Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 8130289 | Self-care agency in persons with rheumatoid arthritis. | 1993 Sep | Using a framework based on Orem's self-care deficit theory, five hypotheses related to conditioning factors in self-care agency were tested. The study sample consisted of 60 outpatients with a diagnosis of rheumatoid arthritis in a large research hospital. Patients completed the Exercise of Self-Care Agency instrument and the Health Assessment Questionnaire; a physician rated their arthritis severity. Twenty percent of subjects had high scores on self-care agency, 63% had average scores, and 16% had low scores. The conditioning factor of age was not related to self-care agency. However, education and the duration of illness were related to self-care agency in this group of persons with rheumatoid arthritis. | |
| 1417131 | Clinical significance of rheumatoid factors in early rheumatoid arthritis: results of a fo | 1992 Sep | Serum rheumatoid factors (RF) were measured yearly in 135 women with rheumatoid arthritis by the Waaler-Rose and latex fixation tests and IgM, IgA, and IgG RF were measured by enzyme linked immunosorbent assays (ELISAs). The patients were followed up from an early phase of the disease for a mean duration of six years. Patients with a persistently positive RF test, irrespective of the type of test used, had more radiological abnormalities, more disease activity, worse functional ability, more extra-articular manifestations, and needed more treatment with second line drugs than patients with persistently negative or variably positive and negative test results during the follow up. Increased RF levels, especially a high level of IgA RF within three years of the onset of symptoms, was prognostic for a more severe disease outcome six years after the onset of symptoms. | |
| 7626934 | Drug therapy for patients with rheumatoid arthritis. | 1995 Jun 8 | Many rheumatic diseases such as rheumatoid arthritis are chronic with no known cure. In mild rheumatic disease analgesia and non-steroidal anti-inflammatory drugs are often sufficient to control symptoms; however, when the disease is severe disease-modifying and antirheumatic drugs are prescribed which are potentially toxic. Nurses have an important role in the monitoring and administration of these drugs. | |
| 8316869 | The radiographic features of rheumatoid arthritis in HLA-B27-positive patients. | 1993 | Radiographs were reviewed in a group of nine patients with classical seropositive rheumatoid arthritis who on tissue typing were found to express the class I HLA-B27 allele. Radiographs were analyzed with regard to whether or not they demonstrated radiographic features of (1) classical rheumatoid arthritis, (2) seronegative arthritis, or (3) mixed features of rheumatoid and seronegative arthritis. Five patients (55%) displayed radiographic features consistent with a diagnosis of rheumatoid arthritis, two patients (22%) showed radiographic features of seronegative disorder (periostitis and sacroiliitis), and two patients (22%) showed a mixed picture with evidence of both rheumatoid arthritis and a seronegative disorder. Thus, the HLA-B27 allele contributed to the radiographic features in 44% of patients with rheumatoid arthritis and associated HLA-B27. Thus, the wide range of findings in our population indicates that the radiographic attributes are not specific enough to constitute a unique subpopulation of patients with rheumatoid arthritis. | |
| 7512900 | Clinical pharmacology and modification of autoimmunity and inflammation in rheumatoid dise | 1994 Feb | The increased understanding of the mechanisms which underlie rheumatoid disease has been accompanied by a more appropriate use of the limited repertoire of therapeutic agents. Conventional second-line drugs still have a role in everyday practice. The efficacy of these agents in reducing the severity of clinical signs of joint inflammation, whilst at the same time causing significant reductions in the laboratory measures of the acute phase response is undoubtedly confirmed by meta-analysis of several therapeutic trials of these agents. Whether or not these agents can influence outcome, usually assessed in terms of radiological progression, is more contentious. Furthermore, their toxicity in long term use is not inconsiderable. However, newer agents may play a more important part in therapy in the future. Such therapy can be designed to specifically interfere with the abnormalities of the immune system which characterise rheumatoid arthritis. Many of the agents reviewed have been successfully applied to animal models of arthritis but we still await large randomised controlled studies in humans to determine their clinical efficacy and toxicity. In view of the complexity of the immunological abnormalities in rheumatoid arthritis, it may be necessary to consider using a number of such agents in any particular patient. This should result in more rational therapy in rheumatoid arthritis. | |
| 1613736 | Epidemiologic studies of rheumatoid arthritis: future directions. | 1992 Jan | We (1) review the current status of epidemiologic studies of rheumatoid arthritis (RA); (2) consider the strengths and weaknesses of such studies and (3) offer suggestions regarding directions which future work might take. We will not examine any particular studies in great detail, but, instead, will focus on those broad aspects of epidemiologic work concerning RA which seem most important. In this process, it may be useful to draw comparisons with cancer epidemiology, since etiologic possibilities in cancer often resemble those seen in RA and similar methodologic issues are involved. | |
| 8846649 | Prognostic factors of severe rheumatoid arthritis. | 1995 Sep | As one proposes sometimes more aggressive immunomodulatory treatment early in the process of rheumatoid arthritis, it becomes necessary to think about the prognostic factors early in the disease process that can predict eventual later poor outcome. We summarize the literature of the last 10 years dealing with this topic. | |
| 1295091 | Geographic distribution of rheumatoid arthritis in ancient North America: implications for | 1992 Dec | The fifth centennial of Columbus stimulates renewed interest in New World origins of disease. The earliest documentation of rheumatoid arthritis was in the New World. Subsequent study of its distribution in the New World in antiquity defines localization to a very specific geographic region. The absence of rheumatoid arthritis in 63 archaeological sites surrounding the original "catchment area" and in five Old World sites, with documented spread over time, suggests that it is a vector (microorganism or allergen)-transmitted disease. | |
| 8102674 | Rheumatoid arthritis: opposing actions of haemopoietic growth factors and slow-acting anti | 1993 Aug 28 | The pathogenesis of rheumatoid arthritis and the mode of action of anti-rheumatic drugs are unknown. This hypothesis proposes that haemopoietic growth factors (colony stimulating factors [CSFs]) have an important role in rheumatoid arthritis as regulators of myelopoiesis and as activators of inflammatory leucocytes. It also suggests that slow-acting anti-rheumatic drugs may work by inhibiting myelopoiesis. This opposition to one of the actions of the CSFs would result in fewer inflammatory cells in the inflamed joints. | |
| 8310203 | Prevalence of rheumatoid arthritis in the adult Indian population. | 1993 | The prevalence of rheumatoid arthritis was studied in the adult Indian population. As the first step, a house-to-house survey of a rural population near Delhi was conducted by two trained health workers. The target population comprised 44,551 adults (over 16 years old). The health workers identified the possible cases of rheumatoid arthritis (RA) using a questionnaire. These cases were then further evaluated by the authors using the 1987 revised ARA criteria for the diagnosis of RA. A response rate of 89.5% was obtained and 3393 persons were listed as possible cases of RA by the health workers. Of these, 299 satisfied the revised ARA criteria for the diagnosis of RA, giving a prevalence of 0.75%. Projected to the whole population, this would give a total of about seven million patients in India. The prevalence of RA in India is quite similar to that reported from the developed countries. It is higher than that reported from China, Indonesia, Philippines and rural Africa. These findings are in keeping with the fact that the north Indian population is genetically closer to the Caucasians than to other ethnic groups. | |
| 8718235 | Living with rheumatoid arthritis: a phenomenological exploration. | 1996 Jul 3 | The objective of this research was to elicit the experience of living with rheumatoid arthritis (RA) from the patient's frame of reference and to understand the global impact that this chronic illness has on social, psychological and physical well-being. A phenomenological methodology incorporating Colaizzi's procedural steps (1978) was used. Five main themes emerged from the research which highlighted the enormous impact that RA has on a patient's life. Nurses need to adopt an holistic approach to care and ensure that they understand the illness from the patient's perspective. | |
| 1445692 | Oncogene activation in rheumatoid synovium. | 1992 Oct | Rheumatoid arthritis (RA) is a chronic systemic disorder that is dominated by the debilitating sequelae associated with the progressive destruction of articular joints. The molecular and cellular basis of rheumatoid joint destruction is characterized by an abnormal expression of oncogenes modulating cellular proliferation and the induction of lysosomal and metalloproteinases. Based on the observation that the synovial hyperplasia in RA is associated with the proliferation of transformed-appearing synovial lining cells and an overexpression of such oncogenes, the possibility that a hitherto unknown HTLV related retrovirus is involved in the etiopathogenesis of RA is discussed. | |
| 1502563 | The paradox of effective therapies but poor long-term outcomes in rheumatoid arthritis. | 1992 Jun | Treatment of rheumatoid arthritis (RA) presents a paradox: Many effective therapies are extensively documented in numerous clinical trials, but all long-term studies from clinical settings indicate that most patients with RA have progressive disease. This paradox may be explained in part on the basis of four observations: (1) Results of therapies for RA have been evaluated primarily according to clinical trials over short periods rather than according to long-term clinical observations over many years; (2) increased mortality rates in RA have not been widely recognized because RA is not included on death certificates of more than half of the patients who die with this disease; (3) mortality in RA generally has been attributed to causes unrelated to RA or to drug toxicity, but higher mortality in specific patients is predicted primarily by more severe clinical status; and (4) published reports indicating an optimistic prognosis in RA have been based on epidemiological studies rather than on patients in clinical settings. In epidemiological studies of large populations, 75% of individuals who meet the 1958 American Rheumatism Association (ARA) criteria for RA have no evidence of disease 3 to 5 years later; in contrast, in clinical settings more than 90% of patients with RA have evidence of disease 3 to 5 years later, generally with progression. | |
| 8293012 | [Malignant lymphoma in rheumatoid arthritis treated by low doses of methotrexate]. | 1993 Mar | The authors report a case of non-Hodgkin's malignant lymphoma which developed in a patient under low-dose methotrexate for rheumatoid arthritis. Although rheumatoid arthritis without immunosuppressive therapy may be associated with an increased incidence of malignant lymphoma, the immunosuppressive effects of methotrexate may further promote the development of malignant lymphoma. | |
| 8339121 | The epidemiology of rheumatoid arthritis in Indonesia. | 1993 Jul | The prevalence of RA was investigated as part of a house-to-house survey of musculoskeletal pain in a total population of 4683 rural and 1071 urban subjects 15 years of age and over in Central Java. Those identified as having peripheral joint pain of more than 6 weeks duration (82 men and 129 women) were examined by a rheumatologist (JD) and serology tests and X-rays arranged. The prevalence of definite RA by ARA criteria was 0.2% in rural and 0.3% in urban subjects. The severity of diagnosed cases was indicated by Steinbrocker's functional classification of grades 2 and 3 and erosive arthritis on hand X-rays of grades 2-4. The low prevalence rate of RA compared with that found in developed countries is due partly to the different age structure of the population and lower life expectancy. There is also evidence of high mortality from the disease. This is thought to be due to the deprived socio-economic circumstances, the intermittent use of high dose corticosteroids and the frequent presence of severe infections in these communities. These factors should be considered when assessing the low prevalence of RA in surveys in other developing countries. | |
| 8976636 | Relation between heel position and the distribution of forefoot plantar pressures and skin | 1996 Nov | OBJECTIVE: To investigate the relation between the position of the rearfoot and the distribution of forefoot plantar pressures and skin callosities in rheumatoid arthritis. METHOD: Plantar pressures and callosity patterns were measured in 102 rheumatoid arthritis patients (120 feet with normal heel alignment and 84 feet with valgus heel alignment measured by goniometry) and in 42 (84 feet) age matched healthy adults. Peak pressures (kPa) were measured across the metatarsal heads in-shoe using an FScan system and the distribution of plantar callosities was visually mapped for each foot. RESULTS: Peak pressures were significantly greater at all but the first metatarsal head in the rheumatoid normal heel alignment and healthy adult groups than in the rheumatoid valgus heel group. The feet of both the rheumatoid normal heel group and the healthy adult group behaved the same, the highest peak pressures registering on the central metatarsal heads. However, only in the rheumatoid group were plantar callosities found at these sites. In the rheumatoid valgus heel group, lateral metatarsal heads were frequently non-weightbearing, producing gross loading patterns with a dominant medial distribution. Peak pressures were shifted to the medial fore-foot accompanied by a higher prevalence of callosities. The results, however, failed to establish clearly an association between peak pressures and callus formation. CONCLUSIONS: In rheumatoid arthritis there is an important interrelation between the rearfoot position and forefoot pressure sites. | |
| 8024957 | Clinical assessment and clinical trials in rheumatoid arthritis. | 1994 Mar | Important progress has been reported over the past year on evaluation and standardization of disease activity variables in rheumatoid arthritis and their relation to outcome measures. Core sets of variables have been established both in the United States and Europe, showing a high degree of resemblance. A recently proposed classification of antirheumatic drugs seeks to make a clear distinction between drugs that modify symptoms and those that actually control the disease. This classification may have a definite impact on design and methodology of future clinical trials. | |
| 7945473 | A cross-sectional and longitudinal comparison of the Rome criteria for active rheumatoid a | 1994 Oct | OBJECTIVE: To compare the diagnostic properties of the Rome 1961 criteria for active rheumatoid arthritis (RA) and the American College of Rheumatology (ACR; formerly, the American Rheumatism Association) 1987 criteria for RA with regard to their ability to classify, diagnose, and predict outcome in RA. METHODS: Analysis of cross-sectional and longitudinal data from repeated health examinations and review of clinical records of 3,509 Pima Indians followed up from January 1966 to December 1990. RESULTS: The ACR 1987 criteria identified approximately 50% of the cases identified by the Rome 1961 criteria, in both cross-sectional and longitudinal analyses. The ACR 1987 criteria were better predictors of subsequent development of a clinically supported diagnosis and treatment with slow-acting antirheumatic drugs (both P < 0.001), but were less sensitive than the Rome 1961 criteria for detecting cases for which there already was a clinically supported diagnosis (P < 0.001). CONCLUSION: In a population-based analysis, the ACR 1987 criteria are less sensitive for detecting clinical disease, but predict a clinically more severe prognosis, compared with the Rome 1961 criteria. The sensitivity of both sets of criteria to identify clinical disease is improved if multiple examinations or inactive disease are taken into account. | |
| 8356247 | Do nonimmunologically mediated pathways play a role in the pathogenesis of rheumatoid arth | 1993 Feb | The association between elevated serum rheumatoid factor and rheumatoid arthritis (RA) has been confirmed repeatedly and interpreted as strong evidence for an immunologic basis for the disease. In recent years, considerable additional evidence supporting this view has been obtained, strongly suggesting a role for CD4+ T cells in the pathogenesis of RA. An alternative view has also gained support, however. Based on studies of animal models and of RA itself, several lines of evidence have emerged that indicate that nonimmunologic pathways are operative in established RA. These observations have fostered the hypothesis that the evolution of RA may be associated with the emergence of non-T-cell-dependent autonomous pathways that dominate the latter stages of the disease. | |
| 1365773 | Generalized secondary amyloidosis in rheumatoid arthritis. | 1992 | The autopsy material of 215 RA patients was studied to determine 1) the frequency of generalized secondary amyloidosis (GSA), 2) the frequency and extent of amyloid deposits in various organs, 3) the chronological succession of amyloid deposition in various organs. The tissue specimens were fixed in 8% formaldehyde solution and embedded in paraffin. Serial sections were cut and stained with HE and Congo-red according to Romhányi, without alcoholic differentiation. The average amount of amyloid deposition in various organs was determined on a 0 to 4 plus scale. Thirty-seven cases were found to contain stainable amyloid (17.2%). The frequency and degree of amyloid deposition in different organs of RA cases with GSA are summarized in the following table. [table: see text] The frequency and extent of amyloid deposits in various organs may be linked to the ratio of cardiac output distributed over a different tissue mass. In conclusion, the tissues and organs often showing high quantities of amyloid are the sites where the deposits begin. Where deposits are infrequent or of low quantity deposits develop later. Amyloid deposits early in the wall of blood vessels, first of all within the GI tract, heart, kidneys, thyroid gland, spleen and the adrenal glands. |