Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
ID | PMID | Title | PublicationDate | abstract |
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3117277 | Reference bias in reports of drug trials. | 1987 Sep 12 | Articles published before 1985 describing double blind trials of two or more non-steroidal anti-inflammatory drugs in rheumatoid arthritis were examined to see whether there was any bias in the references they cited. Althogether 244 articles meeting the criteria were found through a Medline search and through examining the reference lists of the articles retrieved. The drugs compared in the studies were classified as new or as control drugs and the outcome of the trial as positive or not positive. The reference lists of all papers with references to other trials on the new drug were then examined for reference bias. Positive bias was judged to have occurred if the reference list contained a higher proportion of references with a positive outcome for that drug than among all the articles assumed to have been available to the authors (those published more than two years earlier than the index article). Altogether 133 of the 244 articles were excluded for various reasons--for example, 44 because of multiple publication and 19 because they had no references. Among the 111 articles analysed bias was not possible in the references of 35 (because all the references gave the same outcome); 10 had a neutral selection of references, 22 a negative selection, and 44 a positive selection--a significant positive bias. This bias was not caused by better scientific standing of the cited articles over the uncited ones. Thus retrieving literature by scanning reference lists may produce a biased sample of articles, and reference bias may also render the conclusions of an article less reliable. | |
3294250 | Tendon transfers in surgery of the rheumatoid hand. | 1988 May | Tendon transfer procedures are used in the reconstructive surgery of the rheumatoid hand in cases of tendon ruptures, deformities, and compression neuropathies with subsequent muscle atrophy. The prerequisites and essential principles for tendon transfers are discussed, including the following: 1) correction of contractures, 2) adequate power of the muscle, 3) sufficient amplitude, 4) straight line of pull, and 5) maintenance of the integrity of the muscle. | |
1863829 | A comparison of disability measured by the Stanford Health Assessment Questionnaire disabi | 1991 Aug | Eighty-five consecutive rheumatoid patients (M:F = 22:63) seen during a 10-week period were studied. There were significant differences between the sexes for haemoglobin (means (SD) M = 13.5 (1.2), F = 12.0 (1.6) g/dl, P less than 0.01), presence of nodules (M = 50%, F = 19%, P less than 0.05) and for the HAQ scores (mean (SD) score M = 1.1 (0.9), F = 1.7 (0.9), P = 0.03) but not for age, disease duration, presence of erosions, Larsen score, treatment, pain, early morning stiffness, articular index, ESR, and C-reactive protein. The results suggest that the patients were matched for age, disease activity, severity and duration. The difference in haemoglobin between the sexes is in keeping with a reference population. The data suggest that the impact of RA has a greater effect on the functional status of women. | |
1950677 | Evidence for nonrenal synthesis of 1,25-dihydroxyvitamin D in patients with inflammatory a | 1991 Jul | The extrarenal synthesis of 1,25-dihydroxyvitamin D [1,25-(OH)2D] is a characteristic of activated macrophages and has been demonstrated to occur in vitro in synovial fluid macrophages from patients with inflammatory arthritis. To examine whether such synthesis occurs in vivo, 19 patients with rheumatoid arthritis, 5 patient controls, and 5 healthy controls received a challenge oral dose of 250 micrograms 25-hydroxyvitamin D3 (25-OHD3) and the serum 1,25-(OH)2D3 response was measured. The median rise in serum 1,25-(OH)2D3 was significantly greater (22 pg/ml) in the rheumatoid patients compared to either of the control groups (8 pg/ml), although the increase in precursor 25-OHD3 was similar in all groups. The serum 1,25-(OH)2D concentration did not rise above the normal upper limit in any of the control subjects but exceeded the normal range in 8 of the rheumatoid patients. Extrarenal 1,25-(OH)2D synthesis is substrate dependent, unlike renal 1 alpha-hydroxylation, which is homeostatically controlled. Excessive 1,25-(OH)2D3 synthesis in the rheumatoid group on raising the 25-OHD3 concentration is indicative of nonrenal production of the hormonal metabolite. Further evidence for substrate-dependent extrarenal synthesis came from measurements of 25-OHD and 1,25-(OH)2D in paired serum and synovial fluid samples from 19 patients with inflammatory arthritis, including 15 with rheumatoid arthritis. Synovial fluid 1,25-(OH)2D was usually present at a lower concentration than serum 1,25(OH)2D, with which it was strongly correlated (Kendall's R = 0.46, P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) | |
2810284 | Clinical use of multiple nonsteroidal antiinflammatory drug preparations within individual | 1989 Sep | The clinical use of nonsteroidal antiinflammatory drugs (NSAID) was studied in 15 rheumatology private practices in the USA (in California, the District of Columbia, Florida, Idaho, Minnesota, Pennsylvania and Tennessee). Among 1,423 patients with rheumatoid arthritis (RA) under care in these 15 practices, the most extensively used NSAID preparation within any of the 15 individual practices was taken by a median of 19.5% of patients (mean 20.7%, range 8-36%), and the 3 most extensively used preparations by a median of 45.9% (mean 47.7%, range 34.7-63.5%). The median number of NSAID preparations used (singly) in each of the individual practices was 15 (range 8-20), including a median of 7 (range 4-10) used by more than 5% of the patients with each practice. The NSAID usage of these patients with RA seen in private practice settings was met by 8 preparations for 70%, by 10 preparations for 80%, and by 14 preparations for 90% of the 1,423 patients. | |
2682980 | Double-blind, placebo-controlled study of OM-8980 in rheumatoid arthritis. | 1989 | A total of 95 patients suffering from active rheumatoid arthritis were included in this double-blind, placebo-controlled study of the immunomodulator OM-8980. Treatment was one capsule daily of OM-8980 or placebo for 6 months. A significant improvement was observed in the OM-8980 group in comparison with the placebo group as regards the Ritchie index (P = 0.002), grip strength (P = 0.02) and pain (P = 0.03). The number of swollen joints, duration of morning stiffness and erythrocyte sedimentation rate decreased more markedly under OM-8980 than under the placebo, without reaching the level of statistical significance. A significant difference in favour of OM-8980 was observed in the intake of non-steroidal anti-inflammatory drugs and oral corticosteroids. Clinical tolerance was on the whole good (10 cases with side effects out of 49 in the OM-8980 group and 7 out of 46 in the placebo group, ns), with the majority of the side effects concerning the gastrointestinal system. The global assessment of the therapeutic efficacy both by the physician and the patient showed a highly significant superiority of OM-8980 over the placebo (P = 0.001). | |
2328028 | T cell receptor expression and activation of synovial lymphocyte subsets in patients with | 1990 Apr | Two-color flow cytometry analysis of peripheral blood and synovial lymphocytes from rheumatoid arthritis patients was performed using monoclonal antibodies directed against T cell subsets, T cell activation markers, and T cell receptors. The results showed an abnormally high percentage (greater than 15%) of CD3+, CD4-, and CD8- T cells expressing a specific receptor containing a gamma chain. Phenotypic analysis of lymphocytes infiltrating both knee joints of individual rheumatoid arthritis patients revealed very similar subset distribution and activation levels, despite strong differences in the clinical status between the 2 sites. | |
2069941 | PCR-SSO typing in HLA-disease association studies. | 1991 Feb | Associations between a large number of diseases and markers within the major histocompatibility complex (MHC) have been described. In particular, susceptibility to several autoimmune disorders, including type I diabetes mellitus and rheumatoid arthritis, is linked to genes within the MHC and strong population associations are demonstrable between certain HLA class II alleles and these conditions. Genetic mapping of HLA susceptibility loci has traditionally relied on the use of phenotypic markers defined by alloantisera, cellular typing reagents and biochemical analysis of histocompatibility antigens. Polymerase chain reaction sequence-specific oligonucleotide (PCR-SSO) typing combines the ability to define the finest of HLA specificities, by analysis of the corresponding DNA sequences, with the possibility of study large populations of normal and affected individuals. The applications of this technology to characterizing precisely the MHC loci associated with susceptibility to autoimmune diseases such as rheumatoid arthritis, type I diabetes mellitus, coeliac disease and pemphigus vulgaris are reviewed here. | |
2003021 | Rheumatic disease of temporomandibular joint with development of anterior disk displacemen | 1991 Feb | A 34-year-old woman with known rheumatic disease (psoriatic arthritis) in joints other than the temporomandibular joint (TMJ) developed condylar posterosuperior destruction and anterior disk displacement of the right symptomatic TMJ during a 7-month period, as revealed by magnetic resonance imaging. A theory is proposed that destruction of the posterior attachment by pannus was the main reason for the disk displacement, although the pannus formation itself could not be depicted. Follow-up studies also indicated the potential of magnetic resonance imaging to demonstrate fluctuation of inflammatory changes in the TMJ. | |
2287940 | Cardiac compression in rheumatoid pericarditis. | 1990 Dec | Rheumatoid pericarditis occurs in approximately one third of rheumatoid arthritis (RA) patients. However, clinically apparent rheumatoid pericarditis is infrequent. The authors found clinical pericarditis in 12 of 960 patients admitted for RA, 5 of whom had manifestations of cardiac compression. These 5 had longer duration of RA, worse functional class, and more extraarticular features than the patients without cardiac compression. Presenting features of cardiac compression included dyspnea, edema, chest pain, and pulsus paradoxus. Treatment of patients with cardiac compression due to rheumatoid pericarditis may include a trial of systemically administered corticosteroids, but this should not delay surgical intervention for impending tamponade. Pericardiocentesis should only be performed as an emergency, life-saving procedure. It may be followed by intrapericardiac injection of corticosteroids, but this does not prevent recurrence. Longer-lasting benefit is obtained by surgical decompression. Two-year mortality in patients with cardiac compression was 100%. The literature on the subject is reviewed. | |
2330400 | A curriculum in clinical sexuality for arthritis health care professionals. | 1990 Spring | The results of an experimental training program in sexologic interviewing for a multidisciplinary arthritis patient care team are reported. The program included didactic instruction, observation and practice of interviewing skills, a seminar, and a case presentation. Trainees had gained more knowledge than control subjects at one year. Both groups improved their interviewing skills, but trainees showed more improvement than controls on problem-list generation. All participants showed more improvement when interviewing male than female patients. The data show that training programs in sexologic interviewing can improve both knowledge and skills. Programs should include actual practice interviewing patients. | |
1872045 | [Morphology and growth behavior of synovial cells in monolayer culture]. | 1991 Mar | Synovial fluid cells from patients with rheumatoid arthritis, psoriatic arthritis, peripheral arthritis in ankylosing spondylitis, dialysis arthropathy, osteoarthrosis, and joint disorders due to acute trauma were grown in monolayer cultures and examined by light and electron microscopy at arbitrarily chosen times and in various subcultures. The cultivated cells from these sources were compared with the cells of synovial tissue (cultured under the same conditions) from patients with osteoarthrosis and traumatized joints. Our results are not in agreement with those of most other authors. In contrast to many authors, we could not find any differences between the cultures from synovial fluid and the cultures from synovial tissue: the same cell types were observed with a slight quantitative difference in both cultures. Furthermore, no morphological features (except an abundance of filopodia of rheumatoid polykaryocytes) which would be characteristic of the rheumatoid synovial cells could be determined. Due to our experiments the synovial fluid seems to be more advantageous than synovial tissue for cell culture studies of different types of arthritis. This may be attributed to the following factors: a) the easy accessibility of synovial-fluid samples by ambulant aspiration from affected joints; b) the possibility of repeating this procedure frequently without any essential danger for the patient; c) the maintainability of synovial fluid (when chilled to 4 degrees C) up to 2-4 days without cessation of the growth ability of the cells under normal culture conditions. Apparently, synovial fluid represents an appropriate medium for synovial cells to survive in vitro.(ABSTRACT TRUNCATED AT 250 WORDS) | |
3262468 | Spontaneous recovery of the decreased expression in vitro of interleukin 2 receptors in rh | 1988 Jul | Peripheral blood mononuclear cells (PBM) from 11 patients with rheumatoid arthritis (RA) stimulated with 0.13 and 0.25 microgram/ml phytohaemagglutinin (PHA) for 3 days showed a depressed expression of interleukin 2 receptor (IL-2R) when compared with 14 normal controls (P less than 0.01). At these two doses of PHA a depressed lymphocyte proliferative response was also observed (P less than 0.01). However the kinetics of the response of the RA group differed from those of the control group. Whereas by day 6 IL-2R expression and lymphocyte proliferation in the control group was decreased compared with day 3, responses of the RA cells were increased. Following stimulation with the higher dose of PHA (1 microgram/ml) the kinetics of lymphocyte proliferation and IL-2R expression were equivalent in control and RA cultures. These results demonstrate that the impaired IL-2R expression and lymphocyte proliferation observed with sub-optimally stimulated PBM from RA patients is spontaneously reversed during prolonged culture and is consistent with the hypothesis that there is a lack of available IL-2 in the early stages of culture. | |
3738397 | [Myasthenia induced by D-penicillamine during the treatment of rheumatoid polyarthritis]. | 1986 May | Seven cases of myasthenia induced by D-penicillamine treatment of rheumatoid arthritis are presented. The 86 cases published so far are reviewed. The clinical symptoms do not differ from those of the idiopathic form. Progress is rapid and, generally, good. The duration and dosage of the treatment are not involved. The presence of acetylcholine-antireceptor antibodies confirms the autoimmune origin of the condition. Possible mechanisms by which this disorder could be induced are discussed. Investigation of HLA phenotypes suggests that the genetic basis of induced myasthenia differs from that of the idiopathic form (increased prevalence of DR1). | |
2498513 | Gold sodium thiomalate compared to low dose methotrexate in the treatment of rheumatoid ar | 1989 Mar | Thirty-five patients with definite or classic rheumatoid arthritis (RA) entered a prospective, double blind, randomized study of 26 weeks duration. All patients had active RA that was unresponsive to greater than or equal to 2 nonsteroidal antiinflammatory medications and/or antimalarials. Eighteen patients were randomized to receive methotrexate (MTX) 12.5 mg weekly (oral and noncycled) + placebo, and 17 patients to gold sodium thiomalate (GSTM) 50 mg IM weekly + placebo (schedule I) after initial test dose of 10 and 25 mg. Dose reductions from Schedule I to Schedule II (i.e. MTX 5.0 mg and GSTM 25 mg) were permitted at Weeks 6 and 12. The GSTM group showed statistically significant improvement at Week 26 compared with baseline status in all of the clinical efficacy variables and the MTX group in 7. There were no statistically significant differences in these outcome variables between the 2 groups at Week 26. However, this small sample size may not have detected a clinically significant difference between treatment groups (alpha = 0.05, beta = 0.20). Two of the 18 patients treated with MTX and 6 of the 17 patients treated with gold withdrew because of drug toxicity, but this difference was not statistically significant. In conclusion, GSTM and MTX are similarly efficacious in the short term treatment of RA. | |
3718564 | Complement activation in rheumatoid arthritis evaluated by C3dg and the terminal complemen | 1986 Jun | Complement activation was evaluated in plasma and synovial fluid from patients with rheumatoid arthritis. The activation fragment C3dg and the fluid-phase terminal complement complex were used as indicators of initial and terminal activation, respectively. Considerable activation of the whole complement cascade was demonstrated in most synovial fluid samples and in one-third of the plasma samples. No correlation was found between the level of activation products in synovial fluid and the level in plasma. Therefore, both compartments must be examined in order to evaluate local and systemic complement activation in rheumatoid arthritis. | |
3196083 | Predictive clinical and laboratory parameters for serum zinc and copper in rheumatoid arth | 1988 Oct | Zinc and copper have important effects on T cell mediated immunity and on neutrophil function, but it is not known how the causes or effects, of low serum zinc and high serum copper relate to the clinical picture of rheumatoid arthritis (RA). In this study serum zinc and copper determined by flame atomic absorption spectrometry and 30 other clinical, immunological, and laboratory parameters in 60 patients with RA were analysed by stepwise multiple linear regression analysis. Joint score index, rheumatoid factor titre, seropositivity, haemoglobin, and C reactive protein (CRP) were among the nine independent variables which together predicted 73% of the serum zinc variation. This suggests that there is an association between the immune-inflammatory rheumatoid process and the serum zinc concentration. CRP alone had only a 3% independent predicting value for serum zinc, however. This suggests that metallothionein mediated sequestration in the liver, induced by interleukin 1, is not an important explanatory factor in a cross sectional study of chronic inflammation. Furthermore, serum zinc did not have any predictive value at all for serum copper concentration. This does not support the hypothesis suggesting that serum zinc deficiency leads to high serum copper by inducing gastrointestinal metallothionein and high caeruloplasmin. | |
1969604 | The Felty syndrome: a case-matched study of clinical manifestations and outcome, serologic | 1990 Mar | Thirty-two patients with the Felty syndrome, defined by the presence of rheumatoid arthritis, splenomegaly, and neutropenia, have been studied in comparison with 32 patients with rheumatoid arthritis matched for age, sex, and disease duration, and 9 patients with rheumatoid arthritis and idiopathic neutropenia. Patients with the Felty syndrome had severe destructive arthritis, which progressed during follow-up despite little evidence of objective synovitis, and a higher frequency of extra-articular manifestations, including vasculitis. Bacterial infection tended to occur in patients with the lowest neutrophil count but continued to occur in some despite normalization of the WBC. Prognosis was poor and 8 deaths occurred, predominantly from sepsis. Serologic features were prominent. High titers of IgG rheumatoid factor and circulating immune complexes characterized patients with persistent neutropenia. A family history of rheumatoid arthritis was more common in patients with the Felty syndrome. The association with HLA DR4 was very strong; in addition there was an increased frequency of the DQw3 variant, 3b, suggesting that HLA Class II genes in linkage with DR4 may contribute to disease expression. | |
3495853 | Esophageal manometric findings in autoimmune rheumatic diseases: is scleroderma esophagus | 1987 | In order to assess whether distal esophageal hypomotility in scleroderma is unique to this disease or not, we studied 25 normal volunteers and 109 patients with autoimmune rheumatic diseases (27 with primary Sjögren's syndrome, 25 with idiopathic Raynaud's phenomenon, 25 with rheumatoid arthritis, 19 with scleroderma, 5 with undifferentiated connective tissue disease, 3 with systemic lupus erythematosus, 2 with mixed connective tissue disease, 2 with sclerodermatomyositis, and one with morphea). Esophageal dysfunction typical of scleroderma was present in 17 patients (15.6%), of whom 13 had scleroderma (68%) and one each primary Sjögren's syndrome, rheumatoid arthritis, undifferentiated connective tissue disease, and mixed connective tissue disease. Twenty-two percent of all patients had nonspecific esophageal motility changes, clustered among primary Sjögren's syndrome, idiopathic Raynaud's phenomenon, and rheumatoid arthritis. We conclude that lower esophageal hypomotility, although most frequent in scleroderma, is not unique to this disease and can be encountered in several other auto-immune rheumatic diseases. | |
2358812 | A radiological analysis of uncemented PCA tibial implants with a follow-up period of 4-7 y | 1990 Jun | A total of 63 uncemented PCA tibial implants were followed radiologically for a period of 4-7 years to establish whether primary fit, alignment, bone quality, age, and diagnosis have an effect on radiological results. Fifty-eight of the 63 tibial plateaus investigated (92%) showed excellent or good radiological results. In three cases the implant was rated radiologically endangered and in two cases radiologically loose. The results show that successful long-term anchorage depends principally on a primary stable fit. If implantation is inexact, poor bone quality, improper alignment, advanced age, and rheumatoid arthritis may be responsible for unsatisfactory radiological results. The authors conclude that particular importance must be attached to exact primary fixation when several unfavorable factors are encountered. |