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1

New autoantibodies in early rheumatoid arthritis  

PubMed Central

Introduction Rheumatoid arthritis (RA) is a chronic inflammatory joint disease causing articular cartilage and bone destruction. Since irreversible joint destruction can be prevented by intervention at the early stages of disease, early diagnosis of RA is important. In this study, we identified new autoantibodies in the sera of patients with early (less than one year) RA. Methods We screened the sera of 20 RA patients with disease duration less than one year, 19 RA patients with disease duration more than five years and 23 controls on 8,268 human protein arrays. We confirmed the validity of protein array detection by ELISA assays. We then performed epitope mapping with overlapping 15-mers to analyze RA sera reactivity. Results WIBG (within BGCN homolog (Drosophila)), GABARAPL2 (GABA(A) receptor associated protein like 2) and ZNF706 (zinc finger protein 706) proteins are preferentially recognized by autoantibodies from early RA patients. Of interest, autoantibodies to WIBG are very specific for early RA. Indeed, 33% of early RA patients' sera recognize WIBG versus 5% of RA patients with disease duration more than 5 years and 2% of controls. We identified three linear peptides on WIBG GABARAPL2 and ZNF706 that are preferentially recognized by sera of early RA patients. Conclusions We identified new autoantibodies associated with RA with disease duration less than one year. These autoantibodies could be used as diagnosis markers in RA patients. PMID:23886014

2013-01-01

2

Clinical significance of rheumatoid factors in early rheumatoid arthritis: results of a follow up study  

Microsoft Academic Search

Serum rheumatoid factors (RF) were measured yearly in 135 women with rheumatoid arthritis by the Waaler-Rose and latex fixation tests and IgM, IgA, and IgG RF were measured by enzyme linked immunosorbent assays (ELISAs). The patients were followed up from an early phase of the disease for a mean duration of six years. Patients with a persistently positive RF test,

D van Zeben; J M Hazes; A H Zwinderman; A Cats; E A van der Voort; F C Breedveld

1992-01-01

3

Early onset sarcoidosis masquerading as juvenile rheumatoid arthritis.  

PubMed

Symptoms of early onset sarcoidosis characterized by skin eruptions, arthritis, and uveitis mimic those of systemic type juvenile rheumatoid arthritis (JRA). We report 2 Japanese patients with early onset sarcoidosis, both of whom were initially diagnosed and treated as having JRA. Intermittent fever and synovial swelling may mask sarcoidosis in children less than 4 years old. PMID:11044836

Yotsumoto, S; Takahashi, Y; Takei, S; Shimada, S; Miyata, K; Kanzaki, T

2000-11-01

4

Early onset sarcoidosis masquerading as juvenile rheumatoid arthritis  

Microsoft Academic Search

Symptoms of early onset sarcoidosis characterized by skin eruptions, arthritis, and uveitis mimic those of systemic type juvenile rheumatoid arthritis (JRA). We report 2 Japanese patients with early onset sarcoidosis, both of whom were initially diagnosed and treated as having JRA. Intermittent fever and synovial swelling may mask sarcoidosis in children less than 4 years old. (J Am Acad Dermatol

Shinichi Yotsumoto; Yoshihiro Takahashi; Shuji Takei; Shoko Shimada; Koichiro Miyata; Tamotsu Kanzaki

2000-01-01

5

New autoantibodies associated with early rheumatoid arthritis  

Microsoft Academic Search

Background and objectivesRheumatoid arthritis (RA) is an autoantibody mediated disease. Among the various autoantibodies known in RA, autoantibodies to citrullinated proteins (ACPA) are highly specific. ACPAs are detected by an ELISA using synthetic cyclic citrullinated peptides (anti-CCP). Anti-CCP antibodies identify 60% of RA patients. A negative result in anti-CCP antibody testing does not exclude RA. Therefore, there is a great

C Charpin; M Martin; N Balandraud; E Toussirot; D Wendling; J Roudier; I Auger

2011-01-01

6

Managing early presentation of rheumatoid arthritis. Systematic overview.  

PubMed Central

OBJECTIVE: To describe evidence-based management of patients presenting to family physicians with typical signs and symptoms of recent onset of rheumatoid arthritis (RA). STUDY SELECTION: Articles for critical review were included if relevant to primary care management of early RA (less than 1 year duration). Sources included MEDLINE from 1966 to December 1995, the reference library of the Arthritis Community Research and Evaluation Unit, and conference abstracts. FINDINGS: Evidence from randomized, controlled trials supports the short-term benefit of nonsteroidal anti-inflammatory drugs, disease-modifying agents for rheumatic diseases, intravenous pulse corticosteroid therapy, intra-articular therapy, aerobic exercise, patient education, psychologic intervention, home physiotherapy, home occupational therapy, and rehabilitation programs. Some evidence favours acetaminophen for analgesia, low-dose oral corticosteroids for symptom control, and referral to a rheumatologist. Evidence for rest, ice, and heat for symptom control is conflicting and based on low-quality studies. CONCLUSION: Family physicians play an important role in establishing early and accurate diagnosis of RA, coordinating therapy, and providing ongoing support, education, and monitoring to patients and their families. PMID:8688694

Glazier, R.

1996-01-01

7

Candidate autoantigens identified by mass spectrometry in early rheumatoid arthritis are chaperones and citrullinated glycolytic enzymes  

Microsoft Academic Search

ABSTRACT: INTRODUCTION: The aim of our study was to identify new early rheumatoid arthritis (RA) autoantibodies. METHODS: Sera obtained from 110 early untreated RA patients (<6 months) were analyzed by western blot using HL-60 cell extract, separated on one-dimensional and two-dimensional gel electrophoresis (1-DE, 2-DE). Sera from 50 healthy blood donors and 20 patients with non-RA rheumatisms were used as

Vincent Goëb; Marlène Thomas-L'Otellier; Romain Daveau; Roland Charlionet; Patrice Fardellone; Xavier Le Loët; François Tron; Danièle Gilbert; Olivier Vittecoq

2009-01-01

8

Management of the early and late presentations of rheumatoid arthritis: a survey of Ontario primary care physicians.  

PubMed Central

OBJECTIVE: To examine primary care physicians' management of rheumatoid arthritis, ascertain the determinants of management and compare management with that recommended by a current practice panel. DESIGN: Mail survey (self-administered questionnaire). SETTING: Ontario. PARTICIPANTS: A stratified computer-generated random sample of 798 members of the College of Family Physicians of Canada. OUTCOME MEASURES: Proportions of respondents who chose various items in the management of two hypothetical patients, one with early rheumatoid arthritis and one with late rheumatoid arthritis. Scores for investigations, interventions and referrals for each scenario were generated by summing the recommended items chosen by respondents and then dividing by the total number of items recommended in that category. The scores were examined for their association with physician and practice characteristics and physician attitudes. RESULTS: The response rate was 68.3% (529/775 eligible physicians). Recommended investigations were chosen by more than two thirds of the respondents for both scenarios. Referrals to physiotherapy, occupational therapy and rheumatology, all recommended by the panel, were chosen by 206 (38.9%), 72 (13.6%) and 309 (58.4%) physicians respectively for early rheumatoid arthritis. These proportions were significantly higher for late rheumatoid arthritis (p < 0.01). In multiple regression analysis, for early rheumatoid arthritis, internship or residency training in rheumatology was associated with higher investigation and intervention scores, for late rheumatoid arthritis, older physicians had higher intervention scores and female physicians had higher referral scores. CONCLUSIONS: Primary care physicians' investigation of rheumatoid arthritis was in accord with panel recommendations. However, rates of referral to rheumatologists and other health care professionals were very low, especially for the early presentation of rheumatoid arthritis. More exposure to rheumatology and to the role of physiotherapy, occupational therapy and social work during primary care training is strongly recommended. PMID:8823213

Glazier, R H; Dalby, D M; Badley, E M; Hawker, G A; Bell, M J; Buchbinder, R; Lineker, S C

1996-01-01

9

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

10

RESEARCH ARTICLE Open Access New autoantibodies in early rheumatoid arthritis  

E-print Network

(ACPA) [1]. ACPA identify 65% of RA patients. Negative ACPA testing does not exclude RA. To identify new dis- ease affecting 0.5% of the world population. It is character- ized by inflammation of joints of the disease, early diagnosis of RA is important. However, diagnosis of RA can be difficult. Immunologic tests

Paris-Sud XI, Université de

11

Predictors of Change in Bodily Pain in Early Rheumatoid Arthritis: An Inception Cohort Study  

PubMed Central

Objective To investigate possible predictors for lack of pain improvement after 1 year of treatment for early rheumatoid arthritis (RA). Methods The Early Rheumatoid Arthritis Network (ERAN) database was used for analysis of baseline and 1-year pain data. The ERAN is a hospital-based inception cohort of 1,189 people. Short Form 36 questionnaire bodily pain scores were used to calculate change in pain at 1 year as the outcome. The proportion of the Disease Activity Score in 28 joints (DAS28) attributable to patient-reported components (joint tenderness and visual analog scale score; DAS28-P) at baseline was derived as a predictor. Predictors of less improvement in pain were investigated using adjusted odds ratios (ORadj) generated by logistic regression, adjusting for 14 additional clinical and demographic covariates. Results Greater pain at baseline was associated with sex, high DAS28, worse mental health, and smoking. Most patients with early RA reported incomplete improvement in bodily pain after 1 year. The DAS28-P index did not significantly change in the patients whose disease remained active. Less improvement in pain was predicted by female sex (ORadj 3.41, 95% confidence interval [95% CI] 1.35–8.64) and a high DAS28-P index at baseline (ORadj for tertiles 2.09, 95% CI 1.24–3.55). Other conventional RA risk factors did not predict pain changes. Conclusion The factors most likely to predict less improvement in pain in early RA are female sex and a high DAS28-P index. A high DAS28-P index may reflect greater contributions of noninflammatory factors, such as central sensitization, to pain. Strategies in addition to inflammatory disease suppression may be required to adequately treat pain. PMID:22556121

McWilliams, Daniel F; Zhang, Weiya; Mansell, Josephine S; Kiely, Patrick D W; Young, Adam; Walsh, David A

2012-01-01

12

Clinical correlations with Porphyromonas gingivalis antibody responses in patients with early rheumatoid arthritis  

PubMed Central

Introduction Prior studies have demonstrated an increased frequency of antibodies to Porphyromonas gingivalis (Pg), a leading agent of periodontal disease, in rheumatoid arthritis (RA) patients. However, these patients generally had long-standing disease, and clinical associations with these antibodies were inconsistent. Our goal was to examine Pg antibody responses and their clinical associations in patients with early RA prior to and after disease-modifying antirheumatic drug (DMARD) therapy. Methods Serum samples from 50 DMARD-naïve RA patients were tested using an enzyme-linked immunosorbent assay with whole-Pg sonicate. For comparison, serum samples were tested from patients with late RA, patients with other connective tissue diseases (CTDs), age-similar healthy hospital personnel and blood bank donors. Pg antibody responses in early RA patients were correlated with standard RA biomarkers, measures of disease activity and function. Results At the time of enrollment, 17 (34%) of the 50 patients with early RA had positive immunoglobulin G (IgG) antibody responses to Pg, as did 13 (30%) of the 43 patients with late RA. RA patients had significantly higher Pg antibody responses than healthy hospital personnel and blood bank donors (P < 0.0001). Additionally, RA patients tended to have higher Pg antibody reactivity than patients with other CTDs (P = 0.1), and CTD patients tended to have higher Pg responses than healthy participants (P = 0.07). Compared with Pg antibody-negative patients, early RA patients with positive Pg responses more often had anti-cyclic citrullinated peptide (anti-CCP) antibody reactivity, their anti-CCP levels were significantly higher (P = 0.03) and the levels of anti-Pg antibodies correlated directly with anti-CCP levels (P < 0.01). Furthermore, at the time of study entry, the Pg-positive antibody group had greater rheumatoid factor values (P = 0.04) and higher inflammatory markers (erythrocyte sedimentation rate, or ESR) (P = 0.05), and they tended to have higher disease activity scores (Disease Activity Score based on 28-joint count (DAS28)-ESR and Clinical Disease Activity Index) and more functional impairment (Health Assessment Questionnaire). In Pg-positive patients, greater disease activity was still apparent after 12 months of DMARD therapy. Conclusions A subset of early RA patients had positive Pg antibody responses. The responses correlated with anti-CCP antibody reactivity and to a lesser degree with ESR values. There was a trend toward greater disease activity in Pg-positive patients, and this trend remained after 12 months of DMARD therapy. These findings are consistent with a role for Pg in disease pathogenesis in a subset of RA patients. PMID:24017968

2013-01-01

13

Circulating surfactant protein -D is low and correlates negatively with systemic inflammation in early, untreated rheumatoid arthritis  

Microsoft Academic Search

INTRODUCTION: Surfactant protein D (SP-D) is a collectin with immuno-regulatory functions, which may depend on oligomerization. Anti-microbial and anti-inflammatory properties have been attributed to multimeric SP-D variants, while trimeric subunits per se have been suggested to enhance inflammation. Previously, we reported low circulating SP-D in early rheumatoid arthritis (RA), and the present investigation aims to extend these data by serial

Anne Friesgaard Christensen; Grith Lykke Sørensen; Kim Hørslev-Petersen; Uffe Holmskov; Hanne Merete Lindegaard; Kirsten Junker; Merete Lund Hetland; Kristian Stengaard-Pedersen; Søren Jacobsen; Tine Lottenburger; Torkell Ellingsen; Lis Smedegaard Andersen; Ib Hansen; Henrik Skjødt; Jens Kristian Pedersen; Ulrik Birk Lauridsen; Anders Svendsen; Ulrik Tarp; Jan Pødenphant; Aage Vestergaard; Anne Grethe Jurik; Mikkel Østergaard; Peter Junker

2010-01-01

14

Work disability in early rheumatoid arthritis: higher rates but better clinical status in Finland compared with the US  

PubMed Central

Objective To analyse and compare work disability attributed to rheumatoid arthritis in two cohorts of patients with early disease: one in the US and the other in Finland. Patients and methods Two cohorts of patients who were working and aged <65?years at the time of their first symptom of rheumatoid arthritis were studied: 269 patients in Nashville, TN, USA (median age 46?years, 72.5% females), and 364 patients from Jyväskylä, Finland, (median age 47.1?years, 70.9% females). The cohorts were analysed and compared for measures of clinical status and work disability status over a median (interquartile range) of 38.9?months in Nashville and 48.4?months in Jyväskylä. Results The probability of working at 36?months was 0.89 (0.84–0.92) for patients from Nashville and 0.84 (0.80–0.88) for patients from Jyväskylä (p?=?0.02). These rates were lower than in earlier decades. Patients from Jyväskylä had significantly higher rates of work disability (p?=?0.02) than those from Nashville, but better scores for self?report physical function (p<0.001), pain (p<0.001) and global status (p<0.001) at last observation. The likelihood of being disabled from work was 2.6?fold higher in Jyväskylä compared to Nashville (95% confidence interval 1.44 to 4.59, p?=?0.001), after adjustment for demographic and disease?specific variables. Conclusion Rates of work disability in both early rheumatoid arthritis cohorts were improved from earlier decades, but differed significantly in two different social systems. Higher work disability rates with better clinical status was seen in the Finnish early rheumatoid arthritis cohort than in the US cohort. PMID:16740683

Chung, C P; Sokka, T; Arbogast, P G; Pincus, T

2006-01-01

15

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

16

Relationship between inflammation and joint destruction in early rheumatoid arthritis: a mathematical description  

PubMed Central

Background: The relationship between inflammation and joint destruction in rheumatoid arthritis (RA) has not been unequivocally characterised. Joint destruction may result from the cumulative inflammatory burden over time, modified by an individual constant factor. Objective: To test the hypothesis that the relationship between radiological progression and inflammation can mathematically be expressed as: ? where ? is a factor that varies from person to person. Methods: Clinical data and radiographs of 76 patients with early RA receiving different disease modifying antirheumatic drugs were analysed. Radiographs were quantified using the modified Larsen score and the "X-Ray RheumaCoach" software. The cumulative inflammatory burden was estimated by the time integrated 28 joint Disease Activity Score (DAS28), calculated as the area under the curve. Results: 76 patients with early RA who started treatment with methotrexate (n = 20), sulfasalazine (n = 37), or oral gold (n = 19) monotherapy were evaluated. The mean (SEM) DAS28 decreased from 4.6 (0.1) at baseline to 2.3 (0.1) after 2 years. The mean (SEM) ?Larsen score from baseline to year 2 was 10.3 (1.5). Correlation between cumulative inflammation and radiographic change was poor. In contrast, when calculating a person's factor ? in year 1 (?1) and year 2 (?2), a strong and significant correlation (r = 0.58, p<0.000001) was seen between ?1 and ?2. Conclusions: Joint destruction is the result of the cumulative burden of inflammation over time, modified by an individual factor ? that remains relatively constant over the first 2 years of observation. The data support a mathematical model that expresses the interrelationship between inflammation and joint destruction. PMID:15194582

Wick, M; Lindblad, S; Klareskog, L; van Vollenhoven, R F

2004-01-01

17

Synovial mast cell responses during clinical improvement in early rheumatoid arthritis  

PubMed Central

OBJECTIVES—To determine the synovial mast cell response in early rheumatoid arthritis (RA) during clinical improvement, and to examine for relations with clinical and histological parameters of disease activity.?METHODS—Twenty two synovial samples were obtained from six patients with RA using needle arthroscopy. The mean disease duration at baseline was eight months, and two to three further samples were obtained over a mean follow up period of 15 months during which treatment initiated clinical improvement occurred. Sections were immunostained to detect MCT and MCTC mast cells and correlations were sought between clinical and histological data.?RESULTS—The overall mean synovial mast cell density was 40.3 cells/mm2, with regional densities of 60.6 and 34.2 mast cells/mm2 in the superficial and deeper synovial layers respectively. The MCT subset predominated, outnumbering MCTC by 3:1. There was a significant correlation between the histological inflammation index and the MCT density, (r = 0.4, p < 0.05) but not the MCTC subset. The regional distribution and predominant subset of mast cells varied in individual patient's synovia over time, with a trend towards restriction of the mast cell response to the superficial synovium during clinical improvement.?CONCLUSIONS—The mast cell response in early RA is characterised by substantial expansion of predominantly MCT mast cells that correlates with histological indices of inflammation. During clinical improvement, this expansion tended to become more superficial. Taken together with previous studies of long duration RA, which implicate MCTC cells in synovial damage and disease progression, these results suggest that MCT and MCTC mast cells may possess distinct functions in the spectrum of inflammatory events occurring during RA.?? PMID:9924208

Gotis-Graham, I.; Smith, M.; Parker, A.; McNeil, H

1998-01-01

18

Rheumatoid factor and anti-CCP do not predict progressive joint damage in patients with early rheumatoid arthritis treated with prednisolone: a randomised study  

PubMed Central

Objective To analyse if predictors of radiographic progression differ between patients treated with or without prednisolone in early rheumatoid arthritis (RA). Radiographs of hands and feet were assessed using the modified Sharp/van der Heijde score and radiographic progression was defined as an increase in the total Sharp score above 5.8 (the smallest detectable change). Design Prospective, randomised study of patients with early RA. Setting Secondary level of care; six participating centres from southern Sweden; both urban and rural populations. Participants In all, 225 patients, 64% women, with a diagnosis of RA according to the American College of Rheumatology criteria, were included if they were between 18 and 80?years of age and had a disease duration of less than 1?year. Intervention The patients were randomised to 7.5?mg prednisolone daily for 2?years (P-group; n=108) or no prednisolone (NoP-group; n=117) when they started with their first disease-modifying anti-rheumatic drug and were prospectively followed for 2?years. Results The frequency of patients with radiographic progression after 2?years was 26% in the P-group and 39% in the NoP-group (p=0.033). Relevant interactions between treatment and rheumatoid factor (RF) (p=0.061) and between treatment and anti-cyclic citrullinated peptide 2 (anti-CCP) (p=0.096) were found. RF and anti-CCP independently predicted radiographic progression only in the NoP-group, OR (95% CI) 9.4 (2.5 to 35.2), p=0.001 and OR (95% CI) 8.7 (2.5 to 31.3), p=0.001, respectively. Conclusions The presence of RF and anti-CCP predicted radiographic progression in patients not treated with prednisolone but failed to predict progression in patients treated with this drug. The data suggest that early treatment with prednisolone may modulate not only inflammation but also autoimmunity-associated pathogenetic mechanisms. Trial registration number ISRCTN20612367. PMID:25079933

Hafstrom, Ingiald; Engvall, Inga-Lill; Ronnelid, Johan; Boonen, Annelies; van der Heijde, Desiree; Svensson, Bjorn

2014-01-01

19

Do Carotid Artery Diameters Manifest Early Evidence of Atherosclerosis in Women with Rheumatoid Arthritis?  

PubMed Central

Abstract Objective Given the high incidence of cardiovascular disease (CVD) in patients with rheumatoid arthritis (RA), we examined the associations between RA diagnosis and characteristics and evidence of carotid atherosclerosis. We take a unique approach by evaluating lumen and interadventitial diameters in addition to intima-media thickness and plaque. Methods Ninety-three women with RA were matched with 93 healthy women by age, race, and menopause status. In cross-sectional analyses, we compared common carotid artery measures between groups and examined their relationships with measures of RA severity and activity. Results Mean age was 53.3 years, and median RA duration was 14 years. Lumen diameter in patients was significantly greater than in healthy women (5.50 vs. 5.19?mm, p?early indicator of increased cardiovascular risk. PMID:19105681

Kao, Amy H.; Cunningham, Amy; Wildman, Rachel P.; Kuller, Lewis H.; Sutton-Tyrrell, Kim; Wasko, Mary Chester M.

2009-01-01

20

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

21

Initial High-Dose Prednisolone Combination Therapy Using COBRA and COBRA-Light in Early Rheumatoid Arthritis.  

PubMed

Treatment with initial high-dose prednisolone and a combination of methotrexate (MTX) and sulfasalazine (SSZ) according to the COBRA regimen (Dutch acronym for combinatietherapie bij reumatoide artritis, 'combination therapy for rheumatoid arthritis'), has repeatedly been demonstrated to be very effective in early rheumatoid arthritis (RA). COBRA combination therapy is superior to initial monotherapy of SSZ and MTX, is also associated with a good long-term outcome, is as safe as other treatment regimes, and performs as well as the combination of high-dose MTX and the tumor necrosis factor antagonist infliximab. A pilot study with an intensified version of the COBRA combination therapy showed that strict monitoring and aggressive treatment intensification based on the Disease Activity Score can result in a remission rate of 90% in patients with active early RA. Also, the first results indicate that an attenuated variation on COBRA combination therapy, called 'COBRA-light', is effective in decreasing disease activity and is generally well tolerated. Based on these results, we conclude that initial high-dose prednisolone in combination with MTX and SSZ could or should be the first choice in early active RA since it is effective and safe, and the cost price of the drugs is low. © 2014 S. Karger AG, Basel. PMID:25227967

Rasch, Linda A; van Tuyl, Lilian H D; Lems, Willem F; Boers, Maarten

2015-01-01

22

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

23

Adalimumab therapy reduces hand bone loss in early rheumatoid arthritis: explorative analyses from the PREMIER study  

Microsoft Academic Search

Objective: The effect of adalimumab on hand osteo- porosis was examined and related to radiographic joint damage in the three treatment arms of the PREMIER study: adalimumab plus methotrexate, adalimumab and methotrexate monotherapy. Predictors of hand bone loss were also searched for. Methods: 768 patients (537 fulfilled 2 years) with rheumatoid arthritis (RA) for less than 3 years, never treated

M Hoff; T K Kvien; J Kalvesten; A Elden; G Haugeberg

2009-01-01

24

Early referral, diagnosis, and treatment of rheumatoid arthritis: evidence for changing medical practice  

Microsoft Academic Search

OBJECTIVESTo study the delay in starting disease modifying anti-rheumatic drugs (DMARDs) in patients with rheumatoid arthritis (RA), and any changes in medical practice between 1980 and 1997.METHODS198 consecutive RA patients attending the rheumatology clinics at a teaching hospital, for routine review, had their case sheet reviewed. The dates of symptom onset, general practitioner (GP) referral, first clinic appointment and first

S Irvine; R Munro; D Porter

1999-01-01

25

Infliximab therapy increases body fat mass in early rheumatoid arthritis independently of changes in disease activity and levels of leptin and adiponectin: a randomised study over 21 months  

Microsoft Academic Search

INTRODUCTION: Rheumatoid arthritis (RA) is associated with changes in body composition and bone mineral density (BMD). The purpose of the present study was to evaluate whether anti-TNF treatment in early RA has an impact on body composition and BMD besides that which could be achieved by intensive disease-modifying anti-rheumatic drug (DMARD) combination therapy. METHODS: Forty patients with early RA who

Inga-Lill Engvall; Birgitta Tengstrand; Kerstin Brismar; Ingiäld Hafström

2010-01-01

26

Plasma adrenomedullin and proadrenomedullin N-terminal 20 peptide in patients diagnosed as having early rheumatoid arthritis.  

PubMed

The aim of this study was to investigate plasma adrenomedullin (AM) and proadrenomedullin N-terminal 20 peptide (PAMP) level in patients diagnosed with early rheumatoid arthritis (RA). Furthermore, several inflammatory cytokines were measured in those patients to clarify the roles of AM and PAMP. Forty patients diagnosed with early RA (women 46 +/- 8.5 years old) and 10 healthy controls (women 57 +/- 5 years old) were studied. Plasma levels of AM, PAMP, matrix metalloprotease 3 (MMP-3), interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-alpha), and C-reactive protein (CRP) were measured using an immunoradiometric assay and enzyme-linked immunosorbent asay (ELISA) methods. The plasma levels of AM (17.5 +/- 8.4 fmol/ml) and PAMP (2.01 +/- 0.57 fmol/ml) in patients exceeded those in healthy controls (AM 8.6 +/- 1.7, PAMP 1.17 +/- 0.34 fmol/ml). Moreover, plasma AM and PAMP levels demonstrated a significantly positive correlation with plasma MMP-3 and IL-6 levels. Nevertheless, CRP and TNF-alpha levels in these patients showed no significant correlation with plasma AM and PAMP levels. These data support the possible role for AM and PAMP in the pathophysiology of early RA. PMID:20467777

Hamada, Hiroaki; Saisyo, Koichiro; Sekimoto, Tomohisa; Chosa, Etsuo

2010-08-01

27

Causal Modeling Using Network Ensemble Simulations of Genetic and Gene Expression Data Predicts Genes Involved in Rheumatoid Arthritis  

PubMed Central

Tumor necrosis factor ? (TNF-?) is a key regulator of inflammation and rheumatoid arthritis (RA). TNF-? blocker therapies can be very effective for a substantial number of patients, but fail to work in one third of patients who show no or minimal response. It is therefore necessary to discover new molecular intervention points involved in TNF-? blocker treatment of rheumatoid arthritis patients. We describe a data analysis strategy for predicting gene expression measures that are critical for rheumatoid arthritis using a combination of comprehensive genotyping, whole blood gene expression profiles and the component clinical measures of the arthritis Disease Activity Score 28 (DAS28) score. Two separate network ensembles, each comprised of 1024 networks, were built from molecular measures from subjects before and 14 weeks after treatment with TNF-? blocker. The network ensemble built from pre-treated data captures TNF-? dependent mechanistic information, while the ensemble built from data collected under TNF-? blocker treatment captures TNF-? independent mechanisms. In silico simulations of targeted, personalized perturbations of gene expression measures from both network ensembles identify transcripts in three broad categories. Firstly, 22 transcripts are identified to have new roles in modulating the DAS28 score; secondly, there are 6 transcripts that could be alternative targets to TNF-? blocker therapies, including CD86 - a component of the signaling axis targeted by Abatacept (CTLA4-Ig), and finally, 59 transcripts that are predicted to modulate the count of tender or swollen joints but not sufficiently enough to have a significant impact on DAS28. PMID:21423713

Xing, Heming; McDonagh, Paul D.; Bienkowska, Jadwiga; Cashorali, Tanya; Runge, Karl; Miller, Robert E.; DeCaprio, Dave; Church, Bruce; Roubenoff, Ronenn; Khalil, Iya G.; Carulli, John

2011-01-01

28

Treating to the target of remission in early rheumatoid arthritis is cost-effective: results of the DREAM registry  

PubMed Central

Background Where health economic studies are frequently performed using modelling, with input from randomized controlled trials and best guesses, we used real-life data to analyse the cost-effectiveness and cost-utility of a treatment strategy aiming to the target of remission compared to usual care in early rheumatoid arthritis (RA). Methods We used real-life data from comparable cohorts in the Dutch Rheumatoid Arthritis Monitoring (DREAM) registry: the DREAM remission induction cohort (treat-to-target, T2T) and the Nijmegen early RA inception cohort (usual care, UC). Both cohorts were followed prospectively using the DREAM registry methodology. All patients fulfilled the American College of Rheumatology criteria for RA and were included in the cohort at the time of diagnosis. The T2T cohort was treated according to a protocolised strategy aiming at remission (Disease Activity Score in 28 joints (DAS28)?early RA is cost-effective compared with UC. The data suggest that in the third year, T2T becomes cost-saving. PMID:24330489

2013-01-01

29

[Popliteal aneurysm simulating a Baker's cyst in a patient with rheumatoid arthritis: a case presentation].  

PubMed

Baker's cyst is the most common mass located in the back side of the knee, the popliteal fossa, in patients with degenerative and inflamatory disease of the knee. Popliteal mass may also be due to proliferation of adipose tissue, popliteal artery aneurysm, thrombotic vein, or tumor. These lesions are rarer and may easily be misinterpreted as cysts. We show a man with rheumatoid arthritis who is presenting a palpable mass in the popliteal fossa. Ultrasonography examination demostrated a popliteal artery aneurysms. PMID:21794798

Chalmeta Verdejo, Concepción; Alegre Sancho, Juan José; Román Ivorra, José Andrés; Ivorra Cortes, José

2011-01-01

30

Rheumatoid pneumoconiosis  

PubMed Central

The routine chest radiographs of more than 21,000 miners from 23 unselected collieries in the East Midlands have been used for a study of rheumatoid pneumoconiosis and progressive massive fibrosis (P.M.F.). A broadened radiological concept of rheumatoid pneumoconiosis was used in diagnosis. The prevalence of simple pneumoconiosis categories 1, 2, and 3 was 5·5%, and of P.M.F. 0·59%. There were 55 cases accepted as rheumatoid pneumoconiosis, a prevalence of 0·26%. Thirty-two of these had positive latex fixation or Rose-Waaler tests for rheumatoid factor. The prevalence of P.M.F. was found to increase with increasing simple pneumoconiosis prevalence. A slight correlation between rheumatoid pneumoconiosis and simple pneumoconiosis prevalence was also found, but the bulk of the increase in P.M.F. was due to non-rheumatoid cases. The latter was closely paralleled in incidence by that of category 3 simple pneumoconiosis. Grouped results showed that rheumatoid pneumoconiosis occurred in between 2·3% and 6·2% of all men affected by pneumoconiosis. When examined on a geographical basis all areas exhibited a similar prevalence of rheumatoid cases, with the exception of Mansfield, where there was a significant excess. This excess was not significant when serologically positive cases only were considered. The findings are discussed in the light of the auto-immune theory for the development of massive lesions in the lungs of coal miners. PMID:6076507

Lindars, David C.; Davies, Dewi

1967-01-01

31

Further Optimization of the Reliability of the 28-Joint Disease Activity Score in Patients with Early Rheumatoid Arthritis  

PubMed Central

Background The 28-joint Disease Activity Score (DAS28) combines scores on a 28-tender and swollen joint count (TJC28 and SJC28), a patient-reported measure for general health (GH), and an inflammatory marker (either the erythrocyte sedimentation rate [ESR] or the C-reactive protein [CRP]) into a composite measure of disease activity in rheumatoid arthritis (RA). This study examined the reliability of the DAS28 in patients with early RA using principles from generalizability theory and evaluated whether it could be increased by adjusting individual DAS28 component weights. Methods Patients were drawn from the DREAM registry and classified into a “fast response” group (N?=?466) and “slow response” group (N?=?80), depending on their pace of reaching remission. Composite reliabilities of the DAS28-ESR and DAS28-CRP were determined with the individual components' reliability, weights, variances, error variances, correlations and covariances. Weight optimization was performed by minimizing the error variance of the index. Results Composite reliabilities of 0.85 and 0.86 were found for the DAS28-ESR and DAS28-CRP, respectively, and were approximately equal across patients groups. Component reliabilities, however, varied widely both within and between sub-groups, ranging from 0.614 for GH (“slow response” group) to 0.912 for ESR (“fast response” group). Weight optimization increased composite reliability even further. In the total and “fast response” groups, this was achieved mostly by decreasing the weight of the TJC28 and GH. In the “slow response” group, though, the weights of the TJC28 and SJC28 were increased, while those of the inflammatory markers and GH were substantially decreased. Conclusions The DAS28-ESR and the DAS28-CRP are reliable instruments for assessing disease activity in early RA and reliability can be increased even further by adjusting component weights. Given the low reliability and weightings of the general health component across subgroups it is recommended to explore alternative patient-reported outcome measures for inclusion in the DAS28. PMID:24955759

Siemons, Liseth; ten Klooster, Peter M.; Vonkeman, Harald E.; van de Laar, Mart A. F. J.; Glas, Cees A. W.

2014-01-01

32

COBRA combination therapy in patients with early rheumatoid arthritis: Long-term structural benefits of a brief intervention  

Microsoft Academic Search

Objective. The Combinatietherapie Bij Reuma- toide Artritis (COBRA) trial demonstrated that step- down combination therapy with prednisolone, metho- trexate, and sulfasalazine (SSZ) was superior to SSZ monotherapy for suppressing disease activity and radio- logic progression of rheumatoid arthritis (RA). The current study was conducted to investigate whether the benefits of COBRA therapy were sustained over time, and to determine which

Maarten Boers; Arco C. Verhoeven; Rene Westhovens; Mart A. F. J. van de Laar; Harry M. Markusse; J. Christiaan van Denderen; Marie Louise Westedt; Andre J. Peeters; Ben A. C. Dijkmans; Piet Jacobs; Annelies Boonen; Sjef van der Linden

2002-01-01

33

Low prevalence of work disability in early inflammatory arthritis (EIA) and early rheumatoid arthritis at enrollment into a multi-site registry: results from the catch cohort.  

PubMed

We determined the prevalence of work disability in early rheumatoid arthritis (ERA) and undifferentiated early inflammatory arthritis (EIA) patients at first enrollment into the Canadian Early Arthritis Cohort (CATCH) who met the 2010 ACR criteria versus those not meeting criteria, to determine the impact of meeting new criteria on work disability status. Data at first visit into the cohort were analyzed. Descriptive statistics and logistic regression analyses were performed to investigate the association of other variables in our database with work disability. 1,487 patients were enrolled in the CATCH study, a multi-site observational, prospective cohort of patients with EIA. 934 patients were excluded (505 based on missing criteria for ACR 2010 classification, as anti-CCP was absent, and 429 were not working for other reasons). Of the 553 patients included, 71 % were female with mean disease duration of 6.4 months. 524 (94.8 %) were employed while 29 (5.2 %) reported work disability at first visit. There were no differences between those meeting 2010 ACR criteria versus those who did not. Baseline characteristics associated with work disability were male gender, age, education, income, HAQ, and positive RF status. The mean HAQ score in work disabled patients was 1.4 versus 0.9 in those who were working (p < 0.001). Disease activity score (DAS28) was not associated with work disability (p = 0.069), nor was tender joint count, swollen joint count, anti-CCP, patient global assessment, or SF-12v2. In the regression model, work disability was associated with lower income levels (p = 0.01) and worse HAQ scores (OR 2.33; p = 0.001), but not significantly associated with male gender (p = 0.08), older age (>50 years; p = 0.3), lower education (p = 0.3) or RF positivity (p = 0.6). We found rates of work disability to be low at entry into this EIA cohort compared to previous studies. There may be potential for intervention in ERA to prevent the development of work disability. PMID:22461187

Mussen, Lauren; Boyd, Tristan; Bykerk, Vivian; de Leon, Faye; Li, Lihua; Boire, Gilles; Hitchon, Carol; Haraoui, Boulos; Thorne, J Carter; Pope, Janet

2013-02-01

34

Rheumatoid Factor  

MedlinePLUS

... with a variety of other disorders, including other autoimmune disorders such as Sjögren syndrome , as well as persistent ... Related Pages On This Site Conditions: Rheumatoid Arthritis , Autoimmune Disorders Elsewhere On The Web American College of Rheumatology: ...

35

Dark Sky Simulations: Early Data Release  

E-print Network

The Dark Sky Simulations are an ongoing series of cosmological N-body simulations designed to provide a quantitative and accessible model of the evolution of the large-scale Universe. Such models are essential for many aspects of the study of dark matter and dark energy, since we lack a sufficiently accurate analytic model of non-linear gravitational clustering. In July 2014, we made available to the general community our early data release, consisting of over 55 Terabytes of simulation data products, including our largest simulation to date, which used $1.07 \\times 10^{12}~(10240^3)$ particles in a volume $8h^{-1}\\mathrm{Gpc}$ across. Our simulations were performed with 2HOT, a purely tree-based adaptive N-body method, running on 200,000 processors of the Titan supercomputer, with data analysis enabled by yt. We provide an overview of the derived halo catalogs, mass function, power spectra and light cone data. We show self-consistency in the mass function and mass power spectrum at the 1% level over a range ...

Skillman, Samuel W; Turk, Matthew J; Wechsler, Risa H; Holz, Daniel E; Sutter, P M

2014-01-01

36

Combination therapy in early rheumatoid arthritis: a randomised, controlled, double blind 52 week clinical trial of sulphasalazine and methotrexate compared with the single components  

PubMed Central

OBJECTIVES—To investigate the potential clinical benefit of a combination therapy.?METHODS—205 patients fulfilling the ACR criteria for rheumatoid arthritis (RA), not treated with disease modifying anti-rheumatoid drugs previously, with an early (?1 year duration), active (Disease Activity Score (DAS) > 3.0), rheumatoid factor and/or HLA DR 1/4 positive disease were randomised between sulphasalazine (SASP) 2000 (maximum 3000) mg daily (n = 68), or methotrexate (MTX) 7.5 (maximum 15) mg weekly (n = 69) or the combination (SASP + MTX) of both (n = 68).?RESULTS—The mean changes in the DAS during the one year follow up of the study was ?1.15, ?0.87, ?1.26 in the SASP, MTX, and SASP + MTX group respectively (p = 0.019). However, there was no statistically significant difference in terms of either EULAR good responders 34%, 38%, 38% or ACR criteria responders 59%, 59%, 65% in the SASP, MTX, and SASP + MTX group respectively. Radiological progression evaluated by the modified Sharp score was very modest in the three groups: mean changes in erosion score: +2.4, +2.4, +1.9, in narrowing score: +2.3, +2.1, +1.6 and in total damage score: +4.6, +4.5, +3.5, in the SASP, MTX, and SASP + MTX groups respectively. Adverse events occurred more frequently in the SASP + MTX group 91% versus 75% in the SASP and MTX group (p = 0.025). Nausea was the most frequent side effect: 32%, 23%, 49% in the SASP, MTX, and SASP + MTX groups respectively (p = 0.007).?CONCLUSION—This study suggests that an early initiation therapy of disease modifying drug seems to be of benefit. However, this study was unable to demonstrate a clinically relevant superiority of the combination therapy although several outcomes were in favour of this observation. The tolerability of the three treatment modalities seems acceptable.?? Keywords: rheumatoid arthritis; combination therapy; sulphasalazine; methotrexate PMID:10364900

Dougados, M.; Combe, B.; Cantagrel, A.; Goupille, P.; Olive, P.; Schattenkirchner, M.; Meusser, S; Paimela, L; Rau, R.; Zeidler, H.; Leirisalo-Repo, M.; Peldan, K.

1999-01-01

37

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

PubMed Central

OBJECTIVES—To evaluate the role of magnetic resonance imaging (MRI) of the wrist in detecting early joint damage in patients with rheumatoid arthritis (RA).?METHODS—MRI 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 radiography, clinical measures, and HLA-DRB*01/04 genotyping.?RESULTS—Interobserver reliability for the overall MRI score was high (r = 0.81) as was intraobserver reliability (r = 0.94 for observer 1 and 0.81 for observer 2). There was more variation in scoring synovitis (interobserver reliability: r = 0.74). Erosions were detected in 45% of scans (19 of 42), compared with 15% of plain radiographs. The most common site for erosions was the capitate (39%), for synovitis the ulnar aspect of the radiocarpal joint, and for tendonitis, the extensor carpi ulnaris tendon. The total MRI score and MRI synovitis score correlated most significantly with C reactive protein (r = 0.40 and 0.42 respectively, p<0.01). The MRI erosion score was highly correlated with MRI bone marrow oedema (r = 0.83) as well as the Ritchie score and disease activity score (r = 0.32, p<0.05). HLA-DRB1*04 or *01 (shared epitope +ve) was found in 76% of patients; 84% of those with MRI erosions and 69% of those without (NS, p = 0.3).?CONCLUSIONS—A high proportion of RA patients develop MRI erosions very early in their disease, when plain radiography is frequently normal. MRI of the dominant wrist may identify those requiring early aggressive treatment.?? Keywords: magnetic resonance imaging; carpus; rheumatoid arthritis PMID:9771209

McQueen, F.; Stewart, N.; Crabbe, J.; Robinson, E.; Yeoman, S.; Tan, P.; McLean, L.

1998-01-01

38

Masked early symptoms of pneumonia in patients with rheumatoid arthritis during tocilizumab treatment: a report of two cases  

Microsoft Academic Search

Although reports of serious infections in clinical trials for rheumatoid arthritis (RA) with tocilizumab, anti-interleukin6\\u000a (IL-6) receptor antibody, have been relatively few, there is still some concern about infections. We report here two cases\\u000a of patients who developed severe pneumonia during tocilizumab treatment for RA. Both patients initially presented with only\\u000a minimal clinical symptoms and modest elevations in serum C-reactive

Hiroshi Fujiwara; Norihiro Nishimoto; Yoshimasa Hamano; Nobuyuki Asanuma; Shunji Miki; Soji Kasayama; Masaki Suemura

2009-01-01

39

Are there more than cross-sectional relationships of social support and support networks with functional limitations and psychological distress in early rheumatoid arthritis? The European Research on Incapacitating Diseases and Social Support Longitudinal Study  

Microsoft Academic Search

Objective. To investigate whether greater social support and support network are cross-sectionally associated with less functional limitations and psychological distress in patients with early rheumatoid arthritis (RA); whether this associ- ation is constant over time; and whether increases in social support or support network are associated with less functional limitations and psychological distress. Methods. Subjects were from the European Research

V. Demange; F. Guillemin; M. Baumann; T. P. B. M. Suurmeijer; T. Moum; D. Doeglas

2004-01-01

40

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

41

The association and predictive value of the complex immunoglobulin A-alpha 1-antitrypsin in the development of erosions in early rheumatoid arthritis.  

PubMed

Immunoglobulin A-alpha 1 antitrypsin complex (IgA-AT), its constituent components and nine other clinical or laboratory variables were measured in thirty-three patients with early, non-erosive rheumatoid arthritis (RA) in order to assess their value in predicting the subsequent development of erosions. After 12 months, eighteen patients had developed erosions. Comparison of variables measured at outset between the group of patients subsequently developing erosions and those not, showed only the complex IgA-AT level to be significantly different, the mean being higher in the erosive group. In the subgroup of patients with high IgA-AT levels (greater than 3.0 arbitary units) all developed erosions. The possible therapeutic implications of these findings are discussed. PMID:2011713

Davis, M J; Dawes, P T; Fowler, P D; Shadforth, M F; Lewin, I; Stanworth, D R

1991-01-01

42

Matrix to predict rapid radiographic progression of early rheumatoid arthritis patients from the community treated with methotrexate or leflunomide: results from the ESPOIR cohort  

PubMed Central

Introduction Early rheumatoid arthritis (RA) patients may show rapid radiographic progression (RRP) despite rapid initiation of synthetic disease-modifying anti-rheumatic drugs (DMARDs). The present study aimed to develop a matrix to predict risk of RRP despite early DMARD initiation in real life settings. Methods The ESPOIR cohort included 813 patients from the community with early arthritis for < 6 months; 370 patients had early RA and had received methotrexate or leflunomide during the first year of follow-up. RRP was defined as an increase in the van der Heijde-modified Sharp score (vSHS) ? 5 points at 1 year. Determinants of RRP were examined first by bivariate analysis, then multivariate stepwise logistic regression analysis. A visual matrix model was then developed to predict RRP in terms of patient baseline characteristics. Results We analyzed data for 370 patients. The mean Disease Activity Score in 28 joints was 5.4 ± 1.2, 18.1% of patients had typical RA erosion on radiographs and 86.4% satisfied the 2010 criteria of the American College of Rheumatology/European League Against Rheumatism. During the first year, mean change in vSHS was 1.6 ± 5.5, and 41 patients (11.1%) showed RRP. A multivariate logistic regression model enabled the development of a matrix predicting RRP in terms of baseline swollen joint count, C-reactive protein level, anti-citrullinated peptide antibodies status, and erosions seen on radiography for patients with early RA who received DMARDs. Conclusions The ESPOIR matrix may be a useful clinical practice tool to identify patients with early RA at high risk of RRP despite early DMARD initiation. PMID:23164197

2012-01-01

43

ACPA fine-specificity profiles in early rheumatoid arthritis patients do not correlate with clinical features at baseline or with disease progression  

PubMed Central

Introduction Autoantibodies against citrullinated peptides/proteins (ACPA) are found in approximately 75% of the sera of patients with rheumatoid arthritis (RA). The RA-specific ACPA are frequently present prior to disease onset and their presence associates with a more erosive disease course. ACPA can therefore be used to aid the diagnosis and prognosis of RA. Recently, it became clear that ACPA are very heterogeneous, both in an individual patient and among different patients. The aim of this study was to investigate whether clinically meaningful ACPA profiles exist in early RA patients. Methods Twenty citrullinated peptides and the corresponding non-citrullinated control peptides were immobilized on microarray sensor chips. Sera from 374 early arthritis patients were analyzed by surface plasmon resonance imaging (iSPR) of biomolecular interactions on the sensor chip. Results Cluster analysis of the reactivities with the citrullinated peptides, after subtraction of the reactivities with the corresponding control peptides confirmed the heterogeneity of the ACPA response in RA and revealed 12 distinct ACPA profiles. The association of the 5 most frequent profiles with clinical features at diagnosis and during the disease course was examined, showing no statistically significant associations. Conclusions Compared to the detection of ACPA in RA sera by CCP-based assays, ACPA profiling in early arthritis patients did not reveal associations with disease activity and progression scores. PMID:24286543

2013-01-01

44

Emotions related to participation restrictions as experienced by patients with early rheumatoid arthritis: a qualitative interview study (the Swedish TIRA project).  

PubMed

Psychological distress is a well-known complication in rheumatoid arthritis (RA), but knowledge regarding emotions and their relationship to participation restrictions is scarce. The objective of the study was to explore emotions related to participation restrictions by patients with early RA. In this study, 48 patients with early RA, aged 20-63 years, were interviewed about participation restrictions using the critical incident technique. Information from transcribed interviews was converted into dilemmas and linked to International Classification of Functioning, Disability, and Health (ICF) participation codes. The emotions described were condensed and categorized. Hopelessness and sadness were described when trying to perform daily activities such as getting up in the mornings and getting dressed, or not being able to perform duties at work. Sadness was experienced in relation to not being able to continue leisure activities or care for children. Examples of fear descriptions were found in relation to deteriorating health and fumble fear, which made the individual withdraw from activities as a result of mistrusting the body. Anger and irritation were described in relation to domestic and employed work but also in social relations where the individual felt unable to continue valued activities. Shame or embarrassment was described when participation restrictions became visible in public. Feelings of grief, aggressiveness, fear, and shame are emotions closely related to participation restrictions in everyday life in early RA. Emotions related to disability need to be addressed both in clinical settings in order to optimize rehabilitative multi-professional interventions and in research to achieve further knowledge. PMID:24838364

Östlund, Gunnel; Björk, Mathilda; Thyberg, Ingrid; Thyberg, Mikael; Valtersson, Eva; Stenström, Birgitta; Sverker, Annette

2014-10-01

45

Association of circulating miR-223 and miR-16 with disease activity in patients with early rheumatoid arthritis  

PubMed Central

Background Identification of parameters for early diagnosis and treatment response would be beneficial for patients with early rheumatoid arthritis (ERA) to prevent ongoing joint damage. miRNAs have features of potential biomarkers, and an altered expression of miRNAs was shown in established rheumatoid arthritis (RA). Objective To analyse RA associated miRNAs in the sera of patients with ERA to find markers of early disease, clinical activity or predictors of disease outcome. Methods Total RNA was isolated from whole sera in ERA patients (prior to and after 3 and 12?months of therapy with disease modifying antirheumatic drugs), in patients with established RA and in healthy controls (HC) using phenol–chloroform extraction. Expression of miR-146a, miR-155, miR-223, miR-16, miR-203, miR-132 and miR-124a was analysed by TaqMan Real Time PCR. Results From all analysed miRNAs, levels of miR-146a, miR-155 and miR-16 were decreased in the sera of ERA patients in comparison with established RA. A change in circulating miR-16 in the first 3?months of therapy was associated with a decrease in DAS28 in long term follow-up in ERA (p=0.002). Levels of circulating miR-223 in treatment naïve ERA correlated with C reactive protein (p=0.008), DAS28 (p=0.031) and change in DAS28 after 3?months (p=0.003) and 12?months (p=0.011) of follow-up. However, neither miR-16 nor miR-223 could distinguish ERA from HC. Conclusions Differential expression of circulating miR-146a, miR-155 and miR-16 in the sera of ERA patients may characterise an early stage of the disease. We suggest miR-223 as a marker of disease activity and miR-16 and miR-223 as possible predictors for disease outcome in ERA. PMID:23897768

Filkova, Maria; Aradi, Borbala; Senolt, Ladislav; Ospelt, Caroline; Vettori, Serena; Mann, Herman; Filer, Andrew; Raza, Karim; Buckley, Christopher D; Snow, Martyn; Vencovsky, Jiri; Pavelka, Karel; Michel, Beat A; Gay, Renate E; Gay, Steffen; Jungel, Astrid

2014-01-01

46

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. © 2014 S. Karger AG, Basel. PMID:25228126

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

2015-01-01

47

Current Therapy of Rheumatoid Arthritis  

PubMed Central

The well informed and well motivated patient with rheumatoid arthritis today has an excellent chance of avoiding serious disability and deformity. No available pharmacologic agent can permanently alter the course of the disease, and no pharmacologic agent can preclude the need for a balanced program emphasizing moderation, rest and constant attention to physical therapy. Early synovectomy is enjoying increasing popularity although the long-term benefits have yet to be established. The several drugs now undergoing trial hold little promise of materially altering the management of rheumatoid arthritis in the near future. The skills of physician, surgeon, and physiatrist must be brought to bear to provide optimal care. PMID:4883503

Kamin, Edward J.; Multz, Carter V.

1969-01-01

48

The Effect of Stopping Smoking on Disease Activity in Rheumatoid Arthritis (RA). Data from BARFOT, a Multicenter Study of Early RA  

PubMed Central

Objective: We studied the effect of stopping smoking on disease activity in patients with RA. Methods: Between 1992 and 2005, 2,800 adult patients were included in the BARFOT early RA study in Sweden. Disease Activity Score 28 joints (DAS28), C-reactive protein (CRP), Health Assessment Questionnaire (HAQ), rheumatoid factor (RF), anti-CCP, general health and pain visual analog scales (VAS), EULAR response and treatment were registered at inclusion and at follow-up 2, 5 and 8 years. In 2010, a self-completion postal questionnaire was sent to 2,102 patients, enquiring about lifestyle factors, including cessation of smoking. Results: A total of 1,460 adult RA patients with disease duration ?2 years were included in this study. Seventeen percent smoked in 2010. In total, 127 patients stopped smoking after inclusion in the study. Smoking cessation after inclusion in the study was negatively associated with EULAR good outcome at 8 years (OR 0.44, 95% CI 0.22–0.86, p=0.02), controlled for age, disease duration, sex, socioeconomic class, smoking status, RF, and DAS28 at inclusion. Conclusion: Seventeen percent of the RA patients smoked in 2010 in this large Swedish RA cohort. Stopping smoking after onset of RA did not change the poor prognosis of smokers with RA, but all RA patients need to stop smoking because of the high risk of cardiovascular mortality and morbidity and the association of smoking with vasculitis and noduli in RA. PMID:23115602

Andersson, Maria LE; Bergman, Stefan; Soderlin, Maria K

2012-01-01

49

Endogenous glutamate in association with inflammatory and hormonal factors modulates bone tissue resorption of the temporomandibular joint in patients with early rheumatoid arthritis  

PubMed Central

Purposes The aim of this study was to investigate the relation between plasma level of glutamate and extent of radiographic bone erosion of the TMJ in patients with early RA in relation to inflammatory disease activity as well as estradiol and testosterone. Patients and Methods 47 patients (29 women and 18 men) of whom 24 were seropositive were included shortly after being diagnosed with RA. Radiographic signs of bone tissue resorption (erosions) in the TMJ was recorded by cone-beam CT images and an erosion score (0 – 24) was calculated for each patient. Venous blood was analyzed for rheumatoid factor, C-reactive protein, erythrocyte sedimentation rate, leukocyte particle count, glutamate, estradiol and testosterone. Nonparametric and parametric statistical methods were used in the analysis when applicable. Results Resorptive changes of the TMJ were found in a major part of the patients. There was a significant positive correlation between plasma level of glutamate and extension of radiographic erosions that was strongest in the patients with low levels of C-reactive protein, estradiol or testosterone. On the other hand erosions were correlated with C-reactive protein in patients with high levels of estradiol. The highest levels of glutamate were found in patients with low levels of C-reactive protein and estradiol. Conclusion This study shows that a majority of patients with early RA presents radiographic signs of bone tissue resorption of the TMJ and that circulating glutamate is associated with the extent of these changes. The relationship between glutamate and bone resorption seems to be influenced by systemic inflammatory activity as well as estradiol and testosterone levels. PMID:19686927

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

2009-01-01

50

A CD4 T cell gene signature for early rheumatoid arthritis implicates interleukin 6-mediated STAT3 signalling, particularly in anti-citrullinated peptide antibody-negative disease  

PubMed Central

Objective We sought clinically relevant predictive biomarkers present in CD4 T-cells, or in serum, that identified those patients with undifferentiated arthritis (UA) who subsequently develop rheumatoid arthritis (RA). Methods Total RNA was isolated from highly purified peripheral blood CD4 T cells of 173 early arthritis clinic patients. Paired serum samples were also stored. Microarray analysis of RNA samples was performed and differential transcript expression among 111 ‘training cohort’ patients confirmed using real-time quantitative PCR. Machine learning approaches tested the utility of a classification model among an independent validation cohort presenting with UA (62 patients). Cytokine measurements were performed using a highly sensitive electrochemiluminescence detection system. Results A 12-gene transcriptional ‘signature’ identified RA patients in the training cohort and predicted the subsequent development of RA among UA patients in the validation cohort (sensitivity 68%, specificity 70%). STAT3-inducible genes were over-represented in the signature, particularly in anti-citrullinated peptide antibody-negative disease, providing a risk metric of similar predictive value to the Leiden score in seronegative UA (sensitivity 85%, specificity 75%). Baseline levels of serum interleukin 6 (IL-6) (which signals via STAT3) were highest in anti-citrullinated peptide antibodies-negative RA and distinguished this subgroup from non-RA inflammatory synovitis (corrected p<0.05).Paired serum IL-6 measurements correlated strongly with STAT3-inducible gene expression. Conclusion The authors have identified IL-6-mediated STAT-3 signalling in CD4 T cells during the earliest clinical phase of RA, which is most prominent in seronegative disease. While highlighting potential biomarker(s) for early RA, the role of this pathway in disease pathogenesis awaits clarification. PMID:22532634

Pratt, Arthur G; Swan, Daniel C; Richardson, Sarah; Wilson, Gillian; Hilkens, Catharien M U; Young, David A; Isaacs, John D

2012-01-01

51

Adalimumab, a human anti-TNF monoclonal antibody, outcome study for the prevention of joint damage in Japanese patients with early rheumatoid arthritis: the HOPEFUL 1 study  

PubMed Central

Objectives To evaluate the efficacy and safety of adalimumab+methotrexate (MTX) in Japanese patients with early rheumatoid arthritis (RA) who had not previously received MTX or biologics. Methods This randomised, double-blind, placebo-controlled, multicentre study evaluated adalimumab 40?mg every other week+MTX 6–8?mg every week versus MTX 6–8?mg every week alone for 26?weeks in patients with RA (?2-year duration). The primary endpoint was inhibition of radiographic progression (change (?) from baseline in modified total Sharp score (mTSS)) at week 26. Results A total of 171 patients received adalimumab+MTX (mean dose, 6.2±0.8?mg/week) and 163 patients received MTX alone (mean dose, 6.6±0.6?mg/week, p<0.001). The mean RA duration was 0.3?years and 315 (94.3%) had high disease activity (DAS28>5.1). Adalimumab+MTX significantly inhibited radiographic progression at week 26 versus MTX alone (?mTSS, 1.5±6.1 vs 2.4±3.2, respectively; p<0.001). Significantly more patients in the adalimumab+MTX group (62.0%) did not show radiographic progression (?mTSS?0.5) versus the MTX alone group (35.4%; p<0.001). Patients treated with adalimumab+MTX were significantly more likely to achieve American College of Rheumatology responses and achieve clinical remission, using various definitions, at 26?weeks versus MTX alone. Combination therapy was well tolerated, and no new safety signals were observed. Conclusions Adalimumab in combination with low-dose MTX was well tolerated and efficacious in suppressing radiographic progression and improving clinical outcomes in Japanese patients with early RA and high disease activity. PMID:23316080

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

2014-01-01

52

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

53

The Effect of Socioeconomic Class and Immigrant Status on Disease Activity in Rheumatoid Arthritis: Data from BARFOT, a Multi-Centre Study of Early RA  

PubMed Central

Background: There have been no reports on the effect of immigrant status and socioeconomic status on outcome in rheumatoid arthritis (RA) in Sweden. Methods: Between 1992 and 2006, 2,800 patients were included in the BARFOT study on early RA in Sweden. Disease Activity Score 28 joints (DAS28), Health Assessment Questionnaire (HAQ), treatment and European League Against Rheumatism (EULAR) response criteria were registered. In 2010, 1,430 patients completed a questionnaire enquiring about demographics and lifestyle factors. Results: One hundred and thirty-nine of the 1,430 patients (9.7%) were immigrants. At baseline immigrants had higher mean HAQ (1.2 vs 0.97 for non-immigrants, p=0.001), DAS28 (5.6 vs 5.2, p=0.000), visual analog scale (VAS) pain (56 mm vs 45 mm, p=0.000), VAS global health (53 mm vs 44 mm, p=0.000) and tender joint count (TJC) (10 vs 8, p=0.000). These differences persisted for up to 2 years of follow-up (for HAQ, for up to 8 years of follow-up). Immigrant status did not have any effect on swollen joint count (SJC), ESR, CRP or EULAR response. Socioeconomic class did not have any effect on treatment or outcome. Conclusions: Immigrants scored worse in pain, function and TJC for up to 2 years of follow-up, but they did not differ from non-immigrants in objective measures of inflammation or EULAR outcome. This could be due to different perceptions of health and pain and/or the stress of immigration. Socioeconomic class had no effect on treatment or outcome, and this could be due to the relatively egalitarian society in Sweden. PMID:24358069

Andersson, Maria L.E.; Bergman, Stefan; Soderlin, Maria K.

2013-01-01

54

How citrullination invaded rheumatoid arthritis research  

PubMed Central

Citrullination and the immune response to citrullinated proteins have been fundamental for the early recognition of rheumatoid arthritis by serological tests and a better understanding of its pathophysiology. In the first years after the initial publications, the focus was on the antibodies directed to citrullinated proteins. It is now realized that citrullinating enzymes and citrullinated proteins may have important roles in the maintenance of the inflammatory processes in the joints. There is also accumulating evidence for a direct role of citrullination in tissue destruction in the rheumatoid synovium. Here we will discuss the development and importance of anti-citrullinated protein antibodies in rheumatoid arthritis as well as recent findings implicating citrullination in the pathophysiology of rheumatoid arthritis. PMID:24472574

2014-01-01

55

Looking through the 'window of opportunity': is there a new paradigm of podiatry care on the horizon in early rheumatoid arthritis?  

Microsoft Academic Search

Over the past decade there have been significant advances in the clinical understanding and care of rheumatoid arthritis (RA). Major paradigm changes include earlier disease detection and introduction of therapy, and 'tight control' of follow-up driven by regular measurement of disease activity parameters. The advent of tumour necrosis factor (TNF) inhibitors and other biologic therapies have further revolutionised care. Low

James Woodburn; Kym Hennessy; Martijn PM Steultjens; Iain B McInnes; Deborah E Turner

2010-01-01

56

Assessment of the utility of visual feedback in the treatment of early rheumatoid arthritis patients: a pilot study.  

PubMed

Earlier studies revealed that visual feedback has contributed in the management of neuromuscular as well as psychiatric disorders; however, it has not yet been applied in rheumatology. Visual feedback is a relatively new tool that enables the patient to visualize as well as monitor a real-time change of their disease activity parameters as well as the patient's reported outcome measures. Integrating electronic data recording in the standard rheumatology clinical practice made visual feedback possible. To evaluate the feasibility of using the visual feedback in patients with early inflammatory arthritis (EA) and how ubiquitous computing technology can improve the patients' compliance and adherence to therapy, this was a double-blind randomized controlled study, which included 111 patients diagnosed to have EA according to the new ACR/EULAR criteria. All patients received disease-modifying antirheumatic drugs (DMARDs) therapy and monitored regularly over the period of 1 year. By the 6th month of treatment, the patients were randomly allocated to an active group (55 patients) to whom the visual feedback (visualization of charts showing the progression of disease activity parameters) was added to their management protocol, and a control group (56 patients) who continued their standard management protocols. The patients were monitored for another 6-months period. All the patient's disease activity parameters, patient reported outcome measures (PROMs), medications, scores of falls, and cardiovascular risks were recorded electronically. Primary outcome was the change in the patients' adherence to their medications, disease activity score (DAS-28), and PROMs: pain score, patient global assessment, functional disability, and quality of life. Secondary outcome was the answers to a questionnaire completed by every patient in both the active group and control group (using Visual Analogue Scale) by the end of 1 year of management, to rate from the patient's perspective the impact of the management protocol, whether using the standard or visual feedback approach, on them and their disease. The visual feedback provided a significant greater reduction in disease activity parameters as well as improvement of the patients' adherence to antirheumatic therapy (P < 0.01). Also stopping the DMARDs therapy because of intolerance was significantly less in the active group. Concerns about the future was significantly less in the active group whereas inability to coup with daily life and disease stress were significantly more among the control group. The improvement of disease activity parameters was associated with improvement in functional disability and quality of life scores. Mean changes in disease parameters showed no significant differences at 3-6 months of therapy but differences were statistically significant at 12-months follow-up (P < 0.01). Medication compliance was significantly correlated with changes in all measured disease parameters. By recording and monitoring disease activity parameters electronically and incorporating the visual feedback approach into clinical practice, a new experience can be created. Visual feedback enabled the patients to see how they are doing regarding their disease activity and helps to optimize their adherence to their treatment. Visual feedback had a positive and significant impact on the disease activity control. PMID:21909946

El Miedany, Y; El Gaafary, M; Palmer, D

2012-10-01

57

Rheumatoid Arthritis Educational Video Series  

MedlinePLUS

Rheumatoid Arthritis Educational Video Series This series of five videos was designed to help you learn more about Rheumatoid Arthritis (RA). You will ... Activity Role of Body Weight in Osteoarthritis Educational Videos for Patients Rheumatoid Arthritis Educational Video Series Psoriatic ...

58

Optical imaging of rheumatoid arthritis  

PubMed Central

Optical Imaging (OI) for rheumatoid arthritis is a novel imaging modality. With the high number of people affected by this disease, especially in western countries, the availability of OI as an early diagnostic imaging method is clinically highly relevant. In this article we describe the current techniques of OI and discuss potential future applications of this promising technology. Overall, we demonstrate that OI is a fast, inexpensive, noninvasive, nonionizing and accurate imaging modality. Furthermore, OI is a clinically applicable tool allowing for the early detection of inflammation and potentially facilitating the monitoring of therapy. PMID:21826190

Golovko, Daniel; Meier, Reinhard; Rummeny, Ernst; Daldrup-Link, Heike

2011-01-01

59

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

60

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

61

The clinical features of rheumatoid arthritis  

Microsoft Academic Search

Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by progressive damage of synovial-lined joints and variable extra-articular manifestations. Tendon and bursal involvement are frequent and often clinically dominant in early disease. RA can affect any joint, but it is usually found in metacarpophalangeal, proximal interphalangeal and metatarsophalangeal joints, as well as in the wrists and knee. Articular and periarticular

Walter Grassi; Rossella De Angelis; Gianni Lamanna; Claudio Cervini

1998-01-01

62

What is the fate of erosions in early rheumatoid arthritis? Tracking individual lesions using x rays and magnetic resonance imaging over the first two years of disease  

PubMed Central

OBJECTIVES—To investigate the progression of erosions at sites within the carpus, in patients with early rheumatoid arthritis (RA), using magnetic resonance imaging (MRI) and plain radiology over a two year period.?METHODS—Gadolinium enhanced MRI scans of the dominant wrist were performed in 42 patients with RA at baseline (within six months of symptom onset) and one year. Plain wrist radiographs (x rays) and clinical data were obtained at baseline, one year, and two years. Erosions were scored by two musculoskeletal radiologists on MRI and x ray at 15 sites in the wrist. A patient centred analysis was used to evaluate the prognostic value of a baseline MRI scan. A lesion centred analysis was used to track the progression of individual erosions over two years.?RESULTS—The baseline MRI erosion score was predictive of x ray erosion score at two years (p=0.004). Patients with a "total MRI score" (erosion, bone oedema, synovitis, and tendonitis) ?13 at baseline were significantly more likely to develop erosions on x ray at two years (odds ratio 13.4, 95% CI 2.65 to 60.5, p=0.002). Baseline wrist MRI has a sensitivity of 80%, a specificity of 76%, a positive predictive value of 67%, and a high negative predictive value of 86% for the prediction of wrist x ray erosions at two years. A lesion centred analysis, which included erosions scored by one or both radiologists, showed that 84% of baseline MRI erosions were still present at one year. When a more stringent analysis was used which required complete concordance between radiologists, all baseline lesions persisted at one year. The number of MRI erosion sites in each patient increased from 2.1 (SD 2.7) to 5.0 (4.6) (p<0.0001) over the first year of disease. When MRI erosion sites were tracked, 21% and 26% were observed on x ray, one and two years later. A high baseline MRI synovitis score, Ritchie score, and erythrocyte sedimentation rate were predictive of progression of MRI erosions to x ray erosions over one year (p=0.005, 0.01, and 0.03 respectively), but there was no association with the shared epitope. Progression of MRI erosions to x ray erosions was not seen in those with transient polyarthritis.?CONCLUSIONS—MRI scans of the wrist, taken when patients first present with RA, can predict radiographic erosions at two years. MRI may have a role in the assessment of disease prognosis and selection of patients for more or less aggressive treatment. However, only one in four MRI erosions progresses to an x ray erosion over one year, possibly owing to healing, observer error, or technical limitations of radiography at the carpus. Progression of MRI erosions to x ray erosions is greatest in those with high baseline disease activity.?? PMID:11502613

McQueen, F; Benton, N; Crabbe, J; Robinson, E; Yeoman, S; McLean, L; Stewart, N

2001-01-01

63

Osteomalacia in rheumatoid arthritis.  

PubMed Central

Fifty-four patients with rheumatoid arthritis and severe osteomalacia were found to have considerable bone and general deficiency problems. In 46 of them 14 stress fractures occurred and 32 minimal trauma fractures necessitating admission to hospital. Radiological abnormalities of absorption were found in nearly 25% of the total, implying that dietary factors alone are not always responsible for osteomalacia in patients with rheumatoid arthritis. A high index of suspicion is necessary in the diagnosis of osteomalacia in patients with rheumatoid arthritis, so they may benefit from treatment. Images PMID:7377853

O'Driscoll, S; O'Driscoll, M

1980-01-01

64

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 shown that early treatment and therefore an early diagnosis is mandatory to prevent or at least delay

Tresp, Volker

65

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 to diagnose in early stages. An early diagnosis and treatment can delay the onset of severe disability

Payeur, Pierre

66

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

67

Simulating the Warm Climate of the Early Eocene (Invited)  

NASA Astrophysics Data System (ADS)

Past attempts to simulate warm climates of the early Eocene have met with limited success. In particular, simulating the very warm Arctic region and high southern regions has been very difficult to achieve in climate models. This has been of great concern given that we are entering a time period of extreme warming due to increasing levels of atmospheric carbon dioxide. Thus, the question has arisen as to whether current climate models are missing a fundamental feedback that prevents them from capturing high latitude enhanced warming. We present an equilibrium coupled climate simulation using the Community Climate Model (CCSM3) that agrees in many ways with the paleoclimate proxy data for the time period of the Paleocene-Eocene Thermal Maximum (55 Ma). We compare the model simulation to a range of data including sea surface temperatures, benthic temperatures and surface temperatures from terrestrial locations in both the northern and southern hemisphere. The model agrees to within observational uncertainty with this array of data. The model simulation employs increased levels of atmospheric carbon dioxide and methane. We also include a change to warm cloud properties that is based on present day observations for non-industrially affected locations, i.e. naturally occurring aerosol conditions. The concentrations of atmospheric carbon dioxide and methane are within geochemically modeled PETM estimates for these greenhouse gases. We discuss the implications of a warm stratified ocean for modeling atmospheric carbon dioxide levels from simple biogeochemical models and argue that it is important to account for the physical state of the ocean when estimating warm climate greenhouse gas concentrations.

Kiehl, J. T.; Shields, C. A.

2009-12-01

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

[Early and late responses to oxidative stress in human dermal fibroblasts of healthy donors and rheumatoid arthritis patients. Relationship between the cell death rate and the genomic dosage of active ribosomal genes].  

PubMed

A study was made of the effect of the oxidizing agent potassium chromate (K2CrO4, PC) on cultured dermal fibroblasts of a healthy donor and three patients with rheumatoid arthritis (RA). Characteristics of the rRNA gene (RG) complex-RG copy number, active RG (ARG) dosage, and 18S rRNA content--were determined for each cell line. In cells of the healthy donor, oxidative stress caused by low doses of PC (2-4 microM, 1-4 h) induced an early response, including a 50-80% increase in total RNA and rRNA. An appreciable activation of the nucleolus was observed cytochemically, by silver staining and morphometry. The early response grew considerably lower with the increasing passage number and/or PC concentration. Exposure to 6-12 microM PC for 24 h led to a progressive cell death (late response). The existence and intensity of the early response correlated positively with the cell survival during further culturing. Cells of the RA patients displayed almost no early response even at early passages: total RNA did not increase, and rRNA increased by no more than 10%. Cell disruption (apoptosis) during further culturing was more intense than in the line originating from the healthy donor. The apoptosis intensity characterized by the increase in the content of DNA fragments in the culture medium and in the caspase 3 activity, was inversely proportional to the ARG dosage in the genome. The results provide the first quantitative characterization of the early and late responses of cells to PC-induced oxidative stress and suggest a role of the ARG dosage in cell survival in stress. PMID:15856950

Be?ko, N N; Terekhov, S M; Shubaeva, N O; Simirnova, T D; Ivanova, S M; Egolina, N A; Tsvetkova, T G; Spitkovski?, D M; Liapunova, N A

2005-01-01

70

Early-time HANE simulation and experiment. Technical report  

SciTech Connect

This report focuses on the NRL laser facility, new experimental results from it, and computer models for the experiments. It makes a substantial contribution to the understanding of collisionless coupling, both with and without magnetic fields. It remains very important to stay focused on the critical question of early-time debris-air coupling related to late-time spatial structures. Cataloging collisionless phenomena is recommended for consideration while continuing to perform collisional experiments. Early-time shadowgraphy with radiating ambient gases should be considered. While aneurysms remain interesting phenomena, they may not be related to the primary HANEs explorations. Consideration is recommended of blunt-ended probes as a supplement to spherical obstacles in plasma-flow experiments. The use of a fast multichannel device is recommended after the spectrometer and the consideration of two-color interferometry as diagnostic tools. The purposeful exploration of target variation is recommended through the deliberate use of spherical or hemispherical and other non-flat targets of planned inhomogeneity. Increased correspondence between experimental simulations and the HANE data base is recommended. Two-dimensional modeling efforts are anticipated and the consideration is suggested of special-purpose machines or parallel machines before investing in more conventional computers for such modeling.

Cornwall, M.; Hammer, D.; LeLevier, R.; Vesecky, J.

1987-05-01

71

Occupational therapy for rheumatoid arthritis  

Microsoft Academic Search

Background: For persons with rheumatoid arthritis (RA) the physical, personal, familial, social and vocational consequences are extensive. Occupational therapy (OT), with the aim to facilitate task performance and to decrease the consequences of rheumatoid arthritis for daily life activities, is considered to be a cornerstone in the management of rheumatoid arthritis. Till now the efficacy of occupational therapy for patients

E. M. J. Steultjens; J. Dekker; L. M. Bouter; D. J. van Schaardenburg; M. A. H. van Kuyk; C. H. M. van den Ende

2004-01-01

72

Rheumatoid arthritis in a military aviator.  

PubMed

Rheumatoid arthritis is a chronic inflammatory condition whose pathogenesis is determined partially by genetic and environmental factors. Without treatment, 20 to 30% of individuals with this condition will become permanently disabled in a few years. Rheumatoid arthritis and its potential complications can cause significant disability and could seriously affect the performance of an aviator. Traditionally, disease-modifying anti-rheumatic drugs (DMARD) and biologics have not been used until disease progression occurs, but they recently have been added earlier in the course of disease for a more aggressive approach to treatment. It has been shown to significantly reduce the number of affected joints, pain, and disability. This newer treatment regimen has helped a military pilot continue his aviation career. We present the case of an experienced designated military pilot who was diagnosed with rheumatoid arthritis. He was initially treated early with a DMARD and biologic medication. He has remained in remission and currently only uses etanercept (biologic medication) and a non-steriodal anti-inflammatory drug to control his disease. He has responded favorably to therapy and has few limitations. Due to his positive response to treatment, the aviator was granted military aeromedical waivers for rheumatoid arthritis and chronic medication use. PMID:17225486

Moszyk, Danielle J; Sulit, Daryl J

2007-01-01

73

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

74

Profiling of rheumatoid arthritis associated autoantibodies  

Microsoft Academic Search

An increasing number of rheumatoid arthritis (RA)-associated autoantibodies (AAB) are available for AAB profiling that may improve the early diagnosis of RA and provide prognostic and, probably theranostic information. To select AAB specificities for optimal AAB combinations, known AAB should be evaluated with standardized methods by means of standardized study designs and subjected to statistical analysis. Profiling of anti-citrullinated peptide\\/protein

Karsten Conrad; Dirk Roggenbuck; Dirk Reinhold; Thomas Dörner

2010-01-01

75

Dermatoglyphics in rheumatoid arthritis.  

PubMed

Patients with rheumatoid arthritis have been referred to Division of Human Genetics for counselling. Qualitative dermatoglyphics comprising of finger print pattern, interdigital pattern, hypothenar pattern and palmar crease were studied on 26 female and 11 male rheumatoid arthritis patients. Comparison between patient male and control male; and patient female and control female has been done. 'Chi' square test was performed. In male patients, with hands together, arches were increased, loops/ whorls were decreased. Partial Simian crease was significantly increased. In the right hand, patterns were increased in the 3rd interdigital area. On the other hand, in female patients there was a significant increase in whorls and decrease in loops on the first finger on both the hands, increase in arches on the 3rd finger; both arches and whorls on the 4th finger of left hand. Present study has emphasized that dermatoglyphics could be applied as a diagnostic tool to patients with rheumatoid arthritis. PMID:14573963

Ravindranath, Roopa; Shubha, R; Nagesh, H V; Johnson, Job; Rajangam, Sayee

2003-10-01

76

Sensitivity of Numerical Simulation of Early Rapid Intensification of Hurricane Emily (2005) to Cloud Microphysical and Planetary Boundary Layer Parameterizations  

E-print Network

Sensitivity of Numerical Simulation of Early Rapid Intensification of Hurricane Emily (2005 resolution (3 km). A series of numerical simulations is conducted to examine the sensitivity. Results indicate that the numerical simulations of the early rapid intensification of Hurricane Emily

Pu, Zhaoxia

77

Current and future management approaches for rheumatoid arthritis  

Microsoft Academic Search

With the introduction of new disease-modifying antirheumatic drugs (DMARDs) and other therapeutic agents, the management of rheumatoid arthritis (RA) has shifted toward earlier, more aggressive therapy. The ultimate goal is to prevent structural joint damage that leads to pain and functional disability. Early diagnosis of RA is therefore essential, and early DMARD treatment combined with nonsteroidal anti-inflammatory drugs is recommended.

Ferdinand C Breedveld; Leids Universitair

2002-01-01

78

Cause and age at death in a prospective study of 100 patients with rheumatoid arthritis  

Microsoft Academic Search

A series of 100 patients with rheumatoid arthritis (RA), first seen in the early months of their disease, have now been followed up for 18 years, and 43 have died. Rheumatoid disease directly caused death in 9, and the disease or its treatment contributed to death in 7. These 16 patients were younger at onset and younger at death than

J J Rasker; J A Cosh

1981-01-01

79

Laryngeal Manifestations of Rheumatoid Arthritis  

PubMed Central

Rheumatoid arthritis is a destructive autoimmune disease that affects 3% of the adult population. It is characterized by the formation of both articular and extra-articular lesions with predilection for small joints. There are ubiquitous reports on the head and neck manifestations of RA with emphasis on the larynx. The laryngeal presenting features of this systemic disease may mimic a plethora of medical conditions, inflammatory and neoplastic. The main phonatory and respiratory symptoms are often subtle and misleading. This paper represents a literature review of the laryngeal manifestations of RA with emphasis on the clinical symptoms, laryngeal findings, diagnosis, and treatment. An early diagnosis of laryngeal involvement may prevent drastic complications. PMID:23864939

Hamdan, A. L.; Sarieddine, D.

2013-01-01

80

Alcohol consumption is associated with lower self-reported disease activity and better health-related quality of life in female rheumatoid arthritis patients in Sweden: data from BARFOT, a multicenter study on early RA  

PubMed Central

Background Earlier studies have found a positive effect of alcohol consumption, with a reduced disease activity in rheumatoid arthritis (RA). The aim of this study was to assess alcohol consumption and its association with disease activity and health related quality of life (HRQL) in Swedish RA patients. Methods Between 1992 and 2005, 2,800 adult patients were included in the BARFOT study of early RA in Sweden. In 2010 a self-completion postal questionnaire was sent to all 2,102 prevalent patients in the BARFOT study enquiring about disease severity, HRQL, and lifestyle factors. Alcohol consumption was assessed using the validated AUDIT-C questionnaire. Results A total of 1,238 out of 1,460 patients answering the questionnaire had data on alcohol consumption: 11% were non-drinkers, 67% had a non-hazardous drinking, and 21% were classified as hazardous drinkers. Women who drank alcohol reported lower disease activity and better HRQL, but there were no association between alcohol consumption and disease activity in men. For current smokers, alcohol use was only associated with fewer patient-reported swollen joints. The outcome was not affected by kind of alcohol consumed. Conclusions There was an association between alcohol consumption and both lower self-reported disease activity and higher HRQL in female, but not in male, RA patients. PMID:23879655

2013-01-01

81

Rheumatoid factor in Nigerian sera  

PubMed Central

A high prevalence of rheumatoid factor has been found in the sera of apparently healthy inhabitants of two Western Nigerian villages. The prevalence of rheumatoid factor at high titre increased markedly with age. The rheumatoid factor found in the sera of these apparently healthy subjects showed a selective affinity for human ?-globulin rather than rabbit ?-globulin. Rheumatoid factor activity was shown to be restricted to the serum IgM fraction. In one of the two villages a significant correlation was found between the presence of rheumatoid factor at high titre and the presence of IgM malaria antibodies at high titre and the possible role of malaria in the induction of rheumatoid factor formation in these two communities is discussed. PMID:4936803

Greenwood, B. M.; Muller, A. S.; Valkenburg, H. A.

1971-01-01

82

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

83

[Comorbidity in rheumatoid arthritis].  

PubMed

Patients with rheumatoid arthritis (RA) often have one or more comorbid conditions. The prevalence of comorbidities increases with age and disease duration. Comorbidities influence the outcome of RA and limit therapeutic options. Besides suppressing disease activity of RA, screening and tight control of existing comorbidities is essential to avoid further damage. A close cooperation between general practitioners, rheumatologists and attending specialists is important for a successful treatment, taking into account the complex interaction of RA and its comorbidities. PMID:25181002

Albrecht, K

2014-09-01

84

From early virtual garment simulation to interactive fashion design  

Microsoft Academic Search

Virtual garment design and simulation involves a combination of a large range of techniques, involving mechanical simulation, collision detection, and user interface techniques for creating garments. Here, we perform an extensive review of the evolution of these techniques made in the last decade to bring virtual garments to the reach of computer applications not only aimed at graphics, but also

Pascal Volino; Frederic Cordier; Nadia Magnenat-thalmann

2005-01-01

85

The Effects of Infant Simulators on Early Adolescents.  

ERIC Educational Resources Information Center

Examined the effects of infant simulators (computerized dolls designed to simulate normal infants) on 236 8th-grade students. Findings indicated that the doll experience had a significant impact on the students, especially females. It helped them to learn about the challenges of infant care, and to think of the implications before engaging in…

Divine, James H.; Cobbs, Gene

2001-01-01

86

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; Nasstrom, Karin; Alstergren, Per; Bratt, Johan; Kopp, Sigvard

2010-01-01

87

Subchondral pseudocysts in rheumatoid arthritis.  

PubMed

Subchondral cyst formation (geode) is a not uncommon manifestation of rheumatoid arthritis which may at times impede correct radiologic interpretation. Four patients with rheumatoid arthritis who demonstrated striking subarticular cystic erosive disease are described. These cases emphasize the nature and appearance of this interesting finding. PMID:413361

Rennell, C; Mainzer, F; Multz, C V; Genant, H K

1977-12-01

88

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

89

The effects of infant simulators on early adolescents.  

PubMed

The researchers examined the effects of infant simulators (computerized dolls designed to simulate normal infants) on 236 eighth-grade students. As part of their health and sex education curriculum, students had to provide care--24 hours a day, over several days--to dolls that cried when they "were hungry," "needed a diaper change," or "needed attention." The dolls enabled teachers to evaluate the care given by students. Students kept daily charts and journals, and wrote essays about their experiences. One to two years later, the students were surveyed, along with 461 comparison students who did not have the infant simulator experience. The findings indicated that the doll experience had a significant impact on the students, especially the females. It helped them to learn about the challenges of infant care, and to think of the implications before engaging in sexual intercourse. The comparison group felt less knowledgeable about what it takes to care for an infant, and judged infant care as less time consuming, difficult, and expensive than did those who had the infant simulator experience. PMID:11817639

Divine, J H; Cobbs, G

2001-01-01

90

Clotrimazole in rheumatoid arthritis.  

PubMed Central

Forty-seven patients with active rheumatoid arthritis took part in an 8-week controlled study in which clotrimazole was compared with a standard nonsteroidal anti-inflammatory agent, ketoprofen. Although clotrimazole was shown to be effective in the treatment of the disease and superior to ketoprofen in certain measurements, if was also responsible for a high incidence of adverse effects. Improvement with clotrimazole took place more slowly but was more sustained than with ketoprofen. A significant rise in plasma cortisol and a fall in white cell count was observed in the clotrimazole treated patients. PMID:7002065

Wojtulewski, J A; Gow, P J; Walter, J; Grahame, R; Gibson, T; Panayi, G S; Mason, J

1980-01-01

91

Handout on Health: Rheumatoid Arthritis  

MedlinePLUS

... many other rheumatic diseases, rheumatoid arthritis is an autoimmune disease ( auto means self), so-called because a person’s ... risk; it may also help explain why different autoimmune diseases tend to run in families. Other studies have ...

92

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.  

PubMed

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 effects. A complex genetic model including epistasis and genotype-by-environment interaction was applied to a population of 1.9 million nuclear families of size four from which we selected 1500 families with both offspring affected and 2000 unrelated, unaffected individuals all of whose first-degree relatives were unaffected. This process was repeated to produce 100 replicate data sets. In addition, we generated marker data for 22 autosomes consisting of a genome-wide set of 730 simulated STRP markers, 9187 SNP markers and an additional 17,820 SNP markers on chromosome 6. Appropriate linkage disequilibrium between markers and between trait loci and markers was modelled using HapMap Phase 1 data http://www.hapmap.org/downloads/phasing/2005-03_phaseI/. The code base for this project was written primarily in the Octave programming language, but it is being ported to the R language and developed into a larger project for general genetic simulation called GenetSim http://genetsim.org/. All of the source code that was used to generate the GAW 15 Problem 3 data is freely available for download at http://genetsim.org/gaw15/. PMID:18466538

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

2007-01-01

93

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

94

Robust regression and posterior predictive simulation increase power to detect early bursts of trait evolution.  

PubMed

A central prediction of much theory on adaptive radiations is that traits should evolve rapidly during the early stages of a clade's history and subsequently slowdown in rate as niches become saturated--a so-called "Early Burst." Although a common pattern in the fossil record, evidence for early bursts of trait evolution in phylogenetic comparative data has been equivocal at best. We show here that this may not necessarily be due to the absence of this pattern in nature. Rather, commonly used methods to infer its presence perform poorly when when the strength of the burst--the rate at which phenotypic evolution declines--is small, and when some morphological convergence is present within the clade. We present two modifications to existing comparative methods that allow greater power to detect early bursts in simulated datasets. First, we develop posterior predictive simulation approaches and show that they outperform maximum likelihood approaches at identifying early bursts at moderate strength. Second, we use a robust regression procedure that allows for the identification and down-weighting of convergent taxa, leading to moderate increases in method performance. We demonstrate the utility and power of these approach by investigating the evolution of body size in cetaceans. Model fitting using maximum likelihood is equivocal with regards the mode of cetacean body size evolution. However, posterior predictive simulation combined with a robust node height test return low support for Brownian motion or rate shift models, but not the early burst model. While the jury is still out on whether early bursts are actually common in nature, our approach will hopefully facilitate more robust testing of this hypothesis. We advocate the adoption of similar posterior predictive approaches to improve the fit and to assess the adequacy of macroevolutionary models in general. PMID:24149077

Slater, Graham J; Pennell, Matthew W

2014-05-01

95

Rheumatoid lung disease, pneumothorax, and eosinophilia.  

PubMed Central

Four cases of the triad of rheumatoid lung disease, spontaneous pneumothorax, and peripheral blood eosinophilia are reported. Cavitation of a rheumatoid lung nodule caused the pneumothorax in at least 1 case. The significance of eosinophilia and its value as a marker of extra-articular manifestations of rheumatoid disease are discussed. Images PMID:7073341

Crisp, A J; Armstrong, R D; Grahame, R; Dussek, J E

1982-01-01

96

Immunological and immunohistochemical analysis of rheumatoid nodules  

Microsoft Academic Search

An attempt was made to examine the pathophysiology of the rheumatoid nodule. Significant amounts of interleukin 1-like activity and prostaglandin E2 were detected in the supernatants from in vitro organ cultures of rheumatoid nodule tissue. When fresh (but not old) rheumatoid nodules were minced and cultured in vitro prominent outgrowths of cells were observed. These cells expressed both HLA-DR and

N Miyasaka; K Sato; K Yamamoto; M Goto; K Nishioka

1989-01-01

97

Climate model simulations of the observed early-2000s hiatus of global warming  

NASA Astrophysics Data System (ADS)

The slowdown in the rate of global warming in the early 2000s is not evident in the multi-model ensemble average of traditional climate change projection simulations. However, a number of individual ensemble members from that set of models successfully simulate the early-2000s hiatus when naturally-occurring climate variability involving the Interdecadal Pacific Oscillation (IPO) coincided, by chance, with the observed negative phase of the IPO that contributed to the early-2000s hiatus. If the recent methodology of initialized decadal climate prediction could have been applied in the mid-1990s using the Coupled Model Intercomparison Project Phase 5 multi-models, both the negative phase of the IPO in the early 2000s as well as the hiatus could have been simulated, with the multi-model average performing better than most of the individual models. The loss of predictive skill for six initial years before the mid-1990s points to the need for consistent hindcast skill to establish reliability of an operational decadal climate prediction system.

Meehl, Gerald A.; Teng, Haiyan; Arblaster, Julie M.

2014-10-01

98

Statistical reappraisal of the clinical significance of nail beading in rheumatoid arthritis.  

PubMed Central

Nail beading has previously been reported as an accompaniment of rheumatoid arthritis. In order to assess the clinical significance of this form of nychodystrophy the fingernails and toenails of 119 patients with rheumatoid arthritis and an equal number of control subjects were studied. Analysis of data based on 4642 nails indicates that the presence of a global pattern of beading (i.e. greater than or equal to 50% involvement of the nail area) on the surface of at least six fingernails or four toenails is highly suggestive of underlying rheumatoid disease. The positive predictive value of these configurations is in the order of 95%. Nail beading, however, is infrequent in early disease and therefore its diagnostic value is limited. Although there is a strong association between nail beading and rheumatoid arthritis, the aetiology and prognostic implications of this clinical sign remain obscure. Images PMID:4051588

Grant, E N; Bellamy, N; Buchanan, W W; Grace, E M; O'Leary, S

1985-01-01

99

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

100

Simulated Microgravity as a Probe for Understanding the Mechanisms of Early Pattern Specification  

NASA Technical Reports Server (NTRS)

Early pattern specification (e.g., axial structure morphogenesis, doreal ventral polarity, etc.) is monitored in amphibian eggs which were subjected to microgravity simulation by constant rotation on a horizontal clinostat. In contrast to previous clinostat experiments, rotation is initiated either prior to fertilization or immediately thereafter. Large proportions of clinostated eggs developed normal axial structures. A model which employs a multiple set of signals for specifying early pattern is discussed. Effects of microgravity simulation on the earliest post fertilization pattern specification event dorsal/ventral polarization is analyzed in detail. Other models are developed and they are discussed. As a general mechanism for explaining the manner in which regional developmental patterns emerge from the initial, radially symmetrial egg, the density compartment model is described. The identification of the various zones or compartments of egg cytoplasm using inverted eggs is explained.

Neff, A. W.; Malacinski, G. M.

1985-01-01

101

Simulating the climate of the early Eocene, a perturbed physics approach  

NASA Astrophysics Data System (ADS)

Modelling past climates that are very different to the modern provide an important test for the climate models used to predict future climates. The early Eocene was a period of global extreme warmth and simulating the extent of high latitude warmth in this period without overheating the tropics has been problematic, leading to a significant climate model geological data mismatch. There are several areas of uncertainty in climate models but parameter uncertainty is the largest component: sub-grid scale and temporally fast processes such as those that operate in the atmosphere are particularly difficult to measure in the environment and subsequently hard to parameterise in the climate models, resulting in a large range of possible values. Perturbed physics simulations are run by perturbing ten uncertain parameters within their plausible range in the model FAMOUS, an intermediate complexity general circulation model in order to see if the model is capable of generating the global warmth of the early Eocene. The uncertain parameters are perturbed both individually and in combination (single and multiple parameter perturbations). Latin hypercube sampling is used to create the parameter values for the multiple parameter perturbations in order to maximise the parameter space sampled. 2 x pre-industrial atmospheric CO2 is used for the early Eocene simulations. From over one hundred initial parameter sets three simulations have a temperature distribution that overlaps with the available early Eocene proxy data. These are referred to as the good Eocene simulations. In two simulations only a single parameter is varied and in the third parameter all the parameters are co-varied together. In the single parameter perturbations the critical relative humidity for cloud formation and the horizontal atmospheric diffusion parameters are reduced to 89% and 72% of the control value respectively. In the third good simulation all ten uncertain parameters are perturbed; two parameters involved in cloud liquid content and precipitation are increased to the upper end of their plausible range whilst the remaining parameters are only perturbed to within 8% of their original value. Present day and future simulations have also been run with the multiple parameter perturbation sets. Arcsin Mielke scores have been calculated for a number of climate variables for the present day simulations (e.g. surface air temperature, precipitation, sea ice and top of atmosphere energy balance. Our good Eocene simulation with perturbed cloud parameters outperforms the control parameter set for present day boundary conditions. It also has the highest score for present day precipitation out of all 100 parameter sets. These results increase confidence in this parameter set. The good early Eocene simulations are presented along with the reference geological dataset in this work. Present day and future simulations for both the control parameter set and the good multiple parameter perturbation set are also presented.

Sagoo, N.; Valdes, P. J.; Gregoire, L. J.; Flecker, R.

2012-12-01

102

Therapeutic strategies for rheumatoid arthritis  

Microsoft Academic Search

Recent years have seen considerable advances in our understanding of both the clinical and basic-research aspects of rheumatoid arthritis. Clinical progress has come from a better recognition of the natural history of the disease, the development and validation of outcome measures for clinical trials and, consequently, innovative trial designs. In parallel, basic research has provided clues to the pathogenic events

Günter Steiner; Josef S. Smolen

2003-01-01

103

Somatostatin Involvement in Rheumatoid Arthritis  

Microsoft Academic Search

Somatostatin (somatotropin release inhibitory factor; SRIF) peptides are widely distributed in the mammalian body and, acting through a family of genetically homologous cell surface receptors (sst1-5), regulate cellular secretion and proliferation. Compelling evidence implicates SRIF peptides and peptidyl analogues in chronic inflammatory diseases such as rheumatoid arthritis (RA). SRIF membrane receptors exist on immune and synovial cells, thereby providing mo-

Allan D. Blake; Frances Mae West; Sadia Ghafoor; Petros Efthimiou

2007-01-01

104

Reactive molecular dynamic simulations of early stage of wet oxidation of Si (001) surface  

NASA Astrophysics Data System (ADS)

We have investigated the initial stage of oxidation of Si (001) surface by water (H2O) molecules using reactive molecular dynamics (MD) simulation at 300 K and 1200 K without any external constraint on the water molecules. Previously, reported water reaction behaviors on silicon surface by ab initio calculations or experimental observations were reproduced by the present MD simulation. The present simulation further revealed that the hydrogen atom in H2O is more attractive than oxygen atom in O2 to bond with Si, such that it accelerates the dissociation process of H2O. It was also observed that the oxidation reaction was enhanced with increased number of the supplied water molecules. It was suggested that the repulsion between water molecules and their fragments facilitates the dissociation of both water molecules and hydroxyl decomposition on the Si surface. Therefore, the wet oxidation behavior appeared to have more temperature dependence even in the early stage of oxidation.

Pamungkas, Mauludi Ariesto; Kim, Byung-Hyun; Lee, Kwang-Ryeol

2013-08-01

105

Atypical Rheumatoid Nodules: A Possible Precursor to a Rheumatoid Variant in a Rheumatoid-Factor-Negative Patient. Case Report  

PubMed Central

Subcutaneous nodules occur in approximately 20–25% of rheumatoid factor (RF)-positive rheumatoid patients. In this paper, we present a unique case of a 47-year-old healthy RF-negative woman with a 3-year history of necrobiotic nodules over the dorsum of her hands, extensor forearms, and lower extremities. This may represent an atypical presentation or a new rheumatoid variant. PMID:19048351

Kim, Sharon; Parker, Wendy L.

2008-01-01

106

Epigenetics in the pathogenesis of rheumatoid arthritis  

PubMed Central

An increasing number of studies show that besides the inherited genetic architecture (that is, genomic DNA), various environmental factors significantly contribute to the etiology of rheumatoid arthritis. Epigenetic factors react to external stimuli and form bridges between the environment and the genetic information-harboring DNA. Epigenetic mechanisms are implicated in the final interpretation of the encoded genetic information by regulating gene expression, and alterations in their profile influence the activity of the immune system. Overall, epigenetic mechanisms further increase the well-known complexity of rheumatoid arthritis by providing additional subtle contributions to rheumatoid arthritis susceptibility. Although there are controversies regarding the involvement of epigenetic and genetic factors in rheumatoid arthritis etiology, it is becoming obvious that the two systems (genetic and epigenetic) interact with each other and are ultimately responsible for rheumatoid arthritis development. Here, epigenetic factors and mechanisms involved in rheumatoid arthritis are reviewed and new, potential therapeutic targets are discussed. PMID:24568138

2014-01-01

107

Diagnostic and prognostic characteristics of the enzyme linked immunosorbent rheumatoid factor assays in rheumatoid arthritis  

Microsoft Academic Search

OBJECTIVE: To determine the diagnostic and prognostic test qualities of the enzyme linked immunosorbent assays (ELISA) for rheumatoid factor isotypes in rheumatoid arthritis (RA), and to compare them with the latex fixation test. METHODS: Rheumatoid factor tests were performed in 1988 consecutive new rheumatology outpatients within two months after their first visit to the outpatient clinic of the Department of

H Visser; L B Gelinck; A H Kampfraath; F C Breedveld; J M Hazes

1996-01-01

108

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

109

Early human-plant interactions based on palaeovegetation simulations of Africa over glacial-interglacial cycles  

NASA Astrophysics Data System (ADS)

A greater understanding of African palaeovegetation environments over the Pleistocene (1.6 Mya) is important for evaluating potential catalysts underlying the anatomical, social and demographic changes observed in early human populations. We used a state-of-the-art fully-coupled earth system model (HADLEY-GCM3) to simulate typical glacial and interglacial environments likely encountered by late-Pleistocene humans. Our simulations indicate that tropical broadleaf forests of central Africa were not severely restricted by expanding grasslands during the last glacial maximum, although the carbon content of stem and density of leaf components were substantially reduced. We interpret a natural eastern migration corridor between southern Africa and the Rift Valley based on simulations of a no-analogue vegetation assemblage characterised by a unique combination of grass and low density forest. We postulate that early human populations in southern Africa were isolated from northern groups during warm interglacials, and that trans-African migration was facilitated during glacial cycles via a more openly forested eastern corridor.

Cowling, S. A.; Cox, P. M.; Jones, C. D.; Maslin, M. A.; Spall, S. A.

2003-04-01

110

Peripheral corneal ulceration associated with rheumatoid arthritis  

PubMed Central

Patient: Female, 60 Final Diagnosis: Corneal ulceration Symptoms: Blurred vision Medication: Abatacept Clinical Procedure: — Specialty: Ophthalmology Objective: Management of emergency care Background: To report a case of a patient with rheumatoid arthritis (RA) and associated peripheral corneal ulceration. Case Report: A 60-year-old woman with RA diagnosed 15 years ago, under immunosuppressive therapy (IV abatacept 250 mg/month), demonstrated blurring of vision in her RE (right eye). Visual acuity was 6/10 in the RE and 10/10 in the LE. Slit lamp examination revealed a paracentral superior corneal melt in the RE. Anterior chamber reaction was 2+. Laboratory investigations revealed positive anti-Ro and anti-La, anti-Extractable Nuclear Antigens (anti-ENA, ELISA), while anti-Sm, anti-Rnp, anti-Jo1 and anti-Scl70 were found negative. IgG and IgA serum immunoglobulins were found elevated, but IgE and IgM were within normal levels. Further evaluation for the underlying disease revealed highly elevated rheumatoid factor and C-reactive protein. The patient, who had been receiving anti-TNF during the last 6 months, underwent treatment with topical tobramycin and lubricants and oral prednisone 60 mg/day with tapering doses, to which methotrexate p.os. 15 mg/week was added. The condition improved within a few days after the initiation of prednisone treatment. Re-epithelization occurred 1 week after the onset of the immunosuppressive treatment. Only punctate fluorescein dye uptake was detected in the margins of the lesion. Conclusions: The effective control of the underlying disease and early diagnosis of the dry eye syndrome in RA patients may prevent serious corneal complications such as corneal ulceration. The initiation of treatment with steroids and immunosuppresants was found to halt the progression of keratolysis, and assisted re-epithelization. PMID:23986797

Karampatakis, Vasileios; Konidaris, Vasileios; Michailidou, Maria; Gerofotis, Antonios; Daniilidis, Michail

2013-01-01

111

Immunological and immunohistochemical analysis of rheumatoid nodules.  

PubMed Central

An attempt was made to examine the pathophysiology of the rheumatoid nodule. Significant amounts of interleukin 1-like activity and prostaglandin E2 were detected in the supernatants from in vitro organ cultures of rheumatoid nodule tissue. When fresh (but not old) rheumatoid nodules were minced and cultured in vitro prominent outgrowths of cells were observed. These cells expressed both HLA-DR and CD14 antigens but lacked conventional differentiation antigens for T cells and B cells, suggesting that they are of monocyte-macrophage origin. These data suggest that interleukin 1 and prostaglandin E2 may be deeply involved in the formation of rheumatoid nodules. Images PMID:2784661

Miyasaka, N; Sato, K; Yamamoto, K; Goto, M; Nishioka, K

1989-01-01

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

2014-08-01

113

A new multi-sensor approach to simulation assisted tsunami early warning  

NASA Astrophysics Data System (ADS)

A new tsunami forecasting method for near-field tsunami warning is presented. This method is applied in the German-Indonesian Tsunami Early Warning System, as part of the Indonesian Tsunami Warning Center in Jakarta, Indonesia. The method employs a rigorous approach to minimize uncertainty in the assessment of tsunami hazard in the near-field. Multiple independent sensors are evaluated simultaneously in order to achieve an accurate estimation of coastal arrival times and wave heights within very short time after a submarine earthquake event. The method is validated employing a synthetic (simulated) tsunami event, and in hindcasting the minor tsunami following the Padang 30 September 2009 earthquake.

Behrens, J.; Androsov, A.; Babeyko, A. Y.; Harig, S.; Klaschka, F.; Mentrup, L.

2010-06-01

114

Selective involvement of ERK and JNK mitogen-activated protein kinases in early rheumatoid arthritis (1987 ACR criteria compared to 2010 ACR/EULAR criteria): a prospective study aimed at identification of diagnostic and prognostic biomarkers as well as therapeutic targets  

PubMed Central

Objectives To investigate the expression and activation of mitogen-activated protein kinases in patients with early arthritis who are disease-modifying antirheumatic drug (DMARD) naïve. Methods A total of 50 patients with early arthritis who were DMARD naïve (disease duration <1 year) were prospectively followed and diagnosed at baseline and after 2 years for undifferentiated arthritis (UA), rheumatoid arthritis (RA) (1987 American College of Rheumatology (ACR) and 2010 ACR/European League Against Rheumatism (EULAR) criteria), or spondyloarthritis (SpA). Synovial biopsies obtained at baseline were examined for expression and phosphorylation of p38, extracellular signal regulated kinase (ERK) and c-Jun N-terminal kinase (JNK) by immunohistochemistry and digital analysis. Synovial tissue mRNA expression was measured by quantitative PCR (qPCR). Results ERK and JNK activation was enhanced at inclusion in patients meeting RA criteria compared to other diagnoses. JNK activation was enhanced in patients diagnosed as having UA at baseline who eventually fulfilled 1987 ACR RA criteria compared to those who remained UA, and in patients with RA fulfilling 2010 ACR/EULAR criteria at baseline. ERK and JNK activation was enhanced in patients with RA developing progressive joint destruction. JNK activation in UA predicted 1987 ACR RA classification criteria fulfilment (R2=0.59, p=0.02) after follow-up, and disease progression in early arthritis (R2=0.16, p<0.05). Enhanced JNK activation in patients with persistent disease was associated with altered synovial expression of extracellular matrix components and CD44. Conclusions JNK activation is elevated in RA before 1987 ACR RA classification criteria are met and predicts development of erosive disease in early arthritis, suggesting JNK may represent an attractive target in treating RA early in the disease process. PMID:21953337

de Launay, Daphne; van de Sande, Marleen GH; de Hair, Maria JH; Grabiec, Aleksander M; van de Sande, Gijs PM; Lehmann, K Aad; Wijbrandts, Carla A; van Baarsen, Lisa GM; Gerlag, Danielle M; Tak, Paul P; Reedquist, Kris A

2012-01-01

115

Low Incidence of Rheumatoid Factor and Autoantibodies in Nigerian Patients with Rheumatoid Arthritis  

PubMed Central

Sera from 53 Nigerian patients satisfying the American Rheumatism Association criteria for a diagnosis of definite or probable rheumatoid arthritis and sera from sick and healthy Nigerian controls were tested for rheumatoid factor, autoantibodies, and immunoglobulin levels. Rheumatoid factor and autoantibodies were found no more frequently in patients with rheumatoid arthritis than in controls. These findings confirm the clinical impression that Nigerian patients with polyarthritis satisfying the criteria for a diagnosis of rheumatoid arthritis differ from Caucasian patients with the disease in a number of important respects. They suggest that either these patients do not have rheumatoid arthritis but a distinct clinical syndrome or that in Nigeria the course of rheumatoid arthritis is modified by genetic or environmental factors. PMID:5411447

Greenwood, B. M.; Herrick, E. M.

1970-01-01

116

Methotrexate in the treatment of juvenile rheumatoid arthritis and other pediatric rheumatoid and nonrheumatic disorders.  

PubMed

The goal of treatment for juvenile rheumatoid arthritis (JRA) and other pediatric rheumatic disorders is to minimize joint destruction, pain, and deformity and to maximize all aspects of growth and development. Oral and injectable methotrexate are now often given early in the treatment of JRA, childhood dermatomyositis, difficult-to-control arthritis in the pediatric spondyloarthropathies, SLE, sarcoidosis, several of the vasculopathies, and idiopathic iritis. Weekly low-dose MTX has become a mainstay of long-term improved control of these disorders, and is associated with strikingly few documented long-term side effects. Dosages, pharmacology, side effects, efficacy, and treatment strategies are discussed. Although formal studies are lacking, MTX for the pediatric rheumatic disorders seems to be associated with less frequent physician visits, lower total costs, improved function, and fewer late reconstructive surgeries. PMID:9361157

Singsen, B H; Goldbach-Mansky, R

1997-11-01

117

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.; Kefi, Sonia; Livina, Valerie; Seekell, David A.; van Nes, Egbert H.; Scheffer, Marten

2012-01-01

118

Autoimmune correlation of rheumatoid arthritis and periodontitis  

PubMed Central

Rheumatoid arthritis and periodontitis, both, chronic inflammatory diseases share certain common diagnostic, pathological, immunogenetic and therapeutic features. A recently discovered enzymatic mimicry between human and bacterial species is novel and it opens up a new terrain for therapeutic blockade in the management of rheumatoid arthritis.

Arunachalam, Lalitha Tanjore

2014-01-01

119

Schizophrenia, rheumatoid arthritis and natural resistance genes  

Microsoft Academic Search

The strong negative correlation between schizophrenia and rheumatoid arthritis might provide clues as to the aetiology of these two diseases. An immunological explanation has been sought in the HLA sector of the major histocompatibility complex, which has been shown to have a role in the development of rheumatoid arthritis. The search for an association between schizophrenia and HLA haplotypes, however,

Gertrude Rubinstein

1997-01-01

120

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

121

ACPA (anti-citrullinated protein antibodies) and rheumatoid arthritis.  

PubMed

It has recently been discovered that anti-citrullinated protein antibodies (ACPA) are present in 50% of patients with early rheumatoid arthritis (RA). Assays for detecting ACPA have been shown to have very good diagnostic and predictive characteristics, and they may facilitate the identification of patients with early arthritis who need aggressive treatment. In addition to their diagnostic and predictive properties, ACPA have also provided new insights into the pathophysiology of RA. The specific association of certain genetic and environmental risk factors with ACPA-positive but not with ACPA-negative RA, has led to new concepts of the underlying pathogenetic mechanisms. The fact that ACPA-positive patients have a more severe disease course with greater joint destruction has also fueled the hypothesis that ACPA themselves may be pathogenic. Although there is no direct proof for this intriguing theory so far, it is clear that ACPA allow the classification of RA patients into two different disease subsets that are associated with distinct pathophysiological mechanisms and clinical outcomes. Rheumatoid arthritis (RA) is a chronic, potentially destructive, arthritis which has a large impact on patients' quality of life(1). It has become clear that in order to be able to prevent disease progression and joint destruction, RA needs to be diagnosed early, which requires diagnostic markers which can reliably predict disease development and progression(2). Some of the most attractive diagnostic markers are autoantibodies. Rheumatoid factor (RF) has long been known to be a marker of future RA development(3), but more recently, a better diagnostic and predictive marker has emerged in the form of anti-citrullinated protein antibodies (ACPA). PMID:22113596

Toes, Rene E; van der Woude, Diane

2011-01-01

122

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

PubMed Central

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 erosions from the marrow towards the joint surface. There is emerging evidence from animal models that such an infiltrate corresponds with MRI bone oedema, pointing towards the bone marrow as a site for important pathology driving joint damage in rheumatoid arthritis. PMID:17169137

McQueen, Fiona M; Ostendorf, Benedikt

2006-01-01

123

Rheumatoid arthritis in paintings: a tale of two origins.  

PubMed

Rheumatoid arthritis (RA) is thought to be a 'recent' disease in that descriptions of it were only noted in the 17th century. However, a study of paintings would suggest that RA could have been present as early as the 15th century, when artists started to paint the human body accurately rather than figuratively. Thus, it was possible to deduce from their paintings the occurrence of various medical conditions. If present, RA with its typical finger deformities should be apparent. This review discusses the known occurrences of RA-type deformities in paintings and places this in the context of the origins of the disease. PMID:20374373

Yeap, Swan Sim

2009-12-01

124

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

125

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

126

Duration of rheumatoid arthritis influences the degree of functional improvement in clinical trials  

PubMed Central

Background Functional capacity is an important outcome in rheumatoid arthritis and is generally measured using the Health Assessment Questionnaire disability index (HAQ). Functional limitation incorporates both activity and damage. Because irreversible damage increases over time, the HAQ may be less likely to show improvement in late than in early rheumatoid arthritis. Objective To determine the relation between sensitivity to change of the HAQ and duration of rheumatoid arthritis in reports of clinical trials. Methods Data were pooled from clinical trials that measured responses of HAQ scores at three or six months. The effect size of the HAQ was calculated and linear regression used to predict the effect size by duration of rheumatoid arthritis at group level. Treatment effect was adjusted for by including the effect sizes of pain scores and of tender joint counts as additional independent variables in separate models. Subgroup analysis employed contemporary regimens (methotrexate, leflunomide, combination therapies, and TNF inhibitors) only. Results 36 studies with 64 active treatment arms and 7628 patients (disease duration 2.5 months to 12.2 years) were included. The effect sizes of the HAQ decreased by 0.02 for each additional year of mean disease duration using all trials, and by 0.04/year in the subgroup analysis (p?0.01 for both analyses, except for pain adjusted models at three months). Conclusions In individual trials, less improvement in the HAQ might be expected in late than in early rheumatoid arthritis. Comparison of changes in HAQ among rheumatoid arthritis trials should take into consideration the disease stage of the treated groups. PMID:15975967

Aletaha, D

2006-01-01

127

Cardiovascular risk in rheumatoid arthritis.  

PubMed

The objectives of this review are to discuss data on the cardiovascular risk increase associated with rheumatoid arthritis (RA), the effects of RA treatments on the cardiovascular risk level, and the management of cardiovascular risk factors in patients with RA. Overall, the risk of cardiovascular disease is increased 2-fold in RA patients compared to the general population, due to the combined effects of RA and conventional risk factors. There is some evidence that the cardiovascular risk increase associated with nonsteroidal anti-inflammatory drug therapy may be smaller in RA patients than in the general population. Glucocorticoid therapy increases the cardiovascular risk in proportion to both the current dose and the cumulative dose. Methotrexate and TNF? antagonists diminish cardiovascular morbidity and mortality rates. The management of dyslipidemia remains suboptimal. Risk equations may perform poorly in RA patients even when corrected using the multiplication factors suggested by the EUropean League Against Rheumatism (EULAR) (multiply the score by 1.5 when two of the following three criteria are met: disease duration longer than 10 years, presence of rheumatoid factor or anti-cyclic citrullinated peptide (CCP) antibodies, and extraarticular manifestations). Doppler ultrasonography of the carotid arteries in patients at moderate cardiovascular risk may allow a more aggressive approach to dyslipidemia management via reclassification into the high-risk category of patients with an intima-media thickness greater than 0.9 mm or atheroma plaque. PMID:24880190

Soubrier, Martin; Chamoux, Nicolas Barber; Tatar, Zuzana; Couderc, Marion; Dubost, Jean-Jacques; Mathieu, Sylvain

2014-07-01

128

Managed care implications in managing rheumatoid arthritis.  

PubMed

Rheumatoid arthritis (RA) is a systemic inflammatory form of arthritis characterized by joint inflammation, pain, swelling, and stiffness. While contemporary treatment strategies based on early diagnosis, aggressive treatment, and regular monitoring have helped a significant number of patients achieve evidence-based treatment goals, RA still presents substantial management challenges to both clinicians and patients, and has the potential to lead to severe disability over time. In addition to its significant clinical consequences, RA has important economic implications. Both direct and indirect medical costs associated with RA are significant, including costs of medications, ambulatory and office-based care, and quality-of-life and productivity costs. In addition, a significant proportion of patients with prevalent RA have associated cardiovascular disease and other comorbidities, further compounding healthcare costs and complicating management of this disorder. Clinically favorable and cost-effective management must focus on prevention of disease progression and the improved patient health status and productivity than can result from optimal disease control. With the myriad of treatment options both available and emerging, managed care organizations are faced with difficult decisions surrounding the most clinically and cost-effective allocation of treatments designed to improve disease outcomes for patients with RA. It is vital that managed care clinicians and providers analyze both the overall burden and the specific costs of RA. This will allow a better understanding of how costs and issues relating to healthcare utilization affect the treatment of patients with RA and impact individualized therapy, care coordination, and outcomes. PMID:25180623

Owens, Gary M

2014-05-01

129

The electroneurophysiological evaluation of rheumatoid arthritis patients.  

PubMed

In Rheumatoid Arthritis (RA), one clinical hallmark of the vasculitis is the appearance of neurological findings. However, it is often difficult to diagnose these slight or early neuropathies and the study of the peripheral neuromuscular system is often made difficult by symptoms resulting from pain in the joints, and limitations of movement. It is nevertheless often possible, by means of electroneuromyography to show objectively the existence and distribution of even subclinical neuropathies. In order to evaluate the neurophysiological functions of RA patients by means of the peripheral nerve conduction and somatosensory evoked potential studies, 33 RA patients and 20 healthy controls were included in this study. Two (6%) patients were found to have carpal tunnel syndrome, while 6 (18%) patients had mononeuritis multiplex. Delayed N12, N13, N1 and P1 latencies were detected in 6 (18%) of 33 RA patients suggesting central nervous system involvement with intact peripheral nervous system. Our results confirm earlier observations that symptoms of neuropathy are fairly common in cases of RA without there being any clear correlation with any clinical variable. Therefore, the inclusion of an electroneurophysiologic examination of the RA patients is recommended in routine diagnostic procedure. PMID:9805193

Sivri, A; Güler-Uysal, F

1998-01-01

130

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

131

The electroneurophysiological findings in rheumatoid arthritis patients.  

PubMed

In rheumatoid arthritis (RA), vasculitis is a serious complication usually found in patients with long-standing erosive nodular seropositive disease. One clinical hallmark of this systemic arteritis is the appearance of neurological findings. However, it is often difficult to diagnose these slight or early neuropathies and the study of the peripheral neuromuscular system is often made difficult by symptoms resulting from pain in the joints and limitations of movement. It is nevertheless often possible by means of electroneuromyography to show objectively the existence and distribution of even subclinical neuropathies. In order to evaluate the neurophysiological functions of RA patients by means of the peripheral nerve conduction and somatosensorial evoked potential studies, 33 RA patients and 20 healthy controls were included in this study. Two (6%) patients were found to have carpal tunnel syndrome, while 6 (18%) patients had mononeuritis multiplex. Delayed N12, N13, N1 and P1 latencies were detected in 6 (18%) of 33 RA patients suggesting central nervous system involvement with intact peripheral nervous system. Our results confirm earlier observations that symptoms of neuropathy are fairly common in cases of RA without there being any clear correlation with any clinical variable. By means of electroneurophysiological studies, it is to evaluate the integrity of the peripheral nerve, the spine and the central pathways. Besides enabling to detect early subclinical involvement of the peripheral nervous system in RA, SEPs should also be used for the evaluation of subclinical myelopathy due to atlantoaxial subluxation or vasculitis. The inclusion of an electroneurophysiologic examination of the RA patients is recommended in routine diagnostic procedure. PMID:10546073

Sivri, A; Güler-Uysal, F

1999-01-01

132

[Large articular geode cyst in rheumatoid polyarthritis].  

PubMed

A case of a large bone cyst in the tibial condyle of a patient with rheumatoid arthritis is reported. The etiology and pathology are discussed, and preventive surgical treatment is recommended. PMID:2801089

Sabri, F; Calmes, D; Muller, M J

1989-01-01

133

Leprosy and rheumatoid arthritis: consequence or association?  

PubMed

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

134

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

135

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

136

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

137

Anti-citrullinated peptide antibodies and rheumatoid factor isotypes in the diagnosis of rheumatoid arthritis: an assessment of combined tests.  

PubMed

ACPA (anti-citrullinated protein antibody) tests are today systematically added to clinical and radiological investigations when diagnosing rheumatoid arthritis (RA), and the inclusion of ACPA positivity in the new 2010 RA criteria underlines their importance. The aim of this study was to determine the sensitivity and specificity of different ACPA assays and IgA, IgG and IgM isotypes of rheumatoid factor (RF) in a cohort of patients with early RA in order to assess the value of combining the tests. The serum samples were obtained from 46 RA patients, 80 patients with systemic rheumatic disease, and 20 blood donors. ACPAs were measured using five different commercial kits. The receiver operating characteristic (ROC) curves of the anti-ACPA tests had area under the curve (AUC) values of 0.60-0.83. The diagnostic accuracy of the Bio-Rad multiplex flow immunoassay, a new technology for ACPA testing, was very similar to that of the other widely used commercial immunoassays. The EliA CCP-Phadia test was the most specific, and had the best positive likelihood ratio and positive predictive values, whereas the anti-CCP Inova 3.1 test was the most sensitive, and had the best negative likelihood ratio and negative predictive values. The best combination to use for early RA screening was an ACPA test together with IgM and IgA RF. PMID:24892812

Infantino, Maria; Manfredi, Mariangela; Meacci, Francesca; Sarzi-Puttini, Piercarlo; Ricci, Cristian; Atzeni, Fabiola; Benucci, Maurizio

2014-09-25

138

The surgical management of the rheumatoid spine: Has the evolution of surgical intervention changed outcomes?  

PubMed Central

Context: Surgery for the rheumatoid cervical spine has been shown to stabilize the unstable spine; arrest/improve the progression of neurological deficit, help neck pain, and possibly decelerate the degenerative disease process. Operative intervention for the rheumatoid spine has significantly changed over the last 30 years. Aims: The purpose of this study was to review all cases of cervical rheumatoid spine requiring surgical intervention in a single unit over the last 30 years. Materials and Methods: A prospectively-maintained spine database was retrospectively searched for all cases of rheumatoid spine, leading to a review of indications, imaging, Ranawat and Myelopathy Disability Index measures, surgical morbidity, and survival curve analysis. Results: A total of 224 cases were identified between 1981 and 2011. Dividing the data into three time-epochs, there has been a significant increase in the ratio of segment-saving Goel-Harms C1-C2: Occipitocervical fixation (OCF) surgery and survival has increased between 1981 and 2011 from 30% to 51%. Patients undergoing C1-C2 fixation were comparatively less myelopathic and in a better Ranawat class preoperatively, but postoperative outcome measures were well-preserved with favorable mortality rates over mean 39.6 months of follow-up. However, 11% of cases required OCF at mean 28 months post-C1-C2 fixation, largely due to instrumentation failure (80%). Conclusion: We present the largest series of surgically managed rheumatoid spines, revealing comparative data on OCF and C1-C2 fixation. Although survival has improved over the last 30 years, there have been changes in medical, surgical and perioperative management over that period of time too confounding the interpretation; however, the analysis presented suggests that rheumatoid patients presenting early in the disease process may benefit from C1 to C2 fixation, albeit with a proportion requiring OCF at a later time. PMID:25013346

Bhatia, Robin; Haliasos, Nikolas; Vergara, Pierluigi; Anderson, Caroline; Casey, Adrian

2014-01-01

139

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

140

Predicting early dolomitization: outcrop-based numerical simulations of carbonate diagenesis by free-convecting brines  

NASA Astrophysics Data System (ADS)

Free-convection of brines, or reflux, can be an efficient hydrologic mechanism to deliver sufficient magnesium for dolomitization. The replacement of calcite by dolomite, dolomite cementation, and sulfate precipitation and dissolution affect the porosity and permeability of carbonates reservoirs and aquifers. We evaluate hydrologic and geochemical controls on reflux dolomitization using outcrop data to constrain numerical models. First we built a hydrogeologic model of brine circulation during the accumulation of the Permian San Andres Formation (west Texas and southeast New Mexico), where we hypothesize that high-salinity fluids were present in restricted parts of the platform as inferred by the presence of evaporite-rich peritidal deposits. These fluids circulated through the platform in response to density and hydraulic gradients and caused early dolomitization. This model simulates the source of dolomitizing fluids as it migrates across the platform top in response to relative sea-level fluctuations. Brine plumes develop, migrate, grow, and shrink over time in the underlying sediments. We predict that dolomitization is most likely to occur in areas of high- salinity and high fluid flow rate. Mass-balance analysis indicates that this process is capable of delivering enough magnesium to completely dolomitize the San Andres platform. Reactive transport simulations using provide insight on the dissolution and precipitation reactions taking place along flow paths in the reflux system. A model based on Cretaceous Glen Rose Formation in central Texas indicates that concentrated seawater is capable of dolomitizing the top 1.5 m of a high-frequency cycle within 450 years. Reaction kinetics, brine concentration, and brine residence time are critical factors that control the timing, extent, and distribution of dolomitization. A model of episodic high-frequency cycle deposition and brine reflux simulated both complete and partially dolomitized cycles. These experiments illustrate how a single refluxing brine may result in the advance of separate dolomitization fronts and result in separate dolomite bodies. This reveals the importance of the "seed effect", whereby the amount of dolomite in the system is a key control on the dolomitization rate. In general, replacement of calcite by dolomite increases porosity, however, the more saline fluids precipitate sulfates, which tend to reduce porosity.

Garcia-Fresca, B.; Lucia, F. J.; Sharp, J. M.; Kerans, C.; Jones, G. D.

2008-12-01

141

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

142

Effect of Dexamethasone and Nitrogen Mustard on the Production of Rheumatoid Factor in Rheumatoid Arthritis  

PubMed Central

The effect of dexamethasone and nitrogen mustard on the production of rheumatoid factor, as measured by sensitized sheep cell and latex agglutination tests, was studied in 19 patients with classical rheumatoid arthritis. Dexamethasone was given orally in a daily dose of 6-8 mg. which was slowly reduced after a two-week period. Nitrogen mustard was infused in the usual therapeutic dose of 0.3 mg./kg. The level of circulating rheumatoid factor decreased, following administration of each agent, after a latent period of 10 days. The effect was most marked at around 30 days. Dexamethasone was more potent than nitrogen mustard. Both drugs together caused transient disappearance of rheumatoid factor in one patient. It is concluded that dexamethasone and nitrogen mustard have the capacity to suppress the formation of the macroglobulins associated with rheumatoid arthritis. ImagesFig. 2Fig. 3 PMID:14154296

Kelly, H. Garfield; Hinton, Norman A.

1964-01-01

143

Significance of bone marrow edema in pathogenesis of rheumatoid arthritis  

PubMed Central

Summary Assessing the pathology of the synovium, its thickening and increased vascularity through ultrasound and magnetic resonance examinations (more often an ultrasound study alone) is still considered a sensitive parameter in the diagnosis of rheumatoid arthritis and in monitoring of treatment efficacy. Magnetic resonance studies showed that, aside from the joint pannus, the subchondral bone tissue constitutes an essential element in the development of rheumatoid arthritis. Bone marrow edema correlates with inflammation severity, joint destruction, clinical signs and symptoms of rheumatoid arthritis, and thus is considered a predictor of rapid radiological progression of the disease. The newest studies reveal that bone marrow edema may be a more sensitive indicator of the response to therapy than appearance of the synovium. Bone marrow edema presents with increased signal in T2-weighted images, being most visible in fat saturation or IR sequences (STIR, TIRM). On the other hand, it is hypointense and less evident in T1-weighted images. It becomes enhanced (hyperintense) after contrast administration. Histopathological studies confirmed that it is a result of bone inflammation (osteitis/osteomyelitis), i.e. replacememt of bone marrow fat by inflammatory infiltrates containing macrophages, T lymphocytes, B lymphocytes, plasma cells and osteoclasts. Bone marrow edema appears after a few weeks from occurrence of symptoms and therefore is considered an early marker of inflammation. It correlates with clinical assessment of disease activity and elevated markers of acute inflammatory phase, i.e. ESR and CRP. It is a reversible phenomenon and may become attenuated due to biological treatment. It is considered a “herald” of erosions, as the risk of their formation is 6-fold higher in sites where BME was previously noted PMID:23493495

Sudol-Szopinska, Iwona; Kontny, Ewa; Maslinski, Wlodzimierz; Prochorec-Sobieszek, Monika; Warczynska, Agnieszka; Kwiatkowska, Brygida

2013-01-01

144

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. © 2014 S. Karger AG, Basel. PMID:25227591

Cutolo, Maurizio; Sulli, Alberto; Pincus, Theodore

2015-01-01

145

Palisaded neutrophilic granulomatous dermatitis in rheumatoid arthritis.  

PubMed

Palisaded neutrophilic granulomatous dermatitis (PNGD) is an entity that has not been clearly defined either clinically or histopathologically. It is seen in patients with rheumatoid arthritis and other connective tissue diseases. In the past, many cases of PNGD have been described under several different names including palisaded neutrophilic and granulomatous dermatitis, linear subcutaneous bands, interstitial granulomatous dermatitis with cutaneous cords and arthritis, rheumatoid papules, and Churg-Strauss granuloma. We report 7 additional cases of PNGD. Clinically, 6 patients presented with erythematous to violaceous plaques, papules, and nodules on multiple body sites; one presented with subcutaneous linear bands on the shoulder. Five had rheumatoid arthritis; one had adult-onset Still's disease; and one showed clinical signs of rheumatoid arthritis, although serologically the rheumatoid factor was negative. On histologic examination, a spectrum of changes was observed ranging from urticaria-like infiltrates to leukocytoclastic vasculitis and granuloma annulare with neutrophils. We report these cases to expand the histologic spectrum of this entity and to further delineate the different forms of clinical presentation. PMID:12140472

Sangueza, Omar P; Caudell, Misty D; Mengesha, Yebabe M; Davis, Loretta S; Barnes, Cheryl J; Griffin, Julia E; Fleischer, Alan B; Jorizzo, Joseph L

2002-08-01

146

Remission-inducing drugs in rheumatoid arthritis.  

PubMed Central

The administration of certain drugs to patients with established rheumatoid arthritis frequently results in improvement that is slow to appear but persists for long periods, even after the drug is discontinued. The three main drugs with this effect, whose efficacy and toxicity are reviewed in this paper, are gold salts, D-penicillamine and chloroquine. The cytotoxic agents used to treat rheumatoid arthritis, which likely have nonspecific anti-inflammatory actions and have serious long-term side effects, are also briefly reviewed. A new drug, levamisole, is currently being tested in patients with rheumatoid arthritis. It is suggested that the time for considering the introduction of a remission-inducing drug in patients with progressive rheumatoid arthritis is after an adequate trial of therapy with salicylates or other nonsteroidal anti-inflammatory agents, or both, and before the oral administration of steroids. It is difficult, however, on the basis of rigorous clinical comparisons, to recommend which of the three main remission-inducing drugs should be tried first, although gold salts have been used the most. Patients who have improved with 6 months of chrysotherapy may continue treatment for at least 3 years, during which time the frequency of mucocutaneous and renal toxic effects will steadily decrease. Some aspects of the medical economics of therapy with remission-inducing drugs for rheumatoid arthritis are discussed. PMID:6768438

Anastassiades, T. P.

1980-01-01

147

Quality of Life Profiles in the First Years of Rheumatoid Arthritis: Results From the EURIDISS Longitudinal Study  

Microsoft Academic Search

Objective. The aim of this study was to examine the quality of life (QoL) profiles of patients with early rheumatoid arthritis (RA) and to relate these to disease and impairment variables as indicated, respectively, by erythrocyte sedimentation rate (ESR) and by tender joint count (Ritchie Articular Index), fatigue, and pain. Methods. The present study uses part of the European Research

Th. P. B. M. Suurmeijer; M. Waltz; T. Moum; F. Guillemin; F. L. P. van Sonderen; S. Briancon; R. Sanderman

2001-01-01

148

Comparative clinical utility of once-weekly subcutaneous abatacept in the management of rheumatoid arthritis  

PubMed Central

Biologic therapies in rheumatoid arthritis are now part of standard practice for disease that proves difficult to control with conventional disease-modifying anti-rheumatic drugs. While anti-tumor necrosis factor therapies have been commonly used, other targeted biologic therapies with different mechanisms of action are becoming increasingly available. Abatacept is a recombinant fusion protein that inhibits the T-cell costimulatory molecules required for T-cell activation. Intravenous abatacept has good clinical efficacy with an acceptably low toxicity profile in rheumatoid arthritis, but the subcutaneous mode of delivery has only recently become available. In this article, we examine key efficacy and safety data for subcutaneous abatacept in rheumatoid arthritis, incorporating evidence from five large Phase III studies that included people with an inadequate response to methotrexate and an inadequate response to biologic disease-modifying anti-rheumatic drugs. The results demonstrate that subcutaneous abatacept has efficacy and safety comparable with that of intravenous abatacept and adalimumab. In addition, inhibition of radiographic progression at year 1 in relatively early rheumatoid arthritis is consistent with that of adalimumab. Subcutaneous abatacept is well tolerated, with very low rates of discontinuation in both short-term and long-term follow-up. PMID:24812514

Rakieh, Chadi; Conaghan, Philip G

2014-01-01

149

Early exposure to haptic feedback enhances performance in surgical simulator training: a prospective randomized crossover study in surgical residents  

Microsoft Academic Search

Background  In the literature of skill acquisition and transfer of skills, it often is assumed that the rate of skill acquisition depends\\u000a on what has been learned in a similar context (i.e., surgical simulators providing haptic feedback). This study aimed to analyze\\u000a whether the addition of haptic feedback early in the training phase for image-guided surgical simulation improves performance.\\u000a \\u000a \\u000a \\u000a Methods  A randomized

P. Ström; L. Hedman; L. Särnå; A. Kjellin; T. Wredmark; L. Felländer-Tsai

2006-01-01

150

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

151

Genetic analysis of self-associating immunoglobulin G rheumatoid factors from two rheumatoid synovia implicates an antigen-driven response.  

PubMed

Although much has been learned about the molecular basis of immunoglobulin M (IgM) rheumatoid factors (RFs) in healthy individuals and in patients with mixed cryoglobulinemia and rheumatoid arthritis, little is known about the genetic origins of the potentially pathogenic IgG RFs in the inflamed rheumatoid synovia of patients. Recently, we generated from unmanipulated synovium B cells several hybridomas that secreted self-associating IgG RFs. To delineate the genetic origins of such potentially pathogenic RFs, we adapted the anchored polymerase chain reaction to rapidly clone and characterize the expressed Ig V genes for the L1 and the D1 IgG RFs. Then, we identified the germline counterparts of the expressed L1 IgG RF V genes. The results showed that the L1 heavy chain was encoded by a Vh gene that is expressed preferentially during early ontogenic development, and that is probably located within 240 kb upstream of the Jh locus. The overlap between this RF Vh gene and the restricted fetal antibody repertoire is reminiscent of the natural antibody-associated Vh genes, and suggests that at least part of the "potential pathogenic" IgG RFs in rheumatoid synovium may derive from the "physiological" natural antibody repertoire in a normal immune system. Indeed, the corresponding germline Vh gene for L1 encodes the heavy chain of an IgM RF found in a 19-wk-old fetal spleen. Furthermore, the comparisons of the expressed RF V genes and their germline counterparts reveal that the L1 heavy and light chain variable regions had, respectively, 16 and 7 somatic mutations, which resulted in eight and four amino acid changes. Strikingly, all eight mutations in the complementarity determining regions of the V gene-encoded regions were replacement changes, while only 6 of 11 mutations in the framework regions caused amino acid changes. Combined with L1's high binding affinity toward the Fc fragment, these results suggest strongly that the L1 IgG RF must have been driven by the Fc antigen. PMID:1740665

Olee, T; Lu, E W; Huang, D F; Soto-Gil, R W; Deftos, M; Kozin, F; Carson, D A; Chen, P P

1992-03-01

152

Dealing with uncertainty in the simulation-based situation assessment of the GITEWS tsunami early warning system  

NASA Astrophysics Data System (ADS)

The hazard assessment in the simulation-based German-Indonesian Tsunami Early Warning System (GITEWS) relies on a novel multi-sensor quick assimilation technique, and a large number of detailed pre-computed tsunami scenarios. In order to obtain reliable and accurate information about the hazard situation, thorough evaluation of uncertainty is necessary. We present a rational methodology to evaluate and propagate uncertainty through the diverse steps of the early warning process. First, we propose a scheme for quantifying uncertainty from data, we then propagate this uncertainty through the modelling and simulation phase, and finally add several uncertainty measures for the assimilation phase. It turns out that quantitative uncertainty measures may help in the decision making process.

Behrens, J.; Androsov, A.; Harig, S.; Klaschka, F.; Pranowo, W. S.; Schröter, J.; Hiller, W.

2009-04-01

153

Patient preferences for treatment of rheumatoid arthritis  

PubMed Central

Objective: To elicit treatment preferences of patients with rheumatoid arthritis (RA) for disease modifying antirheumatic drugs (DMARDs) with varying risk profiles. Methods: Patient values for 16 DMARD characteristics were ascertained using published data about side effects, effectiveness, and cost. Patient preferences were determined by Adaptive Conjoint Analysis, an interactive computer program that predicts preferences by asking patients to make trade-offs between specific treatment characteristics. Simulations were run to derive preferences for four drugs: methotrexate, gold, leflunomide, and etanercept, under different risk-benefit scenarios. Infliximab was not included because it is given with methotrexate, and we did not include preferences for combination therapy. Based on each patient's expressed preferences, and the characteristics of the treatments available at the time of the study, the option that best fitted each patient's perspective was identified. Results: 120 patients (mean age 70 years) were interviewed. For the base case scenario (which assumed the maximum benefits reported in the literature, a low probability of adverse effects, and low equal monthly "co-pays" (out of pocket costs)), 95% of the respondents preferred etanercept over the other treatment options. When all four options were described as being equally effective, 88% continued to prefer etanercept owing to its safer short term adverse effect profile. Increasing etanercept's co-pay to $30.00 decreased the percentage of patients preferring this option to 80%. Conclusions: In this study, older patients with RA, when asked to consider trade-offs between specific risk and benefits, preferred etanercept over other treatment options. Preference for etanercept is explained by older patients' risk aversion for drug toxicity. PMID:15020312

Fraenkel, L; Bogardus, S; Concato, J; Felson, D; Wittink, D

2004-01-01

154

Early warnings of the potential for malaria transmission in Rural Africa using the Hydrology, Entomology and Malaria Transmission Simulator (HYDREMATS)  

NASA Astrophysics Data System (ADS)

Early warnings of malaria transmission allow health officials to better prepare for future epidemics. Monitoring rainfall is recognized as an important part of malaria early warning systems, as outlined by the Roll Back Malaria Initiative. The Hydrology, Entomology and Malaria Simulator (HYDREMATS) is a mechanistic model that relates rainfall to malaria transmission, and could be used to provide early warnings of malaria epidemics. HYDREMATS is used to make predictions of mosquito populations and vectorial capacity for 2005, 2006, and 2007 in Banizoumbou village in western Niger. HYDREMATS is forced by observed rainfall, followed by a rainfall prediction based on the seasonal mean rainfall for a period two or four weeks into the future. Predictions made using this method provided reasonable estimates of mosquito populations and vectorial capacity, two to four weeks in advance. The predictions were significantly improved compared to those made when HYDREMATS was forced with seasonal mean rainfall alone.

Yamana, T. K.; Eltahir, E. A.

2010-12-01

155

Current view of glucocorticoid co-therapy with DMARDs in rheumatoid arthritis  

Microsoft Academic Search

Glucocorticoids are widely used anti-inflammatory and immunosuppressive drugs for rheumatoid arthritis (RA). The disease-modifying potential of low to medium doses of glucocorticoids has been reconfirmed in the past decade, and co-administration of DMARDs and glucocorticoids has become standard in many treatment protocols, especially those for early disease stages but also for long-standing RA. The glucocorticoid regimens used range from continuous

Johannes W. G. Jacobs; Frank Buttgereit; Johannes W. J. Bijlsma; Jos N. Hoes

2010-01-01

156

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

157

Hypereosinophilia and seroconversion of rheumatoid arthritis.  

PubMed

At the intersection of atopy and autoimmunity, we present a patient with seronegative rheumatoid arthritis (RA) who developed hypereosinophilia, without evidence of other etiologies, as she became rheumatoid factor (RF) positive. Although the magnitude of eosinophilia in patients with RA has been thought to reflect the severity or activity of the RA, in our patient, eosinophilia developed at a time when the patient's synovitis was well controlled. Although eosinophilia may reflect associated drug hypersensitivity, discontinuation of the medications utilized to control our patient's disease, adalimumab and methotrexate, did not promote clinical improvement. Probably the most curious aspect of our patient was the concomitant development of rheumatoid factor seropositivity in the setting of previously seronegative RA. The temporal relationship between the development of peripheral eosinophilia and seroconversion suggests a possible connection between these events. We speculate that the T cell cytokine production that can induce eosinophilia may simultaneously activate RF production. PMID:24609760

Rosenstein, Rachel K; Panush, Richard S; Kramer, Neil; Rosenstein, Elliot D

2014-11-01

158

3D simulations of the early Mars climate with a General Circulation Model  

Microsoft Academic Search

The environmental conditions that existed on early Mars during the Noachian period are subject to debate in the community. While some authors suggest that the difference resulted from a stronger geothermalism during that period, and that a warm climate was not necessary to explain the valley network, others claim that a warm, wet early climate capable of supporting rainfall and

F. Forget; R. M. Haberle; F. Montmessin; E. Marck; A. Colaprete

2004-01-01

159

Chemokines and angiogenesis in rheumatoid arthritis  

PubMed Central

In rheumatoid arthritis, chemokines mediate the migration of inflammatory leukocytes into the synovium. Among the four known chemokine families, CXC, CC chemokines and fractalkine seem to be of outstanding importance in this process. Angiogenesis, the formation of new vessels, is also important during the perpetuation of inflammation underlying rheumatoid arthritis. In this review, authors discuss the role of the most important chemokines and chemokine repetors in arthritis-associated neovascularization. The process and regulation of angiogenesis are described in this context as well. Apart from discussing the pathogenic role of chemokines and chemokine receptors in arthritic vessel formation, authors also review the important relevance of chemokines and angiogenesis for therapeutic intervention. PMID:19482623

Szekanecz, Zoltan; Pakozdi, Angela; Szentpetery, Agnes; Besenyei, Timea; Koch, Alisa E.

2010-01-01

160

Rheumatoid pleural effusion presenting as pseudochylothorax in a patient without previous diagnosis of rheumatoid arthritis  

PubMed Central

Background Rheumatoid pleurisy rarely occurs before a diagnosis of rheumatoid arthritis (RA). It is the second leading cause of pseudochylothorax, but there are few reports of RA-associated pseudochylothorax. Case A 50-year-old man presented to our hospital with an undiagnosed exudative pleural effusion. In order to obtain a definitive diagnosis, we performed medical thoracoscopy under local anesthesia. The pleural effusion was turbid and was identified as a pseudochylothorax. The parietal pleura was white and slightly thickened with numerous scattered small granules and the pleural biopsy showed an infiltration of inflammatory cells including lymphocytes and plasma cells with a lack of normal mesothelial cells, findings that were highly consistent with rheumatoid pleurisy. Additional laboratory data revealed elevated levels of CCP antibody and rheumatoid factor. During an outpatient visit about 30 days after discharge, the patient complained of polyarthralgia and was diagnosed with RA, resulting in a definitive diagnosis of the pleural effusion as rheumatoid pleurisy. Conclusion We encountered a rare case of a rheumatoid pleural effusion without other symptoms of arthritis, which was identified as a pseudochylothorax by medical thoracoscopy.

Yokosuka, Tetsuya; Suda, Asako; Sugisaki, Midori; Suzuki, Manabu; Narato, Ritsuko; Saito, Hitoshi; Enomoto, Tatsuji; Kobayashi, Toshiko; Nomura, Koichiro

2013-01-01

161

Capillaritis : A manifestation of rheumatoid disease  

Microsoft Academic Search

We present seven cases of capillaritis arising in patients with rheumatoid arthritis and suggest that it is primarily related to disease activity and not drugs. In the majority, the rash resolved spontaneously with the use of a topical steroid to treat the symptom of itch.

S. M. Wilkinson; A. G. Smith; M. Davis; P. T. Dawes

1993-01-01

162

Glucocorticosteroids in pregnant patients with rheumatoid arthritis  

Microsoft Academic Search

Zusammenfassung Der günstige Einfluss einer Schwangerschaft auf die rheumatoide Arthritis (RA) ist seit 1938 bekannt und wurde mehrfach für 75% der RA-Schwangerschaften bestätigt. Eine Besserung der Symptome macht sich in der Regel schon im ersten Trimester bemerkbar und nimmt im Verlauf der Schwangerschaft zu. Eine Verschlechterung der RA wird bei den meisten Patienten innerhalb von 6 Monaten nach der Entbindung

M. Østensen

2000-01-01

163

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

164

Palisaded neutrophilic granulomatous dermatitis in rheumatoid arthritis  

Microsoft Academic Search

Palisaded neutrophilic granulomatous dermatitis (PNGD) is an entity that has not been clearly defined either clinically or histopathologically. It is seen in patients with rheumatoid arthritis and other connective tissue diseases. In the past, many cases of PNGD have been described under several different names including palisaded neutrophilic and granulomatous dermatitis, linear subcutaneous bands, interstitial granulomatous dermatitis with cutaneous cords

Omar P. Sangueza; Misty D. Caudell; Yebabe M. Mengesha; Loretta S. Davis; Cheryl J. Barnes; Julia E. Griffin; Alan B. Fleischer; Joseph L. Jorizzo

2002-01-01

165

[Cystic Rheumatoid Arthritis--case report].  

PubMed

Among the many radiological findings seen in Rheumatoid Arthritis RA small subchondral geodes and erosions are typical. Large geodes are far less common abnormalities and their presence may indicate diagnostic and therapeutic difficulties. We present a case report of a 55-year old woman with seronegative RA that developed a large geode in the knee with extensive joint destruction. PMID:18159206

Mourão, Ana Filipa; Santos, Fernando Pimentel; Falcão, Sandra; Pinto, Teresa Laura; Barros, Rita; de Matos, António Alves; Branco, Jaime Cunha

2007-01-01

166

Vertebrobasilar artery insufficiency in rheumatoid atlantoaxial subluxation  

Microsoft Academic Search

Cervical myelopathy has become commonly recognized as a complication of rheumatoid atlantoaxial subluxation. A small group of patients with atlantoaxial subluxation may have intermittent symptoms associated with change of head position and which are due to vertebral artery compression. Two such cases are reported, one with necropsy findings of infarction in the area supplied by the vertebrobasilar system. The pathogenesis

M W Jones; J C Kaufmann

1976-01-01

167

Upper gastrointestinal disease in rheumatoid arthritis  

Microsoft Academic Search

Upper gastrointestinal series were done in 140 consecutive patients with rheumatoid arthritis, irrespective of the presence or absence of symptoms suggesting upper gastrointestinal disease. In addition, intraluminal pH and manometric studies of the esophagus and esophagoscopy were done in 66 of these 140 patients. Gastric ulcers were found in 12 patients, and duodenal ulcers in 27, an incidence of peptic

David C. H. Sun; Sanford H. Roth; Charles S. Mitchell; DeWitt W. Englund

1974-01-01

168

Role of immune complexes in rheumatoid polyarteritis  

Microsoft Academic Search

Serial clinical and serological observations were made on a patient with necrotising polyarteritis associated with rheumatoid arthritis. Significant levels of circulating immune complexes, as determined by a C1q binding assay, were observed up to 2 years before the clinical manifestations of polyarteritis but rose abrumptly immediately before and concurrently with the onset of polyarteritis. Concomitant serial determinations of C3, latex

J B Farrell; D A Person; R D Rossen; M D Lidsky

1979-01-01

169

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

170

SPECIFICITY OF THE REACTION BETWEEN RHEUMATOID FACTORS AND GAMMA GLOBULIN  

PubMed Central

Rheumatoid factors in the sera of patients with rheumatoid arthritis appear to be specifically directed against genetically determined "antigens" in human ?-globulin. At least eight rheumatoid factors of differing specificity exist; usually several are present in combination in the same serum. The different rheumatoid factors can be readily detected through their pattern of reactivity with anti-Rh antibodies from different individuals. Rheumatoid factors in diseases other than rheumatoid arthritis were found to have a more restricted specificity, contrasted to the broader reactivity of the factors in most rheumatoid arthritis sera. A specificity similar to that for incomplete antibodies was not demonstrated for the reaction of rheumatoid factors with aggregated ?-globulin or with ?-globulin to form the "22S complex." In certain instances, using the anti-Rh system, rheumatoid factors were found to react poorly with the patient's own ?-globulin, compared to that of other individuals of different genetic ?-globulin types. These results, as well as additional indirect evidence, indicate that the rheumatoid factors can possess isospecificity. However, a certain degree of autospecificity was also found which was most clearly evident through complex formation with the patients own ?-globulin and in the reaction with aggregates. The relevance of these findings to possible isoantibody as well as autoantibody concepts is discussed. PMID:13702406

Fudenberg, Hugh H.; Kunkel, Henry G.

1961-01-01

171

Recovering the geographic origin of early modern humans by realistic and spatially explicit simulations  

E-print Network

, an incomplete replacement of H. erectus individuals by modern humans, or the multiregional evolution model (MERecovering the geographic origin of early modern humans by realistic and spatially explicit and archeological evidence argue in favor of a recent and unique origin of modern humans in sub-Saharan Africa

Batzoglou, Serafim

172

A simulation model to study the impact of early information on design duration and redesign  

Microsoft Academic Search

In the design process, it is common to utilize early information from precedent activities to shorten the project duration instead of having to wait for the confirmed parameter values to arrive after full analysis. However, the estimated preliminary parameter might be different from that obtained after the full analysis. Consequently, redesign may be needed in downstream activities to correct this

D. K. H. Chua

2011-01-01

173

Collaborative Early EFL Reading among Distributed Learners: A Simulation Pilot Study  

Microsoft Academic Search

In this paper, we designed a wireless peer-assisted leaning system for early EFL reading to enhance online collaborative EFL reading and provide distributed EFL learners with an opportunity to teach and learn with each other. Compare with the control group, the result shows that wireless EFL reading is emerging as a flexible and portable solution to the pedagogical challenges exist

Yu-ju Lan; Yao-ting Sung; Kuo-en Chang; Hsien-sheng Hsiao

2006-01-01

174

Role of anti-citrullinated protein antibodies in diagnosis and prognosis of rheumatoid arthritis  

PubMed Central

Antibodies to citrullinated proteins/peptides (ACPAs) are the second serological marker to have recently been included in the 2010 ACR/EULAR Rheumatoid Arthritis (RA) Classification Criteria, which are focused on early diagnosis and therapy. This review discusses their history and some clinical aspects of ACPAs, focusing on the diagnostic utility of anti-cyclic citrullinated peptide (anti-CCP) antibodies as a marker of RA as compared to the widely used rheumatoid factor (RF). Simultaneously, this review aims to raise physician awareness and interest in anti-citrullinated vimentin antibody (anti-Sa/anti-MCV), another member of the ACPA family, which appears to have a better predictive value as a marker of RA than anti-CCP or RF and correlates closely with disease activity and therapeutic response among patients with RA. PMID:22291756

Puszczewicz, Mariusz; Iwaszkiewicz, Cezary

2011-01-01

175

Graphical Simulation of Early Development of the Cerebral Cortex Elizabeth F. Ryder \\Lambda , Lindsey Bullard, Joel Hone Jonas Olmstead, Matthew O. Ward  

E-print Network

Graphical Simulation of Early Development of the Cerebral Cortex Elizabeth F. Ryder \\Lambda Worcester, MA 01609 Abstract Much experimental data exists concerning the development of the cerebral cortex, which models the early stages of development of the cerebral cortex of the mouse. Version 1.0 of SimCortex

Ward, Matthew

176

Tsunami Simulations With Unstructured Grids in Support of a Tsunami Early Warning System for the Indian Ocean  

NASA Astrophysics Data System (ADS)

A Finite Element Model for simulations of Tsunami waves (TsunAWI) has been developed. It is part of the German Indonesian Tsunami Early Warning System (GITEWS). Model results will be the main source for the prediction of arrival times and expected wave heights. The unstructured triangular grid has a relatively low resolution in the ocean interior (about 10 km) coastal regions however are very well resolved (up to 80 m). This flexibility allows for a good representation of the wave propagation in the deep ocean as well as inundation processes without the need of nesting different grids. Numerical experiments simulating the Indian Ocean Tsunami generated by the earthquake of Dec. 26 in 2004 have been conducted. The role of the model bathymetry and topography (based on the GEBCO dataset as well as data from the SRTM satellite mission and ship cruises) has been investigated. The inundation obtained in the simulations were compared to field measurements as well as to satellite images of Banda Aceh region. Furthermore the results were compared to simulations of the same event by the finite difference model TUNAMI- N3 with three nested grids and resolutions ranging from 900 m in the coarsest grid to 90 m in the finest nested grid. It turned out that the two models coincide fairly well with respect to wave propagation and inundation. However in both approaches a good knowledge of topography and bathymetry especially in the near shore range turned out to be crucial for realistic results.

Harig, S.; Chaeroni, C.; Androsov, A.; Behrens, J.; Braune, S.; Mentrup, L.; Schröter, J.

2007-12-01

177

Observation of early shell-dopant mix in OMEGA direct-drive implosions and comparisons with radiation-hydrodynamic simulations  

NASA Astrophysics Data System (ADS)

Temporally, spatially, and spectrally resolved x-ray image data from direct-drive implosions on OMEGA were interpreted with the aid of radiation-hydrodynamic simulations. Neither clean calculations nor those using a turbulent mix model can explain fully the observed migration of shell-dopant material (titanium) into the core. Shell-dopant migration was observed via time-dependent, spatially integrated spectra, and spatially and spectrally resolved x-ray images of capsule implosions and resultant dopant emissions. The titanium emission was centrally peaked in narrowband x-ray images. In post-processed clean simulations, the peak titanium emission forms in a ring in self-emission images as the capsule implodes. Post-processed simulations with mix reproduce trends in time-dependent, spatially integrated spectra, as well having centrally peaked Ti emission in synthetic multiple monochromatic imager. However, mix simulations still do not transport Ti to the core as is observed in the experiment. This suggests that phenomena in addition to the turbulent mix must be responsible for the transport of Ti. Simple diffusion estimates are unable to explain the early Ti mix into the core. Mechanisms suggested for further study are capsule surface roughness, illumination non-uniformity, and shock entrainment.

Baumgaertel, J. A.; Bradley, P. A.; Hsu, S. C.; Cobble, J. A.; Hakel, P.; Tregillis, I. L.; Krasheninnikova, N. S.; Murphy, T. J.; Schmitt, M. J.; Shah, R. C.; Obrey, K. D.; Batha, S.; Johns, H.; Joshi, T.; Mayes, D.; Mancini, R. C.; Nagayama, T.

2014-05-01

178

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

179

HLA-DR antigens and disease patterns of rheumatoid arthritis  

Microsoft Academic Search

HLA-DR antigens were determined in 111 patients with classic or definite rheumatoid arthritis. HLA-DR4 was significantly (P corr. -6) increased in patients with rheumatoid arthritis (54%) compared with controls (23.2%). HLA-DR 5 was decreased in rheumatoid arthritis (12.6% vs 26.4% of controls); however, the corrected P value was not significant. There were no significant differences with regard to various clinical,

O. Scherak; J. S. Smolen; W. R. Mayr

1983-01-01

180

Early maturation processes in coal. Part 2: Reactive dynamics simulations using the ReaxFF reactive force field on Morwell Brown coal structures  

E-print Network

Early maturation processes in coal. Part 2: Reactive dynamics simulations using the ReaxFF reactive force field on Morwell Brown coal structures Elodie Salmon a , Adri C.T. van Duin b , François Lorant Brown coal using the ReaxFF reactive force field. We find that these reactive MD simulations

Goddard III, William A.

181

Fistulization of rheumatoid joints. Spectrum of identifiable syndromes.  

PubMed Central

Eight patients with rheumatoid arthritis developed cutaneous fistulae adjacent to affected joints. Rheumatoid factor was positive in eight patients; subcutaneous nodules were noted in seven. Two patients had features of rheumatoid vasculitis. A spectrum of syndrome characterized by cutaneous fistulae was observed. Three patients showed classical fistulous rheumatism. Four patients developed septic arthritis which subsequently fistulized; in two, infection was associated with total joint replacement. One patient showed a cutaneous sinus accompanying a large calf cyst. A variety of diagnoses must be considered when cutaneous fistulae appear near joints in patients with rheumatoid arthritis. Images PMID:1221937

Shapiro, R F; Resnick, D; Castles, J J; D'Ambrosia, R D; Lipscomb, P R

1975-01-01

182

Skills of novices early trained or traditionaly trained versus experienced drivers confronted to simulated urban accidents' scenarios.  

PubMed

In order to prevent the over-representation of young drivers in car crashes, France instated an early driver training from the age of 16, but the positive effects of this opportunity have not yet been proven. Three groups of male drivers (12 subjects each) were confronted with some prototypical accident scenarios introduced in a simulated urban circuit. The first and second groups were composed of young drivers having less than one month of driving licence; twelve have had a traditional learning course, and twelve had followed, in addition to the initial course, an early driver training under the supervision of an adult. The third group was composed of experienced drivers. Strategies of the three groups were analyzed through their response time, speed and maneuvers. No difference appeared across groups regarding obstacle detection. But traditionally-trained drivers' position control was more conservative than the two others groups, which were more likely to involve efficient evasive action. The exposure gained during early training could thus increase the development of visuo-motor coordination and involve better skills in case of difficult situations. Others accidents' scenarios could be used to confront young drivers with difficult situations not commonly encountered in natural driving. PMID:22317478

Berthelon, Catherine; Damm, Loïc

2012-01-01

183

Numerical Simulation Of The Segregation Process Of Metal In Early Magma Ocean  

NASA Astrophysics Data System (ADS)

Earth's core is considered to have been formed by separation of iron from the silicate magma ocean. This metal- silicate separation is important because it controls the initial states of the core and mantle, in particular concerning the distribution of heat and chemical species between them. In this process, the size of metal droplet is critical, which is estimated as an order of 1 cm by a simple balance of the surface tension and the shear stress (Rubie et al., 2003). Here we report quantitative estimate how the metal size evolves during the metal-silicate separation based on numerical simulation of two-phase flow under gravity. The gravitational energy that is gained, is transformed in heat by viscous heating and we want to quantify the resulting thermal structure. In the numerical method that simulates the process, tracking of the metal-silicate boundary is crucial. In this study, we adopt the moving particle semi-implicit (MPS) method based on the Lagrangian particle method. This method avoids numerical diffusion in the surface tracking of metal-silicate phase boundary because of its Lagrangian nature. Incorporation of the surface tension between metal and silicate phase is another critical factor in this simulation. In the 2-D simulation, we adopted the model by Nomura et al., 2001 implemented in MPS. In 3-D, we employed a new model that we invented. In the simulations, several interesting features have been clarified: irrespective of the initial size, size of the metal droplets evolve to a stable size of the order of 1 cm, which is mainly controlled by the surface tension and the viscosity of silicate melt. We discuss the size and shape of droplets, their falling speed, the interaction between droplets, and the resulting temperature distribution.

Ichikawa, H.; Labrosse, S.; Kurita, K.

2007-12-01

184

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

PubMed

Abstract Bozzini, Carlos E, Graciela M. Champin, Clarisa Bozzini, and Rosa M. Alippi. Gestational and Early Postnatal Exposure to Simulated High Altitude Does Not Modify Postnatal Body Mass Growth Trajectory in the Rat. High Alt Med Biol 15:418-421, 2014.-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

185

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

186

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

187

The burden of illness of rheumatoid arthritis  

Microsoft Academic Search

It is necessary to understand the full burden of illness of a disease before the value of interventions can be assessed. Rheumatoid\\u000a arthritis (RA) has an impact on a variety of stakeholders, including patients, healthcare systems, and society as a whole.\\u000a This overview discusses the societal and patient perspectives, distinguishing several domains of impact. Epidemiology is important from a societal

Annelies Boonen; Johan L. Severens

2011-01-01

188

Cutaneous manifestations associated with rheumatoid arthritis  

Microsoft Academic Search

Rheumatoid arthritis presents various cutaneous manifestations, either specific or nonspecific skin features, which are induced\\u000a by the activation of inflammatory cells (neutrophils, lymphocytes, macrophages), vasculopathy, vasculitis, acral deformity,\\u000a drugs, and so on. These include (1) specific findings, (2) findings due to vascular impairment, (3) findings due to immune\\u000a dysfunction, (4) characteristic neutrophilic conditions, and (5) miscellaneous conditions. On the other

T. Yamamoto

2009-01-01

189

B cell targets in rheumatoid arthritis  

Microsoft Academic Search

B cells are critical to the pathogenesis of rheumatoid arthritis (RA). There is substantial evidence of the efficacy of depletion\\u000a of B cells in many patients with RA using the first licensed agent, rituximab. Recent research has focused on enhancing efficacy\\u000a using other targets to inhibit B cell function, including other B cell-depleting antibodies and cytokines critical to B cell

Edward M. Vital; Shouvik Dass; Paul Emery

190

Cell-mediated immunity in rheumatoid arthritis  

Microsoft Academic Search

Cell-mediated immunity in rheumatoid arthritis (RA) was assessed by skin testing with six antigens in 107 patients, 94 of whom were age, sex, and race-matched with healthy individuals or patients with diseases unrelated to immunological abnormalities. 20% of RA patients were anergic. Impaired cell-mediated immunity in the RA patients was manifested by a decrease in the magnitude of skin reactivity

A A Andrianakos; J T Sharp; D A Person; M D Lidsky; J Duffy

1977-01-01

191

Early containment of high-alkaline solution simulating low-level radioactive waste stream in clay-bearing blended cement  

SciTech Connect

Portland cement blended with fly ash and attapulgite clay was mixed with high-alkaline solution simulating low-level radioactive waste stream at a one-to-one weight ratio. Mixtures were adiabatically and isothermally cured at various temperatures and analyzed for phase composition, total alkalinity, pore solution chemistry, and transport properties as measured by impedance spectroscopy. Total alkalinity is characterized by two main drops. The early one corresponds to a rapid removal of phosphorous, aluminum, sodium, and to a lesser extent potassium solution. The second drop from about 10 h to 3 days is mainly associated with the removal of aluminum, silicon, and sodium. Thereafter, the total alkalinity continues descending, but at a lower rate. All pastes display a rapid flow loss that is attributed to an early precipitation of hydrated products. Hemicarbonate appears as early as one hour after mixing and is probably followed by apatite precipitation. However, the former is unstable and decomposes at a rate that is inversely related to the curing temperature. At high temperatures, zeolite appears at about 10 h after mixing. At 30 days, the stabilized crystalline composition Includes zeolite, apatite and other minor amounts of CaCO{sub 3}, quartz, and monosulfate Impedance spectra conform with the chemical and mineralogical data. The normalized conductivity of the pastes shows an early drop, which is followed by a main decrease from about 12 h to three days. At three days, the permeability of the cement-based waste as calculated by Katz-Thompson equation is over three orders of magnitude lower than that of ordinary portland cement paste. However, a further decrease in the calculated permeability is questionable. Chemical stabilization is favorable through incorporation of waste species into apatite and zeolite.

Kruger, A.A. [Westinghouse Hanford Co., Richland, WA (United States); Olson, R.A.; Tennis, P.D. [Northwestern Univ., Evanston, IL (United States). Center for Advanced Cement-Based Materials] [and others

1995-04-01

192

Angiogenesis and its targeting in rheumatoid arthritis?  

PubMed Central

Angiogenesis, the development of new capillaries, is involved in leukocyte ingress into the synovium during the development and progression of rheumatoid arthritis. Several soluble and cell surface-bound mediators including growth factors, cytokines, chemokines, proteolytic matrix-degrading enzymes, cell adhesion molecules and others may promote synovial neovascularization. On the other hand, endogenous angiostatic factors, such as angiostatin, endostatin, interleukin-4 (IL-4), IL-13, interferons and some angiostatic chemokines are also produced within the rheumatoid synovium, however, their effects are insufficient to control synovial angiogenesis and inflammation. Several specific and non-specific strategies have been developed to block the action of angiogenic mediators. The first line of angiostatic agents include vascular endothelial growth factor (VEGF), angiopoietin, ?V?3 integrin antagonist, as well as non-specific angiogenesis inhibitors including traditional disease-modifying agents (DMARDs), anti-tumor necrosis factor biologics, angiostatin, endostatin, fumagillin analogues or thalidomide. Potentially any angiostatic compound could be introduced to studies using animal models of arthritis or even to human rheumatoid arthritis trials. PMID:19217946

Szekanecz, Zoltan; Koch, Alisa E.

2010-01-01

193

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

194

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

195

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

196

Bone marrow edema and osteitis in rheumatoid arthritis: the imaging perspective  

PubMed Central

Magnetic resonance imaging bone marrow edema is an imaging feature that has been described in many conditions, including osteomyelitis, overuse syndromes, avascular necrosis, trauma, and inflammatory arthritides. In rheumatoid arthritis (RA), bone edema has special significance as it has been shown to be a common and widespread lesion that is often apparent at the hands and wrists but has also been described elsewhere, including the feet. It may occur in early or late disease and has been shown in several large cohort studies to have major negative implications for prognosis. It is the strongest predictor of erosive progression yet to be identified and characteristically occurs in those patients with the most aggressive and potentially disabling disease. In patients with undifferentiated arthritis, bone edema also predicts progression to criteria-positive RA, both independently and to a greater extent when combined with anti-cyclic citrullinated peptide status or rheumatoid factor positivity. Its histological correlate in the late stages of RA has been shown to be osteitis, in which the bone marrow beneath the joint is invaded by an inflammatory and vascular lymphoplasmacytic infiltrate. This lies adjacent to trabecular bone, where increased numbers of osteoclasts have been observed within resorption lacunae, suggesting a mechanistic link between inflammation and erosive bone damage. This could lead to erosion both of the overlying cortex, leading to classic radiographic rheumatoid erosions, and of local trabecular bone, possibly contributing to periarticular osteopenia and cyst formation. In addition to synovitis, osteitis is now regarded as a major rheumatoid lesion that is responsive to therapeutic intervention. PMID:23043770

2012-01-01

197

Rheumatoid synovial cells from intact joints. Morphology, growth, and polykaryocytosis.  

PubMed Central

Synovial cell lines were isolated by instillation of trypsin or chymotrypsin into intact knee joints of patients with persistent rheumatoid effusions resistant to conventional therapy. Morphology and growth in the primary phase were compared with rheumatoid cells isolated from excised synovium and nonrheumatoid synovial cells obtained from intact joints of cadavers or amputated limbs. Cell populations from all sources included varying proportions of macrophage-like and fibroblast-like cells, with only 1-3% multinucleated cells. In medium supplemented with calf serum alone, rheumatoid cells from intact joints showed negligible changes in morphology. However, in the presence of nonrheumatoid, autologous rheumatoid or homologous rheumatoid serum a rapid increase occurred in size of the macrophage-like cells and numbers of polykaryocytes, including some giant syncytial cells. These effects were directly proportional to serum concentration and were identical in fresh or heat-inactivated serum. In most of these rheumatoid cell lines no multiplication occurred, regardless of serum type or concentration. In rheumatoid synovial cells from excised synovium, human serum induced both polykaryocytosis and rapid growth of fibroblasts. Nonrheumatoid synovial cells grew rapidly but few polykaryocytes developed, mostly with less than 6 nuclei. Evidence of viral infection in rheumatoid synovial cells was sought by electron microscopy after stimulation of polykaryocytosis by human serum. In one of the cultures many cells were found with intranuclear particles possessing characteristics of the adenovirus group. Images PMID:901027

Clarris, B J; Fraser, J R; Moran, C J; Muirden, K D

1977-01-01

198

MIF: a new cytokine link between rheumatoid arthritis and atherosclerosis  

Microsoft Academic Search

Macrophage migration inhibitory factor (MIF) is well established as a key cytokine in immuno-inflammatory diseases such as rheumatoid arthritis. Inflammation is now also recognized as having a crucial role in atherosclerosis, and recent evidence indicates that MIF could also be important in this disease. Here, we review the role of MIF in rheumatoid arthritis and atherosclerosis, discuss the ways in

Michelle Leech; Jürgen Bernhagen; Eric F. Morand

2006-01-01

199

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

200

Investigating the Value of Abatacept in the Treatment of Rheumatoid Arthritis: A Systematic Review of Cost-Effectiveness Studies  

PubMed Central

Background. Rheumatoid arthritis is a progressive inflammatory disease that affects greatly patients' quality of life and demands for aggressive management early on during the course of the disease. The discovery of biologics has equipped rheumatologists with evolutionary treatment tools but has also impacted greatly management costs. Objectives. To conduct a systematic review in order to evaluate the cost effectiveness of abatacept in the treatment of moderate to severe rheumatoid arthritis. Methods. Pubmed, the International Society for Pharmacoeconomics and Outcomes Research Outcomes Research Digest, the National Health System Economic Evaluation Database, and the Database of Abstracts of Reviews of Effects were searched. Results. In total 301 studies were identified and 42?met the inclusion criteria. Half of the selected studies evaluated abatacept in the treatment of rheumatoid arthritis, after failure of or intolerance to tumor necrosis factor alpha inhibitors. Of those, 82% were in favor of abatacept as a cost-effective or dominant strategy versus varying alternatives, whereas 18% favored other treatments. Conclusion. The majority of evidence from the published literature supports that abatacept can be a cost-effective alternative in the treatment of moderate to severe rheumatoid arthritis, especially in patients that have demonstrated inadequate response or intolerance to anti-TNF agents or conventional disease modifying antirheumatic drugs. PMID:23819062

Petrakis, Ioannis; Kyriopoulos, John

2013-01-01

201

Simulations of Early Baryonic Structure Formation with Stream Velocity: II. The Gas Fraction  

E-print Network

Understanding the gas content of high redshift halos is crucial for studying the formation of the first generation of galaxies and reionization. Recently, Tseliakhovich & 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...

Naoz, Smadar; Gnedin, Nickolay Y

2012-01-01

202

Modeling the energy spectrum of precipitating electrons with early RBSP observations and test particle simulations  

NASA Astrophysics Data System (ADS)

The Radiation Belt Storm Probe satellites (RBSP) allow for unprecedented simultaneous measurement of both high time resolution VLF wave fields and local energetic electron pitch angle and energy distributions. By coupling these measurements with relativistic test particle simulations, we attempt to assess the role of oblique whistler wave-particle interactions in the acceleration, transport, and loss of energetic radiation belt electrons. The relativistic test particle code is capable of tracking the individual trajectories of large populations of particles interacting with oblique whistler mode waves through bounce and gyromotion in a magnetic dipole guide field scaled to Earth's surface field, allowing for simple quantification of test particle scattering and loss. By weighting input energy and pitch angle distributions by those observed with RBSP, we attempt to model the expected energy spectrum of the precipitating electron population, e.g., what may be observed at BARREL due to wave-particle interactions in the radiation belts.

Kersten, K.; Cattell, C. A.; Wygant, J. R.; Breneman, A. W.; Bonnell, J. W.; Tao, J.; Blake, B.; Kletzing, C.; Kurth, W. S.; Roth, I.; Zhang, S.

2012-12-01

203

Class-specific rheumatoid factors, DR antigens, and amyloidosis in patients with rheumatoid arthritis.  

PubMed Central

Class-specific rheumatoid factors (RFs) were measured by enzyme immunoassay in 59 patients with rheumatoid arthritis complicated by systemic amyloidosis (RA+A), 47 patients with rheumatoid arthritis without amyloid (RA), 106 patients with other rheumatic diseases (juvenile rheumatoid arthritis, systemic lupus erythematosus, Sjögren's syndrome), and 55 blood donors. The patients with RA+A were characterised by a high prevalence of RF negativity; the IgM RF concentration was raised in only 18 of the 59 patients (31%, p less than 0.001 v RA), the IgG RF concentration in 20 of 59 (34%, p less than 0.001 v RA), and the IgA RF concentration in 24 of 59 (41%, p less than 0.001 v RA). A higher prevalence of HLA-DR4 (p less than 0.001) and a lower prevalence of DR2 (p less than 0.05) were found among 48 tested patients with RA+A when compared with a control panel consisting of 500 blood donors. No significant differences in the prevalence of DR1-DR7 or B27 antigens were observed, however, between patients with RA with or without amyloid. PMID:3401051

Maury, C P; Teppo, A M; Wafin, F; Wegelius, O; Friman, C; Koskimies, S

1988-01-01

204

2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology\\/European League Against Rheumatism collaborative initiative  

Microsoft Academic Search

ObjectiveThe 1987 American College of Rheumatology (ACR; formerly the American Rheumatism Association) classification criteria for rheumatoid arthritis (RA) have been criticised for their lack of sensitivity in early disease. This work was undertaken to develop new classification criteria for RA.MethodsA joint working group from the ACR and the European League Against Rheumatism developed, in three phases, a new approach to

Daniel Aletaha; Tuhina Neogi; Alan J. Silman; Julia Funovits; David T. Felson; Clifton O Bingham III; Neal S. Birnbaum; Gerd R. Burmester; Vivian P. Bykerk; Marc D. Cohen; Bernard Combe; Karen H. Costenbader; Maxime Dougados; Paul Emery; Gianfranco Ferraccioli; Johanna M. W. Hazes; Kathryn Hobbs; Tom W. J. Huizinga; Arthur Kavanaugh; Jonathan Kay; Tore K Kvien; Timothy Laing; Philip Mease; Henri A Ménard; Larry W. Moreland; Raymond L. Naden; Theodore Pincus; Josef S Smolen; Ewa Stanislawska-Biernat; Deborah Symmons; Paul P. Tak; Katherine S. Upchurch; Ji?í Vencovský; Frederick Wolfe; Gillian Hawker

2010-01-01

205

Panel discussion on B cells and rituximab: mechanistic aspects, efficacy and safety in rheumatoid arthritis and non-Hodgkin's lymphoma  

Microsoft Academic Search

The clinical potential of rituximab (MabThera\\/Rituxan), a selective B-cell-depleting agent, in the treatment of patients with rheumatoid arthritis (RA) is rapidly becoming apparent. The data presented at an official satellite symposium of the European League Against Rheumatism (EULAR) Congress (2003, Lisbon, Portugal), reinforce the rationale for the use of this novel agent in RA and have provided an early indication

G. S. Panayi; J. D. Hainsworth; R. J. Looney; E. C. Keystone

2005-01-01

206

Effects of rheumatoid arthritis on employment and social participation during the first years of disease in The Netherlands  

Microsoft Academic Search

SUMMARY Objective. To study the eVect of rheumatoid arthritis (RA) on working capabilities and social participation, including non- paying jobs, during the first 6 yr of disease. Design. Cross-sectional study. Methods. In April 1996, a self-reporting questionnaire was sent to 424 participants of a population-based clinical trial of therapeutic strategies for early RA initiated in 1990. Results. A total of

C. H. M. VAN JAARSVELD; J. W. G. JACOBS; A. J. P. SCHRIJVERS; G. A. VAN ALBADA-KUIPERS; D. M. HOFMAN; J. W. J. BIJLSMA

1998-01-01

207

Correlation of rheumatoid arthritis severity with the genetic functional variants and circulating levels of macrophage migration inhibitory factor  

Microsoft Academic Search

OBJECTIVE: To study whether genetic variants of macrophage migration inhibitory factor (MIF), the MIF -173G>C and CATT(5-8) alleles, are associated with disease severity and levels of circulating MIF in patients with rheumatoid arthritis (RA). METHODS: Genotyping was performed in patients with early RA and in healthy controls. Demographic data, disease activity, and outcome measurements were compared between patients with and

Timothy R. D. J. Radstake; C. G. J. Sweep; Paco Welsing; Barbara Franke; Sita H. H. M. Vermeulen; Anneke Geurts-Moespot; Thierry Calandra; Rachelle Donn

2005-01-01

208

Frequency dependence of dynamic compliance in patients with rheumatoid arthritis.  

PubMed Central

An investigation of lung function was carried out in 99 randomly selected patients with calssic or definite rheumatoid arthritis and in 60 control subjects matched for age, sex, and smoking habits. Mean FEV1 and mean VC were both significantly lower in the rheumatoid patients due to significant differences for women but mean FEV/VC ratio was 73.0% in the rheumatoid group and 72.1% in the control. Steady-state transfer factor was significantly greater in the normal men than in the comparable rheumatoid group, but there was no difference for women. After excluding patients with FEV1 less than 80% predicted normal and patients with low compliance, 72 rheumatoid patients and 45 controls provided series of tracings that could be assessed for a fall in Cdyn of 20% between 20 cycles and 60 cycles a minute. Dynamic compliance was not significantly different in any group at any rate of respiration. Fourteen of 72 rheumatoid patients and three of 45 controls showed frequency dependence (FDC). After the age of 50 the prevalence in the rheumatoid groupwas 11/38 and in the control group 2/27. This difference was significant (P less than 0.05). FDC was not consistently related to other abnormalities of lung function or to the duration, severity, or treatment of the rheumatoid arthritis. In various categories of smoking habits, dust exposure, or allergic tendency, the prevalence was always greater in the rheumatoid group. This provides evidence of patchy involvement of small airways, or alveoli and connective tissue, by the rheumatoid process. PMID:542915

Hills, E A; Davies, S; Geary, M

1979-01-01

209

Simulations of Early Baryonic Structure Formation with Stream Velocity. II. The Gas Fraction  

NASA Astrophysics Data System (ADS)

Understanding the gas content of high-redshift halos is crucial for studying the formation of the first generation of galaxies and reionization. Recently, Tseliakhovich & 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; Yoshida, Naoki; Gnedin, Nickolay Y.

2013-01-01

210

Marine methane cycle simulations for the period of early global warming  

SciTech Connect

Geochemical environments, fates, and effects are modeled for methane released into seawater by the decomposition of climate-sensitive clathrates. A contemporary global background cycle is first constructed, within the framework of the Parallel Ocean Program. Input from organics in the upper thermocline is related to oxygen levels, and microbial consumption is parameterized from available rate measurements. Seepage into bottom layers is then superimposed, representing typical seabed fluid flow. The resulting CH{sub 4} distribution is validated against surface saturation ratios, vertical sections, and slope plume studies. Injections of clathrate-derived methane are explored by distributing a small number of point sources around the Arctic continental shelf, where stocks are extensive and susceptible to instability during the first few decades of global warming. Isolated bottom cells are assigned dissolved gas fluxes from porous-media simulation. Given the present bulk removal pattern, methane does not penetrate far from emission sites. Accumulated effects, however, spread to the regional scale following the modeled current system. Both hypoxification and acidification are documented. Sensitivity studies illustrate a potential for material restrictions to broaden the perturbations, since methanotrophic consumers require nutrients and trace metals. When such factors are considered, methane buildup within the Arctic basin is enhanced. However, freshened polar surface waters act as a barrier to atmospheric transfer, diverting products into the deep return flow. Uncertainties in the logic and calculations are enumerated including those inherent in high-latitude clathrate abundance, buoyant effluent rise through the column, representation of the general circulation, and bacterial growth kinetics.

Elliott, S.; Maltrud, M.; Reagan, M.T.; Moridis, G.J.; Cameron-Smith, P.J.

2011-01-02

211

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

212

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

213

Association between low density lipoprotein and rheumatoid arthritis genetic factors with low density lipoprotein levels in rheumatoid arthritis and non-rheumatoid arthritis controls  

E-print Network

Objectives: While genetic determinants of low density lipoprotein (LDL) cholesterol levels are well characterised in the general population, they are understudied in rheumatoid arthritis (RA). Our objective was to determine ...

Liao, K. P.

214

Did Philippe Pinel frame the concept of the disease rheumatoid arthritis in the year 1800?  

PubMed

The dissertation from 1800 by Landré-Beauvais (LB) is quoted as an early description of rheumatoid arthritis (RA) with the implication that the disease was new at that time. However, physicians of the past may not have been able to perceive an already existing disease due to a lacking concept of it. The dissertation has been studied in the context of contemporary medical literature, modern historical and biographical texts. LB's dissertation seems to have been influenced by LB's mentor Philippe Pinel. The present study does not permit to conclude whether RA was a new disease. PMID:19922026

Hansen, S E

2009-01-01

215

Rheumatoid arthritis association at 6q23.  

PubMed

The Wellcome Trust Case Control Consortium (WTCCC) identified nine single SNPs putatively associated with rheumatoid arthritis at P = 1 x 10(-5) - 5 x 10(-7) in a genome-wide association screen. One, rs6920220, was unequivocally replicated (trend P = 1.1 x 10(-8)) in a validation study, as described here. This SNP maps to 6q23, between the genes oligodendrocyte lineage transcription factor 3 (OLIG3) and tumor necrosis factor-alpha-induced protein 3 (TNFAIP3). PMID:17982455

Thomson, Wendy; Barton, Anne; Ke, Xiayi; Eyre, Steve; Hinks, Anne; Bowes, John; Donn, Rachelle; Symmons, Deborah; Hider, Samantha; Bruce, Ian N; Wilson, Anthony G; Marinou, Ioanna; Morgan, Ann; Emery, Paul; Carter, Angela; Steer, Sophia; Hocking, Lynne; Reid, David M; Wordsworth, Paul; Harrison, Pille; Strachan, David; Worthington, Jane

2007-12-01

216

Low free testosterone levels in rheumatoid arthritis.  

PubMed Central

The androgen status of 25 male patients with rheumatoid arthritis (RA) was assessed and compared with that of age matched controls with osteoarthritis (OA). Significantly reduced levels of serum free testosterone were found in the RA group. Within that group free testosterone was unrelated to all indices of disease activity measured, though it was strongly related to latex positivity. These results support the hypothesis that male sex hormones may have a protective role in RA, though prospective studies would be necessary to determine whether the relation was one of cause or effect. PMID:3345107

Spector, T D; Perry, L A; Tubb, G; Silman, A J; Huskisson, E C

1988-01-01

217

Fluorodeoxyglucose (FDG) uptake in pulmonary rheumatoid nodules diagnosed by video-assisted thoracic surgery lung biopsy: two case reports and a review of the literature.  

PubMed

Two cases of rheumatoid nodules evaluated by fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) and video-assisted thoracic surgery (VATS) biopsy are reported. The first case was that of a 44-year-old woman who presented with a cavitated nodule with intense standardized uptake values (SUVs) both in the early (max 3.4) and delayed (max 4.4) phases, suggesting malignancy. However, after VATS biopsy, she was diagnosed as having a rheumatoid nodule with vasculitis. The second case was that of a 74-year-old woman admitted with bilateral lung nodules, two of which showed intense early (max 2.2) and delayed (max 6.0) phase SUVs, and mild early (max 0.6) and delayed (max 0.9) phase SUVs. These two nodules were finally proven to be a lung cancer and rheumatoid nodule without vasculitis, respectively. These cases show that rheumatoid nodules with an enhanced inflammatory process, such as vasculitis, can appear false-positive for malignancy on FDG-PET/CT scan images. PMID:22669597

Saraya, Takeshi; Tanaka, Ryota; Fujiwara, Masachika; Koji, Hitoshi; Oda, Miku; Ogawa, Yukari; Nagatomo, Tomoko; Watanabe, Masato; Yokoyama, Takuma; Ishii, Haruyuki; Takei, Hidefumi; Goya, Tomoyuki; Takizawa, Hajime; Goto, Hajime

2013-03-01

218

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

219

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

220

A case of bilateral rheumatoid pleuritis successfully treated with tocilizumab.  

PubMed

Abstract The patient was a 77-year-old woman diagnosed as having rheumatoid arthritis (RA) in 1973. She was initiated on infliximab therapy in addition to methotrexate administration in 2009. The therapeutic response decreased after the fifth dose of infliximab, and the patient developed rheumatoid pleuritis due to increased RA disease activity. The therapy was switched from infliximab to tocilizumab, which resulted in amelioration of the arthralgias well as pleuritis. Our results suggest that tocilizumab is an effective treatment alternative for the treatment of rheumatoid pleuritis. PMID:24533552

Ohtsuka, Keiko; Takeuchi, Kimihiko; Matsushita, Masatoshi; Aramaki, Tetsuo

2014-11-01

221

Rheumatoid arthritis of TMJ--a diagnostic dilemma?  

PubMed

Rheumatoid arthritis is a chronic disease affecting the musculo-skeletal connective tissue of the body with a strong predilection for the joints. The temporomandibular joint (TMJ) is commonly affected with rheumatoid arthritis in adults and children, but it is usually among the last joints to be affected. A case report is presented of a patient undergoing orthodontic treatment who developed unilateral condylar changes and whose serum was also positive for rheumatoid factor. The involvement of TMJ in several systemic disorders is a well established fact. When such disorders manifest in an atypical manner, it poses a diagnostic dilemma. This article aims to discuss various disorders causing condylar erosions. PMID:15116488

Bathi, Renuka J; Taneja, Neeraj; Parveen, Sameena

2004-04-01

222

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

223

Where do T cells stand in rheumatoid arthritis?  

PubMed

Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by destruction of cartilage and bone. The destructive lesions result from both immune responses and non-antigen-specific inflammatory processes. Little is known about the primary cause of RA. Although the primacy of T-cell-related events early in the disease remains debated, strong evidence indicates that autoantigen recognition by specific T cells is crucial to the pathophysiology of rheumatoid synovitis. We will discuss evolving concepts about T-cell involvement in RA and the roles for various T cell subsets in the development of joint abnormalities. The hypothesis that RA is a T-cell driven disease was put forward when studies of RA synovium showed numerous T cells carrying activation markers. These T cells were found to participate in the complex network of cell- and mediator-driven events leading to joint destruction. Conceivably, these T cells may be stimulated by an autoantigen (whether specific to the joints or ubiquitous), a highly conserved foreign protein cross-reacting with its human homolog, or a neo-antigen expressed as a result of posttranslational events. For many years, animal models have provided valuable evidence supporting a role for T cells in RA. We will review three murine models of arthritis caused by different mechanisms. In collagen-induced arthritis, the immune response to a joint antigen is mediated by pathogenic Th1 cells that elicit severe inflammatory synovitis. Spontaneous arthritis in K/BxN T-cell-receptor transgenic mice is related to an adaptive immune response against a ubiquitous protein whose end-stage effector mechanisms are heavily dependent on the innate immune system. In the SKG model of autoimmune inflammatory arthritis, a point mutation in the gene encoding a key signal-transduction molecule in T cells causes defective T cell selection in the thymus, which releases polyclonal autoreactive T cells. Studies in these and other animal models have established that a variety of T-cell subsets whose roles vary with cell location and disease stage can contribute to synovitis. Finally, in addition to direct autoimmune attack by effector T cells, arthritis may result from defective homeostatic control of immunity by regulatory T cells. PMID:16087382

Fournier, Catherine

2005-12-01

224

Modeling and simulation of blast-induced, early-time intracranial wave physics leading to traumatic brain injury.  

SciTech Connect

The objective of this modeling and simulation study was to establish the role of stress wave interactions in the genesis of traumatic brain injury (TBI) from exposure to explosive blast. A high resolution (1 mm{sup 3} voxels), 5 material model of the human head was created by segmentation of color cryosections from the Visible Human Female dataset. Tissue material properties were assigned from literature values. The model was inserted into the shock physics wave code, CTH, and subjected to a simulated blast wave of 1.3 MPa (13 bars) peak pressure from anterior, posterior and lateral directions. Three dimensional plots of maximum pressure, volumetric tension, and deviatoric (shear) stress demonstrated significant differences related to the incident blast geometry. In particular, the calculations revealed focal brain regions of elevated pressure and deviatoric (shear) stress within the first 2 milliseconds of blast exposure. Calculated maximum levels of 15 KPa deviatoric, 3.3 MPa pressure, and 0.8 MPa volumetric tension were observed before the onset of significant head accelerations. Over a 2 msec time course, the head model moved only 1 mm in response to the blast loading. Doubling the blast strength changed the resulting intracranial stress magnitudes but not their distribution. We conclude that stress localization, due to early time wave interactions, may contribute to the development of multifocal axonal injury underlying TBI. We propose that a contribution to traumatic brain injury from blast exposure, and most likely blunt impact, can occur on a time scale shorter than previous model predictions and before the onset of linear or rotational accelerations traditionally associated with the development of TBI.

Ford, Corey C. (University of New Mexico, Albuquerque, NM); Taylor, Paul Allen

2008-02-01

225

Association of rheumatoid factor with complement activation in rheumatoid arthritis and other diseases.  

PubMed Central

Rheumatoid factor (RF) is a complement activating autoantibody. In rheumatoid arthritis (RA) the rate of catabolism of complement is closely related to the titre of RF. Therefore, we have examined whether these relationships are unique to RA or will be found in non-RA disorders in which RF may be found in the circulation. We studied patients with subacute bacterial endocarditis, leprosy, tuberculosis, and a variety of other rheumatic and vasculitic disorders. We found that in all the disorders examined the RF had a complement activating potential which was equivalent to that of the RF of RA patients. Furthermore in vivo activation of complement, as exhibited by the appearance of C3 degradation products, was significantly related to higher titres of haemolytically active RF in non-RA as well as the RA group. In these respects, therefore, the RF in RA and non-RA patients is indistinguishable. A possible survival value for RF is discussed. PMID:6883809

Reyes, P A; Maluf, J G; Curd, J G; Vaughan, J H

1983-01-01

226

A Study of the Early-stage Evolution of Relativistic Electron-Ion Shock using 3D PIC Simulations  

E-print Network

We report the results of a 3D particle-in-cell (PIC) 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, whi...

Choi, E J; Nishikawa, K -I; Choi, C R

2014-01-01

227

Early-season effects of solar UV-B enhancement on plant canopy structure, simulated photosynthesis and competition  

SciTech Connect

Mixed-species stands of wheat (Triticum aestivum) and wild oat (Avena fatua) were exposed to enhanced solar UV-B radiation simulating a 20% reduction in column ozone to assess the timing and seasonal development of the UV-B-induced alterations in competitive balance between these species. Results from two years of field studies revealed that UV-B enhancement did not significantly affect the magnitude or timing of seeding emergence of the combined-species LAI of 4-week old mixtures (near 2 for both years). The UV-B did, however, significantly increase (5-9%) the relative proportion of the mixture LAI contributed by wheat which then resulted in a 6-8% increase in its calculated relative light interception and canopy carbon gain. These findings, and others indicate that the effects of enhanced UV-B on competitive balance are realized very early during canopy development and suggest that UV-B-induced alterations in seedling growth may have peristent and significant consequences for light competition later in the growing season.

Barnes, P.W.; Flint, S.D.; Caldwell, M.M. (Southwest Texas State Univ., San Marcos, TX (United States))

1994-06-01

228

Impact of Rheumatoid Arthritis Disease Activity Test on Clinical Practice  

PubMed Central

Background Variability exists in the assessment of disease activity in rheumatoid arthritis (RA) patients that may affect quality of care. Objectives To measure the impact on quality of care of a Multi-Biomarker Disease Activity (MBDA) test that quantitatively assesses RA disease activity. Methods Board-certified rheumatologists without prior experience with the MBDA test (N?=?81) were randomized into an intervention or control group as part of a longitudinal randomized-control study. All physicians were asked to care for three simulated RA patients, using Clinical Performance and Value (CPV™) vignettes, in a before and after design. CPV™ vignettes have been validated to assess the quality of clinical practice and identify variation in care. The vignettes covered all domains of a regular patient visit; scores were determined as a percentage of explicit predefined criteria completed. Three vignettes, representing typical RA cases, were administered each round. In the first round, no physician received information about the MBDA test. In the second round, only physicians in the intervention group were given educational materials about the test and hypothetical test results for each of the simulated patients. The outcome measures were the overall quality of care, disease assessment and treatment. Results The overall quality scores in the intervention group improved by 3 percent (p?=?0.02) post-intervention compared with baseline, versus no change in the control group. The greatest benefit in the intervention group was to the quality of disease activity assessment and treatment decisions, which improved by 12 percent (p<0.01) compared with no significant change in the control group. The intervention was associated with more appropriate use of biologic and/or combination DMARDs in the co-morbidity case type (p<0.01). Conclusions Based on these results, use of the MBDA test improved the assessment and treatment decisions for simulated cases of RA and may prove useful for rheumatologists in clinical practice. PMID:23667587

Peabody, John W.; Strand, Vibeke; Shimkhada, Riti; Lee, Rachel; Chernoff, David

2013-01-01

229

Juvenile rheumatoid arthritis and bronchiolitis obliterans organized pneumonia.  

PubMed

Diverse pleuropulmonary manifestations, including pleural effusion, rheumatoid nodulosis, fibrosis, obliterans brochiolitis, bronchiectasias, vasculitis, drug-induced lung disease, and obliterans bronchiolitis with organized pneumonia, have been described in patients with rheumatoid arthritis (RA). Bronchiolitis obliterans organized pneumonia (BOOP) is an uncommon condition described in patients with RA but not in juvenile RA (JRA). We described a patient with JRA who developed a BOOP. PMID:16362444

Sohn, Debora Ingrid; Laborde, Hugo Armando; Bellotti, Marta; Seijo, Luis

2007-02-01

230

Renal Involvement in Juvenile Rheumatoid Arthritis: Report of Two Cases  

Microsoft Academic Search

:   Renal involvement is a rare occurrence in juvenile rheumatoid arthritis (JRA). We report on two JRA patients with kidney\\u000a disease. The first was a 14-year-old African-American female with a 12-month history of polyarthritis. On presentation she\\u000a was found to have an ESR of 127?mm\\/h and a positive ANA, rheumatoid factor (RF), perinuclear antineutrophil cytoplasmic antibodies\\u000a (pANCA), haematuria, proteinuria with

A. Gedalia; E. A. Mendez; R. Craver; M. Vehaskari; L. R. Espinoza

2001-01-01

231

T cells as Secondary Players in Rheumatoid Arthritis  

Microsoft Academic Search

\\u000a Rheumatoid arthritis (RA) is a chronic inflammatory disease that affects about 1% of the general population worldwide [1]. The pathogenesis of RA remains a subject of debate, and many paradigms have been proposed and disputed over the years.\\u000a The concept of autoimmunity in RA appeared in the 1940’s when it was first appreciated that self-reacting antibodies (rheumatoid\\u000a factors) are present

Katherine H. Y. Nguyen; Gary S. Firestein

232

Diclofenac and Ibuprofen in Rheumatoid Arthritis and Osteoarthritis  

Microsoft Academic Search

Forty patients with arthritis (26 rheumatoid and 14 osteoarthrosis) entered a five-week double-blind crossover trial of diclofenac and ibuprofen. Four patients failed to complete the 10-week trial. There was no statistically significant difference in parameters of disease activity for the rheumatoid arthritis patients, but patients with osteoarthrosis fared significantly better on diclofenac. There was a low incidence of side effects

P. M. BROOKS; W. HILL; R. GEDDES

233

Treatment of rheumatoid hand synovitis with a regional block technique  

Microsoft Academic Search

This study reports a novel technique for treating painful rheumatoid hand synovitis using a regional block techique.\\u000a \\u000a Nine patients with symptomatic rheumatoid hand synovitis were treated. Assessments of symptoms, grip strength and synovial\\u000a swelling were made in each hand before the injection, and at 1 and 4 weeks after the procedure. A sphygmomanometer cuff was\\u000a inflated, on the side of

C. J. McCarthy; M. Regan; R. J. Coughlan

1993-01-01

234

Moving towards personalized medicine in rheumatoid arthritis  

PubMed Central

To develop personalized medicine strategies for improvement of patient management in rheumatoid arthritis, the clinical and molecular properties of the individual patients need to be well characterized. A crucial step in this approach is to discover subgroups of patients that are characterized by a good or poor treatment outcome. Dennis and colleagues have identified distinct pretreatment gene expression profiles in affected synovial tissue specimens and a tissue type-related systemic protein pattern which are associated with a positive or negative clinical outcome to monotherapy with adalumimab (anti-TNF?) and tocilizumab (anti-IL-6 receptor). These observations assign biological pathways associated with response outcome and provide evidence for the existence of systemic, easy-to-measure predictive biomarkers for clinical benefit of these biologics. PMID:25166016

2014-01-01

235

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

236

Adipokines as Potential Biomarkers in Rheumatoid Arthritis  

PubMed Central

Rheumatoid arthritis (RA) is a chronic systemic inflammatory autoimmune disease characterized by severe joint injury. Recently, research has been focusing on the possible identification of predictor markers of disease onset and/or progression, of joint damage, and of therapeutic response. Recent findings have uncovered the role of white adipose tissue as a pleiotropic organ not only specialized in endocrine functions but also able to control multiple physiopathological processes, including inflammation. Adipokines are a family of soluble mediators secreted by white adipose tissue endowed with a wide spectrum of actions. This review will focus on the recent advances on the role of the adipokine network in the pathogenesis of RA. A particular attention will be devoted to the action of these proteins on RA effector cells, and on the possibility to use circulating levels of adipokines as potential biomarkers of disease activity and therapeutic response. PMID:24799765

Del Prete, Annalisa; Salvi, Valentina; Sozzani, Silvano

2014-01-01

237

Impact of rheumatoid arthritis on sexual function  

PubMed Central

Sexuality is a complex aspect of the human being’s life and is more than just the sexual act. Normal sexual functioning consists of sexual activity with transition through the phases from arousal to relaxation with no problems, and with a feeling of pleasure, fulfillment and satisfaction. Rheumatic diseases may affect all aspects of life including sexual functioning. The reasons for disturbing sexual functioning are multifactorial and comprise disease-related factors as well as therapy. Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease characterized by progressive joint destruction resulting from chronic synovial inflammation. It leads to various degrees of disability, and ultimately has a profound impact on the social, economic, psychological, and sexual aspects of the patient’s life. This is a systemic review about the impact of RA on sexual functioning. PMID:24829873

Tristano, Antonio G

2014-01-01

238

[Anti-TNF alpha in rheumatoid arthritis].  

PubMed

Thanks to the better understanding of the physiopathological mechanisms in action in rheumatoid arthritis (RA), new therapeutic weapons have appeared, which have dramatically modified our approach of the disease. These so-called "biological" therapies antagonize the action of the cytokine at the top of the cascade which maintains the synovial inflammation, and leads to the joint destruction, i.e. the Tissue Necrosis Factor alpha (TNF alpha). Several controlled clinical studies have clearly demonstrated their short and middle term efficacy and safety profile, and they will soon become at the Belgian clinicians disposal. They have a rapid and dramatic effect on the signs and symptoms of RA and they slow down the radiologic progression. Some questions remain unresolved concerning their place in the general therapeutic strategy against RA, due to the uncertainties of their use in the long run, and to their cost. PMID:11488086

Schreiber, S; Sternon, J

2001-06-01

239

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

240

Early identification of drug-induced impairment of gastric emptying through physiologically based pharmacokinetic (PBPK) simulation of plasma concentration-time profiles in rat.  

PubMed

Inhibition of gastric emptying rate can have adverse effects on the absorption of food and nutrients. The absorption phase of the plasma concentration-time profile of a compound administered orally to pre-clinical species reflects among others, the gastric and intestinal transit kinetics, and can thus assist in the early identification of delayed gastric emptying. The purpose of this article is to demonstrate the value of Physiologically Based Pharmacokinetic (PBPK) modelling in the early identification of drug induced impairment of gastric emptying from pharmacokinetic profiles. To our knowledge, this is first time that the value of a generic PBPK model for hypothesis testing has been demonstrated with examples. A PBPK model built in-house using MATLAB package and incorporating absorption, metabolism, distribution, biliary and renal elimination models has been employed for the simulation of concentration-time profiles. PBPK simulations of a few compounds that are currently in drug discovery projects show that the observed initial absorption phase of their concentration-time profiles in rat were consistent with reduced gastric emptying rates. The slow uptake of these compounds into the systemic circulation is reflected in their pharmacokinetic profiles but it is not obvious until PBPK simulations are done. Delayed gastric emptying rates of these compounds in rats were also independently observed in x-ray imaging. PBPK simulations can provide early alerts to drug discovery projects, besides aiding the understanding of complex mechanisms that determine the lineshapes of pharmacokinetic profiles. The application of PBPK simulations in the early detection of gastric emptying problems with existing data and without the need to resort to additional animal studies, is appealing both from an economic and ethical standpoint. PMID:17963025

Peters, Sheila Annie; Hultin, Leif

2008-02-01

241

Inflammatory lesions in the bone marrow of rheumatoid arthritis patients: a morphological perspective  

PubMed Central

The synovial tissue stands at the epicenter of joint pathology in rheumatoid arthritis (RA). As a primary target of the disease, studies on the synovium have provided invaluable insights into the mechanisms involved in disease pathogenesis. Recent work has, however, revealed the importance of a previously unseen anatomic compartment in direct contact with the joint space, namely the subchondral bone marrow. Bone marrow edema (BME) visible on magnetic resonance imaging (MRI) is clinically meaningful in both early and late RA as it associates with future development of bone erosions and poor functional outcomes. Although the histopathologic correlates of MRI-based BME in early RA remain obscure, studies in advanced disease are consistent in describing lymphocytic inflammatory infiltrates within the subchondral marrow cavity of affected joints. In this review, we discuss the nature of bone marrow lesions in patients with RA, analyze their relationship with synovitis, and explore their potential contribution to the pathological processes of the disease. PMID:23270711

2012-01-01

242

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

MedlinePLUS

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

243

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

244

Association of susceptible genetic markers and autoantibodies in rheumatoid arthritis.  

PubMed

Rheumatoid arthritis (RA) is a chronic autoimmune disorder of unknown aetiology resulting in inflammation of the synovium, cartilage and bone. The disease has a heterogeneous character, consisting of clinical subsets of anti-citrullinated protein antibody (ACPA)-positive and APCA-negative disease. Although, the pathogenesis of RA is incompletely understood, genetic factors play a vital role in susceptibility to RA as the heritability of RA is between 50 and 60%, with the human leukocyte antigen (HLA) locus accounting for at least 30% of overall genetic risk. Non-HLA genes, i.e. tumour necrosis factor-? (TNF-?) within the MHC (major histocompatibility complex) have also been investigated for association with RA. Although, some contradictory results have originated from several studies on TNF-? gene, the data published so far indicate the possible existence of TNF-? gene promoter variants that act as markers for disease severity and response to treatment in RA. The correlation of HLA and non-HLA genes within MHC region is apparently interpreted. A considerable number of confirmed associations with RA and other autoimmune disease susceptibility loci including peptidylarginine deiminase type 4 (PADI4), protein tyrosine phosphatase non-receptor type 22 (PTPN22), signal transducer and activator of transcription (STAT4), cluster of differentiation 244 (CD244) and cytotoxic T lymphocyte-associated antigen 4 (CTLA4), located outside the MHC have been reported recently. In this review, we aim to give an update on recent progress in RA genetics, the importance of the combination of HLA-DRB1 alleles, non-HLA gene polymorphism, its detection and autoantibodies as susceptibility markers for early RA disease. PMID:25189266

Mohan, Vasanth Konda; Ganesan, Nalini; Gopalakrishnan, Rajasekhar

2014-08-01

245

Ann Rheum Dis . Author manuscript Measure of function in rheumatoid arthritis: individualised or classical  

E-print Network

Index ; Treatment Outcome Author Keywords Health assessment questionnaire ; Rheumatoid arthritisAnn Rheum Dis . Author manuscript Page /1 8 Measure of function in rheumatoid arthritis Questionnaire Disability Index (HAQ-DI) is the most widely used measure of function in rheumatoid arthritis (RA

Paris-Sud XI, Université de

246

Sleep Loss Exacerbates Fatigue, Depression, and Pain in Rheumatoid Arthritis  

PubMed Central

Study Objectives: Disturbances of sleep are hypothesized to contribute to pain. However, experimental data are limited to healthy pain-free individuals. This study evaluated the effect of sleep loss during part of the night on daytime mood symptoms and pain perceptions in patients with rheumatoid arthritis in comparison with control subjects. Design: A between-groups laboratory study with assessment of mood symptoms and pain perception before and after partial night sleep deprivation (PSD; awake 23:00 hr to 03:00 hr). Setting: General clinical research center. Participants: Patients with rheumatoid arthritis (n = 27) and volunteer comparison control subjects (n = 27). Measurements: Subjective reports of sleep, mood symptoms and pain, polysomnographic assessment of sleep continuity, and subjective and objective assessment of rheumatoid arthritis-specific joint pain. Results: PSD induced differential increases in self-reported fatigue (P < 0.09), depression (P < 0.04), anxiety (P < 0.04), and pain (P < 0.01) in patients with rheumatoid arthritis compared with responses in control subjects, in whom differential increases of self-reported pain were independent of changes in mood symptoms, subjective sleep quality, and objective measures of sleep fragmentation. In the patients with rheumatoid arthritis, PSD also induced increases in disease-specific activity as indexed by self-reported pain severity (P < 0.01) and number of painful joints (P < 0.02) as well as clinician-rated joint counts (P < 0.03). Conclusion: This study provides the first evidence of an exaggerated increase in symptoms of mood and pain in patients with rheumatoid arthritis after sleep loss, along with an activation of rheumatoid arthritis-related joint pain. Given the reciprocal relationship between sleep disturbances and pain, clinical management of pain in patients with rheumatoid arthritis should include an increased focus on the prevention and treatment of sleep disturbance in this clinical population. Citation: Irwin MR; Olmstead R; Carrillo C; Sadeghi N; FitzGerald JD; Ranganath VK; Nicassio PM. Sleep loss exacerbates fatigue, depression, and pain in rheumatoid arthritis. SLEEP 2012;35(4):537-543. PMID:22467992

Irwin, Michael R.; Olmstead, Richard; Carrillo, Carmen; Sadeghi, Nina; FitzGerald, John D.; Ranganath, Veena K.; Nicassio, Perry M.

2012-01-01

247

A new method to determine joint range of movement and stiffness in rheumatoid arthritic patients.  

PubMed

Rheumatoid arthritis affects 0.5-1% of the general population. The prediction and prognosis of the disease varies for each individual and its course can detrimentally affect the psychosocial condition of the patient. Clinicians and Therapists aim to quickly diagnose and treat those with this debilitating disease. Detection relies heavily on manual evaluation methods that are dependent on training and can vary between observers. Angle measuring instrument, tape measure and grip strength dynamometer are used to assess the joint range and strength of a patient to determine their hand function. Joint stiffness can be a determining factor when diagnosing the advancement and improvement of Rheumatoid Arthritis (RA). This paper outlines the development of a hand movement measurement tool to accurately quantify patients' flexion, extension, abduction and adduction movement of each finger joint and quantifies the symptom of "early morning stiffness". It also describes the problems that arise when using a data glove to accurately measure Range Of Movement and discusses alternative methods to overcome these issues. PMID:23367390

Connolly, James; Condell, Joan; Curran, Kevin; Gardiner, Philip

2012-01-01

248

Results of cementless total knee arthroplasty in an older rheumatoid arthritis population.  

PubMed

Fifty-five total knee arthroplasties (TKAs) in thirty-nine adult (mean age, 62 years) patients with rheumatoid arthritis were studied prospectively for a period of 1-7 years. All of the procedures were performed using cementless fixation of the tibial and femoral components. The Knee Society clinical rating system mean knee scores increased 56 points after operation (mean, 88 points), and the mean functional scores increased 28 points (mean, 64 points). Two revisions (4%) have been required, one for secondary late infection and one for failure of a cementless metal-backed patellar component. Good bone stock was retained in both, allowing for uneventful cementless revision. Forty-two arthroplasties (76%) were completely pain-free, twelve (22%) had mild, occasional discomfort with weight-bearing, and one (2%) had moderate pain at last examination. In this older rheumatoid population, cementless TKA offers good or excellent early clinical results and excellent preservation of bone stock should revision become necessary. PMID:1770373

Armstrong, R A; Whiteside, L A

1991-12-01

249

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

250

Remodeling a rheumatology practice to facilitate early referral.  

PubMed

In the next 12 months, 7500 Canadians and 75,000 Americans will be afflicted with the onset of rheumatoid arthritis. Little is known about the health care use of patients with early RA. Nonetheless, rheumatologists and outcomes researchers strongly endorse the need for early diagnosis and treatment of this population. This article reviews trends and impediments to early referral of new-onset arthritis patients. The slow growth of early arthritis clinics is summarized in a survey that characterizes 23 early arthritis programs in North America. Also, several screening tools and models to capture these early-onset arthritis patients are presented. PMID:16287586

Cush, John J

2005-11-01

251

Dwyer's operation for the rheumatoid forefoot.  

PubMed

In 1970, A. F. Dwyer described an operation for severe toe deformities with the objectives of creating a more stable foot and improving toe function, in addition to relieving pain. This was achieved by fusing the metatarsophalangeal joint of the hallux and the proximal interphalangeal joints of the lateral four toes. The metatarsal heads of the second, third, fourth, and fifth rays were then resected with their respective extensor tendons interposed so as to provide a tenodesis effect. Our study presented in this paper consists of 36 consecutive procedures performed on 22 rheumatoid patients. Follow-up of 33 operations in the 20 patients who were available for recall averaged 42.2 months. Assessment emphasized a subjective report including patient satisfaction, relief of pain, ability to fit shoes, cosmetic result, and walking ability. Objective examination was used to evaluate the presence of a successful arthrodesis of the metatarsophalangeal joint of the great toe, the position of this arthrodesis, the presence of tender callosities, the attitude of the lateral four toes, and symmetry. Results were good or excellent in 76%, satisfactory in 12%, and poor in 12%. PMID:7349862

MacClean, C R; Silver, W A

1981-05-01

252

Mesenchymal stem cells, autoimmunity and rheumatoid arthritis  

PubMed Central

The vast majority of literature pertaining to mesenchymal stem cells (MSC) immunomodulation has focussed on bone marrow-derived MSC that are systemically infused to alleviate inflammatory conditions. Rheumatoid arthritis (RA) is the commonest autoimmune joint disease that has witnessed significant therapeutic advances in the past decade, but remains stubbornly difficult to treat in a subset of cases. Pre-clinical research has demonstrated that bone marrow, adipose, synovial and umbilical cord-derived MSC all suppress the functions of different immune cells thus raising the possibility of new therapies for autoimmune diseases including RA. Indeed, preliminary evidence for MSC efficacy has been reported in some cases of RA and systemic lupus erythromatosis. The potential use of bone marrow-MSC (BM-MSC) for RA therapy is emerging but the use of synovial MSC (S-MSC) to suppress the exaggerated immune response within the inflamed joints remains rudimentary. Synovial fibroblasts that are likely derived from S-MSCs, also give rise to a cell-cultured progeny termed fibroblast-like synoviocytes (FLS), which are key players in the perpetuation of joint inflammation and destruction. A better understanding of the link between these cells and their biology could be a key to developing novel MSC-based strategies for therapy. The review briefly focuses on BM-MSC and gives particular attention to joint niche synovial MSC and FLS with respect to immunoregulatory potential therapy roles. PMID:24518000

El-Jawhari, J.J.; El-Sherbiny, Y.M.; Jones, E.A.

2014-01-01

253

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

254

[Colonic microbial biocenosis in rheumatoid arthritis].  

PubMed

The aim of the work was to study colonic microbial biocenosis and colonizing ability of opportunistic bacteria in 32 patients with rheumatoid arthritis (RA) and 30 healthy subjects. RA was diagnosed based on the American Rheumatism Association criteria (1987). Qualitative and quantitative composition of the microflora was detected by a bacteriological method. StatSoft Statistics 6.0 was used to treat the data obtained. RA was associated with significant modification of the intestinal flora, viz. decrease in lactobacteria and significant increase of enterococci, clostridia, colibacteria showing reduced enzymatic activity, and opportunistic species. Also, symbiotic relationships between microorganisms altered. The fraction of bifidobacteria, bacteroids, and lactopositive colibacteria reduced while the abundance of opportunistic enterobacteria and staphylococci was elevated. Opportunistic Enterobacteriaceae were present in urine and nasal mucosa which suggested their translocation from the intestines. It is concluded that changes in intestinal microflora and colonization by opportunistic bacteria enhance the risk of development of co-morbid conditions in patients with RA. PMID:21932563

Gul'neva, M Iu; Noskov, S M

2011-01-01

255

"Yellow nail syndrome" and rheumatoid arthritis.  

PubMed

A nail dystrophy characterized by the slow growth of nails and their yellowish discoloration, the so-called yellow nail syndrome (YNS), has been associated with various conditions including rheumatoid arthritis (RA). We reviewed the histories of RA patients reported in the literature and our own cases. Most of the RA patients with YNS had been treated with the anti-rheumatic agents D-penicillamine and bucillamine. In non-treated patients, spontaneous YNS was very rare. However, pulmonary diseases, edema and other systemic complications were frequently observed in both drug-induced and spontaneous YNS associated with RA. Although the nail changes and systemic complications are probably due to different causes in drug-induced YNS, a careful search for systemic complications are necessary in patients who develop nail changes. The exact mechanism of nail growth retardation is not understood in patients with YNS, including those with drug-induced YNS. The nail changes in the latter were not associated with deficiencies of inorganic elements in either nails or sera. PMID:1820660

Ichikawa, Y; Shimizu, H; Arimori, S

1991-12-01

256

Compliance with treatment of rheumatoid arthritis.  

PubMed

Rheumatoid arthritis (RA) is a chronic, progressive, debilitating disease that demands continuous therapy with multiple medications. Noncompliance with disease-modifying drugs may cause disease flares, preventable functional impairment, unnecessary treatment changes, and loss of health care resources. The aim of the current study was to explore self-reported compliance with treatment and the factors contributing to this compliance using a representative sample of an RA patient population in Estonia. Two thousand patients diagnosed with RA were randomly selected from the Estonian Health Insurance Fund database. The eligible response rate of the study was 60%. Using prestructured questionnaires, the following information about the disease and treatment was evaluated: self-reported compliance with treatment, reasons for noncompliance, disease history, sociodemographic variables, health care utilization, and satisfaction with health care providers. The self-reported compliance rate was 80.3%, reflecting the percentage of patients who reported that they always took their medications exactly as described. The most often reported reasons for noncompliance were side effects and fear of side effects. Compliance was found to be the lowest in a group of younger and active patients with higher income. Higher frequency of visits to the rheumatologist, satisfaction with health care providers, and sufficient information about RA treatment correlated with better compliance. PMID:21947350

Müller, Raili; Kallikorm, Riina; Põlluste, Kaja; Lember, Margus

2012-10-01

257

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; Sejourne, Alice; Paccou, Julien; Goeb, Vincent

2014-01-01

258

Reduction in Long-term Functional Disability in Rheumatoid Arthritis from 1977 to 1998: A Longitudinal Study of 3035 Patients  

Microsoft Academic Search

PURPOSE: If newer, more aggressive treatment strategies in rheumatoid arthritis are more effective, long-term outcomes in rheumatoid arthritis should be improving substantially. We therefore assessed trends in disability over time in a large cohort of patients with rheumatoid arthritis. METHODS: We examined functional disability data from 3035 patients with rheumatoid arthritis whose disease onset was from 1977 to 1998. Disability

Eswar Krishnan; James F. Fries

259

A simulation model for compensatory plasticity in the prefrontal cortex inducing a cortico-cortical dysconnection in early brain development  

Microsoft Academic Search

Summary.  In the present work, an abstract prefrontal cortex simulation model is used to predict compensatory structural alterations\\u000a of the cortico-cortical connectivity pattern in the normal and pathologic forebrain maturation. The simulation network shows\\u000a different representative courses of morphogenesis when developing undisturbed or when suffering from disturbing excitatory\\u000a afferences. The simulative results could be affirmed by an immuno-histochemical study, revealing a

M. Butz; G. Teuchert-Noodt

2006-01-01

260

Baseline RANKL:OPG ratio and markers of bone and cartilage degradation predict annual radiological progression over 11 years in rheumatoid arthritis  

Microsoft Academic Search

ObjectiveTo determine to what extent baseline measurements of the ratio receptor activator of nuclear factor-?B ligand (RANKL):osteoprotegerin (OPG) and C-terminal cross linking of type-I and type-II (CTX-I and CTX-II), in addition to traditional markers of disease severity, could predict annual radiological progression.MethodsA cohort of 155 patients with early, active, untreated rheumatoid arthritis (RA) who participated in the Combination Therapy in

Lilian H D van Tuyl; Alexandre E Voskuyl; Maarten Boers; Piet Geusens; Robert B M Landewé; Ben A C Dijkmans; Willem F Lems

2010-01-01

261

Bone loss in rheumatoid arthritis: systemic, periarticular, and focal.  

PubMed

Rheumatoid arthritis is a chronic inflammatory disease that results in generalized bone loss and increased fracture risk. Characteristic radiologic features of rheumatoid arthritis include periarticular osteopenia and marginal erosions. An emerging literature highlights the importance of osteoclasts as mediators of the erosive process, with an impairment of bone formation by inhibition of the Wnt signaling pathway as a cause of lack of repair of erosions. MRI has demonstrated the importance of inflammation in the bone marrow compartment as a cause of periarticular osteopenia. The term osteoimmunology has evolved to highlight the association between cells and cytokines of the immune system and their relationship to bone metabolism in rheumatoid arthritis and other forms of chronic inflammatory arthritis. PMID:22527950

Deal, Chad

2012-06-01

262

Concurrent validation of activity monitors in patients with rheumatoid arthritis?  

PubMed Central

Background Physical activity is frequently reported in rheumatology but it is difficult to measure objectively outside the gait laboratory. A new generation of activity monitors offers this potential but it has not yet been evaluated in patients with rheumatoid arthritis. This study aimed to evaluate three types of activity monitors in patients with rheumatoid arthritis. Methods The Step-N-Tune, Activ4Life Pro V3.8, and the Intelligent Device for Energy Expenditure and Activity activity monitors were tested concurrently in 12 patients with rheumatoid arthritis as well as in a healthy control group of 12 volunteers. Participants walked at a self selected speed for two minutes and were filmed for later review. Temporal and spatial gait parameters were also validated against the GAITRite walkway and the total number of steps recorded by each activity monitor was compared to a gold standard derived from half speed video replays. Findings Activity monitor performance varied between devices but all showed poorer performance when used in the group with rheumatoid arthritis. Bland–Altman plots demonstrated wider 95% limits of agreement in the group with rheumatoid arthritis and a systematic decrease in agreement between activity monitors and the gold standard with decreasing functional ability. Interpretation Despite some variation between devices, all the activity monitors tested performed reasonably well in healthy young volunteers. All except the Activ4Life showed a marked decrease in performance in patients with rheumatoid arthritis, suggesting Activ4Life could be the most suitable for use in this patient group. The marked between group difference in functional ability, and systematic decrease in device performance with deteriorating gait, indicate that activity monitors require specific validation in target clinical populations. PMID:23522723

Backhouse, Michael R.; Hensor, Elizabeth M.A.; White, Derrick; Keenan, Anne-Maree; Helliwell, Philip S.; Redmond, Anthony C.

2013-01-01

263

The early phase of psoriatic arthritis  

Microsoft Academic Search

Evaluation of the preclinical phases of the classic autoimmune diseases including rheumatoid arthritis has been facilitated by the availability of autoantibody and genetic markers that point firmly towards the early dysregulation of the adaptive immune responses. The association of psoriatic disease with the human leucocyte antigen—Cw0602 (HLA-Cw0602) gene has likewise led to the perception that autoimmunity has a pivotal role

Dennis McGonagle; Zoe Ash; Laura Dickie; Michael McDermott; Sibel Zehra Aydin

2011-01-01

264

Interdecadal variations in ENSO influences on Northwest Pacific -East Asian early summertime climate simulated in CMIP5 models  

E-print Network

, Hawaii 5 State Key Laboratory of Tropical Oceanography, South China Sea Institute of Oceanology, Chinese Coupled Model Intercomparison Project Phase 5 (CMIP5) simulations. In the historical run, 8 out of 19 summertime climate simulated in CMIP5 models Kaiming Hu1 , Gang Huang2 , Xiao-Tong Zheng3 , Shang-Ping Xie4

Xie, Shang-Ping

265

Tocilizumab-induced psoriasiform rash in rheumatoid arthritis.  

PubMed

Tocilizumab (TCZ) is a humanized monoclonal antibody against the interleukin-6 (IL-6) receptor and has been approved for the treatment of rheumatoid arthritis (RA) patients who have had an inadequate response to previous biological therapies. Psoriasiform skin lesions, especially palmoplantar pustulosis lesions, are well described following anti-tumour necrosis factor therapy. We describe a 79-year-old woman with rheumatoid factor-positive, anti-citrullinated protein antibody-positive erosive RA, who developed a psoriasiform palmoplantar pustulosis reaction following treatment with TCZ therapy (IL-6 receptor). The rash showed histological features compatible with psoriasis and disappeared following discontinuation of TCZ. PMID:24942661

Palmou-Fontana, Natalia; Sánchez Gaviño, Juan Antonio; McGonagle, Dennis; García-Martinez, Eva; Iñiguez de Onzoño Martín, Luis

2014-01-01

266

Trends in Serious Infections in Rheumatoid Arthritis  

PubMed Central

Objective To examine trends in the rates of serious infections among patients diagnosed with rheumatoid arthritis (RA) in 1995-2007 compared to rates previously reported from the same geographical area diagnosed in 1955-1994. Methods A population-based inception cohort of patients with RA in 1995-2007 was assembled and followed through their complete medical records until death, migration, or December 31, 2008. All serious infections (requiring hospitalization or IV antibiotics) were recorded. Person-year (py) methods were used to compare rates of infection. Results Among 464 patients with incident RA in 1995-2007, 54 had ?1 serious infection (178 total). These were compared to609 patients with incident RA in 1955-1994 (290 experienced ?1 serious infection; 740 total). The rate of serious infections declined from 9.6 per 100py in the 1955-1994 cohort to 6.6 per 100py in the 1995-2007 cohort. However, serious gastrointestinal infection rates increased from 0.5 per 100py in the 1955-1994 cohort to 1.25 per 100py in the 1995-2007 cohort. Among patients with a history of serious infection, the rate of subsequent infection increased from 16.5 per 100py in 1955-1994 to 37.4 per 100py in 1995-2007. There was an increase in the rate of serious infections in patients who received biologic agents, but this did not reach significance. Conclusions Aside from gastrointestinal infections, the rate of serious infections in patients with RA has declined in recent years. However, the rate of subsequent infections was higher in recent years than previously reported. PMID:23547208

Mhuircheartaigh, Orla Ni; Matteson, Eric L.; Green, Abigail B.; Crowson, Cynthia S.

2013-01-01

267

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

Kurko, Julia; Besenyei, Timea; Laki, Judit; Glant, Tibor T.; Mikecz, Katalin

2013-01-01

268

Genetics of rheumatoid arthritis - a comprehensive review.  

PubMed

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; Szekanecz, Zoltán

2013-10-01

269

Methotrexate: Optimizing the Efficacy in Rheumatoid Arthritis  

PubMed Central

Methotrexate (MTX) is currently the most frequently used drugs in the treatment of rheumatoid arthritis (RA). The drug had been synthesized in 1948 and first tests to treat patients with psoriasis and RA were published in 1951. However, until the 1980s there was only limited use of MTX in the treatment of RA. Since the 1990s MTX is the disease-modifying antirheumatic drug (DMARD) of first choice for the treatment of RA in most countries worldwide. By definition, DMARDs in RA are those compounds for which an inhibiting effect on radiographic progression has been demonstrated. Several combinations of DMARDs have been tested, most commonly with MTX as the anchor drug. Regarding the route of administration of MTX there is some evidence that the parenteral route, most often performed subcutaneously, has some additional benefits over the oral route. In MTX monotherapy, dosages up to 30 mg/week are now used. There are now three main combinations that are playing an important role: MTX + sulfasalazine (SSZ) + hydroxychloroquine, MTX + leflunomide (LEF), and MTX + biologics such as antitumour necrosis factor (anti-TNF) and other new compounds which block the interleukin 6 (IL6) receptor or T-cell activation and delete B cells. Regarding clinical efficacy, MTX monotherapy has performed almost similarly well in comparison with biologic mono-therapy, both usually combined with glucocorticoids. However, structural damage is usually inhibited to a significantly greater degree with the biologics. The combination of MTX with biologics has proven superior to either agent alone in all aspects. Current strategic regimens which concentrate on systematic ways to bring patients into remission all include MTX as first choice. PMID:22870474

Braun, Jurgen

2011-01-01

270

Development of macromolecular prodrug for rheumatoid arthritis?  

PubMed Central

Rheumatoid arthritis (RA) is a chronic autoimmune disease that is considered to be one of the major public health problems worldwide. The development of therapies that target tumor necrosis factor-? (TNF-?), interleukin-6 (IL-6) and co-stimulatory pathways that regulate the immune system have revolutionized the care of patients with RA. Despite these advances, many patients continue to experience symptomatic and functional impairment. To address this issue, more recent therapies that have been developed are designed to target intracellular signaling pathways involved in immunoregulation. Though this approach has been encouraging, there have been major challenges with respect to off-target organ side effects and systemic toxicities related to the widespread distribution of these signaling pathways in multiple cell types and tissues. These limitations have led to an increasing interest in the development of strategies for the macromolecularization of anti-rheumatic drugs, which could target them to the inflamed joints. This approach enhances the efficacy of the therapeutic agent with respect to synovial inflammation, while markedly reducing non-target organ adverse side effects. In this manuscript, we provide a comprehensive overview of the rational design and optimization of macromolecular prodrugs for treatment of RA. The superior and the sustained efficacy of the prodrug may be partially attributed to their Extravasation through Leaky Vasculature and subsequent Inflammatory cell-mediated Sequestration (ELVIS) in the arthritic joints. This biologic process provides a plausible mechanism, by which macromolecular prodrugs preferentially target arthritic joints and illustrates the potential benefits of applying this therapeutic strategy to the treatment of other inflammatory diseases. PMID:22433784

Yuan, Fang; Quan, Ling-dong; Cui, Liao; Goldring, Steven R.; Wang, Dong

2012-01-01

271

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

272

Functional affinity of IgM rheumatoid factor in patients with rheumatoid arthritis and other autoimmune diseases.  

PubMed Central

The functional affinity of IgM rheumatoid factors (RF) was measured in 31 patients with rheumatoid arthritis (RA), 24 with systemic lupus erythematosus (SLE), 13 with Sjögren's syndrome (SS), and in 13 seropositive healthy individuals. The functional affinity of IgM RF from patients with RA was significantly lower than in the other clinical groups studied. In addition, there was a significant inverse correlation between functional affinity and titre of IgM RF in all the groups. These results suggest that the usual mechanisms of affinity based selective pressure (somatic diversification and antigen selection) may operate differently for autoantibodies to serum antigens such as IgG. PMID:3365027

Rath, S; Hogben, D N; Devey, M E

1988-01-01

273

The Past versus the Present, 1980-2004: Reduction of Mean Initial Low-Dose, Long-Term Glucocorticoid Therapy in Rheumatoid Arthritis from 10.3 to 3.6 mg/Day, Concomitant with Early Methotrexate, with Long-Term Effectiveness and Safety of Less than 5 mg/Day.  

PubMed

Quantitative observations are presented concerning treatment with glucocorticoids of 308 patients with rheumatoid arthritis (RA) at a weekly academic rheumatology setting over 25 years from 1980 to 2004. A database of all visits included medications and multidimensional health assessment questionnaire scores for physical function, pain and routine assessment of patient index data (RAPID3; and a surrogate RAPID3-EST), completed by each patient at each visit in routine care. Over the 5-year periods of 1980-1984, 1985-1989, 1990-1994, 1995-1999 and 2000-2004, the mean initial prednisone daily dose declined from 10.3 to 6.5, 5.1, 4.1 and 3.6 mg/day, as initial doses were >5 mg/day in 49, 16, 7, 7 and 3% of patients, 5 mg/day in 51, 80, 70, 26 and 10%, and <5 mg/day in 0, 4, 23, 67 and 86%. Reduction of prednisone doses in the respective five-year periods was accompanied by increased and earlier use of methotrexate as the first disease-modifying antirheumatic drug (DMARD) in 10, 26, 57, 71 and 78%, and methotrexate treatment in 10, 26, 74, 82 and 92% of patients within the first year of disease. Higher methotrexate doses in the respective five-year periods were used after 1990, along with lower prednisone doses. Most patients were treated indefinitely with both low-dose prednisone and methotrexate; 80% continued both medications for more than 5 years. The primary adverse events were skin-thinning and bruising. New hypertension, diabetes and cataracts were seen in fewer than 10% of patients. While efficacy and safety cannot be analyzed definitively from observational data, the data suggest that many patients with RA might be treated effectively with weekly low-dose methotrexate along with initial and long-term, low-dose prednisone of <5 mg/day. © 2014 S. Karger AG, Basel. PMID:25228430

Pincus, Theodore; Sokka, Tuulikki; Cutolo, Maurizio

2015-01-01

274

The role of side-chain interactions in the early steps of aggregation: Molecular dynamics simulations of an  

E-print Network

are highly ordered protein aggregates asso- ciated with severe human disorders including Alzheimer's disease remain unanswered. What energetic contri- butions stabilize the species formed early in the aggregation process? In particular, what is the role of side-chain interactions and what are the most favorable side

Caflisch, Amedeo

275

Identification of potential serum biomarkers for rheumatoid arthritis by high-resolution quantitative proteomic analysis.  

PubMed

The aim of this study was to find serum biomarkers of rheumatoid arthritis (RA) by high-resolution proteomic analysis. Low-abundance proteins from pooling serum sample of early RA patients and healthy controls were enriched using ProteoMiner™ enrichment kits. The enriched proteins were separated on SDS-PAGE, digested by trypsin, labeled with tandem mass tag (TMT) reagents, and desalted by C18 stage tip column. Then, the labeled peptides were analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) with nano-LC combined with Orbitrap Q Exactive mass spectrometer, and experiments were carried out three times using different specimens, and differentially expressed proteins were screened by intensity ratios of identified peptides. Enzyme-linked immunosorbent assays (ELISAs) were performed to confirm differentially expressed proteins. Twenty-six proteins were found differentially expressed in RA serum by high-resolution proteomic analysis. Among them, levels of thrombospondin-1, ficolin-2, isoform 10 of fibronectin, and apolipoprotein E were higher in RA patients than in healthy controls (RA/healthy control (HC)???1.5, p?rheumatoid factor, and IgM in RA patients and with DAS28 and IgM in early RA patients through statistical analysis. The results of this study suggest that ficolin-2, as a newly screened biomarker by high-resolution quantitative proteomic analysis, offers the potentiality to become a diagnostic or disease evaluation tool in RA. PMID:24682873

Cheng, Yongjing; Chen, Yuling; Sun, Xiaolin; Li, Yuhui; Huang, Cibo; Deng, Haiteng; Li, Zhanguo

2014-10-01

276

Analysis of the molecular basis of synovial rheumatoid factors in rheumatoid arthritis.  

PubMed

The objective of this study was to better understand the molecular basis of IgM rheumatoid factor in rheumatoid arthritis (RA). We recently generated 10 different monoclonal IgM RF (mRF) molecules isolated from the synovium of a single patient with RA. The heavy (H) and light chain (L) variable region (V) genes of these 10 mRFs were cloned and sequenced. Six mRFs used kappa light chains and 4 mRFs used lambda light chains. Of particular interest, 8 of 10 heavy chains used the JH4 joining region gene, and all five VH4 heavy chains used the DK4 diversity region gene with the JH4. Four of the VH4 clones used the same germline gene, likely representing a novel but closely related germline gene to VH4.18, and may be clonally related because of the extensive homology in their heavy chain sequence. Two VH4 clones shared the same light chain gene, VkappaIIIb kv325 (99% homology) and the same JK4 joining region gene, while three VH4 clones used two different light chain genes, an uncommon Vkappa4 and a Vlambda4 gene, respectively. In this RA patient, there was recurrent utilization of VH4-DK4-21/10-JH4 genes and a recurring association with gene elements Vkappa3 and Vlambda4. Recurring usage of Vkappa3 (kv325) and Vlambda4 (lv418) gene elements may result from a light chain editing process whereby immature autoreactive B cells encountering self-antigen attempt, and often succeed, in altering their specificities through secondary Ig light chain gene rearrangement. Moreover, the oligoclonality of these RFs suggest clonal relatedness secondary to an antigen-driven response. PMID:9281390

Ermel, R W; Kenny, T P; Wong, A; Chen, P P; Malyj, W; Robbins, D L

1997-09-01

277

Ab Initio computer simulation of the early stages of crystallization: application to Ge(2)Sb(2)Te(5) phase-change materials.  

PubMed

By virtue of the ultrashort phase-transition time of phase-change memory materials, e.g., Ge(2)Sb(2)Te(5), we successfully reproduce the early stages of crystallization in such a material using ab initio molecular-dynamics simulations. A stochastic distribution in the crystallization onset time is found, as generally assumed in classical nucleation theory. The critical crystal nucleus is estimated to comprise 5-10 (Ge,Sb)(4)Te(4) cubes. Simulated growth rates of crystalline clusters in amorphous Ge(2)Sb(2)Te(5) are consistent with extrapolated experimental measurements. The formation of ordered planar structures in the amorphous phase plays a critical role in lowering the interfacial energy between crystalline clusters and the amorphous phase, which explains why Ge-Sb-Te materials exhibit ultrafast crystallization. PMID:22107213

Lee, T H; Elliott, S R

2011-09-30

278

Occupational therapy for rheumatoid arthritis: A systematic review  

Microsoft Academic Search

Patients with rheumatoid arthritis (RA) show a reduction in physical capacities compared with healthy persons. Symptoms such as pain, fatique, stiffness, and decreased muscle strength cause difficulties with daily activities such as grooming and dressing, cooking a meal, cleaning, shopping, work, and leisure activities. The physical, personal, familial, social, and vocational consequences of RA are extensive. Occupational therapy (OT) is

Esther M. J. Steultjens; Joost Dekker; Lex M. Bouter; Dirkjan van Schaardenburg; Marie-Antoinette H. van Kuyk; Cornelia H. M. van den Ende

2002-01-01

279

Cells of the synovium in rheumatoid arthritis. B cells  

Microsoft Academic Search

There is significant evidence arising from experimental models that autoantibodies play a key role in the pathogenesis of inflammatory arthritis. In addition to autoantibody production, B cells efficiently present antigen to T cells, produce soluble factors, including cytokines and chemokines, and form B cell aggregates in the target organ of rheumatoid arthritis. In this review we analyze the multifaceted role

Claudia Mauri; Michael R Ehrenstein

2007-01-01

280

Geode development and multiple fractures in rheumatoid arthritis.  

PubMed

The radiological development from normal bone of geodes and subsequent fractures in phalanges of two adjacent fingers is described in a patient with classical rheumatoid arthritis. Presentation was as a septic, discharging focus, but infection was excluded; the pathology is described. PMID:3977410

Lowthian, P J; Calin, A

1985-02-01

281

Geode development and multiple fractures in rheumatoid arthritis.  

PubMed Central

The radiological development from normal bone of geodes and subsequent fractures in phalanges of two adjacent fingers is described in a patient with classical rheumatoid arthritis. Presentation was as a septic, discharging focus, but infection was excluded; the pathology is described. Images PMID:3977410

Lowthian, P J; Calin, A

1985-01-01

282

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

283

Attitude of rheumatoid arthritis patients to treatment with oral corticosteroids  

Microsoft Academic Search

Objective. To assess the attitudes of rheumatoid arthritis (RA) patients to oral corticosteroid treatment, factors influencing these views and their likely clinical impact. Methods. A cross-sectional survey of 158 consecutive RA out-patients was carried out at two centres over 2 weeks. Demography, disease duration, function (Health Assessment Questionnaire (HAQ)), erythrocyte sedimentation rate (ESR), years of formal education and social deprivation

E. Morrison; D. Crosbie; H. A. Capell

2003-01-01

284

Optimizing Long-Term Treatment of Rheumatoid Arthritis  

E-print Network

Optimizing Long-Term Treatment of Rheumatoid Arthritis with Systematic Documentation K. M. Simonic- toid arthritis. They not only experience pain, but during the course of the disease their mobility for treatment optimization and as a measure for the quality of patient outcome. Graphical data acquisition

Hammerton, James

285

Auranofin. New oral gold compound for treatment of rheumatoid arthritis  

Microsoft Academic Search

Eight patients with rheumatoid arthritis were treated with SK & F D-39162 (auranofin), a new oral gold compound which was effective in suppressing adjuvant-induced arthritis in rats. Clinical and humoral parameters were studied during a 3-month period of drug administration followed by a 3-month period under placebo. The drug was absorbed, well tolerated, and its action was manifested by a

A E Finkelstein; D T Walz; V Batista; M Mizraji; F Roisman; A Misher

1976-01-01

286

Folate supplementation and methotrexate treatment in rheumatoid arthritis: a review  

Microsoft Academic Search

Objectives. The folate antagonist methotrexate (MTX) has become established as the most commonly used disease-modifying anti-rheumatic drug (DMARD) in the treatment of rheumatoid arthritis (RA) but is commonly discontinued due to adverse effects. Adverse effects are thought to be mediated via folate antagonism. In this paper we summarize the current data on the use of folates as a supplement to

S. L. Whittle; R. A. Hughes

2003-01-01

287

A Cognitive-Behavioral Treatment for Rheumatoid Arthritis  

Microsoft Academic Search

This experiment tested a cognitive-behavioral rheumatoid arthritis treatment designed to confer skills in managing stress, pain, and other symptoms of the disease. We hypothesized that a mediator of the magnitude of treatment effects might be enhancement of perceived self-efficacy to manage the disease. It was predicted that the treatment would reduce arthritis symptoms and possibly would improve both immunologic competence

Ann O’Leary; Stanford Shoor; Kate Lorig; Halsted R. Holman

1988-01-01

288

Macrophage migration inhibitory factor in rheumatoid arthritis: clinical correlations  

Microsoft Academic Search

Objective. Cytokines play an important role in the pathology of rheumatoid arthritis (RA). Macrophage migration inhibitory factor (MIF) is a cytokine with a broad spectrum of actions, including induction of monocyte tumour necrosis factor a (TNF-a). Evidence of the expression and proinflammatory activity of MIF has recently been demonstrated in RA synovium and in animal models of RA. We wished

E. F. Morand; M. Leech; H. Weedon; C. Metz; R. Bucala; M. D. Smith

2002-01-01

289

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

290

Nonathymulin in rheumatoid arthritis: two double blind, placebo controlled trials  

Microsoft Academic Search

Two randomised double blind, placebo controlled trials have been carried out to assess the effectiveness of nonathymulin, a synthetic thymic peptide hormone, in the treatment of rheumatoid arthritis (RA) and to compare three different dosage schedules (1, 5, and 10 mg\\/day). Nonathymulin 5 mg proved to be the most efficient dose, providing significant clinical improvement as evaluated by the global

B Amor; M Dougados; C Mery; M Dardenne; J F Bach

1987-01-01

291

The epigenome of synovial fibroblasts: an underestimated therapeutic target in rheumatoid arthritis.  

PubMed

Perturbed epigenetic landscape and deregulated microRNA networks are central to the permanent activation and aggressiveness of synovial fibroblasts in rheumatoid arthritis. Current anti-cytokine therapies, although effectively halting synovitis, cannot reverse the stably activated destructive phenotype of rheumatoid arthritis synovial fibroblasts,offering rather limited protection against ongoing joint destruction in rheumatoid arthritis. Targeting the deregulated epigenome of rheumatoid arthritis synovial fibroblasts is key to developing joint-protective strategies in rheumatoid arthritis. To date, different pathogenic mechanisms have been identified that can profoundly impact the epigenetic derangements in rheumatoid arthritis synovial fibroblasts, including increased consumption of S-adenosylmethionine,a principal methyl donor in DNA methylation reactions, together with deregulation of crucial DNA- and histonemodifying enzymes. Re-establishing globally disturbed DNA methylation patterns in rheumatoid arthritis synovial fibroblasts by supplementing S-adenosylmethionine while preventing its leakage into polyamine cycles may bea promising therapeutic strategy in rheumatoid arthritis and the first epigenetic treatment to target rheumatoid arthritis synovial fibroblasts at the scene of the crime. Given the dynamic nature and reversibility of epigenetic modifications, their involvement in human diseases and recent perspectives on epigenetic therapies in cancer, epigenetic targeting of rheumatoid arthritis synovial fibroblasts should be within future reach. PMID:25165988

Frank-Bertoncelj, Mojca; Gay, Steffen

2014-01-01

292

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

E-print Network

, Environmental Energy Technologies Division, Ernest Orlando Lawrence Berkeley National Laboratory, U.S.A. http compliance tools move towards incorporating performance simulation models. U.S. energy codes, for example that handles multiple thermal and hygrothermal prescriptive codes of Austrian counties. By making

293

Early bedside care during preclinical medical education: can technology-enhanced patient simulation advance the Flexnerian ideal?  

PubMed

Flexner wanted medical students to study at the patient bedside-a remarkable innovation in his time-so that they could apply science to clinical care under the watchful eye of senior physicians. Ever since his report, medical schools have reserved the latter years of their curricula for such an "advanced" apprenticeship, providing clinical clerkship experiences only after an initial period of instruction in basic medical sciences. Although Flexner codified the segregation of preclinical and clinical instruction, he was committed to ensuring that both domains were integrated into a modern medical education. The aspiration to fully integrate preclinical and clinical instruction continues to drive medical education reform even to this day. In this article, the authors revisit the original justification for sequential preclinical-clinical instruction and argue that modern, technology-enhanced patient simulation platforms are uniquely powerful for fostering simultaneous integration of preclinical-clinical content in a way that Flexner would have applauded. To date, medical educators tend to focus on using technology-enhanced medical simulation in clinical and postgraduate medical education; few have devoted significant attention to using immersive clinical simulation among preclinical students. The authors present an argument for the use of dynamic robot-mannequins in teaching basic medical science, and describe their experience with simulator-based preclinical instruction at Harvard Medical School. They discuss common misconceptions and barriers to the approach, describe their curricular responses to the technique, and articulate a unifying theory of cognitive and emotional learning that broadens the view of what is possible, feasible, and desirable with simulator-based medical education. PMID:20107370

Gordon, James A; Hayden, Emily M; Ahmed, Rami A; Pawlowski, John B; Khoury, Kimberly N; Oriol, Nancy E

2010-02-01

294

The presence of anti-citrullinated protein antibodies (ACPA) and rheumatoid factor on patients with rheumatoid arthritis (RA) does not interfere with the chance of clinical remission in a follow-up of 3 years.  

PubMed

Autoantibodies in early rheumatoid arthritis (RA) have important diagnostic value. The association between the presence of autoantibodies against cyclic citrullinated peptide and the response to treatment is controversial. To prospectively evaluate a cohort of patients with early rheumatoid arthritis (<12 months of symptoms) in order to determine the association between serological markers (rheumatoid factor (RF), anti-citrullinated protein antibodies) such as anti-cyclic citrullinated peptide antibodies (anti-CCP) and citrullinated anti-vimentin (anti-Sa) with the occurrence of clinical remission, forty patients diagnosed with early RA at the time of diagnosis were evaluated and followed for 3 years, in use of standardized therapeutic treatment. Demographic and clinical data were recorded, disease activity score 28 (DAS 28), as well as serology tests (ELISA) for RF (IgM, IgG, and IgA), anti-CCP (CCP2, CCP3, and CCP3.1) and anti-Sa in the initial evaluation and at 3, 6, 12, 18, 24, and 36 months of follow-up. The outcome evaluated was the percentage of patients with clinical remission, which was defined by DAS 28 lower than 2.6. Comparisons were made through the Student t test, mixed-effects regression analysis, and analysis of variance (significance level of 5%). The mean age was 45 years, and a female predominance was observed (90%). At the time of diagnosis, RF was observed in 50% of cases (RF IgA-42%, RF IgG-30%, and RF IgM-50%), anti-CCP in 50% (no difference between CCP2, CCP3, and CCP3.1) and anti-Sa in 10%. After 3 years, no change in the RF prevalence and anti-CCP was observed, but the anti-Sa increased to 17.5% (P = 0.001). The percentage of patients in remission, low, moderate, and intense disease activity, according to the DAS 28, was of 0, 0, 7.5, and 92.5% (initial evaluation) and 22.5, 7.5, 32.5, and 37.5% (after 3 years). There were no associations of the presence of autoantibodies in baseline evaluation and in serial analysis with the percentage of clinical remission during follow-up of 3 years The presence of autoantibodies in early RA has no predictive value for clinical remission in early RA. PMID:22187055

da Mota, Licia Maria Henrique; Dos Santos Neto, Leopoldo Luiz; de Carvalho, Jozélio Freire; Pereira, Ivânio Alves; Burlingame, Rufus; Ménard, Henri A; Laurindo, Ieda Maria Magalhães

2012-12-01

295

Simulating the early stage of high-shear granulation using a two-dimensional Monte-Carlo approach  

Microsoft Academic Search

A two-dimensional (2-D) model of a granulation process is presented in this paper. It aims to simulate an entire granulation batch without the use of an initial experimental or fictitious 2-D density function, by taking the experimental operating conditions into account. The mass of liquid and solid in the granules are the two predicted internal variables. The 2-D population balance

M. Oullion; G. K. Reynolds; M. J. Hounslow

2009-01-01

296

Differences in early contrail evolution of two-engine versus four-engine aircraft: Lidar measurements and numerical simulations  

Microsoft Academic Search

Jet- and vortex-regime evolution of contrails behind cruising aircraft is investigated by focusing on the role of aircraft type. Cross-section measurements by ground-based lidar and observational analysis are combined with numerical simulations of fluid dynamics and microphysics in the wake of a two-engine aircraft. Depending on ambient humidity levels, contrail evolution behind short-\\/medium-range twin-turbofan airliners is classified into two scenarios,

Ralf Sussmann; Klaus M. Gierens

2001-01-01

297

Laboratory Drop Towers for the Experimental Simulation of Dust-aggregate Collisions in the Early Solar System  

PubMed Central

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, Jurgen; Beitz, Eike; Bukhari, Mohtashim; Gundlach, Bastian; Hagemann, Jan-Hendrik; Heisselmann, Daniel; Kothe, Stefan; Schrapler, Rainer; von Borstel, Ingo; Weidling, Rene

2014-01-01

298

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

299

A randomized controlled trial examining Iyengar yoga for young adults with rheumatoid arthritis: a study protocol  

Microsoft Academic Search

BACKGROUND: Rheumatoid arthritis is a chronic, disabling disease that can compromise mobility, daily functioning, and health-related quality of life, especially in older adolescents and young adults. In this project, we will compare a standardized Iyengar yoga program for young people with rheumatoid arthritis to a standard care wait-list control condition. METHODS\\/DESIGN: Seventy rheumatoid arthritis patients aged 16-35 years will be

Subhadra Evans; Laura Cousins; Jennie CI Tsao; Saskia Subramanian; Beth Sternlieb; Lonnie K Zeltzer

2011-01-01

300

Ulcerative colitis complicating seronegative HLA-A2B27 rheumatoid arthritis with sacroiliitis  

Microsoft Academic Search

The case is reported of a 50 year old man with longstanding seronegative rheumatoid arthritis who developed ulcerative colitis. The patient also had sacroiliitis and his tissue was typed as HLA-A2-B27 several years before the bowel disease began. A possible overlap between primary inflammatory bowel disease, complications to the treatment of rheumatoid arthritis with drugs, and gastrointestinal rheumatoid vasculitis is

T Klausen; K Amris; P Helin

1992-01-01

301

Methotrexate chronotherapy is effective against rheumatoid arthritis.  

PubMed

Methotrexate (MTX) is the most important drug for treating rheumatoid arthritis (RA). It has been stated that cytokines play an important role in the pathogenesis of RA, and that cytokine levels increase and show 24-h rhythms in RA patients. Previously, we found that arthritis was relieved after the administration of MTX at specific times in synchronization with the 24-h rhythm of tumor necrosis factor (TNF)-? in collagen-induced arthritis (CIA) animals. Based on our findings in an earlier study of the dosing time-dependent effects of MTX in MRL/lpr mice, which develop autoimmune disorders that share similarities with human RA, we examined here the utility of MTX chronotherapy in Japanese RA patients. In an initial animal modeling study, we collected blood from MRL/lpr mice at different times (2, 6, 10, 14, 18, or 22 hours after the light was turned on [HALO]), and we measured TNF-? mRNA expression in leukocytes. MTX was administered to the mice at two different dosing times (6 or 18 HALO), and various blood parameters were measured to estimate arthritis activity. TNF-? mRNA levels showed a clear 24-h rhythm with a peak at 22 HALO and a trough at 18 HALO after RA had developed. In these MRL/lpr mice, inflammation and TNF-? were markedly reduced when the MTX dosing time was matched to the time (18 HALO) when the TNF-? level began to increase. We then applied these findings to Japanese RA patients by switching them from the standard MTX three times/wk (day 1: after breakfast and supper; day 2: after breakfast schedule), to chronotherapy, in which the dose and number of doses/wk were not changed but MTX was administered once-a-day at bedtime. Disease Activity Score (DAS)28, modified health assessment questionnaire (MHAQ), and adverse effects were assessed. With MTX chronotherapy, DAS28, which is commonly used to quantitatively assess RA symptoms, was significantly improved at all follow-up clinical visit times compared with the baseline (vs. 1 mo: p?=?.0197, 2 mos: p?=?.0107, 3 mos: p?=?.0087). Significant symptom recovery was observed in 41.2% of patients, and 23.5% of patients achieved clinical remission during the 3 mos of follow-up. Functional capacity of RA patients, as indicated by the MHAQ, was markedly improved by chronotherapy. There were no severe adverse effects. Thus, we demonstrated (i) inflammation and plasma TNF-? concentrations were significantly reduced in MRL/lpr mice treated with MTX at 18 HALO, the time when TNF-? mRNA level began to increase; and (ii) MTX bedtime chronotherapy was safe, markedly reduced disease activity, and improved the functional capacity of RA patients. The findings on RA patients show that bedtime MTX chronotherapy can improve RA symptoms compared to the current standard dosing methods. PMID:21452922

To, Hideto; Yoshimatsu, Hiromichi; Tomonari, Mari; Ida, Hiroaki; Tsurumoto, Toshiyuki; Tsuji, Yasuhiro; Sonemoto, Emi; Shimasaki, Noriko; Koyanagi, Satoru; Sasaki, Hitoshi; Ieiri, Ichiro; Higuchi, Shun; Kawakami, Atsushi; Ueki, Yukitaka; Eguchi, Katsumi

2011-04-01

302

Database of tsunami scenario simulations for Western Iberia: a tool for the TRIDEC Project Decision Support System for tsunami early warning  

NASA Astrophysics Data System (ADS)

TRIDEC is a EU-FP7 Project whose main goal is, in general terms, to develop suitable strategies for the management of crises possibly arising in the Earth management field. The general paradigms adopted by TRIDEC to develop those strategies include intelligent information management, the capability of managing dynamically increasing volumes and dimensionality of information in complex events, and collaborative decision making in systems that are typically very loosely coupled. The two areas where TRIDEC applies and tests its strategies are tsunami early warning and industrial subsurface development. In the field of tsunami early warning, TRIDEC aims at developing a Decision Support System (DSS) that integrates 1) a set of seismic, geodetic and marine sensors devoted to the detection and characterisation of possible tsunamigenic sources and to monitoring the time and space evolution of the generated tsunami, 2) large-volume databases of pre-computed numerical tsunami scenarios, 3) a proper overall system architecture. Two test areas are dealt with in TRIDEC: the western Iberian margin and the eastern Mediterranean. In this study, we focus on the western Iberian margin with special emphasis on the Portuguese coasts. The strategy adopted in TRIDEC plans to populate two different databases, called "Virtual Scenario Database" (VSDB) and "Matching Scenario Database" (MSDB), both of which deal only with earthquake-generated tsunamis. In the VSDB we simulate numerically few large-magnitude events generated by the major known tectonic structures in the study area. Heterogeneous slip distributions on the earthquake faults are introduced to simulate events as "realistically" as possible. The members of the VSDB represent the unknowns that the TRIDEC platform must be able to recognise and match during the early crisis management phase. On the other hand, the MSDB contains a very large number (order of thousands) of tsunami simulations performed starting from many different simple earthquake sources of different magnitudes and located in the "vicinity" of the virtual scenario earthquake. In the DSS perspective, the members of the MSDB have to be suitably combined based on the information coming from the sensor networks, and the results are used during the crisis evolution phase to forecast the degree of exposition of different coastal areas. We provide examples from both databases whose members are computed by means of the in-house software called UBO-TSUFD, implementing the non-linear shallow-water equations and solving them over a set of nested grids that guarantee a suitable spatial resolution (few tens of meters) in specific, suitably chosen, coastal areas.

Armigliato, Alberto; Pagnoni, Gianluca; Zaniboni, Filippo; Tinti, Stefano

2013-04-01

303

Linkage proof for PTPN22, a rheumatoid arthritis susceptibility gene and a human autoimmunity gene  

PubMed Central

The tyrosine phosphatase PTPN22 allele 1858T has been associated with rheumatoid arthritis (RA) and other autoimmune diseases. RA is the most frequent of those multifactorial diseases. The RA association was usually restricted to serum rheumatoid factor positive disease (RF+). No interaction was shown with HLA-DRB1, the first RA gene. Many case-control studies replicated the RA association, showing an allele frequency increase of ?5% on average and large variations of population allele frequencies (2.1–15.5%). In multifactorial diseases, the final proof for a new susceptibility allele is provided by departure from Mendel's law (50% transmission from heterozygous parents). For PTPN22–1858T allele, convincing linkage proof was available only for type 1 diabetes. We aimed at providing this proof for RA. We analyzed 1,395 West European Caucasian individuals from 465 “trio” families. We replicated evidence for linkage, demonstrating departure from Mendel's law in this subset of early RA onset patients. We estimated the overtransmission of the 1858T allele in RF+ families: T = 63%, P < 0.0007. The 1858T allele frequency increased from 11.0% in controls to 17.4% in RF+ RA for the French Caucasian population and the susceptibility genotype (1858T/T or T/C) from 20.2% to 31.6% [odds ratio (OR) = 1.8 (1.2–2.8)]. In conclusion, we provided the linkage proof for the PTPN22–1858T allele and RF+ RA. With diabetes and RA, PTPN22 is therefore a “linkage-proven” autoimmunity gene. PTPN22 accounting for ?1% of the RA familial aggregation, many new genes could be expected that are as many leads to definitive therapy for autoimmune diseases. PMID:17237219

Michou, Laetitia; Lasbleiz, Sandra; Rat, Anne-Christine; Migliorini, Paola; Balsa, Alejandro; Westhovens, Rene; Barrera, Pilar; Alves, Helena; Pierlot, Celine; Glikmans, Elodie; Garnier, Sophie; Dausset, Jean; Vaz, Carlos; Fernandes, Manuela; Petit-Teixeira, Elisabeth; Lemaire, Isabelle; Pascual-Salcedo, Dora; Bombardieri, Stefano; Dequeker, Jan; Radstake, Timothy R.; Van Riel, Piet; van de Putte, Leo; Lopes-Vaz, Antonio; Prum, Bernard; Bardin, Thomas; Dieude, Philippe; Cornelis, Francois

2007-01-01

304

Linkage proof for PTPN22, a rheumatoid arthritis susceptibility gene and a human autoimmunity gene.  

PubMed

The tyrosine phosphatase PTPN22 allele 1858T has been associated with rheumatoid arthritis (RA) and other autoimmune diseases. RA is the most frequent of those multifactorial diseases. The RA association was usually restricted to serum rheumatoid factor positive disease (RF+). No interaction was shown with HLA-DRB1, the first RA gene. Many case-control studies replicated the RA association, showing an allele frequency increase of approximately 5% on average and large variations of population allele frequencies (2.1-15.5%). In multifactorial diseases, the final proof for a new susceptibility allele is provided by departure from Mendel's law (50% transmission from heterozygous parents). For PTPN22-1858T allele, convincing linkage proof was available only for type 1 diabetes. We aimed at providing this proof for RA. We analyzed 1,395 West European Caucasian individuals from 465 "trio" families. We replicated evidence for linkage, demonstrating departure from Mendel's law in this subset of early RA onset patients. We estimated the overtransmission of the 1858T allele in RF+ families: T = 63%, P < 0.0007. The 1858T allele frequency increased from 11.0% in controls to 17.4% in RF+ RA for the French Caucasian population and the susceptibility genotype (1858T/T or T/C) from 20.2% to 31.6% [odds ratio (OR) = 1.8 (1.2-2.8)]. In conclusion, we provided the linkage proof for the PTPN22-1858T allele and RF+ RA. With diabetes and RA, PTPN22 is therefore a "linkage-proven" autoimmunity gene. PTPN22 accounting for approximately 1% of the RA familial aggregation, many new genes could be expected that are as many leads to definitive therapy for autoimmune diseases. PMID:17237219

Michou, Laëtitia; Lasbleiz, Sandra; Rat, Anne-Christine; Migliorini, Paola; Balsa, Alejandro; Westhovens, René; Barrera, Pilar; Alves, Helena; Pierlot, Céline; Glikmans, Elodie; Garnier, Sophie; Dausset, Jean; Vaz, Carlos; Fernandes, Manuela; Petit-Teixeira, Elisabeth; Lemaire, Isabelle; Pascual-Salcedo, Dora; Bombardieri, Stefano; Dequeker, Jan; Radstake, Timothy R; Van Riel, Piet; van de Putte, Leo; Lopes-Vaz, Antonio; Prum, Bernard; Bardin, Thomas; Dieudé, Philippe; Cornélis, François

2007-01-30

305

The Prevalence of Bronchopulmonary Infection Among Patients with Rheumatoid Arthritis Versus Non Rheumatoid Arthritis Patients  

PubMed Central

A high frequency of bronchopulmonary infections complicating rheumatoid arthritis has been described in reports of case series. This study was undertaken to confirm and compare these finding in patients with RA and control. 117 patients with RA and 103 patients with OA/soft tissue rheumatism as controls. Study subjects were studied using their medical records available from hospitals‘ casenotes and GP data base. Details of all documented bronchopulmonary infections for the preceding year including lower and upper respiratory tract infections were recorded. Details of hospital admissions due to bronchopulmonary infection, antibiotic usage and functional capacity were also recorded. Mean age for RA was 56 and 59 for control. There were 34 males and 83 females in RA group, however, 14 males and 55 females in control group. There were at least 1 episodes of BPI in 66.7% (p<0.05) patients with RA and 48.5% in control. 69.2% (p<0.05) of subgroup patients with RA were noted to have poorer functional capacity compared to 50% in control. More RA patients with BPI (15%) (p<0.05) were admitted to hospital compared to control (3.8%). Significance findings were noted in terms of prevalence of BPI in RA patients compared to controls as well as patients with RA have severe course of BPI warranting hospitalization. RA patients with poorer functional capacity also noted to have high incidence of BPI. PMID:22589621

Arshad, Anwar; Rashid, Rozita

2008-01-01

306

Simulated Surface Energy Budgets Over the Southeastern US: The GHCC Satellite Assimilation System and the NCEP Early Eta  

NASA Technical Reports Server (NTRS)

A technique has been developed for assimilating GOES-derived skin temperature tendencies and insolation into the surface energy budget equation of a mesoscale model so that the simulated rate of temperature change closely agrees with the satellite observations. A critical assumption of the technique is that the availability of moisture (either from the soil or vegetation) is the least known term in the model's surface energy budget. Therefore, the simulated latent heat flux, which is a function of surface moisture availability, is adjusted based upon differences between the modeled and satellite-observed skin temperature tendencies. An advantage of this technique is that satellite temperature tendencies are assimilated in an energetically consistent manner that avoids energy imbalances and surface stability problems that arise from direct assimilation of surface shelter temperatures. The fact that the rate of change of the satellite skin temperature is used rather than the absolute temperature means that sensor calibration is not as critical. An advantage of this technique for short-range forecasts (0-48h) is that it does not require a complex land-surface formulation within the atmospheric model. As a result, we can avoid having to specify land surface characteristics such as vegetation resistances, green fraction, leaf area index, soil physical and hydraulic characteristics, stream flow, runoff, and the vertical and horizontal distribution of soil moisture.

Lapenta, William M.; Suggs, Ron; McNider, Richard T.; Jedlovec, Gary

1999-01-01

307

Angiogenesis and rheumatoid arthritis: pathogenic and therapeutic implications.  

PubMed Central

Rheumatoid arthritis can be considered as one of the family of 'angiogenesis dependent diseases'. Angiogenesis in rheumatoid arthritis is controlled by a variety of factors found in the synovial fluid and pannus tissue. Modulation of the angiogenic component of the disease may alter the pathogenesis of the condition, and subsequent cartilage and joint destruction, by reducing the area of the endothelium in the pannus and restricting pannus growth. Current therapeutic strategies exert, to varying extents, an inhibitory effect on the angiogenic process. In particular, the mode of action of the slow acting antirheumatic drugs may be due to their effect on the angiogenic response. The development of novel angiostatic treatments for chronic inflammatory joint disease may lead to a new therapeutic approach in controlling disease progression. PMID:1378718

Colville-Nash, P R; Scott, D L

1992-01-01

308

An extreme value theory approach for the early detection of time clusters. A simulation-based assessment and an illustration to the surveillance of Salmonella.  

PubMed

We propose a new method that could be part of a warning system for the early detection of time clusters applied to public health surveillance data. This method is based on the extreme value theory (EVT). To any new count of a particular infection reported to a surveillance system, we associate a return period that corresponds to the time that we expect to be able to see again such a level. If such a level is reached, an alarm is generated. Although standard EVT is only defined in the context of continuous observations, our approach allows to handle the case of discrete observations occurring in the public health surveillance framework. Moreover, it applies without any assumption on the underlying unknown distribution function. The performance of our method is assessed on an extensive simulation study and is illustrated on real data from Salmonella surveillance in France. Copyright © 2014 John Wiley & Sons, Ltd. PMID:25060768

Guillou, A; Kratz, M; Strat, Y Le

2014-12-10

309

Acid Phosphatase and Catheptic Activity in Rheumatoid Synovial Tissue  

Microsoft Academic Search

ACID phosphatase and cathepsin are two of the hydrolytic enzymes shown by de Duve1 to be present in the lysosomal fraction of liver, and similar particles have been shown in many other tissues2. Increases in lysosomal enzymes have been shown to be present in cases of rapid tissue breakdown3,4. The synovial tissue in a rheumatoid arthritic patient may proliferate rapidly,

Mollie Luscombe

1963-01-01

310

Course and prognosis in seropositive and seronegative rheumatoid arthritis.  

PubMed

Long since it have been suggested that a subpopulation of patients with rheumatoid arthritis (RA), diagnosed with negative rheumatoid factor (RF) tests, represents a clinical entity quite distinct from that of seropositive rheumatoid arthritis. The aim of the study was to establish a scientific comparative analysis between RA seronegative and seropositive, regarding course and prognoses of the disease. Two hundred fifty patients with rheumatoid arthritis according to the (American College of Rheumatology) criteria were retrospectively studied by analysis the course and prognoses of disease. All examinees were between 25-60 years of age (Xb=49.9, SD=10.3) with disease duration between 1-27 years (Xbox=6.41, SD=6.47). Course of the disease with "remissions and exacerbations", progressive continual course and bad prognoses, were more presented in seropositive group ofpatients. Partial remission was more common in seronegative patients but according to serostatus and gender has not shown statistically significant difference. Duration of the disease was a specific prognostic sign for both subsets [(r=0.32, p<0.01) seronegative, (r=0.22, p<0.05) seropositive], while age was only a specific prognostic sign for the seropositive subset [(r=0.01, p>0.05) seronegative, (r=0.18, p<0.05) seropositive]. Seropositive and seronegative RA distinguish in course and prognostic feature, but not enough to differentiate them in two different forms of the disease. Regarding the sero-status, differences within sex, with some exceptions, are not relevant. PMID:24003679

Sahatçiu-Meka, Vjollca; Rexhepi, Sylejman; Kukeli, Anton; Manxhuka-Kërliu, Suzana; Pallaskas, Kelmend; Murtezani, Ardiana; Rexhepi, Mjellma; Rexhepi, Blerta

2013-01-01

311

Antigen-specific T cells in rheumatoid arthritis  

Microsoft Academic Search

There is considerable evidence of a key role for CD4+ T cells in the pathogenesis of rheumatoid arthritis. Several attractive candidate antigens, mostly joint-specific, have been\\u000a studied, but information regarding T cell responses to these antigens in patients is limited and occasionally contra-dictory.\\u000a Novel reagents (such as major histocompatibility complex and peptide tetramers) and sensitive techniques (such as intracellular\\u000a cytokine

Sean R. Bennett; Michael T. Falta; Jerry Bill; Brian L. Kotzin

2003-01-01

312

Stretch reflexes and joint dynamics in rheumatoid arthritis  

Microsoft Academic Search

In clinically diagnosed rheumatoid arthritis (RA), studies were conducted to investigate the reflex and passive tissue contribution\\u000a to measured increases in joint stiffness in the resting upper limb and during constant contractions of an attached muscle.\\u000a The tonic stretch reflex was induced by a servo-controlled sinusoidal stretch perturbation of the metacarpophalangeal joint\\u000a of RA patients, and age- and sex-matched controls.

Aparna Rajagopalan; John A. Burne

2010-01-01

313

Interstitial granulomatous dermatitis in rheumatoid arthritis responsive to etanercept  

Microsoft Academic Search

Interstitial granulomatous dermatitis (IGD) is a rare dermatological condition presenting as erythematous plaques. It may\\u000a be associated with drug-related adverse reactions and autoimmune diseases. Recent cases of IGD have been reported in rheumatoid\\u000a arthritis (RA) patients treated with biologic agents. We report a case of RA patient with persistent erythematous plaques\\u000a who did not respond to traditional disease-modifying anti-rheumatic drugs

Angelo Zoli; Guido Massi; Michela Pinnelli; Chiara Di Blasi Lo Cuccio; Federica Castri; Gianfranco Ferraccioli

2010-01-01

314

Variables Related to Posttraumatic Growth in Turkish Rheumatoid Arthritis Patients  

Microsoft Academic Search

Rheumatoid arthritis (RA) is a chronic, deteriorative disease, which can cause great psychological distress. Although RA has\\u000a negative psychological consequences, it may also lead to positive changes, which has been given relatively little attention\\u000a in the research literature. The Posttraumatic Growth Inventory (PTGI) has been used to evaluate growth in survivor’s thinking,\\u000a feeling and\\/or behavior following the experiencing of traumatic

Gulay Dirik; A. Nuray Karanci

2008-01-01

315

Infectious Aspects and the Etiopathogenesis of Rheumatoid Arthritis  

Microsoft Academic Search

Infections are believed to contribute to the maturation of the immune system from the innate to the adaptive phases and therefore\\u000a may take part in the induction of autoimmune conditions. In the current study, we present an extensive analysis conducted\\u000a on sera samples of patients with rheumatoid arthritis in order to seek evidence of previous or coexisting infectious processes\\u000a using

Michal Kasher Meron; Howard Amital; Daniel Shepshelovich; Ori Barzilai; Maya Ram; Juan-Manuel Anaya; Roberto Gerli; Bizzaro Nicola; Yehuda Shoenfeld

2010-01-01

316

Excision of the ulnar head in patients with rheumatoid arthritis.  

PubMed Central

In 40 patients with rheumatoid arthritis 43 operations for excision of the ulnar head were performed. A follow-up study was performed after 35 months. In 38 patients wrist pain had disappeared completely or almost completely. The function in use, supination and pronation of the wrists, and wrist strength had all much improved. The stability of the radiocarpal joint was good after operation. Only minor complications were seen. PMID:7416818

Rasker, J J; Veldhuis, E F; Huffstadt, A J; Nienhuis, R L

1980-01-01

317

Occupational therapy in elderly patients with rheumatoid arthritis  

Microsoft Academic Search

This study aimed to assess the value of periodic review by an occupational therapist (OT) of elderly patients with rheumatoid arthritis (RA). Twenty-four patients aged over 65 years who had longstanding RA and had had at least one previous contact with an OT completed a modified health assessment questionnaire (HAQ)1.2 to give an assessment of their self perceived functional ability

CH McAlpine; E. Woodhouse; J. MacDonald; J. Hunter

1991-01-01

318

Why do Patients with Rheumatoid Arthritis use Alternative Treatments?  

Microsoft Academic Search

:   The aim of this study was to analyse the characteristics of patients with rheumatoid arthritis (RA) who make use of alternative\\u000a or complementary medicine (CM). Two hundred and sixty-two randomly chosen patients with RA filled out self-assessment health\\u000a status and pain questionnaires. Differences between the group of patients making use of both CM and conventional treatment\\u000a (n?=?52) and the

J. W. G. Jacobs; F. W. Kraaimaat; J. W. J. Bijlsma

2001-01-01

319

Permittivity and performance of dielectric pads with sintered ceramic beads in MRI: early experiments and simulations at 3 T.  

PubMed

Passive dielectric materials have been used to improve aspects of MRI by affecting the distribution of radiofrequency electromagnetic fields. Recently, interest in such materials has increased with the number of high-field MRI sites. Here, we introduce a new material composed of sintered high-permittivity ceramic beads in deuterated water. This arrangement maintains the ability to create flexible pads for conforming to individual subjects. The properties of the material are measured and the performance of the material is compared to previously used materials in both simulation and experiment at 3 T. Results show that both permittivity of the beads and effect on signal-to-noise ratio and required transmit power in MRI are greater than those of materials consisting of ceramic powder in water. Importantly, use of beads results in both higher permittivity and lower conductivity than use of powder. PMID:22890908

Luo, Wei; Lanagan, Michael T; Sica, Christopher T; Ryu, Yeunchul; Oh, Sukhoon; Ketterman, Matthew; Yang, Qing X; Collins, Christopher M

2013-07-01

320

Adalimumab reduces hand bone loss in rheumatoid arthritis independent of clinical response: Subanalysis of the PREMIER study  

E-print Network

in the treatment of rheumatoid arthritis. Anti-Tumorarthritis who had not had previous methotrexate treatment.treatment with adalimumab (a human anti-tumor necrosis factor monoclonal antibody) in patients with active rheumatoid arthritis

Hoff, Mari; Kvien, Tore K; Kälvesten, Johan; Elden, Aake; Kavanaugh, Arthur; Haugeberg, Glenn

2011-01-01

321

Adalimumab reduces hand bone loss in rheumatoid arthritis independent of clinical response: Subanalysis of the PREMIER study  

E-print Network

in the treatment of rheumatoid arthritis. Anti-Tumorprevious methotrexate treatment. Arthritis Rheum 2006, 54:treatment with adalimumab (a human anti-tumor necrosis factor monoclonal antibody) in patients with active rheumatoid arthritis

Hoff, Mari; Kvien, Tore K; Kälvesten, Johan; Elden, Aake; Kavanaugh, Arthur; Haugeberg, Glenn

2011-01-01

322

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

323

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

324

Familial rheumatoid arthritis: linkage of HLA to disease susceptibility locus in four families where proband presented with juvenile rheumatoid arthritis.  

PubMed Central

The occurrence of a chronic seronegative polyarthritis has been studied in four families in which the proband presented with some form of juvenile rheumatoid arthritis. In these families, histocompatibility testing suggested that susceptibility to arthritis was controlled by a dominant allele with variable penetrance and expressivity at the rheumatoid-like arthritis, first locus (RLA-1). The combined lod scores for the four families (2.70) indicated that the odds in favor of genetic linkage between the major histocompatibility complex and the postulated disease susceptibility gene, RLA-1, were 500:1. In one family, a recombinant event permitted localization of RLA-1 centromeric to HLA-D. Of major interest was the fact that there was significant pleomorphism in the clinical manifestations of arthritis in affected individuals. In some, symptoms first occurred in childhood and in others, in adult life. Even among those with childhood-onset arthritis, different types of juvenile rheumatoid arthritis were observed within the same family. PMID:6766468

Rossen, R D; Brewer, E J; Sharp, R M; Ott, J; Templeton, J W

1980-01-01

325

Patient-reported outcome after rheumatoid arthritis-related surgery in the lower extremities  

PubMed Central

Background and purpose Although decreasing with the development of effective pharmacological regimes, joint surgery has improved the function and quality of life of patients with rheumatoid arthritis (RA). Few studies have assessed patient-reported outcomes after RA surgery to the lower extremities. Here we report patient-relevant outcome after RA-related surgery based on the first data from the Swedish National Register of Rheuma Surgery (RAKIR). Patients and methods 258 RA patients (212 women) who had joint surgery performed at the Department of Orthopaedics, Spenshult Hospital between September 2007 and June 2009 were included. Mean age at surgery was 64 (20–86) years. The patients completed the SF-36 and HAQ questionnaires preoperatively and 6 months postoperatively, and 165 patients completed them after 12 months. Results Improvement was seen as early as at 6 months. At 12 months, 165 patients (141 women)—including hip (n = 15), knee (n = 27), foot (n = 102), and ankle (n = 21) patients—reported statistically significant improvements from preoperatively to 12 months postoperatively in HAQ (mean change: –0.11) and SF-36 subscales physical function (11), role physical (12), bodily pain (13), social functioning (6.4), and role emotional (9.4). Hip and knee patients reported the greatest improvements. Interpretation Orthopedic RA-related surgery of the lower extremities has a strong effect on pain and physical function. Improvement is evident as early as 6 months postoperatively and remains after 12 months. PMID:22206446

2012-01-01

326

Rheumatoid arthritis: a clinical overview of new diagnostic and treatment approaches.  

PubMed

Rheumatoid arthritis (RA) is the most frequent form of chronic polyarthritis, affecting 0.5-1% of adults worldwide. In recent years there have been important advances in the pathogenesis of RA, together with new diagnostic and therapeutic insights. Early diagnosis is essential in order to prevent joint damage and improve the prognosis and quality of life of patients with RA. New classification diagnostic criteria have been proposed to achieve this objective. New therapeutic strategies have proved to be effective, including early and better use of synthetic disease-modifying anti-rheumatic drugs (DMARDS), mainly methotrexate, and a treat-to-target strategy focusing on achieving remission and with tight control of the disease. In the last decade, the introduction of various biological agents in the therapeutic armamentarium of RA has changed the disease prognosis, although no definite cure is currently possible. In this chapter, we present an overview of recent advances in the epidemiology, diagnosis, prognosis and treatment of this severe but treatable disease. PMID:23574518

Sanmartí, Raimon; Ruiz-Esquide, Virginia; Hernández, Maria Victoria

2013-01-01

327

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

328

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

329

Fine Specificity, Idiotypy, and Nature of Cloned Heavy-Chain Variable Region Genes of Murine Monoclonal Rheumatoid Factor Antibodies  

Microsoft Academic Search

We investigated the immunochemical and molecular characteristics of murine monoclonal rheumatoid factors. Study of the fine specificity of 20 monoclonal rheumatoid factor antibodies shows a wide degree of heterogeneity. However, many express an interstrain cross-reactive idiotype. We show that our rheumatoid factors utilize a restricted set of the heavy-chain variable region (VH) repertoire representing the more 3' VH families. Preferential

Audrey J. Manheimer-Lory; Marc Monestier; Blanche Bellon; Frederick W. Alt; Constantin A. Bona

1986-01-01

330

Treatment of Rheumatoid Arthritis by Selective Inhibition of T-Cell Activation with Fusion Protein CTLA4Ig  

Microsoft Academic Search

conclusions In patients with active rheumatoid arthritis who were receiving methotrexate, treatment with CTLA4Ig significantly improved the signs and symptoms of rheumatoid arthritis and the health-related quality of life. CTLA4Ig is a promising new therapy for rheumatoid arthritis. abstract

Joel M. Kremer; Rene Westhovens; Marc Leon; Rieke Alten; Serge Steinfeld; Anthony Russell; Maxime Dougados; Paul Emery; Isaac F. Nuamah; G. Rhys Williams; Jean-Claude Becker; David T. Hagerty; Larry W. Moreland; Bristol-Myers Squibb

2010-01-01

331

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

332

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

333

Characterisation of T cell clonotypes that accumulated in multiple joints of patients with rheumatoid arthritis  

Microsoft Academic Search

OBJECTIVETo investigate whether identical T cell clonotypes accumulate in multiple rheumatoid joints, the clonality of T cells that had infiltrated into synovial tissue (ST) samples simultaneously obtained from multiple joints of patients with rheumatoid arthritis (RA) was analysed.METHODST cell receptor (TCR) ? gene transcripts, amplified by reverse transcription-polymerase chain reaction from ST and peripheral blood lymphocytes of five RA patients,

Manae Kurokawa; Tomohiro Kato; Kayo Masuko-Hongo; Shin-ichiro Ueda; Tetsuji Kobata; Mitsuo Okubo; Tomoe Nishimaki; Tatsuya Akaza; Shin-ich Yoshino; Reiji Kasukawa; Kusuki Nishioka; Kazuhiko Yamamoto

1999-01-01

334

Pneumoconiose reumatoide (síndrome de Caplan) com apresentação clássica* Rheumatoid pneumoconiosis (Caplan's syndrome) with a classical presentation  

Microsoft Academic Search

Although rare, rheumatoid pneumoconiosis, also known as Caplan's syndrome, can occur in workers exposed to silica, as well as in patients with silicosis, coal workers' pneumoconiosis or asbestosis. Prevalence is higher among patients with silicosis, despite the fact that it was originally described in coal workers with pneumoconiosis. The classical finding that defines this syndrome is that of rheumatoid nodules

Eduardo Mello De Capitani; Marcelo Schweller; Cristiane Mendes da Silva; Konradin Metze; Elza Maria Figueiras; Pedreira de Cerqueira; Manoel Barros Bértolo

2009-01-01

335

Rheumatoid arthritis in workers exposed to silica in the pottery industry  

Microsoft Academic Search

OBJECTIVETo investigate the relation between rheumatoid arthritis and occupational exposure to silica in pottery and related industries.METHODSMedical records of 8325 men and women born 1916–45 and employed in pottery, refractory material (aluminosilicate or silica), and sandstone industries were examined to identify cases of rheumatoid arthritis. Medical and employment histories were extracted for cases and matched referents. Indices of duration, cumulative

Susan Turner; Nicola Cherry

2000-01-01

336

Geode of the femur: an uncommon manifestation potentially reflecting the pathogenesis of rheumatoid arthritis.  

PubMed

Geodes are noted frequently in rheumatoid arthritis (RA), but large geodes of the femur are uncommon. We describe a patient with RA and a large geode in his femur; histological findings were consistent with a rheumatoid nodule and chronically inflamed synovium. We review the literature of large femoral geodes and what this particular manifestation may reflect about the pathogenesis of RA. PMID:17080513

Lee, Wonuk; Terk, Michael R; Hu, Bing; Garber, Elayne K; Weisman, Michael H

2006-12-01

337

A single tumor necrosis factor haplotype influences response to adalimumab in rheumatoid arthritis  

E-print Network

1 A single tumor necrosis factor haplotype influences response to adalimumab in rheumatoid by the Club Rhumatismes et Inflammation with a grant from Abbott France. Key words: TNF, adalimumab are geneticpredictors of response to adalimumab (ADA) in rheumatoid arthritis (RA). Methods. This ancillary study

Paris-Sud XI, Université de

338

[Mixed neuropathies in rheumatoid arthritis. Motor and sensory nerve conduction velocities].  

PubMed

Nerve conduction studies and analysis of the sensory action potential (110 nerves investigated) demons treated abnormalities in 15 to 20 patients with rheumatoid arthritis. It is concluded that moderate, often subclinical peripheral neuropathy is a common complication in rheumatoid arthritis. PMID:184511

Frenay, J; Goor, C; Kievitis, J H; Endtz, J

1976-01-01

339

Apolipoprotein A-I and platelet factor 4 are biomarkers for Infliximab response in Rheumatoid Arthritis  

E-print Network

: rheumatoid arthritis, SELDI-TOF-MS, infliximab, biomarkers, treatment response Word count: 3000 inserm improved the treatment of rheumatoid arthritis (RA). However, factors predictive of therapeutic response Arthritis Candice Trocmé1,2 (PhD), Hubert Marotte3 (MD, PhD), Athan Baillet1,5 , Béatrice Pallot- Prades4

Paris-Sud XI, Université de

340

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 approaches to stratify patients into severity of illness prior to, and after receiving treatment. Keywords

Payeur, Pierre

341

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

342

PTPRC rheumatoid arthritis risk allele is also associated with response to anti-TNF therapy  

E-print Network

is a mainstay of treatment in rheumatoid arthritis (RA). The aim of our study is to test established RA geneticPTPRC rheumatoid arthritis risk allele is also associated with response to anti- TNF therapy Jing Research Center for Arthritis, Department of Medicine, University of California, San Francisco, California

Raychaudhuri, Soumya

343

Low-Dose Methotrexate: A Mainstay in the Treatment of Rheumatoid Arthritis  

Microsoft Academic Search

Methotrexate administered weekly in low doses is a mainstay in the therapy of rheumatoid arthritis. Although originally developed as a folate an- tagonist for the treatment of cancer, its mechanism of action in the therapy of rheumatoid arthritis remains less clear. Several mechanisms have been proposed including inhibition of T cell proliferation via its ef- fects on purine and pyrimidine

BRUCE N. CRONSTEIN

2005-01-01

344

Angiotensin converting enzyme in human synovium: increased stromal [125I]351A binding in rheumatoid arthritis  

Microsoft Academic Search

OBJECTIVETo determine whether tissue angiotensin converting enzyme (ACE) is increased in synovia from patients with rheumatoid arthritis, osteoarthritis or chondromalacia patellae.METHODSSections of synovia from patients with rheumatoid arthritis (n = 7), osteoarthritis (n = 7) or chondromalacia patellae (n = 6) were tested for immunoreactivity for ACE, and for binding of the ACE inhibitor [125I]351A. The amount of ACE was

David Andrew Walsh; John Catravas; John Wharton

2000-01-01

345

Multicentric Castleman's disease associated with rheumatoid arthritis: a possible role of hepatitis B antigen.  

PubMed Central

A patient with seropositive rheumatoid arthritis and a carrier of hepatitis B surface antigen developed angiofollicular hyperplasia (multicentric Castleman's disease). The hepatitis B virus and the rheumatoid factor may have had a role in the aetiology of this lymphatic disorder. The development of Castleman's disease in association with these factors may provide another clue supporting the reactive nature of this disease. Images PMID:2712614

Ben-Chetrit, E; Flusser, D; Okon, E; Ackerman, Z; Rubinow, A

1989-01-01

346

A Genomewide Screen in Multiplex Rheumatoid Arthritis Families Suggests Genetic Overlap with Other Autoimmune Diseases  

Microsoft Academic Search

Rheumatoid arthritis (RA) is an autoimmune\\/inflammatory disorder with a complex genetic component. We report the first major genomewide screen of multiplex families with RA gathered in the United States. The North American Rheumatoid Arthritis Consortium, using well-defined clinical criteria, has collected 257 families containing 301 affected sibling pairs with RA. A genome screen for allele sharing was performed, using

Damini Jawaheer; Michael F. Seldin; Christopher I. Amos; Wei V. Chen; Russell Shigeta; Joanita Monteiro; Marlene Kern; Lindsey A. Criswell; Salvatore Albani; J. Lee Nelson; Daniel O. Clegg; Richard Pope; Harry W. Schroeder; S. Louis Bridges; David S. Pisetsky; Ryk Ward; Daniel L. Kastner; Ronald L. Wilder; Theodore Pincus; Leigh F. Callahan; Donald Flemming; Mark H. Wener; Peter K. Gregersen

2001-01-01

347

Time-resolved Study of Early-stage Formation of Iron Oxyhydroxide Nanoparticles in Simulated Acid Mine Drainage (AMD) Solutions  

NASA Astrophysics Data System (ADS)

Early stage development of ferric iron oxyhydroxide (FeOOH) nanoparticles from bicarbonate-neutralized Fe2(SO4)3 solutions was investigated using time-resolved UV-Vis spectroscopy and quick extended X-ray absorption fine structure (Q-EXAFS) spectroscopy. Two neutralization ratio ( h =[HCO3-]/[Fe3+]) of 1 and 2 were used. The neutralized systems changed visually from transparent solutions after the base addition to blurry and then opaque suspensions at extended reaction time. For the h=1 solution, its absorbance measured at 600 nm (due to scattering because of no absorption bands at this wavelength) increased quickly within initial 10 min, slightly between 10 - 26 min, and explosively afterwards. These three stages have been previously ascribed to hydrolysis and initial condensation, condensation, and aggregation processes, respectively. For the h=2 solution, only the two later evolution stages were recorded. UV-Vis spectra of the h=1 solution show that three absorption bands, likely resulting from Fe3+-sulfate species, gradually disappeared with the increase of reaction time and were not visible at about 10 min. Meanwhile, an electron pair transition (EPT) band centered at 485 nm emerged and gradually grew in its amplitude, indicating particles of a FeOOH phase being formed. For h=2, the three bands were not observed, but the EPT band at 485 nm was pronounced in the first collected spectrum and also grew with time, indicating that FeOOH particles were already formed from the very beginning. In addition, in both of the h=1 and 2 solutions the bands around 370 - 400 nm shifted to higher wavelength, suggesting that FeOOH particle size increased with time. Time-resolved Q-EXAFS spectra were collected every 2 s and were averaged over 15 consecutive scans, resulting in a time resolution of 30 s. For the h=1 solution, the EXAFS radial structural functions (RSF) initially had no or very weak peaks at positions corresponding to edge- and corner-sharing Fe shells. After 10 min of reaction time, the two Fe shells became obvious. This corroborates with the UV-Vis analysis that Fe-sulfate clusters were present at the beginning and FeOOH particles emerged later. For the h=2 solution, RSF shows high amplitudes of the two Fe shells in the first EXAFS spectrum. The amplitudes significantly grew with time, consistent with increasing Fe coordination numbers obtained by EXAFS shell-by-shell fitting. The EXAFS fitting also shows that the second Fe-Fe distance decreased from 3.41 to 3.36 Å with time while the first Fe-Fe distance was almost constant at 3.03 Å. X-ray diffraction identified the final precipitates as schwertmannite, a FeOOH phase containing structural sulfate.

Zhu, M.; Legg, B.; Zhang, H.; Waychunas, G. A.; Banfield, J. F.

2011-12-01

348

Rheumatoid arthritis educational series: a nurse-led project.  

PubMed

Nurses in the rheumatology clinic at New York University Hospital for Joint Diseases realized a need to provide patients with rheumatoid arthritis with more healthcare information than was routinely given during clinic visits. This project goal was to support patient involvement in decision making and encourage participation in treatment planning. To address these concerns, a team of staff registered nurses developed an educational program based on various arthritis-related topics. This article shares the experiences of these nurses as they developed and led a patient education project. Various elements of the project are discussed, including institutional history, program needs, project start-up, challenges, outcomes, and the lessons learned. PMID:22828520

Lemon, Joyce; Marichal-Williams, Blanca; Blum, Eileen; Bracero, Maria

2012-01-01

349

Cellular targets of interleukin-18 in rheumatoid arthritis  

PubMed Central

Recent data are presented which indicate a critical role for interleukin (IL)?18 in rheumatoid arthritis (RA). The T cells and macrophages invading the synovium or in the synovial fluid are the chief cellular targets of IL?18 in RA. Neutrophils, dendritic cells and endothelial cells may also be cellular mediators of IL?18. The direct effect of IL?18 on fibroblast?like synoviocytes or chondrocytes may not be essential or important. In RA, IL?18, which is mainly produced by macrophages, activates T cells and macrophages to produce proinflammatory cytokines, chemokines, adhesion molecules and RANKL which, in turn, perpetuate chronic inflammation and induce bone and cartilage destruction. PMID:17502360

Dai, Sheng-Ming; Shan, Zheng-Zheng; Xu, Huji; Nishioka, Kusuki

2007-01-01

350

p53 in rheumatoid arthritis: friend or foe?  

Microsoft Academic Search

The knowledge of transcription factors and proto-oncogenes has\\u0009\\u0009\\u0009 influenced the understanding of cell regulation, cell cycle, and apoptotic cell death in rheumatoid arthritis (RA)\\u0009\\u0009\\u0009 synovium. In addition, the development of normal synovial fibroblasts into\\u0009\\u0009\\u0009 transformed-appearing aggressive synovial fibroblasts may be triggered by the\\u0009\\u0009\\u0009 lack of antiproliferative factors, such as p53, p53-associated molecules, other\\u0009\\u0009\\u0009 tumor suppressors, as well as by upregulation

Ulf Müller-Ladner; Kusuki Nishioka

2000-01-01

351

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

352

Relation between bone erosions and rheumatoid factor isotypes.  

PubMed Central

Total rheumatoid factor (RF) activity and individual RF isotypes were measured in 62 patients with rheumatic diseases. Retrospective analysis of available x rays showed an association between IgA RF and the occurrence of periarticular bone erosions in hands. In contrast, IgG RF and IgM RF did not show any significant association with erosions. Furthermore, a close correlation was observed between the RF isotype levels in simultaneously drawn serum and synovial fluid samples. The possible significance of IgA RF in the pathogenesis of bone erosions is discussed. PMID:3592799

Arnason, J A; Jonsson, T; Brekkan, A; Sigurjonsson, K; Valdimarsson, H

1987-01-01

353

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

354

Poor Survival in Rheumatoid Arthritis Associated with Bronchiectasis: A Family-Based Cohort Study  

PubMed Central

Background Diffuse bronchiectasis (DB) may occur in rheumatoid arthritis (RA). CFTR (cystic fibrosis transmembrane conductance regulator) mutations predispose RA patients to DB, but the prognosis of RA-associated DB (RA-DB) is unclear. Methods We report long-term mortality data from a nationwide family-based association study of patients with RA only, DB only or RA-DB. We assessed mortality as a function of clinical characteristics and CF/CFTR-RD (CFTR-related disorders) mutations in 137 subjects from 24 kindreds. Potential risk factors were investigated by Cox proportional-hazard analysis with shared Gaussian random effects to account for within-family correlations. Results During a median follow-up of 11 years after inclusion, 18 patients died, mostly from cardiorespiratory causes. Survival was significantly lower for RA-DB patients than for unaffected relatives and for patients with RA or DB only. RA patients with DB had also a poorer prognosis in terms of survival after RA diagnosis (HR, 8.6; 95% CI, 1.5–48.2; P?=?0.014) and from birth (HR, 9.6; 95% CI, 1.1–81.7; P?=?0.039). Early onset of DB (HR, 15.4; 95% CI, 2.1–113.2; P?=?0.007) and CF/CFTR-RD mutation (HR, 7.2; 95% CI, 1.4–37.1; P?=?0.018) were associated with poorer survival in patients with RA-DB. Thus, CF/CFTR-RD mutations in RA patients with early-onset DB defined a subgroup of high-risk patients with higher mortality rates (log-rank test P?=?1.28×10?5). Conclusion DB is associated with poorer survival in patients with RA. Early-onset DB and CFTR mutations are two markers that identify RA patients at a high risk of death, for whom future therapeutic interventions should be designed and evaluated. PMID:25310716

Puechal, Xavier; Genin, Emmanuelle; Bienvenu, Thierry; Le Jeunne, Claire; Dusser, Daniel J.

2014-01-01

355

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

356

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

NASA Astrophysics Data System (ADS)

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.; Nishikawa, K.-I.; Choi, C. R.

2014-07-01

357

Immune complexes in sera and synovial fluids of patients with rheumatoid arthritis. Radioimmunoassay with monocylonal rheumatoid factor.  

PubMed Central

Evidence for the presence of immune complexes in blood, synovial fluid, and tisues of patients with rheumatoid arthritis (RA) includes low complement levels in blood and effusions, deposition of immunoreactants in tissues and vessel walls, precipitate formation after addition of monoclonal rheumatoid factor (mRF) to serum or synovial fluid. To quantitate immune complex-like material in RA patients, we developed a radioimmunoassay based on inhibition by test samples of the interaction of (125I)aggregated IgG (agg IgG) and mRF coupled to cellulose. This method could measure immune complexes of human antibody with hemocyanine prepared in vitro. The assay was not influenced by presence of polyclonal RF in test samples, nor by freezing and thawing. Normal levels of immune complex-like material in serum were less than 25 mug agg IgG EQ/ML. 12 of 51 RA sera examined (26%) contained more than 25 mug/ml. The presence of this material in RA sera was found to correlate with severity of disease, as measured by anatomical stage and functional class. There was an inverse correlation of the material with serum C4 level. Rheumatoid synovial fluids generally contained higher levels than serum, and five of 23 contained very much higher levels. The frequency of elevated levels of immune complex-like material in sera of patients with systemic lupus erythematosus (2 of 29) and with miscellaneous vasculitides (2 of 21 was much lower than in RA, suggesting that mRF exhibits a specificity for only certain kinds of immune complexes. The reason for this apparent specificity may explain such distinctive features of RA as the high frequency of polyclonal RF, the lack of immune complex nephritis, and the generally normal levels of serum complement. Images PMID:125289

Luthra, H S; McDuffie, F C; Hunder, G G; Samayoa, E A

1975-01-01

358

A new classification of HLA-DRB1 alleles differentiates predisposing and protective alleles for autoantibody production in rheumatoid arthritis  

PubMed Central

The HLA-DRB1 gene was reported to be associated with anticitrullinated protein/peptide autoantibody (ACPA) production in rheumatoid arthritis (RA) patients. A new classification of HLA-DRB1 alleles, reshaping the shared epitope (SE) hypothesis, was recently found relevant in terms of RA susceptibility and structural severity. We investigated the relevance of this new classification of HLA-DRB1 SE+ alleles in terms of rheumatoid factor (RF) and ACPA production in a sample of French RA patients. We studied 160 early RA patients included in a prospective longitudinal cohort of French Caucasian patients with recent-onset arthritis. RF, anticyclic citrullinated peptide 2 (anti-CCP2) and antideiminated human fibrinogen autoantibodies (AhFibA) were assessed in all patients at inclusion. The HLA-DRB1 gene was typed by PCR-sequence specific oligonucleotides probes (PCR-SSOP), and SE+ alleles were classified into four groups (S1, S2, S3P, S3D) according to the new classification. The new classification of HLA-DRB1 SE+ alleles distinguishes predisposing and protective alleles for RF, anti-CCP2 or AhFibA production. The presence of S2 or S3P alleles is associated with both RF, anti-CCP2 or AhFibA positivity, whereas the presence of S3D or S1 alleles appears to be protective for RF, anti-CCP2 or AhFibA positivity. The new classification of HLA-DRB1 SE+ alleles is relevant in terms of autoantibody production in early RA patients by differentiating predisposing and protective alleles for RF or ACPA production. PMID:17328818

Gourraud, Pierre-Antoine; Dieude, Philippe; Boyer, Jean-Frederic; Nogueira, Leonor; Cambon-Thomsen, Anne; Mazieres, Bernard; Cornelis, Francois; Serre, Guy; Cantagrel, Alain; Constantin, Arnaud

2007-01-01

359

Vitamin D status and its associations with disease activity and severity in African Americans with recent onset rheumatoid arthritis  

PubMed Central

Objective To examine the prevalence of vitamin D insufficiency and the associations of vitamin D concentration with disease status in African Americans with rheumatoid arthritis (RA). Methods Study participants (n = 266) were enrolled in the Consortium for the Longitudinal Evaluation of African Americans with Early RA (CLEAR) Registry. 25(OH)-D was measured on baseline plasma and associations of 25(OH)-D with disease status (baseline and at 3 years disease duration) were examined using univariate and multivariate regression. Results The prevalence of 25(OH)-D insufficiency (? 37.5 nmol/L or 15 ng/ml) was 50%, with the highest prevalence in winter. In unadjusted analyses, vitamin D concentrations were inversely associated with baseline pain (p = 0.04), swollen joints (p = 0.04), and Disease Activity Score (DAS-28, p = 0.05) but not with measures at 3 years disease duration. There were no multivariate associations of 25(OH)-D with any disease measures at baseline or at 3 years with the exception of a positive borderline association with rheumatoid factor positivity at enrollment (p = 0.05). Conclusions Vitamin D insufficiency is common in African Americans with recent-onset RA. Unadjusted associations of circulating vitamin D with baseline pain, swollen joints, and DAS-28 were explained by differences in season, age, and gender and were not significant in multivariate analyses. In contrast to reports of Northern Europeans with early inflammatory arthritis, there are not strong associations of 25(OH)-D concentration with symptoms or disease severity in African Americans with RA. PMID:20032100

Craig, Steven M.; Yu, Fang; Curtis, Jeffrey R.; Alarcon, Graciela S.; Conn, Doyt L.; Jonas, Beth; Callahan, Leigh F.; Smith, Edwin A.; Moreland, Larry W.; Bridges, S. Louis; Mikuls, Ted R.

2011-01-01

360

Ethnogenetic heterogeneity of rheumatoid arthritis-implications for pathogenesis.  

PubMed

Autoimmune diseases such as rheumatoid arthritis and systemic lupus erythematosus are generally considered multifactorial-that is, they involve both genetic and environmental factors. Technical advances in human genetics over the past 5 years have enabled the survey of the entire human genome for disease susceptibility genes and have contributed to a greater understanding of the molecular mechanisms underlying autoimmunity. Among the genetic predisposition factors identified to date, some variants have been found to be restricted to specific ethnic groups, which might reflect migration history and the natural selection that shaped genetic variation in these populations. Other genetic factors could also have exerted different magnitudes of risk for the disease among the different populations, which might be explained by their interactions with other genetic and environmental factors. These pieces of evidence suggest that substantial heterogeneity exists in the genetics underlying autoimmunity among different ethnic populations. This Review discusses the genetic heterogeneity in autoimmunity, with a focus on rheumatoid arthritis, between Asian and European populations. In addition to the most-studied and well-characterized gene HLA-DRB1, we will also describe examples of the gene-environment interactions between PADI4 and smoking, and the gene-gene interactions between PTPN22 and FCRL3. PMID:20234359

Kochi, Yuta; Suzuki, Akari; Yamada, Ryo; Yamamoto, Kazuhiko

2010-05-01

361

Therapy gloves for patients with rheumatoid arthritis: a review  

PubMed Central

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.

Troynikov, Olga; Massy-Westropp, Nicola

2014-01-01

362

Lysosomal ?-glucuronidase regulates Lyme and rheumatoid arthritis severity.  

PubMed

Lyme disease, caused by the spirochete Borrelia burgdorferi, is the most prevalent arthropod-borne illness in the United States and remains a clinical and social challenge. The spectrum of disease severity among infected patients suggests that host genetics contribute to pathogenic outcomes, particularly in patients who develop arthritis. Using a forward genetics approach, we identified the lysosomal enzyme ?-glucuronidase (GUSB), a member of a large family of coregulated lysosomal enzymes, as a key regulator of Lyme-associated arthritis severity. Severely arthritic C3H mice possessed a naturally occurring hypomorphic allele, Gusbh. C57BL/6 mice congenic for the C3H Gusb allele were prone to increased Lyme-associated arthritis severity. Radiation chimera experiments revealed that resident joint cells drive arthritis susceptibility. C3H mice expressing WT Gusb as a transgene were protected from severe Lyme arthritis. Importantly, the Gusbh allele also exacerbated disease in a serum transfer model of rheumatoid arthritis. A known GUSB function is the prevention of lysosomal accumulation of glycosaminoglycans (GAGs). Development of Lyme and rheumatoid arthritis in Gusbh-expressing mice was associated with heightened accumulation of GAGs in joint tissue. We propose that GUSB modulates arthritis pathogenesis by preventing accumulation of proinflammatory GAGs within inflamed joint tissue, a trait that may be shared by other lysosomal exoglycosidases. PMID:24334460

Bramwell, Kenneth K C; Ma, Ying; Weis, John H; Chen, Xinjian; Zachary, James F; Teuscher, Cory; Weis, Janis J

2014-01-01

363

Drug trial in rheumatoid arthritis: a new design.  

PubMed

The comparative efficacy and safety of naproxen and ibuprofen were studied in 64 patients with rheumatoid arthritis. A new trial design with three aspirin periods interspersed during the study was used. By passing a smooth curve through the values obtained for the various measures of disease activity during the aspirin periods, one could calculate the difference between what would have been expected on aspirin therapy and what was found during therapy with the two trial drugs. These differences, or "incremental values," allowed each patient's variations to be analyzed individually, thus eliminating the necessity of assuming that a patient's disease was constant. Napoxen and ibuprofen were comparable in efficacy to each other and to aspirin, but both drugs caused significantly less severe side effects than aspirin. Although analysis of the incremental values showed essentially the same results as a standard analysis of the raw data with only a modest increase in sensitivity in this particular study, the novel trial design may prove useful in future drug studies in patients with rheumatoid arthritis and other chronic but fluctuating diseases. PMID:340113

Arendt-Racine, E C; Atkinson, M H; Decoteau, W E; Flatt, V L; Varady, J

1978-02-01

364

Does rheumatoid arthritis represent an adaptive, thrifty condition?  

PubMed

The present article presents epidemiological, and comparative evidence supporting the hypothesis that rheumatoid arthritis (RA) may represent a thrifty adaptation selected to compel animals to minimize voluntary energy expenditure. The autoimmune, pathophysiological manifestations underlying RA are framed here as constituting an evolved, protective mechanism that would have influenced animals to avoid exertion and maintain a sedentary lifestyle in order to minimize metabolic output and ultimately escape starvation. Arthritic pain is characterized here as a defensive, innate signal much like fatigue, fever, nausea and reflexive pain, and like these, is seen on a continuum varying between imperceptible encumbrance and debilitating disability. The epigenetic relationship between acute psychological stress and flare-up of arthritic symptoms is examined and taken to suggest that arthritis may be a predictive, adaptive response to severe stress allowing reductions in metabolism to follow adverse conditions or nutritional scarcity. The close associations between rheumatoid arthritis and the metabolic syndrome are also explored along with potential ties to the "thrifty genotype" and "thrifty phenotype" phenomena. This hypothesis is examined in the contexts of evolutionary medicine, phenotypic plasticity, the stress response and the bioenergetics of thrift. A brief and exploratory review of pertinent evidence suggests that RA, its subclinical manifestations, and even other forms of arthropathy may possibly represent adaptations that promoted metabolic thrift during our evolutionary past. PMID:19716239

Reser, Jared E; Reser, William W

2010-01-01

365

Determinants of direct costs in Dutch rheumatoid arthritis patients  

PubMed Central

Objectives: To estimate annual direct costs in four distinct disease duration groups (0 to ?2, 2 to ?6, 6 to ?10, and >10 years) of patients with rheumatoid arthritis (RA), to determine predictors of high costs and to describe characteristics of patients with high and with low costs. Methods: A questionnaire assessing RA related care and resource utilisation rates and costs was completed by 615 RA patients. Predictive variables for incurred costs, as observed during the first year after disease onset, were determined in a subgroup of patients (n = 347). Results: Mean (median) annual direct costs for the four groups with increasing disease duration were respectively: €5235 (2923), €3930 (1968), €4664 (1952), and €8243 (3778), (p < 0.05). During the first 2 years of the disease total direct costs comprised mainly of consultations with heatlhcare workers (28%). After 10 years, devices and adaptations were the main contributors (40%) to total costs. Positive rheumatoid factor results at the time of diagnosis and deterioration of functional disability in the first year of disease were predictors of high costs later on in the course of the disease. Conclusion: Annual direct costs among patients with a disease duration of less than 2 years tend to be lower among patients with a disease duration of between 2 and 10 years than among patients with a disease duration of more than 10 years. In addition, the proportional distribution of different cost categories to total costs increases with with increasing disease duration. PMID:15194577

Verstappen, S; Verkleij, H; Bijlsma, J; Buskens, E; Kruize, A; Heurkens, A; van der Veen, M J; Jacobs, J

2004-01-01

366

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

367

Emerging Role of Endosomal Toll-Like Receptors in Rheumatoid Arthritis  

PubMed Central

Toll-like receptors (TLRs) and their downstream signaling pathways have been comprehensively characterized in innate immunity. In addition to this function, these receptors have also been suggested to be involved in the pathogenesis of many autoimmune diseases, including rheumatoid arthritis (RA). Murine in vivo models and human in vitro tissue models of RA have provided a wealth of information on the potential activity of TLRs and components of the downstream signaling pathways. Whilst most early work investigated the cell surface TLRs, more recently the focus has moved to the endosomal TLRs 3, 7, 8, and 9. These receptors recognize self and foreign double-stranded RNA and single-stranded RNA and DNA. The development of therapeutics to inhibit the endosomal TLRs or components of their signaling cascades may represent a way to target inflammation upstream of cytokine production. This may allow for greater specificity than existing therapies including cytokine blockade. Here, we review the current information suggesting a role for the endosomal TLRs in RA pathogenesis and the efforts to target these receptors therapeutically. PMID:24474949

Thwaites, Ryan; Chamberlain, Giselle; Sacre, Sandra

2013-01-01

368

The role of endothelial function and its assessment in rheumatoid arthritis.  

PubMed

Patients with rheumatoid arthritis (RA) have a reduced life expectancy when compared with the general population, largely attributable to cardiovascular disease. Factors that contribute to this increased cardiovascular risk include traditional risk factors, which account for only part of the excess, along with manifestations of the disease itself. RA is characterized by inflammation, which also is a key component in the development of atherosclerosis. Inflammation leads to the activation of endothelial cells, which, through an increase in the expression of leukocyte adhesion molecules, promotes a pro-atherosclerotic environment. Endothelial dysfunction is an early preclinical marker of atherosclerosis, and is commonly found in patients with RA. Several methods are available for the assessment of endothelial function, such as flow-mediated dilatation and laser Doppler flowmetry combined with iontophoresis, each with its own advantages and limitations. Studies have shown that endothelial dysfunction in RA is closely associated with inflammation, and therapeutic reduction of inflammation leads to improvements in endothelial function. As such, assessments of endothelial function could prove to be useful tools in the identification and monitoring of cardiovascular risk in patients with RA. Given the increase in cardiovascular mortality associated with RA, effective management must involve prevention of cardiovascular risk, in addition to control of disease activity and inflammation. PMID:20351705

Khan, Faisel; Galarraga, Bernat; Belch, Jill J F

2010-05-01

369

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

370

EGF rs11568835 G/A polymorphism is associated with increased risk of rheumatoid arthritis.  

PubMed

Abstract Rheumatoid arthritis (RA) is an autoimmune rheumatological disease thought to have substantial genetic contributions. Epidermal growth factor (EGF) can activate DNA synthesis and cellular proliferation. Early RA synovial fluid was characterized by significantly elevated levels stromal cell and macrophage-related cytokines including EGF. We therefore hypothesized that EGF polymorphisms may contribute to RA susceptibility in the Chinese population. We studied EGF rs11568835 G/A and EGF rs3756261 T/C polymorphisms in 520 patients with RA and 520 controls in a Chinese population. When the EGF rs11568835 GG homozygote genotype was used as the reference group, the AA genotype was associated with an increased risk for RA (AA versus GG, odds ratio [OR]?=?3.64, 95% confidence interval [CI]?=?1.19-11.17, p?=?0.024), the GA or GA/AA genotype was not associated with the risk for RA (GA versus GG, OR?=?0.99, 95% CI?=?0.75-1.31, p?=?0.931; GA?+?AA versus GG, OR?=?1.06, 95% CI?=?0.81-1.40, p?=?0.659). EGF rs3756261 T/C was not associated with susceptibility to RA. These results provide the first positive evidence for an association between EGF rs11568835 G/A polymorphism and RA. PMID:25089940

Wang, Liqun; Bo, Lin; Yan, Ting; Zhang, Hui; Zhou, Guoxin; Liu, Ruiping

2014-11-01

371

Pathogenetic, clinical and pharmaco-economic assessment in rheumatoid arthritis (RA).  

PubMed

Rheumatoid arthritis (RA) has become one of the most studied autoimmune chronic inflammatory diseases (ACIDs), either from the pathogenetic or from the therapeutic point of view. It is recognized that synovial fibroblasts, TH1 and TH17 cells likely play along with the B cells the most relevant role. The disease has a polygenic background that characterizes the seropositive and the seronegative subsets. Over the years, we realized that no more than 15-20% of long-standing RA (LSRA) treated with conventional drugs can reach full remission, whereas the most recent data in early RA (ERA) have demonstrated that 40-60% can be put into clinical and biological remission. This of course is of crucial importance to avoid any progression of the structural damage that leads to functional disability. If we consider that a disability index score (Health Assessment Questionnaire 0-3) of a severe arthritis can cost up to 21,000 EUs, while a mild disease will cost not more than 5,500 EUs per year, it appears very clear that a low disease activity (LDA) or a remission state (Rem) should be the aim in each single patient, in order to keep the workability and maintain the productivity. This is and should be the major aim in each RA patient. PMID:22009608

Ferraccioli, Gianfranco; Gremese, Elisa

2011-10-01

372

Acute lymphoblastic leukemia masquerading as juvenile rheumatoid arthritis: diagnostic pitfall and association with survival.  

PubMed

Acute lymphoblastic leukemia (ALL) often presents with osteoarthritic manifestations which may lead to misdiagnosis with juvenile rheumatoid arthritis (JRA). This study was designed to identify ALL patients with initial diagnosis of JRA, compare their clinicolaboratory characteristics and outcome with other ALL patients treated at our center. Case records of 762 patients with ALL were analyzed. Information regarding the clinical-demographic profile, therapy and outcome were recorded. Of the children, 49 (6.4%) had initial presentation mimicking JRA. Asymmetric oligoarthritis was the most common pattern of joint involvement. Majority presented with fever, pallor, arthritis, night pain, and bone pain. None of the routine prognostic factors including age, gender, lymphadenopathy, hepatosplenomegaly, total leukocytes count (TLC), and platelet count were significantly associated with relapse/death. The mean symptom-presentation interval (SPI), hemoglobin was significantly higher whilst the TLC was significantly lower in these patients compared to other ALL patients. The 5 year overall-survival was better than other patients with ALL (p = 0.06, by logrank test). Significantly longer SPI in these patients underscores the need for prompt and early investigations to rule out ALL in patients of JRA with atypical features and pointers of ALL. Children with ALL-mimicking JRA may belong to a subgroup of ALL with a better prognosis. PMID:19727722

Marwaha, Ram Kumar; Kulkarni, Ketan Prasad; Bansal, Deepak; Trehan, Amita

2010-03-01

373

Biochemical Markers of Bone Turnover Associated with Calcium Supplementation in Children with Juvenile Rheumatoid Arthritis  

PubMed Central

OBJECTIVE To determine the effects of calcium supplementation on bone physiology in corticosteroid-free juvenile rheumatoid arthritis (JRA) children by measuring serum and urinary bone-related hormones, minerals, bone formation and resorption markers. METHODS In this double-blind trial, patients were randomized to receive daily oral supplementation of 1000 mg of calcium and 400 IU vitamin D or placebo and 400 IU vitamin D for 24 months. The physiologic effect of calcium supplementation on bone physiology was followed periodically using markers of bone turnover. RESULTS 198 patients met inclusion criteria and were followed in the study. At baseline there were no differences in markers of bone turnover between the two groups. Subjects with <4 active joints had higher serum calcium and higher PTH. Individuals receiving calcium with <4 active joints had lower osteocalcin. At follow-up1,25 (OH)2 vitamin D, PTH, osteocalcin and urine phosphorus were lower in the calcium supplementation group. Hypercalciuria noted with urine Ca/Creatinine were not noted on 24-hour urine studies. CONCLUSIONS Markers of bone physiology were significantly decreased in children with JRA receiving calcium supplementation. The physiologic changes were noted as early as 12 months into calcium supplementation. The hypercalciuria noted on spot testing did not correlate with further evaluation nor did it lead to renal pathology. These findings suggesting that the calcium supplementation met physiologic needs and caused an increased calcium loss in urine. PMID:19035501

Carrasco, Ruy; Lovell, Daniel J.; Giannini, Edward H.; Henderson, Carol J.; Huang, Bin; Kramer, Sandy; Ranz, Julie; Heubi, James; Glass, David

2008-01-01

374

Septic arthiritis due to Prevotella bivia in a patient with rheumatoid arthritis.  

PubMed

Prevotella bivia is a gram-negative anaerobic bacteria traditionally classified in the genus Bacteroides, and usually reported in obstetric and gynecologic infections. To date, there has been only one description of infectious arthritis secondary to this germ. We report the first case of septic arthritis due to Prevotella bivia in a patient with severe, long-lasting rheumatoid arthritis (RA) treated with low doses of corticosteroids. RA is a well-known predisposing factor to septic arthritis, whose causes are multifactorial (general immunosuppression induced by the disease and its therapy, presence of prosthetic joints, etc.). However, infectious arthritis due to anaerobic bacteria is rarely observed. In general, clinical presentation varies widely: insidious onset, apyrexia, and lack of inflammatory signs or systemic disturbance are frequent features. Joint infection is generally secondary to hematogenous spread, the Bacteroides fragilis group being the most commonly isolated pathogens. Early diagnosis and prompt treatment, with drainage and debridement of the affected joint and specific antimicrobial treatment with Metronidazole are essential for a successful outcome. PMID:10875323

Alegre-Sancho, J J; Juanola, X; Narvaez, F J; Roig-Escofet, D

2000-01-01

375

Acute non-infectious arthritis of the hip in rheumatoid arthritis: synovial membrane findings.  

PubMed

A case of acute hip pain in rheumatoid arthritis is presented, with synovial membrane findings. A patient with classical rheumatoid arthritis suffered three unusual bouts of sudden, severe but transient hip pain. The hips were clinically normal between these episodes. The clinical picture on two of these occasions strongly suggested septic arthritis. Although the synovial fluid was highly inflammatory, cultures were negative. The synovial membrane showed mild lining cell hyperplasia, vascular congestion, and scattered inflammatory cells, predominantly lymphocytes. These findings were not compatible with either pyogenic infection or longstanding rheumatoid arthritis. The clinical and pathological features of acute non-infectious arthritis of the hip appear to delineate a distinct syndrome. PMID:2930281

Wohlgethan, J R; Stilmant, M M; Harris, J M; Smith, H R

1989-03-01

376

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

377

Determining Thermal Inactivation of Escherichia coli O157:H7 in Fresh Compost by Simulating Early Phases of the Composting Process ?  

PubMed Central

A three-strain mixture of Escherichia coli O157:H7 was inoculated into fresh dairy compost (ca. 107 CFU/g) with 40 or 50% moisture and was placed in an environmental chamber (ca. 70% humidity) that was programmed to ramp from room temperature to selected composting temperatures in 2 and 5 days to simulate the early composting phase. The surviving E. coli O157:H7 population was analyzed by direct plating and enrichment. Optimal and suboptimal compost mixes, with carbon/nitrogen (C/N) ratios of 25:1 and 16:1, respectively, were compared in this study. In the optimal compost mix, E. coli O157:H7 survived for 72, 48, and 24 h in compost with 40% moisture and for 72, 24, and 24 h with 50% moisture at 50, 55, and 60°C, respectively, following 2 days of come-up time (rate of heating up). However, in the suboptimal compost mix, the pathogen survived for 288, 72, and 48 h in compost with 40% moisture and for 240, 72, 24 h in compost with 50% moisture at the same temperatures, respectively. Pathogen survival was longer, with 5 days of come-up time compared with 2 days of come-up. Overall, E. coli O157:H7 was inactivated faster in the compost with 50% moisture than in the compost with 40% at 55 and 60°C. Both moisture and come-up time were significant factors affecting Weibull model parameters. Our results suggest that slow come-up time at the beginning of composting can extend pathogen survival during composting. Additionally, both the C/N ratio and the initial moisture level in the compost mix affect the rate of pathogen inactivation as well. PMID:21498743

Singh, Randhir; Kim, Jinkyung; Shepherd, Marion W.; Luo, Feng; Jiang, Xiuping

2011-01-01

378

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

379

A Functional RANKL Polymorphism Associated with Younger Age at Onset of Rheumatoid Arthritis  

PubMed Central

Objective We previously reported association of co-occurrence of HLA-DRB1 shared epitope (SE) and RANKL SNPs with younger age of RA onset in 182 rheumatoid factor positive (RF) European American (EA) early RA patients. Here, we fine-mapped the 48 kb RANKL region in the extended 210 EA RF-positive early RA cohort, sought replication of RA-associated SNPs in additional 501 EA and 298 African-Americans (AA) RA cohorts, and explored functional consequences of RA-associated SNPs. Methods SNP genotyping was conducted using pyrosequencing or TaqMan PCR assays. Associations of rs7984870 with RANKL expression in plasma, PBMC and isolated T cells were quantified using ELISA and RT-PCR. Site-directed mutagenesis of rs7984870 within the 2kb RANKL promoter was performed to drive the luciferase reporter gene in osteoblast and stromal cell lines. Interaction of DNA and protein was determined by electrophoretic mobility shift assay. Results A single promoter SNP rs7984870 was consistently significantly associated with earlier age of RA onset in 3 independent seropositive (RF or anti-cyclic citrullinated peptide antibody positive) RA cohorts but not in seronegative RA patients. The risk C allele of rs7984870 conferred 2-fold higher plasma RANKL levels in RF-positive RA patients, significantly elevated RANKL mRNA expression in activated normal T cells, and increased promoter activity after stimulation in vitro via differential binding to transcription factor SOX5. Conclusion The RANKL promoter allele that increased transcriptional levels upon stimulation might promote interaction between activated T cells and dendritic cells, predisposing to younger RA onset in seropositive EA and/or AA individuals. PMID:20533289

Tan, Wenfeng; Wu, Hui; Zhao, Jian; Derber, Lezlie A.; Lee, David M.; Shadick, Nancy A.; Conn, Doyt L.; Smith, Edwin A.; Gersuk, Vivian H.; Nepom, Gerald T.; Moreland, Larry W.; Furst, Daniel E.; Thompson, Susan D.; Jonas, Beth L.; Holers, V. Michael; Glass, David N.; Chen, Pojen P.; Bridges, S. Louis; Weinblatt, Michael E.; Paulus, Harold E.; Tsao, Betty P.

2010-01-01

380

Patients' views about treatment with combination therapy for Rheumatoid Arthritis: a comparative qualitative study  

PubMed Central

Background Combinations of disease-modifying anti-rheumatic drugs (DMARDs) are increasingly used to control active rheumatoid arthritis (RA); however there is little information about patients’ perspectives, their expectations, concerns and experiences of this intensive treatment. Method We interviewed a quota sample of 18 patients from a single tertiary outpatient clinic, stratified by gender, ethnicity and age, based on the outpatient clinic population. Patients with early RA (<2 years) received combined conventional DMARDs; patients with established RA (>2 years) received combined conventional DMARDs or DMARDs with biologics. Results Four main themes emerged from the analytical framework: (i) patients’ expectations about the combined treatment focuses mainly on physical symptoms; (ii) the impact of the treatment on quality of life varied with the new medication in both groups (iii) concerns about new interventions concentrated mainly on potential side effects; and (iv) combination therapy can be self-managed in close collaboration with clinic staff, but this requires individualised management approaches. These themes resonate with von Korff’s collaborative management of chronic illness model. Conclusion To our knowledge this is the first qualitative study that examined systematically in patients with early and established RA their expectations, impact on quality of life, concerns about side effects and the management of the treatment when taking combined medication with DMARDs or DMARDs and biologics. Patients have generally positive views of combination DMARDs. Within routine practice settings, achieving medication concordance with complex combined DMARD regimens is challenging, and the concerns vary between patients; careful individual assessments are essential to successfully deliver such intensive treatment. PMID:23078166

2012-01-01

381

Clinical and immunogenetic characteristics of European multicase rheumatoid arthritis families  

PubMed Central

OBJECTIVE—To describe the characteristics of a new set of European families with affected sib pairs (ASP) collected by the European Consortium on Rheumatoid Arthritis Families (ECRAF) to replicate the results of our first genome scan. Potential gradients for disease severity in Europe and concordance within families were studied.?PATIENTS AND METHODS—From 1996 to 1998 European white families with at least two affected siblings were enrolled in the study. Demographic (sex, age at onset), clinical data (rheumatoid factor (RF), disease duration, erosive disease, extra-articular features (EF)), and HLA-DRB1 oligotyping were analysed.?RESULTS—565 patients with rheumatoid arthritis (RA), belonging to 271 families including 319 affected sib pairs (ASP) were collected. Belgium, France, Italy, the Netherlands, Portugal, and Spain contributed 20, 96, 52, 24, 9, and 70 families, respectively. Sex (78% women), age at onset (mean 44 years), and RF positivity (79%) were similar among the countries. Differences were found in disease duration (11-18 years) and in the prevalence of erosive disease (70-93%), nodules (15-44%), subjective Sjögren's syndrome (5-38%), and EF (3-16%) (p<0.05 in all cases). A total of 22% RA sibs were shared epitope (SE) negative, whereas 47% and 30% carried one and two SE alleles respectively. Carriage of SE differed widely among countries (p<0.0001): no SE alleles (6-36%), one allele (43-60%), and two alleles (20-39%). SE encoding alleles were mainly DRB1*04 in the Netherlands and Belgium, whereas SE carriage was less common and evenly distributed between DRB1*01, *04, and *10 in Mediterranean countries. No concordance within families was found either in age/calendar year of onset (intraclass correlation coefficient <0.50) or in clinical and radiological features (?<0.22).?CONCLUSIONS—The differences in RA characteristics between European countries and within families underline the heterogeneity of the disease. No clear cut gradient of disease severity was seen in Europe.?? PMID:11350845

Balsa, A; Barrera, P; Westhovens, R; Alves, H; Maenaut, K; Pascual-Salcedo, D; Cornelis, F; Bardin, T; Riente, L; Radstake, T; de Almeida, G; Lepage, V; Stravopoulos, C; Spaepen, M; Lopes-Vaz, A; Charron, D; Martinez, M; Prudhomme, J; Migliorini, P; Fritz, P

2001-01-01

382

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

383

Turmeric inhibits parathyroid hormone-related protein (PTHrP) secretion from human rheumatoid synoviocytes  

E-print Network

Excessive production of parathyroid hormone-related protein (PTHrP) by tumor-like synoviocytes contributes to joint destruction in rheumatoid arthritis (RA). Having previously demonstrated that curcuminoid-only and essential ...

Frye, J.; Timmermann, Barbara N.; Funk, J.

2012-06-12

384

Rheumatoid Arthritis in Moms-to-Be Linked to Premature Births  

MedlinePLUS

... enable JavaScript. Rheumatoid Arthritis in Moms-to-Be Linked to Premature Births Low birth weight also more ... were 1.3 times higher. The researchers also linked slightly lower birth weights to infants born to ...

385

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

386

[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

387

Effects of Oral Administration of Type II Collagen on Rheumatoid Arthritis  

NASA Astrophysics Data System (ADS)

Rheumatoid arthritis is an inflammatory synovial disease thought to involve T cells reacting to an antigen within the joint. Type II collagen is the major protein in articular cartilage and is a potential autoantigen in this disease. Oral tolerization to autoantigens suppresses animal models of T cell-mediated autoimmune disease, including two models of rheumatoid arthritis. In this randomized, double-blind trial involving 60 patients with severe, active rheumatoid arthritis, a decrease in the number of swollen joints and tender joints occurred in subjects fed chicken type II collagen for 3 months but not in those that received a placebo. Four patients in the collagen group had complete remission of the disease. No side effects were evident. These data demonstrate clinical efficacy of an oral tolerization approach for rheumatoid arthritis.

Trentham, David E.; Dynesius-Trentham, Roselynn A.; Orav, E. John; Combitchi, Daniel; Lorenzo, Carlos; Sewell, Kathryn Lea; Hafler, David A.; Weiner, Howard L.

1993-09-01

388

Are somatosensory evoked potential recording and magnetic resonance imaging useful for evaluating the risk of neurologic compromise in rheumatoid arthritis patients with atlantoaxial subluxation?  

PubMed

The objective of this study was to determine whether early somatosensory evoked potential recording and/or magnetic resonance imaging are helpful for evaluating and monitoring the risk of neurologic compromise in rheumatoid arthritis patients. Thirty-seven patients with definite rheumatoid arthritis were studied, including 18 with atlantoaxial subluxation. A physical examination, roentgenograms of the cervical spine, early somatosensory evoked potential recording at all four limbs and magnetic resonance imaging of the cervical spine were done in each case. Alterations in somatosensory evoked potentials and magnetic resonance imaging evidence of compression of the medulla oblongata or spinal cord were found in similar proportions of patients with and without atlantoaxial subluxation. These results support the view that physical findings and changes on plain films of the cervical spine are the most reliable data for evaluating and monitoring the risk of neurologic damage in patients with atlantoaxial subluxation. Somatosensory evoked potential studies and magnetic resonance imaging should be reserved for those cases in which physical and roentgenographic data cannot be collected in a satisfactory manner and for patients who are included in study protocols that require accurate evaluation of lesions. PMID:8938867

Cartry, O; Collet, P; Convers, P; Barral, F G; Michel, D; Alexandre, C

1996-10-01

389

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

390

Cutaneous nodules in patients with rheumatoid arthritis: a case report and review of literatures  

Microsoft Academic Search

We report a case of 57-year-old Japanese woman with an overlap syndrome of both rheumatoid arthritis (RA) and autoimmune hepatitis,\\u000a who developed multiple skin nodules. An extensive biopsies of the nodules revealed rheumatoid neutrophilic dermatitis, showing\\u000a panniculitis without vasculitis, combining with granulomatous formation histopathologically. Since cutaneous nodules in patients\\u000a with RA are very complex, differential diagnosis should be done according

Tadashi Nakamura; Syu-ichi Higashi; Kunihiko Tomoda; Michishi Tsukano; Ken-ichi Iyama

2011-01-01

391

A population-based register study of the association between schizophrenia and rheumatoid arthritis  

Microsoft Academic Search

The authors investigated the association between schizophrenia and rheumatoid arthritis.The design is a population-based case-control and follow-up study. The cases were 20495 patients admitted for schizophrenia and registered in the Danish Psychiatric Case Register. A total of 204912 persons matched on age and gender and chosen from the general population served as controls. Admissions for rheumatoid arthritis and other non-autoimmune,

O Mors; P. B Mortensen; H Ewald

1999-01-01

392

Treatment of DMARDs-resistant rheumatoid arthritis with minocycline: a local experience among the Chinese  

Microsoft Academic Search

We report a local experience with minocycline (100 mg b.i.d.) in treating Chinese patients with rheumatoid arthritis (RA)\\u000a who were resistant to the conventional disease-modifying antirheumatic drug (DMARD) treatment. In contrast to a preliminary\\u000a observation in seven patients with rheumatoid arthritis, minocycline was effective and safe in treating our patients when\\u000a added to the previous, relatively ineffective DMARD regimen. The

N. S. Lai; J. L. Lan

1998-01-01

393

STAT4 and the Risk of Rheumatoid Arthritis and Systemic Lupus Erythematosus  

Microsoft Academic Search

A SNP haplotype in the third intron of STAT4 was associated with susceptibility to both rheumatoid arthritis and systemic lupus erythematosus. The minor alleles of the haplotype-defining SNPs were present in 27% of chromosomes of patients with es- tablished rheumatoid arthritis, as compared with 22% of those of controls (for the SNP rs7574865, P = 2.81×10?7; odds ratio for having

Elaine F. Remmers; Robert M. Plenge; Annette T. Lee; Robert R. Graham; Geoffrey Hom; Timothy W. Behrens; Paul I. W. de Bakker; Julie M. Le; Hye-Soon Lee; Franak Batliwalla; Wentian Li; Seth L. Masters; Matthew G. Booty; John P. Carulli; Leonid Padyukov; Lars Alfredsson; Lars Klareskog; Wei V. Chen; Christopher I. Amos; Lindsey A. Criswell; Michael F. Seldin; Daniel L. Kastner; Peter K. Gregersen

2007-01-01

394

Spontaneous bilateral distal ulna fracture: an unusual complication in a rheumatoid patient  

Microsoft Academic Search

Bilateral ulna stress fractures are extremely rare. Patients with rheumatoid arthritis have osteopenic bone secondary to a\\u000a variety of causes. We report a case of bilateral stress fractures of the ulna in an elderly patient with rheumatoid arthritis,\\u000a and literature on this condition is reviewed. Prompt recognition and activity modification are essential to treat this rare\\u000a injury. Recovery can take

Santosh Venkatachalam; Paul Dixon

2011-01-01

395

Ramsay Hunt Syndrome in a Patient with Rheumatoid Arthritis after Treatment with Infliximab  

PubMed Central

A 39-year-old female patient with rheumatoid arthritis developed Ramsay Hunt syndrome after infliximab treatment. This condition is caused by the reactivation of varicella zoster virus infection in the geniculate ganglion of facial nerve in the host's immunosuppression. She was treated immediately with valaciclovir and hydrocortisone, and the complete recovery was achieved at 6 months after the onset. This is the first report of Ramsay Hunt syndrome as an adverse effect of infliximab in rheumatoid arthritis. PMID:24660085

Nagayama, Yoshio; Matsushiro, Naoki; Nampei, Akihide; Hashimoto, Hideo; Shi, Kenrin

2014-01-01

396

Polymorphisms in cytochrome P450 2C19 enzyme and cessation of leflunomide in patients with rheumatoid arthritis  

PubMed Central

Introduction Rational selection of disease modifying anti-rheumatic drugs in the treatment of rheumatoid arthritis (RA) has many potential advantages, including rapid disease control, reduced long-term disability and reduced overall cost to the healthcare system. Inter-individual genetic differences are particularly attractive as markers to predict efficacy and toxicity, as they can be determined rapidly prior to drug selection. The aims of this study, therefore, were to investigate the association between differences in genes associated with the metabolism, clearance and efficacy of leflunomide with its cessation in a group of rheumatoid arthritis patients who were treated with an intensive contemporary, treat-to-target approach. Methods This retrospective cohort study identified all individuals who received leflunomide and were enrolled in the Early Arthritis inception cohort at the Royal Adelaide Hospital between 2001 and July 2011. Inclusion criteria were age (>18) and a diagnosis of rheumatoid arthritis. Patients were excluded if a DNA sample was not available, if they withdrew from the cohort or if clinical data were insufficient. Subjects were followed for 12 months or until either another disease modifying antirheumatic drug was added or leflunomide was ceased. The following single nucleotide polymorphisms (SNPs) were determined: CYP2C19*2 (rs4244285), CYP2C19*17 (rs12248560), ABCG2 421C>A (rs2231142), CYP1A2*1F (rs762551) and DHODH 19C>A (rs3213422). The effects of variables on cessation were assessed with Cox Proportional Hazard models. Results Thirty-three of 78 (42.3%) patients ceased leflunomide due to side effects. A linear trend between cytochrome P450 2C19 (CYP2C19) phenotype and leflunomide cessation was observed, with poor and intermediate metabolizers ceasing more frequently (adjusted Hazard Ratio = 0.432 for each incremental change in phenotype, 95% CI 0.237 to 0.790, P = 0.006). Previously observed associations between cytochrome P450 1A2 (CYP1A2) and dihydro-orotate dehydrogenase (DHODH) genotype and toxicity were not apparent, but there was a trend for ATP-binding cassette sub-family G member 2 (ABCG2) genotype to be associated with cessation due to diarrhea. Conclusions CYP2C19 phenotype was associated with cessation due to toxicity, and since CYP2C19 intermediate and poor metabolizers have lower teriflunomide concentrations, it is likely that they have a particularly poor risk:benefit ratio when using this drug. PMID:22784880

2012-01-01

397

Clinical efficacy of infliximab plus methotrexate in DMARD naive and DMARD refractory rheumatoid arthritis is associated with decreased synovial expression of TNF? and IL18 but not CXCL12  

PubMed Central

Background: Tumour necrosis ? (TNF?) blocking agents lead to pronounced clinical effects and reduced synovial infiltrate in rheumatoid arthritis. Laboratory and clinical studies suggest that TNF? independent pathways play a role in the disease. Objectives: To evaluate the immunopathological effects of combination therapy on rheumatoid synovial tissue in order to identify TNF? independent mechanisms. Methods: 12 rheumatoid patients, including four DMARD (disease modifying antirheumatic drug) naive patients with early disease, were studied for the effect of combination therapy with infliximab and methotrexate on the synovial infiltrate. Biopsies and clinical assessments (DAS28) were carried out before the first and after the third infusion of infliximab. Synovial inflammation was scored semiquantitatively. Co-expression of CD38+ cells was studied by an immunofluorescent double labelling technique. Results: Marked clinical responses were associated with a global reduction in the synovial infiltrate and expression of cytokines, notably interleukin 18 and TNF?, but low grade disease activity persisted. There was no effect on the expression of CXC chemokine ligand (CXCL12), and germinal centre-like structures were still detectable in synovial tissue in two patients after treatment. CD38+ activated T cells were more resistant to treatment than CD38+ plasma cells. No differences in clinical response or effects on synovial infiltrate were observed between DMARD refractory and DMARD naive patients. Conclusions: Persistent expression of CXCL12 and incomplete resolution of lymphocytic infiltrates after infliximab plus methotrexate indicates that TNF? independent mechanisms are operative in rheumatoid arthritis. This may contribute to low grade disease activity, even in DMARD naive patients with early disease. PMID:15769913

van Oosterhout, M; Levarht, E; Sont, J; Huizinga, T; Toes, R; van Laar, J M

2005-01-01

398

Clinical Biomarkers and Pathogenic-Related Cytokines in Rheumatoid Arthritis  

PubMed Central

Rheumatoid arthritis (RA) is a common autoimmune disease with unknown etiology and pathogenesis. Although major therapeutic advances have been made in recent years, there is no cure for the disease. Current medications mainly reduce inflammation in order to relieve pain and slow joint damage, but many have potentially serious side effects. Therefore, to find specific biomarkers will benefit both RA patients to find relief from the disease and physicians to monitor the disease development. A number of biomarkers have been discovered and used clinically, and others are still under investigation. The autoantibodies, which are widely used in diagnosis and prognosis, novel biomarkers, which reflect clinical disease activity, and newly found biomarkers and pathogenic-related cytokines are discussed in this review. PMID:25215307

Niu, Xiaoyin; Chen, Guangjie

2014-01-01

399

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

400

[Fractalkine--a proinflammatory chemokine in rheumatoid arthritis].  

PubMed

Fractalkine (CX3CL1), so far the only member of the CX3C class of chemokines, and its receptor, CX3CR1, are strongly expressed in the chronically inflamed synovial tissue of patients with rheumatoid arthritis (RA). Due to the specific binding of Fractalkine to its receptor, many proinflammatory reactions involved in the pathogenesis of RA are triggered. Functionally, fractalkine plays an important proinflammatory role in RA pathogenesis as characterized by induction of synovial angiogenesis, chemotaxis, activation of monocytes and T cells as well as the stimulation of proliferation and synthesis of matrix degrading enzymes (matrix metalloproteinases, MMP) in synovial fibroblasts. Fractalkine thus may represent a novel target molecule for therapeutic intervention in RA. PMID:18633630

Blaschke, S; Müller, G A

2008-09-01

401

Genetics in neuroendocrine immunology: implications for rheumatoid arthritis and osteoarthritis.  

PubMed

Both genetic and environmental factors contribute to rheumatoid arthritis (RA) as well as osteoarthritis (OA). For RA, most of the known genetic markers are linked with genes from immunological pathways. Recent genome-wide association studies (GWAS) on RA identified known and novel susceptibility genes like HLA-DRB1, PTPN22, STAT4, TRAF1/C5, OLIG3/TNFAIP3, CD40, CCL21, MMEL1-TNFRSF14, CDK6, PRKCQ, IL2RB, and KIF5A-PIP4K2C. These association signals explain more than 50% of the genetic influence on RA. In contrast, less GWAS data for OA exist. Most OA susceptibility genes arose from classical candidate gene analyses and were not replicated in all study samples. Neuroendocrine factors are hypothesized to play an important role both in RA and OA etiology. Here, we discuss these findings and present an outlook for genetic association studies after GWAS. PMID:20398001

Stark, Klaus; Straub, Rainer H; Blazicková, Stanislava; Hengstenberg, Christian; Rovenský, Jozef

2010-04-01

402

Decreased plasma fibrinolysis in patients with rheumatoid arthritis.  

PubMed Central

We have investigated the fibrinolytic status of 56 patients with rheumatoid arthritis (RA). Plasma fibrinogen and plasminogen were significantly elevated. Levels of these two substrates, along with alpha 2 macroglobulin and antithrombin III correlated with disease activity. Plasminogen activator (PA) activity was decreased in patients with severe disease. Twelve patients were given stanozolol, a fibrinolytic enhancing agent, for two months as a test for endothelial production of plasminogen activator. This caused a significant increase in blood plasminogen and PA activity. Five patients received a two-week course of stanozolol with joint aspiration before and after. Joint plasminogen levels were increased. We suggest that inadequate fibrinolysis occurs in RA, and that this may contribute to some of the pathological features of the disease. It is possible to stimulate both blood and joint fibrinolysis by stanozolol. A more prolonged increase in plasminogen activator activity might decrease joint fibrin deposition, and stanozolol should be investigated as a therapeutic agent in RA. PMID:6084477

Belch, J J; McArdle, B; Madhok, R; McLaughlin, K; Capell, H A; Forbes, C D; Sturrock, R D

1984-01-01

403

p53 in rheumatoid arthritis: friend or foe?  

PubMed Central

The knowledge of transcription factors and proto-oncogenes has influenced the understanding of cell regulation, cell cycle, and apoptotic cell death in rheumatoid arthritis (RA) synovium. In addition, the development of normal synovial fibroblasts into transformed-appearing aggressive synovial fibroblasts may be triggered by the lack of antiproliferative factors, such as p53, p53-associated molecules, other tumor suppressors, as well as by upregulation of anti-apoptotic genes. Therefore, data derived from experiments such as those performed by Tak and colleagues in this issue of Arthritis Research not only enrich the intensive discussion addressing the impact of p53 on RA pathophysiology, they also may facilitate development of novel therapeutic approaches including p53-targeted gene therapy. PMID:11094424

Muller-Ladner , Ulf; Nishioka, Kusuki

2000-01-01

404

Rheumatoid arthritis is linked to oral bacteria: etiological association.  

PubMed

The purpose of this review is to evaluate the association between rheumatoid arthritis (RA) and periodontopathic bacteria. Clinical studies of RA and periodontal disease have provided evidence for a significant association between the two disorders. Patients with long-standing active RA have a substantially increased frequency of periodontal disease compared with that among healthy subjects. High levels of oral anaerobic bacterial antibodies have been found in the serum and synovial fluid of RA patients. Porphyromonas gingivalis, Tannerella forsythensis, and Prevotella intermedia have been identified in RA synovial fluid. Ornidazole, levofloxacin, and clarithromycin are used in the treatment of infections caused by anaerobic bacteria. These antibiotics have been shown to be effective against RA. The evidence in this review indicates that oral bacteria directly associate with etiopathogenesis of RA. PMID:19554393

Ogrendik, Mesut

2009-01-01

405

Pulmonary vasculitis as the first manifestation of rheumatoid arthritis  

PubMed Central

In this report, we describe a 61-year-old man that presented with isolated pulmonary vasculitis and a positive anti-cyclic citrullinated peptide (CCP) antibody. Within a few months, the patient developed the symmetric polyarthritis consistent with rheumatoid arthritis (RA). Because the anti-CCP antibody is highly specific for RA and vasculitis is a known association of RA, we suspect the pulmonary vasculitis in this patient was the first manifestation of underlying RA. This case extends on previous reports that have shown that lung disease may predate the development of articular RA and that anti-CCP positivity and lung disease may represent a pre-RA phenotype. To our knowledge, this is the first case report of pulmonary vasculitis as the first manifestation of RA.

Tourin, Olga; de la Torre Carazo, Salvador; Smith, Daniel R.; Fischer, Aryeh

2013-01-01

406

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

407

Mechanisms of Premature Atherosclerosis in Rheumatoid Arthritis and Lupus  

PubMed Central

Rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), the two most common systemic autoimmune disorders, have both unique and overlapping manifestations. One feature they share is a significantly enhanced risk of atherosclerotic cardiovascular (CV) disease that significantly contributes to morbidity and mortality. The primary mechanisms that drive CV damage in these diseases remain to be fully characterized, but recent discoveries indicate that distinct inflammatory pathways and immune dysregulation characteristic of RA and SLE likely play prominent roles. This review focuses on analyzing the major mechanisms and pathways potentially implicated in the acceleration of atherothrombosis [**AU: Should this be atherosclerosis for consistency?**] and CV risk in SLE and RA, as well as in the identification of putative preventive strategies that may mitigate vascular complications in systemic autoimmunity. PMID:23020882

Kahlenberg, J. Michelle; Kaplan, Mariana J.

2014-01-01

408

Rheumatoid Arthritis-Associated Interstitial Lung Disease: Diagnostic Dilemma  

PubMed Central

Interstitial lung disease (ILD) is an increasingly recognized complication of rheumatoid arthritis (RA) contributing to significantly increased morbidity and mortality. Diagnosis can be challenging since patients are unlikely to report dyspnea due to an overall decrease in physical activity with advanced arthritic symptoms. Additionally, infections, drug toxicity, and environmental toxins can mimic ILD, creating significant diagnostic dilemmas for the clinician. In this paper we will explore an effective clinical algorithm for the diagnosis of RA-ILD. We will also discuss features of drug-related toxicities, infections, and environmental toxins that comprise the main entities in the differential diagnosis of RA-ILD. Finally, we will explore the known and experimental treatment options that may have some benefit in the treatment of RA-ILD. PMID:21660199

Hamblin, Mark J.; Horton, Maureen R.

2011-01-01

409

Depression in patients with rheumatoid arthritis: description, causes and mechanisms.  

PubMed

Two sets of contributory factors to depression among patients with rheumatoid arthritis (RA) are generally examined - the social context of the individual and the biologic disease state of that person's RA. This article will review the evidence for both. RA affects patients both physically and psychologically. Comorbid depression is common with RA and leads to worse health outcomes. Low socioeconomic status, gender, age, race/ethnicity, functional limitation, pain and poor clinical status have all been linked to depression among persons with RA. Systemic inflammation may also be associated with, cause, or contribute to depression in RA. Understanding the socioeconomic factors, individual patient characteristics and biologic causes of depression in RA can lead to a more comprehensive paradigm for targeting interventions to eliminate depression in RA. PMID:22211138

Margaretten, Mary; Julian, Laura; Katz, Patricia; Yelin, Edward

2011-01-01

410

Depression in patients with rheumatoid arthritis: description, causes and mechanisms  

PubMed Central

Two sets of contributory factors to depression among patients with rheumatoid arthritis (RA) are generally examined – the social context of the individual and the biologic disease state of that person’s RA. This article will review the evidence for both. RA affects patients both physically and psychologically. Comorbid depression is common with RA and leads to worse health outcomes. Low socioeconomic status, gender, age, race/ethnicity, functional limitation, pain and poor clinical status have all been linked to depression among persons with RA. Systemic inflammation may also be associated with, cause, or contribute to depression in RA. Understanding the socioeconomic factors, individual patient characteristics and biologic causes of depression in RA can lead to a more comprehensive paradigm for targeting interventions to eliminate depression in RA. PMID:22211138

Margaretten, Mary; Julian, Laura; Katz, Patricia; Yelin, Edward

2011-01-01

411

[Role of Porphyromonas gingivalis in rheumatoid arthritis and inflammatory spondyloarthropathies].  

PubMed

The most recent studies confirm the link between rheumatoid arthritis (RA) and periodontal disease. RA patients have higher prevalence of chronic periodontitis and periodontal disease is often more severe in these patients. Both RA and PD show similar pathophysiological mechanisms and risk factors. Autoimmunity to citrullinated peptides is the primary element in the pathogenesis of RA, not found in other diseases. Porphyromonas gingivalis, the major periodontal pathogen associated with the etiology of chronic periodontitis, is the only bacterium currently known to produce the enzyme peptidylarginine deiminase (PAD) allowing protein citrullination. This bacterium likely fulfils a significant role in the pathogenesis of RA due to its capacity for citrullination of its own protein and host peptides, which may result in a loss of immune tolerance. A few epidemiological studies also indicate the potential link between spondyloarthropathies and periodontal disease. PMID:25228525

Bia?ow?s, Katarzyna; Swierkot, Jerzy; Radwan-Oczko, Ma?gorzata

2014-01-01

412

Cancer Morbidity in Rheumatoid Arthritis: Role of Estrogen Metabolites  

PubMed Central

Estrogen metabolites have been implicated in rheumatoid arthritis (RA) and cancer, although the mechanism remains unestablished. Some estrogen metabolites, which are used for the assessment of cancer risk, play an important role in RA. The pathways by which malignancies associated with RA remain elusive. Possible mechanism involves enzymatic or nonenzymatic oxidation of estrogen into catecholestrogen metabolites through semiquinone and quinone redox cycle to produce free radicals that can cause DNA modifications. Modifications of DNA alter its immunogenicity and trigger various immune responses leading to elevated levels of cancer and RA antibodies. However, the role of different estrogen metabolites as a mediator of immune response cannot be ruled out in various immune-related diseases. PMID:24151619

Khan, Wahid Ali; Khan, Mohd Wajid Ali

2013-01-01

413

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

414

Exposure to Traffic Pollution and Increased Risk of Rheumatoid Arthritis  

PubMed Central

Background Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease that affects approximately 1% of the adult population, and to date, genetic factors explain < 50% of the risk. Particulate air pollution, especially of traffic origin, has been linked to systemic inflammation in many studies. Objectives We examined the association of distance to road, a marker of traffic pollution exposure, and incidence of RA in a prospective cohort study. Methods We studied 90,297 U.S. women in the Nurses’ Health Study. We used a geographic information system to determine distance to road at the residence in 2000 as a measure of traffic exposure. Using Cox proportional hazard models, we examined the association of distance to road and incident RA (1976–2004) with adjustment for a large number of potential confounders. Results In models adjusted for age, calendar year, race, cigarette smoking, parity, lactation, menopausal status and hormone use, oral contraceptive use, body mass index, physical activity, and census-tract-level median income and house value, we observed an elevated risk of RA [hazard ratio (HR) = 1.31; 95% confidence interval (CI), 0.98–1.74] in women living within 50 m of a road, compared with those women living 200 m or farther away. We also observed this association in analyses among nonsmokers (HR = 1.62; 95% CI, 1.04–2.52), nonsmokers with rheumatoid factor (RF)-negative RA (HR = 1.77; 95% CI, 0.93–3.38), and nonsmokers with RF-positive RA (HR = 1.51; 95% CI, 0.82–2.77). We saw no elevations in risk in women living 50–200 m from the road. Conclusions The observed association between exposure to traffic pollution and RA suggests that pollution from traffic in adulthood may be a newly identified environmental risk factor for RA. PMID:19654914

Hart, Jaime E.; Laden, Francine; Puett, Robin C.; Costenbader, Karen H.; Karlson, Elizabeth W.

2009-01-01

415

RADB: a database of rheumatoid arthritis-related polymorphisms.  

PubMed

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

416

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

417