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PMID	Title	PublicationDate	abstract
2652938	[Topical use of salicylic acid esters in pharmacotherapy--pharmacologic principles].	1989 Jan	The local application of 2-hydroxyethyl salicylic acid esters and ether salicylic acid esters offers the possibility of therapy with salicylic acid that avoids a systemic burden of the body. This justifies the unavoidable uptake of ethylene glycol. Under therapeutic conditions and following guidelines for the recommended amount and frequency of application, the amount of ethylene glycol taken into the organism appears to be without risk for the user.
1943031	Non-Lyme disease.	1991 Aug	Four syndromes of non-Lyme disease are described on the basis of the history and serologic test result. Recognition of non-Lyme disease enables the physician to avoid unnecessary treatment and to keep considering the possibility of alternative diagnoses.
1899408	Do non-steroidal anti-inflammatory drugs increase colonic permeability?	1991 Jan	Urinary excretion of orally administered lactulose and 51 chromium labelled ethylenediamine tetra-acetate (51Cr-EDTA) was measured in 12 healthy adult subjects and in six patients with ileostomies to assess intestinal permeability. In normal subjects, 24 hour urinary recovery of 51Cr-EDTA was significantly greater than that of lactulose (mean (SEM) 2.27 (0.15) v 0.50 (0.08)% oral dose; p less than 0.001), but in ileostomy patients recovery of the two markers was the same. In normal subjects, therefore, the difference between the two markers may arise from bacterial break-down of lactulose but not of 51Cr-EDTA in the distal bowel, urinary excretion of lactulose representing small intestinal permeation and that of 51Cr-EDTA representing both small and large intestinal permeation. The markers were then given simultaneously to nine patients receiving non-steroidal anti-inflammatory drugs (NSAIDs) for rheumatoid arthritis and osteoarthritis. The 24 hour urinary recovery of 51Cr-EDTA in the patients was significantly greater than normal (4.64 (1.20) v 2.27 (0.15)% oral dose; p less than 0.01), but that of lactulose was not significantly affected. Moreover, the increase in 51Cr-EDTA recovery was most noticeable in the later urine collections. Both of these findings suggest that NSAIDs may increase colonic permeability.
3729074	Acute congestive heart failure due to the arteritis of rheumatoid arthritis: early diagnos	1986 Jun	A 49-year-old man with rheumatoid arthritis presented with acute congestive heart failure. Acute viral myocarditis was suspected clinically as a Gallium-67 myocardial scan was positive. Percutaneous catheter-directed biopsy of the right ventricular endomyocardium, however, revealed heavy endothelial deposits of IgM in the small blood vessels of the myocardium. Prednisone therapy resulted in normalization of both the myocardial Gallium-67 scan and left ventricular ejection fraction with resolution of the symptoms of congestive heart failure. This is the first report documenting rheumatoid arteritis antemortem by myocardial biopsy.
3359945	Synovial fluid and plasma kinetics of repeat dose sustained action tiaprofenic acid in pat	1988	Tiaprofenic acid is a potent non-steroidal anti-inflammatory drug which, in conventional tablet form, has been shown to be rapidly absorbed and eliminated from the plasma, while synovial fluid concentrations remain constant for at least 8 hours. Recently, a sustained action formulation of tiaprofenic acid has been developed to provide the patient with the convenience of a once daily dosage. The purpose of this study was to measure plasma and synovial fluid concentrations over a 24-hour period following repeated administration of the sustained action formulation, and thus determine the pharmacokinetic profile. Eight patients suffering from rheumatoid arthritis were included in this open study (of whom 3 were subsequently excluded from the analysis). All were hospital outpatients requiring aspiration of the knee joint. The patients received sustained action tiaprofenic acid in a dosage of 600 mg once daily for a period of 7 days. Plasma and synovial fluid samples were taken on the final treatment day at 0, 4, 8, 12, and 18 hours following administration of the last treatment dose. Areas under the concentration-time curves, maximum plasma and synovial fluid concentrations, times to maximum concentration, and apparent elimination half-lives are presented and the findings compared and discussed. The drug was found to be retained in both the plasma and synovial fluid over a 24-hour period. Synovial fluid concentrations exceeded plasma concentrations at 24 hours in 4 of the 5 patients who were analysed, while in the fifth patient the levels were very similar.
3371623	Concordant occurrence of gastric and hypertensive diseases.	1988 Jul	Epidemiologic evidence shows a strong relationship between gastric cancer and cerebrovascular disease. It was speculated that salt intake might be the linking factor causing hypertension and vascular damage as well as damage to the gastric mucosa. This study tested whether hypertensive diseases, such as ischemic heart disease and cerebrovascular disease, occurred more frequently in patients with gastric cancer and gastric ulcer than expected by chance alone. In addition, it was studied whether gastric and duodenal ulcer coincided more frequently with other diseases that in the past have been associated with peptic ulcer, such as liver cirrhosis, chronic lung disease, and rheumatoid arthritis. The German statistics of rehabilitation were used to assess the frequency of coincidences. The statistics include a description of the primary, secondary, and tertiary diagnoses leading to rehabilitation. This study confirms the presence of a high coincidence of both ulcer types with liver cirrhosis. In patients with rheumatoid arthritis, both ulcer types also occurred more frequently than expected from their general distribution. Gastric but not duodenal ulcer coincided more frequently with ischemic heart disease than expected. Gastric cancer occurred more frequently in patients who had concomitant ischemic heart disease or cerebrovascular disease. Duodenal ulcer was not associated with an increased risk for any disease related to hypertension. The results of the study support the contention that gastric diseases and diseases related to hypertension share a common etiologic factor.
3518431	International experience with diclofenac in rheumatoid arthritis.	1986 Apr 28	Rheumatoid arthritis, although not the most common of the rheumatic diseases, is potentially the most disabling. For this reason, it is considered the principal disorder for determining the therapeutic effectiveness of any new antirheumatic agent. Diclofenac sodium, a nonsteroidal anti-inflammatory drug, has been studied extensively in international clinical trials since the early 1970s. It has proved to be at least equal in efficacy to other nonsteroidal anti-inflammatory drugs. In addition, its superior safety profile suggests that diclofenac will be a valuable agent in the treatment of rheumatoid arthritis, for which long-term drug therapy is usually required.
2752611	Cast immobilization after total elbow arthroplasty. A safe cost-effective method of initia	1989 Aug	Seventeen nonconstrained total elbow replacements were inserted in 12 patients. One patient died prior to the one-year follow-up examination, and two others required revision in the immediate postoperative period. The remaining 14 primary total elbow arthroplasties in 11 patients were included in this study. There were eight women and three men with an average age of 58.1 years. The diagnosis was rheumatoid arthritis in 12 patients and posttraumatic arthritis and juvenile rheumatoid arthritis each in one patient. Postoperatively, patients were immobilized in a long arm cast. The mean hospital stay was 4.3 days. At four weeks, the patients were seen for cast removal. Instructions were given for range of motion (ROM) exercises and patients were encouraged to resume normal daily activities as tolerated. No formal physical therapy was prescribed. The average follow-up period was 32 months. Preoperatively, the mean elbow motions were flexion 124 degrees, extension 34 degrees, pronation 65 degrees, and supination 44 degrees. At the last follow-up examination, ROM had improved significantly in all directions except extension (flexion 141 degrees, extension 36 degrees, pronation 77 degrees, and supination 61 degrees). There was one ulnar nerve palsy that only partially resolved. Another patient's elbow had initially subluxed due to excessive shortening of the humerus; however, he had an excellent ROM and was asymptomatic at 31 months. There were no dislocations or wound healing problems. Cast immobilization provides an effective means of promoting soft-tissue healing, permitting early discharge from the hospital and simplifying the postoperative rehabilitation while achieving satisfactory ROM without formal physical therapy.
2805483	A prospective study of forefoot arthroplasty.	1989 Nov	The Kates et al. metatarsal head resection arthroplasty has been modified and evaluated clinically and objectively using a dynamic pedobarograph in 35 adult rheumatoid arthritis patients. Preoperatively, all patients complained of severe forefoot pain, but only 70% recorded abnormal plantar pressure measurements. After a mean follow-up time of 36 months, 91% of the patients were satisfied with the result following surgery. Forty-two feet were pain-free, 16 feet still painful but less than preoperatively, and two feet worse. Thirteen of the 18 painful feet recorded abnormal pressure, but 16 additional feet with normal pressures were symptomatic. The clinical and pedobarographic results show that, in the majority of patients, the Kates et al. forefoot arthroplasty relieves pain, improves mobility, effectively decreases high abnormal plantar pressures, and should be considered when conservative methods of treatment have failed.
3518031	[Penicillamine in 1985].	1986 Jan	After reviewing the history of the discovery of the action of D-penicillamine in rheumatoid arthritis, the authors define the practical modalities for the management of treatment based on their own experience and on the data from the literature. The therapeutic score remains relatively low because of the frequency of side effects and therapeutic escapes, even when an encouraging result has been obtained during the first years of treatment.
1706003	Immunolocalization of endothelial and leukocyte adhesion molecules in human rheumatoid and	1991 Mar	Leukocyte adhesion to endothelium plays an important role in the development and perpetuation of chronic inflammatory diseases such as rheumatoid arthritis (RA). In order to help define the role of adhesion molecules in arthritic disorders, we have studied the expression of CD11c, endothelial leukocyte adhesion molecule-1 (ELAM-1), vascular cell adhesion molecule-1 (VCAM-1), and intercellular adhesion molecule-1 in synovial tissues from patients with RA and osteoarthritis (OA) by immunohistochemistry. CD11c is expressed predominantly on macrophages deep within RA and OA synovial tissues, as well as on some synovial tissue lining cells. ELAM-1 has endothelial reactivity, being present mainly on venules and capillaries and staining more blood vessels in RA than OA. VCAM-1 is present predominantly on synovial tissue macrophages and, to a lesser degree, on synovial tissue endothelial cells of venules, capillaries, and arterioles in both RA and OA. Like ELAM-1, VCAM-1 appears to be present more often on endothelial cells in RA than in OA tissues. VCAM-1 is present on macrophages isolated from RA synovium as well as macrophages in situ. Intercellular adhesion molecule-1 is more broadly distributed than the other adhesion molecules, being found on endothelium, macrophages, some fibroblasts, and some lymphocytes in both RA and OA tissues. This study shows that ELAM-1, a molecule that was previously thought to be important mainly in acute inflammatory reactions, is also found in RA, a chronic inflammatory disease, as well as in OA. Thus, ELAM-1 as well as VCAM-1 and intercellular adhesion molecule-1 may be involved in mediating the leukocyte traffic into RA and OA synovium.
2011714	Clinical reliability of shoulder function assessment in patients with rheumatoid arthritis	1991	A model for functional assessment and a dynamic test of the shoulder joint were designed and tested for normal variation and clinical inter- and intra-rater reliability. The functional assessments, which covered four common shoulder functions, were compared with assessments of pain, recordings of active motion range and the results of a Health Assessment Questionnaire, in eight patients with rheumatoid arthritis according to the ARA criteria. Intra-rater reliability was satisfactory for all four functions and inter-rater reliability was satisfactory for the hand-raising and hand-to-opposite-shoulder functions but less so for hand-behind-back and hand-to-neck. A second test-retest study in 15 patients, with a slight modification of one of the functional tests, confirmed the results and improved the reliability of the modified test. The reliability of the dynamic test and of the active motion range measurement was less satisfactory or not satisfactory. No significant correlation was found between shoulder functional assessment and the Fries index, but there were positive significant correlations between active motion range and shoulder functions. It is concluded that the method presented for evaluating shoulder functions has satisfactory reliability and in the first test-retest study was more reliable than conventional motion range measurement of the shoulder joint.
1947294	Nuclear medicine techniques in arthritis.	1991 Aug	An historical review of radionuclide applications to the assessment of synovitis is presented. Contemporary radiopharmaceuticals are grouped into vascular, bone, and inflammatory markers, and their clinical utility and efficacy in disclosing peripheral synovitis and osteoarthritis are surveyed. There is focus on the debate over the usefulness of quantitative sacroiliac joint measurements for screening sacroiliitis, the significance of the negative peripheral joint scan in patients presenting with polyarthralgia, and the suitability of the joint scan to monitor the response to medical treatment objectively.
2595343	Tenoxicam milk formulation in the treatment of rheumatic conditions.	1989	Tenoxicam milk formulation is a new galenical form of a non-steroidal anti-inflammatory drug (NSAID). It is especially suitable for patients having compliance problems or difficulty in swallowing tablets. This formulation has proved to be a useful alternative oral treatment in various rheumatic conditions. Combining rapid onset of action and maintenance of active plasma levels, tenoxicam achieved good clinical efficacy and tolerability in the vast majority of the patients studied.
3685911	Serum aluminium concentrations in patients with rheumatoid arthritis.	1987	Aluminium (AlS) and zinc (ZnS) concentrations in serum were measured in patients with rheumatoid arthritis (RA) with and without Al-containing drugs and compared with levels in healthy controls. In RA patients without Al-containing antacids, the AlS levels did not differ from those of the healthy controls (mean 9.9, SEM 0.9 microgram/l and mean 8.6, SEM 0.5 microgram/l). However, the AlS levels in RA patients treated with Al-containing drugs were significantly (p less than 0.05) higher than in the other two groups (mean 14.1, SEM 1.1 microgram/l). Serum zinc (ZnS) levels in both RA groups were significantly (0.01 less than p less than 0.025) lower than in the healthy controls (mean 10.5, SEM 0.4 mumol/l and mean 10.2, SEM 0.4 mumol/l for the RA groups with and without Al-containing drugs, and in healthy volunteers mean 14.4, SEM 0.6 mumol/l). The difference in AlS levels might be due not only to the intestinal absorption of Al from Al-containing drugs, but also to a slightly impaired renal function, serum creatinine being slightly but significantly higher (p less than 0.05) in the Al-treated RA group than in non-Al-treated one. This difference in serum creatinine between the two RA groups might be explained by the more frequent use of cimetidine in the Al-treated RA group.
3088186	[An immunochemical study of extracts from synovial fluid cells in rheumatoid arthritis].	1986 Mar	Extracts were obtained by ultrasonic vibration from synovial fluid cells of patients with rheumatoid arthritis and rabbit antisera against the extracts were prepared. The antisera were absorbed with normal human plasma. Double immunodiffusion revealed two precipitin lines between the extracts and the antisera. These antigens were called P1 and P2. P1 and P2 antigens were detected in 17 (94%) and 10 (56%), respectively, out of 18 rheumatoid synovial fluids. In osteoarthritic fluids, P1 antigen was detected in only one (4%) of 25 cases but P2 antigen was never detected. The P1 antigen was not inactivated by trypsin or deoxyribonuclease but P2 antigen was digested by trypsin suggesting its protein character. Though it is not clear that these antigens are specific for rheumatoid arthritis, these antigens in synovial fluid cells seem to be associated with the rheumatoid synovial fluid.
2271983	[Is there a role for parasites in the etiology of inflammatory rheumatism?].	1990 Jun	Parasitic rheumatism is a rare condition characterized by inflammatory joint manifestations due to a parasitic infestation without parasites into joint cavity, (but, with circulating immune complexes, in serum, and synovial fluid; and with immunoglobulins and complement deposits in synovium in some cases reported in the literature). The number of parasites (now 15) which can induce such an arthritis by immune mechanisms is steadily increasing. In all, but few cases of parasitic rheumatism, usual parasitic manifestations (diarrhea, abdominal pain, nausea...) are mild or absent; but, if present, they are a very good criteria to evoke the diagnosis. Clinical pictures of arthritis induced by parasitic infestation are very polymorphic, and non specific of the involved parasite; they seem to depend on genetic predisposition: the symptoms are monoarticular, pauciarticular, or polyarticular, involving small, medium, and or large joints. They can mimic the clinical picture of different inflammatory rheumatic diseases. The most striking feature of parasitic rheumatism is the failure of antirheumatic agents (especially non steroidal anti-inflammatory agents), contrasting with the dramatic efficacy of specific anti-parasitic treatment. The proof of the responsibility of parasitic infestation by indirect mechanism is given by an exceptional case report of a patient with arthritis, dramatically cured after removal of larvae from Anisakiasis gastric granuloma. To explain the uncommon occurrence of this variety of reactive arthritis, due to parasitic infestation, despite the high prevalence of parasitic infestation in the world, hypothesis of genetic predisposition seems valuable. Among 34 well documented reported cases of parasitic rheumatism in the literature, HLA B 27 antigen has been researched in 13; out of these 13, HLA B 27 is absent in 9; in 7 out of these 9, clinical picture is symmetrical polyarthritis. Out of the 13 cases, HLA B 27 is present in 4: In all these 4 cases, clinical picture is asymmetrical pauciarthritis, mimicking arthritis of Reiter's disease.
2224955	Effects of human recombinant IL-1 beta on rheumatoid and non rheumatoid human synovial cel	1990	The growth of adherent synovial cells passaged once was studied in response to human recombinant interleukin 1 (hr IL-1) beta. Human synovial cell cultures were established from tissues obtained during therapeutic joint surgery for patients with rheumatoid arthritis (rheumatoid synovial cells, RSC) or non inflammatory rheumatic diseases (non rheumatoid synovial cells, NRSC). The effect of IL-1 beta (0.1 to 10 ng/ml) on the time course of proliferation showed that values for DNA synthesis and cell numbers in RSC cultures were higher than in NRSC cultures. Similarly, untreated control RSC cultures grew more quickly than NRSC. These results demonstrate that RSC, which are continuously stimulated by IL-1 beta produced in the rheumatoid pannus in vivo, have a higher capacity for proliferation than NRSC but are less responsive to IL-1 beta. A dose-response curve of proliferation was established 72 hrs. after the addition of IL-1 to the medium. The stimulating effect of IL-1 beta (0.001 to 10 ng/ml) was dose-dependent in both RSC and NRSC and reached a plateau at 10 ng/ml; the response of NRSC was stronger than that of RCS.
2374042	Early morbidity after total hip replacement: rheumatoid arthritis versus osteoarthritis.	1990 Jul	The authors used the California Health Facilities Discharge data for 1984 and 1985 to compare retrospectively in-hospital morbidity and mortality of all 721 patients with rheumatoid arthritis versus all 8,859 patients with osteoarthritis who underwent a non-emergent, first-time, unilateral total hip arthroplasty. The lengths of hospitalization, in-hospital mortality rates, and incidences of postoperative complications were similar in the two groups except for higher rates of wound infection and wound dehiscence in the patients with rheumatoid arthritis and a higher rate of thromboembolic events in the osteoarthritis group. The short-term outcome of patients with rheumatoid arthritis appears comparable to that of patients with osteoarthritis.
2034709	Interrater reliability of videotaped observational gait-analysis assessments.	1991 Jun	The purpose of this study was to determine the interrater reliability of videotaped observational gait-analysis (VOGA) assessments. Fifty-four licensed physical therapists with varying amounts of clinical experience served as raters. Three patients with rheumatoid arthritis who demonstrated an abnormal gait pattern served as subjects for the videotape. The raters analyzed each patient's most severely involved knee during the four subphases of stance for the kinematic variables of knee flexion and genu valgum. Raters were asked to determine whether these variables were inadequate, normal, or excessive. The temporospatial variables analyzed throughout the entire gait cycle were cadence, step length, stride length, stance time, and step width. Generalized kappa coefficients ranged from .11 to .52. Intraclass correlation coefficients (2,1) and (3,1) were slightly higher. Our results indicate that physical therapists' VOGA assessments are only slightly to moderately reliable and that improved interrater reliability of the assessments of physical therapists utilizing this technique is needed. Our data suggest that there is a need for greater standardization of gait-analysis training.