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Sample records for arthritis damage index

  1. Prognostic laboratory markers of joint damage in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Lindqvist, E; Henriksen, Karen Eberhardt; Bendtzen, K

    2005-01-01

    To investigate whether determination of a set of laboratory markers at baseline provides prognostic information on joint damage in hands and feet in rheumatoid arthritis.......To investigate whether determination of a set of laboratory markers at baseline provides prognostic information on joint damage in hands and feet in rheumatoid arthritis....

  2. Measurement of damage in systemic vasculitis: a comparison of the Vasculitis Damage Index with the Combined Damage Assessment Index

    DEFF Research Database (Denmark)

    Suppiah, Ravi; Flossman, Oliver; Mukhtyar, Chetan;

    2011-01-01

    To compare the Vasculitis Damage Index (VDI) with the Combined Damage Assessment Index (CDA) as measures of damage from vasculitis.......To compare the Vasculitis Damage Index (VDI) with the Combined Damage Assessment Index (CDA) as measures of damage from vasculitis....

  3. Co-morbidity index in rheumatoid arthritis: time to think.

    Science.gov (United States)

    El Miedany, Yasser

    2015-12-01

    Rheumatoid arthritis patients are clinically complex, and the interplay of their disease activity together with the other associated conditions may lead to increased morbidity and mortality. The recent advances in the disease management attracted the attention to its associated co-morbidities and highlighted the need for a tool to provide clinicians and potential payers with a clinically powerful measure of the disease burden and prognosis. Predicting outcome or co-morbidity probability has been previously implemented successfully for calculating 10-year fracture probability (FRAX) as well as for predicting 1-year patient mortality using co-morbidity data obtained (Charlson index). Developing a specific rheumatoid arthritis-independent tool able to predict morbidity, mortality, cost and hospitalization would be a step forward on the way to achieve full disease remission. The co-morbidity index should be used both at baseline as well as a continuous variable in analyses. It should be implemented regularly in the clinical assessment as a confounder of outcomes. This article will review the redefined health outcomes in rheumatoid arthritis and the concept of co-morbidity index for patients with inflammatory arthritis. It will also present a proposed co-morbidity index for rheumatoid arthritis patients.

  4. Early biomarkers of joint damage in rheumatoid and psoriatic arthritis.

    Science.gov (United States)

    Mc Ardle, Angela; Flatley, Brian; Pennington, Stephen R; FitzGerald, Oliver

    2015-06-01

    Joint destruction, as evidenced by radiographic findings, is a significant problem for patients suffering from rheumatoid arthritis and psoriatic arthritis. Inherently irreversible and frequently progressive, the process of joint damage begins at and even before the clinical onset of disease. However, rheumatoid and psoriatic arthropathies are heterogeneous in nature and not all patients progress to joint damage. It is therefore important to identify patients susceptible to joint destruction in order to initiate more aggressive treatment as soon as possible and thereby potentially prevent irreversible joint damage. At the same time, the high cost and potential side effects associated with aggressive treatment mean it is also important not to over treat patients and especially those who, even if left untreated, would not progress to joint destruction. It is therefore clear that a protein biomarker signature that could predict joint damage at an early stage would support more informed clinical decisions on the most appropriate treatment regimens for individual patients. Although many candidate biomarkers for rheumatoid and psoriatic arthritis have been reported in the literature, relatively few have reached clinical use and as a consequence the number of prognostic biomarkers used in rheumatology has remained relatively static for several years. It has become evident that a significant challenge in the transition of biomarker candidates to clinical diagnostic assays lies in the development of suitably robust biomarker assays, especially multiplexed assays, and their clinical validation in appropriate patient sample cohorts. Recent developments in mass spectrometry-based targeted quantitative protein measurements have transformed our ability to rapidly develop multiplexed protein biomarker assays. These advances are likely to have a significant impact on the validation of biomarkers in the future. In this review, we have comprehensively compiled a list of candidate

  5. Early biomarkers of joint damage in rheumatoid and psoriatic arthritis.

    LENUS (Irish Health Repository)

    Mc Ardle, Angela

    2015-01-01

    Joint destruction, as evidenced by radiographic findings, is a significant problem for patients suffering from rheumatoid arthritis and psoriatic arthritis. Inherently irreversible and frequently progressive, the process of joint damage begins at and even before the clinical onset of disease. However, rheumatoid and psoriatic arthropathies are heterogeneous in nature and not all patients progress to joint damage. It is therefore important to identify patients susceptible to joint destruction in order to initiate more aggressive treatment as soon as possible and thereby potentially prevent irreversible joint damage. At the same time, the high cost and potential side effects associated with aggressive treatment mean it is also important not to over treat patients and especially those who, even if left untreated, would not progress to joint destruction. It is therefore clear that a protein biomarker signature that could predict joint damage at an early stage would support more informed clinical decisions on the most appropriate treatment regimens for individual patients. Although many candidate biomarkers for rheumatoid and psoriatic arthritis have been reported in the literature, relatively few have reached clinical use and as a consequence the number of prognostic biomarkers used in rheumatology has remained relatively static for several years. It has become evident that a significant challenge in the transition of biomarker candidates to clinical diagnostic assays lies in the development of suitably robust biomarker assays, especially multiplexed assays, and their clinical validation in appropriate patient sample cohorts. Recent developments in mass spectrometry-based targeted quantitative protein measurements have transformed our ability to rapidly develop multiplexed protein biomarker assays. These advances are likely to have a significant impact on the validation of biomarkers in the future. In this review, we have comprehensively compiled a list of candidate

  6. Chlorambucil induced chromosome damage in juvenile chronic arthritis.

    Science.gov (United States)

    Palmer, R G; Varonos, S; Doré, C J; Denman, A M; Ansell, B M

    1985-01-01

    Sister chromatid exchanges, a sensitive measure of chromosome damage, were counted in peripheral blood lymphocytes from 23 patients with juvenile chronic arthritis receiving long term, low dose chlorambucil treatment. Thirty five patients with juvenile chronic arthritis who had not been treated with cytotoxic drugs served as controls. All of the treated patients have cells with abnormal sister chromatid exchange frequencies. Damage is related to the daily dose and may, in part, be determined by the duration of treatment. Sister chromatid exchanges from nine patients who had received chlorambucil at some time in the past remained high for at least five months after stopping the drug. Long term follow up will determine whether sister chromatid exchange analysis can help predict those most at risk of drug induced malignancies. Images Fig. 1 PMID:4073932

  7. Gender, body mass index and rheumatoid arthritis disease activity: results from the QUEST-RA Study

    DEFF Research Database (Denmark)

    Jawaheer, D; Olsen, J; Lahiff, M

    2010-01-01

    To investigate whether body mass index (BMI), as a proxy for body fat, influences rheumatoid arthritis (RA) disease activity in a gender-specific manner.......To investigate whether body mass index (BMI), as a proxy for body fat, influences rheumatoid arthritis (RA) disease activity in a gender-specific manner....

  8. SUM06 Index for Damage to Flora from Ozone

    Data.gov (United States)

    U.S. Environmental Protection Agency — In addition to health effects in humans, Ozone exposure also causes damage to plants. One index used in calculating the potential damage to plants from Ozone...

  9. Study of Residual Strength Index of Damaged Ship Hulls

    Institute of Scientific and Technical Information of China (English)

    QIEn-rong; CUIWei-cheng; WANZheng-quan; QIUQiang

    2004-01-01

    This paper studies the effect of non-symmetric flood and rigidity loss of damaged ship hulls to external loads. Based on the calculation method of ultimate strength of damaged ship hulls under non-symmetric bending, the effect of collision, grounding and explosion damage on the ultimate strength of ship hull is also analyzed. Then, residual strength index of damaged ship hulls is given based on extreme loads and ultimate strength calculations. The critical sea state of damaged shin hulls is also predicted.

  10. Damage Model of Brittle Coal-Rock and Damage Energy Index of Rock Burst

    Institute of Scientific and Technical Information of China (English)

    尹光志; 张东明; 魏作安; 李东伟

    2003-01-01

    Based on the mechanical experiment of brittle coal-rock and the damage mechanical theory, a damage model was established. Coal-Rock damage mechanical characteristic was researched. Furthermore, interior energy transformation mechanism of rock was analyzed from the point of view of damage mechanics and damage energy release rate of brittle coal rock was derived. By analyzing the energy transformation of rock burst, a new conception, damage energy index of rock burst, was put forward. The condition of rock burst was also established.

  11. MRI assessment of suppression of structural damage in patients with rheumatoid arthritis receiving rituximab

    DEFF Research Database (Denmark)

    Peterfy, Charles; Emery, Paul; Tak, Paul P;

    2014-01-01

    OBJECTIVE: To evaluate changes in structural damage and joint inflammation assessed by MRI following rituximab treatment in a Phase 3 study of patients with active rheumatoid arthritis (RA) despite methotrexate (MTX) who were naive to biological therapy. METHODS: Patients were randomised to receive...

  12. The course of radiologic damage during the first six years of rheumatoid arthritis

    NARCIS (Netherlands)

    Hulsmans, HMJ; Jacobs, JWG; van der Heijde, DMFM; van Albada-Kuipers, GA; Schenk, Y; Bijlsma, JWJ

    2000-01-01

    Objective. To describe the radiologic course in a large cohort of patients with early rheumatoid arthritis (RA) and to analyze individual components of damage. Methods. Five hundred two patients with recent-onset RA (disease duration Results. Stable rates of progression of the SHS, erosion score, an

  13. Aspects of methodology in assessing inflammation and damage in rheumatoid arthritis and axial spondyloarthritis

    NARCIS (Netherlands)

    Navarro Compan, Maria Victoria

    2015-01-01

    This thesis is two-fold focused on rheumatoid arthritis and axial spondyloarthritis. It covers outstanding aspects of research methodology in the assessment of inflammation and damage in patients with these diseases. The studies pertaining to the first part of the thesis focus on rheumatoid arthrit

  14. Juvenile idiopathic arthritis in adulthood: fulfilment of classification criteria for adult rheumatic diseases, long-term outcomes and predictors of inactive disease, functional status and damage

    Science.gov (United States)

    Oliveira-Ramos, Filipa; Eusébio, Mónica; M Martins, Fernando; Mourão, Ana Filipa; Furtado, Carolina; Campanilho-Marques, Raquel; Cordeiro, Inês; Ferreira, Joana; Cerqueira, Marcos; Figueira, Ricardo; Brito, Iva; Santos, Maria José; Melo-Gomes, José A; Fonseca, João Eurico

    2016-01-01

    Objectives To determine how adult juvenile idiopathic arthritis (JIA) patients fulfil classification criteria for adult rheumatic diseases, evaluate their outcomes and determine clinical predictors of inactive disease, functional status and damage. Methods Patients with JIA registered on the Rheumatic Diseases Portuguese Register (Reuma.pt) older than 18 years and with more than 5 years of disease duration were included. Data regarding sociodemographic features, fulfilment of adult classification criteria, Health Assessment Questionnaire, Juvenile Arthritis Damage Index—articular (JADI-A) and Juvenile Arthritis Damage Index—extra-articular (JADI-E) damage index and disease activity were analysed. Results 426 patients were included. Most of patients with systemic JIA fulfilled criteria for Adult Still's disease. 95.6% of the patients with rheumatoid factor (RF)-positive polyarthritis and 57.1% of the patients with RF-negative polyarthritis matched criteria for rheumatoid arthritis (RA). 38.9% of the patients with extended oligoarthritis were classified as RA while 34.8% of the patients with persistent oligoarthritis were classified as spondyloarthritis. Patients with enthesitis-related arthritis fulfilled criteria for spondyloarthritis in 94.7%. Patients with psoriatic arthritis maintained this classification. Patients with inactive disease had lower disease duration, lower diagnosis delay and corticosteroids exposure. Longer disease duration was associated with higher HAQ, JADI-A and JADI-E. Higher JADI-A was also associated with biological treatment and retirement due to JIA disability and higher JADI-E with corticosteroids exposure. Younger age at disease onset was predictive of higher HAQ, JADI-A and JADI-E and decreased the chance of inactive disease. Conclusions Most of the included patients fulfilled classification criteria for adult rheumatic diseases, maintain active disease and have functional impairment. Younger age at disease onset was predictive

  15. Investigation of Sideband Index Response to Prototype Gear Tooth Damage

    Science.gov (United States)

    Dempsey, Paula J.

    2013-01-01

    The objective of this analysis was to evaluate the ability of gear condition indicators (CI) to detect contact fatigue damage on spiral bevel gear teeth. Tests were performed in the NASA Glenn Spiral Bevel Gear Fatigue Rig on eight prototype gear sets (pinion/gear). Damage was initiated and progressed on the gear and pinion teeth. Vibration data was measured during damage progression at varying torque values while varying damage modes to the gear teeth were observed and documented with inspection photos. Sideband indexes (SI) and root mean square (RMS) CIs were calculated from the time synchronous averaged vibration data. Results found that both CIs respond differently to varying torque levels, damage levels and damage modes

  16. Analysis of foot structural damage in rheumatoid arthritis: clinical evaluation by validated measures and serological correlations

    Directory of Open Access Journals (Sweden)

    E. Bartoloni Bocci

    2011-06-01

    Full Text Available Objective: To examine foot involvement in rheumatoid arthritis (RA and to characterize structural alterations in patients with anti-cyclic citrullinated peptide (CCP antibody-positive and -negative disease. Methods: Seventy-eight patients with RA with foot pain were consecutively enrolled. The Manchester Hallux Valgus (MHV rating scale was used to evaluate the hallux valgus deformity degree. The Foot Posture Index (FPI6, a novel, foot-specific outcome measure, was adopted in order to quantify variation in the position of the foot. The findings were correlated with disease duration and presence or absence of anti-CCP antibodies. Results: About 84.6% patients had different degrees of hallux valgus and 65.4% subjects had a pronated foot. These two foot alterations were prevalently found in patients with long-standing disease and circulating anti-CCP antibodies. On the contrary, RA patients without anti-CCP and early disease essentially displayed a supinated foot without relevant hallux valgus deformity. Conclusion: Our findings allowed to identify different anatomic foot alterations in RA patients according to disease duration and negative prognostic factors such as anti-CCP antibodies. Our findings support the role of an accurate analysis of foot structural damage and may suggest the usefulness of a correct plantar orthosis prescription also in early phases of the disease.

  17. Radiographic damage in large joints in early rheumatoid arthritis : Relationship with radiographic damage in hands and feet, disease activity, and physical disability

    NARCIS (Netherlands)

    Kuper, HH; VanLeeuwen, MA; VanRiel, PLCM; Prevoo, MLL; Houtman, PM; Lolkema, WF; VanRijwijk, MH

    1997-01-01

    An assessment of the onset of radiographic damage in the large joints (hip, knees, shoulders, elbows, ankles and tarsus) in patients with early rheumatoid arthritis, and the relationship of the progression of large joint damage with joint damage in hands and feet, with physical disability, and with

  18. Inflammation and damage in an individual joint predict further damage in that joint in patients with early rheumatoid arthritis.

    Science.gov (United States)

    Boers, M; Kostense, P J; Verhoeven, A C; van der Linden, S

    2001-10-01

    OBJECTIVE; Several factors predict joint damage in early rheumatoid arthritis (RA). In the context of a trial in early RA, we studied the relationship between clinical signs in individual joints and their propensity to develop progressive damage. The COBRA (Combinatietherapie Bij Reumatoide Artritis) multicenter trial compared the efficacy of prednisolone, methotrexate, and sulfasalazine against sulfasalazine alone in 155 patients with early RA. Two blinded observers interpreted radiographs in sequence (using the Sharp/Van der Heijde scoring system); in each center, one blinded observer performed clinical assessments every 3 months. The current analysis is based on clinical and radiologic data of the individual metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints of 135 patients. Conditional stepwise logistic regression analyzed the relationship between damage (progression) and clinical signs at baseline and followup for each of these joints individually in each patient. Combination therapy strongly retarded the progression of damage. Progression was stronger in patients with rheumatoid factor, HLA-DR4, and high levels of disease activity at baseline. At baseline, 6% of the MCP and PIP joints showed damage; after 1 year, disease had progressed in 10% of these joints. Baseline damage, swelling, or pain in a joint independently and strongly predicted the progression of damage in that joint (P < 0.001). Each additional point in the swelling score (range 0-2) tripled the risk for subsequent progression. Each additional point on the Sharp scale (range 0-8 per joint) and each additional point on the pain scale (range 0-3) doubled the risk. The mean pain and swelling scores over the year were even stronger predictors of damage. Local expression of early RA disease activity, both at baseline and at 1-year followup, is strongly related to progression of damage in the individual joint.

  19. Quantifying disease activity and damage by imaging in rheumatoid arthritis and osteoarthritis

    DEFF Research Database (Denmark)

    Kubassova, Olga; Boesen, Mikael; Peloschek, Philipp;

    2009-01-01

    an impression of the actual disease processes, which subsequently lead to the damage. Such information is required to facilitate the development of efficient therapy against arthritis. Newer technology, exemplified by MRI and ultrasound Doppler, supplements images of structural change with functional data...... of ongoing disease activity. This chapter focuses on the possibilities for quantification of images in MRI and ultrasound, in which postcontrast enhancement and Doppler information, respectively, are of special interest for the evaluation of the inflammatory changes of arthritis. To save time and eliminate...... human bias, automation is mandatory. In ultrasound, semiautomatic evaluations are coming that allow for a real-time, reproducible estimate of disease activity. With MRI fully automated algorithms have been developed for processing of data of bony structures, cartilage, and soft tissue, and are currently...

  20. Structural damage in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis: traditional views, novel insights gained from TNF blockade, and concepts for the future

    Science.gov (United States)

    2011-01-01

    Structural changes of bone and cartilage are a hallmark of inflammatory joint diseases such as rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS). Despite certain similarities – in particular, inflammation as the driving force for structural changes – the three major inflammatory joint diseases show considerably different pathologies. Whereas RA primarily results in bone and cartilage resorption, PsA combines destructive elements with anabolic bone responses, and AS is the prototype of a hyper-responsive joint disease associated with substantial bone and cartilage apposition. In the present review we summarize the clinical picture and pathophysiologic processes of bone and cartilage damage in RA, PsA, and AS, we describe the key insights obtained from the introduction of TNF blockade, and we discuss the future challenges and frontiers of structural damage in arthritis. PMID:21624183

  1. Damage detection of flexural structural systems using damage index method – Experimental

    Directory of Open Access Journals (Sweden)

    Atef Eraky

    2015-09-01

    Full Text Available In the framework of structural health monitoring, continuous dynamic records are essential for good judgment of structures. Overall degradation of structures can be obtained with reasonable accuracy using various system identification techniques. It is however, challenging to obtain precisely the position and size of local damages. The current research focuses on Damage Index Method (DIM as a tool for determining local damages occurred in flexural structural elements. The DIM technique depends on comparing modal strain energies of structures at different degradation stages. Self-made computer module was developed to encounter DIM for damage detection. First, the method was verified experimentally. Simply supported steel beam of 1500 mm (length, 50 mm (width and 6 mm (thickness, in addition to steel plate of area 930 × 910 mm and 3 mm (thickness was implemented in the experimental program. Both the beam and plate were subjected to different damage configurations. Collected acceleration time history was processed and used to verify the adequacy of DIM in identifying damages in the used physical models. Numerical parametric study was also conducted on a variety of beams and plates with various damage degrees and locations. It was noticed that both the experimental and numerical results showed good agreement in identifying damages in flexural structural elements.

  2. Comparison between quality and quantity seismic damage index for LSF systems

    Directory of Open Access Journals (Sweden)

    Hossein Mirzaaghabeik

    2016-03-01

    Since the damage index of light steel structure for Model 1 and Model 3 are between 0.4 and 0.8, it is necessary to rehabilitate these structures using the modified method and the proposed qualitative damage index.

  3. MRI assessment of suppression of structural damage in patients with rheumatoid arthritis receiving rituximab

    DEFF Research Database (Denmark)

    Peterfy, Charles; Emery, Paul; Tak, Paul P

    2016-01-01

    Objective. To evaluate changes in structural damage and joint inflammation assessed by MRI following rituximab treatment in a Phase 3 study of patients with active rheumatoid arthritis (RA) despite methotrexate (MTX) who were naive to biological therapy. Methods. Patients were randomised to receive...... two infusions of placebo (n=63), rituximab 500 mg (n=62), or rituximab 1000 mg (n=60) intravenously on days 1 and 15. MRI scans and radiographs of the most inflamed hand and wrist were acquired at baseline, weeks 12 (MRI only), 24 and 52. The primary end point was the change in MRI erosion score from...

  4. A formyl peptide receptor agonist suppresses inflammation and bone damage in arthritis.

    Science.gov (United States)

    Kao, W; Gu, R; Jia, Y; Wei, Xuemin; Fan, H; Harris, J; Zhang, Zhiyi; Quinn, J; Morand, E F; Yang, Y H

    2014-09-01

    Annexin A1 (AnxA1) is an endogenous anti-inflammatory protein and agonist of the formyl peptide receptor 2 (FPR2). However, the potential for therapeutic FPR ligands to modify immune-mediated disease has been little explored. We investigated the effects of a synthetic FPR agonist on joint disease in the K/BxN model of rheumatoid arthritis (RA) and RA fibroblast-like synoviocytes (FLS). Arthritis was induced by injection of K/BxN serum at day 0 and 2 in wild-type (WT) or AnxA1(-/-) mice and clinical and histopathological manifestations measured 8-11 days later. WT mice were given the FPR agonist compound 43 (Cpd43) (6 or 30 mg·kg(-1) i.p.) for 4 days. Effects of AnxA1 and Cpd43 on RANKL-induced osteoclastogenesis were assessed in RAW 264.7 cells and human RA FLS and macrophages. Treatment with Cpd43 before or after the onset of arthritis reduced clinical disease severity and attenuated synovial TNF-α and osteoclast-associated gene expression. Deletion of AnxA1 in mice exacerbated arthritis severity in the K/BxN model. In vitro, Cpd43 suppressed osteoclastogenesis and NFAT activity elicited by RANKL, and inhibited IL-6 secretion by mouse macrophages. In human RA joint-derived FLS and monocyte-derived macrophages, Cpd43 treatment inhibited IL-6 release, while blocking FPR2 or silencing AnxA1 increased this release. The FPR agonist Cpd43 reduced osteoclastogenesis and inflammation in a mouse model of RA and exhibited anti-inflammatory effects in relevant human cells. These data suggest that FPR ligands may represent novel therapeutic agents capable of ameliorating inflammation and bone damage in RA. © 2014 The British Pharmacological Society.

  5. Proposal for levels of evidence schema for validation of a soluble biomarker reflecting damage endpoints in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis, and recommendations for study design

    DEFF Research Database (Denmark)

    Maksymowych, Walter P; Fitzgerald, Oliver; Wells, George A

    2009-01-01

    arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS). We also aimed to generate consensus on minimum standards for the design of longitudinal studies aimed at validating biomarkers. METHODS: Before the meeting, the Soluble Biomarker Working Group prepared a preliminary framework...... and discussed various models for association and prediction related to the statistical strength domain. In addition, 3 Delphi exercises addressing longitudinal study design for RA, PsA, and AS were conducted within the working group and members of the Assessments in SpondyloArthritis International Society (ASAS...... Biomarker Group has successfully formulated a levels of evidence scheme and a study design template that will provide guidance to conduct validation studies in the setting of soluble biomarkers proposed to replace the measurement of damage endpoints in RA, PsA, and AS....

  6. Autoimmunity as a trigger for structural bone damage in rheumatoid arthritis.

    Science.gov (United States)

    Schett, Georg

    2017-03-01

    Bone loss is a central feature of rheumatoid arthritis (RA). It is considered to represent a sign of irreversible structural damage triggered by chronic inflammation. Recent evidence, however, suggests that autoantibodies are an important and earlier driver for bone damage in RA. This article summarizes current evidence for the role of RA-related autoantibodies in mediating bone loss. Rheumatoid factor and antibodies recognizing modified (citrullinated) proteins are the central features of autoimmunity in RA patients. Despite being used as diagnostic markers for many years, ascertaining the differentiation of RA from other forms of inflammatory arthritides, the role of these antibodies as pathogenic players has long been unrecognized. Recently, several pieces of evidence suggested that bone-resorbing osteoclasts are highly responsive to RA-related autoantibodies, providing a novel link between autoimmunity and bone. These developments have allowed unraveling the underlying mechanisms, which are responsible for the well-known clinical observation that RA-related autoantibodies are associated with a more severe disease course. At present, rheumatoid factor and antibodies recognizing citrullinated proteins are considered as potent osteoclast inducers and triggers for bone loss in arthritis.

  7. Assessment of cardiovascular risk in patients with rheumatoid arthritis using the SCORE risk index.

    Science.gov (United States)

    de Campos, Otávio Augusto Martins; Nazário, Nazaré Otília; de Magalhães Souza Fialho, Sônia Cristina; Fialho, Guilherme Loureiro; de Oliveira, Fernando José Savóia; de Castro, Gláucio Ricardo Werner; Pereira, Ivânio Alves

    2016-01-01

    Rheumatoid arthritis is an autoimmune disease that causes systemic involvement and is associated with increased risk of cardiovascular disease. To analyze the prediction index of 10-year risk of a fatal cardiovascular disease event in female RA patients versus controls. Case-control study with analysis of 100 female patients matched for age and gender versus 100 patients in the control group. For the prediction of 10-year risk of a fatal cardiovascular disease event, the SCORE and modified SCORE (mSCORE) risk indexes were used, as suggested by EULAR, in the subgroup with two or more of the following: duration of disease ≥10 years, RF and/or anti-CCP positivity, and extra-articular manifestations. The prevalence of analyzed comorbidities was similar in RA patients compared with the control group (p>0.05). The means of the SCORE risk index in RA patients and in the control group were 1.99 (SD: 1.89) and 1.56 (SD: 1.87) (p=0.06), respectively. The means of mSCORE index in RA patients and in the control group were 2.84 (SD=2.86) and 1.56 (SD=1.87) (p=0.001), respectively. By using the SCORE risk index, 11% of RA patients were classified as of high risk, and with the use of mSCORE risk index, 36% were at high risk (p<0.001). The SCORE risk index is similar in both groups, but with the application of the mSCORE index, we recognized that RA patients have a higher 10-year risk of a fatal cardiovascular disease event, and this reinforces the importance of factors inherent to the disease not measured in the SCORE risk index, but considered in mSCORE risk index. Copyright © 2015 Elsevier Editora Ltda. All rights reserved.

  8. Assessment by MRI of inflammation and damage in rheumatoid arthritis patients with methotrexate inadequate response receiving golimumab: results of the GO-FORWARD trial

    DEFF Research Database (Denmark)

    Conaghan, Philip G; Emery, Paul; Østergaard, Mikkel;

    2011-01-01

    To evaluate golimumab's effect on MRI-detected inflammation and structural damage in patients with active rheumatoid arthritis (RA) despite methotrexate (MTX).......To evaluate golimumab's effect on MRI-detected inflammation and structural damage in patients with active rheumatoid arthritis (RA) despite methotrexate (MTX)....

  9. Simulating of marble subjected to uni-axial loading using index-parabola damage model

    Institute of Scientific and Technical Information of China (English)

    温世游; 李夕兵; 骆达成

    2001-01-01

    The limitations of several existing classical rock damage models were critically appraised. Thereafter, a description of a new model to estimate the response of rock was provided. The results of an investigation lead to the development and confirmation of a new index-parabola damage model. The new model is divided into two parts, fictitious damage and real damage and bordered by the critical damage point. In fictitious damage, the damage variable follows the index distribution, while in the real damage a parabolic distribution is used. Thus, the so-called index-parabola damage model is derived. The proposed damage model is applied to simulate the damage procedure of marble under uni-axial loading. The results of the tests show that the proposed model is in excellent agreement with experimental data, in particular the nonlinear characteristic of rock deformation is adequately represented.

  10. Osteoarthritis-like damage of cartilage in the temporomandibular joints in mice with autoimmune inflammatory arthritis

    Science.gov (United States)

    Ghassemi-Nejad, S.; Kobezda, T.; Rauch, T.A.; Matesz, C.; Glant, T.T.; Mikecz, K.

    2011-01-01

    Summary Objective To study temporomandibular joint (TMJ) involvement in an autoimmune murine model of rheumatoid arthritis (RA), a disease characterized by inflammatory destruction of the synovial joints. Although TMJ dysfunction is frequently found in RA, TMJ involvement in RA remains unclear, and TMJ pathology has not been studied in systemic autoimmune animal models of RA. Methods Proteoglycan (PG) aggrecan-induced arthritis (PGIA) was generated in genetically susceptible BALB/c mice. TMJs and joint tissues/cartilage were harvested for histological and immunohistochemical analyses and RNA isolation for quantitative polymerase chain reaction. Serum cytokine levels were measured in mice with acute or chronic arthritis, and in non-arthritic control animals. Results Despite the development of destructive synovitis in the limbs, little or no synovial inflammation was found in the TMJs of mice with PGIA. However, the TMJs of arthritic mice showed evidence of aggrecanase- and matrix metalloproteinase-mediated loss of glycosaminoglycan-containing aggrecan, and in the most severe cases, structural damage of cartilage. Serum levels of pro-inflammatory cytokines, including interleukin (IL)-1β, were elevated in arthritic animals. Expression of the IL-1β gene was also high in the inflamed limbs, but essentially normal in the TMJs. Local expression of genes encoding matrix-degrading enzymes (aggrecanases and stromelysin) was upregulated to a similar degree in both the limbs and the TMJs. Conclusion We propose that constantly elevated levels of catabolic cytokines, such as IL-1β, in the circulation (released from inflamed joints) create a pro-inflammatory milieu within the TMJ, causing local upregulation of proteolytic enzymes and subsequent loss of aggrecan from cartilage. PMID:21262368

  11. Rituximab inhibits structural joint damage in patients with rheumatoid arthritis with an inadequate response to tumour necrosis factor inhibitor therapies

    NARCIS (Netherlands)

    Keystone, E.; Emery, P.; Peterfy, C.G.; Tak, P.P.; Cohen, S.; Genovese, M.C.; Dougados, M.; Burmester, G.R.; Greenwald, M.; Kvien, T.K.; Williams, S.; Hagerty, D.; Cravets, M.W.; Shaw, T.

    2009-01-01

    OBJECTIVE: To determine if treatment with a B cell-targeted therapy can inhibit the progression of structural joint damage in patients with rheumatoid arthritis (RA), exhibiting an inadequate response to tumour necrosis factor (TNF) inhibitors. METHODS: In this phase III study, patients with an inad

  12. Anaemia may add information to standardised disease activity assessment to predict radiographic damage in rheumatoid arthritis: a prospective cohort study.

    Science.gov (United States)

    Möller, Burkhard; Scherer, Almut; Förger, Frauke; Villiger, Peter M; Finckh, Axel

    2014-04-01

    Anaemia in rheumatoid arthritis (RA) is prototypical of the chronic disease type and is often neglected in clinical practice. We studied anaemia in relation to disease activity, medications and radiographic progression. Data were collected between 1996 and 2007 over a mean follow-up of 2.2 years. Anaemia was defined according to WHO (♀ haemoglobinAnaemia prevalence was studied in relation to disease parameters and pharmacological therapy. Radiographic progression was analysed in 9731 radiograph sets from 2681 patients in crude longitudinal regression models and after adjusting for potential confounding factors, including the clinical disease activity score with the 28-joint count for tender and swollen joints and erythrocyte sedimentation rate (DAS28ESR) or the clinical disease activity index (cDAI), synthetic antirheumatic drugs and antitumour necrosis factor (TNF) therapy. Anaemia prevalence decreased from more than 24% in years before 2001 to 15% in 2007. Erosions progressed significantly faster in patients with anaemia (panaemia, suggesting a 'dose-response effect'. The effect of anaemia on damage progression was maintained in subgroups of patients treated with TNF blockade or corticosteroids, and without non-selective nonsteroidal anti-inflammatory drugs (NSAIDs). Anaemia in RA appears to capture disease processes that remain unmeasured by established disease activity measures in patients with or without TNF blockade, and may help to identify patients with more rapid erosive disease.

  13. Diffuse damage to central nervous system in progressive rheumatoid arthritis complicated by cerebral hermorrhage after radioisotope cisternography

    Energy Technology Data Exchange (ETDEWEB)

    Tarnowska-Dziduszko, E.; Lazarowicz, J. (Instytut Psychoneurologiczny, Warsaw (Poland))

    1980-01-01

    Presented case reveals unusual reaction of central nervous system in the course of progressive rheumatoid arthritis and cerebral hemorrhage as a rare complication after radioisotope investigation of cerebro-spinal fluid spaces. Female, 58 years old which was treated for 22 years for progressive rheumatoid arthritis developed during last 3 years of life a psychoorganic syndrome with temporal epilepsy and slight left sided hemiparesis. After radioisotope cisternography appeared decerebration followed by death. On autopsy the hemorrhagic foci were found in left cerebral hemisphere and in the brain stem. Histological finding was generalized severe damage to interstitial vessels diagnosed as fibrinotic, necrotizing degeneration of capillary and arteriolar wall, significant proliferation of microglia in the white matter and brain stem. Chronic inflammatory infiltrates were present in leptomeninges. Pathogenesis of findings in connection with progressive rheumatoid arthritis and complications due to cisternography is discussed.

  14. Cut-Offs and Response Criteria for the Hospital Universitario La Princesa Index (HUPI) and Their Comparison to Widely-Used Indices of Disease Activity in Rheumatoid Arthritis

    OpenAIRE

    González-Álvaro, Isidoro; Castrejón, Isabel; Ortiz, Ana M; Toledano, Esther; Castañeda, Santos; García-Vadillo, Alberto; Carmona, Loreto; ,

    2016-01-01

    Objective To estimate cut-off points and to establish response criteria for the Hospital Universitario La Princesa Index (HUPI) in patients with chronic polyarthritis. Methods Two cohorts, one of early arthritis (Princesa Early Arthritis Register Longitudinal [PEARL] study) and other of long-term rheumatoid arthritis (Estudio de la Morbilidad y Expresión Clínica de la Artritis Reumatoide [EMECAR]) including altogether 1200 patients were used to determine cut-off values for remission, and for ...

  15. Association of Body Mass Index with Physical Function and Health-Related Quality of Life in Adults with Arthritis

    Directory of Open Access Journals (Sweden)

    Danielle E. Schoffman

    2013-01-01

    Full Text Available Arthritis and obesity, both highly prevalent, contribute greatly to the burden of disability in US adults. We examined whether body mass index (BMI was associated with physical function and health-related quality of life (HRQOL measures among adults with arthritis and other rheumatic conditions. We assessed objectively measured BMI and physical functioning (six-minute walk, chair stand, seated reach, walking velocity, hand grip and self-reported HRQOL (depression, stiffness, pain, fatigue, disability, quality of life-mental, and quality of life, physical were assessed. Self-reported age, gender, race, physical activity, and arthritis medication use (covariates were also assessed. Unadjusted and adjusted linear regression models examined the association between BMI and objective measures of functioning and self-reported measures of HRQOL. BMI was significantly associated with all functional (Ps≤0.007 and HRQOL measures (Ps≤0.03 in the unadjusted models. Associations between BMI and all functional measures (Ps≤0.001 and most HRQOL measures remained significant in the adjusted models (Ps≤0.05; depression and quality of life, physical, were not significant. The present analysis of a range of HRQOL and objective measures of physical function demonstrates the debilitating effects of the combination of overweight and arthritis and other rheumatic conditions. Future research should focus on developing effective group and self-management programs for weight loss for people with arthritis and other rheumatic conditions (registered on clinicaltrials.gov: NCT01172327.

  16. Development of the autoinflammatory disease damage index (ADDI)

    DEFF Research Database (Denmark)

    Ter Haar, Nienke M; Annink, Kim V; Al-Mayouf, Sulaiman M

    2016-01-01

    OBJECTIVES: Autoinflammatory diseases cause systemic inflammation that can result in damage to multiple organs. A validated instrument is essential to quantify damage in individual patients and to compare disease outcomes in clinical studies. Currently, there is no such tool. Our objective was to...

  17. Cartilage damage and bone erosion are more prominent determinants of functional impairment in longstanding experimental arthritis than synovial inflammation

    Directory of Open Access Journals (Sweden)

    Silvia Hayer

    2016-11-01

    Full Text Available Chronic inflammation of articular joints causing bone and cartilage destruction consequently leads to functional impairment or loss of mobility in affected joints from individuals affected by rheumatoid arthritis (RA. Even successful treatment with complete resolution of synovial inflammatory processes does not lead to full reversal of joint functionality, pointing to the crucial contribution of irreversibly damaged structural components, such as bone and cartilage, to restricted joint mobility. In this context, we investigated the impact of the distinct components, including synovial inflammation, bone erosion or cartilage damage, as well as the effect of blocking tumor necrosis factor (TNF on functional impairment in human-TNF transgenic (hTNFtg mice, a chronic inflammatory erosive animal model of RA. We determined CatWalk-assisted gait profiles as objective quantitative measurements of functional impairment. We first determined body-weight-independent gait parameters, including maximum intensity, print length, print width and print area in wild-type mice. We observed early changes in those gait parameters in hTNFtg mice at week 5 – the first clinical signs of arthritis. Moreover, we found further gait changes during chronic disease development, indicating progressive functional impairment in hTNFtg mice. By investigating the association of gait parameters with inflammation-mediated joint pathologies at different time points of the disease course, we found a relationship between gait parameters and the extent of cartilage damage and bone erosions, but not with the extent of synovitis in this chronic model. Next, we observed a significant improvement of functional impairment upon blocking TNF, even at progressed stages of disease. However, blocking TNF did not restore full functionality owing to remaining subclinical inflammation and structural microdamage. In conclusion, CatWalk gait analysis provides a useful tool for quantitative

  18. Development of a preliminary composite disease activity index in psoriatic arthritis.

    LENUS (Irish Health Repository)

    Mumtaz, Aizad

    2012-02-01

    OBJECTIVES: To develop a preliminary composite psoriatic disease activity index (CPDAI) for psoriasis and psoriatic arthritis. METHODS: Five domains were assessed and specific instruments were employed for each domain to determine the extent of domain involvement and the effect of that involvement on quality of life\\/function. Disease activity for each domain was then graded from 0 to 3 giving a CPDAI range of 0-15. Patient and physician global disease activity measures were also recorded and an independent physician was asked to indicate if treatment change was required. Bivariate correlation analysis was performed. Factor, tree analysis and standardised response means were also calculated. RESULTS: Significant correlation was seen between CPDAI and both patient (r = 0.834) and physician (r = 0.825) global disease activity assessments (p = 0.01). Tree analysis revealed that 96.3% of patients had their treatment changed when CPDAI values were greater than 6; no patient had their treatment changed when CPDAI values were less than 5. CONCLUSION: CPDAI correlates well with patient and physician global disease activity assessments and is an effective tool that clearly distinguishes those who require a treatment change from those who do not.

  19. Low body mass index is associated with impaired quality of life in patients with rheumatoid arthritis.

    Science.gov (United States)

    Fukuda, Wataru; Omoto, Atsushi; Ohta, Tamaki; Majima, Saori; Kimura, Toshihiro; Tanaka, Toru; Kohno, Masataka; Kawahito, Yutaka

    2013-06-01

    To investigate the relationship between quality of life (QOL) and rheumatoid chachesia, malnutrition in patients with rheumatoid arthritis (RA). EuroQol Group 5-Dimension Self-Report Questionnaire (EQ5D) and Japanese Health Assessment Questionnaire (JHAQ) scores, body mass index (BMI), arm muscle area (AMA) and clinical indicators were measured in 385 RA patients. One-way analysis of variance for obtained data was conducted among three groups: 131 with low BMI (< 20), 163 with moderate (20-25) and 91 with high BMI (≥25). Then multiple regression analyses for JHAQ and EQ5D scores with nutritional and clinical indicators as independent variables were performed. EQ5D and JHAQ scores were significantly lower and higher, respectively, in the low BMI group than those in the moderate BMI group. Clinical indicators including doses of corticosteroid were similar among the three groups except for disease duration. Disease activity score (DAS) 28, disease duration, C-reactive protein and AMA were significant variables in the regression model for EQ5D. Low BMI deteriorates the QOL of RA patients. Muscle protein loss apparently leads to a reduction in BMI and QOL. © 2013 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  20. Body Mass Index, Weight Loss, and Cause-Specific Mortality in Rheumatoid Arthritis.

    Science.gov (United States)

    England, Bryant R; Baker, Joshua F; Sayles, Harlan; Michaud, Kaleb; Caplan, Liron; Davis, Lisa A; Cannon, Grant W; Sauer, Brian C; Solow, E Blair; Reimold, Andreas M; Kerr, Gail S; Mikuls, Ted R

    2017-04-20

    To examine associations of body mass index (BMI) and weight loss with cause-specific mortality in rheumatoid arthritis (RA). A cohort of U.S. Veterans with RA were followed until death or through 2013. BMI was categorized as underweight, normal, overweight, and obese. Weight loss was calculated as the: 1) annualized rate of change over the preceding 13 months and 2) cumulative percent. Vital status and cause of death were obtained from the National Death Index. Multivariable competing-risks regression models were utilized to assess the time-varying associations of BMI and weight loss with cause-specific mortality. Among 1,600 participants and 5,789 patient-years of follow-up, 303 deaths occurred (95 cardiovascular, 74 cancer, 46 respiratory). The highest weight loss rate and weight loss percentage were associated with a higher risk of cardiovascular (rate: sHR 2.27 [95% CI 1.61-3.19]; percent: sHR 2.31[1.06-5.01]) and cancer mortality (rate: sHR 2.36 [1.11-5.01]; percent: sHR 1.90 [1.00-3.62]). Overweight BMI was protective of cardiovascular mortality (sHR 0.59 [0.38-0.91]), while underweight BMI was associated with a near 3-fold increased risk of respiratory mortality (sHR 2.93 [1.28-6.67]). Incorporation of time-varying BMI and weight loss in the same models did not substantially alter individual associations for cardiovascular and cancer mortality, but an association between weight loss percent and respiratory mortality was attenuated after BMI adjustment. Both BMI and weight loss are predictors of cause-specific mortality in RA. Weight loss is a strong predictor of cardiovascular and cancer mortality, while underweight BMI is a stronger predictor of respiratory mortality. This article is protected by copyright. All rights reserved. © 2017, American College of Rheumatology.

  1. Anti-type II collagen antibodies, anti-CCP, IgA RF and IgM RF are associated with joint damage, assessed eight years after onset of juvenile idiopathic arthritis (JIA).

    Science.gov (United States)

    Berntson, Lillemor; Nordal, Ellen; Fasth, Anders; Aalto, Kristiina; Herlin, Troels; Nielsen, Susan; Rygg, Marite; Zak, Marek; Rönnelid, Johan

    2014-01-01

    Early appearance of antibodies specific for native human type II collagen (anti-CII) characterizes an early inflammatory and destructive phenotype in adults with rheumatoid arthritis (RA). The objective of this study was to investigate the occurrence of anti-CII, IgM RF, IgA RF and anti-CCP in serum samples obtained early after diagnosis, and to relate the occurrence of autoantibodies to outcome after eight years of disease in children with juvenile idiopathic arthritis (JIA). The Nordic JIA database prospectively included JIA patients followed for eight years with data on remission and joint damage. From this database, serum samples collected from 192 patients, at a median of four months after disease onset, were analysed for IgG anti-CII, IgM RF, IgA RF and IgG anti-CCP. Joint damage was assessed based on Juvenile Arthritis Damage Index for Articular damage (JADI-A), a validated clinical instrument for joint damage. Elevated serum levels of anti-CII occurred in 3.1%, IgM RF in 3.6%, IgA RF in 3.1% and anti-CCP in 2.6% of the patients. Occurrence of RF and anti-CCP did to some extent overlap, but rarely with anti-CII. The polyarticular and oligoarticular extended categories were overrepresented in patients with two or more autoantibodies. Anti-CII occurred in younger children, usually without overlap with the other autoantibodies and was associated with high levels of C-reactive protein (CRP) early in the disease course. All four autoantibodies were significantly associated with joint damage, but not with active disease at the eight-year follow up. Anti-CII, anti-CCP, IgA RF and IgM RF detected early in the disease course predicted joint damage when assessed after eight years of disease. The role of anti-CII in JIA should be further studied.

  2. Diet quality of individuals with rheumatoid arthritis using the Healthy Eating Index (HEI)-2010.

    Science.gov (United States)

    Berube, Lauren Thomas; Kiely, Mary; Yazici, Yusuf; Woolf, Kathleen

    2017-03-01

    Rheumatoid arthritis (RA) afflicts approximately 1.5 million American adults and is a major cause of disability. As disease severity worsens, individuals with RA may experience functional decline that can impact dietary intake. The objective of this study is to assess the diet quality of individuals with RA using the Healthy Eating Index (HEI)-2010 and examine associations between diet quality and disease activity and functional status. This cross-sectional study assessed diet quality and disease activity and functional status in adults with RA. Participants completed seven-day weighed food records, which were scored using the HEI-2010. Participants had a fasting blood draw and completed the Multidimensional Health Assessment Questionnaire to determine disease activity and functional status. The mean age of individuals with RA ( N = 84) was 53 ± 14 years, and 86.9% were female. The mean HEI-2010 total score was 58.7 ± 15.9, with 7.1% of participants scoring "good", 58.3% "fair", and 34.5% "poor". Most participants did not adhere to recommended intakes of total fruit, total vegetables, whole grains, fatty acids, refined grains, sodium, and empty calories. An unadjusted multiple linear regression model found duration of morning stiffness and C-reactive protein concentration to be significant variables to inversely predict HEI-2010 total score. The diet quality of many individuals with RA needs improvement and may be related to functional disability associated with RA. Healthcare providers should encourage individuals with RA to meet dietary guidelines and maintain a healthy diet. Moreover, healthcare providers should be aware of the potential impacts of functional disability on diet quality in individuals with RA.

  3. Association with joint damage and physical functioning of nine composite indices and the 2011 ACR/EULAR remission criteria in rheumatoid arthritis.

    Science.gov (United States)

    Klarenbeek, N B; Koevoets, R; van der Heijde, D M F M; Gerards, A H; Ten Wolde, S; Kerstens, P J S M; Huizinga, T W J; Dijkmans, B A C; Allaart, C F

    2011-10-01

    To compare nine disease activity indices and the new American College of Rheumatology (ACR)/European League against Rheumatism (EULAR) remission criteria in rheumatoid arthritis (RA) and to relate these to physical function and joint damage progression. Five-year data from the BeSt study were used, a randomised clinical trial comparing four treatment strategies in 508 patients with recent-onset RA. Every three months disease activity was assessed with nine indices (Disease Activity Score (DAS), DAS-C reactive proteine (DAS-CRP), Disease Activity Score in 28 joints (DAS-28), DAS28-CRP, Simplified Disease Activity Index (SDAI), Clinical Disease Activity Index (CDAI) and three DAS versions with adjusted tender joint scores) and categorized into remission, low, moderate and high disease activity (LDA, MDA, HDA). In addition, the recent ACR/EULAR clinical trial and practice remission was assessed 3-monthly with 28 and 68/66 joint counts. For each index, Generalized Estimating Equations analyses were performed to relate disease activity levels and the absence/presence of remission to 3-monthly assessments of physical functioning and annual radiological progression. From the composite indices, CDAI and SDAI were the most stringent definitions of remission and classified more patients as LDA. DAS28 and DAS28-CRP had the highest proportions of remission and MDA and a smaller proportion of LDA. ACR/EULAR remission percentages were comparable to CDAI/SDAI: remission percentages. The variant including CRP and 68/66 joint counts was the most stringent. For all indices, higher levels of disease activity were associated with decreased physical functioning and more radiological damage progression. Despite differences in classification between the indices, no major differences in relation to the two outcomes were observed. The associations of nine composite indices and ACR/EULAR remission criteria with functional status and joint damage progression showed high accordance, whereas

  4. A new method to assess damage to RCMRFs from period elongation and Park-Ang damage index using IDA

    Science.gov (United States)

    Aghagholizadeh, Mehrdad; Massumi, Ali

    2016-09-01

    Despite a significant progress in loading and design codes of seismic resistant structures and technology improvements in building structures, the field of civil engineering is still facing critical challenges. An example of those challenges is the assessment of the state of damage that has been imposed to a structure after earthquakes of different intensities. To determine the operability of a structure and its resistance to probable future earthquakes, quick assessment of damages and determining the operability of a structure after an earthquake are crucial. Present methods to calculate damage to structures are time consuming and do not accurately provide the rate of damage. Damage estimation is important task in the fields of structural health monitoring and decision-making. This study examines the relationship between period elongation and the Park-Ang damage index. A dynamic non-linear analysis is employed with IDARC program to calculate the amount of damage and period of the current state. This new method is shown to be a quick and accurate technique for damage assessment. It is easy to calculate the period of an existing structure and changes in the period which reflects changes in the stiffness matrix.

  5. Monoarticular Arthritis.

    Science.gov (United States)

    Singh, Namrata; Vogelgesang, Scott A

    2017-05-01

    Monoarticular arthritis is inflammation characterized by joint pain, swelling, and sometimes periarticular erythema. Although chronic causes are seen, the onset is often acute. An infected joint can quickly lead to permanent damage, making it a medical emergency. However, acute gout presenting as monoarticular arthritis is often so uncomfortable it requires urgent attention. Monoarticular crystalline arthritis is common and a septic joint is a medical emergency so it is no surprise that these diagnoses come to mind with complaint of inflammation in 1 joint. However, there are many causes of monoarticular arthritis that clinicians must consider. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Significance of liver biopsy for the evaluation of methotrexate-induced liver damage in patients with rheumatoid arthritis.

    Science.gov (United States)

    Osuga, Tatsuya; Ikura, Yoshihiro; Kadota, Chikara; Hirano, Seiichi; Iwai, Yasuhiro; Hayakumo, Takanobu

    2015-01-01

    It is well recognized that long-term administration of methotrexate (MTX) in patients with rheumatoid arthritis (RA) can induce liver fibrosis via a steatohepatitis-like inflammatory process. Several non-invasive tests have been investigated as alternatives to liver biopsy, which is, however, still recognized as a final diagnostic modality to detect the MTX-induced liver damage. To clarify whether there is a significant discrepancy between clinical estimations and pathologic findings of this hepatic condition, we performed a following comparative study. Four RA patients (4 women, age 67-80 yr) with MTX-induced liver damage were reviewed. The severity of hepatic damage estimated clinically was compared with histopathologic findings. Consequently, the liver biopsies showed the relatively earlier stages of and milder degrees of hepatic damages than the clinical estimations. The histopathologic findings were more reliable and useful than any other clinical examinations, to plan and modify the treatment strategies, especially in cases of liver damages with multiple etiologies besides MTX. These findings suggest that liver biopsy is an unavoidable examination to assess precisely MTX-induced liver damage. Non-invasive tests may be useful to monitor the hepatic condition of RA patients receiving MTX but do not constitute an acceptable alternative to liver biopsy.

  7. An external validation study reporting poor correlation between the claims-based index for rheumatoid arthritis severity and the disease activity score

    OpenAIRE

    Desai, Rishi J.; Solomon, Daniel H.; Michael E Weinblatt; Shadick, Nancy; Kim, Seoyoung C.

    2015-01-01

    Introduction: We conducted an external validation study to examine the correlation of a previously published claims-based index for rheumatoid arthritis severity (CIRAS) with disease activity score in 28 joints calculated by using C-reactive protein (DAS28-CRP) and the multi-dimensional health assessment questionnaire (MD-HAQ) physical function score. Methods: Patients enrolled in the Brigham and Women’s Hospital Rheumatoid Arthritis Sequential Study (BRASS) and Medicare were identified and t...

  8. Changes of CD4+ CD25+ Regulatory T Cells, FoxP3 in Adjuvant Arthritis Rats with Damage of Pulmonary Function and Effects of Tripterygium Glycosides Tablet

    OpenAIRE

    Wan Lei; Liu Jian

    2012-01-01

    Objective. To observe the effects of tripterygium glycosides tablet (TPT) on swelling degree, arthritis index (AI), pulmonary function, cytokines, the expression of regulatory T cells (Treg), and Foxp3 in rats of adjuvant arthritis. Methods. Rats were averagely divided into normal control (NC) group, model control (MC) group, methotrexate (MTX) group, and tripterygium glycosides tablet (TPT) group. Except for the rats of normal group, the others were intracutaneously injected with 0.1 mL of F...

  9. Damage Location Index of Shear Structures Based on Changes in First Two Natural Frequencies

    Directory of Open Access Journals (Sweden)

    Hien HoThu

    2014-01-01

    Full Text Available A method of detecting the location of damage in shear structures by using only the changes in first two natural frequencies of the translational modes is proposed. This damage detection method can determine the damage location in a shear building by using a Damage Location Index (DLI based on two natural frequencies for undamaged and damaged states. In this study, damage is assumed to be represented by the reduction in stiffness. This stiffness reduction results in a change in natural frequencies. The uncertainty associated with system identification methods for obtaining natural frequencies is also carefully considered. Some simulations and experiments on shear structures were conducted to verify the performance of the proposed method.

  10. VALIDITY OF SINGLE VARIABLES AND COMPOSITE INDEXES FOR MEASURING DISEASE-ACTIVITY IN RHEUMATOID-ARTHRITIS

    NARCIS (Netherlands)

    VANDERHEIJDE, DMFM; VANTHOF, MA; VANRIEL, PLCM; VANLEEUWEN, MA; VANRIJSWIJK, MH; VANDEPUTTE, LBA

    1992-01-01

    There is no agreement as to which variable best mirrors disease activity in rheumatoid arthritis (RA) and no studies have been performed on the validity of disease activity variables. In this study the validity of 10 commonly used single variables and three composite indices was tested. All patients

  11. Studies on ageing and the severity of radiographic joint damage in rheumatoid arthritis

    NARCIS (Netherlands)

    Mangnus, Lukas; van Steenbergen, Hanna W.; Lindqvist, Elisabet; Brouwer, Elisabeth; Reijnierse, Monique; Huizinga, Tom W. J.; Gregersen, Peter K.; Berglin, Ewa; Rantapaa-Dahlqvist, Solbritt; van der Heijde, Desiree; van der Helm-van Mil, Annette H. M.

    2015-01-01

    Introduction: The western population is ageing. It is unknown whether age at diagnosis affects the severity of Rheumatoid Arthritis (RA), we therefore performed the present study. Method: 1,875 RA-patients (7,219 radiographs) included in five European and North-American cohorts (Leiden-EAC, Wichita,

  12. Clinimetric criteria of rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Domenico Galasso

    2012-10-01

    Full Text Available Rheumatoid arthritis is a systemic autoimmune disease, mainly poli-artycular, among wide-spread chronic inflammatory diseases, that cause pain, functional limitation, damage and joints deformations, and disability. It is characterized by turns of active inflammation and remission phases. Inflammation degree and persistence are associated to a bad functional prognosis and progressive joint disability. These patients management require a continuous valuation of inflammatory activity index of disease both therapeutic management and to prevent disablement process. We focus on many valuation index of joint disability and functional damage. Very important are both the scales of auto-values concerning the pain and the joint swelling and clinical data get by physician to valuate activity index of disease as defined by DAS28. Significant data come by health-related quality of life, disability and by AIMS2 (Arthritis Impact Measurement Scale.

  13. Soluble transferrin receptor and transferrin receptor-ferritin index in iron deficiency anemia and anemia in rheumatoid arthritis.

    Science.gov (United States)

    Margetic, Sandra; Topic, Elizabeta; Ruzic, Dragica Ferenec; Kvaternik, Marina

    2005-01-01

    The aim of the study was to evaluate the clinical efficiency of soluble transferrin receptor and transferrin receptor-ferritin index (sTfR/logF) in the diagnosis of iron deficiency anemia, as well as the differential diagnosis of iron deficiency anemia and anemia in rheumatoid arthritis. The study included 96 patients with anemia and 61 healthy volunteers as a control group. In healthy subjects there were no significant sex and age differences in the parameters tested. The study results showed these parameters to be reliable in the diagnosis of iron deficiency anemia, as well as in the differential diagnosis of iron deficiency anemia and anemia of chronic disease. The results indicate that sTfR/logF could be used to help differentiate coexisting iron deficiency in patients with anemia of chronic disease. Receiver operating characteristic analysis showed a higher discriminating power of transferrin receptor-ferritin index vs. soluble transferrin receptor in the diagnosis of iron deficiency anemia, as well as in the differential diagnosis between iron deficiency anemia and anemia of chronic disease. In patients with anemia in rheumatoid arthritis, the parameters tested showed no significant differences with respect to C-reactive protein concentration. These results suggested that the parameters tested are not affected by acute or chronic inflammatory disease.

  14. Intelligent Monitoring System on Prediction of Building Damage Index using Artificial Neural Network

    Directory of Open Access Journals (Sweden)

    Reni Suryanita

    2012-03-01

    Full Text Available An earthquake potentially destroys a tall building. The building damage can be indexed by FEMA into three categories namely Immediate Occupancy (IO, Life Safety (LS, and Collapse Prevention (CP. To determine the damage index, the building model has been simulated into structure analysis software. Acceleration data has been analyzed using non linear method in structure analysis program. The earthquake load is time history at surface, PGA=0105g. This work proposes an intelligent monitoring system utilizing Artificial Neural Network to predict the building damage index. The system also provides an alert system and notification to inform the status of the damage. Data learning is trained on ANN utilizing feed forward and back propagation algorithm. The alert system is designed to be able to activate the alarm sound, view the alert bar or text, and send notification via email to the security or management. The system is tested using sample data represented in three conditions involving IO, LS, and CP. The results show that the proposed intelligent monitoring system could provide prediction of up to 92% rate of accuracy and activate the alert. Implementation of the system in building monitoring would allow for rapid, intelligent and accurate prediction of the building damage index due to earthquake.

  15. Lactobacillus casei reduces the inflammatory joint damage associated with collagen-induced arthritis (CIA) by reducing the pro-inflammatory cytokines: Lactobacillus casei: COX-2 inhibitor.

    Science.gov (United States)

    Amdekar, Sarika; Singh, Vinod; Singh, Rambir; Sharma, Poonam; Keshav, Poonam; Kumar, Avnish

    2011-04-01

    This study evaluated the therapeutic efficacy of Lactobacillus casei in treating rheumatoid arthritis using collagen-induced arthritis (CIA) animal model. Healthy female Wistar rats (weight-180-200 g) were included in this study. Oral administration of L. casei was started on the same day. Indomethacin was used as standard reference drug. Serum level of IL-6, α-TNF, and IL-10 were observed. Four-point arthritis indexes were also assessed at the end of week for 28th day. L. casei-treated rats had shown normal histopathology without any synovial infiltration, pannus formation, cartilage, and bone destruction. Arthritis score was also lower for the group treated with L. casei. Oral administration of L. casei significantly decreased the pro-inflammatory cytokines. Present study suggests that L. casei has potent antiarthritic effect in CIA model. Inhibition of COX-2 via inhibiting the pro-inflammatory cytokines is an understanding of the complex interactions involved in these pathways.

  16. Effect of a high-intensity weight-bearing exercise program on radiologic damage progression of the large joints in subgroups of patients with rheumatoid arthritis.

    NARCIS (Netherlands)

    Munneke, M.; Jong, Z. de; Zwinderman, A.H.; Ronday, H.K.; Schaardenburg, D. van; Dijkmans, B.A.C.; Kroon, H.M.; Vliet Vlieland, T.P.M.; Hazes, J.M.W.

    2005-01-01

    OBJECTIVE: To investigate whether a high-intensity exercise program accelerates the rate of radiologic damage of the large joints in predefined subgroups of patients with rheumatoid arthritis. METHODS: The data of 277 participants in a 2-year randomized controlled trial, comparing the effects of hig

  17. Disability and health-related quality of life among patients with rheumatoid arthritis: association with radiographic joint damage, disease activity, pain, and depressive symptoms

    NARCIS (Netherlands)

    I. Rupp; H.C. Boshuizen; H.J. Dinant; C.E. Jacobi; G.A.M. van den Bos

    2006-01-01

    Objective: To study the associations between disability and health-related quality of life ( HRQoL), respectively, and radiographic joint damage, disease activity, pain, and depressive symptoms among patients with rheumatoid arthritis ( RA). Methods: Data were collected through questionnaires and cl

  18. Drug-free remission, functioning and radiographic damage after 4 years of response-driven treatment in patients with recent-onset rheumatoid arthritis

    NARCIS (Netherlands)

    van der Kooij, S.M.; Goekoop-Ruiterman, Y.P.M.; de Vries-Bouwstra, J.K.; Güler-Yüksel, M.; Zwinderman, A.H.; Kerstens, P.J.S.M.; van der Lubbe, P.A.H.M.; de Beus, W.M.; Grillet, B.A.M.; Ronday, H.K.; Huizinga, T.W.J.; Breedveld, F.C.; Dijkmans, B.A.C.; Allaart, C.F.

    2009-01-01

    Objectives: To compare the occurrence of drug-free remission, functional ability and radiological damage after 4 years of response-driven treatment according to four different treatment strategies for rheumatoid arthritis (RA). Methods: Patients with recent-onset, active RA (n = 508) were randomly a

  19. MP Joint Arthritis

    Science.gov (United States)

    ... Find a Hand Surgeon Home Anatomy MP Joint Arthritis Email to a friend * required fields From * To * ... important for both pinching and gripping. MP joint arthritis is most common in the thumb and index ...

  20. MRI bone oedema scores are higher in the arthritis mutilans form of psoriatic arthritis and correlate with high radiographic scores for joint damage

    DEFF Research Database (Denmark)

    Tan, Yu M; Østergaard, Mikkel; Doyle, Anthony;

    2009-01-01

    INTRODUCTION: The aim of this study was to investigate the magnetic resonance imaging (MRI) features of bone disease in the arthritis mutilans (AM) form of psoriatic arthritis (PsA). METHODS: Twenty-eight patients with erosive PsA were enrolled (median disease duration of 14 years). Using x...

  1. Proposal for levels of evidence schema for validation of a soluble biomarker reflecting damage endpoints in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis, and recommendations for study design

    DEFF Research Database (Denmark)

    Maksymowych, W.P.; Fitzgerald, O.; Wells, G.A.

    2009-01-01

    arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS). We also aimed to generate consensus on minimum standards for the design of longitudinal studies aimed at validating biomarkers. METHODS: Before the meeting, the Soluble Biomarker Working Group prepared a preliminary framework...... and discussed various models for association and prediction related to the statistical strength domain. In addition, 3 Delphi exercises addressing longitudinal study design for RA, PsA, and AS were conducted within the working group and members of the Assessments in SpondyloArthritis International Society (ASAS...

  2. Ultraviolet laser damage and optical properties of high-refractive-index single layers, multiple layers, and high/low index multilayer stacks

    Science.gov (United States)

    McInnes, Hazel A.; Andrew, James E.; Bazin, Nicholas J.; Morris, A. J.; Porter, K. J.

    1998-04-01

    Laser induced damage thresholds, measured using N-on-1 and R-on-1 testing, of single layer high index zirconia and hafnia coatings, derived from nitric or acetic acid stabilized sol-gel processing, are reported. Single layer acetic acid, nitric acid and base catalyzed silica sol-gel coatings have also been tested. The sol-gels were dip coated onto fused silica substrates at a rate of 3mm/s. The refractive index of the materials were measured using transmission spectra of multiple pairs of high and low refractive index materials. Absorption in the UV region was similarly measured with multiple layers of the same material and fitting to a Beer's law behavior. The high index materials used were zirconia or hafnia, the low index material was silica. The compatibility of the various combinations of high and low index materials for physical stacking without cracking, achieving high reflectivity and high damage thresholds are discussed and compared.

  3. Significance of arthrosonography for knee joint damage diagnosis in patients with early rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    L V Sizova

    2008-01-01

    Full Text Available Objective. To assess significance of arthrosonography in diagnosis of in knee joint changes in patients with early rheumatoid arthritis (RA. Material and methods. 44 patients with early RA aged 19 to 73 years were examined. 29,5% of pts had early RA without primary osteoarthritis (OA, 70,5% had early RA with primary OA. Ultrasonography of knee joints was performed with Diasonics (USA, 1997 by the linear sensor with frequency of 7 MHz. The protocol of ultrasonic examination of knee joints was filled for each pt. Results. Clinical signs of of knee joint synovitis have been revealed in 61,5% of pts with early RA without primary OA, and in 80,6% of pts with early RA with primary OA, ultrasonic - in 100% of pts. Intraarticular knee joint effusion resulted in increase of suprapatellar bursa and lateral recesses size. Extraarticular inflammation was frequently shown by thickening of semymemranous muscles tendons, especially in pts with the early RA with primary OA (p<0,005. Degenerative changes in the group of pts with primary OA were more expressed in early RA and usually accompanied by non-uniform decrease of cartilage thickness and occurrence of osteophytes while cartilage in pts with early RA without primary OA had normal thickness or thickening because of swelling, and osteophytes were absent. Conclusion. Prevalence of knee joint intraarticular and extraarticular inflammatory changes over degenerate changes (symmetric thickening of the synovium, primary increase of the sizes of suprapatellar bursa and lateral recesses because of effusion, thickening of tendons of knee joints at the normal or increased thickness of cartilage because of inflammation can be considered sonographic sign of early RA. In pts with early RA coincided with primary OA these changes were usually found in combination with non-uniform decrease of cartilage thickness. In case of cartilage inflammatory edema, detection of osteophytes allows to confirm presence of OA in pts with

  4. Assessing the physical vulnerability of check dams through an empirical damage index

    Directory of Open Access Journals (Sweden)

    Andrea Dell'Agnese

    2013-06-01

    Full Text Available A comprehensive analysis of flood risk in mountain streams has to include an assessment of the vulnerability of the protection systems, in addition to an assessment of the vulnerability of the constructed environment on alluvial fans and floodplains. Structures forming the protection systems are of a dual nature, i.e. they are designed to mitigate natural process-related hazards and, on the other hand, are prone to be damaged during their lifecycle by the same processes they should mitigate. Therefore, their effectiveness declines over time. Hence, the knowledge of how effectively control structures perform is essential for risk management. A procedure was developed to assess the physical vulnerability of check dams based on empirical evidence collected in South Tyrol, Northern Italy. A damage index defined on pre- and postevent comparisons of check dam conditions was evaluated for 362 structures in 18 mountain streams along with the relevant processes and the structural characteristics affecting it. Although the available dataset did not allow conclusive functional relationships between damage index and impact variables to be established, it was possible to assess the average expected residual functionality of check dams according to structure characteristics, and event type and intensity. These results may help plan appropriate check dam maintenance.

  5. Weather-Related Flood and Landslide Damage: A Risk Index for Italian Regions.

    Science.gov (United States)

    Messeri, Alessandro; Morabito, Marco; Messeri, Gianni; Brandani, Giada; Petralli, Martina; Natali, Francesca; Grifoni, Daniele; Crisci, Alfonso; Gensini, Gianfranco; Orlandini, Simone

    2015-01-01

    The frequency of natural hazards has been increasing in the last decades in Europe and specifically in Mediterranean regions due to climate change. For example heavy precipitation events can lead to disasters through the interaction with exposed and vulnerable people and natural systems. It is therefore necessary a prevention planning to preserve human health and to reduce economic losses. Prevention should mainly be carried out with more adequate land management, also supported by the development of an appropriate risk prediction tool based on weather forecasts. The main aim of this study is to investigate the relationship between weather types (WTs) and the frequency of floods and landslides that have caused damage to properties, personal injuries, or deaths in the Italian regions over recent decades. In particular, a specific risk index (WT-FLARI) for each WT was developed at national and regional scale. This study has identified a specific risk index associated with each weather type, calibrated for each Italian region and applicable to both annual and seasonal levels. The risk index represents the seasonal and annual vulnerability of each Italian region and indicates that additional preventive actions are necessary for some regions. The results of this study represent a good starting point towards the development of a tool to support policy-makers, local authorities and health agencies in planning actions, mainly in the medium to long term, aimed at the weather damage reduction that represents an important issue of the World Meteorological Organization mission.

  6. Diffuse alveolar damage in a patient with rheumatoid arthritis under prolonged leflunomide treatment: A Case Report and Literature Review.

    Science.gov (United States)

    Keng, Li-Ta; Lin, Mong-Wei; Huang, Hsien-Neng; Chung, Kuei-Pin

    2016-06-01

    Patients with rheumatoid arthritis (RA) often have pulmonary involvement, and interstitial lung disease (ILD) is the primary manifestation, in which diffuse alveolar damage (DAD) is a rare histopathologic pattern. Leflunomide (LEF) is a frequently prescribed disease-modifying antirheumatic drug for treating RA. LEF-related ILD in the form of DAD has been reported in patients with RA, with the duration of LEF treatment before symptom onset ranging from 6 to 1204 days.We present a case of elderly woman with RA under prolonged LEF treatment for >9 years (3291 days), who had acute respiratory failure with the initial presentation of exertional dyspnea, fever, chills, and productive cough for 2 days. The histopathologic result of surgical lung biopsy was compatible with DAD. She was diagnosed as having LEF-related ILD, based on correlated clinical history, compatible histopathologic examination and excluding possible infection after extensive survey.Although the causative role of LEF cannot be confirmed, this case still hints that LEF-related DAD may occur even if LEF has been prescribed for a prolonged period.

  7. Reappraisal of OMERACT 8 draft validation criteria for a soluble biomarker reflecting structural damage endpoints in rheumatoid arthritis, psoriatic arthritis, and spondyloarthritis

    DEFF Research Database (Denmark)

    Maksymowych, Walter P; Landewé, Robert; Tak, Paul-Peter

    2009-01-01

    ) Onsite interactive electronic voting on the importance of specific criteria. The framework was presented and discussed at OMERACT 9 in both breakout and plenary sessions followed by a vote on its acceptance. RESULTS: The objectives of rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis......3, CTX-II, RANKL, OPG, CTX-I) followed by a Delphi consensus exercise addressing the importance of individual criteria and identification of omissions in the draft set. (B) Formal debate as well as group discussion centered on the key arguments for inclusion/exclusion of specific criteria. (C...

  8. Cut-Offs and Response Criteria for the Hospital Universitario La Princesa Index (HUPI) and Their Comparison to Widely-Used Indices of Disease Activity in Rheumatoid Arthritis

    Science.gov (United States)

    Castrejón, Isabel; Ortiz, Ana M.; Toledano, Esther; Castañeda, Santos; García-Vadillo, Alberto; Carmona, Loreto

    2016-01-01

    Objective To estimate cut-off points and to establish response criteria for the Hospital Universitario La Princesa Index (HUPI) in patients with chronic polyarthritis. Methods Two cohorts, one of early arthritis (Princesa Early Arthritis Register Longitudinal [PEARL] study) and other of long-term rheumatoid arthritis (Estudio de la Morbilidad y Expresión Clínica de la Artritis Reumatoide [EMECAR]) including altogether 1200 patients were used to determine cut-off values for remission, and for low, moderate and high activity through receiver operating curve (ROC) analysis. The areas under ROC (AUC) were compared to those of validated indexes (SDAI, CDAI, DAS28). ROC analysis was also applied to establish minimal and relevant clinical improvement for HUPI. Results The best cut-off points for HUPI are 2, 5 and 9, classifying RA activity as remission if ≤2, low disease activity if >2 and ≤5), moderate if >5 and <9 and high if ≥9. HUPI’s AUC to discriminate between low-moderate activity was 0.909 and between moderate-high activity 0.887. DAS28’s AUCs were 0.887 and 0.846, respectively; both indices had higher accuracy than SDAI (AUCs: 0.832 and 0.756) and CDAI (AUCs: 0.789 and 0.728). HUPI discriminates remission better than DAS28-ESR in early arthritis, but similarly to SDAI. The HUPI cut-off for minimal clinical improvement was established at 2 and for relevant clinical improvement at 4. Response criteria were established based on these cut-off values. Conclusions The cut-offs proposed for HUPI perform adequately in patients with either early or long term arthritis. PMID:27603313

  9. Cut-Offs and Response Criteria for the Hospital Universitario La Princesa Index (HUPI) and Their Comparison to Widely-Used Indices of Disease Activity in Rheumatoid Arthritis.

    Science.gov (United States)

    González-Álvaro, Isidoro; Castrejón, Isabel; Ortiz, Ana M; Toledano, Esther; Castañeda, Santos; García-Vadillo, Alberto; Carmona, Loreto

    2016-01-01

    To estimate cut-off points and to establish response criteria for the Hospital Universitario La Princesa Index (HUPI) in patients with chronic polyarthritis. Two cohorts, one of early arthritis (Princesa Early Arthritis Register Longitudinal [PEARL] study) and other of long-term rheumatoid arthritis (Estudio de la Morbilidad y Expresión Clínica de la Artritis Reumatoide [EMECAR]) including altogether 1200 patients were used to determine cut-off values for remission, and for low, moderate and high activity through receiver operating curve (ROC) analysis. The areas under ROC (AUC) were compared to those of validated indexes (SDAI, CDAI, DAS28). ROC analysis was also applied to establish minimal and relevant clinical improvement for HUPI. The best cut-off points for HUPI are 2, 5 and 9, classifying RA activity as remission if ≤2, low disease activity if >2 and ≤5), moderate if >5 and <9 and high if ≥9. HUPI's AUC to discriminate between low-moderate activity was 0.909 and between moderate-high activity 0.887. DAS28's AUCs were 0.887 and 0.846, respectively; both indices had higher accuracy than SDAI (AUCs: 0.832 and 0.756) and CDAI (AUCs: 0.789 and 0.728). HUPI discriminates remission better than DAS28-ESR in early arthritis, but similarly to SDAI. The HUPI cut-off for minimal clinical improvement was established at 2 and for relevant clinical improvement at 4. Response criteria were established based on these cut-off values. The cut-offs proposed for HUPI perform adequately in patients with either early or long term arthritis.

  10. Do Short and Sustained Periods of American College of Rheumatology/European League Against Rheumatism Remission Predict Functional and Radiographic Outcome in Early Rheumatoid Arthritis Patients With Low Overall Damage Progression?

    Science.gov (United States)

    Konijn, Nicole P C; van Tuyl, Lilian H D; Boers, Maarten; den Uyl, Debby; Ter Wee, Marieke M; Kerstens, Pit; Voskuyl, Alexandre E; van Schaardenburg, Dirkjan; Nurmohamed, Michael T; Lems, Willem F

    2017-07-01

    To investigate whether remission at single and consecutive visits predicts good outcome in early rheumatoid arthritis (RA). The presence of remission according to American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) and other criteria (Boolean clinical, Clinical Disease Activity Index, Disease Activity Score [DAS], DAS in 28 joints, and Routine Assessment of Patient Index Data 3) was assessed in early RA patients during the first year of the Combination Therapy for Rheumatoid Arthritis light trial. Likelihood ratios were used to assess whether meeting the remission criteria at single visits (13, 26, 39, or 52 weeks) and consecutive visits (13 and 26, 26 and 39, or 39 and 52 weeks) predicted good outcome in the second year (52-104 weeks). Good outcome was defined for function (Health Assessment Questionnaire score consistently ≤0.5 and no deterioration), radiographic damage progression (no deterioration in Sharp/van der Heijde scores), and both ("overall good outcome"). Of the original 164 trial patients, 144 had evaluable data. In the second year, good functional outcome was observed in 35%, good radiographic outcome in 79%, and both in 28% of the patients. Almost all criteria predicted good functional and good overall outcome, at both single and consecutive visits; only single DAS remission did not significantly predict good overall outcome (P = 0.07). Sustained remission periods resulted in higher likelihood ratios than remission at single visits. None of the criteria predicted good radiographic outcome. Early RA patients who reached remission according to ACR/EULAR and other criteria during short or sustained periods were likely to retain good physical function in the subsequent months. Sustained remission periods were a stronger predictor than remission at single visits. However, in the setting of low overall damage progression, (sustained) remission was not predictive of good radiographic outcome. © 2016, American College of

  11. Association of high body mass index with decreased treatment response to combination therapy in recent-onset rheumatoid arthritis patients.

    Science.gov (United States)

    Heimans, L; van den Broek, M; le Cessie, S; Siegerink, B; Riyazi, N; Han, K H; Kerstens, P J S M; Huizinga, T W J; Lems, W F; Allaart, C F

    2013-08-01

    To assess the association between high body mass index (BMI) and treatment response in recent-onset rheumatoid arthritis. In the Behandelstrategieën voor Reumatoide Artritis (Treatment Strategies for Rheumatoid Arthritis) study, 508 patients were randomized to initial monotherapy or combination therapy with prednisone or infliximab (IFX). The response to Disease Activity Score (DAS) ≤2.4-steered treatment (first dose and after 1 year) was compared between patients with a BMI <25 kg/m(2) and ≥25 kg/m(2) , using relative risk (RR) regression analyses. DAS, components of DAS, and functional ability during the first year were compared using linear mixed models. High BMI was independently associated with failure to achieve a DAS ≤2.4 on initial therapy (RR 1.20 [95% confidence interval (95% CI) 1.05, 1.37]). The effect for combination therapy with prednisone was RR 1.55 (95% CI 1.06, 2.28) and for combination therapy with IFX 1.42 (95% CI 0.98, 2.06). The RRs for failure after 1 year were 1.46 (95% CI 0.75, 2.83) and 2.20 (95% CI 0.99, 4.92), respectively. High BMI was also associated with failure on delayed combination therapy with IFX, after adjustment for selection bias related to previous failure on disease-modifying antirheumatic drugs. No significant association was observed in the initial monotherapy groups. In the first year, patients with a high BMI had higher DAS and worse functional ability, with more tender joints and a higher visual analog scale global health, but not more swollen joints and similar systemic inflammation. High BMI was independently associated with failure to achieve low DAS on initial combination therapy with prednisone and on initial and delayed treatment with IFX. Patients with a high BMI experienced more pain, but not more swelling or systemic inflammation. Copyright © 2013 by the American College of Rheumatology.

  12. No overall damage progression despite persistent inflammation in adalimumab-treated psoriatic arthritis patients

    DEFF Research Database (Denmark)

    Poggenborg, René Panduro; Wiell, Charlotte; Bøyesen, Pernille;

    2014-01-01

    OBJECTIVE: In a comparative conventional MRI, dynamic contrast-enhanced (DCE)-MRI, CT and radiography study, the authors aimed to monitor whether inflammation is reduced or even eliminated and damage halted in PsA patients receiving anti-TNF therapy. METHODS: A 48-week prospective open......-label investigator-initiated trial of 41 biologic-naive patients treated with 40 mg adalimumab every other week. Hand CT, MRI (according to the PsA MRI scoring system method) and radiography (Sharp-van der Heijde method) were obtained at weeks 0, 6 (only MRI), 24 and 48. Clinical response was assessed by the Ps......A Response Criteria (PsARC). RESULTS: In the 23 PsARC responders at week 48, significant decreases from baseline in MRI synovitis (mean -2.0, P MRI signs...

  13. Association of Body Mass Index with Chromosome Damage Levels and Lung Cancer Risk among Males

    Science.gov (United States)

    Li, Xiaoliang; Bai, Yansen; Wang, Suhan; Nyamathira, Samuel Mwangi; Zhang, Xiao; Zhang, Wangzhen; Wang, Tian; Deng, Qifei; He, Meian; Zhang, Xiaomin; Wu, Tangchun; Guo, Huan

    2015-01-01

    Epidemiological studies have shown an etiological link between body mass index (BMI) and cancer risk, but evidence supporting these observations is limited. This study aimed to investigate potential associations of BMI with chromosome damage levels and lung cancer risk. First, we recruited 1333 male workers from a coke-oven plant to examine their chromosome damage levels; and then, a cohort study of 12 052 males was used to investigate the association of BMI with lung cancer incidence. We further carried out a meta-analysis for BMI and male lung cancer risk based on cohort studies. We found that men workers with excess body weight (BMI ≥ 25 kg/m2) had lower levels of MN frequencies than men with normal-weight (BMI: 18.5–24.9). Our cohort study indicated that, the relative risk (RR) for men with BMI ≥ 25 to develop lung cancer was 35% lower than RR for normal-weight men. Further meta-analysis showed that, compared to normal-weight men, men with BMI ≥ 25 had decreased risk of lung cancer among both the East-Asians and others populations. These results indicate that men with excess body weight had significant decreased chromosome damage levels and lower risk of lung cancer than those with normal-weight. However, further biological researches were needed to validate these associations. PMID:25820198

  14. Diagnostic utility of oxidative damage markers for early rheumatoid arthritis in non-smokers and negative anti-CCP patients

    Directory of Open Access Journals (Sweden)

    E. Melguizo

    2014-04-01

    Full Text Available Background. Besides the development of new markers and diagnostic criteria for rheumatoid arthritis (RA, many patients are still diagnosed after several years of symptoms. Oxidative stress markers are already increased at an early stage of RA. Our aim was to evaluate the additional diagnostic value of these markers. Methods. A case-control study was performed. Patients met the 1987 RA ACR criteria, less than 2 years of symptoms and no previous treatment with disease-modifying anti-rheumatic drugs (DMARD, steroids or vitamin E. Controls were selected from patient's relatives and matched (1:1 by gender, age, and current smoking habit. Oxidative damage markers were malonyldialdehyde (MDA, Lipid hydroperoxides (LOOH and Carbonyl proteins (CP. Statistical analysis was performed in agreement with the STARD initiative. Results. Sixty-five RA patients without treatment and 65 healthy controls were included. LOOH, CP, antibodies against citrullinated peptides (anti-CCP and rheumatoid factor (RF were significantly higher in patients, and MDA higher in controls. The same results were obtained in the subgroups of patients who smoke or not, and in anti-CCP positive or negative. The diagnosis performance of traditional markers showed good specificity but low sensitivity. The addition of LOOH and CP increased the sensitivity and the area under the receiving operating characteristic (ROC curve especially in non-smoking (66% and negative anti-CCP (51% patients. Conclusions. The separate or combined addition of LOOH or CP to the traditional disease markers improved the diagnosis of RA, especially in non-smoking or negative anti-CCP patients.

  15. Remission in rheumatoid arthritis: a comparison of the 2 newly proposed ACR/EULAR remission criteria with the rheumatoid arthritis disease activity index-5, a patient self-report disease activity index.

    Science.gov (United States)

    Rintelen, Bernhard; Sautner, Judith; Haindl, Pia; Mai, Harsono; Brezinschek, Hans-Peter; Leeb, Burkhard F

    2013-04-01

    We analyzed whether a patient self-report remission criterion, such as that according to the Rheumatoid Arthritis Disease Activity Index-5 (RADAI-5), meets the criteria of the 2011 proposed American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) definition of remission. The 2 approaches of the ACR/EULAR proposal [Boolean- and Simplified Disease Activity Index (SDAI)-based] as well as the RADAI-5 were used to assess whether patients with RA are in remission. Sensitivity, specificity, positive and negative predictive values (PPV, NPV), and kappa analyses were performed to illustrate the relationship among the different approaches defining remission at a group level. In total, 705 patients' assessments were included. Eighty-nine patients were classified as being in remission according to the Boolean-based and 169 according to the SDAI-based definition of the ACR/EULAR proposals, and 154 according to the RADAI-5. Sixty-eight assessments were classified as being in remission according to all 3 definitions. In the case of RADAI-5 remission, sensitivity was 78%, specificity 86%, PPV 45%, and NPV 96%, indicating remission according to the Boolean-based definition; and 60%, 92%, 66%, and 90%, respectively, indicating remission according to the SDAI-based definition. In the case of remission according to the SDAI-based ACR/EULAR definition, sensitivity was 52%, specificity 100%, PPV 98%, and NPV 87%, also indicating remission according to the Boolean definition; while according to the Boolean definition the values were 98%, 87%, 52%, and 100%, respectively. Kappa statistics showed fair to good agreement for all 3 definitions. Nearly twice as many assessments were classified as being in remission using the SDAI-based or the RADAI-5 definitions when compared to the Boolean-based definition. Remission according to the RADAI-5 also was highly specific for both ACR/EULAR criteria. Sensitivity for the RADAI-5 criterion was even better for the Boolean

  16. Hair breakage index: an alternative tool for damage assessment of human hair.

    Science.gov (United States)

    Mhaskar, Sudhakar; Kalghatgi, Bhargavi; Chavan, Madhavi; Rout, Suryamani; Gode, Vaishali

    2011-01-01

    Improper hair care, mechanical abrasion, sun damage and chemical treatment changes the physical and morphological characteristics of hair. Several methods involving microscopic techniques, protein loss and assessment of tensile properties of the hair are generally used to evaluate the extent of damage caused. These are also used to determine the protective effect of hair care products. In the present investigation, the hair breakage index (HBI) was used as an alternative tool to determine the change in the properties of hair on weathering. HBI is a measure of the diameter of hair in a given cross sectional area of a marked region of hair on the scalp. The hair diameter changes as we progress towards the tip of the hair due to breakage. The ratio of the diameter of hair bundle in the distal region to the diameter of hair bundle in the proximal region from the scalp is used as an indicator of hair breakage. Higher HBI value is an indicator of hair damage.A study was conducted for duration of 16 weeks to assess the effect of weathering due to grooming practices on HBI values. The HBI and break stress for a group of 30 subjects were measured at baseline and at the end of 16 weeks (NU). Since Coconut oil (CNO) is known to have a positive benefit on tensile properties of hair, another matched group of 30 subjects who oiled their hair daily with CNO was used as a positive control (CNO). The HBI and break stress for this group were also measured at the baseline and after 16 weeks. It was observed that the HBI significantly increased in the NU group versus the CNO user group. The break stress also significantly decreased in the NU group suggesting its correlation with the HBI data. This study demonstrates the usefulness of HBI as a simple and effective tool for determining hair damage and its protection by different hair care products.

  17. Arthritis - resources

    Science.gov (United States)

    Resources - arthritis ... The following organizations provide more information on arthritis : American Academy of Orthopaedic Surgeons -- orthoinfo.aaos.org/menus/arthritis.cfm Arthritis Foundation -- www.arthritis.org Centers for Disease Control and Prevention -- www. ...

  18. Patient Acceptable Symptom State in Self-Report Questionnaires and Composite Clinical Disease Index for Assessing Rheumatoid Arthritis Activity: Identification of Cut-Off Points for Routine Care

    Directory of Open Access Journals (Sweden)

    Fausto Salaffi

    2015-01-01

    Full Text Available Objective. To provide information on the value of Patient Acceptable Symptom State (PASS in rheumatoid arthritis (RA by the identification of PASS thresholds for patient-reported outcomes (PROs composite scores. Methods. The characteristics of RA patients with affirmative and negative assignment to PASS were compared. Contributors to physician response were estimated by logistic regression models and PASS thresholds by the 75th percentile and receiver-operating characteristic (ROC curve methods. Results. 303 RA patients completed the study. All PROs were different between the PASS (+ and PASS (− groups (p<0.0001. The thresholds with the 75th percentile approach were 2.0 for the RA Impact of Disease (RAID score, 2.5 for the PRO-CLinical ARthritis Activity (PRO-CLARA index, and 1.0 for the Recent-Onset Arthritis Disability (ROAD questionnaire. The cut-off values for Clinical Disease Activity Index (CDAI were in the moderate range of disease activity. Assessing the size of the logistic regression coefficients, the strongest predictors of PASS were the disease activity (p=0.0007 and functional state level (0.006. Conclusion. PASS thresholds were relatively high and many patients in PASS had moderate disease activity states according to CDAI. Factors such as disease activity and physical function may influence a negative PASS.

  19. Assessment of cardiovascular risk in rheumatoid arthritis: impact of the new EULAR recommendations on the score cardiovascular risk index.

    Science.gov (United States)

    Gómez-Vaquero, Carmen; Robustillo, Montserrat; Narváez, Javier; Rodríguez-Moreno, Jesús; González-Juanatey, Carlos; Llorca, Javier; Nolla, Joan Miquel; González-Gay, Miguel Angel

    2012-01-01

    To assess the impact of the application of the European League against Rheumatism (EULAR) task force recommendations in the cardiovascular (CV) risk of a series of Spanish patients diagnosed with rheumatoid arthritis (RA). Two hundred consecutive RA patients seen at the rheumatology outpatient clinics of Bellvitge Hospital, Barcelona, were studied. Information on clinical features of the disease, classic CV risk factors, and history of CV events was assessed. Both the systematic coronary risk evaluation (SCORE) CV risk index and the modified SCORE (mSCORE) according to the last EULAR recommendations were calculated. Based on the classic CV risk factors, the mean ± standard deviation SCORE was 2.1 ± 2.3% (median, 2; interquartile range [IQR], 1-3). Twenty-three (11%) patients were above the threshold of high CV risk for the Spanish population (≥5%). Following the EULAR recommendations, a change in the score was required in 119 (59%) patients. Therefore, the mean mSCORE was 2.7 ± 2.9% (median, 2; IQR, 1-3) and, due to this, 28 (14%) patients were above the threshold of high CV risk. Nine (5%) had at least one ischemic CV event. Patients with CV events were older and had more CV risk factors and higher SCORE and mSCORE than those without CV events. Although a large proportion of patients from this series fulfilled the criteria for the application of the EULAR recommendations, the final impact on the calculated CV risk was low and clinically significant in only a few patients. However, an association between the mSCORE and the presence of ischemic CV events was observed.

  20. Cardiovascular risk assessment in rheumatoid arthritis: impact of the EULAR recommendations on a national calibrated score risk index.

    Science.gov (United States)

    Rosales-Alexander, J L; Salvatierra, J; Llorca, J; Magro-Checa, C; González-Gay, M A; Cantero-Hinojosa, J; Raya-Álvarez, E

    2014-01-01

    To evaluate the impact of the application of the EULAR task force recommendations in the cardiovascular (CV) risk assessment of rheumatoid arthritis (RA) patients according to a national calibrated SCORE. Two hundred and one consecutive RA patients seen at the rheumatology outpatient clinics of the University Hospital 'San Cecilio', Granada, Southern Spain, were studied. Information on demographic, classic CV risk factors, history of CV events and disease clinical features were obtained. Both the systematic coronary risk evaluation (SCORE) risk index and the modified SCORE (mSCORE) following the EULAR recommendations were performed. Based on the classic CV risk factors the mean ± standard deviation SCORE was 2.2 ± 2.6 (median 2). Twenty-two (11%) patients were above the threshold of high risk for the Spanish population. Following the EULAR recommendations 52 of the 124 patients (41.93%) initially classified as having intermediate risk were reclassified as having high CV risk. Therefore, the mean mSCORE was 3.3 ± 4 (median 3) and, due to this, 74 (36.8%) patients were above the threshold of high CV risk for the Spanish population. As expected, patients who had experienced CV events were older, had more CV risk factors and higher mSCORE than those without CV events. These observations support the claim that the mSCORE should be specifically adapted to the population to be assessed. However, the use of additional tools should be considered in an attempt to fully identify high-risk RA patients.

  1. Inflammatory biomarkers, disease activity index, and self-reported disability may be predictors of chronic arthritis after chikungunya infection: brief report.

    Science.gov (United States)

    Sepúlveda-Delgado, J; Vera-Lastra, O L; Trujillo-Murillo, K; Canseco-Ávila, L M; Sánchez-González, R A; Gómez-Cruz, O; Lugo-Trampe, A; Fernández-Salas, I; Danis-Lozano, R; Contreras-Contreras, A; Mendoza-Torres, A; Domínguez-Arrevillaga, S; Mena-Vela, B A; Ocaña-Sibilla, M; Ramirez-Valdespino, J C; Jara, L J

    2017-03-01

    The chikungunya virus (ChikV) is a reemerging mosquito-borne pathogen that causes disabling chronic arthritis. The relationship between clinical evolution and inflammatory biomarkers in patients with ChikV-induced arthritis has not been fully described. We performed a prospective case series to evaluate the association among joint involvement, self-reported disability, and inflammatory biomarkers. Patients with ChikV infection were followed for 1 year. Joint involvement and self-reported disability were evaluated with disease activity index 28 (DAS-28) and World Health Organization Disablement Assessment Schedule II (WHODAS-II). Interleukin-6 (IL-6), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and rheumatoid factor (RF) were used as biomarkers. Ten patients with mean age 48 ±15.04 years were included. Symptoms at diagnosis were fever, arthralgias, myalgias, rash, arthritis, nausea, vomiting, and back pain. Polyarticular involvement was present in seven cases. At diagnosis, measures were as follows: DAS-28, 5.08±1.11; WHODAS-II score, 72.3±10.3 %; CRP, 5.09±7.23 mg/dL; ESR, 33.5±17.5 mm/h; RF, 64±21.7 IU/mL; and IL-6, 17.6±10.3 pg/mL. Six patients developed subacute and chronic symptoms. During follow-up, DAS-28 index, WHODAS-II score, ESR, and IL-6 were statistically different in patients with subacute and chronic symptoms compared to those who resolved in the acute phase (p arthritis.

  2. Condition monitoring of induction motor bearing based on bearing damage index

    Directory of Open Access Journals (Sweden)

    Patel R.K.

    2017-03-01

    Full Text Available The rolling element bearings are used broadly in many machinery applications. It is used to support the load and preserve the clearance between stationary and rotating machinery elements. Unfortunately, rolling element bearings are exceedingly prone to premature failures. Vibration signal analysis has been widely used in the faults detection of rotating machinery and can be broadly classified as being a stationary or non-stationary signal. In the case of the faulty rolling element bearing the vibration signal is not strictly phase locked to the rotational speed of the shaft and become “transient” in nature. The purpose of this paper is to briefly discuss the identification of an Inner Raceway Fault (IRF and an Outer Raceway Fault (ORF with the different fault severity levels. The conventional statistical analysis was only able to detect the existence of a fault but unable to discriminate between IRF and ORF. In the present work, a detection technique named as bearing damage index (BDI has been proposed. The proposed BDI technique uses wavelet packet node energy coefficient analysis method. The well-known combination of Hilbert transform (HT and Fast Fourier Transform (FFT has been carried out in order to identify the IRF and ORF faults. The results show that wavelet packet node energy coefficients are not only sensitive to detect the faults in bearing but at the same time they are able to detect the severity level of the fault. The proposed bearing damage index method for fault identification may be considered as an ‘index’ representing the health condition of rotating machines.

  3. Rheumatoid arthritis.

    Science.gov (United States)

    Smolen, Josef S; Aletaha, Daniel; McInnes, Iain B

    2016-10-22

    Rheumatoid arthritis is a chronic inflammatory joint disease, which can cause cartilage and bone damage as well as disability. Early diagnosis is key to optimal therapeutic success, particularly in patients with well-characterised risk factors for poor outcomes such as high disease activity, presence of autoantibodies, and early joint damage. Treatment algorithms involve measuring disease activity with composite indices, applying a treatment-to-target strategy, and use of conventional, biological, and newz non-biological disease-modifying antirheumatic drugs. After the treatment target of stringent remission (or at least low disease activity) is maintained, dose reduction should be attempted. Although the prospects for most patients are now favourable, many still do not respond to current therapies. Accordingly, new therapies are urgently required. In this Seminar, we describe current insights into genetics and aetiology, pathophysiology, epidemiology, assessment, therapeutic agents, and treatment strategies together with unmet needs of patients with rheumatoid arthritis.

  4. The new ACR/EULAR criteria for rheumatoid arthritis can identify patients with same disease activity but less damage by ultrasound.

    Science.gov (United States)

    Aydın, Sibel Zehra; Castillo-Gallego, Concepcion; Nam, Jackie; Freeston, Jane; Horton, Sarah; Wakefield, Richard J; Emery, Paul

    2017-06-01

    We aimed to compare the ultrasound findings of patients fulfilling the 1987 ACR [OLD-rheumatoid arthritis (RA)] and the new ACR/EULAR (NEW-RA) classification criteria to examine the impact of the new criteria on disease characteristics, particularly disease duration. A total of 2730 hands, wrists, elbows, knees, ankles, and foot joints of 105 consecutive patients with inflammatory arthritis, i.e., 82 patients fulfilling the RA criteria (60 patients, OLD-RA; 22 patients, NEW-RA alone) and 23 patients with undifferentiated arthritis, were scanned using ultrasound. Synovitis, erosions, and power Doppler (PD) findings were scored using a scale of 0-3 and scores form each joint were added up to calculate synovitis, PD and erosion scores for each patient. OLD-RA and NEW-RA patients had similar swollen joint count, tender joint count, acute-phase response, patient global, and disease activity assessment 28 scores. The disease duration was longer in OLD-RA patients [30 (3-179) months] than in NEW-RA patients [16 (0-45) months; p=0.009]. Both the groups had similar synovitis and PD scores, whereas erosion scores were higher in OLD-RA patients than in NEW-RA patients (p=0.009). Patients with undifferentiated arthritis were older than those with RA and had fewer swollen joints than NEW-RA patients [0 (0-4) vs. 2 (0-9); p=0.017]. All other disease activity parameters were similar in both NEW-RA and OLD-RA patients. Both the synovitis (p=0.006) and erosion (p=0.007) scores were lower in patients with undifferentiated arthritis than in OLD-RA patients, despite the scores being similar to those in NEW-RA patients. The new ACR/EULAR RA criteria enabled the classification of patients with similar disease activity (by clinical assessment and ultrasound) but with less damage. A similar disease activity should ensure suitability for an intervention, and a shorter duration and less damage should improve the outcome with patient benefit.

  5. Testing of the OMERACT 8 draft validation criteria for a soluble biomarker reflecting structural damage in rheumatoid arthritis: a systematic literature search on 5 candidate biomarkers

    DEFF Research Database (Denmark)

    Syversen, Silje W; Landewe, Robert; van der Heijde, Désirée;

    2009-01-01

    OBJECTIVE: To test the OMERACT 8 draft validation criteria for soluble biomarkers by assessing the strength of literature evidence in support of 5 candidate biomarkers. METHODS: A systematic literature search was conducted on the 5 soluble biomarkers RANKL, osteoprotegerin (OPG), matrix...... metalloprotease (MMP-3), urine C-telopeptide of types I and II collagen (U-CTX-I and U CTX-II), focusing on the 14 OMERACT 8 criteria. Two electronic voting exercises were conducted to address: (1) strength of evidence for each biomarker as reflecting structural damage according to each individual criterion...... and the importance of each individual criterion; (2) overall strength of evidence in support of each of the 5 candidate biomarkers as reflecting structural damage endpoints in rheumatoid arthritis (RA) and identification of omissions to the criteria set. RESULTS: The search identified 111 articles. The strength...

  6. Testing of the preliminary OMERACT validation criteria for a biomarker to be regarded as reflecting structural damage endpoints in rheumatoid arthritis clinical trials: the example of C-reactive protein

    DEFF Research Database (Denmark)

    Keeling, Stephanie O; Landewe, Robert; van der Heijde, Desiree;

    2007-01-01

    OBJECTIVE: A list of 14 criteria for guiding the validation of a soluble biomarker as reflecting structural damage endpoints in rheumatoid arthritis (RA) clinical trials was drafted by an international working group after a Delphi consensus exercise. C-reactive protein (CRP), a soluble biomarker...

  7. Ozone oxidative postconditioning ameliorates joint damage and decreases pro-inflammatory cytokine levels and oxidative stress in PG/PS-induced arthritis in rats.

    Science.gov (United States)

    Vaillant, Jaqueline Dranguet; Fraga, Angela; Díaz, María Teresa; Mallok, A; Viebahn-Hänsler, Renate; Fahmy, Ziad; Barberá, Ariana; Delgado, Liván; Menéndez, Silvia; Fernández, Olga Sonia León

    2013-08-15

    Rheumatoid Arthritis (RA) is the most prevalent chronic condition present in ~1% of the adult population. Many pro-inflammatory mediators are increased in RA, including Reactive Oxygen Species such as nitric oxide NO, pro-inflammatory cytokines as tumor necrosis factor alpha (TNF-α), interleukin-1beta (IL-1β) and other molecules. Ozone oxidative postconditioning has regulatory effects on some pathological targets associated with RA. Thus, the aim of this study was to investigate the efficacy of ozone therapy in PG/PS-induced arthritis in rats in point of joints inflammation and morphology. Moreover, cytokines, nitric oxide and oxidative stress levels in spleen homogenates were evaluated. Ozone treatment ameliorated joint damage, reduced TNF-α concentrations as well as TNF-α and IL-1β mRNA levels. Besides, cellular redox balance, nitric oxide and fructolysine levels were reestablished after ozone oxidative postconditioning. It was concluded that pleiotropic ozone's effects clarify its therapeutic efficacy in RA. Decreasing inflammation and joint injury, reduction of pro-inflammatory cytokines, TNF-α and IL-1β transcripts and re-establishment of cellular redox balance after ozone treatment were demonstrated.

  8. Refractive-index changes in lithium niobate crystals by radiation damages; Brechungsindexaenderungen in Lithiumniobat-Kristallen durch Strahlenschaeden

    Energy Technology Data Exchange (ETDEWEB)

    Zamani Meymian, Mohammad Reza

    2007-12-18

    For the study in this thesis {sup 3}He{sup 2+} ions with the energy of about 40 MeV were applied. The results of these studies show a timely very stable anisotrope refractive-index change in the range of some 10{sup -3}. The radiation damages caused by ions cause a decreasement of the ordinary refractive index n{sub o} and an increasement of the extra-ordinary refractive index n{sub e}. While the absolute values for {delta}n{sub o} and {delta}n{sub e} are nearly equal the birefringence of the material (n{sub e}-n{sub o}) smaller. The generated refractive-index change is dose dependent and the curve {delta}n has at increasing dose a strongly nonlinear slope with a characteristic stage at the radiation dose of about 2 x 10{sup 20} ions/m{sup 2}.

  9. Investigation of a multi-biomarker disease activity score in rheumatoid arthritis by comparison with magnetic resonance imaging, computed tomography, ultrasonography, and radiography parameters of inflammation and damage.

    Science.gov (United States)

    Krabbe, S; Bolce, R; Brahe, C H; Døhn, U M; Ejbjerg, B J; Hetland, M L; Sasso, E H; Chernoff, D; Hansen, M S; Knudsen, L S; Hansen, A; Madsen, O R; Hasselquist, M; Møller, J; Østergaard, M

    2017-09-01

    To investigate the multi-biomarker disease activity (MBDA) score by comparison with imaging findings in an investigator-initiated rheumatoid arthritis (RA) trial (HURRAH trial, NCT00696059). Fifty-two patients with established RA initiated adalimumab treatment and had magnetic resonance imaging (MRI), ultrasonography (US), computed tomography (CT), and radiography performed at weeks 0, 26, and 52. Serum samples were analysed using MBDA score assays and associations between clinical measures, MBDA score, and imaging findings were investigated. The MBDA score correlated significantly with MRI synovitis (rho = 0.65, p  44) MBDA scores, respectively. In this cohort, the MBDA score correlated poorly with MRI/US inflammation. However, the MBDA score and MRI/US were generally concordant in showing signs of inflammation in most patients in clinical remission during anti-tumour necrosis factor (anti-TNF) therapy. MBDA scores were elevated in all patients with structural damage progression.

  10. IGF-I and IGF-binding proteins in articular exudates of children with post-traumatic knee damage and juvenile idiopathic arthritis.

    Science.gov (United States)

    Guszczyn, Tomasz; Rzeczycka, Justyna; Popko, Janusz

    2009-01-01

    IGF-I stimulates multiple functions of connective tissue cells and its activity is modulated by IGF-binding proteins (BPs). Some metalloproteinases are expected to modify IGF-I activity by digestion of IGF-BPs. It was decided to evaluate the concentration of IGF-I, IGF-BPs and the activity of gelatinases A and B in knee exudates of children with post-traumatic damage (PTD) and children with juvenile idiopathic arthritis (JIA) in comparison with those in the sera of the same patients. ELISA (for IGF-I assay), polyacrylamine gel electrophoresis following Western immunoblotting (for IGF-I and IGF-BPs expression), and zymography (for gelatinase detection) were used. The knee exudates, especially those taken from patients with JIA, contained large amounts of IGF-I. The exudates of PTD and JIA patients contained some forms of IGF-BP-1 of molecular weight lower than those occurring in serum. Low expression BP-3 and high activity of gelatinase B were detected in the JIA exudates. The high gelatinase activities in exudates imply joint tissue damage. The cellular response to damage of this kind is an increase in IGF-I production, which stimulates repair processes. High proteolytic activities of gelatinase B in JIA patients may lower the amount of BP-3, possibly causing a relative decrease of IGF-I concentration and impairing the reparation processes stimulated by IGF-I. Copyright 2009 S. Karger AG, Basel.

  11. Relationship between time-integrated disease activity estimated by DAS28-CRP and radiographic progression of anatomical damage in patients with early rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Filippucci Emilio

    2011-05-01

    Full Text Available Abstract Background The main aim of the study was to investigate the relationship between persistent disease activity and radiographic progression of joint damage in early rheumatoid arthritis (ERA. Methods Forty-eight patients with active ERA was assessed every 3 months for disease activity for 3 years. Radiographic damage was measured by the Sharp/van der Heijde method (SHS. The cumulative inflammatory burden was estimated by the time-integrated values (area under the curve-AUC of Disease Activity Score 28 joint based on C-reactive protein (DAS28-CRP in rapid progressors versus non-progressors. Bland and Altman's 95% limits of agreement method were used to estimate the smallest detectable difference (SDD of radiographic progression. The relationship between clinical and laboratory predictors of radiographic progression and their interactions with time was analysed by logistic regression model. Results After 3-years of follow-up, radiographic progression was observed in 54.2% (95%CI: 39.8% to 67.5% of patients and SDD was 9.5 for total SHS. The percentage of patients with erosive disease increased from 33.3% at baseline to 76% at 36 months. The total SHS of the progressors worsened from a median (interquartile range of 18.5 (15-20 at baseline to 38.5 (34-42 after 3 years (p Conclusions These data indicate that the level of disease activity, as measured by time-integrated DAS28-CRP, anti-CCP and IgM-RF positivity and a high baseline joint damage, affects subsequent progression of radiographic damage in ERA.

  12. Gonococcal arthritis

    Science.gov (United States)

    Disseminated gonococcal infection (DGI); Disseminated gonococcemia; Septic arthritis - gonococcal arthritis ... Gonococcal arthritis is an infection of a joint. It occurs in people who have gonorrhea , which is caused by ...

  13. Viral arthritis

    Science.gov (United States)

    Infectious arthritis - viral ... Arthritis may be a symptom of many virus-related illnesses. It usually disappears on its own without ... the rubella vaccine, only a few people develop arthritis. No risk factors are known.

  14. Rheumatoid Arthritis

    Science.gov (United States)

    Rheumatoid arthritis (RA) is a form of arthritis that causes pain, swelling, stiffness and loss of function in ... wrist and fingers. More women than men get rheumatoid arthritis. It often starts in middle age and is ...

  15. Risk factors for cardiovascular damage in rheumatoid arthritis patients%类风湿关节炎心血管损害的危险因素

    Institute of Scientific and Technical Information of China (English)

    徐子涵; 张群燕; 蔡辉

    2016-01-01

    Cardiovascular disease is the most common cause for death in patients with rheumatoid arthritis(RA),while the pathogenesis of cardiovascular damage in RA is still not clear.Conventional cardiovascular risk factors behave differently in RA patients,which may be related to the specificity of RA and therefore nonconventional cardiovascular risk factors play an important role in cardiovascular damage in RA.Inflammation is one of the most important factors which link RA with cardiovascular disease,and it can strengthen the role of some conventional risk factors.%心血管疾病是类风湿关节炎(RA)患者最常见的死亡原因,然而 RA 心血管损害的确切机制尚不清楚。心血管疾病的传统危险因素在 RA 中的表现与一般人群不同,这可能与 RA 疾病的特异性有关,因此非传统心血管危险因素对 RA 心血管损害的影响不容忽视。其中炎症是联系 RA 与心血管的最重要因素,并加强了部分传统危险因素的作用。

  16. Novel association between sperm deformity index and oxidative stress-induced DNA damage in infertile male patients

    Institute of Scientific and Technical Information of China (English)

    Tamer M. Said; Nabil Aziz; Rakesh K. Sharma; Iwan Lewis-Jones; Anthony J. Thomas Jr; Ashok Agarwal

    2005-01-01

    Aim: To investigate the impact of abnormal sperm morphology using the sperm deformity index (SDI) on reactive oxygen species (ROS) production and its correlation with sperm DNA damage. Methods: Semen samples were collected from men undergoing infertility screening (n = 7) and healthy donors (n = 6). Mature spermatozoa were isolated and incubated with 5 mmol/L β-nicotinamide adenine dinucleotide phosphate (NADPH) for up to 24 h to induce ROS. Sperm morphology was evaluated using strict Tygerberg's criteria and the SDI. ROS levels and DNA damage were assessed using chemiluminescence and terminal deoxynucleotidyl transferase-mediated fluoresceindUTP nick end labeling (TUNEL) assays, respectively. Results: SDI values (median [interquartiles]) were higher in patients than donors (2 [1.8, 2.1] vs. 1.53 [1.52, 1.58], P = 0.008). Aliquots treated with NADPH showed higher ROS levels (1.22 [0.30, 1.87] vs. 0.39 [0.10, 0.57], P = 0.03) and higher incidence of DNA damage than those not treated (10 [4.69, 24.85] vs. 3.85 [2.58, 5.10], P = 0.008). Higher DNA damage was also seen following 24 h of incubation in patients compared to donors. SDI correlated with the percentage increase in sperm DNA damage following incubation for 24 h in samples treated with NADPH (r = 0.7, P = 0.008) and controls (r = 0.58, P = 0.04).Conclusion: SDI may be a useful tool in identifying potential infertile males with abnormal prevalence of oxidative stress (OS)-induced DNA damage. NADPH plays a role in ROS-mediated sperm DNA damage, which appears to be more evident in infertile patients with semen samples containing a high incidence of morphologically abnormal spermatozoa.

  17. The concomitant use of meloxicam and methotrexate does not clearly increase the risk of silent kidney and liver damages in patients with rheumatoid arthritis.

    Science.gov (United States)

    Park, Hee-Jin; Park, Min-Chan; Park, Yong-Beom; Lee, Soo-Kon; Lee, Sang-Won

    2014-06-01

    We investigated whether the concomitant use of meloxicam and methotrexate might induce kidney and liver damages in patients with rheumatoid arthritis (RA). We enrolled 101 RA patients with normal kidney and liver functions taking meloxicam and methotrexate concomitantly for more than 6 months. Blood and urine tests were performed. Estimated glomerular filtration rate (eGFR) and liver stiffness measurement (LSM) were used for evaluating silent kidney and liver damages. Ultrasonography was also performed to exclude structural abnormalities. We adopted 90 mL/min/1.73 mm(2) and 5.3 kPa as the cutoff for an abnormal eGFR and LSM. The mean age (85 women) was 51.9 years. The mean eGFR was 97.0 mL/min/1.73 m(2) and the mean LSM was 4.7 kPa. The mean weekly dose of methotrexate was 13.4 mg. The mean weekly dose of methotrexate did not correlate with eGFR or LSM. Neither the cumulative dose of meloxicam or methotrexate nor the mean weekly dose of methotrexate showed the significant odds ratio or relative risk for abnormal eGFR and LSM values. The use of higher-dose MTX, above 15 mg per week, with meloxicam did not significantly increase the risk for abnormal LSM and eGFR (RR = 2.042, p = 0.185; RR = 0.473, p = 0.218). The concomitant use of meloxicam and MTX did not clearly increase the risk of silent kidney or liver damage in RA patients with normal laboratory results taking MTX and meloxicam concurrently for over 6 months.

  18. Changes of CD4+ CD25+ Regulatory T Cells, FoxP3 in Adjuvant Arthritis Rats with Damage of Pulmonary Function and Effects of Tripterygium Glycosides Tablet

    Directory of Open Access Journals (Sweden)

    Wan Lei

    2012-01-01

    Full Text Available Objective. To observe the effects of tripterygium glycosides tablet (TPT on swelling degree, arthritis index (AI, pulmonary function, cytokines, the expression of regulatory T cells (Treg, and Foxp3 in rats of adjuvant arthritis. Methods. Rats were averagely divided into normal control (NC group, model control (MC group, methotrexate (MTX group, and tripterygium glycosides tablet (TPT group. Except for the rats of normal group, the others were intracutaneously injected with 0.1 mL of Freund’s complete adjuvant in the right hindlimb. NC group and MC group were treated with physiological saline. MTX group and TPT group were treated with MTX, TPT, respectively. Results. The levels of swelling degree, AI, the alveolar inflammation integral, TNF alpha (TNF-, and endothelium-1 (ET-1 in MC group were significantly increased (, and the levels of forced vital capacity (FVC, 25% vital capacity of the peak expiratory flow (FEF25, 50% vital capacity of the peak expiratory flow (FEF50, 75% vital capacity of the peak expiratory flow (FEF75, maximum midexpiratory flow (MMF, peak expiratory flow (PEF, interleukin-10 (IL-10, CD4+ CD25+ Treg, and Foxp3 were decreased (. The scores of alveolitis and ET-1 were decreased with treatment of TPT. The levels of FVC, FEF25, FEF50, FEF75, MMF, PEF, IL-10, and CD4+ CD25+ Treg in peripheral blood were increased. The expressions of Foxp3 protein and mRNA in lung tissue were also increased in TPT group. Conclusions. The paw swelling can be inhibited by TPT, and the inflammatory response in lung tissue was also decreased, which is a significant improvement in pulmonary function. The mechanism is probably associated with upregulating the expression of IL-10, Foxp3, and downregulating the level of TNF-.

  19. Progression of joint damage in early rheumatoid arthritis: association with HLA-DRB1, rheumatoid factor, and anti-citrullinated protein antibodies in relation to different treatment strategies.

    Science.gov (United States)

    de Vries-Bouwstra, J K; Goekoop-Ruiterman, Y P M; Verpoort, K N; Schreuder, G M T; Ewals, J A P M; Terwiel, J P; Ronday, H K; Kerstens, P J S M; Toes, R E M; de Vries, R R P; Breedveld, F C; Dijkmans, B A C; Huizinga, T W J; Allaart, C F

    2008-05-01

    To determine the association of HLA-DRB1, rheumatoid factor (RF), and anti-citrullinated protein antibody (ACPA) status with progression of joint damage in early rheumatoid arthritis (RA) treated according to different treatment strategies. The present study was conducted using data from the BeSt study (Behandelstrategieën voor Reumatoide Artritis [treatment strategies for rheumatoid arthritis]), a randomized trial comparing 4 targeted (toward achievement of a Disease Activity Score [DAS] of < or =2.4) treatment strategies: sequential monotherapy (group 1), step-up combination therapy (group 2), initial combination therapy with methotrexate, sulfasalazine, and prednisone (group 3), and initial combination therapy with methotrexate and infliximab (group 4), in 508 patients with early RA. Multivariate logistic regression analysis was used to predict progressive disease (increase of Sharp/van der Heijde score over 2 years beyond the smallest detectable change [4.6]) according to the presence or absence of the shared epitope (SE), DERAA, RF, and ACPA, with correction for other baseline characteristics. Progressive disease could not be predicted by presence of the SE: the odds ratio in groups 1, 2, 3, and 4, respectively, was 1.4, 2.6, 1.9, and 3.0. DERAA carriership did not protect against progressive disease (odds ratio 0.4, 1.4, 0.9, and 0.9 in groups 1, 2, 3, and 4, respectively). RF positivity and ACPA positivity predicted progressive disease in group 1 (odds ratio 4.7 [95% confidence interval 1.5-14.5] for RF and 12.6 [95% confidence interval 3.0-51.9] for ACPA), but not in groups 2-4 (for RF, odds ratio [95% confidence interval] 1.5 [0.5-4.9], 1.0 [0.3-3.3], and 1.4 [0.4-4.8] in group 2, group 3, and group 4, respectively; for ACPA, odds ratio [95% confidence interval] 3.4 [0.8-14.2], 1.7 [0.5-5.4], and 1.8 [0.5-6.8] in group 2, group 3, and group 4). In patients with early RA treated with the goal of tight control of the DAS, no significant association between

  20. Extra-virgin olive oil and its phenolic extract prevent inflammatory response and joint damage in murine experimental arthritis

    Directory of Open Access Journals (Sweden)

    M. A. Rosillo

    2016-12-01

    Full Text Available The consumption of EVOO in Mediterranean countries has shown beneficial effects. A wide range of evidence indicates that the phenolic compounds present in EVOO are endowed with anti-inflammatory properties. In this work, we evaluated the effects of dietary EVOO and treatment with its phenolic extract (PE in a model of RA, the collagen-induced arthritis (CIA in mice. On day 0, DBA-1/J mice were immunized with bovine collagen type II (CII. On day 21, the mice received a booster injection. We have demonstrated that EVOO and its PE decreases joint edema, cell migration, cartilage degradation and bone erosion. Our data indicate that dietary EVOO and PE treatment inhibit JNK, p38 and signal transducer and STAT-3. In addition, both EVOO and PE decrease NF-κB translocation leading to the down-regulation of the arthritic process. These results support the interest of natural diet components in the development of therapeutic products for arthritic conditions.

  1. Septic arthritis in adult horses.

    Science.gov (United States)

    Carstanjen, B; Boehart, S; Cislakova, M

    2010-01-01

    Septic arthritis in horses is a serious disease which can become life-threatening. In case the infection can be eliminated before irreversible joint damage occurs, complete recovery is possible. This article gives an overview of the literature concerning etiology, diagnosis and strategies of therapy in cases of septic arthritis in adult horses, with special reference to novel options of treatment.

  2. Validity of early MRI structural damage end points and potential impact on clinical trial design in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Baker, Joshua F; Conaghan, Philip G; Emery, Paul;

    2016-01-01

    Wilcoxon rank sum tests and tests of proportion estimated the sample size required to detect differences between combination therapy (methotrexate+golimumab) and methotrexate-monotherapy arms in (A) change in damage score and (B) proportion of patients progressing. RESULTS: Patients with early MRI...

  3. Juvenile Arthritis

    Science.gov (United States)

    Juvenile arthritis (JA) is arthritis that happens in children. It causes joint swelling, pain, stiffness, and loss of motion. It can affect any joint, but ... of JA that children get is juvenile idiopathic arthritis. There are several other forms of arthritis affecting ...

  4. Testing of the preliminary OMERACT validation criteria for a biomarker to be regarded as reflecting structural damage endpoints in rheumatoid arthritis clinical trials: the example of C-reactive protein

    DEFF Research Database (Denmark)

    Keeling, Stephanie O; Landewe, Robert; van der Heijde, Desiree

    2007-01-01

    OBJECTIVE: A list of 14 criteria for guiding the validation of a soluble biomarker as reflecting structural damage endpoints in rheumatoid arthritis (RA) clinical trials was drafted by an international working group after a Delphi consensus exercise. C-reactive protein (CRP), a soluble biomarker......-based survey. RESULTS: Minimal data were extracted from the literature pertaining to those criteria listed under the category of truth. Ratings for strength of evidence were moderate to low (

  5. Indexed

    CERN Document Server

    Hagy, Jessica

    2008-01-01

    Jessica Hagy is a different kind of thinker. She has an astonishing talent for visualizing relationships, capturing in pictures what is difficult for most of us to express in words. At indexed.blogspot.com, she posts charts, graphs, and Venn diagrams drawn on index cards that reveal in a simple and intuitive way the large and small truths of modern life. Praised throughout the blogosphere as “brilliant,” “incredibly creative,” and “comic genius,” Jessica turns her incisive, deadpan sense of humor on everything from office politics to relationships to religion. With new material along with some of Jessica’s greatest hits, this utterly unique book will thrill readers who demand humor that makes them both laugh and think.

  6. An experimental evaluation of patient decision aid design to communicate the effects of medications on the rate of progression of structural joint damage in rheumatoid arthritis.

    Science.gov (United States)

    Martin, Richard W; Brower, Matthew E; Geralds, Alexander; Gallagher, Patience J; Tellinghuisen, Donald J

    2012-03-01

    To explore how effectively information presentation formats used in a patient decision aid communicated the ability of a disease modifying anti-rheumatic drug to slow the rate of progression of rheumatoid arthritis related structural joint damage (SJD). 91 first year psychology students and 91 RA patients participated in a prospective randomized, single blind, factorial experimental design evaluating the effect of four information formats on: satisfaction with risk communication, verbatim and gist recall of a hypothetical anti-rheumatic drug's ability to slow the rate of progression of SJD. Both groups underestimated the hypothetical drug's ability to slow SJD. Formats that supported the narrative statement with a reinforcing graphic element resulted in recall closer to the true value. Comparison of the results from testing of RA patients and college students were remarkably similar across formats. Rate of progression as communicated by narrative statement plus a graphic element (i.e. speedometer metaphor or pictograph) aided recall better than a narrative statement alone. Our results suggest that testing decision aid components with non-patients may provide data generalizable to patient populations. Graphics must be used carefully in patient decision aids as they can enhance recall, but may also introduce unintended recall bias. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  7. Anti–citrullinated protein antibody positivity correlates with cartilage damage and proteoglycan levels in patients with rheumatoid arthritis in the hand joints.

    Science.gov (United States)

    Renner, Nina; Krönke, Gerhard; Rech, Jürgen; Uder, Michael; Janka, Rolf; Lauer, Lars; Paul, Dominik; Herz, Barbara; Schlechtweg, Philipp; Hennig, Friedrich Frank; Schett, Georg; Welsch, Götz

    2014-12-01

    Objective: To investigate the factors associated with cartilage proteoglycan content in patients with rheumatoid arthritis (RA) Methods: 32 RA patients received high-field 3 Tesla Gadolinium-Enhanced MRI of Cartilage (dGEMRIC) for determining cartilage proteoglycan content. Measurements were performed in three individual cartilage regions (medial, central, lateral) of the metacarpophalangeal joints 2 and 3. dGEMRIC values were then related to disease duration, disease activity, anti-citrullinated protein antibody (ACPA) status, rheumatoid factor status and C-reactive protein level. Results: dGEMRIC values were not significantly different between the MCP2 and MCP3 joint. Inter-class correlations were high (>0.92) for all three (medial, central and lateral) cartilage compartments. dGEMRIC values were significantly lower in RA patients with longer disease duration (≥3 years) and those with ACPA positivity than those with a short disease duration (<3 years)(p=0.034) or negative ACPA (p=0.0002), respectively. In contrast, no association between cartilage proteoglycan content and disease activity, C-reactive protein level and rheumatoid factor status was found. Conclusion: Decreased cartilage proteoglycan content in RA patients is associated with disease duration and ACPA positivity but not with the actual disease activity, CRP level or rheumatoid factor status. These data suggest that the cumulative burden of inflammation as well as ACPA are the determinants for cartilage damage in RA.

  8. Case study: the use of technescan HIG to differentiate between old damage and active inflammation in arthritis in a 11-year-old-boy

    Energy Technology Data Exchange (ETDEWEB)

    Moorin, R.E.

    1997-09-01

    Full text: A {sup 99m}Tc Technescan HIG (Polyclonal Human Immunoglobulin G, `Mallinkrodt Medical`) scan was undertaken on an 11 year old boy with a nine year history of juvenile arthritis. He recently suffered in creased pain in his neck with tenderness over the right C6 dorsal facet joint. The question was posed as to whether this represented an area of old damage or new active inflammation. Whole body imaging was carried out following an IV injection of 600 MBq of {sup 99m}Tc HIG at four and 24 hours using a rectangular Millenium gamma camera. (GE Milwaukee) Both four and 24 hour images failed to show any area of focal uptake in the neck. Focal uptake was demonstrated in both knees, the right more pronounced than the left in keeping with the patient current symptoms. From this scan it was decided that the cervical problem was related to old damage. Scintigraphy with HIG labelled with either {sup 111}ln or {sup 99m}Tc is recognised as a reliable method for the detection of infection and inflammation. Recently, reports have suggested that it may be useful in detecting synovitis, identifying those joints which have current active inflammation. We conclude that this modality is a non-invasive accurate diagnostic tool which may be used to routinely monitor the status of arthritic joints. In addition, we feel that serial scanning may provide a more accurate insight into the nature of the disease progression within an individual than is available with current practices.

  9. Early and aggressive treatment of rheumatoid arthritis patients affects the association of HLA class II antigens with progression of joint damage.

    Science.gov (United States)

    Lard, L R; Boers, M; Verhoeven, A; Vos, K; Visser, H; Hazes, J M W; Zwinderman, A H; Schreuder, G M T; Breedveld, F C; De Vries, R R P; van der Linden, S; Zanelli, E; Huizinga, T W J

    2002-04-01

    The presence of certain HLA class II antigens is strongly associated with the progression of joint destruction in rheumatoid arthritis (RA). Such antigens may be more effective than other class II antigens in inducing the formation of autoreactive T cells after presentation of (auto)antigens. We investigated whether early and aggressive treatment with disease-modifying antirheumatic drugs could modify this relationship. We analyzed data from 2 studies of patients with early RA treated according to different strategies. The first study consisted of 2 cohorts, one (n = 109; median disease duration before treatment 4 months) was treated according to the pyramid strategy (initial nonsteroidal antiinflammatory drugs, followed by chloroquine [CQ] or sulfasalazine [SSZ] when necessary), and the other (n = 97; median disease duration before treatment 2 weeks) was immediately treated with CQ or SSZ. The second study comprised 155 patients (median disease duration 4 months) from the Combinatietherapie Bij Reumatoide Artritis (COBRA) trial, in which patients were randomly assigned to combination treatment with step-down prednisolone, methotrexate (MTX), and SSZ (n = 76) or with SSZ alone (n = 79). Prednisolone and MTX dosages were tapered and stopped after 28 and 40 weeks, respectively. The extent of joint damage was measured by the modified Sharp method. In the pyramid treatment cohort, the median increase in Sharp score after 2 years was 12 in patients positive for the shared epitope (SE) and 1 in SE- patients. In the immediate treatment cohort, the median increase was 3 in SE+ patients and 2 in SE- patients. In the SSZ group of the COBRA study, the median increase in Sharp score after 1 year was 11 in DR4+ patients and 3 in DR4- patients. In the combination treatment group, the median increase was 4 in DR4+ patients and 2 in DR4- patients. Significance was confirmed by multiple regression using log-transformed scores. Early and aggressive antirheumatic drug treatment

  10. Antibodies to Mutated Citrullinated Vimentin in Rheumatoid Arthritis: Diagnostic Value, Association with Radiological Damage and Axial Skeleton Affection

    Directory of Open Access Journals (Sweden)

    Howaida E. Mansour

    2010-05-01

    Full Text Available Abstract Background: Early definitive diagnosis and effective treatment are mandatory in rheumatoid arthritis (RA as it can halt the disease progression and subsequent joints destruction. Objective: To investigate the diagnostic and prognostic value of anti-mutated citrullinated vimentin (anti-MCV and its correlation with disease activity, peripheral and axial skeleton affection in RA patients. Patients and methods: A total of 123 patients with different rheumatic diseases were enrolled in a prospective-two year study at Ain Shams University hospital: 64 patients with RA and 59 patients with other rheumatic diseases as controls. RA patients were fulfilling the traditional and the new ACR/EULAR diagnostic criteria for RA. They have been followed up for two years. At baseline, all RA patients were subjected to: Clinical assessment of disease activity by taking full histories, general and local examination, measurement of 28 joint count of tender and swollen joints with calculation of disease activity score (DAS-28 for each patient. Complete blood count, erythrocytes sedimentation rate, C-reactive protein and rheumatoid factor titers were performed. Anti-MCV IgG immunoglobulins’ assay was performed at the study endpoint by ELISA. RA patients were then classified into; anti-MCV positive and anti-MCV negative groups for statistical comparison. Plain X-ray was performed on the peripheral joints and scored by the Simple Erosion Narrowing score (SEN-score. Magnetic Resonance Imaging (MRI scans were carried out to 22 RA patients on cervical and lumbosacral regions. Results: Anti-MCV antibodies were found to be of high sensitivity (79.6% and specificity (96.6% in diagnosing RA. The area under the curve was 0.893 at 95% confidence interval (CI, confers an odds ratio of 23.5. Anti-MCV positive RA patients had significantly higher DAS-28 and SEN-scores than anti-MCV negative patients; who were found to have more benign disease with lower incidence of

  11. The effects of chronic periodontitis and rheumatoid arthritis on serum and gingival crevicular fluid total antioxidant/oxidant status and oxidative stress index.

    Science.gov (United States)

    Esen, Cağrı; Alkan, Banu Arzu; Kırnap, Mehmet; Akgül, Ozgür; Işıkoğlu, Semra; Erel, Ozcan

    2012-06-01

    Chronic periodontitis (CP) and rheumatoid arthritis (RA) appear to share many pathologic features. Oxygen metabolism has an important role in the pathogenesis of both CP and RA. The aim of this study is to evaluate the relationship between these two chronic inflammatory diseases with regard to antioxidant and oxidant status. A total of 80 participants were divided into four groups of 20 each: group RA-CP (patients with RA and CP), group RA (periodontally healthy patients with RA), group CP (systemically healthy patients with CP), and group C (periodontally and systemically healthy volunteers) were included in the study. After assessment of periodontal measurements, gingival crevicular fluid (GCF) samples were taken at one incisor, premolar, and molar tooth and stored with serum samples at -80°C for the antioxidant/oxidant assay. Although all clinical measurements in groups RA-CP and CP were statistically higher compared to those of C and RA groups (P 0.05). GCF total oxidant status (TOS) values of CP and RA-CP groups were higher than those of the RA group (P oxidative stress index (OSI) values of the RA-CP group were higher than those of the RA group (P 0.05). Local OSI values in groups with patients with CP were higher, whereas systemic OSI values showed no difference among the groups. The presence of RA seems not to affect local and systemic OSI values in patients with CP.

  12. Quality-Adjusted Life Expectancies in Patients with Rheumatoid Arthritis-Comparison of Index Scores from EQ-5D, 15D, and SF-6D

    DEFF Research Database (Denmark)

    Sørensen, Jan; Linde, Louise; Østergaard, Mikkel;

    2012-01-01

    The aim of this study was to compare quality-adjusted life expectancy (QALE) for patients with rheumatoid arthritis generated from three generic health-related quality-of-life instruments.......The aim of this study was to compare quality-adjusted life expectancy (QALE) for patients with rheumatoid arthritis generated from three generic health-related quality-of-life instruments....

  13. Real-world validation of the minimal disease activity index in psoriatic arthritis: an analysis from a prospective, observational, biological treatment registry.

    Science.gov (United States)

    Rahman, Proton; Zummer, Michel; Bessette, Louis; Baer, Philip; Haraoui, Boulos; Chow, Andrew; Kelsall, John; Kapur, Suneil; Rampakakis, Emmanouil; Psaradellis, Eliofotisti; Lehman, Allen J; Nantel, Francois; Osborne, Brendan; Tkaczyk, Cathy

    2017-08-30

    To describe the minimal disease activity (MDA) rate over time in patients with psoriatic arthritis (PsA) receiving antitumour necrosis factor agents, evaluate prognostic factors of MDA achievement and identify the most common unmet criteria among MDA achievers. Biologic Treatment Registry Across Canada (BioTRAC): ongoing, prospective registry of patients initiating treatment for rheumatoid arthritis, ankylosing spondylitis or PsA with infliximab (IFX), golimumab (GLM) or ustekinumab. 46 primary-care Canadian rheumatology practices. 223 patients with PsA receiving IFX (enrolled since 2005) and GLM (enrolled since 2010) with available MDA information at baseline, 6 months and/or 12 months. MDA was defined as ≥5 of the following criteria: 28-item tender joint count (TJC28) ≤1, 28-item swollen joint count (SJC28) ≤1, Psoriasis Area and Severity Index (PASI) ≤1 or body surface area≤3, Pain Visual Analogue Scale (VAS) ≤15 mm, patient's global assessment (PtGA) (VAS) ≤20 mm, Health Assessment Questionnaire (HAQ) ≤0.5, tender entheseal points ≤1. Independent prognostic factors of MDA achievement were assessed with multivariate logistic regression. MDA was achieved by 11.7% of patients at baseline, 43.5% at 6 months, 44.8% at 12 months and 48.8% at either 6 or 12 months. Among MDA achievers at 6 months, 75.7% had sustained MDA at 12 months. Lower baseline HAQ (OR=0.210; 95% CI: 0.099 to 0.447) and lower TJC28 (OR=0.880; 95% CI: 0.804 to 0.964), were significant prognostic factors of MDA achievement over 12 months of treatment. The most commonly unmet MDA criteria among MDA achievers was patient reported pain (25%), PtGA (15%) and PASI (12%). Almost 50% of patients treated with IFX or GLM in routine clinical care achieved MDA within the first year of treatment. Lower baseline HAQ and lower TJC28, were identified as significant prognostic factors of MDA achievement. The most commonly unmet criteria in patients who achieved MDA were pain, PtGA and

  14. Infectious Arthritis

    Science.gov (United States)

    Most kinds of arthritis cause pain and swelling in your joints. Joints are places where two bones meet, such as your elbow or knee. Infectious arthritis is an infection in the joint. The infection ...

  15. Psoriatic Arthritis

    Science.gov (United States)

    ... your body. Some people with psoriasis have psoriatic arthritis. It causes pain, stiffness, and swelling of the ... physical exam and imaging tests to diagnose psoriatic arthritis. There is no cure, but medicines can help ...

  16. Thumb Arthritis

    Science.gov (United States)

    ... Media Find a Hand Surgeon Home Anatomy Thumb Arthritis Email to a friend * required fields From * To * ... A joint is where bones connect and move. Arthritis is thinning of the cartilage, which is the ...

  17. Fungal arthritis

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000444.htm Fungal arthritis To use the sharing features on this page, please enable JavaScript. Fungal arthritis is swelling and irritation (inflammation) of a joint ...

  18. Sporotrichal arthritis.

    OpenAIRE

    1991-01-01

    Sporotrichal arthritis is a rare disease entity. Diagnosis is often difficult and delayed. Presentation may be either monoarticular or polyarticular. A case of polyarticular sporotrichal arthritis which exemplifies these problems is reported.

  19. Psoriatic Arthritis

    Science.gov (United States)

    ... Call for Letters of Interest Call for Topics Axial Spondyloarthritis Glucocorticoid-Induced Osteoporosis Gout Juvenile Idiopathic Arthritis ... be affected. Psoriatic arthritis in the spine, called spondylitis , causes stiffness in the back or neck, and ...

  20. Osteitis and synovitis, but not bone erosion, is associated with proteoglycan loss and microstructure damage in the cartilage of patients with rheumatoid arthritis.

    Science.gov (United States)

    Herz, Barbara; Albrecht, Andreas; Englbrecht, Matthias; Welsch, Götz H; Uder, Michael; Renner, Nina; Schlechtweg, Philipp; Paul, Dominik; Lauer, Lars; Engelke, Klaus; Janka, Rolf; Rech, Jürgen; Schett, Georg; Finzel, Stephanie

    2014-06-01

    To investigate the relation between anatomic changes of the synovium, the bone, the bone marrow and the cartilage to biochemical properties of the cartilage in patients with rheumatoid arthritis (RA). 33 patients with RA received 3-T MRI scans of the metacarpophalangeal joints. Two independent methods, (A) the delayed gadolinium enhanced MRI of the cartilage (dGEMRIC, T2-mapping), which was used to assess the biochemical properties of the cartilage; (B) synovitis, osteitis and bone erosions were quantified according to the RA MRI scoring (RAMRIS) method and cartilage thickness (CT), interbone joint space (IBJS, distance between proximal and distal bone surface) and intercartilage joint space (ICJS, distance between proximal and distal cartilage surface) were measured. Biochemical changes of the cartilage, corresponding to low dGEMRIC and high T2 values, were more likely to be seen in joints with decreased IBJS and ICJS as well as decreased CT. For instance, dGEMRIC was directly correlated to the IBJS (p=0.001) and ICJS (p=0.001), whereas T2 mapping was inversely correlated to IBJS and ICJS (both p=0.017). Moreover, the degree of osteitis, and to some extent synovitis, was correlated to biochemical cartilage changes as measured by dGEMRIC (p=0.003) or the T2 mapping (p=0.013). By contrast, bone erosions did not correlate to the degree of biochemical cartilage changes. These data support the concept that synovitis and osteitis may be two main triggers for cartilage damage. Thus, the actual inflammatory state of a joint, but not so much the degree of bone erosion, appears to influence cartilage properties in RA.

  1. Humanized anti-interleukin-6-receptor antibody (tocilizumab) monotherapy is more effective in slowing radiographic progression in patients with rheumatoid arthritis at high baseline risk for structural damage evaluated with levels of biomarkers, radiography, and BMI: data from the SAMURAI study.

    Science.gov (United States)

    Hashimoto, Jun; Garnero, Patrick; van der Heijde, Désirée; Miyasaka, Nobuyuki; Yamamoto, Kazuhiko; Kawai, Shinichi; Takeuchi, Tsutomu; Yoshikawa, Hideki; Nishimoto, Norihiro

    2011-02-01

    Our aim was to assess the ability of tocilizumab monotherapy to reduce progressive structural joint damage in rheumatoid arthritis patients at high risk of progression. This study was a subanalysis from a prospective 1-year, multicenter, X-ray-reader-blinded, randomized controlled trial of tocilizumab [Study of Active Controlled Monotherapy Used for Rheumatoid Arthritis, an IL-6 Inhibitor (SAMURAI) trial]. All patients were categorized into two or three groups according to four independent predictive markers for progressive joint damage [urinary C-terminal crosslinking telopeptide (uCTX-II), urinary pyridinoline/deoxypyridinoline (uPYD/DPD) ratio, body mass index (BMI), and joint-space narrowing (JSN) score at baseline]. One-year progression of joint destruction was assessed in high-risk versus low-risk groups receiving tocilizumab monotherapy and compared with patients receiving conventional disease-modifying antirheumatic drugs (DMARDs) (n = 157 and 145, respectively). In patients at high risk of progression of erosion as estimated by high uCTX-II, uPYD/DPD, or low BMI, and at high risk of progression of JSN as estimated by low BMI or high JSN score, the 52-week changes in radiological erosion and JSN, respectively, were significantly less in patients treated with tocilizumab monotherapy compared with those receiving DMARDs for each type of risk factor. In patients at low risk, those receiving tocilizumab also progressed less than those on DMARDs, although the difference did not reach statistical significance. Tocilizumab monotherapy is more effective in reducing radiological progression in patients presenting with risk factors for rapid progression than in low-risk patients. Patients at high risk for progression may benefit more from tocilizumab treatment.

  2. A treat-to-target strategy with methotrexate and intra-articular triamcinolone with or without adalimumab effectively reduces MRI synovitis, osteitis and tenosynovitis and halts structural damage progression in early rheumatoid arthritis

    DEFF Research Database (Denmark)

    Axelsen, Mette Bjørndal; Eshed, Iris; Hørslev-Petersen, Kim

    2014-01-01

    OBJECTIVES: To investigate whether a treat-to-target strategy with methotrexate and intra-articular glucocorticosteroid injections suppresses MRI inflammation and halts structural damage progression in patients with early rheumatoid arthritis (ERA), and whether adalimumab provides an additional...... effect. METHODS: In a double-blind, placebo-controlled trial, 85 disease-modifying antirheumatic drug-naïve patients with ERA were randomised to receive methotrexate, intra-articular glucocorticosteroid injections and placebo/adalimumab (43/42). Contrast-enhanced MRI of the right hand was performed...

  3. What Is Reactive Arthritis?

    Science.gov (United States)

    ... Arthritis PDF Version Size: 69 KB November 2014 What is Reactive Arthritis? Fast Facts: An Easy-to- ... Information About Reactive Arthritis and Other Related Conditions What Causes Reactive Arthritis? Sometimes, reactive arthritis is set ...

  4. Sex and Arthritis

    Science.gov (United States)

    ... Well with Rheumatic Disease Sex & Arthritis Sex and Arthritis Fast Facts Sex and arthritis can coexist. Open ... ability for sexual expression and enjoyment. Impact of Arthritis on Sexual Expression Aspects of arthritis which can ...

  5. A Two-Stage Method for Structural Damage Prognosis in Shear Frames Based on Story Displacement Index and Modal Residual Force

    Directory of Open Access Journals (Sweden)

    Asghar Rasouli

    2015-01-01

    Full Text Available A two-stage method is proposed to properly identify the location and the extent of damage in shear frames. In the first stage, a story displacement index (SDI is presented to precisely locate the damage in the shear frame which is calculated using the modal analysis information of the damaged structure. In the second stage, by defining a new objective function, the extent of the actual damage is determined via an imperialist competitive algorithm. The performance of the proposed method is demonstrated by implementing the technique to three examples containing five-, ten-, and twenty-five-story shear frames with noises and without them in modal data. Moreover, the performance of the proposed method has been verified through using a benchmark problem. Numerical results show the high efficiency of the proposed method for accurately identifying the location and the extent of structural damage in shear frames.

  6. Reactive Arthritis

    Directory of Open Access Journals (Sweden)

    Eren Erken

    2013-06-01

    Full Text Available Reactive arthritis is an acute, sterile, non-suppurative and inflammatory arthropaty which has occured as a result of an infectious processes, mostly after gastrointestinal and genitourinary tract infections. Reiter syndrome is a frequent type of reactive arthritis. Both reactive arthritis and Reiter syndrome belong to the group of seronegative spondyloarthropathies, associated with HLA-B27 positivity and characterized by ongoing inflammation after an infectious episode. The classical triad of Reiter syndrome is defined as arthritis, conjuctivitis and urethritis and is seen only in one third of patients with Reiter syndrome. Recently, seronegative asymmetric arthritis and typical extraarticular involvement are thought to be adequate for the diagnosis. However, there is no established criteria for the diagnosis of reactive arthritis and the number of randomized and controlled studies about the therapy is not enough. [Archives Medical Review Journal 2013; 22(3.000: 283-299

  7. Atherogenic index and high-density lipoprotein cholesterol as cardiovascular risk determinants in rheumatoid arthritis: the impact of therapy with biologicals

    NARCIS (Netherlands)

    Popa, C.D.; Arts, E.; Fransen, J.; Riel, P.L. van

    2012-01-01

    Cardiovascular (CV) diseases are a serious concern in rheumatoid arthritis (RA), accounting for approximately one-third to one-half of all RA-related deaths. Besides the attempts to identify new risk factors, the proper management of traditional CV risk factors such as dyslipidemia should become a p

  8. A potent and selective p38 inhibitor protects against bone damage in murine collagen-induced arthritis : a comparison with neutralization of mouse TNF alpha

    NARCIS (Netherlands)

    Mihara, K.; Almansa, C.; Smeets, R. L.; Loomans, E. E. M. G.; Dulos, J.; Vink, P. M. F.; Rooseboom, M.; Kreutzer, H.; Cavalcanti, F.; Boots, A. M.; Nelissen, R. L.

    2008-01-01

    Background and purpose: The p38 kinase regulates the release of proinflammatory cytokines including tumour-necrosis factor-alpha (TNF alpha) and is regarded as a potential therapeutic target in rheumatoid arthritis (RA). Using the novel p38 inhibitor Org 48762-0, we investigated the therapeutic pote

  9. Lack of effect of doxycycline on disease activity and joint damage in patients with rheumatoid arthritis. A double blind, placebo controlled trial

    NARCIS (Netherlands)

    Laan, W. van der; Molenaar, E.; Ronday, K.; Verheijen, J.; Breedveld, F.; Greenwald, R.; Dijkmans, B.; Tekoppele, J.

    2001-01-01

    Objective. To investigate the effects of doxycycline on disease activity and joint destruction in patients with rheumatoid arthritis (RA). Methods. A 36 week double blind, placebo controlled crossover trial was conducted. Patients (n = 66) received 50 mg doxycycline or placebo twice a day during 12,

  10. Disease activity index and damage index in Sjogren's syndrome%干燥综合征疾病活动及脏器损伤指数的研究进展

    Institute of Scientific and Technical Information of China (English)

    徐东; 赵岩

    2015-01-01

    干燥综合征(sjogren's syndrome,SS)是一种进展缓慢的结缔组织疾病,随时间延长会出现疾病的活动或脏器损伤,评估疾病的活动性及损伤情况对疾病的进一步治疗、评估疗效及了解预后甚为重要。目前为止,SS 仍缺乏统一的评估病情状态的有效指标,1998年以来各国风湿病学专家在积极寻找评估的方法以用于临床实验和临床实践。目前用于临床的活动性指数主要有 SS 疾病活动性指数(SS disease activity index,SSDAI)、SS 临床活动性指数(SS clinical activity index,SCAI)以及欧洲抗风湿病联盟 SS 疾病活动性指数(EULAR SS disease activity index,ESSDAI)三种,脏器损伤指数有 SS 疾病损伤指数(SS disease damage index,SSDDI)和 SS 损伤指数(SS damage index,SSDI)两种。此外,还有评估患者主观症状的欧洲抗风湿病联盟SS 患者汇报指数(ESSPRI)与 ESSDAI 配合应用。几种活动性指数及损伤指数各有优缺点,总体来说,ESSDAI 和 ESSPRI 是评估活动性最有希望的工具,也是目前国际上 SS 临床实验中应用最多的活动评估体系。相信在不久的将来,用于评估 SS 活动和损伤的国际公认指标将被提供。%Sjogren's syndrome is a slowly progressive connective tissue disease ,disease activity or organ damage maybe e-merged with the extension of the course of disease .So it is very important to evaluate the activity and damage for the treatment and esti -mating prognosis.Till now no agreed valid index were accepted for evaluating disease .Now activity index used clinically mainly included SS disease activity index(SSDAI),SS clinical activity index(SCAI)and EULAR SS disease activity index (ESSDAI).Damage index in-cluded SS disease damage index (SSDDI) and SS damage index (SSDI).Moreover,EULAR Sjogren's syndrome patients report index (ESSPRI),which were used to evaluate subjective symptoms of patients ,were used

  11. A higher score on the dermatology life quality index, being on systemic treatment and having a diagnosis of psoriatic arthritis is associated with increased costs in patients with plaque psoriasis.

    Science.gov (United States)

    Ekelund, Mats; Mallbris, Lotus; Qvitzau, Susanne; Stenberg, Berndt

    2013-11-01

    The aim of this study was to examine the relationship between measures of disease severity and costs from a societal perspective in patients with plaque psoriasis. Dermatologists in Sweden recruited 443 consecutive patients who had had no biological treatment during the past 12 months. Following a Psoriasis Area and Severity Index (PASI) assessment, subjects completed self-assessments on health status/quality of life and a healthcare resource utilization/work status questionnaire. The costs of healthcare resources and sick-leave due to plaque psoriasis were estimated and related to the subject's health status. A patient's Dermatology Life Quality Index (DLQI) and being on systemic therapy, or having diagnosis of psoriatic arthritis, appeared to be more strongly associated with direct and indirect costs than did their PASI. The cost of biological therapy should be considered from the perspective of the already high costs of patients with high DLQI undergoing traditional systemic treatment.

  12. [Study on optimal selection of structure of vaneless centrifugal blood pump with constraints on blood perfusion and on blood damage indexes].

    Science.gov (United States)

    Hu, Zhaoyan; Pan, Youlian; Chen, Zhenglong; Zhang, Tianyi; Lu, Lijun

    2012-12-01

    This paper is aimed to study the optimal selection of structure of vaneless centrifugal blood pump. The optimal objective is determined according to requirements of clinical use. Possible schemes are generally worked out based on structural feature of vaneless centrifugal blood pump. The optimal structure is selected from possible schemes with constraints on blood perfusion and blood damage indexes. Using an optimal selection method one can find the optimum structure scheme from possible schemes effectively. The results of numerical simulation of optimal blood pump showed that the method of constraints of blood perfusion and blood damage is competent for the requirements of selection of the optimal blood pumps.

  13. Metabolomics in psoriatic disease: pilot study reveals metabolite differences in psoriasis and psoriatic arthritis [v1; ref status: indexed, http://f1000r.es/3vr

    OpenAIRE

    April W. Armstrong; Julie Wu; Mary Ann Johnson; Dmitry Grapov; Baktazh Azizi; Jaskaran Dhillon; Oliver Fiehn

    2014-01-01

    Importance: While “omics” studies have advanced our understanding of inflammatory skin diseases, metabolomics is mostly an unexplored field in dermatology. Objective: We sought to elucidate the pathogenesis of psoriatic diseases by determining the differences in metabolomic profiles among psoriasis patients with or without psoriatic arthritis and healthy controls. Design: We employed a global metabolomics approach to compare circulating metabolites from patients with psoriasis, psoriasis and ...

  14. Arthritis and the Feet

    Science.gov (United States)

    ... RSS Home » Learn About Feet » Foot Health Information Arthritis What is Arthritis? Arthritis, in general terms, is inflammation and swelling of ... an increase in the fluid in the joints. Arthritis has multiple causes; just as a sore throat ...

  15. Physiotherapy in rheumatoid arthritis.

    Science.gov (United States)

    Kavuncu, Vural; Evcik, Deniz

    2004-05-17

    Rheumatoid arthritis (RA) is a chronic and painful clinical condition that leads to progressive joint damage, disability, deterioration in quality of life, and shortened life expectancy. Even mild inflammation may result in irreversible damage and permanent disability. The clinical course according to symptoms may be either intermittent or progressive in patients with RA. In most patients, the clinical course is progressive, and structural damage develops in the first 2 years. The aim of RA management is to achieve pain relief and prevent joint damage and functional loss. Physiotherapy and rehabilitation applications significantly augment medical therapy by improving the management of RA and reducing handicaps in daily living for patients with RA. In this review, the application of physiotherapy modalities is examined, including the use of cold/heat applications, electrical stimulation, and hydrotherapy. Rehabilitation treatment techniques for patients with RA such as joint protection strategies, massage, exercise, and patient education are also presented.

  16. Comparative analysis of laboratory indexes for rheumatoid arthritis%类风湿关节炎实验诊断指标的比较分析

    Institute of Scientific and Technical Information of China (English)

    邵耀明; 倪芳颖; 陈国千

    2011-01-01

    Objective  To investigate the sensitivity and specificity of anti-CCP antibody and rheumatoid factor in laboratory diagnosis of rheumatoid arthritis ,and their correlation .Methods  Determination results of anti-CCP antibody and rheumatoid factor were statistically analysed in 102 healthy subjects ,128 cases with rheumatoid arthritis and 151 patients without rheumatoid arthritis .AntiCCP antibody and rheumatoid factor were detected by ELISA and immunoturbidimetry ,respectively .Results  The sensitivity of AntiCCP antibody and rheumatoid factor for rheumatoid arthritis was 76 .6% and 86 .7% ( P < 0 .05) ,specificity 94 .9% and 69 .9% ( P< 0 .01) ,respectively .The correlation coefficient between the quantitative results of anti-CCP antibody and rheumatoid factor was 0.187( P > 0 .05)in rheumatoid arthritis .The positive rate of anti-CCP antibody or rheumatoid factor showed no significant difference between different sex orage .Conclusion  The specificity of anti-CCP antibody is markedly better than rheumatoid factor for rheumatoid arthritis ,as the sensitivity is reverse .Nosignificant correlation is found in the quantitative results between anti-CCP antibody and rheum atoid factor in rheumatoid arthritis .%目的 调查抗环瓜氨酸肽(CCP)抗体和类风湿因子在类风湿关节炎实验诊断中的敏感性、特异性和结果相关性.方法 对健康体检者102例、类风湿关节炎患者128例和非类风湿关节炎患者151例的抗CCP抗体和类风湿因子检测结果进行统计分析.抗CCP抗体采用ELISA法检测,类风湿因子采用免疫比浊法检测.结果 抗CCP抗体和类风湿因子对于类风湿关节炎的敏感性分别为76.6%、86.7%(P<0.05),特异性分别为94.9%、69.9%(P<0.01).类风湿关节炎患者抗CCP抗体和类风湿因子定量检测结果之间的相关系数为0.187(P>0.05).抗CCP抗体、类风湿因子阳性率在不同性别或年龄

  17. Juvenile Arthritis

    Science.gov (United States)

    ... increased risk of developing an inflammatory eye problem (iritis or uveitis). Eye inflammation may persist independently of the arthritis. Because iritis usually does not cause symptoms, regular exams by ...

  18. Rheumatoid arthritis

    African Journals Online (AJOL)

    Mahmood Ally

    ... therapy in RA. Keywords: immune, inflammatory, rheumatoid arthritis, therapy ... are more sensitive and care needs to be taken to exclude viral infections, conditions .... RF is an antibody to immunoglobulin G, seen in 80–90% of patients with ...

  19. Rheumatoid Arthritis Educational Video Series

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    Full Text Available ... is Happening to the Joints? Rheumatoid Arthritis: Gaining Control – Working with your Rheumatologist Rheumatoid Arthritis: Additional Conditions ... Arthritis Nutrition & Rheumatoid Arthritis Arthritis and Health-related Quality of Life Rehabilitation Management for Rheumatoid Arthritis Patients ...

  20. Rheumatoid Arthritis Educational Video Series

    Science.gov (United States)

    ... Corner / Patient Webcasts / Rheumatoid Arthritis Educational Video Series Rheumatoid Arthritis Educational Video Series This series of five videos ... Your Arthritis Managing Chronic Pain and Depression in Arthritis Nutrition & Rheumatoid Arthritis Arthritis and Health-related Quality of Life ...

  1. Comparison of defects responsible for nanosecond laser-induced damage and ablation in common high index optical coatings

    Science.gov (United States)

    Xu, Yejia; Abdulameer, Mohammed R.; Emmert, Luke A.; Day, Travis; Patel, Dinesh; Menoni, Carmen S.; Rudolph, Wolfgang

    2017-01-01

    Spatiotemporally resolved optical laser-induced damage is an experimental technique used to study nanosecond laser damage and initiation of ablation in dielectric metal-oxide films used for optical coatings. It measures the fluence (intensity) at the initiation of damage during a single laser pulse. The technique was applied to coatings of HfO2, Sc2O3, and Ta2O5, which were prepared by ion-beam sputtering, and HfO2 which was prepared by electron-beam evaporation. Using the data obtained, we were able to retrieve the defect density distributions of these films without a priori assumptions about their functional form.

  2. Posttraumatic Arthritis

    OpenAIRE

    Pickering, Robert D.

    1984-01-01

    Posttraumatic arthritis (i.e., degenerative joint disease secondary to injury) is a particular problem in young, active patients. It limits the activities of these vigorous individuals, and the compromised joint must be endured for a long time. The knee is used as an example of a joint commonly involved in this process. Conditions predisposing patients to posttraumatic arthritis are discussed, as are some treatment modalities, including rest, ice therapy, anti-inflammatory medications, physio...

  3. Testing of the preliminary OMERACT validation criteria for a biomarker to be regarded as reflecting structural damage endpoints in rheumatoid arthritis clinical trials: the example of C-reactive protein

    DEFF Research Database (Denmark)

    Keeling, Stephanie O; Landewe, Robert; van der Heijde, Desiree;

    2007-01-01

    OBJECTIVE: A list of 14 criteria for guiding the validation of a soluble biomarker as reflecting structural damage endpoints in rheumatoid arthritis (RA) clinical trials was drafted by an international working group after a Delphi consensus exercise. C-reactive protein (CRP), a soluble biomarker...... of individual criteria in the draft set. METHODS: A systematic literature review was conducted to elicit evidence in support of each specific criterion composing the 14-criteria draft set. A summary of the key literature findings per criterion was presented to both the working group and to participants......-based survey. RESULTS: Minimal data were extracted from the literature pertaining to those criteria listed under the category of truth. Ratings for strength of evidence were moderate to low (

  4. The time to trade-off method versus the EQ-5D index to determine health utility in patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Dmitriy Vladimirovich Goryachev

    2010-01-01

    The values of the utility index calculated by TTO failed to correlate with those of HAQ and EQ-5D. The disease duration was unrelated to the values of the utility index calculated by any of the methods used. The association of TTO index was found only for VAS-GH "thermometer". Conclusion. EQ-5D index and VAS-GH are the methods of choice in determining health utility for a clinicoeconomic analysis in patients with RA.

  5. Rheumatoid Arthritis Educational Video Series

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    Full Text Available ... Arthritis Information Disease Information Rheumatoid Arthritis Psoriatic Arthritis Ankylosing Spondylitis Osteoarthritis Gout Lyme Disease Osteoporosis News Rheumatoid Arthritis ...

  6. Rheumatoid Arthritis Educational Video Series

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    Full Text Available ... Arthritis Nutrition & Rheumatoid Arthritis Arthritis and Health-related Quality of Life Rehabilitation Management for Rheumatoid Arthritis Patients Rehabilitation of Older Adult ...

  7. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Arthritis Managing Chronic Pain and Depression in Arthritis Nutrition & Rheumatoid Arthritis Arthritis and Health-related Quality of Life Rehabilitation Management for Rheumatoid ...

  8. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available Appointments • Support Our Research Arthritis Information Disease Information Rheumatoid Arthritis Psoriatic Arthritis Ankylosing Spondylitis Osteoarthritis Gout Lyme Disease Osteoporosis News Rheumatoid Arthritis News ...

  9. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Arthritis Nutrition & Rheumatoid Arthritis Arthritis and Health-related Quality of Life Rehabilitation Management for Rheumatoid Arthritis Patients Rehabilitation of Older Adult ...

  10. IMAGING OF PSORIATIC ARTHRITIS

    Directory of Open Access Journals (Sweden)

    S. D'Angelo

    2011-09-01

    Full Text Available Imaging of psoriatic arthritis (PsA is important for two reasons: the differential diagnosis from other arthritides and the assessment of structural damage that can be inhibited by the new drugs such as the anti-TNFα agents. Plain film radiographic findings of peripheral arthritis have been important in elaborating the concept of PsA as a separate disease entity. Characteristic aspects of psoriatic peripheral arthritis help the differentiation from rheumatoid arthritis. High-resolution ultrasonography (US, US combined with power Doppler (PDUS and magnetic resonance imaging (MRI can be used to image joint synovitis of PsA. Radiologic features of spondylitis associated with psoriasis are similar to spondylitis associated with reactive arthritis and differ from those of primary ankylosing spondylitis (AS and the spondylitis associated with inflammatory bowel disease. MRI is very sensitive for the early diagnosis of sacroiliitis. There have been no MRI studies on the spine of patients with PsA. In primary AS bone oedema in the vertebral bodies is an indicator of active disease and can ameliorate during anti-TNFα therapy. Historically, plain film radiography have played a pivotal role in defining enthesitis lesions of SpA. However, entheseal bone changes appear late. US and MRI have proved to be a highly sensitive and non invasive tools. Recent US and MRI studies on both finger and toe dactylitis have established that dactylitis is due to flexor tenosynovitis and marked adjacent soft tissue swelling with a variable degree of small joint synovitis. There is no evidence of enthesitis of the insertion of the flexor digitorum tendons and of the attachment of the caspsule of the digit joints. Key words: Enthesitis, dactylitis, spondyloarthritis, ultrasound, magnetic resonance, imaging

  11. Investigation of a multi-biomarker disease activity score in rheumatoid arthritis by comparison with magnetic resonance imaging, computed tomography, ultrasonography, and radiography parameters of inflammation and damage

    DEFF Research Database (Denmark)

    Krabbe, S.; Bolce, R.; Brahe Pedersen, C.

    2017-01-01

    resonance imaging (MRI), ultrasonography (US), computed tomography (CT), and radiography performed at weeks 0, 26, and 52. Serum samples were analysed using MBDA score assays and associations between clinical measures, MBDA score, and imaging findings were investigated. Results: The MBDA score correlated......Objectives: To investigate the multi-biomarker disease activity (MBDA) score by comparison with imaging findings in an investigator-initiated rheumatoid arthritis (RA) trial (HURRAH trial, NCT00696059). Method: Fifty-two patients with established RA initiated adalimumab treatment and had magnetic...

  12. Diagnostic Delay in Rheumatoid Arthritis

    DEFF Research Database (Denmark)

    Mølbaek, Karen; Hørslev-Petersen, Kim; Primdahl, Jette

    2016-01-01

    BACKGROUND: To prevent joint damage among patients with rheumatoid arthritis (RA), there is a need to minimize delays from the onset of symptoms until the initiation of appropriate therapy. The present study explored the factors that have an impact on the time it takes for Danish patients with RA...

  13. Dietary protein restriction decreases oxidative protein damage, peroxidizability index, and mitochondrial complex I content in rat liver.

    Science.gov (United States)

    Ayala, Victoria; Naudí, Alba; Sanz, Alberto; Caro, Pilar; Portero-Otin, Manuel; Barja, Gustavo; Pamplona, Reinald

    2007-04-01

    Caloric restriction (CR) decreases oxidative damage, which contributes to the slowing of aging rate. It is not known if such decreases are due to calories themselves or specific dietary components. In this work, the ingestion of proteins of Wistar rats was decreased by 40% below that of controls. After 7 weeks, the liver of the protein-restricted (PR) animals showed decreases in oxidative protein damage, degree of membrane unsaturation, and mitochondrial complex I content. The results and previous information suggest that the decrease in the rate of aging induced by PR can be due in part to decreases in mitochondrial reactive oxygen species production and DNA and protein oxidative modification, increases in fatty acid components more resistant to oxidative damage, and decreased expression of complex I, analogously to what occurs during CR. Recent studies suggest that those benefits of PR could be caused, in turn, by the lowered methionine intake of that dietary manipulation.

  14. Biologic therapy of rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Damjanov Nemanja

    2009-01-01

    Full Text Available Rheumatoid arthritis (RA and juvenile idiopathic/rheumatoid arthritis (JIA are chronic, inflammatory, systemic, auto-immune diseases characterized by chronic arthritis leading to progressive joint erosions. The individual functional and social impact of rheumatoid arthritis is of great importance. Disability and joint damage occur rapidly and early in the course of the disease. The remarkably improved outcomes have been achieved initiating biologic therapy with close monitoring of disease progression. Biologic agents are drugs, usually proteins, which can influence chronic immune dysregulation resulting in chronic arthritis. According to the mechanism of action these drugs include: 1 anti-TNF drugs (etanercept, infiximab, adalimumab; 2 IL-1 blocking drugs (anakinra; 3 IL-6 blocking drugs (tocilizumab; 4 agents blocking selective co-stimulation modulation (abatacept; 5 CD 20 blocking drugs (rituximab. Biologics targeting TNF-alpha with methotrexate have revolutionized the treatment of RA, producing significant improvement in clinical, radiographic, and functional outcomes not seen previously. The new concept of rheumatoid arthritis treatment defines early diagnosis, early aggressive therapy with optimal doses of disease modifying antirheumatic drugs (DMARDs and, if no improvement has been achieved during six months, early introduction of biologic drugs. The three-year experience of biologic therapy in Serbia has shown a positive effect on disease outcome.

  15. Validation of the Spanish, Portuguese and French versions of the Lupus Damage Index questionnaire: data from North and South America, Spain and Portugal.

    Science.gov (United States)

    Pons-Estel, B A; Sánchez-Guerrero, J; Romero-Díaz, J; Iglesias-Gamarra, A; Bonfa, E; Borba, E F; Shinjo, S K; Bernatsky, S; Clarke, A; García, M A; Marcos, J C; Duarte, A; Berbotto, G A; Scherbarth, H; Marques, C D; Onetti, L; Saurit, V; Souza, A W S; Velozo, E; Catoggio, L J; Neira, O; Burgos, P I; Ramirez, L A; Molina, J F; De La Torre, I G; Silvariño, R; Manni, J A; Durán-Barragán, S; Vilá, L M; Fortin, P R; Calvo-Alén, J; Santos, M J; Portela, M; Esteva-Spinetti, M H; Weisman, M; Acevedo, E M; Segami, M I; Gentiletti, S B; Roldán, J; Navarro, I; Gonzalez, E; Liu, J M; Karlson, E W; Costenbader, K H; Wolfe, F; Alarcón, G S

    2009-10-01

    We have previously developed and validated a self-administered questionnaire, modelled after the Systemic Lupus International Collaborating Clinics Damage Index (SDI), the Lupus Damage Index Questionnaire (LDIQ), which may allow the ascertainment of this construct in systemic lupus erythematosus (SLE) patients followed in the community and thus expand observations made about damage. We have now translated, back-translated and adapted the LDIQ to Spanish, Portuguese and French and applied it to patients followed at academic and non-academic centres in North and South America, Portugal and Spain while their physicians scored the SDI. A total of 887 patients (659 Spanish-speaking, 140 Portuguese-speaking and 80 French-speaking patients) and 40 physicians participated. Overall, patients scored all LDIQ versions higher than their physicians (total score and all domains). Infrequent manifestations had less optimal clinimetric properties but overall agreement was more than 95% for the majority of items. Higher correlations were observed among the Spanish-speaking patients than the Portuguese-speaking and French-speaking patients; further adjustments may be needed before the Portuguese and French versions of the LDIQ are applied in community-based studies. The relationship between the LDIQ and other outcome parameters is currently being investigated in a different patient sample.

  16. Development of a Relationship Between Residual Ultimate Longitudinal Strength Versus Grounding Damage Index Diagram For Container Ships

    DEFF Research Database (Denmark)

    Kim, Do Kyun; Kim, Han Byul; Zhang, Xiaoming

    2012-01-01

    Various accidents such as grounding, collision, fire, and explosion commonly occur on operating ships. The structural damage caused by such accidents is often accompanied by casualties and serious pollution. Therefore, an accidental risk- based approach that is in line with the goal-based standard...

  17. Vibration based structural health monitoring and the modal strain energy damage index algorithm applied to a composite T-beam

    NARCIS (Netherlands)

    Loendersloot, R.; Ooijevaar, T.H.; Warnet, L.; Boer, de A.; Akkerman, R.; Vasques, C.M.A.; Dias Rodrigues, J.

    2011-01-01

    A Finite Element based numerical model for a vibration based damage identification method for a 2.5D composite structure is discussed in this chapter. The linear dynamic response of an intact and a locally delaminated 16-layer unidirectional carbon fibre PEKK reinforced T-beam is analysed. A commerc

  18. Gouty arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Barthelemy, C.R.; Nakayama, D.A.; Lightfoot, R.W. Jr.; Wortmann, R.L.; Carrera, G.F.

    1984-01-01

    A prospective analysis of 60 patients with gout was undertaken to evaluate the radiographic spectrum of gouty arthritis in patients treated in the era of hypouricemic therapy. Twenty-two of these patients were clinically tophaceous; 36 were considered to have radiographic findings diagnostic of gouty arthritis by strict radiographic criteria. Up to 24% of the patients denied symptoms in joints with radiographic changes of gout; 42% with no evidence of tophi on clinical examination had radiographic changes characteristic of gout. Radiographic assessment can be extremely helpful in the management of gout by documenting the degree and extent of bony involvement, particularly in patients with limited symptoms or without clinical tophi.

  19. Bone pathology inpsoriatic arthritis

    Directory of Open Access Journals (Sweden)

    V. V. Badokin

    2007-01-01

    Full Text Available Objective. To study different variants of osteolysis in pts with psoriatic arthritis (PA and to reveal their relationship with other clinico-radiological features of joint damage. Material and methods. 370 pts with definite PA having different variants of joint damage were included. Radiological examination of bones and joints (in some cases large picture frame was performed. Morphological evaluation of synovial biopsies was done in 34 pts with PA and 10 pts with rheumatoid arthritis (RA. Results. Different types of osteolysis were revealed in 80 (21,6% pts. Osteolytic variant of joint damage was present in 29 pts. 33 pts had acral, 48 — intra-articular osteolysis and 16 - true bone atrophy. Frequency and intensity of bone resorption were associated with severity of PA. Acral osteolysis correlated with arthritis of distal interphalangeal joints and onychodystrophy. Intra-articular osteolysis was most often present in distal interphalangeal joints of hands and metacarpophalangeal joints (39,6% and 41,7% respectively. Characteristic feature of PA was combination of prominent resorption with formation of bone ankylosis and periosteal reaction. Ankylosis was present in 33,3% of pts with intra-articular osteolysis and in 60% of pts with combination of different osteolysis variants. Systemic reaction of microcirculation in synovial biopsies was most prominent in osteolytic variant: marked thickening of capillary and venule basal membrane with high level of acid phosphatase, increased capillary and precapillary blood flow with stasis features, vascular lymphocyte and macrophage infiltration, productive vasculitis with annular wall thickening, thrombovasculitis and villi deep layer sclerosis. Conclusion. Different variants of osteolysis show bone involvement in PA. Acral and intra- articular osteolysis association with bone ankylosis and periostitis proves their common pathogenetic entity.

  20. An angular vegetation index for imaging spectroscopy data—Preliminary results on forest damage detection in the Bavarian National Park, Germany

    Science.gov (United States)

    Fassnacht, Fabian Ewald; Latifi, Hooman; Koch, Barbara

    2012-10-01

    A vegetation index (VI) is presented which is calculated as the inner angles of a triangle. The triangle is spanned between three distinct points (on a spectral curve of imaging spectroscopy data) which are defined for each individual pixel by the wavelength (x-axis) and the reflection value (y-axis). The ideal wavelengths of the three points are dependent on the response variable investigated. The case-study within this paper in which this angular VI is applied, aims at the development of an index to automatically detect spruce bark beetle infections in the Bavarian National Park, Germany. In order to determine the optimum wavelengths to separate damaged from non-damaged trees the three-angle-indices (TAIs) for all possible combinations of available wavelengths of HyMap imaging spectroscopy data in the vis-NIR-region (0.455-0.986 μm) were calculated. The resulting 27,417 images served as input predictor variables to a genetic algorithm (GA) which used nearest centroid classifier as fitness functions to detect the most stable predictors and separate the six classes (three damage classes) defined within the study area. The fitness functions integrated in the GA reached classification accuracies of up to 94.8% when using forward selection models of the most stable genes featuring maximum 50 predictors. Based on those results, three from the original 27,417 predictors were extracted to map forest damages over the full image extent based on a support vector machines (SVMs) classification. We conducted the same experiment with 82 vegetation indices described in literature and achieved slightly lower GA overall accuracies of 86.8% using the nearest centroid classifier. The SVM maps produced with the three best VI predictors were comparable to the TAI results.

  1. [Sport and rheumatoid arthritis].

    Science.gov (United States)

    Proschek, D; Rehart, S

    2014-06-01

    Sport is becoming increasingly more important in our society. Due to the changing age spectrum with a greater number of elderly and substantially more active people, an increasing number of people with underlying orthopedic diseases are becoming interested in participating in sport. This article deals with the possibilities and effects of sporting activities for people with rheumatoid arthritis within the framework of a conservative therapy. A literature search was carried out using medical search engines, in particular PubMed, and also via the recommendations of specialist societies and patient help groups. The quality of life of patients with rheumatoid arthritis consists of physical, mental and social components. Sport as a means of rehabilitation influences all of these components. Sport should be comprehended as a form of therapy and be adapted to the needs of the individual patient. The willingness to actively participate in sport should always be highly rated and encouraged. Sport is therefore an important pillar of therapy in a conservative total concept. The main aspects of sport therapeutic activities are functional, pedagogical and experience-oriented aspects. The clinical symptoms, extent of damage and physical impairment must, however, be evaluated and taken into consideration for the therapeutic concept. The amount of data on the complex topic of sport and rheumatoid arthritis is low and is mainly dealt with as retrospective reviews. A prospective randomized study basis is lacking. The aim must therefore be to confirm the currently available recommendations for various types of sport in controlled studies.

  2. Biomarkers for rheumatoid and psoriatic arthritis.

    Science.gov (United States)

    Verheul, M K; Fearon, U; Trouw, L A; Veale, D J

    2015-11-01

    Rheumatic diseases, such as rheumatoid and psoriatic arthritis are systemic inflammatory conditions characterized by a chronic form of arthritis, often leading to irreversible joint damage. Early treatment for patients with rheumatic diseases is required to reduce or prevent joint injury. However, early diagnosis can be difficult and currently it is not possible to predict which individual patient will develop progressive erosive disease or who may benefit from a specific treatment according to their clinical features at presentation. Biomarkers are therefore required to enable earlier diagnosis and predict prognosis in both rheumatoid arthritis and psoriatic arthritis. In this review we will examine the evidence and current status of established and experimental biomarkers in rheumatoid and psoriatic arthritis for three important purposes; disease diagnosis, prognosis and prediction of response to therapy.

  3. Psoriatic arthritis: from pathogenesis to therapy.

    LENUS (Irish Health Repository)

    Fitzgerald, Oliver

    2012-02-01

    Psoriatic arthritis is a multigenic autoimmune disease that involves synovial tissue, entheseal sites and skin, and that may result in significant joint damage. Although there are no diagnostic tests for psoriatic arthritis, research has identified consistent features that help to distinguish the condition from other common rheumatic diseases. Comparison of HLA-B and HLA-C regions in psoriatic arthritis with those in psoriasis without joint involvement demonstrates significant differences, such that psoriatic arthritis cannot be viewed simply as a subset of genetically homogeneous psoriasis. T-cell receptor phenotypic studies have failed to identify antigen-driven clones, and an alternative hypothesis for CD8 stimulation involving innate immune signals is proposed. Finally, imaging studies have highlighted entheseal involvement in psoriatic arthritis, and it is possible that entheseal-derived antigens may trigger an immune response that is critically involved in disease pathogenesis.

  4. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Arthritis Managing Chronic Pain and Depression in Arthritis Nutrition & Rheumatoid Arthritis Arthritis and Health-related Quality of ... on this website. Copyright Johns Hopkins Arthritis Center © 2017 Patient Privacy Johns Hopkins Rheumatology

  5. Calcium pyrophosphate arthritis

    Science.gov (United States)

    ... are similar, CPPD arthritis can be confused with: Gouty arthritis (gout) Osteoarthritis Rheumatoid arthritis Exams and Tests Most arthritic ... A.M. Editorial team. Related MedlinePlus Health Topics Gout Browse the Encyclopedia A.D.A.M., Inc. ...

  6. Arthritis in America

    Science.gov (United States)

    ... Digital Press Kit Read the MMWR Science Clips Arthritis in America Time to Take Action! Language: English ( ... by about 40% by being physically active. Problem Arthritis is common and a growing health threat. Arthritis ...

  7. Arthritis: Frequently Asked Questions

    Science.gov (United States)

    ... Recommend on Facebook Tweet Share Compartir What is Arthritis? The word arthritis actually means joint inflammation, but ... provided for you. Who is at risk for arthritis? Certain factors are associated with a greater risk ...

  8. Juvenil idiopatisk arthritis

    DEFF Research Database (Denmark)

    Herlin, Troels

    2002-01-01

    The new classification of juvenile idiopathic arthritis (JIA) is described in this review. Clinical characteristics divide JIA in to subtypes: systemic, oligoarticular (persistent and extended type), RF-positive and--negative polyarticular, enthesitis-related arthritis and psoriatic arthritis...

  9. Arthritis of the Hand

    Science.gov (United States)

    .org Arthritis of the Hand Page ( 1 ) The hand and wrist have multiple small joints that work together to ... a shoelace. When the joints are affected by arthritis, activities of daily living can be difficult. Arthritis ...

  10. Therapeutical approach to rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Paraskevi Gourni

    2008-10-01

    Full Text Available Rheumatoid arthritis (RA is a chronic disease characterized by inflammation of the synovial joints, and loss of the function leading to disability. The ultimate goal in managing RA is to prevent joint damage and to maintain functional ability. Although, οver the past decade, major advances have been made in our understanding of the factors that are crucial in regulating this disease, still the managment of the disease remains difficult.Aim : Τhe aim of the present study was the evaluation of the therapeutical approch on rheumatoid arthritis. The method οf this study included bibliography research from both the review and the research literature which referred to the relation between therapy and rheumatoid arthritis.Results : The majority of research studies showed thatthe main therapy on rheumatoid arthritis included medication therapy, modification of everyday living ensuring rest, physical exercise and finally surgical procedure. Individuals suffering from rheumatoid arthritis, apart from physical problems usually cope with mental disorders, that exert a negative indluence on their quality of life.Conclusively :Information and early screening of high risk may decrease the long-term consequnences on health. Monitoring from a group of specialists should serve as a cornerstone when planning a program of intervention.

  11. APOPTOSIS SYSTEM AND ITS RELATIONS TO HEPATOCELLULAR DAMAGE AND SOME INDEXES OF LOCAL CYTOKINE PROFILE CHRONIC HCV INFECTION

    Directory of Open Access Journals (Sweden)

    L. Ph. Skljar

    2008-01-01

    Full Text Available Abstract. At present time, some conflicting data concern a possible importance of apoptosis in pathogenesis of chronic hepatitis C. A significant role is ascribed to FAS/FAS-L, as a factor of hepatocyte apoptosis. CD95+ levels at the cell surfaces were studied in liver homogenates. A significant decrease in CD95+ cells was revealed in liver samples from the patients with higher histological indexes of hepatitis activity and fibrosis. A reverse relationship between CD95+ level and local concentrations of cytokines (TNFα, IL-1, IL-10, as well as significant direct correlation with IFNγ, IL-2 values were detected, thus suggesting a failure of compensatory mechanisms of immune regulation, and predominance of anti-apoptotic viral potential over protective cellular responses. (Med. Immunol., vol. 10, N 4-5, pp 415-422.

  12. Septic arthritis in patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Al-Ahaideb Abdulaziz

    2008-07-01

    Full Text Available Abstract There is an increasing number of rheumatoid patients who get septic arthritis. Chronic use of steroids is one of the important predisposing factors. The clinical picture of septic arthritis is different in immunocompromised patients like patients with rheumatoid arthritis. The diagnosis and management are discussed in this review article.

  13. Septic arthritis in patients with rheumatoid arthritis

    OpenAIRE

    Al-Ahaideb Abdulaziz

    2008-01-01

    Abstract There is an increasing number of rheumatoid patients who get septic arthritis. Chronic use of steroids is one of the important predisposing factors. The clinical picture of septic arthritis is different in immunocompromised patients like patients with rheumatoid arthritis. The diagnosis and management are discussed in this review article.

  14. 合并肾脏病变的类风湿关节炎临床表现分析%Clinical study of kidney damage with rheumatoid arthritis

    Institute of Scientific and Technical Information of China (English)

    孙建; 李雯

    2012-01-01

    [目的]探讨类风湿性关节炎(RA)中肾脏受累患者临床特点.[方法]回顾性分析2006-2008年RA合并肾脏病变(肾病组)患者35例及同期住院的未合并肾损害且无重要合并症的89例RA患者(非肾病组)的临床资料,比较两组的临床资料包括首发症状、病程中临床特点、化验室检查以及肾脏组织活检等情况.[结果](1)肾脏病变组首发症状以发热乏力者多于非肾脏病变组(P<0.05);在病程中肾脏病变组关节肿痛总数较非肾病组多见(P<0.05);两组患者入院时的ESR、CRP、WBC、IgG、IgM、IgA以及RF分别为(85 ± 32) mm/h和(75±36)mm/h;(59±34)mg/L和(48±25) mg/L;(10.3 ±2.9)×109/L和(9.3±3.0)×109/L;(11.1±3.0) g/L和(10±2.1) g/L;(2.1±1.00) g/L和(1.6±0.98) g/L; (32±2.10) g/L和(29±0.98) g/L; (35±15) U/mL和(41±21) U/mL,两组中除ESR、WBC和IgG以及RF以外,IgM、IgA以及CRP比较差异有显著性意义(P<0.05).(2)肾病组在停用疑似对肾脏有损害药物或使用肾毒性小的药物治疗2个月后分别有5例血尿8例蛋白尿患者转阴,与非肾脏病组相比差异无显著性意义(P>0.05);肾病组24 h尿蛋白治疗前后分别为(2.54±0.56) g/24 h和(1.63±0.21)g/24h,两组比较差异有显著性意义(P<0.05).肾病组ESR、CRP、WBC、IgM、IgA在治疗前后相比差异有显著性意义(P<0.05).(3)选取其中5例持续性肾损害患者肾组织活检发现,2例系膜增生性肾小球肾炎,1例膜性肾病,1例新月体肾炎,1例膜增生性肾炎.[结论]合并肾脏病变的RA患者在首发症状和病程中的临床表现与未合并肾脏病变RA患者有所不同;肾脏病变者大多有用药史,临床肾脏损害以药物性和免疫炎症引起为主,排除药物因素后诊断不明者应尽早行肾穿刺明确病理诊断.%To investigate the features of renal lesion in patients with rheumatoid arthritis. [Methods] To select the 35 patients with rheumatoid arthritis and 89 RA Patients without

  15. In rheumatoid arthritis patients treated with tocilizumab, the rate of clinical disease activity index (CDAI) remission at 24 weeks is superior in those with higher titers of IgM-rheumatoid factor at baseline.

    Science.gov (United States)

    Kawashiri, Shin-Ya; Kawakami, Atsushi; Iwamoto, Naoki; Fujikawa, Keita; Aramaki, Toshiyuki; Tamai, Mami; Yamasaki, Satoshi; Nakamura, Hideki; Origuchi, Tomoki; Ueki, Yukitaka; Migita, Kiyoshi; Mizokami, Akinari; Aoyagi, Kiyoshi; Eguchi, Katsumi

    2011-08-01

    We aimed to evaluate the efficacy of tocilizumab in patients with rheumatoid arthritis (RA), using the clinical disease activity index (CDAI), and to determine the baseline variables associated with CDAI remission. Fifty-eight patients with active RA were enrolled. We tried to evaluate whether baseline variables were associated with CDAI remission at 24 weeks. Twenty-two of the 58 patients (37.9%) had received tumor necrosis factor (TNF) inhibitors. The continuation rate of tocilizumab at 24 weeks was 87.9%. The seropositivity rates of IgM-rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies at baseline were both 91.4%. The rate of CDAI remission at 24 weeks was 20.7%. We selected baseline variables including age, gender, duration of disease, concomitant use of glucocorticoids, concomitant use of methotrexate (MTX), previous anti-TNF therapy, titer of anti-CCP antibodies (high or low toward median), titer of IgM-RF (high or low toward median), and CDAI, and found that a high titer of IgM-RF was the only variable to be associated with CDAI remission, according to univariate and logistic regression analyses. This is a new finding, and may be specific to tocilizumab as compared with previous observations in anti-TNF therapy.

  16. Midcarpal and STT Arthritis in Patients With CMC Arthritis

    National Research Council Canada - National Science Library

    Katzel, Evan B; Shakir, Sameer; Fowler, John; Buterbaugh, Glenn A; Imbriglia, Joseph E

    2016-01-01

    .... The prevalence of midcarpal arthritis in patients with basal joint arthritis is unknown. The goal of this study is to establish the radiographic prevalence of midcarpal arthritis in patients with CMC arthritis and/or STT...

  17. [Rheumatoid arthritis].

    Science.gov (United States)

    Strunk, J; Lange, U; Müller-Ladner, U

    2005-07-29

    The development of novel anti-rheumatic drugs revolutionizes currently therapeutic strategies and diagnostic management of patients with rheumatoid arthritis, facilitating the goal of true remission instead of only symptomatic treatment as in former years. Since early treatment is known to be crucial for the longterm outcome, imaging modalities such as magnetic resonance imaging and high-frequency ultrasonography including Doppler sonography, which allow direct visualization of very early pathologic alterations of synovitis, or even initial destruction, become increasingly important. Besides the established therapy with methotrexate, new drugs such as leflunomide or the use of various combination therapies have been successfully introduced into the therapeutic armamentarium. Especially the introduction of cytokine-antagonists such as TNF-a inhibitors target the aim of remission. In addition, the upcoming therapeutic agents, which influence very effectively the inflammatory and destructive process need also to be integrated into the concert of different therapeutic strategies in the management of patients with rheumatoid arthritis, which includes the mandatory complementary factors such as physiotherapy, ergotherapy and orthopedic surgery.

  18. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Patient Webcasts / Rheumatoid Arthritis Educational Video Series Rheumatoid Arthritis Educational Video Series This series of five videos ... member of our patient care team. Managing Your Arthritis Managing Your Arthritis Managing Chronic Pain and Depression ...

  19. Rheumatoid Arthritis Educational Video Series

    Science.gov (United States)

    ... Patient Webcasts / Rheumatoid Arthritis Educational Video Series Rheumatoid Arthritis Educational Video Series This series of five videos ... member of our patient care team. Managing Your Arthritis Managing Your Arthritis Managing Chronic Pain and Depression ...

  20. [Relationship between periodontal disease and rheumatoid arthritis].

    Science.gov (United States)

    Zhang, Dai-zun; Zhong, De-yu; Deng, Jing; Wang, Ji-bo

    2005-12-01

    To study a population of rheumatoid arthritis patients and determine the extent of periodontal disease in these patients, in order to investigate the relationship between periodontal disease and rheumatoid arthritis. The experimental group was composed of 70 patients with rheumatoid arthritis and the control group consisted of 70 age- and gender-matched individuals without rheumatoid arthritis. The relationship between periodontal status in rheumatoid arthritis and control groups as well as the relationship between periodontal status and rheumatological findings in patients were analyzed. The percentage of periodontal disease was statistically significant between experimental and control group (P 0.05). There were more number of periodontal disease index 5 or 6 in experimental group than in control group ( P Rheumatoid arthritis patients with moderate to severe bone loss had deeper degree of morning stiffness, erythrocyte sedimentation rate levels and serum C-reactive protein levels than patients with no or mild bone loss. Individuals with rheumatoid arthritis are more likely to experience periodontal disease compares to healthy subjects. They are also very likely to suffer from moderate to severe periodontitis.

  1. Artritis Temprana Early Arthritis

    Directory of Open Access Journals (Sweden)

    2011-02-01

    Full Text Available Hasta la década de los años ochenta se consideraba a la artritis reumatoide (AR como una enfermedad poco frecuente, de gravedad leve a moderada, que tenía una evolución lentamente, progresiva hacia el daño articular y la incapacidad. El aborde terapéutico convencional hasta ese momento, era el tratamiento clásico de la pirámide.Until the early the eighties was considered rheumatoid arthritis to (RA as a rare disease of mild to moderate severity, which had a slowly evolution towards joint damage and disability. The conventional therapeutic option until then, was the classic treatment of the pyramid.

  2. Inter- relationship between rheumatoid arthritis and periodontitis.

    Science.gov (United States)

    Rajkarnikar, J; Thomas, B S; Rao, S K

    2013-01-01

    Periodontal medicine defines a rapidly emerging branch of Periodontology focusing on establishing a strong relationship between periodontal health and systemic health. It is speculated that the major common dysregulation which links Periodontitis with Rheumatoid arthritis (RA) is being played by the mediators of immune inflammatory response. To determine whether there is any relationship between periodontal disease and Rheumatoid arthritis. A total of 100 patients were included for the present study which was divided into two groups: one group (cases) included 50 patients attending the Department of Orthopedics, Kasturba Medical College, Manipal who were diagnosed of Rheumatoid arthritis. Another subject population included 50 patients as controls attending the Department of Oral Medicine, Manipal College of Dental Sciences, Manipal with age and gender matched with those of rheumatoid arthritis group. Specific measures for periodontitis included plaque index, gingival index, number of missing teeth, and radiographic alveolar bone loss scores. Measures of rheumatoid arthritis included health assessment questionaires, levels of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Various periodontal parameters were compared between the cases and controls. The average alveolar bone loss was statistically more severe in Rheumatoid arthritis (RA) group than in the controls although there were similar plaque index in both the groups. The gingival index was statistically higher in the RA group. The Erythrocyte Sedimentation Rate (ESR) and C- Reactive Protein (CRP) levels of RA patients were also significantly associated with the severity of periodontal disease. There was a significant association between Rheumatoid arthritis and Periodontitis which may be due to a common underlying deregulation of the inflammatory response in these individuals.

  3. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Arthritis Center since 2000, currently serving as the Nurse Manager. She is a critical member of our patient care team. Managing Your Arthritis Managing Your Arthritis Managing Chronic Pain and Depression in Arthritis Nutrition & Rheumatoid Arthritis Arthritis and Health-related Quality of ...

  4. A treat-to-target strategy with methotrexate and intra-articular triamcinolone with or without adalimumab effectively reduces MRI synovitis, osteitis and tenosynovitis and halts structural damage progression in early rheumatoid arthritis: results from the OPERA randomised controlled trial.

    Science.gov (United States)

    Axelsen, Mette Bjørndal; Eshed, Iris; Hørslev-Petersen, Kim; Stengaard-Pedersen, Kristian; Hetland, Merete Lund; Møller, Jakob; Junker, Peter; Pødenphant, Jan; Schlemmer, Annette; Ellingsen, Torkell; Ahlquist, Palle; Lindegaard, Hanne; Linauskas, Asta; Dam, Mette Yde; Hansen, Ib; Horn, Hans Christian; Ammitzbøll, Christian Gytz; Jørgensen, Anette; Krintel, Sophine B; Raun, Johnny; Krogh, Niels S; Johansen, Julia Sidenius; Østergaard, Mikkel

    2015-05-01

    To investigate whether a treat-to-target strategy with methotrexate and intra-articular glucocorticosteroid injections suppresses MRI inflammation and halts structural damage progression in patients with early rheumatoid arthritis (ERA), and whether adalimumab provides an additional effect. In a double-blind, placebo-controlled trial, 85 disease-modifying antirheumatic drug-naïve patients with ERA were randomised to receive methotrexate, intra-articular glucocorticosteroid injections and placebo/adalimumab (43/42). Contrast-enhanced MRI of the right hand was performed at months 0, 6 and 12. Synovitis, osteitis, tenosynovitis, MRI bone erosion and joint space narrowing (JSN) were scored with validated methods. Dynamic contrast-enhanced MRI (DCE-MRI) was carried out in 14 patients. Synovitis, osteitis and tenosynovitis scores decreased highly significantly (p<0.0001) during the 12-months' follow-up, with mean change scores of -3.7 (median -3.0), -2.2 (-1) and -5.3 (-4.0), respectively. No overall change in MRI bone erosion and JSN scores was seen, with change scores of 0.1 (0) and 0.2 (0). The tenosynovitis score at month 6 was significantly lower in the adalimumab group, 1.3 (0), than in the placebo group, 3.9 (2), Mann-Whitney: p<0.035. Furthermore, the osteitis score decreased significantly during the 12-months' follow-up in the adalimumab group, but not in the placebo group, Wilcoxon: p=0.001-0.002 and p=0.062-0.146. DCE-MRI parameters correlated closely with conventional MRI inflammatory parameters. Clinical measures decreased highly significantly during follow-up. A treat-to-target strategy with methotrexate and intra-articular glucocorticosteroid in patients with ERA effectively decreased synovitis, osteitis and tenosynovitis and halted structural damage progression as judged by MRI. The findings suggest that addition of adalimumab is associated with further suppression of osteitis and tenosynovitis. Published by the BMJ Publishing Group Limited. For

  5. Evaluation of the activity of rheumatoid arthritis in clinical practice. Agreement between self-rated clinimetric evaluation and clinical evaluation with activity indexes: DAS28, CDAI and SDAI.

    Science.gov (United States)

    Horta-Baas, Gabriel; Pérez Bolde-Hernández, Arturo; Hernández-Cabrera, María Fernanda; Vergara-Sánchez, Imelda; Romero-Figueroa, María Del Socorro

    2017-04-10

    To achieve control of rheumatoid arthritis (RA) it is necessary to be able to evaluate its activity. The American College of Rheumatology (ACR) recommends for this purpose indexes of activity that can be performed by the patient (PAS-II and RAPID-3) and IA including medical evaluation with laboratory studies (DAS28 and SDAI) or without them (CDAI). The objective was to analyze the concordance between self-rated clinimetric evaluation and clinimetric evaluation performed by the physician. Analytical cross-sectional study in 126 patients with RA. The agreement was evaluated through the weighted κ coefficient and the Krippendorff's α coefficient. The PAS-II and RAPID-3 significantly correlated with all variables included in the core set of measures recommended by the ACR/EULAR. The agreement between PAS-II and CDAI-SDAI was good (κ: 0.6, α: 0.61-0.62), and moderate with DAS28-ESR (κ: 0.53, α: 0.56). The concordance between RAPID-3 and CDAI-SDAI was moderate (κ: 0.55-0.57, α: 0.50-0.51), and moderate with DAS28-ESR (κ: 0.55, α: 0.53). When categorizing the activity in remission/low activity vs. moderate/severe activity, the agreement was greater with the PAS-II (0.59 vs. 0.34; P=.012). The good concordance between PAS-II and SDAI supports their use in clinical practice, especially if biomarkers of inflammation or the possibility of joint count are not available. However, in order to recommend its routine application in clinical practice, it is necessary to perform longitudinal studies that assess its responsiveness. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  6. Investigation on crystalline perfection, optical transmittance, birefringence, temperature-dependent refractive index, laser damage threshold and pyroelectric characteristics of inversely soluble lithium sulfate monohydrate single crystals

    Science.gov (United States)

    Silambarasan, A.; Rajesh, P.; Bhatt, Rajeev; Bhaumik, Indranil; Karnal, A. K.; Ramasamy, P.; Gupta, P. K.

    2016-08-01

    Bulk prismatic lithium sulfate monohydrate (LSMH) single crystals were grown by seed rotation with slow heating method from aqueous solution. Small FWHM obtained from high-resolution X-ray diffraction spectrum shows that the crystals grown by this method have less defects and absence of low-angle grain boundaries. The high transmittance and low reflectance nature of the grown crystal was observed using UV-Vis-NIR spectrometer. The principal refractive indices of a LSMH crystal have been measured by a prism coupling method for the wavelengths of 0.407, 0.532, 0.828, 1.064 and 1.551 µm at room temperature, and Sellmeier equations are determined from the fitting of the data point. The refractive index data confirm that LSMH crystal is negative biaxial and the optic axis lies in YZ plane with an angle (2 V y ) of 51.74° with respect to y axis at 532 nm wavelength. The thermo-optic coefficients were determined from the temperature-dependent refractive indices measured in the range of 30-125 °C for the wavelengths of 532 and 1064 nm. The surface laser damage threshold studies reveal the higher optical radiation stability against 532-nm laser. The pyroelectric coefficients and pyroelectric figure of merit were determined from the pyroelectric current measurement by the Byer and Roundy method.

  7. Periodontitis is associated with rheumatoid arthritis: a study with longstanding rheumatoid arthritis patients in Korea.

    Science.gov (United States)

    Choi, In Ah; Kim, Jin-Hee; Kim, Yong Mi; Lee, Joo Youn; Kim, Kyung Hwa; Lee, Eun Young; Lee, Eun Bong; Lee, Yong-Moo; Song, Yeong Wook

    2016-09-01

    A cross-sectional study was undertaken to investigate the association between severity of periodontitis and clinical manifestation of rheumatoid arthritis (RA). Two hundred sixty-four RA patients and 88 age- and sex-matched controls underwent dental exam. Additionally, clinical manifestations including disease activity and anti-citrullinated protein antibodies were evaluated in RA patients. The prevalence of moderate or severe periodontitis was higher in RA patients compared to controls (63.6% vs 34.1%, p periodontal inflammation, bleeding on probing was correlated with disease activity score 28 (r = 0.128, p = 0.041), RA disease duration (r = 0.211, p = 0.001), erythrocyte sedimentation rate (ESR; r = 0.141, p = 0.023), anti-cyclic citrullinated peptide antibody (r = 0.183, p = 0.009), and anti-citrullinated α-enolase peptide-1 antibody (r = 0.143, p = 0.025). Gingival index was correlated with RA duration (r = 0.262, p Periodontal structural damage represented by probing pocket depth and clinical attachment level were less in RA patients with human leukocyte antigen (HLA)-DRB1 shared epitope compared than those without shared epitope (p = 0.005 and p =0.006, respectively). The prevalence of moderate or severe periodontitis was increased in RA patients compared to controls. Periodontal inflammation was correlated with RA disease duration, ESR, and anti-citrullinated protein antibodies. Periodontal structural damage was less in RA patients with HLA-DRB1 shared epitope.

  8. Anxiety and depression in Slovak patients with rheumatoid arthritis.

    Science.gov (United States)

    Soósová, Mária Sováriová; Macejová, Želmíra; Zamboriová, Mária; Dimunová, Lucia

    2017-02-01

    Rheumatoid arthritis (RA) is significantly associated with psychiatric morbidity. Mental health conditions are often unrecognized and untreated in primary care. To assess prevalence of anxiety and depression and their impact on arthritis pain and functional disability in Slovak patients with rheumatoid arthritis. Anxiety was assessed by the Beck Anxiety Inventory (BAI), depression by the Zung self-rating depression scale (SDS), pain by the visual analog scale (VAS) and functional disability by the health assessment questionnaire - disability index (HAQ-DI) in 142 patients with rheumatoid arthritis. Spearman's rho was calculated to assess relations between variables. Stepwise linear regression analysis was used to assess impact of anxiety and depression on arthritis pain and functional disability. High prevalence of anxiety and depression was observed in arthritis patients. Anxiety and depression were significant predictors of arthritis pain and functional disability. Sex, education, marital status, disease duration and comorbidity had no impact on arthritis pain and functional disability. These findings support the notions that psychological negative affect can influence subjective perception of arthritis pain and disability. The regular screening of anxiety and depression and the psychological approaches can be useful for managing arthritis patients.

  9. What Is Juvenile Arthritis?

    Science.gov (United States)

    ... Analgesics for Osteoarthritis (Report from AHRQ) Joint Replacement Surgery: Health Information Basics for You and Your Family NIH Pediatric Rheumatology Clinic Health Information Juvenile Arthritis Find a Clinical Trial Journal Articles Juvenile Arthritis PDF Version Size: 123 KB ...

  10. Juvenile idiopathic arthritis

    Science.gov (United States)

    Juvenile rheumatoid arthritis (JRA); Juvenile chronic polyarthritis; Still disease; Juvenile spondyloarthritis ... The cause of juvenile idiopathic arthritis (JIA) is not known. It ... illness . This means the body attacks and destroys healthy body ...

  11. Forms of Arthritis

    Science.gov (United States)

    ... this page please turn Javascript on. Forms of Arthritis Past Issues / Fall 2006 Table of Contents Today, ... of Linda Saisselin Osteoarthritis (OA) — the form of arthritis typically occurring during middle or old age, this ...

  12. Imaging in Psoriatic Arthritis

    DEFF Research Database (Denmark)

    Poggenborg, René Panduro; Østergaard, Mikkel; Terslev, Lene

    2015-01-01

    Psoriatic arthritis (PsA) is an inflammatory joint disease characterized by arthritis and often enthesitis in patients with psoriasis, presenting a wide range of manifestations in various patterns. Imaging procedures are primarily conventional radiography, ultrasonography (US), and magnetic...

  13. Rheumatoid arthritis (image)

    Science.gov (United States)

    Rheumatoid arthritis is an autoimmune disease in which the body's immune system attacks itself. The pattern of joints ... other joints and is worse in the morning. Rheumatoid arthritis is also a systemic disease, involving other body ...

  14. Sex and Arthritis

    Science.gov (United States)

    ... Call for Letters of Interest Call for Topics Axial Spondyloarthritis Glucocorticoid-Induced Osteoporosis Gout Juvenile Idiopathic Arthritis ... fibromyalgia , scleroderma , osteoarthritis , rheumatoid ... spondylitis , Raynaud’s phenomenon and juvenile arthritis also may experience: ...

  15. 基于模态应变能变异指标的斜拉桥模型损伤识别研究%Experimental Study on Damage Identification of a Cable-stayed Bridge Model with Modal-strain-energy-damage Change Index

    Institute of Scientific and Technical Information of China (English)

    葛继平; 李胡生; 陈明

    2011-01-01

    基于动力测试采用模态应变能变化率方法对一座独塔斜拉桥模型进行了损伤识别实用性研究,识别过程基于动力模态分析,激励方式包括车辆激励、环境激励和冲击激励.从识别得到的各阶试验模态的模态应变能变异指标的计算结果可知:在合适的激励条件下,模态应变能指标可以识别梁式结构主梁的损伤位置和大小关系;激励的充分条件会影响模态应变能指标的识别效果,冲击激励产生的激励较充分,因而损伤识别的效果最好;各阶试验模态包含的损伤信息完备程度不同,建议综合多阶模态应变能变异指标的计算结果进行损伤识别.%Modal-strain-energy-damage change index based on dynamic test was carried on the damage recognition to a single tower cable-stayed bridge model.Recognition process was based on dynamic modal analysis.Exciting way included vehicles excitation, environment excitation and impact excitation.The results of modal strain energy damage change index from damage recognition of various experimental modal shapes show that, under the appropriate excitation condition, the modal strain energy damage change index could be served as to distinguish damage position and damage degree in beam structure; The degree of excitation sufficient condition will affect the damage recognition effect of modal-strain-energy-damage change index, the damage recognition effect of impact excitation is better for the sufficient excitation from impact load; Different experiment modal shape contains different amount of damage information, thus combining computed results from multi-step modal strain energy change index to the damage recognition is suggested.

  16. [Cardiovascular risk factors in psoriatic and rheumatoid arthritis].

    Science.gov (United States)

    Rebrov, A P; Nikitina, N M; Gaĭdukova, I Z

    2011-01-01

    To study the role of conventional and new factors of cardiovascular risk in development of atherosclerosis in patients with rheumatoid arthritis (RA) and psoriatic arthritis (PA). Sixty patients with psoriatic arthritis, 414 RA patients and 79 healthy controls entered the trial. All of them had no manifestations of cardiovascular diseases. Screening was made of the leading risk factors of cardiovascular diseases and cardiovascular complications, thickness of the complex intima-media (TIM) of the carotid arteries, vascular wall stiffness were measured, vasoregulatory function of the endothelium, markers of endothelial damage were examined. Patients with psoriatic and rheumatoid arthritis were found to have increased TIM of the carotid arteries, high incidence of atherosclerotic plaques, increased stiffness, damage of the vascular wall, affected endothelial vasoregulation. These alterations were associated with high arthritis activity, systemic manifestations, seropositivity by rheumatoid factor (in RA), presence of entesitis, uveitis and dactilitis (in psoriatic arthritis), dislipidemia, arterial hypertension (AH). To determine cardiovascular risk in patients with arthritis, it is necessary to consider not only standard risk factors (dislipidemia and AH), but also severity of systemic inflammation, arterial stiffness, endothelial damage and ability of the vascular wall to relax reflecting endothelial dysfunction.

  17. Septic arthritis caused by Peptostreptococcus asaccharolyticus

    Directory of Open Access Journals (Sweden)

    Carlos Costa

    2016-07-01

    Full Text Available Peptostreptococcus spp are commensal organisms, usually involved in periodontal disease. Peptostreptococcus asaccharolyticus is an anaerobic gram-negative cocci, difficult to isolate due to its slow growth. Septic arthritis by this microorganism is a rare entity, but it can occur by hematogenous dissemination from a distant focus. Colonization and growth are more likely to occur in an already damaged articulation. We report the case of a 57 year-old woman with peripheral spondyloarthritis who developed knee septic arthritis by Peptostreptococcus asaccharolyticus.

  18. Do visual analogue scale (VAS derived standard gamble (SG utilities agree with Health Utilities Index utilities? A comparison of patient and community preferences for health status in rheumatoid arthritis patients

    Directory of Open Access Journals (Sweden)

    Anis Aslam H

    2006-04-01

    Full Text Available Abstract Background Assessment of Health Related Quality of Life (HRQL has become increasingly important and various direct and indirect methods and instruments have been devised to measure it. In direct methods such as Visual Analog Scale (VAS and Standard Gamble (SG, respondent both assesses and values health states therefore the final score reflects patient's preferences. In indirect methods such as multi-attribute health status classification systems, the patient provides the assessment of a health state and then a multi-attribute utility function is used for evaluation of the health state. Because these functions have been estimated using valuations of general population, the final score reflects community's preferences. The objective of this study is to assess the agreement between community preferences derived from the Health Utilities Index Mark 2 (HUI2 and Mark 3 (HUI3 systems, and patient preferences. Methods Visual analog scale (VAS and HUI scores were obtained from a sample of 320 rheumatoid arthritis patients. VAS scores were adjusted for end-aversion bias and transformed to standard gamble (SG utility scores using 8 different power conversion formulas reported in other studies. Individual level agreement between SG utilities and HUI2 and HUI3 utilities was assessed using the intraclass correlation coefficient (ICC. Group level agreement was assessed by comparing group means using the paired t-test. Results After examining all 8 different SG estimates, the ICC (95% confidence interval between SG and HUI2 utilities ranged from 0.45 (0.36 to 0.54 to 0.55 (0.47 to 0.62. The ICC between SG and HUI3 utilities ranged from 0.45 (0.35 to 0.53 to 0.57 (0.49 to 0.64. The mean differences between SG and HUI2 utilities ranged from 0.10 (0.08 to 0.12 to 0.22 (0.20 to 0.24. The mean differences between SG and HUI3 utilities ranged from 0.18 (0.16 to 0.2 to 0.28 (0.26 to 0.3. Conclusion At the individual level, patient and community preferences

  19. Establishment and Application of Index System of Evaluating Landscape Ecology Damage%景观生态破坏评价指标体系的建立方法和应用

    Institute of Scientific and Technical Information of China (English)

    龙开元; 谢炳庚; 谢光辉

    2001-01-01

    Landscape ecology damage is a very serious problem in the world, In order to evaluate the landscape ecology damage. By means of Analytical Hierarchy Process(AHP),this dissertation established the synthetical index system from three aspects of landscape-stability,productivity,heterogeneity. On the aspect of stability, mostly choosing ratio of soil degenerating, ratio of cultivating wilderness , ratio of soil washed away, frequency of calamity, covering ratio of forest, cultivated area per capitia, population density, index of population diathesis 8 indexes; on the aspect of productivity, mostly choosing index of biological quantity,index of biological diversity,index of soil fertility 3 indexes;on the aspect of heterogeneity, mostly choosing diversity of landscape type, fragmentation of landscape,landscape isolation 3 indexes. By means of specialist consultation, make the weight of stability, productivity, heterogeneity 0.5179, 0.2468, 0.2353 separately, and calculated the compounded weight of indexes and ranked them, at last, it analyzed and discussed the reliability and suitability of the index system through an example and drew a conclusion: ratio of cultivating wilderness, ratio of soil washed away, diversity of landscape type, index of biological quantity and ratio of soil degeneration can be regarded as “indicator” of landscape ecology damage.%本文在探讨景观生态破坏评价指标体系建立的目的和原则以及分析人类对景观生态系统影响的成因和表现的基础上,通过实例分析、讨论指标体系的可靠性和适应性。结果说明:水土流失率、景观类型多样性指数、生物量指数、开荒率、森林覆盖率等指标能够指示景观生态破坏的程度。

  20. Impact of arthritis on disability among older Mexican Americans.

    Science.gov (United States)

    Al Snih, S; Markides, K S; Ostir, G V; Goodwin, J S

    2001-01-01

    To estimate the impact of self-reported diagnosis of arthritis at baseline on the two year incidence of limitation in activities of daily living and instrumental activities of daily living in initially non-disabled Mexican-American elderly. Longitudinal study. SETTING Southwestern United States (Texas, New Mexico, Colorado, Arizona and California). A probability sample of 2,167 non-institutionalized Mexican-American men and women, aged 65 or older. Having ever been told by a doctor that a subject had arthritis, Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), depressive symptomatology, presence of chronic diseases (diabetes mellitus, heart attack, stroke, cancer), and body mass index (BMI). Among non-disabled persons at baseline, 11.2% of subjects with arthritis reported at least one ADL limitation after two years, compared to 6.9% of subjects without arthritis. Similarly, among non-disabled persons at baseline, 34.7% of subjects with arthritis reported at least one IADL limitation after two years, compared to 27.0% of subjects without arthritis. In logistic regression analysis, depression, diabetes, and arthritis were found to be predictive of the development of ADL disability, controlling for sociodemographic variables. Depression was the only condition that significantly predicted IADL disability. Subjects with arthritis were more likely to develop ADL and IADL disability over a two-year period than those without arthritis.

  1. Can imaging be used for inflammatory arthritis screening?

    DEFF Research Database (Denmark)

    Østergaard, Mikkel

    2012-01-01

    This article reviews the utility of imaging in the diagnostic work-up of suspected and undifferentiated axial and peripheral inflammatory arthritis. Radiographic findings, that is, late damage but not early inflammation, are part of the classification criteria for rheumatoid arthritis (RA......), ankylosing spondylitis, spondyloarthritis (SpA), and psoriatic arthritis (PsA), and they are generally part of the early examination program in arthritis.Computed tomography visualizes calcified tissue with high resolution but is rarely used unless radiography is unclear and MRI unavailable...... of RA, PsA, and SpA.MRI and US are part of the recent American College of Rheumatology/European League against Rheumatism 2010 classification criteria for RA (can be used to count involved joints), and MRI is part of the SpondyloArthritis International Society criteria for axial and peripheral Sp...

  2. Laser damage comparisons of broad-bandwidth, high-reflection optical coatings containing TiO2, Nb2O5, or Ta2O5 high-index layers

    Science.gov (United States)

    Field, Ella S.; Bellum, John C.; Kletecka, Damon E.

    2017-01-01

    Broad bandwidth coatings allow angle of incidence flexibility and accommodate spectral shifts due to aging and water absorption. Higher refractive index materials in optical coatings, such as TiO2, Nb2O5, and Ta2O5, can be used to achieve broader bandwidths compared to coatings that contain HfO2 high index layers. We have identified the deposition settings that lead to the highest index, lowest absorption layers of TiO2, Nb2O5, and Ta2O5, via e-beam evaporation using ion-assisted deposition. We paired these high index materials with SiO2 as the low index material to create broad bandwidth high reflection coatings centered at 1054 nm for 45 deg angle of incidence and P polarization. High reflection bandwidths as large as 231 nm were realized. Laser damage tests of these coatings using the ISO 11254 and NIF-MEL protocols are presented, which revealed that the Ta2O5/SiO2 coating exhibits the highest resistance to laser damage, at the expense of lower bandwidth compared to the TiO2/SiO2 and Nb2O5/SiO2 coatings.

  3. Biologic interventions for fatigue in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Almeida, Celia; Choy, Ernest H S; Hewlett, Sarah

    2016-01-01

    BACKGROUND: Fatigue is a common and potentially distressing symptom for patients with rheumatoid arthritis (RA), with no accepted evidence-based management guidelines. Evidence suggests that biologic interventions improve symptoms and signs in RA as well as reducing joint damage. OBJECTIVES......: To evaluate the effect of biologic interventions on fatigue in rheumatoid arthritis. SEARCH METHODS: We searched the following electronic databases up to 1 April 2014: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, Current Controlled Trials...... and contacted key authors. SELECTION CRITERIA: We included randomised controlled trials if they evaluated a biologic intervention in people with rheumatoid arthritis and had self reported fatigue as an outcome measure. DATA COLLECTION AND ANALYSIS: Two reviewers selected relevant trials, assessed methodological...

  4. Atherosclerosis in Juvenile Idiopathic Arthritis

    Directory of Open Access Journals (Sweden)

    Ewa Jednacz

    2012-01-01

    Full Text Available Atherosclerosis is a chronic inflammatory disease of the arteries. Clinical consequences of the atherosclerotic process occur in the adult population, however atherosclerotic process begins in childhood. The classic risk factors for atherosclerosis include obesity, dyslipidaemia, age, gender or family history. In recent years, attention has been drawn to the similarity between atherosclerotic inflammatory processes and inflammatory changes in the course of systemic connective tissue disease, in particular systemic lupus etythematosus (SLE or rheumatoid arthritis (RA. There is also observed the similarity of the pathogenetic background of development of atherosclerosis and juvenile idiopathic arthritis (JIA. Elevated levels of pro-inflammatory cytokines are observed in the course of juvenile idiopathic arthritis. Also homocysteine concentrations, which may play a significant role in the development of atherosclerotic lesions, are observed higher in patients with JIA. Some studies revealed higher carotid intima-media thickness (IMT index values in children with JIA. In view of the fact that atherosclerotic process begins as early as in childhood, the introduction of appropriate preventive measures in children is a matter of utmost importance.

  5. Arthritis of the hand - Rheumatoid

    Science.gov (United States)

    ... Media Find a Hand Surgeon Home Anatomy Rheumatoid Arthritis Email to a friend * required fields From * To * DESCRIPTION In its most literal sense, arthritis means “inflamed joint.” Arthritis describes any condition where ...

  6. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Corner / Patient Webcasts / Rheumatoid Arthritis Educational Video Series Rheumatoid Arthritis Educational Video Series This series of five videos was designed to help you learn more about Rheumatoid Arthritis (RA). You will learn how the diagnosis of ...

  7. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... is Happening to the Joints? Rheumatoid Arthritis: Gaining Control – Working with your Rheumatologist Rheumatoid Arthritis: Additional Conditions Rheumatoid Arthritis: The Immune System Don’t have SilverLight? Get it here. A ...

  8. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... for Patients Arthritis Drug Information Sheets Benefits and Risks of Opioids in Arthritis ... within the Johns Hopkins Arthritis Center website is intended for educational purposes only. Physicians and other health care professionals ...

  9. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Management for Rheumatoid Arthritis Patients Rehabilitation of Older Adult Patients with Arthritis Complementary and Alternative Medicine for ... Patient Update Transitioning the JRA Patient to an Adult Rheumatologist Drug Information for Patients Arthritis Drug Information ...

  10. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Arthritis and Health-related Quality of Life Rehabilitation Management for Rheumatoid Arthritis Patients Rehabilitation of Older Adult ... Sheets Benefits and Risks of Opioids in Arthritis Management How to Give a Subcutaneous Injection Connect With ...

  11. Body mass index modifies the relationship between γ-H2AX, a DNA damage biomarker, and pathological complete response in triple-negative breast cancer.

    Science.gov (United States)

    Barba, Maddalena; Vici, Patrizia; Pizzuti, Laura; Di Lauro, Luigi; Sergi, Domenico; Di Benedetto, Anna; Ercolani, Cristiana; Sperati, Francesca; Terrenato, Irene; Botti, Claudio; Mentuccia, Lucia; Iezzi, Laura; Gamucci, Teresa; Natoli, Clara; Vitale, Ilio; Mottolese, Marcella; De Maria, Ruggero; Maugeri-Saccà, Marcello

    2017-02-06

    Body mass index (BMI) is largely investigated as a prognostic and predictive factor in triple-negative breast cancer (TNBC). Overweight and obesity are linked to a variety of pathways regulating tumor-promoting functions, including the DNA damage response (DDR). The DDR physiologically safeguards genome integrity but, in a neoplastic background, it is aberrantly engaged and protects cancer cells from chemotherapy. We herein verified the role of BMI on a previously assessed association between DDR biomarkers and pathological complete response (pCR) in TNBC patients treated with neoadjuvant chemotherapy (NACT). In this retrospective analysis 54 TNBC patients treated with NACT were included. The relationship between DDR biomarkers, namely phosphorylated H2A Histone Family Member X (γ-H2AX) and phosphorylated checkpoint kinase 1 (pChk1), and pCR was reconsidered in light of BMI data. The Pearson's Chi-squared test of independence (2-tailed) and the Fisher Exact test were employed to assess the relationship between clinical-molecular variables and pCR. Uni- and multivariate logistic regression models were used to identify variables impacting pCR. Internal validation was carried out. We observed a significant association between elevated levels of the two DDR biomarkers and pCR in patients with BMI < 25 (p = 0.009 and p = 0.022 for γ-H2AX and pChk1, respectively), but not in their heavier counterpart. Results regarding γ-H2AX were confirmed in uni- and multivariate models and, again, for leaner patients only (γ-H2AX(high) vs γ-H2AX(low): OR 10.83, 95% CI: 1.79-65.55, p = 0.009). The consistency of this finding was confirmed upon internal validation. The predictive significance of γ-H2AX varies according to BMI status. Indeed, elevated levels of γ-H2AX seemed associated with lower pCR rate only in leaner patients, whereas differences in pCR rate according to γ-H2AX levels were not appreciable in heavier patients. Larger investigations are warranted

  12. The prevalence of low bone mineral density in Brazilian patients with systemic lupus erythematosus and its relationship with the disease damage index and other associated factors.

    Science.gov (United States)

    Souto, Maria Isabel Dutra; Coelho, Alycia; Guo, Carina; Mendonça, Laura Maria C; Pinheiro, Maria Fernanda M C; Papi, Jose Angelo S; Farias, Maria Lucia F

    2012-01-01

    The aim of this study was to examine the prevalence of osteoporosis, osteopenia, and bone mineral density (BMD) less than the expected range based on age in patients with systemic lupus erythematosus (SLE) in a tropical region of Brazil and the relationship between reduced BMD and several associated factors, especially the SLE disease damage index (SDI). We scored 159 patients with creatinine clearance of 60 mL/min or more for SDI, which was modified by excluding the osteoporosis item. For postmenopausal women and men older than 50 yr, T-scores identified osteopenia (-2.5) and osteoporosis (≤-2.5). For all patients, a Z-score of -2.0 or less identified BMD less than the expected range for age. Other variables that influence BMD were studied. The prevalence of osteoporosis, osteopenia, and BMD less than the expected range for age was 28%, 54%, and 29.6%, respectively. The Z-scores were significantly lower in patients with a modified SDI ≥ 1 (mean ± standard deviation [SD]=-1.45 ± 1.18) compared with patients with a modified SDI=0 (mean ± SD=-0.94 ± 1.01; p=0.01). The lowest Z-score had a significant association with postmenopausal status (p=0.038) and significant correlations with the duration of glucocorticoid (GC) usage (p=0.033, r=-0.17), the cumulative amount of GC (p=0.000, r=-0.28), and parathyroid hormone levels (p=0.003, r=-0.24). A multiple linear regression revealed that the modified SDI (p=0.003) and the cumulative amount of GC (p=0.006) had significant independent associations with the lowest Z-score. In conclusion, a BMD less than the expected range for age occurs frequently in Brazilian patients with SLE independent of the renal failure. The patients with greater SDIs had lower Z-scores, which suggests a direct association between chronic inflammation from disease and a reduced BMD.

  13. How undifferentiated arthritis evolves into chronic arthritis.

    Science.gov (United States)

    van der Woude, D; Toes, R E M; Scherer, H U

    2014-08-01

    Undifferentiated arthritis (UA) is a frequently occurring clinical presentation with a variable outcome. While some forms of UA will spontaneously remit, other forms will progress to chronic arthritis; an outcome that would preferably be prevented. Which immunological factors are normally at the basis of resolution of inflammation, and what, on the other hand, causes inflammation to persist? This review provides an overview of the immunological mechanisms involved in these two scenarios, including specific examples of how these mechanisms apply, or can be influenced in rheumatic diseases. Furthermore, what do we know about risk factors for chronic arthritis, such as the development of autoantibodies? The recent years have provided many insights concerning risk factors for autoantibody-positive versus autoantibody-negative rheumatoid arthritis, which are discussed along with a possible pathophysiological model incorporating autoantibodies into the larger process of disease development. Finally, the evolution of the autoantibody response over time is described.

  14. Fungal arthritis simulating juvenile rheumatoid arthritis.

    OpenAIRE

    Haapasaari, J; Essen, R V; Kahanpää, A; Kostiala, A A; Holmberg, K; Ahlqvist, J

    1982-01-01

    Petriellidium boydii is often isolated from maduromycosis but has recently been associated with arthritis. A previously healthy 6-year-old boy developed chronic purulent arthritis of the knee after a bicycle accident. Culture of aspirate grew no pathogens and antibiotic treatment had no effect. Culture of synovial fluid grew P boydii, which responded initially to amphotericin but reappeared after six months. Subsequent treatment with miconazole was stopped after development of haematuria. The...

  15. Infections and arthritis.

    Science.gov (United States)

    Mathew, Ashish Jacob; Ravindran, Vinod

    2014-12-01

    Bacteria, viruses, fungi, and parasites can all cause arthritis of either acute or chronic nature, which can be divided into infective/septic, reactive, or inflammatory. Considerable advances have occurred in diagnostic techniques in the recent decades resulting in better treatment outcomes in patients with infective arthritis. Detection of emerging arthritogenic viruses has changed the epidemiology of infection-related arthritis. The role of viruses in the pathogenesis of chronic inflammatory arthritides such as rheumatoid arthritis is increasingly being recognized. We discuss the various causative agents of infective arthritis and emphasize on the approach to each type of arthritis, highlighting the diagnostic tests, along with their statistical accuracy. Various investigations including newer methods such as nucleic acid amplification using polymerase chain reaction are discussed along with the pitfalls in interpreting the tests.

  16. 类风湿关节炎患者25羟基维生素D水平及临床常用炎性指标相关性分析%Analysis on the Correlation between the Level of 25-(OH)D and the Commonly Used Inflammatory Indexes in Clinic in Patients with Rheumatoid Arthritis

    Institute of Scientific and Technical Information of China (English)

    黄颖; 匡萍; 李蓉; 曹跃朋; 唐芳; 姚血明

    2016-01-01

    目的:研究类风湿关节炎患者外周血25羟基维生素D[25-(OH)D]水平与疾病活动炎性指标的相关性。方法:收集60例类风湿关节炎患者(类风湿关节炎组)和60例健康成人(对照组),分析研究2组血清25-(OH)D水平,并分析类风湿关节炎患者外周血清类风湿因子、C-反应蛋白及红细胞沉降率等临床常用指标的相关性,采用Spearman及Pearson相关性分析。结果:类风湿关节炎组25-(OH)D水平较对照组显著降低,2组比较,差异有统计学意义(P <0.05)。类风湿关节炎患者外周血25-(OH)D水平与红细胞沉降率及类风湿因子呈负相关,与C-反应蛋白无明显相关性。结论:25-(OH)D在类风湿关节炎诊治过程中可能起到对病情评估及预后的双重作用。%Objective:To study the correlation between the level of 25-(OH)D and the commonly used inlfammatory indexes in clinic in patients with rheumatoid arthritis.Methods:Selected 60 cases of rheumatoid arthritis(as a rheumatoid arthritis group) and 60 healthy adults(as a control group) and analyzed their 25-(OH) D levels.The correlation of commonly used clinical indexes such as peripheral serum rheumatoid factor,C-reactive protein and erythrocyte sedimentation rate in the rheumatoid arthritis group was analyzed using the correlation analysis ofSpearman andPearson.Results:The level of 25-(OH)D in the rheumatoid arthritis group was signiifcantly lower than that in the control group,and the difference was statistically signiifcant(P< 0.05).The levels of 25-(OH)D in peripheral blood of patients with rheumatoid arthritis were negatively correlated with erythrocyte sedimentation rate and rheumatoid factor,and no significant correlation was found with C-reactive protein.Conclusion:25-(OH)D in the diagnosis and treatment of rheumatoid arthritis may play a dual role of assessment and prognosis.

  17. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Spondylitis News Osteoarthritis News Gout News Osteoporosis News Lupus News Fibromyalgia News Patient Corner Arthritis Drug Information Sheets Managing Your Arthritis Educational Videos for Patients ...

  18. Ultrasound in Arthritis.

    Science.gov (United States)

    Sudoł-Szopińska, Iwona; Schueller-Weidekamm, Claudia; Plagou, Athena; Teh, James

    2017-09-01

    Ultrasound is currently performed in everyday rheumatologic practice. It is used for early diagnosis, to monitor treatment results, and to diagnose remission. The spectrum of pathologies seen in arthritis with ultrasound includes early inflammatory features and associated complications. This article discusses the spectrum of ultrasound features of arthritides seen in rheumatoid arthritis and other connective tissue diseases in adults, such as Sjögren syndrome, lupus erythematosus, dermatomyositis, polymyositis, and juvenile idiopathic arthritis. Ultrasound findings in spondyloarthritis, osteoarthritis, and crystal-induced diseases are presented. Ultrasound-guided interventions in patients with arthritis are listed, and the advantages and disadvantages of ultrasound are discussed. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Gouty arthritis in the human aging process

    Directory of Open Access Journals (Sweden)

    Juliana Secchi Batista

    2012-09-01

    Full Text Available The aging process has gained universal recognition and is occurring at an accelerated pace. Gout is a metabolic disorder in which an overproduction and / or decreased excretion of uric acid, leading to the deposition of crystals of sodium monourato joints and soft tissue. The present study was based on a literature review that aimed to analyze the incidence of gouty arthritis in the human aging process. To this end, we searched for articles indexed journals, books, among others, published in English and Portuguese, using the keywords "Human Aging", "Rheumatic Diseases", "Drop" and "Gouty Arthritis". The data obtained suggest that the prevalence of gout is higher in men, affecting oligo / polyarticular inflammatory symptoms with smaller and often with involvement of small joints of the hands also may be the coexistence of gout with other autoimmune diseases such as ankylosing spondylitis and rheumatoid arthritis, should be performed nutritional treatment and medication.

  20. [Pathophysiology of rheumatoid arthritis].

    Science.gov (United States)

    Lequerré, Thierry; Richez, Christophe

    2012-10-01

    These last years were especially marked by the best understanding of the physiopathological mechanisms at the onset of rheumatoid arthritis (RA) and in the processes of joint inflammation and joint destruction. RA is more and more considered as a syndrome with at least two clinical entities with different phenotype and profiles: seronegative RA and seropositive RA. In RA with ACPA, it is the process of immunization, that is the immunological reaction against citrullinated peptides, that leads to the disease. The peptide citrullination is directly favored by environmental factors such as tobacco, infection to Porphyromonas gingivalis and alcohol. The immunization supposes a genetic predisposition including approximately 22 genetic factors including the molecules of the major histocompatibility complex (MHC) and PTPN22. Finally, joint damage result at the same time from an excess of destruction (RANK/RANKL, TNFalpha) and from a defect of bone reparation by the way Wnt/Frizzled. It is thanks to the best understanding of RA physiopathology that leads to development of targeted treatments and specially processing for this disease.

  1. Medical ozone increases methotrexate clinical response and improves cellular redox balance in patients with rheumatoid arthritis.

    Science.gov (United States)

    León Fernández, Olga Sonia; Viebahn-Haensler, Renate; Cabreja, Gilberto López; Espinosa, Irainis Serrano; Matos, Yanet Hernández; Roche, Liván Delgado; Santos, Beatriz Tamargo; Oru, Gabriel Takon; Polo Vega, Juan Carlos

    2016-10-15

    Medical ozone reduced inflammation, IL-1β, TNF-α mRNA levels and oxidative stress in PG/PS-induced arthritis in rats. The aim of this study was to investigate the medical ozone effects in patients with rheumatoid arthritis treated with methotrexate and methotrexate+ozone, and to compare between them. A randomized clinical study with 60 patients was performed, who were divided into two groups: one (n=30) treated with methotrexate (MTX), folic acid and Ibuprophen (MTX group) and the second group (n=30) received the same as the MTX group+medical ozone by rectal insufflation of the gas (MTX+ozone group). The clinical response of the patients was evaluated by comparing Disease Activity Score 28 (DAS28), Health Assessment Questionnaire Disability Index (HAQ-DI), Anti-Cyclic Citrullinated (Anti-CCP) levels, reactants of acute phase and biochemical markers of oxidative stress before and after 20 days of treatment. MTX+ozone reduced the activity of the disease while MTX merely showed a tendency to decrease the variables. Reactants of acute phase displayed a similar picture. MTX+ozone reduced Anti-CCP levels as well as increased antioxidant system, and decreased oxidative damage whereas MTX did not change. Glutathione correlated with all clinical variables just after MTX+ozone. MTX+ozone increased the MTX clinical response in patients with rheumatoid arthritis. No side effects were observed. These results suggest that ozone can increase the efficacy of MTX probably because both share common therapeutic targets. Medical ozone treatment is capable of being a complementary therapy in the treatment of rheumatoid arthritis.

  2. Arthritis and Veterans

    Centers for Disease Control (CDC) Podcasts

    2015-11-09

    One in three veterans has arthritis. This podcast provides information on how veterans can improve their quality of life with physical activity and other arthritis management strategies.  Created: 11/9/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 11/9/2015.

  3. What Is Rheumatoid Arthritis?

    Science.gov (United States)

    ... in Chinese 繁體中文 ) What Is Rheumatoid Arthritis? (in Korean 한국어 ) What Is Rheumatoid Arthritis? (in Vietnamese bằng ... his or her own body tissues. Researchers are learning many things about why and how this happens. ...

  4. Juvenile idiopathic arthritis

    NARCIS (Netherlands)

    Prakken, Berent; Albani, Salvatore; Martini, Alberto

    2011-01-01

    Juvenile idiopathic arthritis is a heterogeneous group of diseases characterised by arthritis of unknown origin with onset before age of 16 years. Pivotal studies in the past 5 years have led to substantial progress in various areas, ranging from disease classification to new treatments. Gene expres

  5. [Biopharmaceuticals in the treatment of rheumatoid arthritis

    DEFF Research Database (Denmark)

    Baslund, B.; Bendtzen, K.

    2008-01-01

    The current status on the use of biopharmaceuticals in the treatment of rheumatoid arthritis is reviewed. Blocking of TNF-alpha, co-stimulation of CD28+ T-cells and depletion of CD20+ B-cells are all effective ways to diminish inflammation and joint damage. However, not all patients react...... to these treatments, and the development of biomarkers to predict which patients will benefit from these drugs is therefore warranted Udgivelsesdato: 2008/6/9...

  6. Periodontal status of rheumatoid arthritis patients in khartoum state.

    Science.gov (United States)

    Abdelsalam, Safa K; Hashim, Nada T; Elsalamabi, Emitithal M; Gismalla, Bakri G

    2011-10-28

    Few studies have investigated the periodontal condition among Rheumatoid arthritis in Sudan. The present study described the periodontal condition among Sudanese patients suffering from rheumatoid arthritis and to compare them with those of non-rheumatic subjects. A group of eighty rheumatoid arthritis patients was selected from Patient's Rheumatoid Clinics in Khartoum State during the period of January to May 2010. A control group of eighty patients with the same age and gender was selected for the study. Both Rheumatoid arthritis patients and the control group were examined for their plaque index, gingival index, and clinical attachment loss. The results revealed that there were no significant differences in plaque and gingival index among study and control groups, with mean plaque index of (1.25 ± 0.4) for patients and (1.17 ± 0.28) for the control group (p-value is 0.3597). The mean gingival index was (1.2 ± 0.24) for the patients and (1.2 ± 0.33) for the control (p = is 0.3049). The results showed statistically significant differences in clinical attachment loss between study and control groups, with mean clinical attachment loss of (1.03 ± 0.95) for the study group and (0.56 ± 0.63) for the control group (p = 0.0002). The study revealed that no association exists between the type of drug used to treat rheumatoid arthritis (NSAIDs & DMARDs) and the periodontal parameters (plaque index, gingival index, and clinical attachment loss). A significant relationship between periodontal disease and Rheumatoid Arthritis does exist, but no difference between plaque and gingival index has been detected among study and control groups.

  7. Periodontal status of rheumatoid arthritis patients in khartoum state

    Directory of Open Access Journals (Sweden)

    Abdelsalam Safa K

    2011-10-01

    Full Text Available Abstract Background Few studies have investigated the periodontal condition among Rheumatoid arthritis in Sudan. The present study described the periodontal condition among Sudanese patients suffering from rheumatoid arthritis and to compare them with those of non-rheumatic subjects. Methods A group of eighty rheumatoid arthritis patients was selected from Patient's Rheumatoid Clinics in Khartoum State during the period of January to May 2010. A control group of eighty patients with the same age and gender was selected for the study. Both Rheumatoid arthritis patients and the control group were examined for their plaque index, gingival index, and clinical attachment loss. Results The results revealed that there were no significant differences in plaque and gingival index among study and control groups, with mean plaque index of (1.25 ± 0.4 for patients and (1.17 ± 0.28 for the control group (p-value is 0.3597. The mean gingival index was (1.2 ± 0.24 for the patients and (1.2 ± 0.33 for the control (p = is 0.3049. The results showed statistically significant differences in clinical attachment loss between study and control groups, with mean clinical attachment loss of (1.03 ± 0.95 for the study group and (0.56 ± 0.63 for the control group (p = 0.0002. The study revealed that no association exists between the type of drug used to treat rheumatoid arthritis (NSAIDs & DMARDs and the periodontal parameters (plaque index, gingival index, and clinical attachment loss. Conclusion A significant relationship between periodontal disease and Rheumatoid Arthritis does exist, but no difference between plaque and gingival index has been detected among study and control groups.

  8. Periodontitis and rheumatoid arthritis : A search for causality and role of Porphyromonas gingivalis

    NARCIS (Netherlands)

    de Smit, Menke

    2015-01-01

    There is currently much attention for early detection of rheumatoid arthritis, as early recognition enables timely treatment with a chance of remission of the disease before irreversible damage has occurred. In this respect, important questions are: who will develop rheumatoid arthritis, when and wh

  9. Periodontitis and rheumatoid arthritis : A search for causality and role of Porphyromonas gingivalis

    NARCIS (Netherlands)

    de Smit, Menke

    2015-01-01

    There is currently much attention for early detection of rheumatoid arthritis, as early recognition enables timely treatment with a chance of remission of the disease before irreversible damage has occurred. In this respect, important questions are: who will develop rheumatoid arthritis, when and wh

  10. [Guidelines for diagnosis and treatment of oligoarticular and polyarticular juvenile idiopathic arthritis].

    Science.gov (United States)

    Bader-Meunier, B; Wouters, C; Job-Deslandre, C; Cimaz, R; Hofer, M; Pillet, P; Quartier, P

    2010-07-01

    A guideline group of pediatric rheumatologist experts elaborated guidelines related to the management of idiopathic juvenile arthritis in association with the Haute Autorité de santé (HAS). A systematic search of the literature published between 1998 and August 2008 and indexed in Pubmed was undertaken. Here, we present the guidelines for diagnosis and treatment in oligoarticular and polyarticular juvenile idiopathic arthritis (except for spondylarthropathy and rheumatoid arthritis).

  11. 岩体冻融疲劳损伤模型与评价指标研究%FATIGUE DAMAGE MODELAND EVALUATION INDEX FOR ROCK MASS UNDER FREEZING-THAWING CYCLES

    Institute of Scientific and Technical Information of China (English)

    刘泉声; 黄诗冰; 康永水; 黄兴

    2015-01-01

    Frost heaving pressure in rock mass undergoes a process of initiation,development and dissipation under the freezing-thawing condition,which results in the fatigue degradation of the physical and mechanical properties of rock. The freezing-thawing damage model and the damage evaluation method are the key problems for the rock mass in cold regions. There are many evaluation indexes of freezing-thawing damage including the porosity,the longitudinal wave velocity and the elastic modulus. The frost heaving pressure was considered to be equivalent to the triaxial tensile stress for frozen rock mass. A freezing-thawing fatigue damage model was established based on the equivalent triaxial tensile stress. The equation describing the freezing-thawing damage variation has the same expression but the different physical meaning with that obtained under repeated uniaxial tensile stress. A new unified damage variable depending on the p-wave velocity and the porosity was deduced based on the definition of the dynamic modulus of elasticity. The damage variable includes the effect of dual physical parameters,and is a better prediction index for the uniaxial compressive strength under different freeze-thaw cycles. The loss of 40% of dynamic elastic modulus was defined as the damage threshold. With the damage threshold,the maximum failure freeze-thaw cycle was determined. The freezing-thawing damage model was solved in combination with the unified damage variable. Finally,the validity and applicability of the freezing-thawing fatigue damage model were illustrated through two examples.%岩体冻融损伤模型与评价是研究岩体经历冻胀力萌生、发展与消散反复作用后物理力学性质劣化的主要内容,现有对岩体冻融循环后的损伤评价指标主要有孔隙率、纵波波速、静动弹性模量等物理参数。冻胀力对于岩体可等效为三轴拉伸应力,首先基于三向等效拉应力建立岩体冻融疲劳损伤模型,该冻融

  12. Cardiovascular comorbidity in rheumatoid arthritis

    OpenAIRE

    Holmqvist, Marie E

    2010-01-01

    This thesis is based on four different studies, all focusing on co-morbidities in rheumatoid arthritis. Diabetes mellitus is assessed as a risk factor for rheumatoid arthritis, the temporal relationship between ischemic heart disease and rheumatoid arthritis, and the extent of coronary stenosis in rheumatoid arthritis, is studied. The rationale for this is that patients with rheumatoid arthritis suffer an increased risk of ischemic heart disease that cannot be explained by traditional risk fa...

  13. Cardiovascular involvement in psoriatic arthritis

    Directory of Open Access Journals (Sweden)

    V. De Gennaro Colonna

    2011-11-01

    Full Text Available Psoriasis is a chronic, genetically determined and immunomediated inflammatory skin disease that affects 2-3% of the Caucasian population. A considerable proportion of these patients develop a form of inflammatory arthritis known as psoriatic arthritis (PsA, although the prevalence of this has not been well defined. Patients with PsA have a higher mortality rate than the general population and the risk of mortality is related to disease severity at the time of presentation. Endothelial dysfunction and early atherosclerosis have been found in patients with PsA without any cardiovascular disease (CVD risk factors, and experts believe that CVD is one of the leading causes of death, as it is in patients with rheumatoid arthritis (RA. Various disease-related mechanisms may be involved in the development of premature vascular damage in both cases, including an increased synthesis of proinflammatory mediators (such as cytokines, chemokines and adhesion molecules, autoantibodies against endothelial cell components, perturbations in T-cell subsets, genetic polymorphisms, hyperhomocysteinemia, oxidative stress, abnormal vascular repair, and iatrogenic factors. In a recent study of 22 patients with PsA without any signs of CVD, we found that the plasma concentration of asymmetric dimethylarginine (ADMA levels were significantly high and coronary flow reserve (CFR was significantly reduced. Moreover, there was a significant correlation between CFR and plasma ADMA levels in the PsA group. The significant correlation between the reduced CRF and increased ADMA levels suggests that, like patients with early RA, PsA patients suffer from endothelial dysfunction and impaired coronary microcirculation. Active PsA is a risk factor for CVD, and so PsA patients should be screened for subclinical forms of the disease and its risk factors, and an early treatment approach should be adopted.

  14. IL33 in rheumatoid arthritis: potencial contribution to pathogenesis.

    Science.gov (United States)

    Macedo, Rafaela Bicalho Viana; Kakehasi, Adriana Maria; Andrade, Marcus Vinicius Melo de

    2016-03-22

    A better understanding of the inflammatory mechanisms of rheumatoid arthritis and the development of biological therapy revolutionized its treatment, enabling an interference in the synovitis-structural damage-functional disability cycle. Interleukin 33 was recently described as a new member of the interleukin-1 family, whose common feature is its pro-inflammatory activity. Its involvement in the pathogenesis of a variety of diseases, including autoimmune diseases, raises the interest in the possible relationship with rheumatoid arthritis. Its action has been evaluated in experimental models of arthritis as well as in serum, synovial fluid and membrane of patients with rheumatoid arthritis. It has been shown that the administration of interleukin-33 exacerbates collagen-induced arthritis in experimental models, and a positive correlation between cytokine concentrations in serum and synovial fluid of patients with rheumatoid arthritis and disease activity was found. This review discusses evidence for the role of interleukin-33 with a focus on rheumatoid arthritis. Copyright © 2016 Elsevier Editora Ltda. All rights reserved.

  15. IL33 in rheumatoid arthritis: potential contribution to pathogenesis.

    Science.gov (United States)

    Macedo, Rafaela Bicalho Viana; Kakehasi, Adriana Maria; Melo de Andrade, Marcus Vinicius

    A better understanding of the inflammatory mechanisms of rheumatoid arthritis and the development of biological therapy revolutionized its treatment, enabling an interference in the synovitis - structural damage - functional disability cycle. Interleukin 33 was recently described as a new member of the interleukin-1 family, whose common feature is its pro-inflammatory activity. Its involvement in the pathogenesis of a variety of diseases, including autoimmune diseases, raises the interest in the possible relationship with rheumatoid arthritis. Its action has been evaluated in experimental models of arthritis as well as in serum, synovial fluid and membrane of patients with rheumatoid arthritis. It has been shown that the administration of interleukin-33 exacerbates collagen-induced arthritis in experimental models, and a positive correlation between cytokine concentrations in serum and synovial fluid of patients with rheumatoid arthritis and disease activity was found. This review discusses evidence for the role of interleukin-33 with a focus on rheumatoid arthritis. Copyright © 2016 Elsevier Editora Ltda. All rights reserved.

  16. Therapeutic effect of quercetin in collagen-induced arthritis.

    Science.gov (United States)

    Haleagrahara, Nagaraja; Miranda-Hernandez, Socorro; Alim, Md Abdul; Hayes, Linda; Bird, Guy; Ketheesan, Natkunam

    2017-03-22

    Quercetin, a bioactive flavonoid with anti-inflammatory, immunosuppressive, and protective properties, is a potential agent for the treatment of rheumatoid arthritis (RA). Collagen-induced arthritis (CIA) is the most commonly used animal model for studying the pathogenesis of RA. This study analysed the therapeutic role of quercetin in collagen-induced arthritis in C57BL/6 mice. The animals were allocated into five groups that were subjected to the following treatments: negative (untreated) control, positive control (arthritis-induced), arthritis+methotrexate, arthritis+quercetin, and arthritis+methotrexate+quercetin. Assessments of weight, oedema, joint damage, and cytokine production were used to determine the therapeutic effect of quercetin. This study demonstrated for the first time the anti-inflammatory and protective effects of quercetin in vivo in CIA. The results also showed that the concurrent administration of quercetin and methotrexate did not offer greater protection than the administration of a single agent. The use of quercetin as a monotherapeutic agent resulted in the lowest degree of joint inflammation and the highest protection. The reduced severity of the disease in animals treated with quercetin was associated with decreased levels of TNF-α, IL-1β, IL-17, and MCP-1. In conclusion, this study determined that quercetin, which was non-toxic, produced better results than methotrexate for the protection of joints from arthritic inflammation in mice. Quercetin may be an alternative treatment for RA because it modulates the main pathogenic pathways of RA.

  17. In Vivo Quantitative Measurement of Arthritis Activity Based on Hydrophobically Modified Glycol Chitosan in Inflammatory Arthritis: More Active than Passive Accumulation

    Directory of Open Access Journals (Sweden)

    Kyeong Soon Park

    2012-09-01

    Full Text Available We demonstrated that arthritis could be visualized noninvasively using hydrophobically modified glycol chitosan nanoparticles labeled with Cy5.5 (HGC-Cy5.5 and an optical imaging system. Activated macrophages expressing Mac-1 molecules effectively phagocytosed HGC-Cy5.5, which formed spherical nanoparticles under physiologic conditions. We estimated the applicability of HGC-Cy5.5 to quantitative analysis of arthritis development and progression. Near-infrared fluorescence images, captured after HGC-Cy5.5 injection in mice with collagen-induced arthritis, showed stronger fluorescence intensity in the active arthritis group than in the nonarthritis group. According to the progression of arthritis in both collagen-induced arthritis and collagen antibody-induced arthritis models, total photon counts (TPCs increased in parallel with the clinical arthritis index. Quantitative analysis of fluorescence after treatment with methotrexate showed a significant decrease in TPC in a dose-dependent manner. Histologic evaluation confirmed that the mechanism underlying selective accumulation of HGC-Cy5.5 within synovitis tissues included enhanced phagocytosis of the probe by Mac-1-expressing macrophages as well as enhanced permeability through leaky vessels. These results suggest that optical imaging of arthritis using HGC-Cy5.5 can provide an objective measurement of disease activity and, at the same time, therapeutic responses in rheumatoid arthritis.

  18. Determinants of physical function in rheumatoid arthritis: association with the disease process.

    NARCIS (Netherlands)

    J.M.W. Hazes (Mieke)

    2003-01-01

    textabstractRheumatoid arthritis (RA) is a chronic, debilitating disease that follows a progressive course characterized by persistent inflammation and erosive joint damage leading to functional disability. The Health Assessment Questionnaire is now viewed as a key instrument to me

  19. Determinants of physical function in rheumatoid arthritis: association with the disease process.

    NARCIS (Netherlands)

    J.M.W. Hazes (Mieke)

    2003-01-01

    textabstractRheumatoid arthritis (RA) is a chronic, debilitating disease that follows a progressive course characterized by persistent inflammation and erosive joint damage leading to functional disability. The Health Assessment Questionnaire is now viewed as a key instrument to me

  20. Quality of life of healthy subjects and patients with arthritis and ...

    African Journals Online (AJOL)

    the prevalence of these conditions, supportive roles for the elderly and married women as well as cost effective ... Keywords: Arthritis, diabetes, Quality of life, Niger Delta, Nigeria. Tropical Journal ..... damage, fatigue, disability and depression.

  1. Early detection of patients at risk for rheumatoid arthritis : A challenge for primary and secondary care

    NARCIS (Netherlands)

    C. Alves (Celina)

    2015-01-01

    markdownabstract__Abstract__ Rheumatoid arthritis (RA) is a systemic auto-immune disease mainly characterized by articular manifestations [1]. Patients present initially with synovitis and joint damage, while extra-articular manifestations such as vasculitis, pleuritis and pericarditis are manifest

  2. [Pathogenesis of rheumatoid arthritis].

    Science.gov (United States)

    Branimir Anić; Miroslav Mayer

    2014-01-01

    Rheumatoid arthritis (RA) is an autoimmune systemic disease that primarily affects joints. Etiology and the pathogenesis of RA are complex, involving many types of cells, among others macrophages, T and B cells, fibro- blasts, chondrocytes and dendritic cells. Despite well documented role of many genes and epigenetic modifications in the development and evolution of the disease, in most RA patients there is no clear predisposing factor present. Environmental factors involved in RA pathogenesis are cigarette smoke, industrial pollutants like silica crystals, disturbances of intestinal, lung, and oral microbiota and some specific bacterial and viral infectious agents and their components. In the initial disease stage there are qualitative and quantitative disturbances ofpeptide citrulination as well as other protein modifications, followed by antigen presenting cell (APC) (macrophages and dendritic cells) and fibroblast like synoviocytes (FLS) activation. Some microbes foster this processes by APC and FLS direct and indirect activation. In the second stage APC's elicit specific humoral B cell re- sponse resulting in specific antibodies production and T cell autoreactivity. Inherited and acquired defects in T and B cell responses caused by repeated activation of innate immunity as well as loss of tolerance, elicit chronic autoimmune inflammation, primarily of synovial membranes, and development of cellular panus. Pathologic activation of the osteoclasts and release of the immune system effector molecules and the proteolytic enzymes damage the cartilage, bone and tendons composition and structure. Persistent inflammation through its complex mechanisms results in many systemic and extraarticular RA manifestations of almost all organ systems, resulting in severe complications and comorbidities such as rheumatoid lung, carditis, vasculitis, cahexia, anemia, accelerated atherosclerosis, myocardial and cerebrovascular vascular disease, lymphoma, osteoporosis, depression etc

  3. [Septic arthritis and spondylitis].

    Science.gov (United States)

    Fujikawa, Yosuke

    2014-10-01

    Septic arthritis and spondylitis in elderly adult are uncommon disease. But symptoms and signs of septic arthritis and spondylitis are an important medical emergency, with high mortality and morbidity. Delayed or inadequate treatment can result in irreversible joint destruction and neurological condition. Early diagnoses as well as prompt and effective treatment are essential for avoiding severe outcomes. In spite of advances in diagnostic imaging techniques, the incidence of septic arthritis and spondylitis appears to have been increased. The aging of the population, the widespread use of immunosuppressant therapies, including systemic corticosteroids, cytokines and anticytokines, and growing resistance to conventional antibiotics seem to be the major cause.

  4. A rare cause of septic arthritis: melioidosis.

    Science.gov (United States)

    Caldera, Aruna Sanjeewa; Kumanan, Thirunavukarasu; Corea, Enoka

    2013-10-01

    Melioidosis is a pyogenic infection with high mortality caused by the bacterium Burkholderia pseudomallei. As the clinical presentation is not distinctive, a high index of clinical suspicion is required for diagnosis. We present a case of a 50-year-old farmer who was diabetic and a chronic alcoholic, who presented to us with pneumonia, followed by septic arthritis. He was ultimately diagnosed as having melioidosis.

  5. Crocin reduces the inflammation response in rheumatoid arthritis.

    Science.gov (United States)

    Li, Xiang; Jiang, Chao; Zhu, Wenyong

    2017-05-01

    This study is to determine the role and mechanism of crocin in rheumatoid arthritis (RA). Totally 60 Wistar SD rats were randomly divided into control group, RA model group, methotrexate group, crocin high dose, middle dose, and low dose groups. The paw swelling degree, arthritis score, thymus and spleen index, the mRNA and protein levels of iNOS, and the serum content of TNF-α, IL-1β, and IL-6 were evaluated. Crocin treatment significantly alleviated the paw swelling of RA rats. The arthritis score in crocin treatment groups was significantly lower than that in RA model group. Additionally, the thymus index, but not the spleen index, declined remarkably in crocin treatment groups than in RA model group. Besides, crocin administration significantly reduced the iNOS production and the serum content of TNF-α, IL-1β, and IL-6. Crocin may exert potent anti-RA effects through inhibiting cytokine.

  6. Septic arthritis in the newborn and infants

    Directory of Open Access Journals (Sweden)

    Gajdobranski Đorđe R.

    2003-01-01

    Full Text Available Introduction Septic arthritis represents an intra-articular infection caused by pyogenic bacteria. During the earliest childhood it is considered to be a systemic septic condition and demands early diagnosis and prompt surgical treatment. Material and methods This is a retrospective analysis of patients with septic arthritis treated at the Department of Orthopedics of the Pediatric Surgery Clinic in Novi Sad, over a 10-year period. We are also presenting a case of a 12-day-old newborn baby, with clear radiological signs of osteoarthritis of the right knee. Results A retrospective study included the period 1991-2000, and showed that 15 patients, aged 10 days - 12 months were treated for osteoarthritis. The most common localization was the hip, in 60% of cases. In 11 patients the causative agent was Staphylococcus aureus while in the 4 remaining patients the bacteriologic finding was negative. One patient died of generalized sepsis. Discussion In neonates and infants septic arthritis is characterized by atypical clinical picture, often causing delayed diagnosis. In the initial phases of the disease ultrasonographic findings were of greater use compared to radiological imaging, due to relatively late appearance of radiological signs of disease. Conclusions Due to possible development of serious and irreversible damage, even lethal outcome, septic arthritis requires early diagnosis, prompt administration of antibiotics and early surgical treatment. It is a quite unique area in Pediatric Orthopedics where missed or delayed diagnosis may have serious consequences.

  7. Systemic-onset juvenile idiopathic arthritis.

    Science.gov (United States)

    Cimaz, Rolando

    2016-09-01

    Systemic-onset juvenile idiopathic arthritis (SoJIA) is a systemic inflammatory disease which has up to now been classified as a category of juvenile idiopathic arthritis. However, in this context, systemic inflammation has been associated with dysregulation of the innate immune system, suggesting that it may rather be part of the spectrum of autoinflammatory disorders. The disease is in fact unique with regard to the other JIA categories, in terms of clinical manifestations, prognosis, and response to conventional immunosuppressant therapies. It is characterized clinically by fever, lymphadenopathy, arthritis, rash, and serositis. IL-1 and IL-6 play a major role in the pathogenesis of SoJIA, and treatment with IL-1 and IL-6 inhibitors has shown to be highly effective. However, complications of SoJIA, including macrophage activation syndrome, limitations in functional outcome by arthritis and long-term damage from chronic inflammation continue to be a major issue in patients' care. Recent advances on the pathogenesis and treatment have revolutionized the care and prognosis of this potentially life-threatening pediatric condition.

  8. INDEXING AND INDEX FUNDS

    Directory of Open Access Journals (Sweden)

    HAKAN SARITAŞ

    2013-06-01

    Full Text Available Proponents of the efficient market hypothesis believe that active portfolio management is largely wasted effort and unlikely to justify the expenses incurred. Therefore, they advocate a passive investment strategy that makes no attempt to outsmart the market. One common strategy for passive management is indexing where a fund is designed to replicate the performance of a broad-based index of stocks and bonds. Traditionally, indexing was used by institutional investors, but today, the use of index funds proliferated among individual investors. Over the years, both international and domestic index funds have disproportionately outperformed the market more than the actively managed funds have.

  9. LABORATORY FINDINGS IN PSORIATIC ARTHRITIS

    Directory of Open Access Journals (Sweden)

    S. Todesco

    2011-09-01

    Full Text Available Psoriatic arthritis (PsA has been classically defined as an inflammatory arthritis associated with psoriasis. However, in comparison with other relevant inflammatory arthropathies, in which a definite diagnosis is frequently possible only by means of laboratory investigations, in PsA true laboratory diagnostic markers are lacking. Some markers are utilised more to differentiate other diseases than to characterise PsA. For example in polyarticular PsA, which may be in some cases indistinguishable from RA, the rheumatoid factor (RF or the more specific and recently introduced antibodies to cyclic citrullinated peptides (anti-CCP, may be useful to better identify RA. However, RF was found in 5% to 13% of patients with PsA, and anti-CCP may be observed in almost similar percentage. The determination of ESR and/or CRP is frequently disappointing in PsA, since they are both elevated in only half of the patients with PsA. However, ESR and/or CRP are included in the most utilised response criteria for RA, such as ACR and DAS, and, in addition are also considered reliable in the assessment of PsA. Furthermore, elevated levels of ESR have been proposed as one of the best predictors of damage progression and, in addition, a low ESR seems protective, while an ESR >15 mm/h is one of the factors associated with an increased mortality in PsA. The synovial fluid (SF effusion is much higher in PsA, in comparison with other arthropathies. When available, SF analysis may offer additive information useful for the diagnosis, such as the increased number of leukocytes, which underlines the inflammatory nature of the effusion even in a patient with normal serum levels of acute phase response. We found that elevated IL-1 levels in SF of patients with early disease (<6 months, may be predictive of an evolution in polyarticular form at follow-up. This observation is in keeping with the crucial role that inflammatory cytokines play in PsA, probably related to a genetic

  10. [Isokinetic assessment of ankles in patients with rheumatoid arthritis].

    Science.gov (United States)

    Oliveira, Silvia Cristina Gutierrez; Oliveira, Leda Magalhaes; Jones, Anamaria; Natour, Jamil

    2015-01-01

    The foot and ankle in rheumatoid arthritis undergo highly destructive synovitis with loss of muscle strength. To evaluate the muscle strength of ankles in patients with rheumatoid arthritis based on isokinetic dynamometry parameters. Thirty patients with a diagnosis of rheumatoid arthritis involving the ankle(s) and 30 healthy subjects (control group) matched for age, gender, race, body mass index and lower limb dominance were studied. Dorsiflexion, plantarflexion, inversion and eversion were evaluated in all subjects on an isokinetic Cybex Norm dynamometer. The variables were compared between the rheumatoid arthritis and control groups and between the right and left ankles, and the dorsiflexor/plantar flexor and invertor/evertor muscle strength ratio was determined. Patients with rheumatoid arthritis performed statistically worse in the isokinetic dynamometry test for all ankle movements. The muscle strength ratio between dorsiflexors and plantar flexors was different in the two groups. No significant differences were observed in the invertor and evertor ratios. In the two groups the plantar flexor musculature was statistically stronger than dorsiflexors. We conclude that patients with rheumatoid arthritis perform worse in isokinetic dynamometry regarding all ankle movements than control subjects, with similar isokinetic test results being observed for the right and left side in both groups, with few exceptions. Isokinetic evaluation posed no additional risk such as important pain or inflammatory activity to patients with rheumatoid arthritis. Copyright © 2014 Elsevier Editora Ltda. All rights reserved.

  11. [Team management of rheumatoid arthritis].

    Science.gov (United States)

    Le Loët, X; Vittecoq, O

    2001-12-01

    The main objectives of team management of rheumatoid arthritis are to stop structural damage of joints and to reduce functional, psychological, socioprofessional and economic consequences. Team management requires the collaboration, around the patient, of a rheumatologist, a nurse, a psychologist, a physiotherapist, an occupational therapist, an orthopaedic surgeon at the same time, in the same place. More and more patients wish to manage their disease by themselves. Team care should not be proposed to every patient; it must be reserved to patients whose condition required such an approach because of the severity of the disease, comorbidity, psychological or socioprofessionnal difficulties. Team management should be personalized. Utility of team management is now accepted; out-patient administration is as effective as in-patient one. A good educational program is very important. However, search is still needed to define optimal modalities of team management and tools to measure the efficiency of this approach.

  12. Juvenile chronic arthritis.

    Science.gov (United States)

    Southwood, T R; Woo, P

    1995-05-01

    The nomenclature and classification criteria for arthritis in children should be dealt with initially as separate issues, although they are undoubtedly intertwined. The classification criteria should aim to delineate homogeneous patient populations, yet should be flexible enough to incorporate advances in disease knowledge. It should be recognized that arriving at an international consensus for classification criteria will merely provide a set of operational definitions to facilitate research, and not a set of diagnostic criteria. Indeed the only point to obtaining consensus is to begin a process of systematic ongoing review of the criteria. The labels attached to any of these diseases should facilitate accurate communication. In view of the heterogeneous nature of childhood arthritis, consideration should be given to using a broad umbrella term such as juvenile or childhood arthritis only for communicating with the lay public. Medical nomenclature should be formulated to reflect accurately homogeneous subgroups of arthritis, and should not artificially proscribe a relationship between paediatric and adult disease.

  13. Arthritis in Children

    Science.gov (United States)

    ... Asthma Autism Cancer Chest & Lungs Chronic Conditions Cleft & Craniofacial ... Content Article Body Arthritis is an inflammation of the joints that produces swelling, redness, heat, and pain. Although it is typically thought of as a ...

  14. Arthritis and IBD

    Science.gov (United States)

    ... pain and stiffness in the lower spine and sacroiliac joints (at the bottom of the back). Interestingly, and ... addition to causing arthritis of the spine and sacroiliac joints, ankylosing spondylitis can cause inflammation of the eyes, ...

  15. Oxygen radical induced fluorescence in proteins; identification of the fluorescent tryptophan metabolite, N-formyl kynurenine, as a biological index of radical damage.

    Science.gov (United States)

    Griffiths, H R; Lunec, J; Blake, D R

    1992-06-01

    The effect of oxygen derived free radicals (OFR) on aromatic and sulphur containing amino acids has been investigated, both in their free form and within protein backbones. Aerated amino acids and proteins in solution were exposed to three discrete OFR generating systems; (1) gamma radiation in the presence or absence of formate (2) photolysis by UV light at 254 and 366 nm, and (3) site specific modification by H2O2 in the presence of CuII ions.A sensitive reverse-phase HPLC technique with dual detection systems (UV absorbance and fluorescence monitoring) was developed to analyse the products of amino acid oxidation. OFR denatured amino acids were chromatographed by this procedure, and all radical species generated, with the exception of the superoxide anion, resulted in the formation of identifiable fluorescent metabolites of tryptophan, kynurenines. The identity of peaks was confimed by spiking with authentic material and scanning absorption spectroscopy. After complete proteolytic hydrolysis, OFR treated proteins were also analysed by this technique; again the dose dependent production of kynurenines was detected in IgG,γ lens crystallins and albumin. Bityrosine was not detected in any of the proteins studied using this procedure, however, several novel unidentified fluorophores were detected in proteolytic hydrolysates, possibly the product of two different amino acid radicals.Immunoglobulin G isolated from the sera of normals and rheumatoid arthritis (RA) patients was examined for the presence of one specific tryptophan metabolite, N-formyl kynurenine. Significantly elevated levels of this metabolite were detected in rheumatoid sera, suggesting increased OFR activity in RA.These results have demonstrated firstly, that specific oxidised products of amino acids are retained in the protein backbone after exposure to OFR generating systems. Secondly, in aerated solution, oxidised tryptophan residues confer the major new visible fluorescence in non-haem proteins

  16. Review article: moving towards common therapeutic goals in Crohn's disease and rheumatoid arthritis.

    Science.gov (United States)

    Allen, P B; Olivera, P; Emery, P; Moulin, D; Jouzeau, J-Y; Netter, P; Danese, S; Feagan, B; Sandborn, W J; Peyrin-Biroulet, L

    2017-04-01

    Crohn's disease (CD) and rheumatoid arthritis are chronic, progressive and disabling conditions that frequently lead to structural tissue damage. Based on strategies originally developed for rheumatoid arthritis, the treatment goal for CD has recently moved from exclusively controlling symptoms to both clinical remission and complete mucosal healing (deep remission), with the final aim of preventing bowel damage and disability. To review the similarities and differences in treatment goals between CD and rheumatoid arthritis. This review examined manuscripts from 1982 to 2016 that discussed and/or proposed therapeutic goals with their supportive evidence in CD and rheumatoid arthritis. Proposed therapeutic strategies to improve outcomes in both rheumatoid arthritis and CD include: (i) evaluation of musculoskeletal or organ damage and disability, (ii) tight control, (iii) treat-to-target, (iv) early intervention and (v) disease modification. In contrast to rheumatoid arthritis, there is a paucity of disease-modification trials in CD. Novel therapeutic strategies in CD based on tight control of objective signs of inflammation are expected to change disease course and patients' lives by halting progression or, ideally, preventing the occurrence of bowel damage. Most of these strategies require validation in prospective studies, whereas several disease-modification trials have addressed these issues in rheumatoid arthritis over the last decade. The recent approval of new drugs in CD such as vedolizumab and ustekinumab should facilitate initiation of disease-modification trials in CD in the near future. © 2017 John Wiley & Sons Ltd.

  17. Magnetic resonance imaging in rheumatoid arthritis advances and research priorities

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; McQueen, FM; Bird, P;

    2005-01-01

    Magnetic resonance imaging (MRI) has now been used extensively in cross-sectional and observational studies as well as in controlled clinical trials to assess disease activity and joint damage in rheumatoid arthritis (RA). MRI measurements or scores for erosions, bone edema, and synovitis have been...

  18. Monitoring anti-TNFalpha treatment in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Haavardsholm, E A; Østergaard, Mikkel; Hammer, H B

    2009-01-01

    OBJECTIVES: To evaluate the responsiveness of magnetic resonance imaging (MRI) and ultrasonography (US) compared with conventional measures of disease activity and structural damage in patients with rheumatoid arthritis (RA) during the first year of treatment with anti-tumour necrosis factor alpha...

  19. Systemic immune markers characterizing early stages of rheumatoid arthritis

    NARCIS (Netherlands)

    Chalan, Paulina Luiza

    2016-01-01

    Rheumatoid arthritis is a chronic autoimmune disease occurring in ~1% of the world population. The main feature of the disease is ongoing joint inflammation, caused by immune cells and their soluble factors, leading to irreversible bone erosions and cartilage damage. Early treatment can halt progres

  20. Understanding Rheumatoid Arthritis (RA): Research

    Science.gov (United States)

    ... page please turn JavaScript on. Feature: Understanding Rheumatoid Arthritis (RA) Research Past Issues / Summer 2014 Table of ... project plan to address relevant challenges for rheumatoid arthritis. Read Part 1 on Lupus in MedlinePlus magazine, ...

  1. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... any advice you receive from your rheumatologist. Click A Link Below To Play Rheumatoid Arthritis: Symptoms and ... About Victoria Ruffing, RN Ms. Ruffing has been a member of the Arthritis Center since 2000, currently ...

  2. Handout on Health: Rheumatoid Arthritis

    Science.gov (United States)

    ... that are prone to fracture). Like many other rheumatic diseases, rheumatoid arthritis is an autoimmune disease ( auto means self), so ... arthritis than men. The disease may improve during pregnancy and flare after pregnancy. Breastfeeding may also aggravate ...

  3. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Arthritis Vital Education Initiative Rheumatology Conference Rheumatology Rounds Case Rounds Radiology Rounds Pathophysiology of the Rheumatic Diseases Our Research Patient-Centered Outcomes Research Research Studies The Camille Julia Morgan Arthritis Research and Education ...

  4. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Ruffing has been a member of the Arthritis Center since 2000, currently serving as the Nurse Manager. She is a critical ... Management for Rheumatoid Arthritis Patients Rehabilitation of Older ...

  5. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Adult Rheumatologist Drug Information for Patients Arthritis Drug Information Sheets Benefits and Risks of Opioids in Arthritis Management How to Give a Subcutaneous Injection Connect With ...

  6. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Spondylitis News Osteoarthritis News Gout News Osteoporosis News Lupus News Fibromyalgia News Patient Corner Arthritis Drug Information ... Connect With Us Johns Hopkins Rheumatology Arthritis Center Lupus Center Lyme Disease Clinical Research Center Myositis Center ...

  7. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Spondylitis News Osteoarthritis News Gout News Osteoporosis News Lupus News Fibromyalgia News Patient Corner Arthritis Drug Information ... Connect With Us Johns Hopkins Rheumatology Arthritis Center Lupus Center Lyme Disease Clinical Research Center Myositis Center ...

  8. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... are available, what is happening in the immune system and what other conditions are associated with RA. ... Rheumatoid Arthritis: Additional Conditions Rheumatoid Arthritis: The Immune System Don’t have SilverLight? Get it here. A ...

  9. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Arthritis 101 2010 E.S.C.A.P.E. Study Patient Update Transitioning the JRA Patient to an Adult Rheumatologist Drug Information for Patients Arthritis Drug Information Sheets Benefits and Risks of Opioids in Arthritis Management How ...

  10. Th17 cytokines and arthritis

    NARCIS (Netherlands)

    E.W. Lubberts (Erik)

    2010-01-01

    textabstractTh17 cells are implicated in human autoimmune diseases, such as rheumatoid arthritis (RA), although it has not been established whether this persistent destructive arthritis is driven by Th1 and/or Th17 cells. Interleukin-17A (IL-17A) contributes to the pathogenesis of arthritis as has b

  11. Physical activity in men and women with arthritis National Health Interview Survey, 2002.

    Science.gov (United States)

    Shih, Margaret; Hootman, Jennifer M; Kruger, Judy; Helmick, Charles G

    2006-05-01

    Regular physical activity in persons with arthritis has been shown to decrease pain, improve function, and delay disability. This study estimates the national prevalence of leisure-time physical activity and identifies factors associated with physical inactivity in adults with arthritis. Data from the 2002 National Health Interview Survey were analyzed in 2004-2005 to estimate the proportion of adults with arthritis meeting four physical activity recommendations put forward in Healthy People 2010 and one arthritis-specific recommendation established by a national expert panel in arthritis and physical activity. Multivariate logistic regression was used to evaluate the association between inactivity and sociodemographic factors, body mass index, functional limitations, social limitations, need for special equipment, frequent anxiety/depression, affected joint location, joint pain, physical activity counseling, and access to a fitness facility. Adults with arthritis were significantly less likely than adults without arthritis to engage in recommended levels of moderate or vigorous physical activity, and 37% of adults with arthritis were inactive. In both men and women with arthritis, inactivity was associated with older age, lower education, and having functional limitations; having access to a fitness facility was inversely associated with inactivity. Among women, inactivity was also associated with being Hispanic, non-Hispanic black, having frequent anxiety/depression or social limitations, needing special equipment, and not receiving physical activity counseling. Among men, inactivity was also associated with severe joint pain. Although physical activity is a recommended therapy for people with arthritis, levels among adults with arthritis are insufficient, and those with arthritis have worse activity profiles than their peers without arthritis. Efforts to promote physical activity should include expanding access to evidence-based interventions and recreational

  12. Rat Bite Fever Resembling Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Ripa Akter

    2016-01-01

    Full Text Available Rat bite fever is rare in Western countries. It can be very difficult to diagnose as blood cultures are typically negative and a history of rodent exposure is often missed. Unless a high index of suspicion is maintained, the associated polyarthritis can be mistaken for rheumatoid arthritis. We report a case of culture-positive rat bite fever in a 46-year-old female presenting with fever and polyarthritis. The clinical presentation mimicked rheumatoid arthritis. Infection was complicated by discitis, a rare manifestation. We discuss the diagnosis and management of this rare zoonotic infection. We also review nine reported cases of rat bite fever, all of which had an initial presumptive diagnosis of a rheumatological disorder. Rat bite fever is a potentially curable infection but can have a lethal course if left untreated.

  13. [Juvenile idiopathic arthritis].

    Science.gov (United States)

    Herlin, Troels

    2002-08-19

    The new classification of juvenile idiopathic arthritis (JIA) is described in this review. Clinical characteristics divide JIA in to subtypes: systemic, oligoarticular (persistent and extended type), RF-positive and--negative polyarticular, enthesitis-related arthritis and psoriatic arthritis. In addition to the clinical characteristics, genetic and biochemical differences suggest that JIA could be regarded as a general term covering various diseases. Complications described are uveitis, temporomandibular joint affection and growth disturbances. The therapeutic strategy should be planned individually according to age, subtype and disease activity and carried out as teamwork with several specialties. Drugs showing significant effectiveness in controlled studies are primarily methotrexate and sulphasalazine. An immunomodulating agent, etanercept, a soluble TNF alpha-receptor fusion protein, has shown a promising effect in severe polyarticular JIA refractory to methotrexate treatment.

  14. Dermatoglyphics in rheumatoid arthritis.

    Directory of Open Access Journals (Sweden)

    Ravindranath R

    2003-10-01

    Full Text Available 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.

  15. [Arthritis and clinical history].

    Science.gov (United States)

    Silva, Lígia; Sampaio, Luzia; Pinto, José; Ventura, Francisco S

    2011-01-01

    In front of a patient with arthritis, clinical good-sense tells that the most probable diagnosis are the most prevalent ones. Nevertheless, we have to exclude a multiplicity of other aetiologies, less frequent, but with highest implications in the therapeutic conduct. Infections by Brucella and by Borrelia are rare causes of chronic arthritis, yet are diagnosis to consider, even when the clinical manifestations aren't the most typical, as there still exist endemic areas in Portugal. Here we report two clinical cases about patients with arthritis for more than one year, subject to ineffective exams ant treatments. Only the clinical history could put on evidence clinical-epidemiological data, suggestive of Brucellosis and Lyme Disease, namely the professional contact with infected animals, and the history of probable erythema migrans, that pointed toward the correct diagnosis. So, with directed therapeutic, there was complete resolution of the inflammatory symptoms.

  16. Neonatal Candida arthritis

    Directory of Open Access Journals (Sweden)

    Saurabh Sharma

    2014-01-01

    Full Text Available Fungal arthritis is an uncommon yet serious disorder in the newborn. Delay in diagnosis and management can lead to significant morbidity. We report our experience with management of two such cases. Two preterm neonates with multifocal arthritis caused by Candida were studied. Diagnosis was made by clinical examination, laboratory investigations, radiological investigations and culture. Both were treated by aspiration, arthrotomy and antifungal therapy. One patient recovered fully from the infection while the other had growth disturbances resulting in limb length inequality at recent followup. Prompt and expeditious evacuation of pus from joints and antifungal therapy is imperative for treatment. Associated osteomyelitis leads to further difficulty in treatment.

  17. Psoriatic Arthritis Registries.

    Science.gov (United States)

    Sarzi-Puttini, Piercarlo; Varisco, Valentina; Ditto, Maria Chiara; Benucci, Maurizio; Atzeni, Fabiola

    2015-11-01

    The introduction of new biological drugs for the treatment of rheumatoid arthritis and spondyloarthritis has led to the creation of a number of registries in Europe and the United States. Most of them are sponsored by national rheumatology societies, and provide information that is useful in clinical practice concerning the clinical characteristics, efficacy, and safety of all licensed biological drugs. Their findings also help to improve our understanding of the quality of life and working ability of patients receiving biological drugs, and suggest methods for allocating resources. However, there are only a few registries for psoriatic arthritis, and efforts should be made to increase their number to obtain further reliable and useful data.

  18. Vasculitis and inflammatory arthritis.

    Science.gov (United States)

    Watts, Richard A; Scott, David G I

    2016-10-01

    Vasculitis has been described in most types of inflammatory arthritis. The best described and most widely recognised form is rheumatoid vasculitis. The incidence of systemic rheumatoid vasculitis has declined significantly following the general early use of methotrexate in the 1990s, and it is now a rare form of vasculitis. Treatment of rheumatoid vasculitis is conventionally with glucocorticoids and cyclophosphamide, but there is an increasing role for rituximab similar to that in other types of vasculitis. Despite these developments the mortality of rheumatoid vasculitis remains high. Vasculitis in other types of inflammatory arthritis is less well described and the treatment remains empirical. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Diagnostic sensitivity and specificity of Doppler ultrasound in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Terslev, L.; Recke, P. von der; Torp-Pedersen, S.

    2008-01-01

    Objective. To evaluate the sensitivity and specificity of Doppler ultrasound (DUS) in diagnosing arthritis in the wrist and hands, and, if possible, to define a cutoff level for our ultrasound measures for inflammation, resistive index (RI), and color fraction. Methods. Using DUS, 88 patients...

  20. Gold nephropathy in juvenile rheumatoid arthritis.

    Science.gov (United States)

    Husserl, F E; Shuler, S E

    1979-01-01

    A 2-year-old girl was treated with gold salts for juvenile rheumatoid arthritis. Treatment had to be discontinued when persistent proteinuria was detected. As this case report indicates, close monitoring of the urine is mandatory during treatment with gold salts to detect early signs of toxicity: hematuria followed by casts and then proteinuria as therapy is continued. Histologic examination with electron microscopy will help to differentiate the different forms of gold toxicity. When the findings are consistent with gold-induced renal involvement, therapy should be discontinued. The gold nephropathy usually resolves in time, with no permanent renal damage.

  1. Psoriatic arthritis: treatment strategies using biologic agents

    Directory of Open Access Journals (Sweden)

    C. Palazzi

    2012-06-01

    Full Text Available The traditional management of psoriatic arthritis (PsA includes NSAIDs, corticosteroids and DMARDs. Advancement in the knowledge of the immunopathogenesis of PsA has been associated with the development of biologic agents which have revolutionized the management of the disease. Among biologics drugs, there are the 4 currently availablee anti-TNFα blocking agents (etanercept, infliximab, adalimumab and golimumab which are more effective than traditional DMARDs on symptoms/signs of inflammation, quality of life, function, and in inhibiting the progression of the structural joint damage. Despite of the high cost, TNF inhibitors are costeffective on both the musculoskeletal and skin manifestations of psoriatic disease.

  2. GCF Resistin As A Novel Marker in Patients with Chronic Periodontitis and Rheumatoid Arthritis.

    Science.gov (United States)

    Mittal, Manoj; Hassan, Basit; Desai, Khushboo; Duseja, Shilpa; Kumar, Santosh; Reddy, Sharaschandra G

    2015-04-01

    The associational studies between periodontitis and rheumatoid arthritis are less documented, although they are found to have similar inflammatory pathogenesis. Resistin, a novel adipokine is suggested to be a common link between periodontitis and rheumatoid arthritis. The aim of the present study was to reinforce the inter-relationship between periodontitis and rheumatoid arthritis by using resistin as a potent inflammatory marker. Hundred patients (aged >30 y) of either sex were selected for this study and were divided equally into four groups of 25 patients each. Group A consisted of healthy individuals, Group B consisted of patients with chronic periodontitis, Group C of patients with rheumatoid arthritis and Group D had patients suffering from both arthritis and periodontitis. Periodontal parameters assessed were plaque index (PI), modified gingival index (GI) and probing depth (PD). Panoramic radiographs were taken to confirm the diagnosis of periodontitis. Rheumatoid arthritis was confirmed by the rheumatologists and seropositivity for rheumatoid factor (RF) was checked. Resistin levels were analysed in GCF collected from all the four groups and statistical analysis was done by using Pearson correlation coefficient. The GCF of all the patients showed presence of resistin. The level of resistin was highest in Group D patients and least in Group A patients. On analysing the samples together positive co-relation was found between GCF resistin and PD, PI, GI and RF. Resistin levels are increased in both chronic periodontitis and rheumatoid arthritis. Therefore, the increased level of GCF resistin can be regarded as potential inflammatory marker for periodontitis and rheumatoid arthritis.

  3. Adipokines in psoriatic arthritis patients: the correlations with osteoclast precursors and bone erosions.

    Directory of Open Access Journals (Sweden)

    Yu Xue

    Full Text Available Significant bone remodeling with disordered osteoclastogenesis has been implicated in the pathogenesis of psoriatic arthritis (PsA. And there is a high prevalence of the metabolic syndrome (MS in PsA patients. Adipokines, especially leptin and adiponectin, have recently been reported to be involved in the development and regulation of some autoimmune diseases. In this study, we examined the alternation of circulating osteoclastogenesis related cytokines [tumor necrosis factor-α (TNF-α, osteoprotegerin (OPG and receptor activator of nuclear factor-κB ligand (RANKL] and adipokines (leptin, adiponectin, resistin, chemerin, omentin in PsA patients, and analysed the correlations between these factors and osteoclast precursors numbers, radiographic damage scores, and disease activity index. 41 PsA patients, 20 psoriasis patients, and 24 healthy controls were recruited. Blood samples were obtained for detecting the levels of TNF-α, OPG, RANKL and the adipokines. The numbers of osteoclast precursors (OCs in peripheral blood were assessed. Radiographs of affected joints in PsA patients were scored for erosion, joint-space narrowing, osteolysis, and new bone formation. Compared with healthy controls, patients with PsA had higher TNF-α, RANKL, OCs, leptin and omentin but lower adiponectin and chemerin. Increased serum levels of TNF-α, RANKL, leptin, and omentin were positively correlated with OCs numbers. In contrast, serum adiponectin levels were decreased in PsA patients and negatively correlated with OCs numbers. TNF-α, RANKL and leptin were positively correlated with Psoriatic Arthritis Joint Activity Index (PsAJAI. Only TNF-α was positively correlated with radiographic damage scores. Our data demonstrated that systemic expression of soluble mediators of osteoclastogenesis and adipokines were disordered in PsA. Certain adipokines were elevated in the circulation of patients with PsA and might contribute to pathogenesis of arthritis. Prospective

  4. Arthritis Pain Reliever

    Centers for Disease Control (CDC) Podcasts

    2011-12-27

    Learn more about the benefits of physical activity and the types and amounts of exercise helpful for people with arthritis.  Created: 12/27/2011 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 12/27/2011.

  5. Monitoring rheumatoid arthritis

    NARCIS (Netherlands)

    Gvozdenovic, Emilia

    2016-01-01

    In this thesis we focussed on so-called ‘treat to target’ therapy in rheumatoid arthritis (RA). Treat to target relies on repetitive measurements of disease activity using a composite score that incorporates signs of disease activity such as laboratory results, findings of physical joint assessments

  6. Juvenile arthritis and uveitis.

    Science.gov (United States)

    Kanski, J J

    1990-01-01

    The association between juvenile arthritis and uveitis is reviewed. Some children with the HLA-B27 related spondyloarthropathies develop anterior uveitis. About 20% of patients with juvenile rheumatoid arthritis (JRA) who are negative for IgM rheumatoid factor develop a frequently bilateral, nongranulomatous chronic anterior uveitis. Risk factors for uveitis in JRA patients are: female gender, pauciarticular onset of arthritis, presence of circulating antinuclear antibodies, and the antigens HLA-DW5 and HLA-DPw2. Uveitis is rare after seven years or more have elapsed from the onset of arthritis. The visual prognosis in patients with uveitis is good in 25% and fair in 50%. The remaining 25% develop visual impairment from complicated cataract and/or secondary inflammatory glaucoma. The potential benefit of cytotoxic agents in the treatment of intractable uveitis is outweighed by the risk of serious side effects. The management of secondary inflammatory glaucoma is unsatisfactory, but the results of treatment of complicated cataracts by lensectomy-vitrectomy are good.

  7. Neonatal septic arthritis.

    Science.gov (United States)

    Halder, D; Seng, Q B; Malik, A S; Choo, K E

    1996-09-01

    Neonatal septic arthritis has always been considered as separate from its counterpart in older children. The condition is uncommon but serious. Affected neonates usually survive, but with permanent skeletal deformities. Ten cases of neonatal septic arthritis were diagnosed between January 1989 and December 1993 in the neonatal intensive care units of two referral hospitals in the state of Kelantan, Malaysia. All except one neonate was born prematurely. The mean age of presentation was 15.6 days. Joint swelling (10/10), increased warmth (7/10) and erythema of the overlying skin (7/10) were the common presenting signs. Vague constitutional symptoms preceded the definitive signs of septic arthritis in all cases. The total white cell counts were raised with shift to the left. The knee (60%) was not commonly affected, followed by the hip (13%) and ankle (13%). Three neonates had multiple joint involvement. Coexistence of arthritis with osteomyelitis was observed in seven neonates. The commonest organism isolated was methicillin resistant Staphylococcus aureus (9/10). Needle aspiration was performed in nine neonates and one had incision with drainage. Follow up data was available for five neonates and two of these had skeletal morbidity. Early diagnosis by frequent examination of the joints, prompt treatment and control of nosocomial infection are important for management.

  8. Role of golimumab, a TNF-alpha inhibitor, in the treatment of the psoriatic arthritis

    Directory of Open Access Journals (Sweden)

    Melissa A Michelon

    2010-05-01

    Full Text Available Melissa A Michelon1, Alice B Gottlieb1,21Tufts University School of Medicine, 2Department of Dermatology, Tufts Medical Center, Boston, MA, USAAbstract: Psoriatic arthritis (PsA is an inflammatory arthritis that affects many psoriasis patients and can often have a debilitating disease progression. Golimumab is a new tumor necrosis factor (TNF antagonist recently approved by the FDA for controlling signs and symptoms of psoriatic arthritis. In a Phase III clinical trial in patients with PsA, patients receiving golimumab showed significant improvement in the signs and symptoms of disease. It was usually well tolerated, but adverse events generally occurred more in patients receiving golimumab compared to placebo. Golimumab has also recently shown efficacy in slowing structural damage in PsA. This new biologic therapy provides physicians with another option in the treatment of this inflammatory arthritis while offering patients certain advantages over other TNF antagonists.Keywords: golimumab, psoriatic arthritis, TNF-alpha inhibitor

  9. A population-based study on the association between rheumatoid arthritis and voice problems.

    Science.gov (United States)

    Hah, J Hun; An, Soo-Youn; Sim, Songyong; Kim, So Young; Oh, Dong Jun; Park, Bumjung; Kim, Sung-Gyun; Choi, Hyo Geun

    2016-07-01

    The objective of this study was to investigate whether rheumatoid arthritis increases the frequency of organic laryngeal lesions and the subjective voice complaint rate in those with no organic laryngeal lesion. We performed a cross-sectional study using the data from 19,368 participants (418 rheumatoid arthritis patients and 18,950 controls) of the 2008-2011 Korea National Health and Nutrition Examination Survey. The associations between rheumatoid arthritis and organic laryngeal lesions/subjective voice complaints were analyzed using simple/multiple logistic regression analysis with complex sample adjusting for confounding factors, including age, sex, smoking status, stress level, and body mass index, which could provoke voice problems. Vocal nodules, vocal polyp, and vocal palsy were not associated with rheumatoid arthritis in a multiple regression analysis, and only laryngitis showed a positive association (adjusted odds ratio, 1.59; 95 % confidence interval, 1.01-2.52; P = 0.047). Rheumatoid arthritis was associated with subjective voice discomfort in a simple regression analysis, but not in a multiple regression analysis. Participants with rheumatoid arthritis were older, more often female, and had higher stress levels than those without rheumatoid arthritis. These factors were associated with subjective voice complaints in both simple and multiple regression analyses. Rheumatoid arthritis was not associated with organic laryngeal diseases except laryngitis. Rheumatoid arthritis did not increase the odds ratio for subjective voice complaints. Voice problems in participants with rheumatoid arthritis originated from the characteristics of the rheumatoid arthritis group (higher mean age, female sex, and stress level) rather than rheumatoid arthritis itself.

  10. REGIONAL RADIOGRAPHIC DAMAGE AND FUNCTIONAL LIMITATIONS IN PATIENTS WITH ANKYLOSING SPONDYLITIS: DIFFERENCES IN EARLY AND LATE DISEASE

    Science.gov (United States)

    Ward, Michael M.; Learch, Thomas J.; Gensler, Lianne S.; Davis, John C.; Reveille, John D.; Weisman, Michael H.

    2012-01-01

    Objective Radiographic damage and functional limitations both increase with the duration of ankylosing spondylitis (AS). We examined whether radiographic damage contributed more to functional limitations in late AS than in early AS, and if the strength of association varied with the anatomic region of damage. Methods In this cross-sectional study of 801 patients with AS, we examined associations of the lumbar modified Stoke AS Spine Score (mSASSS), cervical mSASSS, lumbar posterior fusion, cervical posterior fusion, and hip arthritis with the Bath AS Functional Index (BASFI) and the Health Assessment Questionnaire (HAQ-S). Results Higher lumbar and cervical mSASSS were associated with more functional limitations, but there was an interaction between mSASSS and the duration of AS such that the strength of their association with functional limitations decreased with increasing duration of AS. Cervical posterior fusion was associated with worse functioning independent of mSASSS. Hip arthritis was significantly associated with functional limitations independent of measures of spinal damage. Among patients with AS ≥ 40 years, the number of comorbid conditions accounted for most of the variation in functioning. Results were similar for both the BASFI and HAQ-S. Conclusions Although both radiographic damage and functional limitations increase over time in AS, the relative contribution of radiographic damage to functional limitations is lower among patients with longstanding AS than early AS, suggesting patients may accommodate to limited flexibility. Damage in different skeletal regions impacts functioning over the duration of AS. Functional limitations due to comorbidity supervene in late AS. PMID:23042639

  11. Genetics Home Reference: juvenile idiopathic arthritis

    Science.gov (United States)

    ... Home Health Conditions juvenile idiopathic arthritis juvenile idiopathic arthritis Printable PDF Open All Close All Enable Javascript ... view the expand/collapse boxes. Description Juvenile idiopathic arthritis refers to a group of conditions involving joint ...

  12. Rheumatoid Arthritis: Can It Affect the Eyes?

    Science.gov (United States)

    ... arthritis: Can it affect the eyes? Can rheumatoid arthritis affect the eyes? Answers from April Chang-Miller, M.D. Rheumatoid arthritis is a chronic inflammatory disease that primarily affects ...

  13. Rheumatoid Arthritis and Complementary Health Approaches

    Science.gov (United States)

    ... T U V W X Y Z Rheumatoid Arthritis: In Depth Share: On This Page Key Points ... help ensure coordinated and safe care. About Rheumatoid Arthritis Rheumatoid arthritis is an inflammatory autoimmune disease—a ...

  14. Accommodation and Compliance Series: Employees with Arthritis

    Science.gov (United States)

    ... Resources Home | Accommodation and Compliance Series: Employees with Arthritis By Beth Loy, Ph.D. Preface Introduction Information ... SOAR) at http://AskJAN.org/soar . Information about Arthritis How prevalent is arthritis? An estimated 50 million ...

  15. Rheumatoid Arthritis: Can It Affect the Lungs?

    Science.gov (United States)

    ... arthritis: Can it affect the lungs? Can rheumatoid arthritis affect your lungs? Answers from April Chang-Miller, M.D. Although rheumatoid arthritis primarily affects joints, it sometimes causes lung disease ...

  16. EXTRACORPOREAL PHOTOCHEMOTHERAPY IN PSORIASIS AND PSORIATIC ARTHRITIS

    Directory of Open Access Journals (Sweden)

    E. S. Yakubovskaya

    2016-01-01

    Full Text Available Background: Psoriasis is the most prevalent chronic dermatosis of an autoimmune origin that is characterized by increasing incidence of both severe clinical forms and complications, the most threatening of which is psoriatic arthritis. Its treatment includes aromatic retinoids, immunosuppressant therapies (immunosuppressant agents, glucocorticosteroids, PUVA-therapy and other methods. However, these are insufficiently effective in clinical practice and are frequently associated with serious adverse reactions and complications. Aim: To increase the efficacy of treatment for psoriasis associated with psoriatic arthritis by means of incorporation of a new immunobiological method, the extracorporeal photochemotherapy (EPCT into the standard treatment protocol. Materials and methods: We conducted a  prospective cohort study with an active control. Seventy patients with various forms of psoriasis associated with psoriatic arthritis were randomized with stratifi-cation into two groups. The patients of the main group (n = 35 were treated with EPCT, whereas those from the control group (n = 35 received the standard treatment. The EPCT method included isolation of mononuclear cells preliminary sensitized with 8-methoxypsoralen with a cell separator Haemonetics MCS+. After the cell suspension was treated with UV А  (λ = 320–400  nm, it was re-infused to the patient. The treatment course included 4 sessions performed every other day. Results: The analysis of clinical efficacy of EPCT in the combination treatment of psoriasis associated with psoriatic arthritis demonstrated that in the majority of cases a  significant therapeutic effect was achieved. The mean PASI index decreased from 28.5 ± 1.63 to 6.6 ± 1.7 (p < 0.05, the activity of psoriatic arthritis (DAS score, from 3.7 ± 0.35 to 1.7 ± 0.36 (p < 0.05. This significant treatment effect was associated with a  decreased correlation between expression of activation molecules HLADr by

  17. Application physiotherapy in rehabilitation rheumatoid arthritis

    OpenAIRE

    Nogas, Angela; Grygus, Igor; Prymachok, Liudmyla

    2016-01-01

    Nogas Angela, Grygus Igor, Prymachok Liudmyla. Application physiotherapy in rehabilitation rheumatoid arthritis. Journal of Education, Health and Sport. 2016;6(11):184-194. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.166045 http://ojs.ukw.edu.pl/index.php/johs/article/view/3985       The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 755 (23.12.2015). 755 Journal of Education, Health and Sport eISSN 239...

  18. The comparisons between thermography and ultrasonography with physical examination for wrist joint assessment in juvenile idiopathic arthritis.

    Science.gov (United States)

    Lerkvaleekul, Butsabong; Jaovisidha, Suphaneewan; Sungkarat, Witaya; Chitrapazt, Niyata; Fuangfa, Praman; Ruangchaijatuporn, Thumanoon; Vilaiyuk, Soamarat

    2017-03-01

    This study aimed to assess infrared thermography (IRT) and ultrasonography (US) for detecting wrist arthritis in juvenile idiopathic arthritis (JIA) patients. Although IRT could help us detecting joint inflammation, IRT studies in JIA patients with wrist arthritis are still limited. Currently, no validated US criteria exist for detecting arthritis, and the most useful parameters between Gray-scale ultrasound (GSUS) or Power Doppler ultrasound (PDUS) remain unclear. Therefore, this study focused on detecting wrist arthritis in varying degrees using IRT and US compared with physical examination. Of 46 JIA patients, 16 had previous wrist arthritis but currently inactive, 30 still had wrist arthritis, and the median ages (IQR) were 7.7 (4.3) and 10.2 (4.8) years respectively. Fifteen healthy participants were included, with a median age (IQR) of 9.2 (2.0) years. Using IRT, mean temperature (Tmean) and maximum temperature (Tmax) at skin surface in the region of interest (ROI) in the arthritis group were higher than in the inactive group and the healthy controls with p examination, the moderate to severe arthritis had Tmean and Tmax higher than the mild arthritis group with statistical significance. The Heat Distribution Index (HDI), two standard deviations of all pixel temperature values in the ROI, in the moderate to severe arthritis group was higher than in the healthy controls (p = 0.027). The receiver operating characteristic analysis in arthritis detection revealed diagnostic sensitivity of 85.7% and 71.4% and specificity of 80.0% and 93.3% at a cut-off points of Tmean ≥ 31.0 C and Tmax ≥ 32.3 C respectively. For US, GSUS and PDUS are useful in detecting arthritis, providing high sensitivity (83.3%) and specificity (81.3%). Our study demonstrated that both IRT and US were applicable tools for detecting wrist arthritis.

  19. Study of serum Malondialdehyde, Nitric oxide, Vitamin E levels in patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Jambale Triveni A, Halyal SS, Jayaprakash Murthy DS

    2014-04-01

    Full Text Available Background: Rheumatoid arthritis (RA is a chronic progressive autoimmune disorder characterized by symmetric erosive synovitis and sometimes shows multisystem involvement. The long-term outcome of the disease is characterized by significant morbidity and increased mortality. Elevated free radical generations in inflamed joints and impaired antioxidant system have been implicated in RA. Nitric oxide (NO can also induce tissue damage, especially after conversion into peroxynitrite radical (ONOO·. Aims: To estimate the serum levels of MDA, Nitric Oxide (NO and Vitamin E in patients with Rheumatoid Arthritis. Materials and Methods: The study includes 50 RA patients who were fulfilling the American Rheumatism Association 1987 revised criteria for classification of RA and 50 age and sex matched healthy subjects without any major illness were considered as controls. MDA, NO and Vitamin E were estimated in serum. Results: The estimated mean levels (mean ± SD of serum MDA, NO, Vitamin E, in control group were 3.55 ± 0.30, 36.23 ± 7.03, 14.61 ± 1.74, respectively and in patients with RA they were 5.39 ± 0.79, 78.81 ± 8.56, 10.56 ± 1.72, respectively. The statistical analysis by unpaired t-test shows that the levels of serum MDA and NO significantly increased (p< 0.001 and the vitamin E levels were significantly decreased (p < 0.001 in RA patients when compared to healthy controls. Conclusion: The serum values of MDA, NO and Vitamin E all together provided fairly useful index of oxidative stress in RA patients. The results of current study support the concept of oxidative stress leading to tissue damage.

  20. Periodontitis and rheumatoid arthritis: A search for causality and role of Porphyromonas gingivalis

    OpenAIRE

    de Smit, Menke

    2015-01-01

    There is currently much attention for early detection of rheumatoid arthritis, as early recognition enables timely treatment with a chance of remission of the disease before irreversible damage has occurred. In this respect, important questions are: who will develop rheumatoid arthritis, when and why? The main research question of this thesis was if chronic bacterial infection of oral soft- and hard tissues (periodontitis), in particular with the periodontal pathogen Porphyromonas gingivalis,...

  1. Elbow septic arthritis associated with pediatric acute leukemia: a case report and literature review.

    Science.gov (United States)

    Uemura, Takuya; Yagi, Hirohisa; Okada, Mitsuhiro; Yokoi, Takuya; Shintani, Kosuke; Nakamura, Hiroaki

    2015-01-01

    Acute leukemia in children presents with various clinical manifestations that mimic orthopaedic conditions. The association of septic arthritis of the elbow with acute leukemia is very rare, and the correct diagnosis of acute leukemia is often established only after treatment of the septic arthritis. In this article, we present a three-year-old child patient with elbow septic arthritis related to acute leukemia, diagnosed promptly by bone marrow aspiration on the same day as emergency surgical debridement of the septic elbow joint due to the maintenance of a high index of suspicion, and treated with chemotherapy as soon as possible. The emergency physician and orthopaedist must recognize unusual patterns of presentation like this. Since delay in initiating treatment of septic arthritis may result in growth disturbance, elbow septic arthritis associated with pediatric acute leukemia must be treated promptly and appropriately. Early diagnosis is a good prognostic feature of childhood acute leukemia.

  2. S100-alarmins: potential therapeutic targets for arthritis.

    Science.gov (United States)

    Austermann, Judith; Zenker, Stefanie; Roth, Johannes

    2017-07-01

    In arthritis, inflammatory processes are triggered by numerous factors that are released from joint tissues, promoting joint destruction and pathological progression. During inflammation, a novel family of pro-inflammatory molecules called alarmins is released, amplifying inflammation and joint damage. Areas covered: With regard to the role of the alarmins S100A8 and S100A9 in the pathogenesis of arthritis, recent advances and the future prospects in terms of therapeutic implications are considered. Expert opinion: There is still an urgent need for novel treatment strategies addressing the local mechanisms of joint inflammation and tissue destruction, offering promising therapeutic alternatives. S100A8 and S100A9, which are the most up-regulated alarmins during arthritis, are endogenous triggers of inflammation, defining these proteins as promising targets for local suppression of arthritis. In murine models, the blockade of S100A8/S100A9 ameliorates inflammatory processes, including arthritis, and there are several lines of evidence that S100-alarmins may already be targeted in therapeutic approaches in man.

  3. Subtalar joint septic arthritis in a patient with hypogammaglobulinemia.

    Science.gov (United States)

    Wynes, Jacob; Harris, William; Hadfield, Robert A; Malay, D Scot

    2013-01-01

    The clinical presentation of a monoarticular, red, hot, and swollen joint has many possible diagnoses, including septic arthritis, which is 1 of the most devastating. The morbidity associated with this pathologic process involves permanent joint damage and the potential for progression to systemic illness and, even, mortality. The common risk factors for joint sepsis include a history of rheumatoid arthritis, previous joint surgery, joint prosthesis, intravenous drug abuse, alcoholism, diabetes, previous intra-articular steroid use, and cutaneous ulceration. The diagnosis is primarily determined from the culture results after arthrocentesis and correlation with direct visualization, imaging, and various serologies, including synovial analysis. In the present report, a case of an insidious presentation of subtalar joint septic arthritis and its association with a unique patient presentation concomitant with primary immunodeficiency and culture-proven Myocplasma hominis infection is discussed. Septic arthritis has a predilection for the lower extremities and typically is isolated to the hip or knee, with less common involvement of the ankle or metatarsophalangeal joints. Owing to the uncommon nature of primary immunodeficiency disorders and the paucity of studies discussing their association with septic arthridites, we aimed to raise awareness of subtalar joint septic arthritis and to provide a brief overview of the pathogenesis as it presented in a 33-year-old male with X-linked hypogammaglobulinemia/agammaglobulinema.

  4. Treatment strategies in surgery for rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Trieb, Klemens [Department of Orthopaedics, Klinikum Kreuzschwestern, Grieskirchnerstr 42, 4600 Wels (Austria)], E-mail: klemens.trieb.co@klinikum-wegr.at; Hofstaetter, Stefan G. [Department of Orthopaedics, Klinikum Kreuzschwestern, Grieskirchnerstr 42, 4600 Wels (Austria)

    2009-08-15

    Rheumatoid arthritis due to the chronic inflammation of the synovial joints leads to permanent articular cartilage and bone damage. Subsequent instability and mutilation of the joint might happen, and the resulting joint pain and stiffness cause impaired function. The degree of damage is traditionally assessed by radiograph and represents a clinical tool for the evaluation of both disease progression and the effectiveness of interventional therapy. The classification of destruction is therefore done with radiograph and the assessment of the clinical picture. Depending on the radiologic stage different therapy concepts, ranging from conservative to operative, are established. It is the goal of surgery to restore motion and function in a painless joint. Surgery can be done to prevent the joint from further destruction or to replace the joint after resection. Different concepts based on radiologic findings are presented in this review.

  5. Pain in rheumatoid arthritis: a critical review

    Directory of Open Access Journals (Sweden)

    P. Sarzi-Puttini

    2014-06-01

    Full Text Available Patients with rheumatoid arthritis (RA are frequently afflicted by pain, which may be caused by joint inflammation (leading to structural joint damage or secondary osteoarthritis, and may be increased by central sensitisation. Non-inflammatory pain may also confuse the assessment of disease activity, and so the aim of treatment is not only to combat inflammatory disease, but also relieve painful symptoms. In order to ensure effective treatment stratification, it is necessary to record a patients medical history in detail, perform a physical examination, and objectively assess synovitis and joint damage. The management of pain requires various approaches that include pharmacological analgesia and biological and non-biological treatments. Although joint replacement surgery can significantly improve RA-related pain, it may only be available to patients with the most severe advanced disease.

  6. Clinical management of septic arthritis.

    Science.gov (United States)

    Sharff, Katie A; Richards, Eric P; Townes, John M

    2013-06-01

    Septic arthritis is a rheumatologic emergency as joint destruction occurs rapidly and can lead to significant morbidity and mortality. Accurate diagnosis can be particularly challenging in patients with underlying inflammatory joint disease. This review outlines the risk factors for septic arthritis and summarizes the causative bacterial organisms. We highlight advances in antibiotic management with a focus on new drugs for methicillin-resistant Staphylococcus aureus (MRSA) and discuss the use of adjunctive therapies for treatment of septic arthritis in adults.

  7. Macrophages - silent enemies in juvenile idiopathic arthritis.

    Science.gov (United States)

    Świdrowska-Jaros, Joanna; Orczyk, Krzysztof; Smolewska, Elżbieta

    2016-07-06

    The inflammatory response by secretion of cytokines and other mediators is postulated as one of the most significant factors in the pathophysiology of juvenile idiopathic arthritis (JIA). The effect of macrophage action depends on the type of their activation. Classically activated macrophages (M1) are responsible for release of molecules crucial for joint inflammation. Alternatively activated macrophages (M2) may recognize self antigens by scavenger receptors and induce the immunological reaction leading to autoimmune diseases such as JIA. Molecules essential for JIA pathophysiology include: TNF-α, the production of which precedes synovial inflammation in rheumatoid arthritis; IL-1 as a key mediator of synovial damage; chemotactic factors for macrophages IL-8 and MCP-1; IL6, the level of which correlates with the radiological joint damage; MIF, promoting the secretion of TNF-α and IL-6; CCL20 and HIF, significant for the hypoxic synovial environment in JIA; GM-CSF, stimulating the production of macrophages; and IL-18, crucial for NK cell functions. Recognition of the role of macrophages creates the potential for a new therapeutic approach.

  8. Effect of kidney damage indicators on ankle-brachial index of patients with chronic kidney disease%慢性肾脏病患者肾脏损伤指标对踝臂指数的影响

    Institute of Scientific and Technical Information of China (English)

    牛福坤; 阎磊; 邵凤民

    2012-01-01

    目的:探讨慢性肾脏病(CKD)患者肾脏损伤指标对踝臂指数(ABI)的影响.方法:收集295例CKD患者及体检中心170例无CKD的对照人群的资料,对2组尿白蛋白/肌酐比值(ACR)、估计肾小球滤过率(eGFR)与ABI进行logistic回归分析.结果:对CKD患者进行的多变量logistic回归分析显示,在校正了传统的心血管危险因素后,ACR与eGFR<60 mL/(min·1.73m2)均是低ABI的独立危险因素,OR(95%CI)分别为1.065(1.022~1.105)和1.122(1.032~2.577).结论:高ACR与低 eGFR可能导致CKD患者ABI降低.%Aim:To explore the effect of kidney damage indicators on abnormal ankle-brachial index( ABI ) of patients with chronic kidney disease( CKD ). Methods:A total of 295 patients with CKD and 170 non-CKD participants were enrolled. Association between kidney damage indicators, including estimated glomerular filtration rate ( eGFR ) and urinary albumin to creatinine ratio( ACR ) and abnormal ABI were analyzed by multivariable logistic regression model. Results: After adjusting for traditional cardiovascular risk factors among patients with CKD, ACR and eGFR were both independently associated with low ABI,OR( 95% CI) was 1.065( 1.022 ~ 1. 105 ) and 1. 122( 1.032~2.577 ),respectively. Conclusion: High ACR and low eGFR may induce low ABI of CKD patients.

  9. Significant improvement in synovitis, osteitis, and bone erosion following golimumab and methotrexate combination therapy as compared with methotrexate alone: A magnetic resonance imaging study of 318 methotrexate-naive rheumatoid arthritis patients

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Emery, Paul; Conaghan, Philip G;

    2011-01-01

    To evaluate the effects of golimumab on inflammation/structural damage detected by magnetic resonance imaging (MRI) in patients with rheumatoid arthritis (RA).......To evaluate the effects of golimumab on inflammation/structural damage detected by magnetic resonance imaging (MRI) in patients with rheumatoid arthritis (RA)....

  10. Relationship Between Disease Activity and Hearing Loss in Rheumatoid Arthritis Patients A Case Control Study

    Directory of Open Access Journals (Sweden)

    Ilham RKAIN

    2016-06-01

    Full Text Available ObjectivesRheumatoid arthritis (RA is well known to affect many different organ systems. Previous work suggests that this includes the auditory system.The objectives of this work are to evaluate the pattern of hearing impairment in patients with rheumatoid arthritis and also to examine the possible associations between hearing impairment and related RA features especially disease activity.Materials and methodsThirty RA patients (mean age of 44.5 ± 9.9 years; female sex (90% and 17 healthy controls (mean age of 41.5±9.1 years; female sex (76.4% were included in our study. The 2 groups were matched for age and sex (p>0.05. Otoscopic examination was normal in all participants.No subject of the 2 groups has had any abnormalities at otoscopic examination. Hearing impairment was evaluated by pure tone audiometry and tympanometry including the static compliance, middle ear pressure, stapedial reflex threshold test. In all patients the clinical features, laboratory data, X-rays, disease activity index-DAS 28 were performed.ResultsHearing loss was more prevalent in RA patients compared to healthy controls (56.7 vs 11.8%; p=0.005. RA patients have conductive, sensorineural and mixed hearing loss in respectively 43.4, 3.3 and 10 % of cases. Association analysis between hearing characteristics and remission in RA patients shows that RA patients in remission have significantly lower mean hearing thresholds (12.8±5.2dB vs 18.8±6.9 dB ; p=0.04.ConclusionThis study suggests that hearing loss risk is higher in RA patients and seems to be associated to disease duration. Hearing loss in RA was directly proportional to the disease activity index-DAS 28. Audiological evaluation must be performed periodically to identify possible audiological damage.

  11. PULMONARY INVOLVEMENT IN RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    D. V. Bestaev

    2014-01-01

    Full Text Available Rheumatoid arthritis (RA is an autoimmune disease with erosive and destructive polyarthritis and systemic manifestations. Pulmonary involvement (PI is common in RA. With high-resolution computed tomography, the detection rate of PI in RA is as high as 50%. PI is a direct cause of death in 10–20% of patients with RA. Autoimmune mechanisms play a leading part in the development of PI in RA. Under the hypothesis advanced by M. Selman et al., that impaired alveolocyte regeneration processes after injury rather inflammation underlie the pathogenesis of pulmonary fibrosis. The pathological process is triggered by damaged alveolocytes and characterized by the migration and proliferation of fibroblasts and myofibroblasts, the suppressed apoptosis of the latter, and the enhanced activity of pneumofibrosis-stimulating cytokines. This gives rise to remodeling of the extracellular matrix, including destruction of the basement membrane, angiogenesis, and fibrosis. The paper considers the types of lung injury in RA and main methods for diagnosis and therapy.

  12. Risks and benefits of low-dosage cyclosporin in rheumatoid arthritis.

    Science.gov (United States)

    Pasero, G; Ferraccioli, G F; Portioli, I

    1997-05-01

    The effects of cyclosporin on the activity of rheumatoid arthritis have mainly been investigated in patients with active, refractory, long-standing disease. The data obtained in these trials suggest that cyclosporin is not only a symptomatic treatment for rheumatoid arthritis but can also be considered a disease-modifying antirheumatic drug (DMARD), since it seems to be capable of slowing the progression of cartilage and bone damage due to rheumatoid arthritis. The trials conducted so far have led to a better understanding of cyclosporin toxicity and, therefore, to better monitoring of patients in order to avoid it. The reasons for studying the role of cyclosporin in patients with early, active and potentially severe rheumatoid arthritis are the poor prognosis of the disease despite the use of the presently available DMARDs, and the hypothesis that the drug is more efficacious and better tolerated in early rheumatoid arthritis. A new classification of antirheumatic drugs proposes that disease-controlling antirheumatic therapies decrease inflammatory synovitis and prevent structural joint damage or significantly reduce its rate of progression. However, few existing drugs meet these criteria. The 12-month results of a disease-controlling antirheumatic therapy clinical trial with a blinded radiological end-point, named GRISAR (Gruppo Reumatologi Italiani Studio Artrite Reumatoide) comparing cyclosporin with conventional DMARDs in patients with early rheumatoid arthritis provide strong evidence that cyclosporin offers better control of ongoing joint damage than do conventional DMARDs.

  13. Análise dos índices de Helkimo e craniomandibular para diagnóstico de desordens temporomandibulares em pacientes com artrite reumatóide Analysis of helkimo and craniomandibular indexes for temporomandibular disorder diagnosis on rheumatoid arthritis patients

    Directory of Open Access Journals (Sweden)

    Suzana C. da Cunha

    2007-02-01

    Full Text Available OBJETIVO: O estudo teve como finalidade avaliar a utilização de dois índices (Helkimo e craniomandibular para o diagnóstico da desordem temporomandibular (DTM em pacientes com Artrite Reumatóide (AR. MATERIAIS E MÉTODOS: A amostra foi de 80 pacientes divididos em dois grupos: pacientes com AR e pacientes sem AR. Em ambos os grupos os dois índices foram utilizados. No diagnóstico da DTM foram avaliados os seguintes sinais e sintomas: dor na ATM; limitação de abertura de boca e ruídos articulares. RESULTADOS: Os resultados mostram que dos pacientes com AR 87,1% eram do gênero feminino e 12,9% do masculino. Entre os pacientes sem AR, 70% eram do gênero feminino e 30% do masculino. A idade dos pacientes com AR variou de 24 a 78 anos. Entre os pacientes sem AR, a idade variou de 22 a 72 anos. Foi verificado que a prevalência de DTM foi mais elevada no grupo de pacientes com AR (98,6% - Helkimo e 87,1% - craniomandibular do que no grupo sem a doença (80% - Helkimo e 50% - craniomandibular. CONCLUSÃO: Em resumo, temos que ambos os índices são capazes de diagnosticar a desordem temporomandibular em pacientes com AR, entretanto o Índice de Helkimo é menos preciso.AIM: The aim of this study was to evaluate the use of two indexes (Helkimo and Craniomandibular for the diagnosis of temporomandibular disorder (TMD in patients with Rheumatoid Arthritis (RA. PATIENTS AND METHODS: The sample was composed of 80 patients divided into two groups: patients with RA and patients without RA. In both groups the two indexes were used. For TMD diagnosis, the following signs and symptoms were evaluated: TMJ pain, limited mouth opening and joint sounds. RESULTS: Results showed that of the RA patients, 87.1% were females and 12.9% were males. Among the patients without RA, 70% were females and 30% were males. The age of these RA patients ranged between 24 and 78 years. Among patients without RA, the age of the patients ranged between 22 and 72 years. It

  14. Surgical Procedures Needed to Eradicate Infection in Knee Septic Arthritis.

    Science.gov (United States)

    Dave, Omkar H; Patel, Karan A; Andersen, Clark R; Carmichael, Kelly D

    2016-01-01

    Septic arthritis of the knee is encountered on a regular basis by orthopedists and nonorthopedists. No established therapeutic algorithm exists for septic arthritis of the knee, and there is much variability in management. This study assessed the number of surgical procedures, arthroscopic or open, required to eradicate infection. The study was a retrospective analysis of 79 patients who were treated for septic knee arthritis from 1995 to 2011. Patients who were included in the study had native septic knee arthritis that had resolved with treatment consisting of irrigation and debridement, either open or arthroscopic. Logistic regression analysis was used to explore the relation between the interval between onset of symptoms and index surgery and the use of arthroscopy and the need for multiple procedures. Fifty-two patients met the inclusion criteria, and 53% were male, with average follow-up of 7.2 years (range, 1-16.2 years). Arthroscopic irrigation and debridement was performed in 70% of cases. On average, successful treatment required 1.3 procedures (SD, 0.6; range, 1-4 procedures). A significant relation (P=.012) was found between time from presentation to surgery and the need for multiple procedures. With arthroscopic irrigation and debridement, most patients with septic knee arthritis require only 1 surgical procedure to eradicate infection. The need for multiple procedures increases with time from onset of symptoms to surgery.

  15. Imaging of Posttraumatic Arthritis, Avascular Necrosis, Septic Arthritis, Complex Regional Pain Syndrome, and Cancer Mimicking Arthritis.

    Science.gov (United States)

    Rupasov, Andrey; Cain, Usa; Montoya, Simone; Blickman, Johan G

    2017-09-01

    This article focuses on the imaging of 5 discrete entities with a common end result of disability: posttraumatic arthritis, a common form of secondary osteoarthritis that results from a prior insult to the joint; avascular necrosis, a disease of impaired osseous blood flow, leading to cellular death and subsequent osseous collapse; septic arthritis, an infectious process leading to destructive changes within the joint; complex regional pain syndrome, a chronic limb-confined painful condition arising after injury; and cases of cancer mimicking arthritis, in which the initial findings seem to represent arthritis, despite a more insidious cause. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Effect of Semecarpus anacardium Linn. nut milk extract on rat neutrophil functions in adjuvant arthritis.

    Science.gov (United States)

    Ramprasath, V R; Shanthi, P; Sachdanandam, P

    2006-01-01

    Neutrophils play an important role in the pathogenesis of rheumatoid arthritis (RA) and various inflammatory conditions, by accumulation and liberation of active proteolytic enzymes. The effect of milk extract of Semecarpus anacardium Linn. nuts (SA) at a dosage of 150 mg kg(-1) body weight day(-1) for 14 days on adjuvant arthritis was studied to gain some insight into this intriguing disease in relation to neutrophil functions. The decreased phagocytic function of neutrophils (phagocytic index and avidity index) found in adjuvant arthritis was significantly increased by the administration of the drug SA. Increased levels of reactive oxygen species (superoxide radical, hydroxyl radical, H2O2 and myeloperoxidase), lysosomal enzymes (acid phosphatase and cathepsin D) and increased accumulation of neutrophils in the joints observed in adjuvant arthritic animals were reverted back to near normal levels by treatment with SA. The results of this study indicate that SA can be considered to be a good therapeutic agent for inflammation and arthritis.

  17. Cardiovascular risk factors in patients with rheumatoid arthritis in combination with hypertension depending on body weight

    Directory of Open Access Journals (Sweden)

    Sіrenko O.Yu.

    2014-11-01

    Full Text Available The objective was to evaluate the frequency of cardiovascular risk factors and hypertension in patients with rheumatoid arthritis depending on body weight. The study involved 100 patients with rheumatoid arthritis and stably selected therapy for more than 6 months at the age from 45 to 65 years (mean age 53,19 ± 5,40 years. Traditional cardiovascular risk was assessed, taking into account risk factors by SCORE scale and amended for patients with RA. The levels of total cholesterol, triglycerides, C-reactive protein, serum creatinine, body mass index, body area index were determined. Arterial hypertension was diagnosed in 41 (41% patients with rheuma¬toid arthritis and was associated with traditional risk factors (age, obesity, rheumatoid factor, hyperuricemia and the duration of glucocorticoid therapy. Obesity and excess body mass occurred in the majority of patients with rheumatoid arthritis, herewith the highest level of inflammation indicators and risk of cardiovascular events was in overweight patients. Obesity was associated with duration of rheumatoid arthritis, the activity of the inflammatory process, the duration of glucocorticoids taking. It is found that the traditional SCORE scale does not fully reflect the risk of cardiovascular events in rheumatoid arthritis. Identification of hypertension and obesity increases the information content of the risk assessment of cardiovascular events in rheumatoid arthritis.

  18. Damage Distributions

    DEFF Research Database (Denmark)

    Lützen, Marie

    2001-01-01

    the damage location, the damage sizes and the main particulars of the struck vessel. From the numerical simulation and the analyse of the damage statistics it is found that the current formulation from the IMO SLF 43/3/2 can be used as basis for determination of the p-, r-, and v-factors. Expressions...... and methods of calculation have been discussed. The damage distributions for the different vessels have been compared and analyses regarding relations between damage parameters and main particulars have been performed. The damage statistics collected in work package 1 have been analysed for relations between...... for the distribution of the non-dimensional damage location, the non-dimensional damage length and the non-dimensional penetrations have been derived. These distributions have been used as basis for a proposal for the p- and r-factors. Two proposals for the v-factor have been performed using the damage statistics...

  19. Laboratory findings in psoriatic arthritis.

    Science.gov (United States)

    Punzi, L; Podswiadek, M; Oliviero, F; Lonigro, A; Modesti, V; Ramonda, R; Todesco, S

    2007-01-01

    Psoriatic arthritis (PsA) has been classically defined as an inflammatory arthritis associated with psoriasis. However, in comparison with other relevant inflammatory arthropathies, in which a definite diagnosis is frequently possible only by means of laboratory investigations, in PsA true laboratory diagnostic markers are lacking. Some markers are utilised more to differentiate other diseases than to characterise PsA. For example in polyarticular PsA, which may be in some cases indistinguishable from RA, the rheumatoid factor (RF) or the more specific and recently introduced antibodies to cyclic citrullinated peptides (anti-CCP), may be useful to better identify RA. However, RF was found in 5% to 13% of patients with PsA, and anti-CCP may be observed in almost similar percentage. The determination of ESR and/or CRP is frequently disappointing in PsA, since they are both elevated in only half of the patients with PsA. However, ESR and/or CRP are included in the most utilised response criteria for RA, such as ACR and DAS, and, in addition are also considered reliable in the assessment of PsA. Furthermore, elevated levels of ESR have been proposed as one of the best predictors of damage progression and, in addition, a low ESR seems protective, while an ESR >15 mm/h is one of the factors associated with an increased mortality in PsA. The synovial fluid (SF) effusion is much higher in PsA, in comparison with other arthropathies. When available, SF analysis may offer additive information useful for the diagnosis, such as the increased number of leukocytes, which underlines the inflammatory nature of the effusion even in a patient with normal serum levels of acute phase response. We found that elevated IL-1 levels in SF of patients with early disease (anti-TNF-alpha agents and the demonstration of their efficacy in the management of many clinical disease expressions including peripheral arthropathy, axial involvement, enthesopathy and skin manifestations, have stimulated

  20. Bone mineral density in patients with juvenile idiopathic arthritis

    Directory of Open Access Journals (Sweden)

    Sušić Gordana

    2009-01-01

    Full Text Available Introduction. It is well known that juvenile idiopathic arthritis (JIA as a chronic inflammatory disease with onset during the childhood, beside other complication, can lead to bone metabolism disturbance and osteoporosis. Objective. To assess bone mineral density (BMD in children with JIA and to identify factors playing role in bone mineral disturbance. Methods. Seventy-five patients (26 male and 49 female average disease duration 7.2 (2.4-16.8 years, and 73 age matched healthy control subjects (29 male and 44 female participated in the study. Mean age of the groups was about 14.5 years. BMD was determined by dual x-ray absorptiometry (DEXA of the lumbar spine (L2-L4. For further analysis we used the absolute value of BMD, expressed as g/cm2, Z score expressed as SD (relative value as standard deviation decline of normal BMD values of referent Italian population with identical age and gender, bone mineral content (BMC as g/cm, and corrected BMD - BMDv as g/cm3. Results. Z score in the group of patients was significantly lower (-1.02±1.6 in comparison to the control group (-0.09±1.4; p<0.001. BMD, BMDv and BMC were also statistically lower in patients with JIA. The lowest Z score was found in patients with systemic onset (-2.63 SD. Z score showed a statistically significant positive correlation with arthritis course (polyarticular course had lower Z score, body mass index and standard deviation score for height and weight. Statistically significant negative correlation was detected in regard to Z score and glucocorticoid (GC treatment duration, GC cumulative dose, number of joints with limited range of motion, radiological stage and functional class. Conclusion. The results showed a decreased BMD in patients with JIA in comparison to the control group. Systemic onset, polyarthritis, longer treatment with GC and higher cumulative dosage, as well as higher damage level (functional status and radiological stage are factors playing negative role

  1. Mouse Models of Rheumatoid Arthritis.

    Science.gov (United States)

    Caplazi, P; Baca, M; Barck, K; Carano, R A D; DeVoss, J; Lee, W P; Bolon, B; Diehl, L

    2015-09-01

    Rheumatoid arthritis (RA) is a chronic debilitating autoimmune disorder characterized by synovitis that leads to cartilage and bone erosion by invading fibrovascular tissue. Mouse models of RA recapitulate many features of the human disease. Despite the availability of medicines that are highly effective in many patient populations, autoimmune diseases (including RA) remain an area of active biomedical research, and consequently mouse models of RA are still extensively used for mechanistic studies and validation of therapeutic targets. This review aims to integrate morphologic features with model biology and cover the key characteristics of the most commonly used induced and spontaneous mouse models of RA. Induced models emphasized in this review include collagen-induced arthritis and antibody-induced arthritis. Collagen-induced arthritis is an example of an active immunization strategy, whereas antibody- induced arthritis models, such as collagen antibody-induced arthritis and K/BxN antibody transfer arthritis, represent examples of passive immunization strategies. The coverage of spontaneous models in this review is focused on the TNFΔ (ARE) mouse, in which arthritis results from overexpression of TNF-α, a master proinflammatory cytokine that drives disease in many patients.

  2. Occupational therapy for rheumatoid arthritis.

    NARCIS (Netherlands)

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

    2004-01-01

    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 con

  3. Kartagener syndrome and rheumatoid arthritis.

    Science.gov (United States)

    Rébora, Martin Esteban; Cuneo, Julia Ana; Marcos, Josefina; Marcos, Juan Carlos

    2006-02-01

    We report the case of a 38-year-old female patient, affected with Kartagener syndrome (primary ciliary dyskinesia), who developed seropositive and erosive rheumatoid arthritis. According to our review, there are only 6 cases reported so far with this association without a definite etiopathogenic linkage recognized in common. Chronic infections resulting from the ciliary dysfunction might be a trigger for rheumatoid arthritis.

  4. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Sheets Benefits and Risks of Opioids in Arthritis Management How to Give a Subcutaneous Injection Connect With Us Johns Hopkins Rheumatology Arthritis Center Lupus Center Lyme Disease Clinical Research Center Myositis Center Scleroderma Center Sjogren’s Syndrome Center ...

  5. 类风湿性关节炎患者韧带及关节囊组织炎性浸润机制研究%Tissue damage mechanism of ligament and joint capsule injury in patients with rheumatoid arthritis

    Institute of Scientific and Technical Information of China (English)

    李颖; 刘英娜; 覃仕化; 杨俊生; 冷冬妮; 王珺; 杜秀銮; 汪悦

    2011-01-01

    目的 探讨类风湿性关节炎患者的韧带及关节囊组织的浸润机制,为临床针对类风湿性关节炎患者关节周围软组织保护的药物筛选提供新的思路.方法 收集27例关节置换术中切取的关节囊和部分韧带组织,其中类风湿性关节炎(RA)6例,骨性关节炎(OA)9例,关节创伤(AT)12例,观察关节囊和韧带组织大体病变,光学显微镜下病理切片检查,并行组织匀浆免疫组化检测肿瘤坏死因子-α(TNF-α)水平.结果 RA组的关节囊和韧带组织明显增厚,平均厚度0.81cm,镜下见韧带及关节囊组织中血管扩张,周围淋巴细胞浸润,纤维、胶原细胞增生,淋巴细胞数量明显多于OA组;RA组、OA组髋关节囊前壁厚度与AT组比较,差异有显著性(P0.05).结论 RA患者的韧带及关节囊组织的病变是血管扩张后的炎性细胞的浸润过程,是一个慢性非特异性炎性浸润过程,与关节滑膜组织及血管翳的关系不大.RA的浸润过程与OA的炎性过程基本相同,但是炎性细胞浸润在数量上明显多于0A.%Objective To investigate the infiltration mechanism of ligament and joint capsule in patients with rheumatoid arthritis ( RA ), with new ideas of screening drug for clinical protection against RA.Methods The part of the joint capsule and ligament tissues of 27 cases underwent joint replacement surgery were collected,including RA 6 cases,osteoarthritis (OA) 9 cases,and joint trauma (AT) 12 cases.The joint capsule and ligament were observed in general lesions, pathological examination under the light microscope, and TNF-α levels of tissue immunohistochemistry.Results The joint capsule and ligament tissue of RA patients was significantly thicker (0.81 cm in the average), with vasodilatation, lymphocyte infiltration surrounded, fibrosis, and collagen proliferation in the microscope.The number of lymphocytes in RA group was significantly more than that in OA group.The front wall thicknesses of the hip joint

  6. Rheumatoid arthritis-associated interstitial lung disease: lung inflammation evaluated with high resolution computed tomography scan is correlated to rheumatoid arthritis disease activity.

    Science.gov (United States)

    Pérez-Dórame, Renzo; Mejía, Mayra; Mateos-Toledo, Heidegger; Rojas-Serrano, Jorge

    2015-01-01

    To describe the association between rheumatoid arthritis disease activity (RA) and interstitial lung damage (inflammation and fibrosis), in a group of patients with rheumatoid arthritis-associated interstitial lung disease (RA-ILD). A retrospective study of RA patients with interstitial lung disease (restrictive pattern in lung function tests and evidence of interstitial lung disease in high resolution computed tomography (HRCT)). Patients were evaluated to exclude other causes of pulmonary disease. RA disease activity was measured with the CDAI index. Interstitial lung inflammation and fibrosis were determined by Kazerooni scale. We compared Kazerooni ground-glass score with the nearest CDAI score to HRCT date scan of the first medical evaluation at our institution. In nine patients, we compared the first ground-glass score with a second one after treatment with DMARDs and corticosteroids. Spearman's rank correlation coefficient was used to evaluate association between RA disease activity and the Kazerooni ground-glass and fibrosis scores. Thirty-four patients were included. A positive correlation between CDAI and ground-glass scores was found (rs=0.3767, PFibrosis and CDAI scores were not associated (rs=-0.0747, P<0.6745). After treatment, a downward tendency in the ground-glass score was observed (median [IQR]): (2.33 [2,3] vs. 2 [1.33-2.16]), P<0.056, along with a lesser CDAI score (27 [8-43] vs. 9 [5-12]), P<0.063. There is a correlation between RA disease activity and ground-glass appearance in the HRCT of RA-ILD patients. These results suggest a positive association between RA disease activity and lung inflammation in RA-ILD. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  7. Clinical Biomarkers and Pathogenic-Related Cytokines in Rheumatoid Arthritis

    OpenAIRE

    Xiaoyin Niu; Guangjie Chen

    2014-01-01

    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 n...

  8. Ultrasound versus high field magnetic resonance imaging in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Tan, York Kiat; Østergaard, Mikkel; Bird, Paul;

    2014-01-01

    Over the past decade there have been significant advances in the field of musculoskeletal imaging, especially in the application of ultrasound (US) and magnetic resonance imaging (MRI) to the management of rheumatoid arthritis (RA). Both modalities offer significant advantages over the previous...... standards of clinical examination and radiography, and allow direct visualisation of both joint inflammation and structural damage. Although measuring similar pathology, each of these imaging tools has its own benefits and limitations; understanding these will help researchers and clinicians to determine...

  9. Psoriatic arthritis as a mountain

    Directory of Open Access Journals (Sweden)

    J.M. Berthelot

    2011-09-01

    Full Text Available There is no doubt that inflammatory arthritis/enthesitis and psoriasis coexist more frequently than would be expected by chance: for instance, in a study of 1285 patients with psoriasis seen in an hospital, 483 (38% were suffering from arthritis/ enthesitis, including 40 patients classified as Rheumatoid Arthritis (RA (3%, 177 (14% as undifferentiated arthritis (UA, and 266 (21% as Psoriatic Arthritis (PsA (1. Although lower percentages have been noticed in the general population with psoriasis (6% of PsA in an extensive study of 1844 patients with psoriasis (2, they were superior to 5% (i.e. at least 5 times greater than the figures found for patients without psoriasis (3-7.

  10. Minimal clinically important difference in radiological progression of joint damage. A definition based on patient perspective.

    NARCIS (Netherlands)

    Welsing, P.M.J.; Borm, G.F.; Riel, P.L.C.M. van

    2006-01-01

    OBJECTIVE: To estimate a threshold for minimal clinically important radiological progression of joint damage using its longitudinal relation with functional disability in patients with rheumatoid arthritis (RA). To validate existing estimates of minimal clinically important difference (MCID) using

  11. Indexing Images.

    Science.gov (United States)

    Rasmussen, Edie M.

    1997-01-01

    Focuses on access to digital image collections by means of manual and automatic indexing. Contains six sections: (1) Studies of Image Systems and their Use; (2) Approaches to Indexing Images; (3) Image Attributes; (4) Concept-Based Indexing; (5) Content-Based Indexing; and (6) Browsing in Image Retrieval. Contains 105 references. (AEF)

  12. Evaluación del daño estructural de manos mediante RM en pacientes con artritis reumatoidea temprana, sin evidencia de erosiones radiográficas Assessment of structural damage of hands by MRI in patients with early rheumatoid arthritis, without evidence of erosions in radiography

    Directory of Open Access Journals (Sweden)

    Juan C. Spina (h

    2009-12-01

    los pacientes presentaron sinovitis y 7 (70 %, edema óseo. Apesar de no observarse erosiones en la radiografía, 7 pacientes (70 % las mostraron en RM. La erosión representó el 26,25% del score total de RM. Conclusión: Tradicionalmente, el daño estructural de la AR se mide utilizando diferentes métodos de score radiológicos. Dado que la detección precoz de erosiones predice una enfermedad más agresiva, la RM debería ser considerada en pacientes con AR temprana para la evaluación del pronóstico. Sin embargo, es necesario evaluar a un mayor número de pacientes para certificar esta observación.Introduction: Rheumatoid Arthritis (RA is characterized by chronic inflammation of the joints, leading to destruction of articular cartilage and bone. Approximately 75% of RA patients develop joint erosions within the first two years of onset of symptoms. The presence of early erosions reveals more aggressive disease and is associated with an unfavorable prognosis. It has been shown that erosion damage can be seen on magnetic resonance imaging (MRI even before 6 months of the disease onset. This technique appears to be more sensitive than conventional radiology. MRI evaluation using the score of Outcome Measures in Rheumatology Clinical Trials (OMERACT / Rheumatoid Arthritis Magnetic Resonance Imaging Score (RAMRIS allows semiquantitative assessment of bone edema, synovitis and erosions. Objective: To evaluate the characteristics of structural damage by MRI in patients with early RA (less than one year of progression, with no erosions of hands on the X-ray. Materials and methods: We selected 10 patients with RA according to the ACR criteria 1987, whose score showed radiographic Sharp / van der Heijde equal to 0 (zero for erosions. They underwent MRI of both hands. The Sharp / van der Heijde method was used to assess articular impingement, and the OMERACT-RAMRIS score to quantify joint lesions detected by MRI. The final scores obtained by both methods were compared

  13. Reduced articular cartilage thickness in joints without a history of active arthritis in children with juvenile idiopathic arthritis

    DEFF Research Database (Denmark)

    Pradsgaard, Dan Østergaard; Spannow, Anne Helene; Heuck, Carsten;

    Background: The functional disability experienced in juvenile idiopathic arthritis is primarily caused by degeneration of the osteocartilaginous structures due to the inflammatory process in the synovium. It is therefore essential for evaluating the therapeutic efficacy to closely monitor...... the structural damage during the disease course. During the past decade musculoskeletal ultrasound (US) has become an established diagnostic method in adult rheumatology and within recent years an increased attention for utilizing US in pediatric rheumatology has emerged. Previously we have found differences...

  14. Combination therapy for pain management in inflammatory arthritis (rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, other spondyloarthritis)

    NARCIS (Netherlands)

    S. Ramiro; H. Radner; D. van der Heijde; A. van Tubergen; R. Buchbinder; D. Aletaha; R.B.M. Landewé

    2011-01-01

    Despite optimal therapy with disease-modifying antirheumatic drugs, many people with inflammatory arthritis (IA) continue to have persistent pain that may require additional therapy. To assess the benefits and safety of combination pain therapy for people with IA (rheumatoid arthritis (RA), ankylosi

  15. Autoantibodies in inflammatory arthritis.

    Science.gov (United States)

    Conigliaro, P; Chimenti, M S; Triggianese, P; Sunzini, F; Novelli, L; Perricone, C; Perricone, R

    2016-07-01

    Rheumatoid arthritis (RA) is a systemic chronic inflammatory disease characterized by extensive synovitis resulting in erosions of articular cartilage and marginal bone with joint destruction. The lack of immunological tolerance in RA represents the first step toward the development of autoimmunity. Susceptible individuals, under the influence of environmental factors, such as tobacco smoke, and silica exposure, develop autoimmune phenomena that result in the presence of autoantibodies. HLA and non-HLA haplotypes play a major role in determining the development of specific autoantibodies differentiating anti-citrullinated antibodies (ACPA)-positive and negative RA patients. Rheumatoid factor (RF) and ACPA are the serological markers for RA, and during the preclinical immunological phase, autoantibody titers increase with a progressive spread of ACPA antigens repertoire. The presence of ACPA represents an independent risk factor for developing RA in patients with undifferentiated arthritis or arthralgia. Moreover, anti-CarP antibodies have been identified in patients with RA as well as in individuals before the onset of clinical symptoms of RA. Several autoantibodies mainly targeting post-translational modified proteins have been investigated as possible biomarkers to improve the early diagnosis, prognosis and response to therapy in RA patients. Psoriatic arthritis (PsA) is distinguished from RA by infrequent positivity for RF and ACPA, together with other distinctive clinical features. Actually, specific autoantibodies have not been described. Recently, anti-CarP antibodies have been reported in sera from PsA patients with active disease. Further investigations on autoantibodies showing high specificity and sensibility as well as relevant correlation with disease severity, progression, and response to therapy are awaited in inflammatory arthritides.

  16. Treating axial and peripheral spondyloarthritis, including psoriatic arthritis, to target: results of a systematic literature search to support an international treat-to-target recommendation in spondyloarthritis

    Science.gov (United States)

    Schoels, M M; Braun, J; Dougados, M; Emery, P; Fitzgerald, O; Kavanaugh, A; Kvien, T K; Landewé, R; Luger, T; Mease, P; Olivieri, I; Reveille, J; Ritchlin, C; Rudwaleit, M; Sieper, J; Smolen, J S; de Wit, M; van der Heijde, D

    2014-01-01

    Background Current recommendations for the management of axial spondyloarthritis (SpA) and psoriatic arthritis are to monitor disease activity and adjust therapy accordingly. However, treatment targets and timeframes of change have not been defined. An international expert panel has been convened to develop ‘treat-to-target’ recommendations, based on published evidence and expert opinion. Objective To review evidence on targeted treatment for axial and peripheral SpA, as well as for psoriatic skin disease. Methods We performed a systematic literature search covering Medline, Embase and Cochrane, conference abstracts and studies in http://www.clinicaltrials.gov. Results Randomised comparisons of targeted versus routine treatment are lacking. Some studies implemented treatment targets before escalating therapy: in ankylosing spondylitis, most trials used a decrease in Bath Ankylosing Spondylitis Disease Activity Index; in psoriatic arthritis, protocols primarily considered a reduction in swollen and tender joints; in psoriasis, the Modified Psoriasis Severity Score and the Psoriasis Area and Severity Index were used. Complementary evidence correlating these factors with function and radiographic damage at follow-up is sparse and equivocal. Conclusions There is a need for randomised trials that investigate the value of treat-to-target recommendations in SpA and psoriasis. Several trials have used thresholds of disease activity measures to guide treatment decisions. However, evidence on the effect of these data on long-term outcome is scarce. The search data informed the expert committee regarding the formulation of recommendations and a research agenda. PMID:23740234

  17. Fungal arthritis and osteomyelitis.

    Science.gov (United States)

    Kohli, Rakhi; Hadley, Susan

    2005-12-01

    Fungal arthritis and osteomyelitis are uncommon diseases and generally present in an indolent fashion. The incidence of fungal bone and joint dis-ease is increasing with an increase in the prevalence of factors predisposing to invasive fungal disease, such as the use of central venous catheters, broad spectrum antibiotics, immunosuppression, and abdominal surgery. Definitive diagnosis relies on bone or synovial culture or biopsy. Successful management has traditionally consisted of amphotericin B in combination with surgical debridement. Given the rarity of this disease, treatment is not well defined, but reports of success with the use of azole antifungal agents, including itraconazole, fluconazole, voriconazole, and posaconazole, are promising.

  18. Efficacy of Fish Oil in Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    B. Heidari

    1998-04-01

    Full Text Available Ingestion of fish oil fatty acids (omega - 3 fatty acids inhibits the formation of arachidonic acid - derived cytokines and leads to production of compounds with diminished biological activity. Beneficial effects of dietary supplementation with fish oil in rheumatoid arthritis have been shown in many controlled trials."nMethods : 43 patients with active rheumatoid arthritis entered in a prospective, double-blind, placebo-controlled clinical trial to recieve either lOgr fish oil daily (treatment group or corn oil (placebo group. Baseline drugs and usual diet were continued without any changes. Disease variables were evaluated at baseline and after completion of study period."nThe changes in disease variables were compared by paired t-tesl in each group. Comparison of the two groups was done by t-test. Functional capacity was compared by Wilcoxon ranks test."nResults : 19 patients in treatment group and 20 patients in placebo group completed the study which lasted eight weeks . In the treatment group, joint pain index decreased from 30±11 at baseline, to 18±11 at the end of study period (P < 0.01. Joint swelling index decreased from 8 ± 4 to 2 ± 4, (P< 0.01, morning stiffness from 87 ± 41 to 24±16 minutes (P < 0.01. In the placebo group the above variable changes were from 19±14 to 25±14 ; 8±8 to 7±6 and 80±71 to 76±75 minutes respectively, which were not significant . The differences between the treatment and placebo groups were significant in joint swelling index (P < 0.05, morning stiffness (P<0.01 and functioal capacity (p< 0.005, the differences in joint pain index and grip strenght did not quite achieve statstical significance. During study period there were no adverese effects with fish oil consumption."nConclusion : Fish oil supplemention has anti-inflamatory effects in rheumatoid arthritis. Further studies are needed to recommend its long - term usage concomittant with other drugs in all patients

  19. Mimicry of lyme arthritis by synovial hemangioma.

    Science.gov (United States)

    Hospach, Toni; Langendörfer, M; Kalle, T V; Tewald, F; Wirth, T; Dannecker, G E

    2011-12-01

    To report on the differential diagnosis of lyme arthritis and synovial hemangioma due to similar clinical and radiological signs and symptoms. A 15-year-old boy presented at the age of 9 with recurrent rather painless swelling of the right knee. Altogether four episodes lasting for 1-2 weeks each occurred over a period of 18 months before medical advice was sought. Physical examination revealed only a slightly limited range of motion. Living in an endemic area of borreliosis, he reported a tick bite 6 months prior to onset of his symptoms with erythema migrans and was treated for 10 days with amoxicillin. Serology revealed two positive unspecific bands in IgG immunoblot (p41 and 66) with slight positivity for ELISA. Ultrasound revealed synovial thickening and increased fluid. Despite the weak positive serology a diagnosis of lyme arthritis could not be excluded and intravenous antibiotic treatment with ceftriaxone was started. After two further relapses antiinflammatory therapy including intraarticular steroids were introduced with no long lasting effect. A chronical disease developed with alternate periods of swelling and almost complete remission. Ultrasound as well as MRI demonstrated ongoing signs of synovitis, therefore after further progression, a diagnostic arthroscopy was performed showing an inconspicuous knee joint. A second MRI showed focal suprapatellar enhancement and was followed by open arthrotomy revealing a histopathological proven synovial cavernous juxtaarticular hemangioma. To our knowledge, the differential diagnosis of lyme arthritis and synovial hemangioma has not yet been reported despite obvious clinical similarities. In conclusion, in children and adolescents synovial hemangioma has to be considered in differential diagnosis of recurrent knee swelling. Early diagnosis is important to prevent prolonged suffering from chronic joint swelling with probable joint damages, unnecessary treatment procedures and as well school and sports

  20. Overview of epidemiology, pathophysiology, and diagnosis of rheumatoid arthritis.

    Science.gov (United States)

    Gibofsky, Allan

    2012-12-01

    Rheumatoid arthritis (RA) is a common autoimmune systemic inflammatory disease affecting approximately 1% of the worldwide population. The interaction of genetic and environmental factors results in a cascade of immune reactions, which ultimately lead to the development of synovitis, joint damage, and structural bone damage. These, in turn, lead to pain, disability, and emotional, social, and economic challenges. A number of extraarticular manifestations and comorbidities are present in patients with RA, which result in increased mortality. The American College of Rheumatology and European League Against Rheumatism recently published updated disease classification criteria in an effort to identify RA earlier so that effective treatment can be employed to prevent irreversible changes.

  1. A comparison of disease burden in rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis.

    Directory of Open Access Journals (Sweden)

    Brigitte Michelsen

    Full Text Available The main objective of this study was to compare disease burden in rheumatoid arthritis (RA, psoriatic arthritis (PsA and axial spondyloarthritis (ax-SpA.In this cross-sectional study, all the RA (1093, PsA (365 and ax-SpA (333 patients who visited the out-patient clinic of the Hospital of Southern Norway Trust during the year 2013 were included; the RA patients all had a RA diagnosis verified by the treating rheumatologist, the PsA patients all fulfilled the ClASsification for Psoriatic ARthritis (CASPAR criteria and the ax-SpA patients all fulfilled the Assessment of SpondyloArthritis international Society (ASAS classification criteria for ax-SpA. Patient-reported health status, demographic variables, medications, and composite scores of disease activity were assessed. The main analyses were performed using General Linear Models adjusted for age, sex and multiple comparisons. Correlation analyses were performed using Spearman's rho.The reported pain, joint pain, patient's global assessment and fatigue were similar in PsA and ax-SpA, but significantly lower in RA. The 28-joint Disease Activity Score (DAS28 (0.3±0.1, p = 0.003, Clinical Disease Activity Index (CDAI (1.0±0.4, p = 0.028 and Routine Assessment of Patient Index Data 3 (RAPID3 (0.4±0.1, p = 0.004 were all significantly higher in PsA vs. RA. RAPID3 showed moderate to high correlation with DAS28 (rho = 0.521, p<0.001 and CDAI (rho = 0.768, p<0.001 in RA and PsA, and with Bath Ankylosing Spondylitis Disease Activity Index (BASDAI (rho = 0.902, p<0.001 and Bath Ankylosing Spondylitis Functional Index (BASFI (0.865, p<0.001 in ax-SpA and PsA.In conclusion, patient- reported outcome measures were similar in our population of PsA and ax-SpA patients, but significantly lower for the RA patients. Composite disease activity measures were lower in RA than in PsA and ax-SpA, but the magnitude of these differences was small and probably not of clinical significance. Our study indicates that

  2. A Comparison of Disease Burden in Rheumatoid Arthritis, Psoriatic Arthritis and Axial Spondyloarthritis

    Science.gov (United States)

    Michelsen, Brigitte; Fiane, Ragnhild; Diamantopoulos, Andreas P.; Soldal, Dag Magnar; Hansen, Inger Johanne W.; Sokka, Tuulikki; Kavanaugh, Arthur; Haugeberg, Glenn

    2015-01-01

    Objective The main objective of this study was to compare disease burden in rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis (ax-SpA). Methods In this cross-sectional study, all the RA (1093), PsA (365) and ax-SpA (333) patients who visited the out-patient clinic of the Hospital of Southern Norway Trust during the year 2013 were included; the RA patients all had a RA diagnosis verified by the treating rheumatologist, the PsA patients all fulfilled the ClASsification for Psoriatic ARthritis (CASPAR) criteria and the ax-SpA patients all fulfilled the Assessment of SpondyloArthritis international Society (ASAS) classification criteria for ax-SpA. Patient-reported health status, demographic variables, medications, and composite scores of disease activity were assessed. The main analyses were performed using General Linear Models adjusted for age, sex and multiple comparisons. Correlation analyses were performed using Spearman’s rho. Results The reported pain, joint pain, patient’s global assessment and fatigue were similar in PsA and ax-SpA, but significantly lower in RA. The 28-joint Disease Activity Score (DAS28) (0.3±0.1, p = 0.003), Clinical Disease Activity Index (CDAI) (1.0±0.4, p = 0.028) and Routine Assessment of Patient Index Data 3 (RAPID3) (0.4±0.1, p = 0.004) were all significantly higher in PsA vs. RA. RAPID3 showed moderate to high correlation with DAS28 (rho = 0.521, p<0.001) and CDAI (rho = 0.768, p<0.001) in RA and PsA, and with Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) (rho = 0.902, p<0.001) and Bath Ankylosing Spondylitis Functional Index (BASFI) (0.865, p<0.001) in ax-SpA and PsA. Conclusion In conclusion, patient- reported outcome measures were similar in our population of PsA and ax-SpA patients, but significantly lower for the RA patients. Composite disease activity measures were lower in RA than in PsA and ax-SpA, but the magnitude of these differences was small and probably not of

  3. Obesity Trends Among US Adults With Doctor-Diagnosed Arthritis 2009-2014.

    Science.gov (United States)

    Barbour, Kamil E; Helmick, Charles G; Boring, Michael; Qin, Jin; Pan, Liping; Hootman, Jennifer M

    2017-03-01

    Arthritis and obesity are common co-occurring conditions that can increase disability and the risk of adverse outcomes (e.g., total knee replacement). We estimated recent obesity trends among adults with arthritis from 2009 to 2014, overall and by various sociodemographic and health characteristics using data from National Health Interview Survey, an ongoing, nationally representative, in-person household self-reported survey of the noninstitutionalized civilian US. A secondary aim was to examine the distribution of body mass index categories among adults with and without arthritis. Obesity prevalence did not change significantly over time among middle-aged and younger adults with doctor-diagnosed arthritis either overall (P = 0.925 for both groups) or by demographic and health characteristics. Among older adults with doctor-diagnosed arthritis, the unadjusted obesity prevalence was 29.4% in 2009 and 34.3% in 2014; after adjusting for all demographic and health characteristics, there was a significant relative increase in obesity prevalence (15% [95% confidence interval 6-25]) and over time (P = 0.001). The age-standardized prevalence of obesity and the obesity subclasses I, II, and III among adults with doctor-diagnosed arthritis (compared with adults without doctor-diagnosed arthritis) was 40.3% versus 26.3%, 20.1% versus 16.4%, 10.4% versus 6.2%, and 9.8% versus 3.6%, respectively (P arthritis and remains high when compared with adults without arthritis. A greater dissemination of interventions focused on physical activity and diet are needed in order to reduce adverse outcomes associated with obesity and arthritis. © 2016, American College of Rheumatology.

  4. [Association between arthritis, functional disability and quality of life using a structural equation].

    Science.gov (United States)

    Cordero-Ampuero, J; Darder, A; Santillana, J; Caloto, M T; Nocea, G

    2012-01-01

    To establish a conceptual model that links arthritis, functional disability in activities of daily living, and quality of life (QoL). A multicentre, cross-sectional, observation study was performed. The location of the arthritis (presence/absence) was recorded. Disability was measured using the Health Assessment Questionnaire Disability Index and the QoL determined using the EQ-5D-3 Level questionnaire. The relationship between the arthritis, disability, and the QoL was evaluated using the structural equation model (SEM). 965 patients with arthritis (mean age=64 years, with 75% females). Arthritis: mean areas affected: 2.8. Areas most frequently affected: knees (67%); lumbar spine (60%) and cervical spine (45%). QoL: The majority of patients did not mention serious problems in the five domains assessed. Disability: «other activities» (mean=1.2); «reach» (mean=1.1) and «walking» (mean=1.0) were the categories that demonstrated greater disability. The SEM showed arthritis, disability and QoL as associated latent variables. Although 92% of the QoL explained the disability, only 5% of the disability was due to the presence/absence of arthritis. The global model that describes arthritis as a cause of disability, and disability was affecting the QoL, had a reasonable goodness of fit (CMIN/DF=5.42; RMR=0.026; RMSEA=0.069). Functional disability can explain the decrease in QoL. In theory, arthritis is closely related with disability and QoL, but the model did not mange to fully explain this link. As statistical techniques required good measurement models to correctly determine relationships, conventional medical records seem to be insufficient for this purpose. Other valid measurements of arthritis are needed to provide tests of its direct effect on disability and QoL. Copyright © 2011 SECOT. Published by Elsevier Espana. All rights reserved.

  5. Alpha-1 antitrypsin protein and gene therapies decrease autoimmunity and delay arthritis development in mouse model

    Directory of Open Access Journals (Sweden)

    Atkinson Mark A

    2011-02-01

    Full Text Available Abstract Background Alpha-1 antitrypsin (AAT is a multi-functional protein that has anti-inflammatory and tissue protective properties. We previously reported that human AAT (hAAT gene therapy prevented autoimmune diabetes in non-obese diabetic (NOD mice and suppressed arthritis development in combination with doxycycline in mice. In the present study we investigated the feasibility of hAAT monotherapy for the treatment of chronic arthritis in collagen-induced arthritis (CIA, a mouse model of rheumatoid arthritis (RA. Methods DBA/1 mice were immunized with bovine type II collagen (bCII to induce arthritis. These mice were pretreated either with hAAT protein or with recombinant adeno-associated virus vector expressing hAAT (rAAV-hAAT. Control groups received saline injections. Arthritis development was evaluated by prevalence of arthritis and arthritic index. Serum levels of B-cell activating factor of the TNF-α family (BAFF, antibodies against both bovine (bCII and mouse collagen II (mCII were tested by ELISA. Results Human AAT protein therapy as well as recombinant adeno-associated virus (rAAV8-mediated hAAT gene therapy significantly delayed onset and ameliorated disease development of arthritis in CIA mouse model. Importantly, hAAT therapies significantly reduced serum levels of BAFF and autoantibodies against bCII and mCII, suggesting that the effects are mediated via B-cells, at least partially. Conclusion These results present a new drug for arthritis therapy. Human AAT protein and gene therapies are able to ameliorate and delay arthritis development and reduce autoimmunity, indicating promising potential of these therapies as a new treatment strategy for RA.

  6. Functional state of knee arthritis patients and related factors

    Science.gov (United States)

    Lee, Jiyeon; Kim, Jung-Hee; Chung, EunJung; Lee, Byoung-Hee

    2017-01-01

    [Purpose] The objective of this study is to provide a direction for efficient management of arthritis through the analysis of multiple factors related to the functional state of patients. [Subjects and Methods] The Visual Analog Scale, Knee Society Knee Score & Function Score, Hospital for Special Surgery, Short Form-36 Health Survey and Western Ontario McMaster Universities Osteoarthritis Index for a total of 135 patients with knee arthritis were determined with a survey. [Results] There is a significant correlation between age, pain, Knee Society Knee Score, Hospital for Special Surgery, Knee Society Function Score, and Western Ontario McMaster Universities Osteoarthritis Index score. [Conclusion] It is necessary to improve the factors that affect knee function and quality of life, and a study on knee joint muscle strength is suggested as a follow-up study. PMID:28265166

  7. The aggravation of arthritis by periodontitis is dependent of IL-17 receptor A activation.

    Science.gov (United States)

    de Aquino, Sabrina G; Talbot, Jhimmy; Sônego, Fabiane; Turato, Walter M; Grespan, Renata; Avila-Campos, Mario J; Cunha, Fernando Q; Cirelli, Joni A

    2017-09-01

    To evaluate whether Porphyromonas gingivalis-induced periodontitis aggravates the antigen-induced arthritis (AIA) model, and whether this effect is dependent on the Th17/IL-17 signalling pathway. Antigen-induced arthritis was triggered by local injection of methylated bovine serum albumin into the knee joint of previously immunized C57BL/6 wild-type (WT) and IL-17 receptor A (IL-17RA)-knockout mice. Periodontal disease in naïve or arthritic mice was induced by oral infection with P. gingivalis. Animals were sacrificed 7, 15 and 30 days after infection. Alveolar bone loss, joint histopathology, articular hyperalgesia and joint cytokine production were assessed, in addition to the proportion of Th17 and Treg cells isolated from the inguinal lymph nodes. No influence of experimentally-induced arthritis was found on the alveolar bone resorption induced by P. gingivalis. However, mice with experimentally-induced arthritis that were exposed to P. gingivalis presented higher joint damage and Th17 frequencies when compared to non-infected mice. The aggravation of arthritis by periodontitis was accompanied by increased TNF and IL-17 production and articular neutrophil infiltration, whereas arthritis aggravation and changes in neutrophil infiltration were absent in IL-17RA-deficient mice. The effects of P. gingivalis-induced periodontitis on arthritis are dependent on Th17 expansion and IL-17RA signalling, which lead to increased neutrophil infiltration into the joints. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. APLAR rheumatoid arthritis treatment recommendations.

    Science.gov (United States)

    Lau, Chak Sing; Chia, Faith; Harrison, Andrew; Hsieh, Tsu-Yi; Jain, Rahul; Jung, Seung Min; Kishimoto, Mitsumasa; Kumar, Ashok; Leong, Khai Pang; Li, Zhanguo; Lichauco, Juan Javier; Louthrenoo, Worawit; Luo, Shue-Fen; Nash, Peter; Ng, Chin Teck; Park, Sung-Hwan; Suryana, Bagus Putu Putra; Suwannalai, Parawee; Wijaya, Linda Kurniaty; Yamamoto, Kazuhiko; Yang, Yue; Yeap, Swan Sim

    2015-09-01

    Rheumatoid arthritis is a chronic inflammatory condition that affects approximately 1% of the world's population. There are a wide number of guidelines and recommendations available to support the treatment of rheumatoid arthritis; however, the evidence used for these guidelines is predominantly based on studies in Caucasian subjects and may not be relevant for rheumatoid arthritis patients in the Asia-Pacific region. Therefore, the Asia Pacific League of Associations for Rheumatology established a Steering Committee in 2013 to address this issue. The AGREE II instrument and the ADAPTE Collaboration framework were applied to systematically identify, appraise, synthesize, and adapt international rheumatoid arthritis guidelines for use in the Asia-Pacific region. Forty rheumatoid arthritis treatment recommendations, based on evidence and expert opinion, were drafted and are presented in this report. The Asia Pacific of Associations for Rheumatology rheumatoid arthritis treatment recommendations are intended to serve as a reference for best practice management of rheumatoid arthritis in Asia-Pacific, focusing on local issues to ensure the delivery of basic care for these patients, and to improve their outcomes. In addition, the document will serve as a reference for national rheumatology associations in Asia-Pacific for developing guidelines in their respective countries. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  9. JUVENILE RHEUMATOID ARTHRITIS

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    I N Sartika

    2012-11-01

    Full Text Available Juvenile rheumatoid arthritis (JRA is the most common rheumatic condition in children. JRA is defined as persistent arthritis in 1 or more joints for at least 6 weeks, with the onset before age 16 years. The etiology of JRA is unknown. Antigen activated CD4+ T cell stimulate monocytes, macrophages, and synovial fibroblasts to produce the cytokines Interleukin-1 (IL-1, IL-6, and tumor necrosis factor ? (TNF-? and to secrete matrix metalloproteinases, which lead to chronic inflammation due to infiltration of inflammatory cell, angiogenesis, destruction of cartilage and bone with pannus formation. The 3 major subtypes of JRA are based on the symptoms at disease onset and are designated systemic onset, pauciarticular onset, and polyarticular onset. For all patients, the goals of therapy are to decrease chronic joint pain and suppress the inflammatory process. Poor prognostic have been observed in patients with polyarticular onset, rheumatoid factor, persistent morning stiffness, tenosynovitis, involvement of the small joints, rapid appearance of erosions, active late onset childhood, subcutaneous nodules, or antinuclear antibody.

  10. Pain and microcrystalline arthritis

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    R. Ramonda

    2014-06-01

    Full Text Available Microcrystals are responsible for some of the most common and complex arthropathies which are often accompanied by intense, severe pain and inflammatory reactions. The main pathogens are crystals of monosodium urate (MSU, responsible for the gout, calcium pyrophosphate (CPP, which deposits also in various clinical forms of arthopathies, and basic calcium phosphate associated with osteoarthritis. In this context, the microcrystal arthritis is characterized by multiple, acute attacks followed by chronic pain, disability, impaired quality of life, and increased mortality. Given their chronic nature, they represent an ever more urgent public health problem. MSU and CPP crystals are also able to activate nociceptors. The pain in mycrocrystalline arthritis (MCA is an expression of the inflammatory process. In the course of these diseases there is an abundant release of inflammatory molecules, including prostaglandins 2 and kinins. Interleukin-1 represents the most important cytokine released during the crystal-induced inflammatory process. Therefore, clinically, pain is the most important component of MCA, which lead to functional impairment and disability in a large proportion of the population. It is fundamental to diagnose these diseases as early as possible, and to this aim, to identify appropriate and specific targets for a timely therapeutic intervention.

  11. Effect of biologic agents on radiographic progression of rheumatoid arthritis

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    Gabriel J Tobón

    2010-08-01

    Full Text Available Gabriel J Tobón1, Alain Saraux1,2, Valérie Devauchelle-Pensec1,21Immunology Laboratory, Morvan Hospital, Université de Bretagne Occidentale, Brest, France; 2Rheumatology Unit, Hôpital de la Cavale Blanche, CHU Brest, FranceAbstract: The treatment of rheumatoid arthritis (RA has benefited over the last few years from the introduction of biologic agents whose development was based on new insights into the immunological factors involved in the pathogenesis of RA and the development of joint damage. These biological agents have been proven effective in RA patients with inadequate responses to synthetic disease-modifying antirheumatic drugs (DMARDs. Preventing joint damage is now the primary goal of RA treatment, and guidelines exist for the follow-up of joint abnormalities. Most biologic agents produced high clinical and radiological response rates in patients with established or recent-onset RA. Thus, for the first time, obtaining a remission is a reasonable treatment goal in RA patients. Factors that are crucial to joint damage control are: early initiation of DMARDs, use of intensive treatments including biological agents, and close monitoring of clinical disease activity and radiographic progression. However, some patients remain unresponsive to all available treatments and continue to experience joint damage progression. A major objective now is to identify patients at high risk for severe joint damage, in order to tailor the treatment regimen to their specific needs.Keywords: rheumatoid arthritis, radiographic progression, biologics

  12. Kidney involvement in rheumatoid arthritis

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    P. Lazzarini

    2011-09-01

    Full Text Available Rheumatoid Arthritis (RA is a widespread disease and its renal involvement, relatively common, is clinically significant because worsens course and mortality of the primary disease. There is still no agreement on the prevalence of renal disorders in RA: data analysis originates from different sources, as death certificates, autopsies, clinical and laboratory findings and kidney biopsies, each with its limitations. Histoimmunological studies on bioptical specimens of patients with RA and kidney damage, led to clarify prevalent pathologies. In order of frequency: glomerulonephritis and amyloidosis (60-65% and 20-30% respectively, followed by acute or chronic interstitial nephritis. Kidney injury during RA includes secondary renal amyloidosis, nephrotoxic effects of antirheumatic drugs and nephropathies as extra-articular manifestations (rheumatoid nephropathy. Amyloidosis affects survival, increases morbidity and is the main cause of end stage renal disease in patients with RA and nephropathy. Strong association between RA activity and amyloidosis needs the use of immunosuppressive and combined therapies, to prevent this complication and reduce risk of dialysis. Long-lasting and combined RA pharmacotherapy involves various renal side effects. In this review we describe NSAIDs and DMARDs (Disease-Modifying Antirheumatic Drugs nephrotoxicity, particularly by gold compounds, D-penicillamine, cyclosporine A and methotrexate. Rare cases of IgA glomerulonephritis during immunomodulating therapy with leflunomide and TNF blocking receptor (etanercept are reported; real clinical significance of this drug-related nephropathy will be established by development of RA treatment. In RA nephropathies, mesangial glomerulonephritis is the most frequent histological lesion (35-60 % out of biopsies from patients with urinary abnormalities and/or kidney impairment, followed by minimal change glomerulopathy (3-14% and p-ANCA positive necrotizing crescentic

  13. SECONDARY OSTEOARTHRITIS IN RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    I. A. Starodubtseva

    2015-01-01

    Full Text Available The paper considers the problems of comorbidities in patients with rheumatoid arthritis (RA. Two or more RA-related conditions were diagnosed according to the results of the QUEST-RA program implemented in 34 countries. Osteoarthritis along with hypertension, hyperlipidemia, and osteoporosis was detected among the most commonly diseases. Owing to expanded diagnostic capabilities, the recognition and treatment of the comorbidities have recently received much attention, as embodied in the draft Association of Rheumatologists of Russia Guidelines for RA management (2014; Part 1. The concept and major characteristics of secondary osteoarthritis in RA are analyzed. It is precisely the inflammatory process and underlying disease-related risk factors, including treatment, that have impact on the development of secondary osteoarthritis and patients’ quality of life as a whole. All this allows an inference about the mechanisms closely intertwined with the underlying disease for the development of secondary osteoarthritis, which initiates cartilage damage and further remodeling. Primary and secondary osteoarthritis was comparatively analyzed. Particular emphasis is placed on current cartilage biomarkers, their diagnostic value and role in monitoring the efficiency of treatment in clinical trials. The paper provides a comparative analysis of detectable serum and urine biomarkers according to the results of the complex analysis made by the National Institutes of Health. Particular attention is given to cartilage oligomeric matrix protein (COMP. Foreign authors’ investigations suggest that there is a relationship between serum COMP levels and disease severity and joint X-ray changes. There is evidence for the efficacy of hyaluronic acid used in the treatment of secondary osteoarthritis in patients with RA. 

  14. TREATMENT OF RHEUMATOID ARTHRITIS BY A

    Directory of Open Access Journals (Sweden)

    B.Sai Mrudula,

    2010-06-01

    Full Text Available The immune system is a complex organization of cells and antibodies designed normally to seek and destroy invaders of the body particularly infections. Rheumatoid arthritis is an auto immune disease that mistakenly attacks our own immune system and damage tissues around joints, tendons, ligaments and muscles by means of T-cell differentiation. Dendritic cells are main important APC’s .These cells on maturation combines with MHC molecules and co-receptors like CD-80, CD-40 activates T-cells and B-cells. This main action is regulated by IL-12gene in dendritic cells. Tolerogenic vaccination signifies exotic tool that is launched in to humans or domestic animals with an intention to enroot immunity and to generate immunological tolerance that is condition marked by stolidity to a specific antigen. Here in this critique we have cited applicability of RNA modified DC in treatment of Rheumatoid arthritis. By using the method of RNA interference using siRNAIL12 treated DC we can treat RA by decreasing T-cell responses towards our own cells.

  15. Radiological aspects of rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Schacherl, M.

    1985-09-23

    An introductory summary of the imaging-diagnosis will be given. The necessity of acquiring a catalogue of application to particular imaging methods is emphasized. Discussion of step by step diagnosis regarding rheumatologic questions is given on example of the hand. Technically insufficient radiographs and bad habits during diagnostic analysis are pointed out. Radiologic problems in differentiating arthritis/osteoarthrosis will be mentioned. The discussion of these points is followed by outlining the radiology of rheumatoid arthritis and the complexity of this disease. Introduction of a new stage classification. Finally twelve basic radiologic types of rheumatoid arthritis will be presented.

  16. RAACFDb: Rheumatoid arthritis ayurvedic classical formulations database.

    Science.gov (United States)

    Mohamed Thoufic Ali, A M; Agrawal, Aakash; Sajitha Lulu, S; Mohana Priya, A; Vino, S

    2017-02-02

    In the past years, the treatment of rheumatoid arthritis (RA) has undergone remarkable changes in all therapeutic modes. The present newfangled care in clinical research is to determine and to pick a new track for better treatment options for RA. Recent ethnopharmacological investigations revealed that traditional herbal remedies are the most preferred modality of complementary and alternative medicine (CAM). However, several ayurvedic modes of treatments and formulations for RA are not much studied and documented from Indian traditional system of medicine. Therefore, this directed us to develop an integrated database, RAACFDb (acronym: Rheumatoid Arthritis Ayurvedic Classical Formulations Database) by consolidating data from the repository of Vedic Samhita - The Ayurveda to retrieve the available formulations information easily. Literature data was gathered using several search engines and from ayurvedic practitioners for loading information in the database. In order to represent the collected information about classical ayurvedic formulations, an integrated database is constructed and implemented on a MySQL and PHP back-end. The database is supported by describing all the ayurvedic classical formulations for the treatment rheumatoid arthritis. It includes composition, usage, plant parts used, active ingredients present in the composition and their structures. The prime objective is to locate ayurvedic formulations proven to be quite successful and highly effective among the patients with reduced side effects. The database (freely available at www.beta.vit.ac.in/raacfdb/index.html) hopefully enables easy access for clinical researchers and students to discover novel leads with reduced side effects. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Promising Results for Drug to Fight Arthritis Linked to Psoriasis

    Science.gov (United States)

    ... Results for Drug to Fight Arthritis Linked to Psoriasis Psoriatic arthritis causes painful joint swelling, but new ... of a form of arthritis often linked to psoriasis. According to Stanford University researchers, psoriatic arthritis is ...

  18. Magnetic resonance imaging findings in horses with septic arthritis.

    Science.gov (United States)

    Easley, Jeremiah T; Brokken, Matthew T; Zubrod, Chad J; Morton, Alison J; Garrett, Katherine S; Holmes, Shannon P

    2011-01-01

    Fourteen horses with septic arthritis underwent high-field (1.5 T) magnetic resonance imaging (MRI). Septic arthritis was diagnosed based on results from historical and clinical findings, synovial fluid analyses and culture, and radiographic, ultrasonographic, arthroscopic, and histopathologic findings. MR findings included diffuse hyperintensity within bone and extracapsular tissue on fat-suppressed images in 14/14 horses (100%), joint effusion, synovial proliferation, and capsular thickening in 13/14 horses (93%), bone sclerosis in 11/14 horses (79%), and evidence of cartilage and subchondral bone damage in 8/14 horses (57%). Intravenous gadolinium was administered to five of the 14 horses and fibrin deposition was noted in all horses. Other findings after gadolinium administration included synovial enhancement in 4/5 (80%) horses, and bone enhancement in 1/5 (20%) horses. The MR findings of septic arthritis in horses were consistent with those reported in people. MRI may allow earlier and more accurate diagnosis of septic arthritis in horses as compared with other imaging modalities, especially when the clinical diagnosis is challenging. It also provides additional information not afforded by other methods that may influence and enhance treatment.

  19. Adipokines as Potential Biomarkers in Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Annalisa Del Prete

    2014-01-01

    Full Text Available 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.

  20. Coexistence of rheumatoid arthritis and ankylosing spondylitis.

    Science.gov (United States)

    Barczyńska, Tacjana Anna; Węgierska, Małgorzata; Żuchowski, Paweł; Dura, Marta; Zalewska, Joanna; Waszczak, Marzena; Jeka, Sławomir

    2015-01-01

    Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are chronic progressive inflammatory diseases, leading to joint damage and reducing the physical fitness of patients. They are among the most common rheumatic diseases. However, their etiology and symptomatology are different. Formerly, AS was often wrongly diagnosed as RA. Today there are no major diagnostic difficulties in differentiation between these diseases, thanks to modern laboratory tests and imaging. However, a problem may arise when the patient has symptoms typical for both diseases simultaneously. Cases of coexistence of RA with AS - according to our best knowledge - are rare. This study aims to compare our experience in diagnosis and treatment of concomitant RA and AS with the experience of other researchers. Implementation of the proper diagnostic algorithm, allowing for correct diagnosis of both diseases in one patient, may be useful for differential diagnosis of similar cases in the future.

  1. Emerging role of leptin in rheumatoid arthritis

    Science.gov (United States)

    Tian, G; Liang, J-N; Wang, Z-Y; Zhou, D

    2014-01-01

    Numerous studies have suggested the importance of leptin against autoimmune diseases such as systemic lupus erythematosus (SLE), multiple sclerosis (MS) and psoriasis. To summarize our current understanding of the role of leptin in inflammatory responses and rheumatoid arthritis (RA), a systematic review was conducted to assess the discrepancy of leptin in RA and its effect on immunity according to different studies. Recently, emerging data have indicated that leptin is involved in the pathological function of RA, which is common in autoimmune disorders. This review discusses the possible consequences of leptin levels in RA. Blocking the key signal pathways of leptin and inhibiting the leptin activity-like leptin antagonist may be a promising way for potential therapeutic treatment of RA at risk of detrimental effects. However, leptin was increased in patients with RA and may also regulate joint damage. Thus, more understanding of the mechanism of leptin in RA would be advantageous in the future. PMID:24802245

  2. Effects of cigarette smoking on early arthritis: a cross-sectional study-data from the Argentine Consortium for Early Arthritis (CONAART).

    Science.gov (United States)

    Haye Salinas, María Jezabel; Retamozo, Soledad; Alvarez, Ana Cecilia; Maldonado Ficco, Hernán; Dal Pra, Fernando; Citera, Gustavo; Benegas, Mariana; Chaparro del Moral, Rafael; Rillo, Oscar; Secco, Anastasia; Marino Claverie, Lucila; Catalan Pellet, Antonio; Marcos, Josefina; García, Mercedes Argentina; Marcos, Juan Carlos; Barbaglia, Ana; Bellomio, Verónica; Berman, Alberto; Quiroz, Cristian; Soriano, Enrique R; Ceccato, Federico; Paira, Sergio; Vazquez, Doralia; Juarez, Vicente Ricardo; Velozo, Edson Javier; Salvatierra, Gabriela; Caeiro, Francisco

    2015-05-01

    Our objective was to analyze the effects of cigarette smoking on disease activity, functional capacity, radiographic damage, serology and presence of extraarticular manifestations in patients with rheumatoid arthritis and undifferentiated arthritis. This is a cross-sectional study of 1,305 patients (729 with rheumatoid arthritis and 576 with undifferentiated arthritis) from CONAART, the Argentine Consortium for Early Arthritis that includes patients older than 16 years with <2 years of disease. Sociodemographic data, clinical characteristics of the disease and smoking history were collected. In patients with rheumatoid arthritis the disease activity score of 28 joints was 5.4 ± 1.3 in current smokers, 5.2 ± 1.4 in former smokers and 5.1 ± 1.4 in never smokers (p = 0.011). The simple erosion narrowing score was higher in current smokers and former smokers than in never smokers (M 14.0, R Q 6.0-21.0; M 15.0, R Q 7.0-24.0; M 10.0, R Q 5.0-17.0; p = 0.006). Current smokers had higher rheumatoid factor titer (M 160.0, R Q 80.0-341.0) than former smokers (M 146.8, R Q 6.03-255.5) and never smokers (M 15.0, R Q 9.0-80.0) (p = 0.004). The variable independently associated with tobacco exposure was simple erosion narrowing score (OR = 1.03, 95 % CI 1.00-1.05; p = 0.012). In patients with undifferentiated arthritis, an association between smoking status and parameters of activity or radiographic damage was not observed. Neither was tobacco exposure related to the presence of extraarticular manifestations or to the degree of disability in any of the two groups of patients. No relation was found between disease activity and severity, and number of packs smoked per year. Tobacco.

  3. Dermatitis herpetiformis and rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Singal Archana

    2002-01-01

    Full Text Available A 35- year-old deaf and dumb woman with clinical and histopothological diagnosis of dermatitis herpetiforrnis (DH is reported for its rare association with rheumatoid arthritis (PA.

  4. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... a Question Physician Corner Rheumatology Conference Rheumatology Rounds Case Rounds Radiology Rounds Pathophysiology of the Rheumatic Diseases Our Research Patient-Centered Outcomes Research Research Studies The Camille Julia Morgan Arthritis Research and Education ...

  5. Genetics Home Reference: rheumatoid arthritis

    Science.gov (United States)

    ... D; Biologics in Rheumatoid Arthritis Genetics and Genomics Study Syndicate; Wellcome Trust Case Control Consortium, Concannon P, Onengut-Gumuscu S, Rich SS, Deloukas P, Gonzalez-Gay MA, Rodriguez-Rodriguez L, Ärlsetig L, Martin J, ...

  6. Therapy strategies in psoriatic arthritis.

    Science.gov (United States)

    Coates, Laura C

    2015-01-01

    Psoriatic arthritis (PsA) is a heterogeneous condition with a myriad of different clinical presentations. It commonly affects the skin and musculoskeletal system causing psoriasis, peripheral arthritis, axial arthritis, enthesitis and dactylitis. Many patients also have related conditions, such as those within the metabolic syndrome and associated spondyloarthritis (SpA) conditions including inflammatory bowel disease and uveitis. Any therapeutic strategy must be tailored to the individual patient, taking into account her/his complete clinical presentation and comorbidities. New treatment recommendations from the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) provide evidence based recommendations on effective therapies for the management of each different manifestation of PsA, and how treatment may be affected by comorbidities (1). However, the limited evidence comparing different treatment strategies in PsA is recognised as a limitation in these recommendations and further information is detailed below.

  7. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Expert Ask a Question Physician Corner RAVE: The Rheumatoid Arthritis Vital Education Initiative Rheumatology Conference Rheumatology Rounds Case Rounds Radiology Rounds Pathophysiology of the Rheumatic Diseases Our Research Patient-Centered ...

  8. Fetal Programming in Rheumatoid Arthritis

    NARCIS (Netherlands)

    F.D.O. de Steenwinkel (Florentien)

    2013-01-01

    markdownabstract__Abstract__ Rheumatoid arthritis (RA) is a chronic, systemic, inflammatory, autoimmune disease mainly affecting synovial tissues, which can lead to severe morbidity and progressive joint destruction resulting in deformations and disability. Other important outcomes include

  9. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... any advice you receive from your rheumatologist. Click A Link Below To Play Rheumatoid Arthritis: Symptoms and ... System Don’t have SilverLight? Get it here. A Small Favor More than 15 years ago the ...

  10. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... it here. A Small Favor More than 15 years ago the Arthritis Center launched this website with ... valuable information to over 1 million visitors each year. Contribute Today More Ways to Give Updated: July ...

  11. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Sheets Benefits and Risks of Opioids in Arthritis Management How to Give a Subcutaneous Injection ... website is intended for educational purposes only. Physicians and other health care professionals are encouraged to consult other sources ...

  12. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Studies The Camille Julia Morgan Arthritis Research and Education Fund About Us Appointment Information Contact Us Our ... the mission to bring current and accurate disease education to health care professionals and patients alike. Content ...

  13. Physical activity advice to manage chronic conditions for adults with arthritis or hypertension, 2007.

    Science.gov (United States)

    Carlson, Susan A; Maynard, L Michele; Fulton, Janet E; Hootman, Jennifer M; Yoon, Paula W

    2009-01-01

    To describe the prevalence and characteristics of persons with arthritis or hypertension who received advice from their health-care professional to manage their condition. Data from 9 states were obtained from the 2007 Behavioral Risk Factor Surveillance System. Two modules (Arthritis Management and Actions to Control High Blood Pressure) were analyzed (sample sizes: arthritis 29,698, hypertension 29,783). Fifty-five percent of persons with arthritis and 75.8% of persons with hypertension reported that their health-care professional ever suggested physical activity or exercise to help manage their condition. Correlates for being less likely to receive advice were lower levels of education, longer time since last routine doctor visit, being physically inactive, and having lower body mass index. Among inactive, normal weight persons, 43.0% (95% CI: 38.7, 47.4) with arthritis and 50.0% (95% CI: 44.4, 55.6) with hypertension reported receiving advice; among inactive, obese patients, 59.1% (95% CI: 55.8, 62.3) with arthritis and 74.0% (95% CI: 70.5, 77.3) with hypertension reported receiving advice. Findings suggest that health-care professionals may base physical activity counseling more on body mass index than a patient's activity level. To manage chronic health conditions, health-care professionals should assess patient's physical activity and offer all patients appropriate counseling.

  14. Analysis and comparison of serum immune index in patients with rheumatoid arthritis or systemic lupus erythematosus%类风湿关节炎及系统性红斑狼疮患者血液免疫指标的分析与比较

    Institute of Scientific and Technical Information of China (English)

    谢健敏; 莫石兰; 叶珮玑

    2012-01-01

    Objective To analyze and compare the serum immune index of rheumatoid arthritis and systemic lupus erythematosus and to achieve an accurate diagnosis of these two kinds of autoimmune diseases. Methods 46 cases of RA patients were selected as RA group and 40 cases of SLE patients were selected as SLE group. 30 cases of healthy persons as the control group, indirect immunofluorescence assay was used to detect the serum ANA, Western blot was used to detect the ENA polypeptide antibody and ds-DNA, the positive rate of variety of antibodies in RA group, SLE group and control group. Results In RA group, the positive rate of ANA was 37.0%, the positive rate of anti ds-DNA antibody was 13.0%, the positive rate of anti-ENA peptide antibody was 19.6%, positive rate by joint detection was 50.0%. In SLE group, the positive rate were 92.5%, 70.0%, 87.5% and 95.0% correspondingly. Conclusion Patients with autoimmune disease always have various auto antibodies, joint detection of ANA, anti ds-DNA and anti-ENA polypeptide antibody can improve the detection rate, they have the advantage of diagnosis of autoimmune diseases, also can avoid misdiagnosis and missed diagnosis.%目的 分析和比较类风湿关节炎(rheumatoid arthritis,RA)及系统性红斑狼疮(systemic lupus erythematosus,SLE)患者血液中的免疫指标,从而实现对这两种自身免疫性疾病的准确诊断.方法 分别选择RA患者46例为RA组、SLE患者40例为SLE组、健康体检者30例为对照组,用间接免疫荧光法检测血清抗核抗体(ANA),免疫印迹法检测可提取核抗原(ENA)多肽抗体及ds-DNA,分析各种抗体在不同患者组和对照组的阳性率.结果 在RA患者组中,ANA阳性率为37.0%,抗ds-DNA抗体阳性率为13.0%,抗ENA多肽抗体阳性率为19.6%,三种抗体联合检测阳性率为50.0%;SLE患者组中,阳性率相应分别为92.5%、70.0%、87.5%以及95.0%.结论 自身免疫性疾病患者体内存在多种自身抗体,ANA、抗ds-DNA、抗ENA多肽

  15. Uveitis in juvenile chronic arthritis.

    Science.gov (United States)

    Kanski, J J

    1990-01-01

    About 20% of patients with juvenile chronic arthritis develop uveitis which is frequently bilateral. Risk factors for uveitis are: female gender, pauciarticular onset of arthritis, presence of circulating antinuclear antibodies, and the antigens HLA-DW5 and HLA-DPw2. The visual prognosis in patients with uveitis is good in 25% and fair in 50%. The remaining 25% develop cataract and/or glaucoma. The management of glaucoma is unsatisfactory, but the results of cataract surgery by lensectomy are good.

  16. Arthritis in America PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2017-03-07

    This 60 second public service announcement is based on the March 2017 CDC Vital Signs report. Many adults in the United States have arthritis. Learn how to reduce the pain of arthritis, as well as manage the condition.  Created: 3/7/2017 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 3/7/2017.

  17. Fatigue in Rheumatoid Arthritis.

    Science.gov (United States)

    Katz, Patricia

    2017-05-01

    The purpose of this study was to review the current information on fatigue in rheumatoid arthritis (RA). Severe fatigue is common among individuals with RA and has a significant impact on quality of life (QOL). RA-related factors (e.g., inflammation, pain) are associated with greater fatigue, but other factors, such as obesity, physical inactivity, sleep disturbance, and depression, explain the majority of variation in fatigue. Medications targeting RA have little effect on fatigue. Instead, the most effective interventions seem to address non-RA-specific factors such as physical inactivity or use cognitive behavioral approaches. No recommendations have been made for tools to measure fatigue in RA, leading to potential difficulty comparing studies. Although fatigue has great impact on patients' QOL, effective interventions that are feasible for broad dissemination remain elusive. Additional multi-faceted research is needed to identify modifiable sources of fatigue. Such research would be enhanced by harmonization of fatigue measurement across studies.

  18. Smoking and Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Kathleen Chang

    2014-12-01

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

  19. Juvenile idiopathic arthritis

    Directory of Open Access Journals (Sweden)

    Krupa H Bhatt

    2014-01-01

    Full Text Available Juvenile Idiopathic Arthritis (JIA is the most chronic musculoskeletal disease of pediatric population. The chronic course of disease has a great impact on oral health. Temporomandibular joint is involved in JIA causing limited mouth opening with progressive open bite, retrognathia, microgenia and bird like appearance. Joints of upper and lower extremities are also involved. Effect on upper limb function leads to difficulty with fine motor movements required for brushing and flossing. This increases incidence of caries and periodontal disease in children. The cause of JIA is still poorly understood and none of the available drugs for JIA can cure the disease. However, prognosis has improved as a result of progress in disease classification and management. The dental practitioner should be familiar with the symptoms and oral manifestations of JIA to help manage as multidisciplinary management is essential.

  20. Interstitial Lung Disease of the UIP Variant as the Only Presenting Symptom of Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Abhinav Agrawal

    2015-01-01

    Full Text Available Rheumatoid arthritis is a chronic inflammatory disease primarily manifesting with symptoms of joint pain. It also involves multiple organ systems in the body, including the lungs. Interstitial lung disease (ILD is the most common form of pulmonary involvement in rheumatoid arthritis (RA. Without the typical symptoms such as chronic joint pain, establishing the diagnosis of RA could be quite challenging and a high index of suspicion is thereby required to diagnose ILD in patients with RA, thereby delaying treatment and increasing morbidity and mortality. We report a case of a 67-year-old Hispanic male with no previous history of rheumatoid arthritis or symptoms of typical joint pain who comes to the hospital only with the chief complaints of progressive worsening of shortness of breath for a duration of 6 months and was eventually diagnosed with ILD of the usual interstitial pneumonia variant with serologies positive for rheumatoid arthritis.

  1. Protective effects of Huang-Lian-Jie-Du-Tang and its component group on collagen-induced arthritis in rats.

    Science.gov (United States)

    Hu, Yaohua; Hu, Zhenlin; Wang, Shuping; Dong, Xinxin; Xiao, Cheng; Jiang, Miao; Lv, Aiping; Zhang, Weidong; Liu, Runhui

    2013-12-12

    Huang-Lian-Jie-Du-Tang is a famous Traditional Chinese medicine consisting of Rhizoma coptidis (Coptis chinensis Franch, Ranunculaceae), Radix scutellariae (Scutellaria baicalensis Georgi, Labiatae), Cortex phellodendri (Phellodendron amurense Rupr. Rutaceae) and Fructus gardeniae (Gardenia jasminoide Ellis, Rubiaceae) in a weight ratio of 3:2:2:3.This formula was described by Wang Tao (in the Chinese Tang Dynasty) in his treatise "Wai Tai Mi Yao". It has been used to treat inflammation, hypertension, gastrointestinal disorders, and liver and cerebrovascular diseases in the clinical practice of Traditional Chinese medicine, especially in treating inflammation for nearly two thousand years. However, the essential compounds in it have not been identified, and the mechanisms remain to be addressed. To investigate the protective effects of HLJDT and its component group (HLJDT-CG) on collagen-induced arthritis in rats. CIA was established in male Wistar rats with subcutaneous injection of type II bovine collagen at the base of the tail of animals. CIA rats were treated daily with oral administration of HLJDT aqueous extracts (270 mg/kg) or HLJDT-CG (40 mg/kg) once per day from day 6 to day 28. Rats in normal and vehicle control groups were given an equal volume of vehicle (0.9% saline) and 0.025 mg/kg Dexamethasone was given to the Standard group at the same time. The protective effect of them were assessed by measuring arthritis index, swelling, the cytokines such as TNF-α, IFN-γ and IL-17 in serum, type II collagen antibodies, splenocyte proliferation and so on. The results demonstrated that treatment of CIA rat with either HLJDT aqueous extracts or HLJDT-CG not only ameliorated the symptoms of arthritis, prevented joint damage but also reduced the serum levels of TNF-α, IFN-γ and IL-17 in CIA rats. Anti-CII antibodies showed the similar trend except that of IgG1. Furthermore, HLJDT aqueous extracts and HLJDT-CG administration also suppressed CII

  2. Efficacy and safety of tofacitinib for treatment of rheumatoid arthritis.

    Science.gov (United States)

    Lundquist, Lisa M; Cole, Sabrina W; Sikes, Martha L

    2014-09-18

    Tofacitinib is the first in a new class of nonbiologic disease-modifying antirheumatic drugs (DMARDs), a targeted, synthetic DMARD, approved for the treatment of rheumatoid arthritis (RA) as monotherapy or in combination with methotrexate or other non-biologic DMARD. Tofacitinib, an orally administered Janus kinase (JAK) inhibitor, decreases T-cell activation, pro-inflammatory cytokine production, and cytokine signaling by inhibiting binding of type I cytokine receptors family and γ-chain cytokines to paired JAK1/JAK3 receptors. The net effect of tofacitinb's mechanism of action is decreased synovial inflammation and structural joint damage in RA patients. To date, six phase 3 trials have been conducted to evaluate the safety and efficacy of tofacitinib under the oral rheumatoid arthritis triaLs (ORAL) series. This review describes the pharmacology of the novel agent, tofacitinib, and details the safety and efficacy data of the ORAL trials.

  3. Canakinumab for the treatment of systemic juvenile idiopathic arthritis.

    Science.gov (United States)

    Grom, Alexei A

    2014-11-01

    The introduction of methotrexate in the 1980s and of TNF-inhibiting agents and abatacept in the late 1990s led to a dramatic improvement in the outcomes of non-systemic categories of juvenile idiopathic arthritis. By contrast, the same treatment approaches had no strong impact on the outcome of systemic juvenile idiopathic arthritis (SJIA), and the main effective treatment in these patients remained glucocorticoids with their known side effects. Encouraging findings in small studies involving SJIA patients treated with IL-1 and IL-6 inhibitors led to large Phase III trials, and the results in these trials provide hope that substantial joint damage and disability seen in the majority of patients with persistent SJIA can be prevented. The purpose of this review is to discuss the safety and efficacy of the IL-1 and IL-6 inhibiting agents in SJIA with the main focus on canakinumab, a fully human monoclonal anti-IL-1β antibody.

  4. Therapeutic Drug-Monitoring of Methotrexate-Polyglutamates in Rheumatoid Arthritis

    NARCIS (Netherlands)

    E. den Boer (Ethan)

    2014-01-01

    markdownabstract__Abstract__ Rheumatoid Arthritis (RA) is a chronic autoimmune disease, characterized by the swelling of joints, uncontrolled proliferation of synovial tissue and multisystem co-morbidities. RA mainly affects the joints of the hands, feet, knees, wrist and elbows, with joint damage

  5. [The patient with arthritis: care by both general practitioners and rheumatologists].

    NARCIS (Netherlands)

    Janssens, H.; Lisdonk, E.H. van de; Janssen, M.

    2011-01-01

    Early aggressive treatment of rheumatoid arthritis (RA) with disease-modifying antirheumatic drugs such as TNF inhibitors prevents joint damage and improves the quality of life. There is increasing insight regarding the cardiovascular risks of patients suffering from RA or gout. These aspects and

  6. Pharmacogenetics of anti-TNF treatment in patients with rheumatoid arthritis.

    NARCIS (Netherlands)

    Coenen, M.J.J.; Toonen, E.J.M.; Scheffer, H.; Radstake, T.R.D.J.; Barrera, P.; Franke, B.

    2007-01-01

    TNF-blocking strategies are widely used in the treatment of rheumatoid arthritis (RA). Three anti-TNF agents are registered for use in RA: etanercept, infliximab and adalimumab. Although anti-TNF therapy is very effective in controlling disease activity and slowing down radiological damage, prolonge

  7. OMERACT Rheumatoid Arthritis Magnetic Resonance Imaging Studies. Summary of OMERACT 6 MR Imaging Module

    DEFF Research Database (Denmark)

    McQueen, F; Lassere, M; Edmonds, J;

    2003-01-01

    Magnetic resonance image (MRI) scanning is a new method for imaging and quantifying joint inflammation and damage in rheumatoid arthritis (RA). Over the past 4 years, the OMERACT MR Imaging Group has been developing and testing the RA-MRI scoring system (RAMRIS) for use in RA. The OMERACT filter...

  8. The influence of ageing on the development and management of rheumatoid arthritis

    NARCIS (Netherlands)

    Boots, Annemieke M. H.; Maier, Andrea B.; Stinissen, Piet; Masson, Pierre; Lories, Rik J.; De Keyser, Filip

    2013-01-01

    The population of elderly individuals with rheumatoid arthritis (RA) is expanding, due mainly to increasing life expectancy. A variety of theories have been proposed to explain the ageing process, including accumulation of DNA damage and resultant changes in biological processes. Such changes can in

  9. [The patient with arthritis: care by both general practitioners and rheumatologists].

    NARCIS (Netherlands)

    Janssens, H.; Lisdonk, E.H. van de; Janssen, M.

    2011-01-01

    Early aggressive treatment of rheumatoid arthritis (RA) with disease-modifying antirheumatic drugs such as TNF inhibitors prevents joint damage and improves the quality of life. There is increasing insight regarding the cardiovascular risks of patients suffering from RA or gout. These aspects and ot

  10. Evaluating joint destruction in rheumatoid arthritis : is it necessary to radiograph both hands and feet?

    NARCIS (Netherlands)

    Knevel, R.; Kwok, K. Y.; de Rooy, D. P. C.; Posthumus, M. D.; Huizinga, T. W. J.; Brouwer, E.; van der Helm-van Mil, A. H. M.

    2013-01-01

    Background Radiological damage is an important outcome measure in rheumatoid arthritis (RA), both for research and clinical purposes. Depending on the setting, both hands and feet are radiographed, or only a part of these. It is unknown whether radiographing part of the four extremities gives compar

  11. Validation of automatic joint space width measurements in hand radiographs in rheumatoid arthritis

    NARCIS (Netherlands)

    Schenk, Olga; Huo, Yinghe; Vincken, Koen L; van de Laar, Mart A; Kuper, Ina H H; Slump, Kees C H; Lafeber, Floris P J G; Bernelot Moens, Hein J

    2016-01-01

    Computerized methods promise quick, objective, and sensitive tools to quantify progression of radiological damage in rheumatoid arthritis (RA). Measurement of joint space width (JSW) in finger and wrist joints with these systems performed comparable to the Sharp-van der Heijde score (SHS). A next st

  12. Work and health in early arthritis [werk en gerzondheid bij vroege inflammatoire gewrichtsklachten

    NARCIS (Netherlands)

    Geuskens, G.A.

    2009-01-01

    Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic inflammation of the joints, which may result in joint damage. Any joint may be affected, but most commonly small joints in the hands and feet, wrists, elbows, and knees are involved. The onset of RA increases with age, and

  13. The influence of ageing on the development and management of rheumatoid arthritis

    NARCIS (Netherlands)

    Boots, Annemieke M. H.; Maier, Andrea B.; Stinissen, Piet; Masson, Pierre; Lories, Rik J.; De Keyser, Filip

    2013-01-01

    The population of elderly individuals with rheumatoid arthritis (RA) is expanding, due mainly to increasing life expectancy. A variety of theories have been proposed to explain the ageing process, including accumulation of DNA damage and resultant changes in biological processes. Such changes can

  14. Fish Eaters Report Less Rheumatoid Arthritis Pain

    Science.gov (United States)

    ... fullstory_166848.html Fish Eaters Report Less Rheumatoid Arthritis Pain Study suggests most fish may play role ... reduce the pain and swelling associated with rheumatoid arthritis, a new study says. Prior studies have shown ...

  15. Understanding Rheumatoid Arthritis (RA): Treatment and Causes

    Science.gov (United States)

    ... this page please turn JavaScript on. Feature: Understanding Rheumatoid Arthritis (RA) Treatment and Causes Past Issues / Summer 2014 Table of Contents How Is Rheumatoid Arthritis Treated? Doctors have many ways to treat this ...

  16. Having Rheumatoid Arthritis May Increase Heart Risk

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_162038.html Having Rheumatoid Arthritis May Increase Heart Risk Treating inflammation linked to ... TUESDAY, Nov. 15, 2016 (HealthDay News) -- People with rheumatoid arthritis may have an increased risk for a heart ...

  17. Celecoxib for rheumatoid arthritis.

    Science.gov (United States)

    Fidahic, Mahir; Jelicic Kadic, Antonia; Radic, Mislav; Puljak, Livia

    2017-06-09

    Rheumatoid arthritis is a systemic auto-immune disorder that causes widespread and persistent inflammation of the synovial lining of joints and tendon sheaths. Presently, there is no cure for rheumatoid arthritis and treatment focuses on managing symptoms such as pain, stiffness and mobility, with the aim of achieving stable remission and improving mobility. Celecoxib is a selective non-steroidal anti-inflammatory drug (NSAID) used for treatment of people with rheumatoid arthritis. To assess the benefits and harms of celecoxib in people with rheumatoid arthritis. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase and clinical trials registers (ClinicalTrials.gov and the World Health Organization trials portal) to May 18, 2017. We also searched the reference and citation lists of included studies. We included prospective randomized controlled trials (RCTs) that compared oral celecoxib (200 mg and 400 mg daily) versus no intervention, placebo or a traditional NSAID (tNSAID) in people with confirmed rheumatoid arthritis, of any age and either sex. We excluded studies with fewer than 50 participants in each arm or had durations of fewer than four weeks treatment. We used standard methodological procedures expected by The Cochrane Collaboration. We included eight RCTs with durations of 4 to 24 weeks, published between 1998 and 2014 that involved a total of 3988 adults (mean age = 54 years), most of whom were women (73%). Participants had rheumatoid arthritis for an average of 9.2 years. All studies were assessed at high or unclear risk of bias in at least one domain. Overall, evidence was assessed as moderate-to-low quality. Five studies were funded by pharmaceutical companies. Celecoxib versus placeboWe included two studies (N = 873) in which participants received 200 mg daily or 400 mg daily or placebo. Participants who received celecoxib showed significant clinical improvement compared with those receiving placebo (15% absolute

  18. CORRELATION OF LIPID PARAMETERS AND CARDIOVASCULAR MANIFESTATIONS IN PATIENTS WITH RHEUMATOID ARTHRITIS ATTENDING A TERTIARY CARE CENTRE OF NORTH EAST INDIA

    Directory of Open Access Journals (Sweden)

    Ubedul Islam

    2016-10-01

    Full Text Available BACKGROUND Rheumatoid Arthritis (RA is a chronic inflammatory disease of unknown aetiology marked by a symmetric and peripheral polyarthritis, which often results in joint damage and physical disability. Rheumatoid arthritis is not just only a disease affecting joints, but it goes well beyond the barricade of arthritis into systemic inflammatory manifestations. Various factors play an important role in the morbidity and mortality of the disease. The aim of this study was to investigate the clinical spectrum of rheumatoid arthritis with special reference to dyslipidaemia and cardiovascular manifestations. MATERIALS AND METHODS We conducted a hospital-based observational study comprising of 72 patients of rheumatoid arthritis who had been diagnosed, based on criteria laid down by 2010 ACR/EULAR classification criteria, admitted in Gauhati Medical College and Hospital, Guwahati, Assam (India and fulfilled the inclusion and exclusion criteria. Statistical analysis was performed using GraphPad InStat version 3.00 for Windows 7, GraphPad Software, San Diego, California, USA (www.graphpad.com. P value <0.05 was taken as statistically significant. RESULTS In this study, out of 72 patients, 16 patients were male and 56 patients were female, 31.94% cases were in the 5th decade of life followed by the 4th decade (30.56% with a mean age of 43.63 years. Our study found that the most common derangement of lipid parameter was being attributed to low HDL level (31% followed by a high triglyceride level (20.83%. The prevalence of dyslipidaemia was 41.67%. Atherogenic index was high in 23.6% of the cases with a mean of 4.52 of borderline range. In this study, ECG abnormalities were present in 12.5% of study subjects, abnormal echocardiography findings were present in 11.11% of patients and abnormal carotid Doppler findings were present in 18%. The most common ECG abnormality was nonspecific ST-T changes, most common echocardiographic abnormality was pericardial

  19. The impact of arthritis on the physical function of a rural Maya-Yucateco community and factors associated with its prevalence: a cross sectional, community-based study.

    Science.gov (United States)

    Loyola-Sanchez, Adalberto; Richardson, Julie; Pelaez-Ballestas, Ingris; Alvarez-Nemegyei, José; Lavis, John N; Wilson, Michael G; Wilkins, Seanne

    2016-07-01

    This study aims to evaluate the impact of arthritis on the physical function of people living in a Maya-Yucateco rural community and to assess the association of known modifiable risk factors with the prevalence of overall arthritis and its main types (osteoarthritis and rheumatoid arthritis). Using a cross-sectional, community-based census design, data collected from the adult population (≥18 years) of the Municipality of Chankom, Yucatán, México, were analyzed (n = 1523). Participants' physical function was assessed using a culturized version of the health assessment questionnaire disability index. Social, physical, and behavioral factors linked to overall arthritis, osteoarthritis, and rheumatoid arthritis, were assessed through the "Community-Oriented-Program-for-the-Control-of-Rheumatic-Diseases [COPCORD]" questionnaire. A physiatrist and a rheumatologist confirmed all osteoarthritis and rheumatoid arthritis cases using the American College of Rheumatology criteria. Arthritis was confirmed in 169 cases (22 %, 95 % confidence interval (CI) 19-25) of those assessed for musculoskeletal symptoms (n = 779): osteoarthritis = 144, rheumatoid arthritis = 17, and non-specific arthritis = 8. Arthritis was associated with a higher prevalence of disability after controlling for age, gender, and number of comorbidities (odds ratio = 4.0, 95 % CI 3.0-6.0). Higher level of wealth was associated with lower arthritis prevalence (odds ratio = 0.9, 95% CI 0.8-0.9). Higher body mass index was associated with higher hip and/or knee osteoarthritis prevalence (odds ratio = 1.1, 95 % CI 1.03-1.1). Arthritis is highly associated with disability in the Mayan people living in Chankom. The prevalence of arthritis in Chankom is associated with social factors, such as people's level of wealth, while the prevalence of low-extremity osteoarthritis is associated with people's body mass index.

  20. AP Index

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Planetary Amplitude index - Bartels 1951. The a-index ranges from 0 to 400 and represents a K-value converted to a linear scale in gammas (nanoTeslas)--a scale that...

  1. Speech Indexing

    NARCIS (Netherlands)

    Ordelman, R.J.F.; Jong, de F.M.G.; Leeuwen, van D.A.; Blanken, H.M.; de Vries, A.P.; Blok, H.E.; Feng, L.

    2007-01-01

    This chapter will focus on the automatic extraction of information from the speech in multimedia documents. This approach is often referred to as speech indexing and it can be regarded as a subfield of audio indexing that also incorporates for example the analysis of music and sounds. If the objecti

  2. 9 CFR 311.7 - Arthritis.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Arthritis. 311.7 Section 311.7 Animals... CERTIFICATION DISPOSAL OF DISEASED OR OTHERWISE ADULTERATED CARCASSES AND PARTS § 311.7 Arthritis. (a) Carcasses affected with arthritis which is localized and not associated with systemic change may be passed for human...

  3. Rheumatoid Arthritis: "You Are Not Alone."

    Science.gov (United States)

    ... page please turn JavaScript on. Feature: Understanding Rheumatoid Arthritis (RA) Rheumatoid Arthritis: "You Are Not Alone." Past Issues / Summer 2014 ... Contents Members of the America 2 Anywhere 4 Arthritis (A2A4A) running group after finishing a marathon. Through ...

  4. Differential Diagnosis of Polyarticular Arthritis.

    Science.gov (United States)

    Pujalte, George G A; Albano-Aluquin, Sheila A

    2015-07-01

    Polyarticular arthritis is commonly encountered in clinical settings and has multiple etiologies. The first step is to distinguish between true articular pain and nonarticular or periarticular conditions by recognizing clinical patterns through the history and physical examination. Once pain within a joint or joints is confirmed, the next step is to classify the pain as noninflammatory or inflammatory in origin. Noninflammatory arthritis, which is mostly related to osteoarthritis, has a variable onset and severity and does not have inflammatory features, such as warm or swollen joints. Osteoarthritis usually presents with less than one hour of morning stiffness and pain that is aggravated by activity and improves with rest. A review of systems is usually negative for rashes, oral ulcers, or other internal organ involvement. In contrast, inflammatory arthritis generally causes warm, swollen joints; prolonged morning stiffness; and positive findings on a review of systems. Once inflammatory arthritis is suspected, possible diagnoses are sorted by the pattern of joint involvement, which includes number and type of joints involved, symmetry, and onset. The suspicion for inflammatory arthritis should be confirmed by the appropriate serologic/tissue and/or imaging studies in the clinical setting or in consultation with a subspecialist.

  5. Correlation between subtalar varus angle and disability in patients with patellofemoral arthritis

    Directory of Open Access Journals (Sweden)

    Patel Birenkumar Jagdishbhai

    2009-11-01

    Full Text Available Aim: To find the correlation between subtalar varus angle & disability in patients with patellofemoral arthritis. Methods: A total of 30 subjects aged (48.86±5.74 referred to the department of physiotherapy, with patellofemoral arthritis and fulfilling the criteria of inclusion were recruited for the study, sampling method being convenient sampling. Disability score was measured of each patient by WOMAC index (Western Ontario and McMaster Universities Index of Osteoarthritis disability questionnaire and subtalar varus angle was measured in non weight bearing position in prone lying. Results: Pearson’s correlation coefficient test showed a highly significant (p=0.000 positive correlation (r=0.821 between disability scores and subtalar varus angle. Conclusion: There is a highly significant relation between disabilities due to patellofemoral pain in patellofemoral arthritis patients and sub talar varus angle

  6. Association of arthritis and vitamin D insufficiency with physical disability in Mexican older adults: findings from the Mexican Health and Aging Study.

    Science.gov (United States)

    Valderrama-Hinds, Luis M; Al Snih, Soham; Rodriguez, Martin A; Wong, Rebeca

    2017-04-01

    Arthritis and vitamin D insufficiency are prevalent in older adults and are risk factors for disability. The objective of this study was to examine the effect of co-occurring arthritis and vitamin D deficiency on upper-lower extremity functional limitations and disability in older adults. We examined 1533 participants aged ≥50 years from a subsample of the Mexican Health and Aging Study. Measures included sociodemographics, body mass index, comorbid conditions, falls, physical activity, physical function tests, functional limitations, activities of daily living (ADL), and vitamin D. Participants were categorized into four groups according to arthritis and vitamin D status: no vitamin D insufficiency and no arthritis (58.80%), vitamin D insufficiency only (27.49%), arthritis only (8.47%), and arthritis and vitamin D insufficiency (5.24%). Fourteen percent reported arthritis, and 31.2% had vitamin D insufficiency. The arthritis and vitamin D insufficiency group was associated with upper-lower extremity functional limitations [odds ratio (OR) 1.82, 95% confidence interval (CI) 1.06-3.15, and OR 1.90, 95% CI 1.00-3.62, respectively] and ADL disability (OR 3.00, 95% CI 1.63-5.51) when compared with the no vitamin D insufficiency and no arthritis group (reference group). The arthritis only group was three times more likely to report upper-lower extremity functional limitations and ADL disability. The vitamin D insufficiency only group was not significantly associated with functional limitations nor ADL disability. Arthritis and vitamin D insufficiency increased the risk of ADL disability in this population. However, the effect of arthritis and vitamin D insufficiency on upper-lower extremity functional limitations was not higher than the effect of arthritis only, but higher than the effect on vitamin D insufficiency alone.

  7. Pregnancy and rheumatoid arthritis.

    Science.gov (United States)

    Ince-Askan, Hilal; Dolhain, Radboud J E M

    2015-01-01

    Fertility is impaired in female patients with rheumatoid arthritis (RA), which is related to disease activity and the use of certain medication. During pregnancy, disease activity usually improves, but less than previously thought. Especially in women with high disease activity, the pregnancy outcome is also impaired. All of this underscores the importance of strict control of disease activity in RA patients who wish to conceive. Management of RA disease activity during pregnancy might be a challenge as the treatment options are limited. Evidence is accumulating that tumor necrosis factor (TNF) blockers can be safely used during pregnancy, particularly during the first trimester and the beginning of the second trimester. Far less is known about the problems faced by male RA patients who wish to conceive, in terms of not only fertility and pregnancy outcome but also the safety of medication. In this paper, the fertility issues in patients with RA, the pregnancy-associated improvement of RA, the pregnancy outcomes, including the long-term effects on the offspring, and treatment options, including those during lactation and for male patients wishing to conceive, will be reviewed.

  8. RHEUMATOID ARTHRITIS AND PREGNANCY

    Directory of Open Access Journals (Sweden)

    N. M. Kosheleva

    2014-01-01

    Full Text Available Rheumatoid arthritis (RA generally starts at the age when many women have already become mothers; however, it may occur in childhood or adolescence. Furthermore, there has been recently a women’s tendency to plan pregnacy for a more mature age, which necessitates a discussion about gestation in this disease. Investigation of mechanisms pregnancy can influence the development of RA both in the gestation and long-term periods is of important theoretical and practical value. The results of these investigations may be used to develop new treatments for RA and management tactics for patients during pregnancy and lactation. The  aper gives the data available in the literature on fertility in RA, impact of pregnancy on its activity and that of RA on the course and outcomes of gestation, as well as current ideas on lactation and use of oral contraceptives in RA. Particular attention is given to drug therapy in pregnant and breastfeeding women with RA: groups of anti-rheumatic drugs are considered in detail in relation to the safety of or a potential risk from their use. A therapeutic algorithm and recommendations for pregnancy planning and a follow-up of patients with RA during gestation are proposed.

  9. Pregnancy and rheumatoid arthritis.

    Science.gov (United States)

    Tandon, Vishal R; Sharma, Sudhaa; Mahajan, Annil; Khajuria, Vijay; Kumar, Ajay

    2006-08-01

    Pregnancy in most cases, is associated with remission of rheumatoid arthritis (RA), but a quarter of patients continue to have active disease or even worsening of the disease and most patients who improve, relapse in the postpartum period. The pathophysiology of this improvement in disease activity during pregnancy remains unknown, but hormonal, cell-mediated immunological and humoral immunological changes during pregnancy, have been proposed responsible for this. Most of the pregnant women with RA have an uneventful course, with no significant complications. In general, no significant increase in maternal or fetal morbidity seems to be attributable to RA. Patients with RA do not have decreased fertility. A majority of patients with RA may go in remission and anti-rheumatic treatment may not be required as soon as women become pregnant. But other patients who continue with the disease activity require treatment. The preferred disease-modifying agents during pregnancy are sulfasalazine and hydroxychloroquine. Azathioprine and cyclosporine can be used if the benefits outweigh the risks. Paracetamol and low dose prednisone are preferred and considered safe, both for mother and fetus. Methotrexate and lefunomide are contraindicated and must be prophylactically withdrawn before a planned pregnancy. Biologics generally should be stopped when pregnancy is discovered. An overall rational approach is highly warranted to treat RA during pregnancy.

  10. Prostaglandins and Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Mohammad Javad Fattahi

    2012-01-01

    Full Text Available Rheumatoid arthritis (RA is a chronic, autoimmune, and complex inflammatory disease leading to bone and cartilage destruction, whose cause remains obscure. Accumulation of genetic susceptibility, environmental factors, and dysregulated immune responses are necessary for mounting this self-reacting disease. Inflamed joints are infiltrated by a heterogeneous population of cellular and soluble mediators of the immune system, such as T cells, B cells, macrophages, cytokines, and prostaglandins (PGs. Prostaglandins are lipid inflammatory mediators derived from the arachidonic acid by multienzymatic reactions. They both sustain homeostatic mechanisms and mediate pathogenic processes, including the inflammatory reaction. They play both beneficial and harmful roles during inflammation, according to their site of action and the etiology of the inflammatory response. With respect to the role of PGs in inflammation, they can be effective mediators in the pathophysiology of RA. Thus the use of agonists or antagonists of PG receptors may be considered as a new therapeutic protocol in RA. In this paper, we try to elucidate the role of PGs in the immunopathology of RA.

  11. Psoriatic arthritis: imaging techniques

    Directory of Open Access Journals (Sweden)

    E. Lubrano

    2012-06-01

    Full Text Available Imaging techniques to assess psoriatic arthritis (PsA include radiography, ultrasonography (US, magnetic resonance imaging (MRI, computed tomography (CT and bone scintigraphy. The radiographic hallmark of PsA is the combination of destructive changes (joint erosions, tuft resorption, osteolysis with bone proliferation (including periarticular and shaft periostitis, ankylosis, spur formation and non-marginal syndesmophytes. US has an increasing important role in the evaluation of PsA. In fact, power Doppler US is useful mainly for its ability to assess musculoskeletal (joints, tendons, entheses and cutaneous (skin and nails involvement, to monitor efficacy of therapy and to guide steroid injections at the level of inflamed joints, tendon sheaths and entheses. MRI allows direct visualization of inflammation in peripheral and axial joints, and peripheral and axial entheses, and has dramatically improved the possibilities for early diagnosis and objective monitoring of the disease process in PsA. MRI has allowed explaining the relationships among enthesitis, synovitis and osteitis in PsA, supporting a SpA pattern of inflammation where enthesitis is the primary target of inflammation. CT has little role in assessment of peripheral joints, but it may be useful in assessing elements of spine disease. CT accuracy is similar to MRI in assessment of erosions in sacroiliac joint involvement, but CT is not as effective in detecting synovial inflammation. Bone scintigraphy lacks specificity and is now supplanted with US and MRI techniques.

  12. Overview of the radiology of juvenile idiopathic arthritis (JIA)

    Energy Technology Data Exchange (ETDEWEB)

    Cohen, P.A.; Job-Deslandre, C.H.; Lalande, G.; Adamsbaum, C

    2000-02-01

    Plain films remain the basic tool for diagnosis and follow-up evaluation of juvenile idiopathic arthritis (JIA). In this paper, we review the new classification of JIA: systemic arthritis, oligoarthritis (persistent), oligoarthritis (extended), polyarticular arthritis (rheumatoid factor negative), polyarticular arthritis (rheumatoid factor positive), enthesitis related arthritis, psoriatic arthritis and unclassified arthritis. We will also review regional abnormalities of three stages: an early stage, an intermediate stage, a late stage, as well as the differential diagnosis.

  13. Low-intensity laser therapy efficacy evaluation in FVB mice subjected to acute and chronic arthritis.

    Science.gov (United States)

    Issa, João Paulo Mardegan; Trawitzki, Bianca Ferreira; Ervolino, Edilson; Macedo, Ana Paula; Lilge, Lothar

    2017-08-01

    Rheumatoid arthritis, an autoimmune inflammation, has a high prevalence in the population, and while therapy is available, it required often injection of drugs causing discomfort to patients. This study evaluates the clinical and histological effect of low-intensity laser therapy (LILT) as an alternative treatment, in a murine model of acute and chronic inflammation. FVB mice received either a Zymosan A injection into one knee joint inducing acute inflammation, followed after 15 min or 24 h by LILT or a collagen bovine type II injection emulsified in "Freund's Complete Adjuvant" to induce chronic arthritis, followed at 4 weeks with multiple LILT sessions. LILT mediated by either 660, 808, or 905 nm and tissue response was evaluated based on clinical symptoms and histological analysis of inflammatory infiltrate and damage to the articular surfaces. LILT can be effective in elevating clinical symptoms, so Kruskal-Wallis testing indicated no significant differences between knees affected by acute arthritis and treated once with LILT and an injured knee without treatment (p > 0.05) for 660 and 808 nm with some improvements for the 905-nm LILT. Mice receiving two treatments for acute arthritis showed exacerbation of inflammation and articular resorption following therapy with a 660-nm continuous laser (p  0.05). Among the lasers, the 905 nm tends to show better results for anti-inflammatory effect in acute arthritis, and the 660 nm showed better results in chronic arthritis. In conclusion, LILT wavelength selection depends on the arthritis condition and can demonstrate anti-inflammatory effects for chronic arthritis and reduced resorption area in this murine model.

  14. The chronic damage in systemic lupus erythematosus is driven by flares, glucocorticoids and antiphospholipid antibodies: results from a monocentric cohort.

    Science.gov (United States)

    Conti, F; Ceccarelli, F; Perricone, C; Leccese, I; Massaro, L; Pacucci, V A; Truglia, S; Miranda, F; Spinelli, F R; Alessandri, C; Valesini, G

    2016-06-01

    Literature data suggest a significantly higher mortality in patients affected by systemic lupus erythematosus (SLE) developing chronic damage. Therefore, damage prevention is a major goal in the management of SLE patients. In the present study, we assessed damage by means of the Systemic Lupus International Collaborative Clinics/American College of Rheumatology (SLICC/ACR) damage index (SDI), in a large cohort of SLE patients. Additionally, we aimed at evaluating its association with demographic and clinical features as well as with disease activity and laboratory findings. We enrolled consecutive patients affected by SLE diagnosed according to the American College of Rheumatology (ACR) 1997 revised criteria. Chronic damage was determined by SDI calculated at the last examination in all patients with at least six months of follow-up. Disease activity was assessed by the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K); flare was defined as an increase of SLEDAI-2K ≥ 4 compared with the previous visit. We evaluated 349 SLE patients (M/F 25/324, mean age ± SD 42.7 ± 12.4 years, mean disease duration ± SD 164.9 ± 105.2 months). Among the enrolled patients, 125 (35.8%) showed a SDI ≥ 1 (mean SDI ± SD 1.7 ± 0.9, range 0-5). The musculo-skeletal was the most frequently involved organ/system in SDI score (41/349 patients, 11.7%), with deforming/erosive arthritis in 21/349 (6.0%). The presence of chronic damage was associated with age (P < 0.001), disease duration (P < 0.001), number of flares (P = 0.02) and with the use of glucocorticoids (P = 0.02). The logistic regression analysis revealed the association between neuropsychiatric damage and antiphospholipid syndrome (P = 0.01, OR = 3.9) and between the presence of cardiovascular damage and anti-β2GPI antibodies (P = 0.01, OR 6.2). In the present study chronic damage was identified in about one third of SLE patients. The

  15. BIOBEHAVIORAL THERAPY OF RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    N. A. Shabanova

    2013-01-01

    Full Text Available The relevance of the study is connected with need to expand the arsenal of treatment methods patients with rheumatoid arthritis. The study examined the efficacy of biobehavioral therapy in a comprehensive program of treatment patients with rheumatoid arthritis (medical therapy in combination with biobehavioral therapy. It has been shown when compared with the control group (isolated drug therapy maintaining  clinical  response  in  short-term  follow-up  study  in  the  intervention  group.  Statistically    significant relationship the volitional control of the alpha rhythm of EEG (increased power of the alpha rhythm with a reduction in pain intensity in the in neurofeedback program and positive dynamics of the main characteristics of the alpha rhythm have been drmonstrated. Inclusion in the treatment program of arthritis biobehavioral approach has reduced the dose of pain medication, so reducing aggression of pharmacotherapy.

  16. A RELATIONSHIP BETWEEN QT INTERVAL AND CARDIOVASCULAR RISK FACTORS IN WOMEN WITH RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    D. S. Novikova

    2014-07-01

    Full Text Available Objective: to study a relationship of QT interval to cardiovascular risk factors in women with rheumatoid arthritis (RA.Subjects and methods. 291 female patients aged less than 60 years with a valid diagnosis of RA were examined. A control group consisted of125 women without rheumatic diseases. In addition to the clinical manifestations, acidity, and severity of RA, the authors assessed traditional risk factors (TRF of cardiovascular diseases (CVD, performed Holter ECG monitoring, common carotid artery duplex scanning, transthoracic echocardiographic study, and determined the levels of serum inflammatory markers.Results. The patients with RA differ from the control group in a longer adjusted QT interval, corrected for TRF of CVD. The major factorsassociated with a daily prolonged QTc interval in the women with RA are arterial hypertension, systolic, diastolic, pulse blood pressure level s, body mass index, subclinical target organ damage (carotid artery atherosclerosis, left ventricular (LV diastolic dysfunction, LV hypertrophyand remodeling, and the duration of RA. Leflunomide therapy is an additional factor associated with a prolonged nocturnal QT interval.Conclusion. The RA patients with a prolonged QTc interval and no clinical signs of cardiac lesion need meticulous examination aimed to identify CVD.

  17. A RELATIONSHIP BETWEEN QT INTERVAL AND CARDIOVASCULAR RISK FACTORS IN WOMEN WITH RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    D. S. Novikova

    2013-01-01

    Full Text Available Objective: to study a relationship of QT interval to cardiovascular risk factors in women with rheumatoid arthritis (RA.Subjects and methods. 291 female patients aged less than 60 years with a valid diagnosis of RA were examined. A control group consisted of125 women without rheumatic diseases. In addition to the clinical manifestations, acidity, and severity of RA, the authors assessed traditional risk factors (TRF of cardiovascular diseases (CVD, performed Holter ECG monitoring, common carotid artery duplex scanning, transthoracic echocardiographic study, and determined the levels of serum inflammatory markers.Results. The patients with RA differ from the control group in a longer adjusted QT interval, corrected for TRF of CVD. The major factorsassociated with a daily prolonged QTc interval in the women with RA are arterial hypertension, systolic, diastolic, pulse blood pressure level s, body mass index, subclinical target organ damage (carotid artery atherosclerosis, left ventricular (LV diastolic dysfunction, LV hypertrophyand remodeling, and the duration of RA. Leflunomide therapy is an additional factor associated with a prolonged nocturnal QT interval.Conclusion. The RA patients with a prolonged QTc interval and no clinical signs of cardiac lesion need meticulous examination aimed to identify CVD.

  18. Effect of chronic periodontitis on oxidative status in patients with rheumatoid arthritis.

    Science.gov (United States)

    Sezer, Ufuk; Erciyas, Kamile; Ustün, Kemal; Pehlivan, Yavuz; Şenyurt, Süleyman Ziya; Aksoy, Nurten; Tarakçıoğlu, Mehmet; Taysı, Seyithan; Onat, Ahmet Mesut

    2013-06-01

    Rheumatoid arthritis (RA) and chronic periodontitis (CP) are the most common chronic inflammatory diseases and have remarkable similar pathologies. The aim of this study is to investigate the impact of periodontal status on oxidative stress in patients with RA by evaluating serum oxidative parameters and prolidase levels. For this cross-sectional comparative study, the following four groups were composed of 20 individuals each (80 individuals total): 1) RA with CP (RA-CP group); 2) RA but periodontally healthy (RA-C group); 3) systemically healthy with CP (CP group); and 4) systemically and periodontally healthy (C group). Demographic, periodontal, rheumatological, and serum oxidative parameters as determined by serum total antioxidant status, total oxidant status, oxidative stress index (OSI), lipid hydroperoxide levels, paraoxonase, arylesterase, and ceruloplasmin activity, prolidase level, and total sulfhydryl groups were evaluated. The OSI values of the RA-CP group were statistically significantly higher than those of the C group (P <0.05). The prolidase levels of the RA-C, RA-CP groups and the CP group were statistically higher than those of the C group (P = 0.001, P = 0.007, and P = 0.001, respectively). Although CP and RA each increase oxidative stress, in a small sample size these effects are only significant when both CP and RA are combined relative to neither exposure. In addition, increased prolidase levels in patients with RA and CP may be related to increased oxidative tissue damage.

  19. Protective effects of total flavonoids of Astragalus against adjuvant-induced arthritis in rats by regulating OPG/RANKL/NF-κB pathway.

    Science.gov (United States)

    Liu, Xin-Yu; Xu, Lu; Wang, Ying; Li, Jin-Xia; Zhang, Yu; Zhang, Chong; Wang, Sha-Sha; Zhang, Xue-Mei

    2017-03-01

    Astragalus membranaceus Bunge is one of the oldest and most frequently used crude herbs in traditional Chinese medicine. The total flavonoids of Astragalus (TFA) are the main active components isolated from Astragalus membranaceus Bunge. Our recent study has shown its potential immunomodulatory and anti-inflammatory effects in vivo and in vitro. However, its anti-arthritic effects and mechanisms of action involved have not been elucidated. The aim of this study was to evaluate the protective effects and possible mechanisms of TFA on Freund's complete adjuvant (FCA)-induced arthritis in rats. Wistar rats were intradermally injected FCA into the right hind metatarsal footpads to establish adjuvant-arthritic model. The rats were intragastrically administered daily with TFA at 25, 50 and 100mg/kg for 28days after FCA induction. Body weight, primary paw swelling, arthritis index, thymus and spleen indices were measured. The levels of serum tumor necrosis factor (TNF)-α, interleukin (IL)-1β, prostaglandin (PG)E2, osteoprotegerin (OPG) and receptor activator of nuclear factor-κB ligand (RANKL) were determined using ELISA. Histopathological changes and scores in joint tissues were examined using hematoxylin and eosin (H&E). The expression of nuclear factor (NF)-κB p65 in synovial tissues was assayed using immunohistochemical method. TFA significantly increased body weight, attenuated primary paw swelling and arthritis index, decreased thymus and spleen indices of rats induced by FCA. Furthermore, TFA significantly inhibited serum TNF-α, IL-1β, PGE2 and RANKL production, and promoted serum OPG production and OPG/RANKL ratio of rats induced by FCA. Histopathological examination indicated that TFA significantly attenuated inflammatory cell infiltration, synovial hyperplasia, pannus formation, and bone and cartilage damage. Immunohistochemical assay indicated that TFA inhibited NF-κB p65 expression in synovial tissues of rats induced by FCA. These results suggest that

  20. Arterial stiffness is not increased in patients with short duration rheumatoid arthritis and ankylosing spondylitis.

    Science.gov (United States)

    Dzieża-Grudnik, Anna; Sulicka, Joanna; Strach, Magdalena; Siga, Olga; Klimek, Ewa; Korkosz, Mariusz; Grodzicki, Tomasz

    2017-04-01

    Patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) have increased cardiovascular (CV) morbidity and mortality. Arterial stiffness is an independent predictor of CV events. The aim of the study was to assess arterial stiffness and inflammatory markers in patients with short duration chronic arthritis. We assessed carotid-femoral pulse wave velocity (PWV), augmentation index (AIx), traditional CV risk factors and inflammatory and endothelial markers in 71 chronic arthritis patients (RA and AS) and in 29 healthy controls. We did not find differences in PWV (for RA, AS and controls, respectively: 10 [8.8-10.9] versus 10.7 [9.1-11.8] versus 9.2 [8.3-11.4] m/s; p = .14) and AIx (for RA, AS and controls, respectively: 24.3 ± 11.5 versus 5.7 ± 12.4 versus 10 ± 12.8%; p = .22). Both groups of arthritis patients had active disease with significantly elevated inflammatory markers compared to controls. There were no correlations between endothelial and inflammatory markers and parameters of arterial stiffness in arthritis patients. When analyzing arthritis patients according to median of PVW, there were no significant differences in inflammatory and endothelial markers. We found that in patients with short duration active RA and AS arterial stiffness was not increased and furthermore, there was no association between markers of systemic inflammation and arterial stiffness.

  1. Arthritic disease is more severe in older rats in a kaolin/carrageenan-induced arthritis model.

    Science.gov (United States)

    Kim, Kyoung Soo; Kim, Myung-Hwan; Yeom, Mijung; Choi, Hyun Mi; Yang, Hyung-In; Yoo, Myung Chul; Hahm, Dae-Hyun

    2012-12-01

    This study examined in an arthritis animal model whether elderly onset rheumatoid arthritis (EORA) is a more severe disease than younger onset rheumatoid arthritis. Arthritis was induced by injecting 5% kaolin/carrageenan into the left tibiotarsal ankles of 18-month-old and 4-week-old rats. Various parameters were measured to evaluate the arthritic progression of kaolin/carrageenan-induced arthritis in the rats. Immunohistochemical staining of arthritic joints was performed to determine the degree of inflammation in old and young rats. Measurements of ankle volume and thickness, arthritic index, number of squeaks, and the paw pressure test showed the 18-month-old rats had more severe disease than the young rats in a kaolin/carrageenan-induced arthritis model. The degree of inflammation and MMP-1 expression of arthritic joints in old rats was significantly higher than that of young rats based on histological evaluation with hematoxylin and eosin (H&E) staining and immunochemistry. More severe disease symptoms were found in old rats with EORA, but the molecular mechanisms still remain to be elucidated. Understanding the molecular mechanisms will be helpful to develop clinical protocols to efficiently treat patients with EORA, which is difficult to control with current protocols.

  2. AA Index

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The geomagnetic aa index provides a long climatology of global geomagnetic activity using 2 antipodal observatories at Greenwich and Melbourne- IAGA Bulletin 37,...

  3. Walkability Index

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Walkabiliy Index dataset characterizes every Census 2010 block group in the U.S. based on its relative walkability. Walkability depends upon characteristics of...

  4. Identifying flares in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Bykerk, Vivian P; Bingham, Clifton O; Choy, Ernest H

    2016-01-01

    Set. METHODS: Candidate flare questions and legacy measures were administered at consecutive visits to Canadian Early Arthritis Cohort (CATCH) patients between November 2011 and November 2014. The American College of Rheumatology (ACR) core set indicators were recorded. Concordance to identify flares...... to flare, with escalation planned in 61%. CONCLUSIONS: Flares are common in rheumatoid arthritis (RA) and are often preceded by treatment reductions. Patient/MD/DAS agreement of flare status is highest in patients worsening from R/LDA. OMERACT RA flare questions can discriminate between patients with...

  5. Dietetic recommendations in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    María Rosa Alhambra-Expósito

    2013-12-01

    Full Text Available Rheumatoid arthritis (RA is a chronic autoimmune disease that has a significant effect on patients’ physical, emotional, and social functioning. For decades, patients have used different diets to try to improve the symptoms of RA. The possible benefits of dietary therapy for rheumatoid arthritis are reviewed in this article. Nutritional objectives for RA, are to halt the loss of bone mass, promote healing of bone fractures and improving bone-associated inflammatory disorders and joints. In general, diets low in saturated fat, rich in polyunsaturated fats: omega 3 and omega 6, rich in complex carbohydrates and fiber are recommended.

  6. Cutaneous manifestations of rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Bhanu Prakash

    2015-02-01

    Full Text Available Rheumatoid arthritis (RA is a multisystem autoimmune disease, affecting the joints predominantly, and extra-articular sites like skin, lungs, heart etc. The American College of Rheumatology (ACR in collaboration with the European League Against Rheumatism (EULAR in 2010, revised the 1987 ACR classification criteria for RA. The criteria covered four areas (joint involvement, serodiagnosis, acute phase reactants, duration of arthritis and established a point value on a scale of 0 to 10. Patients with a value of 6 or higher are classified as having RA.

  7. Polysymptomatic Distress in Patients With Rheumatoid Arthritis: Understanding Disproportionate Response and Its Spectrum

    NARCIS (Netherlands)

    Wolfe, Frederick; Michaud, Kaleb; Busch, Ruth E.; Katz, Robert S.; Rasker, Johannes J.; Shahouri, Shadi H.; Shaver, Timothy S.; Wang, Shirley; Walitt, Brian T.; Häuser, Winfried

    2014-01-01

    Objective Fibromyalgia (FM) in rheumatoid arthritis (RA) can cause consternation because symptoms are seen to be out of proportion to physician and laboratory assessments, and composite RA activity scores such as the 28 joint Disease Activity Score, Clinical Disease Activity Index, and Routine Asses

  8. Polysymptomatic Distress in Patients With Rheumatoid Arthritis: Understanding Disproportionate Response and Its Spectrum

    NARCIS (Netherlands)

    Wolfe, Frederick; Michaud, Kaleb; Busch, Ruth E.; Katz, Robert S.; Rasker, Hans J.; Shahouri, Shadi H.; Shaver, Timothy S.; Wang, Shirley; Walitt, Brian T.; Häuser, Winfried

    2014-01-01

    Objective Fibromyalgia (FM) in rheumatoid arthritis (RA) can cause consternation because symptoms are seen to be out of proportion to physician and laboratory assessments, and composite RA activity scores such as the 28 joint Disease Activity Score, Clinical Disease Activity Index, and Routine

  9. Cartilage targeted chemical delivery of naproxen and ibuprofen for the treatment of arthritis

    Directory of Open Access Journals (Sweden)

    Vijay Pawar

    2012-01-01

    Full Text Available NSAIDs are among the most widely used prescription drugs, for the treatment of pain and inflammation, particularly arthritis. Inhibitor of COX and NSAIDs relieve the signs and symptoms of inflammation by decreasing PG production but may cause GI and renal damage. Synthesis, stability studies and Y-imaging studies are carried out. Cartilage targeting strategy for conventional NSAIDs has been explored for reducing their local and systemic side effect of the NSAIDs site specific delivery of quarternary ester derivatives could have to be an effective strategy for long term therapy of inflammatory conditions like arthritis.

  10. Radiation damage

    CERN Document Server

    Heijne, Erik H M; CERN. Geneva

    1998-01-01

    a) Radiation damage in organic materials. This series of lectures will give an overview of radiation effects on materials and components frequently used in accelerator engineering and experiments. Basic degradation phenomena will be presented for organic materials with comprehensive damage threshold doses for commonly used rubbers, thermoplastics, thermosets and composite materials. Some indications will be given for glass, scintillators and optical fibres. b) Radiation effects in semiconductor materials and devices. The major part of the time will be devoted to treat radiation effects in semiconductor sensors and the associated electronics, in particular displacement damage, interface and single event phenomena. Evaluation methods and practical aspects will be shown. Strategies will be developed for the survival of the materials under the expected environmental conditions of the LHC machine and detectors. I will describe profound revolution in our understanding of black holes and their relation to quantum me...

  11. Rituximab for Rheumatoid Arthritis.

    Science.gov (United States)

    Cohen, Marc D; Keystone, Edward

    2015-12-01

    Rituximab is a chimeric monoclonal antibody directed at the CD20 molecule on the surfaces of some but not all B cells. It depletes almost all peripheral B cells, but other niches of B cells are variably depleted, including synovium. Its mechanism of action in rheumatoid arthritis (RA) is only partially understood. Rituximab was efficacious in clinical trials of patients with RA, including those who are methotrexate naïve, those with an incomplete response to methotrexate, and those with an incomplete response to tumor necrosis factor inhibitors. The need for a concomitant traditional disease-modifying drug, the optimal dose of rituximab, and the optimal interval for retreatment remain somewhat uncertain. Rituximab seems to be most efficacious in seropositive patients and those with an incomplete response to only one tumor necrosis factor inhibitor. Rituximab has a reasonable safety profile, with a small risk of serious infectious events, which is stable over time and repeat courses. Opportunistic infections are rare. Reactivation of hepatitis B remains a concern. The possible association of rituximab and progressive multifocal leukoencephalopathy may still require vigilance. Malignancies and cardiovascular events do not appear to be increased. Infusion reactions are more likely with the initial infusion, and are usually mild. Rituximab may cause hypogammaglobulinemia, but any risk of subsequent risk of increased infectious events is not yet well established. Before initiating rituximab, patient screening for hypersensitivity to murine proteins, infections, congestive heart failure, pregnancy, and hypogammaglobulinemia is imperative. Vaccinations should be administered prior to treatment whenever possible. Rituximab has been a significant addition to the rheumatologists' armamentarium for the treatment of RA.

  12. Effectiveness of adalimumab in treating patients with ankylosing spondylitis associated with enthesitis and peripheral arthritis

    Science.gov (United States)

    2010-01-01

    Introduction The purpose of this study was to investigate the effectiveness of adalimumab in enthesitis and peripheral arthritis in patients with ankylosing spondylitis (AS). Methods Adults with active AS (Bath ankylosing spondylitis disease activity index [BASDAI] ≥ 4) received adalimumab 40 mg every other week with standard antirheumatic therapies in a 12-week, open-label study. Effectiveness in enthesitis was assessed using the Maastricht ankylosing spondylitis enthesitis score (MASES, 0-13) and by examining the plantar fascia in patients with enthesitis (≥ 1 inflamed enthesis) at baseline; effectiveness in peripheral arthritis was evaluated using tender and swollen joint counts (TJC, 0-46; SJC, 0-44) in patients with peripheral arthritis (≥ 1 swollen joint) at baseline. Overall effectiveness measures included Assessment of SpondyloArthritis International Society 20% response (ASAS20). Results Of 1,250 patients enrolled, 686 had enthesitis and 281 had peripheral arthritis. In 667 patients with MASES ≥ 1 at baseline, the median MASES was reduced from 5 at baseline to 1 at week 12. At week 12, inflammation of the plantar fascia ceased in 122 of 173 patients with inflammation at baseline. The median TJC in 281 patients with SJC ≥ 1 at baseline was reduced from 5 at baseline to 1 at week 12; the median SJC improved from 2 to 0. ASAS20 responses were achieved by 70.5% of 457 patients with no enthesitis and no arthritis; 71.0% of 512 patients with only enthesitis; 68.0% of 107 patients with only arthritis; and 66.7% of 174 patients with both. Conclusions Treatment with adalimumab improved enthesitis and peripheral arthritis in patients with active AS. Trial registration ClinicalTrials.gov NCT00478660. PMID:20230622

  13. Thyroid Gland in Patients with Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    B T Turumhambetova

    2009-09-01

    Full Text Available The purpose of our study was to investigate the main parameters of thyroid status in patients with rheumatoid arthritis (RA, as well as particularities of course of this disease depending on of thyroid gland function disorder. Materials and methods. 52 women with RA were examined. The first group consisted of 11 women with subclinical and manifestive hypothyroidism the second one 41 women without thyroid gland function disorder. The group comparison was conducted on main indexes of thyroid gland condition the hormon level, AT-TPO, ultrasonic data, as well as clinical and laboratory RA data. Results. In women with hypothyroidism the systemic manifestations of RA were more often truely diagnosed; DAS28 indexes, ESR, the number ot swollen joints were higher. The high level ot AT-TPO was diagnosed in 54,55% – I group and in 31,7% – II group TTG level was really less in patients receiving synthetic glycocorticoids. Small thyroid gland volume was diagnosed in 23,07% of examined patients. The thyroid gland status indexes in them did not differ from patients with normal thyroid gland volume. Reliable increasing of the peripheral resistance index was revealed in lower thyroid artery according to the ultrasonic study data under the reduced thyroid gland size. Conclusions. High incidence of hypothyroidism and AT-TPO carriage in RA was revealed. Hypothyroidism development is accompanied by high clinic-laboratory RA activity. The reduction of the thyroid gland volumes in RA is possibly stipulated not only by autoimmunal pathology, but also chronic ischemia of the organ in the conditions of immune-complex vasculitis and early atherosclerosis. The TTG level in patients with RA is defined not only by pathology of the thyroid gland, but glycocorticoid therapy as well.

  14. SEPTIC ARTHRITIS OF THE HIP IN ADULTS: A RARE PRESENTATION

    OpenAIRE

    Kuppa; Yerukala; Dema; Sujith; Venkateswar Reddy

    2015-01-01

    Septic Arthritis also known as infectious arthritis, can be bacterial or fungal arthritis. The condition is an inflammation of a joint that is caused by an infection. Typically, Septic Arthritis affects one large joint in the body such as knee or hip. Generally, Septic Arthritis is present with complete absorption of the head of the ...

  15. Virginia ESI: INDEX (Index Polygons)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains vector polygons representing the boundaries of all hardcopy cartographic products produced as part of the Environmental Sensitivity Index...

  16. Louisiana ESI: INDEX (Index Polygons)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains vector polygons representing the boundaries of all the hardcopy cartographic products produced as part of the Environmental Sensitivity Index...

  17. Maryland ESI: INDEX (Index Polygons)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains vector polygons representing the boundaries of all hardcopy cartographic products produced as part of the Environmental Sensitivity Index...

  18. Long-term treatment of rheumatoid arthritis with adalimumab

    Directory of Open Access Journals (Sweden)

    Murdaca G

    2013-05-01

    Full Text Available Giuseppe Murdaca, Francesca Spanò, Francesco PuppoDepartment of Internal Medicine, Clinical Immunology Unit, University of Genoa, Genoa, ItalyAbstract: Rheumatoid arthritis (RA is a chronic inflammatory disease that is associated with joint damage and progressive disability, an increased risk of morbidity related to comorbid conditions and substantial socioeconomic costs. Tumor necrosis factor-alpha (TNF-α is a proinflammatory cytokine known to have a central role in the initial host response to infection and in the pathogenesis of various immune-mediated diseases, such as RA, ankylosing spondylitis, psoriasis and/or psoriatic arthritis, Crohn’s disease, and systemic lupus erythematosus. Five TNF-α inhibitors are available for the clinical use: infliximab; adalimumab; etanercept; golimumab; and certolizumab pegol. Infliximab is a chimeric human/murine IgG1 monoclonal antibody (mAb; adalimumab, and golimumab are human mAbs; certolizumab pegol is composed of the fragment antigen-binding anti-binding domain of a humanized anti-TNF-α mAb, combined with polyethylene glycol to increase its half-life in the body; etanercept is a fusion protein that acts as a “decoy receptor” for TNF-α. In this paper, we will briefly review the current data on efficacy and safety of adalimumab in patients with RA, its potential beneficial effects upon comorbid conditions, such as endothelial dysfunction and accelerated atherosclerosis in RA, and the immunogenicity.Keywords: adalimumab, efficacy, safety, rheumatoid arthritis, VEGF, immunogenicity, infections

  19. Intraveous gammaglobulin for the treatment of juvenil idiopathic arthritis

    Directory of Open Access Journals (Sweden)

    Lòpez Ortíz Daniela Jazmin

    2014-07-01

    Full Text Available Recently there has been a growing interest in autoimmune and auto-inflammatory diseases, both entities involving a therapeutic challenge even though more sophisticated therapeutic options have been developed. According to this, juvenile idiopathic arthritis (JIA is an example of this challenge, with proven autoimmune mechanisms as in positive rheumatoid factor arthritis; and autoinflammatory mechanisms in systemic onset juvenile idiopathic arthritis. For both damage mechanisms, intravenous immunoglobulin (IVIG has been used as a successful immunomodulator. The treatment with IVIG for JIA and associated features as macrophage activation syndrome (MAS has shown to be beneficial. Nevertheless more studies are required to support its usefulness, as well as clinical trials to document the IVIG effectiveness in comparison with the rest of therapeutic agents used. Despite its cost, the IVIG is well tolerated and should be considered useful in combination with other drugs as part of the JIA treatment, especially in those patients with associated threatening-life systemic complications or with high risk of infection. The present review pretends to expose, according to previous references from various authors, that IVIG is an alternative therapeutic option in these cases.

  20. CLINICAL HETEROGENEITY OF EARLY PSORIATIC ARTHRITIS

    Directory of Open Access Journals (Sweden)

    V. V. Badokin

    2016-01-01

    Full Text Available Objective: to reveal the characteristic symptoms and syndromes of early-stage psoriatic arthritis (ePsA, which are pivotal to its early diagnosis.Patients and methods. Fifty-one patients with a PsA duration of less than 2 years (mean 12 months were examined. The diagnosis of PsA was established on the basis of the conventional CASPAR criteria and the Russian criteria developed by the expert method. The conventional current criteria, including the number of tender and swollen joints, DAS28, values of acute-phase indicators, were used to detect inflammatory activity. Skin syndrome was evaluated using the Psoriasis Area and Severity Index (PASI. X-ray study of the hands, distal and proximal feet, pelvis, and other involved joints and MRI of the distal hands/feet were performed. The Maastricht Ankylosing Spondylitis Enthesitis Score (MASES and reduced GUESS were used to assess enthesopathy.Results. The types of articular syndrome in ePsA were identified in accordance of the duration of the disease. The authors determined the characteristic features of arthritis, spondylitis, enthesitis, and dactylitis, their diagnostic value and associations with other manifestations in the first 2 years of PsA. There was a relationship of dermatitis and psoriatic onychopathy to the clinical picture of articular syndrome.Conclusion. ePsA is characterized by marked heterogeneity of articular syndrome with predominantly mono/oligoarthritic and polyarthritic articular syndrome. The significant signs are enthesitis and dactylitis, which serve as risk factors for the unfavorable course of the disease. 

  1. Severity indices in rheumatoid arthritis: A systematic review.

    Science.gov (United States)

    Toledano, Esther; García de Yébenes, M Jesús; González-Álvaro, Isidoro; Carmona, Loreto

    2017-08-11

    To identify tools designed to evaluate the severity of patients with rheumatoid arthritis (RA) in order to use them in the investigation of prognostic markers in early arthritis. We conducted a systematic review of studies that developed/validated an index for RA disease severity. They were analyzed using the COSMIN checklist to assess their methodological quality. In addition, all the variables included were evaluated for their clarity of definition, feasibility and probability of being present in each outcome during the first 2 years of the disease course. To estimate redundancy, variables were grouped by domains. After reviewing 3,519 articles, 3 studies were included. The first study, the PAS, assessed whether current and lifetime treatment with disease-modifying antirheumatic drugs and/or biologics accurately predicted RA severity, as measured by the patient-reported PAS. Treatment variables did not fully distinguish patients in the highest and lowest quartiles of PAS scores. Another severity index, the Claims-Based Index for RA Severity (CIRAS), included the variables age, sex, Felty's syndrome, number of rehabilitation and rheumatology visits, test for inflammatory markers, number of chemistry panels/platelet counts ordered and rheumatoid factor test. The correlation was low (r=0.56) with an index previously validated by the same research group, the RA medical records-based index of severity (RARBIS), with Disease Activity Score-C-reactive protein (DAS28-PCR) (r=0.07) and Multidimensional Health Assessment Questionnaire (MD-HAQ) (r=0.008). Finally, the RARBIS, used to validate the CIRAS, was devised as an RA severity index based on medical records. It includes as domains surgery, radiology, extra-articular manifestations, clinical and laboratory variables, previously chosen by an expert panel. RARBIS had a weak correlation with treatment intensity (r=0.35) and with DAS28 (r=0.41). There is no index to assess the severity of RA based on the course of the

  2. Tort Damages

    NARCIS (Netherlands)

    L.T. Visscher (Louis)

    2008-01-01

    textabstractAbstract: In this Chapter, I provide an overview of Law and Economics literature regarding tort damages. Where necessary, attention is also spent to rules of tort liability. Both types of rules provide behavioral incentives to both injurers and victims, with respect to their level of

  3. Tort Damages

    NARCIS (Netherlands)

    L.T. Visscher (Louis)

    2008-01-01

    textabstractAbstract: In this Chapter, I provide an overview of Law and Economics literature regarding tort damages. Where necessary, attention is also spent to rules of tort liability. Both types of rules provide behavioral incentives to both injurers and victims, with respect to their level of car

  4. Vagal influences in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Rasmussen, S E; Pfeiffer-Jensen, M; Drewes, A M

    2017-01-01

    Rheumatoid arthritis (RA) is a chronic immune-mediated inflammatory disease with a prevalence of 0.5-1% in Western populations. Conventionally, it is treated with therapeutic interventions that include corticosteroids, disease-modifying anti-rheumatic drugs, and biological agents. RA exerts...

  5. Treating rheumatoid arthritis to target

    DEFF Research Database (Denmark)

    Smolen, Josef S; Aletaha, Daniel; Bijlsma, Johannes W J

    2010-01-01

    BACKGROUND: Aiming at therapeutic targets has reduced the risk of organ failure in many diseases such as diabetes or hypertension. Such targets have not been defined for rheumatoid arthritis (RA). OBJECTIVE: /st> To develop recommendations for achieving optimal therapeutic outcomes in RA. METHODS...

  6. Treating rheumatoid arthritis to target

    DEFF Research Database (Denmark)

    Smolen, Josef S; Breedveld, Ferdinand C; Burmester, Gerd R

    2016-01-01

    BACKGROUND: Reaching the therapeutic target of remission or low-disease activity has improved outcomes in patients with rheumatoid arthritis (RA) significantly. The treat-to-target recommendations, formulated in 2010, have provided a basis for implementation of a strategic approach towards...

  7. Glucocorticoid Sensitivity in Rheumatoid Arthritis

    NARCIS (Netherlands)

    R.A.M. Quax

    2013-01-01

    textabstractAccumulating observations of women with rheumatoid arthritis (RA) who ‘spontaneously’ experienced less active disease during pregnancy led to the growing belief by Philip Hench that a hormonal substance had to be involved in the improving clinical conditions of pregnant patients with RA.

  8. Genetics in juvenile idiopathic arthritis

    NARCIS (Netherlands)

    Albers, Heleen Marion

    2015-01-01

    Juvenile idiopathic arthritis (JIA) is a non-common disease in children that can persist into adulthood. JIA is considered to be an auto-immune disease. Genetic factors play a role in the pathogenesis. In a new cohort of JIA patients from North-West European descent genetic candidate gene associatio

  9. Citrullinated Chemokines in Rheumatoid Arthritis

    Science.gov (United States)

    2014-10-01

    Clavel C, Arnaud J, Nogueira L, et al. Epitopes of human fibrin recognized by the rheumatoid arthritis-specific autoantibodies to citrullinated... Clavel C, Chapuy-Regaud S, Al Badine R, Mechin MC, et al. Peptidyl arginine deiminase type 2 (PAD-2) and PAD-4 but not PAD-1, PAD-3, and PAD-6 are

  10. Abatacept treatment for rheumatoid arthritis

    National Research Council Canada - National Science Library

    Schiff, Michael

    2011-01-01

    ... of aggressive, erosive disease. Here, one such biologic therapy, the T-cell co-stimulation modulator abatacept, is discussed, exploring clinical evidence published to date on its use in patients with very early arthritis/early RA who are MTX...

  11. Glucocorticoids in early rheumatoid arthritis

    NARCIS (Netherlands)

    Everdingen, Amalia A. van

    2002-01-01

    For 50 years, glucocorticoids (GC) are used for symptomatic treatment of rheumatoid arthritis (RA). In the last decade, results from clinical studies of treatment with GC as additional therapy to long-acting antirheumatic drugs in patients with early RA suggested also disease-modifying properties of

  12. Pulmonary Nodulosis Associated with Leflunomide Therapy in Rheumatoid Arthritis: Report of Four Cases and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Ayse Balkarli

    2016-03-01

    Full Text Available Rheumatoid arthritis (RA is a multisystem inflamma­tory disease characterized by destructive synovitis and systemic extra-articular involvement. Leflunomide is a disease-modifying anti-rheumatic drug with anti-inflam­matory and anti-proliferative features. Leflunomide is an isoxazole immunomodulatory agent, which inhibits dihydroorotate dehydrogenase enzyme involved in de novo pyrimidine synthesis. It was shown that leflunomide can reduce signs and symptoms of rheumatoid arthritis (RA with regression in structural damage. Pulmonary in­volvement is one of the extra-articular manifestations of rheumatoid arthritis and it can occur due to either disease itself or medications used in the treatment. We presented 4 cases with rheumatoid arthritis which developed pul­monary nodules with leflunomide therapy and reviewed literature. J Clin Exp Invest 2016; 7 (1: 98-102

  13. COMORBIDITY IN RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    T. A. Panafidina

    2014-01-01

    Full Text Available The peak onset of rheumatoid arthritis (RA is at 30-55 years of age. At this age, the patients have also other concomi- tant diseases (comorbidities that affect the course and prognosis of RA, the choice of its treatment policy, quality of life of the patients. Objective: to identify the most important and common comorbidities in patients with RA. Subjects and methods. Two hundred patients (median age 55 [46; 61] years were enrolled; there was a preponderance of women (82.5% with median disease duration 5 [1; 10] years, seropositive for IgM rheumatoid factor (83.0% and anti-cyclic citrullinated peptide antibodies (81.6% with moderate and high disease activity (median DAS28 value 3.9 [3.1; 4.9]. Varying degrees of destructive changes in hand and foot joints were radiologically detected in 71.2% of the patients; 64.5% of the patients had Functional Class II. Methotrexate was given to 69.5% of the patients; therapy with biological agents was used in 21.0% of the cases. 15.5% of the patients did not receive DMARD or biologics. 43.0% of the patients with RA received glucocorticoids. Results. Comorbidities were present in 72.0% of the patients with RA. The most common diseases were hypertension (60.0%, dyslipidemia (45.0%, fractures at various sites (29.5%, and coronary heart disease (21.0%. Myocardial infarction and stroke were observed in 1.5 and 1.0% of cases, respectively. There was diabetes mellitus (DM in 7.5% of the cases and osteoporosis in 15.5% of the patients. 81.7% of the patients with RA and hypertension and 80.0% of those with RA and DM received antihypertensive and sugar-lowering therapy, respectively. At the same time the RA patients with dyslipidemia and osteoporosis received specific drugs far less frequently (30.0 and 29.0%, respectively. Conclusion. Comorbidities are frequently encountered in RA. By taking into account the fact that cardiovascular dis- eases are a main cause of death in RA; it is necessary to adequately and timely

  14. Polyunsaturated fatty acids: any role in rheumatoid arthritis?

    Science.gov (United States)

    Navarini, Luca; Afeltra, Antonella; Gallo Afflitto, Gabriele; Margiotta, Domenico Paolo Emanuele

    2017-10-10

    Polyunsaturated fatty acids (PUFAs) are members of the family of fatty acids and are included in the diet. Particularly, western diet is usually low in n-3 PUFAs and high in n-6 PUFAs. PUFAs play a central role in the homeostasis of immune system: n-6 PUFAs have predominantly pro-inflammatory features, while n-3 PUFAs seem to exert anti-inflammatory and pro-resolving properties. Rheumatoid arthritis (RA) is a chronic inflammatory arthritis in which many inflammatory pathways contribute to joint and systemic inflammation, disease activity, and structural damage. Research on PUFAs could represent an important opportunity to better understand the pathogenesis and to improve the management of RA patients. We searched PubMed, Embase, EBSCO-Medline, Cochrane Central Register of Controlled Trials (CENTRAL), CNKI and Wanfang to identify primary research reporting the role of n-3 PUFAs in rheumatoid arthritis both in humans and in animal models up to the end of March 2017. Data from animal models allows to hypothesize that n-3 PUFAs supplementation may represent an interesting perspective in future research as much in prevention as in treating RA. In humans, several case-control and prospective cohort studies suggest that a high content of n-3 PUFAs in the diet could have a protective role for incident RA in subjects at risk. Moreover, n-3 PUFAs supplementation has been assessed as a valuable therapeutic option also for patients with RA, particularly in order to improve the pain symptoms, the tender joint count, the duration of morning stiffness and the frequency of NSAIDs assumption. n-3 PUFAs supplementation could represent a promising therapeutic option to better control many features of RA. The impact of n-3 PUFAs on radiographic progression and synovial histopathology has not been yet evaluated, as well as their role in early arthritis and the combination with biologics.

  15. Manifold learning-based subspace distance for machinery damage assessment

    Science.gov (United States)

    Sun, Chuang; Zhang, Zhousuo; He, Zhengjia; Shen, Zhongjie; Chen, Binqiang

    2016-03-01

    Damage assessment is very meaningful to keep safety and reliability of machinery components, and vibration analysis is an effective way to carry out the damage assessment. In this paper, a damage index is designed by performing manifold distance analysis on vibration signal. To calculate the index, vibration signal is collected firstly, and feature extraction is carried out to obtain statistical features that can capture signal characteristics comprehensively. Then, manifold learning algorithm is utilized to decompose feature matrix to be a subspace, that is, manifold subspace. The manifold learning algorithm seeks to keep local relationship of the feature matrix, which is more meaningful for damage assessment. Finally, Grassmann distance between manifold subspaces is defined as a damage index. The Grassmann distance reflecting manifold structure is a suitable metric to measure distance between subspaces in the manifold. The defined damage index is applied to damage assessment of a rotor and the bearing, and the result validates its effectiveness for damage assessment of machinery component.

  16. Complications of systemic juvenile idiopathic arthritis: risk factors and management recommendations.

    Science.gov (United States)

    Woerner, Andreas; von Scheven-Gête, Annette; Cimaz, Rolando; Hofer, Michaël

    2015-05-01

    Systemic juvenile idiopathic arthritis (SJIA) is an inflammatory condition characterized by fever, lymphadenopathy, arthritis, rash and serositis. Systemic inflammation has been associated with dysregulation of the innate immune system, suggesting that SJIA is an autoinflammatory disorder. IL-1 and IL-6 play a major role in the pathogenesis of SJIA, and treatment with IL-1 and IL-6 inhibitors has shown to be highly effective. However, complications of SJIA, including macrophage activation syndrome, limitations in functional outcome by arthritis and long-term damage from chronic inflammation, continue to be a major issue in SJIA patients' care. Translational research leading to a profound understanding of the cytokine crosstalk in SJIA and the identification of risk factors for SJIA complications will help to improve long-term outcome.

  17. Fever of unknown origin in a patient of systemic onset juvenile idiopathic arthritis

    Directory of Open Access Journals (Sweden)

    Vinod Kolar Vishwanath

    2010-01-01

    Full Text Available Hemophagocytic lymphohistiocytosis is a potentially fatal condition characterized by pathologic immune activation, which can complicate infections, childhood systemic rheumatologic diseases and malignancies. Here we report a case of reactive hemophagocytic lymphohistiocytosis [macrophage activation syndrome] complicating systemic onset juvenile idiopathic arthritis, which was treated successfully with dexamethasone and cyclosporine. Reactive hemophagocytic lymphohistiocytosis or macrophage activation syndrome should be considered in patients of juvenile idiopathic arthritis with prolonged fever of unknown origin and cytopenias. Early diagnosis with high index of suspicion and prompt, aggressive treatment are needed for successful outcomes.

  18. INDEXING MECHANISM

    Science.gov (United States)

    Kock, L.J.

    1959-09-22

    A device is presented for loading and unloading fuel elements containing material fissionable by neutrons of thermal energy. The device comprises a combination of mechanical features Including a base, a lever pivotally attached to the base, an Indexing plate on the base parallel to the plane of lever rotation and having a plurality of apertures, the apertures being disposed In rows, each aperture having a keyway, an Index pin movably disposed to the plane of lever rotation and having a plurality of apertures, the apertures being disposed in rows, each aperture having a keyway, an index pin movably disposed on the lever normal to the plane rotation, a key on the pin, a sleeve on the lever spaced from and parallel to the index pin, a pair of pulleys and a cable disposed between them, an open collar rotatably attached to the sleeve and linked to one of the pulleys, a pin extending from the collar, and a bearing movably mounted in the sleeve and having at least two longitudinal grooves in the outside surface.

  19. Dosimetry, hematological toxicity and evaluation of chromosomal damage of Sm-153-EDTMP in patients with bone metastases and rheumatoid arthritis; Dosimetria, toxicidade hematologica e avaliacao do dano cromossomico do Sm-153-EDTMP em pacientes portadores de metastases osseas e artrite reumatoide

    Energy Technology Data Exchange (ETDEWEB)

    Guimaraes, Maria Ines Calil Cury; Marinho, Norma V.S.; Ono, Carla R.; Rocha, Euclides T.; Buchpiguel, Carlos Alberto [Sao Paulo Univ., SP (Brazil). Faculdade de Medicina. Centro de Medicina Nuclear]. E-mail: micguima@br2001.com.br; Silva, Marcia A. da; Okasaki, Kayo [Instituto de Pesquisas Energeticas e Nucleares (IPEN), Sao Paulo, SP (Brazil)]. E-mail: masilva@net.ipen.br

    2001-07-01

    Samarium-153-EDTMP has been successfully used for pain palliation in metastatic bone cancer to a lesser extend in rheumatoid arthritis. Were studied 110 patients, 90 with metastatic bone cancer and 20 with rheumatoid arthritis. Each patient received 37 MBq/kg (1mCi/kg) of Sm-153-EDTMP, intravenously injected. Urine samples were collected during 6 hours. Blood samples were collected before and one hour after the injection. The MIRD formalism was utilized for dosimetric calculations. The absorbed dose for red marrow, cortical and trabecular for patients with rheumatoid arthritis were respectively: 206{+-}66,38 cGy; 544,04{+-}171,31 cGy; 630,80{+-}197,15 cGy. For the patients with metastatic bone cancer, the absorbed dose for red marrow was 319,07{+-}94,06 cGy, cortical 841,58{+-}236,12 cGy; trabecular 978,23{+-} 264,05 cGy. The leukocyte counts decreased 48,5%{+-}19%, the platelets 54,7%{+-}26% and hemoglobin 13,7%{+-}11%, from the baseline values. The principal kind of the structural aberrations observed were: acentric fragments, breaks, chromosomal gaps, centric ring and double minute. The number of the aberrations in blood cells, after the application of Sm-153-EDTMP, was 2,13 times bigger than the baseline. The absorbed dose radiation, the hematological and genetics effects established were in the limits accepted for this kind of treatment. (author)

  20. Impact of cell wall peptidoglycan O-acetylation on the pathogenesis of Staphylococcus aureus in septic arthritis.

    Science.gov (United States)

    Baranwal, Gaurav; Mohammad, Majd; Jarneborn, Anders; Reddy, Bommana Raghunath; Golla, Archana; Chakravarty, Sumana; Biswas, Lalitha; Götz, Friedrich; Shankarappa, Sahadev; Jin, Tao; Biswas, Raja

    2017-10-01

    Staphylococcus aureus (S. aureus) is one of the most common pathogen causing septic arthritis. To colonize the joints and establish septic arthritis this bacterium needs to resist the host innate immune responses. Lysozyme secreted by neutrophils and macrophages is an important defense protein present in the joint synovial fluids. S. aureus is known to be resistant to lysozyme due to its peptidoglycan modification by O-acetylation of N-acetyl muramic acid. In this study we have investigated the role of O-acetylated peptidoglycan in septic arthritis. Using mouse models for both local and hematogenous S. aureus arthritis we compared the onset and progress of the disease induced by O-acetyl transferase mutant and the parenteral wild type SA113 strain. The disease progression was assessed by observing the clinical parameters including body weight, arthritis, and functionality of the affected limbs. Further X-ray and histopathological examinations were performed to monitor the synovitis and bone damage. In local S. aureus arthritis model, mice inoculated with the ΔoatA strain developed milder disease (in terms of knee swelling, motor and movement functionality) compared to mice inoculated with the wild type SA113 strain. X-ray and histopathological data revealed that ΔoatA infected mice knee joints had significantly lesser joint destruction, which was accompanied by reduced bacterial load in knee joints. Similarly, in hematogenous S. aureus arthritis model, ΔoatA mutant strain induced significantly less severe clinical septic arthritis compared to its parental strain, which is in accordance with radiological findings. Our data indicate that peptidoglycan O-acetylation plays an important role in S. aureus mediated septic arthritis. Copyright © 2017 Elsevier GmbH. All rights reserved.

  1. Experimental models of arthritis in which pathogenesis is dependent on TNF expression.

    Science.gov (United States)

    Drutskaya, M S; Efimov, G A; Zvartsev, R V; Chashchina, A A; Chudakov, D M; Tillib, S V; Kruglov, A A; Nedospasov, S A

    2014-12-01

    Rheumatoid arthritis (RA) is an autoimmune inflammatory disease characterized by joint damage as well as systemic manifestations. The exact cause of RA is not known. Both genetic and environmental factors are believed to contribute to the development of this disease. Increased expression of tumor necrosis factor (TNF) has been implicated in the pathogenesis of RA. Currently, the use of anti-TNF drugs is one of the most effective strategies for the treatment of RA, although therapeutic response is not observed in all patients. Furthermore, due to non-redundant protective functions of TNF, systemic anti-TNF therapy is often associated with unwanted side effects such as increased frequency of infectious diseases. Development of experimental models of arthritis in mice is necessary for studies on the mechanisms of pathogenesis of this disease and can be useful for comparative evaluation of various anti-TNF drugs. Here we provide an overview of the field and present our own data with two experimental models of autoimmune arthritis - collagen-induced arthritis and antibody-induced arthritis in C57Bl/6 and BALB/c mice, as well as in tnf-humanized mice generated on C57Bl/6 background. We show that TNF-deficient mice are resistant to the development of collagen-induced arthritis, and the use of anti-TNF therapy significantly reduces the disease symptoms. We also generated and evaluated a fluorescent detector of TNF overexpression in vivo. Overall, we have developed an experimental platform for studying the mechanisms of action of existing and newly developed anti-TNF drugs for the treatment of rheumatoid arthritis.

  2. Periodontal bacterial colonization in synovial tissues exacerbates collagen-induced arthritis in B10.RIII mice.

    Science.gov (United States)

    Chukkapalli, Sasanka; Rivera-Kweh, Mercedes; Gehlot, Prashasnika; Velsko, Irina; Bhattacharyya, Indraneel; Calise, S John; Satoh, Minoru; Chan, Edward K L; Holoshitz, Joseph; Kesavalu, Lakshmyya

    2016-07-12

    It has been previously hypothesized that oral microbes may be an etiological link between rheumatoid arthritis (RA) and periodontal disease. However, the mechanistic basis of this association is incompletely understood. Here, we investigated the role of periodontal bacteria in induction of joint inflammation in collagen-induced arthritis (CIA) in B10.RIII mice. CIA-prone B10.RIII mice were infected orally with a polybacterial mixture of Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia for 24 weeks before induction of CIA. The ability of polybacterial mixture to colonize the periodontium and induce systemic response, horizontal alveolar bone resorption in infected B10.RIII mice was investigated. Arthritis incidence, severity of joint inflammation, pannus formation, skeletal damage, hematogenous dissemination of the infection, matrix metalloproteinase 3 (MMP3) levels, and interleukin-17 expression levels were evaluated. B10.RIII mice had gingival colonization with all three bacteria, higher levels of anti-bacterial immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies, significant alveolar bone resorption, and hematogenous dissemination of P. gingivalis to synovial joints. Infected B10.RIII mice had more severe arthritis, and higher serum matrix metalloproteinase 3 levels and activity. Histopathological analysis showed increased inflammatory cell infiltration, destruction of articular cartilage, erosions, and pannus formation. Additionally, involved joints showed had expression levels of interleukin-17. These findings demonstrate that physical presence of periodontal bacteria in synovial joints of B10.RIII mice with collagen-induced arthritis is associated with arthritis exacerbation, and support the hypothesis that oral bacteria, specifically P. gingivalis, play a significant role in augmenting autoimmune arthritis due to their intravascular dissemination to the joints.

  3. Endomorphins in rheumatoid arthritis, osteoarthritis, and experimental arthritis.

    Science.gov (United States)

    Jessop, David S; Fassold, Alexander; Wolff, Christine; Hofbauer, Rafael; Chover-Gonzalez, Antonio; Richards, Louise J; Straub, Rainer H

    2010-04-01

    The opioid tetrapeptides endomorphins (EM)-1 and EM-2 are widely expressed in central nervous system and immune tissues of rats and humans. Their analgesic properties are well characterized but they also have anti-inflammatory properties. EM-1 significantly attenuated the onset of hindpaw inflammation in adjuvant-induced arthritis in rats. Immunohistochemical staining demonstrated the presence of EMs in T cells, macrophages, and fibroblasts in synovial tissues from patients with osteo- or rheumatoid arthritis (RA). In an ex vivo superfusion system, EM-1 potently inhibited the release of proinflammatory cytokines interleukin (IL)-6 and IL-8 from synovial tissues from patients with osteo- or RA. These results demonstrate that EMs are endogenously synthesized within human immune cells and have the potential to act as potent therapeutic agents in the treatment of chronic inflammatory disease. We discuss the clinical potential for EM analogues chemically modified to resist proteolytic degradation and identify modified protease-resistant analogues with enhanced bioactivity.

  4. Polyarticular septic arthritis in an immunocompetent patient.

    Science.gov (United States)

    Clements, J; Dinneen, A; Heilpern, G

    2013-03-01

    Septic arthritis is an uncommon condition with an incidence of 2-3/100,000. It is clinically notable, however, as it is a rapidly destructive joint disease with significant associated morbidity and mortality. Polyarticular septic arthritis has an estimated incidence of 15% of all cases of infectious arthritis. We report a case of polyarticular septic arthritis with involvement of bilateral shoulders and wrist to highlight the importance of early diagnosis and treatment as well as the high mortality rates associated with this condition. Bilateral septic shoulder arthritis poses a challenge to treat, and its significance should not be underestimated as even with early surgical intervention and aggressive antibiotic and fluid resuscitation death is a sad but perhaps not uncommon outcome. It is therefore imperative that the diagnosis of polyarticular septic arthritis is kept prominent in the physician's mind when confronted with a patient with symptomatic polyarthralgia.

  5. Preoperative antibiotics for septic arthritis in children: delay in diagnosis.

    Science.gov (United States)

    MacLean, Simon B M; Timmis, Christopher; Evans, Scott; Lawniczak, Dominik; Nijran, Amit; Bache, Edward

    2015-04-01

    To review the records of 50 children who underwent open joint washout for septic arthritis with (n=25) or without (n=25) preoperative antibiotics. Records of 50 children who underwent open joint washout for presumed septic arthritis with (n=25) or without (n=25) preoperative antibiotics were reviewed. 17 boys and 8 girls aged 3 weeks to 16 years (median, 1.5 years) who were prescribed preoperative antibiotics before joint washout were compared with 12 boys and 13 girls aged one month to 14 years (median, 2 years) who were not. Following arthrotomy and washout, all patients were commenced on high-dose intravenous antibiotics. Patients were followed up for 6 to 18 months until asymptomatic. Patients who were referred from places other than our emergency department were twice as likely to have been prescribed preoperative antibiotics (p=0.0032). Patients prescribed preoperative antibiotics had a longer median (range) time from symptom onset to joint washout (8 [2-23] vs. 4 [1-29] days, p=0.05) and a higher mean erythrocyte sedimentation rate (93.1 vs. 54.3 mm/h, p=0.023) at presentation. Nonetheless, the 2 groups were comparable for weight bearing status, fever, and positive culture, as well as the mean (range) duration of antibiotic treatment (4.9 [4-7] vs. 4.7 [1-8] weeks, p=0.586). Preoperative antibiotics should be avoided in the management of septic arthritis in children. Their prescription delays diagnosis and definitive surgery, and leads to additional washouts and complications. A high index of suspicion and expedite referral to a specialist paediatric orthopaedic unit is needed if septic arthritis is suspected.

  6. Improved early identification of arthritis : evaluating the efficacy of Early Arthritis Recognition Clinics

    NARCIS (Netherlands)

    van Nies, Jessica A. B.; Brouwer, Elisabeth; van Gaalen, Floris A.; Allaart, Cornelia F.; Huizinga, Tom W. J.; Posthumus, Marcel D.; van der Helm-van Mil, Annette H. M.

    Objective Only 31% of Dutch rheumatoid arthritis (RA)-patients visit a rheumatologist within 12weeks after symptom onset; this is mainly due to delay at the level of the general practitioner (GP). In order to reduce delay of GPs in identifying early arthritis, we initiated an Early Arthritis

  7. Septic arthritis due to Roseomonas mucosa in a rheumatoid arthritis patient receiving infliximab therapy.

    Science.gov (United States)

    Sipsas, Nikolaos V; Papaparaskevas, Joseph; Stefanou, Ioanna; Kalatzis, Konstantinos; Vlachoyiannopoulos, Panayiotis; Avlamis, Athina

    2006-08-01

    We report a case of septic arthritis due to Roseomonas mucosa in a rheumatoid arthritis patient receiving infliximab therapy. This is the first report of septic arthritis due to R. mucosa, and infliximab therapy might be a predisposing factor because this infection was never reported in the pre-anti-tumor necrosis factor alpha therapy period.

  8. Acromioclavicular septic arthritis and sternoclavicular septic arthritis with contiguous pyomyositis.

    Science.gov (United States)

    Corey, Sally A; Agger, William A; Saterbak, Andrew T

    2015-03-01

    Acromioclavicular (AC) and sternoclavicular (SC) septic arthritis with contiguous pyomyositis are rare, especially in immunocompetent individuals. We report a case of septic AC joint with pyomyositis of the deltoid and supraspinatus muscles and a separate case with septic SC joint with pyomysitis of the sternocleidomastoid muscle. Both patients had similar presentations of infections with Staphylococcus aureus and were successfully treated with surgical incision and drainage followed by prolonged antibiotic therapy.

  9. A review of current knowledge of the complement system and the therapeutic opportunities in inflammatory arthritis.

    Science.gov (United States)

    Mizuno, M

    2006-01-01

    The complement activation system, a key component of the innate immune system, protects the host from microorganisms such as bacteria, and other foreign threats including abnormal cells. However, it is also double-edged in that it can have negative effects in the host; excessive complement activation damages the host and can even kill in anaphylactic shock and septic shock. Regulation of the complement system is a useful strategy to control inflammatory diseases, including inflammatory arthritis. Rheumatoid arthritis is a common inflammatory disease worldwide. Many medicines are developed to control inflammation, including recently developed biological response modifiers such as anti-TNF and IL-6 agents. Nevertheless, in some patients disease remains difficult to control because of complications, side effects and tolerance of medicines. In inflammatory arthritis, including rheumatoid arthritis, there is abundant evidence implicating complement activation in humans and animal models. Therefore, anti-complement agents might be beneficial as part of clinical treatment. However, at present, there are still no applicable agents for therapeutic regulation of excessive complement activation in chronic disease. Novel agents in development might be useful as a strategy to control complement activation. Here I describe recent knowledge of the complement system in inflammatory arthritis, the recent developments in anti-complement agents and their considerable potential for the future.

  10. Protein arginine deiminase 4 inhibition is sufficient for the amelioration of collagen-induced arthritis.

    Science.gov (United States)

    Willis, V C; Banda, N K; Cordova, K N; Chandra, P E; Robinson, W H; Cooper, D C; Lugo, D; Mehta, G; Taylor, S; Tak, P P; Prinjha, R K; Lewis, H D; Holers, V M

    2017-01-27

    Citrullination of joint proteins by the protein arginine deiminase (PAD) family of enzymes is recognized increasingly as a key process in the pathogenesis of rheumatoid arthritis. This present study was undertaken to explore the efficacy of a novel PAD4-selective inhibitor, GSK199, in the murine collagen-induced arthritis model of rheumatoid arthritis. Mice were dosed daily from the time of collagen immunization with GSK199. Efficacy was assessed against a wide range of end-points, including clinical disease scores, joint histology and immunohistochemistry, serum and joint citrulline levels and quantification of synovial autoantibodies using a proteomic array containing joint peptides. Administration of GSK199 at 30 mg/kg led to significant effects on arthritis, assessed both by global clinical disease activity and by histological analyses of synovial inflammation, pannus formation and damage to cartilage and bone. In addition, significant decreases in complement C3 deposition in both synovium and cartilage were observed robustly with GSK199 at 10 mg/kg. Neither the total levels of citrulline measurable in joint and serum, nor levels of circulating collagen antibodies, were affected significantly by treatment with GSK199 at any dose level. In contrast, a subset of serum antibodies reactive against citrullinated and non-citrullinated joint peptides were reduced with GSK199 treatment. These data extend our previous demonstration of efficacy with the pan-PAD inhibitor Cl-amidine and demonstrate robustly that PAD4 inhibition alone is sufficient to block murine arthritis clinical and histopathological end-points.

  11. An update on methotrexate pharmacogenetics in rheumatoid arthritis.

    Science.gov (United States)

    Ranganathan, Prabha

    2008-04-01

    Rheumatoid arthritis (RA) is a systemic inflammatory disorder that mainly affects the joints. When left untreated, the disease can result in irreversible joint damage with high morbidity and mortality. Disease-modifying antirheumatic drugs are the cornerstones of treatment in RA. Disease-modifying antirheumatic drugs not only ameliorate the clinical signs and symptoms of disease, but also prevent the radiographic progression of joint damage. Methotrexate is one such disease-modifying antirheumatic drug that has been used in the treatment of RA for over two decades with excellent long-term efficacy and safety. However, there is significant variability in patients' response to methotrexate, both in terms of efficacy and toxicity. At the present time, there are no reliable means of predicting, a priori, an individual patient's response to methotrexate. In this review, recent published literature on the pharmacogenetics of methotrexate in RA is highlighted. Pharmacogenetics may be a powerful tool for optimizing methotrexate therapy in patients with RA.

  12. Equine Septic Arthritis and Serum Amyloid A

    OpenAIRE

    Ludwig, Elsa Karen

    2016-01-01

    Bacterial infection within a joint, septic arthritis, is a serious condition in horses that can lead to long-term joint disease if the infection is not resolved quickly. Equine septic arthritis is diagnosed primarily based on clinical signs and synovial fluid cytology. Septic synovial fluid is characterized by significant elevations in total protein (TP) and total nucleated cell count (TNCC). However, in some cases it can be difficult to distinguish between septic arthritis and non-septic joi...

  13. Polyarticular septic arthritis following septic circumcision.

    Science.gov (United States)

    Millar, Tim M; McGrath, Patrick; McConnachie, Charles C

    2007-01-01

    Ritual circumcision during an initiation ceremony for young adults is common practice in parts of South Africa. We report on a case of polyarticular septic arthritis in a seventeen-year-old man following septicaemia after circumcision, resulting in severe fixed flexion deformities of both knees. This case illustrates an unusual cause of polyarticular septic arthritis and the treatment difficulties associated with delayed presentation. It is also a reminder of the consequences of untreated acute septic arthritis.

  14. Pathogenesis and Prediction of Future Rheumatoid Arthritis

    Science.gov (United States)

    2016-10-01

    AWARD NUMBER: W81XWH-13-1-0408 TITLE: Pathogenesis and Prediction of Future Rheumatoid Arthritis PRINCIPAL INVESTIGATOR: Kevin D. Deane, MD/PhD...order to understand two major factors: 1) how biomarker changes in preclinical RA can be used to accurately predict the future development of RA in...will be performed. 15. SUBJECT TERMS Prediction of future rheumatoid arthritis; pathogenesis of rheumatoid arthritis 16. SECURITY CLASSIFICATION OF

  15. Septic arthritis in immunocompetent and immunosuppressed hosts.

    Science.gov (United States)

    Wang, Dingyuan Alvin; Tambyah, Paul Anantharajah

    2015-04-01

    Septic arthritis has long been considered an orthopedic emergency. Historically, Neisseria gonorrhoeae and Staphylococcus aureus have been the most common causes of septic arthritis worldwide but in the modern era of biological therapy and extensive use of prosthetic joint replacements, the spectrum of microbiological causes of septic arthritis has widened considerably. There are also new approaches to diagnosis but therapy remains a challenge, with a need for careful consideration of a combined medical and surgical approach in most cases.

  16. Can magnetic resonance imaging differentiate undifferentiated arthritis?

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Duer, Anne; Hørslev-Petersen, K

    2005-01-01

    A high sensitivity for the detection of inflammatory and destructive changes in inflammatory joint diseases makes magnetic resonance imaging potentially useful for assigning specific diagnoses, such as rheumatoid arthritis and psoriatic arthritis in arthritides, that remain undifferentiated after...... conventional clinical, biochemical and radiographic examinations. With recent data as the starting point, the present paper describes the current knowledge on magnetic resonance imaging in the differential diagnosis of undifferentiated arthritis....

  17. Afghanistan Index

    DEFF Research Database (Denmark)

    Linnet, Poul Martin

    2007-01-01

    The Afghanistan index is a compilation of quantitative and qualitative data on the reconstruction and security effort in Afghanistan. The index aims at providing data for benchmarking of the international performance and thus provides the reader with a quick possibility to retrieve valid...... basis. The data are divided into different indicators such as security, polls, drug, social, economic, refugees etc. This represents a practical division and does not indicate that a picture as to for instance security can be obtained by solely looking at the data under security. In order to obtain...... a more valid picture on security this must incorporate an integrated look on all data meaning that for instance the economic data provides an element as to the whole picture of security....

  18. SUBJECT INDEX

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    2, 4, 6-trinitrobenzenesulphonic acid, zinc sulfate, experimental colitis, 2003328AC133 antigen, hematopoietic stem cells, fetal blood, immunophe-notyping, 2003138ALR2 gene, eNOS gene, PON1 gene, RAGE gene, 2003179 ATN-ISI, prognosis, acute renal failure, acute tubular necrosis-individual severity index, acute physiology and chronic health evaluation, 2003118 Alzheimer disease, interleukin-1 beta, tumor necrosis factor alpha,

  19. The sesamoid index in psoriatic arthropathy

    Energy Technology Data Exchange (ETDEWEB)

    Whitehouse, Richard W.; Aslam, Rizwan [Manchester Royal Infirmary, Department of Clinical Radiology, Manchester (United Kingdom); Bukhari, Marwan [Manchester Royal Infirmary, Department of Rheumatology, Manchester (United Kingdom); Groves, Clare; Cassar-Pullicino, Victor [Agnes Hunt and Robert Jones Hospital, Department of Radiology, Oswestry (United Kingdom)

    2005-04-01

    The sesamoid index was originally described as an aid to the diagnosis of acromegaly. We performed this study to assess the value of the thumb sesamoid index in the diagnosis of psoriatic arthropathy. Retrospective measurement of the sesamoid index (length x width of the medial thumb sesamoid), along with the age and sex were recorded for patients as described below. Patients with psoriasis were subdivided into those with or without radiographic evidence of hand arthropathy. Fifty-nine consecutive patients attending rheumatology clinics with arthralgia and psoriasis were studied. Comparison groups with radiographic evidence of rheumatoid arthritis (52 patients), osteoarthritis (44) or normal hands (55) were also recorded. Twenty-one of 59 patients with psoriasis and arthropathy had a sesamoid index >40, compared with two of 52 with rheumatoid arthritis, none of 44 with osteoarthritis and none of 55 normals. Psoriatic arthropathy is a recognised cause of bone enlargement, usually in the phalanges due to periostitis and proliferative enthesopathy. We have confirmed that psoriatic hand arthropathy can cause significant enlargement of the thumb sesamoids, a feature which is easily quantified and may assist diagnosis. (orig.)

  20. Galectin-3: A key player in arthritis.

    Science.gov (United States)

    Hu, Yong; Yéléhé-Okouma, Mélissa; Ea, Hang-Korng; Jouzeau, Jean-Yves; Reboul, Pascal

    2017-01-01

    Arthritis is more and more considered as the leading reason for the disability in the world, particularly regarding its main entities, rheumatoid arthritis and osteoarthritis. The common feature of arthritis is inflammation, which is mainly supported by synovitis (synovial inflammation), although the immune system plays a primary role in rheumatoid arthritis and a secondary one in osteoarthritis. During the inflammatory phase of arthritis, many pro-inflammatory cytokines and mediators are secreted by infiltrating immune and resident joint cells, which are responsible for cartilage degradation and excessive bone remodeling. Amongst them, a β-galactoside-binding lectin, galectin-3, has been reported to be highly expressed and secreted by inflamed synovium of rheumatoid arthritis and osteoarthritis patients. Furthermore, galectin-3 has been demonstrated to induce joint swelling and osteoarthritis-like lesions after intra-articular injection in laboratory animals. However, the mechanisms underlying its pathophysiological role in arthritis have not been fully elucidated. This review deals with the characterization of arthritis features and galectin-3 and summarizes our current knowledge of the contribution of galectin-3 to joint tissue lesions in arthritis.

  1. Retinal occlusive vasculer disorder and rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Huseyin Ortak

    2013-03-01

    Full Text Available Rheumatoid arthritis is a systemic inflammatory disease that affected older women with many ocular manifestations. Also, these systemic diseases can cause retinal vein occlusion and arterial occlusion that lead to serious and permanent visual loss. Rheumatoid arthritis's the most common manifestation is that retinal vasculitis and retinal vascular complications are associated with this complication. In this review, retinal vascular occlusive diseases are presented to associated with rheumatoid arthritis in literature. Rheumatoid arthritis and its complications have been outlined and was made to create a new perspective. [J Contemp Med 2013; 3(1.000: 71-73

  2. Proteome Analysis of Rheumatoid Arthritis Gut Mucosa.

    Science.gov (United States)

    Bennike, Tue Bjerg; Ellingsen, Torkell; Glerup, Henning; Bonderup, Ole Kristian; Carlsen, Thomas Gelsing; Meyer, Michael Kruse; Bøgsted, Martin; Christiansen, Gunna; Birkelund, Svend; Andersen, Vibeke; Stensballe, Allan

    2017-01-06

    Rheumatoid arthritis (RA) is an inflammatory joint disease leading to cartilage damage and ultimately impaired joint function. To gain new insight into the systemic immune manifestations of RA, we characterized the colon mucosa proteome from 11 RA-patients and 10 healthy controls. The biopsies were extracted by colonoscopy and analyzed by label-free quantitative proteomics, enabling the quantitation of 5366 proteins. The abundance of dihydrofolate reductase (DHFR) was statistically significantly increased in RA-patient biopsies compared with controls and correlated with the administered dosage of methotrexate (MTX), the most frequently prescribed immunosuppressive drug for RA. Additionally, our data suggest that treatment with Leflunomide, a common alternative to MTX, increases DHFR. The findings were supported by immunohistochemistry with confocal microscopy, which furthermore demonstrated that DHFR was located in the cytosol of the intestinal epithelial and interstitial cells. Finally, we identified 223 citrullinated peptides from 121 proteins. Three of the peptides were unique to RA. The list of citrullinated proteins was enriched in extracellular and membrane proteins and included known targets of anticitrullinated protein antibodies (ACPAs). Our findings support that the colon mucosa could trigger the production of ACPAs, which could contribute to the onset of RA. The MS data have been deposited to ProteomeXchange with identifiers PXD001608 and PXD003082.

  3. Secukinumab for ankylosing spondylitis and psoriatic arthritis

    Science.gov (United States)

    Lubrano, Ennio; Perrotta, Fabio Massimo

    2016-01-01

    The treatment of ankylosing spondylitis (AS) and psoriatic arthritis (PsA) positively changed since the introduction of anti-TNFα drugs. These treatments were shown to reduce the symptoms and signs of the diseases and improve the quality of life. However, a variable percentage of patients do not respond to anti-TNFα or can exhibit a loss of response and, furthermore, despite anti-TNFα drugs’ proven efficacy in reducing peripheral radiographic progression in PsA, the impact in reducing radiographic damage in AS is still debated. Recently, the discovery of new pathogenic mechanisms paved the way to the development of new drugs that target other pro-inflammatory cytokines. In particular, the inhibition of interleukin (IL)-17, which is the principal cytokine produced by Th17 lymphocytes, a pro-inflammatory subset involved in both inflammation and new bone formation in AS and PsA, demonstrated promising results. The new molecule secukinumab, an IL-17A inhibitor, showed its efficacy and safety in phase III randomized clinical trials in AS and PsA and is the first non-anti-TNFα biologic approved for the treatment of AS, providing a useful alternative treatment strategy in both diseases. The aim of this article was to review the pathophysiological basis, the efficacy and the safety of secukinumab treatment in AS and PsA patients.

  4. Tyrosine kinases in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Kobayashi Akiko

    2011-08-01

    Full Text Available Abstract Rheumatoid arthritis (RA is an inflammatory, polyarticular joint disease. A number of cellular responses are involved in the pathogenesis of rheumatoid arthritis, including activation of inflammatory cells and cytokine expression. The cellular responses involved in each of these processes depends on the specific signaling pathways that are activated; many of which include protein tyrosine kinases. These pathways include the mitogen-activated protein kinase pathway, Janus kinases/signal transducers and activators transcription pathway, spleen tyrosine kinase signaling, and the nuclear factor κ-light-chain-enhancer of activated B cells pathway. Many drugs are in development to target tyrosine kinases for the treatment of RA. Based on the number of recently published studies, this manuscript reviews the role of tyrosine kinases in the pathogenesis of RA and the potential role of kinase inhibitors as new therapeutic strategies of RA.

  5. Fungal osteomyelitis and septic arthritis.

    Science.gov (United States)

    Bariteau, Jason T; Waryasz, Gregory R; McDonnell, Matthew; Fischer, Staci A; Hayda, Roman A; Born, Christopher T

    2014-06-01

    Management of fungal osteomyelitis and fungal septic arthritis is challenging, especially in the setting of immunodeficiency and conditions that require immunosuppression. Because fungal osteomyelitis and fungal septic arthritis are rare conditions, study of their pathophysiology and treatment has been limited. In the literature, evidence-based treatment is lacking and, historically, outcomes have been poor. The most common offending organisms are Candida and Aspergillus, which are widely distributed in humans and soil. However, some fungal pathogens, such as Histoplasma, Blastomyces, Coccidioides, Cryptococcus, and Sporothrix, have more focal areas of endemicity. Fungal bone and joint infections result from direct inoculation, contiguous infection spread, or hematogenous seeding of organisms. These infections may be difficult to diagnose and eradicate, especially in the setting of total joint arthroplasty. Although there is no clear consensus on treatment, guidelines are available for management of many of these pathogens.

  6. Nutritional considerations in rheumatoid arthritis.

    Science.gov (United States)

    Touger-Decker, R

    1988-03-01

    Rheumatoid arthritis is a chronic, systemic, inflammatory disorder of unknown etiology. The severity of the disease process adversely affects nutritional status. Articular changes, such as small joint deformities and temporomandibular joint syndrome, alter the ability to self-feed. The inflammatory process may increase metabolic rate. Ingestion, digestion, absorption, and excretion may be compromised by secondary manifestations of the disease. Comprehensive nutrition assessment incorporates evaluation of disease and treatment-specific factors, along with the usual assessment parameters. Abnormal values for certain assessment parameters do not necessarily reflect nutritional status. Treatment methods, including medications, may have an impact on nutritional status, assessment tools, and self-feeding. Nutrition management goals focus on identification and implementation of feeding strategies. Evaluation of the ability to feed oneself includes consideration of functional status, secondary manifestations, and medical treatment. Multiple feeding modalities may be required. Oral supplements, tube feedings, and parenteral nutrition may be employed to meet the nutrition needs of the individual with rheumatoid arthritis.

  7. Chronic arthritis in systemic lupus erythematosus: distinct features in 336 paediatric and 1830 adult patients.

    Science.gov (United States)

    Gormezano, Natali W S; Silva, Clovis A; Aikawa, Nadia E; Barros, Diego L; da Silva, Mariana A; Otsuzi, Carini I; Kozu, Katia; Seguro, Luciana Parente; Pereira, Rosa M R; Bonfá, Eloisa

    2016-01-01

    The objectives of this study are to assess the frequency of chronic arthritis and compare the clinical and laboratory features in a large population of childhood-onset systemic lupus erythematosus (cSLE) and adult-onset (aSLE) patients. This historical study evaluated 336 cSLE and 1830 aSLE patients. Chronic arthritis was defined as synovitis of at least 6 weeks of duration. Rhupus was characterised as the association of SLE and chronic inflammatory arthritis with erosion and positive rheumatoid factor. Jaccoud's arthropathy is a non-erosive subluxation leading to severe deformity of the hands and feet. Data were compared using Student's t test or the Mann-Whitney test for continuous variables. For categorical variables, differences were assessed by Fisher's exact test and Pearson chi-square. Frequencies of chronic arthritis were similar in cSLE and aSLE (2.4 vs. 3.8%, p = 0.261). The median time from disease onset to appearance of chronic arthritis was shorter in cSLE (0 vs. 10 years, p lupus anticoagulant (40 vs. 1.6%, p = 0.012), anticardiolipin IgM (40 vs. 1.5%, p = 0.012) and median Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) [10.5(1-20) vs. 6(4-16), p = 0.029] were higher in cSLE. Frequency of rhupus, (12 vs. 17%, p = 1.0), Jaccoud's arthropathy (0 vs. 17%, p = 0.343) and treatments were similar in cSLE and aSLE. We determined that chronic arthritis in SLE has distinct features in children, with very early onset, polyarticular involvement and association with active disease. We further demonstrated in this series that a proportion of chronic arthritis involvement in SLE is manifested as rhupus and Jaccoud's arthropathy.

  8. Overlap between systemic sclerosis and rheumatoid arthritis: a distinct clinical entity?

    Directory of Open Access Journals (Sweden)

    Alex Magno Coelho Horimoto

    SSc/RA overlap. Comparing the clinical manifestations among the groups of patients, there was a higher incidence of gastritis and cardiac valvulopathy in patients with SSc and arthritis, but not in the others. In the group of patients with SSc/RA overlap and in patients with SSc and arthritis a significant reduction in quality of life was observed, measured by HAQ index, especially in patients with arthritis present during clinical evaluation. We found radiographic changes in 42.6% of patients with SSc. However, in patients with synovitis, radiological changes consistent with rheumatoid arthritis were found in 50% of patients. Conclusions: While the frequency of clinical arthritis observed in patients with systemic sclerosis was 32.8%, the true overlap between of SSc and RA was 6.6% in this study. We also observed the frequency of positive anti-CCP in 20% of patients with arthritis versus no patients with SSc without arthritis.

  9. Emerging immunotherapies for rheumatoid arthritis

    Science.gov (United States)

    Reynolds, Gary; Cooles, Faye AH; Isaacs, John D; Hilkens, Catharien MU

    2014-01-01

    Novel treatments in development for rheumatoid arthritis target 3 broad areas: cytokines, cells, and signaling pathways. Therapies from each domain share common advantages (for example previously demonstrated efficacy, potential long-term immunomodulation, and oral administration respectively) that have stimulated research in each area but also common obstacles to their development. In this review recent progress in each area will be discussed alongside the factors that have impeded their path to clinical use. PMID:24535556

  10. Citrullinated Chemokines in Rheumatoid Arthritis

    Science.gov (United States)

    2016-12-01

    modified forms of these proteins may serve as potential autoantigens in RA. References: 1. Yoshida Y, Korchynskyi O, Tak PP, Isozaki T, Ruth JH, Campbell ...recruiting chemokine. Arthritis Rheumatol. 66:2716-27, 2014. 2. Edhayan G, Ha CM, Isozaki T, Amin MA, Ohara RA, Morgan R, Campbell PL, Haines GK III, Arbab S...of RA. 6. Publications, Abstracts and Presentations Peer-reviewed manuscripts: 1. Yoshida Y, Korchynskyi O, Tak PP, Isozaki T, Ruth JH, Campbell PL

  11. Metabolite Space of Rheumatoid Arthritis

    OpenAIRE

    van Wietmarschen, Herman; van der Greef, Jan

    2012-01-01

    Metabolites play numerous roles in the healthy and diseased body, ranging from regulating physiological processes to providing building blocks for the body. Therefore, understanding the role of metabolites is important in elucidating the etiology and pathology of diseases and finding targets for new treatment options. Rheumatoid arthritis is a complex chronic disease for which new disease management strategies are needed. The aim of this review is to bring together and integrate information a...

  12. The prognostic value of anti-cyclic citrullinated peptide antibody in patients with recent-onset rheumatoid arthritis

    NARCIS (Netherlands)

    Kroot, EJJA; de Jong, BAW; van Leeuwen, MA; Swinkels, H; van den Hoogen, FHJ; van't Hof, M; van de Putte, LBA; van Rijswijk, MH; van Venrooij, WJ; van Riel, PLCM

    Objective. To study the predictive value of anti-cyclic citrullinated peptide antibody (anti-CCP) in patients with recent-onset rheumatoid arthritis (RA). Methods. Outcome in terms of physical disability (Health Assessment Questionnaire) and radiologic damage (modified Sharp method) over 3-year and

  13. OMERACT Rheumatoid Arthritis Magnetic Resonance Imaging Studies. Exercise 5: an international multicenter reliability study using computerized MRI erosion volume measurements

    DEFF Research Database (Denmark)

    Bird, P; Ejbjerg, B; McQueen, F;

    2003-01-01

    Scoring erosions on magnetic resonance imaging (MRI) is one method of estimating damage in patients with rheumatoid arthritis (RA), but it has limitations. The aim of this pilot study was to assess the feasibility and inter-reader reliability of computer assisted erosion volume estimation...

  14. The prognostic value of anti-cyclic citrullinated peptide antibody in patients with recent-onset rheumatoid arthritis

    NARCIS (Netherlands)

    Kroot, EJJA; de Jong, BAW; van Leeuwen, MA; Swinkels, H; van den Hoogen, FHJ; van't Hof, M; van de Putte, LBA; van Rijswijk, MH; van Venrooij, WJ; van Riel, PLCM

    2000-01-01

    Objective. To study the predictive value of anti-cyclic citrullinated peptide antibody (anti-CCP) in patients with recent-onset rheumatoid arthritis (RA). Methods. Outcome in terms of physical disability (Health Assessment Questionnaire) and radiologic damage (modified Sharp method) over 3-year and

  15. Gadolinium-enhanced MRI features of acute gouty arthritis on top of chronic gouty involvement in different joints

    NARCIS (Netherlands)

    Emad, Yasser; Ragab, Yasser; El-Naggar, Ahmed; El-Shaarawy, Nashwa; Abd-Allah, Mayada A.; Gamal, Rania M.; Fathy, Ahmed; Hawass, Mona; Rasker, Hans

    2015-01-01

    The aims of the current study are to describe gadolinium-enhanced MRI features of an acute flare of established gouty arthritis in different joints and to examine a possible association between serum uric acid and MRI signs indicative of ongoing inflammation and/or structural joint damage as well as

  16. Rheumatoid arthritis as psychic problem

    Directory of Open Access Journals (Sweden)

    Jiří Kaas

    2014-12-01

    Full Text Available The article deals with the issue of psychic problems of rheumatoid arthritis patients. Rheumatoid arthritis is a chronic, inflammatory motor system disease with comprehensive impact on the patient's life. The disease is often considered an exclusively physical disease. But such approach is insufficient because the disease is accompanied by motor limitations of different intensities, by pain and by fatigue that cause considerable exhaustion to the patient. The patients often must give up their hobbies and in some cases even their jobs. In most serious cases, even common daily activities including self-servicing actions become an obstacle to the patient. It is therefore logical that the psyche of a patient with such disease is considerably strained. One of the partial goals of the study consisted in mapping the subjectively perceived quality of life of rheumatoid arthritis patients in facet 8, "negative feelings", and in ascertaining whether there is statistically significant relation to facets 1, "pain and discomfort", and 2, "energy and fatigue". Another goal consisted in comparing the subjectively perceived quality of life between men and women with rheumatoid arthritis, as well as between population of rheumatoid arthritis patients and control healthy population. The study was implemented within the research project of the Grant Agency of the University of South Bohemia in České Budějovice number 120/2012/S, "Reflection of quality of life in nursing", under use of two standardized questionnaires, WHOQOL-100 and HAQ. This article presents exclusively the data acquired based on the WHOQOL-100 questionnaire. The research set consisted of patients suffering from rheumatoid arthritis from all over the Czech Republic. The size of the set was determined by a statistician at 200 individuals suffering from the disease, in a ratio of 150 women and 50 men. The selection set was derived from the basic set of rheumatoid arthritis patients and can

  17. Rheumatoid arthritis as psychic problem

    Directory of Open Access Journals (Sweden)

    Jiří Kaas

    2014-01-01

    Full Text Available The article deals with the issue of psychic problems of rheumatoid arthritis patients. Rheumatoid arthritis is a chronic, inflammatory motor system disease with comprehensive impact on the patient's life. The disease is often considered an exclusively physical disease. But such approach is insufficient because the disease is accompanied by motor limitations of different intensities, by pain and by fatigue that cause considerable exhaustion to the patient. The patients often must give up their hobbies and in some cases even their jobs. In most serious cases, even common daily activities including self–servicing actions become an obstacle to the patient. It is therefore logical that the psyche of a patient with such disease is considerably strained. One of the partial goals of the study consisted in mapping the subjectively perceived quality of life of rheumatoid arthritis patients in facet 8, "negative feelings", and in ascertaining whether there is statistically significant relation to facets 1, "pain and discomfort", and 2, "energy and fatigue". Another goal consisted in comparing the subjectively perceived quality of life between men and women with rheumatoid arthritis, as well as between population of rheumatoid arthritis patients and control healthy population. The study was implemented within the research project of the Grant Agency of the University of South Bohemia in České Budějovice number 120/2012/S, „Reflection of quality of life in nursing", under use of two standardized questionnaires, WHOQOL–100 and HAQ. This article presents exclusively the data acquired based on the WHOQOL–100 questionnaire. The research set consisted of patients suffering from rheumatoid arthritis from all over the Czech Republic. The size of the set was determined by a statistician at 200 individuals suffering from the disease, in a ratio of 150 women and 50 men. The selection set was derived from the basic set of rheumatoid arthritis patients and

  18. Parvovirus infection in early arthritis.

    Science.gov (United States)

    Mauermann, Maria; Hochauf-Stange, Kristina; Kleymann, Alexander; Conrad, Karsten; Aringer, Martin

    2016-01-01

    To analyse the subgroup of early arthritis patients with new onset parvovirus infections for details that may help narrow the population tested. From their routine patient charts, patient histories and clinical and serological data were obtained for all 130 patients of the Rheumatology division with parvovirus serology performed. 11 patients had acute parvovirus infections, defined by specific IgM antibodies. 95 patients had a previous infection, 16 were never infected, together forming the n=111 control group, and 8 patients had to be excluded. Most patients with acute parvovirus infection had an acute onset, highly symmetrical polyarthritis of small joints, which was preceded by prodromal symptoms. Positive ANA were frequently found, whereas C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were only mildly elevated. No frank synovitis was found longer than two weeks after disease onset. Most patients were free of symptoms within three months, and no patient in the parvovirus group developed rheumatoid arthritis or a connective tissue disease. Parvovirus serology may be helpful in patients with acute polyarthritis of very recent onset, and if they give a history of prodromal symptoms, in particular. In most instances, parvovirus arthritis is an acute disease, which is rapidly self-limiting.

  19. Validity of Ultrasonography and Measures of Adult Shoulder Function and Reliability of Ultrasonography in Detecting Shoulder Synovitis in Patients With Rheumatoid Arthritis Using Magnetic Resonance Imaging as a Gold Standard

    NARCIS (Netherlands)

    Bruyn, G. A. W.; Pineda, C.; Hernandez-Diaz, C.; Ventura-Rios, L.; Moya, C.; Garrido, J.; Groen, H.; Pena, A.; Espinosa, R.; Moeller, I.; Filippucci, E.; Iagnocco, A.; Balint, P. V.; Kane, D.; D'Agostino, M-A; Angulo, M.; Ponte, R.; Fernandez-Gallardo, J. M.; Naredo, E.; Moller, I.

    Objective. To assess the intra- and interobserver reproducibility of musculoskeletal ultrasonography (US) in detecting inflammatory shoulder changes in patients with rheumatoid arthritis, and to determine the agreement between US and the Shoulder Pain and Disability Index (SPADI) and the

  20. Validity of Ultrasonography and Measures of Adult Shoulder Function and Reliability of Ultrasonography in Detecting Shoulder Synovitis in Patients With Rheumatoid Arthritis Using Magnetic Resonance Imaging as a Gold Standard

    NARCIS (Netherlands)

    Bruyn, G. A. W.; Pineda, C.; Hernandez-Diaz, C.; Ventura-Rios, L.; Moya, C.; Garrido, J.; Groen, H.; Pena, A.; Espinosa, R.; Moeller, I.; Filippucci, E.; Iagnocco, A.; Balint, P. V.; Kane, D.; D'Agostino, M-A; Angulo, M.; Ponte, R.; Fernandez-Gallardo, J. M.; Naredo, E.; Moller, I.

    2010-01-01

    Objective. To assess the intra- and interobserver reproducibility of musculoskeletal ultrasonography (US) in detecting inflammatory shoulder changes in patients with rheumatoid arthritis, and to determine the agreement between US and the Shoulder Pain and Disability Index (SPADI) and the Disabilitie