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PMID	Title	PublicationDate	abstract
2349170	Calcific constrictive pericarditis due to rheumatoid arthritis.	1990 Jan	A patient with calcific constrictive pericarditis due to rheumatoid arthritis is presented: the literature reveals only one previous case which was attributed to the long duration of the rheumatoid arthritis.
2724250	Increasing methotrexate effect with increasing dose in the treatment of resistant rheumato	1989 Mar	Forty-six patients with recalcitrant rheumatoid arthritis entered a trial encompassing a 2-week inpatient period plus a 16-week, randomized double blind, parallel study comparing placebo, 5 mg/m2 and 10 mg/m2 oral weekly methotrexate (MTX). An additional 6 patients, given 20 mg/m2 MTX, contributed to the toxicity, but not the efficacy analysis. All patients had "failed" either gold or D-penicillamine. A linear dose response relationship (placebo vs 5 mg/m2 vs 10 mg/m2) was found for 5 of 11 outcome variables: patient pain and patient global scale, physician global scale, joint tenderness count and activity of daily living scale (p less than 0.05 for each). Gastrointestinal toxicity (p = 0.002), dyspepsia (p less than 0.03) and stomatitis (p less than 0.09) occurred more commonly with MTX, and a general trend, although not significant, was found toward a dose toxicity relationship.
3263089	Clinical assessment of disease activity in rheumatoid arthritis: evaluation of a functiona	1988 Sep	A cross sectional analysis of the correlation between clinical, laboratory, and radiological markers of disease activity in 98 patients with classical rheumatoid arthritis (RA) is reported. The median age was 38 years, the median age at onset of disease 29 years, and the median duration of disease seven years. The Keitel function test (KFT) showed good correlation with the Ritchie articular index (RAI) (p less than 0.0001; r = 0.5) and the disability questionnaire (DQ) (p less than 0.0001; r = 0.6). The RAI and DQ correlated weakly with laboratory variables, while the KFT showed significant correlation with the erythrocyte sedimentation rate (ESR), C reactive protein (CRP), and plasma viscosity (PV) (p less than 0.001; r = 0.4; 0.3; 0.4). Only the KFT showed significant correlations with bone mass measurements (p less than 0.01; r = -0.3; -0.4), and the Larsen index at the right wrist (p less than 0.0001; r = 0.4). Consensus analysis suggested that the KFT is a useful single clinical test of disease activity in RA. The hand functional index (HFI), a component of the KFT, showed significant correlation with the total KFT (r = 0.9). Prospective drug trials are needed to establish the value of the HFI in the monitoring of patients with RA.
2012963	Increased metacarpal bone mass following 18 months of slow-acting antirheumatic drugs for	1991 Apr	Osteoporosis in RA is mediated by numerous inflammatory substances. This study was undertaken to see if SAARD could modify the rate of metacarpal bone loss in RA. Combined cortical thickness (CCT) measured at the midshaft of the right second metacarpal was used to calculate bone mass (CA%) using a digitizer. Eighty-one subjects were studied, all of whom had at least three sets of hand X-rays, the last of which was approximately 18 months following initiation of SAARD therapy. There were 12 males and 69 females. The mean age at time of starting therapy was 51 (SD 12) years while the mean duration of disease at the time was 7.6 (SD 8) years. The mean time to referral for SAARD from the general clinic was 2.5 (SD 3) years. The percentage fall in bone mass prior to therapy was 2.51%/day compared to a gain of 0.6%/day after therapy (P less than 0.05). Forty-nine patients were aged over 50 years while 32 were 50 years or younger at the time of study. Comparison showed that in the pretreatment period, the rate of change in CCT and CA% was not significantly dependent age (P less than 0.1). During that therapy, the rate of change in CCT and CA% significantly different in the two age groups. Patients aged over 50 years continued to lose bone, but at a slower rate (P less than 0.05). Patients aged 50 years or less either stopped losing or gained metacarpal bone mass during the study period (P less than 0.005). The time to referral for SAARD and disease duration (comparable in the two age groups) did not have a significant effect on changes in CA% during therapy. Change in bone mass could be predicted by change in disease activity. We conclude that SAARD have a significant sparing effect on metacarpal osteoporosis in RA. This positive effect is masked by the overwhelming influence of age (and menopause) and could be missed. Metacarpal osteoporosis seems a pathophysiologically more useful measure of radiological change in RA than erosions or joint space narrowing.
3264875	Interleukin 1 and rheumatoid arthritis.	1988 Nov	The erosive changes seen in the joint structures of the rheumatoid arthritic patient can be attributed to the consequences of the action of interleukin 1. Mononuclear leukocytes have been much studied as a source of the interleukin 1, while polymorphonuclear leukocytes have been largely ignored. The hypothesis promulgated here is that polymorphonuclear leukocytes are the source of the interleukin 1 in the joint space in amounts to be arthritogenic in the susceptible patient. It is proposed that the role of the mononuclear leukocytes, which are activated in the systemic circulation, is to induce infiltration of polymorphonuclear leukocytes into the joint space.
1749638	Analyzing pain in rheumatoid arthritis patients. Pain coping strategies in patients who ha	1991 Aug	This study used the Coping Strategies Questionnaire (CSQ) to investigate pain coping strategies in 52 rheumatoid arthritis patients who reported having knee pain 1 year or more following knee replacement surgery. Data analysis revealed that, as a group, these patients were active copers in that they reported frequent use of a variety of pain coping strategies. Pain coping strategies were found to be related to measures of pain and adjustment. Patients who rated their ability to control and decrease pain high and who rarely engaged in catastrophizing (i.e., who scored high on the Pain Control and Rational Thinking factor of the CSQ) had much lower levels of pain and psychological disability than patients who did not. Coping strategies were not found to relate to age, gender, obesity status or disability/compensation status. Taken together, these results suggest that an analysis of pain coping strategies may be helpful in understanding pain in arthritis patients who have pain following joint replacement surgery.
2684316	Can oestrogens be used as adjuvant therapy in female patients with rheumatoid arthritis?	1989	In this review the arguments for a relation between female sex hormones and rheumatoid arthritis are discussed. Clinical evidence includes a relation between disease activity and menstrual cycle and a clear decrease in disease activity during pregnancy. A protective effect of oral contraceptives on the development of rheumatoid arthritis is claimed. There are conflicting data with regard to the plasma levels of sex hormones in women with rheumatoid arthritis. In vitro gonadal hormones suppress T-lymphocyte proliferation, while B-lymphocyte differentiation is enhanced by oestrogens and diminished by testosterone. Some pilot studies suggest that oestrogens may ameliorate disease activity in women with active rheumatoid arthritis. Presently we are conducting a randomized, double-blind trial comparing oestrogens with placebo as adjuvant therapy in women with rheumatoid arthritis.
2617877	[Empyema--a rare type of pulmonary disease in rheumatoid arthritis].	1989 Oct	In 52-year old patient with rheumatoid arthritis a massive empyema without development of pyopneumothorax was found. The authors discuss the mechanism of development of the empyema, its type and treatment.
1879083	The role of interleukin 1, erythropoietin and red cell bound immunoglobulins in the anaemi	1991 May	Since interleukin 1 (IL-1) and erythropoietin (Epo) are believed to play a role in the pathogenesis of rheumatoid arthritis (RA) anaemia we measured IL-1 alpha and Epo concentrations in 10 RA patients with chronic disease anaemia (CDA) and in 14 RA patients without anaemia. Anaemic RA patients had significantly higher IL-1 alpha concentrations than patients without anaemia. IL-1 alpha correlated negatively with haemoglobin and correlated positively with ESR. The results of a multivariate analysis showed that the best predictors of the presence and absence of anaemia were IL-1 alpha and ESR. No clinical parameters permitted a distinction between these two groups of patients. Epo levels were not different in anaemic and non-anaemic RA patients. No correlation was found between Hb and Epo, indicating the presence of an impaired Epo response in RA patients with CDA. We completed our study with the determination of the mean red cell lifespan and with the quantification of IgG and IgM bound to the surfaces of red blood cells (RBC-IgG and RBC-IgM) using a sensitive ELISA method. We observed a modest reduction in red cell survival in anaemic RA patients compared to normal controls. We did not find any correlation between Hb and red cell lifespan and between Hb and RBC-IgG. RBC-IgG and RBC-IgM were not found to be more elevated in anaemic RA than in non-anaemic patients.
3387929	The relation of radiographic changes to serum acute-phase proteins and rheumatoid factor i	1988	Radiographic parameters in 200 patients with rheumatoid arthritis (RA) were correlated with laboratory parameters, including hemoglobin (Hb), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), orosomucoid (OROS), immunoglobulin G (IgG), IgM, IgA, and rheumatoid factor (RF). CRP, OROS, and Hb showed a significant association with the severity and progress of radiographic parameters. ESR and WARO showed a significant association with the severity of radiographic parameters in late RA only. IgG, IgM, and IgA did not show any significant correlation with radiographic parameters.
1671630	Effect of parenterally administered gold therapy on the course of adult rheumatoid arthrit	1991 Mar 15	OBJECTIVE: To describe the course of rheumatoid arthritis over 5 years in adults and to evaluate the effect of parenterally administered gold salts on that course. DESIGN: A prospective observational study of adults with rheumatoid arthritis. Data derived from annual interviews with patients from 1983 to 1988 and from physician surveys in 1983 and 1987. SETTING: Rheumatology practices in the community. PATIENTS: The study began in 1982 with 822 adults who had rheumatoid arthritis and were under the care of rheumatologists. INTERVENTIONS: Those selected by rheumatologists in the management of their patients. MEASUREMENTS: Information describing sociodemographic and clinical characteristics, course, and therapy was collected from patients and verified by physician reports. Functional status, measured by the Health Assessment Questionnaire, and the number of painful joints were used as outcome variables. Outcome variables were adjusted for age, sex, disease duration, baseline values of the outcome variable, and the use of four disease-remittive agents other than gold. MAIN RESULTS: Multivariate repeated-measures analysis of variance showed no change in the course of rheumatoid arthritis over 5 years. The use of parenteral gold for at least 2 consecutive years at the start of the observation period produced, on average, no change in the course over 5 years in the two outcome variables. CONCLUSION: In our study of a community-based population of adults with rheumatoid arthritis who were under the care of community rheumatologists, we found that there was, on average, no statistically significant change in function or number of painful joints between 1983 and 1988. Patients receiving parenteral gold therapy for at least 2 consecutive years did not show a statistically significant difference in outcome when compared with those not receiving such therapy.
2701956	Biodynamics of the wrist in rheumatoid arthritis--the enigma of stiffness.	1989	The wrist has been moved rhythmically in the horizontal plane by sinusoidal torques provided by a printed motor. Measurements have been made on normal subjects and subjects with rheumatoid arthritis. Both groups exhibited a resonance, the oscillations being greatest when the applied torque was of certain frequency. In both groups the resonant frequency fell to approximately the same constant value when the torque was raised. While the main relationships were similar a somewhat lower torque resulted in the lowering of resonant frequency in the patients. The relationship between applied torque and peak velocity at resonance was also studied. For a given torque the motion was greater in the patients. No objective signs of increased viscous or elastic stiffness were demonstrable at the wrist in patients with rheumatoid arthritis.
3390970	Immune complexes in sera from patients with rheumatoid vasculitis induce polymorphonuclear	1988 Aug	The ability of sera from 11 patients with rheumatoid arthritis (RA) complicated by leukocytoclastic vasculitis (RV) to induce injury to cultured monolayers of human umbilical vein endothelial cells (HEC) was investigated. Injury was assessed in vitro using assays of cell lysis and cell detachment. Sera from patients with RV produced neither direct injury to HEC monolayers nor indirect injury when cocultured with HEC and normal peripheral blood polymorphonuclear cells (PMN). However, immune complexes (Icx) isolated from these sera induced nonlytic PMN-mediated HEC detachment. The inhibitory effect of serum on PMN-mediated HEC detachment induced by Icx could be attributed both to a different response of PMN to Icx present in serum compared to isolated Icx and to the presence of protease inhibitors in serum. The results of this study show that sera from patients with RV do not contain factors that can injure HEC directly and provide further support for the hypothesis that Icx and PMN play important roles in the pathogenesis of immune vascular injury.
3449303	Disease manifestations of progressive systemic sclerosis: sensitivity and specificity.	1987 Dec	The authors conducted a study of 47 patients with a diagnosis of systemic sclerosis in order to determine the sensitivity, specificity and Youden index and consequently the diagnostic value of the generally accepted criteria and of some other common disease features. The control population consisted of 324 patients with rheumatoid arthritis and 35 patients with systemic lupus erythematosus. In addition to proximal scleroderma, the presence of which was required for inclusion in this study, other disease features score a high to moderate Youden index: sclerodactyly, Raynaud's phenomenon, appearance of perioral grooves, cinematographic evidence of esophageal hypomotility, periarticular calcifications, widening of the periodontal membrane on teeth radiographs and specific histologic changes on fingertip biopsy. Finally, a good correlation was found with most of the ARA subcommittee criteria.
3435565	Circulating hyaluronic acid levels vary with physical activity in healthy subjects and in	1987 Dec	We evaluated the possible influence of physical activity on serum levels of hyaluronic acid (HA), plasma levels of elastase, and serum levels of procollagen III peptide. In 15 healthy individuals, HA increased from 26 +/- 9 micrograms/liter (mean +/- SD) before arising from a night's sleep to 54 +/- 24 micrograms/liter 1 hour after arising and performance of normal morning activities (P less than 0.001). HA in 14 patients who had inflammatory arthritis increased from 124 +/- 104 micrograms/liter to 402 +/- 232 micrograms/liter under the same conditions (P less than 0.001). The elevation due to physical activity was significantly (P less than 0.001) higher in patients with rheumatoid arthritis (RA) than that found in controls. A slight increase of HA in the afternoon was also observed in healthy subjects who performed heavy exercise, but a marked increase was seen in RA patients who performed moderate exercise. In another group of 24 RA patients, a more standardized blood sampling was performed before arising and during normal morning activities. An increase in HA was significantly (P less than 0.001) correlated to the synovitis mass, estimated by the Ritchie articular index. Maximum increases of HA were seen 30 and 60 minutes after arising; thereafter, levels decreased to those measured at rest. During the morning activities, procollagen III peptide remained stable, while plasma elastase tended to increase. It is proposed that HA, produced in the joint tissue structures and accumulated at rest, is carried by the lymph vessels to the general circulation during physical activity.(ABSTRACT TRUNCATED AT 250 WORDS)
2327181	[Soluble interleukin 2 receptor (sIL-2R) in chronic polyarthritis].	1990 Jan	An ELISA was used to measure soluble interleukin-2 receptor (sIL-2R) in the sera and synovial fluid (SF) of patients with rheumatoid arthritis (RA). Patients with seropositive, as well as seronegative RA had raised levels of sIL-2R in serum and SF compared to patients with osteoarthritis and sex-age matched healthy subjects. According to literature, sIL-2R levels in the sera of RA-patients may be a useful marker of disease activity. Increased sIL-2R levels in SF show new aspects in pathophysiology of RA.
2567049	Sulphasalazine versus penicillamine in the treatment of rheumatoid arthritis.	1989	Fifty-four patients with rheumatoid arthritis were randomized to either sulphasalazine or D-penicillamine in order to compare the short- and long-term efficacy of these two agents in the treatment of rheumatoid arthritis. Decisive improvement was observed in both treatment groups over a 1 year period. Side effects were common in both groups and accounted for termination of therapy in 11 patients during the first year. Radiological deterioration was evident in both treatment groups. A trend toward greater radiological deterioration was observed in patients receiving sulphasalazine, but this was not statistically significant. Only 11 of the 38 patients who completed 1 year of therapy were continuing to take the same drug 5 years later. Eight patients were continuing D-penicillamine and three were still taking sulphasalazine. Among the patients who completed 1 year of therapy, treatment was subsequently terminated because of loss of effective disease control in a significantly higher proportion of patients receiving sulphasalazine (P less than 0.01). The radiological data and the latter observations suggest that D-penicillamine may be a more effective agent for long-term treatment.
1814899	Iron status in patients of rheumatoid arthritis with special reference to serum ferritin l	1991 Sep	Thirty patients of rheumatoid arthritis comprising 16 classical and 14 definite cases based on the ARA criteria were evaluated in a prospective and controlled study for iron status with special reference to serum ferritin levels. Serum ferritin levels were estimated by RIA technique and marrow iron status was ascertained by semi-quantitative estimation after Pearl's staining of marrow aspirate (G 0-6). Marrow iron stores were found absent to decreased in 17 patients (56.7%), normal in 2 (6.7%) and increased in 11 patients (36.6%). The serum ferritin levels in the iron depleted rheumatoid arthritis patients were significantly lower in comparison to patients with normal to increased marrow iron stores (23.91 +/- 11.45 ug/L vs 69.94 +/- 24.7 ug/L, p less than 0.001). There was a strong positive correlation between serum ferritin levels and marrow iron stores (r = +0.08, p less than 0.001). A serum ferritin value of less than or equal to 32 ug/L was a good predictor of decreased iron stores in the bone marrow, with a sensitivity of 88.2% and specificity of 84.5%. The test had a predictive value of 83.33%. There was no correlation between marrow iron stores and conventional indicators or iron status i.e. serum iron, TIBC, transferrin saturation and MCHC. It is concluded that serum ferritin correlates well with marrow iron stores and can be used as a simple non-invasive test for predicting iron-deficiency in patients of rheumatoid arthritis.
1805326	[Morphometric evaluation of the microcirculatory bed of the synovial membrane in rheumatoi	1991 Oct	Automatic analysis of the image makes objective assessment of the morphological picture of pathological processes much easier. The authors subjected only vascular changes to such an objective assessment. The picture of rheumatoid synovitis as a whole, i.e. including changes in their layers, nature and extent of infiltration can be subjected to the same analysis. This requires elaboration of more intricate programs or a more complex procedure of the analysis with due regard for all sings reflecting exudative and proliferative processes in all the components of the synovial tissue.
2001978	B27-bearing HLA haplotypes in rheumatoid arthritis: characterization in Finnish patients.	1991 Jan	The frequency of human leukocyte antigen (HLA)-B27 has been found to be increased in rheumatoid arthritis (RA) in Finland and marginally also in some other populations. In the present study HLA-B27-bearing haplotypes in RA patients were found to carry DR1 and DR4 genes more often than do B27 haplotypes in control population. B27;DR4,DW14;DQw7 was a typical B27-DR4 haplotype whereas DR4 in the majority of other haplotypes occurs with Dw4 and DQw8 genes. The result indicates that the B27 association with RA is not independent of DR1 and DR4, but whether the B27;DR4;DQw7 haplotype subjects a person to a higher disease risk than do other DR4 haplotypes, or is associated with a more severe course of the disease, remains to be investigated.