Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 3791752 | Survivorship comparison of THARIES and conventional hip arthroplasty in patients younger t | 1987 Jan | Early and high failure rates for conventional hip replacements in young and active patients are well documented. The hypothesis tested in this study is total hip articular replacement by internal eccentric shells (THARIES) resurfacing hip arthroplasty is a sufficiently durable alternative to conventional total hips in patients younger than 40 years old. Survivorship analysis techniques were applied to 106 THARIES and 98 conventional hip replacements. The primary outcome variable investigated was time to failure, as measured by the need for revision of the prosthesis in the absence of sepsis. Other definitions of prosthesis failure were also investigated. Analysis revealed that even within this young, high-risk population there were subpopulations with different risks for failure. The lowest risk patients comprised all rheumatoid arthritis (RA) and juvenile rheumatoid arthritis (JRA) patients, regardless of age. The intermediate risk patients comprised all non-RA, non-JRA patients older than 30 years of age and the highest-risk patients were all non-RA, non-JRA patients younger than 30 years of age. A comparison of THARIES and conventional prostheses within each of these three subpopulations revealed similar patterns of failure over time, with the conventional total hip replacement having significantly better hip function than the THARIES group only in the highest-risk population, when using a failure definition of revision surgery for aseptic loosening. A broader and more important conclusion was that all acrylic-fixed implants, THARIES or THRs are predicted to undergo early mechanical loosenings in younger-than-30, non-RA, non-JRA patients. In patients younger than 30 years age acrylic fixation of THA is inadvisable. | |
| 2661579 | Surgical treatment of the boutonniere rheumatoid thumb deformity. | 1989 May | The boutonniere deformity is the most common rheumatoid thumb deformity. Its treatment is based on the type or stage of the deformity. We have reviewed our recent cases which are the basis for our current recommendations. MP joint synovectomy and EPL rerouting have a high recurrence rate of 64 per cent. MP joint fusion is the procedure of choice for the moderate type with isolated MP joint involvement. There is a low incidence of later IP joint collapse. MP joint arthroplasty is best suited for the low-demand, older patient with borderline proximal and distal joints. IP joint releases have a high degree of recurrence and are not recommended. In a low-demand patient with an advanced thumb, MP joint arthroplasty and IP joint fusion are the procedures of choice. | |
| 2761749 | [Connectivitis and diseases of the digestive system]. | 1989 Apr | Gastroenteric changes in patients suffering from connectivitis observed consecutively between 1977 and 1986 have been examined: of the 24 patients (20 f, 4 m) aged between 13 and 76 yrs observed, 12 suffered from rheumatoid arthritis, 8 systemic lupus erythematosus, 2 sclerodermia, 2 mixed connectivitis. 14 reported gastroenteric disturbances, particularly dyspepsia, rarely dysphagia, diarrhoea, melena. Gastroenteric lesions, gastroesophageal reflux, erosive oesophagitis, oesophageal diverticulum, congestive gastritis, duodenitis, duodenal ulcer, diverticular colonopathy were observed, confirming the frequency of gastroenteric changes in connectivitis. | |
| 2355094 | Serum antibodies and loss of periodontal bone in patients with rheumatoid arthritis. | 1990 May | The number of teeth, % of alveolar bone loss, serum IgG, and serum antibodies to Bacteroides gingivalis, Capnocytophaga ochracea and Eubacterium saburreum were recorded in 37 patients diagnosed with rheumatoid arthritis (RA) and in an age- and sex-matched control group of 37 individuals free from RA. The RA group had a significantly increased loss of teeth and loss of alveolar bone compared to the control group. The RA patients also had a significantly increased level of serum IgG. In the total material, 26% of the variation in loss of alveolar bone was accounted for by age, diagnosis of rheumatoid arthritis, and levels of antibodies against B. gingivalis and E. saburreum. In the RA group, 48% of this variation was accounted for by age, total serum IgG and IgG antibodies to B. gingivalis and E. saburreum. | |
| 3026034 | Increased collagenase activity in human rheumatoid meniscus. | 1986 | Collagenase activity of the knee joint menisci of patients suffering from rheumatoid arthritis was approximately 3-fold higher than that found in menisci of control patients. The mean collagenase activity in the macroscopically more diseased parts of the rheumatoid menisci was significantly higher than that in the less damaged areas. The specific degradation products resulting from the cleavage of human meniscoid type II collagen by rheumatoid meniscoid collagenase were demonstrated by SDS-polyacrylamide gel electrophoresis. Addition of N-ethylmaleimide, which activates latent mammalian collagenases, did not further increase collagenase activity in rheumatoid menisci. Thus in rheumatoid meniscus, collagenase may be synthesized and then activated, probably by proteolytic enzymes involved in the inflammatory reaction. | |
| 2827401 | Superoxide anion production by monocytes and synovial fluid macrophages of patients with c | 1987 Sep | Peripheral blood monocytes (PBMo) and synovial fluid macrophages (SFMO) of patients with rheumatoid arthritis (RA), HLA B27-positive reactive oligoarthritis and controls were investigated for their capacity to generate superoxide anions (O2-) upon stimulation with phorbolmyristoacetate (PMA) in a cytochrome c (cyt c) microassay. PBMo of RA patients, patients with reactive arthritis and controls did not reveal any significant differences and also treatment of RA patients with gold salts or immunosuppressive therapy had no effect on the oxidative burst in PBMo. In contrast, in SFMO of RA patients treated only with nonsteroidal anti-inflammatory drugs (NSAID) we found significantly enhanced O2- release, compared with PBMo of the same group. Treatment with gold salts had no effect on this enhanced oxidative response, whereas immunosuppressive therapy with azathioprin or corticosteroids significantly reduced the O2- release of SFMO. In patients suffering from reactive arthritis we did not find significant differences between SFMO and PBMo. The O2- release of SFMO of this group was significantly reduced, when compared to that of SFMO of RA patients, treated with NSAID. These results indicated that SFMO but not PBMo in RA in cyt c microassay produce increased levels of activated oxygen species. In comparison to PBMo, SFMO of patients suffering from reactive arthritis do not show such an increased oxidative burst. These findings suggest that in RA, activated oxygen species have a local destructive effect in inflamed joints. This seems to be caused by activation of catalytic enzymes and complement components, as well as induction of release of interleukins or prostaglandins, contributing to the augmentation of the chronic inflammatory process. | |
| 1996303 | Comparison of complications of total hip arthroplasty in rheumatoid arthritis, ankylosing | 1991 Jan | Between 1971 and 1985, 3080 arthroplasties were performed. The authors analyze patients reoperated because of primary surgery complications. Of the primary arthroplasties (2889), there were 1788 operations performed for primary osteoarthritis, and 379 hip replacements for rheumatoid arthritis, ankylosing spondylitis, and systemic lupus erythematosus (SLE). Reoperation rates in both groups were the same (3.4%). In the group with rheumatoid arthritis, the rate was 1.45%, much lower than the osteoarthritic group. | |
| 2279437 | [Surgery of rheumatoid polyarthritis of the upper limb in adults. Review of current data]. | 1990 | In a surgical population of adult patients with incipient rheumatoid arthritis, most often women aged 40 to 50 years, the various clinical pictures are difficult to outline, but they include: dominant involvement of the lower limbs, acroarthritis with essentially distal lesions of the wrists, hands and feet, and rheumatoid arthritis with multiple joint involvement, requiring multiple surgery in the upper and lower limbs. The involvement of the upper limb follows Eiken's phases of evolution, which must be studied along with Larsen's stages in order to accurately define the indications for treatment. Synovectomy is indicated at Larsen's stages II and III, but if instability is already noted, isolates synovectomy, whether chemical or surgical, is not to be used. It is essential to associate surgical synovectomy with a procedure aimed at realigning and stabilizing the joints, especially in the wrists and the fingers. Synovectomy, realignment and stabilization make up 75% of the current surgery of the rheumatoid wrist. At Larsen's stages IV and V, the extent of osteoarticular destruction makes either arthrodesis or arthroplasty necessary. The indications depend on the location of the lesions, and arthrodesis produces excellent results on the metacarpophalangeal joint of the thumb, the distal interphalangeal joints and the wrist. On the other hand, arthroplasty is indicated for the other joints, the mobility of which must be preserved, even more so as the over- and underlying joints are most often affected. | |
| 3579536 | Isokinetic and isometric testing of knee musculature in patients with rheumatoid arthritis | 1987 May | This study sought to determine if weakness and poor endurance of quadriceps and hamstring muscles are present in rheumatoid arthritis (RA) patients with minimally involved knees; determine if there is an abnormal hamstring/quadriceps ratio or abnormal torque curves in RA patients; and begin to evaluate the feasibility of isokinetic (IK) exercise in RA patients. Sixteen RA patients with minimally involved knees and 16 matched control subjects were tested bilaterally with a Cybex II dynamometer. Torque values in the RA group were significantly less (78% for isokinetic and 81% for isometric). The hamstring/quadriceps torque ratio was significantly higher in the RA patients than in the controls: 66.8% vs 61.7%. There was no significant difference in endurance between the two groups. In the RA patients the angle at which peak torque occurred shifted later in the range of motion (37.4 degrees) compared with the control subjects (28.7 degrees). Except for IK torque of hamstring muscles in the control group, there was no significant difference in the torque values between the right and left sides in RA patients or control subjects. The findings suggested that even in RA patients with minimally involved joints, muscle weakness was present; exercise of quadriceps should be emphasized since in RA patients quadriceps were weaker than hamstrings; and isokinetic testing is feasible in selected patients with RA. | |
| 3629220 | General practitioner assistance with gold and penicillamine therapy of rheumatoid arthriti | 1987 Jun | One hundred patients with active rheumatoid arthritis, uncontrolled by symptom relieving agents, were allocated randomly to intramuscular gold or oral penicillamine therapy. Their general practitioners (97 in all) were requested to assist with blood, urine, skin and mucous membrane monitoring. After four years, 16 patients in each treatment group remained on their original therapy, and three-quarters of these continued attending their family doctor for toxicity monitoring. Most GP monitoring problems occurred in the first six months of treatment. Sustained improvement in haemoglobin and ESR was seen in both treatment groups. Second-line drug toxicity monitoring by general practitioners allows specialist time to be diverted to rheumatological problem solving but may make it more difficult to relate rare but serious adverse adverse events to drug therapy. | |
| 1690755 | Disease-associated human histocompatibility leukocyte antigen determinants in patients wit | 1990 Apr | The susceptibility to develop seropositive rheumatoid arthritis (RA) has been linked to specific genomic polymorphisms within the HLA complex. Two different haplotypes have been associated with the disease, HLA-DR1 and HLA-DR4. To investigate the link between such phenotypic disease associations and potential immune mechanisms we used alloreactive and antigen-specific human T cell clones. Here we describe a panel of alloreactive T cell clones directed to polymorphic determinants encoded by the third hypervariable region (hvr) of the HLA-DR beta 1-chain. T cell determinants defined by these clones are shared among HLA-DR1, HLA-Dw4, HLA-Dw13, HLA-Dw14, and HLA-Dw15, and are frequent in a population of RA patients. To study the role of such disease-associated epitopes in antigen-restricted T cell recognition we generated T cell clones from RA patients specific for mycobacterial antigens, Epstein-Barr virus antigens, and tetanus toxoid. In all three antigenic systems T cell clones were restricted to either HLA-DR1 or HLA-DR4. These data suggest that the polymorphisms within the first and second hvr of the HLA-DR beta 1-chain that are distinct in HLA-DR1 and HLA-DR4 and not associated with the disease are crucially involved in the recognition of antigens. Polymorphic determinants encoded by the third hvr are shared among disease-associated haplotypes and may function to mediate the interaction of alloreactive T cell receptor molecules with the HLA complex. | |
| 1722347 | Neuropeptides in temporomandibular joints with rheumatoid arthritis: a clinical study. | 1991 Dec | There is evidence that neuropeptides play a role in the development of arthritis. Synovial fluid from arthritic temporomandibular joints in patients with rheumatoid arthritis was therefore investigated for presence of the neuropeptides calcitonin gene-related peptide, substance P, neurokinin A and neuropeptide Y. All four peptides were found in the synovial fluid above plasma level, but calcitonin gene-related peptide showed the highest concentration and substance P the lowest. | |
| 3401646 | Abnormal mitochondria in cultured synovial fibroblasts in rheumatoid and reactive arthriti | 1988 | This paper summarizes our recent studies on synovial fibroblast cultures started from patients with rheumatoid or reactive arthritis and from healthy controls. Analysis of these cultures by flow cytometry, spectroscopy and electron microscopy revealed consistent differences between arthritic and normal fibroblasts. Increased autofluorescence, exceptional light scatter properties, rhodamine-123 staining and electron microscopic findings of fibroblasts from arthritis patients suggest involvement of mitochondria in the disease process. Conditioned media of activated monocytes induced in the mitochondria of normal synovial fibroblasts changes similar to those observed in the fibroblasts originating from patients with rheumatoid or reactive arthritis. | |
| 3816093 | Isokinetic and isometric muscle strength in patients with rheumatoid arthritis. The relati | 1986 Dec | The isometric and isokinetic muscle strength of the legs in forty-six women with rheumatoid arthritis was measured using a Cybex II dynamometer. Twenty-six of the patients had been treated with corticosteroid - prednisone - some for several years (mean 8 years, range 1-35). Twenty-three healthy age-matched women served as a comparable group (controls). In patients treated with prednisone the mean maximal isokinetic muscle strength of the knee extensors was between 64 +/- 26 Nm (SD) and 43 +/- 18 Nm (SD) at the preset angular velocities 30 degrees/s and 180 degrees/s, respectively, which was a reduction to 54%-55% of that found in controls (p less than 0.001). In patients who had not received prednisone the mean maximal isokinetic strength was between 99 +/- 39 Nm (SD) and 67 +/- 27 Nm (SD) which was a reduction to 84%-86% of that found in controls (p less than 0.05). The force velocity curve showed a parallel decrease in maximal strength with increasing velocity when comparing patients with rheumatoid arthritis to controls. Also on measuring the isokinetic muscle strength of plantar flexors a significantly lower mean maximal torque was found in patients treated with prednisone, (33 +/- 21 Nm (SD) (p less than 0.01] as compared with a control group (50 +/- 28 Nm (SD]. The patients who had not been treated with prednisone showed a lower, but not significantly lower isokinetic strength of the plantar flexors, 46 +/- 22 Nm (SD) at a corresponding angular velocity, 30 degrees/s.(ABSTRACT TRUNCATED AT 250 WORDS) | |
| 2529832 | Association between gold induced skin rash and remission in patients with rheumatoid arthr | 1989 Sep | The coincidence of skin eruption and remission induced by gold has not previously been reported. In 50 out of 247 patients with rheumatoid arthritis treated with gold salts (Solganal) between 1977 and 1987 treatment was stopped owing to adverse reactions. Skin rashes were present in 31 patients, 10 had nephropathy, and nine patients had aphthous stomatitis. All 31 patients who developed skin eruption entered a concomitant clinical and laboratory remission. The remission satisfied the American Rheumatism Association preliminary criteria and was accompanied by a significant decrease of mean erythrocyte sedimentation rate from 43 (SD 13) to 25 (11) mm/h. Disease was exacerbated in 23 patients after three to 60 months. Eight patients are in remission at present, five to 68 months after gold treatment was discontinued. In contrast, no remission was noticed among the 19 patients with nephropathy or stomatitis. | |
| 2285751 | Pain management in the older adult with rheumatoid arthritis or osteoarthritis. | 1990 Sep | The study's major purpose was to explore the pain management of the older adult with rheumatic disease. Medication, rest, heat, distraction, exercise, and talking with others were methods most often used by older adults (n = 31). Methods identified by them as most helpful included medication, rest, and heat. When the pain management techniques of those adults 65 and over were compared with those of younger adults (n = 51), several differences were noted. The combined number of methods used by the younger group was significantly greater, and they rated relaxation techniques as being significantly more helpful. Increasing the elderly arthritis patient's repertoire of pain management modalities and measuring the ongoing individual effectiveness of the individual and combined methods used are identified as needs to be addressed in improving pain management. | |
| 3718010 | Long term progression of joint damage in rheumatoid arthritis. | 1986 May | Joint damage in rheumatoid arthritis is assessed radiologically. Previous studies have not examined in detail its long term progression. We evaluated the overall changes of peripheral joint damage radiologically in 50 rheumatoid patients followed up at one rheumatology centre for 10 years. All peripheral joints were scored in 12 groups with Larsen's standard films at 0 and 10 years. In 48 cases the total scored deteriorated (mean increase 13% maximum damage). There was no different pattern of progression in any of the patients, though seropositive patients had more initial damage and a greater rate of progress. The wrist and small joints of the feet were most affected initially. During the 10 years most progression occurred in the wrist, knee, and metacarpophalangeal joints. Progression occurred in both initially normal and abnormal joints. By 10 years only 16.5% joint groups showed no damage. Complete destruction was most common in the wrist, knee, and small joints of the feet. Damage to the hands and wrists have a god indication of overall changes at 0 and 10 years and also the increase in damage (correlation coefficients were from r = 0.74 to r = 0.85). These results show that specific joints are involved in different stages of the disease. Some joints are frequently involved and some less often. The hands and the wrists give a reasonable picture of the overall progression of damage. | |
| 2313679 | Coexistence of rheumatoid arthritis and a monoclonal CD4 T cell lymphoproliferative disord | 1990 Jan | A 33-year-old man developed seropositive rheumatoid arthritis (RA) followed soon after by a monoclonal lymphoproliferative disorder characterized by CD4 positive T lymphocytes in his peripheral blood, bone marrow and lymph nodes. Previous reports of polyarthritis in association with a T cell lymphoproliferative disorder have all involved the CD8 phenotype. | |
| 2009682 | Current medicinal approaches to the treatment of rheumatoid arthritis. | 1991 Apr | Aspirin, nonacetylated salicylates, and numerous other nonsteroidal antiinflammatory drugs (NSAIDs) are used in rheumatoid arthritis (RA) patients to decrease joint inflammation and improve function. The choice of medication and its optimum dosage must be individualized because of marked intersubject variations in drug metabolism, excretion, antiinflammatory and analgesic efficacy, and susceptibility to adverse effects. Equivalent doses of aspirin and of nonacetylated salicylates are equally antiinflammatory in RA, although the nonacetylated salicylate is a poor inhibitor of prostaglandin synthesis. Chronopharmacology studies suggest that many patients may have better efficacy and fewer side effects with evening doses than with morning doses of certain NSAIDs; however, the optimum time must be individualized by trial and error because some patients do better with other regimens. The gastric, renal, and platelet adverse effects of NSAIDs are related to their inhibition of prostaglandin synthesis, and tend to be related to dose and intensity of therapy. Various strategies can minimize the impact of these side effects, such as coadministration of gastric protectants or the use of short half-life NSAIDs to decrease the duration of preoperative NSAID withdrawal needed to ensure adequate platelet coagulation during surgery. An intramuscular analgesic NSAID is now available and is reported to be equivalent to morphine sulfate in some painful postsurgical conditions. Although associated with many problems, chronic corticosteroid therapy is, or has been, a major therapeutic component for many RA patients who consequently are unable to respond adequately to the stresses of general anesthesia and surgery because of complete or partial adrenal insufficiency. These patients must be given appropriate supplemental corticosteroid therapy perioperatively. | |
| 2710084 | [Joint and functional changes in the masticatory system in chronic rheumatoid arthritis in | 1989 Feb | A clinical and radiological study has been carried out to highlight signs and symptoms of mandibular dysfunction in a sample of 66 adult patients suffering from chronic rheumatoid arthritis. Data were quantified on the basis of Helkimo indices. Prevalence proved significantly high, particularly as regards joint crepitus, reduced mandibular mobility, pain in the masticatory muscles and macroglossia. It did not seem to be linked to age. Rather it presented a definite predominance of the female sex, confirmed by comparison with a sample of nonrheumatic controls. Contemporaneous X-ray examination showed a bilateral location, in many cases remodelling and reabsorption of the condyle, an increase in the articular space and erosion of the fossa, at times reduction in the space and sclerosis, dependent on a superimposed degenerative arthrosis (usually more painful). Generally speaking, however, there was a coincidence between severity of clinical dysfunction and seriousness of the morphological lesions whereas subjective symptoms were relatively independent. The need for polyspecialistic cooperation and a multidisciplinary therapeutic approach is reiterated. |