Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 2041980 | Antibodies to arthritis-associated microbes in inflammatory joint diseases. | 1991 | IgM, IgG and IgA class antibodies against Yersinia, Salmonella, Campylobacter and Borrelia were determined by enzyme-linked immunosorbent assay (ELISA) in a group of 340 unselected patients with a recent inflammatory joint disease. The control group consisted of 340 and 100 healthy blood donors using Borrelia-ELISA and other ELISAs, respectively. Of all the patients, 27.4% had increased antibody levels against at least one of the microbes tested. The prevalence of positive antibody levels was highest in Yersinia antibodies (17.9%). The corresponding figures for Salmonella, Campylobacter and Borrelia were 7.0, 6.2 and 1.8%, respectively. Patients with entero-arthritis or clinically typical reactive arthritis who had not had gastrointestinal or urogenital symptoms previously had the highest prevalence of the microbial antibodies (67.6 and 40.7%, respectively). These findings indicate that arthritis may often have a reactive etiopathogenesis without recognized gastrointestinal infection, emphasizing the importance of microbial serology in the differential diagnosis. | |
| 3457853 | Total temporomandibular joint replacement in a patient with rheumatoid arthritis: report o | 1986 Apr | This case is an example of a patient with apparent successful total TMJ replacement. With reconstruction of the joints with artificial implants, the loss of posterior ramus height because of complete erosion of the joints, mandibular retrognathia, and severe open bite were corrected. The improved masticatory function, absence of choking, and disappearance of sleep apnea symptoms allowed the patient to resume a more normal life. The patient will continue to be examined periodically, but the current prognosis is favorable. | |
| 1972634 | Fibrosing alveolitis due to sulphasalazine in a patient with rheumatoid arthritis. | 1990 Jun | Rheumatoid arthritis is being increasingly treated with sulphasalazine. We report the first case of a patient being treated for rheumatoid arthritis who developed severe dyspnoea with chest radiograph shadowing, reversible on discontinuation of sulphasalazine and subsequent steroid therapy. An histological diagnosis of fibrosing alveolitis was made. Thirteen cases of similar reactions to sulphasalazine, all in patients treated for inflammatory bowel disease, can be found in the literature. We identify two types of pulmonary reaction, an eosinophilic pneumonitis and a fibrosing alveolitis. Adequate histological investigation is needed to differentiate between the two and management may be different. The diagnosis of pulmonary reactions are important because they can be easily confused with complications of the underlying disease but the prognosis is much better. | |
| 3493344 | Increased frequency of Gm(1,2;21) phenotype in HLA-DR4 positive seropositive rheumatoid ar | 1986 Oct | Ninety-four patients with seropositive rheumatoid arthritis (RA) were typed for HLA-A, B, C and DR antigens and for immunoglobulin G (Gm) allotypes. Isolated IgG from patient serum was used to avoid interference of IgM rheumatoid factor (RF) with Gm typing in sera with high IgM-RF titer. Besides the association of seropositive RA with the antigen DR4 and an earlier disease onset in DR3/DR4 heterozygotes, we found the uncommon Gm phenotype Gm(1,2;21) significantly more often in our patient group than in healthy controls. Combination of HLA-DR and Gm data shows that individuals with both DR4 and Gm(1,2;21) are at a particularly high disease risk. | |
| 1880167 | Distal ulna resection, extensor carpi ulnaris tenodesis, and dorsal synovectomy for the rh | 1991 May | We conclude from this study that distal ulna resection coupled with stabilization by ECU tenodesis is a highly useful technique with a reproducibly successful outcome for DRUJ destruction resulting from rheumatoid arthritis. In this series, like those noted previously, alleviation of pain, preservation of wrist mobility, prevention of tendon rupture, and improved function have been consistently observed. Moreover, with adjunctive dorsal synovectomy this combined procedure has proved applicable to cases demonstrating not only mild but also moderate stages of radiocarpal disease, thereby avoiding the more extensive and less desirable surgical alternatives of complete wrist arthrodesis or total wrist arthroplasty. Recognizably, the long-term benefit of this surgery depends on maintaining stability of both the reconstructed radioulnar joint and the synovectomized radiocarpal joint. Although the data reported herein strongly support the efficacy of the tenodesis in preserving distal ulna stability and similarly indicate a favorable influence on maintenance of radiocarpal architecture, one must be cognizant that progressive radiocarpal deterioration is a characteristic, albeit somewhat unpredictable, manifestation of the chronic rheumatoid process, and is the principal factor apt to compromise an initially satisfactory result. In such cases demonstrating excessive carpal malalignment preoperatively and for those with an unremitting postoperative course of ulnar translocation or volar subluxation, additional radiocarpal stabilization, preferably by arthrodesis, is essential to salvage the benefits of distal ulna resection and ECU tenodesis. | |
| 3464209 | Secondary fibrositis. | 1986 Sep 29 | Fibrositis is considered primary when there is no associated underlying disorder, and secondary when it occurs in patients with underlying rheumatic or other organic disease. Since fibrositis has become better defined, the list of underlying disorders has grown, and its identification requires careful diagnostic study. The differentiation of primary and secondary fibrositis has therapeutic implications. Secondary fibrositis should respond to treatment of the underlying disorder, whereas the primary syndrome may require additional management directed to the musculoskeletal pain and sleep and emotional disturbances commonly recognized as major manifestations of this syndrome. | |
| 3819419 | Revision total knee arthroplasty. | 1986 | Careful attention to axial alignment, soft tissue balance, and stability will minimize prosthetic failure. In revision arthroplasty a prosthesis designed to replace bone loss with the least constraint possible should be used. In the current series revision of the noninfected failed total knee arthroplasty has provided satisfactory results in 50% to 60% of the patients. We believe that use of the newer implants and instrumentation will improve results markedly. | |
| 2722948 | A follow-up study of an uncemented knee replacement. The results of 312 knees using the Ko | 1989 May | The Kodama-Yamamoto knee is an uncemented surface replacement which has been used since 1970. The design has been improved twice and this present report concerns the results of the Mark II model. Between 1980 and 1984, 350 knees were replaced in 225 patients. In 1987, a survey of 335 of these knees was conducted at two to seven years after operation. The results were excellent or good in 83% of patients. Many of the failures were because of general disorders unrelated to the operation, but in 5.4% of the knees there were local complications which continue to present problems. | |
| 2812774 | [Loosening of hip prostheses in chronic rheumatoid polyarthritis]. | 1989 Sep | The hip with rheumatoid arthritis (RA) is characterized by reduced bone resistance. Protrusion, fatigue fractures and femoral head collapse are the typical consequences. The survival rate of total hip prostheses in hips with RA seems to be higher than for hips with osteoarthritis (OA), possibly due to lower demands. When isolated loosening of the acetabular and femoral component are compared, there is a definite shift towards acetabular loosening in RA compared to OA. This is definitely due to the reduction in the mentioned bone resistance at the acetabular level. In primary joint replacement, well-cemented femoral components provide more reliable clinical results. They will remain the gold standard for long-term performance as well. On the other hand, it is very likely that non-cemented acetabular components, fixed by means of screws in the direction of the resulting force or based on a compression principle, may prove at least as effective as well-cemented acetabuli. For revision of the loose acetabular component, the use of special metal rings fixed with screws and bridging severe bony defects with a bone graft and frequently also bone cement, have proved to be of value. For loose femoral components with a thin and brittle cortical wall, special non-cemented prostheses combined with a bone graft seem to promise a more reliable long-term solution than cemented versions. The follow-up of our revision cases confirms the value of the described methods - at least at the short and medium-term follow-up. More definite conclusions can only be arrived at after long-term follow-ups which have been carried out with different systems and where the results are compared using the same documentation procedure. | |
| 2533024 | [Efficacy and tolerability of flunoxaprofen in the treatment of rheumatoid arthritis. A cr | 1989 Oct 31 | The efficacy and safety of the new non-steroidal antiinflammatory drug flunoxaprofen were compared with those of naproxen in a cross over clinical study in patients with classical or definite rheumatoid arthritis (RA). Twenty female out-patients in the active phase of the disease were randomly assigned to one of the two groups studied; one group (A: 10 patients, mean age 51 years) received flunoxaprofen 400 mg/day p.o. for 30 days, followed by a 7-day wash-out period before starting the second treatment, with naproxen 500 mg/day p.o. for 30 days. Another group (B: 10 patients, mean age 58 years) received naproxen before flunoxaprofen and followed the same schedule of group A. The results showed that flunoxaprofen and naproxen have essentially equivalent therapeutical effects in controlling painful and functional symptoms of RA: both treatments resulted in a significant relief of spontaneous diurnal and nocturnal pain, pain on active and passive motion, morning stiffness, and in a significant improvement of grip strength and Richtie's index. None of the two drugs modified biochemical parameters of inflammation (ESR, CPR) or the laboratory variables measured to assess the tolerability of flunoxaprofen (hepatorenal function tests; haematological parameters). Flunoxaprofen was found to be very well tolerated: this feature together with the good therapeutic efficacy makes flunoxaprofen a very safe and useful tool in the management of severe chronic disease such as RA. | |
| 2288804 | Posterior occipito-cervical fusion in rheumatoid arthritis. | 1990 | The instability of atlanto-axial subluxation remains a challenging problem in patients with rheumatoid arthritis. In order to preserve as much function of the cervical spine as possible, inclusion of the occiput into the fusion should exclusively be performed when there is a radiologically or clinically manifest pathological condition of the atlanto-occipital joint or marked upward migration of the dens axis. In order to prevent irreversible damage to the spinal cord, an early indication of surgical stabilization is recommended. This article presents a retrospective analysis of the clinical and radiological results of occipito-cervical fusion in 26 patients with rheumatoid arthritis using a modified Brattström technique. The complications encountered were mainly due to the use of wire fixation, reinforcement using bone cement and insufficient reduction of atlanto-axial subluxation. | |
| 3196450 | Team treatment. Does a specialized unit improve team performance? | 1988 Dec | The treatment of inpatients in a contiguous hospital area designated the Arthritis Rehabilitation Unit (ARU) as opposed to the treatment of patients on units discretely spaced throughout the hospital was studied by means of independent retrospective audit of randomly chosen charts with the primary diagnosis of rheumatoid arthritis. Three time periods were considered: T-1 (2 months to 0 months prior to the beginning of the ARU), T-2 (0 months to 5 months of operation of the ARU), T-3 (after 18 to 24 months of operation of the ARU). At T-1 only seven charts were reviewed; ten charts were reviewed at T-2 and T-3. The frequency of fulfillment to audit criteria was calculated as the arithmetic mean. No weighting or preference was given to any of the items. P values were calculated utilizing the Mann-Whitney U test for nonparametric measures. The criteria by which the charts were reviewed were developed through the Delphi method of opinion convergence. Criteria were generated using the principle of optimal medical care. The categories included initial evaluation, treatment plan, outcomes and discharge plan. T-1 compared to T-3 yielded results in overall percentage of effectiveness of: physician, 81 v 90 (NS): nurse, 42 v 60 (P 0.043); occupational therapy, 62 v 58 (NS); physical therapy, 69 v 78 (NS); and social worker, 17 v 88 (P less than 0.001) Geographic isolation of arthritis rehabilitation patients improved measured aspects of their care but not uniformly throughout the rehabilitation team. | |
| 2791386 | Effect of total knee arthroplasty on maximal flexion. | 1989 Oct | The advantage of potential flexion offered by total knee arthroplasty (TKA) is limited. In this review of 724 replaced knees, only one-third flexed to 105 degrees, while nearly one-half did not flex beyond 90 degrees. Postoperative flexion depended partly on preoperative flexion and partly on the prosthesis used, but these factors could not be the only determinants of results, for flexion in individual knees could increase, decrease, or remain unchanged whatever the preoperative measurement and whatever the design of prosthesis. Little difference in flexion before or after TKA was found between rheumatoid and osteoarthritic knees. Success or failure of the implant, according to the crude definition used, was not associated with degree of flexion. Patients with the lowest levels of function tended to have TKA with the least flexion and vice versa. Nevertheless, the degree of flexion is only one of the factors influencing mobility. | |
| 3172114 | Patients with rheumatoid arthritis at high risk for noncompliance with salicylate treatmen | 1988 Jul | Recent studies indicate the adherence of many patients with rheumatoid arthritis (RA) to their treatment regimens is poor. Management of this problem depends on identification of noncompliant patients, followed by interventions to increase their level of adherence. In this study, 63 patients with RA receiving salicylate drugs completed a questionnaire during an outpatient visit. The questionnaire contained items believed to be predictive of future compliance, including patient self-predictions regarding future compliance, ratings of behavior in similar situations and barriers to compliance, such as ease of transportation to the clinic. Compliance was estimated via a salicylate assay that was taken during a subsequent outpatient appointment. Multivariate analyses of our data revealed that significant predictions could be made regarding future compliance, with 75% of the noncompliant patients correctly identified. Variables contributing significantly included behavioral self-predictions and a measure of current behavior in similar situations, as assessed by a salicylate assay that was collected during the 1st outpatient visit. | |
| 2175239 | Synovial fluid polymorphonuclear leucocytes from patients with rheumatoid arthritis have r | 1990 Dec | Synovial fluid (SF) polymorphonuclear leucocytes (PMN) from patients with rheumatoid arthritis (RA) were compared to RA and normal circulating blood PMN. RA SF PMN were as viable as blood PMN and remained viable for up to 24 h in culture. Measurement of myeloperoxidase indicated that RA SF PMN had degranulated and secreted their myeloperoxidase prior to isolation, 26.5 +/- 11.7% being found extracellularly compared to less than 2.9% in RA and normal blood PMN. RA SF PMN alone showed a decrease in basal NADPH-oxidase activity as well as an increase in responsiveness to stimulation by chemotactic peptide during culture. Stimulation of PMN with phorbol-12-myrisitate-13-acetate evoked equivalent responses in each population before and after culture. These results demonstrate a major difference in resting and receptor-mediated activation of superoxide release by RA SF PMN. Together, these results have important implications in identifying the role of the activated PMN in RA. | |
| 3055712 | [Cardiac involvement in rheumatic diseases]. | 1988 Aug 15 | In the enclosed paper cardial changes of different rheumatic diseases are concerned. It refers to the change concerning the cardial symptoms of the single diseases and differential diagnostic considerations are made. Essential cardial symptoms and important symptoms and therapeutic possibilities are named. | |
| 3616784 | Important problems identified by patients with chronic arthritis. | 1987 Jul 18 | To assess the impact of their illness on their whole life experience 345 patients with chronic arthritis were interviewed and completed a questionnaire. Four major sub-groups were identified--rheumatoid arthritis, gout, ankylosing spondylitis and osteo-arthritis. Taking into account definite inter-group differences, the commonest problems were pain (65%), stiffness (61%), inability to do everyday tasks (43%) and sexual difficulties (31%). The implications these problems raise in clinical practice are discussed and some suggestions for a rehabilitation programme made. | |
| 3501473 | Penicillamine induced polymyositis and dermatomyositis. | 1987 Oct | Eight Australian cases of D-penicillamine induced polymyositis/dermatomyositis (PM/DM) are reported. In terms of clinical, pathological and electromyographic features, D-penicillamine PM/DM is similar to idiopathic PM/DM but is generally less severe. Recovery is usually rapid when D-penicillamine is withdrawn. Sera were available for study in 6 of the 8 reported cases. Two of the 6 had elevated titers of acetylcholine receptor autoantibodies. Neither of these patients had clinical signs of myasthenia gravis. In 3 of 6 patients typed for C2, no bands were detected suggesting homozygous C2 deficiency. D-penicillamine PM/DM is associated with HLA-B18, B35 and DR4 and is immunogenetically different from idiopathic PM/DM, rheumatoid arthritis and D-penicillamine myasthenia gravis. | |
| 2661065 | Renal side effects of high and low cyclosporin A doses in patients with rheumatoid arthrit | 1989 May | Thirty-nine patients with classical or definite rheumatoid arthritis (RA) entered a randomized double-blind placebo controlled study with low dose cyclosporin A (CyA) (mean whole blood CyA level after 26 weeks 282 +/- 33 micrograms/l) or placebo treatment for 48 weeks. The placebo treatment had to be withdrawn before 48 weeks in 9 out of 19 patients because of a deterioration of their arthritis symptoms. All 20 patients in the CyA group completed 26 weeks of treatment. Fourteen of them were followed up for 48 weeks of treatment on CyA and then 12 weeks after CyA treatment was withdrawn. The side effects in the CyA group were compared with the results from another study with high CyA doses (mean whole blood CyA level 419 +/- 71 micrograms/l) for 26 weeks in 11 other patients with RA. Serum creatinine increased 19.7% (p less than 0.01) in the low CyA dose group after 26 weeks as compared with 59.5% in the high CyA dose group. Creatinine clearance was reduced by 17.9% (low dose) (p less than 0.01) and 26.2% (high dose), respectively. Twelve weeks after withdrawal of the low dose CyA treatment, serum creatinine values were still higher than before treatment (p less than 0.05), but creatinine clearance had normalized. Eight of the 20 patients treated with low CyA doses also started with nonsteroidal anti-inflammatory drugs (NSAIDs) after 20-36 weeks of CyA treatment. Serum creatinine was 16.6% above baseline 4 weeks before NSAIDs compared with an increase of 40.4% (p less than 0.05) 4 weeks after start of NSAID treatment.(ABSTRACT TRUNCATED AT 250 WORDS) | |
| 3464206 | Is the tender point concept valid? | 1986 Sep 29 | The finding of multiple tender points is essential to the diagnosis of the fibrositis/fibromyalgia syndrome. Recent studies have shown that the tender point count seems to correlate with the presence of fibrositis symptoms, and can distinguish fibrositic from normal subjects. Although tender points are present in normal subjects, fibrositis patients have far more tender points that are much more tender. Further work is necessary to establish the reliability of tender point measurement, and to investigate and monitor changes in the tender point count with time or therapy. |