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PMID	Title	PublicationDate	abstract
2255420	[Description of a case of rheumatoid pleuropneumopathy with primary onset].	1990 Nov	A case of pleuropulmonary manifestation as the first symptom of rheumatoid arthritis is reported; articular involvement followed at a later stage. Pleuropulmonary localisation of rheumatoid arthritis is varied and infrequent; it is seldom the first manifestation of illness. This case was particular because isolated pleuropulmonary symptom appeared in a subject negative rheumatoid factor. The patient improved after initial NSAIDS treatment, followed by corticosteroids and NSAIDS together, leading to the resolution of clinical and x-ray symptoms.
2404483	Methotrexate in rheumatoid arthritis. Impact on quality of life assessed by traditional st	1990 Jan	In a double-blind, randomized trial of methotrexate vs placebo in rheumatoid arthritis, the effect of treatment on physical, social, and emotional function was measured in two different ways: the same, standard measurements in all patients, and individualized measurements selected by the patients at the start of the trial as representing the functions they most wanted to have improved by treatment. On the standard measurements, methotrexate-treated patients fared better than placebo-treated patients in their physical, social, and emotional function by 11%, 5%, and 6%, respectively, results that, although statistically significant, were small. However, methotrexate-treated patients were 29% better in the individualized measures, a result that was both highly statistically significant and greater than the differences in the standard measurements or in joint counts, grip strength, proximal interphalangeal joint circumference, morning stiffness, or walking time. Because the individualized measurements were as efficient as the best direct joint examination measures, yet reflected functional outcomes of greatest importance to individual patients, they constitute useful measures for such trials.
2692132	Pathogenesis of Lyme disease.	1989	The etiology and pathogenesis of Lyme disease are reviewed and the value of the condition as a human model for an infectious etiology of rheumatic disease is discussed. Similarities between Lyme disease and rheumatoid arthritis are considered.
3827346	Adherence of rheumatoid polymorphonuclear cells (PMNs) to cultured endothelial cell monola	1987 Feb	Blood polymorphonuclear cells (PMNs) from 40 patients with rheumatoid arthritis (RA) and 40 normal subjects were incubated with confluent cultures of porcine aortic endothelium and their adherence assessed by either a microscopic or radiometric enumeration assay. There was no difference between the number of rheumatoid and control PMNs adhering. The synovial fluid PMNs from patients with RA were less adherent than their paired blood samples when autologous serum was present in the incubation medium and more adherent when serum was absent. Most of the RA sera tested inhibited the adhesion of normal PMNs, an effect that was not due to an increase in PMN aggregation. A similar inhibition was seen with sera obtained from patients with Felty's syndrome. These findings suggest that there is no intrinsic difference between the adhesiveness of rheumatoid PMNs and normal PMNs but that there are soluble factors present in RA serum which inhibit the attachment of normal PMNs to vascular endothelium.
3602908	[Different effects of diclofenac and ketoprofen on the bactericidal action of polynuclear	1987 Apr	The bactericidal action of neutrophil polynuclear cells (NP) is significantly lower in the presence of diclofenac than in the presence of ketoprofen in patients with rheumatoid polyarthritis. This effect perhaps takes place through a serum factor, since the bactericidal action of normal NPs is diminished when the cells are incubated in the serum of patients treated with diclofenac or in the serum of healthy individuals after ingestion of diclofenac, but it is not decreased when the cells are incubated in the serum of patients treated with ketoprofen or the serum of healthy volunteers after ingestion of ketoprofen.
2788004	Comparative analgesic and anti-inflammatory properties of sodium salicylate and acetylsali	1989 May	1. Enteric coated sodium salicylate 4.8 g daily was compared with the same dose of enteric coated aspirin in 18 patients with rheumatoid arthritis. 2. After an initial washout period lasting 3 days, patients were randomly allocated to treatment with sodium salicylate or aspirin. After 2 weeks the two treatments were crossed over. 3. Pain relief, reduction in articular index of joint tenderness, increase in grip strength, decrease in digital joint circumference and patients' assessment showed significant improvement with both treatments compared with the washout period. No significant differences were found between the two therapies. 4. No correlation was found in the degree of improvement in any of the clinical outcomes and the salicylate concentrations at steady state.
3818234	Observer variation in quantitative assessment of rheumatoid arthritis Part II. A simplifie	1987 Jan	A new and more comprehensive simplified scoring system to provide quantitative assessment of radiographic findings in rheumatoid arthritis was studied by six observers with different levels of expertise. Since the observers, film set, and joints scored were the same as in a prior study of a more detailed scoring method, a precise comparison of the results was made. Interobserver variation with the simplified scoring system was small; there were highly significant correlations of the total radiographic scores for all observers (R = .898-.978, P less than .001). There were highly significant correlations between scores obtained with the simplified scoring system and those obtained with the more detailed method (R = .920-.955, P less than .001). When the same joints were evaluated by the two methods, a significantly greater number of possible observations could be scored with the simplified scoring system than with the more detailed method (X2 = 131.07, P less than .001). The simplified scoring system required 2.3 times less time to use in the hands of experienced observers.
3277686	Can 'disease modifying' drugs influence outcome in rheumatoid arthritis?	1988	The treatment of rheumatoid arthritis with disease modifying drugs is based on the hypothesis that they exert a more profound effect on the disease process than non-steroidal anti-inflammatory drugs. Short-term studies of disease modifying drugs show significant clinical and laboratory improvements in comparison to placebo. Longer-term studies suggest that this improvement is not maintained. Attempts to assess the effect of disease modifying and immunosuppressive drugs on radiological progression suggest that they may have a week protective effect, but there is no evidence to suggest that this is maintained in the long term. Studies of corticosteroid therapy indicate that in large doses it possesses disease modifying properties and is capable of retarding radiological progression. The benefit-risk ratio of such doses is unacceptable. Lower doses have not yet been adequately investigated. Rheumatologists should regard existing suppressive agents as moderately effective in the short term. Few patients remain on single drug therapy for prolonged periods and available evidence does not suggest that these drugs are capable of altering the long-term outcome of rheumatoid arthritis.
11188604	A comparison of the full and short versions of the Arthritis Impact Measurement Scales.	1991 Dec	This study examined the validity and reliability of full and short versions of the Arthritis Impact Measurement Scales (AIMS). One hundred fifty-five patients with Rheumatoid Arthritis followed at a University Hospital Rheumatology Clinic completed the full AIMS at baseline, 6 months, 12 months, and 18 months. After reducing the 45-item AIMS to 22, alpha reliabilities and test-retest correlations showed that, with the exception of test-retest correlations for mobility at 6 months and for pain at 12 and 18 months, the full and short scales were comparably reliable. Convergent validity correlations with theoretically related scales were also comparable. However, some of the short scales did not detect the same differences over time that the full scales did. Specifically, the short mobility, pain, anxiety, and depression scales were not as sensitive to change as the full scales. Except for these four scales, the short version appears to be a viable alternative for use by health professionals and researchers.
3550070	Membrane attack complex of complement in rheumatoid synovial tissue demonstrated by immuno	1986 Dec	Rheumatoid and osteoarthritic synovial membranes were examined for evidence of terminal complement pathway activation. Using antiserum highly specific for C9 neoantigen, immunofluorescent microscopy was employed to study synovial membrane specimens from 4 patients with rheumatoid arthritis, one patient with psoriatic arthritis, and 5 patients with osteoarthritis. C9 neoantigen was detected in 3 of the 4 rheumatoid membranes, the one psoriatic membrane, and one of the 5 osteoarthritic membranes. Activation of the terminal pathway of complement through C9 should be added to the spectrum of immunologic events known to occur in some rheumatoid synovial membranes.
3439364	[Lymphocytapheresis in the treatment of chronic polyarthritis. Effect on clinical and labo	1987 Nov	Ten patients with rheumatoid arthritis (RA) were treated by lymphocytapheresis. Only patients with severe disease (Steinbrocker classification III/IV, at least two disease-modifying drugs previously unsuccessful, present treatment insufficient) were selected, concomitant treatment was standardized (NSAID and/or low-dose steroids in a fixed dose, administered constantly for 6 weeks). Using an IBM cell-separator, apheresis was administered three times per week for 2 weeks with continuation only in the case of improvement. Lymphocyte elimination rate was 10(9)-10(10) per apheresis in all cases. Only three patients showed significant clinical improvement (evaluated by the Ritchie Index, grip strength and morning stiffness), little (5 patients) or nor (2 patients) change was registered in the other cases. No side effects occurred during treatment. Standard laboratory parameters (including rheumatoid factor, circulating IC) showed no correlations with the course or success of treatment. Interestingly, all therapy responders showed a markedly depressed lymphocyte proliferative capability (LPC, tested with tetanus toxoid/streptodornase as antigens) compared to the non-responders before apheresis, with complete reversal to normal LPC during treatment. Lymphocytapheresis might be a promising additional treatment in a minority of RA patients characterized by a certain form of lymphocyte dysfunction. Markers to preselect such a subgroup are still to be found.
2889500	Comparison of faecal florae in patients with rheumatoid arthritis and controls.	1987 Oct	The faecal flora of 25 out-patients with active rheumatoid arthritis (RA) was compared with that of 25 age- and sex-matched controls. A comprehensive survey revealed a significantly higher carriage rate of Clostridium perfringens in the RA population (88%) than controls (48%) (p less than 0.01). Coliform counts also tended to be higher, but there were no other significant differences between patients and controls. When the study was enlarged to include a further 113 RA patients with variable disease activity and a further 38 controls, clostridia were again more frequently carried by those with RA (70%) than controls (45%) (p less than 0.01) and clostridial counts were significantly higher in the patient group (p = 0.006). Moreover, counts in patients with active or moderately active disease were significantly higher than in those with inactive disease (p less than 0.001). These data are consistent with the hypothesis that Cl. perfringens plays a role in triggering or is otherwise associated with disease activity in RA. The findings may be alternatively an effect of the disease or its treatment with, for example, anti-inflammatory drugs.
3474777	Auranofin: first choice for remission-inducing drug (RID) therapy in rheumatoid arthritis?	1986	Numerous studies have demonstrated that auranofin (AF) causes less severe side effects than other disease-modifying antirheumatic drugs (DMARDs) such as injectable gold (IG) and D-penicillamine (DPA). As the efficacy of AF appears comparable to that of IG, AF could be the first choice for early and long-term therapy for rheumatoid arthritis (RA). A total of 444 patients were enrolled in 2 uncontrolled, open, multicenter studies in Germany, Austria, and Switzerland; data were evaluated from 300 patients with RA treated for 12 months and 179 patients treated for 24 months. Patients with disease duration of 1 year or less had greater improvement in grip strength, joint index, morning stiffness, and activity index when compared with patients whose disease duration was more than 2 years. Drug treatment prior to AF included IG in 46, DPA in 36, chloroquine in 57, and antineoplastic agents in 5. Within this group, subpopulations were isolated who were withdrawn from prior DMARD therapy due to lack of efficacy or adverse events, and the results of subsequent AF therapy evaluated. Adverse events observed with previous DMARDs, particularly proteinuria, did not necessarily recur with AF. The data from these 2 studies suggest that auranofin can be initiated early in the course of RA and can be used successfully in patients who have experienced lack of efficacy or adverse events with other DMARDs.
3490893	HLA antigens in palindromic rheumatism and palindromic onset rheumatoid arthritis.	1986 Nov	Fifty patients who presented with typical palindromic rheumatism of at least 6 months' duration were tissue-typed for HLA A, B, C antigens. DR typing was also performed but was not possible for technical reasons in three patients. Twenty-three patients who had progressed to definite or classical rheumatoid arthritis (RA) after a mean interval of 5 years were compared with 20 patients whose palindromic attacks had persisted over a similar period. Both groups showed a significantly higher frequency of DR4 antigen than a control population. The RA group also showed an increased frequency of DR1. There was no significant difference in the frequency of DR4 or any other DR antigen between the two patient groups. The frequency of B27 antigen was significantly higher in the palindromic group compared with the controls. It is suggested that although DR4 may be associated with a tendency to inflammatory joint problems, environmental or other unrelated genetic factors may be more important in determining the progression of palindromic rheumatism to RA.
3804659	Observer variation in quantitative assessment of rheumatoid arthritis. Part I. Scoring ero	1986 Dec	Six observers, including two bone and joint radiologists, two general radiologists, and two senior radiology residents, compared scores to quantitate radiographic findings in the hands and wrists of patients with rheumatoid arthritis. In the scoring system used, erosions and joint-space narrowing are graded separately. This scoring system differs from other methods in that equivocal findings are not scored, while ankylosis, subluxation, and dislocation are scored, and data from postoperative joints are included. Total radiographic scores were highly significantly correlated for all observers (R = .908-.958, P less than .001), as were subtotal scores for erosions (R = .723-.931, P less than .001) and joint-space narrowing (R = 0.843-0.966, P less than .001). Analysis of proximal interphalangeal, metacarpophalangeal, and wrist-joint scores showed highly significant correlations for all observers in each location. Highly significant correlations were found among three separate readings of two bone and joint radiologists (R = .950-.961, P less than .001). This scoring system provides highly consistent and reproducible results, even in the hands of less experienced observers.
3802624	Disruption of the symphysis pubis and fatigue fractures of the pelvis in a patient with rh	1987 Feb	A 40-year-old woman, who suffered from severe rheumatoid arthritis causing avascular necrosis of the femoral head and protrusio acetabuli of the right hip, developed a severe spontaneous disruption of the symphysis pubis concomitant with a stress fracture of the left ilium adjacent to the left sacroiliac joint. After successful total hip arthroplasty, the symphysiolysis improved, but a new stress fracture of the left superior pubic ramus developed. Fourteen months after operation both stress fractures are healed. Altered hip and pelvic girdle mechanics acting on osteoporotic bone may account for this sequence of events.
3673535	Metatarsal osteotomy in rheumatoid arthritis.	1987 Aug	Thirty-eight feet in 28 patients with rheumatoid forefoot deformity were operated on with a proximal valgus osteotomy of the first metatarsal bone to reduce splaying of the forefoot. Each patient also underwent additional surgical procedures for associated conditions of the forefoot. The mean follow-up period was 3.7 years. Both the entire forefoot and the medial border of the foot were substantially improved in all but 2 cases. Residual symptoms were slightly more pronounced in the anterior footpad and the lesser toes (5 cases). A proximal valgus osteotomy of the first metatarsal bone, performed in combination with other surgical procedures, affords a good correction of the rheumatoid foot deformity with long-term improvement.
3388258	[Clinical pharmacology of the new Soviet anti-inflammatory preparation ortofen].	1988	Comparative pharmacokinetic and pharmacodynamic studies on ortophen, a new Soviet antiinflammatory drug, and voltaren (Ciba-Geigy, Switzerland) were carried out in 73 patients with rheumatoid arthritis. Pharmacokinetics of both drugs was studied in 19 patients (9 patients were given voltaren, 10--ortophen). Pharmacokinetic difference was statistically indistinguishable. The comparison of the principal routine subjective and objective pharmacodynamic indices revealed no significant difference between ortophen and voltaren action. The new drug was shown to possess a high analgetic and antiinflammatory activity.
3260783	The effects of leucovorin (folinic acid) on methotrexate therapy in rheumatoid arthritis p	1988 Jul	High-dose leucovorin (folinic acid) supplementation was tested in a prospective, unblinded manner for 4 weeks in 7 rheumatoid arthritis patients who were being treated successfully with low-dose methotrexate (MTX). Nausea caused by MTX disappeared; however, the underlying rheumatic disease worsened in all patients. Subjective clinical assessment, Ritchie articular index, grip strength, erythrocyte sedimentation rate, and levels of C-reactive protein showed statistically significant deterioration. All these parameters improved after the leucovorin was stopped. This is the first direct clinical evidence implying folate antagonism in the action of low-dose MTX therapy in rheumatoid arthritis patients.
2363258	[Negative consequences of enterosorption in rheumatoid arthritis].	1990 Mar	Aggravation of the patients with rheumatoid arthritis after enterosorption was apparently related to an increase in the rate of lipid peroxidation and to decrease in the antioxidation activity, which was expressed as a decrease in cholesterol and tocopherol content and an increase in ferrum and cuprum concentration in blood plasma. After-effect of alterations in phospholipid composition in blood plasma, erythrocytes, neutrophils and thrombocytes are also considered.