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PMID	Title	PublicationDate	abstract
1744805	Disease experience and psychosocial adjustment in children with juvenile rheumatoid arthri	1991 Oct	Adjustment in children with juvenile rheumatoid arthritis (JRA) has been evaluated most frequently by parental or teacher reports and with reference to disease severity. In this study, 38 children, ages 7 to 13 with JRA, and their mothers were interviewed. Modest correlations were found between children and mothers in their assessments of children's perceived competence in several domains (i.e., athletic competence, social acceptance, physical attractiveness, and global self-worth) and in their perceptions of how JRA is experienced by children and families. Children's perceptions of the disease experience were significantly correlated with the four measures of perceived competence, even after controlling for disease severity. The results highlight the importance of cross-validating parental reports with children's self-reports, and demonstrate the need to consider variables other than disease severity--in particular how JRA is interpreted by children--in predicting their adjustment.
3263627	[Ankylosing spondylitis with childhood onset. Description of a clinical case].	1988 May	The terms "spondyloarthropathy" and "spondyloarthritis" have been recently introduced to indicate a group of syndromes associated in clinical and genetical peculiarities. The "ankylosing spondylitis with childhood onset", that is usually considered very rare, is, as a matter of fact, a disease difficult to diagnose because of the partial overlap with the "pauciarticular juvenile rheumatoid arthritis type II" for clinical and laboratory data. The Authors, after a recapitulation of the "pauciarticular juvenile rheumatoid arthritis type II" and of the "ankylosing spondylitis with childhood onset" diagnosis definition elements, propose a description of a clinical case that came to their observation. The clinical picture described, even though it presented some clinical peculiarities (particularly a primitive affection of the lumbosacral spine), some radiographic peculiarities (the precocious demineralization of the affected segments) and laboratory characteristics (positive F.A.N. to diffuse pattern) seemed a form of "ankylosing spondylitis with childhood onset", apparently primitive.
3231451	Pars plana lensectomy and vitrectomy for complicated cataracts in juvenile rheumatoid arth	1988 Aug	Anterior surgical approaches to cataracts in juvenile rheumatoid arthritis (JRA) patients are compromised by chronic anterior and posterior uveitis, miotic pupils, and posterior synechiae. The authors retrospectively reviewed the results of pars plana lensectomy and vitrectomy in ten eyes from seven JRA patients with cataracts associated with chronic iridocyclitis and vitritis. Visual acuities improved from 20/100 or worse preoperatively to 20/60 or better postoperatively. Transient postoperative hypotony lasting 1 week to 4 months occurred in four of the ten eyes. Patients with glaucoma continued to require antiglaucoma therapy after surgery. Pars plana lensectomy and vitrectomy provides a theoretically preferrable approach to complicated cataracts and vitritis in JRA patients because it allows removal of peripheral lens material in the presence of a miotic pupil, eliminates the potential for synechiae to the posterior capsule and/or anterior hyaloid, and clears the visual axis of inflammatory debris.
2958194	Activation of OKT4 suppressor cells in the autologous mixed lymphocyte reaction of patient	1987 Jul	Activation of suppressor cells by the autologous mixed lymphocyte reaction (AMLR) was studied in patients with juvenile rheumatoid arthritis (JRA). Isolated OKT4 cells were used as responders and irradiated whole non-T cell preparations, non-adherent non-T cells (B and null cells), adherent non-T cells (monocytes), and B cells preactivated by Staphylococcus aureus Cowan I, as stimulators in the AMLR. Suppression was assessed by a reduction of pokeweed mitogen stimulated immunoglobulin synthesis by lymphocytes of healthy donors upon addition of AMLR-activated OKT4 cells. The results of this study suggest normal activation of OKT4 suppressor cells in the AMLR of patients with JRA.
3315438	Tripterygium wilfordii, a Chinese herb effective in male fertility regulation.	1987 Sep	A refined extract from the root xylem of Tripterygium wilfordii Hook. f. (the so-called multi-glycosides of the plant), available in the market as tablets for the long-term treatment of rheumatoid arthritis and various skin disorders, has recently been shown to possess a powerful antifertility effect in male rats and in men after oral administration at dose levels not showing apparent toxicity or side effects. Fertility appears to be reversible after cessation of treatment. Moreover, preliminary data indicated that the effective antifertility dose in men is only 1/3 of the recommended dose for the treatment of rheumatoid arthritis or skin diseases. This fact supports additional optimism that the side effects of this small dose will be much less as compared with those of the regular dose level. However, a large amount of further investigation is required before one can predict the future of the drug, which seems to hinge upon the successful isolation of the active principle(s) and the careful toxicological evaluation of the safety of the latter. The present paper is a review article summarizing the chemistry, the general pharmacology and the fertility regulatory effect of the plant.
3215154	Mediating effects of family social support on child psychological adjustment in juvenile r	1988	This study assessed the mediating effects of social support on psychological adjustment in children having to cope with the ongoing chronic strain of juvenile rheumatoid arthritis. Disease activity, family social support, and peer social support were entered into hierarchical multiple regression analyses to statistically predict internalizing and externalizing behavior problems. Family social support was a statistically significant predictor of child psychological adjustment for both internalizing and externalizing behavior problems, accounting for 22% of the variance in each. These findings are consistent with the stress-social support-psychological adjustment relationship that has received empirical attention in studies on physically healthy children. The results are discussed in terms of their implications for primary and secondary prevention efforts for those chronically ill and handicapped children who are at increased risk for psychological adjustment problems.
3394095	[Lesions of the digestive organs in Sjogren's disease].	1988	The clinicofunctional and morphological status of the stomach, biliferous system, pancreas, large and small intestine was studied in 83 patients with Sjogren's syndrome and disease (SS and SD). Chronic gastritis with secretory insufficiency was shown to develop in SD. Morphological changes of the gastric mucosa were represented by chronic gastritis with glandular involvement and chronic atrophic gastritis of immune genesis. Pathology of the extrahepatic system of bilification was detected in 87% of patients. The most common pathologies diagnosed in these patients were chronic cholecystitis (51%) and biliary dyskinesia (25%). Changes of the chemical composition of the bile (arise of its lythogenic properties) were observed. Various disorders of pancreatic function were detected in 85% of SS and SD patients. X-ray and endoscopic investigations revealed duodenal, intestinal and colon hypokinesia, less frequently signs of enteritis and colitis in one-third of the patients. The irritable colon syndrome was found in 40%. On the whole, involvement of different parts of the intestine was observed in 92%. Morphological changes in the duodenal and sigmoid colon mucosa were typical of chronic diffuse duodenitis and sigmoiditis in a subacute SD course, and chronic atrophic duodenitis and sigmoiditis in a chronic SD and SS course.
2818655	Development of a disability measurement tool for juvenile rheumatoid arthritis. The Juveni	1989 Nov	A disability assessment tool, the Juvenile Arthritis Functional Assessment Scale, was developed for, and validated in, patients with juvenile rheumatoid arthritis (JRA). Standards for this 10-item tool were developed using the scores of 63 normal school children as controls and comparing these results with those of 71 age-matched JRA patients (age 7-16 years). The JRA patients scored statistically significantly higher on the scale, which also demonstrated excellent internal and convergent validity and internal reliability. The test is easily administered in 10 minutes by a physical or occupational therapist in a clinical or office setting. This tool represents the first normalized disability assessment tool developed for JRA patients.
2663507	Atypical spondyloarthritis in children: proposed diagnostic criteria.	1989 Apr	Clinical and laboratory findings in 26 children with atypical spondyloarthritis were compared with those of 76 children with juvenile rheumatoid arthritis. The sensitivity, specificity, predictive value, and efficiency for diagnosis were calculated. The following findings (major criteria) were much more common in atypical spondyloarthritis than in juvenile rheumatoid arthritis: (1) spondyloarthritis within the family; (2) enthesopathy; (3) arthritis of digital joints; (4) sacro-iliitis; (5) presence of HLA-B27; (6) frequent recurrence of arthritis and arthralgia. Six additional findings (minor criteria) were significantly more common in atypical spondyloarthritis (SA): (1) disease onset after the age of 10 years; (2) male sex; (3) involvement of the lower extremities; (4) acute iridocyclitis or conjunctivitis; (5) arthritis of the hip joints; (6) manifestation following a history of enteritis. In the presence of 4 major criteria or 3 major and 3 minor criteria, the diagnosis of an atypical SA was established with a sensitivity of 84.6%, a specificity of 100%, and an efficiency of 96.1%.
2059235	Pregnancy in patients with a history of juvenile rheumatoid arthritis.	1991 Jul	The present investigation was undertaken to study the relationship between pregnancy and juvenile rheumatoid arthritis (JRA), with regard to possible reactivation of the disease, complications at delivery, and postpartum complications. Data on 76 pregnancies in 51 JRA patients were collected retrospectively. Comparison of pre-pregnancy disease activity with the course during gestation showed that pregnancy did not cause reactivation of the symptoms of quiescent JRA. Patients with minor symptoms at conception and the majority of those with active inflammation experienced improvement or total remission in the second half of gestation. Four JRA patients with active anterior uveitis had active eye disease during pregnancy also. Seventy-four of the pregnancies resulted in births of infants that were healthy and of normal birth weight; 1 infant had low birth weight and 1 was stillborn. Twenty children were delivered by cesarean section, and in 15 cases this was related to sequelae of JRA. A flare 3-6 months postpartum was reported after 45 pregnancies. However, in none of the patients whose disease was quiescent before or during pregnancy did this cause permanent reactivation of the JRA. Comparison of these 51 patients with 45 age-matched female patients without children revealed that disease severity and functional impairment were the limiting factors in the decision for or against having children.
2787640	Antibodies to histones H1 and H5 in sera of patients with juvenile rheumatoid arthritis.	1989 Jul	The specificity of juvenile rheumatoid arthritis (JRA) sera for histone subclasses was examined by immunoblotting. Antibodies to H1 alone were found in 4 of 21 pauciarticular-onset JRA sera, 4 of 19 polyarticular-onset JRA sera, and 2 of 11 systemic-onset JRA sera. Antibodies to H5 alone were found in 1 of 21 pauciarticular JRA sera, 1 of 19 polyarticular JRA sera, and 3 of 11 systemic JRA sera. Antibodies to both H1 and H5 were found in 4 of 21 pauciarticular JRA sera, 4 of 19 polyarticular JRA sera, and 1 of 11 systemic JRA sera. Antibodies to the core histones (H2A and H2B) were found in 1 of 21 pauciarticular JRA sera, 1 of 19 polyarticular JRA sera, and no systemic JRA sera. No reactivity to histones was observed in 30 sera from age-matched children with nonrheumatic diseases. The presence of H1 and H5 antibodies did not correlate with antinuclear antibody titers or with a homogeneous pattern of immunofluorescence. The predominance of H1 and H5 antibodies and relative absence of antibodies binding to core histones in JRA contrast with findings in adult systemic lupus erythematosus. Further, the presence of antibodies to H5 alone in some of the JRA patients indicates that the immune response in these patients is directed to determinants that are not shared by sequences of mammalian proteins.
3816779	Biochemical analysis of synoviocytes from normal and arthritic rats. Evidence for an activ	1987 Jan 2	Adjuvant-induced polyarthritis in rats is a common model system used for the study of the synovitis that occurs in rheumatoid arthritis. Synoviocytes A, the major cell type covering the internal surface of the joint, could be involved in the pathogenesis of rheumatoid arthritis because of their increased proliferation and the intraarticular manifestations of the disease. So far only a few molecular studies have been reported on synoviocytes upon arthritis induction. We report here changes in polypeptides, between control and arthritic synoviocytes, by using two different radiolabeling methods and two-dimensional gel electrophoresis analysis. Major differences were found using metabolic labeling on regions of tropomyosins, cyclin, tubulins and vimentin. In addition, external surface labeling of the cells with lactoperoxidase showed clear differences between control and arthritic synoviocytes in the region of 77-100-kDa proteins. Some of these differences can be reproduced by certain macrophage activators such as phorbol myristate acetate and lipopolysaccharide acting on synoviocytes in vitro and in vivo respectively. These results exclude the possibility that the changes observed were due to a possible infiltration of other cell types in the arthritic synovia and strongly support the existence of an activated state of synoviocytes associated with arthritis induction.
11188598	Aerobic capacity in juvenile rheumatoid arthritis patients and healthy children.	1991 Sep	This study compared aerobic capacity and highest work load completed by children with juvenile rheumatoid arthritis (JRA) and healthy children during bicycle ergometer exercise. A secondary purpose was to determine the relationship between measures of disease severity and (a) aerobic capacity and (b) highest work load completed among the JRA patients. Aerobic capacity was measured using an open-circuit computerized gas analysis system. Sixteen patients with JRA and 16 healthy children were matched for age, sex, and body surface area. The healthy children achieved a significantly higher aerobic capacity than their respective control (p < 0.001, paired t test, two-tailed). The healthy children were able to complete higher work loads than their respective control (p < 0.01, Wilcoxon matched-pairs signed-rank test). There was no relationship between measures of articular disease severity and (a) aerobic capacity and (b) highest work load completed among the JRA patients. Results of this study provide specific direction to clinicians to initiate aerobic conditioning programs for children with JRA soon after diagnosis. Additionally, an individual's functional exercise capacity is not directly related to the severity of the articular disease.
3297621	Proquazone. A review of its pharmacodynamic and pharmacokinetic properties, and therapeuti	1987 May	Proquazone is a non-steroidal anti-inflammatory agent (NSAID) which, unlike most other NSAIDs, does not have a free acid group in its structure. It is advocated for use in rheumatoid arthritis, ankylosing spondylitis, osteoarthritis, musculoskeletal disorders, acute inflammatory conditions and acute pain states such as dysmenorrhoea, postoperative pain and headache. Published data in small groups of patients indicate that proquazone 300 to 900 mg/day in 3 divided doses is a possible alternative to aspirin, ibuprofen, indomethacin, and naproxen in rheumatoid arthritis, and to indomethacin and ibuprofen in ankylosing spondylitis. Similarly, proquazone 300 to 900 mg/day is as effective as aspirin, diclofenac, ibuprofen, indomethacin and naproxen in patients with osteoarthritis. Preliminary studies have confirmed the efficacy of proquazone in acute inflammatory disorders, and shown that it provides useful analgesic relief in acute pain states such as dysmenorrhoea, headache and after minor surgery. Evidence from small groups of patients with rheumatoid arthritis treated for a year or more suggests that proquazone may inhibit or arrest progression of bone erosions. However, these encouraging findings clearly need confirmation in a larger number of patients studied under well-controlled conditions. The overall impression from clinical trials to date is that proquazone at dosages of greater than or equal to 900 mg/day produces a high incidence of gastrointestinal symptoms such as diarrhoea (in approximately 30% of patients). However, these effects were usually of mild to moderate severity and transient in nature and in most comparative studies the overall tolerability of proquazone was assessed as being comparable to that of other NSAIDs tested. Similarly, withdrawal from therapy due to side effects was no greater with proquazone than with other NSAIDs evaluated. Initial experience with lower dosages of proquazone (300 to 450 mg/day) suggest that efficacy is maintained and tolerability markedly improved. Thus, at present, proquazone would seem to be as effective as other NSAIDs used in the management of rheumatoid arthritis and osteoarthritis. However, further studies are needed to fully evaluate the efficacy and tolerability of this agent, especially at the lower daily dosages currently recommended, and to clarify whether it does have significant 'disease modifying' potential.
3763250	Pitfalls in the diagnosis of juvenile rheumatoid arthritis.	1986 Oct	There are many conditions that produce chronic arthritis in childhood, including JRA. The pitfalls associated with proper diagnosis involve underrecognition, misrecognition, and overrecognition of symptoms and signs.
1939459	5-Methylcytosine content of DNA in blood, synovial mononuclear cells and synovial tissue f	1991 May 31	The percentage of 5-methylcytosine (m5Cyt) has been determined in peripheral blood, synovial mononuclear cells and synovial tissue from patients affected by various rheumatic autoimmune diseases. The determination was performed by reversed-phase high-performance liquid chromatography. Fifteen controls were compared to twenty-one patients affected by rheumatoid arthritis and to nine patients affected by systemic lupus erythematosus. The mean percentage of m5Cyt in normal individuals was significantly higher than in the rheumatoid arthritis and systemic lupus erythematosus patients. In addition, patients with active disease showed lower values than patients in remission. This finding is in agreement with the hypothesis that DNA hypomethylation may play a role in the pathogenesis of the autoimmune diseases, resulting in altered oncogene expression. Therapy with cyclosporin A led to a decrease in the percentage of m5Cyt in three rheumatoid arthritis patients, but a rebound was observed when the cyclosporin A was suspended. The percentage of m5Cyt in the DNA of synovial tissue from four rheumatoid arthritis patients and five patients with osteoarthritis was similar; this observation confirms that, in addition to disease-specific and disease activity-specific variations, the percentage of m5Cyt may also show tissue-specific variations.
1930315	HLA and T cell receptor polymorphisms in pauciarticular-onset juvenile rheumatoid arthriti	1991 Oct	The immunogenetic basis of pauciarticular-onset juvenile rheumatoid arthritis is unclear. We therefore analyzed the HLA and T cell receptor genes present in a clinically well-defined group of patients. We found that the DR8 haplotype contributes most of the HLA-associated risk, although alleles at other loci contribute independently. A candidate disease-associated T cell receptor polymorphism, in contrast, was not identified in this population. Mechanistic implications of these findings are discussed.
2403401	Autoantibodies to nonhistone chromosomal proteins HMG-1 and HMG-2 in sera of patients with	1990 Sep	IgG antibodies against the high mobility group (HMG) nonhistone chromosomal proteins HMG-1 and/or HMG-2 were detected in the sera of 49 (39%) of 126 antinuclear antibody (ANA)-positive patients with juvenile rheumatoid arthritis (JRA), by immunoblotting. Clinical diagnosis classified these patients in 2 major groups, 105 with pauciarticular-onset JRA and 21 with polyarticular-onset JRA. Anti-HMG-1 and/or anti-HMG-2 antibodies were found in 8 (25%) of 32 pauciarticular-onset JRA patients with uveitis and in 34 (47%) of 73 patients without uveitis, whereas anti-HMG-1 and/or anti-HMG-2 antibodies were found in 4 (24%) of 17 children with polyarticular-onset JRA without uveitis. Among 53 sera from ANA-negative JRA patients, 3 (6%) were positive for anti-HMG-1 and/or anti-HMG-2 antibodies, whereas no reactivity to HMG-1 or HMG-2 proteins was observed in 48 sera from age-matched children with nonrheumatic diseases.
2043359	Turpentine- and fibrin-induced pleuritis in nude mice. Histopathological, cellular and bio	1991 May	Turpentine was injected into the right pleural cavity of nude immune-incompetent mice, causing a temporary irritative exudative pleuritis. A transient occurrence of so-called rheumatoid arthritis cells was observed in the pleural fluid together with parallel characteristic biochemical changes. In similar experiments in nude mice, however, immunization followed by intrapleural application of bovine fibrin showed irritative "dry" pleuritis without the presence of rheumatoid arthritis cells. This is in contrast with previous results from similar experiments done using normal mice. The conclusion from the present experiments is that in nude immune-incompetent mice only the non-immunological, turpentine-induced pleuritis will generate cellular and biochemical changes typical of the rheumatoid disease in patients, while the fibrin-induced pleuritis fails to show similar changes. This suggests that the rheumatoid-like pleural changes described in the present experiments in nude mice have a non-immunological basis.
2609078	Particular neurological aspects in vascular autoimmune diseases. I. Rheumatoid purpura, St	1989 Oct	This study presents particular clinical manifestations in 7 patients with autoiMmune diseases: rheumatoid purpura with right crural nerve paresis (1 case), Stevens-Johnson syndrome with encephalomyeloradicular syndrome (1 case) and left Wallenberg syndrome (1 case), rheumatoid arthritis with right parieto-occipital syndrome (1 case) and Gowers local panatrophy (1 case), systemic lupus erythematosus with confusional state and meningeal syndrome (1 case) and left ictal hemiplegia (1 case). The importance of neurological clinical manifestations at the onset or during the evolution of the autoimmune diseases is emphasized.