclophosphamide, 30 +/- 24 mg/day; azathioprine, 74 +/- 44 mg/day; and hydroxychloroquine sulfate, 210 +/- 92 mg/day. Disease suppression began in 30 patients within three to 24 months (mean, nine months). Results after 43 months (range, 12 to 102 months) were as follows: 16, complete remission; seven, near remission; seven, partial disease suppression; one, no response. None remained in prolonged remission without some form of therapy. Treatment was discontinued in three patients because of pulmonary infection (two) or thrombocytopenia (one). Four patients had five malignant neoplasms (surgical cures) before therapy (two breast, one colon, one melanoma, one endometrial); four patients developed a malignant neoplasm during combined drug therapy (one colon, one endometrial, one lung, one erythroleukemia); and three died. The absolute risk of malignancy from combined drug therapy is still unclear. We concluded that combined use of remittive agents may have promise in treatment of severe rheumatoid arthritis; cyclophosphamide should be replaced with a nonalkylating agent; and the place of combined drug therapy remains uncertain in the absence of controlled trials.
2182487 [Physical therapy of rheumatoid arthritis]. 1990 Mar 20 Physiotherapy is an important component of the treatment regimen for rheumatoid arthritis, and is aimed mainly at reducing pain and preserving function. Depending on the severity of the disease and the clinical picture, physiotherapy, ergotherapy, hydrotherapy and heat treatment, as well as massage and electrotherapy may all be considered. When properly applied, these treatments have the advantage of being free of side effects. Scientific proof of effectiveness is often lacking in physical medicine, which clearly represents a challenge to the discipline in the years to come.
3396251 Chylous cyst of shoulder joint in a patient with rheumatoid arthritis. 1988 Jan A case of chylous cyst of the shoulder joint containing cholesterol crystals is presented. The patient suffered from rheumatoid arthritis of short duration. The cyst completely disappeared following therapy with gold.
3082572 Massive eosinophilia in rheumatoid arthritis: report of four cases. 1986 Jan We report four cases of massive eosinophilia (greater than 1.5 X 10(9)/l) a phenomenon uncommon in rheumatoid arthritis. In two patients it preceded therapy with second line anti-rheumatic drugs. The others developed it during therapy with penicillamine and gold, though neither had an adverse reaction. It appears there are two patterns of massive eosinophilia in RA; one is related to the disease process the other to drug therapy. It does not necessarily predict adverse drug reactions nor preclude treatment with anti-rheumatic therapy.
2270970 Lifestyle and the risk of rheumatoid arthritis: cigarette smoking and alcohol consumption. 1990 Dec In a search for aspects of behaviour related to oral contraceptive use which might explain the favourable effect of oral contraception on the onset of rheumatoid arthritis (RA), cigarette smoking and alcohol consumption were studied as possible risk factors. Information on cigarette smoking and alcohol consumption was obtained by interview at the first visit to the outpatient clinic of 135 young women with confirmed definite or classical RA of recent onset and 378 control patients with soft tissue rheumatism or osteoarthritis. The diagnosis in all patients was confirmed by at least two years of follow up. Of the patients with RA, 44/135 (33%) were current cigarette smokers compared with 181/378 (48%) of the controls. The percentage of smokers among the controls was similar to that of women smokers in the general population. The adjusted risk of RA in women who smoked at least one cigarette a day was 0.61 (95% confidence interval (CI) 0.42 to 0.89). Thirty one (23%) patients with RA and 137 (36%) controls were alcohol drinkers. The risk of RA in women who consumed alcohol at least once a day was 0.52 (95% CI 0.33 to 0.84). The low relative risk estimates for cigarette smoking and alcohol consumption were mutually independent and also independent of oral contraceptive use, the presence of the HLA-DR4 antigen, or a positive family history of RA. The low incidence of alcohol consumption in the patients with RA might be due to the discontinuation of alcohol consumption after disease onset. The low incidence of cigarette smoking in the patients might reflect a protective effect of cigarette smoking on RA onset, possibly induced by changes in the immune system.
3481157 Relationship between disorder in the stomatognathic system and general joint involvement i 1987 Dec Seventy-one individuals with rheumatoid arthritis (RA) were examined and compared with 52 individuals without history or symptoms of joint disease (C group) with regard to disorders of the stomatognathic system. Laboratory findings and articular and functional rheumatologic indices were compared. The clinical dysfunction index of Helkimo for the stomatognathic system was positively correlated to both the articular Ritchie index and the functional Lee index. The concentration of C-reactive protein (CRP) and the Ritchie index were positively correlated to temporomandibular joint (TMJ) pain. Vertical overbite was negatively correlated to the Ritchie index. In addition, there were positive correlations among TMJ crepitus, anterior open bite, sagittal distance between retruded position and intercuspal position, and erythrocyte sedimentation rate (ESR). The concentration of CRP, the ESR, and the Ritchie and Lee indices were highest in the individuals with bilateral current TMJ symptoms and lowest in those with previous but not current TMJ symptoms. It was concluded that the severity of TMJ involvement in RA is correlated to concentration of serum acute-phase reactants and to rheumatologic indices.
2014742 Increasing demands on orthopedic services. 1991 In Finland, waiting lists have been analyzed country-wide several times during the last two decades. In this presentation, the data obtained are reviewed. The orthopedic waiting lists grew threefold from 1969 to 1987, more rapidly than the total waiting list to hospitals in the country. Meanwhile, the average duration of hospitalization decreased. The reliability and problems of data bases available are discussed; it is concluded that especially the studies on waiting lists need new objective methods.
3488713 Immunogenetic heterogeneity of rheumatoid arthritis. 1986 Jul Association of HLA-DR4/Dw4 with rheumatoid arthritis (RA) is well established, but conflicting data exist on a possible association with the severity of the disease, including its extra-articular manifestations. In order to investigate whether a subgroup of RA is preferentially associated with DR4, HLA typing was performed in two groups of patients with severe extra-articular manifestations (Felty's syndrome and histologically proved leucocytoclastic vasculitis), patients with severe joint destruction (seropositive and seronegative), a group with only mild joint destruction, and in healthy controls. The frequency of HLA-DR4 was significantly raised in all patient groups compared with that in healthy controls. The two groups with severe extra-articular manifestations, however, both had a DR4 frequency of 92%, which was significantly (p = 0.002) higher than the 62.7% found in the remaining patients. No significant differences were observed between severe or mild joint destruction and seropositivity or seronegativity in the groups without the above-mentioned extra-articular manifestations. From these data we concluded that DR4 is preferentially associated with severe extra-articular disease manifestations of RA. This observation provides an immunogenetic basis for the disease heterogeneity and for the immunological analogy between RA and leprosy.
3798042 Tophaceous gout in a nigerian with rheumatoid arthritis. 1986 A male Nigerian patient, with co-existing gouty arthritis and rheumatoid arthritis, is presented. These two conditions rarely co-exist in the same patient. There has been no previous report in black Africans.
1984923 Long-term results of posterior release surgery for severe flexion contracture of the knee 1991 Jan Twelve knees in nine rheumatoid patients with severe flexion contractures were evaluated clinically and roentgenographically for an average of 17.2 years (range, six to 25 years) after posterior release surgery. Preoperatively, the average extension in the 12 knees was 42.5 degrees, and postoperatively it was 10.8 degrees. Even though patients were able to walk postoperatively, the majority had knee pain when they extended their knees soon after surgery. Seven knees required further surgery after correction of the flexion deformity. The average time before reconstructive surgery after posterior release was 11.1 months. In the treatment of severe flexion deformities of the knee in patients with rheumatoid arthritis, posterior release surgery was effective only in correcting the deformity. Posterior subluxation of the tibia, knee pain, and instability occurred soon after surgery. Therefore, patients may require additional reconstructive surgery soon after the posterior release.
1887431 [The potentials of colchicine in the combined therapy of secondary amyloidosis in patients 1991 The authors relate the results of prolonged treatment (up to 3.5 years) with colchicin of 22 patients suffering from rheumatoid arthritis (RA) complicated by morphologically verified secondary amyloidosis of the kidneys and/or of the gingival, rectal and hepatic mucosae. Colchicin prescribed as the only slowly acting agent turned out effective in 5 out of 11 patients and in all the 11 patients given the drug in combination with basic therapy by cytostatics or, rarely, by gold drugs and D-penicillamine. The treatment efficacy could be observed both in respect to the manifestations of rheumatoid disease proper and in respect to the manifestations of amyloidosis. The drug did not produce any side effects and could be administered for a long time. In the overwhelming majority of cases, the withdrawal of colchicin, even in basic therapy continuation caused the enhancement of the manifestations of RA and amyloid nephropathy.
2068538 Is HLA B27 antigen a predictor of cardiac or pulmonary disease in patients with rheumatoid 1991 Pericarditis was a frequent echocardiographic finding in 20 HLA B27 positive patients with erosive, seropositive rheumatoid arthritis (RA) and in 20 B27 negative RA controls (35% and 30% respectively). There was no significant difference in echocardiographic 2-D or M-mode measurements between the groups. A 48 hour continuous electrocardiographic monitoring, showed that ventricular extrasystoles were more frequent (p less than 0.01) in the B27 negative patients. Pulmonary diffusion capacity was reduced in 25% of the patients in both groups. There were no association between clinical or laboratory data and the cardiac or pulmonary findings except for the finding of a higher frequency of treatment with corticosteroids in patients with pericarditis.
2790405 Correlation between clinical and laboratory findings when the whole blood filterability ra 1989 Oct This double-blind study assessed the effects of oral ticlopidine versus placebo on whole blood filterability in two homogenous groups of 20 rheumatoid arthritis patients taking one NSAID. The patients' clinical progress was monitored to see if modifications in the whole blood filterability rate could be correlated with any improvement in the clinical picture. Our results showed treatment with ticlopidine significantly (p less than 0.01) improved both the ESR (-28%) and the whole blood filterability rate (-15%), pain (-24%), and morning stiffness (-28%). These clinical benefits correlated with improvement in the whole blood filterability rate. Clinical benefits may have resulted from improved perfusion and transport of NSAID to target tissues.
2915815 [Treatment of amyloidosis with dimethyl sulfoxide (DMSO)]. 1989 Jan In this study we have investigated the role of oral dimethylsulfoxide (DMSO) therapy in 2 patients with primary amyloidosis (AL) and in 2 patients with secondary amyloidosis (AA) to long-standing rheumatoid arthritis. DMSO treatment produced no beneficial effects in the patients with idiopathic amyloidosis. Instead the patients with secondary amyloidosis experienced a subjective improvement, a decrease of inflammatory activity of the rheumatoid arthritis and an unequivocal improvement of renal function following 3-6 months of DMSO therapy. No serious side effects of DMSO were observed except for unpleasant breath odour. We conclude that a treatment with oral DMSO may prolong life of patients with secondary amyloidosis.
3625627 An evaluation of the efficacy of arthroscopic synovectomy of the knee in rheumatoid arthri 1987 Jun Nine patients with rheumatoid arthritis (10 knees) with chronic knee synovitis unresponsive to medical therapy were entered into a prospective study of arthroscopic total synovectomy of the knee. Histopathological examination of the synovium revealed a proliferative synovitis in all knees. Patients were ambulatory and exhibited 90 degrees of knee flexion on the day after surgery and were discharged at 24 to 48 h postoperation. Mean joint tenderness and swelling improved from the preoperative level and was maintained for the initial 12 months of the study. Knee range of movement was improved in all patients (mean 21 degrees). Improvement of joint function in daily activities was also demonstrated, but patients with Grade IV articular cartilage damage failed to show significant improvement. Nine knees were followed for at least 24 months and 4 required repeat surgery. Arthroscopic synovectomy is comparable to synovectomy by arthrotomy in short term reduction of pain and swelling. The chief benefit of arthroscopic synovectomy is a reduction in morbidity, hospital stay and postoperative rehabilitation.
3629207 HLA-DR versus HLA-B5-CREG antigens in rheumatoid arthritis (RA). 1987 Thirty caucasian patients suffering from classic erosive rheumatoid arthritis (RA), with a condition persisting for more than 8 years, were examined together with 67 healthy control subjects with regard to associations to HLA-DR and HLA-B-CREG antigens (B5-, B8-, B12-, B16- and B27-CREG). We found a significant correlation of seropositive RA (SPRA) with HLA-DR4 (9/14 patients = 64% chi 2 = 11.8, p less than 0.05), and seronegative RA (SNRA) with B5-CREG antigens (14/16 patients = 88%, chi 2 = 7.8, p less than 0.05). This HLA locus-differing association of SPRA and SNRA could, in addition to the known differences in clinicophenomenological parameters, be additional proof of the independent entity of these two forms of illness.
3947406 Distal interphalangeal joint involvement in rheumatoid arthritis. 1986 Jan Sixty-two patients with seropositive rheumatoid arthritis (RA) were evaluated radiographically for distal interphalangeal (DIP) joint involvement and were compared with 50 age- and sex-matched control subjects. The frequency of DIP erosions was 37% in the patients versus 14% in the controls; these erosions were mild and were not related to disease duration. Erosions elsewhere in the hand and wrist were of all degrees of severity and were related in part to disease duration. Osteophytes occurred frequently in both the RA group (71%) and the control group (60%). However, joint space narrowing occurred more frequently in RA patients (77%) than in the controls (46%) (P less than 0.009). The findings from this study suggest that in RA patients, DIP erosions occur frequently, do not occur in isolation, and are not simply a marker for severe global erosive disease in the hand and wrist. The high frequency of osteophytosis and joint space narrowing in both groups probably represents the overlap of osteoarthritis and RA that occurs in many patients.
3823794 Diffuse interstitial lung disease in rheumatoid arthritis. Views on immunological and HLA 1986 Immunological parameters including HLA typing were studied in 32 patients with rheumatoid arthritis (RA) associated diffuse interstitial lung disease (DILD) and in 32 age- and sex-matched RA control patients. The male RA patient group with DILD also included patients with other intrathoracic manifestations and had a higher prevalence of HLA-B8 and Dw3 than did healthy controls, thus agreeing with our earlier results that RA patients with this antigen combination are prone to multiple intrathoracic complications. Patients with DILD had higher titres of rheumatoid factor (RF) and lower complement (C4) levels than matched RA controls. The RF titre was in inverse correlation with C3 and C4 levels, suggesting that RF immune complexes may also promote rheumatoid lung disease via activation of the classical pathway of complement.