These are representative sample records from Science.gov related to your search topic.
For comprehensive and current results, perform a real-time search at Science.gov.
1

[Immunogenetic aspects of early rheumatoid arthritis].  

PubMed

The study is aimed to investigate the distribution of alleles of HLA-DRB1 gene in patients with early rheumatoid arthritis and healthy individuals in Russian population, and evaluate their significance as molecular genetic markers of rheumatoid arthritis predisposition and protection. The association between alleles of HLA-DRB1 genes, antibodies to cyclic citrullinated peptides and IgM rheumatoid factor was also studied. Low and high resolution HLA-DRB1 genotyping were compared. In the cohort of patients with early rheumatoid arthritis, the alleles of HLA-DRB1 gene were found to be markers of rheumatoid arthritis protection/risk, especially in the homozygous state. They determined production of antibodies to cyclic citrullinated peptides but were not associated with rheumatoid factor IgM levels. These findings support different autoimmune mechanisms of rheumatoid arthritis pathogenesis. PMID:24003720

Guseva, I A; Demidova, N V; Soroka, N E; Novikov, A A; Luchikhina, E L; Aleksandrova, E N; Lukina, G V; Fedorenko, E V; Aronova, E S; Samarkina, E Iu; Boldyreva, M N; Trofimov, D Iu; Karateev, D E; Nasonov, E L

2013-01-01

2

Progressive pseudorheumatoid chandrodysplasia simulating juvenile rheumatoid arthritis  

Microsoft Academic Search

Four patients from a Muslim family with an inherited skeletal dyspiasia are presented. It is more crippling than usual form\\u000a of spondyloepi-physial dyspiasia tarda and the onset is very early in the life i.e. at 4 years. The disorder is progressive,\\u000a crippling and has striking clinical resemblance to juvenile rheumatoid arthritis. The striking X-ray appearance is of platyspondyly\\u000a and irregularities

Shreedhar G. Archik; Ravindra D. Kamat

1990-01-01

3

Is early rheumatoid arthritis the same disease process as late rheumatoid arthritis?  

Microsoft Academic Search

Thoughts on treatment for the early control of synovitis have stimulated research on pathobiological events at the site of inflammation in patients with early rheumatoid arthritis. Several studies have thus been conducted to examine synovial biopsy samples at various stages of the disease. The most important conclusion from these studies is that all features of chronic synovial inflammation can be

Paul P. Tak

2001-01-01

4

Raised granzyme B levels are associated with erosions in patients with early rheumatoid factor positive rheumatoid arthritis  

PubMed Central

Background: Raised granzyme B in serum and synovium of patients with rheumatoid arthritis suggests a role for cytotoxic T cells and natural killer cells in the pathogenesis of this disease. Objective: To evaluate serum granzyme B in patients with early arthritis and correlate it with specific diagnosis and clinical indices of disease severity. Methods: 257 patients with inflammatory arthritis for less than one year (46% rheumatoid arthritis, 17% spondyloarthropathy, 37% undifferentiated arthritis) had a prospective clinical, serological, and radiographic evaluation. Granzyme B was measured in initial sera by ELISA. Patients were HLA typed for DR alleles using sequence specific primers. A logistic regression model was used to evaluate the potential prognostic value of serum granzyme B in predicting radiographic erosions after one year of follow up. Results: Granzyme B values were similar in rheumatoid arthritis, spondyloarthropathy, and undifferentiated arthritis. Concentrations were higher in rheumatoid factor (RF) positive patients than in RF negative patients (mean (SD): 3.15 (0.92) v 2.89 (0.71) pg/ml; p<0.05). After one year, erosions were present in 30% of patients in the overall cohort, and in 44% of patients with rheumatoid arthritis. In the entire cohort, serum granzyme B did not predict erosions independently. However, high granzyme B was an independent predictor of early erosions in patients with RF positive rheumatoid arthritis (odds ratio = 4.83 (95% confidence interval, 1.13 to 20.59)) (p<0.05). Conclusions: Granzyme B may be a useful prognostic marker in early rheumatoid arthritis and may provide important clues to the pathogenesis of this disease. PMID:15471892

Goldbach-Mansky, R; Suson, S; Wesley, R; Hack, C; El-Gabalawy, H; Tak, P

2005-01-01

5

DIAGNOSTIC VALUE OF ANTI-RA33 ANTIBODY, ANTIKERATIN ANTIBODY, ANTIPERINUCLEAR FACTOR AND ANTINUCLEAR ANTIBODY IN EARLY RHEUMATOID ARTHRITIS: COMPARISON WITH RHEUMATOID FACTOR  

Microsoft Academic Search

SUMMARY The goal of this prospective longitudinal study was to determine the serological profile of early rheumatoid arthritis (RA), and to test whether antikeratin antibody (AKA), antiperinuclear factor (API7), anti-RA33 antibody and antinuclear antibodies (ANA) had an additional diagnostic value when prescribed after rheumatoid factor (RF)-detecting methods. Sixty-nine patients with early polyarthritis suggestive of RA, seen between 1991 and 1993,

C. CORDONNIER; O. MEYER; E. PALAZZO; M. DE BANDT; A. ELIAS; P. NICAISE; T. HAÏM; M. F. KAHN; G. CHATELLIER

1996-01-01

6

Serum MMP-3 and MMP-1 and progression of joint damage in early rheumatoid arthritis  

Microsoft Academic Search

Objective. Expression and activation of matrix metalloproteinases such as MMP-3 (stromelysin-1) and MMP-1 (collagenase-1) are increased in patients with rheumatoid arthritis (RA). Previous negative reports of their value as predictors of joint damage may be due to the lack of a large longitudinal study of early RA patients. This study evaluated their use in assessing early untreated patients with RA

M. J. Green; A. K. S. Gough; J. Devlin; J. Smith; P. Astin; D. Taylor; P. Emery

2003-01-01

7

Left ventricular function in treatment-naive early rheumatoid arthritis  

PubMed Central

Background: The role of inflammation and anti-cyclic citrullinated peptide antibodies (anti-CCP) in the pathogenesis of cardiovascular disease in early rheumatoid arthritis (RA) remains unclear. Previous studies have suggested that both disease activity and disease duration are associated with atherosclerosis and a higher mortality rate caused primarily by coronary artery disease. Objective: We investigated how disease activity, anti-CCP status and coronary calcium score in treatment-naive early RA impacts left ventricular (LV) systolic function. Methods: Fifty-tree patients (30 women) with mean age 58.3±1.3 years and steroid- and disease-modifying antirheumatic drug (DMARD)-naive early RA were included. Disease activity was scored by the use of the Danish national DANBIO registry (number of swollen joints (NSJ (28)), number of tender joints (NTJ (28)), C-reactive protein (CRP) and Health Assessment Questionnaire (HAQ)). Pain, fatigue, patient and physician global assessment and a composite disease activity score (DAS28-CRP) were assessed by visual analog scales (VAS) 0-100. IgM rheumafactor (IgM-RF) and anti-CCP titers were evaluated by standardized techniques. Coronary calcium score was estimated by computed tomography by calculating the Agaston score. One experienced senior rheumatologist and one experienced cardiologist performed all the clinical assessments as well as all the transthoracic echocardiography (TTE) and coronary CT analysis. Results: Disease activity scores before treatment at baseline were: NSJ (28) 7.1±2.7, NTJ (28) 8.5±3.5, CRP 11.7±12.9 mmol/l, HAQ 0.71±0.6, pain VAS 51.1±23.7, fatigue VAS 49.3±24.9, physician global assessment 54.2±15.0 and DAS28-CRP 4.8±0.7. Twenty-three (43%) patients were IgM-RF positive and 33 (62%) were anti-CCP positive. We found LV systolic function by conventional ejection fraction (EF) to be 54.1±9.2% and to be non-significant correlated to disease activity (CRP: r=0.07, p=0.64; baseline NSJ: r=-0.13, p=0.33; NTJ: r=-0.08, p=0.58; HAQ: r=0.23, p=0.1; pain VAS: r=-0.05, p=0.74; fatigue VAS: r=0.03, p=0,83; physician global assessment: r=-0.09, p=0.54 and DAS28: r=-0.03, p=0.84). However, using a more sensitive measurement of the LV function by global longitudinal systolic strain (GLS), we found a significant correlation: HAQ (r=0.29; p=0.037), patient global assessment by VAS (r=0.35; p=0.011), patient fatigue assessment by VAS (r=0.3; p=0.03) and DAS28-CRP (r=0.28; p=0.043); all corrected for relevant confounders (age, gender, pulse and blood pressure). Furthermore, anti-CCP was highly significantly correlated with GLS (r=-0.44; p=0.001) in univariate analysis. In multivariate analysis, it still remained significantly correlated (p=0.018), after correction for age, gender, pulse, and blood pressure. Using strain analysis of LV function, we found a significant difference in GLS in patients with high values of anti-CCP (titers ?340) compared to patients with anti-CCP (titers <340); (-19.9±2.1% vs. -16.4±2.8%; p=0.0001). For patients with high IgM-RF, results were non-significant. Conclusions: We observed a significant correlation between increased disease activity and cardiac function in treatment-naive early RA. PMID:25006535

Løgstrup, Brian B; Deibjerg, Lone K; Hedemann-Andersen, Agnete; Ellingsen, Torkell

2014-01-01

8

Synovial fluid leukocyte apoptosis is inhibited in patients with very early rheumatoid arthritis  

PubMed Central

Synovial leukocyte apoptosis is inhibited in established rheumatoid arthritis (RA). In contrast, high levels of leukocyte apoptosis are seen in self-limiting crystal arthritis. The phase in the development of RA at which the inhibition of leukocyte apoptosis is first apparent, and the relationship between leukocyte apoptosis in early RA and other early arthritides, has not been defined. We measured synovial fluid leukocyte apoptosis in very early arthritis and related this to clinical outcome. Synovial fluid was obtained at presentation from 81 patients with synovitis of ? 3 months duration. The percentages of apoptotic neutrophils and lymphocytes were assessed on cytospin preparations. Patients were assigned to diagnostic groups after 18 months follow-up. The relationship between leukocyte apoptosis and patient outcome was assessed. Patients with early RA had significantly lower levels of neutrophil apoptosis than patients who developed non-RA persistent arthritis and those with a resolving disease course. Similarly, lymphocyte apoptosis was absent in patients with early RA whereas it was seen in patients with other early arthritides. The inhibition of synovial fluid leukocyte apoptosis in the earliest clinically apparent phase of RA distinguishes this from other early arthritides. The mechanisms for this inhibition may relate to the high levels of anti-apoptotic cytokines found in the early rheumatoid joint (e.g. IL-2, IL-4, IL-15 GMCSF, GCSF). It is likely that this process contributes to an accumulation of leukocytes in the early rheumatoid lesion and is involved in the development of the microenvironment required for persistent RA. PMID:16859518

Raza, Karim; Scheel-Toellner, Dagmar; Lee, Chi-Yeung; Pilling, Darrell; Curnow, S John; Falciani, Francesco; Trevino, Victor; Kumar, Kanta; Assi, Lakhvir K; Lord, Janet M; Gordon, Caroline; Buckley, Christopher D; Salmon, Mike

2006-01-01

9

Implementation of a treat-to-target strategy in very early rheumatoid arthritis: results of the Dutch Rheumatoid Arthritis Monitoring remission induction cohort study  

Microsoft Academic Search

OBJECTIVE: Clinical remission is the ultimate therapeutic goal in rheumatoid arthritis (RA). Although clinical trials have proven this to be a realistic goal, the concept of targeting at remission has not yet been implemented. The objective of this study was to develop, implement, and evaluate a treat-to-target strategy aimed at achieving remission in very early RA in daily clinical practice.

M. Vermeer; H. H. Kuper; M. Hoekstra; C. J. Haagsma; M. D. Posthumus; H. L. Brus; P. L. van Riel; M. A. van der Laar

2011-01-01

10

Approaches to the treatment of early rheumatoid arthritis with disease-modifying antirheumatic drugs  

PubMed Central

This paper reviews recent approaches to treatment of early rheumatoid arthritis (RA) with disease-modifying antirheumatic drugs (DMARDs). The literature on treatment the early RA published between 1995 and 2007 was accessed through the PubMed database from the National Library of Medicine. Keywords were ‘early rheumatoid arthritis’, ‘disease-modifying antirheumatic drugs’, ‘biologic agents’ and ‘combination therapy’. Only results of trials on human subjects that directly measured the effects of DMARDs or biological agents on clinical, laboratory parameters and radiological progression of early RA were selected. Combination therapy suppresses RA activity and radiological progression more effectively than monotherapy. If better control of RA is evident after 3–6 months of treatment with the combination of DMARDs, one must still decide whether to stop the first DMARD, stop the second, or continue with the combination. Combination therapy biological agents (infliximab, adalimumab) with methotrexate and etanercept therapy alone may induce remission in many patients with early RA. It is a method of choice in patients with an adverse prognosis. The main indications for combination therapy ‘standard’ DMARDs or combination 1 DMARDs with a biological agent are such variables as detection of a shared epitope, increase of concentration of anticyclic citrullinated peptide antibodies, rheumatoid factor, C-reactive protein, 28-joint disease activity score, Sharp score and presence of erosion in joints. The majority of rheumatologists believe that patients with RA should be treated with DMARDs earlier rather than later in the disease process. Further trials should establish the optimal approaches to early RA therapy. PMID:18537958

Sizova, Lyudmila

2008-01-01

11

Medical, physical and psychological status related to early rheumatoid arthritis  

Microsoft Academic Search

Summary As part of an international European research project, a longitudinal study was started by the end of 1990 in the northern part of The Netherlands. The study concentrated on recently diagnosed RA patients (N=292), i.e., incident cases up to four years. According to the duration of the disease, five groups of patients had been formed. The early influence of

B. Krol; R. Sanderman; T. Suurmeijer; D. Doeglas; M. VAN RIJSWIJK; M. VAN LEEUWEN

1995-01-01

12

Early combination disease-modifying antirheumatic drug therapy and tight disease control improve long-term radiologic outcome in patients with early rheumatoid arthritis: the 11-year results of the Finnish Rheumatoid Arthritis Combination Therapy trial  

Microsoft Academic Search

INTRODUCTION: Early treatment of rheumatoid arthritis (RA) has been shown to retard the development of joint damage for a period of up to 5 years. The aim of this study was to evaluate the radiologic progression beyond that time in patients with early RA initially treated with a combination of three disease-modifying antirheumatic drugs (DMARDs) or a single DMARD. METHODS:

Vappu Rantalaiho; Markku Korpela; Leena Laasonen; Hannu Kautiainen; Salme Järvenpää; Pekka Hannonen; Marjatta Leirisalo-Repo; Harri Blåfield; Kari Puolakka; Anna Karjalainen; Timo Möttönen

2010-01-01

13

Magnetic resonance imaging applications in early rheumatoid arthritis diagnosis and management.  

PubMed

Early diagnosis and treatment have been recognized as essential for improving clinical outcomes in patients with rheumatoid arthritis (RA). Magnetic resonance imaging (MRI) is a sensitive modality that can assess both inflammatory and structural lesions. MRI can assist in following the disease course in patients treated with traditional disease-modifying antirheumatic drugs and biological therapies both in the clinic and in research trials. Therefore, it is anticipated that MRI becomes the diagnostic imaging modality of choice in RA clinical trials while remaining a useful tool for clinicians evaluating patients with RA. PMID:22819084

Troum, Orrin M; Pimienta, Olga; Olech, Ewa

2012-05-01

14

Early intervention in the treatment of rheumatoid arthritis: focus on tocilizumab  

PubMed Central

Tocilizumab is a fully humanized monoclonal antibody against interleukin-6 receptors that was approved for the treatment of patients with rheumatoid arthritis (RA). Several lines of evidence, obtained both from conventional disease-modifying anti-rheumatic drugs (DMARDs) and tumor necrosis factor (TNF) inhibitors, have supported the concept of “window of opportunity” as showing that these therapies consistently work better in early disease as compared to established RA. This review addresses the question of whether a window of opportunity gained with conventional DMARDs and TNF inhibitors can also be achieved with tocilizumab. To this end, data regarding the use of tocilizumab in early RA patients are summarized. Currently available data suggest that the earlier the treatment with tocilizumab, the better the clinical outcome can be, which may have implications for various aspects of RA treatment strategies. PMID:24179334

Yilmaz, Sedat; Simsek, Ismail

2013-01-01

15

A new strategy for the early diagnosis of rheumatoid arthritis: A combined approach  

Microsoft Academic Search

Rheumatoid arthritis [RA] is one of the most common and severe autoimmune rheumatic diseases, diagnosed primarily according to clinical manifestations and radiological reports. For many years, laboratory diagnosis of rheumatoid arthritis has relied on the detection of rheumatoid factor [RF], as established by the ACR criteria. A recent test to detect antibodies towards citrullinated peptides, called the anti-CCP assay, showed

A. Tedesco; D. D'Agostino; I. Soriente; P. Amato; R. Piccoli; P. Sabatini

2009-01-01

16

Matrix-mini-tablets of lornoxicam for targeting early morning peak symptoms of rheumatoid arthritis  

PubMed Central

Objective(s): The aim of present research was to develop matrix-mini-tablets of lornoxicam filled in capsule for targeting early morning peak symptoms of rheumatoid arthritis. Materials and Methods: Matrix-mini-tablets of lornoxicam were prepared by direct compression method using microsomal enzyme dependent and pH-sensitive polymers which were further filled into an empty HPMC capsule. To assess the compatibility, FT-IR and DSC studies for pure drug, polymers and their physical mixture were performed. The formulated batches were subjected to physicochemical studies, estimation of drug content, in vitro drug release, drug release kinetics, and stability studies. Results: When FTIR and DSC studies were performed it was found that there was no interaction between lornoxicam and polymers which used. All the physicochemical properties of prepared matrix-mini-tablets were found to be in normal limits. The percentage of drug content was found to be 99.60±0.07%. Our optimized matrix mini-tablets-filled-capsule formulation F30 released lornoxicam after a lag time of 5.02±0.92 hr, 95.48±0.65 % at the end of 8 hr and 99.90±0.83 % at the end of 12 hr. Stability was also found for this formulation as per the guidelines of International Conference on Harmonisation of Technical Requirements of Pharmaceuticals for Human Use. Conclusion: A novel colon targeted delivery system of lornoxicam was successfully developed by filling matrix-mini-tablets into an empty HPMC capsule shell for targeting early morning peak symptoms of rheumatoid arthritis. PMID:24967065

Mohd, Abdul Hadi; Raghavendra Rao, Nidagurthi Guggilla; Avanapu, Srinivasa Rao

2014-01-01

17

Auranofin improves outcome in early rheumatoid arthritis. Results from a 2-year, double blind placebo controlled study.  

PubMed

The effect of early initiation of auranofin (AF) therapy on outcome measures was studied in a controlled 24-month double blind trial in 138 patients with early rheumatoid arthritis (RA) using an intent to treat approach. Patients were randomized to AF or placebo but in case of insufficient effect or intolerable adverse events, they switched to open disease modifying antirheumatic drug therapy. Patients who started AF fared significantly better in improved joint swelling. Stanford Health Assessment Questionnaire index, Keitel functional test, and mental depression, and furthermore, radiologic progression was significantly retarded. Our results support a disease modifying beneficial effect of AF in early active RA.se PMID:14552308

Borg, G; Allander, E; Lund, B; Berg, E; Brodin, U; Pettersson, H; Trang, L

1988-12-01

18

MRI in early rheumatoid arthritis: synovitis and bone marrow oedema are independent predictors of subsequent radiographic progression  

Microsoft Academic Search

ObjectivesTo determine whether MRI and conventional (clinical and laboratory) measures of inflammation can predict 3-year radiographic changes measured by the van der Heijde Sharp score in patients with early rheumatoid arthritis (RA).Methods55 patients with RA with disease duration <1 year participated in this 3-year follow-up study. Patients were evaluated at baseline, 3, 6, 12 and 36 months by swollen and

Pernille Bøyesen; Espen A Haavardsholm; Mikkel Østergaard; Désirée van der Heijde; Sølve Sesseng; Tore K Kvien

2011-01-01

19

Aggressive treatment of early rheumatoid arthritis: recognizing the window of opportunity and treating to target goals.  

PubMed

Evidence supports the use of aggressive therapy for patients with early rheumatoid arthritis (RA). Clinical outcomes in patients with early RA can improve with a treat-to-target approach that sets the goal at disease remission. The current selection of antirheumatic therapies, including conventional and biologic disease-modifying antirheumatic drugs (DMARDs), has made disease remission a realistic target for patients with early RA. The challenge is selecting the optimal antirheumatic drug or combination of drugs for initial and subsequent therapy to balance the clinical benefits, risks, and economic considerations. In some cases, the use of biologic agents as part of the treatment regimen has shown superior results compared with conventional DMARDs alone in halting the progression of disease, especially in reducing radiographic damage. However, the use of biologic agents as initial therapy is challenged by cost-effectiveness analyses, which favor the use of conventional DMARDs. The use of biologic agents may be justified in certain patients with poor prognostic factors or those who experience an inadequate response to conventional DMARDs as a means to slow or halt disease progression and its associated disability. In these cases, the higher cost of treatment with biologic agents may be offset by decreased societal costs, such as lost work productivity, and increased health-related quality of life. Further research is needed to understand optimal strategies for balancing costs, benefits, and risks of antirheumatic drugs. Some key questions are (1) when biologic agents are appropriate for initial therapy, and (2) when to conclude that response to conventional DMARDs is inadequate and biologic agents should be initiated. PMID:21517638

Resman-Targoff, Beth H; Cicero, Marco P

2010-11-01

20

Can we prevent rapid radiological progression in patients with early rheumatoid arthritis?  

PubMed

The aim of this study is to test the performance of a matrix model to predict rapid radiological progression (RRP) in a study population of early rheumatoid arthritis (RA) or undifferentiated arthritis (UA) patients. A matrix model using baseline CRP, erosion score, autoantibody status, and initial treatment choice to predict RRP (increase ?5 points in Sharp-van der Heijde score (SHS) in 1 year) was derived from the BeSt study where patients with active RA (1987-criteria) were treated with initial monotherapy or combination therapy, aiming at low disease activity. In the IMPROVED study, patients with early RA (2010 criteria) and UA were initially treated with methotrexate and prednisone aiming at remission. A receiver operating characteristics (ROC) curve was used to assess the discriminative value of the model to predict damage progression in the IMPROVED population. Four hundred thirty-one out of 479 patients with RA and 106/122 with UA could be categorized as high, intermediate, low, or very low risk for RRP. One patient, with a very low risk profile, showed RRP. Thirty-two other patients (5 %) showed radiological progression ?0.5 point SHS; none had a high risk profile and 22 had a very low risk profile. The area under the curve (AUC) of the ROC curve was 0.56 (95% CI 0.45; 0.68). A matrix model predicting RRP based on risk factors identified in recent onset active RA according to the 1987-criteria performed poorly in recent onset RA (2010 criteria) and UA. It appears that known risk factors for damage progression lose their impact with early remission steered treatment, so that RRP might be considered a phenomenon of the past. PMID:25431327

Heimans, L; Boer, K V C Wevers-de; Ronday, H K; Collée, G; de Sonnaville, P B J; Grillet, B A M; Huizinga, T W J; Allaart, C F

2015-01-01

21

Rheumatoid Factors: Clinical Applications  

PubMed Central

Rheumatoid factors are antibodies directed against the Fc region of immunoglobulin G. First detected in patients with rheumatoid arthritis 70 years ago, they can also be found in patients with other autoimmune and nonautoimmune conditions, as well as in healthy subjects. Rheumatoid factors form part of the workup for the differential diagnosis of arthropathies. In clinical practice, it is recommended to measure anti-cyclic citrullinated peptide antibodies and rheumatoid factors together because anti-cyclic citrullinated peptide antibodies alone are only moderately sensitive, and the combination of the two markers improves diagnostic accuracy, especially in the case of early rheumatoid arthritis. Furthermore, different rheumatoid factor isotypes alone or in combination can be helpful when managing rheumatoid arthritis patients, from the time of diagnosis until deciding on the choice of therapeutic strategy. PMID:24324289

Castelli, Roberto

2013-01-01

22

Altered memory T cell differentiation in patients with early rheumatoid arthritis.  

PubMed

The chronic immune response in rheumatoid arthritis (RA) might be driven by activated Th1 cells without sufficient Th2 cell differentiation to down-modulate inflammation. To test whether disordered memory T cell differentiation contributes to the typical Th1-dominated chronic inflammation in RA we investigated differentiation of resting CD4+ memory T cells in patients with early (6 wk to 12 mo) untreated RA and in age- and sex-matched healthy controls in vitro. No difference in cytokine secretion profiles of freshly isolated memory T cells was detected between patients and controls. A cell culture system was then employed that permitted the differentiation of Th effectors from resting memory T cells by short term priming. Marked differences were found in response to priming. Th2 cells could be induced in all healthy controls by priming with anti-CD28 in the absence of TCR ligation. By contrast, priming under those conditions resulted in Th2 differentiation in only 9 of 24 RA patients. Exogenous IL-4 could overcome the apparent Th2 differentiation defect in seven patients but was without effect in the remaining eight patients. In all patients a marked decrease in IL-2-producing cells and a significant increase in well-differentiated Th1 cells that produced IFN-gamma but not IL-2 were evident after priming with anti-CD3 and anti-CD28. The data suggest that CD4+ memory T cells from patients with early untreated RA manifest an intrinsic abnormality in their ability to differentiate into specific cytokine-producing effector cells that might contribute to the characteristic Th1-dominated chronic (auto)immune inflammation in RA. PMID:10384153

Skapenko, A; Wendler, J; Lipsky, P E; Kalden, J R; Schulze-Koops, H

1999-07-01

23

Relationship between pulse wave velocity and serum YKL-40 level in patients with early rheumatoid arthritis.  

PubMed

Subclinical atherosclerosis has been demonstrated in patients with early rheumatoid arthritis (ERA) without any signs of cardiovascular disease (CVD). The aim of this study was to investigate the relationship between serum YKL-40 level and arterial stiffness in patients with ERA. Forty two patients with ERA and 35 healthy controls with no history or current sign of CVD were included in the study. ERA patients with active disease, defined as DAS28 ? 3.2, and symptoms onset <12 months were recruited. Arterial stiffness was evaluated by carotid-femoral pulse wave velocity (CF-PWV), and the intima-media thickness carotid (IMT-C) was measured by carotid ultrasonography. Serum YKL-40 levels were measured by an enzyme-linked immunoassay method. The mean age was 43.1 ± 5.8 years in ERA patients and 41.0 ± 5.9 years in control group. The CFPWV and IMT-C of the ERA patients were determined significantly higher than the control group (P = .001, P < .001, respectively). YKL-40 levels were significantly elevated in ERA patients than controls (P = .008). The serum levels of YKL-40 in the ERA patients showed a strong correlation with CF-PWV (r = .711, P < .001) and IMT-C (r = .733, P < .001). Multiple linear regression analysis revealed that CF-PWV could be explained by serum YKL-40 levels (adjusted R² = .493, P < .001). We have shown that patients with ERA had increased CF-PWV and serum YKL-40 levels. In addition, there was an association between CF-PWV values and serum YKL-40 levels in patients with ERA. As a result, we believe that serum YKL-40 level and CF-PWV might reflect early atherosclerosis in patients with ERA. PMID:23797781

Turkyilmaz, Aysegul Kucukali; Devrimsel, Gul; Kirbas, Aynur; Cicek, Yuksel; Karkucak, Murat; Capkin, Erhan; Gokmen, Ferhat

2013-11-01

24

Cyclosporin A monotherapy versus cyclosporin A and methotrexate combination therapy in patients with early rheumatoid arthritis: a double blind randomised placebo controlled trial  

Microsoft Academic Search

OBJECTIVE: To compare the efficacy and toxicity of cyclosporin A (CsA) monotherapy with CsA plus methotrexate (MTX) combination therapy in patients with early rheumatoid arthritis (RA). PATIENTS AND METHODS: 120 patients with active RA, rheumatoid factor positive and\\/or erosive, were randomly allocated to receive CsA with MTX (n=60) or CsA with placebo (n=60). Treatment with CsA was started in all

A. H. Gerards; RB Landewe; A. P. A. Prins; GA Bruijn; HS Goei The; RF Laan; B. A. C. Dijkmans

2003-01-01

25

PREDICTION OF PERMANENT WORK DISABILITY IN A FOLLOW-UP STUDY OF EARLY RHEUMATOID ARTHRITIS: RESULTS OF A TREE STRUCTURED ANALYSIS USING RECPAM  

Microsoft Academic Search

SUMMARY The objectives of this study are: (a) to determine the occurrence of permanent work disability (PWD) in early rheumatoid arthritis (RA); (b) to identify prognostic groups of patients; (c) to assess the employment rates for these groups over time. Seventy-three gainfully employed consecutive out-patients with early RA (>5 ARA 1958 criteria, disease duration < 12 months) at time one

W. MAU; M. BORNMANN; H. WEBER; H. F. WEIDEMANN; H. HECKER; H. H. Raspef

1996-01-01

26

Magnetic resonance imaging of the wrist in early rheumatoid arthritis reveals a high prevalence of erosions at four months after symptom onset  

Microsoft Academic Search

OBJECTIVESTo evaluate the role of magnetic resonance imaging (MRI) of the wrist in detecting early joint damage in patients with rheumatoid arthritis (RA).METHODSMRI was performed on 42 patients with early RA (median symptom duration of four months). Scans were scored separately by two musculoskeletal radiologists using a newly devised scoring system, which was validated. MRI findings were compared with plain

Fiona M McQueen; Neal Stewart; Jeff Crabbe; Elizabeth Robinson; Sue Yeoman; Paul L J Tan; Lachy McLean

1998-01-01

27

Prediction of erosiveness and rate of development of new erosions in early rheumatoid arthritis  

Microsoft Academic Search

Fifty eight patients suffering from a recent onset of rheumatoid arthritis (RA) were studied. Fifty six patients were followed up for 24 months and two for 18 months. Erosions were detected in 17 patients at the onset and at the end of the follow up period the number of patients with erosions was 44. The erosiveness in the joint groups

T T Möttönen

1988-01-01

28

Expression of the Inherently Autoreactive Idiotope 9G4 on Autoantibodies to Citrullinated Peptides and on Rheumatoid Factors in Patients with Early and Established Rheumatoid Arthritis  

PubMed Central

Background The pre-symptomatic stage of Rheumatoid arthritis (RA) is associated with pro-inflammatory cytokines and autoantibodies. High levels and epitope spread by Rheumatoid factors (RhF) and autoantibodies to citrullinated proteins signify progression towards disease expression. In established RA, the persistence of high autoantibody levels reflects production by both long-lived plasma cells and short-lived plasmablasts. Neither the relative contributions to pathogenesis by autoantibodies from either source, nor the factors responsible for deciding the fate of autoantigen specific ‘parent’ B-cells, is understood. Phenotypic markers identifying subsets of autoreactive B-cells are therefore of interest in understanding the origin and perpetuation of the autoimmune response in RA. One such phenotypic marker is the rat monoclonal antibody, 9G4, which recognises an idiotope on immunoglobuins derived from the inherently autoreactive VH-gene, VH4-34. We therefore investigated whether the 9G4 idiotope was expressed on autoantibodies in patients with RA. Methodology/Principal Findings Sera from 19 patients with established RA and those with <1year history of untreated polyarthritis either resolving into RA (n?=?42) or non-RA diagnosis (n?=?31) were included. Autoantibodies to cyclic citrullinated peptides (CCP), RhF and co-expression of the 9G4 idiotope were measured by ELISA. 9G4 recognised a population of anti-CCP antibodies in the majority of sera from patients with established disease and also in samples from patients with early disaese. 9G4+RhF levels were generally lower and not associated with positivity for, or levels of 9G4+CCP. Conclusions/Significance The persistence of 9G4+ immunoglobulins, of any isotype, in serum is rare. We describe here the novel finding of 9G4 expression on anti-CCP antibodies in patients from the earliest symptoms of RA through to established disease. Our results suggest that 9G4 expression on anti-CCP autoantibodies was not due to polyclonal expansion of VH4-34-encoded immunoglobulins. These studies may therefore provide a new focus for investigation into the evolution of the autoimmune response in RA patients. PMID:25222933

Cambridge, Geraldine; Moura, Rita A.; Santos, Tania; Khawaja, Akif A.; Polido-Pereira, Joaquim; Canhão, Helena; Leandro, Maria J.; Fonseca, João E.

2014-01-01

29

Dilemmas of participation in everyday life in early rheumatoid arthritis: a qualitative interview study (The Swedish TIRA Project).  

PubMed

Abstract Purpose: To explore the experiences of today's patients with early rheumatoid arthritis (RA) with respect to dilemmas of everyday life, especially regarding patterns of participation restrictions in valued life activities. Methods: A total of 48 patients, aged 20-63, three years post-RA diagnosis were interviewed using the Critical Incident Technique. Transcribed interviews were condensed into meaningful units describing actions/situations. These descriptions were linked to ICF participation codes according to the International Classification of Functioning, Disability and Health (ICF) linking rules. Results: Dilemmas in everyday life were experienced in domestic life, interpersonal interactions and relationships, community, social and civic life. Most dilemmas were experienced in domestic life, including participation restrictions in, e.g. gardening, repairing houses, shovelling snow, watering pot plants, sewing or walking the dog. Also many dilemmas were experienced related to recreation and leisure within the domain community, social and civic life. The different dilemmas were often related to each other. For instance, dilemmas related to community life were combined with dilemmas within mobility, such as lifting and carrying objects. Conclusions: Participation restrictions in today's RA patients are complex. Our results underline that the health care needs to be aware of the patients' own preferences and goals to support the early multi-professional interventions in clinical practice. Implications of Rehabilitation Today's rheumatoid arthritis (RA) patients experience participation restrictions in activities not included in International Classification of Functioning, Disability and Health (ICF) core set for RA or in traditionally questionnaires with predefined activities. The health care need to be aware of the patients' own preferences and goals to meet the individual needs and optimize the rehabilitation in early RA in clinical practice. PMID:25243767

Sverker, Annette; Ostlund, Gunnel; Thyberg, Mikael; Thyberg, Ingrid; Valtersson, Eva; Björk, Mathilda

2014-09-22

30

Early rheumatoid arthritis is characterized by a distinct and transient synovial fluid cytokine profile of T cell and stromal cell origin  

PubMed Central

Pathological processes involved in the initiation of rheumatoid synovitis remain unclear. We undertook the present study to identify immune and stromal processes that are present soon after the clinical onset of rheumatoid arthritis (RA) by assessing a panel of T cell, macrophage, and stromal cell related cytokines and chemokines in the synovial fluid of patients with early synovitis. Synovial fluid was aspirated from inflamed joints of patients with inflammatory arthritis of duration 3 months or less, whose outcomes were subsequently determined by follow up. For comparison, synovial fluid was aspirated from patients with acute crystal arthritis, established RA and osteoarthritis. Rheumatoid factor activity was blocked in the synovial fluid samples, and a panel of 23 cytokines and chemokines measured using a multiplex based system. Patients with early inflammatory arthritis who subsequently developed RA had a distinct but transient synovial fluid cytokine profile. The levels of a range of T cell, macrophage and stromal cell related cytokines (e.g. IL-2, IL-4, IL-13, IL-17, IL-15, basic fibroblast growth factor and epidermal growth factor) were significantly elevated in these patients within 3 months after symptom onset, as compared with early arthritis patients who did not develop RA. In addition, this profile was no longer present in established RA. In contrast, patients with non-rheumatoid persistent synovitis exhibited elevated levels of interferon-? at initiation. Early synovitis destined to develop into RA is thus characterized by a distinct and transient synovial fluid cytokine profile. The cytokines present in the early rheumatoid lesion suggest that this response is likely to influence the microenvironment required for persistent RA. PMID:15987480

Raza, Karim; Falciani, Francesco; Curnow, S John; Ross, Emma J; Lee, Chi-Yeung; Akbar, Arne N; Lord, Janet M; Gordon, Caroline; Buckley, Christopher D; Salmon, Mike

2005-01-01

31

Decreased Circulating Visfatin Is Associated with Improved Disease Activity in Early Rheumatoid Arthritis: Data from the PERAC Cohort  

PubMed Central

Objective To evaluate circulating visfatin and its relationship with disease activity and serum lipids in patients with early, treatment-naïve rheumatoid arthritis (RA). Methods Serum visfatin was measured in 40 patients with early RA before and after three months of treatment and in 30 age- and sex-matched healthy individuals. Disease activity was assessed using the Disease Activity Score for 28 joints (DAS28) at baseline and at three and 12 months. Multivariate linear regression analysis was performed to evaluate whether improved disease activity is related to serum visfatin or a change in visfatin level. Results Serum visfatin was significantly elevated in early RA patients compared to healthy controls (1.92±1.17 vs. 1.36±0.93 ng/ml; p?=?0.034) and significantly decreased after three months of treatment (to 0.99±0.67 ng/ml; p<0.001). Circulating visfatin and a change in visfatin level correlated with disease activity and improved disease activity over time, respectively. A decrease in visfatin after three months predicted a DAS28 improvement after 12 months. In addition, decreased serum visfatin was not associated with an improved atherogenic index but was associated with an increase in total cholesterol level. Conclusion A short-term decrease in circulating visfatin may represent an independent predictor of long-term disease activity improvement in patients with early RA. PMID:25068448

Sglunda, Ond?ej; Mann, He?man; Hulejová, Hana; Kuklová, Markéta; Pecha, Ond?ej; Pleštilová, Lenka; Filková, Mária; Pavelka, Karel; Vencovský, Ji?í; Šenolt, Ladislav

2014-01-01

32

Associations between HLA-DRB1 , RANK , RANKL , OPG , and IL17 genotypes and disease severity phenotypes in Japanese patients with early rheumatoid arthritis  

Microsoft Academic Search

We examined associations between human leukocyte antigen DRB1 (HLA-DRB1) shared epitope (SE), receptor activator of nuclear factor-kappaB (RANK), RANK ligand (RANKL), osteoprotegerin (OPG), and interleukin 17 (IL-17) genotypes with age of disease onset and radiographic progression in Japanese patients with early rheumatoid arthritis (RA).\\u000a HLA-DRB1 genotypes were evaluated in 123 patients with early RA (98 female, 25 male) within 1 year

Takefumi Furuya; Masayuki Hakoda; Naomi Ichikawa; Kenshi Higami; Yuki Nanke; Toru Yago; Naoyuki Kamatani; Shigeru Kotake

2007-01-01

33

Is the disease course of rheumatoid arthritis becoming milder? Time trends since 1985 in an inception cohort of early rheumatoid arthritis  

Microsoft Academic Search

OBJECTIVE: Based on comparisons of short-term cohort studies or cross-sectional samples of patients from different calendar times, it has been suggested that present patients with rheumatoid arthritis (RA) have a milder disease course compared with that of patients in past decades. This study was undertaken to investigate whether the course of disease activity and functional disability in patients with RA

Paco M. J. Welsing; Jaap Fransen

2005-01-01

34

The impact of rheumatoid arthritis on foot function in the early stages of disease: a clinical case series  

PubMed Central

Background Foot involvement occurs early in rheumatoid arthritis but the extent to which this impacts on the structure and function leading to impairment and foot related disability is unknown. The purpose of this study was to compare clinical disease activity, impairment, disability, and foot function in normal and early rheumatoid arthritis (RA) feet using standardised clinical measures and 3D gait analysis. Methods Twelve RA patients with disease duration ?2 years and 12 able-bodied adults matched for age and sex underwent 3D gait analysis to measure foot function. Disease impact was measured using the Leeds Foot impact Scale (LFIS) along with standard clinical measures of disease activity, pain and foot deformity. For this small sample, the mean differences between the groups and associated confidence intervals were calculated using the t distribution Results Moderate-to-high foot impairment and related disability were detected amongst the RA patients. In comparison with age- and sex-matched controls, the patients with early RA walked slower (1.05 m/s Vs 1.30 m/s) and had a longer double-support phase (19.3% Vs 15.8%). In terminal stance, the heel rise angle was reduced in the patients in comparison with normal (-78.9° Vs -85.7°). Medial arch height was lower and peak eversion in stance greater in the RA patients. The peak ankle plantarflexion power profile was lower in the patients in comparison with the controls (3.4 W/kg Vs 4.6 W/kg). Pressure analysis indicated that the RA patients had a reduced lesser toe contact area (7.6 cm2 Vs 8.1 cm2), elevated peak forefoot pressure (672 kPa Vs 553 kPa) and a larger mid-foot contact area (24.6 cm2 Vs 19.4 cm2). Conclusion Analysis detected small but clinically important changes in foot function in a small cohort of RA patients with disease duration <2 years. These were accompanied by active joint disease and impairment and disability. PMID:17184535

Turner, Deborah E; Helliwell, Philip S; Emery, Paul; Woodburn, James

2006-01-01

35

Prevalence of osteoporosis and osteopenia among African Americans with early rheumatoid arthritis: the impact of ethnic-specific normative data.  

PubMed Central

PURPOSE: To examine the prevalence of osteopenia and/or osteoporosis among African Americans with early rheumatoid arthritis (RA) and to assess the effect of using race/ethnicity-specific normative data. METHODS: Bone mineral density (BMD) of the hip and spine was assessed in African Americans with early RA. To examine the impact of using different normative data on disease classification, we calculated two sets of T scores, the first using sex-matched reference data from Caucasians and the second using data from African Americans. Osteoporosis was defined as a BMD at either site > or =2.5 SD below the young adult mean. Osteopenia was defined as a BMD > or =1 SD and <2.5 SD below this mean. RESULTS: Using Caucasian referent data, 33% (n=48) of patients had osteopenia or worse (n=48, 32.9%) and 5% (n=8) were osteoporotic. With the use of African-American normative data, 55% (n=94) were osteopenic or worse, and 16% (n=27) were osteoporotic. CONCLUSION: African Americans with RA are at risk of osteopenia and/or osteoporosis. Different diagnostic classifications may occur in this population based solely on the normative data used for assessing fracture risk. These results underscore the need for a standardized approach in defining osteopenia and osteoporosis in African Americans. PMID:16173331

Mikuls, Ted R.; Saag, Kenneth G.; Curtis, Jeffrey; Bridges, S. Louis; Alarcon, Graciela S.; Westfall, Andrew O.; Lim, Sam S.; Smith, Edwin A.; Jonas, Beth L.; Moreland, Larry W.

2005-01-01

36

The comparison of ultrasonographic and scintigraphic findings of early arthritis in revealing rheumatoid arthritis according to criteria of American College of Rheumatology  

Microsoft Academic Search

We aimed to investigate the diagnostic significance of high frequency ultrasonography (USG), comparing the findings in USG,\\u000a bone scintigraphy and clinical stuation. Fifty-one patients who had early symptoms of inflammatory arthritis, but not fulfilling\\u000a the ACR diagnostic criteria for rheumatoid arthritis (RA) were included in this study. They were referred to USG and bone\\u000a scintigraphy for examination of the synovial

Ahmet Ozgul; Evren Yasar; Nuri Arslan; Birol Balaban; M. Ali Taskaynatan; Kutay Tezel; Korhan Baklaci; M. Ali Özgüven; T. Alp Kalyon

2009-01-01

37

Early use of simulation in medical education.  

PubMed

An oft-cited belief that, until recently, simulators used in education of health care professionals were simple models is wrong. Hundreds of years ago and, in one instance, thousands of years ago, intricate models were used to help teach anatomy and physiology and in training in obstetrics and many surgical disciplines. Simulators were used to learn skills before performing them on patients and in high-stakes assessment.The newest technologies were often used in simulators to improve fidelity. In the 18th century, obstetric simulators could leak amniotic fluid, and blood were used to train midwives and obstetricians to recognize and manage complications of childbirth. Italy was the major source of simulators early in the 18th century, but in the 19th century, dominance in clinical simulation moved to France, Britain, and then Germany. In comparison, much of the 20th century was a "dark age" for simulation. PMID:22374231

Owen, Harry

2012-04-01

38

Evolving concepts of rheumatoid arthritis  

Microsoft Academic Search

Rheumatoid arthritis is the most common inflammatory arthritis and is a major cause of disability. It existed in early Native American populations several thousand years ago but might not have appeared in Europe until the 17th century. Early theories on the pathogenesis of rheumatoid arthritis focused on autoantibodies and immune complexes. T-cell-mediated antigen-specific responses, T-cell-independent cytokine networks, and aggressive tumour-like

Gary S. Firestein

2003-01-01

39

Role overload, pain and physical dysfunction in early rheumatoid or undifferentiated inflammatory arthritis in Canada  

PubMed Central

Background Inflammatory arthritis impairs participation in societal roles. Role overload arises when the demands by a given role set exceed the resources; time and energy, to carry out the required tasks. The present study examines the association between role overload and disease outcomes in early inflammatory arthritis (EIA). Methods Patients (n?=?104) of 7.61?months mean duration of inflammatory arthritis completed self-report questionnaires on sociodemographics, disease characteristics and role overload. Pain was assessed using the Short Form McGill Pain Questionnaire (MPQ) and physical functioning was measured with the Medical Outcomes Study Short Form 36 (SF-36) physical functioning score. Role overload was measured by the Role Overload Scale. Patients indicated the number of social roles they occupied from a total of the three typical roles; marital, parental and paid work. Results Participants’ mean age was 56?years and 70.2% were female. Role overload was not correlated to the number of social roles, however, it was positively associated with pain (p?=?0.004) and negatively associated with physical functioning (p?=?0.001). On multivariate analysis, role overload was negatively associated with physical functioning after controlling for the relevant sociodemographic variables. Conclusion This study identifies a possible reciprocal relationship between role overload and physical functioning in patients with EIA. PMID:22554167

2012-01-01

40

Rheumatoid Arthritis  

MedlinePLUS Videos and Cool Tools

... vertebrae to prevent slippage of the vertebrae. Self-Care Rheumatoid arthritis cannot be cured but it can be managed through medications and self-care. The following are important self-care tips: Exercise ...

41

A rare association of early-onset inclusion body myositis, rheumatoid arthritis and autoimmune thyroiditis: a case report and literature review  

PubMed Central

Summary Sporadic inclusion body myositis (sIBM) is a slowly progressive, red-rimmed vacuolar myopathy leading to muscular atrophy and progressive weakness; it predominantly affects males older than fifty years, and is resistant to immunotherapy. It has been described in association with immuno-mediated thrombocytopenic purpura, multiple sclerosis, connective tissue disorders and, occasionally, rheumatoid arthritis. A 37-year-old man with longstanding rheumatoid arthritis and autoimmune thyroiditis with hypothyroidism was referred to us with slowly progressive, diffuse muscle weakness and wasting, which had initially involved the volar finger flexors, and subsequently also the ankle dorsiflexors and knee extensors. Needle electromyography showed typical myopathic motor unit potentials, fibrillation and positive sharp waves with normal nerve conduction studies. Quadriceps muscle biopsy was suggestive of sIBM. Considering data published in the literature, this case may be classified as an early-onset form. The patient was treated with long-term intravenous immunoglobulin and obtained a substantial stabilization of his muscle strength. PMID:24125563

Clerici, Angelo Maurizio; Bono, Giorgio; Delodovici, Maria Luisa; Azan, Gaetano; Cafasso, Giuseppina; Micieli, Giuseppe

2013-01-01

42

Clinical and radiological dissociation of anti-TNF plus methotrexate treatment in early rheumatoid arthritis in routine care: Results from the ABRAB study  

PubMed Central

Background Rheumatoid arthritis (RA) is a chronic autoinflammatory joint disease which leads to the destruction of joints and disability of the patients. Anti-tumour necrosis factor (anti-TNF) drugs can halt radiological progression better than conventional DMARDs even in clinical non-responders. Methods The efficacy of anti-TNF plus methotrexate (MTX) treatment versus MTX monotherapy on clinical and radiological outcomes were compared in early rheumatoid arthritis (RA) patients in clinical practice by retrospective analysis of an observational cohort. 49 early RA patients (group A) on first-line MTX monotherapy and 35 early RA patients (group B) on anti-TNF plus MTX treatment were selected from an observational cohort and evaluated retrospectively focusing on their first twelve months of treatment. Data on disease activity (DAS28) and functional status (HAQ-DI) were collected three monthly. One-yearly radiological progression was calculated according to the van der Heijde modified Sharp method (vdHS). Clinical non-responder patients in both groups were selectively investigated from a radiological point of view. Results Disease activity was decreased and functional status was improved significantly in both groups. One-yearly radiological progression was significantly lower in group B than in group A. The percentage of patients showing radiological non-progression or rapid radiological progression demonstrated a significant advantage for group B patients. In addition non-responder patients in group B showed similar radiological results as responders, while a similar phenomenon was not observed in patients in group A. Conclusions Clinical efficacy within our study was similar for tight-controlled MTX monotherapy as well as for combination treatment with anti-TNF and MTX. However MTX monotherapy was accompanied by more rapid radiological progression and less radiological non-progression. Anti-TNF plus MTX decreased radiological progression even in clinical non-responders supporting the advantage of anti-TNF plus MTX combination in dissociating clinical and radiological effects. PMID:25059769

2014-01-01

43

[Progression of rheumatoid arthritis].  

PubMed

In order to recognize courses with high and low progression in rheumatoid arthritis deviating from former approach the values of a locomotor function test were used which do not belong to the dispersion region for the adequate classes of duration of a disease. With the help of a material of an electronic data processing study of 1,000 cases with ascertained diagnosis correlations between high progression and, among others, following criteria could be ascertained: male sex, old age, early beginning of the disease, manual trades, unfavourable functional values and very much changed laboratory values including high titres of the rheumatoid factor. In this method there was no relation to the duration of the disease, as it was existing with other methods of the determination of progression which were comparatively included into the investigation. PMID:960871

Keitel, W; Uhle, R

1976-07-01

44

Health Assessment Questionnaire disability progression in early rheumatoid arthritis: Systematic review and analysis of two inception cohorts  

PubMed Central

Objective The Health Assessment Questionnaire is widely used for patients with inflammatory polyarthritis (IP) and its subset, rheumatoid arthritis (RA). In this study, we evaluated the progression of HAQ scores in RA (i) by systematically reviewing the published literature on the methods used to assess changes in functional disability over time and (ii) to study in detail HAQ progression in two large prospective observational studies from the UK. Methods Data from two large inception cohorts, ERAS and NOAR, were studied to determine trajectories of HAQ progression over time by applying latent class growth models (LCGMs) to each dataset separately. Age, sex, baseline DAS28, symptom duration, rheumatoid factor, fulfilment of the 1987 ACR criteria and socio-economic status (SES) were included as potential predictors of HAQ trajectory subgroup membership. Results The literature search identified 49 studies showing that HAQ progression has mainly been based on average changes in the total study population. In the HAQ progression study, a LCGM with four HAQ trajectory subgroups was selected as providing the best fit in both cohorts. In both the cohorts, older age, female sex, longer symptom duration, fulfilment of the 1987 ACR criteria, higher DAS28 and lower SES were associated with increased likelihood of membership of subgroups with worse HAQ progression. Conclusion Four distinct HAQ trajectory subgroups were derived from the ERAS and NOAR cohorts. The fact that the subgroups identified were nearly identical supports their validity. Identifying distinct groups of patients who are at risk of poor functional outcome may help to target therapy to those who are most likely to benefit. PMID:24925692

Norton, Sam; Fu, Bo; Scott, David L.; Deighton, Chris; Symmons, Deborah P.M.; Wailoo, Allan J.; Tosh, Jonathan; Lunt, Mark; Davies, Rebecca; Young, Adam; Verstappen, Suzanne M.M

2014-01-01

45

Glucocorticoids in early rheumatoid arthritis: are the benefits of joint-sparing effects offset by the adverse effect of osteoporosis? the effects on bone in the utrecht study and the CAMERA-II study.  

PubMed

This paper reviews the clinical effects on bone of 10 mg of prednisone daily in early rheumatoid arthritis, given for 2 years in the Utrecht Study and in the second CAMERA (Computer- Assisted Management in Early Rheumatoid Arthritis) Study, and addresses the question whether there were joint-sparing effects and whether these were offset by adverse effects, especially osteoporosis. We conclude that a 2-year adjunct treatment with 10 mg of prednisone daily increases the benefits of disease-modifying antirheumatic drug therapy and has joint-sparing properties, even if added to the tight control methotrexate-based strategy aiming for remission. Importantly, with good control of inflammation and adequate use of calcium, vitamin D and bisphosphonates - according to national or international guidelines - steroid-induced osteoporosis is rare over 2 years. PMID:25228126

Jacobs, Johannes W G; Bijlsma, Johannes W J; van Laar, Jacob M

2015-01-01

46

Differential diagnosis of rheumatoid and psoriatic arthritis at an early stage in the small hand and foot joints using magnetic resonance imaging.  

PubMed

The 2 major and clinically most important primary inflammatory rheumatic diseases which affect small hand and feet joints are rheumatoid arthritis (RA) and psoriatic arthritis (PsA). The most important initial histopathological feature of RA is synovitis followed by chronic proliferative granulomatous pannus-tissue, which is associated with cartilage and bone destruction. Early inflammatory changes in RA also develop synchronously within the subchondral bone marrow. Enthesitis is the hallmark of SNSA, and is often seen as one of the first radiological manifestations of the diseases. As a rule inflammation within the synovial joints, histologically similar to RA, is not so pronounced. Consequently destructive changes within the synovial joints are much less with the exception of PsA in which pronounced bone destruction may develop (arthritis mutilans). Considerable overlapping in clinical and morphological manifestation of RA and PsA may be present. For evaluation of hand and feet joints and surrounding soft tissue structures in RA and PsA different imaging modalities are used, which include projection radiography, ultrasonography (US), radionuclide techniques and magnetic resonance imaging (MRI). MRI has become the imaging modality of choice for evaluation of arthritis, when conventional radiography is not conclusive. PMID:22833070

Jevtic, V; Lingg, G

2012-06-01

47

Synovial membrane immunohistology in early-untreated rheumatoid arthritis reveals high expression of catabolic bone markers that is modulated by methotrexate  

PubMed Central

Introduction We aimed to investigate the expression and therapeutic modulation of the receptor activator of the NF-?B ligand (RANKL) system in early-untreated rheumatoid arthritis (RA). Methods In this study, 15 patients with newly diagnosed RA (median symptom duration 7 months) were started on methotrexate (MTX) 20 mg weekly. Synovial biopsies were obtained by needle arthroscopy at baseline and 8 weeks after initiation of therapy. X-rays of the hands and feet were obtained at baseline and 1 year after diagnosis. Immunohistochemistry was performed to detect RANKL, receptor activator of nuclear factor-?B (RANK) and osteoprotegerin (OPG) in the synovial biopsies. The in vitro effect of MTX was tested on RA-derived primary fibroblasts and the osteoblasts-like osteosarcoma cell line (rtPCR, Western blot and ELISA) and in osteoclasts (tartrate-resistant acid phosphatase staining and dentine pit formation assay). Results MTX decreased synovial cellularity as well as RANK expression and the RANKL/OPG ratio. We confirmed this effect by a decrease of the mRNA and protein RANKL/OPG ratio in synovial-derived fibroblasts and osteoblasts-like tumoral cells exposed in vitro to methotrexate. Supernatants from MTX treated osteoblasts-like tumoral cells prevented pre-osteoclast formation in the absence of exogenous RANKL. Furthermore, MTX blocked osteoclastogenesis from peripheral blood mononuclear cells despite the presence of macrophage colony stimulating factor and RANKL, which indicates that MTX directly inhibits osteoclastogenesis. Conclusions The synovial membrane of early-untreated RA is characterized by a high RANKL/OPG ratio that can be reversed by methotrexate. PMID:24295447

2013-01-01

48

My Treatment Approach to Rheumatoid Arthritis  

PubMed Central

The past decade has brought important advances in the understanding of rheumatoid arthritis and its management and treatment. New classification criteria for rheumatoid arthritis, better definitions of treatment outcome and remission, and the introduction of biologic response-modifying drugs designed to inhibit the inflammatory process have greatly altered the approach to managing this disease. More aggressive management of rheumatoid arthritis early after diagnosis and throughout the course of the disease has resulted in improvement in patient functioning and quality of life, reduction in comorbid conditions, and enhanced survival. PMID:22766086

Davis, John M.; Matteson, Eric L.

2012-01-01

49

Genetic Analysis Workshop 15: simulation of a complex genetic model for rheumatoid arthritis in nuclear families including a dense SNP map with linkage disequilibrium between marker loci and trait loci  

Microsoft Academic Search

Data for Problem 3 of the Genetic Analysis Workshop 15 were generated by computer simulation in an attempt to mimic some of the genetic and epidemiological features of rheumatoid arthritis (RA) such as its population prevalence, sex ratio, risk to siblings of affected individuals, association with cigarette smoking, the strong effect of genotype in the HLA region and other genetic

Michael B Miller; Gregg R Lind; Na Li; Soon-Young Jang

2007-01-01

50

Early development of Xenopus embryos is affected by simulated gravity  

NASA Technical Reports Server (NTRS)

Early amphibian (Xenopus laevis) development under clinostat-simulated weightlessness and centrifuge-simulated hypergravity was studied. The results revealed significant effects on (i) 'morphological patterning' such as the cleavage furrow pattern in the vegetal hemisphere at the eight-cell stage and the shape of the dorsal lip in early gastrulae and (ii) 'the timing of embryonic events' such as the third cleavage furrow completion and the dorsal lip appearance. Substantial variations in sensitivity to simulated force fields were observed, which should be considered in interpreting spaceflight data.

Yokota, Hiroki; Neff, Anton W.; Malacinski, George M.

1994-01-01

51

Evaluating drug-free remission with abatacept in early rheumatoid arthritis: results from the phase 3b, multicentre, randomised, active-controlled AVERT study of 24?months, with a 12-month, double-blind treatment period  

PubMed Central

Objectives To evaluate clinical remission with subcutaneous abatacept plus methotrexate (MTX) and abatacept monotherapy at 12?months in patients with early rheumatoid arthritis (RA), and maintenance of remission following the rapid withdrawal of all RA treatment. Methods In the Assessing Very Early Rheumatoid arthritis Treatment phase 3b trial, patients with early active RA were randomised to double-blind, weekly, subcutaneous abatacept 125?mg plus MTX, abatacept 125?mg monotherapy, or MTX for 12?months. Patients with low disease activity (Disease Activity Score (DAS)28 (C reactive protein (CRP)) <3.2) at month 12 entered a 12-month period of withdrawal of all RA therapy. The coprimary endpoints were the proportion of patients with DAS28 (CRP) <2.6 at month 12 and both months 12 and 18, for abatacept plus MTX versus MTX. Results Patients had <2?years of RA symptoms, DAS28 (CRP) ?3.2, anticitrullinated peptide-2 antibody positivity and 95.2% were rheumatoid factor positive. For abatacept plus MTX versus MTX, DAS28 (CRP) <2.6 was achieved in 60.9% versus 45.2% (p=0.010) at 12?months, and following treatment withdrawal, in 14.8% versus 7.8% (p=0.045) at both 12 and 18?months. DAS28 (CRP) <2.6 was achieved for abatacept monotherapy in 42.5% (month 12) and 12.4% (both months 12 and 18). Both abatacept arms had a safety profile comparable with MTX alone. Conclusions Abatacept plus MTX demonstrated robust efficacy compared with MTX alone in early RA, with a good safety profile. The achievement of sustained remission following withdrawal of all RA therapy suggests an effect of abatacept's mechanism on autoimmune processes. Trial registration number NCT01142726. PMID:25367713

Emery, Paul; Burmester, Gerd R; Bykerk, Vivian P; Combe, Bernard G; Furst, Daniel E; Barré, Emilie; Karyekar, Chetan S; Wong, Dennis A; Huizinga, Tom W J

2015-01-01

52

Quasars, the early universe, and plasma simulations  

SciTech Connect

Quasars are among the most luminous objects in the universe, and the most distant for which we can obtain good spectroscopy. These spectra carry with them information about the formation of the first large structures in the universe and the first generations of star formation in newly born galaxies. The spectrum of a quasar has strong broad emission lines, formed by a non-equilibrium low-density photoionized gas. This spectrum can best be interpreted by reference to large-scale simulations of the full environment. This in turn is strongly coupled to many basic plasma physics questions. Here we discuss the current status of quasar research, numerical plasma simulations, and the atomic database.

Ferland, Gary J.; Verner, Dmitri A. [Physics Department, University of Kentucky, Lexington, Kentucky 40506 (United States)

1998-09-28

53

Subcutaneous rheumatoid nodules  

Microsoft Academic Search

We describe seven children with subcutaneous rheumatoid nodules who had no clinical evidence of rheumatoid arthritis. Only one girl was seropositive for antinuclear factors and had a slightly raised erythrocyte sedimentation rate. Clinical aspects, risks for developing rheumatoid arthritis, and treatment of this entity are discussed.

W J Mastboom; F H van der Staak; C Festen; M H Postma

1988-01-01

54

Comparing Five Year Out-Come in Two Cohorts of Patients with Early Rheumatoid Arthritis – A BARFOT Study  

PubMed Central

The objective of the study was to compare disease characteristics over the first 5 years of disease in patients with RA, with disease onset in 1990s and 2000s, respectively. Methods : All 2235 patients with early RA (disease duration ?12 months) were recruited from the BARFOT prospective observational study. These patients were divided into group 1 included 1992 to 1999 (N=1084, 66% women) and group 2 included 2000 to 2006 (N=1151, 69% women). Disease Activity Score (DAS28), VAS pain and Health Assessment Questionnaire (HAQ) were assessed during 5 years. Remission was defined as DAS28 <2.6. Results : At inclusion, both women and men in group 2 had higher mean DAS28 (SD) than group 1, 5.42 (1.22) vs 5.26 (1.19), p=0.004 and 5.28 (1.22) vs 5.00 (1.27), p=0.004, respectively, mainly dependant on pain and not on inflammatory related measures. Over time DAS28 decreased and was in both genders, from 6 months to the 5-year follow-up, significantly lower in group 2. At 5-year, both women and men in group 2 had higher rate of remission than women and men in group 1. However, despite reduction of VAS pain and HAQ there were no differences in pain and HAQ between groups at any time point. Conclusion : Patients included in the 2000s achieved higher frequency of remission at the 5 year follow-up compared with those included in the 1990s, suggested to reflect the more active medical treatment. Interestingly, however, improvement in pain and HAQ did not differ between the two patient cohorts.

Andersson, Maria L.E; Forslind, Kristina; Hafström, Ingiäld

2015-01-01

55

Pathophysiology of rheumatoid arthritis.  

PubMed

Understanding the pathophysiologic joint changes of rheumatoid arthritis will help the nurse practitioner educate clients in therapeutic modalities such as drugs, exercise, rest, heat and cold, and splints. Uncontrolled inflammation of the affected joints is the client's worst enemy. If inflammation could be controlled early in the disease process and thus limited to synovial tissue without pannus formation and subsequent cartilage destruction, normal joint function could be more optimally maintained. But once fibrotic tissue has formed, the resulting damage to the cartilage and joint destruction cannot be reversed. The earlier treatment is initiated and the sooner the client is educated, the less advanced and crippling this disease could be physically, psychologically, emotionally and socially. PMID:7110643

Strodthoff, C

1982-06-01

56

CRP genotype and haplotype associations with serum C-reactive protein level and DAS28 in untreated early rheumatoid arthritis patients.  

PubMed

IntroductionSingle nucleotide polymorphisms (SNPs) in the CRP gene are implicated in the regulation of the constitutional C-reactive protein (CRP) expression and its response to pro-inflammatory stimuli. Previous reports suggest these effects may have an impact on clinical decision-making based on CRP, for example DAS28. We aimed to investigate the possible association between 7 CRP SNPs, their haplotypes, and the serum level of CRP as well as the DAS28 score in two cohorts of untreated active early rheumatoid arthritis (RA) patients followed during their initial treatment.MethodsOverall, 315 disease-modifying anti-rheumatic drugs and steroid naïve RA patients with disease duration <6 months were included from two randomized controlled trials (the CIMESTRA and OPERA trials). Seven CRP SNPs were investigated: rs11265257, rs1130864, rs1205, rs1800947, rs2808632, rs3093077 and rs876538. The genotype and haplotype associations to CRP and DAS28 levels were evaluated using linear regression analysis adjusted for age, sex and treatment.ResultsThe minor allele of rs1205 C¿>¿T was associated with decreased CRP levels at baseline (P =0.03), with the TT genotype having a 50% reduction in CRP from 16.7 to 8.4 mg/L (P =0.005) compared to homozygosity of the major allele, but no association was observed at year one (P =0.38). The common H2 haplotype, characterized by the T allele of rs1205, was associated with a 26% reduction in CRP at baseline (P =0.043), although no effect was observed at year one (P =0.466). No other SNP or haplotype was associated with CRP at baseline or year one (P ¿0.09). We observed no associations between SNPs or haplotypes and DAS28 scores at baseline or year one (P ¿0.10).Conclusion CRP genotype and haplotype were only marginally associated with serum CRP levels and without any association to the DAS28 score. This study shows that DAS28, the core parameter for inflammatory activity in RA, can be used for clinical decision-making without adjustment for CRP gene variants.Trial registrationThe OPERA study is registered at clinicaltrials.gov (NCT00660647). The Cimestra study is not listed in a clinical trials registry due to inclusion of patients between October 1999 and October 2002. PMID:25359432

Ammitzbøll, Christian; Steffensen, Rudi; Bøgsted, Martin; Hørslev-Petersen, Kim; Hetland, Merete L; Junker, Peter; Johansen, Julia S; Pødenphant, Jan; Ostergaard, Mikkel; Ellingsen, Torkell; Stengaard-Pedersen, Kristian

2014-10-31

57

Rheumatoid Arthritis Educational Video Series  

MedlinePLUS

... Rheumatoid Arthritis Educational Video Series Rheumatoid Arthritis Educational Video Series This series of five videos was designed ... Activity Role of Body Weight in Osteoarthritis Educational Videos for Patients Rheumatoid Arthritis Educational Video Series Psoriatic ...

58

An historical review of rheumatoid arthritis treatment:1948 to 1952  

Microsoft Academic Search

Objectives:The early responses by practicing physicians to the discovery of the effect of cortisone (compound E) and adrenocorticotropic hormone (ACTH) on acute rheumatoid arthritis in 1948 and their reactions to the drugs' scarcity have been reviewed.

Jacob Karsh; Geza Hetenyi

1997-01-01

59

Early chemistry in hot and dense nitromethane: Molecular dynamics simulations  

Microsoft Academic Search

We report density functional molecular dynamic simulations to determine the early chemical events of hot (T=3000 K) and dense (&rgr;=1.97 g\\/cm3, V\\/V0=0.68) nitromethane (CH3NO2). The first step in the decomposition process is an intermolecular proton abstraction mechanism that leads to the formation of CH3NO2H+ and the aci ion H2CNO2?. This event is also confirmed to occur in a fast annealing

M. Riad Manaa; Evan J. Reed; Laurence E. Fried; Giulia Galli

2004-01-01

60

Early chemistry in hot and dense nitromethane: Molecular dynamics simulations  

Microsoft Academic Search

We report density functional molecular dynamic simulations to determine the early chemical events of hot (T=3000 K) and dense (rho=1.97 g\\/cm3, V\\/V0=0.68) nitromethane (CH3NO2). The first step in the decomposition process is an intermolecular proton abstraction mechanism that leads to the formation of CH3NO2H+ and the aci ion H2CNO2-. This event is also confirmed to occur in a fast annealing

M. Riad Manaa; Evan J. Reed; Laurence E. Fried; Giulia Galli; François Gygi

2004-01-01

61

Rheumatoid arthritis affecting temporomandibular joint  

PubMed Central

Rheumatoid arthritis (RA) is a chronic, systemic, autoimmune inflammatory disorder that is characterized by joint inflammation, erosive properties and symmetric multiple joint involvement. Temporomandibular joint (TMJ) is very rare to be affected in the early phase of the disease, thus posing diagnostic challenges for the dentist. Conventional radiographs fail to show the early lesions due to its limitations. More recently cone-beam computed tomography (CBCT) has been found to diagnose the early degenerative changes of TMJ and hence aid in the diagnosis of the lesions more accurately. Our case highlights the involvement of TMJ in RA and the role of advanced imaging (CBCT) in diagnosing the bony changes in the early phase of the disease.

Sodhi, Amandeep; Naik, Shobha; Pai, Anuradha; Anuradha, Ardra

2015-01-01

62

Treatment of rheumatoid arthritis using photodynamic therapy  

NASA Astrophysics Data System (ADS)

The only early therapy of rheumatoid arthritis in orthopedic surgery is a synovectomy, which is restricted to more or less big joints. A laser-synovectomy of small joints is ineffective yet. An alternative method may be photodynamic therapy. In our study we describe the photodynamic effect of Photosan 3 in a cell culture study.

Hendrich, Christian; Diddens, Heyke C.; Nosir, Hany R.; Siebert, Werner E.

1994-10-01

63

Treatment of rheumatoid arthritis using photodynamic therapy  

NASA Astrophysics Data System (ADS)

The only early therapy of rheumatoid arthritis in orthopedic surgery is a synovectomy, which is restricted to more or less big joints. A laser-synovectomy of small joints is ineffective yet. An alternative method may be photodynamic therapy. In our study we describe the photodynamic effect of Photosan 3 in a cell culture study.

Hendrich, Christian; Diddens, Heyke C.; Nosir, Hany R.; Siebert, Werner E.

1995-03-01

64

Evaluation of serum IL-6 level as a surrogate marker of synovial inflammation and as a factor of structural progression in early rheumatoid arthritis: Results from the ESPOIR cohort.  

PubMed

Objective: Interleukin-6 (IL-6) is a key cytokine in Rheumatoid Arthritis (RA) pathogenesis. We aimed to analyze the association between IL-6 serum levels and joint inflammation at baseline and the correlation of time-integrated IL-6 values with structural damage during the first 36 months of early arthritis. Methods: IL-6 was assessed by two different methods in 813 patients of the French early arthritis cohort ESPOIR over 36 months. IL-6 and C-reactive protein (CRP) changes were correlated to radiographic progression assessed by total Sharp-van der Heijde score (SHS). Synovium inflammation was assessed in a subgroup of 126 patients by ultrasonography (US). The relationship between SHS change and IL-6 or CRP levels at baseline was investigated by a univariate regression and a multivariable analysis. A longitudinal model nested by visit and patient was conducted to assess the role of IL-6 on SHS at each visit. Results: At baseline, IL-6 was more strongly correlated with the swollen joint count than CRP. In the univariate analysis, time-integrated value of IL-6 was more strongly correlated with the swollen joint count and the variation of SHS than time-integrated CRP. Baseline IL-6 was not independently associated with SHS change. Longitudinal models nested by patient showed that IL-6 levels were associated with structural damage independently from DAS28, smocking status, Rheumatoid Factor and Anti-Citrullinated Protein/Peptide Antibody serology, treatments and CRP levels. Conclusion: IL-6 level was a marker of US synovitis at baseline. Repeated measurements of IL-6 are associated with structural damage. © 2014 American College of Rheumatology. PMID:25384758

Baillet, Athan; Gossec, Laure; Paternotte, Simon; Etcheto, Adrien; Combe, Bernard; Meyer, Olivier; Mariette, Xavier; Gottenberg, Jacques-Eric; Dougados, Maxime

2014-11-10

65

Early attempts at atmospheric simulations for the Cherenkov Telescope Array  

E-print Network

The Cherenkov Telescope Array (CTA) will be the world's first observatory for detecting gamma-rays from astrophysical phenomena and is now in its prototyping phase with construction expected to begin in 2015/16. In this work we present the results from early attempts at detailed simulation studies performed to assess the need for atmospheric monitoring. This will include discussion of some lidar analysis methods with a view to determining a range resolved atmospheric transmission profile. We find that under increased aerosol density levels, simulated gamma-ray astronomy data is systematically shifted leading to softer spectra. With lidar data we show that it is possible to fit atmospheric transmission models needed for generating lookup tables, which are used to infer the energy of a gamma-ray event, thus making it possible to correct affected data that would otherwise be considered unusable.

Rulten, Cameron B

2014-01-01

66

Cachexia in rheumatoid arthritis.  

PubMed

Rheumatoid arthritis is a debilitating, chronic, systemic, autoimmune disease of unknown etiology that causes destruction of joint cartilage and bone. It generally occurs between the fourth and sixth decades of life, and affects two to three times more women than men. It is characterized by joint stiffness, pain, and swelling, and is accompanied by a loss of body cell mass. This loss of cell mass, known as rheumatoid cachexia, predominates in skeletal muscle, but also occurs in the viscera and immune system. Thus, rheumatoid cachexia leads to muscle weakness and a loss of functional capacity, and is believed to accelerate morbidity and mortality in rheumatoid arthritis. Currently there is no established mechanism for rheumatoid cachexia, but it is accompanied by elevated resting energy expenditure, accelerated whole-body protein catabolism, and excess production of the inflammatory cytokines, tumor necrosis factor-alpha and interleukin-1beta. Tumor necrosis factor-alpha is probably the central mediator of muscle wasting in rheumatoid arthritis, and is known to act synergistically with interleukin-1beta to promote cachexia. In general, tumor necrosis factor-alpha and interleukin-1beta are thought to alter the balance between protein degradation and protein synthesis in rheumatoid arthritis to cause muscle wasting. The precise mechanism by which they do this is not known. Reduced peripheral insulin action and low habitual physical activity are important consequences of rheumatoid arthritis, and have also been implicated as mediators of rheumatoid cachexia. Insulin inhibits muscle protein degradation. Consequently, reduced peripheral insulin action in rheumatoid arthritis is thought to be permissive to cytokine-driven muscle loss. The cause of reduced peripheral insulin action in rheumatoid arthritis is not known, but tumor necrosis factor-alpha has been shown to interfere with insulin receptor signaling and is probably an important contributor. Low habitual physical activity has consistently been observed in rheumatoid arthritis and is an important consequence of, and contributor to, muscle wasting. In addition, low physical activity predisposes to fat gain and is believed to precipitate a negative reinforcing cycle of muscle loss, reduced physical function, and fat gain in rheumatoid arthritis, which leads to 'cachectic obesity'. To date, there is no standard treatment for rheumatoid cachexia. However, physical exercise is currently believed to be the most important and clinically relevant countermeasure against rheumatoid cachexia. In general, a combination of skeletal muscle strength training and aerobic exercise is recommended, but must be prescribed with the patient's disease status, overall health, and safety in mind. Future studies should investigate the safety, efficacy, and required dose of anti-cytokine therapy for the treatment of rheumatoid cachexia. In this review, we outline the current definition of rheumatoid cachexia, and discuss the etiology, pathogenesis, and treatment of rheumatoid cachexia. PMID:12163213

Walsmith, Joseph; Roubenoff, Ronenn

2002-09-01

67

Genotyping for disease associated HLA DR ?1 alleles and the need for early joint surgery in rheumatoid arthritis: a quantitative evaluation  

PubMed Central

OBJECTIVE—To determine the value of HLA DR ?1 disease associated epitope (DAE) and erythrocyte sedimentation (ESR) in predicting the need for major joint replacement in rheumatoid arthritis (RA).?METHODS—Sixty five RA patients who had undergone hip, knee or shoulder arthroplasty within 15 years of disease onset and 65 who had not. HLA DR ?1 genotype was determined by polymerase chain reaction. ESR at first hospital visit was noted.?RESULTS—Significantly more patients with two DAE required surgery, (32% v 9%), ?2 = 13.9, p=0.001, odds ratio=5.4 (95% CI: 1.8, 16). Sensitivity was poor, 32%, specificity high, 91%. Presentation ESR was higher in surgery patients compared with non-surgery patients, 52 mm 1st h v 25 mm 1st h, p< 0.001, but was independent of DAE status. Sensitivity of an ESR of 30 mm 1st h was 75%, specificity 53%.?CONCLUSION—The presence of two DAE is a risk factor for major joint surgery in RA and is independent of ESR, whereas in those with one or no DAE, a high ESR is an important predictor.?? Keywords: HLA DR ?1; erythrocyte sedimentation rate; rheumatoid arthritis PMID:10343527

Crilly, A.; Maiden, N.; Capell, H.; Madhok, R.

1999-01-01

68

Early Eocene's climate and ocean circulation from coupled model simulations  

NASA Astrophysics Data System (ADS)

While proxy data provide a snapshot of climate conditions at a specific location, coupled atmosphere-ocean models are able to expand this knowledge over the globe. Therefore, they are indispensable tools for understanding past climate conditions. We model the dynamical state of atmosphere and ocean during the Early Eocene and pre-industrial times, using the coupled atmosphere-ocean model ECHAM5/MPIOM with realistic reconstructions of vegetation and CO2. The resulting simulated climate variables are compared to terrestrial and oceanic proxies. The Early Eocene climate is in the global mean warmer (~13°C) and wetter (~1 mm/d) than in pre-industrial times. Especially temperatures in the Southern Ocean, the Greenland Sea and Arctic Ocean raise by up to 25K, being in accordance with surface temperature estimates from terrestrial and marine proxy data. The oceans are hereby rendered ice-free, leading to a decrease of polar albedo and thereby facilitating polar warming. This leads to a by 5K diminished equator-to-pole temperature gradient. Warmer temperatures as well as changed bathymetry have an effect on ocean dynamics in the Early Eocene. Although deep-water formation can be found in the Greenland Sea, Weddell Sea, and Tethys Sea, it is weaker than in the pre-industrial run and the resulting circulation is shallower. This is not only visible in water transport through sea gates but also in the Atlantic Meridional Overturning Circulation (AMOC), adopting its maximum at 700m depths in the Early Eocene, while maximum transport is reached in the pre-industrial control run at 1200m. Albeit a shallow and weak thermohaline circulation, a global ocean conveyor belt is being triggered, causing a transport from the areas of subduction through the Atlantic and Southern Oceans into the Indian and Pacific Oceans.

Weber, Tobias; Thomas, Maik

2014-05-01

69

Organizing Pneumonia Preceding Rheumatoid Arthritis  

PubMed Central

Rheumatoid arthritis patients are susceptible to interstitial lung disease, and joint manifestations of rheumatoid arthritis usually precede lung involvements by several years. Organizing pneumonia, as the first manifestation of rheumatoid arthritis, is extremely rare, and its clinical features remain currently unknown. We present a case and a literature review of patients who were pathologically diagnosed with organizing pneumonia first and met the diagnostic criteria of rheumatoid arthritis later. In this review, we observed the following: (1) patients with organizing pneumonia preceding rheumatoid arthritis have a high prevalence of rheumatoid factor or anticyclic citrullinated peptide antibodies; (2) almost all patients developed rheumatoid arthritis within one year after the diagnosis of organizing pneumonia. We suggest that patients with organizing pneumonia and positive for either rheumatoid factor or anticyclic citrullinated peptide antibody should be cautiously followed up regarding the development of rheumatoid arthritis, particularly during the first year after the diagnosis of organizing pneumonia. PMID:24600522

Kinoshita, Yoshiaki; Sakamoto, Atsuhiko; Hidaka, Kouko

2014-01-01

70

Juvenile Rheumatoid Arthritis  

MedlinePLUS

Juvenile rheumatoid arthritis (JRA) is a type of arthritis that happens in children age 16 or younger. It causes joint swelling, ... reduce swelling and pain. NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

71

A Simulation Environment for Early Lifecycle Software Reliability Research and Prediction  

Microsoft Academic Search

It is important to apply models of software reliability early in the development lifecycle. This paper describes a software reliability simulation environment that will allow us to investigate early application of software reliablity models. The simulation environment uses information available during the design and coding phases to assist an model selection and early software reliability prediction. While we have just

Anneliese Von Mayrhauser; James Keables

1992-01-01

72

Early chemistry in hot and dense nitromethane: Molecular dynamics simulations  

NASA Astrophysics Data System (ADS)

We report density functional molecular dynamic simulations to determine the early chemical events of hot (T=3000 K) and dense (?=1.97 g/cm3, V/V0=0.68) nitromethane (CH3NO2). The first step in the decomposition process is an intermolecular proton abstraction mechanism that leads to the formation of CH3NO2H+ and the aci ion H2CNO2-. This event is also confirmed to occur in a fast annealing simulation to a final temperature of 4000 K at ?=2.20 g/cm3. An intramolecular hydrogen transfer that transforms nitromethane into the aci acid form, CH2NO2H, accompanies this event. To our knowledge, this is the first confirmation of chemical reactivity with bond selectivity for an energetic material near the Chapman-Jouget state of the fully reacted material. We also report the decomposition mechanism followed up to the formation of H2O as the first stable product. We note that similarities in the global features of reactants, intermediates, and products of the reacting fluid seem to indicate a threshold for similar chemistry in the range of high densities and temperatures reported herein.

Riad Manaa, M.; Reed, Evan J.; Fried, Laurence E.; Galli, Giulia; Gygi, François

2004-06-01

73

Handout on Health: Rheumatoid Arthritis  

MedlinePLUS

... prevent or reduce the effects of rheumatoid arthritis. Moving to a new place with a different climate ... role in rheumatoid arthritis and thus are potential targets for new treatments. The path between identifying the ...

74

N-acetyl-beta-D-glucosaminidase urinary excretion as an early indicator of kidney damage in rheumatoid arthritis patients starting on parenteral gold and Depo-Medrone/placebo injections.  

PubMed

The purpose of the study was to determine the effect of initiation of gold therapy on glomerular and tubular integrity. Urine albumin was used as a marker of glomerular damage. N-acetyl-beta-D-glucosaminidase (NAG) urinary excretion served as an indicator of proximal tubular damage. This study was an adjunct to a clinical trial that investigated the safety and the efficacy of Depo-Medrone during the induction phase of gold therapy. The NAG activities and albumin levels in the urine of 36 patients with active rheumatoid arthritis treated with sodium aurothiomalate weekly up to a total of 1 g were investigated. NAG was assayed in 565 early morning urine samples of these patients at weekly intervals for 24 weeks. The mean NAG level rose from 50.2 nmol/mg of creatinine on entry to peak NAG excretion of 120.4 nmol/mg of creatinine at week 4 and then fell to 56.3 nmol/mg of creatinine at week 24. Urinary albumin was assayed in 252 early morning urine samples at monthly intervals during gold treatment. Values greater than 20 mg/l were observed in 7.5% of urine samples. Microalbuminuria was present in 9% of patients at baseline. Two patients who were withdrawn because of proteinuria and macroalbuminuria had normoalbuminuria on entry. We conclude that raised levels of NAG associated with tubular damage are more frequent than glomerular damage on entry to, and during, treatment with gold salts. PMID:10357114

Wiland, P; Szechi?ski, J

1999-01-01

75

The MIT Design Advisor : simple and rapid energy simulation of early-stage building designs  

E-print Network

Simulation tools, when applied early in the design process, can considerably reduce the energy demand of newly constructed buildings. For a simulation tool to assist with design, it must be easy to use, provide feedback ...

Urban, Bryan J. (Bryan James)

2007-01-01

76

Rheumatoid arthritis impact survey.  

PubMed

A survey was undertaken to determine the effects of rheumatoid arthritis on the daily lives of patients. A randomly selected group of 135 Indians and blacks with rheumatoid arthritis were interviewed. Only 24% were employed and 35% were dependent on financial support from the state. Twenty-two per cent did not know the name of their illness and 89% expressed a desire to learn more about it. The most important problems encountered were pain (96%), stiffness (80%) and financial (58%). Activities such as toilet after-care, combing hair, bathing and dressing presented problems for a significant proportion of patients. The majority (73%) reported improvement on therapy. The survey showed that in rheumatoid arthritis, there is a great need for education and counselling of patients, there is a high unemployment rate and there is also a need for total patient care by a team of health professionals. PMID:3187821

Mody, G M; Shaw, J; Ramchurren, A

1988-10-15

77

Simulations of nucleation and early growth stages of protein crystals.  

PubMed Central

Analysis of known protein crystal structures reveals that interaction energies between monomer pairs alone are not sufficient to overcome entropy loss related to fixing monomers in the crystal lattice. Interactions with several neighbors in the crystal are required for stabilization of monomers in the lattice. A microscopic model of nucleation and early growth stages of protein crystals, based on the above observations, is presented. Anisotropy of protein molecules is taken into account by assigning free energies of association (proportional to the buried surface area) to individual monomer-monomer contacts in the lattice. Lattice simulations of the tetragonal lysozyme crystal based on the model correctly reproduce structural features of the movement of dislocation on the (110) crystal face. The dislocation shifts with the speed equal to the one determined experimentally if the geometric probability of correct orientation is set to 10(-5), in agreement with previously published estimates. At this value of orientational probability, the first nuclei, the critical size of which for lysozyme is four monomers, appear in 1 ml of supersaturated solution on a time scale of microseconds. Formation of the ordered phase proceeds through the growth of nuclei (rather then their association) and requires nucleations on the surface at certain stages. Images FIGURE 2 PMID:9251778

Kierzek, A M; Wolf, W M; Zielenkiewicz, P

1997-01-01

78

Update on the surgical treatment for rheumatoid arthritis of the wrist and hand.  

PubMed

Surgical procedures for the treatment of rheumatoid arthritis are aimed at restoring function and decreasing pain. Over the past four decades multiple procedures have been described in the management of early and late disease. This article will review the most common forms of surgery used in the treatment of rheumatoid arthritis. PMID:24530143

Chim, Harvey W; Reese, Sandra K; Toomey, Stephanie N; Moran, Steven L

2014-01-01

79

Investigation of Turbulence in the Early Stages of a High Resolution Supernova Simulation  

E-print Network

Investigation of Turbulence in the Early Stages of a High Resolution Supernova Simulation Robert curves of Type Ia supernovae (SN Ia) as tools for surveying vast distances. Previous simulations have. In this video, we show the turbulence within the early "bubble" of a supernova via renderings of the magnitude

Bell, John B.

80

Cachexia in rheumatoid arthritis  

Microsoft Academic Search

Rheumatoid arthritis is a debilitating, chronic, systemic, autoimmune disease of unknown etiology that causes destruction of joint cartilage and bone. It generally occurs between the fourth and sixth decades of life, and affects two to three times more women than men. It is characterized by joint stiffness, pain, and swelling, and is accompanied by a loss of body cell mass.

Joseph Walsmith; Ronenn Roubenoff

2002-01-01

81

What Is Rheumatoid Arthritis?  

MedlinePLUS

... publication. To order Rheumatoid Arthritis Handout on Health full-text version, please contact NIAMS using the contact information ... mailed to you? Visit our online order form. Full NIAMS Site NIH… Turning Discovery Into Health ® ... Comments Moderation Policy Site Map | Viewers and Players

82

Temporomandibular Joint Bone Tissue Resorption in Patients with Early Rheumatoid Arthritis Can Be Predicted by Joint Crepitus and Plasma Glutamate Level  

PubMed Central

The aim was to investigate whether bone tissue resorption in early RA is related to crepitus of the temporomandibular joint (TMJ) and systemic levels of inflammatory mediators and markers and sex steroid hormones. Twentynine women and 18 men with recently diagnosed RA were examined for TMJ bone erosions with computerized tomography and TMJ crepitus was assessed. Blood samples were analyzed for glutamate, 5-HT, TNF, IL-1?, IL-6, VEGF, inflammatory markers, and estradiol, progesterone and testosterone. The TMJ erosion score was positively correlated to glutamate, and TMJ crepitus where crepitus, glutamate and ESR explained 40% of the variation in the bone erosion score. In the patients without crepitus, bone erosion score was positively correlated to glutamate, which was not the case in the patients with crepitus. In conclusion, the results of this study show that TMJ bone tissue resorption can be predicted by TMJ crepitus and glutamate in early RA. PMID:20671920

Hajati, Anna-Kari; Näsström, Karin; Alstergren, Per; Bratt, Johan; Kopp, Sigvard

2010-01-01

83

Evaluation of a modified ACR20 scoring system in patients with rheumatoid arthritis receiving treatment with etanercept  

Microsoft Academic Search

Objective: To evaluate a modified American College of Rheumatology 20 (mACR20) scoring system for patients with rheumatoid arthritis.Methods: The data were evaluated from one study on patients with methotrexate (MTX)-naive early rheumatoid arthritis (ERA) and another study on patients with DMARD-refractory late rheumatoid arthritis (LRA). For mACR20 scoring, acute-phase reactant measurements were excluded, and 20% improvement from baseline was determined

J A Goldman; H A Xia; B White; H Paulus

2006-01-01

84

Management of Rheumatoid Arthritis  

PubMed Central

Rheumatoid arthritis is a common disease, for which every physician should have a sound approach. This paper details the global management of the disease. Guidelines are given for educating the patient and assessing the level of disease activity. Common questions about the indications and uses of non-steroidal anti-inflammatory drugs, local corticosteroid injections, slow-acting agents, immunosuppressive drugs and steroids are discussed. PMID:21278947

Carette, Simon

1984-01-01

85

Lower limb joint replacement in rheumatoid arthritis  

PubMed Central

Introduction There is limited literature regarding the peri-operative and surgical management of patients with rheumatoid disease undergoing lower limb arthroplasty. This review article summarises factors involved in the peri-operative management of major lower limb arthroplasty surgery for patients with rheumatoid arthritis. Methods We performed a search of the medical literature, using the PubMed search engine (http://www.pubmed.gov). We used the following terms: ‘rheumatoid’ ‘replacement’ ‘arthroplasty’ and ‘outcome’. Findings The patient should be optimised pre-operatively using a multidisciplinary approach. The continued use of methotrexate does not increase infection risk, and aids recovery. Biologic agents should be stopped pre-operatively due the increased infection rate. Patients should be made aware of the increased risk of infection and periprosthetic fracture rates associated with their disease. The surgical sequence is commonly hip, knee and then ankle. Cemented total hip replacement (THR) and total knee replacement (TKR) have superior survival rates over uncemented components. The evidence is not clear regarding a cruciate sacrificing versus retaining in TKR, but a cruciate sacrificing component limits the risk early instability and potential revision. Patella resurfacing as part of a TKR is associated with improved outcomes. The results of total ankle replacement remain inferior to THR and TKR. RA patients achieve equivalent pain relief, but their rehabilitation is slower and their functional outcome is not as good. However, the key to managing these complicated patients is to work as part of a multidisciplinary team to optimise their outcome. PMID:22697352

2012-01-01

86

Randomized controlled trial design in rheumatoid arthritis: the past decade  

Microsoft Academic Search

Much progress has occurred over the past decade in rheumatoid arthritis trial design. Recognized challenges have led to the establishment of a clear regulatory pathway to demonstrate efficacy of a new therapeutic. The use of pure placebo beyond 12 to 16 weeks has been demonstrated to be unethical and thus background therapy and\\/or early rescue has become regular practice. Goals

Vibeke Strand; Jeremy Sokolove

2009-01-01

87

Patients with rheumatoid arthritis have an altered circulatory aggrecan profile  

Microsoft Academic Search

BACKGROUND: Rheumatoid arthritis (RA) is a chronic auto-immune disease with extensive articular cartilage destruction. Aggrecan depletion, mediated by aggrecanases is one of the first signs of early cartilage erosion. We investigated, whether measurement of aggrecan and fragments thereof in serum, could be used as biomarkers for joint-disease in RA patients and furthermore characterized the fragments found in the circulation. METHODS:

Jean C Rousseau; Eren U Sumer; Gert Hein; Bodil C Sondergaard; Suzi H Madsen; Christian Pedersen; Thomas Neumann; Andreas Mueller; Per Qvist; Pierre Delmas; Morten A Karsdal

2008-01-01

88

Anglo-French contributions to the recognition of rheumatoid arthritis  

PubMed Central

Early descriptions of rheumatoid arthritis in the English and French literature are reviewed. Charcot pointed out that the disease was recognised as distinct from gout in eighteenth century England, and pictorial evidence for this is presented. His own work on arthritis led to a series of noteworthy interactions with Alfred Baring Garrod, which are discussed. Images PMID:7051988

Fraser, Kevin J.

1982-01-01

89

Airway obstruction and rheumatoid arthritis  

Microsoft Academic Search

The aim of this study was to assess the percentage of respiratory disorders and airway obstruction in patients with rheumatoid arthritis by com- paring lung function test results between patients with rheumatoid arthritis and control subjects with other rheumatological conditions. A prospective case-control study of respiratory symptoms and lung function abnormalities was performed in a series of 100 patients with

A. Vergnenègre; N. Pugnere; M. T. Antonini; M. Arnaud; B. Melloni; R. Treves; F. Bonnaud

1997-01-01

90

Evolution of Direct Costs in the First Years of Rheumatoid Arthritis: Impact of Early versus Late Biologic Initiation - An Economic Analysis Based on the ESPOIR Cohort  

PubMed Central

Objectives To estimate annual direct costs of early RA by resource component in an inception cohort, with reference to four distinct treatment strategies: no disease modifying antirheumatic drugs (DMARDs), synthetic DMARDs only, biologic DMARDs in the first year (‘first-year biologic’, FYB), and biologic DMARDs from the second year after inclusion (‘later-year biologic’, LYB); to determine predictors of total and non-DMARD related costs. Methods The ESPOIR cohort is a French multicentric, prospective study of 813 patients with early arthritis. Data assessing RA-related resource utilisation and disease characteristics were collected at baseline, biannually during the first two years and annually thereafter. Costs predictors were determined by generalised linear mixed analyses. Results Over the 4-year follow-up, mean annual direct total costs per treatment strategy group were €3,612 for all patients and €998, €1,922, €14,791, €8,477 respectively for no DMARDs, synthetic DMARDs only, FYB and LYB users. The main predictors of higher costs were biologic use and higher Health Assessment Questionnaire (HAQ) scores at baseline. Being a biologic user led to a higher total cost (FYB Rate Ratio (RR) 7.22, [95% CI 5.59–9.31]; LYB RR 4.39, [95% CI 3.58–5.39]) compared to non-biologic users. Only LYB increased non-DMARD related costs compared to all other patients by 60%. Conclusions FYB users incurred the highest levels of total costs, while their non-DMARD related costs remained similar to non-biologic users, possibly reflecting better RA control. PMID:24811196

Chevreul, Karine; Haour, Georges; Lucier, Sandy; Harvard, Stephanie; Laroche, Marie-Laure; Mariette, Xavier; Saraux, Alain; Durand-Zaleski, Isabelle; Guillemin, Francis; Fautrel, Bruno

2014-01-01

91

Predominant activation of MAP kinases and pro?destructive/pro?inflammatory features by TNF ? in early?passage synovial fibroblasts via TNF receptor?1: failure of p38 inhibition to suppress matrix metalloproteinase?1 in rheumatoid arthritis  

PubMed Central

Objective To examine the relative importance of tumour necrosis factor?receptor 1 (TNF?R1) and TNF?R2 and their signalling pathways for pro?inflammatory and pro?destructive features of early?passage synovial fibroblasts (SFB) from rheumatoid arthritis (RA) and osteoarthritis (OA). Methods Cells were stimulated with tumour necrosis factor (TNF)? or agonistic anti?TNF?R1/TNF?R2 monoclonal antibodies. Phosphorylation of p38, ERK and JNK kinases was assessed by western blot; proliferation by bromodesoxyuridine incorporation; interleukin (IL)6, IL8, prostaglandin E2 (PGE2) and matrix metalloproteinase (MMP)?1 secretion by ELISA; and MMP?3 secretion by western blot. Functional assays were performed with or without inhibition of p38 (SB203580), ERK (U0126) or JNK (SP600125). Results In RA? and OA?SFB, TNF??induced phosphorylation of p38, ERK or JNK was exclusively mediated by TNF?R1. Reduction of proliferation and induction of IL6, IL8 and MMP?1 were solely mediated by TNF?R1, whereas PGE2 and MMP?3 secretion was mediated by both TNF?Rs. In general, inhibition of ERK or JNK did not significantly alter the TNF? influence on these effector molecules. In contrast, inhibition of p38 reversed TNF? effects on proliferation and IL6/PGE2 secretion (but not on IL8 and MMP?3 secretion). The above effects were comparable in RA? and OA?SFB, except that TNF??induced MMP?1 secretion was reversed by p38 inhibition only in OA?SFB. Conclusion In early?passage RA/OA?SFB, activation of MAPK cascades and pro?inflammatory/pro?destructive features by TNF? is predominantly mediated by TNF?R1 and, for proliferation and IL6/PGE2 secretion, exclusively regulated by p38. Strikingly, RA?SFB are insensitive to p38 inhibition of MMP?1 secretion. This indicates a resistance of RA?SFB to the inhibition of pro?destructive functions and suggests underlying structural/functional alterations of the p38 pathway, which may contribute to the pathogenesis or therapeutic sensitivity of RA, or both. PMID:17223661

Kunisch, Elke; Gandesiri, Muktheshwar; Fuhrmann, Reneé; Roth, Andreas; Winter, Rando; Kinne, Raimund W

2007-01-01

92

Just Running Around: Some Reminiscences of Early Simulation/Gaming in the United Kingdom  

ERIC Educational Resources Information Center

The article begins with an abbreviated CV of the author and then recounts the formation of Society for the Advancement of Games and Simulation in Education and Training (SAGSET) and the early days of simulation and gaming in the United Kingdom. Four strands of elements of development are described together with the key events of the 1970s and…

van Ments, Morry

2011-01-01

93

SERS-based immunoassay of anti-cyclic citrullinated peptide for early diagnosis of  

E-print Network

to be a new clinical tool for the early diagnosis of rheumatoid arthritis (RA). Rheumatoid arthritis (RASERS-based immunoassay of anti-cyclic citrullinated peptide for early diagnosis of rheumatoid arthritis Hyangah Chon,a Sangyeop Lee,a Rui Wang,a So-Young Bang,b Hye-Soon Lee,b Sang-Cheol Bae,b Hyoban

Kim, Bongsoo

94

[The comparative effectiveness of high-intensity dynamic training with the use of exercise machines and therapeutic gymnastics for the joints in the patients presenting with early rheumatoid arthritis].  

PubMed

The objective of the present work was to compare the effectiveness of two therapeutic exercise programs for the patients presenting with early rheumatoid arthritis (RA). The study included 51 patients. Fifteen of them (group 1) were given conventional medicamental therapy in combination with high-intensity dynamic physical exercises with the use of the Enraf-Nonius training devices (45-60 min). Eighteen patients of group 2 were offered 10 sessions of remedial gymnastics for the joints (45 min each) under the guidance of an instructor that were continued under the domestic conditions (45 min each session thrice weekly for 3 months). Eighteen patients of group 3 were given medicamental therapy alone (control). The parameters estimated in the study included the mean strength of knee joint extension and ankle joint flexion measured with the use of En-TreeM devices, articular pain (100 mm BAHI), DAS28, HAQ, and RAPID3 indices. It was shown that both programs of therapeutic exercises reduced the severity of the disease, improved the functional and motor activity of the patients and their quality of life. The majority of these characteristics were significantly different from those documented in the control group (p<0.05). The clinical effectiveness of high-intensity training with the use of exercise machines was higher than without them (articular pain was reduced by 57.9% (p<0.01), DAS28 by 24.7% (p<0.05), HAQ by 60.7% (p<0.01). RAPID3 by 47.5% (p<0.01), mean strength of extension of the weak and strong knee joints increased by 87.9% (p<0.01) and 70.5% (p<0.01) respectively, the strength of flexion of the severely and less severely affected ankle joints increased by 84.6 (p<0.01) and 68.8% (p<0.01) respectively. Compliance with regular performance of therapeutic joint exercises during 3 months was higher (83.3%) than with high-intensity dynamic training with the use of exercise machines (60%). It is concluded that the latter modality should be recommended to the younger patients with RA (below 40 years), a short history of the disease, and its low activity. PMID:23718079

Orlova, E V; Karateev, D E; Kochetkov, A V; Mozhar, T E

2013-01-01

95

Certolizumab for rheumatoid arthritis.  

PubMed

This is a review of the pharmacology of certolizumab pegol and its efficacy and safety in the treatment of patients with rheumatoid arthritis refractory to synthetic disease-modifying anti-rheumatic drugs (DMARDs). Certolizumab is a new anti-TNF-? biologic agent injected subcutaneously with an innovative molecular structure and unique pharmacodynamic and pharmacokinetic properties. Data from controlled clinical trials indicate that the drug is effective in reducing disease activity and disability. It also inhibits radiographic progression. Certolizumab administration has an acceptable safety profile. The clinical data available suggest that the nature of adverse events is generally comparable to that of other TNF-? blockers. Given its rapid onset of action certolizumab presents an attractive alternative therapeutic option for patients with moderate to severe RA refractory to DMARDs. PMID:24447441

Markatseli, T E; Papagoras, C; Nikoli, A; Voulgari, P V; Drosos, A A

2014-01-01

96

Smoking and Rheumatoid Arthritis  

PubMed Central

Rheumatoid arthritis (RA) is a chronic inflammatory disease caused by both genetic and environmental factors. Smoking has been implicated as one of the most important extrinsic risk factors for its development and severity. Recent developments have shed light on the pathophysiology of RA in smokers, including oxidative stress, inflammation, autoantibody formation and epigenetic changes. The association of smoking and the development of RA have been demonstrated through epidemiologic studies, as well as through in vivo and animal models of RA. With increased use of biological agents in addition to standard disease-modifying antirheumatic drugs (DMARDs), there has been interest in how smoking affects drug response in RA treatment. Recent evidence suggests the response and drug survival in people treated with anti-tumour necrosis factor (anti-TNF) therapy is poorer in heavy smokers, and possible immunological mechanisms for this effect are presented in the current paper. PMID:25479074

Chang, Kathleen; Yang, So Min; Kim, Seong Heon; Han, Kyoung Hee; Park, Se Jin; Shin, Jae Il

2014-01-01

97

Can Rheumatoid Arthritis Be Prevented?  

PubMed Central

The discovery of elevations of rheumatoid arthritis (RA)-related biomarkers prior to the onset of clinically apparent RA raises hopes that individuals who are at risk for future RA can be identified in a preclinical phase of disease that is defined as abnormalities of RA-related immune activity prior to the clinically apparent onset of joint disease. Additionally, there is a growing understanding of the immunologic processes that are occurring in preclinical RA, as well as a growing understanding of risk factors that may be mechanistically related to RA development. Furthermore, there are data supporting that treatment of early RA can lead to drug free remission. Taken as a whole, these findings suggest that it may be possible to use biomarkers and other factors to accurately identify the likelihood and timing of onset of future RA, and intervene with immunomodulatory therapies and/or risk factor modification to prevent the future onset of RA in at-risk individuals. Importantly, several clinical prevention trials for RA have already been tried, and one is underway. However, while our understanding of the growing understanding of the mechanisms and natural history of RA development may be leading us to the implementation of prevention strategies for RA, there are still several challenges to be met. These include developing sufficiently accurate methods of predicting those at high risk for future RA so that clinical trials can be developed based on accurate rates of development of arthritis and subjects can be adequately informed of their risk for disease, identifying the appropriate interventions and biologic targets for optimal prevention, and addressing the psychosocial and economic aspects that are crucial to developing broadly applicable prevention measures for RA. These issues notwithstanding, prevention of RA may be within reach in the near future. PMID:24315049

Deane, Kevin

2013-01-01

98

The Early Jurassic climate: General circulation model simulations and the paleoclimate record  

SciTech Connect

This thesis presents the results of several general circulation model simulations of the Early Jurassic climate. The general circulation model employed was developed at the Goddard Institute for Space Studies while most paleoclimate data were provided by the Paleographic Atlas Project of the University of Chicago. The first chapter presents an Early Jurassic base simulation, which uses detailed reconstructions of paleogeography, vegetation, and sea surface temperature as boundary condition data sets. The resulting climatology reveals an Earth 5.2[degrees]C warmer, globally, than at present and a latitudinal temperature gradient dominated by high-latitude warming (+20[degrees]C) and little tropical change (+1[degrees]C). Comparisons show a good correlation between simulated results and paleoclimate data. Sensitivity experiments are used to investigate any model-data mismatches. Chapters two and three discuss two important aspects of Early Jurassic climate, continental aridity and global warming. Chapter two focuses on the hydrological capabilities of the general circulation model. The general circulation model's hydrologic diagnostics are evaluated, using the distribution of modern deserts and Early Jurassic paleoclimate data as validating constraints. A new method, based on general circulation model diagnostics and empirical formulae, is proposed for evaluating moisture balance. Chapter three investigates the cause of past global warming, concentrating on the role of increased ocean heat transport. Early Jurassic simulations show that increased ocean heat transports may have been a major factor in past climates. Increased ocean heat transports create latitudinal temperature gradients that closely approximate paleoclimate data and solve the problem of tropical overheating that results from elevated atmospheric carbon dioxide. Increased carbon dioxide cannot duplicate the Jurassic climate without also including increased ocean heat transports.

Chandler, M.A.

1992-01-01

99

Painful feet in rheumatoid arthritis.  

PubMed

Pain in the feet is an important diagnostic feature and a major management problem of rheumatoid arthritis. Of 50 hospitalized patients, 28% recalled painful feet as the sole presenting symptom of their disease.RHEUMATOID DISEASE COMMONLY AFFECTS THE FEET: 90% of the patients studied complained of foot pain at some time during the course of their disease, 86% had clinical involvement and 92% had radiological changes in their feet.The forefoot is most frequently involved. Midfoot involvement was noted in 68% but was symptomatic in only 22%. Changes in the ankle were least common but always symptomatic. PMID:4746132

Minaker, K; Little, H

1973-10-20

100

Detection of rheumatoid arthritis using infrared imaging  

NASA Astrophysics Data System (ADS)

Rheumatoid arthritis (RA) is an inflammatory disease causing pain, swelling, stiffness, and loss of function in joints; it is difficult to diagnose in early stages. An early diagnosis and treatment can delay the onset of severe disability. Infrared (IR) imaging offers a potential approach to detect changes in degree of inflammation. In 18 normal subjects and 13 patients diagnosed with Rheumatoid Arthritis (RA), thermal images were collected from joints of hands, wrists, palms, and knees. Regions of interest (ROIs) were manually selected from all subjects and all parts imaged. For each subject, values were calculated from the temperature measurements: Mode/Max, Median/Max, Min/Max, Variance, Max-Min, (Mode-Mean), and Mean/Min. The data sets did not have a normal distribution, therefore non parametric tests (Kruskal-Wallis and Ranksum) were applied to assess if the data from the control group and the patient group were significantly different. Results indicate that: (i) thermal images can be detected on patients with the disease; (ii) the best joints to image are the metacarpophalangeal joints of the 2nd and 3rd fingers and the knees; the difference between the two groups was significant at the 0.05 level; (iii) the best calculations to differentiate between normal subjects and patients with RA are the Mode/Max, Variance, and Max-Min. We concluded that it is possible to reliably detect RA in patients using IR imaging. Future work will include a prospective study of normal subjects and patients that will compare IR results with Magnetic Resonance (MR) analysis.

Frize, Monique; Adéa, Cynthia; Payeur, Pierre; Di Primio, Gina; Karsh, Jacob; Ogungbemile, Abiola

2011-03-01

101

Transferrin microheterogeneity in rheumatoid arthritis  

Microsoft Academic Search

We studied the relation between disease activity in rheumatoid arthritis (RA) and the microheterogeneity of transferrin. Using crossed immuno isoelectric focusing, transferrin microheterogeneity patterns were analyzed in sera of healthy individuals, nonanemic RA patients, iron deficient RA patients and RA patients with the anemia of chronic disease (ACD). In all RA groups a significant shift in the microheterogeneity pattern was

R. A. Feelders; G. Vreugdenhil; G. Jong; A. J. G. Swaak; H. G. Eijk

1992-01-01

102

Current evidence for the management of rheumatoid arthritis with glucocorticoids: a systematic literature review informing the EULAR recommendations for the management of rheumatoid arthritis  

Microsoft Academic Search

Glucocorticoids (GCs) rapidly reduce disease activity in early and advanced rheumatoid arthritis (RA). This systematic review on behalf of the task force on recommendations for the management of RA addresses the efficacy of GCs in RA. A literature search was performed in Medline, Embase, the Cochrane database, and the ACR\\/EULAR abstracts 2007 and 2008 on a set of questions relating

S. L. Gorter; Johannes W Bijlsma; M. Cutolo; J. Gomez-Reino; M. Kouloumas; J. S. Smolen; R. Landewe

2010-01-01

103

Organising pneumonia as the first manifestation of rheumatoid arthritis  

PubMed Central

Organising pneumonia (OP) is an inflammatory lung disease with distinctive clinicopathological features. OP can be evident during the course of rheumatoid arthritis (RA) with increased disease activity. The authors report an OP associated with RA case in which pulmonary symptoms preceded the onset of joint symptoms. An OP patient with elevated serum anticyclic citrullinated peptide antibody is likely to manifest RA in the near future, reflecting its high disease activity. Thus, an early rheumatologic consultation should be taken into consideration to make an early decision to initiate disease-modifying antirheumatic drugs therapy. PMID:22699479

Hoshino, Chisho; Satoh, Noriyuki; Narita, Masashi; Kikuchi, Akio; Inoue, Minoru

2011-01-01

104

Organising pneumonia as the first manifestation of rheumatoid arthritis.  

PubMed

Organising pneumonia (OP) is an inflammatory lung disease with distinctive clinicopathological features. OP can be evident during the course of rheumatoid arthritis (RA) with increased disease activity. The authors report an OP associated with RA case in which pulmonary symptoms preceded the onset of joint symptoms. An OP patient with elevated serum anticyclic citrullinated peptide antibody is likely to manifest RA in the near future, reflecting its high disease activity. Thus, an early rheumatologic consultation should be taken into consideration to make an early decision to initiate disease-modifying antirheumatic drugs therapy. PMID:22699479

Hoshino, Chisho; Satoh, Noriyuki; Narita, Masashi; Kikuchi, Akio; Inoue, Minoru

2011-01-01

105

The Argo simulation - II. The early build-up of the Hubble sequence  

NASA Astrophysics Data System (ADS)

The Hubble sequence is a common classification scheme for the structure of galaxies. Despite the tremendous usefulness of this diagnostic, we still do not fully understand when, where, and how this morphological ordering was put in place. Here, we investigate the morphological evolution of a sample of 22 high-redshift (z ? 3) galaxies extracted from the Argo simulation. Argo is a cosmological zoom-in simulation of a group-sized halo and its environment. It adopts the same high-resolution (˜104 M?, ˜100 pc) and sub-grid physical model that was used in the Eris simulation but probes a sub-volume almost 10 times bigger with as many as 45 million gas and star particles in the zoom-in region. Argo follows the early assembly of galaxies with a broad range of stellar masses (log M?/M? ˜ 8-11 at z ? 3), while resolving properly their structural properties. We recover a diversity of morphologies, including late-type/irregular disc galaxies with flat rotation curves, spheroid dominated early-type discs, and a massive elliptical galaxy, already established at z ˜ 3. We identify major mergers as the main trigger for the formation of bulges and the steepening of the circular velocity curves. Minor mergers and non-axisymmetric perturbations (stellar bars) drive the bulge growth in some cases. The specific angular momenta of the simulated disc components fairly match the values inferred from nearby galaxies of similar M? once the expected redshift evolution of disc sizes is accounted for. We conclude that morphological transformations of high-redshift galaxies of intermediate mass are likely triggered by processes similar to those at low redshift and result in an early build-up of the Hubble sequence.

Fiacconi, Davide; Feldmann, Robert; Mayer, Lucio

2015-01-01

106

Experimental Synthesis of Organic Compounds From Inorganic Materials by the Simulated Impact on the Early Earth  

NASA Astrophysics Data System (ADS)

How to prepare prebiotic organic molecules on the early Earth has been debated vigorously. One of points of debates is how to overcome the difficulty to produce prebiotic organic molecules under moderately oxidizing CO2 and N2-rich early atmosphere. Previous investigators suggested the existence of early oceans well before 4.0 Ga, late heavy bombardments at around 4.0 Ga, and the earliest life at 3.8 Ga. In order to connect these geological evidences, we hypothesized that meteorite impacts, which brought many reductants, on the early oceans followed by interaction with the atmosphere were responsible for production of prebiotic organic molecules. In order to simulate the impact reaction, we performed shock-recovery experiments with single-stage propellant gun. The shocked materials are composed of mixture of iron, nickel, carbon, water and gaseous nitrogen or dissolved ammonia. The carbon in the starting materials is enriched in 99% of 13C so that the C-bearing products can be distinguished from contaminants. These mixtures were encapsulated in metal containers and then shocked with impact velocities of 1 km/s. Analyses of the experimental products were performed using the state-of-the-art LC/MS and GC/MS. Various organic molecules including bio molecules composed only of 13C are detected, verifying syntheses of those organic molecules during the shock experiments. This result further suggests that the late heavy bombardment on the early oceans, dynamic high-pressure conditions, triggered to form a large mass and variety of prebiotic organic molecules on the early Earth.

Furukawa, Y.; Sekine, T.; Oba, M.; Kakegawa, T.; Nakazawa, H.

2008-12-01

107

Pulmonary cryptococcosis that mimicked rheumatoid nodule in rheumatoid arthritis lesion.  

PubMed

Recently, the incidence of pulmonary cryptococcosis is gradually increasing in rheumatoid arthritis (RA) patients. Pulmonary rheumatoid nodules (PRN) are rare manifestations of RA. Eighteen months ago, a 65-year old woman was admitted to hospital due to multiple nodules (2.5×2.1×2 cm) with cavitations in the right lower lobe. She was diagnosed with RA three year ago. She had been taking methotrexate, leflunomide, and triamcinolone. A video-assisted thoracoscopic surgery biopsy was performed and PRN was diagnosed. However, a newly growing huge opacity with cavitation was detected in the same site. Pulmonary cryptococcal infection was diagnosed through a transthoracic computed tomograpy guided needle biopsy. Cryptococcus antigen was detected in serum but not in cerebrospinal fluid. The patient was treated with oral fluconazole which resulted clinical improvement and regression of the nodule on a series of radiography. Herein, we report the case of pulmonary cryptococcosis occurring in the same location as that of the PRN. PMID:25580144

Jang, Dong Won; Jeong, Ina; Kim, Seon Jae; Kim, Seok Won; Park, Soo Yeon; Kwon, Yong Hwan; Jeong, Yeon Oh; Lee, Ji Yeon; Kim, Bo Sung; Kim, Woo-Shik; Joh, Joon-Sung

2014-12-01

108

Pulmonary Cryptococcosis That Mimicked Rheumatoid Nodule in Rheumatoid Arthritis Lesion  

PubMed Central

Recently, the incidence of pulmonary cryptococcosis is gradually increasing in rheumatoid arthritis (RA) patients. Pulmonary rheumatoid nodules (PRN) are rare manifestations of RA. Eighteen months ago, a 65-year old woman was admitted to hospital due to multiple nodules (2.5×2.1×2 cm) with cavitations in the right lower lobe. She was diagnosed with RA three year ago. She had been taking methotrexate, leflunomide, and triamcinolone. A video-assisted thoracoscopic surgery biopsy was performed and PRN was diagnosed. However, a newly growing huge opacity with cavitation was detected in the same site. Pulmonary cryptococcal infection was diagnosed through a transthoracic computed tomograpy guided needle biopsy. Cryptococcus antigen was detected in serum but not in cerebrospinal fluid. The patient was treated with oral fluconazole which resulted clinical improvement and regression of the nodule on a series of radiography. Herein, we report the case of pulmonary cryptococcosis occurring in the same location as that of the PRN. PMID:25580144

Jang, Dong Won; Kim, Seon Jae; Kim, Seok Won; Park, Soo Yeon; Kwon, Yong Hwan; Jeong, Yeon Oh; Lee, Ji Yeon; Kim, Bo Sung; Kim, Woo-Shik; Joh, Joon-Sung

2014-01-01

109

Pangaean climate during the Early Jurassic: GCM simulations and the sedimentary record of paleoclimate  

SciTech Connect

Results from new simulations of the Early Jurassic climate show that increased ocean heat transport may have been the primary force generating warmer climates during the past 180 m.y. The simulations, conducted using the general circulation model (GCM) at the Goddard Institute for Space Studies, include realistic representations of paleocontinental distribution, topography, epeiric seas, and vegetation, in order to facilitate comparisons between model results and paleoclimate data. three major features of the simulated Early Jurassic climate include the following. (1) A global warming, compared to the present, of 5 {degrees}C to 10 {degrees}C, with temperature increases at high latitudes five times this global average. Average summer temperatures exceed 35 {degrees}C in low-latitude regions of western Pangaea where eolian sandstones testify to the presence of vast deserts. (2) Simulated precipitation and evaporation patterns agree closely with the moisture distribution interpreted from evaporites, and coal deposits. High rainfall rates are associated primarily with monsoons that originate over the warm Tethys Ocean. Unlike the {open_quotes}megamonsoons{close_quotes} proposed in previous studies, these systems are found to be associated with localized pressure cells whose positions are controlled by topography and coastal geography. (3) Decreases in planetary albedo, occurring because of reductions in sea ice, snow cover, and low clouds, and increases in atmospheric water vapor are the positive climate feedbacks that amplify the global warming. Similar to other Mesozoic climate simulations, our model finds that large seasonal temperature fluctuations occurred over mid- and high-latitude continental interiors, refuting paleoclimate evidence that suggests more equable conditions. 101 refs., 9 figs., 3 tabs.

Chandler, M.A. [Columbia Univ., Palisades, NY (United States)] [Columbia Univ., Palisades, NY (United States); Rind, D.; Ruedy, R. [Goddard Institute for Space Studies, New York, NY (United States)] [Goddard Institute for Space Studies, New York, NY (United States)

1992-05-01

110

Epidemiology of Rheumatoid Arthritis: Rheumatoid Arthritis and Mortality  

Microsoft Academic Search

Increased mortality in rheumatoid arthritis (RA) is widely recognized but not fully explained. Despite substantial improvements\\u000a in management and growing knowledge of the determinants of increased mortality, evidence for reduction in mortality in RA\\u000a has lagged behind. Indeed, most studies report no apparent reduction in mortality in RA. However, emerging evidence from some\\u000a recent RA inception cohorts suggests no increased

Elena Myasoedova; John M. Davis; Cynthia S. Crowson; Sherine E. Gabriel

2010-01-01

111

Virtually simulated social pressure influences early visual processing more in low compared to high autonomous participants.  

PubMed

In a previous study, we showed that virtually simulated social group pressure could influence early stages of perception after only 100 ?ms. In the present EEG study, we investigated the influence of social pressure on visual perception in participants with high (HA) and low (LA) levels of autonomy. Ten HA and ten LA individuals were asked to accomplish a visual discrimination task in an adapted paradigm of Solomon Asch. Results indicate that LA participants adapted to the incorrect group opinion more often than HA participants (42% vs. 30% of the trials, respectively). LA participants showed a larger posterior P1 component contralateral to targets presented in the right visual field when conforming to the correct compared to conforming to the incorrect group decision. In conclusion, our ERP data suggest that the group context can have early effects on our perception rather than on conscious decision processes in LA, but not HA participants. PMID:24313603

Trautmann-Lengsfeld, Sina Alexa; Herrmann, Christoph Siegfried

2014-02-01

112

The influence of early aging on eye movements during motor simulation.  

PubMed

Movement based interventions such as imagery and action observation are used increasingly to support physical rehabilitation of adults during early aging. The efficacy of these more covert approaches is based on an intuitively appealing assumption that movement execution, imagery and observation share neural substrate; alteration of one influences directly the function of the other two. Using eye movement metrics this paper reports findings that question the congruency of the three conditions. The data reveal that simulating movement through imagery and action observation may offer older adults movement practice conditions that are not constrained by the age-related decline observed in physical conditions. In addition, the findings provide support for action observation as a more effective technique for movement reproduction in comparison to imagery. This concern for imagery was also seen in the less congruent temporal relationship in movement time between imagery and movement execution suggesting imagery inaccuracy in early aging. PMID:25005270

McCormick, Sheree A; Causer, Joe; Holmes, Paul S

2014-01-01

113

Tachycardia-induced early afterdepolarizations: insights into potential ionic mechanisms from computer simulations  

PubMed Central

Although early afterdepolarizations (EADs) are classically thought to occur at slow heart rates, mounting evidence suggests that EADs may also occur at rapid heart rates produced by tachyarrhythmias, due to Ca overload of the sarcoplasmic reticulum (SR) leading to spontaneous SR Ca release. We hypothesized that the mechanism of tachycardia-induced EADs depends on the spatial and temporal morphology of spontaneous SR Ca release, and tested this hypothesis in computer simulations using a ventricular action potential mathematical model. Using two previously suggested spontaneous release morphologies, we found two distinct tachycardia-induced EAD mechanisms: one mechanistically similar to bradycardia-induced EADs, the other to delayed afterdepolarizations (DADs). PMID:18849025

Huffaker, Ray B.; Samade, Richard; Weiss, James N.; Kogan, Boris

2011-01-01

114

Painful feet in rheumatoid arthritis  

PubMed Central

Pain in the feet is an important diagnostic feature and a major management problem of rheumatoid arthritis. Of 50 hospitalized patients, 28% recalled painful feet as the sole presenting symptom of their disease. Rheumatoid disease commonly affects the feet: 90% of the patients studied complained of foot pain at some time during the course of their disease, 86% had clinical involvement and 92% had radiological changes in their feet. The forefoot is most frequently involved. Midfoot involvement was noted in 68% but was symptomatic in only 22%. Changes in the ankle were least common but always symptomatic. ImagesFIG. 1AFIG. 1BFIG. 2AFIG. 2BFIG. 3FIG. 4FIG. 5 PMID:4746132

Minaker, K.; Little, H.

1973-01-01

115

Bayesian inference analyses of the polygenic architecture of rheumatoid arthritis.  

PubMed

The genetic architectures of common, complex diseases are largely uncharacterized. We modeled the genetic architecture underlying genome-wide association study (GWAS) data for rheumatoid arthritis and developed a new method using polygenic risk-score analyses to infer the total liability-scale variance explained by associated GWAS SNPs. Using this method, we estimated that, together, thousands of SNPs from rheumatoid arthritis GWAS explain an additional 20% of disease risk (excluding known associated loci). We further tested this method on datasets for three additional diseases and obtained comparable estimates for celiac disease (43% excluding the major histocompatibility complex), myocardial infarction and coronary artery disease (48%) and type 2 diabetes (49%). Our results are consistent with simulated genetic models in which hundreds of associated loci harbor common causal variants and a smaller number of loci harbor multiple rare causal variants. These analyses suggest that GWAS will continue to be highly productive for the discovery of additional susceptibility loci for common diseases. PMID:22446960

Stahl, Eli A; Wegmann, Daniel; Trynka, Gosia; Gutierrez-Achury, Javier; Do, Ron; Voight, Benjamin F; Kraft, Peter; Chen, Robert; Kallberg, Henrik J; Kurreeman, Fina A S; Kathiresan, Sekar; Wijmenga, Cisca; Gregersen, Peter K; Alfredsson, Lars; Siminovitch, Katherine A; Worthington, Jane; de Bakker, Paul I W; Raychaudhuri, Soumya; Plenge, Robert M

2012-05-01

116

Rheumatoid arthritis and periodontal disease  

Microsoft Academic Search

The prevalence of periodontal disease has increased two-fold among patients with rheumatoid arthritis (RA) compared to the general population. This increased prevalence is unrelated to secondary Sjögren's syndrome but instead reflects shared pathogenic mechanisms, including an increased prevalence of the shared epitope HLA-DRB1-04; exacerbated T-cell responsiveness with high tissue levels of IL-17; exaggerated B-cell responses, with plasma cells being the

Jean-Marie Berthelot; Benoît Le Goff

2010-01-01

117

Pulmonary involvement in rheumatoid arthritis  

Microsoft Academic Search

The primary objective of this investigation was to assess the relationships between clinical characteristics, lung involvement, and frequency of pulmonary involvement in rheumatoid arthritis (RA). Using high-resolution computed tomography (HRCT) and pulmonary function tests (PFT), we prospectively evaluated 52 patients with RA (eight males and 44 females, mean age 53.6 years). The HRCT was abnormal in 35 patients (67.3%), the most

Ayhan Bilgici; H. Ulusoy; O. Kuru; Ç. Çelenk; M. Ünsal; M. Danac?

2005-01-01

118

Decision-making through performance simulation and code compliance from the early, schematic phases of building design  

E-print Network

1 Decision-making through performance simulation and code compliance from the early, schematic. Keywords. Decision-making, Energy, Codes, Simulation, EN832. 1 Institute for Structural Analysis, Graz://eetd.lbl.gov/BT Abstract. This paper is about the merging of two software applications that allows building decision makers

119

Methods for Detecting Early Warnings of Critical Transitions in Time Series Illustrated Using Simulated Ecological Data  

PubMed Central

Many dynamical systems, including lakes, organisms, ocean circulation patterns, or financial markets, are now thought to have tipping points where critical transitions to a contrasting state can happen. Because critical transitions can occur unexpectedly and are difficult to manage, there is a need for methods that can be used to identify when a critical transition is approaching. Recent theory shows that we can identify the proximity of a system to a critical transition using a variety of so-called ‘early warning signals’, and successful empirical examples suggest a potential for practical applicability. However, while the range of proposed methods for predicting critical transitions is rapidly expanding, opinions on their practical use differ widely, and there is no comparative study that tests the limitations of the different methods to identify approaching critical transitions using time-series data. Here, we summarize a range of currently available early warning methods and apply them to two simulated time series that are typical of systems undergoing a critical transition. In addition to a methodological guide, our work offers a practical toolbox that may be used in a wide range of fields to help detect early warning signals of critical transitions in time series data. PMID:22815897

Dakos, Vasilis; Carpenter, Stephen R.; Brock, William A.; Ellison, Aaron M.; Guttal, Vishwesha; Ives, Anthony R.; Kéfi, Sonia; Livina, Valerie; Seekell, David A.; van Nes, Egbert H.; Scheffer, Marten

2012-01-01

120

The use of citrullinated peptides and proteins for the diagnosis of rheumatoid arthritis  

Microsoft Academic Search

ABSTRACT: The presence or absence of antibodies to citrullinated peptides\\/proteins (ACPA) is an important parameter that helps a clinician set a diagnosis of early rheumatoid arthritis and, hence, initiate treatment. There are several commercial tests available to measure ACPA levels, although it can be difficult to decide what the best test for a given clinical question is. We analyzed literature

Ger JM Pruijn; Allan Wiik; Walther J van Venrooij

2010-01-01

121

What is MRI bone oedema in rheumatoid arthritis and why does it matter?  

Microsoft Academic Search

MRI bone oedema occurs in various forms of inflammatory and non-inflammatory arthritis and probably represents a cellular infiltrate within bone. It is common in early rheumatoid arthritis and is associated with erosive progression and poor functional outcome. Histopathological studies suggest that a cellular infiltrate comprising lymphocytes and osteoclasts may be detected in subchondral bone and could mediate the development of

Fiona M McQueen; Benedikt Ostendorf

2006-01-01

122

Reconciling reconstructed and simulated features of the winter Pacific-North-American pattern in the early 19th century  

NASA Astrophysics Data System (ADS)

Reconstructions of past climate behavior often describe prominent anomalous periods that are not necessarily captured in climate simulations. Here, we illustrate the contrast between an interdecadal strong positive phase of the winter Pacific/North American pattern (PNA) in the early 19th century that is described by a PNA reconstruction based on tree-rings from northwestern North America, and a slight tendency towards negative winter PNA anomalies during the same period in an ensemble of state-of-the-art coupled climate simulations. Additionally, a pseudo-proxy investigation with the same simulation ensemble allows assessing the robustness of PNA reconstructions using solely geophysical predictors from northwestern North America for the last millennium. The reconstructed early-19th-century positive PNA anomaly emerges as a potentially reliable feature, although it is subject to a number of sources of uncertainty and potential deficiencies. The pseudo-reconstructions demonstrate that the early-19th-century discrepancy between reconstructed and simulated PNA does not stem from the reconstruction process. Instead, reconstructed and simulated features of the early-19th-century PNA can be reconciled by interpreting the reconstructed evolution during this time as an expression of internal climate variability, hence unlikely to be reproduced in its exact temporal occurrence by a small ensemble of climate simulations. However, firm attribution of the reconstructed PNA anomaly is hampered by known limitations and deficiencies of coupled climate models and uncertainties in the early-19th-century external forcing and background climate conditions.

Zanchettin, D.; Bothe, O.; Lehner, F.; Ortega, P.; Raible, C. C.; Swingedouw, D.

2014-11-01

123

Microalbuminuria in patients with rheumatoid arthritis  

Microsoft Academic Search

OBJECTIVES--To assess (a) the prevalence of microalbuminuria in patients with rheumatoid arthritis, (b) the association between urinary albumin excretion and disease activity as estimated by the erythrocyte sedimentation rate and C reactive protein (CRP), and (c) the association between urinary albumin excretion and treatment with antirheumatic drugs. METHODS--Sixty five patients with rheumatoid arthritis attending two rheumatology clinics were compared with

L M Pedersen; H Nordin; B Svensson; H Bliddal

1995-01-01

124

Comparing stochastic differential equations and agent-based modelling and simulation for early-stage cancer.  

PubMed

There is great potential to be explored regarding the use of agent-based modelling and simulation as an alternative paradigm to investigate early-stage cancer interactions with the immune system. It does not suffer from some limitations of ordinary differential equation models, such as the lack of stochasticity, representation of individual behaviours rather than aggregates and individual memory. In this paper we investigate the potential contribution of agent-based modelling and simulation when contrasted with stochastic versions of ODE models using early-stage cancer examples. We seek answers to the following questions: (1) Does this new stochastic formulation produce similar results to the agent-based version? (2) Can these methods be used interchangeably? (3) Do agent-based models outcomes reveal any benefit when compared to the Gillespie results? To answer these research questions we investigate three well-established mathematical models describing interactions between tumour cells and immune elements. These case studies were re-conceptualised under an agent-based perspective and also converted to the Gillespie algorithm formulation. Our interest in this work, therefore, is to establish a methodological discussion regarding the usability of different simulation approaches, rather than provide further biological insights into the investigated case studies. Our results show that it is possible to obtain equivalent models that implement the same mechanisms; however, the incapacity of the Gillespie algorithm to retain individual memory of past events affects the similarity of some results. Furthermore, the emergent behaviour of ABMS produces extra patters of behaviour in the system, which was not obtained by the Gillespie algorithm. PMID:24752131

Figueredo, Grazziela P; Siebers, Peer-Olaf; Owen, Markus R; Reps, Jenna; Aickelin, Uwe

2014-01-01

125

Treatment of Rheumatoid Arthritis with Traditional Chinese Medicine  

PubMed Central

Rheumatoid arthritis (RA) is a chronic inflammatory disease that will affect quality of life and, working efficiency, and produce negative thoughts for patients. Current therapy of RA is treated with disease-modifying antirheumatic drugs (DMARDs). Although most of these treatment methods are effective, most patients still have a pleasant experience either due to poor efficacy or side effects or both. Interleukin-6 receptor (IL6R) is important in the pathogenesis of RA. In this study, we would like to detect the potential candidates which inhibit IL6R against RA from traditional Chinese medicine (TCM). We use TCM compounds from the TCM Database@Taiwan for virtually screening the potential IL6R inhibitors. The TCM candidate compound, calycosin, has potent binding affinity with IL6R protein. The molecular dynamics simulation was employed to validate the stability of interaction in the protein complex with calycosin. The analysis indicates that protein complex with calycosin is more stable. In addition, calycosin is known to be one of the components of Angelica sinensis, which has been indicated to have an important role in the treatment of rheumatoid arthritis. Therefore, calycosin is a potential candidate as lead compounds for further study in drug development process with IL6R protein against rheumatoid arthritis. PMID:24991562

Lee, Wen-Yuan; Chen, Hsin-Yi

2014-01-01

126

Simulating Earthquake Early Warning Systems in the Classroom as a New Approach to Teaching Earthquakes  

NASA Astrophysics Data System (ADS)

A discussion of P- and S-waves seems an ubiquitous part of studying earthquakes in the classroom. Textbooks from middle school through university level typically define the differences between the waves and illustrate the sense of motion. While many students successfully memorize the differences between wave types (often utilizing the first letter as a memory aide), textbooks rarely give tangible examples of how the two waves would "feel" to a person sitting on the ground. One reason for introducing the wave types is to explain how to calculate earthquake epicenters using seismograms and travel time charts -- very abstract representations of earthquakes. Even when the skill is mastered using paper-and-pencil activities or one of the excellent online interactive versions, locating an epicenter simply does not excite many of our students because it evokes little emotional impact, even in students located in earthquake-prone areas. Despite these limitations, huge numbers of students are mandated to complete the task. At the K-12 level, California requires that all students be able to locate earthquake epicenters in Grade 6; in New York, the skill is a required part of the Regent's Examination. Recent innovations in earthquake early warning systems around the globe give us the opportunity to address the same content standard, but with substantially more emotional impact on students. I outline a lesson about earthquakes focused on earthquake early warning systems. The introductory activities include video clips of actual earthquakes and emphasize the differences between the way P- and S-waves feel when they arrive (P arrives first, but is weaker). I include an introduction to the principle behind earthquake early warning (including a summary of possible uses of a few seconds warning about strong shaking) and show examples from Japan. Students go outdoors to simulate P-waves, S-waves, and occupants of two different cities who are talking to one another on cell phones. The culminating activity is for students to "design" an early warning system that will protect their school from nearby earthquakes. The better they design the system, the safer they will be. Each team of students receives a map of faults in the area and possible sites for real-time seismometer installation. Given a fixed budget, they must select the best sites for detecting a likely earthquake. After selecting their locations, teams face-off two-by-two in a tournament of simulated earthquakes. We created animations of a few simulated earthquakes for our institution and have plans to build a web-based version that will allow others to customize the location to their own location and facilitate the competition between teams. Earthquake early warning is both cutting-edge and has huge societal benefits. Instead of teaching our students how to locate epicenters after an earthquake has occurred, we can teach the same content standards while showing them that earthquake science can really save lives.

D'Alessio, M. A.

2010-12-01

127

Forming Early-type Galaxies in ?CDM Simulations. I. Assembly Histories  

NASA Astrophysics Data System (ADS)

We present a sample of nine high-resolution cosmological simulations in the mass range of M vir = 7 × 1011-4 × 1012 M ? starting from ?CDM initial conditions. Our simulations include primordial radiative cooling, photoionization, star formation, supernova II feedback, but exclude supernova-driven winds and active galactic nucleus feedback. The simulated galaxies assemble in two phases, with the initial growth dominated by compact (r < r eff) in situ star formation fueled by cold, low-entropy gas streams resulting in a very similar mean assembly redshift of z f, ins ~ 2.5 for the in situ stellar component in all galaxies. The late growth is dominated by accretion of old stars formed in subunits outside the main galaxy (r > r eff) resulting in an assembly redshift of z f, acc ~ 0.5-1.5 with much larger scatter. We find a positive correlation between the fraction of accreted stars and the final mass of our galaxies. We show that gravitational feedback strongly suppresses late star formation in massive galaxies contributing to the observed galaxy color bimodality. The accretion of stellar material is also responsible for the observed size growth of early-type galaxies. In addition, we find that the dark matter fractions within the stellar half-mass radii continuously increase toward lower redshift from about f DM ~ 0.05 at z ~ 3 to f DM ~ 0.1-0.3 at z = 0. Furthermore, the logarithmic slope of the total density profile is nearly isothermal at the present day (?' ~ 1.9-2.2). Finally, the input of gravitational heating lowers the central dark matter densities in the galaxies, with the effect being smaller compared to simulations without supernova feedback.

Johansson, Peter H.; Naab, Thorsten; Ostriker, Jeremiah P.

2012-08-01

128

Simulating multiple merger pathways to the central kinematics of early-type galaxies  

NASA Astrophysics Data System (ADS)

Two-dimensional integral field surveys such as ATLAS3D are producing rich observational data sets yielding insights into galaxy formation. These new kinematic observations have highlighted the need to understand the evolutionary mechanisms leading to a spectrum of fast rotators and slow rotators in early-type galaxies. We address the formation of slow and fast rotators through a series of controlled, comprehensive hydrodynamical simulations, sampling idealized galaxy merger scenarios constructed from model spiral galaxies. Idealized and controlled simulations of this sort complement the more `realistic' cosmological simulations by isolating and analysing the effects of specific parameters, as we do in this paper. We recreate minor and major binary mergers, binary merger trees with multiple progenitors, and multiple sequential mergers. Within each of these categories of formation history, we correlate progenitor gas fraction, mass ratio, orbital pericentre, orbital ellipticity, and spin with remnant kinematic properties. We create kinematic profiles of these 95 simulations comparable to ATLAS3D data. By constructing remnant profiles of the projected specific angular momentum (? _R= < R|V|rangle / < R ?{V^2+? ^2}rangle), triaxiality, and measuring the incidences of kinematic twists and kinematically decoupled cores, we distinguish between varying formation scenarios. We find that binary mergers nearly always form fast rotators. Slow rotators can be formed from zero initial angular momentum configurations and gas-poor mergers, but are not as round as the ATLAS3D galaxies. Remnants of binary merger trees are triaxial slow rotators. Sequential mergers form round slow rotators that most resemble the ATLAS3D rotators.

Moody, Christopher E.; Romanowsky, Aaron J.; Cox, Thomas J.; Novak, G. S.; Primack, Joel R.

2014-10-01

129

Metabolic Syndrome in Rheumatoid Arthritis  

PubMed Central

Insulin resistance is an essential feature of the metabolic syndrome that has been linked to rheumatoid arthritis (RA). Understanding how inflammation arising in one tissue affects the physiology and pathology of other organs remains an unanswered question with therapeutic implications for chronic conditions including obesity, diabetes mellitus, atherosclerosis, and RA. Adipokines may play a role in the development of atherogenesis in patients with RA. Biologic therapies, such as TNF-? antagonists, that block proinflammatory cytokines have beneficial effects on the insulin resistance that is often observed in patients with RA. PMID:23431244

Ferraz-Amaro, Iván; González-Juanatey, Carlos; López-Mejias, Raquel; Riancho-Zarrabeitia, Leyre; González-Gay, Miguel A.

2013-01-01

130

Early cardiovascular adaptation to zero gravity simulated by head-down tilt.  

PubMed

The early cardiovascular adaptation to zero gravity, simulated by head-down tilt at 5 degrees, was studied in a series of 10 normal young men. The validity of the model was confirmed by comparing the results with data from Apollo and Skylab flights. Tilt produced a significant central fluid shift with a transient increase in central venous pressure, later followed by an increase in left ventricular size without changes in cardiac output, arterial pressure, or contractile state. The hemodynamic changes were transient with a nearly complete return to the control state within 6 hr. The adaptation included a diuresis and a decrease in blood volume, associated with ADH, renin and aldosterone inhibition. PMID:11541656

Blomqvist, C G; Nixon, J V; Johnson, R L; Mitchell, J H

1980-01-01

131

Specificity of rheumatoid factors in relation to the disease state in rheumatoid arthritis.  

PubMed Central

Rheumatoid factors found in patients with rheumatoid arthritis react with human IgG and with IgG from some other species. The levels of rheumatoid factor give some indication of prognosis, albeit a rather poor one in this highly variable disease. The high degree of variability may, in part, be due to differences in the fine specificity of the rheumatoid factor in each individual patient, leading to differences in the types of immune complex formed. To study this hypothesis the fine specificity of rheumatoid factors of the IgM, IgA, and IgG classes for IgG from human, baboon, orangutan, macaque, owl monkey, gorilla, marmoset, cow, pig, sheep, goat, horse, mouse, and chicken was examined. Differential reactivity for these species was found and associations between the presence of rheumatoid factor and the development of moderate or severe erosions. PMID:2241264

Jones, M G; Shipley, M E; Hearn, J P; Hay, F C

1990-01-01

132

SIMULATIONS OF EARLY BARYONIC STRUCTURE FORMATION WITH STREAM VELOCITY. I. HALO ABUNDANCE  

SciTech Connect

It has been recently shown that the relative velocity between the dark matter and the baryons (v{sub bc}) at the time of recombination can affect the structure formation in the early universe. We statistically quantify this effect using large cosmological simulations. We use three different high-resolution sets of simulations (with separate transfer functions for baryons and dark matter) that vary in box size, particle number, and the value of the relative velocity between dark matter and baryons. We show that the total number density of halos is suppressed by {approx}20% at z = 25 for v{sub bc} = 1{sigma}{sub vbc}, where {sigma}{sub vbc} is the variance of the relative velocity, while for v{sub bc} = 3.4{sigma}{sub vbc} the relative suppression at the same redshift reaches 50%, remaining at or above the 30% level all the way to z = 11. We also find a high abundance of 'empty halos', i.e., halos that have gas fraction below half of the cosmic mean baryonic fraction f-bar{sub b}. Specifically, we find that for v{sub bc} = 1{sigma}{sub vbc} all halos below 10{sup 5} M{sub Sun} are empty at z {>=} 19. The high abundance of empty halos results in significant delay in the formation of gas-rich minihalos and the first galaxies.

Naoz, Smadar [CIERA, Northwestern University, Evanston, IL 60208 (United States); Yoshida, Naoki [IPMU, University of Tokyo, 5-1-5 Kashiwanoha, Kashiwa, Chiba 277-8583 (Japan); Gnedin, Nickolay Y., E-mail: snaoz@northwestern.edu [Particle Astrophysics Center, Fermi National Accelerator Laboratory, Batavia, IL 60510 (United States)

2012-03-10

133

Rheumatoid Arthritis and Cardiovascular Disease  

PubMed Central

Background Rheumatic disease and heart disease share common underpinnings involving inflammation. The high levels of inflammation that characterize rheumatic diseases provide a “natural experiment” to help elucidate the mechanisms by which inflammation accelerates heart disease. Rheumatoid arthritis (RA) is the most common of the rheumatic diseases and has the best studied relationships with heart disease. Methods Review of current literature on heart disease and rheumatoid arthritis Results Patients with RA have an increased risk of developing heart disease that is not fully explained by traditional cardiovascular risk factors. Therapies used to treat RA may also affect the development of heart disease; by suppressing inflammation, they may also reduce the risk of heart disease. However, their other effects, as in the case of steroids, may increase heart disease risk. Conclusions Investigations of the innate and adaptive immune responses occurring in RA may delineate novel mechanisms in the pathogenesis of heart disease, and help identify novel therapeutic targets for the prevention and treatment of heart disease. PMID:24093840

Crowson, Cynthia S; Liao, Katherine P; Davis, John M; Solomon, Daniel H; Matteson, Eric L; Knutson, Keith L; Hlatky, Mark A; Gabriel, Sherine E

2014-01-01

134

The disease formerly known as rheumatoid arthritis  

PubMed Central

Rheumatoid arthritis is a complex disease where predetermined and stochastic factors conspire to confer disease susceptibility. In light of the diverse responses to targeted therapies, rheumatoid arthritis might represent a final common clinical phenotype that reflects many pathogenic pathways. Therefore, it might be appropriate to begin thinking about rheumatoid arthritis as a syndrome rather than a disease. Use of genetics, epigenetics, microbiomics, and other unbiased technologies will probably permit stratification of patients based on mechanisms of disease rather than by clinical phenotype. PMID:25167330

2014-01-01

135

Leptomeningeal rheumatoid nodules: Diagnosis and failed therapeutics.  

PubMed

A 67-year-old woman presented with recurrent transient ischaemic attack-like episodes over a 2year period. Nodular enhancing leptomeningeal changes were detected on MRI and were consistent with meningeal rheumatoid nodules on biopsy. The patient's nodular disease continued to progress and regress clinically and radiologically irrespective of disease modifying agents and peripheral and serological rheumatoid arthritis control. This patient's unique presentation and diagnostic work-up is discussed alongside the dilemma of therapeutic management of meningeal rheumatoid nodules. PMID:25533052

Nesbitt, Cassie; Willshire, Luke; Quan, Doreen; Shaw, Cameron; Batchelor, Peter

2015-02-01

136

Assessment of relative sensitivities during early growth stages of selected crop species subjected to simulated acidic rain  

Microsoft Academic Search

Under greenhouse conditions, experiments were performed to assess the cultivar sensitivity (during early growth stages) to simulated acidic rain treatments of six economically important crop species. The accumulation of dry biomass was investigated for the following crops: alfalfa, barley, cabbage, corn, cucumber, and soybean. For each crop, treatments consisted of eight acidity levels in simulated rain — pH 2.6, 3.0,

A. J. Enyedi; A. L. Kuja

1986-01-01

137

Rheumatoid Arthritis and Complementary and Alternative Medicine  

MedlinePLUS

... et al. Biological basis for the use of botanicals in osteoarthritis and rheumatoid arthritis: a review. Evidence-Based Complementary and Alternative Medicine: e-CAM . 2005;2(3):301–308. Cameron ...

138

ASTROMEDICINE IN THE TREATMENT OF RHEUMATOID ARTHRITIS  

PubMed Central

One patient of rheumatoid arthritis was treated according to astromedicine. Wearing of Coral beads had remarkable effect on the disease. The interesting finding are reported in this paper. PMID:22556538

Janai, Sudhakar; Biviji, A. T.; Naik, D. G.; Lakhe, R. T.; Rao, V. Bhaskar

1991-01-01

139

Update on autoantibodies in rheumatoid arthritis  

Microsoft Academic Search

Detection of rheumatoid factor (RF) in the serum of patients with rheumatoid arthritis (RA) was one of the first indications\\u000a of autoimmunity in RA. The role of RF in the diagnosis of RA has been well-documented, but it has suboptimal sensitivity and\\u000a specificity. Although patients with RF-positive RA generally have more severe disease than those with RF-negative RA, RF is

S. Louis Bridges

2004-01-01

140

A Simulation Study to Assess the Potential of Real-Time GPS for Tsunami Early Warning in Chile  

NASA Astrophysics Data System (ADS)

Global Positioning System (GPS) has been proved to be a powerful tool for measuring co-seismic ground displacement with application to earthquake rupture inversion. Due to the fact that most of the tsunamis are triggered by large earthquakes, GPS could contribute to tsunami early warning by helping to resolve for the tsunami source in almost real-time. Recently, this became a core of the concept of a 'GPS-Shield for Tsunami Early Warning'. In present study we extend this concept to the Chilean Pacific continental margin. Chile is situated at the western margin of the South American plate which experiences constant tectonic forcing due to the actively subducted Nazca oceanic plate. This ongoing subduction makes almost the whole Chilean coast to be vulnerable to earthquake and tsunami threats. New Chilean tsunami early warning system is expected to incorporate the novel real-time GPS-component for fast source inversion. We use numerical simulation technique to evaluate the potential of the coastal real-time GPS arrays for reliable early warning. We provide start-to-end simulations of the related physical processes (earthquake rupture, ground shaking, tsunami generation and propagation) together with their sensor (GPS) imaging and processing. In particular, co-seismic GPS observations are simulated using Bernese 5.2 software. For GPS data processing, both Bernese 5.2 and (real-time) PANDA are adopted for comparison. We demonstrate our 'close-loop' simulation workbench together with main results reflecting the importance of the real-time GPS component for the tsunami early warning in Chile. Special attention is paid to the uncertainty propagation through the early warning chain.

Chen, Kejie; Babeyko, Andrey Y.; Hoechner, Andreas; Ge, Maorong

2014-05-01

141

T cells in rheumatoid arthritis  

PubMed Central

Over the past decade and a half, advances in our understanding of the pathogenesis of immune-mediated diseases such as rheumatoid arthritis (RA) have translated directly into benefit for patients. Much of this benefit has arisen through the introduction of targeted biological therapies. At the same time, technological advances have made it possible to define, at the cellular and molecular levels, the key pathways that influence the initiation and persistence of chronic inflammatory autoimmune reactions. As our understanding grows, it is likely that this knowledge will be translated into a second generation of biological therapies that are tailor-made for the patient. This review summarizes current perspectives on RA disease pathogenesis, with particular emphasis on what RA T cells look like, what they are likely to see, and how they contribute to persistence of the chronic inflammatory response. PMID:19007421

Cope, Andrew P

2008-01-01

142

The Rheumatoid Arthritic At Home  

PubMed Central

Most management of rheumatoid arthritis must take place in the patient's own home with only intermittent professional help. With good planning and instruction it is possible to create in the home a milieu appropriate not only for possible inducement of remission, but also for continuing care during even protracted disability. The mainstay of treatment in all stages of this disease is the achievement of a right balance between rest and activity. In the initial stages, proper rest and support, including splinting of the joints with other simple measures, will greatly relieve pain and help control the inflammatory process. A variety of therapeutic exercises can reduce the likelihood of secondary immobility and promote restoration of strength and function. For the patient in whom the disease has become chronic and disabling a wide variety of self-help devices can be prescribed, together with appropriate home modifications. ImagesFig. 1Fig. 2Fig. 3Figs. 4 & 5Fig. 6Fig. 7 PMID:21307997

Hunt, T. E.

1977-01-01

143

Rheumatoid arthritis: coping with disability.  

PubMed

This article explains the components of disability as related to rheumatoid arthritis (RA) using an expansion of Nagi's Model of Disability (Jette, 2006) and the World Health Organization's (WHO) International Classification of Functioning, Disability, and Health (ICF). In addition, suggestions for ways in which nurses can offer patients choices in physical functional therapy and psychosocial aspects of coping with the chronicity of RA are discussed. Understanding how RA relates to the holistic management of the patient will allow nurses to modify and suggest additional measures to enhance the outcomes of patient-centered care. Many degrees of disability exist that affect the physical and psychosocial domains of RA. Nurses should identify the primary issues influencing disability and assemble supporting resources or a multidisciplinary team to manage a person's disabilities. As nurses develop and maintain relationships with patients, they are able to follow through with the care plan continuum and recognize when modifications are needed. PMID:20306616

Barker, Tara L; Puckett, Theresa L

2010-01-01

144

Microbial Infection and Rheumatoid Arthritis  

PubMed Central

Rheumatoid arthritis (RA) is a complex autoimmune disease affecting 1–2% of general worldwide population. The etiopathogenesis of RA involves the interplay of multiple genetic risk factors and environmental triggers. Microbial infections are believed to play an important role in the initiation and perpetuation of RA. Recent clinical studies have shown the association of microbial infections with RA. Accumulated studies using animal models have also found that microbial infections can induce and/or exaggerate the symptoms of experimental arthritis. In this review, we have identified the most common microbial infections associated with RA in the literature and summarized the current evidence supporting their pathogenic role in RA. We also discussed the potential mechanisms whereby infection may promote the development of RA, such as generation of neo-autoantigens, induction of loss of tolerance by molecular mimicry, and bystander activation of the immune system. PMID:25133066

Li, Song; Yu, Yangsheng; Yue, Yinshi; Zhang, Zhixin; Su, Kaihong

2014-01-01

145

Simulating the early Holocene eastern Mediterranean sapropel formation using an ocean biogeochemical model  

NASA Astrophysics Data System (ADS)

The early Holocene sapropel S1 is an organic-rich sediment layer deposited under oxygen depleted conditions below 1800 m between 10 to 6.5 kyr BP in the eastern Mediterranean Sea. Whereas this silled ocean basin is well-ventilated and has a low biological productivity today, the S1 formation indicates drastic changes in the deep water circulation and/or productivity. Commonly, both of these processes are attributed to an enhanced humidity over the broader Mediterranean area. In particular, an increase in the strength of the African monsoon during the African humid period (AHP) is thought to have provided enhanced Nile runoff and nutrient load. However, the exact mechanisms leading to S1 formation are still being debated. Here we apply a regional ocean general circulation model coupled to a marine biogeochemical model covering the entire Mediterranean Sea to explore some of the many published hypotheses on sapropel formation. With a set of simulations we show that S1 formation cannot be explained by either enhanced biological productivity fueled by increased riverine nutrient input, or by an AHP climatic induced stagnating deep water circulation combined with enhanced biological productivity. The main reasons are: (i) Enhanced biological productivity cannot overcome the effect of a continuous deep ventilation, so that a stagnating deep water circulation is a prerequisite for S1 formation. (ii) The pre-sapropel period is characterized by low particulate organic carbon (POC) sediment burial fluxes, implying that river induced eutrophication is not a viable scenario. (iii) The time span required for complete oxygen depletion within the stagnating deep water circulation exceeds the time span between the beginning of the AHP and the onset of the S1 oxygen deficiency, so that the enhanced Nile runoff fueled by the AHP climate is an unlikely trigger for deep water isolation that caused S1 formation. Available data suggest substantial freshening and warming of the Mediterranean upper ocean during the last glacial-interglacial transition that stabilized stratification and prevented deep water ventilation. Imposing the climatic signals of the last glacial-interglacial transition triggers a persistent (> 4 kyr) deep water stagnation in this simulation. The productivity regime in this simulation was assumed similar to the present-day oligotrophic regime, and the simulated POC burial fluxes agree with observed pre-sapropel burial fluxes in sediments. No deep water anoxia evolves in the short time frame of this simulation (4 kyr) relative to the temporal extent of the deglaciation period, which started at ~17.5 kyr BP. The trend of the modeled oxygen consumption suggests that it takes at least 6.5 kyr until deep water anoxia is established. The simulation also suggests that addition of freshwater is required to maintain the stratification in order to meet the reconstructed spatial extent and duration of the S1 deposition. An examination of records of epibenthic deep-sea foraminifera ?18O supports our findings, and indicates that the stagnation of the deep circulation started ~6 kyr before the onset of the S1 deposition.

Grimm, Rosina; Maier-Reimer, Ernst; Mikolajewicz, Uwe; Schmiedl, Gerhard; Adloff, Fanny; Emeis, Kay

2013-04-01

146

Discrete Element Model for Simulations of Early-Life Thermal Fracturing Behaviors in Ceramic Nuclear Fuel Pellets  

SciTech Connect

A discrete element Model (DEM) representation of coupled solid mechanics/fracturing and heat conduction processes has been developed and applied to explicitly simulate the random initiations and subsequent propagations of interacting thermal cracks in a ceramic nuclear fuel pellet during initial rise to power and during power cycles. The DEM model clearly predicts realistic early-life crack patterns including both radial cracks and circumferential cracks. Simulation results clearly demonstrate the formation of radial cracks during the initial power rise, and formation of circumferential cracks as the power is ramped down. In these simulations, additional early-life power cycles do not lead to the formation of new thermal cracks. They do, however clearly indicate changes in the apertures of thermal cracks during later power cycles due to thermal expansion and shrinkage. The number of radial cracks increases with increasing power, which is consistent with the experimental observations.

Hai Huang; Ben Spencer; Jason Hales

2014-10-01

147

Phase separation kinetics in compressible polymer solutions: Computer simulation of the early stages  

E-print Network

A coarse-grained model for solutions of polymers in supercritical fluids is introduced and applied to the system of hexadecane and carbon dioxide as a representative example. Fitting parameters of the model to the gas-liquid critical point properties of the pure systems, and allowing for a suitably chosen parameter that describes the deviation from the Lorentz-Berthelot mixing rule, we model the liquid-gas and fluid-fluid unmixing transitions of this system over a wide range of temperatures and pressures in reasonable agreement with experiment. Interfaces between the polymer-rich phase and the gas can be studied both at temperatures above and below the end point of the triple line where liquid and vapor carbon dioxide and the polymer rich phase coexist. In the first case interfacial adsorption of fluid carbon dioxide can be demonstrated. Our model can also be used to simulate quenches from the one-phase to the two-phase region. A short animation and a series of snapshots help to visualize the early stages of bubble nucleation and spinodal decomposition. Furthermore we discuss deviations from classical nucleation theory for small nuclei.

P. Virnau; M. Mueller; L. G. MacDowell; K. Binder

2003-04-02

148

Retrospect on the tsunami simulation efforts for the German-Indonesian Tsunami Early Warning System  

NASA Astrophysics Data System (ADS)

Starting in 2005, the GITEWS project (German-Indonesian Tsunami Early Warning System) established from scratch a fully operational tsunami warning system at BMKG in Jakarta. GITEWS was succeeded in 2011 by the smaller project PROTECTS for training the Indonesian staff and consolidating the technical system. With the official end in March 2014, it is time to draw a balance and evaluate the approach. This presentation focuses on the contribution of the tsunami modelling group at the Alfred Wegener Institute. We will give a short overview on the developments of the numerical tsunami simulation model TsunAWI, of the scenario database built with TsunAWI, and of the simulation module SIM that interfaces the database to the decision support system. Some distinctive experiences will be highlighted. Topics include the modeling part as well as the matching process after the database is already set up. On the modeling side, unstructured mesh generation with focus on local bathymetric features and inclusion of precise coastline position as well as numerical parametrization and post processing are covered. The matching of pre calculated scenarios with incoming data in case of a tsunamigenic earthquake is performed in the simulation system SIM, which processes the data of multiple sensors and employs various metrics to limit the choice of possible scenarios from the database. One challenge was that the development of the matching algorithm had to start without having access to real sensor data except seismic information on epicenter and magnitude. Therefore, the algorithm is designed with robustness in mind. Still, the conservative approach allows to narrow down the scenario selection even with limited sensor information. Given more experience in the typical behaviour of sensor data in real events, the algorithm parameters can easily be calibrated towards a more restrictive scenario selection. Another challenge was to ensure the quality control of the data products derived from all 4500 scenarios that currently fill the database. Though we can rely on the high quality of TsunAWI, that does not produce numerical artifacts provided model parameters are calibrated and the computational grid is built with care, manual checking remains essential. During GITEWS and PROTECTS, tools were developed to allow for a semi-automatic process of visualizing, checking, and annotating scenarios.

Rakowsky, Natalja; Androsov, Alexey; Harig, Sven; Immerz, Antonia; Behrens, Jörn; Danilov, Sergey; Hiller, Wolfgang; Schröter, Jens

2014-05-01

149

Common Therapy for Rheumatoid Arthritis Reduces Risk of Death  

MedlinePLUS

... Common Therapy for Rheumatoid Arthritis Reduces Risk of Death Taking methotrexate—a commonly prescribed anti-inflammatory medication—may reduce the risk of death among patients with rheumatoid arthritis (RA), according to ...

150

Simulation Shows That Early Treatment of Chronic Hepatitis B Infection Can Cut Deaths and Be Cost-Effective  

PubMed Central

Chronic hepatitis B affects more than a million people in the U.S. and causes 4,000 deaths each year, yet the costs and benefits of treatment have not been fully evaluated. Using a model that simulates disease progression, we compare treatment programs for hepatitis B that start at an early versus late stage of disease. Early care is shown to improve health, reduce premature deaths, and prevent expensive complications, making it highly cost-effective. Our results demonstrate the importance of linking hepatitis B screening to treatment, and illustrate how predictive models can be used to evaluate strategies for improving access to care. PMID:21289356

Post, Sarah E.; Sodhi, Neetu Khurana; Peng, Chia-hui; Wan, Kejia; Pollack, Henry J.

2014-01-01

151

Circadian use of glucocorticoids in rheumatoid arthritis.  

PubMed

A clear temporal relationship exists in rheumatoid arthritis (RA) patients between increased nocturnal levels of pro-in?ammatory cytokines, such as TNF-? and interleukin (IL)-6, pro-inflammatory hormones (i.e. melatonin, prolactin) and insufficient night production of the anti-in?ammatory cortisol (circadian rhythm). Under long-standing chronic stress of disease, insufficient cortisol is available to inhibit an ongoing nocturnal immune/inflammatory reaction. Clinical RA symptoms follow the same circadian rhythm with highest morning severity. Chronotherapy with nighttime glucocorticoid (GC) availability optimizes the treatment of RA patients with low-dose GCs through more efficient targeting of mediators of the immune/inflammatory reaction during the night to be available on arising. Circadian use of low-dose, long-term prednisone, by using night-release formulations (ingested at 10 to 11 p.m.) especially in early RA patients, appears characterized by a significantly superior efficacy on decreasing morning stiffness and IL-6 serum levels, compared to conventional daytime immediate-release prednisone. Shift from medium-dose, immediate-release prednisone (over 7.5-10 mg/day) to night-release formulations GC low-dose, long-term chronotherapy requires a gradual passage, since the hypothalamic-pituitary-adrenal axis of the treated RA patients, potentially altered by a negative feedback induced by the medium/high daily exogenous GC administration, needs time to re-synchronize control of endogenous GC production into a circadian and more physiological nocturnal hormone availability/optimized efficacy. PMID:25227591

Cutolo, Maurizio; Sulli, Alberto; Pincus, Theodore

2015-01-01

152

Recovery of clinical but not radiographic outcomes by the delayed addition of adalimumab to methotrexate-treated Japanese patients with early rheumatoid arthritis: 52-week results of the HOPEFUL-1 trial  

PubMed Central

Objective. The aim of this study was to compare efficacy outcomes of initial treatment with adalimumab + MTX vs adalimumab addition following 26 weeks of MTX monotherapy in Japanese early RA patients naive to MTX with high disease activity. Methods. Patients completing the 26-week, randomized, placebo-controlled trial of adalimumab + MTX were eligible to receive 26 weeks of open-label adalimumab + MTX. Patients were assessed for mean change from baseline in the 28-joint DAS with ESR (DAS28-ESR) and modified total Sharp score (mTSS), and for the proportions of patients achieving clinical, functional or radiographic remission. Results. Of 333 patients assessed, 278 (137 from the initial adalimumab + MTX and 141 from the initial placebo + MTX groups) completed the 52-week study. Significant differences in clinical and functional parameters observed during the 26-week blinded period were not apparent following the addition of open-label adalimumab to MTX. Open-label adalimumab + MTX slowed radiographic progression through week 52 in both groups, but patients who received adalimumab + MTX throughout the study exhibited less radiographic progression than those who received placebo + MTX during the first 26 weeks (mean ?mTSS at week 52 = 2.56 vs 3.30, P < 0.001). Conclusion. Delayed addition of adalimumab in Japanese MTX-naive early RA patients did not impact clinical and functional outcomes at week 52 compared with the earlier addition of adalimumab. However, the accrual of significant structural damage during blinded placebo + MTX therapy contributed to the persistence of differences between the treatment strategies, suggesting that Japanese patients at risk for aggressive disease should benefit from the early inclusion of adalimumab + MTX combination therapy. Trial registration. ClinicalTrials.gov (http://clinicaltrials.gov/), NCT00870467. PMID:24441150

Ishiguro, Naoki; Takeuchi, Tsutomu; Miyasaka, Nobuyuki; Mukai, Masaya; Matsubara, Tsukasa; Uchida, Shoji; Akama, Hideto; Kupper, Hartmut; Arora, Vipin; Tanaka, Yoshiya

2014-01-01

153

Judging disease activity in clinical practice in rheumatoid arthritis: first step in the development of a disease activity score  

Microsoft Academic Search

An investigation of clinical and laboratory variables which might form the basis for judging disease activity in clinical practice was made by six rheumatologists in a prospective study of up to three years' duration of 113 patients with early rheumatoid arthritis. Decisions to start treatment with slow acting antirheumatic drugs were equated with moments of high disease activity. If treatment

D M van der Heijde; M A van't Hof; P L van Riel; L A Theunisse; E W Lubberts; M A van Leeuwen; M H van Rijswijk; L B van de Putte

1990-01-01

154

Autoantibodies to cyclic citrullinated peptides predict progression to rheumatoid arthritis in patients with undifferentiated arthritis: a prospective cohort study  

Microsoft Academic Search

OBJECTIVE: Rheumatoid arthritis (RA) is a common, severe, chronic inflammatory joint disease. Since the disease may initially be indistinguishable from other forms of arthritis, early diagnosis can be difficult. Autoantibodies seen in RA can be detected years before clinical symptoms develop. In an inception cohort of patients with recent-onset arthritis, we undertook this study to assess the predictive value of

F. A. van Gaalen; S. P. Linn-Rasker; W. J. W. van Venrooij; B. A. de Jong; F. C. Breedveld; C. L. Verweij; R. E. M. Toes; T. W. J. Huizinga

2004-01-01

155

Laboratory biomarkers or imaging in the diagnostics of rheumatoid arthritis?  

PubMed Central

Rheumatoid arthritis (RA) is a common autoimmune disease in which a heterogeneous course and different pathogenic mechanisms are implicated in chronic inflammation and joint destruction. Despite the diagnostic contribution of anti-citrullinated protein/peptide antibodies (ACPAs) and rheumatoid factors, about one-third of RA patients remain seronegative. ACPAs belong to a heterogeneous family of autoantibodies targeting citrullinated proteins, including myelin-basic protein, several histone proteins, filaggrin and fibrin, fibrinogen or vimentin. In addition to ACPAs, antibodies directed against other post-translationally modified-carbamylated proteins (anti-CarP) were detected in up to 30% of ACPA-negative patients. Using phage display technology, further autoantibodies were recently discovered as candidate biomarkers for seronegative RA patients. Furthermore, in clinical practice, ultrasound may reveal subclinical synovitis and radiographically undetected bone erosions. To improve diagnostic certainty in undifferentiated arthritis and seronegative patients, ultrasound imaging and several new biomarkers may help to identify at risk patients and those with early disease. In this commentary we summarize recent advances in joint ultrasound and future potential of serological biomarkers to improve diagnosis of RA. PMID:24642071

2014-01-01

156

The Multifaceted Aspects of Interstitial Lung Disease in Rheumatoid Arthritis  

PubMed Central

Interstitial lung disease (ILD) is a relevant extra-articular manifestation of rheumatoid arthritis (RA) that may occur either in early stages or as a complication of long-standing disease. RA related ILD (RA-ILD) significantly influences the quoad vitam prognosis of these patients. Several histopathological patterns of RA-ILD have been described: usual interstitial pneumonia (UIP) is the most frequent one, followed by nonspecific interstitial pneumonia (NSIP); other patterns are less commonly observed. Several factors have been associated with an increased risk of developing RA-ILD. The genetic background plays a fundamental but not sufficient role; smoking is an independent predictor of ILD, and a correlation with the presence of rheumatoid factor and anti-cyclic citrullinated peptide antibodies has also been reported. Moreover, both exnovo occurrence and progression of ILD have been related to drug therapies that are commonly prescribed in RA, such as methotrexate, leflunomide, anti-TNF alpha agents, and rituximab. A greater understanding of the disease process is necessary in order to improve the therapeutic approach to ILD and RA itself and to reduce the burden of this severe extra-articular manifestation. PMID:24205507

Grosso, Vittorio; Scorletti, Eva; Crepaldi, Gloria; Caporali, Roberto

2013-01-01

157

Optimizing Long-Term Treatment of Rheumatoid Arthritis  

E-print Network

Optimizing Long-Term Treatment of Rheumatoid Arthritis with Systematic Documentation K. M. Simonic OF RHEUMATOID ARTHRITIS The whole body is plagued with pains. They ravage the joints in particular, so that foot Baillou, Liber de rheumatismo et pleuritide (1642) Rheumatoid arthritis [1] is an inflammatory systemic

Hammerton, James

158

Management of Rheumatoid Arthritis: Defining the Role of Leflunomide  

Microsoft Academic Search

Rheumatoid arthritis is a progressive, disabling disease which can lead to long-term deformity and disability. Leflunomide is a disease-modifying antirheumatic drug (DMARD) approved to reduce signs and symptoms, inhibit structural damage and improve physical function in adults with active rheumatoid arthritis. In clinical trials in patients with active rheumatoid arthritis, leflunomide had a more rapid onset of action than methotrexate,

Christopher I. Carswell; Caroline M. Perry; Tim Ibbotson

2003-01-01

159

Insufficiency fractures of the distal tibia misdiagnosed as cellulitis in three patients with rheumatoid arthritis  

SciTech Connect

We describe 3 patients with rheumatoid arthritis who presented with diffuse pain, swelling, and erythema of the distal aspect of the lower extremity, suggestive of either cellulitis or thrombophlebitis, but were found to have insufficiency fractures of the distal tibia. The value of technetium-99m diphosphonate bone scintigraphy in the early recognition of these fractures and a possible explanation for the associated inflammatory symptoms are discussed.

Straaton, K.V.; Lopez-Mendez, A.; Alarcon, G.S. (Univ. of Alabama, Birmingham (USA))

1991-07-01

160

The microbiome and rheumatoid arthritis  

PubMed Central

Humans are not (and have never been) alone. From the moment we are born, millions of micro-organisms populate our bodies and coexist with us rather peacefully for the rest of our lives. This microbiome represents the totality of micro-organisms (and their genomes) that we necessarily acquire from the environment. Micro-organisms living in or on us have evolved to extract the energy they require to survive, and in exchange they support the physiological, metabolic and immune capacities that have contributed to our evolutionary success. Although currently categorized as an autoimmune disorder and regarded as a complex genetic disease, the ultimate cause of rheumatoid arthritis (RA) remains elusive. It seems that interplay between predisposing genetic factors and environmental triggers is required for disease manifestation. New insights from DNA sequence-based analyses of gut microbial communities and a renewed interest in mucosal immunology suggest that the microbiome represents an important environmental factor that can influence autoimmune disease manifestation. This Review summarizes the historical clues that suggest a possible role for the microbiota in the pathogenesis of RA, and will focus on new technologies that might provide scientific evidence to support this hypothesis. PMID:21862983

Scher, Jose U.; Abramson, Steven B.

2012-01-01

161

HLA-linked rheumatoid arthritis.  

PubMed Central

Twenty-eight pedigrees were ascertained through pairs of first-degree relatives diagnosed with rheumatoid arthritis (RA). RA was confirmed in 77 pedigree members including probands; the absence of disease was verified in an additional 261 pedigree members. Pedigree members were serologically typed for HLA. We used likelihood analysis to statistically characterize the HLA-linked RA susceptibility locus. The genetic model assumed tight linkage to HLA. The analysis supported the existence of an HLA-linked RA susceptibility locus, estimated the susceptibility allele frequency as 2.16%, and estimated the lifetime penetrance as 41% in male homozygotes and as 48% in female homozygotes. Inheritance was recessive in males and was nearly recessive in females. In addition, the analysis attributed 78% of the variance within genotypes to genetic or environmental effects shared by siblings. The genetic model inferred in this analysis is consistent with previous association, linkage, and familial aggregation studies of RA. The inferred HLA-linked RA susceptibility locus accounts for approximately one-half of familial RA, although it accounts for only approximately one-fifth of the RA in the population. Although other genes may account for the remaining familial RA, a large portion of RA cases may occur sporadically. PMID:7942852

Hasstedt, S. J.; Clegg, D. O.; Ingles, L.; Ward, R. H.

1994-01-01

162

HLA-linked rheumatoid arthritis  

SciTech Connect

Twenty-eight pedigrees were ascertained through pairs of first-degree relatives diagnosed with rheumatoid arthritis (RA). RA was confirmed in 77 pedigree members including probands; the absence of disease was verified in an additional 261 pedigree members. Pedigree members were serologically typed for HLA. We used likelihood analysis to statistically characterize the HLA-linked RA susceptibility locus. The genetic model assumed tight linkage to HLA. The analysis supported the existence of an HLA-linked RA susceptibility locus, estimated the lifetime penetrance as 41% in male homozygotes and as 48% in female homozygotes. Inheritance was recessive in males and was nearly recessive in females. In addition, the analysis attributed 78% of the variance within genotypes to genetic or environmental effects shared by siblings. The genetic model inferred in this analysis is consistent with previous association, linkage, and familial aggregation studies of RA. The inferred HLA-linked RA susceptibility locus accounts for approximately one-fifth of the RA in the population. Although other genes may account for the remaining familial RA, a large portion of RA cases may occur sporadically. 79 refs., 9 tabs.

Hasstedt, S.J.; Clegg, D.O.; Ingles, L.; Ward, R.H. [Univ. of Utah, Salt Lake City, UT (United States)

1994-10-01

163

Economics of stratified medicine in rheumatoid arthritis.  

PubMed

Clinically relevant examples of stratified medicine are available for patients with rheumatoid arthritis (RA). The aim of this study was to understand the current economic evidence for stratified medicine in RA. Two systematic reviews were conducted to identify: (1) all economic evaluations of stratified treatments for rheumatoid arthritis, or those which have used a subgroup analysis, and (2) all stated preference studies of treatments for rheumatoid arthritis. Ten economic evaluations of stratified treatments for RA, 38 economic evaluations including with a subgroup analysis and eight stated preference studies were identified. There was some evidence to support that stratified approaches to treating a patient with RA may be cost-effective. However, there remain key gaps in the economic evidence base needed to support the introduction of stratified medicine in RA into healthcare systems and considerable uncertainty about how proposed stratified approaches will impact future patient preferences, outcomes and costs when used in routine practice. PMID:25366935

Gavan, Sean; Harrison, Mark; Iglesias, Cynthia; Barton, Anne; Manca, Andrea; Payne, Katherine

2014-12-01

164

Rheumatoid arthritis in population samples in Iraq.  

PubMed Central

A prevalence survey for rheumatoid arthritis was carried out during the summer of 1975 in persons aged 16 years and over in areas of Iraq representative of differences in geography and ethnicity. Definite rheumatoid arthritis was observed in 1% of the 6999 individuals studied, but differences in occurrence rates in relation to various associated characteristics were not detected. It is concluded that present rheumatological services in Iraq have not developed in response to the magnitude of the existing burden. Morning stiffness was reported fairly frequently by individuals without rheumatoid arthritis, but the significance of this observation is not easy to determine. Raynaud's phenomenon was also recorded, but comparative evaluation of the findings is not possible. PMID:629609

Al-Rawi, Z S; Alazzawi, A J; Alajili, F M; Alwakil, R

1978-01-01

165

Early, Accurate and Fast Yield Estimation through Monte Carlo-Alternative Probabilistic Behavioral Analog System Simulations  

Microsoft Academic Search

Monte Carlo analysis has so far been the corner stone for analog statistical simulations. Fast and accurate simulations are necessary for stringent time-to-market, design for manufacturability and yield concerns in the analog domain. Although Monte Carlo attains accuracy, it does so with a sacrifice in run-time for analog simulations. In this paper, we propose a fast and accurate probabilistic simulation

Rasit Onur Topaloglu

2006-01-01

166

The schizophrenia-rheumatoid arthritis connection: infectious, immune, or both?  

PubMed

Schizophrenia and rheumatoid arthritis share an impressive number of similarities. Both are chronic, relapsing diseases of unknown etiology. Both became prominent in the early 19th century and have prevalences of approximately 1% in North America and Europe. Both run in families, have pairwise concordance rates of approximately 30% among monozygotic twins, and are more common among individuals born in urban areas. For both diseases, studies have reported greater exposure to cats in childhood than in controls. Both diseases have been associated with similar class II HLA antigens. Both have also been suspected of having infectious etiology, with similar agents--retroviruses, herpesviruses including EBV, and Toxoplasma gondii--having been associated in some cases. Since there is also a well-documented inverse correlation between these two diseases, it is possible that they share a common infectious and/or immune etiology and that once a person gets one of the diseases then they are relatively immune to the other. PMID:11782106

Torrey, E F; Yolken, R H

2001-12-01

167

Comparative study of the synovial histology in rheumatoid arthritis, spondyloarthropathy, and osteoarthritis: influence of disease duration and activity  

Microsoft Academic Search

OBJECTIVESTo compare the macroscopic and microscopic characteristics of synovial tissue in rheumatoid arthritis (RA), spondyloarthropathy (SpA), and osteoarthritis (OA) after exclusion of possible biases induced by disease duration or activity, or both.METHODSSynovial biopsy specimens were obtained by needle arthroscopy in patients with early RA (n=16), late RA (n=14), early SpA (n=23), and OA (n=12). Macroscopic and microscopic features were scored

D Baeten; P Demetter; C Cuvelier; F Van den Bosch; E Kruithof; N Van Damme; G Verbruggen; H Mielants; E M Veys; F De Keyser

2000-01-01

168

Independent associations of total and high molecular weight adiponectin with cardiometabolic risk and surrogate markers of enhanced early atherogenesis in black and white patients with rheumatoid arthritis: a cross-sectional study  

PubMed Central

Introduction Whether adiponectin levels associate with atherogenesis in RA is uncertain. We examined the independent relationships of total and high molecular weight (HMW) adiponectin concentrations with cardiometabolic risk and surrogate markers of enhanced early atherogenesis in black and white patients with RA. Methods We determined total and HMW adiponectin concentrations and those of endothelial activation molecules including soluble E-selectin, vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1) and monocyte chemoattractant protein-1 (MCP-1), in 210 (119 black and 91 white) RA patients. Associations were determined in potential confounder and mediator adjusted mixed regression models. Results Total and HMW adiponectin concentrations related similarly to metabolic risk factors and endothelial activation. In all patients, total and HMW adiponectin concentrations associated paradoxically with high systolic, diastolic and mean blood pressure (partial R = 0.155 to 0.241, P ?0.03). Ethnic origin did not impact on these relationships (interaction P ?0.09). Total and HMW adiponectin concentrations associated with those of glucose in white and black patients respectively (partial R = -0.304, P = 0.006 and -0.246, P = 0.01). In black but not white participants, total and HMW adiponectin concentrations also related favorably to lipid profiles (partial R = 0.292 to 0.360, P ?0.003 for HDL cholesterol concentrations, -0.269 to -0.299, P ?0.006 for triglyceride concentrations and -0.302 to -0.390, P ?0.002 for total-HDL cholesterol ratio) and the number of metabolic risk factors (partial R = -0.210 to -0.238, P ?0.03). In white but not black patients, total and HMW adiponectin concentrations associated paradoxically with overall endothelial activation as estimated by a standard z-score of endothelial activation molecule concentrations (partial R = 0.262, P = 0.01 and 0.252, P = 0.02); in the respective models, the extent of effect of total and HMW adiponectin concentrations on endothelial activation was larger in white compared to black participants (standardized ? (SE) = 0.260 (0.107) versus -0.106 (0.107), P = 0.01 and 0.260 (0.120) versus -0.100 (0.111), P = 0.02). The HMW-total adiponectin ratio related inconsistently to metabolic risk factors and not to endothelial activation. Conclusion In this study, total and HMW adiponectin concentrations associated with increased blood pressure parameters, and in white patients additionally with endothelial activation. The potential mechanism(s) underlying these paradoxical relationships between adiponectin concentrations and cardiovascular risk in RA merit further investigation. PMID:24286214

2013-01-01

169

Changes in available gonadotropin receptors in the corpus luteum of the rhesus monkey during simulated early pregnancy.  

PubMed

Stimulation of the primate corpus luteum (CL) by endogenous CG in early pregnancy or by exogenous human CG (hCG) in simulated early pregnancy, is transient, despite continued exposure to rising concentrations of CG. The objective of this study was to determine if the transitory response of the CL to CG is related to changes in gonadotropin receptors. Numbers and affinities of available LH/CG binding sites were characterized in the CL of rhesus monkeys (n = 27) during prolonged CG exposure in simulated early pregnancy, and the temporal relationship between changes in receptor parameters and in luteal function was examined. Administration of hCG increased progesterone concentrations above pretreatment levels within 9 h (2.2 +/- 0.8 vs. 7.6 +/- 1.1 ng/ml, mean +/- SE, P less than 0.05); the relative increase (345% of control) in serum progesterone was more profound than that of available hCG binding sites (135%, P greater than 0.05) or luteal weight (128%, P greater than 0.05) over this interval. Receptor affinities for hCG remained comparable to pretreatment values (Kd = 1.1 +/- 0.2 X 10(-10) M) throughout this 9-h period. A significant diminution in available hCG receptors occurred between 9 h (12.7 +/- 2.1 fmol/mg tissue) and 3 days (7.4 +/- 1.5 fmol/mg tissue) of hCG treatment (P less than 0.05). The loss of available CG receptors preceded a significant decline in serum progesterone concentrations. Serum progesterone decreased by 6 days (4.0 +/- 0.6 ng/ml, P less than 0.05) of hCG treatment, as did receptor affinity for hCG (Kd = 4.7 +/- 0.9 X 10(-10) M, P less than 0.05). Numbers and affinities of available receptors for hCG and serum progesterone concentrations fell before any decrease in luteal weight. Binding capacities and receptor affinities for human LH were comparable to those for hCG throughout simulated early pregnancy. In conclusion, the population of available LH/CG receptors in the macaque CL is maintained, or perhaps modestly increased, amidst dramatic stimulation of luteal function during early CG exposure. The subsequent diminution of number and affinity of available LH/CG receptors during prolonged exposure to CG in early pregnancy may compromise CL function and thus participate in the establishment of the transient nature of the luteal response to CG. PMID:6329648

Ottobre, J S; Ottobre, A C; Stouffer, R L

1984-07-01

170

Reconditioning in patients with rheumatoid arthritis  

Microsoft Academic Search

Rheumatologists traditionally have recommended to rheumatoid arthritis (RA) patients that they avoid dynamic and weight-bearing exercises because of concerns about aggravating joint inflammation and accelerating joint damage in such patients. These restrictions may lead to inade- quate levels of physical activity and deconditioning. Objective. - To review the literature on tolerance and benefits of conditioning training, including dynamic and weight-bearing

A. Mayoux Benhamou

2007-01-01

171

Switching rheumatoid arthritis treatments: An update  

Microsoft Academic Search

The first approved biological agents for the treatment of rheumatoid arthritis (RA) were tumour necrosis factor (TNF) antagonists, all of which improve disease signs and symptoms, and slow or prevent structural damage; however, they are not equally effective in all patients. About 30% of patients treated with a TNF agent fail to achieve an improvement of 20% in the American

Fabiola Atzeni; Piercarlo Sarzi-Puttini; Roberto Gorla; Antonio Marchesoni; Roberto Caporali

2011-01-01

172

A New Era in Rheumatoid Arthritis Treatment  

Microsoft Academic Search

Rheumatoid Arthritis (RA) is a systemic autoimmune disease that primarily manifests as a chronic symmetric polyarthritis. Treatment in the past was aimed at symp- tomatic pain relief. The initiation of disease modifying anti-rheumatic drugs (DMARDs) was historically started only after significant disease activity was pres- ent in order to reduce side effects from drug toxicities. Unfortunately, irreversible joint damage may

Jill C. Costello; Paul B. Halverson

2003-01-01

173

Update on Treatment of Rheumatoid Arthritis  

PubMed Central

Treatment of rheumatoid arthritis consists of use of drugs, physical measures, social work interventions, education and reconstructive surgery. The physician plays a co-ordinating role, since most patients with significant rheumatoid arthritis will require treatment by more than one member of the health-care team. Our drug armamentarium, including anti-inflammatory agents, disease suppressants, analgesics, rarely steroids, and even more rarely immunosuppressants, can be used to good effect in suppressing the synovitis of rheumatoid arthritis and in relieving pain. Physiotherapy, occupational therapy, nursing and social work interventions will help the patient to maintain function and to maintain their optimal level of fitness, including exercise tolerance, joint range, muscle strength and psycho-social function. Coping abilities can be greatly enhanced by a positive approach from the physician, and this, together with the very real benefits of the foregoing treatments, can produce a highly rewarding result for physician and patient alike, in terms of improved quality of life for the rheumatoid arthritis patient. PMID:21263856

Patterson, A. Caroline

1987-01-01

174

Leprosy and rheumatoid arthritis: consequence or association?  

PubMed Central

Leprosy or Hansen’s disease is a chronic granulomatous infectious disease caused by Mycobacterium leprae with a high prevalence in some developing countries however, it is rarely seen in non-endemic regions. Arthritis has been described in all types of Hansen’s disease. Chronic arthritis is known to exist even in paucibacillary forms, resolved or treated disease and in patients without reaction, suggesting a perpetuated inflammatory process. In these cases leprosy can mimic some autoimmune diseases such as rheumatoid arthritis. When a patient with a history of leprosy presents with a symmetric, distal, polyarthritis the diagnosis may not be linear. Possibly it is a rheumatoid-like leprous arthritis with M leprae acting as the trigger element for the chronic process or it is an overlap condition, with a concomitant rheumatoid arthritis? A case report of a patient with a chronic inflammatory arthritis with 10 years of evolution is presented. The differential diagnosis between leprous and rheumatoid arthritis is discussed. PMID:22891014

Henriques, Celia Coelho; Lopéz, Begoña; Mestre, Tiago; Grima, Bruno; Panarra, António; Riso, Nuno

2012-01-01

175

Hard Metal Alveolitis Accompanied by Rheumatoid Arthritis  

Microsoft Academic Search

Hard metal lung diseases (HML) are rare, and complex to diagnose. We describe the case of a patient with allergic alveolitis accompanied by rheumatoid arthritis. A sharpener of hard metal by trade, our patient was a 45-year-old, nonsmoking Caucasian female who experienced symptoms of cough and phlegm, and dyspnea on exertion. Preliminary lung findings were inspiratory rales in both basal

Paula A. Hahtola; Ritva E. Järvenpää; Kari Lounatmaa; Jorma J. Mattila; Immo Rantala; Jukka A. Uitti; Seppo Sutinen

2000-01-01

176

Leflunomide or Methotrexate for Juvenile Rheumatoid Arthritis  

Microsoft Academic Search

In patients with polyarticular juvenile rheumatoid arthritis, methotrexate and lefluno- mide both resulted in high rates of clinical improvement, but the rate was slightly greater for methotrexate. At the doses used in this study, methotrexate was more effective than leflunomide. abstract

Earl Silverman; Richard Mouy; Lynn Spiegel; Lawrence K. Jung; Rotraud K. Saurenmann; Pekka Lahdenne; Gerd Horneff; Immaculada Calvo; Ilona S. Szer; Karen Simpson; John A. Stewart; Vibeke Strand; Bridgewater Sanofi-Aventis; Sanofi-Aventis Pharma Cana

2010-01-01

177

Mud pack therapy in rheumatoid arthritis  

Microsoft Academic Search

Summary Twenty-eight patients with classical or definite rheumatoid arthritis were randomly divided into two groups of fourteen patients each. All patients were treated once a day with mud packs derived from the Dead Sea heated to 40°C and applied over the four extremities, neck and back for 20 minutes. Group 1 was treated with the true mud packs and Group

S. Sukenik; D. Buskila; L. Neumann; A. Kleiner-Baumgarten

1992-01-01

178

Group education for patients with rheumatoid arthritis  

Microsoft Academic Search

Patients with rheumatoid arthritis must learn to adjust their exercise, rest and medication to the varying activity of the disease. Patient education can help patients in making the right decisions about adjustments in their treatment regimen and in attaining ¿self-management¿ behaviors. We developed a group education program based on social learning theory and the `Arthritis Self Management Course¿ developed in

Erik Taal; Rob P. Riemsma; Herman L. M. Brus; Erwin R. Seydel; Johannes J. Rasker; Oene Wiegman

1993-01-01

179

ICF Core Sets for rheumatoid arthritis  

Microsoft Academic Search

Objective: To report on the results of the consensus process integrating evidence from preliminary studies to develop the first version of a Comprehensive ICF Core Set and a Brief ICF Core Set for rheumatoid arthritis. Methods: A formal decision-making and consensus process integrating evidence gathered from preliminary studies was followed. Preliminary studies included a Delphi exercise, a systematic review, and

Gerold Stucki; Alarcos Cieza; Szilvia Geyh; Linamara Battistella; Jill Lloyd; Deborah Symmons; Nenad Kostanjsek; Jan Schouten

2004-01-01

180

Emerging MRI methods in rheumatoid arthritis  

Microsoft Academic Search

New MRI techniques have been developed to assess not only the static anatomy of synovial hyperplasia, bone changes and cartilage degradation in patients with rheumatoid arthritis (RA), but also the activity of the physiological events that cause these changes. This enables an estimation of the rate of change in the synovium, bone and cartilage as a result of disease activity

Camilo G. Borrero; James M. Mountz; John D. Mountz

2010-01-01

181

Aerobic Exercise Prescription for Rheumatoid Arthritics.  

ERIC Educational Resources Information Center

The use of exercise as a general treatment for rheumatoid arthritics (RA) has included range of motion, muscular strength, water exercise and rest therapy while virtually ignoring possible benefits of aerobic exercise. The purposes of this project were to examine the guidelines for exercise prescription in relation to this special population and…

Evans, Blanche W.; Williams, Hilda L.

182

Treat-to-target: a tailored treatment approach to rheumatoid arthritis.  

PubMed

In contrast to articles and books written about rheumatoid arthritis (RA) two or more decades ago that largely focused on 'coping' with the disease, there have been significant developments in the treatment of RA over the past 10 years. Patients can now be diagnosed and treated and expect to live functional lives, with less likelihood of experiencing the associated joint damage and disability. An important goal of RA therapy has shifted to initiate treatment early and aggressively, with frequent assessment and a target to achieve remission as quickly as possible. This 'treat-to-target' concept has been endorsed to maximise long-term health-related quality of life through control of symptoms, prevention of structural damage, normalisation of function and social participation. This article will look at therapies and strategies for the treatment of RA. It will also discuss a treatment algorithm for rheumatoid arthritis tailored to the individual patient's disease activity status. PMID:23901448

Palmer, Deborah; El Mledany, Yasser

183

78 FR 32667 - Draft Guidance for Industry on Rheumatoid Arthritis: Developing Drug Products for Treatment...  

Federal Register 2010, 2011, 2012, 2013, 2014

...Industry on Rheumatoid Arthritis: Developing Drug Products for Treatment; Availability...products for the treatment of patients with rheumatoid arthritis (RA). It...Products for the Treatment of Rheumatoid Arthritis...

2013-05-31

184

Sensitivity of seawater oxygen isotopes to climatic and tectonic boundary conditions in an early Paleogene simulation  

E-print Network

Paleogene simulation with GISS ModelER Christopher D. Roberts,1,2 Allegra N. LeGrande,3 and Aradhna K are usually assumed. Citation: Roberts, C. D., A. N. LeGrande, and A. K. Tripati (2011), Sensitivity

185

Case Studies of Systems Integration through Energy Simulation During Early Design Phase  

E-print Network

The paper presents two case studies, a commercial & a community project, in Houston Texas, where energy simulation and a decision matrix were used to solve budget conflicts and meet LEED EA-1 requirements. The first case study consists...

Upadhyaya, K.; McLean, D.

186

Serum melatonin in juvenile rheumatoid arthritis: correlation with disease activity.  

PubMed

The study was conducted to investigate the abnormalities in early morning serum melatonin among patients with Juvenile Rheumatoid Arthritis (JRA) and to outline its relation to disease activity and severity. Twenty one patients with JRA and twenty healthy age and sex matched controls were enrolled in the study. Fifteen patients had polyarticular JRA, 3 had oligoarticular and 3 had systemic onset JRA. Evaluation was carried out clinically, functionally and radiologically by using disease activity score, Juvenile Arthritis Functional Assessment Report for Children (JAFAR-C score) and modified Larsen score, respectively. Laboratory investigations included Complete Blood Picture (CBC), The Erythrocyte Sedimentation Rate (ESR), C-Reactive Protein (CRP), classic IgM Rheumatoid Factor (RF), Anti-nuclear Antibodies (ANA) and melatonin estimation in serum. The serum levels of melatonin were significantly increased in JRA patients (mean +/- SD = 13.9 +/- 8 pg mL(-1)) as compared to healthy controls (mean +/- SD = 8.1 +/- 2.7 pg mL(-1), p < 0.01). A significant positive correlation could link serum melatonin levels to disease activity scores and ESR (r = 0.91, p < 0.001 and r = 0.55, p < 0.01, respectively). No significant correlation was found between melatonin and either Larsen or JAFAR scores (r = 0.19, r = 0.15, respectively). According to melatonin levels, there were 2 groups of patients: Group I with elevated melatonin level (more than 11 pg mL(-1)) (n = 15) and group II with normal melatonin level (less than 11 pg mL(-1)) (n = 6). Patients with elevated melatonin levels had higher ESR (p < 0.05), higher disease activity scores (p < 0.01) and Larsen scores (p < 0.05), than the group of patients with normal serum melatonin. The results of GAFAR scores were comparable between the two groups (p > 0.05). Hence the study conclude that the elevated melatonin levels among JRA patients with active synovitis and its close relation to disease activity rather than disease severity suggests that melatonin might play a promoting role in rheumatoid arthritis. Hence, inhibition of its synthesis and/or action by specific antagonists may be of therapeutic value. PMID:19069959

El-Awady, Hanaa Mahmoud; El-Wakkad, Amany Salah El-Dien; Saleh, Maysa Tawheed; Muhammad, Saadia Ibraheem; Ghaniema, Eiman Mahmoud

2007-05-01

187

Myocardial dysfunction in rheumatoid arthritis: epidemiology and pathogenesis  

PubMed Central

Data from population- and clinic-based epidemiologic studies of rheumatoid arthritis patients suggest that individuals with rheumatoid arthritis are at risk for developing clinically evident congestive heart failure. Many established risk factors for congestive heart failure are over-represented in rheumatoid arthritis and likely account for some of the increased risk observed. In particular, data from animal models of cytokine-induced congestive heart failure have implicated the same inflammatory cytokines produced in abundance by rheumatoid synovium as the driving force behind maladaptive processes in the myocardium leading to congestive heart failure. At present, however, the direct effects of inflammatory cytokines (and rheumatoid arthritis therapies) on the myocardia of rheumatoid arthritis patients are incompletely understood. PMID:16207349

Giles, Jon T; Fernandes, Verônica; Lima, Joao AC; Bathon, Joan M

2005-01-01

188

Computer simulation in conjunction with medical thermography as an adjunct tool for early detection of breast cancer  

PubMed Central

Background Mathematical modelling and analysis is now accepted in the engineering design on par with experimental approaches. Computer simulations enable one to perform several 'what-if' analyses cost effectively. High speed computers and low cost of memory has helped in simulating large-scale models in a relatively shorter time frame. The possibility of extending numerical modelling in the area of breast cancer detection in conjunction with medical thermography is considered in this work. Methods Thermography enables one to see the temperature pattern and look for abnormality. In a thermogram there is no radiation risk as it only captures the infrared radiation from the skin and is totally painless. But, a thermogram is only a test of physiology, whereas a mammogram is a test of anatomy. It is hoped that a thermogram along with numerical modelling will serve as an adjunct tool. Presently mammogram is the 'gold-standard' in breast cancer detection. But the interpretation of a mammogram is largely dependent on the radiologist. Therefore, a thermogram that looks into the physiological changes in combination with numerical simulation performing 'what-if' analysis could act as an adjunct tool to mammography. Results The proposed framework suggested that it could reduce the occurrence of false-negative/positive cases. Conclusion A numerical bioheat model of a female breast is developed and simulated. The results are compared with experimental results. The possibility of this method as an early detection tool is discussed. PMID:15113442

Ng, Eddie Y-K; Sudharsan, NM

2004-01-01

189

Computational simulation of the early stage of bone healing under different configurations of locking compression plates.  

PubMed

Flexible fixation or the so-called 'biological fixation' has been shown to encourage the formation of fracture callus, leading to better healing outcomes. However, the nature of the relationship between the degree of mechanical stability provided by a flexible fixation and the optimal healing outcomes has not been fully understood. In this study, we have developed a validated quantitative model to predict how cells in fracture callus might respond to change in their mechanical microenvironment due to different configurations of locking compression plate (LCP) in clinical practice, particularly in the early stage of healing. The model predicts that increasing flexibility of the LCP by changing the bone-plate distance (BPD) or the plate working length (WL) could enhance interfragmentary strain in the presence of a relatively large gap size (>3 mm). Furthermore, conventional LCP normally results in asymmetric tissue development during early stage of callus formation, and the increase of BPD or WL is insufficient to alleviate this problem. PMID:24261957

Miramini, Saeed; Zhang, Lihai; Richardson, Martin; Pirpiris, Marinis; Mendis, Priyan; Oloyede, Kunle; Edwards, Glenn

2015-06-01

190

Early diagnostic suggestions improve accuracy of GPs: a randomised controlled trial using computer-simulated patients  

PubMed Central

Background Designers of computerised diagnostic support systems (CDSSs) expect physicians to notice when they need advice and enter into the CDSS all information that they have gathered about the patient. The poor use of CDSSs and the tendency not to follow advice once a leading diagnosis emerges would question this expectation. Aim To determine whether providing GPs with diagnoses to consider before they start testing hypotheses improves accuracy. Design and setting Mixed factorial design, where 297 GPs diagnosed nine patient cases, differing in difficulty, in one of three experimental conditions: control, early support, or late support. Method Data were collected over the internet. After reading some initial information about the patient and the reason for encounter, GPs requested further information for diagnosis and management. Those receiving early support were shown a list of possible diagnoses before gathering further information. In late support, GPs first gave a diagnosis and were then shown which other diagnoses they could still not discount. Results Early support significantly improved diagnostic accuracy over control (odds ratio [OR] 1.31; 95% confidence interval [95%CI] = 1.03 to 1.66, P = 0.027), while late support did not (OR 1.10; 95% CI = 0.88 to 1.37). An absolute improvement of 6% with early support was obtained. There was no significant interaction with case difficulty and no effect of GP experience on accuracy. No differences in information search were detected between experimental conditions. Conclusion Reminding GPs of diagnoses to consider before they start testing hypotheses can improve diagnostic accuracy irrespective of case difficulty, without lengthening information search. PMID:25548316

Kostopoulou, Olga; Rosen, Andrea; Round, Thomas; Wright, Ellen; Douiri, Abdel; Delaney, Brendan

2015-01-01

191

[Total ankle arthroplasty for rheumatoid arthritis].  

PubMed

Modern second generation total ankle arthroplasty is now a serious alternative to ankle fusion in patients with rheumatoid arthritis after careful assessment of the indications. The midterm results with 10-year survival rates between 70% and 90% and the possible revision for implant exchange or arthrodesis are the reasons for the increasing importance of ankle arthroplasty. Patients with rheumatoid arthritis in particular with generally lower physical requirements can expect a pain-free function of the operated ankle for 8-10 years. In comparison to fusion ankle arthroplasty allows a significantly faster remobilization and reserves the correction capabilities of the ankle. Arthrodesis remains a valuable therapeutic alternative for severe bony destruction and instability as well as a possible fallback for failure of arthroplasty. PMID:21691912

Schill, S; Wetzel, R

2011-07-01

192

Herpes Simplex Keratitis in Rheumatoid Arthritis Patients.  

PubMed

Abstract Purpose: To describe a series of 5 patients with herpes simplex virus keratitis (HSK) and rheumatoid arthritis (RA) under immunosuppressive treatment. Methods: Retrospective study. Detailed data were obtained regarding symptoms and signs at the initial evaluation, treatment, microbiological diagnostic tests, evolution, and outcomes. Results: Five patients with HSK and RA were identified. Bilateral involvement occurred in 2 patients (40%). Epithelial keratitis was diagnosed in 5 eyes. Three eyes showed severe melting with eye perforation. Gram-positive bacterial co-infections were common in the group with stromal keratitis. We did not find differences in the evolution of the disease based on anti-rheumatoid treatment. Conclusions: The characteristics of HSK in patients with RA differed from HSK in immunocompetent patients. The stromal keratitis cases were very aggressive and difficult to manage, with perforation and gram-positive bacterial co-infection as frequently associated conditions. Prophylactic therapy at standard doses was unsuccessful to avoid recurrences. PMID:25140583

Larrañaga Fragoso, Paula; Boto de Los Bueis, Ana; Bravo Ljubetic, Luciano; Del Hierro Zarzuelo, Almudena; Romero Gómez, M Pilar; Mora Rillo, Marta

2014-08-20

193

Naproxen in rheumatoid arthritis. Extended trial.  

PubMed Central

121 patients with active rheumatoid arthritis, 91 of whom had proved intolerant of other nonsteroidal anti-inflammatory agents, were treated for a mean of 10 months with naproxen. A dosage of 250 mg twice daily produced sustained improvement in most of the standard clinical measurements. 28 patients complained of side effects, with a lower than expected incidence of gastrointestinal complaints and no drug-induced rash being recorded. 19 patients withdrew from the trial because of side effects, while a further 22 withdrew because the drug was ineffective. Naproxen is a useful drug for long-term use in patients with rheumatoid arthritis, including those who have proved intolerant of or experienced inadequate symptomatic relief from other nonsteriodal anti-inflammatory agents. PMID:795386

Mowat, A G; Ansell, B M; Gumpel, J M; Hill, H F; Hill, A G; Stoppard, M

1976-01-01

194

Abatacept in the treatment of rheumatoid arthritis  

PubMed Central

T-cell biology has regained importance in the pathogenesis of rheumatoid arthritis. Despite the significant improvements associated with the introduction of tumor necrosis factor-? blockade, reasonable proportions of failures and suboptimal responses have been reported, necessitating a search for alternative targeted therapies. This has included drug therapy designed to interrupt T-cell activation via the co-stimulation pathway. Abatacept is a recombinant fusion protein that blocks the co-stimulatory signal mediated by the CD28-CD80/86 pathway, which is required for T-cell activation. Several clinical trials have confirmed the safety and efficacy of this drug in the treatment of rheumatoid arthritis. This review summarizes the clinical data supporting this line of treatment and considers the safety and efficacy data from phase II and III trials. PMID:19007425

Buch, Maya H; Vital, Edward M; Emery, Paul

2008-01-01

195

Autoantibodies to Posttranslational Modifications in Rheumatoid Arthritis  

PubMed Central

Autoantibodies have been associated with human pathologies for a long time, particularly with autoimmune diseases (AIDs). Rheumatoid factor (RF) is known since the late 1930s to be associated with rheumatoid arthritis (RA). The discovery of anticitrullinated protein antibodies in the last century has changed this and other posttranslational modifications (PTM) relevant to RA have since been described. Such PTM introduce neoepitopes in proteins that can generate novel autoantibody specificities. The recent recognition of these novel specificities in RA provides a unique opportunity to understand human B-cell development in vivo. In this paper, we will review the three of the main classes of PTMs already associated with RA: citrullination, carbamylation, and oxidation. With the advancement of research methodologies it should be expected that other autoantibodies against PTM proteins could be discovered in patients with autoimmune diseases. Many of such autoantibodies may provide significant biomarker potential. PMID:24782594

Burska, Agata N.; Hunt, Laura; Strollo, Rocky; Ryan, Brent J.; Vital, Ed; Nissim, Ahuva; Winyard, Paul G.; Emery, Paul; Ponchel, Frederique

2014-01-01

196

3D Simulations of the Early Mars Climate with a General Circulation Model  

NASA Technical Reports Server (NTRS)

The environmental conditions that existed on Mars during the Noachian period are subject to debate in the community. In any case, there are compelling evidence that these conditions were different than what they became later in the amazonian and possibly the Hesperian periods. Indeed, most of the old cratered terrains are disected by valley networks (thought to have been carved by flowing liquid water), whereas younger surface are almost devoid of such valleys. In addition, there are evidence that the erosion rate was much higher during the early noachian than later. Flowing water is surprising on early Mars because the solar luminosity was significantly lower than today. Even with the thick atmosphere (up to several bars).To improve our understanding of the early Mars Climate, we have developed a 3D general circulation model similar to the one used on current Earth or Mars to study the details of the climate today. Our first objective is to answer the following questions : how is the Martian climate modified if 1) the surface pressure is increased up to several bars (our baseline: 2 bars) and 2) if the sun luminosity is decreased by 25 account the heat possibly released by impacts during short periods, although it may have played a role .For this purpose, we have coupled the Martian General Circulation model developed at LMD with a sophisticated correlated k distribution model developped at NASA Ames Research Center. It is a narrow band model which computes the radiative transfer at both solar and thermal wavelengths (from 0.3 to 250 microns).

Forget, F.; Haberle, R. M.; Montmessin, F.; Cha, S.; Marcq, E.; Schaeffer, J.; Wanherdrick, Y.

2003-01-01

197

Patient access to rheumatoid arthritis treatments  

Microsoft Academic Search

This paper is an introduction to the study “The Burden of Rheumatoid Arthritis and Patient Access to Treatment”. The objective\\u000a of the study is to compare patient access to new drugs in Europe, North America and a selection of other countries, and to\\u000a analyse the determinants of differences between countries, as basis for a discussion on how patients’ access to

Bengt Jönsson

2008-01-01

198

Demodex folliculorum in patients with rheumatoid arthritis  

Microsoft Academic Search

The objective of this study was to investigate the incidence and density of Demodex folliculorum in the patients with rheumatoid arthritis (RA). Forty-one patients with RA and twenty-seven age and sex matched healthy controls\\u000a were enrolled in this study. Disease Activity Score (DAS 28) was used for the assessment of disease activity. Out of 41 patients,\\u000a 33 were females and

Ihsan H. Ciftci; Umit Dundar; Zafer Cetinkaya; Mustafa Kulac; Nilay Kiyildi; Aycan Turel; Deniz Evcik; Vural Kavuncu

2007-01-01

199

Environmental Exposures and Rheumatoid Arthritis Risk  

Microsoft Academic Search

In addition to rapidly burgeoning data regarding novel genetic risk factors, a growing list of environmental exposures have\\u000a been implicated in rheumatoid arthritis (RA) susceptibility. Cigarette smoking is chief among the many environmental exposures\\u000a implicated in disease risk, accounting for approximately one in six new cases of RA, with recent results underscoring the\\u000a central importance of select gene–smoking interactions in

Ryan A. Hoovestol; Ted R. Mikuls

200

Magnetohydrodynamic simulations of the collapsar model for early and late evolution of gamma-ray bursts  

E-print Network

I present results from magnetohydrodynamic (MHD) simulations of a gaseous envelope collapsing onto a black hole. These results support the notion that the collapsar model is one of most promising scenarios to explain the huge release of energy in a matter of seconds associated with Gamma Ray Bursts (GRB). Additionally, the MHD simulations show that at late times, when the mass supply rate is expected to decrease, the region in the vicinity of the black hole can play an important role in determining the rate of accretion, its time behaviour, and ultimately the energy output. In particular, the magnetic flux accumulated around the black hole can repeatedly stop and then restart the energy release. As proposed by Proga and Zhang, the episode or episodes of reoccurring of accretion processes can correspond to X-ray flares discovered recently in a number of GRBs.

Daniel Proga

2007-01-06

201

The performance of field scientists undertaking observations of early life fossils while in simulated space suit  

NASA Astrophysics Data System (ADS)

We conducted simulated Apollo Extravehicular Activity's (EVA) at the 3.45 Ga Australian 'Pilbara Dawn of life' (Western Australia) trail with field and non-field scientists using the University of North Dakota's NDX-1 pressurizable space suit to overview the effectiveness of scientist astronauts employing their field observation skills while looking for stromatolite fossil evidence. Off-world scientist astronauts will be faced with space suit limitations in vision, human sense perception, mobility, dexterity, the space suit fit, time limitations, and the psychological fear of death from accidents, causing physical fatigue reducing field science performance. Finding evidence of visible biosignatures for past life such as stromatolite fossils, on Mars, is a very significant discovery. Our preliminary overview trials showed that when in simulated EVAs, 25% stromatolite fossil evidence is missed with more incorrect identifications compared to ground truth surveys but providing quality characterization descriptions becomes less affected by simulated EVA limitations as the science importance of the features increases. Field scientists focused more on capturing high value characterization detail from the rock features whereas non-field scientists focused more on finding many features. We identified technologies and training to improve off-world field science performance. The data collected is also useful for NASA's "EVA performance and crew health" research program requirements but further work will be required to confirm the conclusions.

Willson, D.; Rask, J. C.; George, S. C.; de Leon, P.; Bonaccorsi, R.; Blank, J.; Slocombe, J.; Silburn, K.; Steele, H.; Gargarno, M.; McKay, C. P.

2014-01-01

202

Preliminary numerical simulations of the 27 February 2010 Chile tsunami: first results and hints in a tsunami early warning perspective  

NASA Astrophysics Data System (ADS)

The tsunamigenic earthquake (M 8.8) that occurred offshore central Chile on 27 February 2010 can be classified as a typical subduction-zone earthquake. The effects of the ensuing tsunami have been devastating along the Chile coasts, and especially between the cities of Valparaiso and Talcahuano, and in the Juan Fernandez islands. The tsunami propagated across the entire Pacific Ocean, hitting with variable intensity almost all the coasts facing the basin. While the far-field propagation was quite well tracked almost in real-time by the warning centres and reasonably well reproduced by the forecast models, the toll of lives and the severity of the damage caused by the tsunami in the near-field occurred with no local alert nor warning and sadly confirms that the protection of the communities placed close to the tsunami sources is still an unresolved problem in the tsunami early warning field. The purpose of this study is two-fold. On one side we perform numerical simulations of the tsunami starting from different earthquake models which we built on the basis of the preliminary seismic parameters (location, magnitude and focal mechanism) made available by the seismological agencies immediately after the event, or retrieved from more detailed and refined studies published online in the following days and weeks. The comparison with the available records of both offshore DART buoys and coastal tide-gauges is used to put some preliminary constraints on the best-fitting fault model. The numerical simulations are performed by means of the finite-difference code UBO-TSUFD, developed and maintained by the Tsunami Research Team of the University of Bologna, Italy, which can solve both the linear and non-linear versions of the shallow-water equations on nested grids. The second purpose of this study is to use the conclusions drawn in the previous part in a tsunami early warning perspective. In the framework of the EU-funded project DEWS (Distant Early Warning System), we will try to give some clues for discussion on the deficiencies of the existing tsunami early warning concepts as regards the warning to the areas which are found close to the tsunami source, and on the strategies that should be followed in the near future in order to make significant progress in the protection and safeguarding of local communities.

Tinti, S.; Tonini, R.; Armigliato, A.; Zaniboni, F.; Pagnoni, G.; Gallazzi, Sara; Bressan, Lidia

2010-05-01

203

Heparan sulfate differences in rheumatoid arthritis versus healthy sera.  

PubMed

Heparan sulfate (HS) is a complex and highly variable polysaccharide, expressed ubiquitously on the cell surface as HS proteoglycans (HSPGs), and found in the extracellular matrix as free HS fragments. Its heterogeneity due to various acetylation and sulfation patterns endows a multitude of functions. In animal tissues, HS interacts with a wide range of proteins to mediate numerous biological activities; given its multiple roles in inflammation processes, characterization of HS in human serum has significant potential for elucidating disease mechanisms. Historically, investigation of HS was limited by its low concentration in human serum, together with the complexity of the serum matrix. In this study, we used a modified mass spectrometry method to examine HS disaccharide profiles in the serum of 50 women with rheumatoid arthritis (RA), and compared our results to 51 sera from healthy women. Using various purification methods and online LC-MS/MS, we discovered statistically significant differences in the sulfation and acetylation patterns between populations. Since early diagnosis of RA is considered important in decelerating the disease's progression, identification of specific biomolecule characterizations may provide crucial information towards developing new therapies for suppressing the disease in its early stages. This is the first report of potential glycosaminoglycan biomarkers for RA found in human sera, while acknowledging the obvious fact that a larger population set, and more stringent collection parameters, will need to be investigated in the future. PMID:25217862

Sabol, Jenny K; Wei, Wei; López-Hoyos, Marcos; Seo, Youjin; Andaya, Armann; Leary, Julie A

2014-11-01

204

NETs are a source of citrullinated autoantigens and stimulate inflammatory responses in rheumatoid arthritis  

PubMed Central

The early events leading to the development of rheumatoid arthritis (RA) remain unclear but formation of autoantibodies to citrullinated antigens (ACPA) is considered a key pathogenic phenomenon. Neutrophils isolated from patients with various autoimmune diseases display enhanced extracellular trap formation (NETs), a phenomenon that externalizes autoantigens and immunostimulatory molecules. We investigated whether aberrant NETosis occurs in RA, determined its triggers and examined its deleterious inflammatory consequences. Enhanced NETosis was observed in circulating and synovial fluid RA neutrophils, compared to neutrophils from healthy controls and from patients with osteoarthritis. Further, netting neutrophils infiltrated RA synovial tissue, rheumatoid nodules and skin. NETosis correlated with ACPA presence and levels and with systemic inflammatory markers. RA sera and immunoglobulin fractions from RA patients with high levels of ACPA and/or rheumatoid factor significantly enhanced NETosis, and the NETs induced by these autoantibodies displayed distinct protein content. During NETosis, neutrophils externalized citrullinated autoantigens implicated in RA pathogenesis, whereas anti-citrullinated vimentin antibodies potently induced NET formation. The inflammatory cytokines IL-17A and TNF-? induced NETosis in RA neutrophils. In turn, NETs significantly augmented inflammatory responses in RA and OA synovial fibroblasts, including induction of IL-6, IL-8, chemokines and adhesion molecules. These observations implicate accelerated NETosis in RA pathogenesis, through externalization of citrullinated autoantigens and immunostimulatory molecules that may promote aberrant adaptive and innate immune responses in the joint and in the periphery, and perpetuate pathogenic mechanisms in this disease. PMID:23536012

Khandpur, Ritika; Carmona-Rivera, Carmelo; Vivekanandan-Giri, Anuradha; Gizinski, Alison; Yalavarthi, Srilakshmi; Knight, Jason S.; Friday, Sean; Li, Sam; Patel, Rajiv M.; Subramanian, Venkataraman; Thompson, Paul; Chen, Pojen; Fox, David A.; Pennathur, Subramaniam; Kaplan, Mariana J.

2013-01-01

205

Quantitative lung SPECT applied on simulated early COPD and humans with advanced COPD  

PubMed Central

Background Reduced ventilation in lung regions affected by chronic obstructive pulmonary disease (COPD), reflected as inhomogeneities in the single-photon emission computed tomography (SPECT) lung image, is correlated to disease advancement. An analysis method for measuring these inhomogeneities is proposed in this work. The first aim was to develop a quantitative analysis method that could discriminate between Monte Carlo simulated normal and COPD lung SPECT images. A second aim was to evaluate the ability of the present method to discriminate between human subjects with advanced COPD and healthy volunteers. Methods In the simulated COPD study, different activity distributions in the lungs were created to mimic the healthy lung (normal) and different levels of COPD. Gamma camera projections were Monte Carlo simulated, representing clinically acquired projections of a patient who had inhaled 125 MBq 99mTc-Technegas followed by a 10-min SPECT examination. Reconstructions were made with iterative ordered subset expectation maximisation. The coefficient of variance (CV) was calculated for small overlapping volumes covering the 3D reconstructed activity distribution. A CV threshold value (CVT) was calculated as the modal value of the CV distribution of the simulated normal. The area under the distribution curve (AUC), for CV values greater than CVT, AUC(CVT), was then calculated. Moreover, five patients with advanced emphysema and five healthy volunteers inhaled approximately 75 MBq 99mTc-Technegas immediately before the 20-min SPECT acquisition. In the human study, CVT was based on the mean CV distribution of the five healthy volunteers. Results A significant difference (p < 0.001) was found between the Monte-Carlo simulated normal and COPD lung SPECT examinations. The present method identified a total reduction of ventilation of approximately 5%, not visible to the human eye in the reconstructed image. In humans the same method clearly discriminated between the five healthy volunteers and five patients with advanced COPD (p < 0.05). Conclusions While our results are promising, the potential of the AUC(CVT) method to detect less advanced COPD in patients needs further clinical studies. PMID:23597059

2013-01-01

206

Hand bone mass in rheumatoid arthritis: A review of the literature  

PubMed Central

Rheumatoid arthritis (RA) is a common chronic inflammatory disease and periarticular osteoporosis or osteopenia of the inflamed hand joints is an early feature of RA. Quantitative measurement of hand bone loss may be an outcome measure for the detection of joint destruction and disease progression in early RA. This systematic review examines the published literature reporting hand bone mass in patients with RA, particularly those using the dual X-ray absorptiometry (DXA) methods. The majority of the studies reported that hand bone loss is associated with disease activity, functional status and radiological progression in early RA. Quantitative measurement of hand bone mineral density by DXA may be a useful and practical outcome measure in RA and may be predictive for radiographic progression or functional status in patients with early RA.

Kilic, Gamze; Ozgocmen, Salih

2015-01-01

207

The TRIDEC Virtual Tsunami Atlas - customized value-added simulation data products for Tsunami Early Warning generated on compute clusters  

NASA Astrophysics Data System (ADS)

The development of new Tsunami Early Warning Systems (TEWS) requires the modelling of spatio-temporal spreading of tsunami waves both recorded from past events and hypothetical future cases. The model results are maintained in digital repositories for use in TEWS command and control units for situation assessment once a real tsunami occurs. Thus the simulation results must be absolutely trustworthy, in a sense that the quality of these datasets is assured. This is a prerequisite as solid decision making during a crisis event and the dissemination of dependable warning messages to communities under risk will be based on them. This requires data format validity, but even more the integrity and information value of the content, being a derived value-added product derived from raw tsunami model output. Quality checking of simulation result products can be done in multiple ways, yet the visual verification of both temporal and spatial spreading characteristics for each simulation remains important. The eye of the human observer still remains an unmatched tool for the detection of irregularities. This requires the availability of convenient, human-accessible mappings of each simulation. The improvement of tsunami models necessitates the changes in many variables, including simulation end-parameters. Whenever new improved iterations of the general models or underlying spatial data are evaluated, hundreds to thousands of tsunami model results must be generated for each model iteration, each one having distinct initial parameter settings. The use of a Compute Cluster Environment (CCE) of sufficient size allows the automated generation of all tsunami-results within model iterations in little time. This is a significant improvement to linear processing on dedicated desktop machines or servers. This allows for accelerated/improved visual quality checking iterations, which in turn can provide a positive feedback into the overall model improvement iteratively. An approach to set-up and utilize the CCE has been implemented by the project Collaborative, Complex, and Critical Decision Processes in Evolving Crises (TRIDEC) funded under the European Union's FP7. TRIDEC focuses on real-time intelligent information management in Earth management. The addressed challenges include the design and implementation of a robust and scalable service infrastructure supporting the integration and utilisation of existing resources with accelerated generation of large volumes of data. These include sensor systems, geo-information repositories, simulations and data fusion tools. Additionally, TRIDEC adopts enhancements of Service Oriented Architecture (SOA) principles in terms of Event Driven Architecture (EDA) design. As a next step the implemented CCE's services to generate derived and customized simulation products are foreseen to be provided via an EDA service for on-demand processing for specific threat-parameters and to accommodate for model improvements.

Löwe, P.; Hammitzsch, M.; Babeyko, A.; Wächter, J.

2012-04-01

208

Prediction of efficacy of anti-TNF biologic agent, infliximab, for rheumatoid arthritis patients using a comprehensive transcriptome analysis of white blood cells  

Microsoft Academic Search

Introduction of biologics, such as infliximab, to the therapy of rheumatoid arthritis (RA) patients has revolutionized the treatment of this disease. However, biomarkers for predicting the efficacy of the drug at an early phase of treatment for selecting real responders have not been found. We here present predictive markers based on a thorough transcriptome analysis of white blood cells from

Motohiko Tanino; Ryo Matoba; Seiji Nakamura; Hideto Kameda; Kouichi Amano; Toshitsugu Okayama; Hayato Nagasawa; Katsuya Suzuki; Kenichi Matsubara; Tsutomu Takeuchi

2009-01-01

209

Radiation Magnetohydrodynamic Simulations of Protostellar Collapse: Non-Ideal Magnetohydrodynamic Effects and Early Formation of Circumstellar Disks  

E-print Network

The transport of angular momentum by magnetic fields is a crucial physical process in formation and evolution of stars and disks. Because the ionization degree in star forming clouds is extremely low, non-ideal magnetohydrodynamic (MHD) effects such as ambipolar diffusion and Ohmic dissipation work strongly during protostellar collapse. These effects have significant impacts in the early phase of star formation as they redistribute magnetic flux and suppress angular momentum transport by magnetic fields. We perform three-dimensional nested-grid radiation magnetohydrodynamic (RMHD) simulations including Ohmic dissipation and ambipolar diffusion. Without these effects, magnetic fields transport angular momentum so efficiently that no rotationally supported disk is formed even after the second collapse. Ohmic dissipation works only in a relatively high density region within the first core and suppresses angular momentum transport, enabling formation of a very small rotationally supported disk after the second co...

Tomida, Kengo; Machida, Masahiro N

2015-01-01

210

Simulation of Prebiotic Processing by Comet and Meteoroid Impact: Implications for Life on Early Earth and Other Planets  

NASA Technical Reports Server (NTRS)

We develop a reacting flow model to simulate the shock induced chemistry of comets and meteoroids entering planetary atmospheres. Various atmospheric compositions comprising of simpler molecules (i.e., CH4, CO2, H2O, etc.) are investigated to determine the production efficiency of more complex prebiotic molecules as a function of composition, pressure, and entry velocity. The possible role of comets and meteoroids in creating the inventory of prebiotic material necessary for life on Early Earth is considered. Comets and meteoroids can also introduce new materials from the Interstellar Medium (ISM) to planetary atmospheres. The ablation of water from comets, introducing the element oxygen into Titan's atmosphere will also be considered and its implications for the formation of organic and prebiotic material.

Dateo, Christopher E.

2003-01-01

211

Effects of simulated weightlessness on meiosis. Fertilization, and early development in mice  

NASA Technical Reports Server (NTRS)

The initial goal was to construct a clinostat which could support mammalian cell culture. The clinostat was selected as a means by which to simulate microgravity conditions within the laboratory, by constant re-orientation of cells with respect to the gravity vector. The effects of this simulated microgravity on in-vitro meiotic maturation of oocytes, using mouse as the model system, was investigated. The effects of clinostat rotation on fertilization in-vitro was then examined. Specific endpoints included examining the timely appearance of male and female pronuclei (indicating fertilization) and the efficiency of extrusion of the second polar body. Particular attention was paid to detecting anomalies of fertilization, including parthenogenetic activation and multiple pronuclei. Finally, for the preliminary studies on mouse embryogenesis, a key feature of the clinostat was modified, that of the position of the cells during rotation. A means was found to immobilize the cells during the clinostat reotation, permitting the cells to remain at the axis of rotation yet not interfering with cellular development.

Wolgemuth, D. J.

1986-01-01

212

[Hemosorption combined with plasmapheresis in rheumatoid arthritis patients].  

PubMed

The complex of treatment measures in 36 patients suffering of rheumatoid arthritis included hemosorption in association with plasmapheresis. It was established that treatment of rheumatoid arthritis using this method was followed by a positive dynamics of the articular syndrome, reduction of indices of activity of the inflammatory process. PMID:2339546

Bazhenov, A N

1990-02-01

213

Management of Rheumatoid Arthritis: Defining the Role of Etanercept  

Microsoft Academic Search

Rheumatoid arthritis is associated with substantial costs to both the individual and society; costs increase as disease severity worsens. Current thinking is that disease-modifying antirheumatic drug (DMARD) therapy should be started as soon as possible after the diagnosis of rheumatoid arthritis and that patients should be offered the most effective treatment available. Etanercept is a soluble dimeric fusion protein comprising

Gillian M. Keating; Blair Jarvis

2002-01-01

214

Cells of the synovium in rheumatoid arthritis. Macrophages  

Microsoft Academic Search

The multitude and abundance of macrophage-derived mediators in rheumatoid arthritis and their paracrine\\/autocrine effects identify macrophages as local and systemic amplifiers of disease. Although uncovering the etiology of rheumatoid arthritis remains the ultimate means to silence the pathogenetic process, efforts in understanding how activated macrophages influence disease have led to optimization strategies to selectively target macrophages by agents tailored to

Raimund W Kinne; Bruno Stuhlmüller; Gerd-R Burmester

2007-01-01

215

Bronchial reactivity and airflow obstruction in rheumatoid arthritis  

Microsoft Academic Search

OBJECTIVES--To investigate the prevalence of airways obstruction and bronchial reactivity to inhaled methacholine in rheumatoid arthritis patients and unselected controls. The control population consisted of patients attending the rheumatology department for minor degenerative joint problems. METHODS--One hundred patients with rheumatoid arthritis (RA) [72 (72%) women, 28 (28%) men; mean (SD) age 58 (10) years] and fifty controls [30 (60%) women,

W U Hassan; N P Keaney; C D Holland; C A Kelly

1994-01-01

216

[Urgent indications for spinal surgery in patients with rheumatoid inflammation].  

PubMed

The urgency of spinal procedures for rheumatoid inflammatory disease is presented in three typical spinal involvements. Characteristic connections between rheumatoid arthritis and the cervical spine, spinal fractures in ankylosing spondylitis and the occurrence of bacterial spondylodiscitis as a side effect of immunosuppression are discussed. PMID:17268787

Wiesner, L; Steinhagen, J; Hansen-Algenstaedt, N; Rüther, W

2007-02-01

217

Rheumatoid meningitis: an autopsy report and review of the literature  

Microsoft Academic Search

We report the clinical and autopsy findings of a 71-year-old Japanese woman with rheumatoid meningitis. This patient developed subacute meningitis during an inactive stage of rheumatoid arthritis (RA), and despite intensive examinations no causative agents or underlying disease could be identified except for RA. Based on persistent hypocomplementaemia and increased serum levels of immune complexes she was suspected of having

Takashi Kato; Ken-ichi Hoshi; Yoshiki Sekijima; Masayuki Matsuda; Takao Hashimoto; Masako Otani; Akio Suzuki; Shu-ichi Ikeda

2003-01-01

218

Effects of simulated oilfield produced water on early seedling growth after treatment in a pilot-scale constructed wetland system.  

PubMed

Seed germination and early seedling growth bioassays were used to evaluate phytotoxicity of simulated oilfield produced water (OPW) before and after treatment in a subsurface-flow, pilot-scale constructed wetland treatment system (CWTS). Responses to untreated and treated OPW were compared among seven plant species, including three monocotyledons: corn (Zea mays), millet (Panicum miliaceum), and sorghum (Sorghum bicolor); and four dicotyledons: lettuce (Lactuca sativa), okra (Abelmoschus esculents), watermelon (Citrullus lanatus), and soybean (Glycine max). Phytotoxicity was greater in untreated OPW than in treated OPW. Exposures to untreated and treated OPW enhanced growth in some plant species (sorghum, millet, okra, and corn) relative to a negative control and reduced growth in other plant species (lettuce, soybean, and watermelon). Early seedling growth parameters indicated that dicotyledons were more sensitive to test waters compared to monocotyledons, suggesting that morphological differences between plant species affected phytotoxicity. Results indicated the following sensitivity scale for plant species: lettuce > soybean > watermelon > corn> okra?millet >sorghum. Phytotoxicity of the treated OPW to lettuce and soybean, although concentrations of COCs were less than irrigation guideline concentrations, suggests that chemical characterization and comparison to guideline concentrations alone may not be sufficient to evaluate water for use in growing crops. PMID:25409245

Pardue, Michael J; Castle, James W; Rodgers, John H; Huddleston, George M

2015-01-01

219

Relative sialylation and fucosylation of synovial and plasma fibronectins in relation to the progression and activity of rheumatoid arthritis  

Microsoft Academic Search

The expressions of terminal sugars in synovial and plasma fibronectins were studied in relation to rheumatoid arthritis (RA)\\u000a progression defined according to the early, established and late radiological changes in the patients’ hands. The relative\\u000a amounts of sialic acid and fucose were analyzed by lectin-ELISA using appropriate sialic acid-linked ?2-3 (Maackia amurensis) and ?2-6 (Sambucus nigra) lectins as well as

Magdalena Przybysz; Dorota Maszczak; Krzysztof Borysewicz; Jacek Szechi?ski; Iwona K?tnik-Prastowska

2007-01-01

220

The early stage of formation of self-organized nanocolumns in thin films: Monte Carlo simulations versus atomic-scale observations in Ge-Mn  

SciTech Connect

Formation kinetics of self-organized nanocolumns during epitaxial growth of a thin film composed of immiscible elements (A,B) has been investigated using Kinetic Monte Carlo simulations. Simulated nanostructures show a good agreement with those observed in Ge-Mn using Atom Probe Tomography and Transmission Electron Microscopy. Self organisation is observed although the rigid lattice simulations used do not account for misfit elastic strain. Simulations reveal that the final nanostructure, in term of number density and diameter of nanocolumns, is controlled by the early stages of growth of the film. The influence of both growth temperature and solute concentration on the nanostructure features is discussed in details.

Mouton, I.; Talbot, E., E-mail: etienne.talbot@univ-rouen.fr; Pareige, C.; Lardé, R.; Blavette, D. [Groupe de Physique des Matériaux (GPM) UMR 6634, Normandie Université, Université et INSA de Rouen - CNRS, Av. de l'Université, BP 12, 76801 Saint Etienne du Rouvray (France)

2014-02-07

221

Long-term study of indomethacin and alclofenac in treatment of rheumatoid arthritis.  

PubMed Central

Indomethacin and alclofenac were compared for 13 months under double-blind conditions in 109 patients with active, classical, or definite rheumatoid arthritis at a relatively early stage of the disease. Both indomethacin and alclofenac were clearly effective: most patients either improved or remained as well controlled as on entry. Alclofenac proved the more effective drug, however, producing a significantly greater reduction in morning stiffness, articular index, and erythrocyte sedimentation rate, and only in the alclofenac-treated group did functional capacity improve and latex-agglutination titres diminish. Comprehensive laborabory tests showed no significant deviation from normal which could have been attributed to either drug. PMID:236805

Aylward, M; Parker, R J; Holly, F; Maddock, J; Davies, D B

1975-01-01

222

Successful leukocytapheresis therapy in a patient with rheumatoid arthritis on maintenance hemodialysis.  

PubMed

Abstract We report the case of a 44-year-old female undergoing maintenance hemodialysis in whom early-phase rheumatoid arthritis (RA) was successfully treated by leukocytapheresis (LCAP). The effects of prednisone, tacrolimus, and etanercept were limited, but LCAP was highly effective and its efficacy continued even after cessation of LCAP. Moreover, remission was maintained for 2 years after discontinuation of medication. LCAP may be an important treatment option for RA patients with end-stage renal failure who are on hemodialysis. PMID:24517518

Maeshima, Keisuke; Torigoe, Masataka; Iwakura, Mikako; Yamanaka, Kunitoshi; Ishii, Koji

2015-01-01

223

Treatment of rheumatoid arthritis: a global perspective on the use of antirheumatic drugs  

PubMed Central

Modern therapy for rheumatoid arthritis (RA) is based on knowledge of the severity of the natural history of the disease. RA patients are approached with early and aggressive treatment strategies, methotrexate as an anchor drug, biological targeted therapies in those with inadequate response to methotrexate, and “tight control,” aiming for remission and low disease activity according to quantitative monitoring. This chapter presents a rationale for current treatment strategies for RA with antirheumatic drugs, a review of published reports concerning treatments in clinical cohorts outside of clinical trials, and current treatments at 61 sites in 21 countries in the QUEST-RA database. PMID:18437286

Envalds, Minja; Pincus, Theodore

2008-01-01

224

Cryoimmunoglobulinemia in rheumatoid arthritis. Significance in serum of patients with rheumatoid vasculitis.  

PubMed Central

Cryogloculins were examined in a standardized manner in an unselected group of 35 patients with rheumatoid arthritis (RA) and 8 patients with RA complicated by cutaneous vasuclitis and neuropathy. Optimum conditions for detection and characterization of cryoglobulins were established; the proportion of resolubilized to total precipitable protein remained constant in an individual patient under these conditions. All 8 vascultis patients and 9 of 35 other patients with RA exhibited cryoglobulins; total protein and immunoglobin content were significantly higher in the cryoglobulins of patients with vasculitis. Immunoglobulins G and M constituted two-thirds and three-quarters of the total protein in the cryoglobulins from uncomplicated rheumatoid and vasculitis patients, respectively. Serum antiglobulin titers were higher, and serum C3 levels were lower, in vasculitis patients compared to rheumatoid patients without vasclitis. Anti-gamma globulin activity was detected in all cryoglobulins from vasculitis patients. Cryoglobulin IgG and IgM were polyclonal. Density gradient analyses demonstrated the majority of the cryoglobulin activity to reside in the 19S IgM fraction. There was no evidence of a light weight (8S) IgM. A monoclonal rheumatoid factor did not detect 7S-ANTI-7S complexes in the cryoprecipitates, but acid eluates from some cryoglobulins absorbed with insoluble IgG revealed an antiglobulin of the IgG class. Serial studies performed on vasculitis patients treated with cyclophosphamide disclosed a relationship between clinical evidence of vasculitis and the presence of cryoglobulins. The antigen (IgG) and antibody (largely IgM rheumatoid factor) nature of these cryglobulins is presented as evidence that the widespread vascular complications of RA are mediated, at least in part, by circulating immune complexes. PMID:169295

Weisman, M; Zvaifler, N

1975-01-01

225

Formation and evolution of early-type galaxies: spectro-photometry from cosmo-chemo-dynamical simulations  

NASA Astrophysics Data System (ADS)

Context. One of the major challenges in modern astrophysics is to understand the origin and the evolution of galaxies, the bright, massive early type galaxies (ETGs) in particular. There is strong observational evidence that massive ETGs are already in place at redshift z ~ 2-3 and that they formed most of their stars well before z = 1. Therefore, these galaxies are likely to be good probes of galaxy evolution, star formation and, metal enrichment in the early Universe. Aims: In this context it is very important to set up a diagnostic tool able to combine results from chemo-dynamical N-Body-TSPH (NB-TSPH) simulations of ETGs with those of spectro-photometric population synthesis and evolution so that all key properties of galaxies can be investigated. These go from the integrated spectrum and magnitudes in any photometry, both in the rest-frame and as a function of the redshift, to present-day structural properties. The main goal of this paper is to provide a preliminary validation of the software package before applying it to the analysis of observational data. Methods: The galaxy models in use where calculated by the Padova group in two different cosmological scenarios: the standard cold dark matter cosmology (SCDM), and the so-called Concordance cosmology (? CDM, with ?_? = 0.762). For these template galaxies, we recover their spectro-photometric evolution through the entire history of the Universe. This is done in particular for two important photometric systems, the Bessell-Brett and the Sloan Digital Sky Survey (SDSS) passbands. Results: We computed magnitudes and colors and their evolution with the redshift along with the evolutionary and cosmological corrections for the model galaxies at our disposal, and compared them with data for ETGs taken from the COSMOS and the GOODS databases. Finally, starting from the dynamical simulations and photometric models at our disposal, we created synthetic images in a given photometric system, from which we derived the structural and morphological parameters. In addition to this, we address the question of the scaling relations, and in particular we examine the one by Kormendy. The theoretical results are compared with observational data of ETGs selected form the SDSS database. Conclusions: The simulated colors for the different cosmological scenarios follow the general trend shown by galaxies of the COSMOS and GOODS surveys at lower redshifts and are in good agreement with the data up to z ~ 1, where the number of early-type galaxies observed falls abruptly. In conclusion, within the redshift range considered, all the simulated colors reproduce the observational data quite well. Looking at the structural parameters derived from the surface imaging, the luminosities and effective radii (Kormendy relation) measured for our model galaxies are consistent with the archival data from the SDSS.

Tantalo, R.; Chinellato, S.; Merlin, E.; Piovan, L.; Chiosi, C.

2010-07-01

226

SIMULATIONS OF EARLY BARYONIC STRUCTURE FORMATION WITH STREAM VELOCITY. II. THE GAS FRACTION  

SciTech Connect

Understanding the gas content of high-redshift halos is crucial for studying the formation of the first generation of galaxies and reionization. Recently, Tseliakhovich and Hirata showed that the relative 'stream' velocity between the dark matter and baryons at the time of recombination-formally a second-order effect, but an unusually large one-can influence the later structure formation history of the universe. We quantify the effect of the stream velocity on the so-called characteristic mass-the minimum mass of a dark matter halo capable of retaining most of its baryons throughout its formation epoch-using three different high-resolution sets of cosmological simulations (with separate transfer functions for baryons and dark matter) that vary in box size, particle number, and the value of the relative velocity between the dark matter and baryons. In order to understand this effect theoretically, we generalize the linear theory filtering mass to properly account for the difference between the dark matter and baryonic density fluctuation evolution induced by the stream velocity. We show that the new filtering mass provides an accurate estimate for the characteristic mass, while other theoretical ansatzes for the characteristic mass are substantially less precise.

Naoz, Smadar [Institute for Theory and Computation, Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, MA 02138 (United States)] [Institute for Theory and Computation, Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, MA 02138 (United States); Yoshida, Naoki [Department of Physics, University of Tokyo, Tokyo 113-0033 (Japan)] [Department of Physics, University of Tokyo, Tokyo 113-0033 (Japan); Gnedin, Nickolay Y., E-mail: snaoz@cfa.harvard.edu [Particle Astrophysics Center, Fermi National Accelerator Laboratory, Batavia, IL 60510 (United States)

2013-01-20

227

Color matrix display simulation based upon luminance and chromatic contrast sensitivity of early vision  

NASA Technical Reports Server (NTRS)

This paper describes the design and operation of a new simulation model for color matrix display development. It models the physical structure, the signal processing, and the visual perception of static displays, to allow optimization of display design parameters through image quality measures. The model is simple, implemented in the Mathematica computer language, and highly modular. Signal processing modules operate on the original image. The hardware modules describe backlights and filters, the pixel shape, and the tiling of the pixels over the display. Small regions of the displayed image can be visualized on a CRT. Visual perception modules assume static foveal images. The image is converted into cone catches and then into luminance, red-green, and blue-yellow images. A Haar transform pyramid separates the three images into spatial frequency and direction-specific channels. The channels are scaled by weights taken from human contrast sensitivity measurements of chromatic and luminance mechanisms at similar frequencies and orientations. Each channel provides a detectability measure. These measures allow the comparison of images displayed on prospective devices and, by that, the optimization of display designs.

Martin, Russel A.; Ahumada, Albert J., Jr.; Larimer, James O.

1992-01-01

228

Bilateral TMJ Involvement in Rheumatoid Arthritis  

PubMed Central

Rheumatoid arthritis (RA) is a systemic inflammatory, slowly progressive disease that results in cartilage and bone destruction. Temporomandibular joint (TMJ) involvement is not uncommon in RA, and it is present in about more than 50% of patients; however, TMJ is usually among the last joints to be involved and is associated with many varied clinical signs and symptoms. Hence, RA of TMJ presents to the dentist with great diagnostic challenges. This report presents a case of RA with bilateral TMJ involvement with its classical radiographic findings and review literature. PMID:24804125

Ruparelia, Pritesh B.; Shah, Deep S.; Ruparelia, Kosha; Sutaria, Shreyansh P.; Pathak, Deep

2014-01-01

229

Total Knee Arthroplasty Considerations in Rheumatoid Arthritis  

PubMed Central

The definitive treatment for advanced joint destruction in the late stages of rheumatoid arthritis can be successfully treated with total joint arthroplasty. Total knee arthroplasty has been shown to be a well-proven modality that can provide pain relief and restoration of mobility for those with debilitating knee arthritis. It is important for rheumatologists and orthopedic surgeons alike to share an understanding of the special considerations that must be addressed in this unique population of patients to ensure success in the immediate perioperative and postoperative periods including specific modalities to maximize success. PMID:24151549

Danoff, Jonathan R.; Geller, Jeffrey A.

2013-01-01

230

Abatacept in the treatment of rheumatoid arthritis  

PubMed Central

Abatacept (CTLA4-Ig) is a new agent which targets T-cell activation, an event which is thought to be critical to the onset and maintenance of rheumatoid arthritis (RA). Abatacept now has substantial evidence from phase III trials for efficacy in patients with RA who have failed to respond to disease-modifying antirheumatic drugs (DMARDs) and antitumor necrosis factor-alpha (TNF-?) biologic agents. Safety profile is favorable in combination with DMARDs. The mechanism of action and available evidence of its efficacy and safety are reviewed in this article. PMID:18360649

Vital, Edward M; Emery, Paul

2006-01-01

231

Early black holes in cosmological simulations: luminosity functions and clustering behaviour  

NASA Astrophysics Data System (ADS)

We examine predictions for the quasar luminosity functions (QLFs) and quasar clustering at high redshift (z ? 4.75) using MassiveBlack, our new hydrodynamic cosmological simulation which includes a self-consistent model for black hole (BH) growth and feedback. We show that the model reproduces the Sloan QLF within observational constraints at z ? 5. We find that the high-z QLF is consistent with a redshift-independent occupation distribution of BHs among dark matter haloes (which we provide) such that the evolution of the QLF follows that of the halo mass function. The sole exception is the bright end at z = 6 and 7, where BHs in high-mass haloes tend to be unusually bright due to extended periods of Eddington growth caused by high-density cold flows into the halo centre. We further use these luminosity functions to make predictions for the number density of quasars in upcoming surveys, predicting that there should be ˜119 ± 28 (˜87 ± 28) quasars detectable in the F125W band of the WIDE (DEEP) fields of the Cosmic Assembly Near-infrared Deep Extragalactic Legacy Survey (CANDELS) from z = 5 to 6, ˜19 ± 7 (˜18 ± 9) from z = 6 to 7 and ˜1.7 ± 1.5 (˜1.5 ± 1.5) from z = 7 to 8. We also investigate quasar clustering, finding that the correlation length is fully consistent with current constraints for Sloan quasars (r0 ˜ 17 h-1 Mpc at z = 4 for quasars above mi = 20.2) and grows slowly with redshift up to z = 6 (r0 ˜ 22 h-1 Mpc). Finally, we note that the quasar clustering strength depends weakly on luminosity for low LBH, but gets stronger at higher LBH as the BHs are found in higher mass haloes.

DeGraf, Colin; Di Matteo, Tiziana; Khandai, Nishikanta; Croft, Rupert; Lopez, Julio; Springel, Volker

2012-08-01

232

Catecholamine metabolism in the patients with rheumatoid arthritis.  

PubMed

The amount of urinary catecholamine of healthy subjects and patients with rheumatoid arthritis, particularly before and after synovectomy, was studied. (1) The urinary catecholamine of patients with rheumatoid arthritis showed a lower value than that of healthy subjects. The greater the amount of intraarticularly injected steroids was and the more severe the stage and class of rheumatoid arthritis were, the lower the level of adrenaline was and the more reduced the activity of phenylethanolamine-N-methyltransferase was. (2) The level of urinary noradrenaline in patients with rheumatoid arthritis was lower than that of healthy subjects, but there was no relationship between the level of noradrenaline and the amount of intraarticularly injected steroids. Considering that noradrenaline tended to approach to the normal level as the stage of class of rheumatoid arthritis was more severe, the level of urinary noradrenaline in patients with rheumatoid arthritis seems to reflect the existence of a certain compensatory system in the enzyme system of catecholamine metabolism rather than the influence of the adrenal cortex system. (3) The urinary catecholamine was decreased after synovectomy; especially, noradrenaline level was remarkably decreased. These results suggest that catecholamine plays an important role in the appearance of pain or other clinical signs in rheumatoid arthritis. PMID:918958

Igari, T; Takeda, M; Obara, K; Ono, S

1977-05-01

233

Gestational and early postnatal exposure to simulated high altitude does not modify postnatal body mass growth trajectory in the rat.  

PubMed

Postnatal hypoxia blunts body mass growth. It is also known that the quality of the fetal environment can influence the subsequent adult phenotype. The main purpose of the study was to determine whether gestational hypoxia and early postnatal hypoxia are able to blunt growth when the offspring is raised under normoxia. Hypobaric hypoxia was induced in simulated high altitude (SHA) chambers in which air was maintained at 380?mmHg (5450?m). Mature Sprague-Dawley rats of both sexes were divided in normoxic (NX) and hypoxic (HX) groups and, in the case of the HX group, maintained for 1 month at 5450?m. Mating was then allowed under NX or HX conditions. Offspring were NX-NX, NX-HX, HX-HX, or HX-NX: the first term indicates NX or HX during both gestation and the first 30 days of life; the second term indicates NX or HX during postnatal life between days 30 and 133. Body mass (g) was measured periodically and body mass growth rate (BMGR, g/d) was estimated between days 33 and 65 of postnatal life. Results can be summarized as follows: 1) BM was significantly higher in NX than in HX rats at weaning; 2) BMGR was not significantly different between NX-NX and HX-NX rats, and between HX-HX and NX-HX animals; and 3) BMGR was significantly higher in rats living under NX conditions than in those living under HX conditions during postnatal life. Data suggest that that hypobaric hypoxia during gestational and early postnatal development of rats does not alter the regulation of body mass growth in rats when compared to that seen under sea-level conditions. PMID:25184739

Bozzini, Carlos E; Champin, Graciela M; Bozzini, Clarisa; Alippi, Rosa M

2014-09-01

234

[Occupational therapy in rheumatoid arthritis: what rheumatologists need to know?  

PubMed

Interventions focusing on education and self-management of rheumatoid arthritis (RA) by the patient improves adherence and effectiveness of early treatment. The combination of pharmacologic and rehabilitation treatment aims to maximize the possibilities of intervention, delaying the appearance of new symptoms, reducing disability and minimizing sequelae, decreasing the impact of symptoms on patient's functionality. Occupational therapy is a health profession that aims to improve the performance of daily activities by the patient, providing means for the prevention of functional limitations, adaptation to lifestyle changes and maintenance or improvement of psychosocial health. Due to the systemic nature of RA, multidisciplinary follow-up is necessary for the proper management of the impact of the disease on various aspects of life. As a member of the health team, occupational therapists objective to improve and maintaining functional capacity of the patient, preventing the progression of deformities, assisting the process of understanding and coping with the disease and providing means for carrying out the activities required for the engagement of the individual in meaningful occupations, favoring autonomy and independence in self-care activities, employment, educational, social and leisure. The objective of this review is to familiarize the rheumatologist with the tools used for assessment and intervention in occupational therapy, focusing on the application of these principles to the treatment of patients with RA. PMID:25440699

de Almeida, Pedro Henrique Tavares Queiroz; Pontes, Tatiana Barcelos; Matheus, João Paulo Chieregato; Muniz, Luciana Feitosa; da Mota, Licia Maria Henrique

2014-10-24

235

Molecular imaging of rheumatoid arthritis: emerging markers, tools, and techniques  

PubMed Central

Early diagnosis and effective monitoring of rheumatoid arthritis (RA) are important for a positive outcome. Instant treatment often results in faster reduction of inflammation and, as a consequence, less structural damage. Anatomical imaging techniques have been in use for a long time, facilitating diagnosis and monitoring of RA. However, mere imaging of anatomical structures provides little information on the processes preceding changes in synovial tissue, cartilage, and bone. Molecular imaging might facilitate more effective diagnosis and monitoring in addition to providing new information on the disease pathogenesis. A limiting factor in the development of new molecular imaging techniques is the availability of suitable probes. Here, we review which cells and molecules can be targeted in the RA joint and discuss the advances that have been made in imaging of arthritis with a focus on such molecular targets as folate receptor, F4/80, macrophage mannose receptor, E-selectin, intercellular adhesion molecule-1, phosphatidylserine, and matrix metalloproteinases. In addition, we discuss a new tool that is being introduced in the field, namely the use of nanobodies as tracers. Finally, we describe additional molecules displaying specific features in joint inflammation and propose these as potential new molecular imaging targets, more specifically receptor activator of nuclear factor ?B and its ligand, chemokine receptors, vascular cell adhesion molecule-1, ?V?3 integrin, P2X7 receptor, suppression of tumorigenicity 2, dendritic cell-specific transmembrane protein, and osteoclast-stimulatory transmembrane protein. PMID:25099015

2014-01-01

236

Rheumatoid arthritis: genetic variants as biomarkers of cardiovascular disease.  

PubMed

Rheumatoid arthritis (RA) is a chronic inflammatory disease associated with premature mortality, severe morbidity, and functional impairment leading to considerable financial burden for both patients and society. Since disease progression and complications can differ from one patient to another, genetic markers are of potential relevance for identifying those individuals at a higher risk of more severe disease. RA is a complex polygenic disease. Cardiovascular (CV) disease due to accelerated atherogenesis is the most common cause of premature mortality in patients with RA. Several studies support the implication of genetic factors in the development of CV disease in RA. In addition to the strong association between alleles of the HLA-DRB1*04 shared epitope and both subclinical and clinically evident CV disease, genes implicated in inflammation and metabolism, such as TNFA, MTHFR, and CCR5, seem to be associated with a higher risk of CV disease in patients with RA. We propose the use of these genetic variants as molecular biomarkers that could help to predict disease outcome at diagnosis of RA and, therefore, to optimize the treatment and management of other risk factors from an early stage of the disease. PMID:25163740

Rodriguez-Rodriguez, Luis; López-Mejias, Raquel; Fernández-Gutiérrez, Benjamín; Balsa, Alejandro; González-Gay, Miguel A; Martín, Javier

2015-01-01

237

Diagnostic properties of metabolic perturbations in rheumatoid arthritis  

PubMed Central

Introduction The aim of this study was to assess the feasibility of diagnosing early rheumatoid arthritis (RA) by measuring selected metabolic biomarkers. Methods We compared the metabolic profile of patients with RA with that of healthy controls and patients with psoriatic arthritis (PsoA). The metabolites were measured using two different chromatography-mass spectrometry platforms, thereby giving a broad overview of serum metabolites. The metabolic profiles of patient and control groups were compared using multivariate statistical analysis. The findings were validated in a follow-up study of RA patients and healthy volunteers. Results RA patients were diagnosed with a sensitivity of 93% and a specificity of 70% in a validation study using detection of 52 metabolites. Patients with RA or PsoA could be distinguished with a sensitivity of 90% and a specificity of 94%. Glyceric acid, D-ribofuranose and hypoxanthine were increased in RA patients, whereas histidine, threonic acid, methionine, cholesterol, asparagine and threonine were all decreased compared with healthy controls. Conclusions Metabolite profiling (metabolomics) is a potentially useful technique for diagnosing RA. The predictive value was without regard to the presence of antibodies against cyclic citrullinated peptides. PMID:21303541

2011-01-01

238

Rheumatoid Arthritis (RA) associated interstitial lung disease (ILD).  

PubMed

Rheumatoid Arthritis (RA) is the most common Connective Tissue Disease (CTD) and represents an increasing burden on global health resources. Interstitial lung disease (ILD) has been recognised as a complication of RA but its potential for mortality and morbidity has arguably been under appreciated for decades. New studies have underscored a significant lifetime risk of ILD development in RA. Contemporary work has identified an increased risk of mortality associated with the Usual Interstitial Pneumonia (UIP) pattern which shares similarity with the most devastating of the interstitial pulmonary diseases, namely Idiopathic Pulmonary Fibrosis (IPF). In this paper, we discuss recent studies highlighting the associated increase in mortality in RA-UIP. We explore associations between radiological and histopathological features of RA-ILD and the prognostic implications of same. We emphasise the need for translational research in this area given the growing burden of RA-ILD. We highlight the importance of the respiratory physician as a key stakeholder in the multidisciplinary management of this disorder. RA-ILD focused research offers the opportunity to identify early asymptomatic disease and define the natural history of this extra articular manifestation. This may provide a unique opportunity to define key regulatory fibrotic events driving progressive disease. We also discuss some of the more challenging and novel aspects of therapy for RA-ILD. PMID:23916467

O'Dwyer, David N; Armstrong, Michelle E; Cooke, Gordon; Dodd, Jonathan D; Veale, Douglas J; Donnelly, Seamas C

2013-10-01

239

Trace element analysis in rheumatoid arthritis under chrysotheraphy  

NASA Astrophysics Data System (ADS)

Proton induced X-ray emission (PIXE) analysis is used to measure trace element concentrations in blood serum from patients with rheumatoid arthritis. Initially trace element contaminations in blood-collecting and storing devices are determined. Then mean values and nyctemeral cycles are measured both in normal subjects and patients with rheumatoid arthritis and other similar pathologies. Abnormal concentrations of Cu and Zn and anomalies in the nyctemeral cycle are found in the patients. In the second phase of the project, the special case of chrysotherapeutically treated (gold salt treatment) rheumatoid arthritis patients is studied for extended periods of time (up to 53 weeks).

Lecomte, R.; Paradis, P.; Monaro, S.; Barrette, M.; Lamoureux, G.; Menard, H.-A.

1981-03-01

240

Gene expression profile analysis of rheumatoid synovial fibroblast cultures revealing the overexpression of genes responsible for tumor-like growth of rheumatoid synovium  

Microsoft Academic Search

To elucidate the aberrant growth properties of rheumatoid synoviocytes, we have examined the gene expression profile of rheumatoid synovial fibroblasts (RSFs) and compared with that of normal synovial fibroblasts (NSF). Gene expression profile analysis was conducted with synoviocyte cultures obtained from five rheumatoid arthritis (RA) patients and five control cases using a commercial cDNA array containing the defined 588 cancer-related

Nobuyuki Watanabe; Kiichiro Ando; Shinichi Yoshida; Sawako Inuzuka; Masaaki Kobayashi; Nobuo Matsui; Takashi Okamoto

2002-01-01

241

Is juvenile rheumatoid arthritis\\/juvenile idiopathic arthritis different from rheumatoid arthritis?  

Microsoft Academic Search

CHAPTER SUMMARY: The chronic arthropathies of childhood share clinical and pathological features with rheumatoid arthritis (RA) in adults. Both are autoimmune diseases characterized by a destructive arthropathy. Both are likely to be complex genetic traits, with autoantibodies and with a type-1-T-helper-cell cytokine profile in disease tissues. In common with other autoimmune diseases, both have associations and linkage with human keukocyte

Sampath Prahalad; David N Glass

2002-01-01

242

[A case of calcinomatous polyarthritis presenting rheumatoid arthritis-like polyarthritis as the initial symptom of gastric cancer].  

PubMed

We report a case of calcinomatous polyarthritis presenting rheumatoid arthritis-like polyarthritis as the initial symptom of gastric cancer. A 79-year-old male visited to our hospital with complaint of pain and swelling of multiple joints including bilateral hands, bilateral knees, elbows and small joints of fingers. He also complained of neck and back stiffness. Both of rheumatoid factor test and anti-cyclic citrullinated peptide antibody were negative. Non-steroidal anti-inflammatory drug did not relieve his arthritic pain. He showed anorexia, body weight loss and was anemic. Upper gastrointestinal endoscopic evaluation demonstrated a gastric cancer. The patient underwent subtotal gastrectomy. Within 1 week after the subtotal gastrectomy, both polyarthritis and stiffness started to improve. The polyarthritis in this case was diagnosed as calcinomatous plyarthritis for its features. Paraneoplastic rheumatism remains a rare event, but knowledge of it is essential for early diagnosis of underlying cancer. PMID:23124087

Kurihara, Yuko; Oku, Kayo; Suzuki, Atsushi; Ohsone, Yasuo; Okano, Yutaka

2012-01-01

243

Tissue factor expression in rheumatoid synovium: a potential role in pannus invasion of rheumatoid arthritis.  

PubMed

Angiogenesis, as well as pannus formation within the joint, plays an important role in the erosion of articular cartilage and bone in the pathological process of rheumatoid arthritis (RA). Tissue factor (TF), an essential initiator of the extrinsic pathway of blood coagulation, is also involved in the angiogenesis and the pannus formation of RA progression. In the present study, we used immunofluorescence and confocal scanning methods to characterize TF immunolocalization in RA synovium. We showed that positive staining of TF could be immunolocalized in synoviocytes, CD19(+) B cells and CD68(+) macrophages, whereas weak or negative staining of tissue factor could be found in CD34(+) endothelial cells of neo-vessels, CD3(+) T cells and CD14(+) monocytes in RA synovium tissues. Our study demonstrates a detailed local expression of TF in the rheumatoid synovium, and supports the notion that TF, expressed not only by the synoviocytes themselves, but also the infiltrating CD19(+) B cells and CD68(+) macrophages, is involved in the pannus invasion in the progression of rheumatoid arthritis. PMID:23490466

Chen, Lujun; Lu, Yahua; Chu, Yang; Xie, Jun; Ding, Wen'ge; Wang, Fengming

2013-09-01

244

Progressive cavitating pulmonary changes in rheumatoid arthritis: a case report.  

PubMed Central

Progressive cavitating changes in the lung apices were found in a middle-aged man with seropositive rheumatoid arthritis. These findings were attributed at autopsy to a combination of nodule-type formation, necrosis, and mild fibrosis. Images PMID:6696527

Macfarlane, J D; Franken, C K; van Leeuwen, A W

1984-01-01

245

Serum protein fractions in rheumatoid pneumoconiosis without arthritis  

Microsoft Academic Search

Fractionation of the serum proteins by filter-paper electrophoresis in 14 coal-miners who had the characteristic radiological opacities of rheumatoid pneumoconiosis but no evidence of rheumatoid arthritis showed a reduction in the mean level of albumin and increases in the alpha-2 and gamma-globulins compared with the values in non-arthritic miners with simple coal-workers' pneumoconiosis and in normal subjects. The changes were

R. B. Payne

1962-01-01

246

Galectins in the Pathogenesis of Rheumatoid Arthritis  

PubMed Central

Rheumatoid arthritis (RA) is a complex and common systemic autoimmune disease characterized by synovial inflammation and hyperplasia. Multiple proteins, cells, and pathways have been identified to contribute to the pathogenesis of RA. Galectins are a group of lectins that bind to ?-galactoside carbohydrates on the cell surface and in the extracellular matrix. They are expressed in a wide variety of tissues and organs with the highest expression in the immune system. Galectins are potent immune regulators and modulate a range of pathological processes, such as inflammation, autoimmunity, and cancer. Accumulated evidence shows that several family members of galectins play positive or negative roles in the disease development of RA, through their effects on T and B lymphocytes, myeloid lineage cells, and fibroblast-like synoviocytes. In this review, we will summarize the function of different galectins in immune modulation and their distinct roles in RA pathogenesis. PMID:24416634

Li, Song; Yu, Yangsheng; Koehn, Christopher D; Zhang, Zhixin; Su, Kaihong

2013-01-01

247

DNA methylation: roles in rheumatoid arthritis.  

PubMed

Rheumatoid arthritis (RA) is an immune-mediated disease of unknown cause that primarily affects the joints and ultimately leads to joint destruction. In recent years, the potential role of DNA methylation in the development of RA is raising great expectations among clinicians and researchers. DNA methylation influences diverse aspects of the disease and regulates epigenetic silencing of genes and behavior of several cell types, especially fibroblast-like synoviocytes (FLS), the most resident cells in joints. The activation of FLS is generally regarded as a key process in the development of RA that actively results in the promotion of ongoing inflammation and joint damage. It has also been shown that aberrant DNA methylation occurs in the pathogenesis of RA and contributes to the development of the disease. Recently, there has been an impressive increase in studies involving DNA methylation in RA. In this paper, we consider the role of DNA methylation in the development of RA. PMID:24652004

Yuan, Feng-Lai; Li, Xia; Xu, Rui-Sheng; Jiang, Dong-Lin; Zhou, Xiao-Gang

2014-09-01

248

Genetics of rheumatoid arthritis: confronting complexity  

PubMed Central

The genetic basis for rheumatoid arthritis (RA) is likely to be extremely complex. Even the role of MHC genes remains to be fully defined, and may involve interactive genetic effects. The difficulty of precisely defining the clinical phenotype, as well as underlying genetic heterogeneity, complicates the problem. In addition, stochastic genetic or physiologic events may contribute to the low penetrance of susceptibility genes. This situation parallels developing paradigms for other autoimmune disorders, in which many different genes each appear to contribute a small amount to overall risk for disease, and where severity and specific phenotypic subtypes are subject to genetic effects. The completion of the human genome project, along with advances in informatics, will be required to reach a deeper understanding of RA. It is likely that this will involve an iterative and interactive process between several different scientific disciplines. PMID:11094412

Gregersen, Peter K

1999-01-01

249

Rheumatoid arthritis susceptibility genes: An overview  

PubMed Central

Rheumatoid arthritis (RA) is a chronic, inflammatory autoimmune disease sustained by genetic factors. Various aspects of the genetic contribution to the pathogenetics and outcome of RA are still unknown. Several genes have been indicated so far in the pathogenesis of RA. Apart from human leukocyte antigen, large genome wide association studies have identified many loci involved in RA pathogenesis. These genes include protein tyrosine phosphatase, nonreceptor type 22, Peptidyl Arginine Deiminase type IV, signal transducer and activator of transcription 4, cytotoxic T-lymphocyte-associated protein 4, tumor necrosis factor-receptor associated factor 1/complement component 5, tumor necrosis factor and others. It is important to determine whether a combination of RA risk alleles are able to identify patients who will develop certain clinical outcomes, such myocardium infarction, severe infection or lymphoma, as well as to identify patients who will respond to biological medication therapy. PMID:25232530

Korczowska, Izabela

2014-01-01

250

Arthrodesis of the wrist in rheumatoid arthritis.  

PubMed

In rheumatoid arthritis the small joints of the feet and hands are the first targets of the autoimmune process. In about one half of the patient the wrist is involved in the first stages of the disease (two years) increasing up to nearly 90 percent after a decade often including both sides. Osteoarthritis of the wrist is one of the most common conditions encountered by hand surgeons. One aim of all treatment options is to achieve the best possible hand function without pain. If conservative treatment fails, operative treatment is necessary. Choice of surgical treatment depends on the soft tissue and bone situation. Techniques can be differentiated by joint preservation or joint replacement. The first include radio-synoviorthesis, synovectomy and tendon repair, the latter resection-arthroplasty, total joint arthroplasty and arthrodesis. In this paper arthrodesis of the wrist as one treatment option is reviewed. PMID:25232527

Trieb, Klemens

2014-09-18

251

Arthrodesis of the wrist in rheumatoid arthritis  

PubMed Central

In rheumatoid arthritis the small joints of the feet and hands are the first targets of the autoimmune process. In about one half of the patient the wrist is involved in the first stages of the disease (two years) increasing up to nearly 90 percent after a decade often including both sides. Osteoarthritis of the wrist is one of the most common conditions encountered by hand surgeons. One aim of all treatment options is to achieve the best possible hand function without pain. If conservative treatment fails, operative treatment is necessary. Choice of surgical treatment depends on the soft tissue and bone situation. Techniques can be differentiated by joint preservation or joint replacement. The first include radio-synoviorthesis, synovectomy and tendon repair, the latter resection-arthroplasty, total joint arthroplasty and arthrodesis. In this paper arthrodesis of the wrist as one treatment option is reviewed. PMID:25232527

Trieb, Klemens

2014-01-01

252

[The antioxidant systems in rheumatoid polyarthritis].  

PubMed

The inflammatory process from rheumatoid arthritis (RA) is marked by complexity, maintenance and destruction. The inflammatory lesions are induced by oxygen free radicals, that have a great capacity of destruction. We studied 52 patients with RA (defined by ARA criteria--1987). We have observed the inflammatory rheumatic syndrome, humoral and cellular immune syndrome and the antioxidant systems, i.e.: superoxidedismutaze, glutathione and its fractions, glutathione peroxidase, the total SH groups. We have observed the decrease of the glutathione in 40% of patients and the decrease of the total SH groups in 65% of patients. The total SH groups are correlated with the severe forms of the disease. Superoxide dismutase had decrease values in 85% of cases. We have remarked that the treatment with corticosteroids and D-penicillamina improved the serum levels of the glutathione and total SH groups. PMID:9455440

Chiriac, R; Rezu?, E; Floric?, B; Chiriac, C; Bucur, B; Popârda, O; Manca?, G; Palamaru, I

1996-01-01

253

Rheumatoid factor and tumor-host interaction.  

PubMed

In this survey for rheumatoid factor (RF) seropositivity on patients with neoplasms, an 85% rate of positive screening tests was recorded under certain circumstances. This high rate of RF seropositivity occurred after irradiation and/or chemotherapy of breast and lung cancers. Treated patients with breast cancers who had no evidence of residual tumor had an 89% rate of positive RF tests. Conversely, the incidence of RF seropositivity was low among untreated patients with similar tumors and treated patients with glioblastomas or multiple myeloma. The administration of cytotoxic drugs (e.g., azathiprene) was not itself associated with RF production even in renal allograft recipients. The data indicate that RF production occurs frequently after therapy of certain tumors and suggest that in these circumstances RF may be an expression of tumor-host interaction. PMID:1064877

Twomey, J J; Rossen, R D; Lewis, V M; Laughter, A H; Douglass, C C

1976-06-01

254

Light scattering study of rheumatoid arthritis  

SciTech Connect

The distribution of light scattered by finger joints is studied in the near-IR region. It is shown that variations in the optical parameters of the tissue (scattering coefficient {mu}{sub s}, absorption coefficient {mu}{sub a}, and anisotropy factor g) depend on the presence of the rheumatoid arthritis (RA). At the first stage, the distribution of scattered light was measured in diaphanoscopic experiments. The convolution of a Gaussian error function with the scattering phase function proved to be a good approximation of the data obtained. Then, a new method was developed for the reconstruction of distribution of optical parameters in the finger cross section. Model tests of the quality of this reconstruction method show good results. (laser biology and medicine)

Beuthan, J; Netz, U; Minet, O; Mueller, G [Institut fur Medizinische Physik/Laser-medizin, Freie Universitat Berlin, Universitaetsklinikum Benjamin Franklin, Berlin (Germany); Klose, Annerose D; Hielscher, A H [Columbia University, New York (United States); Scheel, A [Department of Medicine, Nephrology and Rheumatology, Georg-August-University, Goettingen (Germany); Henniger, J [Department of Physics, Technical University Dresden (Germany)

2002-11-30

255

Clinical trial of penicillamine in rheumatoid arthritis.  

PubMed

The medical records of our first 200 consecutive rheumatoid arthritis patients treated with penicillamine were analyzed retrospectively. All but 5 patients (97.5%) had undergone earlier chrysotherapy that resulted in either therapeutic failure or toxicity. Only 57 patients (28.5%) were still receiving penicillamine on January 1, 1981, and the duration of therapy ranged from 23 to 62 months. The dropout rate due to toxicity, therapeutic failure, relapse, or other reasons was very high (71.5%). Toxic effects required permanent discontinuance in 56 patients (28%). Therapy was discontinued for 36 patients (18%) because of no benefit. A striking number (20) had relapse after therapeutic success and while continuing to take penicillamine, and the therapy had to be discontinued, a relapse rate of 10%. Therapy for the remaining 15.5% was discontinued for miscellaneous reasons that were not related to penicillamine per se: patient anxiety (6%), lost to followup (5%), hospitalization for reasons unrelated to penicillamine therapy (2%), lack of cooperation and study protocol (1% each), or pregnancy (0.5%). By our criteria, 142 patients (71%) received benefit (remission or improvement). Therapy results for these patients were as follows: still on penicillamine on January 1, 1981 (28.5%); no longer receiving the drug due to toxicity (19.5%); no longer receiving penicillamine due to relapse while on continuing therapy (10%); no longer receiving penicillamine due to miscellaneous reasons not related to penicillamine therapy (13%). This study shows that penicillamine is a valuable drug in the treatment of rheumatoid arthritis, but its value in clinical practice is limited by a rather high incidence of both toxicity and relapse during treatment. PMID:7034736

Rothermich, N O; Thomas, M H; Phillips, V K; Bergen, W

1981-12-01

256

Anti-Citrullinated Peptide Antibody (ACPA) Assays and their Role in the Diagnosis of Rheumatoid Arthritis  

PubMed Central

Increasingly, assays for the detection of anti-citrullinated peptide antibodies (ACPA) are used in RA diagnosis. This review summarizes the biologic basis and development of ACPA assays, available ACPA assays and their performance characteristics, and diagnostic properties of ACPA alone and compared to rheumatoid factor (RF) in early RA. We also review correlations, precision, costs and cost-effectiveness, availability, stability and reproducibility of the available assays. Taken together, data indicate that ACPA has a higher specificity than RF for early RA, good predictive validity, high sensitivity, apparent cost-effectiveness and good stability and reproducibility. Given its superior performance characteristics and increasing availability, ACPA is emerging as the most useful single assay for the diagnosis of RA. PMID:19877103

Aggarwal, Rohit; Liao, Katherine; Nair, Raj; Ringold, Sarah; Costenbader, Karen H.

2010-01-01

257

Amyloidosis of the small intestine secondary to rheumatoid arthritis or juvenile rheumatoid arthritis: report of two cases  

Microsoft Academic Search

We report two cases of gastrointestinal amyloidosis, complicated with juvenile rheumatoid arthritis (JRA) in one and rheumatoid\\u000a arthritis (RA) in the other. A 21-year-old woman, who had been suffering from JRA for the past 12 years, was transferred to\\u000a our hospital due to intense pain in the epigastrium and back, diarrhea, high fever, and paralytic ileus. Treatment by corticosteroid,\\u000a antibiotics

Michi Hashimoto; Masao Shingu; Yasuji Yoshikawa; Shiro Nonaka; Tetsuya Wada; Yoshihiko Ichibanngase; Masashi Nobunaga

1997-01-01

258

Serum markers of rheumatoid arthritis in visceral leishmaniasis: Rheumatoid factor and anti-cyclic citrullinated peptide antibody  

Microsoft Academic Search

Rheumatoid factor (RF) has been described in visceral leishmaniasis (VL). However, there is no report of RF-isotype or other rheumatoid arthritis (RA) autoantibody in VL. This work investigated RF and anti-cyclic citrullinated peptide antibody (CCP-Ab) in sera from 35 inhabitants from a VL area: 15 from healthy persons (HIEA); 10 from VL patients (VL), and 10 from subjects cured of

A. M. Atta; E. M. Carvalho; S. M. B. Jerônimo; M. L. B. Sousa Atta

2007-01-01

259

[An ultrasonographic study of the major arteries of the neck in patients with rheumatoid arthritis].  

PubMed

We examined a total of 125 patients, of whom 70 suffered from rheumatoid arthritis (RA). The comparison group was composed of 40 patients diagnosed with osteoarthrosis deformans (OD) and 15 with atherosclerosis of the major arteries of the head (MAH). The control group consisted of 40 subjects randomized by sex and age. Studied were the carotid, vertebral arteries and the cerebral blood flow by means of colour duplex scanning on the unit "Vingmed system, 5, Norway, 2002". Patients with RA as compared with those from the control group showed thickening of the vascular wall of the carotid arteries, especially manifested in patients with seropositive rheumatoid arthritis and in those suffering from RA with systemic manifestations of the disease. The findings obtained by the duplex scanning in patients with RA as compared with those of the control group and OD patients demonstrated an increased number of stenotic lesions of the carotid and vertebral arteries particularly pronounced in seropositive RA and RA with extraarticular manifestations of the disease. Statistically reliable findings were obtained while studying the deformities of the carotid arteries. Comparing the RA groups revealed significant differences: in the group of patients suffering from RA with the systemic manifestations noted was an increased percentage of the kinking along both the common carotid artery (chi(2) = 1.76; NS) and the interpal carotid artery (chi(2) = 8.44; p = 0.01). The findings obtained in the present study strongly suggest that in RA patients there take place alterations in the IMC in the form of a thickening with disordered differentiation of the intima-medial layers and the lesion of the cardiovascular system, which is characterized by an early development of atherosclerosis. The degree of atherosclerotic alterations is associated with the presence of systemic manifestations of RA, high activity of the inflammatory process, and seropositivity by the rheumatoid factor. PMID:19156028

Churakov, O Iu; Shilkina, N P

2008-01-01

260

Simulation of the early startup period of high-temperature heat pipes from the frozen state by a rarefied vapor self-diffusion model  

NASA Technical Reports Server (NTRS)

The heat pipe startup process is described physically and is divided into five periods for convenience of analysis. The literature survey revealed that none of the previous attempts to simulate the heat pipe startup process numerically were successful, since the rarefied vapor flow in the heat pipe was not considered. Therefore, a rarefied vapor self-diffusion model is proposed, and the early startup periods, in which the rarefied vapor flow is dominant within the heat pipe, are first simulated numerically. The numerical results show that large vapor density gradients existed along the heat pipe length, and the vapor flow reaches supersonic velocities when the density is extremely low. The numerical results are compared with the experimental data of the early startup period with good agreement.

Cao, Y.; Faghri, A.

1993-01-01

261

Pachymeningitis and Optic Neuritis in Rheumatoid Arthritis: Successful Treatment with Cyclophosphamide  

Microsoft Academic Search

:   Pachymeningitis is a rare complication of rheumatoid arthritis. The case of a 52-year-old male rheumatoid arthritis patient\\u000a with pachymeningitis and optic neuritis who was successfully treated with intravenous cyclophosphamide is described.

A. E. Yücel; H. Kart; P. Aydin; A. M. A?ildere; S. Benli; N. Altinörs; B. Demirhan

2001-01-01

262

Rheumatoid Arthritis When Your Immune System Attacks Your Body | NIH MedlinePlus the Magazine  

MedlinePLUS

... In an autoimmune disease like rheumatoid arthritis, the immune system turns against parts of the body it is ... In an autoimmune disease like rheumatoid arthritis, the immune system turns against parts of the body it is ...

263

Rheumatoid Arthritis When Your Immune System Attacks Your Body | NIH MedlinePlus the Magazine  

MedlinePLUS

... Understanding Rheumatoid Arthritis (RA) Rheumatoid Arthritis When Your Immune System Attacks Your Body Past Issues / Summer 2014 Table ... disease, which means the arthritis results from your immune system attacking your body's own tissues. The course of ...

264

The role of RANK ligand/osteoprotegerin in rheumatoid arthritis  

PubMed Central

In the complex system of bone remodeling, the receptor activator of nuclear factor ?B ligand (RANKL)/osteoprotegerin (OPG) pathway is the coupling factor between bone formation and bone resorption. RANKL binds to the RANK receptor of pre-osteoclasts and mature osteoclasts and stimulates their activation and differentiation. The production of RANKL/OPG by osteoblasts is influenced by hormones, growth factors and cytokines, which each have a different effect on the production of RANKL and OPG. Ultimately, the balance between RANKL and OPG determines the degree of proliferation and activity of the osteoclasts. In rheumatoid arthritis (RA), bone erosions are the result of osteoclastic bone resorption at the sites of synovitis, where RANKL expression is also found. Furthermore, magnetic resonance imaging (MRI) bone edema in RA indicates the presence of active inflammation within bone and the presence of osteitis, which is also associated with the expression of RANKL. Bone loss has been documented in the cortical and trabecular bone in the joints of the hand of RA patients. Both synovitis and periarticular bone involvement (osteitis and bone loss) are essential components of RA: they occur early in the disease and both are predictive for the occurrence and progression of bone damage. RANKL knockout mice and mice treated with OPG did not develop focal bone loss, in spite of persistent joint inflammation. Inhibition of osteoclasts by denosumab, a humanized antibody that selectively binds RANKL, has revealed in patients with RA that the occurrence of erosions and periarticular bone loss can be halted, however without affecting synovial inflammation. This disconnect between inflammation and bone destruction opens new ways to separately focus treatment on inflammation and osteoclastogenesis for preventing and/or minimizing the connection between joints and subchondral bone and bone marrow. PMID:22859921

2012-01-01

265

Clonality of T lymphocytes expanded with IL-2 from rheumatoid arthritis peripheral blood, synovial fluid and synovial membrane.  

PubMed

The association of rheumatoid arthritis (RA) with particular MHC class II genes suggests that autoantigen-specific T cell clones present in joints could be central to the pathogenesis of the disease. Previous investigations on the clonal diversity of T cells infiltrating the rheumatoid synovial membrane have yielded conflicting results. With the use of Southern blot analysis, we investigated the clonality of rheumatoid T cell lines expanded from peripheral blood, synovial fluid and synovial tissue. From peripheral blood lymphocyte (PBL) of RA patients and healthy normal controls, we also checked the consequences of two different culture conditions on the clonality of these cell lines. From control PBL, we found that in vitro non-specific expansion of non-clonal T cell populations does not create artefactual clonal selection. However, growing T cells in vitro with IL-2 seems to be able to lead to preferential expansion of cells bearing IL-2 receptor (IL-2R). We identified such in vivo activated IL-2-sensitive T cell clones frequently in RA synovial tissue (8/13) and more rarely in synovial fluid and peripheral blood (3/12). One patient presents the same T cell receptor gene rearrangements in synovial membrane of two affected joints. In RA synovial tissue, the frequency of these IL-2-responsive T cells is most prevalent among actively inflamed membranes removed early in the disease process. The role and the relevance to the disease of these IL-2-responsive T cells remain to be elucidated. PMID:8380369

Cantagrel, A; Alam, A; Coppin, H L; Mazieres, B; De Preval, C

1993-01-01

266

Dendritic cells provide a potential link between smoking and inflammation in rheumatoid arthritis  

PubMed Central

Introduction Smoking increases the risk of developing rheumatoid arthritis (RA) and affects the severity of established RA. Smoking can impact on Th17 lymphocyte differentiation and function through activation of the aryl hydrocarbon receptor (AHR), a process with implications for the pathogenic mechanisms in RA that involve the cytokine, interleukin (IL)-17A. The objective of this study was to establish any effect of smoking on the inflammatory tissue lesions of rheumatoid arthritis via the AHR and IL-17A. Methods Twenty synovial and eighteen subcutaneous nodule tissue samples from 31 patients with RA were studied. Patient smoking status at the time of tissue collection was established. Expression of AHR, CYP1A1, AHRR, IL6, IL17A, IL17F, IL22, IL23, IL23R, IFNG, TBX21, IDO1 and FOXP3 genes were assessed in tissues and cultured cells using real-time PCR. Two-colour immunofluorescence was used to co-localise AHR and CYP1A1 protein in synovial tissues. The response of monocytes and monocyte-derived dendritic cells (mo-DCs) to the AHR agonist, benzo(a)pyrene (BaP) was compared in vitro. Results AHR gene expression was demonstrated in rheumatoid synovial tissues and nodules with significantly greater expression in synovia. Expression was not influenced by smoking in either tissue. Evidence of AHR activation, indicated by CYP1A1 and AHRR gene expression, was found only in synovia from patients who smoked. However, IL17A gene expression was lower in synovia from smokers. TBX21 and FOXP3 expression was not affected by smoking. Within the synovial tissues of smokers the principal cell type with evidence of AHR activation was a subset of synovial DCs. This observation was consistent with the sensitivity of human mo-DCs to BaP stimulation demonstrated in vitro. Exposure to BaP affected mo-DC function as demonstrated by decreased IL6 expression induced by PolyI:C, without affecting indoleamine 2,3 dioxygenase (IDO)1 expression. Conclusion Our findings show that one effect of smoking on inflamed rheumatoid synovial tissue involves activation of the AHR pathway. A subset of synovial DCs is important in the response to cigarette smoke. The potential for smoking to affect DC behaviour in joint tissues has relevance to both early and late phases of RA pathogenesis and warrants further investigation. PMID:23036591

2012-01-01

267

A case of rheumatoid arthritis with unilateral knee synovial hypertrophy in hemiplegia.  

PubMed

A 64-year-old woman suffering right hemiplegia came in with pain and swelling on her left knee, general weakness and poor oral intake for 2 months. On physical examination we were able to palpate a mass with irregular margin around the left suprapatellar area. From the results of the magnetic resonance imaging (MRI), synovial proliferative disease, infectious arthritis, or gouty arthritis was suspected. We performed a blood laboratory test to detect rheumatologic diseases, knee joint aspiration, and bone scan for differential diagnosis, and were able to diagnose rheumatoid arthritis (RA) from the results of blood laboratory, physical examination, and bone scan. Consequently, we started medications for controlling RA. Herein, we report a case of rheumatoid arthritis with unilateral knee synovial hypertrophy in hemiplegia. If a right hemiplegic patient has recurrent pain on the left knee and synovial hypertrophy, and fails to respond to treatment for osteoarthritis, early detection by evaluation for rheumatic disease is crucial to prevent severe sequelae influencing rehabilitation of hemiplegia. PMID:22506248

Kim, Chan Woo; Kim, Mi Jung; Park, Si Bog; Han, Seung Hoon

2012-02-01

268

Evaluation of human serum of severe rheumatoid arthritis by confocal Raman spectroscopy  

NASA Astrophysics Data System (ADS)

Rheumatoid Arthritis is a systemic chronic inflammatory disease, recurrent and systemic, initiated by autoantibodies and maintained by inflammatory mechanisms cellular applicants. The evaluation of this disease to promote early diagnosis, need an associations of many tools, such as clinical, physical examination and thorough medical history. However, there is no satisfactory consensus due to its complexity. In the present work, confocal Raman spectroscopy was used to evaluate the biochemical composition of human serum of 40 volunteers, 24 patients with rheumatoid arthritis presenting clinical signs and symptoms, and 16 healthy donors. The technique of latex agglutination for the polystyrene covered with human immunoglobulin G and PCR (protein c-reactive) was performed for confirmation of possible false-negative results within the groups, facilitating the statistical interpretation and validation of the technique. This study aimed to verify the changes for the characteristics Raman peaks of biomolecules such as immunoglobulins amides and protein. The results were highly significant with a good separation between groups mentioned. The discriminant analysis was performed through the principal components and correctly identified 92% of the donors. Based on these results, we observed the behavior of arthritis autoimmune, evident in certain spectral regions that characterize the serological differences between the groups.

Carvalho, C. S.; Raniero, L.; Santo, A. M. E.; Pinheiro, M. M.; Andrade, L. E. C.; Cardoso, M. A. G.; Junior, J. S.; Martin, A. A.

2010-02-01

269

Ultrasound versus conventional radiography in the assessment of bone erosions in rheumatoid arthritis.  

PubMed

Bone erosions are the hallmark of joint damage in rheumatoid arthritis and both their detection and increase in number and/or in size are indicative of a poor outcome. To date, conventional radiography is still the most common imaging tool adopted for detecting and scoring joint damage in daily clinical practice, in spite of its low sensitivity with respect computerised tomography, magnetic resonance imaging or ultrasound. Ultrasound is a rapidly evolving technique that is gaining an increasing success in the assessment of patients with rheumatoid arthritis. It permits an early detection and careful characterisation of bone erosions playing a key role in both diagnostic and therapeutic procedures. Ultrasound presents several advantages over other imaging techniques: it is patient-friendly, safe and non-invasive, free of ionising radiation, less expensive, and permit multiple target assessment in real time without the need for external referral. The aim of this review is to compare conventional radiography and ultrasound in the assessment of bone erosions in RA in daily rheumatology practice and to provide insights into which modality can provide the optimal information for a desired outcome in a given clinical trial or practice situation. PMID:24528649

Salaffi, Fausto; Gutierrez, Marwin; Carotti, Marina

2014-01-01

270

Detection of rheumatoid arthritis using infrared imaging Monique Frizea,b  

E-print Network

Detection of rheumatoid arthritis using infrared imaging Monique Frizea,b , Cynthia Adéaa , Pierre Rheumatology, Ottawa Hospital, Riverside Dr., Ottawa, ON, Canada. ABSTRACT Rheumatoid arthritis (RA subjects and 13 patients diagnosed with Rheumatoid Arthritis (RA), thermal images were collected from

Payeur, Pierre

271

The RA Scanner: Prediction of Rheumatoid Joint Inflammation Based on Laser Imaging  

E-print Network

the RA scanner, a novel system for the examination of pa- tients suffering from rheumatoid arthritis for a further development from prototype to product stage. 1 Introduction Rheumatoid arthritis (RA) is the most. Conclusions and an outlook are given in Sec. 6. 2 The RA Scanner The rheumatoid arthritis (RA) scanner

Tresp, Volker

272

Preliminary Results of Severity of Illness Measures of Rheumatoid Arthritis Using Infrared Imaging  

E-print Network

Preliminary Results of Severity of Illness Measures of Rheumatoid Arthritis Using Infrared Imaging with rheumatoid arthritis (RA) by a rheumatologist. The ultimate goal is to create a low cost effective method- infrared imaging; measuring temperatures; rheumatoid arthritis patients; normal subjects. I. INTRODUCTION

Payeur, Pierre

273

MeasureofFunctioninRheumatoidArthritis:IndividualizedorClassicalScales? Raphale Seror 1  

E-print Network

1 MeasureofFunctioninRheumatoidArthritis:IndividualizedorClassicalScales? Raphaèle Seror 1, Rheumatoid arthritis, Patient-specific index, Individualization, Patient reported outcome, Patient for individual RA patients. inserm-00376884,version1-20Apr2009 #12;3 Outcome assessment in rheumatoid arthritis

Boyer, Edmond

274

Coronary arterial calcification in rheumatoid arthritis: comparison with the MultiEthnic Study of Atherosclerosis  

Microsoft Academic Search

INTRODUCTION: Although cardiovascular morbidity and mortality are increased in rheumatoid arthritis, little is known about the burden of subclinical coronary atherosclerosis in these patients. METHODS: Using computed tomography, coronary artery calcification was measured in 195 men and women with rheumatoid arthritis aged 45 to 84 years without clinical cardiovascular disease and compared with 1,073 controls without rheumatoid arthritis enrolled in

Jon T Giles; Moyses Szklo; Wendy Post; Michelle Petri; Roger S Blumenthal; Gordon Lam; Allan C Gelber; Robert Detrano; William W Scott Jr; Richard A Kronmal; Joan M Bathon

2009-01-01

275

Site-specific Ground-Motion Predictions for Earthquake Early Warning in the LA Basin using CyberShake Simulations  

NASA Astrophysics Data System (ADS)

Predicting site-specific ground-motion intensity measures for large earthquakes (M>6.5) in real-time is a major challenge in earthquake early warning (EEW). Commonly, ground-motion parameters are predicted indirectly from magnitude and distance using empirical ground-motion attenuation relations. This approach though bears two major problems: (1) the extent of fault ruptures is usually unknown in real-time and the earthquake has to be approximated by a simple point-source; (2) directivity and basin effects are generally neglected. This can lead to a serious under estimation of ground-motions and result in warnings not being issued. To overcome these shortcomings, we have developed a novel approach for site-specific ground-motion prediction based on physics-based statistical models. Our models were derived from the SCEC CyberShake dataset that consists of around 400,000 full 3D wave-propagation simulations (6.5?M?8.5) at around 200 locations in and around the Los Angeles (LA) basin. The original purpose of this dataset was to develop a physics-based computational approach to probabilistic seismic hazard analysis (PSHA) based on southern California ruptures defined in Unified California Earthquake Rupture Forecast 2.0 (UCERF2.0). Here we extend the application of the CyberShake dataset to improve ground-motion predictions in the LA area for EEW and other purposes. The aim of our study is to provide fast and realistic site-specific ground-motion estimates for any large earthquake (M>6.5) in southern California. For this purpose we developed statistical models based on Support Vector Machines (SVMs) which were trained with source and ground-motion parameters from the CyberShake dataset to predict the expected long-period spectral acceleration (3 to 10 seconds) in the LA basin. SVMs are supervised learning models for classification and regression. Once trained, our SVM models are able to predict the spectral acceleration (SA) for any given earthquake magnitude and location in southern California. The results from our study show that due to the combined effects of fault geometries, wave propagation, and rupture directivity, it is not necessarily the closest fault ruptures that cause strongest shaking in the LA basin in the long-period range, but can be those that are considerably far away (such as those on the southern San Andreas Fault). This observation suggests that warnings could be provided some tens of seconds to around one minute before long-period shaking in the LA basin starts. Our approach does not only give a qualitative, but quantitative description of this shaking in terms of SA levels. Long-period shaking as analyzed in this study is most critical for high-rise buildings; the ground-motion predictions from our models can thus find possible application in structural control systems. However, as wave propagation simulations covering a broader frequency band become available, our ground-motion prediction models can be easily extended to shorter periods.

Boese, M.; Graves, R. W.; Callaghan, S.; Maechling, P. J.

2012-12-01

276

Correlative studies of rheumatoid factors and anti-viral antibodies in patients with rheumatoid arthritis.  

PubMed Central

An analysis of the relationship between the immune response to ubiquitous herpes family viruses, namely Epstein-Barr virus (EBV), cytomegalovirus (CMV), and varicella-zoster virus (VZV) and the presence of rheumatoid factors (RF), which are autoantibodies characteristic of patients with rheumatoid arthritis (RA), was conducted. Antibody profiles (RF, anti-viral antibodies) were monitored in the serum of the RA patients, and in normal individuals. No patient was found to have circulating RF in the absence of anti-viral antibodies. When the patients and normal controls were subdivided according to the presence of serum RF, it was found that when RF were present, the frequency of anti-CMV antibodies, but not anti-EBV or anti-VZV antibodies, was significantly higher (P = 0.02) when compared with RF-negative individuals. The titres of anti-CMV but not anti-VZV antibodies were found to increase in the RA patients with disease duration. To see if these viruses could stimulate RF production in vitro, peripheral blood mononuclear cells (PBMC) isolated from the patients and normal controls were stimulated with viral antigens. PBMC from normal controls, but not from RA patients, appeared to be responsive to viral antigen stimulation and produced RF. These data suggest that the immune response to CMV, to a greater extent than to EBV or VZV, correlates with the presence of RF. PMID:8390334

Ferraro, A S; Newkirk, M M

1993-01-01

277

Genetics and epigenetics of rheumatoid arthritis.  

PubMed

Investigators have made key advances in rheumatoid arthritis (RA) genetics in the past 10 years. Although genetic studies have had limited influence on clinical practice and drug discovery, they are currently generating testable hypotheses to explain disease pathogenesis. Firstly, we review here the major advances in identifying RA genetic susceptibility markers both within and outside of the MHC. Understanding how genetic variants translate into pathogenic mechanisms and ultimately into phenotypes remains a mystery for most of the polymorphisms that confer susceptibility to RA, but functional data are emerging. Interplay between environmental and genetic factors is poorly understood and in need of further investigation. Secondly, we review current knowledge of the role of epigenetics in RA susceptibility. Differences in the epigenome could represent one of the ways in which environmental exposures translate into phenotypic outcomes. The best understood epigenetic phenomena include post-translational histone modifications and DNA methylation events, both of which have critical roles in gene regulation. Epigenetic studies in RA represent a new area of research with the potential to answer unsolved questions. PMID:23381558

Viatte, Sebastien; Plant, Darren; Raychaudhuri, Soumya

2013-03-01

278

Genetics and epigenetics of rheumatoid arthritis  

PubMed Central

Investigators have made key advances in rheumatoid arthritis (RA) genetics in the past 10 years. Although genetic studies have had limited influence on clinical practice and drug discovery, they are currently generating testable hypotheses to explain disease pathogenesis. Firstly, we review here the major advances in identifying RA genetic susceptibility markers both within and outside of the MHC. Understanding how genetic variants translate into pathogenic mechanisms and ultimately into phenotypes remains a mystery for most of the polymorphisms that confer susceptibility to RA, but functional data are emerging. Interplay between environmental and genetic factors is poorly understood and in need of further investigation. Secondly, we review current knowledge of the role of epigenetics in RA susceptibility. Differences in the epigenome could represent one of the ways in which environmental exposures translate into phenotypic outcomes. The best understood epigenetic phenomena include post-translational histone modifications and DNA methylation events, both of which have critical roles in gene regulation. Epigenetic studies in RA represent a new area of research with the potential to answer unsolved questions. PMID:23381558

Viatte, Sebastien; Plant, Darren; Raychaudhuri, Soumya

2013-01-01

279

Utilizing Regulatory T Cells Against Rheumatoid Arthritis  

PubMed Central

Regulatory T (Treg) cells are essential for normal immune surveillance systems, and their dysfunction leads to development of diseases, such as autoimmune disorders. CD4+CD25+ Treg cells are well-known suppressive cells, which express the transcription factor Foxp3, are indispensable for the maintenance of immune self-tolerance and homeostasis by suppressing aberrant or excessive immune response. Other Foxp3? Treg cells include Tr1, Th3, CD8+CD28?/?, and Qa1-restricted T cells; however, the contribution of these Treg cells to self-tolerance, immune homeostasis as well as preventing autoimmunity is not well defined. Here, we discuss the phenotypes and function of Foxp3+ Treg cells and the potential use of such Treg cells against rheumatoid arthritis (RA). Of note, even though most expanded populations of Foxp3+ Treg cells exhibit suppressive activity, tissue-associated or antigen-specific Treg cells appear superior in suppressing local autoimmune disorders such as RA. In addition, utilizing tissue-associated Foxp3+ Treg cells from stem cells may stable Foxp3 expression and avoid induction of a potentially detrimental systemic immunosuppression. PMID:25152867

Haque, Mohammad; Fino, Kristin; Lei, Fengyang; Xiong, Xiaofang; Song, Jianxun

2014-01-01

280

Rheumatoid arthritis, spondyloarthropathies, and relapsing polychondritis.  

PubMed

The neurologic complications of rheumatic disease are highly variable and their manifestations are linked to the pathogenesis and clinical phenotype of the specific rheumatologic syndrome. In active rheumatoid arthritis (RA), the peripheral nervous system is most commonly involved and mononeuritis multiplex, nerve entrapment and vascultitic sensorimotor neuropathy are not uncommon. Central nervous system complications such as pachymeningitis and cerebral vasculitis are rare. TNF blockade therapy of RA is rarely associated with demyelinating syndromes. In the spondyloarthropathies, especially ankylosing spondylitis (AS), neurologic complications are more frequent in long-standing, advanced disease and include atlantoaxial subluxation, cauda equina syndrome, spinal stenosis, and acute vertebral fractures. Peripheral nervous system involvement in any of the spondyloarthropaties is rare. Relapsing polychondritis (RP) is characterized by recurring bouts of inflammation, destruction of cartilaginous structures, and systemic and rarely central nervous system vasculitis. Visual-oculo and auditory complications are common. Definitive treatment of the neurologic complications and prevention of subsequent ones is dependent upon effective treatment of RA, AS or RP. PMID:24365312

Ostrowski, Rochella A; Takagishi, Troy; Robinson, John

2014-01-01

281

Bone Remodelling Markers in Rheumatoid Arthritis  

PubMed Central

Bone loss in rheumatoid arthritis (RA) patients results from chronic inflammation and can lead to osteoporosis and fractures. A few bone remodeling markers have been studied in RA witnessing bone formation (osteocalcin), serum aminoterminal propeptide of type I collagen (PINP), serum carboxyterminal propeptide of type I collagen (ICTP), bone alkaline phosphatase (BAP), osteocalcin (OC), and bone resorption: C-terminal telopeptide of type 1 collagen (I-CTX), N-terminal telopeptide of type 1 collagen (I-NTX), pyridinolines (DPD and PYD), and tartrate-resistant acid phosphatase (TRAP). Bone resorption can be seen either in periarticular bone (demineralization and erosion) or in the total skeleton (osteoporosis). Whatever the location, bone resorption results from activation of osteoclasts when the ratio between osteoprotegerin and receptor activator of nuclear factor kappa-B ligand (OPG/RANKL) is decreased under influence of various proinflammatory cytokines. Bone remodeling markers also allow physicians to evaluate the effect of drugs used in RA like biologic agents, which reduce inflammation and exert a protecting effect on bone. We will discuss in this review changes in bone markers remodeling in patients with RA treated with biologics. PMID:24839355

Fardellone, Patrice; Séjourné, Alice; Paccou, Julien; Goëb, Vincent

2014-01-01

282

Introduction Simulations  

E-print Network

Introduction Method Simulations The End Cosmic signatures of the early Universe Umberto Maio LF, GRBs, Non-G, RT 4 The End Umberto Maio Cosmic signatures of the early Universe #12;Introduction evolution. Techniques: N-body/Sph simulations (with Gadget). Umberto Maio Cosmic signatures of the early

Â?umer, Slobodan

283

Is yoga a suitable treatment for rheumatoid arthritis: current opinion.  

PubMed

We reviewed published literature regarding the use of yoga for managing rheumatoid arthritis to determine whether adequate evidence exists to suggest its usefulness as a therapy. A search for previous studies involving yoga and rheumatoid arthritis in PubMed yielded eight reports. These studies reported the benefits of yoga in the physical and mental health of patients with rheumatoid arthritis (RA), suggesting that yoga is a useful add-on therapy for RA patients. However, all studies showed limitations with respect to sample size, study design, description and duration of yoga intervention, and assessment tools and statistical methods used. Additionally, the studies did not attempt to understand the mechanisms underlying observed benefits. Hence, evidence suggests a definite role of yoga in RA improvement, reducing pain, improving function, and creating a positive mental state. However, detailed analysis and additional studies are necessary to verify these observations. PMID:24198591

Telles, Shirley; Singh, Nilkamal

2012-01-01

284

Case-control association analysis of rheumatoid arthritis with candidate genes using related cases  

PubMed Central

We performed a case-control association analysis of rheumatoid arthritis (RA) for several candidate genes using the North American Rheumatoid Arthritis Consortium (NARAC) data provided in Genetic Analysis Workshop 15. We conducted the case-control association analysis using all related cases and unrelated controls and compared the results with those from the analysis of samples using only one randomly selected case from each family and all unrelated controls. For both analyses we used a weighted composite likelihood ratio test based on single-nucleotide polymorphism (SNP) markers or haplotypes accounting for the correlation among samples within a family. Several SNPs, including R620W in the candidate gene PTPN22, showed an association with RA status, which confirmed previously reported results. Several other SNPs in the candidate genes, such as CTLA4, HAVCR1, and SUMO4, also had rather small p-values (<0.05), suggesting the associations between them and RA. Our results showed that the p-values obtained from the analysis including all related cases were generally smaller than those obtained from the analysis including only one randomly selected case per family. These results, together with the results, based on simulated data, showed that higher power could be achieved using all related cases. PMID:18466531

Yoo, Yun Joo; Gao, Guimin; Zhang, Kui

2007-01-01

285

Computer simulation in conjunction with medical thermography as an adjunct tool for early detection of breast cancer  

Microsoft Academic Search

BACKGROUND: Mathematical modelling and analysis is now accepted in the engineering design on par with experimental approaches. Computer simulations enable one to perform several 'what-if' analyses cost effectively. High speed computers and low cost of memory has helped in simulating large-scale models in a relatively shorter time frame. The possibility of extending numerical modelling in the area of breast cancer

Eddie Y-K Ng; NM Sudharsan

2004-01-01

286

Cells of the synovium in rheumatoid arthritis. Macrophages  

PubMed Central

The multitude and abundance of macrophage-derived mediators in rheumatoid arthritis and their paracrine/autocrine effects identify macrophages as local and systemic amplifiers of disease. Although uncovering the etiology of rheumatoid arthritis remains the ultimate means to silence the pathogenetic process, efforts in understanding how activated macrophages influence disease have led to optimization strategies to selectively target macrophages by agents tailored to specific features of macrophage activation. This approach has two advantages: (a) striking the cell population that mediates/amplifies most of the irreversible tissue destruction and (b) sparing other cells that have no (or only marginal) effects on joint damage. PMID:18177511

Kinne, Raimund W; Stuhlmüller, Bruno; Burmester, Gerd-R

2007-01-01

287

Demodex mite infestation in patients with and without rheumatoid arthritis.  

PubMed

In the present study we compared the prevalence of Demodex mites in patients with rheumatoid arthritis and in one control group involving individuals of similar mean age. From each person we epilated 3-4 lashes from each eyelid and examined them under a microscope to find Demodex mites. In total 147 patients were examined. The prevalence of Demodex mites was 33% in rheumatoid arthritis (RA) patients and 31% in the control group. Our results demonstrated that the prevalence of Demodex mites was similar in RA patients as compared to the control group. PMID:22807020

Garbacewicz, Aleksandra; Jaworski, Janusz; Grytner-Zi?cina, Barbara

2012-03-01

288

Pathogenesis of rheumatoid arthritis and the immune response  

SciTech Connect

The interrelationship among lymphocytes, macrophages, and neutrophils appears to be an important aspect of the synovial inflammation that is characteristic of rheumatoid arthritis. In a study comparing gold sodium aurothiomalate (GST) with auranofin (Au), an orally absorbed compound, both appeared to inhibit the disease process and no difference between parenteral and oral administration was observed. Another study involved two groups of nine patients with severe rheumatoid arthritis. One group underwent plasmapheresis. The second group underwent total lymphoid irradiation. Both agents appeared to inhibit the disease process. Plasmapheresis was better tolerated that irradiation.

Scheinberg, M.A.

1983-08-01

289

Etanercept-Induced Sarcoidosis in Rheumatoid Arthritis: FDG PET Findings.  

PubMed

We report the F-FDG PET/CT findings of an etanercept-induced sarcoidosis in a patient with rheumatoid arthritis. A 68-year-old woman with rheumatoid arthritis who had been treated with etanercept and methotrexate showed multiple lung nodules and hilar lymph node swellings on CT. She underwent FDG PET/CT for cancer screening. Intense FDG uptakes were found in the multiple lung nodules, bilateral hilar lymph nodes, a periurethral masslike lesion, and cranial meningeal nodules. A histopathological examination revealed epithelioid granuloma with multinucleated giant cells, which was compatible with sarcoidosis. PMID:25188646

Nakajima, Reiko; Abe, Koichiro; Nakajima, Ayako; Nishikawa, Toshio; Sakai, Shuji

2015-01-01

290

Adiponectin stimulates IL-8 production by rheumatoid synovial fibroblasts  

SciTech Connect

The adipokines are linked not only to metabolic regulation, but also to immune responses. Adiponectin, but not leptin or resistin induced interleukin-8 production from rheumatoid synovial fibroblasts (RSF). The culture supernatant of RSF treated with adiponectin induced chemotaxis, although adiponectin itself had no such effect. Addition of antibody against adiponectin, and inhibition of adiponectin receptor gene decreased adiponectin-induced IL-8 production. Nuclear translocation of nuclear factor-kappa B was increased by adiponectin. The induction of interleukin-8 was inhibited by mitogen-activated protein kinase inhibitors. These findings suggest that adiponectin contributes to the pathogenesis of rheumatoid arthritis.

Kitahara, Kanako [Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo 143-8541 (Japan); Department of Immunology, Toho University School of Medicine, Tokyo (Japan); Kusunoki, Natsuko [Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo 143-8541 (Japan); Kakiuchi, Terutaka [Department of Immunology, Toho University School of Medicine, Tokyo (Japan); Suguro, Toru [Department of Orthopaedic Surgery, Toho University School of Medicine, Tokyo (Japan); Kawai, Shinichi [Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo 143-8541 (Japan)], E-mail: skawai@med.toho-u.ac.jp

2009-01-09

291

Biomarkers for radiographic progression in rheumatoid arthritis.  

PubMed

Treatment of patients with rheumatoid arthritis (RA) is rarely personalized, since predictors of disease course are lacking. The severity of RA can be measured objectively by radiographic progression. The most reliable way to measure radiographic progression is in a longitudinal cohort with serial time points, scoring on a quantitative scale, with a validated scoring method and trained readers. Current models used to predict radiographic progression are based on C-reactive protein and anti-citrullinated protein antibodies. Other biomarkers could increase the prognostic ability of these models. In this review, we evaluated the published (and partly nonpublished) data on genetic, serologic, and imaging biomarkers for the severity of joint destruction in RA. We evaluated variants in 10 genes (CD40, IL2RA, IL4R, IL15, OPG, DKK1, SOST, GRZB, MMP9, and SPAG16). In 5 variants (IL2RA, DKK1, GRZB, MMP9, and SPAG16), we found evidence of an association at the functional level. We evaluated several serological biomarkers, namely, autoantibodies (RF, ACPA, anti-CarP), markers related to inflammation (ESR, CRP), and proteinases or components of the extracellular matrix of bone and cartilage (MMP3, CTX-I, CTX-II, COMP, TIMP1, PYD, RANKL/OPG, CXCL13). Finally, we evaluated markers that can be visualized by ultrasound or MRI, including erosions, bone marrow edema, synovitis, and tenosynovitis. Several studies showed that bone marrow edema and synovitis on MRI are robust predictors of radiographic progression. Some studies showed that inflammation detected with ultrasound predicted radiographic progression. Future studies will reveal whether adding and combining all these different biomarkers will increase the accuracy of risk models predicting radiographic progression in RA. PMID:25163742

Krabben, A; Huizinga, T W J; Mil, A H M van der Helm-van

2015-01-01

292

Exercise and fatigue in rheumatoid arthritis.  

PubMed

Fatigue, the enduring sensation of weakness, lack of energy, tiredness or exhaustion, is described by 40%-80% of patients with rheumatoid arthritis as their most disabling symptom with wide-ranging consequences for quality of life. Little attention has been paid to its multidimensional nature or to its reliability as a measure to evaluate progression of the disease. Low impact aerobic exercise affects the level of fatigue, and this same level of fatigue influences the exercise itself. We searched Medline, Cochrane Collaboration Register of Controlled Trials (CCRCT), Lilacs, PubMed and Scopus databases for randomized controlled trials (with appropriate description of methods, materials and results) on the assessment of fatigue and exercise. Review articles, case reports, letters to the editor and editorials were excluded. Of 121 references initially identified, 4 randomized controlled trials met the inclusion criteria. Two studies used the MAF scale (Multidimensional Assessment of Fatigue), one used the MAC (Mental Adjustment to Cancer) fatigue scale, and all trials used POMS (Profile of Mood States) to assess fatigue. All four trials conducted a 12 week program of two to three times/ week and different periods of follow-up. Two studies used low impact aerobic exercise, one used dance-based exercise, and another study followed a home cardiopulmonary conditioning program using a stationary bicycle. While fatigue appears to be a reliable outcome measure in the clinical management of RA, especially when related to exercise prescription, further research is needed to evaluate the correlation between exercise, fatigue and quality of life, using fatigue scales validated to explore the different components of fatigue and its wide-ranging consequences. PMID:24575509

Balsamo, Sandor; Diniz, Leonardo R; dos Santos-Neto, Leopoldo L; da Mota, Licia M H

2014-01-01

293

Lymphocytes subsets in osteoarthritis versus rheumatoid arthritis.  

PubMed

It has been suggested that osteoarthritis (OA) is induced by mechanical stress manifested by cartilage destruction with no or minimal involvement of the immune response as compared to that in rheumatoid arthritis (RA). This study is a trial to investigate the hypothesis that the immune response has a critical role in the pathogenesis of OA. This work was performed on 2 groups of patients: the first group included 20 primary OA knee patients and the second group included 18 RA patients as autoimmune controls. Patients of both groups were diagnosed according to the revised criteria of the American college of Rheumatology (ACR). All patients were subjected to complete history taking, clinical examination, degree of severity of OA, disease activity for RA patients and routine laboratory assays. Radiological examinations were done for the wrists, hands and both knees for both RA and OA patients. Flow cytometric assessment of T cell (T helper, T cytotoxic), B cell, Natural killer cells and the CD4/CD8 ratio in the peripheral blood (PB) was carried out for both groups. The results of this study showed no statistical difference between the two studied groups regarding the percentages of the different lymphocyte subsets. These findings reflect the similarity of immune cell profile in both RA and OA patients, and raised the possibility that abnormalities in T cell and its subsets may contribute to the pathogenesis of OA, and predispose to chronic progressive immune response in the synovial membrane (SM) with cartilage destruction. Targeting the cascade that leads to abnormal immune response may open new avenues for treating OA. PMID:17977216

Leheita, Ola; Abed Elrazek, Nahed Y; Younes, Soha; Mahmoud, Amany Zakareya

2005-01-01

294

Genetics of Rheumatoid Arthritis — A Comprehensive Review  

PubMed Central

The “Bermuda triangle” of genetics, environment and autoimmunity is involved in the pathogenesis of rheumatoid arthritis (RA). Various aspects of genetic contribution to the etiology, pathogenesis and outcome of RA are discussed in this review. The heritability of RA has been estimated to be about 60 %, while the contribution of HLA to heritability has been estimated to be 11–37 %. Apart from known shared epitope (SE) alleles, such as HLA-DRB1*01 and DRB1*04, other HLA alleles, such as HLA-DRB1*13 and DRB1*15 have been linked to RA susceptibility. A novel SE classification divides SE alleles into S1, S2, S3P and S3D groups, where primarily S2 and S3P groups have been associated with predisposition to seropositive RA. The most relevant non-HLA gene single nucleotide polymorphisms (SNPs) associated with RA include PTPN22, IL23R, TRAF1, CTLA4, IRF5, STAT4, CCR6, PADI4. Large genome-wide association studies (GWAS) have identified more than 30 loci involved in RA pathogenesis. HLA and some non-HLA genes may differentiate between anti-citrullinated protein antibody (ACPA) seropositive and seronegative RA. Genetic susceptibility has also been associated with environmental factors, primarily smoking. Some GWAS studies carried out in rodent models of arthritis have confirmed the role of human genes. For example, in the collagen-induced (CIA) and proteoglycan-induced arthritis (PgIA) models, two important loci — Pgia26/Cia5 and Pgia2/Cia2/Cia3, corresponding the human PTPN22/CD2 and TRAF1/C5 loci, respectively — have been identified. Finally, pharmacogenomics identified SNPs or multiple genetic signatures that may be associated with responses to traditional disease-modifying drugs and biologics. PMID:23288628

Kurkó, Júlia; Besenyei, Timea; Laki, Judit; Glant, Tibor T.; Mikecz, Katalin

2013-01-01

295

Management of rheumatoid arthritis: consensus recommendations from the Hong Kong Society of Rheumatology.  

PubMed

Given the recent availability of novel biologic agents for the treatment of rheumatoid arthritis (RA), the Hong Kong Society of Rheumatology has developed consensus recommendations on the management of RA, which aim at providing guidance to local physicians on appropriate, literature-based management of this condition, specifically on the indications and monitoring of the biologic disease-modifying anti-rheumatic drugs (DMARDs). The recommendations were developed using the European League Against Rheumatism (EULAR) recommendations for the management of early arthritis as a guide, along with local expert opinion. As significant joint damage occurs early in the course of RA, initiating therapy early is key to minimizing further damage and disability. Patients with serious disease or poor prognosis should receive early, aggressive therapy. Because of its good efficacy and safety profile, methotrexate is considered the standard first-line DMARD for most treatment-naïve RA patients. Patients with a suboptimal response to methotrexate monotherapy should receive step-up (combination) therapy with either the synthetic or biologic DMARDs. In recent years, combinations of methotrexate with tocilizumab, abatacept, or rituximab have emerged as effective therapies in patients who are unresponsive to traditional DMARDs or the anti-tumor necrosis factor (TNF)-? agents. As biologic agents can increase the risk of infections such as tuberculosis and reactivation of viral hepatitis, screening for the presence of latent tuberculosis and chronic viral hepatitis carrier state is recommended before initiating therapy. PMID:21046421

Mok, Chi Chiu; Tam, Lai Shan; Chan, Tak Hin; Lee, Gavin K W; Li, Edmund K M

2011-03-01

296

Isolated talonavicular arthrodesis in patients with rheumatoid arthritis of the foot and tibialis posterior tendon dysfunction  

PubMed Central

Background The foot is often affected in patients with rheumatoid arthritis. Subtalar joints are involved more frequently than ankle joints. Deformities of subtalar joints often lead to painful flatfoot and valgus deformity of the heel. Major contributors to the early development of foot deformities include talonavicular joint destruction and tibialis posterior tendon dysfunction, mainly due to its rupture. Methods Between 2002 and 2005 we performed isolated talonavicular arthrodesis in 26 patients; twenty women and six men. Tibialis posterior tendon dysfunction was diagnosed preoperatively by physical examination and by MRI. Talonavicular fusion was achieved via screws in eight patients, memory staples in twelve patients and a combination of screws and memory staples in six cases. The average duration of immobilization after the surgery was four weeks, followed by rehabilitation. Full weight bearing was allowed two to three months after surgery. Results The mean age of the group at the time of the surgery was 43.6 years. MRI examination revealed a torn tendon in nine cases with no significant destruction of the talonavicular joint seen on X-rays. Mean of postoperative followup was 4.5 years (3 to 7 years). The mean of AOFAS Hindfoot score improved from 48.2 preoperatively to 88.6 points at the last postoperative followup. Eighteen patients had excellent results (none, mild occasional pain), six patients had moderate pain of the foot and two patients had severe pain in evaluation with the score. Complications included superficial wound infections in two patients and a nonunion developed in one case. Conclusions Early isolated talonavicular arthrodesis provides excellent pain relief and prevents further progression of the foot deformities in patients with rheumatoid arthritis and tibialis posterior tendon dysfunction. PMID:20187969

2010-01-01

297

Simulated NASA Satellite Data Products for the NOAA Integrated Coral Reef Observation Network/Coral Reef Early Warning System  

NASA Technical Reports Server (NTRS)

This RPC (Rapid Prototyping Capability) experiment will demonstrate the use of VIIRS (Visible/Infrared Imager/Radiometer Suite) and LDCM (Landsat Data Continuity Mission) sensor data as significant input to the NOAA (National Oceanic and Atmospheric Administration) ICON/ CREWS (Integrated Coral Reef Observation System/Coral Reef Early Warning System). The project affects the Coastal Management Program Element of the Applied Sciences Program.

Estep, Leland; Spruce, Joseph P.

2007-01-01

298

Rheumatoid interstitial lung disease presenting as cor pulmonale  

PubMed Central

Rheumatiod arthritis (RA) is a multisystem connective tissue disorder. The predominant presentation is polyarticular, symmetric peripheral arthritis with relative sparing of axial skeleton. Inflammatory synovitis is the pathologic hallmark. Extra-articular manifestations of RA can involve several other organ systems and amongst them pulmonary manifestations occur commonly. We report a case of rheumatoid interstitial lung disease presenting as cor pulmonale. PMID:21139729

Acharya, Sourya; Mahajan, S. N.; Shukla, Samarth; Diwan, S. K.; Banode, Pankaj; Kothari, Nirmesh

2010-01-01

299

Periodontal disease and rheumatoid arthritis: a systematic review.  

PubMed

This systematic review considers the evidence available for a relationship between periodontal disease and rheumatoid arthritis. MEDLINE/PubMed, CINAHL, DOSS, Embase, Scopus, Web of Knowledge, MedNar, and ProQuest Theses and Dissertations were searched from the inception of the database until June 2012 for any quantitative studies that examined the association between periodontal disease and rheumatoid arthritis. Nineteen studies met our inclusion criteria. Good evidence was found to support an association between these conditions with regard to tooth loss, clinical attachment levels, and erythrocyte sedimentation rates. Moderate evidence was noted for C-reactive protein and interleukin-1?. Some evidence for a positive outcome of periodontal treatment on the clinical features of rheumatoid arthritis was noted. These results provide moderate evidence based on biochemical markers and stronger evidence with regard to clinical parameters that common risk factors or common pathologic processes may be responsible for an association between rheumatoid arthritis and periodontal disease. Further studies are required to fully explore both the biochemical processes and clinical relationships between these 2 chronic inflammatory conditions. There is a need to move from case-control studies to more rigorous studies using well-defined populations and well-defined biochemical and clinical outcomes as the primary outcome measures with consideration of potential confounding factors. PMID:23525531

Kaur, S; White, S; Bartold, P M

2013-05-01

300

Effective rheumatoid arthritis treatment requires comprehensive management strategies  

Microsoft Academic Search

ABSTRACT: Work by Lee and colleagues has shown that decreased sleep quality and increased psychiatric distress increase pain sensitivity at both articular and nonarticular sites in rheumatoid arthritis (RA) patients. This work is consistent with prior studies showing that factors independent of RA disease activity can influence RA outcome measures. Owing to increasing pressure on rheumatologists to use outcome measures

Chad S Boomershine; Ave S

2009-01-01

301

Total ankle replacement in rheumatoid arthritis: treatment strategy  

Microsoft Academic Search

Rheumatoid arthritis (RA) of the ankle poses specific problems, since the tibiotalar joint is rarely affected in isolation,\\u000a and treatment will need to be designed so as to manage all the aspects of the disease in the particular patient. Some management\\u000a aspects are of particular importance.

M. Bonnin; M. Bouysset; J. Tebib; E. Noël

302

Cognitive Distortion in Rheumatoid Arthritis: Relation to Depression and Disability.  

ERIC Educational Resources Information Center

Examined the relation between cognitive distortion, as measured by the Cognitive Error Questionnaire, and both self-reported and interview-rated depression and disability in 92 rheumatoid arthritis (RA) patients. Found cognitive distortion significantly associated with depression, and also related to physical disability. Discusses the results,…

Smith, Timothy W.; And Others

1988-01-01

303

Tyrosine kinases as targets for the treatment of rheumatoid arthritis  

Microsoft Academic Search

As critical regulators of numerous cell signaling pathways, tyrosine kinases are implicated in the pathogenesis of several diseases, including rheumatoid arthritis (RA). In the absence of disease, synoviocytes produce factors that provide nutrition and lubrication for the surrounding cartilage tissue; few cellular infiltrates are seen in the synovium. In RA, however, macrophages, neutrophils, T cells and B cells infiltrate the

Christina D'Aura Swanson; Ricardo T. Paniagua; Tamsin M. Lindstrom; William H. Robinson

2009-01-01

304

Effect of Resisted Dynamic Exercise on Patients with Rheumatoid Arthritis  

Microsoft Academic Search

Overall Clinical Bottom Line: Based on current available research, a program of dynamic exercise appears to statistically significantly increase lower extremity muscle strength, as measured by a dynamometer, as compared to a program of no exercise or a more conservative and traditional program of range of motion, stretching and\\/or isometric exercise in patients with rheumatoid arthritis. The impact of a

Ann Horinouchi; Martha Ragsdale

2008-01-01

305

Rheumatoid Arthritis and Salivary Biomarkers of Periodontal Disease  

PubMed Central

Aim To test the hypothesis that rheumatoid arthritis influenced levels of salivary biomarkers of periodontal disease. Methods Medical assessments, periodontal examinations, and pain ratings were obtained from 35 rheumatoid arthritis, 35 chronic periodontitis and 35 age and gender-matched healthy controls in a cross-sectional, case-controlled study. Unstimulated whole saliva samples were analyzed for interleukin-1? (IL-1?), matrix-metalloproteinase-8 (MMP-8) and tumor necrosis factor-? (TNF)-? concentrations. Results The arthritis and healthy groups had significantly less oral disease than the periodontitis group (p<0.0001), with the arthritis group having significantly more sites bleeding on probing (BOP) than matched controls (p=0.012). Salivary levels of MMP-8 and IL-1? were significantly elevated in the periodontal disease group (p?0.002), and IL-1? was the only biomarker with significantly higher levels in the arthritis group compared with controls (p=0.002). Arthritis patients receiving anti-TNF-? antibody therapy had significantly lower IL-1? and TNF-? levels compared with arthritis patients not on anti-TNF-? therapy (p=0.016, p=0.024) and healthy controls (p<0.001, p=0.011), respectively. Conclusion Rheumatoid arthritis patients have higher levels of periodontal inflammation than healthy controls, ie. increased BOP. Systemic inflammation appears to influence levels of select salivary biomarkers of periodontal disease, and anti-TNF-? antibody-based disease modifying therapy significantly lowers salivary IL-1? and TNF-? levels in rheumatoid arthritis. PMID:20880053

Mirrielees, Jeffrey; Crofford, Leslie J.; Lin, Yushun; Kryscio, Richard J.; Dawson, Dolphus R.; Ebersole, Jeffrey L.; Miller, Craig S.

2010-01-01

306

Predicting 'normal' grip strength for rheumatoid arthritis patients  

Microsoft Academic Search

Objective. An ability to predict accurately 'normal' grip strength in rheumatoid arthritis (RA) patients would facilitate a more accurate assessment of the degree of their functional loss. This, in turn, would allow the setting of more meaningful treatment goals aimed at restoring hand function towards normal. This study carefully measures three modalities of hand grip strength and their correlation with

A. Fraser; J. Vallow; A. Preston; R. G. Cooper

1999-01-01

307

Thyroid dysfunction in rheumatoid arthritis: a controlled prospective survey  

Microsoft Academic Search

OBJECTIVES--To determine whether thyroid dysfunction is found with increased frequency in patients with rheumatoid arthritis (RA). METHODS--A controlled prospective survey was conducted on a cohort of patients with RA derived from a hospital clinic and a private surburban rheumatology practice. A control group with similar demographic features was generated from the same sources and included subjects with either osteoarthritis or

J B Shiroky; M Cohen; M L Ballachey; C Neville

1993-01-01

308

Rheumatoid arthritis, Proteus, anti-CCP antibodies and Karl Popper  

Microsoft Academic Search

Rheumatoid arthritis (RA) is a crippling joint disease affecting over 20million people worldwide. The cause of RA is most probably linked to the triad of microbial trigger, genetic association and autoimmunity and can be explained using the philosophical method of Karl Popper or Popperian sequences. Ten “Popper sequences” have been identified which point to the urinary microbe Proteus mirabilis as

Alan Ebringer; Taha Rashid; Clyde Wilson

2010-01-01

309

Dynamic exercise therapy in rheumatoid arthritis: a systematic review  

Microsoft Academic Search

The aim of this systematic review was to determine the effectiveness of dynamic exercixe therapy in improving joint mobility, muscle strength, aerobic capacity and daily functioning in patients with rheumatoid arthritis (RA). In addition, possible unwanted effects such as an increase in pain, disease activity and radiological progression were studied. A computer-aided search of the MEDLINE , Embase and SCISEARCH

C. H. M. van den Ende; T. P. M. Vliet Vlieland; M. Munneke; J. M. W. Hazes

1998-01-01

310

Home Care Guide on Juvenile Rheumatoid Arthritis (For Parents).  

ERIC Educational Resources Information Center

The booklet, written by the medical staff of a children's hospital, provides information for parents of children with juvenile rheumatoid arthritis (JRA). Arthritis is a swelling of the joint(s) in children and lasts for over 6 weeks (sometimes many years). Aspirin is the main medicine given for JRA, and it works not only to control pain but also,…

Giesecke, Linda L.; And Others

311

Views on Exercise Maintenance: Variations Among Patients With Rheumatoid Arthritis  

Microsoft Academic Search

Background and Purpose. Individuals with rheumatoid arthritis (RA) often have to make changes in exercise behavior in order to gain and sustain health benefits. The purpose of this study was to explore and describe ways of understand- ing exercise maintenance among individuals with RA who had already started to exercise. Participants. Fourteen women and 4 men with RA of at

Emma Swardh; Gabriele Biguet; Christina H Opava

2008-01-01

312

Reliability of the ICF Core Set for rheumatoid arthritis  

Microsoft Academic Search

Background: The comprehensive ICF Core Set for rheumatoid arthritis (RA) is a selection of 96 categories from the International Classification of Functioning, Disability and Health (ICF), representing relevant aspects in the functioning of RA patients.Objectives: To study the reliability of the ICF Core Set for RA in rheumatological practice, and to explore the metric of the qualifiers’ scale.Methods: 25 RA

Till Uhlig; Solva?r Lillemo; Rikke Helene Moe; Tanja Stamm; Alarcos Cieza; Annelies Boonen; Petter Mowinckel; Tore Kristian Kvien; Gerold Stucki

2007-01-01

313

Early Algebra, Early Arithmetic  

NSDL National Science Digital Library

This site offers a variety of early algebra resources for teachers in grades 1-6, parents, researchers, policy makers, administrators, and curriculum developers. Site includes early algebra activities, handouts and overheads in PDF format (requires Acrobat Reader), articles, short reviews of articles and books focusing on early math and early algebra, news and events, and more. A valuable source for pre algebra activities in the elementary classroom.

National Science Foundation (NSF)

2007-12-12

314

Sputum Autoantibodies in Patients With Established Rheumatoid Arthritis and Subjects at Risk of Future Clinically Apparent Disease  

PubMed Central

Objective To evaluate the generation of rheumatoid arthritis (RA)–related autoantibodies in the lung. Methods Simultaneous collection of serum and induced sputum was performed in 21 healthy controls, 49 at-risk subjects without inflammatory arthritis but at risk of RA due to family history or seropositivity for anti–citrullinated protein antibodies, and 14 subjects with early RA. Samples were tested for anti–cyclic citrullinated peptide 2 (anti-CCP2), anti-CCP3, anti-CCP3.1, rheumatoid factor isotypes IgM, IgG, and IgA, and total IgM, IgG, and IgA. Results One or more autoantibodies were present in sputum of 39% of at-risk seronegative subjects, 65% of at-risk seropositive subjects, and 86% of subjects with early RA. In at-risk seronegative subjects, the rate of anti-CCP3.1 positivity and the median number of autoantibodies were elevated in sputum versus serum. In subjects with early RA, the rate of positivity for several individual autoantibodies and the median number of autoantibodies were higher in serum than in sputum. Results in at-risk seropositive subjects were intermediate between these groups. In at-risk subjects with autoantibody positivity in sputum, the ratios of autoantibody to total Ig were higher in sputum than in serum, suggesting that these autoantibodies are generated or sequestered in the lung. Conclusion RA-related autoantibodies are detectable in sputum in subjects at risk of RA and in subjects with early RA. In a subset of at-risk subjects, the presence of sputum autoantibodies in the absence of seropositivity, and the increased autoantibody-to–total Ig ratios in sputum, suggest that the lung may be a site of autoantibody generation in the early development of RA. These findings suggest an important role of the lung in the pathogenesis of RA. PMID:23817979

Willis, Van C.; Demoruelle, M. Kristen; Derber, Lezlie A.; Chartier-Logan, Catherine J.; Parish, Mark C.; Pedraza, Isabel F.; Weisman, Michael H.; Norris, Jill M.; Holers, V. Michael; Deane, Kevin D.

2014-01-01

315

Laboratory drop towers for the experimental simulation of dust-aggregate collisions in the early solar system.  

PubMed

For the purpose of investigating the evolution of dust aggregates in the early Solar System, we developed two vacuum drop towers in which fragile dust aggregates with sizes up to ~10 cm and porosities up to 70% can be collided. One of the drop towers is primarily used for very low impact speeds down to below 0.01 m/sec and makes use of a double release mechanism. Collisions are recorded in stereo-view by two high-speed cameras, which fall along the glass vacuum tube in the center-of-mass frame of the two dust aggregates. The other free-fall tower makes use of an electromagnetic accelerator that is capable of gently accelerating dust aggregates to up to 5 m/sec. In combination with the release of another dust aggregate to free fall, collision speeds up to ~10 m/sec can be achieved. Here, two fixed high-speed cameras record the collision events. In both drop towers, the dust aggregates are in free fall during the collision so that they are weightless and match the conditions in the early Solar System. PMID:24962693

Blum, Jürgen; Beitz, Eike; Bukhari, Mohtashim; Gundlach, Bastian; Hagemann, Jan-Hendrik; Heißelmann, Daniel; Kothe, Stefan; Schräpler, Rainer; von Borstel, Ingo; Weidling, René

2014-01-01

316

Infrared signature of the early stage microsolvation in the NaSO??(H?O)??? clusters: a simulation study.  

PubMed

Infrared photon dissociation (IRPD) spectra of the NaSO4(-)(H2O)n clusters with up to five water molecules have been studied using quantum chemical calculations. Our calculation reveals that the splitting of the peaks in the ~800-1300 cm(-1) region of the IRPD spectra, which contains the information on S-O bond stretching of the anion, indicates the deviation of the cation from the C(3v) axis as well as the asymmetric distribution of the water molecules. The frequency of the H-bonded O-H stretching peak in the ~2300-3000 cm(-1) window, on the other hand, provides information on the position of the newly added water molecule with respect to the cation. The IRPD technique thus provides abundant structural information on the early stage of the microsolvation and has the potential to become a powerful tool complementary to photoelectron spectroscopy. PMID:24878274

Jin, Tan; Zhang, BingBing; Song, Jian; Jiang, Ling; Qiu, Yishen; Zhuang, Wei

2014-10-01

317

Early Growth in a Perturbed Universe: Exploring Dark Matter Halo Populations in 2LPT and ZA Simulations  

E-print Network

We study the structure and evolution of dark matter halos from z = 300 to z = 6 for two cosmological N-body simulation initialization techniques. While the second order Lagrangian perturbation theory (2LPT) and the Zel'dovich approximation (ZA) both produce accurate present day halo mass functions, earlier collapse of dense regions in 2LPT can result in larger mass halos at high redshift. We explore the differences in dark matter halo mass and concentration due to initialization method through three 2LPT and three ZA initialized cosmological simulations. We find that 2LPT induces more rapid halo growth, resulting in more massive halos compared to ZA. This effect is most pronounced for high mass halos and at high redshift. Halo concentration is, on average, largely similar between 2LPT and ZA, but retains differences when viewed as a function of halo mass. For both mass and concentration, the difference between typical individual halos can be very large, highlighting the shortcomings of ZA-initialized simulati...

Sissom, Daniel J; Sinha, Manodeep

2014-01-01

318

[Aortic valve replacement for rheumatoid aortic valve regurgitation].  

PubMed

Valve replacement for aortic regurgitation in patient with rheumatoid arthritis was rare in Japan. We report a successful case in which aortic regurgitation necessitated aortic valve replacement. A 62-year-old woman was admitted for shortness of breath, chest pain and progressive edema. She had been treated for rheumatoid arthritis for more than ten years using steroids. The aortic valve was successfully replaced by a prosthetic mechanical valve. The histopathological examination of the excised aortic valve demonstrated rheumatic nodules in the right- and non-coronary cusp. It was supported that these changes caused shrinkage of cusp and resulted in aortic regurgitation. This patient was discharged on the 20th postoperative day. There was no evidence of detachment of the prosthetic valve. PMID:7474590

Uwabe, K; Tsuchiya, K; Hosaka, S; Morishita, A; Iida, Y; Oyama, T

1995-09-01

319

Redox signalling and the inflammatory response in rheumatoid arthritis  

PubMed Central

Reactive oxygen species (ROS) are produced mainly during oxidative phosphorylation and by activated phagocytic cells during oxidative burst. The excessive production of ROS can damage lipids, protein, membrane and nucleic acids. They also serve as important intracellular signalling that enhances the inflammatory response. Many studies have demonstrated a role of ROS in the pathogenesis of inflammatory chronic arthropathies, such as rheumatoid arthritis. It is known that ROS can function as a second messenger to activate nuclear factor kappa-B, which orchestrates the expression of a spectrum of genes involved in the inflammatory response. Therefore, an understanding of the complex interactions between these pathways might be useful for the development of novel therapeutic strategies for rheumatoid arthritis. PMID:18422737

Filippin, L I; Vercelino, R; Marroni, N P; Xavier, R M

2008-01-01

320

Treatment of intractable rheumatoid arthritis with lymphoid irradiation  

SciTech Connect

Subdiaphragmatic lymphoid radiation was used as an alternative to cytotoxic drug therapy to treat six patients with progressive erosive rheumatoid arthritis. All were previously unresponsive to conventional therapy. Radiation (4,000 rad) was given to subdiaphragmatic lymphoid tissues in fractionated doses of 150 to 250 rad each. Three of the six patients demonstrated long-lasting clinical improvement with a decrease in synovitis and morning stiffness and an increase in joint function. All six patients showed a profound depression in the peripheral blood lymphocyte count which persisted for at least six months. The irradiation was well tolerated; there have been no serious complications due to radiotherapy with follow-up ranging from 13 to 36 months. The substantial efficacy in some patients and the lack of severe toxicity in all suggests that radiotherapy deserves further study as an alternative to cytotoxic drugs in the treatment of rheumatoid arthritis.

Strober, S.; Kotzin, B.L.; Hoppe, R.T.; Slavin, S.; Gottlieb, M.; Calin, A.; Fuks, Z.; Kaplan, H.S.

1981-01-01

321

Indium-111 leukocyte imaging in patients with rheumatoid arthritis  

SciTech Connect

This study evaluates the usefulness of labeled leukocyte imaging in patients with rheumatoid arthritis. In 33 patients, the incidence of pain and swelling in 66 wrist joints and 66 knee joints was compared with the accumulation of (/sup 111/In)leukocytes. No accumulation of (/sup 111/In)leukocytes was seen in any of the patients' wrists (0/12) or knee joints (0/14) when both pain and swelling were absent. In contrast, 93% (25/27) of wrist joints and 80% (24/30) of knee joints with both pain and swelling were positive by (/sup 111/In)leukocyte scintigraphy. There was little correlation between the stage of the disease, as determined by radiography, and (/sup 111/In)leukocyte accumulation. This study suggests that (/sup 111/In)leukocyte imaging may be a reliable procedure for monitoring the activity of rheumatoid arthritis, especially for confirming the lack of an ongoing inflammatory response.

Uno, K.; Matsui, N.; Nohira, K.; Suguro, T.; Kitakata, Y.; Uchiyama, G.; Miyoshi, T.; Uematsu, S.; Inoue, S.; Arimizu, N.

1986-03-01

322

Genotyping in rheumatoid arthritis: a game changer in clinical management?  

PubMed

Rheumatoid arthritis (RA) is a genetically complex disease of immune dysregulation characterized by painful inflammation of synovial joints. Despite advances in its management afforded by biologic drug development, efforts to improve outcomes for patients are confounded by the condition's heterogeneous pathobiology, and consequent variability in therapeutic responses. Great strides have been made in understanding the genetic epidemiology of rheumatoid arthritis since its association with the HLA locus was established in the 1980s, with over 100 additional disease-associated variants now confirmed through cumulative genome-wide association studies. Yet translation of this new knowledge for patient benefit - whether as a route to predicting disease risk, drug development or personalized medicine - has been slow. To address this, collaborating teams of interdisciplinary scientists will need to pool resources, including ever larger, well-characterized patient cohorts and sophisticated biostatistical approaches. Recent advances suggest that the fruits of these endeavors are beginning to come within reach. PMID:25644535

Pratt, Arthur G; Isaacs, John D

2015-03-01

323

Reversing myocardial microvascular disease in a patient with rheumatoid arthritis.  

PubMed

Rheumatoid arthritis (RA) is associated with increased cardiovascular mortality. This is regarded as being due to accelerated coronary atherosclerosis. We describe a 62-year-old man with seropositive erosive RA and extraarticular manifestations but no history of cardiovascular disease. Noninvasive assessment of myocardial blood flow by adenosine stressed thallium scanning showed reversible ischemia and diffusely poor myocardial perfusion. Repeat assessment after intensive immunosuppression for rheumatoid vasculitis revealed resolution of the ischemic changes and generally increased myocardial perfusion. Coronary angiography revealed no significant atheroma, suggesting that myocardial microvascular disease was responsible for the ischemia. This may be an important determinant of cardiovascular outcome in RA, and this case indicated that it can be reversed with immunosuppression. PMID:15801038

Raza, Karim; Banks, Matthew; Kitas, George D

2005-04-01

324

Impairment and disability: Renoir's adaptive coping strategies against rheumatoid arthritis.  

PubMed

Pierre-Auguste Renoir was one of the most influential painters in art history, but few people know that he suffered from debilitating rheumatoid arthritis. Despite his arthritis, he was able to maintain an incredible level of precision and efficiency with his painting. More importantly, he remained positive and did not let his condition affect his passion for painting or take away from the beauty that he saw in the world around him. Renoir applied a wide variety of coping mechanisms and used his ingenuity to come up with different ways to continue painting even as his arthritis weakened him. Renoir's long battle with rheumatoid arthritis serves as an inspiration to patients who experience the pain and limited mobility associated with this disease, encouraging them to persevere and to develop coping mechanisms that prevent the effects of their impairment from disabling them. PMID:24294153

Kowalski, Evan; Chung, Kevin C

2012-12-01

325

Multiple intracranial nodules associated with rheumatoid arthritis: case report.  

PubMed

A 71-year-old woman with active rheumatoid arthritis (RA) was referred to our department because of multiple intracranial nodules. On admission, the RA disease activity was very high even after the treatment of methotrexate in other hospital. She underwent open biopsy to confirm a histopathological diagnosis of the intracranial lesions. Surgical specimen mainly consisted of necrosis surrounded by epithelioid cells. The masses were reduced spontaneously in size without additional treatment. Eleven month later, the lesions were relapsed. She underwent treatment with corticosteroid, and the lesions were remarkably regressed. The clinical course and histological examination were compatible with rheumatoid nodule (RN). Intracranial RN is extremely rare and its clinical course is not completely understood. In active RA patients, RNs should be considered, and histological diagnosis is inevitable for following suitable treatment. PMID:24140764

Takahashi, Mayu; Yamamoto, Junkoh; Idei, Masaru; Nakano, Yoshiteru; Soejima, Yoshiteru; Saito, Takeshi; Akiba, Daisuke; Nishizawa, Shigeru

2014-01-01

326

Circadian rhythm of serum interleukin-6 in rheumatoid arthritis  

Microsoft Academic Search

OBJECTIVES--To test the hypothesis of a diurnal variation in circulating levels of interleukin-6 (IL-6) and\\/or tumour necrosis factor-alpha (TNF-alpha) in rheumatoid arthritis and other inflammatory connective tissue diseases. METHODS--Serum levels of IL-6 and TNF-alpha were measured at three hour intervals from 7:30 to 22:30 in 48 patients with different rheumatic diseases as well as ten healthy controls. In four of

N G Arvidson; B Gudbjörnsson; L Elfman; A C Rydén; T H Tötterman; R Hällgren

1994-01-01

327

Animal models of rheumatoid arthritis and related inflammation  

Microsoft Academic Search

The major, extensively studied, experimentally-induced rat and mouse models of arthritis with features resembling rheumatoid\\u000a arthritis are reviewed here. Etiopathogenetic studies that were recently published are emphasized. In summary, multiple triggering\\u000a stimuli can induce disease in genetically-prone strains of inbred rats and mice. Multiple genetic loci, including both MHC\\u000a and non-MHC, regulate disease expression in these animals. By comparison with

Bina Joe; Marie M. Griffiths; Elaine F. Remmers; Ronald L. Wilder

1999-01-01

328

Assistive devices: usage in patients with rheumatoid arthritis  

Microsoft Academic Search

We describe the usage of various assistive devices and identify factors associated with usage in patients with rheumatoid\\u000a arthritis (RA). A cross-sectional, multicentre study was performed in three outpatient rheumatology clinics in the Netherlands.\\u000a Two hundred forty patients with RA participated in the study. The main measures were questionnaires and a semi-structured\\u000a interview regarding the possession and usage of 21

I. G. de Boer; A. J. Peeters; H. K. Ronday; B. J. A. Mertens; T. W. J. Huizinga; T. P. M. Vliet Vlieland

2009-01-01

329

Chronic eosinophilic pneumonia associated with an initiation of rheumatoid arthritis  

Microsoft Academic Search

Although peripheral blood eosinophilia is observed in patients with active inflammatory rheumatoid arthritis (RA), RA is not a recognised cause of pulmonary eosinophilia. We describe a 55-year-old woman affected by chronic eosinophilic pneumonia (CEP) concomitantly with an initiation of RA. Both diseases responded rapidly and completely to high-dose corticosteroid therapy. In this patient, the initiation of RA and CEP was

J.-J. Kwak; J.-E. Chang; J. Lee; Y.-J. Cho; S. H. Sung

2003-01-01

330

Conservative treatments for rheumatoid arthritis in the foot and ankle.  

PubMed

Rheumatoid arthritis (RA) is a systemic inflammatory disease that attacks peripheral joints, causing their destruction. Several pharmacologic therapies and physical modalities are available for its treatment. Because of the progressive nature of RA, complementary and alternative medicine therapy in conjunction with conventional medicine is administered to patients with RA. This article discusses the presence of undiagnosed RA in the foot and ankle and reviews the concurrent nonoperative measures in treatment, including pharmacologic and physical modalities. PMID:20470952

Anain, Joseph M; Bojrab, Angela R; Rhinehart, Francine C

2010-04-01

331

Rheumatoid arthritis and proteus: a possible aetiological association  

Microsoft Academic Search

The presence of specific anti-Proteus antibodies in active, rheumatoid arthritis (RA) patients, has been demonstrated by four different techniques: indirect bacterial agglutination, ELISA, Western blotting and immunofluorescence. Furthermore, anti-HLA-DR4 tissue typing sera have been shown to bind to Proteus microorganisms, thereby suggesting some molecular similarity or cross-reactivity between bacteria and HLA antigens. The concept is proposed that Proteus-reactive arthritis occurs

A. Ebringer; S. Khalafpour; C. Wilson

1989-01-01

332

Hemophagocytic syndrome in a patient with rheumatoid arthritis  

Microsoft Academic Search

A 76-year-old man with rheumatoid arthritis, who had been treated with oral prednisolone and methotrexate, presented with\\u000a high fever and generalized fatigability. Laboratory data demonstrated marked pancytopenia, which we first regarded as a side\\u000a effect of methotrexate, and leucovorin was administered with granulocyte-colony stimulating factor and transfusions. Because\\u000a no recovery was recognized, however, bone marrow aspiration was performed, by which

Hideki Tsuboi; Hirokazu Iwata; Akihide Nampei; Masato Matsushita; Kenrin Shi

333

25(OH) vitamin D serum values and rheumatoid arthritis disease activity (DA S28 ESR)  

PubMed Central

Background: The role of vitamin D in the pathogenesis of rheumatoid arthritis is under investigation. This study was designed to evaluate the correlation between serum values of 25(OH) vitamin D [25(OH)D] and disease activity in rheumatoid arthritis (RA) patients according to Disease Activity Score 28 joints and ESR (DA S28 ESR). Methods: Ninety-nine patients according to ACR classification criteria for RA and 68 healthy controls were included in this study. The participants with known confounding risk factors affecting serum values of 25(OH)D were excluded. All patients were under treatment with supplementary calcium carbonate (1500mg), 25(OH)D (800U), and Hydroxychloroquine (6mg/kg). The control group was mostly recruited from patients’ relatives who lived with them to minimize the impact of diverse lifestyles on 25(OH)D status. Disease activity was assessed by DA S28 ESR. Serum concentrations of 25(OH)D were measured. Serum values of 25(OH)D less than 50 nmol/L were considered 25(OH)D deficiency. Results: The mean 25(OH)D serum values were 83.74±46.45 nmol/L in patients and 46.53±34.07 nmol/L in controls. After adjustment for age, sex and BMI, multivariate analysis showed no correlation between 25(OH)D serum levels and DAS in RA (P=0.29, rp=0.11). However, 25(OH)D serum values were significantly lower in patients with early diagnosed RA compared with the other patients (p=0.012). In the early diagnosed patients, 25(OH)D and anti-CCP serum values were negatively correlated (P=0.04, rs=-0.5). Conclusion: This study showed that there was no correlation between 25(OH)D serum values and DAS over a short duration of disease course. However, in early RA, 25(OH) D serum values were lower than the established RA. PMID:25202442

Sahebari, Maryam; Mirfeizi, Zahra; Rezaieyazdi, Zahra; Rafatpanah, Houshang; Goshyeshi, Ladan

2014-01-01

334

Simulating the formation of massive seed black holes in the early Universe. I: An improved chemical model  

E-print Network

The direct collapse model for the formation of massive seed black holes in the early Universe attempts to explain the observed number density of supermassive black holes (SMBHs) at $z \\sim 6$ by assuming that they grow from seeds with masses M > 10000 solar masses that form by the direct collapse of metal-free gas in atomic cooling halos in which H2 cooling is suppressed by a strong extragalactic radiation field. The viability of this model depends on the strength of the radiation field required to suppress H2 cooling, $J_{\\rm crit}$: if this is too large, then too few seeds will form to explain the observed number density of SMBHs. In order to determine $J_{\\rm crit}$ reliably, we need to be able to accurately model the formation and destruction of H2 in gas illuminated by an extremely strong radiation field. In this paper, we use a reaction-based reduction technique to analyze the chemistry of H2 in these conditions, allowing us to identify the key chemical reactions that are responsible for determining the...

Glover, Simon

2015-01-01

335

Psychological factors associated with response to treatment in rheumatoid arthritis.  

PubMed

This paper presents a comprehensive review of research relating psychological domains with response to therapy in patients with rheumatoid arthritis. A holistic approach to the disease was adopted by incorporating not only disease activity but also dimensions of the impact of disease on patients' lives. Psychological distress, including depression and anxiety, is common among patients with rheumatoid arthritis and has a significant negative impact on response to therapy and on patients' abilities to cope with chronic illness. Evidence regarding the influence of positive psychological dimensions such as acceptance, optimism, and adaptive coping strategies is scarce. The mechanisms involved in these interactions are incompletely understood, although changes in neuro-endocrine-immune pathways, which are common to depression and rheumatoid arthritis, seem to play a central role. Indirect psychological influences on therapeutic efficacy and long-term effectiveness include a myriad of factors such as adherence, placebo effects, cognition, coping strategies, and family and social support. Data suggest that recognition and appropriate management of psychological distress may improve response to treatment and significantly reduce disease burden. PMID:25163734

Santiago, T; Geenen, R; Jacobs, J W G; Da Silva, J A P

2015-01-01

336

Tocilizumab improves systemic rheumatoid vasculitis with necrotizing crescentic glomerulonephritis.  

PubMed

Abstract We report a Japanese woman with systemic rheumatoid vasculitis (SRV) complicated by necrotizing crescentic glomerulonephritis (NCGN). Rheumatoid arthritis first occurred at the age of 19 years, followed by interstitial pneumonia, hepatitis, rheumatoid nodules, mononeuritis multiplex, and hypocomplementemia in chronological order. At the age of 51 years, rapidly progressive renal failure occurred with nephrotic proteinuria, and NCGN with subepithelial deposits was revealed by renal biopsy. Severe destructive changes of multiple joints and scleritis were detected, but anti-neutrophil cytoplasmic antibody was negative on enzyme-linked immunosorbent assays and indirect immunofluorescence. SRV was diagnosed due to involvement of multiple extra-articular organs. An anti-interleukin (IL)-6 receptor antibody (tocilizumab) was started at dosage of 280 mg (8 mg/kg) monthly. After 18 months, her serum creatinine decreased from 1.7 to 1.3 mg/dL, and urinary protein excretion declined from 5.2 to 1.2 g daily. Tocilizumab may be a therapeutic option for SRV associated with NCGN. PMID:24533557

Iijima, Takashi; Suwabe, Tatsuya; Sumida, Keiichi; Hayami, Noriko; Hiramatsu, Rikako; Hasegawa, Eiko; Yamanouchi, Masayuki; Hoshino, Junichi; Sawa, Naoki; Takaichi, Kenmei; Oohashi, Kenichi; Fujii, Takeshi; Ubara, Yoshifumi

2015-01-01

337

[Osteocalcin and anomalies of cellular immunity in rheumatoid polyarthritis].  

PubMed

Spinal and peripheral skeletal demineralisation is sometimes observed in rheumatoid arthritis (RA). Numerous studies have shown the role of osteoclasts in its genesis, but few studies have been conducted to demonstrate a functional anomaly of osteoblasts. Synthesized by osteoblasts, osteocalcin enables to approach the osteoblastic activity, through titration of its serum level. In 31 patients suffering from erosive classical RA, we titrated the serum osteocalcin. In 9 cases, we found a definite decrease of the serum osteocalcin levels. There was a statistically significant difference between these 9 patients and the 21 others, in the presence of anomalies of the CD4/CD8 lymphocytic ratio, the presence of extra-articular manifestations, a high level of rheumatoid factors, class IgM, with an immuno-enzymatic technique. On the contrary, there was no difference regarding the mean duration of the RA course, the mean age, calcemia, and alkaline phosphatases level. Thus, in the course of severe clinical and immunological rheumatoid arthritis, an anomaly of cellular immunity was observed associated with abnormal serum osteocalcin levels. The exact mechanism of this decrease remains to be specified. Other prospective studies are necessary to confirm this preliminary research. PMID:3262913

Fouquet, B; Valat, C; Bergemer, A M; Goupille, P; Valat, J P; Besnard, J C

1988-06-01

338

Intensive intervention can lead to a treatment holiday from biological DMARDs in patients with rheumatoid arthritis.  

PubMed

Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by inflammation and joint destruction that causes significant morbidity and mortality. However, the combined use of methotrexate (MTX), a synthetic disease-modifying anti-rheumatic drug (sDMARD) and biological DMARDs (bDMARDs) has revolutionized treatment of RA and clinical remission or low disease activity (LDA) are now realistic targets, achieved by a large proportion of RA patients. We are now in a position to evaluate if it is possible to maintain remission or LDA while at the same time reducing the burden of treatment on the patient and healthcare system. Data are emerging from large, well-conducted studies designed to answer this question, shedding light on which patient populations and treatment algorithms can survive treatment discontinuation or tapering with low risk of disease flare. For early RA, approximately half of early RA patients could discontinue TNF-targeted bDMARDs without clinical flare and functional impairment after obtaining clinical remission by bDMARDs with MTX. In contrast, for established RA, fewer patients sustained remission or LDA after the discontinuation of bDMARDs and "deep remission" at the discontinuation was a key factor to maintain the treatment holiday of bDMARDs. Thus, this article provides a brief outline on withdrawing or tapering bDMARDs once patients have achieved remission or LDA in RA. PMID:25389048

Tanaka, Yoshiya; Hirata, Shintaro

2014-12-01

339

Biochemical markers of ongoing joint damage in rheumatoid arthritis - current and future applications, limitations and opportunities  

PubMed Central

Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease associated with potentially debilitating joint inflammation, as well as altered skeletal bone metabolism and co-morbid conditions. Early diagnosis and aggressive treatment to control disease activity offers the highest likelihood of preserving function and preventing disability. Joint inflammation is characterized by synovitis, osteitis, and/or peri-articular osteopenia, often accompanied by development of subchondral bone erosions, as well as progressive joint space narrowing. Biochemical markers of joint cartilage and bone degradation may enable timely detection and assessment of ongoing joint damage, and their use in facilitating treatment strategies is under investigation. Early detection of joint damage may be assisted by the characterization of biochemical markers that identify patients whose joint damage is progressing rapidly and who are thus most in need of aggressive treatment, and that, alone or in combination, identify those individuals who are likely to respond best to a potential treatment, both in terms of limiting joint damage and relieving symptoms. The aims of this review are to describe currently available biochemical markers of joint metabolism in relation to the pathobiology of joint damage and systemic bone loss in RA; to assess the limitations of, and need for additional, novel biochemical markers in RA and other rheumatic diseases, and the strategies used for assay development; and to examine the feasibility of advancement of personalized health care using biochemical markers to select therapeutic agents to which a patient is most likely to respond. PMID:21539724

2011-01-01

340

The differentiation of anaemia in rheumatoid arthritis: parameters of iron-deficiency in an Indian rheumatoid arthritis population  

Microsoft Academic Search

Iron deficiency anaemia (IDA) is common in Indian patients with rheumatoid arthritis (RA). We evaluated red blood cell indices,\\u000a serum iron related and bone marrow iron stores measurements in diagnosing iron deficiency in patients with RA. Fifty consecutive\\u000a anaemic patients with RA had their complete blood counts, red cell indices, serum iron, serum ferritin and serum total iron\\u000a binding capacity

Vinod Ravindran; Sandeep Jain; Dinesh S. Mathur

2008-01-01

341

Explaining the cardiovascular risk associated with rheumatoid arthritis: traditional risk factors versus markers of rheumatoid arthritis severity  

Microsoft Academic Search

BackgroundCardiovascular (CV) disease has a major impact on patients with rheumatoid arthritis (RA), however, the relative contributions of traditional CV risk factors and markers of RA severity are unclear. The authors examined the relative importance of traditional CV risk factors and RA markers in predicting CV events.MethodsA prospective longitudinal cohort study was conducted in the setting of the CORRONA registry

Daniel H Solomon; Joel Kremer; Jeffrey R Curtis; Marc C Hochberg; George Reed; Peter Tsao; Michael E Farkouh; Soko Setoguchi; Jeffrey D Greenberg

2010-01-01

342

The effects of simulated solar UVB radiation on early developmental stages of the Northwestern Salamander (Ambystoma gracile) from three lakes  

USGS Publications Warehouse

Solar ultraviolet radiation (UV) has received much attention as a factor that could play a role in amphibian population declines. UV can be hazardous to some amphibians, but the resultant effects depend on a variety of environmental and behavioral factors. In this study, the potential effects of UV on the Northwestern Salamander, Ambystoma gracile, from three lakes were assessed in the laboratory using a solar simulator. We measured the survival of embryos and the survival and growth of larvae exposed to four UV treatments in controlled laboratory studies, the UV absorbance of egg jelly, oviposition depths in the lakes, and UV absorbance in water samples from the three lakes. Hatching success of embryos decreased in the higher UV treatments as compared to the control treatments, and growth of surviving larvae was significantly reduced in the higher UVB irradiance treatments. The egg jelly exhibited a small peak of absorbance within the UVB range (290–320 nm). The magnitude of UV absorbance differed among egg jellies from the three lakes. Oviposition depths at the three sites averaged 1.10 m below the water surface. Approximately 66% of surface UVB radiation was attenuated at 10-cm depth in all three lakes. Results of this study indicate that larvae may be sensitive to UVB exposure under laboratory conditions; however, in field conditions the depths of egg deposition in the lakes, absorbance of UV radiation by the water column, and the potential for behavioral adjustments may mitigate severe effects of UV radiation.

Calfee, Robin D.; Little, Edward E.; Pearl, Christopher A.; Hoffman, Robert L.

2010-01-01

343

The impact of rheumatoid foot on disability in Colombian patients with rheumatoid arthritis  

PubMed Central

Background Alterations in the feet of patients with rheumatoid arthritis (RA) are a cause of disability in this population. The purpose of this research was to evaluate the impact that foot impairment has on the patients' global quality of life (QOL) based on validated scales and its relationship to disease activity. Methods This was a cross-sectional study in which 95 patients with RA were enrolled. A complete physical examination, including a full foot assessment, was done. The Spanish versions of the Health Assessment Questionnaire (HAQ) Disability Index and of the Disease Activity Score (DAS 28) were administered. A logistic regression model was used to analyze data and obtain adjusted odds ratios (AORs). Results Foot deformities were observed in 78 (82%) of the patients; hallux valgus (65%), medial longitudinal arch flattening (42%), claw toe (lesser toes) (39%), dorsiflexion restriction (tibiotalar) (34%), cock-up toe (lesser toes) (25%), and transverse arch flattening (25%) were the most frequent. In the logistic regression analysis (adjusted for age, gender and duration of disease), forefoot movement pain, subtalar movement pain, tibiotalar movement pain and plantarflexion restriction (tibiotalar) were strongly associated with disease activity and disability. The positive squeeze test was significantly associated with disability risk (AOR = 6,3; 95% CI, 1.28–30.96; P = 0,02); hallux valgus, and dorsiflexion restriction (tibiotalar) were associated with disease activity. Conclusion Foot abnormalities are associated with active joint disease and disability in RA. Foot examinations provide complementary information related to the disability as an indirect measurement of quality of life and activity of disease in daily practice. PMID:19527518

Rojas-Villarraga, Adriana; Bayona, Javier; Zuluaga, Natalia; Mejia, Santiago; Hincapie, Maria-Eugenia; Anaya, Juan-Manuel

2009-01-01

344

Lower Serum Androstenedione Levels in Pre-Rheumatoid Arthritis versus Normal Control Women: Correlations with Lower Serum Cortisol Levels  

PubMed Central

Serum adrenal androgens (AAs), including androstenedione (?4A) and dehydroepiandrosterone sulfate (DHEAS), have been reported to be lower in female rheumatoid arthritis (RA) patients with early disease. Few data are available on hormonal status of women before the onset of clinical rheumatoid arthritis (pre-RA). A broad baseline panel of serum adrenal and sex steroids was compared in 36 female pre-RA to 144 matched cohort control (CN) subjects to determine differences in their mean values and in patterns of hormonal correlations. Study subjects having lower versus higher baseline serum cortisol levels than the total group's mean value were also analyzed separately to investigate differences in their hormonal levels and correlational patterns. In total subjects, mean (±SE) ?4A level (nmol/L) was lower (P = 0.018) in 28 pre-RA cases (6.4 ± 0.40) versus 108 CN (7.8 ± 0.28). The significant (P = 0.013) difference was restricted to 9 pre-RA versus 53?CN subjects having lower cortisol levels (5.6 ± 0.73 versus 8.0 ± 0.42?nmol/L, resp.). In total subjects, no significant difference was found between study subjects in their bivariate correlations of the hormonal panel variables, unlike results found in the subgroups stratified by lower versus higher cortisol levels. A subgroup of pre-RA females may have relative adrenal cortical insufficiency, as reflected by lower ?4A, especially observed among those subjects with lower cortisol levels. PMID:23762532

Masi, Alfonse T.; Elmore, Kevin B.; Rehman, Azeem A.; Chatterton, Robert T.; Goertzen, Ned J.; Aldag, Jean C.

2013-01-01

345

Red cell ferritin content: a re-evaluation of indices for iron deficiency in the anaemia of rheumatoid arthritis  

Microsoft Academic Search

In iron deficiency anaemia basic red cell content of ferritin is appreciably reduced. This variable was determined in 62 patients with rheumatoid arthritis to evaluate conventional laboratory indices for iron deficiency in the anaemia of rheumatoid arthritis. For 23 patients with rheumatoid arthritis and normocytic anaemia irrespective of plasma ferritin concentration, red cell ferritin content did not differ significantly from

A Davidson; M B Van der Weyden; H Fong; M J Breidahl; P F Ryan

1984-01-01

346

Detection of Luse bodies, spiralled collagen, dysplastic collagen, and intracellular collagen in rheumatoid connective tissues: an electron microscopic study  

Microsoft Academic Search

BACKGROUND--Rheumatoid arthritis is a chronic inflammatory disease leading to alterations of the extracellular matrix in tendons, ligaments, and cartilage. The structural changes of the collagenous systems in rheumatoid connective tissues are largely unknown, however. METHODS--Thirty four samples of menisci, 36 cruciate ligaments, and four tendons were taken during joint surgery in patients with rheumatoid arthritis. Eighteen menisci, 35 ligaments, and

M F Neurath

1993-01-01

347

Effects of simulated solar UVB radiation on early developmental stages of the northwestern salamander (Ambystoma gracile) from three lakes  

USGS Publications Warehouse

Solar ultraviolet radiation (UV) has received much attention as a factor that could play a role in amphibian population declines. UV can be hazardous to some amphibians, but the resultant effects depend on a variety of environmental and behavioral factors. In this study, the potential effects of UV on the Northwestern Salamander, Ambystoma gracile, from three lakes were assessed in the laboratory using a solar simulator. We measured the survival of embryos and the survival and growth of larvae exposed to four UV treatments in controlled laboratory studies, the UV absorbance of egg jelly, oviposition depths in the lakes, and UV absorbance in water samples from the three lakes. Hatching success of embryos decreased in the higher UV treatments as compared to the control treatments, and growth of surviving larvae was significantly reduced in the higher UVB irradiance treatments. The egg jelly exhibited a small peak of absorbance within the UVB range (290-320 nm). The magnitude of UV absorbance differed among egg jellies from the three lakes. Oviposition depths at the three sites averaged 1.10 m below the water surface. Approximately 66 of surface UVB radiation was attenuated at 10-cm depth in all three lakes. Results of this study indicate that larvae may be sensitive to UVB exposure under laboratory conditions; however, in field conditions the depths of egg deposition in the lakes, absorbance of UV radiation by the water column, and the potential for behavioral adjustments may mitigate severe effects of UV radiation. Copyright 2010 Society for the Study of Amphibians and Reptiles.

Calfee, R.D.; Little, E.E.; Pearl, C.A.; Hoffman, R.L.

2010-01-01

348

Low-mass galaxy assembly in simulations: regulation of early star formation by radiation from massive stars  

NASA Astrophysics Data System (ADS)

Despite recent success in forming realistic present-day galaxies, simulations still form the bulk of their stars earlier than observations indicate. We investigate the process of stellar mass assembly in low-mass field galaxies, a dwarf and a typical spiral, focusing on the effects of radiation from young stellar clusters on the star formation (SF) histories. We implement a novel model of SF with a deterministic low efficiency per free-fall time, as observed in molecular clouds. Stellar feedback is based on observations of star-forming regions, and includes radiation pressure from massive stars, photoheating in H II regions, supernovae and stellar winds. We find that stellar radiation has a strong effect on the formation of low-mass galaxies, especially at z > 1, where it efficiently suppresses SF by dispersing cold and dense gas, preventing runaway growth of the stellar component. This behaviour is evident in a variety of observations but had so far eluded analytical and numerical models without radiation feedback. Compared to supernovae alone, radiation feedback reduces the SF rate by a factor of ˜100 at z ? 2, yielding rising SF histories which reproduce recent observations of Local Group dwarfs. Stellar radiation also produces bulgeless spiral galaxies and may be responsible for excess thickening of the stellar disc. The galaxies also feature rotation curves and baryon fractions in excellent agreement with current data. Lastly, the dwarf galaxy shows a very slow reduction of the central dark matter density caused by radiation feedback over the last ˜7 Gyr of cosmic evolution.

Trujillo-Gomez, Sebastian; Klypin, Anatoly; Colín, Pedro; Ceverino, Daniel; Arraki, Kenza S.; Primack, Joel

2015-01-01

349

Rheumatoid factor and anti-citrullinated protein antibody positivity, but not level, are associated with increased mortality in patients with rheumatoid arthritis: results from two large independent cohorts.  

PubMed

IntroductionTo investigate rheumatoid factor (RF) and anti-citrullinated protein antibody (ACPA) status and levels as predictors of mortality in two large cohorts of patients with early inflammatory arthritis (EIA).MethodsData from the Norfolk Arthritis Register (NOAR) and Leiden Early Arthritis Clinic (EAC) cohorts were used. At baseline, patients had demographic data and smoking status recorded; RF, ACPA and inflammatory markers were measured in the local laboratories. Patients were flagged with national death registers until death or censor date. Antibody status was stratified as negative, low or high positive by RF and ACPA levels individually. In addition, patients were grouped as seronegative, RF positive, ACPA positive or double antibody (RF and ACPA) positive. Cox regression models explored associations between antibody status and mortality adjusting for age, sex, smoking status, inflammatory markers and year of enrolment.Results4962 (NOAR:3053, EAC:1909) patients were included, 64% were female. Median age at onset was 56 (NOAR) and 54 (EAC) years. 35% and 42% of patients were ACPA/RF positive in NOAR and EAC respectively. When antibody status was stratified as negative, low or high positive, there were no consistent findings between the two cohorts. Double antibody positivity was associated with excess mortality in both cohorts compared to seronegative patients: NOAR and EAC respective adjusted HR (95% CI): 1.35 (1.09-1.68) and 1.58 (1.16-2.15).ConclusionsPatients with EIA who are seropositive for both RF and ACPA have increased mortality compared to those who are single positive or seronegative. Antibody level in seropositive patients was not consistently associated with excess mortality. PMID:25471696

Humphreys, Jennifer H; van Nies, Jessica; Chipping, Jackie; Marshall, Tarnya; Mil, Annette; Symmons, Deborah; Verstappen, Suzanne

2014-12-01

350

Adalimumab for Rheumatoid Arthritis: Considerations for Reimbursement by Third-Party Payors  

Microsoft Academic Search

Third-party payors and national health systems require evidence that new medications for rheumatoid arthritis are cost effective. To determine cost effectiveness, one must consider the cost of a given therapy versus the long-term cost of the disease, with and without therapy. The direct and indirect costs of rheumatoid arthritis over the course of the disease, including the considerable costs related

Leo van de Putte; Michael B. Nichol

2004-01-01

351

Rheumatoid Arthritis Treatment and Causes | NIH MedlinePlus the Magazine  

MedlinePLUS

... this page please turn JavaScript on. Feature: Understanding Rheumatoid Arthritis (RA) Treatment and Causes Past Issues / Summer 2014 Table of ... quality of life. Self-management programs teach about rheumatoid arthritis ... exercise and relaxation approaches, communication between patients and ...

352

Methotrexate and mortality in patients with rheumatoid arthritis: a prospective study  

Microsoft Academic Search

Summary Background Methotrexate is the most frequent choice of disease-modifying antirheumatic therapy for rheumatoid arthritis. Although results of studies have shown the efficacy of such drugs, including methotrexate, on rheumatoid arthritis morbidity measures, their effect on mortality in patients with the disease remains unknown. Our aim was to prospectively assess the effect on mortality of methotrexate in a cohort of

Hyon K Choi; Miguel A Hernán; John D Seeger; James M Robins; Frederick Wolfe

2002-01-01

353

Efficacy of B-Cell–Targeted Therapy with Rituximab in Patients with Rheumatoid Arthritis  

Microsoft Academic Search

background An open-label study indicated that selective depletion of B cells with the use of rituxi- mab led to sustained clinical improvements for patients with rheumatoid arthritis. To confirm these observations, we conducted a randomized, double-blind, controlled study. methods We randomly assigned 161 patients who had active rheumatoid arthritis despite treat- ment with methotrexate to receive one of four treatments:

Jonathan C. W. Edwards; Leszek Szczepa?ski; Jacek Szechi?ski; Anna Filipowicz-Sosnowska; Paul Emery; David R. Close; Randall M. Stevens; Tim Shaw

2004-01-01

354

Peripheral ulcerative keratitis in the setting of rheumatoid arthritis: Treatment with immunosuppressive therapy  

Microsoft Academic Search

Peripheral ulcerative keratitis (PUK) is a rare but serious inflammatory eyecondition that can complicate rheumatoid arthritis. PUK can be a warning sign of impending vasculitis, and cytotoxic therapy may be necessary to induce remission. We have encountered three patients with PUK in the past year. Two patients had long-standing quiescent rheumatoid arthritis who developed photophobia. Diagnosis was made by slit

Haitham Jifi-Bahlool; Constantine Saadeh; James O'Conner

1995-01-01

355

La medicina complementare nell'artrite reumatoide Complementary medicine in rheumatoid arthritis  

Microsoft Academic Search

SUMMARY Use of complementary and alternative medicine (CAM) for chronic conditions has increased in recent years. CAM is immensely popular for musculoskeletal conditions and patients suffering from rheumatoid arthritis (RA) frequently try CAM. This review summarises the trial data for or against CAM as a symptomatic treatment for rheumatoid arthritis. Collectively the evidence demonstrates that some CAM modalities show significant

P. Sarzi-Puttini; F. Atzeni; E. Lubrano

356

Nodular, non-cirrhotic liver associated with portal hypertension in a patient with rheumatoid arthritis  

Microsoft Academic Search

A patient with rheumatoid arthritis developed portal hypertension and died from bleeding oesophageal varices. The liver was small and showed a nodular, non-cirrhotic pattern similar to that described by Blendis et al (1970 and 1974) in association with Felty's syndrome. This appears to be the first report of a patient with this liver lesion associated with rheumatoid arthritis in the

M. Harris; R. M. Rash; I. W. Dymock

1974-01-01

357

The utility of clinical decision tools for diagnosing osteoporosis in postmenopausal women with rheumatoid arthritis  

Microsoft Academic Search

BACKGROUND: Patients with rheumatoid arthritis have a higher risk of low bone mineral density than normal age matched populations. There is limited evidence to support cost effectiveness of population screening in rheumatoid arthritis and case finding strategies have been proposed as a means to increase cost effectiveness of diagnostic screening for osteoporosis. This study aimed to assess the performance attributes

Caroline Brand; Adrian Lowe; Stephen Hall

2008-01-01

358

Involvement of valgus hindfoot deformity in hallux valgus deformity in rheumatoid arthritis.  

PubMed

The involvement of valgus hindfoot deformity in hallux valgus deformity was confirmed in a rheumatoid arthritis case with a destructive valgus hindfoot deformity. Correction of severe valgus, calcaneal lateral offset, and pronated foot deformity instantly normalized hallux valgus deformities postoperatively. Thus, careful hindfoot status evaluation is important when assessing forefoot deformity, including hallux valgus, in rheumatoid arthritis cases. PMID:24533550

Yamada, Shutaro; Hirao, Makoto; Tsuboi, Hideki; Akita, Shosuke; Matsushita, Masato; Ohshima, Shiro; Saeki, Yukihiko; Hashimoto, Jun

2014-09-01

359

Effect of circulating immune complexes on the binding of rheumatoid factor to histones  

Microsoft Academic Search

OBJECTIVETo determine whether the reaction of rheumatoid factor (RF) with solid phase histone is due to the simultaneous presence of circulating immune complexes (CICs) or aggregated IgG.METHODSSerum samples from 56 patients with seropositive rheumatoid arthritis (RA) and 50 random blood bank donors were used. Binding of immunoglobulins to histone was determined by enzyme linked immunosorbent assay (ELISA) and by western

Hélène A Elicha Gussin; Katherine L Russo; Marius Teodorescu

2000-01-01

360

Are static resting wrist splints beneficial in early RA?  

Microsoft Academic Search

In a randomized controlled trial, Adams et al. compared the effectiveness of static resting wrist splints plus occupational therapy with occupational therapy alone in 120 patients with early rheumatoid arthritis. Self-reported adherence with splint wear was moderate, with 24.5% of patients reporting that they had never worn the splints over the 12-month study period. Except for a small benefit of

Theodora PM Vliet Vlieland

2009-01-01

361

Finalisation and validation of the rheumatoid arthritis impact of disease score, a patient-derived composite measure of impact of rheumatoid arthritis: a EULAR initiative  

Microsoft Academic Search

ObjectiveA patient-derived composite measure of the impact of rheumatoid arthritis (RA), the rheumatoid arthritis impact of disease (RAID) score, takes into account pain, functional capacity, fatigue, physical and emotional wellbeing, quality of sleep and coping. The objectives were to finalise the RAID and examine its psychometric properties.MethodsAn international multicentre cross-sectional and longitudinal study of consecutive RA patients from 12 European

L. Gossec; S. Paternotte; G. J. Aanerud; A. Balanescu; D. T. Boumpas; L. Carmona; M de Wit; B. A. C. Dijkmans; M. Dougados; M. Englbrecht; F. Gogus; T. Heiberg; C. Hernandez; J. R. Kirwan; E Martin Mola; M Matucci Cerinic; K. Otsa; G. Schett; M. Scholte-Voshaar; T. Sokka; G von Krause; G. A. Wells; T. K. Kvien

2011-01-01

362

A transient peak of infections during onset of rheumatoid arthritis: a 10-year prospective cohort study  

PubMed Central

Objectives The role of infection in rheumatoid arthritis (RA) has not been determined. We aimed to document the infectious burden and some aspects of antibacterial immunity in a large and prospective cohort study of RA patients in the early and late stages of the disease and in their relatives predisposed to RA. Setting Clinical and laboratory examination of all individuals enrolled in the study was performed in the Republican Clinical Hospital, Kazan, Russia. Participants 376 patients with RA, 251 healthy first-degree relatives and 227 healthy controls without a family history of autoimmune disease (all females) were examined twice annually over more than 10?years. Primary and secondary outcome measures The following parameters were investigated: type, duration and frequency of infections, bacterial colonisation and serum levels of IgG to bacteria, serum levels of total Ig, plasma cytokine levels, granulocyte reactive oxygen species production, lysozyme activity and phagocytosis. Results There were no significant differences in infection rate between healthy controls (median 14?days/year) and RA patients (13). However, infection rates were higher (p<0.001) in healthy relatives (53) and early stage patients (62), which groups also showed heavy bacterial skin colonisation. In contrast, late stage patients had fewer infection days (12; p<0.001) than healthy controls, although bacterial colonisation was still heavy. Phagocyte function and antibacterial antibody generation, together with compensatory cytokine production, were observed to be subnormal in the healthy relatives as well as in RA patients. Conclusions We observed a marked increase in overall infections at the time of RA onset, and signs of a defective antibacterial defence mechanism, contrasting with fewer infections in the late RA stage. It can be speculated that frequent early infections initiate a compensatory immune hyper-reactivity which reduces the infection load while stimulating the development of RA in predisposed individuals. PMID:25180052

Arleevskaya, Marina I; Gabdoulkhakova, Aida G; Filina, Yulia V; Miftakhova, Regina R; Bredberg, Anders; Tsybulkin, Anatoly P

2014-01-01

363

Bone metabolism in rheumatoid arthritis compared with postmenopausal osteoporosis.  

PubMed Central

Calcium and bone metabolism in 29 rheumatoid arthritis (RA) patients were compared with those in 27 postmenopausal osteoporotic patients. Signs of vitamin D deficiency were found in 20 RA patients, including 12 who took recommended amounts of vitamin D in their diets and were exposed to sufficient sunlight, and in none of the osteoporotic patients. There were no signs of malabsorption. In six out of 15 patients we found increased liver enzyme activity, which may have a role in vitamin D metabolism. We propose the influence of non-steroidal anti-inflammatory drugs (NSAIDs) on vitamin D metabolism in the liver as a possible explanation. PMID:3947143

van Soesbergen, R M; Lips, P; van den Ende, A; van der Korst, J K

1986-01-01

364

Cardiovascular complications of Rheumatoid Arthritis - Assessment, prevention and treatment  

PubMed Central

Synopsis Morbidity and mortality rates are higher in individuals with rheumatoid arthritis (RA) than in the general population. Ischemic heart disease and heart failure now represent one of the most common causes of death in RA. Indeed, RA appears to represent an independent risk factor for ischemic heart disease, similar to diabetes mellitus. However, no clear guidelines with regards to cardiovascular disease diagnosis and prevention in RA have been developed. This review highlights recent investigations on the assessment, prevention and treatment of cardiovascular disease in RA. PMID:20510241

Kaplan, Mariana J.

2010-01-01

365

iRHOM2 takes control of rheumatoid arthritis  

PubMed Central

The cytokine TNF-? is a major drug target for rheumatoid arthritis, an inflammatory joint disorder. An alternative approach is to target the protease TNF-? convertase (TACE), which releases TNF-? from cells. However, because TACE cleaves other proteins involved in development and cancer, a tissue-specific inhibition of TACE in immune cells appears mandatory. In this issue of the JCI, Issuree et al. report that iRHOM2 is a TACE activator in immune cells. Loss of iRHOM2 largely protects mice from inflammatory arthritis, making iRHOM2 a potential drug target for this condition. PMID:23348732

Lichtenthaler, Stefan F.

2013-01-01

366

Potential food-drug interactions in patients with rheumatoid arthritis.  

PubMed

Various medications are used for the treatment of rheumatoid arthritis (RA). Food-drug interactions may occur with concomitant ingestion of particular food. For example, methotrexate (MTX), the anchor drug in the therapeutic strategy against RA, is an antifolate agent. Excessive presence or absence of dietary folic acid may regulate MTX metabolism, possibly leading to unexpected adverse reactions. In this review, we focus on MTX, isoniazide and calcineurin inhibitors, and the implications of potential food-drug reactions in rheumatology, suggesting the important role of nutritional evaluations in RA patients. PMID:23773634

Masuko, Kayo; Tohma, Shigeto; Matsui, Toshihiro

2013-04-01

367

Spontaneous "spaghetti" flexor tendon ruptures in the rheumatoid wrist.  

PubMed

A 54-year-old woman who had been treated for rheumatoid arthritis for 12 years developed spontaneous multiple flexor tendon ruptures during a 5-month period. Radiography revealed volar subluxation of the lunate bone. Surgery was performed 5 months after the first onset of tendon rupture. All eight flexors, except the flexor pollicis longus tendons, had ruptured, and the damage resembled spaghetti. Four flexor digitorum profundus tendons were reconstructed by bridge graft using their respective sublimis tendons. Wrist joint fusion and tenolysis were performed 3 months after the first operation. Each finger achieved a good range of motion 2 years and 6 months after the second operation. PMID:17143686

Hashizume, Hiroyuki; Nishida, Keiichiro; Fujiwara, Kazuo; Inoue, Hajime

2004-01-01

368

A study of the early-stage evolution of relativistic electron-ion shock using three-dimensional particle-in-cell simulations  

SciTech Connect

We report the results of a 3D particle-in-cell simulation carried out to study the early-stage evolution of the shock formed when an unmagnetized relativistic jet interacts with an ambient electron-ion plasma. Full-shock structures associated with the interaction are observed in the ambient frame. When open boundaries are employed in the direction of the jet, the forward shock is seen as a hybrid structure consisting of an electrostatic shock combined with a double layer, while the reverse shock is seen as a double layer. The ambient ions show two distinct features across the forward shock: a population penetrating into the shocked region from the precursor region and an accelerated population escaping from the shocked region into the precursor region. This behavior is a signature of a combination of an electrostatic shock and a double layer. Jet electrons are seen to be electrostatically trapped between the forward and reverse shock structures showing a ring-like distribution in a phase-space plot, while ambient electrons are thermalized and become essentially isotropic in the shocked region. The magnetic energy density grows to a few percent of the jet kinetic energy density at both the forward and the reverse shock transition layers in a rather short time scale. We see little disturbance of the jet ions over this time scale.

Choi, E. J.; Min, K.; Choi, C. R. [Korea Advanced Institute of Science and Technology, Daejeon 305-701 (Korea, Republic of); Nishikawa, K.-I. [Department of Physics, ZP12, University of Alabama in Huntsville, Huntsville, Alabama 35899 (United States)

2014-07-15

369

The effects of galaxy shape and rotation on the X-ray haloes of early-type galaxies - II. Numerical simulations  

NASA Astrophysics Data System (ADS)

By means of high-resolution 2D hydrodynamical simulations, we study the evolution of the hot interstellar medium (ISM) for a large set of early-type galaxy models, characterized by various degrees of flattening and internal rotation. The galaxies are described by state-of-the-art axisymmetric two-component models, tailored to reproduce real systems; the dark matter haloes follow the Navarro-Frenk-White or the Einasto profile. The gas is produced by the evolving stars, and heated by Type Ia supernovae. We find that, in general, the rotation field of the ISM in rotating galaxies is very similar to that of the stars, with a consequent negligible heating contribution from thermalization of the ordered motions. The relative importance of flattening and rotation in determining the final X-ray luminosity LX and temperature TX of the hot haloes is a function of the galactic mass. Flattening and rotation in low-mass galaxies favour the establishment of global winds, with the consequent reduction of LX. In medium- to high-mass galaxies, flattening and rotation are not sufficient to induce global winds; however, in the rotating models, the nature of the gas flows is deeply affected by conservation of angular momentum, resulting in a reduction of both LX and TX.

Negri, Andrea; Posacki, Silvia; Pellegrini, Silvia; Ciotti, Luca

2014-12-01

370

Identifying Target Areas of Treatment for Depressed Early Inflammatory Arthritis Patients  

Microsoft Academic Search

Background: The goal of this study was to identify target areas for psychosocial intervention for depressed patients with earlyinflammatory arthritis. Methods:One hundred and sixty-five patients with early inflammatory arthritis (?1 joint with synovitis for ?6 weeks and <1 year with a diagnosis of either rheumatoid or undifferentiated inflammatory arthritis) were referred to the McGill Early Arthritis Registry (McEAR) by their

Patricia L. Dobkin; Marta Filipski; Karl Looper; Orit Schieir; Murray Baron

2008-01-01

371

Metacarpal Index Estimated by Digital X-ray Radiogrammetry as a Tool for Differentiating Rheumatoid Arthritis Related Periarticular Osteopenia  

PubMed Central

To investigate Metacarpal Index (MCI) and Bone Mineral Density (BMD) estimated by Digital X-ray Radiogrammetry (DXR) with respect to its ability to quantify severity-dependent variations of bone mineralisation in patients with early rheumatoid arthritis compared to Dual Energy X-ray Absorptiometry (DXA), 122 patients underwent a prospective analysis of BMD and MCI by DXR, whereas both DXR-parameters were estimated from plain radiographs of the non-dominant hand. In comparison DXA measured BMD on total femur and lumbar spine (L2-L4). Additionally Steinbrocker Stage was assessed to differentiate the severity of rheumatoid arthritis (RA). Disease activity of RA was estimated by C-reactive Protein (CRP; in mg/l), Erythrocyte Sedimentation Rate (ESR in mm/1st hour) and by the disease activity score with 28-joint count (DAS 28). In consequence, The DXR-parameters, in particular DXR-MCI, revealed significant associations to age, Body Mass Index, CRP, DAS 28 and Steinbrocker graduation; no significant associations could be verified between DXA-parameters and all characteristics of disease activity and severity of RA. The highest correlation was found between DXR-MCI and DXR-BMD with R=0.89 (independent from severity of RA). In all patients DXR-MCI significantly decreased (-14.3%) from 0.42 ± 0.09 (stage 1) to 0.36 ± 0.07 (stage 2) dependent on severity of RA. The comparable relative reduction of DXR-BMD was -11.1%. The group of patients with minor disease activity (DAS 28>5.1) showed a significant flattened reduction (-11.4%) for DXR-MCI from 0.44 ± 0.08 (stage 1) to 0.39 ± 0.08 (stage 2). For accentuated disease activity (DAS 28>5.1) the DXR-MCI revealed a pronounced reduction (-23.1 %). No significant declines were observed for DXA-BMD of the lumbar spine and total femur in all patients as well as dependent on disease activity. Conclusion: DXR can exactly quantify cortical thinning of the metacarpal bones and can identify cortical demineralisation in patients suffering from early rheumatoid arthritis surpassing DXA-measurements at axial bone sites. In this context DXR-MCI seems to be the most sensitive parameter for differentiation of patients with minor or accentuated disease activity following severity-dependent cortical bone loss. PMID:23674987

Böttcher, Joachim; Pfeil, Alexander; Petrovitch, Alexander; Schmidt, Mirco; Kramer, Anika; Schäfer, Max Ludwig; Gajda, Mieczyslaw; Hein, Gert; Wolf, Gunter; Kaiser, Werner A.

2006-01-01

372

Silica exposure and rheumatoid arthritis: a follow up study of granite workers 1940-81.  

PubMed Central

The incidence and prevalence of subjects awarded disability pensions and the prevalence of subjects receiving free medicines because of rheumatoid arthritis were studied in a Finnish cohort of 1026 granite workers hired between 1940 and 1971 and followed up until 31 December 1981. The incidence of awards of disability pensions because of rheumatoid arthritis during 1969-81, the prevalence of rheumatoid arthritis on 31 December 1981, and the prevalence of subjects receiving free medicines for rheumatoid arthritis at the end of 1981 were significantly higher among the granite workers than in the general male population of the same age. Retrospective analysis of the records of all patients with rheumatoid arthritis in the cohort showed a predominance of a severe, serologically positive and erosive form of rheumatoid arthritis, usually with an age at onset of 50 or over. The possible aetiological or pathophysiological role of granite dust in rheumatoid arthritis may be based on the effects of quartz on the immune system. PMID:2823951

Klockars, M; Koskela, R S; Järvinen, E; Kolari, P J; Rossi, A

1987-01-01

373

Primary Hepatic Lymphoma in a Patient with Rheumatoid Arthritis Treated with Methotrexate  

PubMed Central

Primary hepatic lymphoma (PHL) has rarely been reported in patients with immunosuppression. We herein describe a case of Epstein-Barr virus- (EBV-) positive PHL in a 67-year-old Japanese woman receiving methotrexate (MTX) treatment for rheumatoid arthritis (RA). The patient, who had been receiving MTX therapy for more than 6 years, presented with low-grade fever and abdominal pain. Initial laboratory tests showed mildly elevated liver enzymes with normal levels of alpha-fetoprotein and carcinoembryonic antigen, and computed tomography scans revealed multiple hepatic tumors with no lymph-node swelling. Examination of liver specimens obtained via ultrasonography-guided needle biopsy indicated EBV-positive diffuse large B cell lymphoma; therefore, she was diagnosed with PHL. MTX was discontinued, and she was carefully monitored thereafter owing to the prolonged history of MTX administration for RA. Rapid progression of PHL was observed; therefore 10 days after the PHL diagnosis, she received 6 cycles of R-THP-COP (rituximab, cyclophosphamide, pirarubicin, vincristine, and prednisolone) therapy and achieved complete remission for more than 1 year. Although MTX-associated lymphoproliferative disorders often show remission after withdrawal of MTX, early diagnosis and treatment are essential for PHL in patients with RA treated with MTX, because of the aggressive nature of the disease. PMID:25610674

Tatsumi, Goichi; Ukyo, Naoya; Hirata, Hirokazu; Tsudo, Mitsuru

2014-01-01

374

The cyclooxygenase-2/thromboxane A2 pathway: a bridge from rheumatoid arthritis to lung cancer?  

PubMed

Patients with rheumatoid arthritis (RA) appear to be at a higher risk of lung cancer (LC). Although the connection between RA and LC has been an active area of research for many years, the molecular pathogenesis of the disease process remains unclear. The cyclooxygenase (COX)-2/thromboxane A2 (TxA2) pathway has been shown to play a potential role in LC development through an auto-regulatory feedback loop. An increased level of TxA2 has been found in RA patients, and intriguingly, the positive feedback loop for the COX-2/TxA2 pathway was shown to have a potential function in RA fibroblast-like synoviocytes (RA-FLS). Thus, the molecular basis of LC development in patients with RA has been at least in partly described. It is possible that COX-2-derived TxA2 could be monitored for the early detection of LC in RA patients, and targeting this molecular pathway may decrease the risk of LC in patients with RA. PMID:25168478

Huang, Qing-Chun; Huang, Run-Yue

2014-11-01

375

Recommendations for the use of ultrasound in rheumatoid arthritis: literature review and SONAR score experience.  

PubMed

Ultrasound (US) has become a useful tool in the detection of early disease, differential diagnosis, guidance of treatment decisions and treatment monitoring of rheumatoid arthritis (RA). In 2008, the Swiss Sonography in Arthritis and Rheumatism (SONAR) group was established to promote the use of US in inflammatory arthritis in clinical practice. A scoring system was developed and taught to a large number of Swiss rheumatologists who already contributed to the Swiss Clinical Quality Management (SCQM) database, a national patient register. This paper intends to give a Swiss consensus about best clinical practice recommendations for the use of US in RA on the basis of the current literature knowledge and experience with the Swiss SONAR score. Literature research was performed to collect data on current evidence. The results were discussed among specialists of the Swiss university centres and private practice, following a structured procedure. Musculoskelatal US was found to be very helpful in establishing the diagnosis and monitoring the evolution of RA, and to be a reliable tool if used by experienced examiners. It influences treatment decisions such as continuing, intensifying or stepping down therapy. The definite modalities of integrating US into the diagnosis and monitoring of RA treatments will be defined within a few years. There are, however, strong arguments to use US findings as of today in daily clinical care. Some practical recommendations about the use of US in RA, focusing on the diagnosis and the use of the SONAR score, are proposed. PMID:24363082

Zufferey, Pascal; Tamborrini, Giorgio; Gabay, Cem; Krebs, Andreas; Kyburz, Diego; Michel, Beat; Moser, Urs; Villiger, Peter M; So, Alexander; Ziswiler, Hans Rudolf

2013-01-01

376

Type I IFNs as biomarkers in rheumatoid arthritis: towards disease profiling and personalized medicine.  

PubMed

RA (rheumatoid arthritis) is a chronic rheumatic condition hallmarked by joint inflammation and destruction by self-reactive immune responses. Clinical management of RA patients is often hampered by its heterogeneous nature in both clinical presentation and outcome, thereby highlighting the need for new predictive biomarkers. In this sense, several studies have recently revealed a role for type I IFNs (interferons), mainly IFN?, in the pathogenesis of a subset of RA patients. Genetic variants associated with the type I IFN pathway have been linked with RA development, as well as with clinical features. Moreover, a role for IFN? as a trigger for RA development has also been described. Additionally, a type I IFN signature has been associated with the early diagnosis of RA and clinical outcome prediction in patients undergoing biological drug treatment, two challenging issues for decision-making in the clinical setting. Moreover, these cytokines have been related to endothelial damage and vascular repair failure in different autoimmune disorders. Therefore, together with chronic inflammation and disease features, they could probably account for the increased cardiovascular disease morbidity and mortality of these patients. The main aim of the present review is to provide recent evidence supporting a role for type I IFNs in the immunopathology of RA, as well as to analyse their possible role as biomarkers for disease management. PMID:25630235

Rodríguez-Carrio, Javier; López, Patricia; Suárez, Ana

2015-04-01

377

Efficacy, tolerability and safety of biologic therapy in rheumatoid disease: patient considerations  

PubMed Central

Rheumatoid arthritis (RA) is a systemic inflammatory disease in which chronic inflammation leads to joint destruction and extra-articular complications. Early and effective inhibition of inflammation is critical in order to prevent the progressive joint damage that occurs rapidly after onset of the disease. In the past, treatment for this purpose was limited to conventional disease-modifying antirheumatic drugs (DMARDs), which were often suboptimal. Within the last decade however, the development of biologic therapies, targeted against cytokines and cells involved in the inflammatory process, has revolutionized the management of RA. Disease remission is now an achievable goal in newly diagnosed patients. Since the advent of the first tumor necrosis factor-? inhibitor in 1999, other biologics have proved necessary as individuals respond to varying degrees with different therapies. Several are now available for the treatment of patients with RA that remains active despite DMARD treatment. This article reviews the evidence, over the last decade, of the efficacy and safety of biologic therapies used in this context, and the recent clinical data supporting the use of biologic therapy earlier in the disease process as first-line therapy. PMID:21701623

Horton, Sarah; Buch, Maya H; Emery, Paul

2010-01-01

378

Neutropenia in rheumatoid arthritis: studies on possible contributing factors.  

PubMed Central

Twenty-five patients with rheumatoid arthritis (RA) and neutropenia, of whom 19 had a palpable spleen, were compared with 24 patients with uncomplicated RA, and 16 patients with RA and associated splenomegaly without neutropenia. Clinically patients with neutropenia had evidence of a more systemic disease as assessed by prevalence of rheumatoid nodules, weight loss, and recurrent infections. However, there was less evidence of active synovitis than in the other 2 groups. Marrow neutrophil reserve was studied by means of a hydrocortisone stimulation test and was found to be lower in all 3 groups than in normal persons but with most marked depletion in the neutropenic group. Removal of the spleen in some patients with neutropenia resulted in a significant increase in marrow neutrophil reserve. Circulating immune complexes as detected by anticomplementary activity and platelet aggregation tests were detected in 68% of the RA neutropenia group, 31% of the RA splenomegaly group, and 8% of the uncomplicated RA group. Our results show that, assessed both clinically and by the above tests, patients with neutropenia have a greater prevalence of abnormalities which may be directly related to their neutropenia. Patients with splenomegaly alone closely resemble patients with uncomplicated RA. PMID:6979979

Bucknall, R C; Davis, P; Bacon, P A; Jones, J V

1982-01-01

379

Increased TTS expression in patients with rheumatoid arthritis.  

PubMed

Immune system activation is known to be involved in the progression of rheumatoid arthritis (RA). The aim of this work was to study the imbalance expressions of indoleamine 2,3-dioxygenase (IDO) and tryptophanyl-tRNA synthetase (TTS) with RA patients. Forty-nine RA patients and 49 healthy controls were studied. The expressions of IDO and TTS were analyzed by real-time quantitative polymerase chain reaction and flow cytometry in peripheral blood mononuclear cells. The expression of TTS mRNA increased significantly in RA patients when compared with healthy controls and correlated with erythrocyte sedimentation rate (r = 0.424, P < 0.01). In addition, we found TTS increased significantly mainly in CD3(+) T cells in rheumatoid arthritis group. Increased TTS expressions from CD3(+) T cells might link to a pathogenic mechanism involved in increasing survival of autoreactive T cells in RA patients. Determination of expressions of TTS may provide a better understanding of progression of the disease. PMID:24515434

Chen, Jiaxi; Jun, Li; Shiyong, Chen; Li, Hou; Zhu, Ming; Shen, Bo

2015-02-01

380

Application of Liposomes in Treatment of Rheumatoid Arthritis: Quo Vadis  

PubMed Central

The most common treatments for rheumatoid arthritis include nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, disease modifying antirheumatic drugs (DMARDs), and some biological agents. However, none of the treatments available is able to achieve the ultimate goal of treatment, that is, drug-free remission. This limitation has shifted the focus of treatment to delivery strategies with an ability to deliver the drugs into the synovial cavity in the proper dosage while mitigating side effects to other tissues. A number of approaches like microemulsions, microspheres, liposomes, microballoons, cocrystals, nanoemulsions, dendrimers, microsponges, and so forth, have been used for intrasynovial delivery of these drugs. Amongst these, liposomes have proven to be very effective for retaining the drug in the synovial cavity by virtue of their size and chemical composition. The fast clearance of intra-synovially administered drugs can be overcome by use of liposomes leading to increased uptake of drugs by the target synovial cells, which in turn reduces the exposure of nontarget sites and eliminates most of the undesirable effects associated with therapy. This review focuses on the use of liposomes in treatment of rheumatoid arthritis and summarizes data relating to the liposome formulations of various drugs. It also discusses emerging trends of this promising technology. PMID:24688450

Singh, Sachin Kumar; Gulati, Monica

2014-01-01

381

Therapy gloves for patients with rheumatoid arthritis: a review.  

PubMed

Rheumatoid arthritis is a chronic inflammatory disease that causes pain, joint stiffness and swelling leading to impaired hand function and difficulty with daily activities. Wearing therapy gloves has been recommended by occupational therapists as one of the alternative treatment methods for rheumatoid arthritis. This study aims to review the available literature on the effects of wearing therapy gloves on patients' hand function and symptoms as well as to discuss the attributes of gloves that might influence the glove performance. An electronic databases search of MEDLINE, Physiotherapy Evidence Database, Occupational Therapy Systematic Evaluation of Evidence, Wiley Online Library, ScienceDirect and Cochrane Central Register of Controlled Trial was performed. Eight articles met the inclusion criteria, and covered seven clinical trials and one case study. Seven outcome measures were identified from the included studies and were then classified into two categories: hand function and hand symptoms. The hand symptoms such as pain, stiffness and swelling improve substantially when the therapy gloves are used. However, marginal or no improvement in hand function (with the exception of grip strength) linked to the use of therapy gloves is being reported. Further research is needed to quantify the effectiveness of therapy gloves, especially in improvement of hand function and in patients' interest in wearing therapy gloves. Furthermore, future studies should include parameters which might influence therapy gloves' performance, such as duration of trials, interface pressure generated by the gloves on the underlying skin and tissue, glove fit and construction, as well as thermophysiological comfort. PMID:25435925

Nasir, Siti Hana; Troynikov, Olga; Massy-Westropp, Nicola

2014-12-01

382

Amyloid Goiter Associated with Amyloidosis Secondary to Rheumatoid Arthritis  

PubMed Central

Amyloidosis refers to a variety of conditions in which amyloid proteins are abnormally deposited in organs and/or tissues. The most common forms of systemic amyloidosis are primary amyloidosis (PA) of light chains and secondary amyloidosis (SA) caused by chronic inflammatory diseases such as rheumatoid arthritis (RA). Although involvement of the thyroid gland by amyloid is a relatively common phenomenon, clinically significant enlargement of the thyroid owing to amyloid deposition is a rare occurrence. In SA, the deposition of amyloid associated (AA) protein is associated with atrophy of thyroid follicles. The clinical picture of these patients is characterized by rapid, painless thyroid gland enlargement which may be associated with dysphagia, dyspnea, or hoarseness. Thyroid function is not impaired in most cases. Although amyloid goitre secondary to systemic amyloidosis due to chronic inflammatory diseases is relatively common, specifically related to RA is much more uncommon one and it is reported less in the literature. In this report, A 52-old-year female patient with amyloid goiter associated with amyloidosis secondary to rheumatoid arthritis is presented. PMID:24368922

Uzum, Gungor; Kaya, Fatih Oner; Uzum, Ayse Kubat; Kucukyilmaz, Meltem; Duzkoylu, Yigit; Leblebici, Cem; Koc, Oguz

2013-01-01

383

Sustained improvement of intractable rheumatoid arthritis after total lymphoid irradiation  

SciTech Connect

Total lymphoid irradiation (TLI) was administered to 11 patients who had intractable rheumatoid arthritis that was unresponsive to conventional medical therapy, including aspirin, multiple nonsteroidal antiinflammatory drugs, gold salts, and D-penicillamine. Total lymphoid irradiation was given as an alternative to cytotoxic drugs such as azathioprine and cyclophosphamide. After radiotherapy, 9 of the 11 patients showed a marked improvement in clinical disease activity as measured by morning stiffness, joint tenderness, joint swelling, and overall functional abilities. The mean improvement of disease activity in all patients ranged from 40-70 percent and has persisted throughout a 13-28 month followup period. This improvement permitted the mean daily steroid dose to be reduced by 54%. Complications included severe fatigue and other constitutional symptoms during radiotherapy, development of Felty's syndrome in 1 patient, and an exacerbation of rheumatoid lung disease in another. After therapy, all patients exhibited a profound T lymphocytopenia, and a reversal in their T suppressor/cytotoxic cell to helper cell ratio. The proliferative responses of peripheral blood mononuclear cells to phytohemagglutinin, concanavalin A, and allogeneic leukocytes (mixed leukocyte reaction) were markedly reduced, as was in vitro immunoglobulin synthesis after stimulation with pokeweed mitogen. Alterations in T cell numbers and function persisted during the entire followup period, except that the mixed leukocyte reaction showed a tendency to return to normal values.

Field, E.H.; Strober, S.; Hoppe, R.T.; Calin, A.; Engleman, E.G.; Kotzin, B.L.; Tanay, A.S.; Calin, H.J.; Terrell, C.P.; Kaplan, H.S.

1983-08-01

384

Sulphasalazine versus penicillamine in the treatment of rheumatoid arthritis.  

PubMed

Fifty-four patients with rheumatoid arthritis were randomized to either sulphasalazine or D-penicillamine in order to compare the short- and long-term efficacy of these two agents in the treatment of rheumatoid arthritis. Decisive improvement was observed in both treatment groups over a 1 year period. Side effects were common in both groups and accounted for termination of therapy in 11 patients during the first year. Radiological deterioration was evident in both treatment groups. A trend toward greater radiological deterioration was observed in patients receiving sulphasalazine, but this was not statistically significant. Only 11 of the 38 patients who completed 1 year of therapy were continuing to take the same drug 5 years later. Eight patients were continuing D-penicillamine and three were still taking sulphasalazine. Among the patients who completed 1 year of therapy, treatment was subsequently terminated because of loss of effective disease control in a significantly higher proportion of patients receiving sulphasalazine (P less than 0.01). The radiological data and the latter observations suggest that D-penicillamine may be a more effective agent for long-term treatment. PMID:2567049

Carroll, G J; Will, R K; Breidahl, P D; Tinsley, L M

1989-01-01

385

Spontaneous talar and calcaneal fracture in rheumatoid arthritis: a case report  

PubMed Central

Rheumatoid arthritis (RA) leads to a progressive weakening of the skeleton which may result in bone fractures. However, spontaneous fractures (exclusive of stress fractures, vertebral collapse, and superficial articular fragmentation) in patients with rheumatoid arthritis have been only occasionally reported in the medical literature. A case of spontaneous talar and calcaneal fracture in rheumatoid arthritis is described. Bone lesions were identified on radiographs, MR images and scintigraphy in a patient with right ankle pain. The absence of episodes of acute trauma, and the presence of acute clinical manifestations should guide the clinical suspicion. PMID:22470803

Spina, Antonio; Clemente, Alberto; Vancini, Chiara; Fejzo, Majlinda; Campioni, Paolo

2011-01-01

386

Applying Evidence In The Care Of Patients With Rheumatoid Hand And Wrist Deformities  

PubMed Central

The traditional approach in managing rheumatoid hand deformities is based on the individual surgeon’s experiences. In the current era of evidence-based medicine (EBM), formulating treatment for the rheumatoid hand fits perfectly within the framework of EBM by leveraging the best evidence from the literature, incorporating surgeons’ experience, and considering patients’ preferences. In this special article, we use a case example to illustrate how EBM can be practiced within the framework of treating rheumatoid hand deformities by distilling the best evidence from the literature to guide surgeons in a rational approach for treating this common condition. PMID:23783062

Rehim, Shady A.; Chung, Kevin C.

2014-01-01

387

Thoracic and lower cervical spine involvement in a case of rheumatoid arthritis.  

PubMed

The authors report a case of spine involvement in a severe case of rheumatoid arthritis treated with corticosteroids. First, the patient developed acute back pain, related to costovertebral joints arthritis at levels T9-T10. Then, neck pain and cord involvement yielded to diagnosis of cervical interapophyseal joints arthritis; there was a C5-C6 subluxation which necessitated surgical treatment. The conjunction of these two rheumatoid localizations is an uncommon feature. Study by the CT scan is valuable when rheumatoid arthritis of the spine is suspected. Lower cervical spine subluxation, even severe, may be well tolerated. Surgery is necessary when there is medullary involvement. PMID:2772485

Benhamou, C L; Roux, C; Viala, J F; Gervais, T

1989-01-01

388

Molecular Hydrogen: New Antioxidant and Anti-inflammatory Therapy for Rheumatoid Arthritis and Related Diseases  

PubMed Central

Rheumatoid arthritis (RA) is a chronic inflammatory disease in which the progressive destruction of joint causes morbidity. It is also associated with an increased risk of atherosclerosis, which can result in cardiovascular disease and mortality. The therapeutic goal is to control the systemic inflammation to obtain not only the remission of symptoms, but also improve general state of health. Although recent biologic immunosuppressive therapies targeting pro-inflammatory cytokines have spawned a paradigm shift regarding the prognosis of RA, these therapies possess inherent side effects. Also, early diagnosis of the disease remains confounded by uncertainty. While the mechanisms responsible for the onset of RA remain unclear, reactive oxygen species (ROS) play a significant role in the pathogenesis of RA. ROS play a central role both upstream and downstream of NF-?B and TNF? pathways, which are located at the center of the inflammatory response. Among the ROS, the hydroxyl radical is the most harmful, and molecular hydrogen (H2) is a selective scavenger for this species. Recently, it has been shown that H2 is useful when administered along with the conventional therapy in RA as it acts to reduce oxidative stress in the patients. Especially in the early stage, H2 showed significant therapeutic potential, which also seemed to assist diagnosis and treatment decisions of RA. The possible expectations regarding the potential benefits of H2 by reducing the oxidative stress, resulting from inflammatory factors, are raised and discussed here. They include prevention of RA and related atherosclerosis, as well as therapeutic validity for RA PMID:23859555

Ishibashi, Toru

2013-01-01

389

Rheumatoid arthritis and periodontitis – inflammatory and infectious connections. Review of the literature  

PubMed Central

An association between oral disease/periodontitis and rheumatoid arthritis (RA) has been considered since the early 1820s. The early treatment was tooth eradication. Epidemiological studies suggest that the prevalence of RA and periodontitis may be similar and about 5% of the population are aged 50 years or older. RA is considered as an autoimmune disease whereas periodontitis has an infectious etiology with a complex inflammatory response. Both diseases are chronic and may present with bursts of disease activity. Association studies have suggested odds ratios of having RA and periodontitis varying from 1.8:1 (95% CI: 1.0–3.2, NS) to 8:1 (95% CI: 2.9–22.1, p<0.001). Genetic factors are driving the host responses in both RA and periodontitis. Tumor necrosis factor-?, a proinflammatory cytokine, regulates a cascade of inflammatory events in both RA and periodontitis. Porphyromonas gingivalis is a common pathogen in periodontal infection. P. gingivalis has also been identified in synovial fluid. The specific abilities of P. gingivalis to citrullinate host peptides by proteolytic cleavage at Arg-X peptide bonds by arginine gingipains can induce autoimmune responses in RA through development of anticyclic citrullinated peptide antibodies. In addition, P. gingivalis carries heat shock proteins (HSPs) that may also trigger autoimmune responses in subjects with RA. Data suggest that periodontal therapies combined with routine RA treatments further improve RA status. Conclusions Periodontal infection (P. gingivalis) carries a unique risk for development of autoimmune antibodies associated with RA. Patients with RA have either lost many teeth or usually have severe periodontitis. Additional research, both in regards to basic mechanisms as well as clinical studies, are necessary before it can be said that there are causative links between RA and periodontitis. Cross-disciplinary research in well-defined populations should be performed to further enhance knowledge and develop clinical strategies how to coordinate therapy and risk assessments of RA and periodontitis. PMID:22347541

Rutger Persson, G.

2012-01-01

390

Epstein-Barr Virus Serologic Abnormalities and risk of Rheumatoid Arthritis among Women  

PubMed Central

Background EBV infection and the immune response may be involved in the pathogenesis of rheumatoid arthritis (RA). Past studies have suggested an association between EBV and RA. Methods We studied the association between EBV serologies and RA risk in a nested case-control study in the Nurses’ Health Study cohorts. We confirmed incident RA cases from 1990–2002 by questionnaire and medical record review. Each incident case with blood collected prior to RA symptoms was matched to a healthy participant by time of day and date of blood collection, birth year, menopausal status and postmenopausal hormone use. Immunofluorescence assays measured serologic EBV responses: viral capsid antigen (VCA), early-antigen-diffuse (EA-D) and early antigen-complex (EA-restricted and diffuse), Epstein Barr nuclear antigen (EBNA)-1, EBNA-2 and cytomegalovirus (CMV), as control. All were reported as titers, except BZLF-1 and CMV, which were reported as positive or negative. ANA positive samples were excluded. Elevated EBV antibody titers were defined as the upper 20% (or nearest titer) among controls. Conditional logistic regression analyses modeled RA risk associated with elevated EBV titers or the presence/absence CMV, further adjusted for pack-years smoking and alcohol intake. Results 87 incident RA cases were identified. Mean time to RA after blood draw was 6.2 (±3.5) years in NHS and 1.9 (±0.6) years in NHSII. Antibody titers against EBV were not significantly different between pre-RA cases and controls. Conclusions In this prospective study of women, we observed no association between EBV serologies and RA risk. PMID:22011088

Goldstein, Barbara L.; Chibnik, Lori B.; Karlson, Elizabeth W.; Costenbader, Karen H.

2013-01-01

391

Complementary and Alternative Medicine Use in African Americans With Rheumatoid Arthritis  

PubMed Central

Objective. Racial/ethnic differences with regard to complementary and alternative medicine (CAM) use have been reported in the US. However, specific details of CAM use by African Americans with rheumatoid arthritis (RA) are lacking. Methods. Data were collected from African Americans with RA enrolled in a multicenter registry regarding the use of CAM, including food supplements, topical applications, activities, and alternative care providers. Factors associated with CAM use by sex and disease duration were assessed using t-test, Wilcoxon’s rank sum test, chi-square test, and logistic regression analyses. Results. Of the 855 participants, 85% were women and mean age at enrollment was 54 years. Overall, ever using any of the CAM treatments, activities, and providers was 95%, 98%, and 51%, respectively (median of 3 for number of treatments, median of 5 for activities, and median of 1 for providers). Those with longer disease duration (>2 years) were significantly more likely (odds ratio >2.0, P < 0.05) to use raisins soaked in vodka/gin, to take fish oils, or to drink alcoholic beverages for RA treatment than those with early disease. As compared to men, women were significantly (P < 0.05) more likely to pray/attend church, write in a journal, and use biofeedback, but were less likely to smoke tobacco or topically apply household oils for treatment of RA. Conclusion. CAM use was highly prevalent in this cohort, even in individuals with early disease. Health care providers need to be aware of CAM use as some treatments may potentially have interactions with conventional medicines. This could be important within this cohort of African Americans, where racial disparities are known to affect access to conventional care. PMID:23983105

TAMHANE, ASHUTOSH; McGWIN, GERALD; REDDEN, DAVID T.; HUGHES, LAURA B.; BROWN, ELIZABETH E.; WESTFALL, ANDREW O.; CONN, DOYT L.; JONAS, BETH L.; SMITH, EDWIN A.; BRASINGTON, RICHARD D.; MORELAND, LARRY W.; BRIDGES, S. LOUIS; CALLAHAN, LEIGH F.

2014-01-01

392

An imprinted rheumatoid arthritis methylome signature reflects pathogenic phenotype  

PubMed Central

Background A DNA methylation signature has been characterized that distinguishes rheumatoid arthritis (RA) fibroblast like synoviocytes (FLS) from osteoarthritis (OA) FLS. The presence of epigenetic changes in long-term cultured cells suggest that rheumatoid FLS imprinting might contribute to pathogenic behavior. To understand how differentially methylated genes (DMGs) might participate in the pathogenesis of RA, we evaluated the stability of the RA signature and whether DMGs are enriched in specific pathways and ontology categories. Methods To assess the RA methylation signatures the Illumina HumanMethylation450 chip was used to compare methylation levels in RA, OA, and normal (NL) FLS at passage 3, 5, and 7. Then methylation frequencies at CpGs within the signature were compared between passages. To assess the enrichment of DMGs in specific pathways, DMGs were identified as genes that possess significantly differential methylated loci within their promoter regions. These sets of DMGs were then compared to pathway and ontology databases to establish enrichment in specific categories. Results Initial studies compared passage 3, 5, and 7 FLS from RA, OA, and NL. The patterns of differential methylation of each individual FLS line were very similar regardless of passage number. Using the most robust analysis, 20 out of 272 KEGG pathways and 43 out of 34,400 GO pathways were significantly altered for RA compared with OA and NL FLS. Most interestingly, we found that the KEGG 'Rheumatoid Arthritis' pathway was consistently the most significantly enriched with differentially methylated loci. Additional pathways involved with innate immunity (Complement and Coagulation, Toll-like Receptors, NOD-like Receptors, and Cytosolic DNA-sensing), cell adhesion (Focal Adhesion, Cell Adhesion Molecule), and cytokines (Cytokine-cytokine Receptor). Taken together, KEGG and GO pathway analysis demonstrates non-random epigenetic imprinting of RA FLS. Conclusions The DNA methylation patterns include anomalies in key genes implicated in the pathogenesis of RA and are stable for multiple cell passages. Persistent epigenetic alterations could contribute to the aggressive phenotype of RA synoviocytes and identify potential therapeutic targets that could modulate the pathogenic behavior. PMID:23631487

2013-01-01

393

Diagnostic strategy for the assessment of rheumatoid vasculitis  

PubMed Central

Objective: To determine the clinical features associated with histologically proven rheumatoid vasculitis (HRV) and the additional diagnostic value of serological markers in an inception cohort of 81 patients with rheumatoid arthritis (RA) suspected of RV. Methods: The presence and number of recently developed extra-articular manifestations (EAMs) and a weighted EAM score, as well as the levels of serological markers, were compared between 31 patients with RA with histologically proven vasculitis and 50 patients with RA in whom vasculitis could not be documented histologically. The following markers were evaluated: circulating immune complexes, complement components C3 and C4, class-specific rheumatoid factors (IgM RF, IgG RF, IgA RF), antineutrophil cytoplasmic antibodies, antinuclear antibodies, antiendothelial antibodies, circulating intercellular adhesion molecule-1 and -3, circulating vascular cell adhesion molecule and E-selectin, cellular fibronectin, von Willebrand factor antigen, and C reactive protein. The diagnostic value of these markers, in addition to the clinical features, was evaluated with logistic regression analysis. Results: Peripheral neuropathy or purpura/petechiae, or both, were the most important clinical features to discriminate patients with RA with and without histologically proven RV. The presence of a high number of EAMs and a higher weighted EAM score in patients with RA suspected of vasculitis were also associated with an increased probability of histologically proven RV. After adjustment for EAMs, only the combination of an increased serum IgA RF level and a decreased serum C3 level appeared to make an additional contribution to the diagnosis histologically proven RV. Evidence of systemic vasculitis was found in a muscle biopsy of the rectus femoris in 9/14 (64%) patients with vasculitis with neuropathy and in 3/11 (27%) patients with purpura/petechiae and vasculitis of the skin. Conclusions: In the diagnostic process of RV the presence of peripheral neuropathy and/or purpura/petechiae or a high weighted EAM score will increase the probability of histologically proven RV. Of the circulating factors previously suggested to be markers for RV only IgA RF and C3 further increase the probability of histologically proven RV and may be useful to guide diagnostic decisions. PMID:12695150

Voskuyl, A; Hazes, J; Zwinderman, A; Paleolog, E; van der Meer, F J M; Daha, M; Breedveld, F

2003-01-01

394

Somatic mutations in the p53 tumor suppressor gene in rheumatoid arthritis?synovium  

PubMed Central

The factors that regulate the perpetuation and invasiveness of rheumatoid synovitis have been the subject of considerable inquiry, and the possibility that nonimmunologic defects can contribute to the disease has not been rigorously addressed. Using a mismatch detection system, we report that synovial tissue from the joints of severe chronic rheumatoid arthritis patients contain mutant p53 transcripts, which were not found in skin samples from the same patients or in joints of patients with osteoarthritis. Mutant p53 transcripts also were identified in synoviocytes cultured from rheumatoid joints. The predicted amino acid substitutions in p53 were identical or similar to those commonly observed in a variety of tumors and might influence growth and survival of rheumatoid synoviocytes. Thus, mutations in p53 and subsequent selection of the mutant cells may occur in the joints of patients as a consequence of inflammation and contribute to the pathogenesis of the disease. PMID:9380731

Firestein, Gary S.; Echeverri, Fernando; Yeo, Michele; Zvaifler, Nathan J.; Green, Douglas R.

1997-01-01

395

[Practical guide for the use of biological agents in rheumatoid arthritis - December 2011 update].  

PubMed

The authors review the practical aspects of biological therapy use for rheumatoid arthritis patients, commenting safety issues before and after treatment initiation and the best treatment strategies to optimize efficacy. PMID:22472930

Mourão, Ana Filipa; Fonseca, João Eurico; Canhão, Helena; Santos, Maria José; Bernardo, Alexandra; Cordeiro, Ana; Cravo, Ana Rita; Ribeiro, Ana; Teixeira, Ana; Barcelos, Anabela; Malcata, Armando; Faustino, Augusto; Duarte, Cátia; Ribeiro, Célia; Nour, Dolores; Araújo, Domingos; Sousa, Elsa; Mariz, Eva; Ramos, Filipa; Vinagre, Filipe; Ventura, Francisco Simões; Sequeira, Graça; Santos, Helena; Branco, Jaime Cunha; Gomes, J A; Silva, J A; Ramos, João; Santo, Jorge Espírito; Costa, José António; Silva, J A; Ribeiro, José Saraiva; Inês, Luís; Miranda, Luís; Sampaio, Luzia; Costa, Maria Lúcia; Rodrigues, Mário; Afonso, Maria Carmo; Cunha, Maria Inês; Saavedra, Maria João; Queiroz, Mário Viana; Couto, Maura; Bernardes, Miguel; Bogas, Mónica; Pinto, Patrícia; Valente, Paula; Coelho, Paulo; Abreu, Pedro; Cortes, Sara; Pimenta, Sofia; Ramiro, Sofia; Figueira, Ricardo; Nóvoa, Teresa

2011-01-01

396

Two-dimensional electrophoretic analysis of human leukocyte proteins from patients with rheumatoid arthritis  

SciTech Connect

Human leukocyte proteins from more than 150 patients with rheumatoid arthritis, together with age- and sex-matched controls, were analyzed by use of the ISO-DALT technique of two-dimensional polyacrylamide gel electrophoresis. Patients with ankylosing spondylitis, polymyalgia rheumatica, psoriatic arthritis, calcium tendinitis, post-infectious arthritis, and asymmetrical seronegative arthritis were also included as positive controls. Synthesis of several proteins, referred to by number as members of the Rheuma set, is shown to increase in the leukocyte preparations from patients with classical rheumatoid arthritis. Several of these proteins are specific to monocytes or granulocytes; others are of unknown cellular origin, but appear to be unique to rheumatoid arthritis. The Rheuma proteins appear to be indicators of disease activity, because their increased synthesis can be correlated with sedimentation rate and other clinical indices of rheumatoid disease activity.

Willard, K.E. (Argonne National Lab., IL); Thorsrud, A.K.; Munthe, E.; Jellum, E.

1982-04-01

397

Pan-metatarsophalangeal joint arthrodesis for the severe rheumatoid forefoot deformity.  

PubMed

The standard approach for correction of severe painful rheumatoid forefoot deformities has involved resection of the metatarsal heads with realignment of the lesser toe deformities and first metatarsophalangeal joint (MTPJ) arthrodesis. Modifications of this procedure may include a pan-metatarsal head resection, including the first metatarsal head, or resection of the lesser metatarsal heads in conjunction with an interpositional arthroplasty of the first MTPJ. The authors describe a novel surgical approach that involves the correction of severe rheumatoid forefoot deformities through a pan-MTPJ arthrodesis. Arthrodesis of all five MTPJs for the surgical treatment of the painful rheumatoid forefoot deformity with chronic plantar callosities and dislocated digits has yet to be reported in the scientific literature. The goal of this article is to provide the treating physician with another alternative and safe surgical approach when dealing with the painful rheumatoid forefoot deformity. PMID:19121760

Jeffries, Luke C; Rodriguez, Roberto H; Stapleton, John J; Zgonis, Thomas

2009-01-01

398

The Future of Rheumatoid Arthritis and Hand Surgery - Combining Evolutionary Pharmacology and Surgical Technique  

PubMed Central

Rheumatoid arthritis is a systemic autoimmune disease of uncertain aetiology, which is characterized primarily by synovial inflammation with secondary skeletal destructions. Rheumatoid Arthritis is diagnosed by the presence of four of the seven diagnostic criteria, defined by The American College of Rheumatology. Approximately half a million adults in the United Kingdom suffer from rheumatoid arthritis with an age prevalence between the second and fourth decades of life; annually approximately 20,000 new cases are diagnosed. The management of Rheumatoid Arthritis is complex; in the initial phase of the disease it primarily depends on pharmacological management. With disease progression, surgical input to correct deformity comes to play an increasingly important role. The treatment of this condition is also intimately coupled with input from both the occupational therapists and physiotherapy. PMID:22423304

M, Malahias; H, Gardner; S, Hindocha; A, Juma; Khan, W

2012-01-01

399

Economics of non-adherence to biologic therapies in rheumatoid arthritis.  

PubMed

Adherence to biologic therapies among patients with rheumatoid arthritis is sub-optimal, with the proportion of adherent patients reported to be as low as 11 %. We found few studies evaluating economic outcomes, including health care costs, associated with non-adherence with biologic therapies. Findings suggest that while higher pharmacy costs drive total health care costs among adherent patients, non-adherent patients incur greater health care utilization including inpatient, outpatient, and laboratory services. Finally, economic factors are important determinants of adherence to biologics in patients with rheumatoid arthritis. Evidence to date has shown that higher out-of-pocket payments have a negative association with adherence to biologics. Furthermore, cost-related non-adherence is a highly prevalent problem in rheumatoid arthritis. Given the high costs of biologics and continued expansion of use in rheumatoid arthritis, there is need for more research to understand the economic implications of adherence to these therapies. PMID:25227187

De Vera, Mary A; Mailman, Jonathan; Galo, Jessica S

2014-11-01

400

Population pharmacokinetics of ofatumumab in patients with chronic lymphocytic leukemia, follicular lymphoma, and rheumatoid arthritis.  

PubMed

Ofatumumab is a human monoclonal antibody directed at CD20 approved for treatment of chronic lymphocytic leukemia. The population pharmacokinetics of intravenous ofatumumab were characterized in patients with relapsed/refractory chronic lymphocytic leukemia, relapsed/refractory follicular lymphoma, and rheumatoid arthritis, diseases with widely varying CD20? B-cell counts in blood. Serum concentration data from a total of 477 patients who received ofatumumab doses ranging from 100?mg to 2000?mg in different dosing regimens were analyzed to determine the pharmacokinetic characteristics of ofatumumab across different patient groups and to identify factors contributing to the pharmacokinetic variability. Ofatumumab pharmacokinetics were well described by a linear two-compartment model component to represent non-specific monoclonal antibody clearance from the central compartment interacting with a model component representing the target-mediated clearance of ofatumumab by binding to CD20 expressed on B cells. The clearance (7.5?mL/h) and steady-state volume of distribution (5.3?L) for the linear, non-specific component were consistent with results obtained for other monoclonal antibodies. The target-mediated clearance component was related to the disease-specific number of circulating B cells, which will allow simulation of the contribution of target-mediated clearance to ofatumumab pharmacokinetics in untested disease states with data on B-cell counts and turnover. PMID:24443277

Struemper, Herbert; Sale, Mark; Patel, Bela R; Østergaard, Mikkel; Österborg, Anders; Wierda, William G; Hagenbeek, Anton; Coiffier, Bertrand; Jewell, Roxanne C

2014-07-01

401

Seropositive rheumatoid arthritis associated with decreased diffusion capacity of the lung.  

PubMed Central

Sixty-two patients with classical or definite rheumatoid arthritis were subjected to lung function analysis. The various parameters--spirography, plethysmography, blood gas analysis, measurement of lung compliance, and diffusion capacity--were correlated with duration and stage of disease, and with rheumatoid factor titres. A statistically significant correlation was found to exist between Rose-Waaler titre and specific diffusion capacity. Similar results between Rose-Waaler titre and lung compliance, however, were not statistically significant. PMID:984906

Schernthaner, G; Scherak, O; Kolarz, G; Kummer, F

1976-01-01

402

Osteopoikilosis in a patient with rheumatoid arthritis complicated with dry eyes  

Microsoft Academic Search

Osteopoikilosis is an uncommon sclerosing bone dysplasia of unknown etiology. It is usually detected as a coincidental finding\\u000a at radiographic examination. Mild joint pain and swelling may be seen in 15–20% of cases. Osteopoikilosis is rarely associated\\u000a with rheumatoid arthritis. In this case report a young man with osteopoikilosis who was diagnosed as having rheumatoid arthritis\\u000a complicated with dry eyes

Kemal Ureten

2007-01-01

403

Temporomandibular joints in patients with rheumatoid arthritis using magnetic resonance imaging.  

PubMed

The aim of this study was to determine the relationship between the pathogenic duration of rheumatoid arthritis in joints other than the temporomandibular joint and bone and soft tissue involvement of the temporomandibular joint using magnetic resonance imaging. Twenty-six symptomatic patients diagnosed with rheumatoid arthritis were enrolled in this study. All patients were classified according to the duration of rheumatoid arthritis in joints other than the temporomandibular joint. The relationships between the duration of rheumatoid arthritis in these various joints and magnetic resonance findings in the temporomandibular joint were analyzed using the chi-square test. Bony changes in the mandibular condyle were observed in 43 of 52 (82.7 %) temporomandibular joints, but the frequency of such changes was not significantly correlated with the duration of rheumatoid arthritis in other joints. We found a significant correlation between the duration of rheumatoid arthritis in other joints and the type and number of bony changes in the mandibular condyle (P?rheumatoid arthritis in other joints was significantly correlated with the mobility of the mandibular condyle (P?rheumatoid arthritis in other joints in the body (P?

Uchiyama, Yuka; Murakami, Shumei; Furukawa, Souhei

2013-11-01

404

Immortalized B-lymphocytes from rheumatoid synovial tissue show specificity for bacterial HSP 60  

Microsoft Academic Search

Several studies indicate a pathogenetic role of T-lymphocytes with specificity for heat shock proteins (HSP) in rheumatoid arthritis (RA). Surprisingly, there are no experimental data for B-lymphocytes with specificity for HSP. To investigate whether B-lymphocytes from rheumatoid synovial tissue show a specificity for HSP 60 we immortalized synovial tissue B-lymphocytes by the electrofusion technique and tested the specificity of the

V. Krenn; H. P. Vollmers; P. Landenberg; B. Schmaußer; H. K. Müller-Hermelink; M. Rupp; A. Roggenkamp

1996-01-01

405

Restless Legs Syndrome as a Comorbidity in Rheumatoid Arthritis  

PubMed Central

Rheumatoid arthritis (RA) is a multisystem disease with a complex immunologic pathophysiology. Likewise, sleep disorders can involve a complicated interplay between the neurologic pathways, immune system, and respiratory system. Recent studies have shown an elevated prevalence of sleep abnormalities in connective tissue disorders compared to the general population. Restless legs syndrome (RLS) may be present in up to 30% of RA patients. These findings may be related to cytokine release and other immunomodulatory responses. TNF-? levels relate to sleep physiology and anti-TNF-? therapy may improve sleep patterns. Most of the patients with this disorder can distinguish their RLS sensations from their arthritic symptoms. RLS is a common comorbidity seen with RA, and prompt recognition and treatment can improve patient quality of life. PMID:23840943

Gjevre, John A.; Taylor Gjevre, Regina M.

2013-01-01

406

Angiotensin II in inflammation, immunity and rheumatoid arthritis.  

PubMed

Rheumatoid arthritis (RA) is an autoimmune inflammatory disease that is characterized by increased cardiovascular morbidity and mortality, independent of the traditional risk factors for cardiovascular disease. Although classically known for its role in the regulation of circulatory homeostasis, angiotensin II (Ang II) is recognized to act as a powerful proinflammatory mediator. Some research has showed that Ang II plays important roles in autoimmune diseases, including RA, systemic lupus erythematosus and multiple sclerosis. Ang II blockers prove effective in reducing inflammation and autoimmunity in rheumatic diseases and their relative safety, together with their effects for reducing the cardiovascular disease risk, suggest that Ang II blockers may at least act as effective adjunctive therapy for disease control in patients with RA. The present review focuses systematically on the potential impact of Ang II and its receptors on inflammation and immunomodulation in patients with RA. PMID:25302847

Chang, Y; Wei, W

2015-02-01

407

Rheumatoid arthritis and the alpha-chemokine IP-10.  

PubMed

Interferon(IFN)-gamma-induced protein 10 (IP-10) and its receptor, CXCR3, appear to contribute to the pathogenesis of rheumatoid arthritis (RA). IP-10 has been detected in sera, synovial fluid (SF), and synovial tissue in RA patients. IP-10 is mainly expressed by infiltrating macrophage-like cells and fibroblast-like synoviocytes in RA synovium. The elevated expression of CXCR3 on T cells from SF has been associated with high levels of IFN-gamma, which suggest a preferential Th1 phenotype. A human phase II clinical trial using an anti-IP-10 monoclonal antibody (MDX-1100) for RA patients who had an inadequate response to methotrexate treatment has shown that blocking IP-10 significantly increased response rate compared to the placebo group, suggesting a possible therapeutic use in humans. PMID:25524204

Di Domenicantonio, A

2014-01-01

408

Management of rheumatoid arthritis (Aamavata) using symbiohealth healthcare system  

PubMed Central

Rheumatoid Arthritis (RA), according to modern medicine, and Aamavata according to Ayurveda, has an etiological and clinical relationship. Aamavata is a disease complex of which RA is a part. A comparative study of the pathophysiology of this disease by both systems reveals that modern medicine has investigated the mechanism of inflammation and has developed an offense strategy to control it. Ayurveda follows a defense strategy and it focuses its search on the etiological process, where disequilibrium at a higher level of physiology affects the gastrointestinal tract, causing an immune response that results in inflammation. Understanding the pathophysiology of both systems will help the treating physician to institute a dual treatment plan of modern medicine's offense strategy and Ayurvedic medicine's defense strategy at appropriate stages of the disease. Studying the pathophsiology of the two systems also gives insight into the genetic and epigenetic phenomenon in the treatment of disease and opens the doors for groundbreaking research. PMID:23723661

Basisht, Gopal K.; Singh, Ram Harsh; Chandola, Harimohan

2012-01-01

409

Zingiber officinale: A Potential Plant against Rheumatoid Arthritis  

PubMed Central

Rheumatoid arthritis (RA) is an autoimmune disease particularly affecting elderly people which leads to massive bone destruction with consequent inflammation, pain, and debility. Allopathic medicine can provide only symptomatic relief. However, Zingiber officinale is a plant belonging to the Zingiberaceae family, which has traditionally been used for treatment of RA in alternative medicines of many countries. Many of the phytochemical constituents of the rhizomes of this plant have therapeutic benefits including amelioration of RA. This review attempts to list those phytochemical constituents with their reported mechanisms of action. It is concluded that these phytochemicals can form the basis of discovery of new drugs, which not only can provide symptomatic relief but also may provide total relief from RA by stopping RA-induced bone destruction. As the development of RA is a complex process, further research should be continued towards elucidating the molecular details leading to RA and drugs that can stop or reverse these processes by phytoconstituents of ginger. PMID:24982806

Al-Nahain, Abdullah; Jahan, Rownak

2014-01-01

410

Bee venom acupuncture for rheumatoid arthritis: a systematic review protocol  

PubMed Central

Introduction This systematic review aims to analyse the trial data on the effects of bee venom acupuncture (BVA) for rheumatoid arthritis (RA). Methods and analysis The following 14 databases will be searched from their inception to March 2014: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), AMED, CINAHL, six Korean medical databases (OASIS, Korean Traditional Knowledge Portal, Korean Studies Information Service System, KoreaMed, Korean Medical Database and DBPIA) and three Chinese databases including CNKI (China National Knowledge Infrastructure), Wanfang and VIP. The methodological quality will be assessed using the Cochrane risk of bias tool. Dissemination The systematic review will be published in a peer-reviewed journal. The review will also be disseminated electronically and in print. Trial registration number PROSPERO 2013: CRD42013005853 PMID:24760349

Lee, Ju Ah; Son, Mi Ju; Choi, Jiae; Yun, Kyung-Jin; Jun, Ji Hee; Lee, Myeong Soo

2014-01-01

411

[A case report of rheumatoid arthritis patient with thoracic myelopathy].  

PubMed

The authors report a 39-year-old woman with rheumatoid arthritis associated with myelopathy at the thoracic level. X-ray films of thoracic spine showed scoliosis which had its apex at T6. Myelography demonstrated incomplete block at the level of T6. Computerized tomogram revealed destruction of left pedicle of the sixth thoracic vertebra and dislocation of the sixth rib into the spinal canal which compressed cord at T6 level. Hemi-laminectomy at T5-T7 level and decompression were performed. Pathological investigations of soft tissue around the cord and dura mater showed infiltration of small round cells. We concluded that the synovitis of costo-transverse joint or costovertebral joint led to the destruction of the pedicle. As a result, dislocation of the rib, scoliotic deformity and thoracic myelopathy occurred. PMID:1523524

Nakamura, H; Yoshino, S; Fujimori, J; Koiwa, M; Shiga, H; Mukai, E; Tanaka, H

1992-06-01

412

CIITA is not associated with risk of developing rheumatoid arthritis  

PubMed Central

The major histocompatibility complex (MHC) class II transactivator gene (CIITA) encodes an important transcription factor regulating genes required for human leukocyte antigen (HLA) class II MHC-restricted antigen presentation. Major histocompatibility complex (MHC) genes, particularly HLA class II, are strongly associated with risk of developing rheumatoid arthritis (RA). Given the strong biological relationship between CIITA and HLA class II genes, a comprehensive investigation of CIITA variation in RA was conducted. This study tested 31 CIITA SNPs in 2542 RA cases and 3690 controls (N = 6232). All individuals were of European ancestry, as determined by ancestry informative genetic markers. No evidence for association between CIITA variation and RA was observed after a correction for multiple testing was applied. This is the largest study to fully characterize common genetic variation in CIITA, including an assessment of haplotypes. Results exclude even a modest role for common CIITA polymorphisms in susceptibility to RA. PMID:21248776

Bronson, Paola G.; Ramsay, Patricia P.; Seldin, Michael F.; Gregersen, Peter K.; Criswell, Lindsey A.; Barcellos, Lisa F.

2012-01-01

413

Biological agents in monotherapy for the treatment of rheumatoid arthritis.  

PubMed

Rheumatoid arthritis (RA) is a chronic, systemic, inflammatory disease, which results in joint destruction and permanent disability. The advent of disease-modifying antirheumatic drugs (DMARDs) has made a profound impact on the outcome and prognosis of RA. Methotrexate (MTX) is a central agent in RA therapy, and is used either alone or in combination with biological DMARDs. However, a large proportion of RA patients (20%-40%) either do not respond to or are unable to tolerate MTX or the alternative agents used in place of MTX (including leflunomide, sulfasalazine, azathioprine, hydroxycholoquine and combination DMARDs). For these patients, monotherapy with biological DMARDs is a key treatment option that balances tolerability with improved clinical outcomes. This article reviews the data for four biological agents approved for use as monotherapy in Switzerland (adalimumab, certolizumab pegol, etanercept and tocilizumab) in order to formulate a consensus statement on their roles in biologic monotherapy of RA. PMID:24723273

Gabay, C; Hasler, P; Kyburz, D; So, A; Villiger, P; von Kempis, J; Walker, U

2014-01-01

414

Pigmented villonodular synovitis developing in a patient with rheumatoid arthritis.  

PubMed

A 56-year-old man developed pigmented villonodular synovitis (PVNS) 3 years after he was diagnosed with rheumatoid arthritis (RA). He had been successfully treated with methotrexate, leflunomide, sulfadiazine, and intra-articular knee injection of etanercept (tumor necrosis factor ? inhibitor) in 2010. He stopped all drugs for arthritis 1 year later for disease remission. He was readmitted for right knee pain and swelling in 2013, when the magnetic resonance imaging and arthroscopy of the right knee indicated PVNS. Following surgical resection, the patient was doing well after 1 year. This rare case is the first reported case in English-language literature of PVNS of the knee seen in RA patients and illustrates the importance of differential diagnosis of this condition with synovial cysts, which are commonly found in RA. PMID:25036563

Zhao, Xia; Ji, Wei; Qian, Xian; Lu, Yan

2014-08-01

415

Current concepts in the genetic diagnostics of rheumatoid arthritis.  

PubMed

Rheumatoid arthritis (RA) is a systemic, chronic and inflammatory disease of unknown etiology. HLA-DRB1 and PTPN22 1858T gene variants are risk factors of RA, clinical manifestations and rate of progression of joint destruction in this autoimmune disease. Currently, several immunopathogenetic models of other genes (CTLA4, MIF, PADI4 and SLC22A4) are under debate. The clinical influence of some of the gene polymorphisms associated with RA and the principles of pharmacogenetics applied to different therapies, such as classical disease-modifying anti-rheumatic drugs and new biological agents. Pharmacogenetics is a rapidly advancing area of research that holds the promise that therapies will soon be tailored to an individual patient's genetic profile. PMID:20629510

Nagy, Zsolt B; Csanád, Mónika; Tóth, Katalin; Börzsönyi, Balázs; Demendi, Csaba; Rigó, János; Joó, József Gábor

2010-07-01

416

Gout Initially Mimicking Rheumatoid Arthritis and Later Cervical Spine Involvement  

PubMed Central

Gout is clinically characterized by episodes of monoarthritis, but if not treated properly, it can lead to a chronic polyarthritis, which may eventually mimic rheumatoid arthritis (RA). We present the case of a 59-year-old man, with a history of symmetrical polyarthritis of the large and small joints with later development of subcutaneous nodules, which was initially misdiagnosed as RA, being treated with prednisone and methotrexate for a long period of time. He complained of occipital pain and paresthesia in his left upper limb, and computed tomography (CT) and magnetic resonance imaging (MRI) revealed the presence of an expansive formation in the cervical spine with compression of the medulla. He was admitted for spinal decompressive surgery and the biopsy specimen demonstrated a gouty tophus. Chronic gout can mimic RA and rarely involves the axial skeleton, and thus its correct diagnosis and the implementation of adequate therapy can halt the development of such damaging complications. PMID:25574418

Nunes, Eduardo Araújo Santana; Rosseti, Adroaldo Guimarães; Ribeiro, Daniel Sá; Santiago, Mittermayer

2014-01-01

417

Synoviocyte-derived CXCL12 is displayed on endothelium and induces angiogenesis in rheumatoid arthritis.  

PubMed

CXCL12 (stromal cell-derived factor-1) is a potent CXC chemokine that is constitutively expressed by stromal resident cells. Although it is considered a homeostatic rather than an inflammatory chemokine, CXCL12 has been immunodetected in different inflammatory diseases, but also in normal tissues, ant its potential functions and regulation in inflammation are not well known. In this study, we examined the cellular sources of CXCL12 gene expression and the mechanism and effects of its interactions with endothelial cells in rheumatoid arthritis synovium. We show that CXCL12 mRNA was not overexpressed nor induced in cultured rheumatoid synoviocytes, but it specifically accumulated in the rheumatoid hyperplastic lining layer and endothelium. CXCL12 gene expression was restricted to fibroblast-like synoviocytes, whereas endothelial cells did not express CXCL12 mRNA, but displayed the protein on heparitinase-sensitive factors. CXCL12 colocalized with the angiogenesis marker alpha(v)beta(3) integrin in rheumatoid endothelium and induced angiogenesis in s.c. Matrigel plugs in mice. The angiogenic activity of rheumatoid synovial fluid in vivo was abrogated by specific immunodepletion of CXCL12. Our results indicate that synoviocyte-derived CXCL12 accumulates and it is immobilized on heparan sulfate molecules of endothelial cells, where it can promote angiogenesis and inflammatory cell infiltration, supporting a multifaceted function for this chemokine in the pathogenesis of rheumatoid arthritis. PMID:12574387

Pablos, José L; Santiago, Begoña; Galindo, María; Torres, Carmen; Brehmer, María T; Blanco, Franciso J; García-Lázaro, Francisco J

2003-02-15

418

Anti-neutrophil cytoplasmic antibodies in rheumatoid arthritis: two case reports and review of literature  

PubMed Central

Background Anti-neutrophil cytoplasmic antibodies are typically detected in anti-neutrophil cytoplasmic antibody associated vasculitis, but are also present in a number of chronic inflammatory non-vasculitic conditions like rheumatoid arthritis. Rare cases of granulomatosis with polyangiitis (formerly known as Wegener’s granulomatosis, a vasculitic disorder frequently associated with the presence of anti-neutrophil cytoplasmic antibodies) in patients with rheumatoid arthritis have been described in literature. Case presentation We report two middle-aged female patients with rheumatoid arthritis who developed anti-neutrophil cytoplasmic antibodies and symptoms reminiscent of granulomatosis with polyangiitis. Despite the lack of antibodies specific for proteinase 3 and the absence of a classical histology, we report a probable case of granulomatosis with polyangiitis in the first patient, and consider rheumatoid vasculitis in the second patient. Conclusion Taken together with previous reports, these cases highlight that anti-neutrophil cytoplasmic antibodies have to be evaluated very carefully in patients with rheumatoid arthritis. In this context, anti-neutrophil cytoplasmic antibodies detected by indirect immunofluorescence appear to have a low diagnostic value for granulomatosis with polyangiitis. Instead they may have prognostic value for assessing the course of rheumatoid arthritis. PMID:23253567

2012-01-01

419

Inverse Association between Air Pressure and Rheumatoid Arthritis Synovitis  

PubMed Central

Rheumatoid arthritis (RA) is a bone destructive autoimmune disease. Many patients with RA recognize fluctuations of their joint synovitis according to changes of air pressure, but the correlations between them have never been addressed in large-scale association studies. To address this point we recruited large-scale assessments of RA activity in a Japanese population, and performed an association analysis. Here, a total of 23,064 assessments of RA activity from 2,131 patients were obtained from the KURAMA (Kyoto University Rheumatoid Arthritis Management Alliance) database. Detailed correlations between air pressure and joint swelling or tenderness were analyzed separately for each of the 326 patients with more than 20 assessments to regulate intra-patient correlations. Association studies were also performed for seven consecutive days to identify the strongest correlations. Standardized multiple linear regression analysis was performed to evaluate independent influences from other meteorological factors. As a result, components of composite measures for RA disease activity revealed suggestive negative associations with air pressure. The 326 patients displayed significant negative mean correlations between air pressure and swellings or the sum of swellings and tenderness (p?=?0.00068 and 0.00011, respectively). Among the seven consecutive days, the most significant mean negative correlations were observed for air pressure three days before evaluations of RA synovitis (p?=?1.7×10?7, 0.00027, and 8.3×10?8, for swellings, tenderness and the sum of them, respectively). Standardized multiple linear regression analysis revealed these associations were independent from humidity and temperature. Our findings suggest that air pressure is inversely associated with synovitis in patients with RA. PMID:24454853

Furu, Moritoshi; Nakabo, Shuichiro; Ohmura, Koichiro; Nakashima, Ran; Imura, Yoshitaka; Yukawa, Naoichiro; Yoshifuji, Hajime; Matsuda, Fumihiko; Ito, Hiromu; Fujii, Takao; Mimori, Tsuneyo

2014-01-01

420

Altered immunoglobulin metabolism in systemic lupus erythematosus and rheumatoid arthritis  

PubMed Central

IgG and IgM metabolism was evaluated in 10 patients with systemic lupus erythematosus (SLE), 10 patients with rheumatoid arthritis (RA), and in seven normal volunteers. The biological half-lives of purified IgG and IgM, labeled with 131I and 125I, respectively, were determined by serial measurements of radioactivity in the blood and urine with a gamma well counter, and by serial counts of total body radioactivity in a total body counting chamber. The mean survival half-life for IgG in patients with SLE was 8.2 days as compared to an average of 18 days in normal controls. An average of 10.1% of total body IgG was catabolized daily compared to a mean of 3.9% in normal controls. Turnover of IgM in patients with SLE was, with very few exceptions, normal. In contrast, patients with rheumatoid arthritis revealed a milder abnormality of IgG metabolism, but markedly abnormal IgM catabolism with a mean half-life averaging 5.9 days as compared to 9.3 days in control subjects. An average of 14.2% of total body IgM was catabolized daily in patients with RA as compared to 8.1% in normal controls. Our data suggest that there are basic differences between patients with RA and SLE in the synthesis and catabolism of IgG and IgM not readily apparent from serum IgG and IgM concentration. Abnormal IgG and IgM metabolism may be related to underlying immunological mechanisms in these diseases. Immunoglobulin turnover studies appear to be an additional means for the characterization of rheumatic diseases. PMID:5309797

Levy, Joshua; Barnett, Eugene V.; MacDonald, Norman S.; Klinenberg, James R.

1970-01-01

421

Mental Health Status of Women With Rheumatoid Arthritis in Iran  

PubMed Central

Background: Chronic diseases are usually accompanied by psychological abnormalities. Anxiety and depression occur in a significant number of patients with rheumatoid arthritis (RA). These psychological problems are likely, to be the results of chronic physical symptoms such as pain and disability. Objectives: The aim of this study was the evaluation of mental health in patients with rheumatoid arthritis in Iran. Patients and Methods: One hundred women with definite diagnosis of RA were evaluated in the outpatient clinic of the Tabriz University of Medical Sciences during one year period. Activity of RA disease was determined according to the Disease Activity Score-28 (DAS-28) scaling system and mental health was evaluated using the General Health Questionnaire-28 (GHQ-28). Based on the cut of point score of 22, prevalence of psychological problems was determined and a comparison was made the between two groups (with and without psychological problems). Results: GHQ28 screening test showed that psychological problems were seen in 49% of studied patients. There were significant difference between duration of disease and DAS-28 score between the two groups (P = 0.001 and P = 0.001, respectively). Somatic symptoms were more frequent in patients with psychological problems (P = 0.001). Somatic symptoms in patient with high disease activity was also more frequent than the other group (P = 0.002). There was a significant positive correlation between the scores of DAS-28 and GHQ-28 (r = 0.329, P = 0.001). Conclusions: This study showed that a considerable portion of patients with RA may have mental problems. The probability of these problems increased with more severe and more prolonged disease. PMID:24719738

Kolahi, Sousan; Noshad, Hamid; Fakhari, Ali; Khabbazi, Ali Reza; Hajaliloo, Mehrzad; Ghahremani Nasab, Leila

2014-01-01

422

RADB: a database of rheumatoid arthritis-related polymorphisms  

PubMed Central

Rheumatoid arthritis (RA) is an autoimmune disease that has a complex genetic basis. Therefore, it is important to explore the genetic background of RA. The extensive recent application of polymorphic genetic markers, especially single nucleotide polymorphisms, has presented us with a large quantity of genetic data. In this study, we developed the Database of Rheumatoid Arthritis-related Polymorphisms (RADB), to integrate all the RA-related genetic polymorphisms and provide a useful resource for researchers. We manually extracted the RA-related polymorphisms from 686 published reports, including RA susceptibility loci, polymorphisms associated with particular clinical features of RA, polymorphisms associated with drug response in RA and polymorphisms associated with a higher risk of cardiovascular disease in RA. Currently, RADB V1.0 contains 3235 polymorphisms that are associated with 636 genes and refer to 68 countries. The detailed information extracted from the literature includes basic information about the articles (e.g. PubMed ID, title and abstract), population information (e.g. country, geographic area and sample size) and polymorphism information (e.g. polymorphism name, gene, genotype, odds ratio and 95% confidence interval, P-value and risk allele). Meanwhile, useful annotations, such as hyperlinks to dbSNP, GenBank, UCSC, Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway, are included. In addition, a tool for meta-analysis was developed to summarize the results of multiple studies. The database is freely available at http://www.bioapp.org/RADB. Database URL: http://www.bioapp.org/RADB. PMID:25228593

Zhang, Ruijie; Luan, Meiwei; Shang, Zhenwei; Duan, Lian; Tang, Guoping; Shi, Miao; Lv, Wenhua; Zhu, Hongjie; Li, Jin; Lv, Hongchao; Zhang, Mingming; Liu, Guiyou; Chen, He; Jiang, Yongshuai

2014-01-01

423

[Anxiety level and its determinants in rheumatoid arthritis patients].  

PubMed

Rheumatoid arthritis (RA) is a chronic disease with many somatic, psychological and social consequences. Somatic consequences are connected mainly with increasing levels of negative emotions such as depression, anxiety and a tendency to react with anger to many daily life situations. Additionally, loss of hope has been reported as another effect of rheumatoid arthritis. The goal of the study was to describe anxiety levels and its determinants in RA patients. The study was carried out on 31 RA patients, 22 (71%) of whom were females and 9 (29%) of whom were males. The respondents were assessed with a set of questionnaires such as Spielberger's State-Trait Anxiety Inventory (STAI), Multidimensional Health Locus of Control Scale (MHLC), The Coping Inventory for Stressful Situations (CISS) and Eysenck's Personality Questionnaire - Revised (EPQ-R). We have found the relationship between anxiety as (1) a state and external locus of control - powerful others (tau-b = 0.23, p = 0.09), task - oriented style of coping (tau-b = -0.34, p = 0.01), emotion-oriented style of coping (tau-b = 0.33, p = 0.02) and neuroticism levels (tau-b = 0.29, p = 0.03) and (2) anxiety as a trait and external locus of control - powerful others (tau-b = 0.40, p = 0.01), task - oriented style of coping (tau-b = 0.36, p = 0.01), emotion-oriented style of coping (tau-b = 0.33, p = 0.02) and neuroticism levels (tau-b = 0.47, p = 0,01). PMID:22235646

Mojs, Ewa; Ziarko, Micha?; Kaczmarek, ?ukasz; Samborski, W?odzimierz

2011-01-01

424

Differential expression of Ia antigens by rheumatoid synovial lining cells.  

PubMed Central

The differential expression of Ia antigens was studied in freshly isolated rheumatoid nonlymphoid synovial lining cells (SLC) and rheumatoid synovial fibroblast cell lines cultured in the presence of Interferon-gamma, using a large panel of anti-Ia reagents with monomorphic or polymorphic specificities. All the HLA-DR or -DQ specificities detectable on the corresponding peripheral blood B cells were also expressed in freshly isolated SLC. However, in all instances, the number of DR-positive SLC exceeded the percentage of cells expressing DQ antigens. In addition, the epitope expression of Ia antigens varied within the DR or DQ populations of Ia molecules as revealed by polymorphic reagents. Double-label experiments or using the ingestion of Latex particles as a marker demonstrated that the synovial macrophages (type I SLC) primarily bear the DR+DQ+ phenotype, while there is an additional population of nonphagocytic SLC (previously termed type II SLC) that has a DR+ and monocyte marker negative phenotype but did not have detectable levels of DQ antigens as analyzed by both fluorescence microscopy and cell sorter analysis. This latter population frequently had a morphology showing dendritic processes and rapidly lost the expression of Ia antigens upon culture. Cells with a similar, primarily DR+ phenotype were readily obtained in synovial fibroblast cultures after treatment with Interferon-gamma. These data suggest that there are two populations of Ia+ synovial lining cells: the synovial macrophages (type I cells) with the DR+DQ+ phenotype, and cells probably related to fibroblasts with a DR+ phenotype without detectable DQ antigens (type II cells). The fact that the latter phenotype could be induced by Interferon-gamma treatment of cultured synovial fibroblasts suggests that this mediator may have a similar role in vivo in the activation of certain synovial cell populations. Images PMID:2442194

Burmester, G R; Jahn, B; Rohwer, P; Zacher, J; Winchester, R J; Kalden, J R

1987-01-01

425

Early maturation processes in coal. Part 2: Reactive dynamics simulations using the ReaxFF reactive force field on Morwell Brown coal structures  

Microsoft Academic Search

This paper reports reactive dynamics (RD) simulations of a macro-model of Morwell Brown coal using the ReaxFF reactive force field. We find that these reactive MD simulations successfully reproduce thermal decomposition processes of defunctionalization, depolymerization and rearrangement of the residual structure observed in various experimental studies. For example, our simulations indicate that the decarboxylation and dehydroxylation of the lignin side

Elodie Salmon; Adri C. T. van Duin; François Lorant; Paul-Marie Marquaire; William A. Goddard III

2009-01-01

426

Prevalence of antihuman parvovirus B19 IgG antibodies in patients with refractory rheumatoid arthritis and polyarticular juvenile rheumatoid arthritis  

Microsoft Academic Search

We investigated the prevalence of antihuman parvovirus B19 immunoglobulin G (IgG) antibody in 108 Japanese patients with rheumatoid arthritis (RA) and 11 patients with polyarticular juvenile rheumatoid arthritis (JRA). Seropositivity of anti-B19 was significantly higher in patients with refractory RA (57.6%, 38\\/66) compared with patients with remittent RA (19.0%, 8\\/42; P>0.001) or age-matched controls (24.3%, 19\\/78; P>0.001). Patients with refractory

A. Mimori; Y. Misaki; T. Hachiya; K. Ito; S. Kano

1994-01-01

427

14-3-3? is a novel mediator associated with the pathogenesis of rheumatoid arthritis and joint damage  

PubMed Central

Introduction The aim of this study was to investigate whether 14-3-3?, a specific isoform of a family of proteins regulating processes such as cellular signalling, activates cell-signalling pathways and induces factors known to contribute to the pathophysiology of rheumatoid arthritis (RA). We also investigated whether 14-3-3? is associated with more severe disease in both early and established RA. Methods We investigated the effect of 14-3-3? on the activation of RA-relevant signalling cascades and induction of proinflammatory mediators that contribute to the joint damage process. 14-3-3? titres from 33 patients with early RA (mean RA duration?=?1.8 months) and from 40 patients with established RA were measured in serum drawn at the 3-year time point of the Behandel Strategieën study. The relationship between 14-3-3? titres and standard clinical variables was investigated by correlation analysis. The association with radiographic damage and radiographic progression over at least a 2-year period was investigated using univariate and multivariate regression analyses. Results 14-3-3? activated selected members of the mitogen-activated protein kinase (MAPK) family, mainly extracellular regulated kinase 1/2 and c-Jun kinase, but not p38MAPK. Activation by 14-3-3?, using levels spanning the concentration range found in RA patient serum, resulted in the induction of inflammatory transcripts such as interleukin 1 (IL-1) and IL-6 and factors linked to the joint damage process, such as receptor activator of nuclear factor ?B ligand and matrix metalloproteinase 1. Serum 14-3-3? correlated significantly with rheumatoid factor (RF) (r?=?0.43) and anticitrullinated protein antibodies (ACPAs) (r?=?0.31) in the early RA cohort, but not with C-reactive protein (CRP) or the Disease Activity Score in 28 joints in either cohort. Serum 14-3-3? concentrations were significantly higher in patients with radiographically assessed joint damage and in those who had radiographic progression. By multivariate analysis, we show that 14-3-3? complemented markers such as CRP, RF and ACPA in informing RA radiographic status and/or progression. Conclusions Extracellular 14-3-3? activates key signalling cascades and induces factors associated with the pathogenesis of RA at concentrations found in patients with RA, and its expression is higher in patients with radiographic damage and RA progression. PMID:24751211

2014-01-01

428

Climate model simulation of anthropogenic influence on greenhouse-induced climate change (early agriculture to modern): the role of ocean feedbacks  

Microsoft Academic Search

We present further steps in our analysis of the early anthropogenic hypothesis (Ruddiman, Clim Change 61:261–293, 2003) that increased levels of greenhouse gases in the current interglacial, compared to lower levels in previous interglacials,\\u000a were initiated by early agricultural activities, and that these increases caused a warming of climate long before the industrial\\u000a era (?1750). These steps include updating observations

John E. Kutzbach; W. F. Ruddiman; S. J. Vavrus; G. Philippon

2010-01-01

429

Constitutive upregulation of the transforming growth factor-? pathway in rheumatoid arthritis synovial fibroblasts  

PubMed Central

Genome-wide gene expression was comparatively investigated in early-passage rheumatoid arthritis (RA) and osteoarthritis (OA) synovial fibroblasts (SFBs; n = 6 each) using oligonucleotide microarrays; mRNA/protein data were validated by quantitative PCR (qPCR) and western blotting and immunohistochemistry, respectively. Gene set enrichment analysis (GSEA) of the microarray data suggested constitutive upregulation of components of the transforming growth factor (TGF)-? pathway in RA SFBs, with 2 hits in the top 30 regulated pathways. The growth factor TGF-?1, its receptor TGFBR1, the TGF-? binding proteins LTBP1/2, the TGF-?-releasing thrombospondin 1 (THBS1), the negative effector SkiL, and the smad-associated molecule SARA were upregulated in RA SFBs compared to OA SFBs, whereas TGF-?2 was downregulated. Upregulation of TGF-?1 and THBS1 mRNA (both positively correlated with clinical markers of disease activity/severity) and downregulation of TGF-?2 mRNA in RA SFBs were confirmed by qPCR. TGFBR1 mRNA (only numerically upregulated in RA SFBs) and SkiL mRNA were not differentially expressed. At the protein level, TGF-?1 showed a slightly higher expression, and the signal-transducing TGFBR1 and the TGF-?-activating THBS1 a significantly higher expression in RA SFBs than in OA SFBs. Consistent with the upregulated TGF-? pathway in RA SFBs, stimulation with TGF-?1 resulted in a significantly enhanced expression of matrix-metalloproteinase (MMP)-11 mRNA and protein in RA SFBs, but not in OA SFBs. In conclusion, RA SFBs show broad, constitutive alterations of the TGF-? pathway. The abundance of TGF-?, in conjunction with an augmented mRNA and/or protein expression of TGF-?-releasing THBS1 and TGFBR1, suggests a pathogenetic role of TGF-?-induced effects on SFBs in RA, for example, the augmentation of MMP-mediated matrix degradation/remodeling. PMID:17594488

Pohlers, Dirk; Beyer, Andreas; Koczan, Dirk; Wilhelm, Thomas; Thiesen, Hans-Jürgen; Kinne, Raimund W

2007-01-01

430

Inflammation, adiposity, and atherogenic dyslipidemia in rheumatoid arthritis: is there a paradoxical relationship?  

PubMed

Dyslipidemia is highly prevalent in rheumatoid arthritis (RA) and appears to be present very early in the RA disease process, in some studies even before a diagnosis of clinical RA has been made. The association between lipid measures and the risk of cardiovascular disease (CVD) in RA appears to be paradoxical, whereby lower levels of total cholesterol (TC), low-density lipoprotein (LDL-C), and atherogenic ratios are associated with higher CVD risk. This may be due to the lipid-lowering effects of RA-related systemic inflammation. Therefore, standard CVD risk calculators have been shown to underperform in RA. Data also suggest that lipoprotein particle sizes and the apolipoprotein cargo of lipoproteins skew toward atherogenic dyslipidemia in RA and may contribute to the initiation and progression of atherosclerosis. Inflammatory burden in RA may also alter the anti-inflammatory and atheroprotective roles associated with high-density lipoprotein cholesterol (HDL-C). Adipose tissue is quantitatively increased in RA patients compared with matched non-RA controls and may be more inflamed and metabolically dysfunctional compared with an otherwise similar non-RA patient. In vitro, animal, and a handful of non-RA human, studies suggest that inflamed, metabolically dysfunctional adipose tissue contributes directly to lower HDL-C levels. In turn, lower HDL-C that has been altered functionally by inflammation may lead to expanded adipose mass and further adipose dysfunction and inflammation. In the last part of this review, we speculate how the RA disease state may recapitulate these processes. PMID:25504261

Bag-Ozbek, Ayse; Giles, Jon T

2015-02-01

431

The supplementary therapeutic DMARD role of low-dose glucocorticoids in rheumatoid arthritis.  

PubMed

The management of rheumatoid arthritis (RA) is primarily based on the use of disease-modifying antirheumatic drugs (DMARDs), mainly comprising synthetic chemical compounds (that is, methotrexate or leflunomide) and biological agents (tumor necrosis factor inhibitors or abatacept). On the other hand, glucocorticoids (GCs), used for decades in the treatment of RA, are effective in relieving signs and symptoms of the disease, but also interfere with radiographic progression, either as monotherapy or in combination with conventional synthetic DMARDs. GCs exert most of their biological effects through a genomic action, using the cytosolic GC receptor and then interacting with the target genes within target cells that can result in increased expression of regulatory--including anti-inflammatory--proteins (transactivation) or decreased production of proinflammatory proteins (transrepression). An inadequate secretion of GCs from the adrenal gland, in relation to stress and inflammation, seems to play an important role in the pathogenesis and disease progression of RA. At present there is clear evidence that GC therapy, especially long-term low-dose treatment, slows radiographic progression by at least 50% when given to patients with early RA, hence satisfying the conventional definition of a DMARD. In addition, long-term follow-up studies suggest that RA treatment strategies which include GC therapy may favorably alter the disease course even after their discontinuation. Finally, a low-dose, modified night-release formulation of prednisone, although administered in the evening (replacement therapy), has been developed to counteract the circadian (night) rise in proinflammatory cytokine levels that contributes to disease activity, and might represent the way to further optimize the DMARD activity exerted by GCs in RA. PMID:25608624

Cutolo, Maurizio; Spies, Cornelia M; Buttgereit, Frank; Paolino, Sabrina; Pizzorni, Carmen

2014-01-01

432

The supplementary therapeutic DMARD role of low-dose glucocorticoids in rheumatoid arthritis  

PubMed Central

The management of rheumatoid arthritis (RA) is primarily based on the use of disease-modifying antirheumatic drugs (DMARDs), mainly comprising synthetic chemical compounds (that is, methotrexate or leflunomide) and biological agents (tumor necrosis factor inhibitors or abatacept). On the other hand, glucocorticoids (GCs), used for decades in the treatment of RA, are effective in relieving signs and symptoms of the disease, but also interfere with radiographic progression, either as monotherapy or in combination with conventional synthetic DMARDs. GCs exert most of their biological effects through a genomic action, using the cytosolic GC receptor and then interacting with the target genes within target cells that can result in increased expression of regulatory - including anti-inflammatory - proteins (transactivation) or decreased production of proinflammatory proteins (transrepression). An inadequate secretion of GCs from the adrenal gland, in relation to stress and inflammation, seems to play an important role in the pathogenesis and disease progression of RA. At present there is clear evidence that GC therapy, especially long-term low-dose treatment, slows radiographic progression by at least 50% when given to patients with early RA, hence satisfying the conventional definition of a DMARD. In addition, long-term follow-up studies suggest that RA treatment strategies which include GC therapy may favorably alter the disease course even after their discontinuation. Finally, a low-dose, modified night-release formulation of prednisone, although administered in the evening (replacement therapy), has been developed to counteract the circadian (night) rise in proinflammatory cytokine levels that contributes to disease activity, and might represent the way to further optimize the DMARD activity exerted by GCs in RA. PMID:25608624

2014-01-01

433

Consensus statement on a framework for the management of comorbidity and extra-articular manifestations in rheumatoid arthritis.  

PubMed

The objective of the study was to develop evidence-based and practical recommendations for the detection and management of comorbidity in patients with rheumatoid arthritis (RA) in daily practice. We used a modified RAND/UCLA methodology and systematic review (SR). The process map and specific recommendations, based on the SR, were established in discussion groups. A two round Delphi survey permitted (1) to prioritize the recommendations, (2) to refine them, and (3) to evaluate their agreement by a large group of users. The recommendations cover: (1) which comorbidities should be investigated in clinical practice at the first and following visits (including treatments, risk factors and patient's features that might interfere with RA management); (2) how and when should comorbidities and risk factors be investigated; (3) how to manage specific comorbidities, related or non-related to RA, including major adverse events of RA treatment, and to promote health (general and musculoskeletal health); and (4) specific recommendations to assure an integral care approach for RA patients with any comorbidity, such as health care models for chronic inflammatory patients, early arthritis units, relationships with primary care, specialized nursing care, and self-management. These recommendations are intended to guide rheumatologists, patients, and other stakeholders, on the early diagnosis and management of comorbidity in RA, in order to improve disease outcomes. PMID:25543267

Loza, Estíbaliz; Lajas, Cristina; Andreu, Jose Luis; Balsa, Alejandro; González-Álvaro, Isidoro; Illera, Oscar; Jover, Juan Ángel; Mateo, Isabel; Orte, Javier; Rivera, Javier; Rodríguez Heredia, José Manuel; Romero, Fredeswinda; Martínez-López, Juan Antonio; Ortiz, Ana María; Toledano, Esther; Villaverde, Virginia; Carmona, Loreto; Castañeda, Santos

2015-03-01

434

Development and delivery of an exercise intervention for rheumatoid arthritis: Strengthening and stretching for rheumatoid arthritis of the hand (SARAH) trial  

Microsoft Academic Search

This paper describes the development and implementation of a hand exercise intervention for rheumatoid arthritis (RA) as part of a large multi-centred randomised controlled trial in a UK National Health Service (NHS) setting. Participants are eligible if diagnosed with RA according to American College of Rheumatology criteria, have a history of disease activity, functional deficit or impairment in the hand

P. J. Heine; M. A. Williams; E. Williamson; C. Bridle; J. Adams; A. O’Brien; D. Evans; S. E. Lamb

435

Loss of collagen type IV in rheumatoid synovia and cytokine effect on the collagen type-IV gene expression in fibroblast-like synoviocytes from rheumatoid arthritis  

Microsoft Academic Search

Collagen type IV is a structural matrix protein which contributes to the structural organization of the synovia. In order to characterize the distribution of this protein in synovia with chronic synovitis, collagen type IV was detected by immunochemistry in normal synovia and in synovia from patients with osteoarthritis (OA) and rheumatoid arthritis (RA). A decrease of collagen type IV was

N. Rinaldi; M. Willhauck; D. Weis; B. Brado; P. Kern; M. Lukoschek; M. Schwarz-Eywill; T. Barth

2001-01-01

436

Representation of genetic association via attributable familial relative risks in order to identify polymorphisms functionally relevant to rheumatoid arthritis.  

PubMed

The results from association studies are usually summarized by a measure of evidence of association (frequentist or Bayesian probability values) that does not directly reflect the impact of the detected signals on familial aggregation. This article investigates the possible advantage of a two-dimensional representation of genetic association in order to identify polymorphisms relevant to disease: a measure of evidence of association (the Bayes factor, BF) combined with the estimated contribution to familiality (the attributable sibling relative risk, lambdas). Simulation and data from the North American Rheumatoid Consortium (NARAC) were used to assess the possible benefit under several scenarios. Simulation indicated that the allele frequencies to reach the maximum BF and the maximum attributable lambdas diverged as the size of the genetic effect increased. The representation of BF versus attributable lambdas for selected regions of NARAC data revealed that SNPs involved in replicated associations clearly departed from the bulk of SNPs in these regions. In the 12 investigated regions, and particularly in the low-recombination major histocompatibility region, the ranking of SNPs according to BF differed from the ranking of SNPs according to attributable lambdas. The present results should be generalized using more extensive simulations and additional real data, but they suggest that a characterization of genetic association by both BF and attributable lambdas may result in an improved ranking of variants for further biological analyses. PMID:20017963

Bermejo, Justo Lorenzo; Fischer, Christine; Schulz, Anke; Cremer, Nadine; Hein, Rebecca; Beckmann, Lars; Chang-Claude, Jenny; Hemminki, Kari

2009-01-01

437

Treatment of Rheumatoid Arthritis with Biologic DMARDS (Rituximab and Etanercept)  

PubMed Central

ABSTRACT Goal: To determine efficacy and safety of treatment with Rituximab and Etanercept plus Methotrexate in patients with active Rheumatoid Arthritis (RA), who had an inadequate response to nonbiologic DMARDS therapies and to explore the pharmacogenetics and pharmacodynamics of Rituximab and Etanercept in our populations. Study was done at Rheumatology Clinic of University Clinical Centre in P