Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 8533040 | William Musgrave's (1655-1721) system of arthritides. Did it include rheumatoid arthritis? | 1995 | Three dissertations on arthritis in Latin by the Englishman William Musgrave have been reviewed to find possible descriptions of rheumatoid arthritis. Polyarticular long-lasting joint pain in women are the cases most probable to be rheumatoid arthritis. This was found in 18 of 150 case stories. In the general sections the description of an arthritis after rheumatism has many traits compatible with rheumatoid arthritis. This sort of arthritis is reported to be frequent. It seems reasonable to conclude that rheumatoid arthritis was not uncommon at the turn of the seventeenth and eighteenth centuries. The difficulties in diagnostic interpretation of old medical texts are demonstrated. | |
| 7659452 | Extraarticular manifestations of rheumatoid arthritis. | 1995 Jul | Rheumatoid arthritis affects joints and other systems in the body. Dryness of the eyes and mucous membranes are referred to as Sjogren's Syndrome. The heart is usually spared but the lungs can be affected by pleurisy, scarring, and the formation of nodules in the lungs. The nervous system may be involved by compression neuropathy (e.g. carpal tunnel syndrome), peripheral neuropathy, or occasionally from cervical cord compression. The rare complication of vasculitis (inflammation of blood vessels) may be devastating because of gangrene or severe internal organ damage. Some of the effects of rheumatoid arthritis may be "invisible" such as anemia or abnormalities in the white blood cell count. Osteoporosis is usually asymptomatic until a fracture occurs. | |
| 8961574 | Suffering in people with rheumatoid arthritis. | 1996 Nov | Knowledge of the nature, meaning, and impact of suffering from the perspective of people with rheumatoid arthritis is needed to determine what nursing interventions are most helpful in reducing suffering. Grounded theory was used to identify the nature of suffering in 14 people with rheumatoid arthritis. Suffering was found to be a process directed toward regaining normalcy and consisted of three phases: disintegration of self; the shattered self; and reconstruction of self. Experiencing suffering resulted in struggling, lose of dreams, restructuring a future orientation, and withdrawing. Finding meaning through positive life changes was an outcome of suffering. The informants' differentiation between pain and suffering also was examined. The provision of comfort measures along with a caring and empathetic attitude were identified as helpful nursing interventions in reducing suffering. | |
| 8448634 | The 'side effects' of rheumatoid arthritis: joint destruction, disability and early mortal | 1993 Mar | Most patients with RA experience disease progression over periods longer than 5 years, characterized by radiographic joint destruction, declines in functional capacity to perform activities of daily living, frequent work disability, high levels of co-morbidities, and death earlier than expected. These long-term consequences of RA may be viewed as 'side effects' of disease, which must be balanced against possible side effects of drugs in planning treatments of patients with RA. Aggressive approaches, which may include acceptance of mild and even moderate side effects of drugs, may be appropriate in efforts to prevent 'side effects' of RA. | |
| 1307402 | [Role of oxygen free radicals in the physiopathology of rheumatoid arthritis]. | 1992 Jan | The authors present a review of the mechanisms of free radicals production and report the results of "in vivo" and "in vitro" studies correlating these agent with the physiopathologic changes of the rheumatoid arthritis. The data reviewed in this paper support the idea of the participation of free radicals in the articular lesion. However new studies are necessary to determine the contribution of free radicals on disease development, chronicity and the efficacy of antioxidant agents. | |
| 8823213 | Management of the early and late presentations of rheumatoid arthritis: a survey of Ontari | 1996 Sep 15 | OBJECTIVE: To examine primary care physicians' management of rheumatoid arthritis, ascertain the determinants of management and compare management with that recommended by a current practice panel. DESIGN: Mail survey (self-administered questionnaire). SETTING: Ontario. PARTICIPANTS: A stratified computer-generated random sample of 798 members of the College of Family Physicians of Canada. OUTCOME MEASURES: Proportions of respondents who chose various items in the management of two hypothetical patients, one with early rheumatoid arthritis and one with late rheumatoid arthritis. Scores for investigations, interventions and referrals for each scenario were generated by summing the recommended items chosen by respondents and then dividing by the total number of items recommended in that category. The scores were examined for their association with physician and practice characteristics and physician attitudes. RESULTS: The response rate was 68.3% (529/775 eligible physicians). Recommended investigations were chosen by more than two thirds of the respondents for both scenarios. Referrals to physiotherapy, occupational therapy and rheumatology, all recommended by the panel, were chosen by 206 (38.9%), 72 (13.6%) and 309 (58.4%) physicians respectively for early rheumatoid arthritis. These proportions were significantly higher for late rheumatoid arthritis (p < 0.01). In multiple regression analysis, for early rheumatoid arthritis, internship or residency training in rheumatology was associated with higher investigation and intervention scores, for late rheumatoid arthritis, older physicians had higher intervention scores and female physicians had higher referral scores. CONCLUSIONS: Primary care physicians' investigation of rheumatoid arthritis was in accord with panel recommendations. However, rates of referral to rheumatologists and other health care professionals were very low, especially for the early presentation of rheumatoid arthritis. More exposure to rheumatology and to the role of physiotherapy, occupational therapy and social work during primary care training is strongly recommended. | |
| 1622412 | Rheumatoid arthritis in Greek and British patients. A comparative clinical, radiologic, an | 1992 Jul | OBJECTIVE: To compare the clinical, radiologic, and serologic expression of rheumatoid arthritis (RA) in 2 different populations. METHODS: Standard protocols and assessment criteria were used in this study of 108 Greek and 107 British patients with RA. RESULTS: British patients had more severe articular involvement than did Greeks, as judged by the duration of morning stiffness (P less than 0.005), grip strength (P less than 0.0001), and the numbers of swollen (P less than 0.001) and tender (P less than 0.0001) joints. The British RA patients also had more severe joint damage on radiologic examination, as evidenced by Steinbrocker stage III (P less than 0.005) and IV (P less than 0.025) disease and had more extraarticular manifestations (P less than 0.0001), including rheumatoid nodules (P less than 0.0001) and Raynaud's phenomenon (P less than 0.05). Greek RA patients, however, more frequently presented with sicca manifestations (P less than 0.001) and serum antibodies to Ro/SS-A (P less than 0.025). Furthermore, Ro/SS-A antibodies were associated with a high incidence of side effects to D-penicillamine only in the Greeks. CONCLUSION: Genetic and environmental factors may be responsible for these striking differences in disease expression between these 2 European populations with RA. | |
| 8316772 | Early rheumatoid arthritis--some social, economical, and psychological aspects. | 1993 | Physical, psychological, and social features were assessed with standardized methods in 84 early RA patients followed prospectively for 2 years. During this time disease activity decreased, and disability evaluated by HAQ remained small. Psychological distress measured by SCL-90 (Symptom Check List) was in general not very pronounced and fairly stable over time. A high pain level at baseline provided a 4 times higher risk for a high level of psychological distress after 2 years. The prevalence of early retirement was 37% at the end of the study. Physical demanding work and a high initial HAQ score were the best predictors of work disability, increasing the risk of not working 10.7 and 5.5 times, respectively. At least 28% of patients had lower annual income compared to the year before disease onset. The ability to do shopping, home work, leisure time activities and social activities were negatively influenced by the disease in more than half of the patients. The social and economical consequences were thus considerable in the early stages of RA. | |
| 7732168 | Surgical and rehabilitation options in the treatment of the rheumatoid arthritis patient r | 1995 Feb | People with rheumatoid arthritis whose disease is poorly controlled with pharmacologic agents require treatment designed to reduce pain and inflammation and promote function and mechanical alignment. The proper evaluation of the musculoskeletal system and the patient's functional level must be performed. Heat, cold, splints, adaptive equipment, exercise, alternative therapies, and surgery are important adjunctive treatments for disease modulation and to maintain function and well being. | |
| 7979927 | Elderly rheumatoid arthritis patients on steroid treatment tolerate physical training with | 1994 Nov | The effects of physical training on elderly, fragile patients with rheumatoid arthritis (RA) who are on low-dose steroids were investigated. The controlled study included 24 patients who had been treated with low-dose steroids for 2 years. Each patient was assigned either to a treatment group receiving training or to an untrained control group. The training took place over a 3-month period and was based on a protocol using progressive interval training consisting of bicycle exercises, heel lifts, and step-climbing. The exercises were performed twice weekly for 45 minutes. Comparison of the two groups showed that disease activity did not increase in the trained group and that fewer, but not significantly fewer, swollen joints were observed in this group (p = 0.06). No significant changes were noticed in erythrocyte sedimentation rate, tender joints, or morning stiffness. The work capacity of the trained patients were doubled and the numbers of repetitions increased 76%. Individually adapted exercise programs can therefore be recommended for elderly rheumatoid arthritis patients on steroid treatment. | |
| 8434246 | Rifampicin in early rheumatoid arthritis. | 1993 | Sixteen patients with definite or classical Rheumatoid Arthritis (RA) of less than twelve months duration were recruited into a randomised, open twelve month study comparing Rifampicin 600 mg daily (9 patients) with Hydroxychloroquine (HCQ) 400 mg daily (7 patients). Ten patients completed twelve months of treatment (4 Rifampicin, 6 HCQ). Five patients were withdrawn from the study due to lack of efficacy (1 HCQ, 4 on Rifampicin). One further patient on rifampicin was withdrawn due to development of abnormal liver function tests. Significant improvement (p < 0.03) was noted in the Stoke Index (SI) at six and twelve months in the HCQ group which was not seen in the rifampicin group. In both groups there was no significant improvement in the single variables (Ritchie index, morning stiffness, grip strength, synovitis score, ESR, CRP). The results fail to confirm that Rifampicin may be useful in the treatment of RA in early stages of disease. | |
| 8339120 | The pathogenesis of rheumatoid arthritis: from molecules to the whole patient. | 1993 Jul | The pathogenesis of RA has now been worked out in considerable detail. The cell types involved have been characterized: monocyte/macrophages, T and B cells, synoviocytes and endothelial cells. The processes which are involved include cell adhesion and migration, T and B cell activation, cytokine release and joint destruction. The molecules which participate in these complex interactions have, for the most part, been cloned and sequenced and the function of their products studied intensively. However, despite the knowledge gathered by this reductionist approach we still do not understand fully the pathogenesis of the disease. This problem is resolvable by considering the fact that the synovitis is taking place within an individual in whom a number of other complex systems are interacting with the immune system. Of these, the neuroendocrine system is probably one of the most important as it has the ability to downregulate inflammation through the secretion of cortisol. Study of the hypothalamic-pituitary-adrenal axis in patients with RA has shown that it responds poorly to inflammatory stimuli. This defect may not only be an important factor in determining the severity of joint inflammation but could be an important early event in the switch from acute to joint inflammation. These findings reinforce the belief that exciting and high quality clinical research is still of crucial importance in our understanding of complex biological processes such as RA. | |
| 7849976 | Foot and ankle problems in rheumatoid arthritis. | 1994 Nov | The purpose of this study was to examine the prevalence of foot and ankle problems in 99 patients with clinically proven rheumatoid arthritis. Patients were recruited from outpatient rheumatology clinics; no attempt was made to select patients on the basis of the severity of their disease, duration of disease, or symptom constellation. Each patient was examined by an investigator utilizing a predesigned protocol to assess their functional status, functional capacity, and overall joint involvement. Ninety-three of 99 patients had complaints referable to the foot or ankle at some time since diagnosis of rheumatoid arthritis. Ankle problems were paramount in 42%, forefoot difficulties in 28%, and equal ankle and forefoot problems in another 14%. Only four patients had had any treatment involving foot orthotic devices or special shoe wear. The prevalence of foot and ankle symptoms was related to the duration of systemic illness, but was present in > 50% of patients at any time after diagnosis of rheumatoid arthritis. Patients with longstanding rheumatoid arthritis have a high prevalence of foot and ankle symptoms. Unlike previous reports, the present study found a high prevalence of ankle and hindfoot symptoms, as opposed to forefoot complaints. Despite this finding, the patients had been treated infrequently by either conservative nonoperative management directed at accommodating footwear or surgical intervention to favorably alter their foot and ankle mechanics. | |
| 8308767 | The stress process in rheumatoid arthritis. | 1993 Nov | OBJECTIVE: To evaluate the Stress Process Model proposed by Pearlin and colleagues by examining the role of personal and social resources in mediating the relationship between the rheumatoid arthritis (RA) related stressors of functional disability, pain, and flares, and the outcome of depressive symptoms. METHODS: Data are from 285 patients who participated in a study of the natural history of RA, comorbidity and depression. Measures include the Center for Epidemiologic Studies-Depression (CES-D) scale, the Arthritis Impact Measurement Scale Functioning and Pain scales, the Lubben Social Network scale, and items indicating sociodemographic status, health status and personal resources. A series of hierarchical regression analyses with multiplicative interaction terms were conducted. RESULTS: Substantial consistency between the Stress Process Model and relationships observed in the data was demonstrated. CONCLUSION: Although no claim is made to having demonstrated that the observed relationships are causal, the fact that the data are consistent with the model invites a prospective analysis in which the ordering of the variables over time can be established unambiguously. Because of the implications of the Stress Process Model for the design of psychosocial interventions, such a test is especially important. | |
| 8441165 | Outcome of rheumatoid arthritis in relation to age and rheumatoid factor at diagnosis. | 1993 Jan | Our retrospective followup study reports the outcome of rheumatoid arthritis (RA) in relation to age (under 60 vs 60 years and over) and rheumatoid factor status at diagnosis. A sample of 130 adult patients with RA was assessed at a mean of 5.6 years after diagnosis. At final evaluation disease activity and radiographic damage in seropositive patients were similar in both age groups, but functional capacity was markedly lower in the older onset group, indicating lower functional reserves in this group. In seronegative patients the outcome was favorable in both age groups, especially in the older patients. Seropositive patients in both age groups had more disease activity, a lower functional capacity and more radiographic damage than seronegative patients; these differences were greater in the older onset patients. The mortality in patients with RA compared to the general population (standardized mortality ratio, SMR) was higher in seropositive patients (SMR 2.78, 95% CI 1.70-4.13) but not in seronegative patients (SMR 0.45, 95% CI 0.08-1.13). The relative risk of dying was 6 times higher in seropositive patients than in seronegative patients (95% CI 1.7-20.9). | |
| 8497640 | Rheumatoid arthritis: evaluation of wrist extensor tendons with clinical examination versu | 1993 Jun | To determine whether magnetic resonance (MR) imaging can improve assessment of the extensor tendons of the wrist and their propensity to rupture, the dorsal tendons in 23 wrists in 20 patients with rheumatoid arthritis were clinically assessed and then examined with MR imaging. Clinical and MR imaging evaluations were performed blindly and independently. The six extensor tendon compartments were assessed with MR imaging for presence of pannus, synovial effusion, and tendon involvement or rupture. Clinical scores of systemic disease, dorsal tendon sheath swelling, and risk of tendon rupture ranged from 0 to 3 in each category; the overall score was not associated with any MR imaging category. Clinical assessment of enlargement of the dorsal tendon sheath and clinical risk of rupture correlated poorly with findings on MR images. All eight wrists with clinically minimal risk of rupture had pannus, effusions, and tendon involvement on MR images; the findings were similar in the wrists with moderate (grade 2) risk of rupture. MR imaging depicts involvement of the dorsal tendon sheath and dorsal tendons that cannot be assessed with other radiologic or clinical means. | |
| 8761187 | Raynaud's phenomenon in rheumatoid arthritis. | 1996 Aug | The aim of this study was to evaluate the prevalence of Raynaud's phenomenon in patients with rheumatoid arthritis (RA), and to relate this symptom to clinical, radiological and serological characteristics of the patients. All relevant information was retrospectively obtained from the standardized clinical records of 322 RA in-patients first admitted to the Rheumatology Unit of Brest University Medical School. Raynaud's phenomenon was found in 54 (17.2%) of 322 RA patients. There was no significant correlation between demographic, clinical or radiological characteristics. However, the subgroup of RA patients with Raynaud's phenomenon had a slightly higher prevalence of vasculitis than the subgroup without Raynaud's phenomenon. CRP level and C4 level were found to be lower in the former than in the latter group, whereas ESR and various serological findings (rheumatoid factor, antinuclear antibodies) were comparable in the two groups. We conclude that the prevalence of Raynaud's phenomenon is high in French RA in-patients, and that some clinical and biological abnormalities (vasculitis, low CRP level and low C4 level) suggest an association between Raynaud's phenomenon and vasculitis in a few cases, whereas this association might be fortuitous in the remainder. | |
| 8219773 | Rheumatoid factor: primary or secondary event in the pathogenesis of RA? | 1993 | Rheumatoid factors have been recognised and studied for over fifty years. They are anti-IgG immunoglobulins which occur in most patients with rheumatoid arthritis. Their precise contribution to the pathology of this disease however remains an enigma, since they are also demonstrable in other autoimmune and infectious diseases, as well as in normal healthy controls. Thus the importance of RF in RA may not pertain merely to their presence, but to the nature of the autoantibodies themselves. RF in RA are found to differ from those in control subjects and in other diseases such Waldenstrom's macroglobulinaemia in terms of their binding affinities for IgG, subclass specificity and V gene usage. The role of RF as either the initiating factor or its occurrence as a secondary event in RA is discussed. | |
| 8633113 | Scoring radiographic abnormalities in rheumatoid arthritis. | 1996 Mar | Serial radiologic examinations can demonstrate the initial development and stability or progression of erosions and cartilage damage during the course of rheumatoid arthritis. Measurements of the radiographic progression rate is potentially the most powerful tool available to the individual practitioner and the clinical investigator. This article examines various methods for scoring radiographic abnormalities in rheumatoid arthritis. | |
| 8870010 | Rheumatoid arthritis complicated by pachy- and leptomeningeal rheumatoid nodule-like granu | 1996 Jul | Rheumatoid nodule is a frequent and characteristic extra-articular manifestation of rheumatoid arthritis (RA). Its involvement of central nervous system is a rare occurrence with only a few reported cases. A 78-year-old man with severe arthritis showing the formation of rheumatoid nodule-like granulomas in the dura and subarachnoid space along with the spleen is presented. The characteristic morphological finding of the granulomas was the presence of neutrophils and the absence of definite fibrinoid necrosis, which differed from the typical features of rheumatoid nodules previously described. The diagnosis should be based on the exclusion of diseases that may cause similar granulomatous reactions including infectious diseases. Additionally, there was systemic necrotizing vasculitis in the dura and multiple cerebral infarcts, although the association between vasculitis and cerebral infarcts was not clear. |