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Sample records for arthritis idea trial

  1. The Intensive Diet and Exercise for Arthritis (IDEA trial: design and rationale

    Directory of Open Access Journals (Sweden)

    Eckstein Felix

    2009-07-01

    Full Text Available Abstract Background Obesity is the most modifiable risk factor, and dietary induced weight loss potentially the best nonpharmacologic intervention to prevent or to slow osteoarthritis (OA disease progression. We are currently conducting a study to test the hypothesis that intensive weight loss will reduce inflammation and joint loads sufficiently to alter disease progression, either with or without exercise. This article describes the intervention, the empirical evidence to support it, and test-retest reliability data. Methods/Design This is a prospective, single-blind, randomized controlled trial. The study population consists of 450 overweight and obese (BMI = 27–40.5 kg/m2 older (age ≥ 55 yrs adults with tibiofemoral osteoarthritis. Participants are randomized to one of three 18-month interventions: intensive dietary restriction-plus-exercise; exercise-only; or intensive dietary restriction-only. The primary aims are to compare the effects of these interventions on inflammatory biomarkers and knee joint loads. Secondary aims will examine the effects of these interventions on function, pain, and mobility; the dose response to weight loss on disease progression; if inflammatory biomarkers and knee joint loads are mediators of the interventions; and the association between quadriceps strength and disease progression. Results Test-retest reliability results indicated that the ICCs for knee joint load variables were excellent, ranging from 0.86 – 0.98. Knee flexion/extension moments were most affected by BMI, with lower reliability with the highest tertile of BMI. The reliability of the semi-quantitative scoring of the knee joint using MRI exceeded previously reported results, ranging from a low of 0.66 for synovitis to a high of 0.99 for bone marrow lesion size. Discussion The IDEA trial has the potential to enhance our understanding of the OA disease process, refine weight loss and exercise recommendations in this prevalent disease, and

  2. Formative research in clinical trial development: attitudes of patients with arthritis in enhancing prevention trials

    OpenAIRE

    Taylor, Holly A.; Sugarman, Jeremy; Pisetsky, David S; Bathon, Joan

    2007-01-01

    In preparation for randomised controlled trials (RCTs) of disease‐modifying antirheumatic drugs in patients with early inflammatory arthritis (EIA), formative research was conducted to enhance the design of such trials. The objectives of this research were to (1) determine patients' educational needs as they relate to the necessary elements of informed consent; and (2) assess patients' interest in enrolling in a hypothetical prevention trial. In‐depth interviews were conducted with nine patie...

  3. Proposed outcome measures for prospective clinical trials in juvenile idiopathic arthritis-associated uveitis

    DEFF Research Database (Denmark)

    Heiligenhaus, Arnd; Foeldvari, Ivan; Edelsten, Clive;

    2012-01-01

    To develop a set of core outcome measures for use in randomized controlled trials (RCTs) and longitudinal observational studies in juvenile idiopathic arthritis (JIA)-associated uveitis.......To develop a set of core outcome measures for use in randomized controlled trials (RCTs) and longitudinal observational studies in juvenile idiopathic arthritis (JIA)-associated uveitis....

  4. Methodological considerations for a randomised controlled trial of podiatry care in rheumatoid arthritis: lessons from an exploratory trial

    OpenAIRE

    Helliwell Philip S; Turner Deborah E; Woodburn James

    2007-01-01

    Abstract Background Whilst evidence exists to support the use of single treatments such as orthoses and footwear, the effectiveness of podiatry-led care as a complex intervention for patients with rheumatoid arthritis (RA) related foot problems is unknown. The aim of this study was to undertake an exploratory randomised controlled parallel arm clinical trial (RheumAFooT) to inform the design and implementation of a definitive trial and to understand the potential benefits of this care. Method...

  5. Reporting disease activity in clinical trials of patients with rheumatoid arthritis: EULAR/ACR collaborative recommendations.

    NARCIS (Netherlands)

    Aletaha, D.; Landewe, R.B.; Karonitsch, T.; Bathon, J.; Boers, M.; Bombardier, C.; Bombardieri, S.; Choi, H.; Combe, B.; Dougados, M.; Emery, P.; Gomez-Reino, J.; Keystone, E.C.; Koch, G.; Kvien, T.K.; Martin-Mola, E.; Matucci-Cerinic, M.; Michaud, K.; O'Dell, J.; Paulus, H.; Pincus, T.; Richards, P.; Simon, L.; Siegel, J.; Smolen, J.S.; Sokka, T.; Strand, V.; Tugwell, P.; Heijde, D. van der; Riel, P.L.C.M. van; Vlad, S.; Vollenhoven, R. van; Ward, M.; Weinblatt, M.; Wells, G.A.; White, B.; Wolfe, F.; Zhang, B.; Zink, A.; Felson, D.T.

    2008-01-01

    OBJECTIVE: To make recommendations on how to report disease activity in clinical trials of rheumatoid arthritis (RA) endorsed by the European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR). METHODS: The project followed the EULAR standardised operating procedures, w

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

    Directory of Open Access Journals (Sweden)

    Sternlieb Beth

    2011-01-01

    Full Text Available Abstract Background Rheumatoid arthritis is a chronic, disabling disease that can compromise mobility, daily functioning, and health-related quality of life, especially in older adolescents and young adults. In this project, we will compare a standardized Iyengar yoga program for young people with rheumatoid arthritis to a standard care wait-list control condition. Methods/Design Seventy rheumatoid arthritis patients aged 16-35 years will be randomized into either the 6-week Iyengar yoga program (12 - 1.5 hour sessions twice weekly or the 6-week wait-list control condition. A 20% attrition rate is anticipated. The wait-list group will receive the yoga program following completion of the first arm of the study. We will collect data quantitatively, using questionnaires and markers of disease activity, and qualitatively using semi-structured interviews. Assessments include standardized measures of general and arthritis-specific function, pain, mood, and health-related quality of life, as well as qualitative interviews, blood pressure/resting heart rate measurements, a medical exam and the assessment of pro-inflammatory cytokines. Data will be collected three times: before treatment, post-treatment, and two months following the treatment. Discussion Results from this study will provide critical data on non-pharmacologic methods for enhancing function in rheumatoid arthritis patients. In particular, results will shed light on the feasibility and potential efficacy of a novel intervention for rheumatoid arthritis symptoms, paving the way for a larger clinical trial. Trial Registration ClinicalTrials.gov NCT01096823

  7. Efficacy of Shenshi Qianghuo Dihuang Decoction in rheumatoid arthritis: a randomized controlled trial

    OpenAIRE

    Zhao-wei CHEN; Chen, Yong-Qiang

    2010-01-01

    Background: In China, patients with rheumatoid arthritis (RA) are often treated with traditional Chinese herbal medicine. There are certain advantages of traditional Chinese medicine therapy in treatment of RA.Objective: To assess the efficacy and adverse reaction of Shenshi Qianghuo Dihuang Decoction (SQDD), a compound traditional Chinese herbal medicine, in treatment of RA.Design, setting, participants and interventions: This was a 24-week prospective, randomized, controlled trial. Ninety R...

  8. A commentary on TREAT: The trial of early aggressive drug therapy in juvenile idiopathic arthritis

    Directory of Open Access Journals (Sweden)

    Baildam Eileen

    2012-06-01

    Full Text Available Abstract Polyarticular juvenile idiopathic arthritis (JIA is a category of JIA where multiple joints are affected by chronic inflammation, and where serious and lasting damage to joints is the expected natural history in untreated disease. There is evidence of response to disease-modifying antirheumatic and biologic drugs, but little evidence of permanent remission from any of the existing therapeutic trials. The TREAT trial by Wallace et al., recently published in Arthritis and Rheumatism, used a collaborative multicenter approach to studying early aggressive treatment of polyarticular JIA in an attempt to achieve full clinical inactive disease after 6 months of treatment. The study's main finding that the earlier in the disease course that treatment is started, the better the chance of disease control, has provided evidence that there is a 'window of opportunity' for treating JIA as there is in adult rheumatoid arthritis (RA. The study provides both a platform and an impetus for concentrating future treatment trials on early rather than established disease and investigating a standard of starting treatment within 10 to 12 weeks.

  9. What Is Rheumatoid Arthritis?

    Science.gov (United States)

    ... Arthritis Find a Clinical Trial Journal Articles Rheumatoid Arthritis PDF Version Size: 57 KB Audio Version Time: ... 9.7 MB November 2014 What Is Rheumatoid Arthritis? Fast Facts: An Easy-to-Read Series of ...

  10. Performance of GUNGEN Idea Generation Support Groupware: Lessons from Over A Few Hundred Trial Sessions

    Science.gov (United States)

    Yuizono, Takaya; Munemori, Jun

    GUNGEN-DXII, a new version of the GUNGEN groupware, allows the users to process hundreds of qualitative data segments (phrases and sentences) and compose a coherent piece of text containing a number of emergent ideas. The idea generation process is guided by the KJ method, a leading idea generation technique in Japan. This paper describes functions of GUNGEN supporting three major sub-activities of idea generation, namely, brainstorming, idea clustering, and text composition, and also summarizes the results obtained from a few hundred trial sessions with the old and new GUNGEN systems in terms of some qualitative and quantitative measures. The results show that the sessions with GUNGEN yield intermediate and final products at least as good as those from the original paper-and-pencil KJ method sessions, in addition to the advantages of the online system, such as distance collaboration and digital storage of the products. Moreover, results from the new GUNGEN-DXII raises hope for enabling the users to handle an extremely large number of qualitative data segments in the near future.

  11. Ultrasound in management of rheumatoid arthritis: ARCTIC randomised controlled strategy trial

    Science.gov (United States)

    Aga, Anna-Birgitte; Olsen, Inge Christoffer; Lillegraven, Siri; Hammer, Hilde B; Uhlig, Till; Fremstad, Hallvard; Madland, Tor Magne; Lexberg, Åse Stavland; Haukeland, Hilde; Rødevand, Erik; Høili, Christian; Stray, Hilde; Noraas, Anne; Hansen, Inger Johanne Widding; Bakland, Gunnstein; Nordberg, Lena Bugge; van der Heijde, Désirée; Kvien, Tore K

    2016-01-01

    Objective To determine whether a treatment strategy based on structured ultrasound assessment would lead to improved outcomes in rheumatoid arthritis, compared with a conventional strategy. Design Multicentre, open label, two arm, parallel group, randomised controlled strategy trial. Setting Ten rheumatology departments and one specialist centre in Norway, from September 2010 to September 2015. Participants 238 patients were recruited between September 2010 and April 2013, of which 230 (141 (61%) female) received the allocated intervention and were analysed for the primary outcome. The main inclusion criteria were age 18-75 years, fulfilment of the 2010 American College of Rheumatology/European League Against Rheumatism classification criteria for rheumatoid arthritis, disease modifying anti-rheumatic drug naivety with indication for disease modifying drug therapy, and time from first patient reported swollen joint less than two years. Patients with abnormal kidney or liver function or major comorbidities were excluded. Interventions 122 patients were randomised to an ultrasound tight control strategy targeting clinical and imaging remission, and 116 patients were randomised to a conventional tight control strategy targeting clinical remission. Patients in both arms were treated according to the same disease modifying anti-rheumatic drug escalation strategy, with 13 visits over two years. Main outcome measures The primary endpoint was the proportion of patients with a combination between 16 and 24 months of clinical remission, no swollen joints, and non-progression of radiographic joint damage. Secondary outcomes included measures of disease activity, radiographic progression, functioning, quality of life, and adverse events. All participants who attended at least one follow-up visit were included in the full analysis set. Results 26 (22%) of the 118 analysed patients in the ultrasound tight control arm and 21 (19%) of the 112 analysed patients in the

  12. Methods of deriving EULAR/ACR recommendations on reporting disease activity in clinical trials of patients with rheumatoid arthritis.

    NARCIS (Netherlands)

    Karonitsch, T.; Aletaha, D.; Boers, M.; Bombardieri, S.; Combe, B.; Dougados, M.; Emery, P.; Felson, D.; Gomez-Reino, J.; Keystone, E.; Kvien, T.K.; Martin-Mola, E.; Matucci-Cerinic, M.; Richards, P.; Riel, P.L.C.M. van; Siegel, J.; Smolen, J.S.; Sokka, T.; Heijde, D. van der; Vollenhoven, R. van; Ward, M.; Wells, G.; Zink, A.; Landewe, R.

    2008-01-01

    OBJECTIVE: To use an evidence-based and consensus-based approach to elaborate recommendations on how to report disease activity in clinical trials of patients with rheumatoid arthritis (RA) endorsed by the European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR). MET

  13. Comparison of lumiracoxib with naproxen and ibuprofen in the Therapeutic Arthritis Research and Gastrointestinal Event Trial (TARGET), cardiovascular outcomes: randomised controlled trial.

    NARCIS (Netherlands)

    Farkouh, M.E.; Kirshner, H.; Harrington, R.A.; Ruland, S.; Verheugt, F.W.A.; Schnitzer, T.J.; Burmester, G.R.; Mysler, E.; Hochberg, M.C.; Doherty, M.; Ehrsam, E.; Gitton, X.; Krammer, G.; Mellein, B.; Gimona, A.; Matchaba, P.; Hawkey, C.J.; Chesebro, J.H.

    2004-01-01

    BACKGROUND: The potential for cyclo-oxygenase 2 (COX2)-selective inhibitors to increase the risk for myocardial infarction is controversial. The Therapeutic Arthritis Research and Gastrointestinal Event Trial (TARGET) aimed to assess gastrointestinal and cardiovascular safety of the COX2 inhibitor l

  14. Safety of biologics in rheumatoid arthritis: data from randomized controlled trials and registries.

    Science.gov (United States)

    Codreanu, Catalin; Damjanov, Nemanja

    2015-01-01

    Over the past decade, the use of biologics has significantly changed the management of rheumatoid arthritis (RA). Biologics selectively target components of the immune system, resulting in better disease control. However, the growing use of biologics in RA has increased safety concerns among rheumatologists. Randomized controlled trials (RCTs) and registries are the most reliable sources of clinical safety data. Although safety data from RCTs provide certain insights into the clinical safety profile of an agent, strict constraints in study design (eg, exclusion criteria and restrictive treatment protocols) often do not accurately reflect possible safety issues in the use of the agent, either in the clinical setting or over long-term treatment. Registries, on the other hand, are not restrictive regarding patient enrollment, making them more reliable in evaluating long-term safety. A number of registries have been established globally: in Europe, the United States, and Asia. However, the availability of registry data from Eastern Europe is lacking. The notable exceptions so far are registries from the Czech Republic (ATTRA, a registry of patients treated with anti-tumor necrosis factor-alpha drugs) and Serbia (National registry of patients with rheumatoid arthritis in Serbia [NARRAS]). The current report provides an overview of safety data with biologics in RA from RCTs and registries. Availability of regional safety data from Eastern Europe is of great importance to its clinicians for making evidence-based treatment decisions in RA. PMID:25670881

  15. Methylsulfonylmethane and boswellic acids versus glucosamine sulfate in the treatment of knee arthritis: Randomized trial.

    Science.gov (United States)

    Notarnicola, Angela; Maccagnano, Giuseppe; Moretti, Lorenzo; Pesce, Vito; Tafuri, Silvio; Fiore, Alessandra; Moretti, Biagio

    2016-03-01

    Until now glucosamine sulfate (GS) has been the most widely used supplement and has been shown to be efficacious in the treatment of osteoarthritis (OA). Methylsulfonylmethane (MSM) and boswellic acids (BA) are new effective supplements for the management of inflammation and joint degeneration, according to previous experimental studies. The aim of our study is to test the effectiveness of association of MSM and BA in comparison with GS in knee arthritis.In this prospective randomized clinical trial, MEBAGA (Methylsulfonylmethane and Boswellic Acids versus Glucosamine sulfate in the treatment of knee Arthritis), 120 participants affected by arthritis of the knee were randomly assigned to an experimental group (MB group) or a control group (GS group) treated for 60 days with 5 g of MSM and 7.2 mg of BA or with 1500 mg of GS daily, respectively. At the 2-month (T1) and 6-months (T2) follow-up , the efficacy of these two nutraceuticals was assessed using the visual analog pain scale (VAS) and the Lequesne Index (LI) for joint function, along with the use of anti-inflammatory drugs (non-steroidal anti-inflammatory drugs and anti-cyclooxygenase-2).The repeated measures ANOVA analysis shows that for VAS, LI, and the use of anti-inflammatory drugs scores there are improvements due to the time in the two groups (respectively, F=26.0; P<0.0001; F=4.15; P=0.02; F=3.38; P=0.04), with a tendency to better values for the MB group at T2.On the basis of these preliminary data, we could support the efficacy of the MSM in association with BA in the treatment of OA. These results are consistent with the anti-inflammatory and chondroprotective effects previously occurred in experimental studies. This new combination of integration (MSM and BS) has presented good results and satisfactory in comparison with GS, until now the cornerstone of the treatment of arthritis in according to guidelines. PMID:26684635

  16. Algorithm development for corticosteroid management in systemic juvenile idiopathic arthritis trial using consensus methodology

    Directory of Open Access Journals (Sweden)

    Ilowite Norman T

    2012-08-01

    Full Text Available Abstract Background The management of background corticosteroid therapy in rheumatology clinical trials poses a major challenge. We describe the consensus methodology used to design an algorithm to standardize changes in corticosteroid dosing during the Randomized Placebo Phase Study of Rilonacept in Systemic Juvenile Idiopathic Arthritis Trial (RAPPORT. Methods The 20 RAPPORT site principal investigators (PIs and 4 topic specialists constituted an expert panel that participated in the consensus process. The panel used a modified Delphi Method consisting of an on-line questionnaire, followed by a one day face-to-face consensus conference. Consensus was defined as ≥ 75% agreement. For items deemed essential but when consensus on critical values was not achieved, simple majority vote drove the final decision. Results The panel identified criteria for initiating or increasing corticosteroids. These included the presence or development of anemia, myocarditis, pericarditis, pleuritis, peritonitis, and either complete or incomplete macrophage activation syndrome (MAS. The panel also identified criteria for tapering corticosteroids which included absence of fever for ≥ 3 days in the previous week, absence of poor physical functioning, and seven laboratory criteria. A tapering schedule was also defined. Conclusion The expert panel established consensus regarding corticosteroid management and an algorithm for steroid dosing that was well accepted and used by RAPPORT investigators. Developed specifically for the RAPPORT trial, further study of the algorithm is needed before recommendation for more general clinical use.

  17. Current smoking status is a strong predictor of radiographic progression in early rheumatoid arthritis: results from the SWEFOT trial

    Science.gov (United States)

    Saevarsdottir, Saedis; Rezaei, Hamed; Geborek, Pierre; Petersson, Ingemar; Ernestam, Sofia; Albertsson, Kristina; Forslind, Kristina; van Vollenhoven, Ronald F

    2015-01-01

    Objectives To study clinical predictors for radiographic progression after 1 year in an early rheumatoid arthritis (RA) trial. Methods In the SWEFOT trial population, disease modifying antirheumatic drug (DMARD) naïve RA patients started methotrexate; 3-month responders (DAS28 1, both RF and anti-CCP positivity were significant predictors in the unadjusted, but not the adjusted analyses. The other parameters also remained significant using this lower cut-off. Conclusions In addition to previously described predictors, we identified smoking as a strong independent risk factor for radiographic progression in early RA. Trial registration number NCT00764725. PMID:24706006

  18. Most Trial Eligibility Criteria and Patient Baseline Characteristics Do Not Modify Treatment Effect in Trials Using Targeted Therapies for Rheumatoid Arthritis

    DEFF Research Database (Denmark)

    Christensen, Anton Wulf; Tarp, Simon; Furst, Daniel E;

    2015-01-01

    rheumatoid arthritis (RA). METHODS: We conducted a meta-epidemiological study of all trials evaluating a targeted therapy approved by regulatory authorities for treating RA. The database search was completed on December 11th 2013. Eligible trials reported ACR20 data at months 3-6 and used an add-on design......OBJECTIVE: To determine if variations in trial eligibility criteria and patient baseline characteristics could be considered effect modifiers of the treatment response when testing targeted therapies (biological agents and targeted synthetic disease modifying antirheumatic drugs (DMARDs)) for...

  19. Methodological considerations for a randomised controlled trial of podiatry care in rheumatoid arthritis: lessons from an exploratory trial

    Directory of Open Access Journals (Sweden)

    Helliwell Philip S

    2007-11-01

    Full Text Available Abstract Background Whilst evidence exists to support the use of single treatments such as orthoses and footwear, the effectiveness of podiatry-led care as a complex intervention for patients with rheumatoid arthritis (RA related foot problems is unknown. The aim of this study was to undertake an exploratory randomised controlled parallel arm clinical trial (RheumAFooT to inform the design and implementation of a definitive trial and to understand the potential benefits of this care. Methods Patients with a definite diagnosis of RA, stable drug management 3 months prior to entry, and a current history of foot problems (pain, deformity, stiffness, skin or nail lesions, or footwear problems were recruited from a hospital outpatient rheumatology clinic and randomised to receive 12 months of podiatry treatment or no care. The primary outcome was change in foot health status using the impairment/footwear (LFISIF and activity limitation/participation restriction (LFISAP subscales of the Leeds Foot Impact Scale. Disease Activity Score (DAS, Health Assessment Questionnaire (HAQ score and walking speed (m/s were also recorded. Results Of the 80 patients identified, 64 patients were eligible to participate in the pilot and 34 were recruited. 16 patients were randomised to receive podiatry led foot care and 18 received no care. Against a backdrop of stable disease (DAS and HAQ scores, there was a statistically significant between group difference in the change in foot health status for foot impairment (LFISIF but not activity/participation (LFISAP or function (walking speed over 12 months. In the podiatry arm, 1 patient declined treatment following randomisation (did not want additional hospital visits and 3 self-withdrew (lost to follow-up. Patients received an average of 3 consultations for assessment and treatment comprising routine care for skin and nail lesions (n = 3, foot orthoses (n = 9, footwear referral to the orthotist (n = 5, and ultrasound

  20. Exercise and manual physiotherapy arthritis research trial (EMPART): a multicentre randomised controlled trial.

    LENUS (Irish Health Repository)

    French, Helen P

    2009-01-01

    Osteoarthritis (OA) of the hip is a major cause of functional disability and reduced quality of life. Management options aim to reduce pain and improve or maintain physical functioning. Current evidence indicates that therapeutic exercise has a beneficial but short-term effect on pain and disability, with poor long-term benefit. The optimal content, duration and type of exercise are yet to be ascertained. There has been little scientific investigation into the effectiveness of manual therapy in hip OA. Only one randomized controlled trial (RCT) found greater improvements in patient-perceived improvement and physical function with manual therapy, compared to exercise therapy.

  1. Clinical trials of new drugs for the treatment of rheumatoid arthritis: focus on early disease.

    Science.gov (United States)

    Smolen, Josef S; Collaud Basset, Sabine; Boers, Maarten; Breedveld, Ferdinand; Edwards, Christopher J; Kvien, Tore K; Miossec, Pierre; Sokka-Isler, Tuulikki; van Vollenhoven, Ronald F; Abadie, Eric C; Bruyère, Olivier; Cooper, Cyrus; Mäkinen, Heidi; Thomas, Thierry; Tugwell, Peter; Reginster, Jean-Yves

    2016-07-01

    The European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases convened a task force of experts in rheumatoid arthritis (RA) and clinical trial methodology to comment on the new draft 'Guideline on clinical investigation of medicinal products for the treatment of RA' released by the European Medicines Agency (EMA). Special emphasis was placed by the group on the development of new drugs for the treatment of early RA. In the absence of a clear definition of early RA, it was suggested that clinical investigations in this condition were conducted in disease-modifying antirheumatic drugs naïve patients with no more than 1 year disease duration. The expert group recommended using an appropriate improvement in disease activity (American College of Rheumatology (ACR) or Simplified/Clinical Disease Activity Index (SDAI/CDAI) response criteria) or low disease activity (by any score) as primary endpoints, with ACR/European League Against Rheumatism remission as a secondary endpoint. Finally, as compelling evidence showed that the Disease Acrivity Score using 28-joint counts (DAS28) might not provide a reliable definition of remission, or sometimes even low disease activity, the group suggested replacing DAS28 as a measurement instrument to evaluate disease activity in RA clinical trials. Proposed alternatives included SDAI, CDAI and Boolean criteria. PMID:27037326

  2. Treatment Comparison in Rheumatoid Arthritis: Head-to-Head Trials and Innovative Study Designs

    Directory of Open Access Journals (Sweden)

    Ennio Giulio Favalli

    2014-01-01

    Full Text Available Over the last decades, the increasing knowledge in the area of rheumatoid arthritis has progressively expanded the arsenal of available drugs, especially with the introduction of novel targeted therapies such as biological disease modifying antirheumatic drugs (DMARDs. In this situation, rheumatologists are offered a wide range of treatment options, but on the other side the need for comparisons between available drugs becomes more and more crucial in order to better define the strategies for the choice and the optimal sequencing. Indirect comparisons or meta-analyses of data coming from different randomised controlled trials (RCTs are not immune to conceptual and technical challenges and often provide inconsistent results. In this review we examine some of the possible evolutions of traditional RCTs, such as the inclusion of active comparators, aimed at individualising treatments in real-life conditions. Although head-to-head RCTs may be considered the best tool to directly compare the efficacy and safety of two different DMARDs, surprisingly only 20 studies with such design have been published in the last 25 years. Given the recent advent of the first RCTs truly comparing biological DMARDs, we also review the state of the art of head-to-head trials in RA.

  3. Protocol for the Foot in Juvenile Idiopathic Arthritis trial (FiJIA: a randomised controlled trial of an integrated foot care programme for foot problems in JIA

    Directory of Open Access Journals (Sweden)

    Hendry Gordon J

    2009-06-01

    Full Text Available Abstract Background Foot and ankle problems are a common but relatively neglected manifestation of juvenile idiopathic arthritis. Studies of medical and non-medical interventions have shown that clinical outcome measures can be improved. However existing data has been drawn from small non-randomised clinical studies of single interventions that appear to under-represent the adult population suffering from juvenile idiopathic arthritis. To date, no evidence of combined therapies or integrated care for juvenile idiopathic arthritis patients with foot and ankle problems exists. Methods/design An exploratory phase II non-pharmacological randomised controlled trial where patients including young children, adolescents and adults with juvenile idiopathic arthritis and associated foot/ankle problems will be randomised to receive integrated podiatric care via a new foot care programme, or to receive standard podiatry care. Sixty patients (30 in each arm including children, adolescents and adults diagnosed with juvenile idiopathic arthritis who satisfy the inclusion and exclusion criteria will be recruited from 2 outpatient centres of paediatric and adult rheumatology respectively. Participants will be randomised by process of minimisation using the Minim software package. The primary outcome measure is the foot related impairment measured by the Juvenile Arthritis Disability Index questionnaire's impairment domain at 6 and 12 months, with secondary outcomes including disease activity score, foot deformity score, active/limited foot joint counts, spatio-temporal and plantar-pressure gait parameters, health related quality of life and semi-quantitative ultrasonography score for inflammatory foot lesions. The new foot care programme will comprise rapid assessment and investigation, targeted treatment, with detailed outcome assessment and follow-up at minimum intervals of 3 months. Data will be collected at baseline, 6 months and 12 months from baseline

  4. Safety of biologics in rheumatoid arthritis: data from randomized controlled trials and registries

    Directory of Open Access Journals (Sweden)

    Codreanu C

    2015-01-01

    Full Text Available Catalin O Codreanu,1 Nemanja Damjanov2 1Rheumatology Department, Center of Rheumatic Diseases, Bucharest, Romania; 2Institute of Rheumatology, School of Medicine, University of Belgrade, Belgrade, SerbiaAbstract: Over the past decade, the use of biologics has significantly changed the management of rheumatoid arthritis (RA. Biologics selectively target components of the immune system, resulting in better disease control. However, the growing use of biologics in RA has increased safety concerns among rheumatologists. Randomized controlled trials (RCTs and registries are the most reliable sources of clinical safety data. Although safety data from RCTs provide certain insights into the clinical safety profile of an agent, strict constraints in study design (eg, exclusion criteria and restrictive treatment protocols often do not accurately reflect possible safety issues in the use of the agent, either in the clinical setting or over long-term treatment. Registries, on the other hand, are not restrictive regarding patient enrollment, making them more reliable in evaluating long-term safety. A number of registries have been established globally: in Europe, the United States, and Asia. However, the availability of registry data from Eastern Europe is lacking. The notable exceptions so far are registries from the Czech Republic (ATTRA, a registry of patients treated with anti-tumor necrosis factor-alpha drugs and Serbia (National registry of patients with rheumatoid arthritis in Serbia [NARRAS]. The current report provides an overview of safety data with biologics in RA from RCTs and registries. Availability of regional safety data from Eastern Europe is of great importance to its clinicians for making evidence-based treatment decisions in RA. Keywords: biologic therapy, biologic drugs, adverse events, infections, pregnancy, malignancies

  5. USE OF SUBCUTANEOUS METHOTREXATE FOR THE TREATMENT OF PATIENTS WITH ACTIVE RHEUMATOID ARTHRITIS: THE REMARCA TRIAL

    Directory of Open Access Journals (Sweden)

    D. E. Karateev

    2016-01-01

    Full Text Available The early administration of methotrexate (MTX and the use of its high (by the rheumatology practice standards doses contribute to the enhanced efficiency of therapy and the reduced severity of rheumatoid arthritis (RA. One of the important merits of MTX in the treatment of RA is the possibility of adjusting its dose and choosing its (oral or subcutaneous administration routes, which makes it possible to individualize treatment. Particular emphasis has been recently placed just on a subcutaneous MTX formulation that creates prerequisites for substantially improving the efficiency of RA therapy. The paper gives the data of the REMARCA (Russian investigation of methotrexate and biologicals for early active arthritis trial assessing the results of RA treatment in the use of the subcutaneous MTX dosage form as a first-line drug and in the elaboration of management tactics for this disease.Subjects and methods. The investigation included 191 patients (34 men and 157 women with active RA; of whom 51.8% had very early RA (< 6 months' disease duration. 115 patients with RA completed a 24-month follow-up period; and their data were analyzed in more detail.Results and discussion. The findings may substantiate treatment policy based on the prescription of subcutaneous MTX (without previously administering its oral formulation in patients with early RA and high disease activity, starting the drug at 15 mg/week and rapidly escalating with the highest tolerable doses during 4-8 weeks, which allows remission (or low disease activity in the majority of patients without using glucocorticoids and biological agents.

  6. One Year Effects of a Workplace Integrated Care Intervention for Workers with Rheumatoid Arthritis: Results of a Randomized Controlled Trial

    OpenAIRE

    Boot, C.R.L.; Twisk, J.W.R.; Steenbeek, R.; Voskuyl, A E; Schaardenburg. D. van; Anema, J.R.

    2016-01-01

    Purpose To evaluate the effectiveness of a workplace integrated care intervention on at-work productivity loss in workers with rheumatoid arthritis (RA) compared to usual care. Methods In this randomized controlled trial, 150 workers with RA were randomized into either the intervention or control group. The intervention group received an integrated care and participatory workplace intervention. Outcome measures were the Work Limitations Questionnaire, Work Instability Scale for RA, pain, fati...

  7. A Randomized, Controlled, Single-Blind Trial of Leflunomide in the Treatment of Rheumatoid Arthritis

    Institute of Scientific and Technical Information of China (English)

    胡永红; 涂胜豪; 刘沛霖

    2001-01-01

    The efficacy and safety of leflunomide (LEF) in the treatment of rheumatoid arthritis (RA) were evaluated and the comparison with methotrexate's (MTX's) was performed in a 12-week, single-blind, randomized, parallel trial for treating 81 patients with RA. There were 56 cases in LEF group and 25 cases in MTX group. The dose of LEF was 20 mg per day and MTX 15 mg per week. All patients took oxaproxin simultaneously at the 4th to 6th week after the trail. The results showed that the general effective rate and notable effective rate were 94.64 % and 73.21 % in LEF group, 72 % and 44 % in MTX group, respectively, with the differences being statistically significant between the two groups (P<0.05). LEF and oxaprozin could obviously improve the symptoms, signs and joint functions. The incidence of side reactions was lower in LEF group (17.86 %) than in MTX group (40.00 %, P<0.05). LEF had a good therapeutic effect for RA, especially for refractory RA and had slight side reactions, and could be regarded as a superior immunosuppressive agent used in the treatment of RA and other connective tissue diseases.

  8. The Effects of Aromatherapy Massage and Reflexology on Pain and Fatigue in Patients with Rheumatoid Arthritis: A Randomized Controlled Trial.

    Science.gov (United States)

    Gok Metin, Zehra; Ozdemir, Leyla

    2016-04-01

    Nonpharmacologic interventions for symptom management in patients with rheumatoid arthritis are underinvestigated. Limited data suggest that aromatherapy massage and reflexology may help to reduce pain and fatigue in patients with rheumatoid arthritis. The aim of this study was to examine and compare the effects of aromatherapy massage and reflexology on pain and fatigue in patients with rheumatoid arthritis. The study sample was randomly assigned to either an aromatherapy massage (n = 17), reflexology (n = 17) or the control group (n = 17). Aromatherapy massage was applied to both knees of subjects in the first intervention group for 30 minutes. Reflexology was administered to both feet of subjects in the second intervention group for 40 minutes during weekly home visits. Control group subjects received no intervention. Fifty-one subjects with rheumatoid arthritis were recruited from a university hospital rheumatology clinic in Turkey between July 2014 and January 2015 for this randomized controlled trial. Data were collected by personal information form, DAS28 index, Visual Analog Scale and Fatigue Severity Scale. Pain and fatigue scores were measured at baseline and within an hour after each intervention for 6 weeks. Pain and fatigue scores significantly decreased in the aromatherapy massage and reflexology groups compared with the control group (p aromatherapy massage (week 1 vs week 2 for pain, week 1 vs week 4 for fatigue) (p Aromatherapy massage and reflexology are simple and effective nonpharmacologic nursing interventions that can be used to help manage pain and fatigue in patients with rheumatoid arthritis. PMID:27091583

  9. Magnet therapy for the relief of pain and inflammation in rheumatoid arthritis (CAMBRA: A randomised placebo-controlled crossover trial

    Directory of Open Access Journals (Sweden)

    Richmond Stewart J

    2008-09-01

    Full Text Available Abstract Background Rheumatoid arthritis is a common inflammatory autoimmune disease. Although disease activity may be managed effectively with prescription drugs, unproven treatments such as magnet therapy are sometimes used as an adjunct for pain control. Therapeutic devices incorporating permanent magnets are widely available and easy to use. Magnets may also be perceived as a more natural and less harmful alternative to analgesic compounds. Of interest to health service researchers is the possibility that magnet therapy might help to reduce the economic burden of managing chronic musculoskeletal disorders. Magnets are extremely cheap to manufacture and prolonged treatment involves a single cost. Despite this, good quality scientific evidence concerning the safety, effectiveness and cost-effectiveness of magnet therapy is scarce. The primary aim of the CAMBRA trial is to investigate the effectiveness of magnet therapy for relieving pain and inflammation in rheumatoid arthritis. Methods/Design The CAMBRA trial employs a randomised double-blind placebo-controlled crossover design. Participant will each wear four devices: a commercially available magnetic wrist strap; an attenuated wrist strap; a demagnetised wrist strap; and a copper bracelet. Device will be allocated in a randomised sequence and each worn for five weeks. The four treatment phases will be separated by wash out periods lasting one week. Both participants and researchers will be blind, as far as feasible, to the allocation of experimental and control devices. In total 69 participants will be recruited from general practices within the UK. Eligible patients will have a verified diagnosis of rheumatoid arthritis that is being managed using drugs, and will be experiencing chronic pain. Outcomes measured will include pain, inflammation, disease activity, physical function, medication use, affect, and health related costs. Data will be collected using questionnaires, diaries, manual

  10. Effectiveness of a measurement feedback system on outcome in rheumatoid arthritis: a controlled clinical trial

    OpenAIRE

    Fransen, J.; Stucki, G.; Twisk, J.; Chamot, A; Gerster, J; Langenegger, T; Seitz, M; Michel, B.; m the,

    2003-01-01

    Background: With the help of a measurement feedback system, the treatment strategy for individual patients with rheumatoid arthritis (RA) can be adjusted to achieve optimal control of disease activity.

  11. Adjuvant auricular electroacupuncture and autogenic training in rheumatoid arthritis: a randomized controlled trial

    DEFF Research Database (Denmark)

    Bernateck, M.; Becker, M.; Schwacke, C.;

    2008-01-01

    BACKGROUND: In contrast to psychological interventions the usefulness of acupuncture as an adjuvant therapy in rheumatoid arthritis (RA) has not yet been demonstrated. OBJECTIVE: The efficacy of auricular electroacupuncture (EA) was directly compared with autogenic training (AT). METHODS: Patient...

  12. Alzheimer's disease - input of vitamin D with mEmantine assay (AD-IDEA trial: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Gautier Jennifer

    2011-10-01

    Full Text Available Abstract Background Current treatments for Alzheimer's disease and related disorders (ADRD are symptomatic and can only temporarily slow down ADRD. Future possibilities of care rely on multi-target drugs therapies that address simultaneously several pathophysiological processes leading to neurodegeneration. We hypothesized that the combination of memantine with vitamin D could be neuroprotective in ADRD, thereby limiting neuronal loss and cognitive decline. The aim of this trial is to compare the effect after 24 weeks of the oral intake of vitamin D3 (cholecalciferol with the effect of a placebo on the change of cognitive performance in patients suffering from moderate ADRD and receiving memantine. Methods The AD-IDEA Trial is a unicentre, double-blind, randomized, placebo-controlled, intent-to-treat, superiority trial. Patients aged 60 years and older presenting with moderate ADRD (i.e., Mini-Mental State Examination [MMSE] score between 10-20, hypovitaminosis D (i.e., serum 25-hydroxyvitamin D [25OHD] Discussion The combination of memantine plus vitamin D may represent a new multi-target therapeutic class for the treatment of ADRD. The AD-IDEA Trial seeks to provide evidence on its efficacy in limiting cognitive and functional declines in ADRD. Trial Registration ClinicalTrials.gov number, NCT01409694

  13. Golimumab 3-year safety update: an analysis of pooled data from the long-term extensions of randomised, double-blind, placebo-controlled trials conducted in patients with rheumatoid arthritis, psoriatic arthritis or ankylosing spondylitis

    OpenAIRE

    Kay, Jonathan; Fleischmann, Roy; Keystone, Edward; Hsia, Elizabeth C.; Hsu, Benjamin; Mack, Michael; Goldstein, Neil; Braun, Jürgen; Kavanaugh, Arthur

    2013-01-01

    Objective To assess pooled golimumab safety up to year 3 of rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS) trials. Methods Golimumab 50 and 100 mg, administered subcutaneously (SC) every 4 weeks (q4wk), were assessed in patients with active RA (methotrexate-naïve, methotrexate-experienced and anti-TNF (tumour necrosis factor)-experienced), PsA or AS, despite conventional therapy. Placebo control continued up to week (wk) 24 (wk 52, methotrexate-naïve), wi...

  14. Effects of intensive exercise on patients with active rheumatoid arthritis: a randomised clinical trial.

    NARCIS (Netherlands)

    Ende, C.H.M. van den; Breedveld, F.C.; Cessie, S. le; Dijkmans, B.A.C.; Mug, A.W. de

    2000-01-01

    Objectives: To investigate the effects of a dynamic, intensive exercise regimen on pain, disease activity, and physical functioning in active rheumatoid arthritis (RA). Methods: 64 patients with RA with a mean age of 60 (13) years and mean disease duration of 8 (8) years, admitted to hospital becaus

  15. 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,

  16. Safety of biologics in rheumatoid arthritis: data from randomized controlled trials and registries

    OpenAIRE

    Codreanu C; Damjanov N

    2015-01-01

    Catalin O Codreanu,1 Nemanja Damjanov2 1Rheumatology Department, Center of Rheumatic Diseases, Bucharest, Romania; 2Institute of Rheumatology, School of Medicine, University of Belgrade, Belgrade, SerbiaAbstract: Over the past decade, the use of biologics has significantly changed the management of rheumatoid arthritis (RA). Biologics selectively target components of the immune system, resulting in better disease control. However, the growing use of biologics in RA has increased safety concer...

  17. Homoeopathic therapy in rheumatoid arthritis: evaluation by double-blind clinical therapeutic trial.

    OpenAIRE

    Gibson, R G; Gibson, S L; MacNeill, A D; Buchanan, W W

    1980-01-01

    Twenty-three patients with rheumatoid arthritis on orthodox first-line anti-inflammatory treatment plus homeopathy were compared wtih a similar group of twenty-three patients on orthodox first-line treatment plus an inert preparation. There was a significant improvement in subjective pain, articular index, stiffness and grip strength in those patients receiving homoeopathic remedies whereas there was no significant change in the patients who received placebo. Two physicians were involved in p...

  18. Effects of intensive exercise on patients with active rheumatoid arthritis: a randomised clinical trial.

    OpenAIRE

    Ende, C.H.M. van den; Breedveld, F C; Cessie, S Le; Dijkmans, B.A.C.; de Mug, A W

    2000-01-01

    Objectives: To investigate the effects of a dynamic, intensive exercise regimen on pain, disease activity, and physical functioning in active rheumatoid arthritis (RA). Methods: 64 patients with RA with a mean age of 60 (13) years and mean disease duration of 8 (8) years, admitted to hospital because of active disease, were randomly assigned to an intensive exercise programme or to a conservative exercise programme during their period in hospital with a mean length of 30 (14) days. The intens...

  19. Treatment Comparison in Rheumatoid Arthritis: Head-to-Head Trials and Innovative Study Designs

    OpenAIRE

    Ennio Giulio Favalli; Serena Bugatti; Martina Biggioggero; Roberto Caporali

    2014-01-01

    Over the last decades, the increasing knowledge in the area of rheumatoid arthritis has progressively expanded the arsenal of available drugs, especially with the introduction of novel targeted therapies such as biological disease modifying antirheumatic drugs (DMARDs). In this situation, rheumatologists are offered a wide range of treatment options, but on the other side the need for comparisons between available drugs becomes more and more crucial in order to better define the strategies fo...

  20. A multinational randomized, controlled, clinical trial of etoricoxib in the treatment of rheumatoid arthritis [ISRCTN25142273

    Directory of Open Access Journals (Sweden)

    Zhao Peng

    2002-05-01

    Full Text Available Abstract Background Etoricoxib is a highly selective COX-2 inhibitor which was evaluated for the treatment of rheumatoid arthritis (RA. Methods Double-blind, randomized, placebo and active comparator-controlled, 12-week study conducted at 67 sites in 28 countries. Eligible patients were chronic NSAID users who demonstrated a clinical worsening of arthritis upon withdrawal of prestudy NSAIDs. Patients received either placebo, etoricoxib 90 mg once daily, or naproxen 500 mg twice daily (2:2:1 allocation ratio. Primary efficacy measures included direct assessment of arthritis by counts of tender and swollen joints, and patient and investigator global assessments of disease activity. Key secondary measures included the Stanford Health Assessment Questionnaire, patient global assessment of pain, and the percentage of patients who achieved ACR20 responder criteria response (a composite of pain, inflammation, function, and global assessments. Tolerability was assessed by adverse events and routine laboratory evaluations. Results 1171 patients were screened, 891 patients were randomized (N = 357 for placebo, N = 353 for etoricoxib, and N = 181 for naproxen, and 687 completed 12 weeks of treatment (N = 242 for placebo, N = 294 for etoricoxib, and N = 151 for naproxen. Compared with patients receiving placebo, patients receiving etoricoxib and naproxen showed significant improvements in all efficacy endpoints (p Conclusions In this study, etoricoxib 90 mg once daily was more effective than placebo and similar in efficacy to naproxen 500 mg twice daily for treating patients with RA over 12 weeks. Etoricoxib 90 mg was generally well tolerated in RA patients.

  1. Arthritis Advice

    Science.gov (United States)

    ... Connected Home » Arthritis Advice Heath and Aging Arthritis Advice Common Kinds of Arthritis Warning Signs Treating ... cause damage to your joints. Common Kinds of Arthritis Arthritis is one of the most common diseases ...

  2. 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. ...

  3. Compositional ideas in the bayesian analysis of categorical data with application to dose finding clinical trials

    OpenAIRE

    Gasparini, Mauro; Eisele, J

    2003-01-01

    Compositional random vectors are fundamental tools in the Bayesian analysis of categorical data. Many of the issues that are discussed with reference to the statistical analysis of compositional data have a natural counterpart in the construction of a Bayesian statistical model for categorical data. This note builds on the idea of cross-fertilization of the two areas recommended by Aitchison (1986) in his seminal book on compositional data. Particular emphasis is put on the pro...

  4. Low-dose prednisone chronotherapy for rheumatoid arthritis: a randomised clinical trial (CAPRA-2)

    OpenAIRE

    Buttgereit, Frank; Mehta, Daksha; Kirwan, John; Szechinski, Jacek; Boers, Maarten; Alten, Rieke E; Supronik, Jerzy; Szombati, Istvan; Romer, Ulrike; Witte, Stephan; Saag, Kenneth G.

    2012-01-01

    Objective To assess the efficacy and safety of low-dose prednisone chronotherapy using a new modified-release (MR) formulation for the treatment of rheumatoid arthritis (RA). Methods In this 12-week, double-blind, placebo-controlled study, patients with active RA (n=350) were randomised 2:1 to receive MR prednisone 5 mg or placebo once daily in the evening in addition to their existing RA disease-modifying antirheumatic drug (DMARD) treatment. The primary end point was the percentage of patie...

  5. Effect of intensive exercise on patients with active rheumatoid arthritis: a randomised clinical trial

    OpenAIRE

    Van den Ende, C H M; Breedveld, F.; Le Cessie, S; Dijkmans, B; de Mug, A W; Hazes, J

    2000-01-01

    OBJECTIVE—To investigate the effects of a dynamic, intensive exercise regimen on pain, disease activity, and physical functioning in active rheumatoid arthritis (RA).
METHODS—64 patients with RA with a mean age of 60 (13) years and mean disease duration of 8 (8) years, admitted to hospital because of active disease, were randomly assigned to an intensive exercise programme or to a conservative exercise programme during their period in hospital with a mean length of 30 (14) days. The intensive...

  6. Adjuvant auricular electroacupuncture and autogenic training in rheumatoid arthritis: a randomized controlled trial. Auricular acupuncture and autogenic training in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Bernateck, M; Becker, M; Schwake, C;

    2008-01-01

    BACKGROUND: In contrast to psychological interventions the usefulness of acupuncture as an adjuvant therapy in rheumatoid arthritis (RA) has not yet been demonstrated. OBJECTIVE: The efficacy of auricular electroacupuncture (EA) was directly compared with autogenic training (AT). METHODS: Patients...

  7. Employment and Arthritis: Making It Work a Randomized Controlled Trial Evaluating an Online Program to Help People with Inflammatory Arthritis Maintain Employment (Study Protocol)

    OpenAIRE

    Carruthers, Erin; Rogers, Pamela; Backman, Catherine; Goldsmith, Charles; Gignac, Monique; Marra, Carlo; Village, Judy; Li, Linda; Esdaile, John; Lacaille, Diane

    2014-01-01

    Background Arthritis and musculoskeletal conditions are the leading cause of long-term work disability (WD), an outcome with a major impact on quality of life and a high cost to society. The importance of decreased at-work productivity has also recently been recognized. Despite the importance of these problems, few interventions have been developed to reduce the impact of arthritis on employment. We have developed a novel intervention called “Making It Work”, a program to help people with ...

  8. Efficacy of Turmeric Extracts and Curcumin for Alleviating the Symptoms of Joint Arthritis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.

    Science.gov (United States)

    Daily, James W; Yang, Mini; Park, Sunmin

    2016-08-01

    Although turmeric and its curcumin-enriched extracts have been used for treating arthritis, no systematic review and meta-analysis of randomized clinical trials (RCTs) have been conducted to evaluate the strength of the research. We systemically evaluated all RCTs of turmeric extracts and curcumin for treating arthritis symptoms to elucidate the efficacy of curcuma for alleviating the symptoms of arthritis. Literature searches were conducted using 12 electronic databases, including PubMed, Embase, Cochrane Library, Korean databases, Chinese medical databases, and Indian scientific database. Search terms used were "turmeric," "curcuma," "curcumin," "arthritis," and "osteoarthritis." A pain visual analogue score (PVAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were used for the major outcomes of arthritis. Initial searches yielded 29 articles, of which 8 met specific selection criteria. Three among the included RCTs reported reduction of PVAS (mean difference: -2.04 [-2.85, -1.24]) with turmeric/curcumin in comparison with placebo (P < .00001), whereas meta-analysis of four studies showed a decrease of WOMAC with turmeric/curcumin treatment (mean difference: -15.36 [-26.9, -3.77]; P = .009). Furthermore, there was no significant mean difference in PVAS between turmeric/curcumin and pain medicine in meta-analysis of five studies. Eight RCTs included in the review exhibited low to moderate risk of bias. There was no publication bias in the meta-analysis. In conclusion, these RCTs provide scientific evidence that supports the efficacy of turmeric extract (about 1000 mg/day of curcumin) in the treatment of arthritis. However, the total number of RCTs included in the analysis, the total sample size, and the methodological quality of the primary studies were not sufficient to draw definitive conclusions. Thus, more rigorous and larger studies are needed to confirm the therapeutic efficacy of turmeric for arthritis. PMID:27533649

  9. Evaluation of a patient-initiated review system in rheumatoid arthritis: an implementation trial protocol

    Directory of Open Access Journals (Sweden)

    Paudyal Priyamvada

    2012-07-01

    Full Text Available Abstract Background Rheumatoid arthritis is a chronic inflammatory condition that affects the joints causing unpredictable episodes of pain, stiffness and disability. People with rheumatoid arthritis usually require lifelong specialist follow-up but frequently have periods when their disease can be managed through self-care or that provided by their general practitioner. Compared to the traditional clinician-driven care in rheumatoid arthritis, patient-initiated care has proven to be more beneficial in terms of reducing unnecessary medical reviews, providing greater satisfaction to patients and staffs and maintaining the patient’s physical and psychological status. We aim to evaluate the implementation of a patient-initiated review system in a routine secondary care rheumatology service in a public hospital in England, where patients get the opportunity to self-manage their disease by requesting specialist reviews at times of need instead of clinician-scheduled appointments. Methods/design Three hundred and eighty patients attending routine review at Plymouth Hospitals NHS Trust will be randomised to either enrol immediately into a patient-initiated review system (direct access group, or to be seen regularly by a clinician at the hospital (regular clinician-initiated group. Patients (or their general practitioner in the direct access group can arrange a review by calling a rheumatology nurse-led advice line that enables telephone delivered clinical advice, or where appropriate, an appointment with a rheumatologist within 10 working days. Patients in the regular clinician-initiated group will attend their planned appointments at regular intervals during the intervening period of 12 months. The primary outcome of interest is patient satisfaction; secondary outcomes include service use, waiting times and clinical measures. Semi-structured, in-depth interviews will be conducted with a subset of patients and staff with the aim of identifying

  10. The outcome and cost-effectiveness of nurse-led care in people with rheumatoid arthritis: a multicentre randomised controlled trial

    OpenAIRE

    Ndosi , Mwidimi; Lewis, Martyn; Hale, Claire; Quinn, Helen; Ryan, Sarah; Emery, Paul; Bird, Howard; Hill, Jackie

    2013-01-01

    Objective To determine the clinical effectiveness and cost-effectiveness of nurse-led care (NLC) for people with rheumatoid arthritis (RA). Methods In a multicentre pragmatic randomised controlled trial, the assessment of clinical effects followed a non-inferiority design, while patient satisfaction and cost assessments followed a superiority design. Participants were 181 adults with RA randomly assigned to either NLC or rheumatologist-led care (RLC), both arms carrying out their normal pract...

  11. A pragmatic randomised controlled trial of hydrotherapy and land exercises on overall well being and quality of life in rheumatoid arthritis

    OpenAIRE

    Nightingale Peter; Maggs Fiona; Eversden Lis; Jobanputra Paresh

    2007-01-01

    Abstract Background Hydrotherapy is highly valued by people with rheumatoid arthritis yet few studies have compared the benefits of exercises in heated water against exercises on land. In particular, data on quality of life is rarely reported. This is especially important because patients treated with hydrotherapy often report an enhanced sense of well-being. We report a randomised controlled trial in which we compared the effects of hydrotherapy with exercises on land on overall response to ...

  12. Enteropathic Arthritis

    Science.gov (United States)

    ... Info For Teens Message Boards & Forums Donate Enteropathic Arthritis Learn About Spondylitis / Enteropathic Arthritis Overview For The ... Work and Spondylitis Spondylitis Awareness Month Overview: Enteropathic Arthritis Enteropathic (en-ter-o-path-ic) arthritis is ...

  13. Comparison of auranofin, gold sodium thiomalate, and placebo in the treatment of rheumatoid arthritis. A controlled clinical trial.

    Science.gov (United States)

    Ward, J R; Williams, H J; Egger, M J; Reading, J C; Boyce, E; Altz-Smith, M; Samuelson, C O; Willkens, R F; Solsky, M A; Hayes, S P

    1983-11-01

    A prospective controlled, double-blind multicenter trial compared placebo, auranofin (an orally administered gold complex), and parenteral gold sodium thiomalate (GST) in patients with active rheumatoid arthritis (RA). Of 193 patients who received any treatment, the only important improvement identified for either auranofin or GST was for pain/tenderness scores. When 161 patients who completed 20 weeks of treatment were examined, both auranofin and GST treatments were superior to placebo as measured by improvement in number of painful and/or tender joints, joint pain/tenderness scores, physician's assessment of disease activity, and decrease in erythrocyte sedimentation rate when elevated at entry. GST was superior to placebo in improvement of joint swelling scores, anemia, thrombocytosis, and rheumatoid factor. No drug-related remissions were observed. The only statistically significant advantages of GST over auranofin for efficacy were an increase in hemoglobin concentration and decrease of thrombocytosis with GST. Withdrawals for adverse effects were 5 times more frequent with GST treatment. Thrombocytopenia, proteinuria, elevated liver enzymes, "nitritoid" reactions, and "gold pneumonitis" were observed only in the GST treatment group. These results confirm that both parenteral and oral gold may be effective for the treatment of RA, that GST tends to show greater efficacy than auranofin, and that auranofin has fewer significant adverse effects than GST. However, long-term benefits, tolerability, and safety cannot be inferred from this study. PMID:6416259

  14. Exercise and Manual therapy Arthritis Research Trial (EMPART) for osteoarthritis of the hip: A Multicentre Randomised Controlled trial.

    LENUS (Irish Health Repository)

    French, Helen P

    2012-10-16

    OBJECTIVE: To determine the effectiveness of exercise therapy (ET) compared to ET with adjunctive manual therapy (ET+MT) for people with hip osteoarthritis (OA). A secondary aim was to identify if immediate commencement of ET or ET+MT was more beneficial than a 9 week waiting period for either intervention. DESIGN: Assessor-blind randomised controlled trial with 9 and 18 week follow-ups. SETTING: Four academic teaching hospitals, Dublin, Ireland. PARTICIPANTS: 131 patients with hip OA recruited from general practitioners, rheumatologists, orthopaedic surgeons, and other hospital consultants were randomised to one of three groups: ET (n=45), ET+MT (n=43) and wait-list control (n=43). INTERVENTIONS: Participants in both ET and ET+ MT groups received up to 8 treatments over 8 weeks. Control group participants were re-randomised into either ET or ET+MT group after 9 week follow-up. Their data were pooled with original treatment group data: ET (n=66) and ET+MT (n=65). MAIN OUTCOME MEASURES: The primary outcome was the WOMAC physical function (PF) subscale. Secondary outcomes included physical performance, pain, hip range of motion (HROM), anxiety\\/depression, quality of life, medication usage, patient-perceived change and patient satisfaction. RESULTS: There was no significant difference in WOMAC PF between ET (n=66) and ET+MT (n=65) groups at 9 weeks (mean diff 0.09 (95% CI -4.41, 5.25)) or at 18 weeks (mean diff 0.42 (95% CI -3.98, 6.83)), or other outcomes, except \\'patient satisfaction with outcome\\' which was higher in the ET+MT group (p=0.02). Improvements in WOMAC, HROM and patient-perceived change occurred in both treatment groups compared with the control group. CONCLUSION: Self-reported function, HROM and patient-perceived improvement occurred after an 8 week programme of ET for patients with hip OA MT as an adjunct provided no further benefit, except for higher patient satisfaction.

  15. Experimental Drug for Rheumatoid Arthritis Shows Promise

    Science.gov (United States)

    ... medlineplus/news/fullstory_158076.html Experimental Drug for Rheumatoid Arthritis Shows Promise Baricitinib helped patients who failed other ... 2016 (HealthDay News) -- An experimental drug to treat rheumatoid arthritis showed promise in a new six-month trial. ...

  16. Efficacy and safety of certolizumab pegol plus methotrexate in active rheumatoid arthritis: the RAPID 2 study. A randomised controlled trial

    Science.gov (United States)

    Smolen, J; Landewé, R B; Mease, P; Brzezicki, J; Mason, D; Luijtens, K; van Vollenhoven, R F; Kavanaugh, A; Schiff, M; Burmester, G R; Strand, V; Vencovský, J; van der Heijde, D

    2009-01-01

    Background: Certolizumab pegol is a PEGylated tumour necrosis factor inhibitor. Objective: To evaluate the efficacy and safety of certolizumab pegol versus placebo, plus methotrexate (MTX), in patients with active rheumatoid arthritis (RA). Methods: An international, multicentre, phase 3, randomised, double-blind, placebo-controlled study in active adult-onset RA. Patients (n = 619) were randomised 2:2:1 to subcutaneous certolizumab pegol (liquid formulation) 400 mg at weeks 0, 2 and 4 followed by 200 mg or 400 mg plus MTX, or placebo plus MTX, every 2 weeks for 24 weeks. The primary end point was ACR20 response at week 24. Secondary end points included ACR50 and ACR70 responses, change from baseline in modified Total Sharp Score, ACR core set variables and physical function. Results: Significantly more patients in the certolizumab pegol 200 mg and 400 mg groups achieved an ACR20 response versus placebo (p⩽0.001); rates were 57.3%, 57.6% and 8.7%, respectively. Certolizumab pegol 200 and 400 mg also significantly inhibited radiographic progression; mean changes from baseline in mTSS at week 24 were 0.2 and −0.4, respectively, versus 1.2 for placebo (rank analysis p⩽0.01). Certolizumab pegol-treated patients reported rapid and significant improvements in physical function versus placebo; mean changes from baseline in HAQ-DI at week 24 were −0.50 and −0.50, respectively, versus −0.14 for placebo (p⩽0.001). Most adverse events were mild or moderate, with low incidence of withdrawals due to adverse events. Five patients developed tuberculosis. Conclusion: Certolizumab pegol plus MTX was more efficacious than placebo plus MTX, rapidly and significantly improving signs and symptoms of RA and physical function and inhibiting radiographic progression. Trial registration number: NCT00175877 PMID:19015207

  17. Adalimumab for long-term treatment of psoriatic arthritis: 2-year data from the Adalimumab Effectiveness in Psoriatic Arthritis Trial (ADEPT)

    OpenAIRE

    Mease, P J; Ory, P; Sharp, J T; Ritchlin, C T; Van den Bosch, F; Wellborne, F; Birbara, C.; Thomson, G T D; Perdok, R J; Medich, J; Wong, R L; Gladman, D D

    2008-01-01

    Objective: To evaluate the long-term effectiveness and tolerability of adalimumab in the treatment of psoriatic arthritis (PsA). Methods: Patients with PsA who completed a 24-week, double-blind study of adalimumab versus placebo were eligible to enroll in an open-label extension study and receive adalimumab 40 mg subcutaneously every other week for up to an additional 120 weeks. At the time of this analysis, available efficacy evaluations throughout 2 years of treatment (n  =  245) included A...

  18. A randomised trial of differentiated prednisolone treatment in active rheumatoid arthritis. Clinical benefits and skeletal side effects

    DEFF Research Database (Denmark)

    Hansen, M; Podenphant, J; Florescu, A; Stoltenberg, M; Borch, A; Kluger, E; Sørensen, S F; Hansen, T M

    1999-01-01

    OBJECTIVES: To study benefits and skeletal side effects of carefully monitored prednisolone treatment in patients with active rheumatoid arthritis. METHODS: One hundred and two patients with active rheumatoid arthritis were randomly allocated to treatment with disease modifying anti-inflammatory ......OBJECTIVES: To study benefits and skeletal side effects of carefully monitored prednisolone treatment in patients with active rheumatoid arthritis. METHODS: One hundred and two patients with active rheumatoid arthritis were randomly allocated to treatment with disease modifying anti...... radiological disease progression, although there was a trend towards less progression in Larsen score in the prednisolone group, a matter that was further underlined in an intention to treat analysis. BMD data revealed a significant reduction in spinal BMD in the prednisolone group, whereas prednisolone seemed...

  19. Safety and efficacy of ocrelizumab in combination with methotrexate in MTX-naive subjects with rheumatoid arthritis: the phase III FILM trial

    OpenAIRE

    Stohl, William; Gomez-Reino, Juan; Olech, Ewa; Dudler, Jean; Fleischmann, Roy M; Zerbini, Cristiano A F; Ashrafzadeh, Ali; Grzeschik, Susanna; Bieraugel, Rebecca; Green, Jennifer; Francom, Steven; Dummer, Wolfgang

    2012-01-01

    Objective To determine the efficacy and safety of ocrelizumab (OCR) with methotrexate (MTX) in MTX-naive rheumatoid arthritis (RA) patients. Methods In a randomised, double-blind, controlled trial, patients received placebo+MTX (MTX; n=210), OCR 200 mg×2+MTX (OCR 200; n=200) or OCR 500 mg×2+MTX (OCR 500; n=203). OCR/placebo (two intravenous infusions) was given on days 1 and 15, with fixed re-treatment scheduled at weeks 24/26, 52/54 and 76/78. Due to early termination of OCR dosing, there wa...

  20. Protocol for the Foot in Juvenile Idiopathic Arthritis trial (FiJIA): a randomised controlled trial of an integrated foot care programme for foot problems in JIA

    OpenAIRE

    Hendry Gordon J; Turner Deborah E; McColl John; Lorgelly Paula K; Sturrock Roger D; Watt Gordon F; Browne Michael; Gardner-Medwin Janet; Friel Lorraine; Woodburn Jim

    2009-01-01

    Abstract Background Foot and ankle problems are a common but relatively neglected manifestation of juvenile idiopathic arthritis. Studies of medical and non-medical interventions have shown that clinical outcome measures can be improved. However existing data has been drawn from small non-randomised clinical studies of single interventions that appear to under-represent the adult population suffering from juvenile idiopathic arthritis. To date, no evidence of combined therapies or integrated ...

  1. THE FIRST RUSSIAN STRATEGIC STUDY OF PHARMACOTHERAPY FOR RHEUMATOID ARTHRITIS (REMARCA TRIAL: RESULTS OF 12-MONTH TREATMENT IN 130 PATIENTS

    Directory of Open Access Journals (Sweden)

    D. E. Karateev

    2014-01-01

    Full Text Available To introduce treat-to-target recommendations is an important task of modern rheumatology; however, there is still a diversity of serious problems relating to a scientific rationale and a clinical one for this strategy and to the possibilities of its implementation in real clinical practice, in the rheumatology service of the Russian Federation in particular, by taking into account the specific features of funding for high-tech medical care.Objective: to determine the efficiency and safety of combined therapy with subcutaneous methotrexate (MT and biological agents (BA when using the treat-to-target strategy in patients with active early and extended-stage rheumatoid arthritis (RA who have risk factors for a poor prognosis.Subjects and methods.The results of the REMARCA (Russian InvEstigation of MethotrexAte and biologicals in eaRly aCtive inflammatory Arthritis trial of 130 patients followed up for 12 months or more were given. There was a female preponderance; mean age 48.9±13.9 years, rheumatoid factor positivity (86.9%; anti-cyclic citrullinated peptide antibody positivity (89.2%. Seventy patients formed a subgroup of early RA (disease duration ≤6 months (mean 4.17±1.39 months; 60 patients were a subgroup of advanced-stage RA (disease duration >6 months (mean 30.8±32.7 months. In all the patients, therapy was initiated by using subcutaneous MT with its rapid dose escalation up to 20–30 mg/week and the achievement of the treatment goal (low disease activity or remission was checked every 3 months and depending on the result a decision had been taken to add or not to add a biological agent (BA (a tumor necrosis factor inhibitor or abatacept. If the former was insufficiently effective, it was substituted for a BA from another class.Results. Subcutaneous MT monotherapy provided remission or low disease activity in 49 (37.7% patients; a BA was given to 81 (62.3% patients. Following 6 and 12 months, low activity or remission

  2. 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.

  3. Lipid Extract from Hard-Shelled Mussel (Mytilus coruscus Improves Clinical Conditions of Patients with Rheumatoid Arthritis: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Yuanqing Fu

    2015-01-01

    Full Text Available Studies have suggested a lipid extract from hard-shelled mussel (Mytilus coruscus (HMLE possessed strong anti-inflammatory activity in arthritis model of rats. This study investigated whether HMLE could improve clinical conditions of rheumatoid arthritis patients. Fifty rheumatoid arthritis patients (28–75 years were randomly assigned to receive HMLE capsules or receive placebo capsules for 6 months. Forty-two subjects and 50 subjects were included in per-protocol and intention-to-treat analysis, respectively. Significant differences in changes on disease activity score (DAS28 and clinical disease activity index (CDAI after 6-month intervention (p < 0.01 were observed in both analyses with more evident efficacy shown in per-protocol population (∆DAS28 = 0.47; ∆CDAI = 4.17, which favored the benefits of the HMLE group. TNF-α (tumor necrosis factor α, interleukin (IL-1β and PGE2 (prostaglandin E2 but not IL-6, were significantly decreased in both groups, and the decrements were much larger in the HMLE group for TNF-α and PGE2 after 6 months from baseline (p < 0.05. IL-10 was significantly increased in both groups and the change was much more evident in the HMLE group (p < 0.05. In conclusion, HMLE exhibited benefits for the clinical conditions of rheumatoid patients in relation to improvement in the balance between pro- and anti-inflammatory factors, which indicated its potential to serve as adjunctive treatment for rheumatoid arthritis. (ClinicalTrials.gov NCT02173587.

  4. 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 ...

  5. Psoriatic arthritis

    International Nuclear Information System (INIS)

    This book contains 11 chapters. Some of the titles are: The history and epidemiologic definition of psoriatic arthritis as a distinct entity; Psoriatic arthritis: Further epidemiologic and genetic considerations; The radiologic features of psoriatic arthritis; and Laboratory findings and pathology of psoriatic arthritis

  6. Psoriatic arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Gerber, L.H.; Espinoza, L.R.

    1985-01-01

    This book contains 11 chapters. Some of the titles are: The history and epidemiologic definition of psoriatic arthritis as a distinct entity; Psoriatic arthritis: Further epidemiologic and genetic considerations; The radiologic features of psoriatic arthritis; and Laboratory findings and pathology of psoriatic arthritis.

  7. Effectiveness of radiation synovectomy with samarium-153 particulate hydroxyapatite in rheumatoid arthritis patients with knee synovitis: a controlled randomized double-blind trial

    International Nuclear Information System (INIS)

    Objectives: the aim of the present study was to investigate the effectiveness of Samarium153-particulate hydroxyapatite radiation synovectomy in rheumatoid arthritis patients with chronic knee synovitis. Methods: fifty-eight rheumatoid arthritis patients (60 knees) with chronic knee synovitis participated in a controlled double-blinded trial. Patients were randomized to receive either an intra-articular injection with 40 mg triamcinolone hexacetonide alone (TH group) or 40 mg triamcinolone hexacetonide combined with 15 mCi Samarium153-particulate hydroxyapatite (Sm/TH group). Blinded examination at baseline (T0) and at 1 (T1), 4 (T4), 12 (T12), 32 (T32), and 48 (T48) weeks post-intervention were performed on all patients and included a visual analog scale for joint pain and swelling as well as data on morning stiffness, flexion, extension, knee circumference, Likert scale of improvement, percentage of improvement, SF-36 generic quality of life questionnaire, Stanford Health Assessment Questionnaire (HAQ), Lequesne index, use of non-steroidal anti-inflammatory drugs or oral corticosteroids, events and adverse effects, calls to the physician, and hospital visits. Results: the sample was homogeneous at baseline, and there were no withdrawals. Improvement was observed in both groups in relation to T0, but no statistically significant differences between groups were observed regarding all variables at the time points studied. The Sm/TH group exhibited more adverse effects at T1 (p153-particulate hydroxyapatite (15 mCi) with 40 mg of triamcinolone hexacetonide is not superior to triamcinolone hexacetonide alone for the treatment of knee synovitis in patients with rheumatoid arthritis at 1 y of follow-up. (author)

  8. Impact of a magnetic resonance imaging-guided treat-to-target strategy on disease activity and progression in patients with rheumatoid arthritis (the IMAGINE-RA trial)

    DEFF Research Database (Denmark)

    Møller-Bisgaard, Signe; Hørslev-Petersen, Kim; Ejbjerg, Bo Jannik;

    2015-01-01

    BACKGROUND: Rheumatoid arthritis (RA) is a chronic, progressive joint disease, which frequently leads to irreversible joint deformity and severe functional impairment. Although patients are treated according to existing guidelines and reach clinical remission, erosive progression still occurs. This....../absence of BME may therefore be clinically beneficial. We present the design of a randomized controlled trial (RCT) aiming to evaluate whether an MRI-guided treatment strategy compared to a conventional treatment strategy in anti-CCP-positive erosive RA is better to prevent progression of erosive joint...... damage and increase the remission rate in patients with low disease activity or clinical remission. METHODS/DESIGN: The study is a non-blinded, multicenter, 2-year RCT with a parallel group design. Two hundred anti-CCP-positive, erosive RA patients characterized by low disease activity or remission, no...

  9. Fungal arthritis

    Science.gov (United States)

    ... and irritation (inflammation) of a joint by a fungal infection. It is also called mycotic arthritis. Causes Fungal ... symptoms of fungal arthritis. Prevention Thorough treatment of fungal infections elsewhere in the body may help prevent fungal ...

  10. 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 ...

  11. 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 ...

  12. Thumb Arthritis

    Science.gov (United States)

    ... Hand Therapist? Media Find a Hand Surgeon 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 ...

  13. Relationship between clinical and patient-reported outcomes in a phase 3 trial of tofacitinib or MTX in MTX-naïve patients with rheumatoid arthritis

    Science.gov (United States)

    Fleischmann, Roy; Strand, Vibeke; Wilkinson, Bethanie; Kwok, Kenneth; Bananis, Eustratios

    2016-01-01

    Objective To compare the relationship between clinical measures and patient-reported outcomes (PROs) in patients with rheumatoid arthritis (RA) treated with tofacitinib or methotrexate (MTX). Methods In a phase 3 randomised controlled trial, patients (N=956) who were MTX-naïve or had received ≤3 doses were randomised and received tofacitinib 5 or 10 mg twice daily or MTX titrated to 20 mg/week. Outcomes included: per cent of patients achieving American College of Rheumatology 70% responses (ACR70), ACR50, low disease activity (LDA) by Simplified Disease Activity Index (SDAI ≤11) and Clinical Disease Activity Index (CDAI ≤10), remission by SDAI (≤3.3) and CDAI (≤2.8), patient-reported Health Assessment Questionnaire-Disability Index (HAQ-DI scores <0.5), pain and global assessment of disease activity. Results At month 6, most patients who achieved LDA/remission by one definition achieved LDA/remission with others; however, discordance between measures was greater with MTX than with tofacitinib. As expected, concordance between CDAI and SDAI responses was high. Overall, patients achieving LDA or ACR50 responses reported less improvement in PROs (HAQ-DI, pain and patient global assessment) compared with clinical measures (tender and swollen joint counts). Conclusions Variability in levels of responses between clinical outcomes and PROs should be considered when setting treat-to-target goals in patients with RA. Trial registration number NCT01039688; Post-results. PMID:27175296

  14. A pragmatic randomised controlled trial of hydrotherapy and land exercises on overall well being and quality of life in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Nightingale Peter

    2007-03-01

    Full Text Available Abstract Background Hydrotherapy is highly valued by people with rheumatoid arthritis yet few studies have compared the benefits of exercises in heated water against exercises on land. In particular, data on quality of life is rarely reported. This is especially important because patients treated with hydrotherapy often report an enhanced sense of well-being. We report a randomised controlled trial in which we compared the effects of hydrotherapy with exercises on land on overall response to treatment, physical function and quality of life in patients with rheumatoid arthritis. Methods One hundred and fifteen patients with RA were randomised to receive a weekly 30-minute session of hydrotherapy or similar exercises on land for 6 weeks. Our primary outcome was a self-rated global impression of change – a measure of treatment effect on a 7-point scale ranging from 1(very much worse to 7 (very much better assessed immediately on completion of treatment. Secondary outcomes including EuroQol health related quality of life, EuroQol health status valuation, HAQ, 10 metre walk time and pain scores were collected at baseline, after treatment and 3 months later. Binary outcomes were analysed by Fisher's exact test and continuous variables by Wilcoxon or Mann-Whitney tests. Results Baseline characteristics of the two groups were comparable. Significantly more patients treated with hydrotherapy (40/46, 87% were much better or very much better than the patients treated with land exercise (19/40, 47.5%, p Conclusion Patients with RA treated with hydrotherapy are more likely to report feeling much better or very much better than those treated with land exercises immediately on completion of the treatment programme. This perceived benefit was not reflected by differences between groups in 10-metre walk times, functional scores, quality of life measures and pain scores.

  15. Alzheimer's disease - input of vitamin D with mEmantine assay (AD-IDEA trial): study protocol for a randomized controlled trial

    OpenAIRE

    Gautier Jennifer; Thiery Samuel; Parot-Schinkel Elsa; Fantino Bruno; Annweiler Cédric; Beauchet Olivier

    2011-01-01

    Abstract Background Current treatments for Alzheimer's disease and related disorders (ADRD) are symptomatic and can only temporarily slow down ADRD. Future possibilities of care rely on multi-target drugs therapies that address simultaneously several pathophysiological processes leading to neurodegeneration. We hypothesized that the combination of memantine with vitamin D could be neuroprotective in ADRD, thereby limiting neuronal loss and cognitive decline. The aim of this trial is to compar...

  16. Randomised controlled trial examining the effect of exercise in people with rheumatoid arthritis taking anti-TNFα therapy medication.

    LENUS (Irish Health Repository)

    Reid, Angela

    2011-01-01

    Substantial progress has been made in the medical management of rheumatoid arthritis (RA) over the past decade with the introduction of biologic therapies, including anti-tumour necrosis factor alpha (anti-TNFα) therapy medications. However, individuals with RA taking anti-TNFα medication continue to experience physical, psychological and functional consequences, which could potentially benefit from rehabilitation. There is evidence that therapeutic exercise should be included as an intervention for people with RA, but to date there is little evidence of the benefits of therapeutic exercise for people with RA on anti-TNFα therapy medication. A protocol for a multicentre randomised controlled three-armed study which aims to examine the effect of dynamic group exercise therapy on land or in water for people with RA taking anti-TNFα therapy medication is described.

  17. 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 ...

  18. Arthritis in Children

    Science.gov (United States)

    ... Issues Listen Español Text Size Email Print Share Arthritis Page Content Article Body Arthritis is an inflammation ... with antibiotics, even if arthritis develops. Juvenile Idiopathic Arthritis (JIA) Juvenile idiopathic arthritis (JIA) has previously been ...

  19. Arthritis and IBD

    Science.gov (United States)

    ... IBD Help Center Home > Resources > Arthritis Go Back Arthritis Email Print + Share Arthritis, or inflammation of the ... joints and a reduction in flexibility. TYPES OF ARTHRITIS In IBD, arthritis may appear in three different ...

  20. Zinc sulphate in rheumatoid arthritis

    OpenAIRE

    Mattingly, P. C.; Mowat, A G

    1982-01-01

    To assess the antirheumatic activity of zinc sulphate, 27 patients with active rheumatoid arthritis took part in a 6-month, randomised, double-blind, between-group trial of oral zinc sulphate versus placebo. Twelve patients on zinc and 9 on placebo completed the trial, but no significant antirheumatic activity of zinc sulphate was demonstrated.

  1. Effects of Nigella sativa oil extract on inflammatory cytokine response and oxidative stress status in patients with rheumatoid arthritis: a randomized, double-blind, placebo-controlled clinical trial

    OpenAIRE

    Vahid Hadi; Sorayya Kheirouri; Mohammad Alizadeh; Alireza Khabbazi; Hossein Hosseini

    2016-01-01

    Objectives: Nigella sativa is a medicinal plant that has long been used in traditional medicine for treating various conditions. Numerous animal studies provided evidences that the seed may elicit a broad anti-inflammatory/anti-oxidant activity. The aim of the present clinical trial was to evaluate anti-inflammatory and antioxidant properties of Nigella sativa oil in patients with rheumatoid arthritis (RA). Materials and Methods: Forty-two patients with RA were assigned into two groups in thi...

  2. 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

  3. Psoriatic arthritis

    International Nuclear Information System (INIS)

    In the past 10 years, a number of well-controlled surveys of psoriatic patients selective for the presence of arthritis have been conducted. A Canadian group reported that of 100 patients admitted to the hospital for treatment of psoriasis, 32 had clinical or radiologic evidence of psoriatic arthritis, and 17 had both types of evidence. Eighty patients with radiologic evidence of spinal or sacroiliac involvement were asymptomatic, and seven had clinical evidence of peripheral arthritis but without radiologic evidence. The authors concluded that psoriatic arthritis is a common event in patients with severe psoriasis and that it is associated with more extensive skin disease than is found in patients without arthritis. The information gathered from these epidemiologic studies coupled with clinical, radiologic, and serologic characteristics have provided the basis for the current belief that psoriatic arthritis is indeed a distinct entity

  4. Complementary medicine in rheumatoid arthritis

    OpenAIRE

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

    2011-01-01

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

  5. Etoricoxib versus indometacin in the treatment of Chinese patients with acute gouty arthritis: a randomized double-blind trial

    Institute of Scientific and Technical Information of China (English)

    LI Ting; CHEN Shun-le; DAI Qing; HAN Xing-hai; LI Zhan-guo; WU Dong-hai; ZHANG Xiao

    2013-01-01

    Background Acute gout is an intensely painful,inflammatory arthritis.Although the non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for this condition,the efficacy is based on only a few studies,particularly in China.We tried to assess the safety and efficacy of etoricoxib in the treatment of acute gouty arthritis in China.Methods A randomized,double-blind,active comparator study was conducted at 10 sites in China.Patients (n=178; ≥18 years of age) with acute gouty attack (<48 hours) were treated for 5 days with etoricoxib (120 mg/d; n=89) or indometacin (75 mg twice daily; n=89).The primary efficacy end point was self-assessed pain in the affected joint (0-4 point Likert scale) from days 2-5.Secondary end points included investigator assessments of tenderness and swelling,patient/ investigator global assessments of response to therapy,and patients discontinuing treatment.Safety was assessed by adverse events (AEs).Results Etoricoxib and indometacin had comparable primary and secondary end points.Mean change difference from baseline from days 2-5 was 0.03 (95% confidence interval (Cl)-0.19 to 0.25; P=0.6364),which fell within the prespecified comparative bounds of-0.5 to 0.5.No severe AEs were associated with etoricoxib use.Non-severe AEs were mainly digestive and general,and most (73.7%) were mild,although they caused withdrawal of two subjects in the etoricoxib group,due to bilateral renal calculi and uronephrosis of the left kidney (unrelated to etoricoxib) and fever and chills (potentially etoricoxib-related).Overall,AEs were similar,although the absolute number of AEs in the etoricoxib group (n=31) was less than the indometacin group (n=34).Conclusions Etoricoxib (120 mg once daily) is effective in treating acute gout,is generally safe and well-tolerated,and is comparable in efficacy to indometacin (75 mg twice daily).

  6. 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)....

  7. Synovial tissue sublining CD68 expression is a biomarker of therapeutic response in rheumatoid arthritis clinical trials: consistency across centers.

    LENUS (Irish Health Repository)

    Bresnihan, Barry

    2012-02-01

    OBJECTIVE: To determine whether the correlation between the mean change in disease activity and the mean change in synovial sublining (sl) CD68 expression could be demonstrated across different academic centers. METHODS: Synovial biopsies obtained at arthroscopy from patients with rheumatoid arthritis before and 160 days after rituximab therapy were selected and coded. Paired sections were processed independently at Amsterdam Medical Center (AMC) and at St. Vincent\\'s University Hospital (SVUH), Dublin. Digital image analysis (DIA) was employed at both centers to quantify sublining CD68 expression. RESULTS: After analysis of CD68sl expression at centers in 2 different countries, high levels of intracenter and intercenter agreement were observed. For the pooled sections stained at AMC, the correlation between 2 investigators was R = 0.942, p = 0.000, and for sections stained at SVUH, R = 0.899, p = 0.001. Similarly, the intracenter correlations for DeltaCD68sl expression after treatment were R = 0.998, p = 0.000, for sections stained at AMC and R = 0.880, p = 0.000, for sections stained at SVUH. The intercenter correlation for the pooled scores of sections stained at AMC was R = 0.85, p = 0.000, and for the sections stained at SVUH, R = 0.62, p = 0.001. The consistent correlation between DeltaDAS (Disease Activity Score) and DeltaCD68sl expression across different studies (Pearson correlation = 0.895, p < 0.001) was confirmed. The standardized response mean values for DeltaCD68sl, calculated from analyses at both AMC and SVUH, were consistently 0.5 or greater, indicating a moderate to high potential to detect change. CONCLUSION: The correlation between mean DeltaDAS and mean DeltaCD68sl expression was confirmed across 2 centers. Examination of serial biopsy samples can be used reliably to screen for interesting biological effects at the site of inflammation at an early stage of drug development.

  8. Reactive arthritis.

    Science.gov (United States)

    Keat, A

    1999-01-01

    Reactive arthritis is one of the spondyloarthropathy family of clinical syndromes. The clinical features are those shared by other members of the spondyloarthritis family, though it is distinguished by a clear relationship with a precipitating infection. Susceptibility to reactive arthritis is closely linked with the class 1 HLA allele B27; it is likely that all sub-types pre-dispose to this condition. The link between HLA B27 and infection is mirrored by the development of arthritis in HLA B27-transgenic rats. In this model, arthritis does not develop in animals maintained in a germ-free environment. Infections of the gastrointestinal, genitourinary and respiratory tract appear to provoke reactive arthritis and a wide range of pathogens has now been implicated. Although mechanistic parallels may exist, reactive arthritis is distinguished from Lyme disease, rheumatic fever and Whipple's disease by virtue of the distinct clinical features and the link with HLA B27. As in these conditions both antigens and DNA of several micro-organisms have been detected in joint material from patients with reactive arthritis. The role of such disseminated microbial elements in the provocation or maintenance of arthritis remains unclear. HLA B27-restricted T-cell responses to microbial antigens have been demonstrated and these may be important in disease pathogenesis. The importance of dissemination of bacteria from sites of mucosal infection and their deposition in joints has yet to be fully understood. The role of antibiotic therapy in the treatment of reactive arthritis is being explored; in some circumstances, both the anti-inflammatory and anti-microbial effects of certain antibiotics appear to be valuable. The term reactive arthritis should be seen as a transitory one, reflecting a concept which may itself be on the verge of replacement, as our understanding of the condition develops. Nevertheless it appropriately describes arthritis that is associated with demonstrable

  9. 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 ...

  10. Arthritis Foundation

    Science.gov (United States)

    ... Bone Bash Dinners & Galas Healing Hands for Arthritis Bike Events Volunteer Search Events About Us Mission & Vision Leadership News Partners & Sponsors Careers Annual Report Financials Contact Us Privacy Policy Donate Make a Donation ...

  11. Enteropathic Arthritis

    Science.gov (United States)

    ... as well. Those who test positive for the HLA-B27 genetic marker are much more likely to have spinal involvement with enteropathic arthritis than those who test negative. Disease Course/Prognosis ...

  12. Gonococcal arthritis

    Science.gov (United States)

    ... people who have gonorrhea caused by the bacteria Neisseria gonorrhoeae . Gonococcal arthritis affects women more often than men. ... Saunders; 2013:chap 109. Marrazzo JM, Apicella MA. Neisseria gonorrhoeae (gonnorrhea). In: Bennett JE, Dolin R, Blaser MJ, ...

  13. Psoriatic arthritis

    Science.gov (United States)

    ... that often occurs with a skin condition called psoriasis . ... inflammatory condition. About 1 in 20 people with psoriasis may develop arthritis with the skin condition. In most cases, psoriasis ...

  14. Yoga for Arthritis: A Scoping Review

    OpenAIRE

    Haaz, Steffany; Bartlett, Susan J.

    2010-01-01

    The aim of this article was to systematically review the existing literature on the use of yoga for persons with arthritis. We included peer-reviewed research from clinical trials (published from 1980-2010) that used yoga as an intervention for arthritis patients and reported quantitative findings. Eleven studies were identified, including four RCTs and four NRCTs. All trials were small and control groups varied. No adverse events were reported and attrition was comparable or better than typi...

  15. Viral arthritis.

    Science.gov (United States)

    Marks, Michael; Marks, Jonathan L

    2016-04-01

    Acute-onset arthritis is a common clinical problem facing both the general clinician and the rheumatologist. A viral aetiology is though to be responsible for approximately 1% of all cases of acute arthritis with a wide range of causal agents recognised. The epidemiology of acute viral arthritis continues to evolve, with some aetiologies, such as rubella, becoming less common due to vaccination, while some vector-borne viruses have become more widespread. A travel history therefore forms an important part of the assessment of patients presenting with an acute arthritis. Worldwide, parvovirus B19, hepatitis B and C, HIV and the alphaviruses are among the most important causes of virally mediated arthritis. Targeted serological testing may be of value in establishing a diagnosis, and clinicians must also be aware that low-titre autoantibodies, such as rheumatoid factor and antinuclear antibody, can occur in the context of acute viral arthritis. A careful consideration of epidemiological, clinical and serological features is therefore required to guide clinicians in making diagnostic and treatment decisions. While most virally mediated arthritides are self-limiting some warrant the initiation of specific antiviral therapy. PMID:27037381

  16. 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 ... Arthritis Nutrition & Rheumatoid Arthritis Arthritis and Health-related Quality of Life Rehabilitation Management for Rheumatoid Arthritis Patients ...

  17. Rheumatoid Arthritis Educational Video Series

    Medline Plus

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

  18. Rheumatoid Arthritis Educational Video Series

    Medline Plus

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

  19. Cost effectiveness of etanercept (Enbrel) in combination with methotrexate in the treatment of active rheumatoid arthritis based on the TEMPO trial

    OpenAIRE

    Kobelt, G; Lindgren, P.; Singh, A.; Klareskog, L

    2005-01-01

    Objective: To estimate the cost effectiveness of combination treatment with etanercept plus methotrexate in comparison with monotherapies in patients with active rheumatoid arthritis (RA) using a new model that incorporates both functional status and disease activity.

  20. A multicentre, double blind, randomised, placebo controlled trial of anakinra (Kineret), a recombinant interleukin 1 receptor antagonist, in patients with rheumatoid arthritis treated with background methotrexate

    OpenAIRE

    Cohen, S.; Moreland, L; Cush, J; Greenwald, M.; Block, S; Shergy, W.; Hanrahan, P; Kraishi, M; Patel, A; Sun, G; Bear, M

    2004-01-01

    Objective: To assess the efficacy and safety of 100 mg daily anakinra (Kineret), a recombinant form of the naturally occurring interleukin 1 receptor antagonist, plus methotrexate (MTX) in reducing the signs and symptoms of rheumatoid arthritis (RA).

  1. The number needed to treat for adalimumab, etanercept, and infliximab based on ACR50 response in three randomized controlled trials on established rheumatoid arthritis

    DEFF Research Database (Denmark)

    Kristensen, L E; Christensen, R; Bliddal, H;

    2007-01-01

    To compare the efficacy of adalimumab, etanercept, and infliximab in patients with established rheumatoid arthritis (RA) taking concomitant methotrexate (MTX) by calculating the number needed to treat (NNT) using three different methods.......To compare the efficacy of adalimumab, etanercept, and infliximab in patients with established rheumatoid arthritis (RA) taking concomitant methotrexate (MTX) by calculating the number needed to treat (NNT) using three different methods....

  2. The number needed to treat for adalimumab, etanercept, and infliximab based on ACR50 response in three randomized controlled trials on established rheumatoid arthritis

    DEFF Research Database (Denmark)

    Kristensen, L E; Christensen, R; Bliddal, H; Geborek, P; Danneskiold-Samsøe, B; Saxne, T

    2011-01-01

    To compare the efficacy of adalimumab, etanercept, and infliximab in patients with established rheumatoid arthritis (RA) taking concomitant methotrexate (MTX) by calculating the number needed to treat (NNT) using three different methods.......To compare the efficacy of adalimumab, etanercept, and infliximab in patients with established rheumatoid arthritis (RA) taking concomitant methotrexate (MTX) by calculating the number needed to treat (NNT) using three different methods....

  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...... 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 in a...

  4. 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 ...

  5. Rheumatoid Arthritis Educational Video Series

    Medline Plus

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

  6. 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 ...

  7. Rheumatoid Arthritis Educational Video Series

    Medline Plus

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

  8. Effect of spa therapy with saline balneotherapy on oxidant/antioxidant status in patients with rheumatoid arthritis: a single-blind randomized controlled trial

    Science.gov (United States)

    Karagülle, Mine; Kardeş, Sinan; Karagülle, Oğuz; Dişçi, Rian; Avcı, Aslıhan; Durak, İlker; Karagülle, Müfit Zeki

    2016-06-01

    Oxidative stress has been shown to play a contributory role in the pathogenesis of rheumatoid arthritis (RA). Recent studies have provided evidence for antioxidant properties of spa therapy. The purpose of this study is to investigate whether spa therapy with saline balneotherapy has any influence on the oxidant/antioxidant status in patients with RA and to assess clinical effects of spa therapy. In this investigator-blind randomized controlled trial, we randomly assigned 50 patients in a 1:1 ratio to spa therapy plus standard drug treatment (spa group) or standard drug treatment alone (control group). Spa group followed a 2-week course of spa therapy regimen consisting of a total of 12 balneotherapy sessions in a thermal mineral water pool at 36-37 °C for 20 min every day except Sunday. All clinical and biochemical parameters were assessed at baseline and after spa therapy (2 weeks). The clinical parameters were pain intensity, patient global assessment, physician global assessment, Health Assessment Questionnaire disability index (HAQ-DI), Disease Activity Score for 28-joints based on erythrocyte sedimentation rate (DAS28-4[ESR]). Oxidative status parameters were malondialdehyde (MDA), nonenzymatic superoxide radical scavenger activity (NSSA), antioxidant potential (AOP), and superoxide dismutase (SOD). The NSSA levels were increased significantly in the spa group (p = 0.003) but not in the control group (p = 0.509); and there was a trend in favor of spa therapy for improvements in NSSA levels compared to control (p = 0.091). Significant clinical improvement was found in the spa group compared to the control in terms of patient global assessment (p = 0.011), physician global assessment (p = 0.043), function (HAQ-DI) (p = 0.037), disease activity (DAS28-4[ESR]) (0.044) and swollen joint count (0.009), and a trend toward improvement in pain scores (0.057). Spa therapy with saline balneotherapy exerts antioxidant effect in patients with RA as reflected by the

  9. Rheumatoid Arthritis

    Science.gov (United States)

    ... Institutes Office of the Director 27 Institutes and Centers that make up the NIH About Mission The NIH ... arthritis is an inflammatory disease affecting about 1.3 million adults, and causes pain, swelling, stiffness, and loss of function in the joints. Several ...

  10. Effects of the live attenuated measles-mumps-rubella booster vaccination on disease activity in patients with juvenile idiopathic arthritis : a randomized trial

    NARCIS (Netherlands)

    Heijstek, Marloes W; Kamphuis, Sylvia; Armbrust, Wineke; Swart, Joost; Gorter, Simone; de Vries, Lara D; Smits, Gaby P; van Gageldonk, Pieter G; Berbers, Guy A M; Wulffraat, Nico M

    2013-01-01

    IMPORTANCE: The immunogenicity and the effects of live attenuated measles-mumps-rubella (MMR) vaccination on disease activity in patients with juvenile idiopathic arthritis (JIA) are matters of concern, especially in patients treated with immunocompromising therapies. OBJECTIVES: To assess whether M

  11. The Effect of Omega-3 Fatty Acids in Patients With Active Rheumatoid Arthritis Receiving DMARDs Therapy: Double-Blind Randomized Controlled Trial

    Science.gov (United States)

    Rajaei, Elham; Mowla, Karim; Ghorbani, Ali; Bahadoram, Sara; Bahadoram, Mohammad; Dargahi-Malamir, Mehrdad

    2016-01-01

    Background: Rheumatoid arthritis is a symmetric peripheral polyarthritis of unknown etiology that, untreated or if unresponsive the therapy, typically leads to deformity and destruction of joints due to erosion of cartilage and bone. Omega-3 fatty acids have been shown to reduce morning stiffness, the number of tender joints and swollen joints in patients with rheumatoid arthritis. This study is designed for evaluation of omega-3 effects on disease activity and remission of rheumatoid arthritis in DMARDs treated patients and on weight changes and reduction of analgesic drugs consumption versus placebo. Methods: Sixty patients with active rheumatoid arthritis (49 female and 11 male) underwent rheumatologist examination and disease activity score were calculated. Then patients were enrolled in this 12 week, double blind, randomized, placebo- controlled study. The patients in both groups continued their pre study standard treatment. The patients were visited every 4 weeks, 4 times and data were recorded. Results: Significant improvement in the patient’s global evaluation and in the physician’s assessment of disease was observed in those taking omega-3. The proportions of patients who improved and of those who were able to reduce their concomitant analgesic medication were significantly greater with omega-3 consumption. There were no weight changes. Conclusion: Daily supplementation with omega-3 results has significant clinical benefit and may reduce the need for concomitant analgesic consumption without weight changes. PMID:26925896

  12. Stopping Tumor Necrosis Factor-inhibitors in Patients with Established Rheumatoid Arthritis in Remission or Stable Low Disease Activity: A Pragmatic Randomized Multicenter Open-Label Controlled Trial

    NARCIS (Netherlands)

    Ghiti Moghadam, M.; Vonkeman, H.E.; Klooster, ten P.M.; Tekstra, J.; Schaardenburg, van Dirk-Jan; Starmans-Kool, M.; Brouwer, Elisabeth; Bos, Reinhard; Lems, Willem F.; Colin, Edgar M.; Allaart, Cornelia F.; Meek, Inger L.; Landewe, R.; Bernelot Moens, Hein J.; Riel, van Piet L.C.M.; Laar, van de Mart A.F.J.; Jansen, Tim L.

    2016-01-01

    OBJECTIVE: TNF-inhibiting biologicals (TNFi) are effective treatments for rheumatoid arthritis (RA). It is unclear if patients in remission or in stable low disease activity need to continue TNFi or can stop this treatment. This study was undertaken to assess whether established RA patients in remi

  13. Idea Bank.

    Science.gov (United States)

    Science Teacher, 1986

    1986-01-01

    Provides descriptions of activities and programs that have been successful with secondary science students. Includes ideas related to repairing radio-controlled cars, cooperative science-library center, observation exercises, recordkeeping skills and peer grading, DC power supply, chemistry of poison ivy, spore science, and a tic-tac-toe review…

  14. 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...... 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...

  15. Diagnosing Psoriatic Arthritis

    Science.gov (United States)

    ... to find out more! Email * Zipcode Diagnosing Psoriatic Arthritis Psoriatic arthritis can develop slowly with mild symptoms, or it ... severe. Early recognition, diagnosis and treatment of psoriatic arthritis can help prevent or limit extensive joint damage ...

  16. Treating Psoriatic Arthritis

    Science.gov (United States)

    ... to find out more! Email * Zipcode Treating Psoriatic Arthritis Treatment for psoriatic arthritis can relieve pain, reduce swelling, help keep joints ... recommend treatments based on the type of psoriatic arthritis, its severity and your reaction to treatment. Download ...

  17. Arthritis: Frequently Asked Questions

    Science.gov (United States)

    ... to complications from the flu? 1. What is arthritis? The word arthritis actually means joint inflammation, but ... for you. 2. Who is at risk for arthritis? Certain factors are associated with a greater risk ...

  18. Calcium pyrophosphate arthritis

    Science.gov (United States)

    Calcium pyrophosphate dihydrate deposition disease; CPPD disease; Acute CPPD arthritis; Pseudogout ... Calcium pyrophosphate arthritis is caused by the collection of salt called calcium pyrophosphate dihydrate (CPPD). The buildup ...

  19. Innovative medicines for treatment of psoriatic arthritis

    OpenAIRE

    Levitan A.l.; Reshetko O.V.

    2015-01-01

    The problem of effective treatment of psoriatic arthritis has not been solved yet. The search for new therapeutic options is very active in many directions. At the stage of clinical trials are drugs that block interleukin-17-a (secukinumab, ixekizumab, brodalumab), drugs that suppress interleukin-12 and interleukin-23 (ustekinumab). To modern means to ensure psoriatic arthritis include drugs that are inhibitors of small molecules orkinase pathways (apremilast, tofacitinib).

  20. Innovative medicines for treatment of psoriatic arthritis

    Directory of Open Access Journals (Sweden)

    Levitan A.l.

    2015-09-01

    Full Text Available The problem of effective treatment of psoriatic arthritis has not been solved yet. The search for new therapeutic options is very active in many directions. At the stage of clinical trials are drugs that block interleukin-17-a (secukinumab, ixekizumab, brodalumab, drugs that suppress interleukin-12 and interleukin-23 (ustekinumab. To modern means to ensure psoriatic arthritis include drugs that are inhibitors of small molecules orkinase pathways (apremilast, tofacitinib.

  1. Reactive Arthritis

    Science.gov (United States)

    ... Submit this page to Yahoo! Buzz '); document.write(' Rank this page on Digg '); document.write(' Bookmark this ... Trials and You was designed to help people learn more about clinical trials, why they matter, and ...

  2. Discriminant validity, responsiveness and reliability of the arthritis-specific Work Productivity Survey assessing workplace and household productivity in patients with psoriatic arthritis

    OpenAIRE

    Osterhaus, Jane T; Purcaru, Oana

    2014-01-01

    Introduction The novel arthritis-specific Work Productivity Survey (WPS) was developed to estimate patient productivity limitations associated with arthritis within and outside the home, which is an unmet need in psoriatic arthritis (PsA). The WPS has been validated in rheumatoid arthritis. This report assesses the discriminant validity, responsiveness and reliability of the WPS in adult-onset PsA. Methods Psychometric properties were assessed using data from the RAPID-PsA trial (NCT01087788)...

  3. Muscle strength, physical fitness and well-being in children and adolescents with juvenile idiopathic arthritis and the effect of an exercise programme: a randomized controlled trial

    OpenAIRE

    Sandstedt, Eva; Fasth, Anders; Eek, Meta Nyström; Beckung, Eva

    2013-01-01

    Background Decreased muscle strength, fitness and well-being are common in children and adolescents with juvenile idiopathic arthritis (JIA) compared to healthy peers. Biological drugs have improved health in children with JIA, but despite this pain is still a major symptom and bone health is reported as decreased in the group. The improvement made by the biological drugs makes it possible to more demanding exercises. To jump is an exercise that can improve bone heath, fitness and muscle stre...

  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...... extensively studied in RA, was then used to test these criteria. Our objectives were: (1) To assess the strength of evidence in support of CRP as a soluble biomarker reflecting structural damage in RA according to the draft validation criteria. (2) To assess the strength of recommendation for inclusion 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 in a...

  5. 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.

  6. Effects of Nigella sativa oil extract on inflammatory cytokine response and oxidative stress status in patients with rheumatoid arthritis: a randomized, double-blind, placebo-controlled clinical trial

    Science.gov (United States)

    Hadi, Vahid; Kheirouri, Sorayya; Alizadeh, Mohammad; Khabbazi, Alireza; Hosseini, Hossein

    2016-01-01

    Objective: Nigella sativa is a medicinal plant that has long been used in traditional medicine for treating various conditions. Numerous animal studies provided evidences that the seed may elicit a broad anti-inflammatory/anti-oxidant activity. The aim of the present clinical trial was to evaluate anti-inflammatory and antioxidant properties of Nigella sativa oil in patients with rheumatoid arthritis (RA). Materials and Methods: Forty-two patients with RA were assigned into two groups in this randomized, double blind, placebo-controlled clinical trial. Subjects in intervention group received two capsules, 500 mg each, of Nigella sativa oil, each day for 8 weeks. The other group consumed two capsules as placebo per day for the same period of time. Serum TNF-α, IL-10, and whole blood levels of oxidative stress parameters were measured at baseline and end of the trial. Results: The serum level of IL-10 was increased in the Nigella sativa group (p0.05). Conclusion: This study indicates that Nigella sativa could improve inflammation and reduce oxidative stress in patients with RA. It is suggested that Nigella sativa may be a beneficial adjunct therapy in this population of patients. PMID:27247920

  7. Arthritis in cystic fibrosis.

    OpenAIRE

    Schidlow, D V; Goldsmith, D P; Palmer, J; Huang, N N

    1984-01-01

    We have confirmed previous observations of a transient, non-disabling recurrent arthritis in patients with cystic fibrosis. This arthritis differs from classic rheumatoid arthritis, is frequently associated with skin arthritis lesions, and its occurrence is unrelated to the severity of lung disease.

  8. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... for Arthritis Yoga Poses for Arthritis Patients from Johns Hopkins Stategies to Increase your Level of Physical ... Arthritis Management How to Give a Subcutaneous Injection Johns Hopkins Rheumatology Arthritis Center Lupus Center Lyme Disease ...

  9. Genetics Home Reference: psoriatic arthritis

    Science.gov (United States)

    ... Understand Genetics Home Health Conditions psoriatic arthritis psoriatic arthritis Enable Javascript to view the expand/collapse boxes. Print All Open All Close All Description Psoriatic arthritis is a condition involving joint inflammation (arthritis) that ...

  10. 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 ...

  11. 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 ...

  12. Current concepts in psoriatic arthritis: pathogenesis and management.

    Science.gov (United States)

    de Vlam, Kurt; Gottlieb, Alice B; Mease, Philip J

    2014-11-01

    Psoriatic arthritis occurs in a subset of psoriasis patients and is therefore commonly encountered in dermatology practice. Although its exact pathogenesis is unknown, psoriatic arthritis is thought to share common mechanisms with psoriatic skin symptoms. Innate and adaptive immune responses are abnormally activated in psoriasis and may acquire the ability to attack peripheral joints and other sites following an environmental trigger (e.g. mechanical stress, trauma, infection) in genetically susceptible patients. The increased cardiovascular risk inherent in psoriasis appears further enhanced in psoriatic arthritis, likely reflecting the overall burden of systemic inflammation contributing to atherogenic processes. Basic research and clinical trials have suggested that tumour necrosis factor is important in psoriatic arthritis pathophysiology, and accumulating evidence suggests that Th17 cells and interleukin-17A may also be important. Basic research and clinical trials inform our understanding of psoriatic arthritis pathophysiology and, in turn, help dermatologists to make better treatment decisions. PMID:24573106

  13. MRI bone oedema is the strongest predictor of subsequent radiographic progression in early rheumatoid arthritis. Results from a 2 year randomized controlled trial (CIMESTRA)

    DEFF Research Database (Denmark)

    Hetland, Merete Lund; Ejbjerg, Bo Jannik; Hørslev-Petersen, Kim;

    2008-01-01

    OBJECTIVE: To identify predictors of radiographic progression in a 2-year randomized, double-blind clinical study (CIMESTRA) of patients with early rheumatoid arthritis (RA). METHODS: Early RA patients (N=130) were treated with methotrexate, intra-articular betamethasone and cyclosporine...... predictor of delta-TSS (wrist+MCP-group: coefficient=0.75 (95%CI: 0.56-0.97), p<0.00001; wrist-only-group: coefficient=0.56 (0.41-0.77), p<0.00001). Bone oedema score explained 41% of the variation in the progression of TSS (wrist+MCP-group), 25% in wrist-only-group, (Pearson's r=0.64 and r=0.......50, respectively). The results were confirmed by sensitivity analyses. CONCLUSION: In a RCT aiming at remission in early RA patients, baseline RAMRIS MRI bone oedema score of MCP and wrist joints (and of wrist only) was the strongest independent predictor of radiographic progression in hands, wrists and forefeet...

  14. 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 ...

  15. MP Joint Arthritis

    Science.gov (United States)

    ... Therapist? Media Find a Hand Surgeon MP Joint Arthritis Email to a friend * required fields From * To * ... in to name and customize your collection. DESCRIPTION Arthritis is the wearing away of the cartilage at ...

  16. 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...

  17. 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 ...

  18. Activity Increase Despite Arthritis (AÏDA: design of a Phase II randomised controlled trial evaluating an active management booklet for hip and knee osteoarthritis [ISRCTN24554946

    Directory of Open Access Journals (Sweden)

    Edwards Rhiannon T

    2009-09-01

    Full Text Available Abstract Background Hip and knee osteoarthritis is a common cause of pain and disability, which can be improved by exercise interventions. However, regular exercise is uncommon in this group because the low physical activity level in the general population is probably reduced even further by pain related fear of movement. The best method of encouraging increased activity in this patient group is not known. A booklet has been developed for patients with hip or knee osteoarthritis. It focuses on changing disadvantageous beliefs and encouraging increased physical activity. Methods/Design This paper describes the design of a Phase II randomised controlled trial (RCT to test the effectiveness of this new booklet for patients with hip and knee osteoarthritis in influencing illness and treatment beliefs, and to assess the feasibility of conducting a larger definitive RCT in terms of health status and exercise behaviour. A computerised search of four general medical practice patients' record databases will identify patients older than 50 years of age who have consulted with hip or knee pain in the previous twelve months. A random sample of 120 will be invited to participate in the RCT comparing the new booklet with a control booklet, and we expect 100 to return final questionnaires. This trial will assess the feasibility of recruitment and randomisation, the suitability of the control intervention and outcome measurement tools, and will provide an estimate of effect size. Outcomes will include beliefs about hip and knee pain, beliefs about exercise, fear avoidance, level of physical activity, health status and health service costs. They will be measured at baseline, one month and three months. Discussion We discuss the merits of testing effectiveness in a phase II trial, in terms of intermediate outcome measures, whilst testing the processes for a larger definitive trial. We also discuss the advantages and disadvantages of testing the psychometric

  19. When is arthritis reactive?

    OpenAIRE

    Hamdulay, S. S.; Glynne, S J; Keat, A

    2006-01-01

    Reactive arthritis is an important cause of lower limb oligoarthritis, mainly in young adults. It is one of the spondyloarthropathy family; it is distinguishable from other forms of inflammatory arthritis by virtue of the distribution of affected sites and the high prevalence of characteristic extra‐articular lesions. Many terms have been used to refer to this and related forms of arthritis leading to some confusion. Reactive arthritis is precipitated by an infection at a distant site and gen...

  20. Genetic epidemiology: Psoriatic arthritis

    OpenAIRE

    Barton, Anne C

    2002-01-01

    The existence of psoriatic arthritis as a distinct clinical entity remains a topic of debate; some authors propose that it is simply the co-occurrence of psoriasis and inflammatory arthritis. However, a distinct entity is likely to have distinct susceptibility factors in addition to those that contribute to psoriasis and inflammatory arthritis alone. These aetiological factors may be genetic and/or environmental, and in this review, the evidence for distinct psoriatic arthritis genetic suscep...

  1. Arthritis in psoriasis.

    OpenAIRE

    Green, L.; Meyers, O L; Gordon, W.; Briggs, B

    1981-01-01

    A group of 61 unselected patients with psoriasis attending a dermatology clinic were studied to determine the prevalence of psoriatic arthritis. On defined criteria arthritis was present in 41.6%. Peripheral arthritis was present in 15.5%, and sacroiliitis in 43%. A strong association of distal interphalangeal arthritis with psoriasis and nail dystrophy was confirmed. Tissue typing showed a strong association of B23, 17, in Caucasoid psoriatics, while the haplotype A1/B8 was increased in mixe...

  2. Psoriatic arthritis

    International Nuclear Information System (INIS)

    Psoriatic arthritis (PsA) is a chronic inflammatory joint disease which develops in patients with psoriasis. It is characteristic that the rheumatoid factor in serum is absent. Etiology of the disease is still unclear but a number of genetic associations have been identified. Inheritance of the disease is multilevel and the role of environmental factors is emphasized. Immunology of PsA is also complex. Inflammation is caused by immunological reactions leading to release of kinins. Destructive changes in bones usually appear after a few months from the onset of clinical symptoms. Typically PsA involves joints of the axial skeleton with an asymmetrical pattern. The spectrum of symptoms include inflammatory changes in attachments of articular capsules, tendons, and ligaments to bone surface. The disease can have divers clinical course but usually manifests as oligoarthritis. Imaging plays an important role in the diagnosis of PsA. Classical radiography has been used for this purpose for over a hundred years. It allows to identify late stages of the disease, when bone tissue is affected. In the last 20 years many new imaging modalities, such as ultrasonography (US), computed tomography (CT) and magnetic resonance (MR), have been developed and became important diagnostic tools for evaluation of rheumatoid diseases. They enable the assessment and monitoring of early inflammatory changes. As a result, patients have earlier access to modern treatment and thus formation of destructive changes in joints can be markedly delayed or even avoided

  3. Clinical trials of Tongbi Capsules on rheumatoid arthritis%通痹胶囊治疗类风湿关节炎临床研究

    Institute of Scientific and Technical Information of China (English)

    车洪勇; 车晓青

    2014-01-01

    目的:观察通痹胶囊治疗类风湿关节炎的临床疗效。方法随机入选病例410例,试验组308例,口服通痹胶囊,1粒/次,2~3次/日;对照组102例,口服壮骨关节丸,6 g/次,2次/日,60 d为1个疗程。结果治疗后,试验组的疾病疗效与中医证候疗效总有效率分别为89.78%、90.51%,与对照组比较,有统计学差异( P <0.05)。结论通痹胶囊临床用于治疗类风湿性关节炎(寒湿阻络、肝肾两虚型痹证)安全、有效。%Objective The effect of Tongbi CaPsules on rheumatoid arthritis( RA)was observed in this PaPer. Meth-ods 410 Patients were randomly divided into treated grouP and control grouP. 308 Patients in treated grouP took one Tongbi CaPsules each time,two or three times Per day. While 102 Patients in control grouP were treated routinely with Zhuanggu Guanjie Pills,6 g for one time,twice a day with a course of sixty days in two grouPs. Results After a course of treatment, the total clinical effective rate and the rate of imProvement of traditional Chinese medical syndrome was 89. 78% and 90.51%,resPectively. Statistically,the difference between two grouPs was significant(P <0.05). Conclusion Tongbi CaPsules was effective and safe in the treating for rheumatoid arthritis( syndrome of cold-damPness blocking collaterals, syndrome of deficiency of liver and kidney).

  4. Safety and efficacy of T-614 in the treatment of patients with active rheumatoid arthritis: a double blind,randomized,placebo-controlled and multicenter trial

    Institute of Scientific and Technical Information of China (English)

    L(U) Liang-jing; TENG Jia-lin; BAO Chun-de; HAN Xing-hai; SUN Ling-yun; XU Jiang-hua; LI Xing-fu; WU Hua-xiang

    2008-01-01

    Background A novel anti-rheumatic drug,T-614,has been shown to have an anti-inflammatory effect and to improve abnormal immunological findings in rheumatoid arthritis(RA).To assess the safety and efficacy of T-614 versus placebo in patients with active RA we conducted a 24-week clinical study in 280 Chinese patients.Methods In a multicenter,randomized,double blind,placebo controlled study,280 patients were randomly assigned to receive placebo(n=95)or T-614 at 50 mg(n=93)or 25 mg(n=92)daily.Active disease was defined by 4 of the following 5 criteria:≥5 tender joints,≥3 swollen joints,morning stiffness lasting for≥60 minutes,and Westergren erythrocyte sedimentation rate(ESR)≥28 mm/h,the assessment of pain at the rest by patient as moderate or severe.Clinical and laboratory parameters were analyzed at baseline,2,4,6,12,18 and 24 weeks.The primary efficacy variable at week 24 was the American College of Rheumatology(ACR)response rate using the intent-to-treat population.Results The ACR response rate was significantly higher in the T-614 treatment group compared with the placebo group within 8 weeks after the initiation of treatment.After 24 weeks,the 25 mg/d and 50 mg/d dosage groups and the placebo group showed 39.13%,61.29% and 24-21% in ACR20 and 23.91%,31.18%and 7.37% in ACR50,respectively.A time-response in ACR response was observed,with clear superiority for the 25 mg/d and 50 mg/d dosage groups compared to placebo(P<0.0001),and the 50 mg/d dose compared to the 25 mg/d dose(P<0.05)when using the ACR response analyses after 24 weeks.ESR and c-reactive protein(CRP)were significantly different in the treatment groups after 24 weeks.The incidence of adverse events(Aes)was not significantly higher with T-614 than with placebo,but upper abdominal discomfort,leucopenia,elevated serum alanine aminotransferase(sALT),skin rash and/or pruritus were more common in the 50 mg and 25 mg dosage groups.Conclusion T-614,a new slow-acting drug,is effective in treatment

  5. Evaluation of several ultrasonography scoring systems for synovitis and comparison to clinical examination: results from a prospective multicentre study of rheumatoid arthritis

    DEFF Research Database (Denmark)

    Dougados, Maxime; Jousse-Joulin, Sandrine; Mistretta, Frederic; d'Agostino, Maria-Antonietta; Backhaus, Marina; Bentin, Jacques; Chalès, Gérard; Chary-Valckenaere, Isabelle; Conaghan, Philip; Etchepare, Fabien; Gaudin, Philippe; Grassi, Walter; van der Heijde, Désirée; Sellam, Jérémie; Naredo, Esperanza; Szkudlarek, Marcin; Wakefield, Richard; Saraux, Alain

    2010-01-01

    To evaluate different global ultrasonographic (US) synovitis scoring systems as potential outcome measures of rheumatoid arthritis (RA) according to the Outcome Measures in Rheumatoid Arthritis Clinical Trials (OMERACT) filter....

  6. Complementary medicine in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    F. Atzeni

    2011-09-01

    Full Text Available Use of complementary and alternative medicine (CAM for chronic conditions has increased in recent years. CAM is immensely popular for musculoskeletal conditions and patients suffering from rheumatoid arthritis (RA frequently try CAM. This review summarises the trial data for or against CAM as a symptomatic treatment for rheumatoid arthritis. Collectively the evidence demonstrates that some CAM modalities show significant promise, e.g. acupuncture, diets, herbal medicine, homoeopathy, massage, supplements. However, for the great majority of these therapies no evidencebased (clinical randomized trials results are available. CAM is usually used in addition to, and not as a substitute for conventional therapies. The motivation of patients to try CAM is complex; the willingness to take control of their healthcare, the desire to try everything available, the mass-media pressure and the erroneous notion that CAM is without risks. In fact, none of these treatments is totally devoid of risks. While the use of complementary and alternative modalities for the treatment of RA continues to increase, rigorous clinical trials examining their efficacy are needed before definitive recommendations regarding the application of these modalities can be made.

  7. Synovial tissue rank ligand expression and radiographic progression in rheumatoid arthritis: observations from a proof-of-concept randomized clinical trial of cytokine blockade.

    LENUS (Irish Health Repository)

    Rooney, Terence

    2012-02-01

    The objective of the study was to evaluate synovial tissue receptor activator of nuclear factor-kappabeta ligand (RANKL) and osteoprotegerin (OPG) as biomarkers of disease activity, progressive joint damage, and therapeutic response, during cytokine blockade in rheumatoid arthritis (RA). Patients with active RA entered a randomized open-label 12-month study of anakinra 100 mg\\/day, administered as monotherapy or in combination with pegsunercept 800 mug\\/kg twice weekly. Arthroscopic synovial tissue biopsies were obtained at baseline, at 4 weeks and at the final time point. Following immunohistochemical staining, RANKL and OPG expression was quantified using digital image analysis. Radiographic damage was evaluated using the van der Heijde modification of the Sharp scoring system. Twenty-two patients were randomized. Baseline expression of RANKL, but not OPG, correlated significantly with baseline CRP levels (r = 0.61, P < 0.01). While a significant reduction in OPG expression following treatment was observed in clinical responders at the final time point (P < 0.05 vs. baseline), RANKL levels did not change, and the RANKL:OPG ratio remained unaltered, even at the highest levels of clinical response. When potential predictors of radiographic outcome were evaluated, baseline RANKL expression correlated with erosive progression at 1 year (r = 0.71, P < 0.01). Distinct, though related, pathophysiologic processes mediate joint inflammation and destruction in RA. Elevated synovial tissue RANKL expression is associated with progressive joint erosion, and may be independent of the clinical response to targeted therapy. The potential therapeutic importance of modulating RANKL in RA is highlighted, if radiographic arrest is to be achieved.

  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. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... of Body Weight in Osteoarthritis Educational Videos for Patients Rheumatoid Arthritis Educational Video Series Psoriatic Arthritis 101 ... Patient to an Adult Rheumatologist Drug Information for Patients Arthritis Drug Information Sheets Benefits and Risks of ...

  10. 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 ...

  11. 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 ...

  12. 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 ...

  13. 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 Johns Hopkins ...

  14. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Rheumatoid Arthritis (RA). You will learn how the diagnosis of RA is made, what happens to your ... Link Below To Play Rheumatoid Arthritis: Symptoms and Diagnosis Rheumatoid Arthritis: What is Happening to the Joints? ...

  15. Arthritis of the hand - Rheumatoid

    Science.gov (United States)

    ... Hand Therapist? Media Find a Hand Surgeon Rheumatoid Arthritis Email to a friend * required fields From * To * ... causes pressure on the nearby nerve. How Rheumatoid Arthritis is Diagnosed The diagnosis of rheumatoid arthritis is ...

  16. Genetics Home Reference: rheumatoid arthritis

    Science.gov (United States)

    ... Understand Genetics Home Health Conditions rheumatoid arthritis rheumatoid arthritis Enable Javascript to view the expand/collapse boxes. Print All Open All Close All Description Rheumatoid arthritis is a disease that causes chronic abnormal inflammation, ...

  17. Rheumatoid Arthritis Educational Video Series

    Medline Plus

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

  18. When is arthritis reactive?

    Science.gov (United States)

    Hamdulay, S S; Glynne, S J; Keat, A

    2006-07-01

    Reactive arthritis is an important cause of lower limb oligoarthritis, mainly in young adults. It is one of the spondyloarthropathy family; it is distinguishable from other forms of inflammatory arthritis by virtue of the distribution of affected sites and the high prevalence of characteristic extra-articular lesions. Many terms have been used to refer to this and related forms of arthritis leading to some confusion. Reactive arthritis is precipitated by an infection at a distant site and genetic susceptibility is marked by possession of the HLA-B27 gene, although the mechanism remains uncertain. Diagnosis is a two stage process and requires demonstration of a temporal link with a recognised "trigger" infection. The identification and management of "sexually acquired" and "enteric" forms of reactive arthritis are considered. Putative links with HIV infection are also discussed. The clinical features, approach to investigation, diagnosis, and management of reactive arthritis are reviewed. PMID:16822921

  19. Outcome of second line therapy in rheumatoid arthritis.

    OpenAIRE

    Porter, D.R.; McInnes, I.; Hunter, J.; Capell, H A

    1994-01-01

    OBJECTIVES--To study the functional outcome in patients with rheumatoid arthritis (RA) who tolerate second line drug therapy for five years. METHODS--We enrolled into prospective controlled trials, 190 patients with rheumatoid arthritis who tolerated 'disease modifying' antirheumatic drug therapy for five years. Demographic data were recorded. Disease activity was measured every six months for two years and annually thereafter, using clinical and laboratory variables. Patient function was mea...

  20. Ustekinumab for the treatment of psoriatic arthritis: an update

    OpenAIRE

    Davari P; Leo MS; Kamangar F; Fazel N

    2014-01-01

    Parastoo Davari, Michael S Leo, Faranak Kamangar, Nasim Fazel Department of Dermatology, University of California, Davis, CA, USA Abstract: Psoriatic arthritis occurs in 30% of psoriasis patients, and the treatment can be challenging in some patients. Recently, the US Food and Drug Administration approved ustekinumab, a fully human monoclonal antibody, for the management of psoriatic arthritis. In this article, we review large-scale randomized clinical trials addressing the efficacy and safe...

  1. 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.

  2. Psoriatic arthritis as a mountain

    OpenAIRE

    Berthelot, J M

    2011-01-01

    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...

  3. Epidemiology of psoriatic arthritis

    Directory of Open Access Journals (Sweden)

    C. Salvarani

    2012-06-01

    Full Text Available Epidemiological studies on psoriatic arthritis have long been hampered by the absence of widely accepted classification criteria. The development of the CASPAR (ClASsification criteria for Psoriatic ARthritis criteria has recently provided the framework for conducting epidemiological studies in psoriatic arthritis using uniform recruitment criteria. However, so far, only a minority of studies have adopted such criteria. In addition to the lack of shared classification criteria, differences in study settings, designs, and ascertainment methods have contributed to yield substantial disparities in the estimates of the incidence (from 3,02 to 23,1 cases per 100,000 people and prevalence (from 49,1 to 420 cases per 100,000 people of psoriatic arthritis around the globe. Overall, the available data suggests that the prevalence of psoriasis in the general population is approximately 2-3%, with about a third of patients with psoriasis having arthritis. Therefore, psoriatic arthritis may affect 0,3- 1,0% of the population, a frequency not dissimilar from that of rheumatoid arthritis. Future epidemiological studies should be carried out in larger numbers of patients diagnosed using consistent criteria.

  4. Arthritis in the buff

    International Nuclear Information System (INIS)

    Understanding the significance of radiologic perturbations in articular diseases is facilitated by correlation with its representation in intact macerated skeletons (from the collections of the Cleveland Museum of Natural History). Classic skeletal involvement is illustrated grossly and radiographically for the following conditions: rheumatoid arthritis calcium pyrophosphate deposition disease, osteoarthritis, ankylosing spondylitis, reactive (Reiter syndrome, psoriatic arthritis) diffuse idiopathic skeletal hyperostosis, and infectious arthritis. Distribution and lesion character is reviewed. Visualization of the gross bone lesion ''in the buff'' provides clear explanation of its radiologic appearance and facilitates the transition from x-ray image to the pathophysiology proposed in the interpretation

  5. Different duration of Colchicine for preventing recurrence of Gouty arthritis

    Directory of Open Access Journals (Sweden)

    H Karimzadeh

    2006-05-01

    Full Text Available Background: Gout is a Common recurrent clinical syndrome characterized by increased serum uric acid and recurrent attacks of acute arthritis. Colchicine is used for Prophylaxis against recurrence of arthritis, but the duration of its administration has mentioned variable. In this study, optimal duration of prophylactic colchicine for prevention of gouty arthritis was assessed. Methods : In a clinical trial 190 patients with gouty arthritis divided randomly to group 1,2and 3 and received colchicine for 3 to 6, 7 to 9 and 10 to 12 months then colchicine discontinued and the patients followed one year for recurrence of arthritis. Result assessed by survival analysis with Kaplan –Meier method. Results: The probability of recurrence of arthritis (in order of duration of colchicine prophylaxis was 54%, 27.5% and 23%, respectively. The difference between group one and others was statistically significant, but between group 2 and 3 was not statistically significant. Conclusion: The most suitable duration of colchicine prophylaxis that accompanied with lower recurrence rate was 7-9 months, which seems more cost -effective than 10-12 months regimen. Key words: Gout, Colchicine, Arthritis, Recurrence

  6. The Emergence of Ideas

    DEFF Research Database (Denmark)

    Halskov, Kim; Dalsgård, Peter

    2007-01-01

    The development of new ideas is an essential concern for many design projects. There are, however, few in-depth studies of how such ideas emerge within these contexts. In this article we offer an analysis of the emergence of ideas from specific sources of inspiration, as they arise through...

  7. Five Big Ideas

    Science.gov (United States)

    Morgan, Debbie

    2012-01-01

    Designing quality continuing professional development (CPD) for those teaching mathematics in primary schools is a challenge. If the CPD is to be built on the scaffold of five big ideas in mathematics, what might be these five big ideas? Might it just be a case of, if you tell me your five big ideas, then I'll tell you mine? Here, there is…

  8. Big Ideas in Art

    Science.gov (United States)

    Day, Kathleen

    2008-01-01

    In this article, the author shares how she was able to discover some big ideas about art education. She relates how she found great ideas to improve her teaching from the book "Rethinking Curriculum in Art." She also shares how she designed a "Big Idea" unit in her class.

  9. Winning green idea

    International Nuclear Information System (INIS)

    The best idea to improve the environment in the last year comes from the Novaky Power Plant. Jozef Gajdusek participated in the Green Idea project and he won with his proposal for mazut collection during start up of the boilers into portable plastic containers. Sixteen employees with twenty-two proposals participated in the pilot year of the Green Idea project. (author)

  10. Arthritis Mechanisms May Vary by Joint

    Science.gov (United States)

    ... Kids Become Lifelong Learners Featured Website: GeneEd: Genetics, Education, Discovery Links Rheumatoid Arthritis Osteoarthritis Gout Rheumatoid Arthritis Juvenile Arthritis Feeling Out of Joint: The Aches of Arthritis CONTACT ...

  11. Juvenile idiopathic arthritis

    Science.gov (United States)

    ... This form of JIA may turn into rheumatoid arthritis. It may involve five or more large and small joints of the legs and arms, as well as the jaw and neck. Pauciarticular JIA involves 4 or less ...

  12. What Is Juvenile Arthritis?

    Science.gov (United States)

    ... Submit this page to Yahoo! Buzz '); document.write(' Rank this page on Digg '); document.write(' Bookmark this ... her normal activities. What Are Researchers Trying to Learn About Juvenile Arthritis? Scientists are looking for the ...

  13. Arthritis of the Hand

    Science.gov (United States)

    ... of hand and wrist arthritis. (Note: The U.S. Food and Drug Administration does not test dietary supplements. These compounds may cause negative interactions with other medications. Always consult your doctor before taking dietary supplements.) ...

  14. Juvenile Idiopathic Arthritis

    Science.gov (United States)

    ... worsen, it's known as a "flare" or a "flare-up." JIA often causes only minor problems, but in ... was possible a few years ago. For arthritis flare-ups, doctors may also use medicines called corticosteroids (like ...

  15. Juvenile Idiopathic Arthritis

    Science.gov (United States)

    ... providers, including the primary care physician, rheumatologist, and physical therapist, will work together to develop the best method ... the management of any type of arthritis. A physical therapist will explain the importance of certain activities and ...

  16. Bone pathology inpsoriatic arthritis

    OpenAIRE

    V. V. Badokin

    2007-01-01

    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). ...

  17. Idea of Quality Versus Idea of Excellence

    Directory of Open Access Journals (Sweden)

    Marko Kiauta

    2012-12-01

    Full Text Available This study investigates professionals on the field of quality, are responsible to give to customer honest clarification of fundamental ideas. Quality movement is losing credibility with suggesting that the idea of quality is replacing with the idea of excellence. Findings are based on more than 25 years of practice in professional promotion of quality: in consulting on private and public sector, from 1990 lead auditor at SIQ (Slovenian Institute of Quality, from 1998 lead assessor – commission for Slovenian Excellence Quality Award. Theory is developed based on: Noriaki Kano theory of Attractive quality, Tito Conti ideas on TQM and applications problems of Excellence model, Practical case of General Hospital Novo Mesto (in 1998 first attempt of using EM, than forced to build QMS based on ISO 9001 and then returned to practice EM. Findings: We really need to amplify and to understand the concept of quality in a much wider way. To treat excellence related activities separated from all others quality management activities is not god solution. The name of EFQM Excellence Model should be replaced with Quality Management Model. Research limitations/implications: This paper present findings mainly based on practice in Slovenia and especially in public sector where practicing of CAF is not giving expected benefits. Practical implications: The three styles of quality management (improvements to reach demands, improvements to reach expectations, improvements to react on new conditions and needs should be connected with personal development. Theory is developed based on: Noriaki Kano theory of Attractive quality, Tito Conti ideas on TQM and applications problems of Excellence model. We need integration moments. Integration is other word for creativity and health. It leads to integrity. Excellence is only one of three states of quality. If we ask: How? The answer is bad, good or excellent. All three are possible states of the same parameter.

  18. IDEA papers no 2

    International Nuclear Information System (INIS)

    The Information network on the Economic Development in Aquitaine (IDEA) aims to collect and spread the environmental information concerning the Aquitaine, in order to implement an observatory of the regional environment and of the sustainable development. The IDEA paper no. 2 is devoted to the IDEA missions and their cooperation with ''Alliance pour la qualite et la performance''. This association groups actors for the development and the promotion of the quality. (A.L.B.)

  19. Nurturing Good Ideas

    OpenAIRE

    van der Ende, Jan; Kijkuit, Bob

    2009-01-01

    textabstractManagers know that simply generating lots of ideas doesn’t necessarily produce good ones. What companies need are systems that nurture good ideas and cull bad ones—before they ever reach the decision maker’s desk. Our research shows that tapping the input of many people early in the process can help ensure that the best ideas rise to the top.

  20. Business Ideas Competition

    CERN Multimedia

    2003-01-01

    Business Ideas Competition "The Rainbow Seed Fund is a UK fund, which provides finance to support the commercialization of good ideas founded on scientific research; it is for the benefit of the UK industry in particular. To encourage ideas from CERN the Rainbow Seed Fund is running a business ideas competition.The winner of this competition will receive an immediate cash prize of GBP £1,000. In addition the Rainbow Seed Fund may well provide finance for market research, for protection of Intellectual Property Rights (IPR) and for prototyping to take the idea forward. Further awards of GBP £750 will be made for ideas which gain investment from the Fund.Candidates will only be required to prepare a 2-4-page summary of their business idea, and not a full business plan. Full details and an entry form are available at www.rainbowseedfund.com ." ALL Members of the Personnel seeking participation in the business ideas competition are asked to submit their ideas via the CERN TT Unit (Jean-Marie.Le Goff@cern.ch) th...

  1. 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. Updated: ...

  2. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... of RA is made, what happens to your joints, what treatments are available, what is happening in ... Diagnosis Rheumatoid Arthritis: What is Happening to the Joints? Rheumatoid Arthritis: Gaining Control – Working with your Rheumatologist ...

  3. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... 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 ...

  4. 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 Johns Hopkins ...

  5. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... to take a more active role in your care. The information in these videos should not take ... She is a critical member of our patient care team. Managing Your Arthritis Managing Your Arthritis Managing ...

  6. Physical Activity and Psoriatic Arthritis

    Science.gov (United States)

    ... out more! Email * Zipcode Physical Activity and Psoriatic Arthritis Physical activity plays an important role in overall well-being. If you have psoriatic arthritis, moderate exercise may offer specific benefits, including improved ...

  7. 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 ...

  8. Establishing a core domain set to measure rheumatoid arthritis flares

    DEFF Research Database (Denmark)

    Bykerk, Vivian P; Lie, Elisabeth; Bartlett, Susan J;

    2014-01-01

    OBJECTIVE: The OMERACT Rheumatoid Arthritis (RA) Flare Group (FG) is developing a data-driven, patient-inclusive, consensus-based RA flare definition for use in clinical trials, longterm observational studies, and clinical practice. At OMERACT 11, we sought endorsement of a proposed core domain set...

  9. 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...

  10. Bee venom acupuncture for rheumatoid arthritis: a systematic review protocol

    OpenAIRE

    Lee, Ju Ah; Son, Mi Ju; Choi, Jiae; Yun, Kyung-Jin; Jun, Ji Hee; Lee, Myeong Soo

    2014-01-01

    Introduction This systematic review aims to analyse the trial data on the effects of bee venom acupuncture (BVA) for rheumatoid arthritis (RA). Methods and analysis The following 14 databases will be searched from their inception to March 2014: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), AMED, CINAHL, six Korean medical databases (OASIS, Korean Traditional Knowledge Portal, Korean Studies Information Service System, KoreaMed, Korean Medical Database and DBPIA) a...

  11. Occupational therapy for rheumatoid arthritis.

    OpenAIRE

    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 considered to be a cornerstone in the management of rheumatoid arthritis. Till now the efficacy of occupational therapy for patients with rheumatoid arthritis on functional performance and social part...

  12. IDEA papers no. 1

    International Nuclear Information System (INIS)

    The Information network on the Economic Development in Aquitaine (IDEA) aims to collect and spread the environmental information concerning the Aquitaine, in order to implement an observatory of the regional environment and of the sustainable development. The IDEA paper no. 1 provides information such as, meeting, Internet addresses and programs, for the month of April 2002. (A.L.B.)

  13. IDEA papers no 10

    International Nuclear Information System (INIS)

    The Information network on the Economic Development in Aquitaine (IDEA) aims to collect and spread the environmental information concerning the Aquitaine, in order to implement an observatory of the regional environment and of the sustainable development. The IDEA paper no.10 is devoted to the sustainable development education. Examples of actions in agriculture schools and colleges are presented. (A.L.B.)

  14. IDEA papers no 6

    International Nuclear Information System (INIS)

    The Information network on the Economic Development in Aquitaine (IDEA) aims to collect and spread the environmental information concerning the Aquitaine, in order to implement an observatory of the regional environment and of the sustainable development. The IDEA paper no. 6 is presents the association and the results of the ordinary general assembly of the 28 June 2003. (A.L.B.)

  15. IDEA papers no 3

    International Nuclear Information System (INIS)

    The Information network on the Economic Development in Aquitaine (IDEA) aims to collect and spread the environmental information concerning the Aquitaine, in order to implement an observatory of the regional environment and of the sustainable development. The IDEA paper no. 3 is devoted to the part of the environment observation in the sustainable development implementation. (A.L.B.)

  16. Ideas worth nurturing

    CERN Multimedia

    Antonella Del Rosso

    2014-01-01

    Originally created in response to requests from experimentalists working in the collaborations, IdeaSquare has evolved into a place where innovative ideas meet established expertise. Although the project is still in its pilot phase, two EU-funded projects have found their home in the IdeaSquare building and 46 students have already participated in the Challenge-Based Innovation courses based there. More to come…   IdeaSquare, which will be inaugurated on 9 December, is the name given to the B3179 refurbished building at LHC Point 1. More importantly, IdeaSquare is the name of a project designed to nurture innovation at CERN. “The scope of the project is to bring together researchers, engineers, people from industry and young students and encourage them to come up with new ideas that are useful for society, inspired by CERN’s ongoing detector R&D and upgrade projects,” explains Markus Nordberg who, together with Marzio Nessi, set up IdeaSquare withi...

  17. Psoriatic arthritis treatment: biological response modifiers.

    Science.gov (United States)

    Mease, P J; Antoni, C E

    2005-03-01

    In recent years there has been a surge of interest in the treatment of chronic inflammatory disorders as a result of the development and application of targeted biological therapies. The elucidation of the overlapping cellular and cytokine immunopathology of such diverse conditions as rheumatoid arthritis (RA), Crohn's disease, and psoriasis points to specific targets for bioengineered proteins or small molecules. Similar to clinical trials in RA, trials in psoriatic arthritis (PsA) have shown excellent clinical results with the tumour necrosis factor (TNF) blockers, etanercept, infliximab, and adalimumab in a variety of domains including the joints, quality of life, function, and slowing of disease progress as evidenced radiologically. In addition, these agents have shown benefit in domains more unique to PsA, such as the skin lesions of psoriasis, enthesitis, and dactylitis, pointing out the similar pathogenesis of the disease in the skin, the tendons, and the synovial membrane. This therapy has been generally safe and well tolerated in clinical trials of PsA. Other logical candidates for targeted therapy in development include other anti-TNF agents, costimulatory blockade agents that affect T cell function, blockers of other cytokines such as interleukin (IL)-1, 6, 12, 15, or 18, and B cell modulatory medicines. Also, it will be useful to learn more about the effects of combining traditional disease modifying drugs and the newer biologicals. PMID:15708944

  18. Cuaderno de H ideas

    OpenAIRE

    Hayes, Inés Margarita

    2008-01-01

    Cuaderno de H ideas es un nuevo emprendimiento editorial generado por el equipo de la Cátedra de Historia de las Ideas y los Procesos Políticos de la Licenciatura en Comunicación Social orientación Periodismo de la Facultad de Periodismo y Comunicación Social (FP y CS) de la Universidad Nacional de La Plata (UNLP). Bajo la necesidad de generar un espacio de divulgación para las actividades científicas en las áreas de la Comunicación y las Ciencias Sociales, Cuaderno de H ideas presentó su ...

  19. A long-term, open-label trial of the safety and efficacy of etanercept (Enbrel) in patients with rheumatoid arthritis not treated with other disease-modifying antirheumatic drugs

    OpenAIRE

    Klareskog, L; Gaubitz, M; Rodriguez-Valverde, V.; Malaise, Michel; Dougados, M; Wajdula, J

    2006-01-01

    Objective: To evaluate the long-term safety and efficacy of etanercept in patients with rheumatoid arthritis. Methods: 549 patients entered this 5-year, open-label extension study and received etanercept 25 mg twice weekly. All patients showed inadequate responses to disease-modifying antirheumatic drugs before entry into the double-blind studies. Safety assessments were carried out at regular intervals. Primary efficacy end points were the numbers of painful and swollen joints; secondary var...

  20. IDEA papers no 8

    International Nuclear Information System (INIS)

    The Information network on the Economic Development in Aquitaine (IDEA) aims to collect and spread the environmental information concerning the Aquitaine, in order to implement an observatory of the regional environment and of the sustainable development. The IDEA paper no 8 presents the regional energy observatories and some news on the wood energy experience, the thermal and energetic improvement of buildings and the green certificates in Aquitaine. (A.L.B.)

  1. IDEA papers no 11

    International Nuclear Information System (INIS)

    The Information network on the Economic Development in Aquitaine (IDEA) aims to collect and spread the environmental information concerning the Aquitaine, in order to implement an observatory of the regional environment and of the sustainable development. The IDEA paper no.11 is devoted to the wastes management in Aquitaine. Data on wastes volume, type and recycling are presented and examples of enterprises actions are provided. (A.L.B.)

  2. IDEA papers no. 9

    International Nuclear Information System (INIS)

    The Information network on the Economic Development in Aquitaine (IDEA) aims to collect and spread the environmental information concerning the Aquitaine, in order to implement an observatory of the regional environment and of the sustainable development. The IDEA paper no. 9 is devoted to the air quality: atmospheric pollution effects on health, nitrogen oxide pollution, air quality monitoring in buildings, the regulations and the atmospheric pollution, emissions land registry objectives and the greenhouse gases. (A.L.B.)

  3. IDEA papers no 7

    International Nuclear Information System (INIS)

    The Information network on the Economic Development in Aquitaine (IDEA) aims to collect and spread the environmental information concerning the Aquitaine, in order to implement an observatory of the regional environment and of the sustainable development. The IDEA paper no. 7 is devoted to the water quality and management in Gironde. The european framework directive on water and the humid zones are discussed. (A.L.B.)

  4. Plagiarism: Words and ideas

    OpenAIRE

    Bouville, Mathieu

    2008-01-01

    Plagiarism is a crime against academy. It deceives readers, hurts plagiarized authors, and gets the plagiarist undeserved benefits. However, even though these arguments do show that copying other people's intellectual contribution is wrong, they do not apply to the copying of words. Copying a few sentences that contain no original idea (e.g. in the introduction) is of marginal importance compared to stealing the ideas of others. The two must be clearly distinguished, and the 'plagiarism' labe...

  5. Classification of Psoriatic Arthritis

    Science.gov (United States)

    ... and psoriatic arthritis. Email * Zipcode The National Psoriasis Foundation (NPF) is a non-profit organization with a mission to drive efforts to cure psoriatic disease and improve the lives of those affected. Copyright © 1996-2015 National Psoriasis Foundation/USA Bottom Menu About NPF About Us Annual ...

  6. 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.

  7. 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

  8. Gap between short- and long-term effects of patient education in rheumatoid arthritis patients: a systematic review.

    NARCIS (Netherlands)

    Niedermann, K.; Fransen, J.; Knols, R.H.; Uebelhart, D.

    2004-01-01

    OBJECTIVE: To systematically review educational or psychoeducational interventions for patients with rheumatoid arthritis focusing on long-term effects, especially health status. METHODS: Two independent reviewers appraised the methodologic quality of the included randomized controlled trials, publi

  9. 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

  10. 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 ...

  11. Genetics Home Reference: juvenile idiopathic arthritis

    Science.gov (United States)

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

  12. Reactive arthritis or post-infective arthritis?

    Science.gov (United States)

    Keat, Andrew

    2002-09-01

    Infective mechanisms probably underlie a wide range of inflammatory arthropathies. There appears to be a spectrum of mechanisms ranging from the frankly septic, through low-grade infection with very small numbers of microorganisms in the joint to arthritides in which no hard evidence for an infective cause exists. In the midst of the spectrum lie 'post-infective' and 'reactive' arthritides, characterized clinically, genetically and by epidemiological links with infection. Identification of bacterial components within joint material from such patients suggested that the causes of the arthritis had been found. It is now clear that many bacteria are present in inflamed joints; establishing their significance will be of crucial importance, but not easy. PMID:12406424

  13. A Wild Idea

    OpenAIRE

    Moscoso, Maria V

    2011-01-01

    A Wild Idea Directed by Verónica Moscoso A Wild Idea is a half-hour documentary about the Yasuní-ITT Initiative, Ecuador’s unprecedented proposal for fighting global climate change: In exchange for payments from the world community, the country will leave untouched its largest oil reserves. The film takes the viewer to the Yasuní National Park, in the Ecuadorian Amazon, capturing the rain forest’s stunning biodiversity. The film also focuses on another kind of wealth—millio...

  14. Web designer's idea book

    CERN Document Server

    McNeil, Patrick

    2014-01-01

    Discover the latest trends in web design! Looking for inspiration for your latest web design project? Expert Patrick McNeil, author of the popular Web Designer's Idea Book series, is back with all new examples of today's best website design. Featuring more than 650 examples of the latest trends, this fourth volume of The Web Designer's Idea Book is overflowing with visual inspiration. Arranged categorically, this fully illustrated guide puts important topics like design styles, elements, themes and responsive design at your fingertips. This new volume also includes a detailed discussion o

  15. Arthritis Associated with Crohn's Disease

    OpenAIRE

    1990-01-01

    A controlled prospective study was undertaken to determine the incidence and characteristic features of peripheral arthritis, sacroiliitis, ankylosing spondylitis and hypertrophic osteoarthropathy in a group of patients with Crohn's disease, and to define the relationship of such arthritides with disease site, duration and activity. Peripheral arthritis occurred in 14.5% of the patients; it was not seen in the control group. This arthritis, which tended to be pauciarticular, was more common i...

  16. Staphylococcus aureus triggered reactive arthritis.

    OpenAIRE

    Siam, A R; M. Hammoudeh

    1995-01-01

    OBJECTIVES--To report two patients who developed reactive arthritis in association with Staphylococcus aureus infection. METHODS--A review of the case notes of two patients. RESULTS--Two adult female patients have developed sterile arthritis in association with Staph aureus infection. The first patient has had two episodes of arthritis; the first followed olecranon bursitis, the second followed infection of a central venous catheter used for dialysis. The second patient developed sterile arth...

  17. CLINICAL PRESENTATION OF PSORIATIC ARTHRITIS

    OpenAIRE

    M. Atteno; Peluso, R.; R. Scarpa

    2011-01-01

    Psoriatic arthritis is a spondyloarthropathy, which occurs in patients with skin and/or nail psoriasis. Basing its characterization on morphological purposes, several types of arthritis have been described. Alternatively, we propose a simplified classification into three subsets, focusing on the levels of expression of cutaneous and articular elements which devise this syndrome. The first is established psoriatic arthritis which occurs in patients with evident or remittent skin and/or nail ps...

  18. INVESTIGATION OF CYTOKINE PROFILE IN PATIENTS WITH REACTIVE ARTHRITIS

    Directory of Open Access Journals (Sweden)

    T. V. Gaponova

    2008-01-01

    Full Text Available Abstract. Pathogenesis of reactive arthritis (ReA is not clear yet. Several trials suggest that increased production of proinflammatory cytokines is responsible for development of arthritis in ReA, while other studies report that Th1 cytokine response in ReA is impaired in favor of Th2 response. The aim of our study was to investigate serum levels of cytokines IL-1β, IL-4, IL-6, TNFα, IFNγ and IL-1Ra in the patients with ReA of different etiology, as compared with infection-related arthritis. The results of our study had demonstrated that serum levels of IL-1β and TNFα in the patients with ReA were significantly higher, whereas IL-1Ra, IL-4, IL-6 proved to be significantly lower than in healthy controls. Serum levels of IL-6 were significantly higher in patients with chronic ReA, as compared to the cases of acute and recurrent ReA. No significant differences in cytokine profiles were found between the patients with ReA, and the persons with infection-related arthritis. The data obtained are, generally, suggestive for proinflammatory Th1 cytokine profile in ReA patients studied, this confirming the mostly assumed pathogenetic hypothesis for reactive arthritis where an underlying cytokine imbalance is suggested. (Med. Immunol., 2008, vol. 10, N 2-3, pp 167-172.

  19. Exercise reduces depressive symptoms in adults with arthritis: Evidential value

    Science.gov (United States)

    Kelley, George A; Kelley, Kristi S

    2016-01-01

    AIM To determine whether evidential value exists that exercise reduces depression in adults with arthritis and other rheumatic conditions. METHODS Utilizing data derived from a prior meta-analysis of 29 randomized controlled trials comprising 2449 participants (1470 exercise, 979 control) with fibromyalgia, osteoarthritis, rheumatoid arthritis or systemic lupus erythematosus, a new method, P-curve, was utilized to assess for evidentiary worth as well as dismiss the possibility of discriminating reporting of statistically significant results regarding exercise and depression in adults with arthritis and other rheumatic conditions. Using the method of Stouffer, Z-scores were calculated to examine selective-reporting bias. An alpha (P) value arthritis and other rheumatic conditions. Right-skew to dismiss selective reporting was identified (Z = −5.28, P 0.99). The relative frequencies of P-values were 66.7% at 0.01, 6.7% each at 0.02 and 0.03, 13.3% at 0.04 and 6.7% at 0.05. The average power of the tests included in P-curve, corrected for publication bias, was 69%. Diagnostic plot results revealed that the observed power estimate was a better fit than the alternatives. CONCLUSION Evidential value results provide additional support that exercise reduces depression in adults with arthritis and other rheumatic conditions. PMID:27489782

  20. Update on the Management of Pediatric Acute Osteomyelitis and Septic Arthritis

    OpenAIRE

    Luca Castellazzi; Marco Mantero; Susanna Esposito

    2016-01-01

    Acute osteomyelitis and septic arthritis are two infections whose frequencies are increasing in pediatric patients. Acute osteomyelitis and septic arthritis need to be carefully assessed, diagnosed, and treated to avoid devastating sequelae. Traditionally, the treatment of acute osteoarticular infection in pediatrics was based on prolonged intravenous anti-infective therapy. However, results from clinical trials have suggested that in uncomplicated cases, a short course of a few days of paren...

  1. Focal adhesion kinase is required for synovial fibroblast invasion, but not murine inflammatory arthritis

    OpenAIRE

    Shelef, Miriam A; Bennin, David A.; Yasmin, Nihad; Warner, Thomas F; Ludwig, Thomas; Beggs, Hilary E.; Huttenlocher, Anna

    2014-01-01

    Introduction Synovial fibroblasts invade cartilage and bone, leading to joint destruction in rheumatoid arthritis. However, the mechanisms that regulate synovial fibroblast invasion are not well understood. Focal adhesion kinase (FAK) has been implicated in cellular invasion in several cell types, and FAK inhibitors are in clinical trials for cancer treatment. Little is known about the role of FAK in inflammatory arthritis, but, given its expression in synovial tissue, its known role in invas...

  2. The Effect of Acupressure on Severity of Pain in Arthritis Rheumatoid Patient

    OpenAIRE

    Seyed Mahmoud Latifi5; Karim Mowla; Firozeh Karimipour; Sadigeh Fayazi

    2012-01-01

    Background and Objective: Rheumatoid arthritis patients have identified pain as a distressing symptom that interfere their ability to enjoy life and to take care of themselves. The purpose of the study was to assess the effect of acupressure on pain intensity in rheumatoid arthritis patients. Subjects and Methods: This is a clinical trial study. The data were collected from the clinic of rheumatology of Golestan hospital in Ahvaz, physician’s private surgery and patient’s home. Regarding the ...

  3. Effect of Acupressure on Severity of Pain in Arthritis Rheumatoid Patient

    OpenAIRE

    Firozeh Karimipour; Sadigeh Fayazi; Karim Mowla; Seyed Mahmoud Latifi5

    2012-01-01

    Background and Objective: Rheumatoid arthritis patients have identified pain as a distressing symptom that interfere their ability to enjoy life and to take care of themselves. The purpose of the study was to assess the effect of acupressure on pain intensity in rheumatoid arthritis patients.Subjects and Methods: This is a clinical trial study. The data were collected from the clinic of rheumatology of Golestan hospital in Ahvaz, physician’s private surgery and patient’s home. Regarding the o...

  4. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Rheumatology Arthritis Center Lupus Center Lyme Disease Clinical Research ... Center website is intended for educational purposes only. Physicians and other health care professionals ...

  5. [Pauciarticular juvenile chronic arthritis].

    Science.gov (United States)

    Hertzberger-ten Cate, R; Fiselier, T

    1991-10-01

    On basis of clinical and immunogenetic factors most children with pauciarticular juvenile chronic arthritis can be included in one of the subtypes: type 1 and type 2 pauciarticular JCA. Type 1 occurs in young children, mainly girls, with involvement of knees, ankles or elbows. In the majority of children antinuclear antibodies can be detected. The presence of these autoantibodies is associated with chronic anterior uveitis. Type 2 or the juvenile spondylarthropathies include morbus Bechterew, the reactive arthritides and arthritis associated with psoriasis and inflammatory bowel diseases. Large joints of the lower extremities are involved, back pain is unusual at onset, but enthesitis is frequently present. There is a strong association with HLA-B27. Treatment of both subsets consists of non-steroidal anti-inflammatory drugs, application of intra-articular steroids, physio- and hydrotherapy and splinting. In children with a polyarticular course of type 1, or a prolonged course of type 2 disease modifying drugs are often needed. PMID:1957301

  6. Clotrimazole in rheumatoid arthritis.

    OpenAIRE

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

    1980-01-01

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

  7. Psoriasis and psoriasic arthritis

    International Nuclear Information System (INIS)

    The psoriasis is an skin inflammatory disease characterized by chronic and recurrent red skin covered with silver scales. In their pathogenesis, immunogenetic and environmental factors are conjugated. Psoriatic arthritis. That is a seronegative arthropathy. In the greater part of cases follow to a chronic course of cutaneous psoriasis. In this paper, we analyzed the most frequent forms of presentation of cutaneous psoriasis and we revised the psoriatic arthropathy, with some indications about its treatment

  8. The Idea of Property

    Science.gov (United States)

    Starr, Isidore

    1987-01-01

    Reviews case law, constitutional principles, and early American writings which deal with the idea of private property. Concludes that, in the future, the issues of laissez-fare capitalism, government regulation, and the welfare state will require further clarification of our conception of private property. (JDH)

  9. Ideas for Intercultural Education

    Science.gov (United States)

    Marginson, Simon; Sawir, Erlenawati

    2011-01-01

    Written by a cross-cultural pair of authors, "Ideas for Intercultural Education" takes a critical look at present approaches to international education, focusing on the intercultural potential that it offers but mostly fails to deliver. The underlying premise of this profound, engaging book is that international education can be a transforming…

  10. Sharing Teaching Ideas.

    Science.gov (United States)

    Crouse, Richard J.; And Others

    1991-01-01

    The first idea concerns a board game similar to tic-tac-toe in which the strategy involves the knowledge of the factorization of quadratic polynomials. The second game uses the calculation of the surface areas of solid figures applying the specific examples of cigar boxes and cylindrical tin cans. (JJK)

  11. Big ideas: innovation policy

    OpenAIRE

    Van Reenen, John

    2011-01-01

    In the last CentrePiece, John Van Reenen stressed the importance of competition and labour market flexibility for productivity growth. His latest in CEP's 'big ideas' series describes the impact of research on how policy-makers can influence innovation more directly - through tax credits for business spending on research and development.

  12. The Force of Ideas

    Science.gov (United States)

    Ascher, Carol

    2005-01-01

    "The Force of Ideas" describes a little-known aspect of both educational history and Viennese psychoanalysis during the interwar years: the movement for psychoanalytic pedagogy. The author traces her father's own story, beginning with his application to the Vienna Psychoanalytic Society for training as a psychoanalytic pedagogue, as a way to…

  13. 御米油软胶囊干预痛风性关节炎缓解期的临床试验研究%Clinical Trial on the Effects of Yumi Oil Soft Capsules on Gouty Arthritis Remission

    Institute of Scientific and Technical Information of China (English)

    马方励; 徐强; 林昌松

    2011-01-01

    Objective: To evaluate the impact of Yumi oil soft capsules on gouty arthritis remission. Method: Using random comparison method ,50 cases of gouty arthritis patients were divided into test group and control group, respectively. The observation period was 8 weeks. Arthralgia indices, VAS score of overall disease condition, body weight, blood pressure, uric acid ( UA), erythrocyte sedimentation rate (ESR) and lipids ( triglyceride and total cholesterol) as the main efficacy indices,nocturia,urinary frequency,urinary urgency and dysuria as the minor efficacy indices,and blood tests,urine tests,stool check,liver function,kidney function and blood sugar level as the main security indices,the effect of Yumi oil soft capsules on gouty arthritis remission was studied. Result: Between the two groups,there was no statistical difference in the minor efficacy indices,while there was significant statistical difference in the other indices,especially in the joint pain and the blood level of UA,ESR and lipids. Conclusion: Under the premise of keeping the existing treatment programs of gouty arthritis patients, Yumi oil soft capsules can significantly improve the total score of clinical symptoms, tenderness and pain VAS score and reduce the uric acid and total cholesterol levels in serum,which enhance the overall efficacy of the treatment programs of gouty arthritis patients.%目的:评价御米油软胶囊对痛风性关节炎缓解期的干预作用.方法:采用随机对照方法,50例痛风性关节炎患者随机分为试验组和对照组,观察8周,疗效评价以关节痛指标、疾病总体状况的VAS评分、体质量、血压、血尿酸值(UA)、血沉(ESR)及血脂(三酰甘油、总胆固醇)为主要疗效指标,夜尿、尿频、尿急及尿痛为次要疗效指标;血尿常规、大便检查、肝肾功能及血糖等指标为主要安全性指标.结果:试验组与对照组除夜尿、尿频、尿急及尿痛次要疗效指标差异无统计学意义外,

  14. A randomised trial comparing the efficacy and safety of topical ketoprofen in Transfersome(®) gel (IDEA-033) with oral ketoprofen and drug-free ultra-deformable Sequessome™ vesicles (TDT 064) for the treatment of muscle soreness following exercise.

    Science.gov (United States)

    Seidel, Egbert J; Rother, Matthias; Regenspurger, Katja; Rother, Ilka

    2016-01-01

    We compared the effectiveness of topical ketoprofen in Transfersome(®) gel (IDEA-033) with oral ketoprofen and drug-free Sequessome™ vesicles (FLEXISEQ(®) Sport; TDT 064) in reducing calf muscle soreness. One hundred and sixty eight healthy individuals with a pain score ≥ 3 (10-point scale) 12-16 h post-exercise (walking down stairs with an altitude of 300-400 m) were randomised to receive IDEA-033 plus oral placebo (two dose groups), oral ketoprofen plus TDT 064, or TDT 064 plus oral placebo. The primary endpoint was muscle soreness reduction from pre-dosing to Day 7. Higher pain scores were recorded with oral ketoprofen plus TDT 064 (mean ± s 462.4 ± 160.4) versus IDEA-033 plus oral placebo (434.7 ± 190.8; P = 0.2931) or TDT 064 plus oral placebo (376.2 ± 159.1; P = 0.0240) in the 7 days post-exercise. Recovery from muscle soreness was longer with oral ketoprofen plus TDT 064 (mean 91.0 ± 19.5 h) versus IDEA-033 plus placebo (mean 81.4 ± 22.9 h; P = 0.5964) or TDT 064 plus placebo (mean 78.9 ± 22.8 h; P = 0.0262). In conclusion, ultradeformable phospholipid vesicles ± ketoprofen did not retard recovery from muscle soreness. TDT 064 improves osteoarthritis-related pain and could be of interest as a treatment for joint pain during and post-exercise. PMID:25893979

  15. Effect of intermittent aerobic exercise on sleep quality and sleep disturbances in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Løppenthin, Katrine; Esbensen, Bente Appel; Jennum, Poul;

    2014-01-01

    BACKGROUND: Poor sleep is prevalent in patients with systemic inflammatory disorders, including rheumatoid arthritis, and, in addition to fatigue, pain, depression and inflammation, is associated with an increased risk of co-morbidity and all-cause mortality. Whereas non-pharmacological intervent......BACKGROUND: Poor sleep is prevalent in patients with systemic inflammatory disorders, including rheumatoid arthritis, and, in addition to fatigue, pain, depression and inflammation, is associated with an increased risk of co-morbidity and all-cause mortality. Whereas non......-pharmacological interventions in patients with rheumatoid arthritis have been shown to reduce pain and fatigue, no randomized controlled trials have examined the effect of non-pharmacological interventions on improvement of sleep in patients with rheumatoid arthritis. The aim of this trial was to evaluate the efficacy of an...... intermittent aerobic exercise intervention on sleep, assessed both objectively and subjectively in patients with rheumatoid arthritis. METHODS/DESIGN: A randomized controlled trial including 44 patients with rheumatoid arthritis randomly assigned to an exercise training intervention or to a control group. The...

  16. Experiencing the Big Idea

    OpenAIRE

    Harrison, Dew; Ch'ng, Eugene; Mount, Sarah; Moore, Sam

    2009-01-01

    Shrewsbury Museum Service invited Dew Harrison to create a work relating to Charles Darwin for the bicentenary of his birth in the UK town. Her research is practise-led and uses computer technology to interlink series of related thoughts and ideas, in multimedia form. Texts, images, animations and sounds are networked into one overarching ‘concept’. The complete concept is then exhibited as a looped projected film or interactive screen work offering a contemporary understanding of a complex i...

  17. Repositories Unleashing Data: Ideas

    OpenAIRE

    Ward, Pauline Nathalie

    2015-01-01

    Participants at Repositories Fringe (RepoFringe) 2015 were invited to discuss how new audiences (particularly beyond the academic community) and new uses for data from institutional repositories could be identified and reached. A number of questions relating to this goal were discussed in groups. Participants contributed their ideas, questions and comments on post-it notes. The post-it notes have been transcribed.

  18. New ideas in calorimetry

    International Nuclear Information System (INIS)

    The problem of operating calorimeters which use scintillators in a strong magnetic field is explored. Ideas include using double wave shifting techniques to concentrate the light into a small area and then measuring it in place with solid state devices or microchannel plate photomultipliers or shipping the light remotely to normal phototubes via flexible light guides. Some novel schemes of casting plastic sheets with heavy metals for gas sampling calorimeters will also be discussed

  19. Indian Cosmological Ideas

    CERN Document Server

    Narayan, R

    2007-01-01

    This paper, third in the series on Indian tradition of physics, describes conceptions of the cosmos with ideas that are clearly spelt out in texts such as Yoga Vasishtha.In particular, the conception of multiple universes that occurs often in this text will be examined in the framework of the Indian physics. The other surprising concepts that are discussed include flow of time and its variability with respect to different observers, and the possibility of passage across universes.

  20. 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

  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. PMID:26063174

  2. Early identification of rheumatoid arthritis

    NARCIS (Netherlands)

    Nies, Jessica Annemarie Bernadette van

    2016-01-01

    The first part is focused on early recognition of Rheumatoid Arthritis (RA). Two large early arthritis recognition clinics were started in Leiden and Groningen. The results showed that this initiative reduces the GP-delay significantly. Secondly, it was investigated whether an association between sh

  3. Rheumatoid arthritis as psychic problem

    OpenAIRE

    Jiří Kaas; Valérie Tóthová; Lukáš Martinek

    2014-01-01

    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 exhaustio...

  4. When ideas grow up

    CERN Multimedia

    Stefania Pandolfi

    2016-01-01

    Challenge: to use basic-research technologies to enhance mobility. A group of Finnish students accepted this challenge in 2014 and now they have come back to CERN’s IdeaSquare to develop their idea: a smart hip protector to protect elderly people in the event of a fall.   The smart hip protector protects elderly people if they fall. (Image: George Atanassov/Aalto University) The intelligent hip protector features two airbags and three different sensors – an accelerometer, a gyroscope and a magnetometer. When the three sensors simultaneously show that the person is falling, a CO2 cartridge releases gas into the airbags and quickly inflates them, thus softening the impact with the ground. “This idea came about during the Challenge-Based Innovation course in 2014, in which participants were asked to use technologies developed for basic research in new solutions to facilitate mobility,” explains Enna Rane, a member of the team. “Together with students...

  5. Shared care or nursing consultations as an alternative to rheumatologist follow-up for rheumatoid arthritis outpatients with low disease activity--patient outcomes from a 2-year, randomised controlled trial

    DEFF Research Database (Denmark)

    Primdahl, Jette; Sørensen, Jan; Horn, Hans Christian;

    2014-01-01

    (-8.8, p=0.004). No statistically significant differences were seen in other outcome variables. CONCLUSIONS: It is safe to implement shared care and nursing consultations as alternatives to rheumatologist consultations for RA outpatients with low disease activity without deterioration in disease......OBJECTIVES: To compare patient outcomes of three regimes of follow-up care for rheumatoid arthritis (RA) outpatients with low disease activity. METHODS: RA outpatients (n=287) with Disease Activity Score (DAS28-CRP)<3.2 and Health Assessment Questionnaire<2.5 from two Danish rheumatology clinics...... were randomised to 2-year follow-up by either: (1) planned rheumatologist consultations, (2) shared care without planned consultations or (3) planned nursing consultations. The primary outcome was change in disease activity. DAS28-CRP, Health Assessment Questionnaire, visual analogue scale (VAS...

  6. Travelling Ideas, Power and Place

    DEFF Research Database (Denmark)

    Tait, Malcolm; Jensen, Ole B.

    2007-01-01

    A multitude of concepts and ideas have shaped practices in professions such as planning, urban design and urban management.  Now, however, the speed and intensity by which these ideas travel seems historically unprecedented. This paper explores how some of these ideas are formed and circulated...... explaining the travel of planning ideas....

  7. [Novel immunodiagnostics for inflammatory arthritis].

    Science.gov (United States)

    Wahle, M; Kling, E

    2016-05-01

    Immunodiagnostics play an important role in the differential diagnostics of arthritis but the test results must be interpreted with respect to the clinical context. The detection of antibodies against citrullinated proteins has significantly improved the immunodiagnostics of arthritis, whereas the importance of testing for rheumatoid factor has decreased due to the low specificity. Antibodies against carbamylated or oxidized proteins will expand the immunodiagnostics of arthritis (especially rheumatoid arthritis) in the future. In contrast, the determination of cytokine concentrations in plasma or synovial fluid plays a subordinate role in the differential diagnostics of arthritis. Indirect immunofluorescence continues to be the gold standard in the detection of antinuclear antibodies (ANA) and in the case of positive results further testing for antigen specificity should be carried out. The presence of ANA is not necessarily associated with autoimmune diseases. An example of a non-pathogenic ANA is anti-DFS70 antibodies. PMID:27142378

  8. 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.

  9. Dynamic exercise therapy in rheumatoid arthritis: a systematic review.

    OpenAIRE

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

    1998-01-01

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

  10. 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. PMID:26970491

  11. Bone pathology inpsoriatic arthritis

    Directory of Open Access Journals (Sweden)

    V. V. Badokin

    2007-10-01

    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.

  12. RHEUMATOID ARTHRITIS AND PREGNANCY

    OpenAIRE

    N M Kosheleva; E. V. Matyanova

    2014-01-01

    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 thes...

  13. Consensus statement on blocking the effects of interleukin-6 and in particular by interleukin-6 receptor inhibition in rheumatoid arthritis and other inflammatory conditions

    DEFF Research Database (Denmark)

    Smolen, Josef S; Schoels, Monika M; Nishimoto, Norihiro;

    2013-01-01

    BACKGROUND: Since approval of tocilizumab (TCZ) for treatment of rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA), interleukin 6 (IL-6) pathway inhibition was evaluated in trials of TCZ and other agents targeting the IL-6 receptor and ligand in various RA populations and other in...

  14. Adopting Employees' Ideas: Moderators of the Idea Generation-Idea Implementation Link

    Science.gov (United States)

    Da Silva, Nancy; Oldham, Greg R.

    2012-01-01

    This study examined the possibility that the relationship between the number of ideas an employee generated and the number of those ideas that were adopted by the organization was moderated by the general radicalness of the employee's ideas (i.e., the extent to which the ideas were breakthrough or groundbreaking), the employee's intention to stay,…

  15. Mechanics: Ideas, problems, applications

    Science.gov (United States)

    Ishlinskii, A. Iu.

    The book contains the published articles and reports by academician Ishlinskii which deal with the concepts and ideas of modern mechanics, its role in providing a general understanding of the natural phenomena, and its applications to various problems in science and engineering. Attention is given to the methodological aspects of mechanics, to the history of the theories of plasticity, friction, gyroscopic and inertial systems, and inertial navigation, and to mathematical methods in mechanics. The book also contains essays on some famous scientists and engineers.

  16. Powering Ideas through Expertise

    DEFF Research Database (Denmark)

    Seabrooke, Leonard; Wigan, Duncan

    2016-01-01

    policy. Corporate reporting for tax purposes is an area where the European Union, Organization for Economic Co-operation and Development, the United Nations, large global accountancy firms and non-governmental organizations have been active. The point of contention here is what form of financial...... reporting multinational corporations should provide to ensure they pay their fair share of tax. Ideas powered by expertise contain shared causal beliefs, as well as principled beliefs about value systems. We demonstrate that professionals can contest the established order when demonstrations of expertise...

  17. HALFORD MACKINDER'S IDEAS TODAY

    OpenAIRE

    Borisova, Ekaterina

    2005-01-01

    There have always been politicians who considered the cornerstone of their foreign policy efforts to be Halford Mackinder's imperative about the need to control the Pivot area (or the Heartland) in order to rule the world. Today, some countries are still guided by the key tenets of this theory in their foreign policy pursuits, even though the idea has been revised by a number of thinkers, its author included. At one time, Mackinder postulated that the maritime nations and the people of the ma...

  18. Pain and microcrystalline arthritis

    Directory of Open Access Journals (Sweden)

    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.

  19. JUVENILE RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    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.

  20. Early rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    P. Sarzi-Puttini

    2011-09-01

    Full Text Available Rheumatoid arthritis (RA is a systemic disease characterized by chronic inflammation of the synovial joints damage and loss of the function. The ultimate goal in managing RA is to prevent joint damage and to maintain functional ability. Consequently, early diagnosis and treatment is important, but predictive markers for RA are still confined to auto- antibodies and also magnetic resonance imaging (MRI and sonography do not appear to sufficiently distinguish between early RA and non RA. Evidence shows that substantial and irreversible joint damage already occurs within the first 2 years after disease onset. This “window of opportunity” hypothesis for therapeutic intervention in RA is based on the existence of a time frame within which there is a potential for a greater response to therapy, resulting in sustained benefits or, perhaps most important, a chance of cure. There is increasing evidence for beneficial effects of early DMARDs (disease-modifying anti-rheumatic drugs therapy over delayed treatment in patients who present with arthritis of recent onset. However, no universal consensus exists concerning the choice of initial drug or whether single drug or combination should be given as initial treatments. Most studies demonstrated superiority of aggressive over conventional approaches. Because the tumor necrosis factor (TNF-α inhibitors have proved to stop joint damage progression in severe progressive RA, the achievement of these agents in early RA are currently of great interest.

  1. Ideas about housing

    DEFF Research Database (Denmark)

    Earon, Ofri

    2009-01-01

    This booklet is a project documentation of a short-term project titled ‘IDEAS ABOUT HOUSING Arkitektkonkurrencernes boligløsninger’. Architectural competitions have been used to develop new living concepts reacting on current political, economical and social flows. Participation in an architectur...... investigated: 1950-55, 1970-75 and 1990-95. The purpose of the research is to explore the relationship between the physical space and the social patterns taking place in the modern family home during the investigated time frames.......This booklet is a project documentation of a short-term project titled ‘IDEAS ABOUT HOUSING Arkitektkonkurrencernes boligløsninger’. Architectural competitions have been used to develop new living concepts reacting on current political, economical and social flows. Participation in an architectural......, or to generate solutions to general problem.”2 This architectural investigation looks into the housing concepts presented in architectural competitions, and seeks to analyse the family patterns taking place in the space. The project is an integrated part of a group of projects working on...

  2. 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. 

  3. Imaging in early rheumatoid arthritis.

    Science.gov (United States)

    McQueen, Fiona M

    2013-08-01

    Imaging in early rheumatoid arthritis (RA) has undergone extraordinary change in recent years and new techniques are now available to help the clinician diagnose and manage patients much more effectively than previously. While established modalities such as plain radiography (X-Ray) remain important, especially for detection of erosions and determining the progression of joint damage, there are many instances where ultrasound (US), magnetic resonance imaging (MRI) and computed tomography (CT) scanning provide added information. MRI and US are now used regularly by clinicians to help diagnose RA in the pre-radiographic stage as they offer improved visualisation of joint erosions. They also have the potential to provide prognostic information as MRI bone oedema/osteitis is linked to the later development of erosions and power Doppler ultrasound (PDUS) joint positivity is also a predictor of joint damage. Nuclear imaging techniques such as single photon emission computed tomography (SPECT) and positron emission tomography (PET) are also highly sensitive for detecting joint change in early RA and pre-RA but not yet used clinically mainly because of accessibility and radiation exposure. MRI, US, scintigraphy, SPECT and PET have all been shown to detect sub-clinical joint inflammation in patients in clinical remission, a state that is now the goal of most treat-to-target management strategies. Thus, imaging may be used to direct therapeutic decision making and MRI is also now being used in clinical trials to determine the impact of disease-suppressing therapy on the course of synovitis and osteitis. As is the case for all tests, it would be unwise to rely completely on any one imaging result, as false positives and negatives can occur for all modalities. Thus, the clinician needs to choose the most relevant and reliable imaging test, while also striving to minimise patient discomfort, radiation burden and economic impact. PMID:24315051

  4. Radiological aspects of rheumatoid arthritis

    International Nuclear Information System (INIS)

    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. (orig.)

  5. Idea Generation Techniques for Sparking Creative Advertising Ideas.

    Science.gov (United States)

    Marra, James L.

    In advertising, a creative idea can be defined as being right or on strategy in a unique way. For a copywriter, it is not easy to create an ad that has the "Big Idea" in it. Some helpful techniques that advertising students can use to generate creative ideas are (1) analogy, (2) forced relationships, (3) doing the opposite of what everyone else is…

  6. Clinical and immunologic effects of fractionated total lymphoid irradiation in refractory rheumatoid arthritis

    International Nuclear Information System (INIS)

    Ten patients with refractory rheumatoid arthritis were given 3000 rad of fractionated total lymphoid irradiation in an uncontrolled therapeutic trial. Total lymphoid irradiation was associated with objective evidence of considerable clinical improvement in eight patients and with reduced blood lymphocyte counts in all 10. On completion of irradiation, there was an abrogation of lymphocyte reactivity in vitro in the patients with clinical responses, but abnormal antibody activities characteristic of rheumatoid arthritis and normal components of humoral immunity were not suppressed. Partial recrudescence of arthritis occurred shortly after a year after the completion of irradiation and was paralleled by a restitution of lymphocyte concentrations and responsiveness to mitogens to levels similar to those observed before irradiation. These data provide further evidence of T-cell involvement in the pathogenesis of rheumatoid arthritis and demonstrate that total lymphoid irradiation can induce temporary relief, but they do not ascertain whether the natural history of this disease was altered

  7. Ideas that break through

    CERN Multimedia

    Antonella Del Rosso

    2013-01-01

    The EU-cofunded project ULICE (Union of Light Ion Centres in Europe) was launched in 2009 in response to the need to share clinical experience in hadron therapy treatment in Europe and knowledge of the associated complex technical aspects. After four successful years of activity the project is now over but the “transnational access” idea will survive thanks to an extension granted by the European Commission.   A treatment room at CNAO, the Italian centre for hadron therapy. CNAO is participating in ULICE’s transnational access initiative. Image: CNAO. Until a few years ago, the landscape of hadron therapy in Europe was advancing in a fragmented way and facilities were being built without a common shared approach. EU-cofunded projects such as ENLIGHT, ULICE, PARTNER, ENVISION and ENTERVISION helped to build a unified platform where the different – private and public – stakeholders were able to share their views and practical experience in the ...

  8. From Idea to Organizational Practice

    DEFF Research Database (Denmark)

    Meyer, Renate E.; Jancsary, Dennis; Höllerer, Markus A.; Boxenbaum, Eva

    representations diffuse more rapidly and further than the practices themselves. Consolidating the relationship between abstract ideas and specific practice, such visual or multi-modal representations facilitate the implementation of novel ideas, reinforce particular translations, and imbue associated...

  9. Good Idea Now What How to Move Ideas to Execution

    CERN Document Server

    Lee, Charles T

    2012-01-01

    Proven pathways for taking ideas to implementation We all have ideas—things we want to do or create—but only some of us will do what it takes to see those ideas come to pass. In Good Idea. Now What? readers will discover some of the essential values and principles that guide successful idea-makers, including the leveraging of mixed environments for creativity, working through resistance and setbacks, developing a practical plan for implementation that works, navigating collaborative opportunities, and communicating your idea to make it truly remarkable. Whether you're just a creati

  10. Changing ideas of bodily cleanliness

    OpenAIRE

    Quitzau, Maj-Britt

    2004-01-01

    The modern bathroom reflects Western ideas on the handling of bodily wastes, and consequently ideas of cleanliness. Taking a historical study as the point of departure, the purpose of this paper is to understand the extent to which the idea of cleanliness influences the possibility of converting the water closet to a more sustainable technology. An examination of historical changes demonstrates that our present ideas on cleanliness are distinct in their own way. It also demonstrates that our ...

  11. MR imaging of tuberculous arthritis

    International Nuclear Information System (INIS)

    Retrospectively, the MR imaging in 6 patients with tuberculous arthritis was reviewed to determine its MR characteristics. Tuberculous arthritis involved the hip (n=4), knee (n=1) and pubic symphysis (n=1). The affected thick synovial tissue was homogeneously hypointense on T1WI and had mixed signal intensity on T2WI. Enhanced T1WI showed irregular contrast enhancement of the abnormal synovium. MRI demonstrated clearly that the thick synovial tissue involved contiguously articular cartilage and subchondral bone. We could see free intraarticular cartilage and subchondral bone. We could see free intraarticular bodies as hypointense nodules on both T1 and T2WI within increased joint effusion. The MR appearances of tuberculous arthritis are not specific. However, MRI is useful in the diagnosis of tuberculous arthritis because it can provide added information about intraarticular abnormalities. (author)

  12. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... Rheumatoid Arthritis Educational Video Series This series of five videos was designed to help you learn more ... Patients from Johns Hopkins Stategies to Increase your Level of Physical Activity Role of Body Weight in ...

  13. Rheumatoid Arthritis Educational Video Series

    Medline Plus

    Full Text Available ... a more active role in your care. The information in these videos should not take the place of any advice you receive ... Management for Rheumatoid Arthritis Patients Rehabilitation of Older Adult ...

  14. Handout on Health: Rheumatoid Arthritis

    Science.gov (United States)

    ... of, and surgery for, bone and joint diseases. Physical therapists: Health professionals who work with patients to improve ... heart. Pericarditis can be caused by rheumatoid arthritis. Physical therapist. A health professional who works with patients to ...

  15. Guiding New Product Idea Generation

    Science.gov (United States)

    Park, Y.

    2003-01-01

    The creation of innovative ideas is the initial step in entrepreneurial practice and venture management. As the management of technology is now on the priority agenda of higher education institutions, there is a need to develop pedagogic schemes for idea generation. Despite its importance, the idea generation process is hard to systematize or to…

  16. Methotrexate monotherapy and methotrexate combination therapy with traditional and biologic disease modifying antirheumatic drugs for rheumatoid arthritis: abridged Cochrane systematic review and network meta-analysis

    OpenAIRE

    Hazlewood, Glen S; Barnabe, Cheryl; Tomlinson, George; Marshall, Deborah; Devoe, Dan; Bombardier, Claire

    2016-01-01

    Objective To compare methotrexate based disease modifying antirheumatic drug (DMARD) treatments for rheumatoid arthritis in patients naive to or with an inadequate response to methotrexate. Design Systematic review and Bayesian random effects network meta-analysis of trials assessing methotrexate used alone or in combination with other conventional synthetic DMARDs, biologic drugs, or tofacitinib in adult patients with rheumatoid arthritis. Data sources Trials were identified from Medline, Em...

  17. 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.

  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. Smoking and Rheumatoid Arthritis

    Science.gov (United States)

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

    2014-01-01

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

  20. Rheumatoid arthritis and bacterial infections

    OpenAIRE

    N L Prokopjeva; N N Vesikova; I M Marusenko; V A Ryabkov

    2008-01-01

    To study features of bacterial infections course in pts with rheumatoid arthritis (RA) and changes of laboratory measures after focus of infection sanation. Material and methods. 46 pts with definite rheumatoid arthritis were examined at the time of comorbid infection (Cl) detection and after infection focus sanation. Bacteriological test with evaluation of flora sensitivity to antibiotics by disco-diffusion method was performed at baseline and after the course of antibacterial therapy to ass...

  1. Biologic therapies for juvenile arthritis

    OpenAIRE

    Wilkinson, N; Jackson, G.; Gardner-Medwin, J.

    2003-01-01

    A group of therapies with exciting potential has emerged for children and young people with severe juvenile idiopathic arthritis (JIA) uncontrolled by conventional disease modifying drugs. Theoretical understanding from molecular biologic research has identified specific targets within pathophysiological pathways that control rheumatoid arthritis (RA) and JIA. This review identifies the pathways of autoimmunity to begin to show how biologic agents have been produced to replicate, mimic, or bl...

  2. 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.

  3. EXPERIENCES WITH IDEA PROMOTING INITIATIVES

    DEFF Research Database (Denmark)

    Gish, Liv

    In new product development a central activity is to provide new ideas. Over the last decades experiences with stimulating employee creativity and establishing idea promoting initiatives have been made in industrial practice. Such initiatives are often labeled Idea Management – a research field with...... a growing interest. In this paper I examine three different idea promoting initiatives carried out in Grundfos, a leading pump manufacturer. In the analysis I address what understandings of idea work are inscribed in the initiatives and what role these initiatives play in the organization with...

  4. EXPERIENCES WITH IDEA PROMOTING INITIATIVES

    DEFF Research Database (Denmark)

    Gish, Liv

    2011-01-01

    In new product development a central activity is to provide new ideas. Over the last decades experiences with stimulating employee creativity and establishing idea promoting initiatives have been made in industrial practice. Such initiatives are often labeled Idea Management – a research field with...... a growing interest. In this paper I examine three different idea promoting initiatives carried out in Grundfos, a leading pump manufacturer. In the analysis I address what understandings of idea work are inscribed in the initiatives and what role these initiatives play in the organization with...

  5. 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

  6. An interesting idea, but….

    CERN Multimedia

    2009-01-01

    The idea of causing the consciousness of the entire human race to jump into the future for about two minutes is an amusing one. However, in this case, imagination has nothing to do with what can really happen in our world and, in particular, nothing that can ever be caused by the LHC operation. John Ellis, from the Theory group, explains why."I like science fiction; when I was a teenager I had a lot of it and I think that it actually contributed to my decision to eventually become a researcher in science", says John Ellis, CERN theoretical physicist. In Robert Sawyer’s book, lead ion collisions at the LHC cause the whole of humankind to experience a flash-forward. However, although the LHC will be the first particle accelerator to collide heavy ions at an unprecedented (for experiments on Earth) energy, Nature does it every day and nothing terrible has ever happened. "It turns out that a large fraction of high energy cosmic rays is actually heavy nuclei", explains Ellis. "So, in fact, heavy ion experimen...

  7. Old and new therapeutics for Rheumatoid Arthritis: in vivo models and drug development

    DEFF Research Database (Denmark)

    Sardar, Samra; Andersson, Åsa

    2016-01-01

    vivo models during development of anti-rheumatic drugs; from Methotrexate to various antibody treatments, to novel drugs that are, or have recently been, in clinical trials. For novel drugs, we have explored websites for clinical trials. Although one Rheumatoid Arthritis in vivo model cannot mirror the......Development of novel drugs for treatment of chronic inflammatory diseases is to a large extent dependent on the availability of good experimental in vivo models in order to perform preclinical tests of new drugs and for the identification of novel drug targets. Here, we review a number of existing...... rodent models for Rheumatoid Arthritis in the context of how these models have been utilized for developing established therapy in Rheumatoid Arthritis and, furthermore, the present use of animal models for studies of novel drug candidates. We have studied the literature in the field for the use of in...

  8. New Product Launching Ideas

    Science.gov (United States)

    Kiruthika, E.

    2012-09-01

    Launching a new product can be a tense time for a small or large business. There are those moments when you wonder if all of the work done to develop the product will pay off in revenue, but there are many things are can do to help increase the likelihood of a successful product launch. An open-minded consumer-oriented approach is imperative in todayís diverse global marketplace so a firm can identify and serve its target market, minimize dissatisfaction, and stay ahead of competitors. Final consumers purchase for personal, family, or household use. Finally, the kind of information that the marketing team needs to provide customers in different buying situations. In high-involvement decisions, the marketer needs to provide a good deal of information about the positive consequences of buying. The sales force may need to stress the important attributes of the product, the advantages compared with the competition; and maybe even encourage ìtrialî or ìsamplingî of the product in the hope of securing the sale. The final stage is the post-purchase evaluation of the decision. It is common for customers to experience concerns after making a purchase decision. This arises from a concept that is known as ìcognitive dissonance

  9. Education for arthritis patients: a community pharmacy based pilot project.

    Directory of Open Access Journals (Sweden)

    Petkova VB

    2009-06-01

    Full Text Available There are different kinds of arthritis, widely spread among the population, that make them a clinical problem with social, psychological and economic burden. Different education programs have been developed in order to improve patients’ disease management, medication compliance and from there patients’ quality of life.Objective: To develop and implement a community pharmacy-based educational program for patients with arthritis. Improvements in pain, medication compliance, decrease in general practitioner’s visits and hospitalizations are expected.Methods: Prospective, randomized, controlled trial. The sample consisted of 43 individuals, with different stages of arthritis (aged 15 - 71, attending pharmacies – intervention group; and 43 individuals – control group. A 4-month education was conducted on the following topics: what causes arthritis and what are the factors that can intensify it; pain management and physical activities; self-management and prevention; pharmacotherapy and possible adverse drug reactions. Patient's health-related quality of life was assessed in the beginning and at the end of the survey. Results: Parameters assessed during the four stages of the program were: frequency of severe pain, frequency of general practitioner’s visits, frequency of urgent medical aid calls, compliance with therapy, satisfaction with pharmacy services. Improvement in patients’ health-related quality of life was observed and also: decrease in the severity of patients’ pain, decrease in the physician’s visits, and increase in satisfaction overall care.Conclusions: Positive results from the educational approach in pharmacy conditions were demonstrated. These consequences have a potential to increase arthritis patient’s quality of life.

  10. The comparison between monotherapy and combination therapy in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Khalvat A

    2007-05-01

    Full Text Available Background: Rheumatoid arthritis (RA is a chronic inflammatory condition. The condition can affected many tissues throught out the body, but the joints are usually most severely affected. The high incidence of RA, the conventional treatments and the experimental observation have shown by combination therapy, the disease symptoms of the patients reduce. To compare the efficacy and tolerability of single-agent Hydroxychloroquin (HCQ with combination therapies composed of (HCQ and Methotrexate (MTX and (HCQ, (MTX and Sulfasalazin (SSZ in active rheumatoid arthritis patients with additive arthritis. Methods: One hundred and twenty RA patients with active arthritis (male/female: 30/90 who were treated in rheumatology clinic between 2003 and 2005 were enrolled in this trial. Patients treated with (HCQ alone(200 mg/daywere include in group (I, patients treated with combination of (HCQ (200 mg/dayand (MTX (7.5mg/weekin group (II,and patents treated with combination of (HCQ (200mg/day,(MTX (7.5mg/weekand (SSZ(1 gr/dayin group (III, Forty patients (male/female:10/30 in group (I,(II and (IIIwere eligible for statistical analysis at the end of study. Changes in variable were compared by the T-test. Results: The combination of (MTX, (HCQand (SSZ and the combination of (MTX and (HCQ were more effective regarding the clinical and laboratory parameters than (HCQ alone (P<0.05. Moreover the combination of (MTX, (HCQ and (SSZ was more effective than the combination of (MTX and (HCQ (P<0.05. Combination therapies seem to be more effective and no more toxic than monotherapy in RA patients with additive arthritis. Conclusion: Combination therapy with methotrexate, hydroxychloroquin and sulfasalazin is more effective than hydroxychloroquin alone or a combination of methotrexate and hydroxychloroquin in RA. We suggest starting combination therapy for the patients with early RA, when the diagnosis has been established.

  11. Golimumab in the treatment of psoriatic arthritis: efficacy and safety

    Directory of Open Access Journals (Sweden)

    Tatiana Viktorovna Korotaeva

    2015-01-01

    Full Text Available Tumor necrosis factor-α (TNF-α holds a central position in the pathogenesis of autoimmune inflammatory diseases of the locomotor apparatus. A separate class of drugs, namely, TNF-α inhibitors, that are effective against multicomponent diseases, such as psoriatic arthritis (PsA, is now available to physicians. The paper reviews the results of clinical trials of the TNF-α inhibitor golimumab, a human TNF-α monoclonal antibody. Golimumab exerts a positive effect on all manifestations of PsA: arthritis, psoriatic skin and nail lesions, dactylitis, enthesitis, and quality of life. The drug is noted for its convenient route of administration – its standard dose is 50 mg injected subcutaneously once a month and for its low molecular immunogenicity. Recent data suggest that golimumab is an effective drug with a safety profile similar to that of the entire class of TNF-α inhibitors.

  12. [Juvenile idiopathic arthritis: Definition and classification].

    Science.gov (United States)

    Deslandre, C

    2016-04-01

    Juvenile idiopathic arthritis (JIA) is a group of diseases defined by the presence of arthritis of more than 6weeks duration in patients aged less than 16years and with unknown etiology. The international classification based on clinical and biological criteria define each type of JIA: systemic, oligoarticular, polyarticular with and without rheumatoid factor, enthesitis-related arthritis, and psoriatic arthritis. However, some discussions persist concerning systemic-onset juvenile idiopathic arthritis, whose clinical symptoms and pathogenic mechanisms are quite similar to those observed in autoinflammatory diseases, arthritis with antinuclear factors (poly- and oligoarticular) that could be considered as a homogenous group, and a family history of psoriasis that frequently led to unclassified arthritis. Better knowledge of the pathogenic mechanisms should improve the initial clinical classification with more homogeneous groups of patients and reduce the number of unclassified cases of arthritis. PMID:26968301

  13. New Treatments Helping Kids with Juvenile Arthritis

    Science.gov (United States)

    ... 159984.html New Treatments Helping Kids With Juvenile Arthritis Several biologics have been approved by the FDA ... 20, 2016 (HealthDay News) -- New treatments for juvenile arthritis offer hope to children with the chronic autoimmune ...

  14. Arthritis - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Arthritis URL of this page: https://medlineplus.gov/languages/arthritis.html Other topics A-Z A B ...

  15. Sick leave as a predictor of job loss in patients with chronic arthritis

    NARCIS (Netherlands)

    de Buck, Petronella D. M.; de Bock, Geertruida H.; van Dijk, Frank; van den Hout, Wilbert B.; Vandenbroucke, Jan P.; Vlieland, Theodora P. M. Vliet

    2006-01-01

    Objectives: To study the occurrence and duration of sick leave as potential risk factors for permanent job loss after 24 months among 112 individuals with chronic arthritis and a disease related problem at work. Methods: Data collection was embedded in a multicentre randomised controlled trial in wh

  16. Updated consensus statement on the use of rituximab in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Buch, Maya H; Smolen, Josef S; Betteridge, Neil;

    2011-01-01

    Since initial approval for the treatment of rheumatoid arthritis (RA), rituximab has been evaluated in clinical trials involving various populations with RA. Information has also been gathered from registries. This report therefore updates the 2007 consensus document on the use of rituximab in th...

  17. Updated consensus statement on the use of rituximab in patients with rheumatoid arthritis

    NARCIS (Netherlands)

    M.H. Buch; J.S. Smolen; N. Betteridge; F.C. Breedveld; G. Burmester; T. Dörner; G. Ferraccioli; J.E. Gottenberg; J. Isaacs; T.K. Kvien; X. Mariette; E. Martin-Mola; K. Pavelka; P.P. Tak; D. van der Heijde; R.F. van Vollenhoven; P. Emery

    2011-01-01

    Background Since initial approval for the treatment of rheumatoid arthritis (RA), rituximab has been evaluated in clinical trials involving various populations with RA. Information has also been gathered from registries. This report therefore updates the 2007 consensus document on the use of rituxim

  18. 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...

  19. 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.

  20. 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.

  1. Biological therapies for the treatment of juvenile idiopathic arthritis: Lessons from the adult and pediatric experiences

    Directory of Open Access Journals (Sweden)

    Matthew L Stoll

    2008-06-01

    Full Text Available Matthew L Stoll, Alisa C GotteDepartment of Pediatrics, Division of Rheumatology, UT Southwestern Medical Center, Dallas, TX, USAAbstract: Biologics have advanced the therapy of adult and pediatric arthritis. They have been linked to rare serious adverse outcomes, but the actual risk of these events is controversial in adults, and largely unknown in pediatrics. Because of the paucity of safety and efficacy data in children, pediatric rheumatologists often rely on the adult literature. Herein, we reviewed the adult and pediatric literature on five classes of medicines: Tumor necrosis factor (TNF inhibitors, anakinra, rituximab, abatacept, and tocilizumab. For efficacy, we reviewed randomized controlled studies in adults, but did include lesser qualities of evidence for pediatrics. For safety, we utilized prospective and retrospective studies, rarely including reports from other inflammatory conditions. The review included studies on rheumatoid arthritis and spondyloarthritis, as well as juvenile idiopathic arthritis. Overall, we found that the TNF inhibitors have generally been found safe and effective in adult and pediatric use, although risks of infections and other adverse events are discussed. Anakinra, rituximab, abatacept, and tocilizumab have also shown positive results in adult trials, but there is minimal pediatric data published with the exception of small studies involving the subgroup of children with systemic onset juvenile idiopathic arthritis, in whom anakinra and tocilizumab may be effective therapies.Keywords: juvenile idiopathic arthritis, biologics, rheumatoid arthritis

  2. 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...... developed and validated by several groups. The OMERACT criteria require that outcome measures demonstrate adequate validity, discriminative power, and feasibility if they are to be useful in clinical trials. Specific performance targets for these criteria depend on the scientific, regulatory, logistical......, and financial context of the study in question. We review the extent to which MRI assessments of joint erosion, bone edema, and synovitis fulfil these criteria, particularly as they relate to proof-of-concept RA clinical trials....

  3. Reference bias in reports of drug trials.

    OpenAIRE

    Dickersin, K

    1987-01-01

    Articles published before 1985 describing double blind trials of two or more non-steroidal anti-inflammatory drugs in rheumatoid arthritis were examined to see whether there was any bias in the references they cited. Althogether 244 articles meeting the criteria were found through a Medline search and through examining the reference lists of the articles retrieved. The drugs compared in the studies were classified as new or as control drugs and the outcome of the trial as positive or not posi...

  4. Overview of the radiology of juvenile idiopathic arthritis (JIA)

    International Nuclear Information System (INIS)

    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

  5. 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.

  6. Apremilast (Otezla). No progress in plaque psoriasis or psoriatic arthritis.

    Science.gov (United States)

    2016-06-01

    When PUVA therapy and immunosuppressants such as methotrexate are ineffective, TNF alpha antagonists are an option for patients with severe plaque psoriasis, in the absence of a better alternative. This is also the case for patients with psoriatic arthritis after failure of a "disease-modifying" antirheumatic drug. Apremilast, an oral immunosuppressant that inhibits phosphodiesterase type 4, has been authorised in the European Union for use in these settings. In patients with plaque psoriasis, oral apremilast was compared with subcutaneous etanercept, aTNF alpha antagonist, in a randomised, doubleblind, placebo-controlled trial lasting 16 weeks and involving 250 patients in whom other treatments had failed or were inappropriate. This trial failed to show that apremilast was more effective than etanercept. And about one-quarter more patients experienced symptom relief compared with placebo. In patients with psoriatic arthritis, there are no clinical trials comparing apremilast with TNF alpha antagonists, and no interpretable trials of apremilast after failure of a TNF alpha antagonist. In three randomised, double-blind trials including a total of 1493 patients treated for 16 weeks, at least a modest improvement in joint status was reported in about 35% of patients treated with apremilast versus 19% with placebo. This would suggest that apremilast is less effective than a TNF alpha antagonist. In the trial versus etanercept, serious adverse events occurred in 3.6% of patients treated with apremilast versus 1.2% of those treated with the TNF alpha antagonist. The main adverse effects of apremilast are diarrhoea, nausea and vomiting, headache, sometimes marked weight loss, and infections. A risk of depression and cardiac arrhythmia must also be taken into account. A risk of cancer in the long-term is likely, given the immunosuppressive action of apremilast. Apremilast is a substrate of cytochrome P450 isoenzyme 3A4 and accumulates in patients with renal failure. This

  7. Revised article: Business Ideas Competition

    CERN Multimedia

    2003-01-01

    THIS ARTICLE REPLACES THAT PUBLISHED IN BULLETIN 27/2003, PAGE 8. "The Rainbow Seed Fund is a UK fund, which provides finance to support the commercialization of good ideas founded on scientific research; it is for the benefit of the UK industry in particular. To encourage ideas from CERN the Rainbow Seed Fund is running a business ideas competition. The winner of this competition will receive an immediate cash prize of GBP £1,000. In addition the Rainbow Seed Fund may well provide finance for market research, for protection of Intellectual Property Rights (IPR) and for prototyping to take the idea forward. Further awards of GBP £750 will be made for ideas which gain investment from the Fund. Candidates will only be required to prepare a 2-4-page summary of their business idea, and not a full business plan. Full details and an entry form are available at http://www.rainbowseedfund.com." ALL Members of the Personnel seeking participation in the business ideas competition are asked to submit their ideas via ...

  8. IDEA papers special number 1

    International Nuclear Information System (INIS)

    The Information network on the Economic Development in Aquitaine (IDEA) aims to collect and spread the environmental information concerning the Aquitaine, in order to implement an observatory of the regional environment and of the sustainable development. The IDEA papers provides information such as, meeting, Internet addresses and programs. This paper is specially devoted to the environment. (A.L.B.)

  9. The IDEA papers no 4

    International Nuclear Information System (INIS)

    The Information network on the Economic Development in Aquitaine (IDEA) aims to collect and spread the environmental information concerning the Aquitaine, in order to implement an observatory of the regional environment and of the sustainable development. The IDEA paper no. 4 presents the point of view of some participants to the third national meeting of the environment observatories. (A.L.B.)

  10. Changing ideas of bodily cleanliness

    DEFF Research Database (Denmark)

    Quitzau, Maj-Britt

    2004-01-01

    About historical shifts in ideas of bodily cleanliness and what impacts this have on the possibility of implementing more ecological toilets.......About historical shifts in ideas of bodily cleanliness and what impacts this have on the possibility of implementing more ecological toilets....

  11. 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.

  12. Pyogenic infection and rheumatoid arthritis.

    Science.gov (United States)

    Rowe, I. F.; Deans, A. C.; Keat, A. C.

    1987-01-01

    Ten episodes of severe pyogenic infection occurring in nine patients with rheumatoid arthritis are reported. There was a wide range of presenting features including pyoarthrosis in 7 episodes. Three cases presented with meningitis, bacterial endocarditis and probable multiple abscesses respectively. Infection was caused by Staphylococcus aureus in 7 episodes and by Staphylococcus epidermidis, Streptococcus pneumoniae and beta-haemolytic Streptococcus in each of one episode. Three infective episodes were fatal. Pyogenic, especially staphylococcal, infection should be considered in patients with rheumatoid arthritis with unexplained illness with or without sudden deterioration in joint symptoms. It is important to recognize and treat infection rapidly. Images Figure 1 Figure 2 PMID:3671222

  13. Rheumatoid arthritis-associated interstitial lung disease

    Directory of Open Access Journals (Sweden)

    Brown KK

    2012-03-01

    Full Text Available Joshua J Solomon, Kevin K BrownAutoimmune Lung Center and Interstitial Lung Disease Program, National Jewish Health, Denver, CO, USAAbstract: Rheumatoid arthritis (RA is a systemic inflammatory disorder affecting 1% of the US population. Patients can have extra-articular manifestations of their disease and the lungs are commonly involved. RA can affect any compartment of the respiratory system and high resolution computed tomography (HRCT of the lung is abnormal in over half of these patients. Interstitial lung disease is a dreaded complication of RA. It is more prevalent in smokers, males, and those with high antibody titers. The pathogenesis is unknown but data suggest an environmental insult in the setting of a genetic predisposition. Smoking may play a role in the pathogenesis of disease through citrullination of protein in the lung leading to the development of autoimmunity. Patients usually present in middle age with cough and dyspnea. Pulmonary function testing most commonly shows reduced diffusion capacity for carbon monoxide and HRCT reveals a combination of reticulation and ground glass abnormalities. The most common pattern on HRCT and histopathology is usual interstitial pneumonia (UIP, with nonspecific interstitial pneumonia seen less frequently. There are no large-scale well-controlled treatment trials. In severe or progressive cases, treatment usually consists of corticosteroids with or without a cytotoxic agent for 6 months or longer. RA interstitial lung disease is progressive; over half of patients show radiographic progression within 2 years. Patients with a UIP pattern on biopsy have a survival similar to idiopathic pulmonary fibrosis.Keywords: rheumatoid arthritis, interstitial lung disease, nonspecific interstitial pneumonia, usual interstitial pneumonia, anti-CCP

  14. Juvenile rheumatoid arthritis

    International Nuclear Information System (INIS)

    Objective: To determine the spectrum of clinical presentation, laboratory parameters and drug therapy in patients with Juvenile Rheumatoid Arthritis (JRA). Study Design: Case series. Place and Duration of Study: The Children's Hospital and The Institute of Child Health, Lahore, from October 2008 to October 2011. Methodology: All patients who fulfilled the American College of Rheumatology criteria for JRA were enrolled. Their clinical features, investigations done and treatment received for JRA were noted. Statistical analysis of data was done on SPSS version 16.0 for obtaining descriptive statistics. Results: Out of 185 patients, 50.3% (n = 93) were females; 54% (n = 100) were between 10 - 15 years of age. Polyarthritis was found in 71.9% (n = 133) followed by oligoarthritis (22.7%, n = 42) and systemic onset disease (5.4%, n = 10). Morning stiffness (78%) and fever (68%) were the most common clinical presentations. All patients with systemic onset disease had fever (n = 10) followed by skin rash, hepatosplenomegaly and lymphadenopathy. Uveitis was found in 2 patients, and both belonged to the oligoarticular group. Rheumatoid factor was found in 10.27% (n = 19) of all patients. All patients were given non-steroidal anti-inflammatory drugs (NSAIDs). Disease modifying agents (methotrexate) were given to 43.8% (n = 81). Steroids were used in 61% (n = 113) of patients either with NSAIDs alone or NSAIDs plus methotrexate. Conclusion: Disease profile of JRA at the study centre showed that polyarthritis is the commonest type. Recognition of subtypes will help in planning the management of these patients. (author)

  15. Treatment of arthritis, including rheumatoid arthritis, with radioactive isotopes

    International Nuclear Information System (INIS)

    A radioactive composition is described for the treatment of arthritis comprising, in combination, a ferric hydroxide or aluminum hydroxide aggregate suspension having a particle size of 3 to 20 microns, wherein a radionuclide is entrapped, the radionuclide being /sup 166/Holmium

  16. Biologic agents for rheumatoid arthritis: 2008 and beyond.

    Science.gov (United States)

    Sweiss, Nadera J; Hushaw, Linda L

    2009-01-01

    Rheumatoid arthritis (RA) is a chronic disease with a complex underlying pathology and varied presentation in patients. Several novel biologic disease-modifying antirheumatic drugs have become available for the treatment of RA. Agents in late-stage clinical trials include golimumab and certolizumab, which are anti-tumor necrosis factor (TNF)-alpha agents; ocrelizumab, an anti-CD20 agent; and tocilizumab, an inhibitor of interleukin-6. As treatment options for RA expand, nursing care will play an increasingly important role in empowering patients through interventions such as patient education and adverse effect management. PMID:19142153

  17. Effect of dietary restrictions on disease activity in rheumatoid arthritis.

    OpenAIRE

    Beri, D; Malaviya, A N; Shandilya, R; Singh, R R

    1988-01-01

    Additions in five steps were made, as a possible therapeutic measure, to the diet of 27 patients with rheumatoid arthritis (RA) after a period of two weeks of a basal isocaloric diet free from pulses, cereals, milk, and non-vegetarian protein foods. Fourteen patients finally took part in the trial, 10 (71%) of whom showed significant clinical improvement. Only three patients (11%) adhered to the diet for a period of 10 months. The others discontinued the diet and were then treated with conven...

  18. Old and new therapeutics for Rheumatoid Arthritis: in vivo models and drug development.

    Science.gov (United States)

    Sardar, Samra; Andersson, Åsa

    2016-01-01

    Development of novel drugs for treatment of chronic inflammatory diseases is to a large extent dependent on the availability of good experimental in vivo models in order to perform preclinical tests of new drugs and for the identification of novel drug targets. Here, we review a number of existing rodent models for Rheumatoid Arthritis in the context of how these models have been utilized for developing established therapy in Rheumatoid Arthritis and, furthermore, the present use of animal models for studies of novel drug candidates. We have studied the literature in the field for the use of in vivo models during development of anti-rheumatic drugs; from Methotrexate to various antibody treatments, to novel drugs that are, or have recently been, in clinical trials. For novel drugs, we have explored websites for clinical trials. Although a single Rheumatoid Arthritis in vivo model cannot mirror the complexity of disease development, there exist a number of good animal models for Rheumatoid Arthritis, each defining some parts in disease development, which are useful for studies of drug response. We find that many of the established drugs were not tested in in vivo models before being used in the clinic, but rather animal models have been subsequently used to find mechanisms for efficacy. Finally, we report a number of novel drugs, tested in preclinical in vivo models, presently in clinical trials. PMID:26769136

  19. Modified intention-to-treat analysis did not bias trial results

    DEFF Research Database (Denmark)

    Dossing, Anna; Tarp, Simon; Furst, Daniel E;

    2016-01-01

    SETTING: Placebo-controlled, blinded randomized trials on biological or targeted interventions for rheumatoid arthritis were identified through a systematic search. Two authors independently extracted data. A random-effects meta-analysis was used to combine odds ratios as an expression of treatment effect...... suggests that the mITT approach in rheumatoid arthritis trials investigating biological or targeted interventions does not introduce bias compared to ITT....

  20. Risk of serious infection in biological treatment of patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Singh, Jasvinder A; Cameron, Chris; Noorbaloochi, Shahrzad;

    2015-01-01

    BACKGROUND: Serious infections are a major concern for patients considering treatments for rheumatoid arthritis. Evidence is inconsistent as to whether biological drugs are associated with an increased risk of serious infection compared with traditional disease-modifying antirheumatic drugs (DMARDs......). We did a systematic review and meta-analysis of serious infections in patients treated with biological drugs compared with those treated with traditional DMARDs. METHODS: We did a systematic literature search with Medline, Embase, Cochrane Central Register of Controlled Trials, and Clinical......Trials.gov from their inception to Feb 11, 2014. Search terms included "biologics", "rheumatoid arthritis" and their synonyms. Trials were eligible for inclusion if they included any of the approved biological drugs and reported serious infections. We assessed the risk of bias with the Cochrane Risk of Bias Tool...

  1. 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...

  2. 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...

  3. 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 this...

  4. On the content of a product idea

    DEFF Research Database (Denmark)

    product ideas. 2. To develop methods and tools for stronger management of product idea portfolios. 3. To develop a product idea description, which enhances the creation of ideas. Hopefully strong ideas, but at least ideas, which has a rich and sound description, in the sense that it contains...

  5. On the content of a product idea

    DEFF Research Database (Denmark)

    Hansen, Claus Thorp; Andreasen, Mogens Myrup

    2005-01-01

    product ideas. 2. To develop methods and tools for stronger management of product idea portfolios. 3. To develop a product idea description, which enhances the creation of ideas. Hopefully strong ideas, but at least ideas, which has a rich and sound description, in the sense that it contains...

  6. Institutionalizing New Ideas Through Visualization

    DEFF Research Database (Denmark)

    Meyer, Renate; Jancsary, Dennis; Höllerer, Markus A.;

    How do visualization and visual forms of communication influence the process of transforming a novel idea into established organizational practice? In this paper, we build theory with regard to the role of visuals in manifesting and giving form to an innovative idea as it proceeds through various...... stages of institutionalization. Ideas become institutionalized not merely through widespread diffusion in a cognitive-discursive form but eventually through their translation into concrete activities and transformation into specific patterns of organizational practice. We argue that visualization plays a...... pivotal and unique role in this process. Visualization bridges the ideational with the practical realm by providing representations of ideas, connecting them to existing knowledge, and illustrating the specific actions that instantiate them. Similar to verbal discourse, and often in tandem, visual...

  7. General ideas on English reading

    Institute of Scientific and Technical Information of China (English)

    祝文瑛

    2015-01-01

    This paper is talking about some general ideas on English reading in order to help teachers and learners foster some reading skills by seeing through its natures aiming at effective and productive English teaching and learning.

  8. Dynamic Visualizations of Calculus Ideas.

    Science.gov (United States)

    Embse, Charles Vonder

    2001-01-01

    Presents three fundamental ideas of calculus and explains using the coordinate plane geometrically. Uses Cabri Geometry II to show how computer geometry systems can facilitate student understanding of general conic objects and its dynamic algebraic equations. (KHR)

  9. From Idea to Organizational Practice

    DEFF Research Database (Denmark)

    Meyer, Renate E.; Jancsary, Dennis; Höllerer, Markus A.;

    How do visualization and visual forms of communication influence the process of transforming a novel idea into established organizational practice? In this paper, we build theory with regard to the role of visuals in manifesting and giving form to an innovative idea as it proceeds through various...... stages of institutionalization. Ideas become institutionalized not merely through widespread diffusion in a cognitive-discursive form but eventually through their translation into concrete activities and transformation into specific patterns of organizational practice. We argue that visualization plays a...... organizational practice with legitimacy – and thus solidify the coupling of innovative ideas and organizational practice. Extending existing research, we develop a set of propositions linking dimensions of visuality and visualization to the different stages of institutionalization in order to explain the...

  10. Stata Hybrids: Updates and Ideas

    Science.gov (United States)

    Fieldler, James

    2014-01-01

    At last year's Stata conference I presented two projects for using Python with Stata: a plugin that embeds the Python programming language within Stata and code for using Stata data sets in Python. In this talk I will describe some small improvements being made to these projects, and I will present other ideas for combining tools with Stata. Some of these ideas use Python, some use JavaScript and a web browser.

  11. Update on the Management of Pediatric Acute Osteomyelitis and Septic Arthritis.

    Science.gov (United States)

    Castellazzi, Luca; Mantero, Marco; Esposito, Susanna

    2016-01-01

    Acute osteomyelitis and septic arthritis are two infections whose frequencies are increasing in pediatric patients. Acute osteomyelitis and septic arthritis need to be carefully assessed, diagnosed, and treated to avoid devastating sequelae. Traditionally, the treatment of acute osteoarticular infection in pediatrics was based on prolonged intravenous anti-infective therapy. However, results from clinical trials have suggested that in uncomplicated cases, a short course of a few days of parenteral antibiotics followed by oral therapy is safe and effective. The aim of this review is to provide clinicians an update on recent controversies and advances regarding the management of acute osteomyelitis and septic arthritis in children. In recent years, the emergence of bacterial species resistant to commonly used antibiotics that are particularly aggressive highlights the necessity for further research to optimize treatment approaches and to develop new molecules able to fight the war against acute osteoarticular infection in pediatric patients. PMID:27258258

  12. Update on the Management of Pediatric Acute Osteomyelitis and Septic Arthritis

    Directory of Open Access Journals (Sweden)

    Luca Castellazzi

    2016-06-01

    Full Text Available Acute osteomyelitis and septic arthritis are two infections whose frequencies are increasing in pediatric patients. Acute osteomyelitis and septic arthritis need to be carefully assessed, diagnosed, and treated to avoid devastating sequelae. Traditionally, the treatment of acute osteoarticular infection in pediatrics was based on prolonged intravenous anti-infective therapy. However, results from clinical trials have suggested that in uncomplicated cases, a short course of a few days of parenteral antibiotics followed by oral therapy is safe and effective. The aim of this review is to provide clinicians an update on recent controversies and advances regarding the management of acute osteomyelitis and septic arthritis in children. In recent years, the emergence of bacterial species resistant to commonly used antibiotics that are particularly aggressive highlights the necessity for further research to optimize treatment approaches and to develop new molecules able to fight the war against acute osteoarticular infection in pediatric patients.

  13. The safety of interleukin-1 receptor antagonist (anakinra in the treatment of rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    L. Riente

    2011-09-01

    Full Text Available The safety profile of interleukin-1 receptor antagonist (anakinra has been studied with randomised, placebo-controlled trials involving 2932 patients affected by rheumatoid arthritis. The most frequently reported adverse events were represented by injection site reactions (71% and headache (13.6%. No statistically significant difference in the incidence of infections was observed among the patients treated with the interleukin-1 receptor antagonist and the patients receiving placebo. In particular, the incidence of serious infections was 1,8% in rheumatoid arthritis patients on anakinra therapy and 0,7% in patients on placebo. The reported serious infections consisted of pneumonia, cellulitis, bone and joint infections, bursitis. No case of opportunistic infections or tubercolosis was observed. The results of clinical studies suggest that anakinra is a new well-tolerated drug for the treatment of patients affected by rheumatoid arthritis.

  14. Novel multimeric IL-1 receptor antagonist for the treatment of rheumatoid arthritis.

    Science.gov (United States)

    Pasi, Shweta; Kant, Ravi; Gupta, Sarika; Surolia, Avadhesha

    2015-02-01

    Protein therapeutics targeting inflammatory mediators have shown great promise for the treatment of autoimmunities such as rheumatoid arthritis (RA). However, a significant challenge in this area has been their low in vivo stability and consequently their severely compromised therapeutic efficacy. One such therapeutic molecule IL-1 receptor antagonist (IL-1ra), used in the treatment of rheumatoid arthritis, has displayed only modest efficacy in human clinical trials owing to its short biological half-life. Herein, we report a novel approach to conglomerate individual protein entities into a drug depot by incorporation of an amyloidogenic motif Lys-Phe-Phe-Glu (KFFE) thereby dramatically improving their systemic persistence and in turn their therapeutic efficacy in a mice model of autoimmune arthritis. PMID:25542800

  15. Composite Measures in Psoriatic Arthritis: a report from the GRAPPA 2009 annual meeting.

    Science.gov (United States)

    Helliwell, Philip S; Fitzgerald, Oliver; Strand, C Vibeke; Mease, Philip J

    2011-03-01

    A composite measure is one way of incorporating an assessment of all relevant clinical outcomes into one single measure. By definition it incorporates several dimensions of disease status often by combining these different domains into a single score. Such instruments are well established in rheumatoid arthritis (RA), and these RA-specific measures have successfully been adopted for use in clinical trials involving patients with psoriatic arthritis (PsA). However, the need for a more PsA-specific composite measure has led to a number of proposals, which, for the large part, incorporate only peripheral articular disease activity. New indices that combine the diverse clinical manifestations of PsA are now under development. These issues were discussed at the 2009 annual meeting of GRAPPA (Group for Research and Assessment of Psoriasis and Psoriatic Arthritis) in Stockholm, Sweden, and are summarized here. PMID:21362782

  16. Treating Rheumatoid Arthritis: Are Biologic Drugs Right for You?

    Science.gov (United States)

    Treating Rheumatoid Arthritis: Are Biologic Drugs Right for You? What is rheumatoid arthritis (RA)? Rheumatoid arthritis (RA) is a serious condition. The body’s immune system attacks the lining of ...

  17. Osteoporosis and Arthritis: Two Common but Different Conditions

    Science.gov (United States)

    ... your browser. Home Osteoporosis Osteoporosis and Other Conditions Osteoporosis and Arthritis: Two Common but Different Conditions Publication available in: PDF (71 KB) Related Resources Alcoholism Anorexia Nervosa Arthritis Artritis (Arthritis) Asthma Bed Rest and Immobilization ...

  18. Genetics of psoriatic arthritis.

    Science.gov (United States)

    O'Rielly, Darren D; Rahman, Proton

    2014-10-01

    Spondyloarthritis (SpA) represents a group of inflammatory rheumatic diseases that cluster within families and possess overlapping clinical features. The pathogenesis of SpA encompasses a complex array of genetic, immunological and environmental factors. In this article, we will briefly review the genetics of PsA, and then focus on the genes that may be potentially linked either directly or indirectly to the immunopathology of the Th-17 pathway. The most consistent and dominant genetic effect of PsV and PsA is located on chromosome 6p21.3 within the major histocompatibility complex (MHC) region, which accounts for approximately one-third of the genetic contribution of PsV and PsA. To date, 36 genes have reached genome-wide significance, accounting for approximately 22% of psoriasis (PsV) heritability. Prominent genes identified via GWAS include HLA-Cw6, IL12B, IL23R, IL23A, TNIP1, TNFAIP3, LCE3B-LCE3C, TRAF3IP2, NFkBIA, FBXL19, TYK2, IFIH1, REL, and ERAP1. Genes identified in psoriatic arthritis (PsA) has largely echoed those in PsV and include HLA-B/C, HLA-B, IL-12B, IL-23R, TNIP1, TRAF3IP2, FBXL19, and REL. The lack of identified genetic susceptibility loci is largely attributed to the much smaller number of PsA patients and the greater clinical heterogeneity of PsA. Searching for different types of genetic variants such as small CNVs and/or insertions/deletions has also led to the identification of several genes with a function relative to PsV in particular including DEFB4, LCE3C_LCE3B, and IL-22 gene (exon 1). The candidate genes identified in PsV/PsA have highlighted pathways of critical importance to psoriatic disease including distinct signaling pathways comprised of barrier integrity, innate immune response and adaptive immune response, mediated primarily by Th-17 and Th-1 signalling. While GWAS studies have yielded great insights into the genes that contribute to the pathogenesis of PsV and PsA, replication in large cohorts, fine-mapping and resequencing

  19. Ideas.

    Science.gov (United States)

    Cook, Marcy

    1993-01-01

    Presents 5 activities for the K-1, 2-3, 4-5, 6-8 grade levels and for in the home in which students explore the concept of combinations. Each activity includes a lesson plan to investigate a combinatorics problem appropriate for that grade level. Provides reproducible worksheets. (MDH)

  20. Technetium scintigraphy in experimental hyperergic arthritis and by rheumatoid arthritis

    International Nuclear Information System (INIS)

    Guinea pigs showed an increased uptake of 99m-TC-04 in the inflamed joints during the first days of experimental arthritis. Tc-04 was found in the joint fluid and inflamed synovia. The uptake of Tc-04 and Tc-MDP was reduced by therapy in 13 patients with RA. Classical RA showed an increased uptake of Tc-MDP compared with probable RA. Scintigraphy offers the possibility of early diagnosis and study of progression. (orig.)

  1. Golimumab for the treatment of psoriatic arthritis.

    Science.gov (United States)

    Yang, H; Epstein, D; Bojke, L; Craig, D; Light, K; Bruce, I; Sculpher, M; Woolacott, N

    2011-05-01

    This paper presents a summary of the evidence review group (ERG) report into the use of golimumab for the treatment of psoriatic arthritis (PsA). The main clinical effectiveness data were derived from a single phase III randomised controlled trial (RCT: GO-REVEAL) that compared golimumab with placebo for treating patients with active and progressive PsA who were symptomatic despite the use of previous disease-modifying antirheumatic drugs or non-steroidal anti-inflammatory drugs. The 14-week data showed that, compared with placebo, golimumab 50 mg significantly improved joint disease response as measured by American College of Rheumatology (ACR) 20 [relative risk (RR) 5.73, 95% confidence interval (CI) 3.24 to 10.56] and Psoriatic Arthritis Response Criteria (PsARC) (RR 3.45, 95% CI 2.49 to 4.87), and skin disease response as measured by the Psoriasis Area and Severity Index (PASI) 75 (RR 15.95, 95% CI 4.62 to 59.11). The 24-week absolute data showed that these treatment benefits were maintained. There was a significant improvement in patients' functional status as measured by the Health Assessment Questionnaire (HAQ) change from baseline at 24 weeks (-0.33, p patient crossover at week 16. The manufacturer conducted a mixed treatment comparison (MTC) analysis. The ERG considered the assumption of exchangeability between the trials for the purpose of the MTC analysis to be acceptable, and the statistical approach in the MTC analysis to be reliable. Regarding the safety evaluation of golimumab, the manufacturer failed to provide longer-term data or to consider adverse event data of golimumab from controlled studies in other conditions, such as rheumatoid arthritis and ankylosing spondylitis. Although the adverse effect profile of golimumab appears similar to other anti-tumour necrosis factor (TNF) agents, the longer-term safety profile of golimumab remains uncertain. The manufacturer's submission presented a decision model to compare etanercept, infliximab, golimumab

  2. Periodontal and hematological characteristics associated with aggressive periodontitis, juvenile idiopathic arthritis, and rheumatoid arthritis

    DEFF Research Database (Denmark)

    Poulsen, Anne Havemose; Westergaard, Jytte; Stoltze, Kaj;

    2006-01-01

    Periodontitis shares several clinical and pathogenic characteristics with chronic arthritis, and there is some degree of coexistence. The aims of this study were to elucidate whether patients with localized aggressive periodontitis (LAgP), generalized aggressive periodontitis (GAgP), juvenile...... idiopathic arthritis (JIA), and rheumatoid arthritis (RA) share periodontal and hematological characteristics distinguishing them from individuals free of diseases....

  3. 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.

    2013-01-01

    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 Recogni

  4. Oil is found with ideas

    International Nuclear Information System (INIS)

    Next year the oil industry will celebrate the hundredth anniversary of its birth at Titusville, Pennsylvania. Some industries have had humble beginnings, but not the oil industry. Its birth was spectacular, and its growth since that time has been marked by intermittent, extravagant booms, or waves of gushers which have often resulted in an acute oversupply. These periods have usually been followed by periods of low discovery rate during which it looked as if we were going to run out of oil. In this paper a review of the history of petroleum technology shows that each of these bursts of increased production was caused by a new idea. We usually find oil in new places with old ideas. Sometimes, also, we find oil in an old place with a new idea, but we seldom find much oil in an old place with an old idea. Several times in the past we have thought we were running out of oil whereas actually we were only running out of ideas. This principle can be illustrated most vividly by reviewing the story of the principal discoveries in each producing area of the world

  5. Biological therapies for rheumatoid arthritis: progress to date.

    Science.gov (United States)

    Malviya, Gaurav; Salemi, Simonetta; Laganà, Bruno; Diamanti, Andrea Picchianti; D'Amelio, Raffaele; Signore, Alberto

    2013-08-01

    Biologic drugs for the management of rheumatoid arthritis (RA) have revolutionized the therapeutic armamentarium with the development of several novel monoclonal antibodies, which include murine, chimeric, humanized, fully human antibodies and fusion proteins. These biologics bind to their targets with high affinity and specificity. Since 1998, nine different biologics have been approved by the US Food and Drug Administration (FDA) and European Medicines Agency (EMA) for the treatment of RA, and several others are in different stages of clinical trials. This field is in continuous evolution and new biologics are tested every year. Therefore a precise analysis is required in order to have a detailed and updated state of the art of this field. In this review, our main aim is to analyse all available biological therapies that are FDA and EMA approved for the treatment of RA and also those that are in clinical trials for the management of RA patients. PMID:23558378

  6. Rehabilitation in patients with Rheumatoid Arthritis

    OpenAIRE

    Evaggelos Giavasopoulos; Paraskevi Gourni

    2008-01-01

    Rehabilitation of patients with rheumatoid arthritis aims to the management of the consequences of disease. It is widely accepted that, no drug therapy at present leads to long‐term orremission f everyone with rheumatoid arthritis (R.A.). Consequently, patients experience physical, psychological, functional, social and role negative effects of the disease. AIM : The am of the present article was to evaluate the role of rehabilitation to patients with rheumatoid arthritis sMethod and material:...

  7. Current Treatments for Juvenile Idiopathic Arthritis

    OpenAIRE

    AlbertoMartini

    2011-01-01

    Juvenile idiopathic arthritis (JIA) differs markedly from adult rheumatoid arthritis (RA). It is not a single disease, but an exclusion diagnosis that gather together all forms of arthritis that begin before the age of 16 years, persist for more than 6 weeks, and are of unknown origin. The advent of the new biological treatments has dramatically changed both the observed responses to treatment and the expectations of therapies. The implementation of an adequate legislation as well as the ...

  8. Can the weather influence arthritis symptoms?

    OpenAIRE

    Wai Chin Li; Ye Zhang

    2014-01-01

    By reviewing twelve previous studies on the relationship between the weather and arthritis symptoms, this article summarized the major findings on this controversial topic. It has been supported by most of the studies that arthritis symptoms are associated with weather conditions. Factors such as barometric pressure and temperature were generally believed to be related to arthritis symptoms. However, controversies arose at minor levels. Whether the weather-symptom relationship depends on the ...

  9. Ethanol prevents development of destructive arthritis

    OpenAIRE

    Jonsson, Ing-Marie; Verdrengh, Margareta; Brisslert, Mikael; Lindblad, Sofia; Bokarewa, Maria; Islander, Ulrika; Carlsten, Hans; Ohlsson, Claes; Nandakumar, Kutty Selva; Holmdahl, Rikard; Tarkowski, Andrej

    2006-01-01

    Environmental factors are thought to play a major role in the development of rheumatoid arthritis. Because the use of ethanol is widespread, we assessed the role of ethanol intake on the propensity to develop chronic arthritis. Collagen type II-immunized mice were given water or water containing 10% (vol/vol) ethanol or its metabolite acetaldehyde. Their development of arthritis was assessed, as well as the impact of ethanol on leukocyte migration and activation of intracellular transcription...

  10. 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....

  11. Which Psoriasis Patients Develop Psoriatic Arthritis?

    OpenAIRE

    Busse, Kristine; Liao, Wilson

    2010-01-01

    Psoriatic arthritis is a major comorbidity of psoriasis that significantly impairs quality of life and physical function. Because skin lesions classically precede joint symptoms, dermatologists are in a unique position to identify patients at risk for psoriatic arthritis before irreversible joint damage occurs. Here we review the literature to identify the clinical and genetic factors most highly associated with development of psoriatic arthritis, with the goal of assisting dermatologists in ...

  12. Immunohistochemical markers for arthritis in psoriasis.

    OpenAIRE

    Veale, D J; Barnes, L.; Rogers, S.; FitzGerald, O

    1994-01-01

    OBJECTIVES--To examine the immunohistological features in the involved skin of patients with psoriatic arthritis (PA) (n = 15), compared with those in involved skin from patients with psoriasis but no arthritis (n = 5), and with a group with normal skin (n = 4), to identify markers for arthritis in psoriasis. METHODS--Skin was obtained from patients by 6 mm punch biopsy and normal skin was provided by the department of plastic surgery. Samples were stained with monoclonal antibodies against T...

  13. Radiobiological ideas and radiotherapeutic practice

    International Nuclear Information System (INIS)

    A review lecture covering the following topics: oxygen effect; radiotherapy in hyperbaric oxygen; low dose rate photon irradiation; densely ionizing radiations; hyperthermia; hypoxic cell sensitizers; fractionated radiotherapy; and rationale and methodology of prospective concomitant controlled clinical trials. (author)

  14. From Ostracism to the Trial of Socrates---On the Historical Evolution of the Athenian Idea of Democracy%从陶片放逐法到苏格拉底的审判--雅典民主制理念的历史嬗变

    Institute of Scientific and Technical Information of China (English)

    姜维端

    2015-01-01

    雅典民主制中的放逐制度即陶片放逐法,通常被看作是平民与精英之间对立关系的表现;而苏格拉底的审判更是这种对立关系在事实上的体现。然而,从陶片放逐法的内容与影响来看却并非如此,它通过象征性的作用将上述张力具象化,以此作为对政治领袖与精英的内在约束,实现了内在张力的缓解与平衡。当这种内在约束失去效力时,不仅民主制的理念产生了嬗变,而且进一步使得张力恶化为对立,在历史上造成了苏格拉底之死的事实。反过来,陶片放逐法与苏格拉底的哲学活动实际上都是对民主制理念的维护而非破坏,平民与精英的差异理应得到尊重,这才是正义与善得以实现的基础。%The ostracism, which is ancient Athenian institution of exile, always seems to be the manifestation of the tense between the masses and the elites. And the trial of Socrates reflected this relationship in reality either. According to ostracism’s content and influence, we may get a different conclusion. That is to say, through its symbolic effect, ostracism became an internal restriction on political leaders and elites, and then to relieve and balance that tense. When this internal restriction was no longer in force, the idea of democracy was changed, leading to the death of Socrates. Conversely, ostracism and the philosophical activities of Socrates were all to maintain rather than harm democracy’s idea. Natural differences among different people should be fully acknowledged, which is the foundation of justice and goodness.

  15. Association of Self-Efficacy and Outcome Expectations with Physical Activity in Adults with Arthritis

    Directory of Open Access Journals (Sweden)

    Thelma J. Mielenz

    2013-01-01

    Full Text Available Background and Purpose. The purpose of this study is to determine whether higher baseline levels of (a self-efficacy for physical activity, (b self-efficacy for arthritis self-management, and (c outcome expectations for exercise are associated with higher physical activity levels following an exercise intervention for adults with arthritis. Methods. A secondary analysis of the intervention cohort (n=130 within a randomized controlled trial of the People with Arthritis Can Exercise program was performed. Multiple linear regression evaluated the relationship between physical activity at a time point three months after the completion of an exercise intervention and three main explanatory variables. Results. After controlling for baseline physical activity, neither self-efficacy for arthritis self-management nor outcome expectations for exercise related to three-month physical activity levels. There was a relationship between three-month physical activity and self-efficacy for physical activity. Conclusions. Future research is needed to evaluate the ability of self-efficacy-enhancing programs to increase physical activity in adults with arthritis.

  16. Systematic review and meta-analysis comparing land and aquatic exercise for people with hip or knee arthritis on function, mobility and other health outcomes

    OpenAIRE

    Heywood Sophie; Batterham Stephanie I; Keating Jennifer L

    2011-01-01

    Abstract Background Aquatic and land based exercise are frequently prescribed to maintain function for people with arthritis. The relative efficacy of these rehabilitation strategies for this population has not been established. This review investigated the effects of aquatic compared to land based exercise on function, mobility or participants' perception of programs for people with arthritis. Methods Medline, CINAHL, AMED and the Cochrane Central Register of Controlled Clinical Trials were ...

  17. 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.

  18. 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.

  19. Janus kinase inhibitors for rheumatoid arthritis.

    Science.gov (United States)

    Yamaoka, Kunihiro

    2016-06-01

    Treatment of autoimmune diseases, such as rheumatoid arthritis (RA), has advanced substantially over the past decade with the development of biologics targeting inflammatory cytokines. Recent progress in treating RA has been achieved with janus kinase (JAK) inhibitors (Jakinibs), an orally available disease-modifying anti-rheumatic drug targeting the intracellular kinase JAK and with similar efficacy to biologics. The first Jakinib approved for RA was tofacitinib, which exerted superiority to methotrexate and non-inferiority to tumor necrosis factor (TNF) inhibitors. In recent years, the Jakinib baricitinib has demonstrated superiority to both methotrexate and a TNF inhibitor, adalimumab. Given these promising findings, Jakinibs are expected to represent the next generation compounds for treating RA, and a number of Jakinibs are currently in clinical trials. Jakinibs can differ substantially in their selectivity against JAKs; tofacitinib and baricitinib target multiple JAKs, whereas the most recently developed Jakinibs target only a single JAK. The influence of Jakinib selectivity on efficacy and side effects is of great interest, requiring further careful observation. PMID:26994322

  20. Sarilumab for the treatment of rheumatoid arthritis.

    Science.gov (United States)

    Cooper, Simon

    2016-03-01

    Simon Cooper is interviewed by Ellen Clarke, Commissioning Editor Simon Cooper has >18 years of global experience in the pharmaceutical industry. He joined Sanofi in July 2014 as the Vice President, Global Project Head. In his current position at Sanofi, Dr Cooper is responsible for the clinical development of sarilumab and the worldwide submission in rheumatoid arthritis. He joined Sanofi after serving as the Global Program Medical Director at Novartis since 2012. In this role, Dr Cooper acted as the clinical lead for secukinumab psoriasis submission. Prior to Novartis, Dr Cooper held various posts at Human Genome Sciences, USA, including Executive Director of Clinical Research, Senior Director of Clinical Research and Director of Clinical Research. During his tenure at Human Genome Sciences, USA, Dr Cooper was involved in the submission of belimumab leading to its approval for SLE, and was responsible for its subsequent clinical development program. Dr Cooper has also previously held positions at MedImmune Ltd, UK, Roche, Napp Pharmaceutical Research Ltd, Wyeth Research and Medeval Ltd. In these roles, his responsibilities ranged from medical oversight of clinical trials to medical support for commercial, medical affairs and business development. He received a Bachelor of Medicine and Bachelor of Surgery from University of Newcastle upon Tyne Medical School. PMID:26860742

  1. Dietary intervention in rheumatoid arthritis

    OpenAIRE

    Jamison, Jennifer R.

    1987-01-01

    Rheumatoid arthritis is a disabling disease prevalent in modern society. Dietary prevention may be possible in a subgroup of individuals who appear to suffer food intolerance; dietary intervention, as an adjunct to other management strategies, may be useful in modifying the inflammatory response. The former suggestion is supported by anecdotal evidence; the latter by some in vitro experimentation which implicates arachidonic acid metabolism in the pathogenesis of rheumatoid tissue inflammatio...

  2. Pyogenic infection and rheumatoid arthritis.

    OpenAIRE

    Rowe, I F; Deans, A. C.; Keat, A C

    1987-01-01

    Ten episodes of severe pyogenic infection occurring in nine patients with rheumatoid arthritis are reported. There was a wide range of presenting features including pyoarthrosis in 7 episodes. Three cases presented with meningitis, bacterial endocarditis and probable multiple abscesses respectively. Infection was caused by Staphylococcus aureus in 7 episodes and by Staphylococcus epidermidis, Streptococcus pneumoniae and beta-haemolytic Streptococcus in each of one episode. Three infective ep...

  3. Glory as an ethical idea

    OpenAIRE

    Chappell, Timothy

    2011-01-01

    There is a gap between what we think and what we think we think about ethics. This gap appears when elements of our ethical reflection and our moral theories contradict each other. It also appears when something that is important in our ethical reflection is sidelined in our moral theories. The gap appears in both ways with the ethical idea glory. The present exploration of this idea is a case study of how far actual ethical reflection diverges from moral theory. This divergence tells against...

  4. 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

  5. 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

  6. Ottawa Panel Evidence-Based Clinical Practice Guidelines for Patient Education in the Management of Rheumatoid Arthritis (RA)

    Science.gov (United States)

    Brosseau, Lucie; Wells, George A.; Tugwell, Peter; Egan, Mary; Dubouloz, Claire-Jehanne; Welch, Vivian A.; Trafford, Laura; Sredic, Danjiel; Pohran, Kathryn; Smoljanic, Jovana; Vukosavljevic, Ivan; De Angelis, Gino; Loew, Laurianne; McEwan, Jessica; Bell, Mary; Finestone, Hillel M.; Lineker, Sydney; King, Judy; Jelly, Wilma; Casimiro, Lynn; Haines-Wangda, Angela; Russell-Doreleyers, Marion; Laferriere, Lucie; Lambert, Kim

    2012-01-01

    Background and purpose: The objective of this article is to create guidelines for education interventions in the management of patients ([greater than] 18 years old) with rheumatoid arthritis (RA). Methods: The Ottawa Methods Group identified and synthesized evidence from comparative controlled trials using Cochrane Collaboration methods. The…

  7. Getting started with Intellij IDEA

    CERN Document Server

    Assumpção, Hudson Orsine

    2013-01-01

    A practical, fast-paced guide with clear, step-by-step exercisesto help you understand the basics of IntelliJ Idea and develop a web application.This book will be ideal if you are a Java developer who has a little knowledge about IntelliJ and wants to get more information on using it to improve your development performance

  8. Exploring Classroom Hydroponics. Growing Ideas.

    Science.gov (United States)

    National Gardening Association, Burlington, VT.

    Growing Ideas, the National Gardening Association's series for elementary, middle, and junior high school educators, helps teachers engage students in using plants and gardens as contexts for developing a deeper, richer understanding of the world around them. This volume's focus is on hydroponics. It presents basic hydroponics information along…

  9. Transforming Ideas: The Design Process

    Science.gov (United States)

    Nicol, Candace

    2004-01-01

    In this article, the author discusses how to teach students to think creatively. In the author's search for a way to teach students that there are multiple approaches to visual problems, she found inspiration from advertising. The author asserts students first need permission to explore their latent ideas, and second, they need the tools to…

  10. Religious ideas and psychiatric disorders.

    Science.gov (United States)

    Beit-Hallahmi, B; Argyle, M

    1977-01-01

    The evidence presented above points to the need for considering factors other than purely religious ones in determining the role of religious ideas in psychiatric disorders. The occurrence of religious ideas as part of the content of individual delusional systems in psychiatric patients can be explained on the basis of exposure to religious ideas through the social environment. It may be also related to the prominence of religion, vis-a-vis other belief systems, in the social envirnment. When considering psychopathological explanations for intense religious experiences, one has to be conscious again of the social factors involved. When an unusual experience having religious content becomes normative in a certain group (for whatever reasons), trying to explain its appearance on the basis of individual psychodynamics or psychopathology becomes very difficult. There seems to be an inverse relationship between the social nature of a religious experience and its psychopathological nature, i.e., there is more psychopathology in individuals reporting solitary religious experiences, or individual religious ideas. Thus the solitary experience seems to be more influenced by disturbed individual dynamics, but in other cases social factors seem to be crucial. Our overall conclusion is that a psychiatric analysis of the role of religious factors in psychopathology has to be first a social-psychiatric analysis. An individual presenting psychiatric symptoms and religious ideas has to be evaluated in light of his social background, since the specific content of psychiatric symptoms seems to be determined by social background factors. Individual psychodynamics determine the appearance of symptoms, but their particular form will be the result of these background factors, one of which is religion. PMID:863602

  11. Socioeconomic status and risk of rheumatoid arthritis

    DEFF Research Database (Denmark)

    Pedersen, Line Merete Blak; Jacobsen, Søren; Klarlund, Mette;

    2006-01-01

    To examine whether markers of socioeconomic status (SES) are associated with risk of rheumatoid arthritis (RA), and if so, whether selected lifestyle-related factors could explain this association.......To examine whether markers of socioeconomic status (SES) are associated with risk of rheumatoid arthritis (RA), and if so, whether selected lifestyle-related factors could explain this association....

  12. Positive psychological qualities and adjustment to arthritis

    OpenAIRE

    Sirois, F.M.

    2014-01-01

    Bisopsychosocial approaches to arthritis emphasize the importance of psychological and individual difference factors as predisposing, precipitating or perpetuating factor in arthritis through their interface with pain-related, inflammatory, and immunological responses. Rather than just focusing on understanding how loss is experienced, positive psychological approaches emphasize the importance of promoting and understanding how adjustment is experienced. In this narrative review, four positiv...

  13. Immune modulation by vaccination in chronic arthritis

    NARCIS (Netherlands)

    Zonneveld - Huijssoon, E.

    2012-01-01

    Vaccination in autoimmunity can have beneficial, but also detrimental effects. In this thesis, we tried to identify factors that contribute to a favourable or an unfavourable outcome of vaccination in Juvenile Idiopathic Arthritis (JIA) and experimental arthritis. In the first part, we focused on th

  14. 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.

  15. Photoacoustic tomography to identify inflammatory arthritis

    Science.gov (United States)

    Rajian, Justin Rajesh; Girish, Gandikota; Wang, Xueding

    2012-09-01

    Identifying neovascularity (angiogenesis) as an early feature of inflammatory arthritis can help in early accurate diagnosis and treatment monitoring of this disease. Photoacoustic tomography (PAT) is a hybrid imaging modality which relies on intrinsic differences in the optical absorption among the tissues being imaged. Since blood has highly absorbing chromophores including both oxygenated and deoxygenated hemoglobin, PAT holds potential in identifying early angiogenesis associated with inflammatory joint diseases. PAT is used to identify changes in the development of inflammatory arthritis in a rat model. Imaging at two different wavelengths, 1064 nm and 532 nm, on rats revealed that there is a significant signal enhancement in the ankle joints of the arthritis affected rats when compared to the normal control group. Histology images obtained from both the normal and the arthritis affected rats correlated well with the PAT findings. Results support the fact that the emerging PAT could become a new tool for clinical management of inflammatory arthritis.

  16. Strength Training for Arthritis Trial (START): design and rationale

    OpenAIRE

    Messier, Stephen P.; Mihalko, Shannon L.; Beavers, Daniel P.; Nicklas, Barbara J.; DeVita, Paul; Carr, J. Jeffery; Hunter, David J.; Williamson, Jeff D.; Kim L Bennell; Guermazi, Ali; Lyles, Mary; Richard F Loeser

    2013-01-01

    Background Muscle loss and fat gain contribute to the disability, pain, and morbidity associated with knee osteoarthritis (OA), and thigh muscle weakness is an independent and modifiable risk factor for it. However, while all published treatment guidelines recommend muscle strengthening exercise to combat loss of muscle mass and strength in knee OA patients, previous strength training studies either used intensities or loads below recommended levels for healthy adults or were generally short,...

  17. Pain mechanisms and ultrasonic inflammatory activity as prognostic factors in patients with psoriatic arthritis

    DEFF Research Database (Denmark)

    Højgaard, Pil; Christensen, Robin; Dreyer, Lene;

    2016-01-01

    INTRODUCTION: Persistent pain is a major concern for patients with psoriatic arthritis (PsA). Pain may be due to inflammatory activity or augmented central pain processing. Unawareness of the origin and mechanisms of pain can lead to misinterpretation of disease activity (by composite scores) and...... NCT02572700). Results will be disseminated through publication in international peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT02572700, Pre-results....

  18. A New Approach to Rheumatoid Arthritis: Treating Inflammation with Computerized Nerve Stimulation

    OpenAIRE

    Andersson, Ulf; Kevin J Tracey

    2012-01-01

    Editor’s note: Doctors currently treat rheumatoid arthritis, a crippling autoimmune disease, with an arsenal of drugs that, while often effective, can have serious side effects. Authors Ulf Andersson and Kevin J. Tracey describe a circuit between the immune system and the nervous system that enabled development of an implanted nerve stimulator to treat the disorder, now being tested by a patient in Bosnia. If further clinical trials show as much promise as this initial case, similar devices m...

  19. Students' Ideas and Radical Constructivism

    Science.gov (United States)

    Sánchez Gómez, Pedro J.

    2016-08-01

    In this article, I study, from the point of view of the analytic philosophy of mind, the compatibility of students' ideas studies (SIS) with radical constructivism (RC). I demonstrate that RC is based on a psychology of narrow mental states; that is, the idea that the mental content of an individual can be fully characterised without any reference external to her or him. I show that this fact imposes some severe restrictions to SIS to be incorporated into RC. In particular, I argue that only qualitative studies can comply with the requirement of narrowness. Nevertheless, I propose that quantitative works can be employed as sources of types in order to study token actual students. I use this type-token dichotomy to put forward an outline of a theory of the relation between school contents and mental contents. In this view, token mental contents regarding a given topic can be defined, and probed, only by resorting to typical school contents.

  20. Students' Ideas and Radical Constructivism

    Science.gov (United States)

    Sánchez Gómez, Pedro J.

    2016-04-01

    In this article, I study, from the point of view of the analytic philosophy of mind, the compatibility of students' ideas studies (SIS) with radical constructivism (RC). I demonstrate that RC is based on a psychology of narrow mental states; that is, the idea that the mental content of an individual can be fully characterised without any reference external to her or him. I show that this fact imposes some severe restrictions to SIS to be incorporated into RC. In particular, I argue that only qualitative studies can comply with the requirement of narrowness. Nevertheless, I propose that quantitative works can be employed as sources of types in order to study token actual students. I use this type-token dichotomy to put forward an outline of a theory of the relation between school contents and mental contents. In this view, token mental contents regarding a given topic can be defined, and probed, only by resorting to typical school contents.

  1. Two recurrences of an idea

    OpenAIRE

    Škof, Lenart

    2013-01-01

    In this paper we discuss two different criticisms of liberal democracy. By analyzing the contemporary Slovenian (radical) political thought of Žižek and some of his followers, which recently are revitalizing the idea of Communism, we first critically reflect upon the emancipatory potential of this strand of contemporary Slovenian philosophy. The interlude focuses on the uses and logic of violence and pleads for a new politico-ethical culture of nonviolence. In the second part of the paper, by...

  2. The Elizabethan Idea of Empire

    OpenAIRE

    Armitage, David

    2004-01-01

    This paper argues that the English idea of empire in the reign of Elizabeth I was derivative, belated and incoherent. Its sources were classical and continental rather than indigenous. It arose more than a century after the Scottish monarchy had elaborated its own conception of empire. Moreover, it expressed a sense of backwardness, isolation and anxiety that mirrored the English failure to establish any permanent settlements in the Atlantic world. As a result, any balance sheet of empire dra...

  3. Exclusion Spirometry: A Good Idea

    OpenAIRE

    Nick R. Anthonise

    2004-01-01

    In this issue of the Canadian Respiratory Journal, Almirall and Bégin (pages 195 to 196) make a suggestion aimed at increasing the use of spirometry by primary care physicians, as well as family and general practitioners. The idea is that spirometry should be performed not necessarily to make specific diagnoses, but to rule in or out the possibility of a number of lung diseases, most notably, chronic obstructive pulmonary disease (COPD). If the patient demonstrates normal forced vital capacit...

  4. Food-induced (allergic) arthritis. Inflammatory arthritis exacerbated by milk.

    Science.gov (United States)

    Panush, R S; Stroud, R M; Webster, E M

    1986-02-01

    Suggestive, but largely unproven, observations have associated arthritis with environmental antigens, including foods. We studied a patient with inflammatory arthritis in a prospective, "blinded," controlled fashion to determine whether her symptoms were associated with food sensitivities. This 52-year-old white woman with 11 years of class I, stage I, active disease, had symptomatic exacerbations allegedly associated with meat, milk, and beans. We observed an increase in symptoms following an unblinded food challenge and then studied her in our clinical research unit. On her normal diet for 6 days, she averaged 30 minutes of morning stiffness, 9 tender joints, 3 swollen joints, 87% subjective assessment (100% = best possible), and 89% examiner assessment. While she was fasting (3 days) or taking Vivonex (2 days), we noted no morning stiffness, tender joint score of 1, swollen joint score of 0, and assessments of 100% (P less than 0.05 versus normal diet). She was then nourished with Vivonex for 33 days without difficulty and challenged in a blinded fashion at mealtimes with lyophilized foods placed into opaque capsules. Four milk challenges (equivalent to greater than or equal to 8 ounces per meal) produced up to 30 minutes of morning stiffness, 14 tender joints, 4 swollen joints, subjective assessment of 85%, and objective assessment of 80% (P less than 0.05 versus fasting-Vivonex), peaking 24-48 hours postchallenge. Placebo and other foods (lettuce and carrots) were without effect.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3513771

  5. Two forms of reactive arthritis?

    OpenAIRE

    Toivanen, P; Toivanen, A

    1999-01-01

    Inflammatory arthritides developing after a distant infection have so far been called reactive or postinfectious, quite often depending on the microbial trigger and/or HLA-B27 status of the patient. For clarity, it is proposed that they all should be called reactive arthritis, which, according to the trigger, occurs as an HLA-B27 associated or non-associated form. In addition to the causative agents and HLA-B27, these two categories are also distinguished by other characteristics. Most import...

  6. Natural history of rheumatoid arthritis

    International Nuclear Information System (INIS)

    In quantitative studies the authors found significant correlations between radiographic scores and physical and functional status in patients with rheumatoid arthritis (RA). The authors review data as it applies to the natural history of RA, with attention to the pathophysiology of specific radiographic features. Cross-sectional analysis in 200 patients demonstrated significant correlations between radiographic scores and duration of disease; longitudinal studies of serial films in 52 patients revealed progression of disease in 92%. The findings of substantial radiographic abnormality and rapid progression early in the disease may provide a rationale for early aggressive therapy of RA

  7. Shoulder arthography in rheumatoid arthritis

    International Nuclear Information System (INIS)

    Shoulder arthrography in a patient with rheumatoid arthritis is performed to differentiate between a rheumatoid flare and limitation of motion secondary to tear in the rotator cuff. Accurate diagnosis is important because of the therapeutic implications. The arthrographic findings characteristic of rheumatoid involvement of the shoulder joint are nodular filling defects of the joint, the subacromial and subdeltoideal bursa in case of rotator cuff tear, irregular capsular attachment, contracted joint space and visualized lymphatic drainage. A dilatation of the biceps tendon sheath has not been shown. (orig.)

  8. Identifying flares in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Bykerk, Vivian P; Bingham, Clifton O; Choy, Ernest H;

    2016-01-01

    ). RESULTS: The 849 patients were 75% female, 81% white, 42% were in remission/low disease activity (R/LDA), and 16-32% were flaring at the second visit. Agreement of flare status was low-strong (κ's 0.17-0.88) and inversely related to RA disease activity level. Flare domains correlated highly (r's≥0...... prior 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...

  9. Bone edema on magnetic resonance imaging is an independent predictor of rheumatoid arthritis development in patients with early undifferentiated arthritis

    DEFF Research Database (Denmark)

    Duer-Jensen, Anne; Hørslev-Petersen, Kim; Hetland, Merete Lund;

    2011-01-01

    To study magnetic resonance imaging (MRI) as a tool for early diagnosis of rheumatoid arthritis (RA) in patients with early undifferentiated arthritis (UA).......To study magnetic resonance imaging (MRI) as a tool for early diagnosis of rheumatoid arthritis (RA) in patients with early undifferentiated arthritis (UA)....

  10. IDEA Clean Energy Application Center

    Energy Technology Data Exchange (ETDEWEB)

    Thornton, Robert

    2013-09-30

    The DOE Clean Energy Application Centers were launched with a goal of focusing on important aspects of our nation’s energy supply including Efficiency, Reliability and Resiliency. Clean Energy solutions based on Combined Heat & Power (CHP), District Energy and Waste Heat Recovery are at the core of ensuring a reliable and efficient energy infrastructure for campuses, communities, and industry and public enterprises across the country. IDEA members which include colleges and universities, hospitals, airports, downtown utilities as well as manufacturers, suppliers and service providers have long-standing expertise in the planning, design, construction and operations of Clean Energy systems. They represent an established base of successful projects and systems at scale and serve important and critical energy loads. They also offer experience, lessons learned and best practices which are of immense value to the sustained growth of the Clean Energy sector. IDEA has been able to leverage the funds from the project award to raise the visibility, improve the understanding and increase deployment CHP, District Energy and Waste Heat Recovery solutions across the regions of our nation, in collaboration with the regional CEAC’s. On August 30, 2012, President Obama signed an Executive Order to accelerate investments in industrial energy efficiency (EE), including CHP and set a national goal of 40 GW of new CHP installation over the next decade IDEA is pleased to have been able to support this Executive Order in a variety of ways including raising awareness of the goal through educational workshops and Conferences and recognizing the installation of large scale CHP and district energy systems A supporting key area of collaboration has involved IDEA providing technical assistance on District Energy/CHP project screenings and feasibility to the CEAC’s for multi building, multi-use projects. The award was instrumental in the development of a first-order screening

  11. Suppression of Experimental Arthritis and Associated Bone Loss by a Tissue-Selective Estrogen Complex.

    Science.gov (United States)

    Andersson, Annica; Bernardi, Angelina I; Nurkkala-Karlsson, Merja; Stubelius, Alexandra; Grahnemo, Louise; Ohlsson, Claes; Carlsten, Hans; Islander, Ulrika

    2016-03-01

    In addition to the systemic inflammation present in rheumatoid arthritis (RA), decreased estradiol levels in postmenopausal RA patients further accelerate bone loss in these patients. The tissue-selective estrogen complex (TSEC), an estrogen combined with a selective estrogen receptor modulator, is a new hormone replacement therapy option. The first approved TSEC, containing conjugated estrogens and bazedoxifene (BZA), reduces menopausal symptoms and prevents osteoporosis with an improved safety profile compared with conventional hormone replacement therapy. Previous studies have shown that estrogens strongly inhibit experimental arthritis whereas BZA is mildly suppressive. In this study the antiarthritic potential of combined BZA and estradiol is explored for the first time. Female ovariectomized DBA/1 mice were subjected to collagen-induced arthritis, an experimental postmenopausal RA model, and treated with BZA, 17β-estradiol (E2), combined BZA and E2 (BZA/E2), or vehicle. BZA/E2 suppressed arthritis severity and frequency, synovitis, and joint destruction, equally efficient as E2 alone. Unwanted estrogenic proliferative effects on the endometrium were blocked by the addition of BZA, determined by collecting uterine weights. Bone mineral density was measured by peripheral quantitative computed tomography, and all treatments protected collagen-induced arthritis mice from both trabecular and cortical bone loss. Moreover, BZA/E2, but not E2 alone, inhibited preosteoclast formation and reduced serum anticollagen type II antibodies. In conclusion, a TSEC, herein combined BZA/E2, suppresses experimental arthritis and prevents associated bone loss as efficiently as E2 alone but with minimal uterine effects, highlighting the need for clinical trials that evaluate the addition of a TSEC to conventional postmenopausal RA treatment. PMID:26745543

  12. Diagnosing Psoriatic Arthritis from the Dermatologist’s View

    OpenAIRE

    Cho, Hyun-Ho; Kim, Byung-Soo

    2013-01-01

    Psoriatic arthritis is a chronic inflammatory arthropathy associated with skin psoriasis. It is considered a unique arthropathy with distinct clinical and radiologic features. Up to 40% of patients with psoriasis may develop psoriatic arthritis. Psoriasis usually precedes psoriatic arthritis, so dermatologists are in a critical position for screening patients of psoriatic arthritis early in the disease course. Psoriatic arthritis may be challenging to diagnose, especially for dermatologists, ...

  13. Classical and new ideas of a university

    DEFF Research Database (Denmark)

    Kristensen, Jens Erik

    The chapter examines what has happened to ideas of the university in the light of current reforms and the implementation of performance management. Taking a retrospective view of the most central ideas of a university, focus will be on why even a modernized and corporatized university apparently...... cannot survive without reference to ideas and idealistic justifications, including a number of classical ideas, as well as on which new ideas may be delineated on the basis of the old....

  14. Challenges in the management of juvenile idiopathic arthritis with etanercept

    Directory of Open Access Journals (Sweden)

    Clare E Pain

    2009-03-01

    Full Text Available Clare E Pain, Liza J McCannAlder Hey Children’s NHS Foundation Trust, Eaton Road, Liverpool, UKAbstract: Biologic agents have been designed with the help of immunological studies to target particular areas of the immune system which are thought to play a role in the pathogenesis of disease. Etanercept is a soluble anti-tumor necrosis factor alpha (TNF-α agent licensed for the treatment of active poly-articular juvenile idiopathic arthritis (JIA in children aged 4 to 17 years who have failed to respond to methotrexate alone, or who have been intolerant of methotrexate. The safety and efficacy of etanercept in this patient group has been established by one randomized controlled trial and several longitudinal studies. This, together with the fact that until recently etanercept was the only anti-TNF licensed in JIA, has made it the most common first choice biologic for many clinicians. However, there are still many unanswered questions about etanercept, including its efficacy and safety in different subtypes of JIA, in children under 4 years of age and in those with uveitis. There are still concerns about the long term safety of TNF antagonists in the pediatric age group and unanswered questions about increased risks of malignancy and infection. Although adult studies are useful to improve understanding of these risks, they are not a substitute for good quality pediatric research and follow-up studies. Adult trials often include greater numbers of patients. However, they evaluate a different population and drug behavior may vary in children due to differences in metabolism, growth and impact on a developing immune system. In addition, rheumatoid arthritis is a different disease than JIA. Clinicians need to carefully weigh up the risk benefit ratio of anti-TNF use in children with JIA and push for robust clinical trials to address the questions that remain unanswered. This article summarizes the evidence available for use of etanercept in children

  15. Combination Therapy With and Without Tumor Necrosis Factor Inhibitors in Rheumatoid Arthritis

    DEFF Research Database (Denmark)

    Graudal, Niels; Hubeck-Graudal, Thorbjørn; Faurschou, Mikkel;

    2015-01-01

    OBJECTIVE: The costs of biologic treatment per patient with rheumatoid arthritis (RA) are approximately 100 times the costs of treatment with a combination of conventional disease-modifying antirheumatic drugs (DMARDs). Despite this, biologic agents have not been proven superior. We compared the...... effects of combination DMARD therapies with and without biologic agents as therapy for patients with RA. METHODS: Eight randomized controlled trials published in 10 articles were selected from a systematic literature search of 1,674 identified studies and integrated in a meta-analysis. These trials...

  16. [Imaging modalities in psoriatic arthritis].

    Science.gov (United States)

    Hermann, K-G A; Ohrndorf, S; Werner, S G; Finzel, S; Backhaus, M

    2013-10-01

    This review presents an overview of the range of imaging modalities used in the diagnostic evaluation of patients with psoriatic arthritis (PsA). Conventional radiography is used to detect structural changes of the joints and tendon attachments. These changes occur late in the course of PsA hence conventional radiography contributes little to the early detection of PsA; however, the detection of periosteal proliferations on radiographs allows a relatively specific diagnosis of PsA. Skeletal scintigraphy and computed tomography are rarely used in PsA. Arthrosonography (ultrasound of the joints) is gaining increasing importance in the early identification of inflammatory soft tissue signs of PsA in the peripheral joints. Sonography enables early detection of synovitis and tenosynovitis as well as superficial erosions and also inflammatory processes of the tendon attachments. Magnetic resonance imaging (MRI) is indispensable for identifying possible involvement of the axial skeleton. Moreover, it allows good visualization of periostitis and arthritis. High resolution microcomputed tomography is an interesting novel diagnostic tool which allows highly sensitive evaluation of the bone structure and can detect very tiny bone lesions where typical signs of PsA are omega-shaped erosions and small corona-like spikes. Another interesting new diagnostic technique is fluorescence optical imaging (FOI) with the Xiralite system which is highly sensitive for detecting inflammatory processes of the hands. PMID:24085530

  17. Rheumatoid arthritis and bacterial infections

    Directory of Open Access Journals (Sweden)

    N L Prokopjeva

    2008-01-01

    Full Text Available To study features of bacterial infections course in pts with rheumatoid arthritis (RA and changes of laboratory measures after focus of infection sanation. Material and methods. 46 pts with definite rheumatoid arthritis were examined at the time of comorbid infection (Cl detection and after infection focus sanation. Bacteriological test with evaluation of flora sensitivity to antibiotics by disco-diffusion method was performed at baseline and after the course of antibacterial therapy to assess its efficacy. Hemogram, serum fibrinogen, rheumatoid factor, circulating immune complexes (CIC, C-reactive protein levels were assessed. Serum interleukin (IL 1(3, IL6 and neopterin concentrations were examined by immune-enzyme assay in a part of pts. Typical clinical features of Cl were present in only 28 (60,9% pts. 13 (28,3% pts had fever, 12 (26,0% — leukocytosis, 15 (32,6% — changes of leucocyte populations. Some laboratory measures (thrombocytes, fibrinogen, CIC, neopterin levels significantly decreased (p<0,05 after infection focus sanation without correction of disease modifying therapy. Cl quite often develop as asymptomatic processes most often in pts with high activity and can induce disturbances promoting appearance of endothelial dysfunction, atherothrombosis and reduction of life duration. So timely detection and proper sanation of infection focuses should be performed in pts with RA

  18. Radiographic manifestations of arthritis in AIDS patients

    International Nuclear Information System (INIS)

    The purpose of this study is to familiarize the radiologist with a newly discovered association between arthritis and acquired immunodeficiency syndrome (AIDS). The authors retrospectively reviewed the clinical and radiographic findings in 31 patients with human immunodeficiency virus (HIV) infection referred to their rheumatology clinic with musculoskeletal complaints. The patients carried a wide range of clinical diagnosis including Reiter syndrome, psoriatic arthritis, undifferentiated seronegative arthritis, isolated enthesopathies, rheumatoid arthritis and osteonecrosis. Radiographs were available in 24 of the 31 patients, and in 20 they showed radiographic features of arthritis, which included soft-tissue swelling periarticular osteoporosis, synovial effusions, sacroiliitis, periosteal reaction, joint space narrowing, marginal erosions, and osteonecrosis. Although the radiographic abnormalities were frequently mild, they were significant, given the short duration of disease in many of their patients (weeks to months) at the time radiographs were obtained. The range of radiographic findings in their series was varied and paralleled the wide range of clinical diagnoses. No findings were pathognomonic for HIV-associated arthritis. Nevertheless, HIV infection needs to be considered in any patient belonging to a recognized risk group who presents with musculoskeletal disease. This is particularly important since immunosupressive drugs used for the treatment of arthritis can be detrimental to patients with HIV infection

  19. Inhibition of inflammatory arthritis using fullerene nanomaterials.

    Directory of Open Access Journals (Sweden)

    Anthony L Dellinger

    Full Text Available Inflammatory arthritis (e.g. rheumatoid arthritis; RA is a complex disease driven by the interplay of multiple cellular lineages. Fullerene derivatives have previously been shown to have anti-inflammatory capabilities mediated, in part, by their ability to prevent inflammatory mediator release by mast cells (MC. Recognizing that MC can serve as a cellular link between autoantibodies, soluble mediators, and other effector populations in inflammatory arthritis, it was hypothesized that fullerene derivatives might be used to target this inflammatory disease. A panel of fullerene derivatives was tested for their ability to affect the function of human skin-derived MC as well as other lineages implicated in arthritis, synovial fibroblasts and osteoclasts. It is shown that certain fullerene derivatives blocked FcγR- and TNF-α-induced mediator release from MC; TNF-α-induced mediator release from RA synovial fibroblasts; and maturation of human osteoclasts. MC inhibition by fullerene derivatives was mediated through the reduction of mitochondrial membrane potential and FcγR-mediated increases in cellular reactive oxygen species and NF-κB activation. Based on these in vitro data, two fullerene derivatives (ALM and TGA were selected for in vivo studies using K/BxN serum transfer arthritis in C57BL/6 mice and collagen-induced arthritis (CIA in DBA/1 mice. Dye-conjugated fullerenes confirmed localization to affected joints in arthritic animals but not in healthy controls. In the K/BxN moldel, fullerenes attenuated arthritis, an effect accompanied by reduced histologic inflammation, cartilage/bone erosion, and serum levels of TNF-α. Fullerenes remained capable of attenuating K/BxN arthritis in mast cell-deficient mice Cre-Master mice, suggesting that lineages beyond the MC represent relevant targets in this system. These studies suggest that fullerene derivatives may hold promise both as an assessment tool and as anti-inflammatory therapy of arthritis.

  20. Glucocorticoids and chronotherapy in rheumatoid arthritis.

    Science.gov (United States)

    Cutolo, Maurizio

    2016-01-01

    It is evident that the morning symptoms of rheumatoid arthritis (RA) are linked to the circadian abnormal increase in night inflammation, favoured by inadequate cortisol secretion under conditions of active disease. Therefore, exogenous glucocorticoid treatment is recommended in RA at low doses since it may partially act like a 'replacement therapy'. The prevention/treatment of the night upregulation of the immune/inflammatory reaction (and related flare of cytokine synthesis) has been shown to be more effective when exogenous glucocorticoid administration is obtained with a night-time-release formulation. Large-scale trials documented that modified-release prednisone has greater efficacy then morning prednisone for long-term low-dose glucocorticoid treatment in patients with RA, showing at least a more significant reduction in morning joint stiffness. Interestingly, despite a considerably higher cost than conventional prednisone, chronotherapy with night-time-release prednisone was recognised as a cost-effective option for patients with RA not on glucocorticoids who are eligible for therapy with biological disease-modifying antirheumatic drugs (DMARDs). Moreover, since different cell populations involved in the inflammatory process are particularly activated during the night, other therapeutical approaches used in RA, for example, conventional DMARDs and non-steroidal anti-inflammatory drugs (NSAIDs), should follow the same concepts of glucocorticoid chronotherapy. Indeed, bedtime methotrexate chronotherapy was found to improve RA symptoms compared to the current standard dosing methods, and several available NSAIDs (ie, indomethacin, aceclofenac, ketoprofen, flurbiporfen, lornoxicam) have been very recently modified in their formulation, in order to obtain chronotherapeutical effects in RA. PMID:27042335

  1. Rehabilitation Idea Begins at Sumers

    OpenAIRE

    Sumerians, The idea of rehabilitation began with th

    2013-01-01

    of the long-lasting fight by PWD and their families and friends in the West (3), in this letter, we wanted to visualize that the human mind in Mesopotamia (3–4000 BC) has been simply enough to recognize real goodness (in Turkish, “erdem”) (5). Since Sumer was the first civilization to use a writing system and initiated many other contemporary social institutions, Kramer pronounced that history begins with the Sumerians (7). This legend shows that the contemporary rehabilitation idea a...

  2. Ayurveda-modern medicine interface: A critical appraisal of studies of Ayurvedic medicines to treat osteoarthritis and rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Arvind Chopra

    2010-01-01

    Full Text Available The potential of Ayurvedic philosophy and medicines needs to be recognized and converted into real life treatment paradigm. This article describes a comprehensive therapeutic approach used in Ayurveda and modern medicine to treat arthritis. We present concise summary of various controlled drug trials carried out by us to validate standardized Ayurvedic drugs using modern medicine protocol to treat Rheumatoid Arthritis and Osteoarthritis knees. Several of the latter are published. The trials consistently demonstrate excellent safety of Ayurvedic medicines but often fail to unequivocally show superior efficacy. Some key findings of a recently unpublished trial in OA knees are also presented to show equivalence between Ayurvedic medicine and celecoxib and glucosamine, and we speculate that equivalence trials may be a way forward. The data from the trials also supports the Ayurvedic ′Rasayana′ concept of immune-modulation and healing. We need to interpret logic of Ayurveda when, adopting modern science tools in drug development and validation and much research is required. Validation of Ayurvedic medicines using the latter approach may lead to an evidence based Ayurveda - Modern Medicine interface. Also, in pursuit of finding better treatment solutions, we ought to step beyond the realm of only drugs and attempt validation of comprehensive specific treatment package as per classical Ayurveda. Finally, validation of a combined (Ayurveda and modern medicine therapeutic approach with superior efficacy and safety is likely to be a major leap in overcoming some of the current frustrations to treat difficult disorders like arthritis using only modern medicines.

  3. Synergy between adjuvant arthritis and collagen-induced arthritis in rats

    OpenAIRE

    1985-01-01

    Adjuvant arthritis (AA) in rats is susceptible to cell-mediated passive transfer. Collagen-induced arthritis (CIA) in rats is susceptible to passive transfer with antibody to type II collagen. We report here the development of strikingly severe arthritis in Lewis rats as the result of synergy between passively transferred antibody to type II collagen from rats with CIA and concanavalin A (Con A)-stimulated lymph node or spleen cells from syngeneic rats with AA. Similar synergy was seen in rat...

  4. Screening for uveitis in juvenile chronic arthritis.

    OpenAIRE

    Kanski, J. J.

    1989-01-01

    Three hundred and fifteen patients with anterior uveitis associated with juvenile chronic arthritis (JCA) were studied in order to identify the various risk factors for uveitis. Girls were more susceptible to uveitis than boys by a ratio of 3:1. In 94% of cases the uveitis was diagnosed after the development of arthritis. The risk of uveitis was small after seven or more years had elapsed from the onset of arthritis. Patients with pauciarticular onset JCA had the highest risk of uveitis and s...

  5. Arthritis: Conventional and Advanced Radiological Imaging

    Directory of Open Access Journals (Sweden)

    Adviye Ergun

    2014-06-01

    Full Text Available Arthritides are acute or chronic inflammation of one or more joints. The most common types of arthritis are osteoarthritis and rheumatoid arthritis, but there are more than 100 different forms. Right and early diagnosis is extremely important for the prevention of eventual structural and functional disability of the affected joint. Imaging findings, especially those of advanced level imaging, play a major role in diagnosis and monitor the progression of arthritis or its response to therapy. The objective of the review is to discuss the findings of conventional and advanced radiological imaging of most common arthritides and to present a simplified approach for their radiological evaluation.

  6. Systemic Juvenile Idiopathic Arthritis: Diagnosis and Management.

    Science.gov (United States)

    Kumar, Sathish

    2016-04-01

    Systemic juvenile idiopathic arthritis (sJIA) is an inflammatory condition characterized by fever, lymphadenopathy, arthritis, rash and serositis. In sJIA, systemic inflammation has been associated with dysregulation of the innate immune system, suggesting that it 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. Recent data suggests that early cytokine blockage might abrogate chronic, destructive, therapy resistant arthritis phase, reflecting a potential "window of opportunity" in the care of children with sJIA. PMID:26916892

  7. Septic and aseptic arthritis: a continuum?

    Science.gov (United States)

    Taylor-Robinson, D; Keat, A

    1999-03-01

    This chapter considers the likelihood that a wide spectrum of infection-provoked arthritis exists, ranging from overt sepsis to apparently aseptic chronic arthritis in which very small numbers of causal bacteria can be detected only by using highly sensitive techniques. It asks whether joints are, as conventionally held, normally devoid of micro-organisms and how to judge the significance of bacteria detected within apparently sterile joints. Through a consideration of known septic, probably infective and apparently aseptic forms of arthritis, a set of criteria for attributing causality to putative arthritogenic micro-organisms is proposed. PMID:10952856

  8. HLA antigens in psoriasis and psoriatic arthritis.

    OpenAIRE

    Woodrow, J. C.; Ilchysyn, A

    1985-01-01

    HLA phenotypes were determined in 50 patients with psoriasis alone and in 50 patients with psoriasis and psoriatic arthritis. Positive associations were found in both groups with B13, B17, B37, Cw6, and DR7, and in addition with C4A6. Higher relative risks were found in respect to the patients with psoriasis alone compared with those with arthritis, and this suggests the involvement of additional genetic factors predisposing to peripheral arthritis. In patients with psoriasis only, the presen...

  9. Dietary recommendations for patients with rheumatoid arthritis: a review

    Directory of Open Access Journals (Sweden)

    Vitetta L

    2012-06-01

    Full Text Available Luis Vitetta,1 Samantha Coulson,1 Janet Schloss,1 Shoshannah L Beck,1 Robert Allen,2 Avni Sali21Centre for Integrative Clinical and Molecular Medicine, The University of Queensland School of Medicine, Brisbane, 2National Institute of Integrative Medicine, Melbourne, AustraliaAbstract: Dietary interventions can assist with the management of disease symptoms that accompany rheumatoid arthritis (RA, such as pain, tender swollen joints, stiffness, and associated disability and disease progression. Dietary interventions have gained widespread appeal for both clinicians and RA patients. Interventions that promote self-help through education can have significant benefits for patients as they negotiate pain and musculoskeletal disability. There is substantial scientific evidence that demonstrates patients diagnosed with RA may benefit from dietary interventions; however, recent systematic reviews remain uncertain about the therapeutic efficacy of dietary manipulation for RA due to clinical trials with a high risk of bias. However, dietary interventions with plausible therapeutic activity may be indicated for reducing RA-associated symptoms, including elimination of foods that may trigger an allergic or intolerant response, introduction of known anti-inflammatory dietary compounds and correction of food, or drug-induced gastrointestinal tract microbiota abnormalities and permeability.Keywords: diet, rheumatoid arthritis, vegetarian, vegan, Mediterranean, fish oils, probiotics

  10. A Comparative Metabolomic Evaluation of Behcet's Disease with Arthritis and Seronegative Arthritis Using Synovial Fluid.

    Directory of Open Access Journals (Sweden)

    Joong Kyong Ahn

    Full Text Available Behcet's disease (BD with arthritis is often confused with seronegative arthritis (SNA because of shared clinical symptoms and the lack of definitive biomarkers for BD. To investigate possible metabolic patterns and potential biomarkers of BD with arthritis, metabolomic profiling of synovial fluid (SF from 6 patients with BD with arthritis and 18 patients with SNA was performed using gas chromatography/time-of-flight mass spectrometry in conjunction with univariate and multivariate statistical analyses. A total of 123 metabolites were identified from samples. Orthogonal partial least square-discriminant analysis showed clear discrimination between BD with arthritis and SNA. A set of 11 metabolites were identified as potential biomarkers for BD using variable importance for projection values and the Wilcoxon-Mann-Whitney test. Compared with SNA, BD with arthritis exhibited relatively high levels of glutamate, valine, citramalate, leucine, methionine sulfoxide, glycerate, phosphate, lysine, isoleucine, urea, and citrulline. There were two markers identified, elevated methionine sulfoxide and citrulline, that were associated with increased oxidative stress, providing a potential link to BD-associated neutrophil hyperactivity. Glutamate, citramalate, and valine were selected and validated as putative biomarkers for BD with arthritis (sensitivity, 100%; specificity, 61.1%. This is the first report to present potential biomarkers from SF for discriminating BD with arthritis from SNA. The metabolomics of SF may be helpful in searching for potential biomarkers and elucidating the clinicopathogenesis of BD with arthritis.

  11. Bioboosters in the treatment of rheumatic diseases: a comprehensive review of currently available biologics in patients with rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis

    Directory of Open Access Journals (Sweden)

    Fabrizio Cantini

    2009-12-01

    Full Text Available Fabrizio Cantini, Carlotta Nannini, Laura NiccoliSecond Division of Medicine, Rheumatology Unit, Hospital of Prato, ItalyAbstract: Immunologic research has clarified many aspects of the pathogenesis of inflammatory rheumatic disorders. Biologic drugs acting on different steps of the immune response, including cytokines, B- and T-cell lymphocytes, have been marketed over the past 10 years for the treatment of rheumatoid arthritis (RA, ankylosing spondylitis (AS, and psoriatic arthritis (PsA. Randomized controlled trials (RCTs of anti-cytokine agents in RA (including the anti-tumor necrosis factor alpha (TNFα drugs infliximab, etanercept, adalimumab, golimumab, certolizumab, anti-interleukin (IL-1 anakinra, and anti-IL-6 tocilizumab demonstrated a significant efficacy compared to traditional therapies, if combined with methotrexate (MTX, as measured by ACR 20, 50 and 70 response criteria. The new therapies have also been demonstrated to be superior to MTX in slowing or halting articular damage. RCTs have shown the efficacy of anti-TNFα in AS patients through significant improvement of symptoms and function. Trials of anti-TNFα in PsA patients showed marked improvement of articular symptoms for psoriasis and radiological disease progression. More recent studies have demonstrated the efficacy of B-cell depletion with rituximab, and T-cell inactivation with abatacept. All these drugs have a satisfactory safety profile. This paper reviews the different aspects of efficacy and tolerability of biologics in the therapy of RA, AS, and PsA.Keywords: anti-TNF, anti-cytokine agents, rituximab, abatacept, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis

  12. Biological therapies for the treatment of juvenile idiopathic arthritis: Lessons from the adult and pediatric experiences.

    Science.gov (United States)

    Stoll, Matthew L; Gotte, Alisa C

    2008-06-01

    Biologics have advanced the therapy of adult and pediatric arthritis. They have been linked to rare serious adverse outcomes, but the actual risk of these events is controversial in adults, and largely unknown in pediatrics. Because of the paucity of safety and efficacy data in children, pediatric rheumatologists often rely on the adult literature. Herein, we reviewed the adult and pediatric literature on five classes of medicines: Tumor necrosis factor (TNF) inhibitors, anakinra, rituximab, abatacept, and tocilizumab. For efficacy, we reviewed randomized controlled studies in adults, but did include lesser qualities of evidence for pediatrics. For safety, we utilized prospective and retrospective studies, rarely including reports from other inflammatory conditions. The review included studies on rheumatoid arthritis and spondyloarthritis, as well as juvenile idiopathic arthritis. Overall, we found that the TNF inhibitors have generally been found safe and effective in adult and pediatric use, although risks of infections and other adverse events are discussed. Anakinra, rituximab, abatacept, and tocilizumab have also shown positive results in adult trials, but there is minimal pediatric data published with the exception of small studies involving the subgroup of children with systemic onset juvenile idiopathic arthritis, in whom anakinra and tocilizumab may be effective therapies. PMID:19707357

  13. Arthritis mutilans: a report from the GRAPPA 2012 annual meeting.

    Science.gov (United States)

    Chandran, Vinod; Gladman, Dafna D; Helliwell, Philip S; Gudbjörnsson, Björn

    2013-08-01

    Arthritis mutilans is often described as the most severe form of psoriatic arthritis. However, a widely agreed on definition of the disease has not been developed. At the 2012 annual meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), members hoped to agree on a definition of arthritis mutilans and thus facilitate clinical and molecular epidemiological research into the disease. Members discussed the clinical features of arthritis mutilans and definitions used by researchers to date; reviewed data from the ClASsification for Psoriatic ARthritis study, the Nordic psoriatic arthritis mutilans study, and the results of a premeeting survey; and participated in breakout group discussions. Through this exercise, GRAPPA members developed a broad consensus on the features of arthritis mutilans, which will help us develop a GRAPPA-endorsed definition of arthritis mutilans. PMID:23908536

  14. Current views on the pharmacotherapy of psoriatic arthritis

    Directory of Open Access Journals (Sweden)

    G. G. Taradin

    2015-01-01

    Full Text Available The review deals with current pharmacological approaches to treating psoriatic arthritis (PsA. It gives data on the prevalence of psoriasis and psoriatic joint injury that is a common cause of early patient disability. Approaches to evaluating the efficacy of drugs are given on the basis of developed and used criteria with regard to the standardized assessment of the dynamics of joint injury in rheumatic diseases and PSA in particular. The review gives brief information on the mechanism of drug actions and the results of clinical trials evaluating the efficacy and safety of different medicaments in PsA. It also covers the experience in using nonsteroidal antiinflammatory drugs, glucocorticoids, synthetic diseasemodifying antirheumatic drugs (methotrexate, cyclosporine, leflunomide, sulfasalazine, and also a promising group of biologicals. Particular emphasis is placed on the results of using tumor necrosis factor inhibitors (etanercept, infliximab, golimumab, certolizumab pegol, adalimumab, interleukin inhibitors (ustekinumab, brodalumab, and phosphodiesterase 4 inhibitors (apremilast.

  15. Arthritis - Imaging and therapy. Past, present and future

    International Nuclear Information System (INIS)

    Osteoarthritis (OA) and rheumatoid arthritis (RA) are chronic diseases in which pathological anatomy changes very slowly. Whilst clinical and laboratory measures can be used to evaluate therapeutic response, assessment of disease progression requires imaging. Conventional radiography has performed well in RA but is too insensitive in OA. Never have imaging techniques been discussed which focus on the sites of fundamental pathological change in cartilage and synovia. Such techniques would provide potential end-points for measuring disease progression and the efficacy of therapeutic intervention. Many are non-invasive but are still at a developmental stage. Expense and complexity currently restricts their use to research. However, improving imaging hardware and information technology provide an exciting future for radiologists involved in joint imaging. Clinical trials involving techniques described here are just around the corner. (orig.)

  16. Subtype specific genetic associations for juvenile idiopathic arthritis: ERAP1 with the enthesitis related arthritis subtype and IL23R with juvenile psoriatic arthritis

    OpenAIRE

    Hinks, Anne; Martin, Paul; Flynn, Edward; Eyre, Steve; Packham, Jon; Barton, Anne; Worthington, Jane; Thomson, Wendy

    2011-01-01

    Introduction Juvenile idiopathic arthritis (JIA) is an umbrella term for all chronic childhood arthropathies and can be divided into seven subtypes. It includes the enthesitis related arthritis (ERA) subtype which displays symptoms similar to ankylosing spondylitis (AS) and juvenile-onset psoriatic arthritis which has similarities to psoriatic arthritis (PsA) and psoriasis (Ps). We, therefore, hypothesized that two well-established susceptibility loci for AS and Ps, ERAP1 and IL23R, could als...

  17. Muramyl dipeptide-induced adjuvant arthritis.

    OpenAIRE

    Nagao, S.; Tanaka, A.

    1980-01-01

    Muramyl dipeptide, N-acetylmuramyl-L-alanyl-D-isoglutamine, induced adjuvant arthritis in WKA rats when injected in a water-in-oil emulsion prepared with Freund incomplete adjuvant (Difco), but not when emulsified with Drackeol and Arlacel A.

  18. Can the weather influence arthritis symptoms?

    Directory of Open Access Journals (Sweden)

    Wai Chin Li

    2014-09-01

    Full Text Available By reviewing twelve previous studies on the relationship between the weather and arthritis symptoms, this article summarized the major findings on this controversial topic. It has been supported by most of the studies that arthritis symptoms are associated with weather conditions. Factors such as barometric pressure and temperature were generally believed to be related to arthritis symptoms. However, controversies arose at minor levels. Whether the weather-symptom relationship depends on the specific type of arthritis, weather variables, demographic and pathological heterogeneity of the patients is still a matter of debate. This article calls for standardization in future research design, and hope the mechanism underlying the weather-symptom association will be found.

  19. Arthritis Genetics Analysis Aids Drug Discovery

    Science.gov (United States)

    ... Matters NIH Research Matters January 13, 2014 Arthritis Genetics Analysis Aids Drug Discovery An international research team ... may play a role in triggering the disease. Genetic factors are also thought to play a role. ...

  20. Tracheomegaly in association with rheumatoid arthritis

    International Nuclear Information System (INIS)

    Herein we present a case of tracheomegaly seen in a patient with rheumatoid arthritis. To the authors' knowledge, and from a review of the literature, this combination has not been previously described. (orig.)

  1. Radiological manifestations of rheumatoid arthritis

    International Nuclear Information System (INIS)

    Rheumatoid arthritis preferrably becomes manifest at the synovial joints of the limbs, especially at the small joints of the hands and feet, at bursae and synovial sheathes. The pathologic lesions are less frequently found at cartilaginous joints or entheses. The lesions very often are symmetrically distributed and are characterized by the following: 1. A periarticular, spindle-shaped opacity with a density similar to soft-tissue, induced by an inflammatory hypertrophy of the synovia, a serosynovitis, or an edematous impregnation of the periarticular tissue. 2. A juxta-articular osteoporosis, most probably caused by a neighbouring synovialitis accompanied by hyperemia. 3. A diffuse joint cavity narrowing due to a destruction of the articular cartilage by the pannus, a fibrovascular resorptive tissue. 4. Central as well as marginal erosions, caused by destruction of ossous material by the pannus. 5. Subchondral signal cysts, likewise unduced by the pannus. (Orig./AJ)

  2. Rheumatoid arthritis affecting temporomandibular joint

    Directory of Open Access Journals (Sweden)

    Amandeep Sodhi

    2015-01-01

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

  3. Psoriasis and psoriatic arthritis treatment.

    Science.gov (United States)

    Menter, Alan

    2016-06-01

    Over the past several years, an increased understanding of the pathophysiology of psoriasis and psoriatic arthritis (PsA) has led to the development of several new biologic therapies. Appropriate treatment selection and timing may slow, and even halt, the progression of psoriasis and PsA; as a result, it can decrease the economic burden. As treatment options vary based on individual disease characteristics and patient preferences, reviewing the patient's complete clinical picture is imperative. An updated treatment algorithm, based on patients' most severe disease domain, is now available to guide the selection of optimal therapy. Special care should be given to patients with both psoriasis and PsA who experience multiple disease domains, a heavy symptom burden, and an increased risk of comorbidities. PMID:27356194

  4. Psoriasis and psoriatic arthritis overview.

    Science.gov (United States)

    Menter, Alan

    2016-06-01

    Psoriasis and psoriatic arthritis (PsA) are chronic immune-mediated diseases that primarily affect the skin and joints, respectively; these diseases are also associated with high rates of cardiovascular and other comorbidities. Despite over 40 genes proven to be related to the disease, the exact causes of psoriasis and PsA are still to be determined. Recent insights into the underlying pathophysiology of these diseases have revealed novel therapeutic targets. Effective management requires timely diagnosis and initiation of treatment. Yet, both psoriasis and PsA remain underrecognized and undertreated in current clinical practice. Recognizing the true physical, social, and emotional burden of psoriasis and PsA, as well as their associated comorbidities, is the first step to improving the prognosis for affected patients. PMID:27356193

  5. Transfer your ideas to society!

    CERN Multimedia

    CERN Bulletin

    2010-01-01

    Science and technology labs are the ideal places for developing innovative solutions. However, inventors sometimes don’t realize that their ideas can find an application in industry, which can in turn have a technical and economic impact on society. Some researchers may think that disclosing an invention is a time-consuming process which is worth doing only in very special cases. But one thing is certain: it is always worth informing the Knowledge and Technology Transfer group, as they will give you the correct advice and support. Don’t be afraid of the paperwork… it can be highly rewarding!   Why should researchers at CERN bother to disclose their inventions to the Knowledge and Technology Transfer Group first? “Because when inventors do so, a process to transfer the technology to industry is set in motion” explains Henning Huuse, Patent Portfolio Manager in the KTT Group. To facilitate this transfer, patent protection can be a useful tool. &...

  6. Exclusion Spirometry: A Good Idea

    Directory of Open Access Journals (Sweden)

    Nick R. Anthonise

    2004-01-01

    Full Text Available In this issue of the Canadian Respiratory Journal, Almirall and Bégin (pages 195 to 196 make a suggestion aimed at increasing the use of spirometry by primary care physicians, as well as family and general practitioners. The idea is that spirometry should be performed not necessarily to make specific diagnoses, but to rule in or out the possibility of a number of lung diseases, most notably, chronic obstructive pulmonary disease (COPD. If the patient demonstrates normal forced vital capacity and forced expiratory volume in 1 s, then he or she does not have COPD; if the results are not normal, then COPD is a possibility that can be further investigated.

  7. GANGGUAN PERTUMBUHAN MANDIBULA PADA JUVENILE RHEUMATOID ARTHRITIS

    OpenAIRE

    Ria Puspitawati

    2015-01-01

    Juvenile Rheumatoid Arthritis (JRA) is a systemic disease on childhood, which has chronic arthritis as its most prominent manifestation. One very common complication of JRA is growth disturbance. JRA involving temporomandibular joint usually result in mandibular growth retardation which eventually can lead to micrognathia, retrognathia, malocclusion and other mandibulofacial developmental aberrations. Factors considered to be the cause of these growth and developmental disturbances are: conge...

  8. Septic arthritis of a lumbar facet joint

    International Nuclear Information System (INIS)

    Septic arthritis of the posterior lumbar joints is extremely rare. The clinical picture of the unusual site of infection can easily lead to confusion with spondylo-discitis which is more common. We report a case of a 50-year-old women with Staphylococcus aureus septic arthritis of the left L5-S1 lumbar facet joint. CT scan was helpful to establish the diagnosis and to guide the percutaneous needle biopsy. (authors)

  9. Seronegative pauciarticular arthritis and HLA B27.

    OpenAIRE

    Eastmond, C J; Rajah, S M; D. Tovey; Wright, V.

    1980-01-01

    Twenty-six patients with a pauciarticular arthritis have been studied clinically, radiologically and with histocompatibility typing. An increased frequency of HLA B27 was found (p = 1.87 x 10(-12)). Low back and buttock pain, Achilles tendinitis and dactylitis of the toes were more frequent in HLA-B27 positive patients. It is suggested that histocompatibility testing may be of some value in diagnosis and in the investigation of the possible 'reactive' nature of this type of arthritis.

  10. Long term prognosis of reactive salmonella arthritis

    OpenAIRE

    Leirisalo-Repo, M; Helenius, P; Hannu, T; Lehtinen, A; Kreula, J; Taavitsainen, M; Koskimies, S

    1997-01-01

    OBJECTIVES—Reactive joint complications triggered by salmonella gastroenteritis are increasingly reported, but the outcome and long term prognosis of the patients is incompletely known. This study looked at the prognosis of salmonella arthritis in patients hospitalised in 1970-1986.
METHODS—Hospital records from two hospitals in southern Finland were screened for patients with the discharge diagnosis of salmonellosis or reactive, postinfectious arthritis or Reiter's disease. For the patients ...

  11. Update on Treatment of Rheumatoid Arthritis

    OpenAIRE

    Patterson, A. Caroline

    1987-01-01

    Treatment of rheumatoid arthritis consists of use of drugs, physical measures, social work interventions, education and reconstructive surgery. The physician plays a co-ordinating role, since most patients with significant rheumatoid arthritis will require treatment by more than one member of the health-care team. Our drug armamentarium, including anti-inflammatory agents, disease suppressants, analgesics, rarely steroids, and even more rarely immunosuppressants, can be used to good effect in...

  12. Monocyte activation in early onset rheumatoid arthritis.

    OpenAIRE

    Fujii, I.; Shingu, M; Nobunaga, M.

    1990-01-01

    Monocytes from peripheral blood and synovial fluid of patients with definite and classic rheumatoid arthritis spontaneously produced significantly greater amounts of prostaglandin E2 (PGE2), leukotriene B4 (LTB4), and interleukin-1 beta (IL-1 beta) than samples of peripheral blood from normal controls. Peripheral blood monocytes from patients with rheumatoid arthritis produced significantly greater amounts of PGE2 than control samples when stimulated with lipopolysaccharide. There were no sig...

  13. Group Education for patients with rheumatoid arthritis

    OpenAIRE

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

    1993-01-01

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

  14. GENETICS OF PSORIASIS AND PSORIATIC ARTHRITIS

    Directory of Open Access Journals (Sweden)

    V. Ibba

    2011-09-01

    Full Text Available Psoriasis and psoriatic arthritis are linked diseases characterised by (distinct ? immune-mediated pathogenetic mechanisms and by a genetic background interacting with environmental factors. Some candidate susceptibility genes have been studied extensively; they include HLA genes, genes within the HLA region and genes outside the HLA region; among them corneodesmosin and other genes of PSORS1 region, MICA and TNF-a polymorphisms. The main findings in the literature are discussed. Key words: Genetics, psosriasis, psoriatic arthritis

  15. Septic Arthritis in the Temporomandibular Joint

    OpenAIRE

    2015-01-01

    Septic arthritis of the temporomandibular joint (TMJ) is a rare event that has only been reported a few dozen times worldwide. This case is remarkable for septic arthritis of the TMJ joint in an otherwise healthy male. Case Report: A 24-year-old male presented to the emergency department with periauricular swelling, erythema, fever, myalgia's and generalized joint pain. He had previously sought medical attention and was placed on ciprofloxacin. However, he developed facial swelling and a rash...

  16. Rousseau' s Philosophy Ideas on Education

    Institute of Scientific and Technical Information of China (English)

    鲁娅妮

    2012-01-01

    Rousseau is a famous man in the history of the education and philosophy over the whole world. His theory of education all based on his philosophy ideas. This paper mainly discusses Rousscau~ two philosophy ideas on education.

  17. Abnormal bone remodelling in inflammatory arthritis

    Science.gov (United States)

    Bogoch, Earl R.; Moran, Erica

    1998-01-01

    Osteopenia is responsible for substantial comorbidity in patients suffering from rheumatoid arthritis and is an important factor in the surgical management of joint disease. In animal models of bone loss stimulated by inflammatory arthritis, increased bone remodelling and altered microstructure of bone have been documented. The subchondral bone plate near the joint surface is narrow and perforated by vascular inflammatory invasion, and in the shaft the thin cortices are weakened by giant resorption defects. Biomechanical tests and a mathematical model of bone strength suggest that cortical defects, much larger than those found in normal osteonal remodelling, are principally responsible for the experimentally observed loss of strength. Similarly, these defects may explain the increased femoral fracture risk in rheumatoid arthritis. The osteoclast, the cell resorbing bone, is demonstrated in increased number and activity in rheumatoid arthritis and in animal models. Bisphosphonates, drugs that inhibit osteoclast function, have been shown experimentally to reduce both focal and generalized osteopenia and to prevent loss of bone strength. Bisphosphonates also protect articular cartilage from damage characteristic of inflammatory arthritis. The mechanism of chondroprotection may be prevention of subchondral bone resorption by the osteoclast and also an altered distribution of bone marrow cells. Thus, bisphosphonates, currently in clinical use for other bone metabolic diseases, appear to have potential as prophylaxis and treatment for osteopenia and joint damage in inflammatory arthritis. PMID:9711159

  18. Rehabilitation in patients with Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Evaggelos Giavasopoulos

    2008-07-01

    Full Text Available Rehabilitation of patients with rheumatoid arthritis aims to the management of the consequences of disease. It is widely accepted that, no drug therapy at present leads to long‐term orremission f everyone with rheumatoid arthritis (R.A.. Consequently, patients experience physical, psychological, functional, social and role negative effects of the disease. AIM : The am of the present article was to evaluate the role of rehabilitation to patients with rheumatoid arthritis sMethod and material: The methodology followed included reviewof tudies which were related to rehabilitation of patients with rheumatoid arthritis Results :The majority of the studies claims that rehabilitation of patients with rheumatoid arthritis, is a matter of primary importance. The importance of early provision of specialist rheumatologycare, patient education and promotion of self‐ management; and the evidence for the effectiveness of therapeutic interventions and multidisciplinary care. Conclusions : Individuals who suffer from rheumatoid arthritis can derive significant benefits from rehabilitation programmes. To provide best care, rehabilitation standards and services should be based on the best available evidence.

  19. Burden of childhood-onset arthritis

    Directory of Open Access Journals (Sweden)

    Hassett Afton L

    2010-07-01

    Full Text Available Abstract Juvenile arthritis comprises a variety of chronic inflammatory diseases causing erosive arthritis in children, often progressing to disability. These children experience functional impairment due to joint and back pain, heel pain, swelling of joints and morning stiffness, contractures, pain, and anterior uveitis leading to blindness. As children who have juvenile arthritis reach adulthood, they face possible continuing disease activity, medication-associated morbidity, and life-long disability and risk for emotional and social dysfunction. In this article we will review the burden of juvenile arthritis for the patient and society and focus on the following areas: patient disability; visual outcome; other medical complications; physical activity; impact on HRQOL; emotional impact; pain and coping; ambulatory visits, hospitalizations and mortality; economic impact; burden on caregivers; transition issues; educational occupational outcomes, and sexuality. The extent of impact on the various aspects of the patients', families' and society's functioning is clear from the existing literature. Juvenile arthritis imposes a significant burden on different spheres of the patients', caregivers' and family's life. In addition, it imposes a societal burden of significant health care costs and utilization. Juvenile arthritis affects health-related quality of life, physical function and visual outcome of children and impacts functioning in school and home. Effective, well-designed and appropriately tailored interventions are required to improve transitioning to adult care, encourage future vocation/occupation, enhance school function and minimize burden on costs.

  20. Clinical Trials

    Science.gov (United States)

    Clinical trials are research studies that test how well new medical approaches work in people. Each study answers ... prevent, screen for, diagnose, or treat a disease. Clinical trials may also compare a new treatment to a ...

  1. Five Companies Receive IDEA10 Achievement Awards

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    Prestigious industry awards presented at IDEA10 in Miami Beach this week;special Entrepreneurial Award also presented at IDEA 10 CARY,NC April 28,2010-The IDEA10 Achievement Awards, which recognize the best new nonwoven and engineered fabric products introduced in the past three years,were presented in six different categories

  2. Biological Basis for the Use of Botanicals in Osteoarthritis and Rheumatoid Arthritis: A Review

    Directory of Open Access Journals (Sweden)

    Salahuddin Ahmed

    2005-01-01

    Full Text Available Osteoarthritis (OA of the knee and hip is a debilitating disease affecting more women than men and the risk of developing OA increases precipitously with aging. Rheumatoid arthritis (RA, the most common form of inflammatory joint diseases, is a disease of unknown etiology and affects ∼1% of the population worldwide, and unlike OA, generally involves many joints because of the systemic nature of the disease. Non-steroidal anti-inflammatory drugs (NSAIDs are the first drugs of choice for the symptomatic treatment of both OA and RA. Because of the risks associated with the use of NSAIDs and other limitations, the use of alternative therapies, such as acupuncture and medicinal herbs, is on the rise and according to reports ∼60–90% of dissatisfied arthritis patients are likely to seek the option of complementary and alternative medicine (CAM. This paper reviews the efficacy of some of the common herbs that have a history of human use and their anti-inflammatory or antiarthritic properties have been evaluated in animal models of inflammatory arthritis, in studies employing well defined and widely accepted in vitro models that use human chondrocytes/cartilage explants or in clinical trials. Available data suggests that the extracts of most of these herbs or compounds derived from them may provide a safe and effective adjunctive therapeutic approach for the treatment of OA and RA. This, in turn, argues for trials to establish efficacy and optimum dosage of these compounds for treating human inflammatory and degenerative joint diseases.

  3. Why golimumab in the treatment of psoriatic arthritis, ankylosing spondylitis and rheumatoid arthritis?

    Directory of Open Access Journals (Sweden)

    M. Rossini

    2015-03-01

    Full Text Available Golimumab is an anti-TNF monoclonal antibody administred subcutaneously once a month and produced with an innovative technology that minimizes immunogenicity. This paper reviews and updates the main studies on the efficacy, safety and pharmacoeconomic aspects of treatment with golimumab of psoriatic arthritis, ankylosing spondylitis and rheumatoid arthritis.

  4. Comprehensive assessment of rheumatoid arthritis susceptibility loci in a large psoriatic arthritis cohort.

    LENUS (Irish Health Repository)

    Bowes, John

    2012-08-01

    A number of rheumatoid arthritis (RA) susceptibility genes have been identified in recent years. Given the overlap in phenotypic expression of synovial joint inflammation between RA and psoriatic arthritis (PsA), the authors explored whether RA susceptibility genes are also associated with PsA.

  5. Tocilizumab in the treatment of rheumatoid arthritis and beyond

    Directory of Open Access Journals (Sweden)

    Shetty A

    2014-03-01

    Full Text Available Anjali Shetty,1 Rebekah Hanson,1 Peter Korsten,2 Munir Shawagfeh,3 Shiva Arami,1 Suncica Volkov,1 Olga Vila1 William Swedler,1 Abdel Naser Shunaigat,4 Sameer Smadi,4 Ray Sawaqed,5 David Perkins,1 Shiva Shahrara,1 Nadera J Sweiss11Department of Rheumatology, Pharmacy, Transplant, University of Illinois at Chicago, Chicago, IL, USA; 2Department of Nephrology and Rheumatology, University Medicine Göttingen, Göttingen, Germany; 3Anesthesia and Pain Management, King Hussein Cancer Center, Amman, Jordan; 4Liver Transplant, Kidney Transplant Royal Medical Services, Jordan; 5Cardiac Surgery Methodist Hospitals, Merrillville, IN, USAAbstract: Rheumatoid arthritis (RA is a systemic inflammatory disease characterized by joint pain, swelling, stiffness, and progressive destruction of the small joints of the hands and feet. Treatment of RA has improved over the past decade. With multiple cytokines well-known now to play a role in the pathogenesis of RA, including tumor necrosis factor alpha, interleukin (IL-1β, and IL-6, many targeted biological treatments against these cytokines have emerged, changing the treatment of this disease. Tocilizumab (TCZ is a recombinant humanized monoclonal antibody against the IL-6 receptor and has been approved in many countries, including the United States, for the treatment of moderate to severe RA in patients who have not adequately responded to one or more disease-modifying antirheumatic drugs (DMARDs or cannot tolerate other approved drug classes for RA. The aim of this review is to discuss the role of IL-6 in RA, and to provide an overview of the mode of action, pharmacokinetics, and safety of TCZ. Furthermore, efficacy studies of TCZ as both monotherapy and combination therapy will be evaluated. There have been several important clinical trials evaluating the efficacy and safety of TCZ in RA patients; this review summarizes this data from 14 key trials with emphasis on Phase III trials. Review of these trials

  6. The Generative Archetypes of Idea Work

    DEFF Research Database (Denmark)

    Avital, Michel; Osch, Wietske van

    2013-01-01

    Anyone who engages with ideas in the context of everyday work is engaged in idea work. Building on Jung’s psychological theory of types, we theorize about the fundamental processes underlying one’s generative capacity, and in turn, one’s ability to generate ideas and engage effectively in idea wo....... Moreover, we provide further insights regarding creativity and innovation in everyday work practices as well as discuss considerations for the design of environments and tools that are conducive to idea work....

  7. A "vaccine" made of ideas.

    Science.gov (United States)

    Owur, M

    1989-03-01

    Mathematical modelling techniques suggest that health education campaigns that promote safe sex--"a vaccine made of ideas"--have a magnified effect on rates of human immunodeficiency virus (HIV) transmission. However, surveys conducted in a range of countries have shown that mass media educational campaigns increase knowledge yet have a limited impact on behavior. Most effective are community-based initiatives that utilize existing networks and draw on local cultural traditions. For example, a Nairobi health education program in which prostitutes selected by their peers led group meetings where condoms were distributed led to increasing rates of condom use and a reduction in the risk of HIV infection. There is agreement that young people should receive education on the transmission of acquired immunodeficiency syndrome (AIDS) before they become sexually active and at risk, yet the age at which such education should begin and the content of the curriculum are controversial issues. It is further essential to recognize that about 40 million of the world's children do not attend school, and many are "street kids" who are forced into prostitution by economic necessity at an early age. Research, pretesting, and evaluation of any AIDS prevention campaigns are essential, especially under conditions of limited resources. PMID:12316486

  8. Agreements and Discrepancies between FDA Reports and Journal Papers on Biologic Agents Approved for Rheumatoid Arthritis

    DEFF Research Database (Denmark)

    Amarilyo, Gil; Furst, Daniel E; Woo, Jennifer M P;

    2016-01-01

    reports on biologic agents developed for the treatment of rheumatoid arthritis. METHODS: Available data on FDA-approved drugs were extracted from the website, and a systematic literature search was conducted to identify matching studies in peer-reviewed medical journals. Outcome measures were the American...... odds ratios. A ratio of odds ratios not equal to 1 was categorized as a discrepancy. RESULTS: FDA reports were available for 8 of 9 FDA-approved biologic agents for rheumatoid arthritis; all identified trials (34) except one were published in peer-reviewed journals. Overall, discrepancies were noted......BACKGROUND: Sponsors that seek to commercialize new drugs apply to the Food and Drug Administration (FDA) which independently analyzes the raw data and reports the results on its website. OBJECTIVES: This study sought to determine if there are differences between the FDA assessments and journal...

  9. JUVENILE CHRONIC ARTHRITIS WITH EYE LESION

    Directory of Open Access Journals (Sweden)

    S O Salugina

    2002-01-01

    Full Text Available A bstract. Objective, to describe a series of pts with JRA/JCA and uveitis. Material and methods. The study included 81 pts with JRA and uveitis. There were 68 girls-84%, 13 boys-16%. We studied the clinical manifestations, the antinuclear antibodies (ANA using HEP-2 cells for the 33 pts with uveitis and 46 pts without uveitis, HLA status was determined for 36 pts. Results. 85,2% of the children had arthritis before uveitis. The mean age at onset of arthritis was 3,5 year (range: 1-10 yrs, the mean age at onset of uveitis was 6 year (range: 2-15 yrs. The mean interval between the onset of arthritis and uveitis was 3,02 years (range: 3,5 yrs before arthritis onset to 12,5 yrs after. In 68,1% pts the diagnosis of uveitis was made within 5 yrs after onset of arthritis. 93% of pts had mono-oligoarticular onset, but 50% had poliarticular course. 23,5% of pts had functional disability 3-4 classes. Ocular complications were developed in 53.1%: cataracts-38,3%, band keratopathy-11,1%, glaucoma-2,5%. 93,9% of 33 studied children with arthritis and uveitis were ANA positive, 9,1% were RF positive. 18,1 % had HLA-DR8 (p<0,001, 83,3% - HLA-A2 (p<0,00l, HLA-B27 - 30,6 % (p<0,00l. Conclusion. Clinical and laboratory data of our pts suggest that: lthe combination of arthritis and uveitis would be named JCA with uveitis; 2 according our opinion JCA with uveitis is separate nosological form among the juvenile arthritides.

  10. Antibodies Act Jointly to Promote Inflammation in Rheumatoid Arthritis

    Science.gov (United States)

    ... Antibodies Act Jointly to Promote Inflammation in Rheumatoid Arthritis Two types of antibody molecules act in concert to stimulate inflammation in people with rheumatoid arthritis, according to research funded in part by the ...

  11. Elevated rheumatoid factor and long term risk of rheumatoid arthritis

    DEFF Research Database (Denmark)

    Nielsen, Sune F; Bojesen, Stig E; Schnohr, Peter;

    2012-01-01

    To test whether elevated concentration of rheumatoid factor is associated with long term development of rheumatoid arthritis.......To test whether elevated concentration of rheumatoid factor is associated with long term development of rheumatoid arthritis....

  12. Risk of atrial fibrillation and stroke in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Lindhardsen, Jesper; Ahlehoff, Ole; Gislason, Gunnar Hilmar;

    2012-01-01

    To determine if patients with rheumatoid arthritis have increased risk of atrial fibrillation and stroke.......To determine if patients with rheumatoid arthritis have increased risk of atrial fibrillation and stroke....

  13. Common Therapy for Rheumatoid Arthritis Reduces Risk of Death

    Science.gov (United States)

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

  14. Pain Treatment in Arthritis-Related Pain: Beyond NSAIDs

    NARCIS (Netherlands)

    Laar, van de Mart A.F.J.; Pergolizzi Jr., Joseph V.; Mellinghoff, Hans-Ulrich; Merchante, Ignacio Morón; Nalamachu, Srinivas; O'Brien, Joanne; Perrot, Serge; Raffa, Robert B.

    2012-01-01

    Managing pain from chronic conditions, such as, but not limited to, osteoarthritis and rheumatoid arthritis, requires the clinician to balance the need for effective analgesia against safety risks associated with analgesic agents. Osteoarthritis and rheumatoid arthritis pain is incompletely understo

  15. Arthritis Possible Side Effect of Certain Cancer Drugs: Study

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_159602.html Arthritis Possible Side Effect of Certain Cancer Drugs: Study ... increase risk for joint and tissue disease, including arthritis, new research suggests. "We keep having referrals coming ...

  16. Down-titration and discontinuation strategies of tumor necrosis factor-blocking agents for rheumatoid arthritis in patients with low disease activity

    NARCIS (Netherlands)

    Herwaarden, N. van; Broeder, A.A. den; Jacobs, W.; Maas, A. van der; Bijlsma, J.W.J.; Vollenhoven, R.F. van; Bemt, B.J.F van den

    2014-01-01

    BACKGROUND: Anti-tumor necrosis factor (TNF) agents are effective in treating patients with rheumatoid arthritis (RA), but they are associated with (dose-dependent) adverse effects and high costs. To prevent overtreatment, several trials have assessed the effectiveness of down-titration compared wit

  17. STUDIES ON ANCIENT INDIAN CONCEPT OF ‘ROLE OF IMPAIRED GASTRO – INTESTINAL FUNCTION – ENTEROPATHY’, IN THE PATHOGENESIS AND TREATMENT OF RHEUMATOID ARTHRITIS - AMAVATA

    OpenAIRE

    Kishore, Prem; Padhi, M.M.

    1987-01-01

    In this paper an attempt has been made to evaluate the theory of Ayurveda on rheumatoid arthritis, in relation to the modern medical concept. The evolution of the disease, its etiopathogenesis, its pathological, biochemical as well as therapeutic data published in support of this concept and finally the details of clinical trial of Sunthi in treating 265 patients are dealt with.

  18. The selection of creative ideas after individual idea generation : Choosing between creativity and impact

    NARCIS (Netherlands)

    Rietzschel, Eric F.; Nijstad, Bernard A.; Stroebe, W.

    2010-01-01

    It is commonly assumed that successful innovation depends on creative idea generation: the more ideas are generated, the higher the probability of selecting a very good idea should be. However, research has shown that people do not perform optimally at idea selection and that ideational output may n

  19. Association between human parvovirus B19 infection and arthritis.

    OpenAIRE

    Cassinotti, P; Bas, S; Siegl, G; Vischer, T L

    1995-01-01

    OBJECTIVE--To gain information concerning the association between parvovirus B19 infection and arthritis. METHODS--Blood or synovial fluid, or both, from a total of 77 adult patients with various arthropathies (rheumatoid arthritis 13; mechanical arthropathies 11; crystal induced arthritis 13; idiopathic mono/oligoarthritis 25; suspicion of viral arthritis 15) were tested for the presence of the viral genome and anti-B19 antibodies. B19 DNA in blood and synovial fluid was investigated by nest...

  20. Aortic incompetence in HLA B27-positive juvenile arthritis.

    OpenAIRE

    Kean, W F; Anastassiades, T. P.; Ford, P M

    1980-01-01

    The early onset of isolated aortic incompetence in a male child with HLA B27 and peripheral arthritis is reported. Acute anterior uveitis and lone aortic incompetence occurred at 1 and 9 months respectively after the development of the acute inflammatory arthritis. The uveitis resolved with local therapy and the arthritis remitted 10 months after the onset. There has been no recurrence of the arthritis after 10 years of close follow-up but the aortic incompetence has persisted, though it rema...

  1. Peripheral arthritis in the elderly: a hospital study.

    OpenAIRE

    Jenkinson, M L; Bliss, M R; Brain, A T; Scott, D.L.

    1989-01-01

    One hundred consecutive patients admitted to an acute geriatric unit were examined for evidence of peripheral arthritis with recognised criteria used to define osteoarthritis, rheumatoid arthritis, pyrophosphate arthropathy, gout, and disorders of the shoulder joint. The presence of arthritis and its severity were related both to functional independence and to a recognition by the patient that joint problems were impairing independence. Seventy six patients had clinical peripheral arthritis; ...

  2. Pseudoseptic Arthritis: A Case Series and Review of the Literature

    OpenAIRE

    Thomas Harrington; Cote, Jonida K.; Stephanie J. Morris; Oppermann, Brian P.

    2011-01-01

    Purpose. Pseudoseptic arthritis is an acute inflammatory monoarthritis with a sterile synovial gram stain and culture. Pseudoseptic arthritis has been previously described in the literature in a variety of settings including rheumatoid arthritis and microcrystalline disease. Despite pseudoseptic arthritis being a described entity, there is little published data on this topic with no published reports since 1992. Methods. This paper was a retrospective chart review over a 20-year period that i...

  3. Reflection enhances creativity: Beneficial effects of idea evaluation on idea generation.

    Science.gov (United States)

    Hao, Ning; Ku, Yixuan; Liu, Meigui; Hu, Yi; Bodner, Mark; Grabner, Roland H; Fink, Andreas

    2016-03-01

    The present study aimed to explore the neural correlates underlying the effects of idea evaluation on idea generation in creative thinking. Participants were required to generate original uses of conventional objects (alternative uses task) during EEG recording. A reflection task (mentally evaluating the generated ideas) or a distraction task (object characteristics task) was inserted into the course of idea generation. Behavioral results revealed that participants generated ideas with higher originality after evaluating the generated ideas than after performing the distraction task. The EEG results revealed that idea evaluation was accompanied with upper alpha (10-13 Hz) synchronization, most prominent at frontal cortical sites. Moreover, upper alpha activity in frontal cortices during idea generation was enhanced after idea evaluation. These findings indicate that idea evaluation may elicit a state of heightened internal attention or top-down activity that facilitates efficient retrieval and integration of internal memory representations. PMID:26808451

  4. Cytokine profiles in peripheral blood and whole blood cell cultures associated with aggressive periodontitis, juvenile idiopathic arthritis, and rheumatoid arthritis

    DEFF Research Database (Denmark)

    Poulsen, Anne Havemose; Sørensen, Lars Korsbaek; Stoltze, Kaj; Bendtzen, Klaus; Holmstrup, Palle

    2005-01-01

    Cytokines play a key role in the pathogenesis of inflammatory diseases. An obvious question is whether patients with aggressive periodontitis, juvenile idiopathic arthritis, or rheumatoid arthritis share blood cytokine profiles distinguishing them from individuals free of disease....

  5. Osteoscintigraphy in the diagnosis of psoriatic arthritis

    International Nuclear Information System (INIS)

    The authors presented the results of clinical, X-ray and osteoscintigraphic investigations of 133 psoriasic arthritis patients and 72 patients with common psoriasis. Osteoscintigraphy was performed using a routine method with 99mTc-pyrophos (USSR) and 99mTc-phosphone (Hungary) on gamma-camera LFOV (Nuclear-Chicago, USA). X-ray signs of the involvement of the osteoarticular system were noted in 69 (51%) patients with psoriasic arthritis and in 16 (22%) patients with common psoriasis. The method permitted the detection of the foci of RP hyperfixation in 129 (97%) potients with psoriasic arthritis and in 51 (70.8%) patients with common psoriasis. They were observed mostly in large and small limb joints, less frequently-in the vertebral column, cranial bones, thorax, and ribs. Thus, osteoscintigraphy is a highly sensitive method for the detection of active inflammatory foci of the osteoarticular system in psoriasis at all stages of arthritis development. It makes it possible to detect the spreading of arthritis and its preclinical forms

  6. Pleural and pulmonary alterations caused by rheumatoid arthritis

    International Nuclear Information System (INIS)

    Pulmonary complications caused by rheumatoid arthritis are a clinically relevant aspect of this chronic arthropathy. This article reviews pulmonary abnormalities induced by rheumatoid arthritis and their clinical and radiological findings. In addition, the role of different imaging modalities in the diagnostic work-up of pulmonary complications caused by rheumatoid arthritis is discussed. (orig./MG)

  7. MRI comes of age in RA clinical trials

    DEFF Research Database (Denmark)

    Peterfy, Charles; Østergaard, Mikkel; Conaghan, Philip G

    2013-01-01

    The success of modern rheumatoid arthritis (RA) therapies and treatment strategies has led to extended placebo phases being unethical in RA randomised controlled trials (RCTs). Modern trials therefore increasingly involve active comparator designs, and this together with some technical issues has......, synovitis and osteitis. An increasing number of recent RCTs using the RA MRI scoring system (RAMRIS) have demonstrated the ability of MRI to discriminate progression and treatment effect. Consistency of erosion progression determination was seen across the majority of these studies. In most studies, MRI...... support of claims of inhibition of progression of structural damage in RA trials....

  8. A Comparative Metabolomic Evaluation of Behcet’s Disease with Arthritis and Seronegative Arthritis Using Synovial Fluid

    OpenAIRE

    Joong Kyong Ahn; Sooah Kim; Jungyeon Kim; Jiwon Hwang; Kyoung Heon Kim; Hoon-Suk Cha

    2015-01-01

    Behcet's disease (BD) with arthritis is often confused with seronegative arthritis (SNA) because of shared clinical symptoms and the lack of definitive biomarkers for BD. To investigate possible metabolic patterns and potential biomarkers of BD with arthritis, metabolomic profiling of synovial fluid (SF) from 6 patients with BD with arthritis and 18 patients with SNA was performed using gas chromatography/time-of-flight mass spectrometry in conjunction with univariate and multivariate statist...

  9. Animal Models of Rheumatoid Arthritis (I): Pristane-Induced Arthritis in the Rat

    Science.gov (United States)

    Tuncel, Jonatan; Haag, Sabrina; Hoffmann, Markus H.; Yau, Anthony C. Y.; Hultqvist, Malin; Olofsson, Peter; Bäcklund, Johan; Nandakumar, Kutty Selva; Weidner, Daniela; Fischer, Anita; Leichsenring, Anna; Lange, Franziska; Haase, Claus; Lu, Shemin; Gulko, Percio S.; Steiner, Günter; Holmdahl, Rikard

    2016-01-01

    Background To facilitate the development of therapies for rheumatoid arthritis (RA), the Innovative Medicines Initiative BTCure has combined the experience from several laboratories worldwide to establish a series of protocols for different animal models of arthritis that reflect the pathogenesis of RA. Here, we describe chronic pristane-induced arthritis (PIA) model in DA rats, and provide detailed instructions to set up and evaluate the model and for reporting data. Methods We optimized dose of pristane and immunization procedures and determined the effect of age, gender, and housing conditions. We further assessed cage-effects, reproducibility, and frequency of chronic arthritis, disease markers, and efficacy of standard and novel therapies. Results Out of 271 rats, 99.6% developed arthritis after pristane-administration. Mean values for day of onset, day of maximum arthritis severity and maximum clinical scores were 11.8±2.0 days, 20.3±5.1 days and 34.2±11 points on a 60-point scale, respectively. The mean frequency of chronic arthritis was 86% but approached 100% in long-term experiments over 110 days. Pristane was arthritogenic even at 5 microliters dose but needed to be administrated intradermally to induce robust disease with minimal variation. The development of arthritis was age-dependent but independent of gender and whether the rats were housed in conventional or barrier facilities. PIA correlated well with weight loss and acute phase reactants, and was ameliorated by etanercept, dexamethasone, cyclosporine A and fingolimod treatment. Conclusions PIA has high incidence and excellent reproducibility. The chronic relapsing-remitting disease and limited systemic manifestations make it more suitable than adjuvant arthritis for long-term studies of joint-inflammation and screening and validation of new therapeutics. PMID:27227821

  10. Magnetic resonance imaging of soft tissue changes in rheumatoid arthritis wrist joints

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Szkudlarek, Marcin

    2001-01-01

    , tendonitis, enthesitis, joint effusions, and ligament and tendon tears, can be visualized. Unfortunately, the image resolution in most clinically available MR units is insufficient for evaluation of wrist joint cartilage. Preliminary data suggest that MRI is a valuable tool in the diagnosis and......An increasingly aggressive therapeutic strategy, improved treatment options, and encouraging preliminary results have attracted growing attention to the potential of magnetic resonance imaging (MRI) in the diagnosis, prognostication, and monitoring of rheumatoid arthritis (RA). MRI offers...... prognostication of RA. The superior sensitivity of MRI may be of major significance in both clinical trials and practice. In trials, MRI may allow reductions in the trial size and length because of its more sensitive separation of responders from nonresponders. Thus, although thorough validation is awaited...

  11. Changing ideas of global limits.

    Science.gov (United States)

    Goddy, D

    1984-03-01

    In this discussion of changing ideas of global limits, attention is directed to world trade, moral restraint, and the "green revolution." A fresh look at the work of those who first considered population problems, e.gg., Malthur, can help make some sense of the population problems the world faces today. Malthus, writing in the late 1700s, concluded that population multiplies with each generation. He saw that food production was limited by the amount of available cropland and that the more people there are, the less food they will have to eat -- assuming that all available cropland is planted. This grim view of the future led Malthus to oppose government aid to the poor maintaining that such assistance would only encourage poor people to have large families. His solution was "moral restratin," seeing it as the duty of each individual to refrain from marriage until he was able to support his children. At the time this advice seemed cruel and Malthus was bitterly attacked by writers everywhere in Europe. Karl Marx and other ctitics of Malthus believed that poverty was caused by unjust governments and the selfishness of the rich. Marx clamied that the problem was too few jobs rather than too many people. The dire predictions of Malthus were soon forgotten as manufacturing industries began to transform the economies of Western Europe in the 1800s. Along with soaring economic growth came a host of developments that improved people's lives, e.g., better transportation, better sanitiation and nutrition, and better medicine. New inventions helped farmers fo produce more food. Next came the "demographic transition." Population grew quickly in Europe and North America as people became healthier and lived longer. Gradually, people in the industrial nations began deciding to have smaller families to enable them to afford an even higher living standard. By the late 1920s birthrates in Europe and the US had dropped so low that mention of the "population problem" usually referred

  12. Power through, over and in Ideas

    DEFF Research Database (Denmark)

    Carstensen, Martin B.; Schmidt, Vivien

    2016-01-01

    Owing to the tendency of discursive institutionalists to conflate the notion that ‘ideas matter' for policy-making with the ‘power of ideas’, little has been done to explicitly theorize ideational power. To fill this lacuna, the contribution defines ideational power as the capacity of actors...... (whether individual or collective) to influence other actors’ normative and cognitive beliefs through the use of ideational elements, and – based on insights from the discursive institutionalist literature – suggests three different types of ideational power: power through ideas, understood as the capacity...... of actors to persuade other actors to accept and adopt their views through the use of ideational elements; power over ideas, meaning the imposition of ideas and the power to resist the inclusion of alternative ideas into the policy-making arena; and power in ideas, which takes place through the...

  13. Novel Oral Therapies for Psoriasis and Psoriatic Arthritis.

    Science.gov (United States)

    Yiu, Zenas Z N; Warren, Richard B

    2016-06-01

    Several classes of new oral therapy are in use or in development for the treatment of psoriasis. Despite the high efficacy of biologics, new oral therapies remain important as patients generally prefer this mode of administration and they offer an alternative risk-benefit profile. In this review, we discuss the novel modes of action of these drugs, including modulation of cellular pathways involving diverse targets such as Janus kinase, phosphodiesterase 4, sphingosine 1-phosphate, A3 adenosine receptor and rho-associated kinase 2. We review the available evidence around licensed drugs (apremilast) and drugs that are advanced (tofacitinib) or early (ponesimod, baricitinib, peficitinib, INCB039110, CF101, KD025) in the development pipeline. The key limitations of these oral therapies are their modest efficacy profile (apremilast, ponesimod) and the limitations of their safety profile (tofacitinib, ponesimod), while the evidence for the early pipeline drugs are at phase II level only. Potential niches of current unmet needs include apremilast for patients with concomitant psoriatic arthritis, as combination treatments with biologic therapies, and/or for patients in whom multiple biologic therapies have failed due to immunogenicity and secondary inefficacy. The present knowledge gap regarding these novel drugs includes the need for longer clinical trials or observational studies to evaluate safety, and randomised phase III trials for the early pipeline drugs. We conclude that further research and data are necessary to conclusively establish the role of these agents in the current psoriasis treatment paradigm. PMID:26923915

  14. Arthritis and pain. Psychosocial aspects in the management of arthritis pain.

    Science.gov (United States)

    Backman, Catherine L

    2006-01-01

    The purpose of this review is to summarize psychosocial factors associated with arthritis pain and highlight recent evidence for psychosocial approaches to managing arthritis pain. By definition, psychosocial factors refer to two dimensions of experience: the psychological (cognitive, affective) and social (interacting with others, engaging in life activities). Psychosocial factors influence the perception of pain and the presence of pain influences psychological well-being and social participation. After discussing the impact of arthritis pain on participation in work, family life, and leisure, evidence for psychosocial interventions is summarized, emphasizing reviews and studies published from January 2000 to August 2006. PMID:17169138

  15. Identifying the emergence of design ideas

    DEFF Research Database (Denmark)

    Inie, Nanna

    This position paper outlines four types of design idea indicators that provide four starting points for exploration of the emergence of design ideas from a micro perspective. The results are derived from two empirical studies of design processes. The research builds on the assumption that we need...... better understanding and definition of design idea emergence and transformation in order to systematically explore the creative process....

  16. A Field Experiment in Motivating Employee Ideas

    OpenAIRE

    Gibbs, Michael; Neckermann, Susanne; Siemroth, Christoph

    2014-01-01

    markdownabstract__Abstract__ We study the effects of a field experiment designed to motivate employee ideas, at a large technology company. Employees were encouraged to submit ideas on process and product improvements via an online system. In the experiment, the company randomized 19 account teams into treatment and control groups. Employees in treatment teams received rewards if their ideas were approved. Nothing changed for employees in control teams. Our main finding is that rewards substa...

  17. Covenant idea in ante-Nicene theology

    OpenAIRE

    Duncan, Jennings Ligon

    1995-01-01

    This thesis argues that the covenant idea was more significant in the writings of particular ante-Nicene theologians than has generally been admitted in patristic research or general surveys of the history of the covenant idea in the Christian tradition. Indeed, this survey of the covenant idea in the ante-Nicene period demonstrates a significant usage, development, and modification of the covenant concept as it is found in the OT and NT writings and in early Judaism. This investigation revea...

  18. Living in the WOW of Your Ideas

    Science.gov (United States)

    Mabry, M. Parker

    2012-01-01

    Recently, the author got to thinking about some of the ideas that have crossed her mind in the last couple of weeks. The list made her smile. And as she went over it point by point in her head she tried to determine what, if any, reasonable or logical patterns were emerging in her myriad of ideas. The four divergent ideas presented in this article…

  19. Rheumatoid Arthritis and Incidence of Twelve Initial Presentations of Cardiovascular Disease: A Population Record-Linkage Cohort Study in England.

    Directory of Open Access Journals (Sweden)

    Mar Pujades-Rodriguez

    Full Text Available While rheumatoid arthritis is an established risk factor for cardiovascular disease (CVD, our knowledge of how the pattern of risk varies for different cardiovascular phenotypes is incomplete. The association between rheumatoid arthritis and the initial presentation of 12 types of CVDs were examined in a contemporary population of men and women of a wide age range.CALIBER data, which links primary care, hospital and mortality data in England, was analysed. A cohort of people aged ≥18 years and without history of CVD was assembled and included all patients with prospectively recorded rheumatoid arthritis from January 1997, until March 2010, matched with up to ten people without rheumatoid arthritis by age, sex and general practice. The associations between rheumatoid arthritis and the initial presentation of 12 types of CVDs were estimated using multivariable random effects Poisson regression models.The analysis included 12,120 individuals with rheumatoid arthritis and 121,191 comparators. Of these, 2,525 patients with and 18,146 without rheumatoid arthritis developed CVDs during a median of 4.2 years of follow-up. Patients with rheumatoid arthritis had higher rates of myocardial infarction (adjusted incidence ratio [IRR] = 1.43, 95%CI 1.21-1.70, unheralded coronary death (IRR = 1.60, 95%CI 1.18-2.18, heart failure (IRR = 1.61, 95%CI 1.43-1.83, cardiac arrest (HR = 2.26, 95%CI 1.69-3.02 and peripheral arterial disease (HR = 1.36, 95%CI 1.14-1.62; and lower rates of stable angina (HR = 0.83, 95%CI 0.73-0.95. There was no evidence of association with cerebrovascular diseases, abdominal aortic aneurysm or unstable angina, or of interactions with sex or age.The observed associations with some but not all types of CVDs inform both clinical practice and the selection of cardiovascular endpoints for trials and for the development of prognostic models for patients with rheumatoid arthritis.

  20. Systematic review, network meta-analysis and economic evaluation of biological therapy for the management of active psoriatic arthritis

    OpenAIRE

    Cawson, Matthew Richard; Mitchell, Stephen Andrew; Knight, Chris; Wildey, Henry; Spurden, Dean; Bird, Alex; Orme, Michelle Elaine

    2014-01-01

    Background An updated economic evaluation was conducted to compare the cost-effectiveness of the four tumour necrosis factor (TNF)-α inhibitors adalimumab, etanercept, golimumab and infliximab in active, progressive psoriatic arthritis (PsA) where response to standard treatment has been inadequate. Methods A systematic review was conducted to identify relevant, recently published studies and the new trial data were synthesised, via a Bayesian network meta-analysis (NMA), to estimate the relat...

  1. Improved functional outcome in patients with early rheumatoid arthritis treated with intramuscular gold: results of a five year prospective study

    OpenAIRE

    Munro, R.; Hampson, R; MCENTEGART, A; Thomson, E.; Madhok, R; Capell, H

    1998-01-01

    OBJECTIVE—To determine whether there is a relation between disease duration and functional outcome in patients with rheumatoid arthritis (RA) treated with intramuscular sodium aurothiomolate (gold) for five years.
METHODS—440 patients with RA were enrolled in a prospective trial of gold treatment. Initial demographic details were recorded. Disease activity was assessed at yearly intervals using a combination of clinical (pain score, Ritchie articular index, duration of morning stiffness) and ...

  2. Optimal dosage and route of administration of methotrexate in rheumatoid arthritis: a systematic review of the literature

    OpenAIRE

    Visser, K.; van der Heijde, D

    2008-01-01

    Objectives: To review systematically the available literature on the optimal dosage and route of administration of methotrexate in patients with rheumatoid arthritis (RA), as an evidence base for generating clinical practice recommendations. Methods: A systematic literature search was carried out in MEDLINE, EMBASE, Cochrane Library and American College of Rheumatology/European League Against Rheumatism meeting abstracts, searching for randomised controlled trials evaluating various dosages o...

  3. Effects of patient education on compliance with basic treatment regimens and health in recent onset active rheumatoid arthritis

    OpenAIRE

    Brus, H; Laar, M. A. F. J.; Taal, E; Rasker, J.; Wiegman, O.

    1998-01-01

    OBJECTIVES—To determine the effects of patient education on compliance and on health in patients with active, recent onset rheumatoid arthritis (RA).
METHODS—A randomised, controlled, assessor blinded, one year trial. The experimental group followed an education programme. All patients started on sulphasalazine therapy. Compliance with sulphasalazine was measured by pill counting. Compliance rates with regimens of physical exercise, endurance activities, and energy conservation were measured ...

  4. Recommendations and the state of the evidence for physical activity interventions for adults with rheumatoid arthritis: 2007 to present

    OpenAIRE

    Iversen, Maura D.; Brawerman, Marisa; Iversen, Christina N

    2012-01-01

    Patients with rheumatoid arthritis (RA) are twice as likely as their healthy peers to suffer from cardiovascular disease. RA is also a major cause of disability and reduced quality of life. Clinical trials of exercise and physical activity interventions demonstrate positive effects on muscle strength, function, aerobic capacity, mood and disability. While RA management guidelines emphasize the role of exercise and physical activity in the management of RA, the description of physical activity...

  5. Case series of feasibility considerations that impact operational delivery strategy in the highly competitive rheumatoid arthritis space in Asia

    OpenAIRE

    Wai, Karen

    2013-01-01

    Karen Wai,1 Lisa Marie Saldanha,1 Elvira Zenaida Lansang,1 Saumya Nayak,1 Anish Sule,2 Ken J Lee31Feasibility and Site Identification Asia, Quintiles East Asia Pte Ltd, Singapore; 2Feasibility and Site Identification India, Quintiles India, Mumbai, India; 3Site Services Asia, Quintiles East Asia Pte Ltd, SingaporeAbstract: The rheumatoid arthritis (RA) clinical trial space is very competitive, and recruiting and retaining subjects is of critical importance. Feasibility studies are a central c...

  6. Overcome IMF crisis with idea and invention

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Yeon Jung

    1998-01-15

    This book introduces the invention as a tool to overcome IMF crisis. These are the titles of the way to create invention and idea : what is idea? everyone can create something, have a confidence, this is patent, replace or change something, invention is not logical, challenge the normal law, throw away stereotype, movement of idea, original imagination, there are a lot of solutions, there is no expert, have a positive thought, why does inventor invent? necessity is invention of mother, three stage of idea and invention and imitation for invention.

  7. Overcome IMF crisis with idea and invention

    International Nuclear Information System (INIS)

    This book introduces the invention as a tool to overcome IMF crisis. These are the titles of the way to create invention and idea : what is idea? everyone can create something, have a confidence, this is patent, replace or change something, invention is not logical, challenge the normal law, throw away stereotype, movement of idea, original imagination, there are a lot of solutions, there is no expert, have a positive thought, why does inventor invent? necessity is invention of mother, three stage of idea and invention and imitation for invention.

  8. On the content of a product idea

    DEFF Research Database (Denmark)

    Hansen, Claus Thorp; Andreasen, Mogens Myrup

    2005-01-01

    In an industrial company developing consumer products for the global marketplace, it is the management’s task to decide which product ideas shall be selected as a basis for developing new and innovative products. The company management has to allocate resources to a portfolio of product ideas for...... further development and to reject others. This is a risky task. If resources are allocated to wrong or wicket product ideas there will be no business for the company in the future. Allocating proper resources to the right product ideas is a first step towards a viable business, a task made difficult...

  9. Numbers and other math ideas come alive

    CERN Document Server

    Pappas, Theoni

    2012-01-01

    Most people don't think about numbers, or take them for granted. For the average person numbers are looked upon as cold, clinical, inanimate objects. Math ideas are viewed as something to get a job done or a problem solved. Get ready for a big surprise with Numbers and Other Math Ideas Come Alive. Pappas explores mathematical ideas by looking behind the scenes of what numbers, points, lines, and other concepts are saying and thinking. In each story, properties and characteristics of math ideas are entertainingly uncovered and explained through the dialogues and actions of its math

  10. A literature review of idea management

    DEFF Research Database (Denmark)

    Jensen, Anna Rose Vagn

    2012-01-01

    The objective of the paper is primarily to conduct a state-of-the-art literature review of Idea Management and secondary to point out unanswered questions which are left behind in the reviewed literature. Scientific knowledge is primarily represented in innovation management literature but also...... considerably in literature on software and IT. On the background of the literature review, there are some weaknesses in the literature to be considered. These weaknesses concern the understanding of how people interact with idea management in their daily work practices and how different types of ideas are...... included or excluded in the idea management processes....

  11. Golimumab: A novel human anti-TNF-α monoclonal antibody for the treatment of rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis

    Directory of Open Access Journals (Sweden)

    Jonathan Kay

    2009-07-01

    Full Text Available Jonathan Kay1, Mahboob U Rahman2,31Division of Rheumatology, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, MA, USA; 2Centocor Research and Development, inc., Malvern, PA, USA; 3University of Pennsylvania School of Medicine, Philadelphia, PA, USAIntroduction: The introduction of tumor necrosis factor-α (TNF-α inhibitors represented a significant advance in the management of rheumatoid arthritis (RA and other chronic inflammatory diseases. Although three TNF-α inhibitors have been approved for the treatment of RA by the US Food and Drug Administration (FDA and the European Medicinal Products Evaluation Agency (EMEA, not all patients achieve a satisfactory clinical improvement with these therapeutic agents. The mode of administration of these medications is inconvenient for some patients.Aims: Golimumab is a novel anti-TNF-α monoclonal antibody that is in clinical development for the treatment of RA, psoriatic arthritis (PsA, and ankylosing spondylitis (AS, either as a first-line biologic therapy or an alternative after other TNF-α inhibitors have been discontinued. This review summarizes the development of, and clinical evidence achieved with, golimumab.Evidence review: Golimumab has demonstrated significant efficacy in randomized, double-blind, placebo-controlled trials when administered subcutaneously once every four weeks. It has been generally well tolerated in clinical trials and demonstrates a safety profile comparable with currently available TNF-α inhibitors.Outcomes summary: Golimumab has been confirmed to be an effective treatment for patients with RA, PsA, and AS in phase III clinical trials as evaluated by traditional measures of disease activity, such as signs and symptoms, as well as measures of physical function, patient reported outcomes, and health economic measures. The efficacy and safety profile of golimumab in RA, PsA, and AS appears to be similar to other anti-TNF agents. However

  12. Therapy of rheumatoid arthritis by radiosynovectomy

    International Nuclear Information System (INIS)

    Radiosynovectomy is a therapeutic modality for local treatment of inflammatory point diseases. It is performed by intraarticular instillation of beta-emitting radionuclides. Its effectiveness is based upon the anti-inflammatory action of beta-radiation. Accordingly, the indication of radiosynovectomy is based upon the evidence of the inflammatory etiology of disease. The principle of its therapeutic action makes radiosynovectomy a valuable device for successful treatment of florid rheumatoid arthritis. It can be performed as an alternative to surgical synovectomy or in combination with it. The following article describes the therapeutic management of rheumatoid arthritis by radiosynovectomy including patient preparation, performance, and follow-up. (orig.)

  13. Is Hearing Impairment Associated with Rheumatoid Arthritis?

    DEFF Research Database (Denmark)

    Emamifar, Amir; Bjoerndal, Kristine; Jensen Hansen, Inger Marie

    2016-01-01

    BACKGROUND: Rheumatoid arthritis (RA) is a systemic, inflammatory disease that affects 1% of the population. The auditory system may be involved during the course of disease; however the association of RA and hearing impairment has not been clearly defined. OBJECTIVE: The objective of this review......, hearing test, audiometry, auditory dysfunction and rheumatoid arthritis. CONCLUSION: Based on our review it can be postulated that patients with RA are at higher risk of hearing impairment compared to healthy subjects in their course of the disease. The hearing impairment in RA seems to be a...

  14. Sedentary behaviour in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Thomsen, Tanja; Beyer, Nina; Aadahl, Mette;

    2015-01-01

    BACKGROUND: Despite increasing interest in investigating sedentary behaviour (SB) in the general population and in patients with rheumatoid arthritis (RA), there is little documentation of the subjective experiences of SB in patients with RA. This study aimed to examine how patients with RA...... modification of physical activity level causing increase in SB, especially during periods of disease flare. Prioritizing and planning of SB also functioned as part of self-management strategies. 3) It has nothing to do with my arthritis; for some patients, SB was not related to RA, but simply reflected a way...

  15. Connective tissue markers of rheumatoid arthritis

    DEFF Research Database (Denmark)

    Møller, H J

    1998-01-01

    Rheumatoid arthritis (RA) is a common systemic autoimmune disorder of unknown aetiology. The most common outcome of RA is a progressive development of joint destruction and deformity. Early introduction of disease-modifying antirheumatic drugs seems important for prevention of the long term...... rheumatoid factor contributes to the classification of arthritis as RA, and acute phase reactants are useful for quantifying and comparing the level of inflammatory activity in the course of a given patient. There is, however, a lack of sensitive and specific biochemical markers for RA, and frontline...

  16. Main Ocular Manifestations in Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Sandra Saray Quignon Santana

    2009-12-01

    Full Text Available Rheumatoid arthritis is considered an autoimmune disease in which articular and extra articular manifestations are produced and contribute to alter the functional capacity of the individual. This study consists on performing a bibliographical review showing the main ocular manifestations in patients with rheumatoid arthritis. It is our purpose to give you our experiences to the students as well as the internal medicine, ophthalmology and rheumatologist residents about this topic. The ophthalmological consultation of sick patients contributes to the prevention of ocular illnesses which are characteristic of the base disease and improve the ocular health.

  17. Assessment of arthritis in rats with CIA:

    DEFF Research Database (Denmark)

    Jasemian, Yousef

    computerized digital infrared thermal imaging, and its association with stages of clinical scores in a rat collagen induced arthritis model. Arthritis was induced with collagen immunization in eight Lewis rats.  Four of the animals were treated with dexamethasone as a negative control. Disease progression was...... monitored by paw edema and body weight. On the basis of paw edema a clinical score was given each paw of the animals involved in the study. The mean temperature of a region covering the metatarsal joint was compared with a reference area on the back of the same rat. The temperature ratios were compared with...

  18. The radiographic features of psoriatic arthritis

    International Nuclear Information System (INIS)

    Psoriatic arthritis is a separate and distinct articular disorder with specific radiographic manifestations occurring in a specific distribution. It manifests a severe erosive element, as well as a bone productive element. The erosive changes help to distinguish it from ankylosing spondylitis, and the bone productive changes, from rheumatoid arthritis. The distribution of the changes, that is, preferential involvement of the hands, will help to distinguish it from Reiter's syndrome. In some patients, it is knowledge of the radiographic changes and distribution of these changes that establishes the correct diagnosis of psoriasis

  19. 水通道蛋白的表达与关节炎关系的研究进展%Research progress on the relationship between expressions of aquaporins and arthritis

    Institute of Scientific and Technical Information of China (English)

    冯芳芳; 于超; 谭春江; 陈文列; 陈赛楠

    2015-01-01

    Aquaporins ( AQPs ) act as an important channel for body water crossing the cell membrane, and are closely related to the balance of water metabolism and water reserves. Recent studies have found that there are signiifcant differences in the expressions of AQPs in arthritis joints and normal joints. The expressions of AQP1, AQP3 and AQP9 in the patients with rheumatoid arthritis and osteoarthritis are all signiifcantly increased, which are enhanced with the occurrence of lesions. The expressions of AQP4 are higher in the patients with gouty arthritis and osteoarthritis than in the patients with normal joints, which can reflect the severity of articular diseases. After medication, the expressions of AQPs are remarkably reduced, and the arthritis symptoms are improved. It points out that a special intimate relationship exists between the upregulation of the expressions of AQPs in arthritis joints and the occurrence and development of pathological changes. With AQPs as therapeutic targets, the cell membrane permeability to water can be reduced through regulation, so as to improve inlfammation. It offers a new research idea for the prevention and control of arthritis. In this paper, the studies on the relationship between AQPs and arthritis in recent years are reviewed.

  20. Assessing the effectiveness of synthetic and biologic disease-modifying antirheumatic drugs in psoriatic arthritis – a systematic review

    Directory of Open Access Journals (Sweden)

    Kingsley GH

    2015-05-01

    Full Text Available Gabrielle H Kingsley, David L Scott Rheumatology Unit, Kings College London, London, UK Background: Psoriatic arthritis is an inflammatory arthritis the primary manifestations of which are locomotor and skin disease. Although a number of guidelines have been published citing strategies for reducing disease progression, the evidence base for disease-modifying agents is unclear. This forms the focus of this systematic review. Methods: The systematic review was undertaken according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009 checklist. We selected randomized controlled trials (RCTs that looked at the impact of interventions with disease-modifying agents, either synthetic drugs or biologics on musculoskeletal outcomes, notably American College of Rheumatology 20 percent responders. Results were analyzed using Review Manager 5.1.6 (Cochrane Collaboration, Oxford, UK. Whilst our primary focus was on published trials, we also looked at new trials presented in abstract form in 2013–2014 that were not yet published to avoid omitting important and up-to-date information on developing treatments. Results: Our in-depth analysis included 28 trials overall enrolling 5,177 patients published between the 1980s and now as well as limited analysis of some studies in abstract form as described earlier. The most frequently available locomotor outcome measure was the American College of Rheumatology 20 percent responders. The risk ratio for achieving an American College of Rheumatology 20 percent responders response was positive in favor of treatment (risk ratio 2.30; 95% confidence interval 1.78–2.96; however, there was evidence of considerable heterogeneity between trials. Overall randomized controlled trials of established synthetic disease-modifying agents were largely negative (methotrexate, ciclosporin and sulfasalazine though leflunomide showed a small positive effect. A new synthetic agent, apremilast, did show a