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Sample records for chronic leprosy-related arthritis

  1. How undifferentiated arthritis evolves into chronic arthritis.

    Science.gov (United States)

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

    2014-08-01

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

  2. Uveitis in juvenile chronic arthritis.

    Science.gov (United States)

    Kanski, J J

    1990-01-01

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

  3. Juvenile chronic arthritis.

    Science.gov (United States)

    Southwood, T R; Woo, P

    1995-05-01

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

  4. Retrocalcaneal bursitis in juvenile chronic arthritis.

    OpenAIRE

    Goldenstein-Schainberg, C; Homsi, C; Rodrigues Pereira, R M; W. Cossermelli

    1992-01-01

    Retrocalcaneal bursitis has been described in various adult rheumatic diseases and septic bursitis unrelated to previous bursal disease has been reported in children. The case is reported here of a girl with juvenile chronic arthritis who developed non-septic retrocalcaneal bursitis; the diagnosis was suggested by a combination of clinical and radiographic studies and was confirmed by ultrasonography.

  5. Antineutrophil cytoplasmic antibodies in juvenile chronic arthritis

    NARCIS (Netherlands)

    Mulder, L; Horst, G; Limburg, P; deGraeffMeeder, ER; Kuis, W; Kallenberg, C

    1997-01-01

    Objective, To evaluate the diagnostic significance of antineutrophil cytoplasmic antibodies (ANCA) by assessing the prevalence of ANCA in juvenile chronic arthritis (JCA) (n = 93) of either oligoarticular, polyarticular, or systemic onset. To investigate the prevalence of ANCA in other diseases of c

  6. Retrocalcaneal bursitis in juvenile chronic arthritis.

    Science.gov (United States)

    Goldenstein-Schainberg, C; Homsi, C; Rodrigues Pereira, R M; Cossermelli, W

    1992-01-01

    Retrocalcaneal bursitis has been described in various adult rheumatic diseases and septic bursitis unrelated to previous bursal disease has been reported in children. The case is reported here of a girl with juvenile chronic arthritis who developed non-septic retrocalcaneal bursitis; the diagnosis was suggested by a combination of clinical and radiographic studies and was confirmed by ultrasonography. Images PMID:1444631

  7. Orofacial pain, jaw function, and temporomandibular disorders in adult women with a history of juvenile chronic arthritis or persistent juvenile chronic arthritis

    DEFF Research Database (Denmark)

    Bakke, M.; Zak, M.; Jensen, B.L.;

    2001-01-01

    Orofacial pain, jaw function, temporomandibular disorders, adult women persistent juvenil chronic arthritis......Orofacial pain, jaw function, temporomandibular disorders, adult women persistent juvenil chronic arthritis...

  8. Screening for uveitis in juvenile chronic arthritis.

    Science.gov (United States)

    Kanski, J J

    1989-03-01

    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 systemic onset patients the least risk. The presence of circulating antinuclear antibody was also an important marker for an increased risk of uveitis. A regimen for routine screening of patients is suggested.

  9. Chronic arthritis in chikungunya virus infection.

    Science.gov (United States)

    Mateo, Lourdes; Roure, Silvia

    2017-07-24

    Chikungunya virus infection causes arthralgia and arthritis in the acute phase of the disease but, in more than half of the cases, musculoskeletal manifestations can be prolonged over time and, in some cases, become chronic. Although polyarthralgia is the most frequent chronic manifestation, forms with polyarthritis, tenosynovitis and enthesopathy are also common. To analyze the clinical characteristics of patients with persistent articular manifestations after infection with the Chikungunya virus. Report of 3 cases of chronic arthritis after infection with chikungunya virus diagnosed at outpatient care in a university hospital of Catalonia, all of them imported after exposure in areas of epidemic infection between 2013-2015. All three patients had inflammatory joint pain for more than one year after acute disease (3, 2 and 1 years, respectively). In all cases, it appeared as polyarthritis with involvement of small joints of hands and feet (pseudorheumatoid arthritis-like). Laboratory tests showed a slight elevation of acute phase reactants, and analyses for immune markers were negative. Two of the patients required treatment with glucocorticoids and hydroxychloroquine. The course led to slow clinical improvement, but only one of them came to be completely asymptomatic. In the differential diagnosis of chronic polyarthritis, Chikungunya virus disease should also be considered in areas in which it is not endemic. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  10. Chronic Lyme disease arthritis: review of the literature and report of a case of wrist arthritis.

    Science.gov (United States)

    Scerpella, T A; Engber, W D

    1992-05-01

    A case of Lyme arthritis with advanced degenerative changes localized to the midcarpal joint was treated with a limited wrist arthrodesis with relief of pain and improved function. Chronic Lyme arthritis occurs as the third stage of Lyme disease. Serologic testing and a history of a characteristic rash may be helpful in the diagnosis. Radiographic and histopathologic findings are nonspecific, with both degenerative and inflammatory characteristics. Intravenous antibiotics provide an effective treatment of chronic Lyme arthritis.

  11. Microcirculation of the juvenile knee in chronic arthritis

    DEFF Research Database (Denmark)

    Bünger, Cody; Bülow, J; Tøndevold, E

    1986-01-01

    In order to investigate pathogenetic factors in growth abnormalities of the knee in hemophilic arthropathy and juvenile rheumatoid arthritis, the hemodynamic changes of the knee following chronic synovial inflammation and elevated joint pressure were studied in puppies. Unilateral arthritis was i....... The growth plates formed borders for the extension of these changes. The increased permeability and surface area between blood and bone in arthritis may accelerate the resorption and subsequent destruction of subchondral bone in chronic arthropathies of the juvenile knee.......In order to investigate pathogenetic factors in growth abnormalities of the knee in hemophilic arthropathy and juvenile rheumatoid arthritis, the hemodynamic changes of the knee following chronic synovial inflammation and elevated joint pressure were studied in puppies. Unilateral arthritis...

  12. Anti-cytokine therapy in chronic destructive arthritis.

    NARCIS (Netherlands)

    Berg, W.B. van den

    2001-01-01

    Tumor necrosis factor (TNF) and interleukin-1 (IL-1) are considered to be master cytokines in chronic, destructive arthritis. Therapeutic approaches in rheumatoid arthritis (RA) patients have so far focused mainly on TNF, which is a major inflammatory mediator in RA and a potent inducer of IL-1; ant

  13. Bite force and temporomandibular disorder in juvenile chronic arthritis.

    Science.gov (United States)

    Wenneberg, B; Kjellberg, H; Kiliaridis, S

    1995-08-01

    The aim of this study was to investigate the functional condition of the stomatognathic system in children suffering from juvenile chronic arthritis, with respect to bite force and temporomandibular disorder in relation to radiographic abnormalities of the mandibular condyle, occlusal factors and systemic disease parameters. Thirty-five children with juvenile chronic arthritis were compared to 89 healthy children with an Angle Class I occlusion and 62 children with an Angle Class II malocclusion. Subjective symptoms and clinical signs of temporomandibular disorder and radiographic mandibular condylar changes were more common in children with juvenile chronic arthritis than in the two comparison groups. Maximal molar and incisal bite forces and maximal molar bite force endurance times were also significantly reduced in children with juvenile chronic arthritis. It is concluded that the differences between the groups are caused mainly by the systemic inflammatory disease itself, but a functional influence of weakened masticatory muscles cannot be excluded.

  14. Pregnancy in Chronic Arthritis: Only a Matter of Planning

    Directory of Open Access Journals (Sweden)

    aloma Vela

    2015-06-01

    Full Text Available Chronic arthritis often affects women of childbearing age. The old concept that having chronic arthritis constitutes a major obstacle to women when planning a pregnancy is now obsolete. Thanks to our current capacity to control the activity of rheumatoid arthritis and other chronic inflammatory conditions, and due to the availability of highly effective drugs such as tumour necrosis factor inhibitor agents and other biological agents, many women with these diseases are now able to consider the challenge of childbearing and raising children. Careful pre-conceptional evaluation and risk assessment constitutes the first step of proper care, which can be individualised according to the disease. More than ever, rheumatologists must know how to deal with this situation, and must be able to provide adequate counselling regarding the control of arthritis during conception and pregnancy.

  15. 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.

  16. Juvenile chronic arthritis and coeliac disease in the Netherlands

    NARCIS (Netherlands)

    George, EK; HertzbergertenCate, R; vanSuijlekomSmit, LWA; vonBlomberg, BME; Stapel, SO; vanElburg, RM; Mearin, ML

    1996-01-01

    Objective. It has been suggested that juvenile chronic arthritis (JCA) is associated with coeliac disease in a frequency of 0.4-2%. In order to investigate the frequency of coeliac disease in cases of JCA and the possibility of underdiagnosis in our area, we screened 62 children with JCA (mean age

  17. Prevalence of chronic diseases at the onset of inflammatory arthritis.

    NARCIS (Netherlands)

    Ursum, J.; Korevaar, J.C.; Twisk, J.W.R.; Peters, M.J.L.; Schellevis, F.G.; Nurmohamed, M.T.; Nielen, M.M.J.

    2012-01-01

    Background: To explore the prevalence of chronic diseases at the onset of inflammatory arthritis (IA) in the general practice and compare this to a group of control patients without IA. Methods: In this nested-case-control study, data were used from the Netherlands Information Network of eneral Pra

  18. Multidisciplinary vocational rehabilitation for patients with chronic arthritis

    NARCIS (Netherlands)

    Buck, de Petronella D.M.

    2006-01-01

    Working gainfully is a major activity of adult life, providing income, structure, social interaction and an opportunity to learn and practice skills, and a source of self-esteem. In people with chronic arthritis work disability is common, having a major impact upon individuals as well as society. In

  19. Rheumatoid Arthritis Drug May Not Ease Chronic Fatigue Syndrome After All

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_163926.html Rheumatoid Arthritis Drug May Not Ease Chronic Fatigue Syndrome After ... had hoped that anakinra (Kineret) -- a medication for rheumatoid arthritis -- also could be used to relieve symptoms of ...

  20. Management of gouty arthritis in patients with chronic kidney disease.

    Science.gov (United States)

    Abdellatif, Abdul A; Elkhalili, Naser

    2014-01-01

    Chronic kidney disease (CKD) is a comorbid condition that affects, based on recent estimates, between 47% and 54% of patients with gouty arthritis. However, data from randomized controlled trials in patients with gouty arthritis and CKD are limited, and current gouty arthritis treatment guidelines do not address the challenges associated with managing this patient population. Nonsteroidal anti-inflammatory drugs and colchicine are recommended first-line treatments for acute gouty arthritis attacks. However, in patients with CKD, nonsteroidal anti-inflammatory drugs are not recommended because their use can exacerbate or cause acute kidney injury. Also, colchicine toxicity is increased in patients with CKD, and dosage reduction is required based on level of kidney function. Allopurinol, febuxostat, and pegloticase are all effective treatments for controlling elevated uric acid levels after the treatment of an acute attack. However, in patients with CKD, required allopurinol dosage reductions may limit efficacy; pegloticase requires further investigation in this population, and febuxostat has not been studied in patients with creatinine clearancegouty arthritis including urate-lowering therapy in patients with CKD. Challenges specific to primary care providers are addressed, including guidance to help them decide when to collaborate with, or refer patients to, rheumatology and nephrology specialists based on the severity of gout and CKD.

  1. Impaired NK cell functionality and increased TNF-α production as biomarkers of chronic chikungunya arthritis and rheumatoid arthritis.

    Science.gov (United States)

    Thanapati, Subrat; Ganu, Mohini; Giri, Prashant; Kulkarni, Shruti; Sharma, Meenal; Babar, Prasad; Ganu, Ashok; Tripathy, Anuradha S

    2017-04-01

    The chronic chikungunya arthritis symptoms closely mimic the rheumatoid arthritis (RA) symptoms, thus making it difficult to distinguish between these two clinical entities. The current comparative study characterizes NK (CD3(-)CD56(+)) and NK-like T (CD3(+)CD56(+)) cell responses in patients with chronic chikungunya arthritis and RA. Phenotype and functions of NK and NK-like T cells repertoire were assessed in 56 chronic chikungunya arthritis, 26 RA patients and 82 controls using flow cytometry. TNF-α and IFN-γ-secreting NK-like T cells were high in both chronic arthritis patients than in controls. Percentage of TNF-α(+) NK cells was higher in RA patients than in controls. Percentage of perforin(+) NK cells was low in both chronic arthritis patient groups. Among the patient groups, expressions of perforin(+) and IFN-γ(+) NK-like T cells were higher in RA. Overall, our data show reduced frequency of NK-like T cells, lower expression of perforin(+) NK, higher expression of TNF-α(+) NK-like T and IFN-γ(+) NK-like T cells as the markers of chronic arthritic diseases. In the absence of any specific treatment for chronic chikungunya induced arthritis and promising results of anti-TNF-α therapy against RA, current data may form the basis for future in vivo studies and has scope as possible therapeutics against chikungunya.

  2. Evolving spectrum of LRBA deficiency-associated chronic arthritis: is there a causative role in juvenile idiopathic arthritis?

    Science.gov (United States)

    Al-Mayouf, Sulaiman M; Naji, Hamzah; Alismail, Khalid; Alazami, Anas M; Sheikh, Farrukh; Conca, Walter; Al-Mousa, Hamoud

    2017-01-01

    Lipopolysaccharide-responsive, beige-like anchor protein (LRBA) deficiency causes common variable immunodeficiency (CVID) disorders and autoimmunity. LRBA deficiency has become a clinically variable syndrome with a wide spectrum of clinical manifestations. We report a patient with LRBA deficiency associated chronic non-erosive arthritis. This report highlights the spectrum of arthritis in such patients and the potential causative role of LRBA gene in juvenile arthritis.

  3. Chlorambucil induced chromosome damage in juvenile chronic arthritis.

    Science.gov (United States)

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

    1985-01-01

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

  4. IL-17/Th17 targeting: On the road to prevent chronic destructive arthritis?

    NARCIS (Netherlands)

    E.W. Lubberts (Erik)

    2008-01-01

    textabstractInterleukin-17A (IL-17A) contributes to the pathogenesis of arthritis. Data from experimental arthritis indicate IL-17 receptor signaling as a critical pathway in turning an acute synovitis into a chronic destructive arthritis. The identification of six IL-17 family members (IL-17A-F) ma

  5. Juvenile chronic arthritis and imaging: comparison of different techniques

    Directory of Open Access Journals (Sweden)

    C. Cervini

    2011-09-01

    Full Text Available Objective: The aim of this study was to compare imaging findings obtained with different techniques in a patient with juvenile chronic arthritis. Methods: The patient was a 12 years-old child with a 7-months history of arthritis of the first metatarsophalangeal joint of the right foot. The involved area was explored with the following imaging techniques: X-ray, technetium bone scintigraphy, magnetic resonance, gray-scale and power-Doppler ultrasonography. Results: No abnormalities were detected with conventional X-ray. Scintigraphy showed an abnormal uptake of the radionuclide in the first metatarsophalangeal joint of the right foot. Magnetic resonance without contrast revealed clearly evident features of an active process of synovitis. Ultrasonography was able to detect the presence of joint effusion, synovial proliferation, bone erosion of the first metatarsal head. Power-Doppler examination revealed evident signs of soft tissue hyperemia. Conclusions: Comparative assessment of different imaging techniques in this patient with recent-onset juvenile chronic arthritis indicates that high resolution ultrasonography provides the most detailed evaluation of the joint involvement with respect to the other imaging techniques.

  6. Refraction in juvenile chronic arthritis: a long-term follow-up study, with emphasis on myopia

    DEFF Research Database (Denmark)

    Fledelius, H; Zak, M; Pedersen, F K

    2001-01-01

    Assessment of refraction anomalies in juvenile chronic arthritis (JCA) on a long-term follow-up basis.......Assessment of refraction anomalies in juvenile chronic arthritis (JCA) on a long-term follow-up basis....

  7. Ocular complications and visual outcome in juvenile chronic arthritis: a 25-year follow-up study

    DEFF Research Database (Denmark)

    Zak, Marek; Fledelius, Hans; Pedersen, Freddy Karup

    2003-01-01

    Assessment of longterm ophthalmic outcome in juvenile chronic arthritis (JCA) with emphasis on visual acuity and identification of disease-related parameters associated with rheumatic eye affection.......Assessment of longterm ophthalmic outcome in juvenile chronic arthritis (JCA) with emphasis on visual acuity and identification of disease-related parameters associated with rheumatic eye affection....

  8. Uveitis in juvenile chronic arthritis: incidence, clinical features and prognosis.

    Science.gov (United States)

    Kanski, J J

    1988-01-01

    Three hundred and fifteen patients with anterior uveitis and juvenile chronic arthritis were reviewed in order to determine the incidence, visual prognosis, and the clinical characteristics of the intraocular inflammation. The overall incidence of uveitis was 20%. Approximately 25% of patients had relatively mild and/or transient involvement and an excellent visual prognosis. In 50% the uveitis was more severe but could be controlled with topical medication. In the remaining 25% the visual prognosis was poor due to the intractable nature of the uveitis and the subsequent development of vision-threatening complications. The majority of patients (74%) were under the age of 8 years when the uveitis was first diagnosed. Clinically, the intraocular inflammation was most frequently an asymptomatic, chronic, non-granulomatous, iridocyclitis which was bilateral in 71% of cases. Other ocular lesions, which were rare, included keratoconjunctivitis sicca and corneal melting.

  9. Experience with conservative rehabilitation in patients with juvenile chronic arthritis

    Directory of Open Access Journals (Sweden)

    T. A. Shelepina

    2016-01-01

    Full Text Available Objective: to estimate a need for conservative rehabilitation treatment in patients with juvenile chronic arthritis (JCA.Material and methods. Data on the principles and procedures of rehabilitation treatment were analyzed in patients with JCA on the basis of 25- year experience. The need for these packages of measures in 1999, 2008, and 2014 was compared. Standard procedures for joints at different sites were described. According to the degree of joint functions, there were rehabilitation treatment packages: corrective, mobilization, and general health-improving.Results and discussion. All patients with juvenile arthritis need rehabilitation (physical, psychological, and social. Comparison of the total number of patients who had received rehabilitation treatment in 1999, 2008, and 2014 showed a small trend towards its reduction. This is due to the smaller number of patients with dysfunctions and to the larger number of those without movement disorders who had received adequate treatment in early periods of the disease. The high percentage of patients having limited joint functions needs a mobilization package. Analysis of the data available in the literature and the authors' experience may lead to the conclusion that all patients with JCA need exercise therapy. The latter is a major procedure for physical rehabilitation and should be included in the standards for adjuvant treatment during basic medical therapy. Emphasis is laid on the importance of the early initiation of treatment to prevent incapacitating deformity at early stages of the disease.

  10. Responding to the challenge of leprosy-related disability and ultra-poverty.

    Science.gov (United States)

    Bowers, Bob; Singh, Suren; Kuipers, Pim

    2014-09-01

    The Millennium Development Goals have provided much needed attention to extreme poverty reduction. However, people with disabilities are disproportionately affected by poverty and in some countries, even the goal of US$1 per day is far out of reach. For people with leprosy-related disability living in ultra-poverty (on less than 50 cents a day), many mainstream poverty reduction strategies are inaccessible and inappropriate. A project in north-west Bangladesh developed a more contextually meaningful definition of ultra-poverty according to nutrition energy intake. A total of 2372 people with leprosy-related disability were surveyed. Of those, 1285 individuals fell below the ultra-poverty line. Individualised interventions were implemented over an extended period of time, comprised of targeted practical assistance, enhancing community links, advocacy for entitlements, and further linking with other initiatives. Follow-up data available for 856 individuals showed an average increase in per capita income of 83%. Personal contribution to the family income increased by 65%. There was a 51% increase in families having access to a latrine. Finally families reported eating 30% more meals per day, up from an average of two meals per day. The initiative sought to address poverty in a wide variety of ways, using minimal inputs. Over several years, the results indicate a significant change in the economic situation of individuals with leprosy related disabilities. Other organisations are encouraged to duplicate the intervention and share their results.

  11. 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 ...

  12. Effects of sulfasalazine treatment on serum immunoglobulin levels in children with juvenile chronic arthritis

    NARCIS (Netherlands)

    van Rossum, MAJ; Fiselier, TJW; Franssen, MJAN; ten Cate, R; van Suijlekom-Smit, LWA; Wulffraat, NM; van Luijk, WHJ; Oostveen, JCM; Kuis, W; Dijkmans, BAC; van Soesbergen, RM

    2001-01-01

    This article describes the effects of sulfasalazine (SSZ) treatment on serum immunoglobulin (Ig) levels in 6 children with oligoarticular- or polyarticular onset juvenile chronic arthritis (JCA). None of the children who developed dysimmunoglobulinemia during treatment showed clinical symptoms of th

  13. Pharmacology Update on Chronic Obstructive Pulmonary Disease, Rheumatoid Arthritis, and Major Depression.

    Science.gov (United States)

    Weatherspoon, Deborah; Weatherspoon, Christopher A; Abbott, Brianna

    2015-12-01

    This article presents a brief review and summarizes current therapies for the treatment of chronic obstructive pulmonary disease, major depression, and rheumatoid arthritis. One new pharmaceutical agent is highlighted for each of the topics.

  14. Rheumatoid Arthritis Educational Video Series

    Science.gov (United States)

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

  15. Leprosy-related mortality in Brazil: a neglected condition of a neglected disease.

    Science.gov (United States)

    Martins-Melo, Francisco Rogerlândio; Assunção-Ramos, Adriana Valéria; Ramos, Alberto Novaes; Alencar, Carlos Henrique; Montenegro, Renan Magalhães; Wand-Del-Rey de Oliveira, Maria Leide; Heukelbach, Jorg

    2015-10-01

    Leprosy is a public health problem and a neglected condition of morbidity and mortality in several countries of the world. We analysed time trends and spatiotemporal patterns of leprosy-related mortality in Brazil. We performed a nationwide population-based study using secondary mortality data. We included all deaths that occurred in Brazil between 2000 and 2011, in which leprosy was mentioned in any field of death certificates. Leprosy was identified in 7732/12 491 280 deaths (0.1%). Average annual age-adjusted mortality rate was 0.43 deaths/100 000 inhabitants (95% CI 0.40-0.46). The burden of leprosy deaths was higher among males, elderly, black race/colour and in leprosy-endemic regions. Lepromatous leprosy was the most common clinical form mentioned. Mortality rates showed a significant nationwide decrease over the period (annual percent change [APC]: -2.8%; 95% CI -4.2 to -2.4). We observed decreasing mortality rates in the South, Southeast and Central-West regions, while the rates remained stable in North and Northeast regions. Spatial and spatiotemporal high-risk clusters for leprosy-related deaths were distributed mainly in highly endemic and socio-economically deprived regions. Leprosy is a neglected cause of death in Brazil since the disease is preventable, and a cost-effective treatment is available. Sustainable control measures should include appropriate management and systematic monitoring of leprosy-related complications, such as severe leprosy reactions and adverse effects to multidrug therapy. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  16. Chronic joint symptoms and prior arthritis diagnosis in community surveys: implications for arthritis prevalence estimates.

    OpenAIRE

    Feinglass, Joe; Nelson, Cynthia; Lawther, Timothy; Chang, Rowland W.

    2003-01-01

    OBJECTIVES: Alternative definitions of arthritis in community surveys provide very different estimates of arthritis prevalence among older Americans. This telephone interview study examines prevalence estimates based on the current Behavioral Risk Factor Surveillance System (BRFSS) arthritis case definition. METHODS: Interviews were conducted with 851 Chicago residents age 45 and older. Logistic regression was used to compare the age and sex controlled prevalence of poor health, restricted ac...

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

    Science.gov (United States)

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

    2015-04-01

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

  18. MRI and ultrasound in children with juvenile chronic arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Lamer, S.; Sebag, G.H

    2000-02-01

    In this era of advancing imaging technology, a knowledge of the relative values of available imaging techniques is necessary to optimize the management of children with juvenile chronic arthritis (JCA). After clinical examination, plain films remain the initial investigation. The need for radiation protection must be a priority in children with JCA. Conventional radiographs allow grouping of the various arthritides (on the base of the distribution and pattern of joint space changes) and staging of disease progression. Ultrasound (US) is very sensitive in the detection of joint effusions, especially in the hip, and guides fluid aspiration. US and Doppler can be used for the evaluation of synovial hypertrophy and activity. Arthrography and to a certain extent nuclear studies have been replaced by magnetic resonance imaging (MRI). MRI can demonstrate articular cartilage, joint effusion, synovial hypertrophy, cortical and medullary bone, cartilage and bone perfusion, and fibrocartilaginous structures (menisci and ligaments). Contrast enhanced MRI is the most sensitive modality to determine whether an arthritic condition is present. However, it does not assist in establishing a specific diagnosis. MRI determines accurately the activity and the extent of the disease and is particularly useful in the early detection of articular damage. Finally, MRI is of major importance in the evaluation of response to local therapy (especially steroids) and the detection of complications.

  19. Chronic arthritis in systemic lupus erythematosus: distinct features in 336 paediatric and 1830 adult patients.

    Science.gov (United States)

    Gormezano, Natali W S; Silva, Clovis A; Aikawa, Nadia E; Barros, Diego L; da Silva, Mariana A; Otsuzi, Carini I; Kozu, Katia; Seguro, Luciana Parente; Pereira, Rosa M R; Bonfá, Eloisa

    2016-01-01

    The objectives of this study are to assess the frequency of chronic arthritis and compare the clinical and laboratory features in a large population of childhood-onset systemic lupus erythematosus (cSLE) and adult-onset (aSLE) patients. This historical study evaluated 336 cSLE and 1830 aSLE patients. Chronic arthritis was defined as synovitis of at least 6 weeks of duration. Rhupus was characterised as the association of SLE and chronic inflammatory arthritis with erosion and positive rheumatoid factor. Jaccoud's arthropathy is a non-erosive subluxation leading to severe deformity of the hands and feet. Data were compared using Student's t test or the Mann-Whitney test for continuous variables. For categorical variables, differences were assessed by Fisher's exact test and Pearson chi-square. Frequencies of chronic arthritis were similar in cSLE and aSLE (2.4 vs. 3.8%, p = 0.261). The median time from disease onset to appearance of chronic arthritis was shorter in cSLE (0 vs. 10 years, p lupus anticoagulant (40 vs. 1.6%, p = 0.012), anticardiolipin IgM (40 vs. 1.5%, p = 0.012) and median Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) [10.5(1-20) vs. 6(4-16), p = 0.029] were higher in cSLE. Frequency of rhupus, (12 vs. 17%, p = 1.0), Jaccoud's arthropathy (0 vs. 17%, p = 0.343) and treatments were similar in cSLE and aSLE. We determined that chronic arthritis in SLE has distinct features in children, with very early onset, polyarticular involvement and association with active disease. We further demonstrated in this series that a proportion of chronic arthritis involvement in SLE is manifested as rhupus and Jaccoud's arthropathy.

  20. Chronic erosive seropositive arthritis in a patient with chronic hepatitis C

    Directory of Open Access Journals (Sweden)

    L P Ananjeva

    2008-01-01

    Full Text Available Joint syndrome evolution was prospectively followed up in a 49-year-old woman who had serum hepatitis in 1990. When she came to a rheumatologist for the first time in 1999 she complained of occasional joint pain. She did not have joint inflammatory changes at that time but chronic hepatitis С was revealed at the examination. Hepatitis С diagnosis was confirmed by morphological and repeated virological evaluations. During antiviral treatment the pt developed symmetrical polyarthritis involving hand joints. Elevation of cryoglobuline, rheumatoid factor and antinuclear antibodies level was revealed. During the next year polyarthritis recurred and later acquired undulatory course with periods of exacerbation and stabilization. Attempts of treatment with sulfasalazine failed due to transaminase elevation. In 2006 ulnar deviation appeared and rheumatoid factor level remained elevated. MRI showed multiple erosions of carpal bones. Considering features of joint syndrome development joint damage in this pt was regarded as arthritis associated with chronic hepatitis C.

  1. Prevalence of chronic diseases at the onset of inflammatory arthritis: a population-based study.

    NARCIS (Netherlands)

    Ursum, J.; Korevaar, J.C.; Twisk, J.W.R.; Peters, M.J.L.; Schellevis, F.G.; Nurmohamed, M.T.; Nielen, M.M.J.

    2013-01-01

    Objective. Little is known about the presence of chronic morbidity in inflammatory arthritis (IA) patients at disease onset. Previous studies have been mainly performed in established IA patients or they focus on isolated co-morbid diseases. Our aim was to determine the prevalence of chronic disease

  2. Community Acquired Chronic Arthritis due to Pseudomonas aeruginosa in a Previously Healthy Pregnant Woman

    Directory of Open Access Journals (Sweden)

    Mesut Yilmaz

    2014-01-01

    Full Text Available Septic arthritis caused by Pseudomonas aeruginosa is uncommon in the immunocompetent population, despite its occurrence in younger patients with open injuries and in intravenous drug abusers. Here we report a case of septic arthritis caused by P. aeruginosa. This case is unique for several reasons. First, it is a case of septic arthritis in a pregnant woman with no traditional risk factors reported in the literature including history of prior traumatic events, hospitalisation, or chronic underlying disease. She was suspected of having transient osteoporosis associated with pregnancy to involve both hip joints. Second, this is the first reported case of a community acquired chronic septic arthritis due to P. aeruginosa involving large joints of both upper and lower extremities. The patient was treated successfully with a combination of ceftazidime and amikacin for 4 weeks followed by oral ciprofloxacin 750 mg twice daily for 8 weeks.

  3. Low-intensity laser therapy efficacy evaluation in FVB mice subjected to acute and chronic arthritis.

    Science.gov (United States)

    Issa, João Paulo Mardegan; Trawitzki, Bianca Ferreira; Ervolino, Edilson; Macedo, Ana Paula; Lilge, Lothar

    2017-08-01

    Rheumatoid arthritis, an autoimmune inflammation, has a high prevalence in the population, and while therapy is available, it required often injection of drugs causing discomfort to patients. This study evaluates the clinical and histological effect of low-intensity laser therapy (LILT) as an alternative treatment, in a murine model of acute and chronic inflammation. FVB mice received either a Zymosan A injection into one knee joint inducing acute inflammation, followed after 15 min or 24 h by LILT or a collagen bovine type II injection emulsified in "Freund's Complete Adjuvant" to induce chronic arthritis, followed at 4 weeks with multiple LILT sessions. LILT mediated by either 660, 808, or 905 nm and tissue response was evaluated based on clinical symptoms and histological analysis of inflammatory infiltrate and damage to the articular surfaces. LILT can be effective in elevating clinical symptoms, so Kruskal-Wallis testing indicated no significant differences between knees affected by acute arthritis and treated once with LILT and an injured knee without treatment (p > 0.05) for 660 and 808 nm with some improvements for the 905-nm LILT. Mice receiving two treatments for acute arthritis showed exacerbation of inflammation and articular resorption following therapy with a 660-nm continuous laser (p  0.05). Among the lasers, the 905 nm tends to show better results for anti-inflammatory effect in acute arthritis, and the 660 nm showed better results in chronic arthritis. In conclusion, LILT wavelength selection depends on the arthritis condition and can demonstrate anti-inflammatory effects for chronic arthritis and reduced resorption area in this murine model.

  4. Rheumatoid Arthritis Educational Video Series

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

  5. Chronic septic arthritis of the adult hip: Computed tomographic features

    Energy Technology Data Exchange (ETDEWEB)

    Resnik, C.S.; Ammann, A.M.; Walsh, J.W.

    1987-10-01

    Abnormalities on computed tomography (CT) are described in 12 adults in whom septic arthritis of the hip was diagnosed. Presenting symptoms varied, as did CT findings. Soft tissue abnormalities ranged from intra-articular effusion to large abscess formation, and bone changes ranged from minimal erosion of articular surfaces to gross destruction of the proximal femur and acetabulum. CT can be helpful in the evaluation of septic arthritis of the hip because of its superior demonstration of soft tissue detail. An accurate diagnosis can be established in unsuspected cases and can be confirmed when clinical indicators are vague.

  6. Acanthamoeba polyphaga in rheumatoid arthritis: possibility for a chronic infection.

    Science.gov (United States)

    Jeansson, S; Kvien, T K

    2001-06-01

    Acanthamoeba polyphaga (AP) is ubiquitous in nature and frequently infects humans. AP has some features, such as persistence, which makes it an attractive candidate in studies of a possible infectious aetiology in rheumatoid arthritis (RA). In this study the occurrence of AP-specific antibodies was compared between RA patients and matched controls.

  7. Increased frequency of HLA-DPw2 in pauciarticular onset juvenile chronic arthritis

    DEFF Research Database (Denmark)

    Ødum, Niels; Morling, Niels; Friis, J;

    1986-01-01

    Thirty-six unrelated Danish patients with pauciarticular Juvenile Chronic Arthritis (PJCA) and 120 controls were typed for HLA-DPw1-w6 and the local specificity CDPHEI with bulk-expanded Primed Lymphocyte Typing (PLT) cells. The frequency of HLA-DPw2 was 52.8% in PJCA patients and 16.7% in contro...

  8. Chronic comorbidity in patients with early rheumatoid arthritis: a descriptive study.

    NARCIS (Netherlands)

    Kroot, E.J.A.; Gestel, A.M. van; Swinkels, H.L.; Albers, M.; Putte, L.B.A. van de; Riel, P.L.C.M. van

    2001-01-01

    OBJECTIVE: To study the presence of chronic coexisting diseases in patients with rheumatoid arthritis (RA) and its effect on RA treatment, disease course, and outcome during the first years of the disease. METHODS: From January 1985 to December 1990, 186 patients with recent onset RA were enrolled i

  9. Erythrocyte-methotrexate and disease activity in children treated with oral methotrexate for juvenile chronic arthritis

    DEFF Research Database (Denmark)

    Kristensen, K; Nielsen, S; Karup Pedersen, F;

    2000-01-01

    The concentration of methotrexate (MTX) in erythrocytes (E-MTX) was measured twice with three months interval in 21 children suffering from juvenile chronic arthritis (JCA). At the same time joint score, visual analogue scale (VAS), and laboratory parameters (CRP, WBC, PMNs, and ALAT) were obtained...

  10. Human intestinal flora and the induction of chronic arthritis : studies in an animal model.

    NARCIS (Netherlands)

    A.J. Severijnen

    1990-01-01

    textabstractThe etiology of rheumatoid arthritis (RA), a chronic joint inflammation, is unknown. A microbial involvement is suspected, but no particular microorganism has been incriminated. The human intestinal microflora is an abundant and continuous source of bacterial antigens and may be involved

  11. Induction of chronic arthritis in rats : the role of intestinal bacteria and bacterial cell wall fragments

    NARCIS (Netherlands)

    J. Kool (Jeanette)

    1992-01-01

    textabstractRheumatoid arthritis is a chronic, disabling joint disease occurring in about 1% of the population. Women are more often affected than men, and there is a genetic predisposition based on the presence of the HLA-DR4 (Dw4, Dw14, Dwl5) gene or the HLA-DRl gene. Results from investigations i

  12. Family Health and Characteristics in Chronic Fatigue Syndrome, Juvenile Rheumatoid Arthritis, and Emotional Disorders of Childhood.

    Science.gov (United States)

    Rangel, Luiza; Garralda, M. Elena; Jeffs, Jim; Rose, Gillian

    2005-01-01

    Objective: To compare family health and characteristics in children with chronic fatigue syndrome (CFS), in juvenile rheumatoid arthritis (JRA), and emotional disorders. Method: Parents of 28 children and adolescents aged 11 to 18 years with CFS, 30 with JRA, and 27 with emotional disorders (i.e., anxiety and/or depressive disorders) were…

  13. How to optimize treatment in patients with gout and chronic arthritis Urisan is in focus

    Directory of Open Access Journals (Sweden)

    A E Ilyina

    2009-01-01

    Full Text Available The paper outlines the specific features of the clinical picture and diagnosis of chronic gouty arthritis. It describes difficulties in treating chronic gout when one has to face the so-called vicious circle, to which is contributed by comorbidity that is present in most patients. A way out of this clinical difficulty is proposed to use the herbal complex Urisan that has antihyperuricemic and inflammatory properties.

  14. How to optimize treatment in patients with gout and chronic arthritis Urisan is in focus

    Directory of Open Access Journals (Sweden)

    A E Ilyina

    2009-03-01

    Full Text Available The paper outlines the specific features of the clinical picture and diagnosis of chronic gouty arthritis. It describes difficulties in treating chronic gout when one has to face the so-called vicious circle, to which is contributed by comorbidity that is present in most patients. A way out of this clinical difficulty is proposed to use the herbal complex Urisan that has antihyperuricemic and inflammatory properties.

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

    Science.gov (United States)

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

    2009-01-01

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

  16. Salivary TNFα levels in groups of subjects with rheumatoid arthritis and chronic periodontitis.

    Science.gov (United States)

    Gamel, Ehsan B; Hashim, Nada T; Satti, Asim; Gismalla, Bakri G

    2017-01-07

    Rheumatoid arthritis (RA) and chronic periodontitis are the most common chronic inflammatory diseases with significant pathological and clinical similarities. Numerous studies have indicated a relationship between rheumatoid arthritis and periodontal disease. The aim of this study was to compare the TNF-α levels in saliva among patients with Rheumatoid arthritis (RA) and chronic periodontitis as well as healthy subjects. One hundred and seventy-one patients were enrolled in this cross-sectional study. Fifty-seven patients diagnosed of RA, 57 patients with chronic periodontitis and 57 healthy subjects. These patients have been examined with regard to TNF-α level from salivary samples. Their teeth were examined with regard to Plaque Index , Gingival Index, probing depth and clinical attachment level.All patients were non-smokers. The results revealed a significant difference in all periodontal parameters among the three groups. The chronic periodontitis group showed a significantly higher value in all clinical periodontal parameters in comparison to both the RA and healthy groups. No significant difference was found between salivary TNF-α level among the three study groups. Patients with chronic periodontitis had the highest periodontal indices. However there was no significant difference regarding the level of salivary TNF-α. Hence, suppression of proinflammatory cytokines might prove beneficial in suppressing periodontal diseases among RA patients.

  17.  Adiponectin in early and chronic rheumatoid arthritis and osteoarthritis

    DEFF Research Database (Denmark)

    Laurberg, Trine Bay

      Dato 31. januar 2006Title Adiponectin in early and chronic rheumatoid arthritis and osteoarthritisAuthors:Trine Bay Laurberg,Torkell Ellingsen,Jan Frystyk,Ib Hansen,Anette Jørgensen,Ulrik Tarp,Merete Lund Hetland,Kim Hørslev-Petersen,Nete Hornung,Jørgen Hjelm Poulsen,Allan Flyvbjerg......,Kristian Stengaard-PedersenBackground: Rheumatoid arthritis (RA) is a systemic, chronic, autoimmune disease, which affects the joints with inflammation leading to destruction of cartilage and bone. Osteoarthritis (OA) is a degenerative joint disease characterised by low level of chronic inflammation, slow...... diabetes mellitus. It is unknown if adiponectin is involved in the disease process of RA and OA.Objectives:  The aim was to quantify plasma adiponectin (p-adiponectin) from RA and OA patients and to evaluate p-adiponectin as a marker of treatment response to methotrexate (MTX) and disease activity in RA...

  18. Chronic sternal osteomyelitis complicating primary manubriosternal septic arthritis.

    Science.gov (United States)

    Sinha, S; Sinha, A; Nagarajah, K; Oei, E L; Critchley, P; McNally, M A

    2006-11-01

    We present a 40-year-old woman complaining of worsening chest pain. She was previously treated with a prolonged course of antibiotics for suspected sternal osteomyelitis. Radiological investigations were suggestive of ongoing inflammation within the manubriosternal joint. Formal surgical debridement yielded evidence corroborating the diagnosis although microbiological samples were negative. Prolonged empirical treatment with intravenous antibiotics leads to a complete resolution of symptoms. Primary culture-negative manubriosternal septic arthritis is rare, and suboptimal treatment, particularly if confused with other conditions such as synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome, compounds its considerable morbidity.

  19. Chronic arthritis and cardiovascular disease: altered blood parameters give rise to a prothrombotic propensity.

    Science.gov (United States)

    Beinsberger, Jilke; Heemskerk, Johan W M; Cosemans, Judith M E M

    2014-12-01

    Rheumatoid arthritis, and to a lesser extent ankylosing spondylitis and psoriatic arthritis, associates with increased morbidity and mortality due to cardiovascular complications. We hypothesized that the increased risk of cardiovascular disease is reflected by changes in blood parameters that are compatible with a prothrombotic propensity. To substantiate this notion, we performed an extensive literature search identifying such parameters. A search through PubMed (1970-2013) was done to find primary articles with the following search terms: rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis or synovial fluid. These were combined with keywords reflecting processes of atherothrombosis: atherosclerosis, cardiovascular disease, coagulation, endothelial, fibrinolysis, mean platelet volume, microparticle, platelet, platelet count and mass, thrombosis, and thrombus. The published studies point to a multitude of blood-related processes that can contribute to a prothrombotic propensity in chronic inflammatory diseases. These include an increase in platelet mass; low-level platelet activation, enforced by interaction with leukocytes and the formation of proinflammatory cytokines; a locally activated endothelium; and an increased coagulant activity. Patient treatment with methotrexate or TNF-α blockers appears to result in normalization of several of these prothrombotic parameters. This analysis provides a first identification of the mechanisms by which inflammatory arthritis can aggravate cardiovascular disease. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Chronic arthritis in children and adolescents in two Indian health service user populations

    Directory of Open Access Journals (Sweden)

    Jeanotte Diane

    2004-08-01

    Full Text Available Abstract Background High prevalence rates for rheumatoid arthritis, spondyloarthopathies, and systemic lupus erythematosus have been described in American Indian and Alaskan Native adults. The impact of these diseases on American Indian children has not been investigated. Methods We used International Classification of Diseases-9 (ICD-9 codes to search two Indian Health Service (IHS patient registration databases over the years 1998–2000, searching for individuals 19 years of age or younger with specific ICD-9-specified diagnoses. Crude estimates for disease prevalence were made based on the number of individuals identified with these diagnoses within the database. Results Rheumatoid arthritis (RA / juvenile rheumatoid arthritis (JRA was the most frequent diagnosis given. The prevalence rate for JRA in the Oklahoma City Area was estimated as 53 per 100,000 individuals at risk, while in the Billings Area, the estimated prevalence was nearly twice that, at 115 per 100,000. These rates are considerably higher than those reported in the most recent European studies. Conclusion Chronic arthritis in childhood represents an important, though unrecognized, chronic health challenge within the American Indian population living in the United States.

  1. [Fear of progression in patients with cancer, diabetes mellitus and chronic arthritis].

    Science.gov (United States)

    Dankert, A; Duran, G; Engst-Hastreiter, U; Keller, M; Waadt, S; Henrich, G; Herschbach, P

    2003-06-01

    Fear of an increasing disease progression (fear of progression) is among the main psychological stresses in patients with cancer, diabetes mellitus (type 1 and type 2) and chronic arthritis. The questions the study seeks to answer are: (1) Which are the main fears of these patients?, (2) How and in which circumstances in life do they occur?, (3) Which are the triggers of the fear? To answer these questions, a sample of 65 patients were researched through interviews. The results indicate that the predominant fears of cancer patients are the fear of dying and the unpredictability of the progression of the disease. Patients with chronic arthritis most frequently fear being physically dependent on someone else. The most common anxiety of diabetes patients are long-term complications. For all three groups of patients job-related fears cause a high amount of distress. These results contribute to the development of a standardised fear of progression questionnaire.

  2. Chronic lymphocytic leukemia/small lymphocytic lymphoma presenting as septic arthritis of the shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Donovan, Andrea; Schweitzer, Mark E.; Nomikos, George [NYU Hospital for Joint Diseases, New York, NY (United States); Garcia, Roberto A. [Bellevue Hospital Center, New York, NY (United States)

    2008-11-15

    We report a case of a 53-year-old man presenting with shoulder pain mimicking septic arthritis. Laboratory findings were atypical. Biopsy performed to assess for possible osteomyelitis demonstrated chronic lymphocytic leukemia/small lymphocytic lymphoma. Intra-articular lymphoma is a rare but important consideration in patients with atypical clinical presentation. Imaging alone may be insufficient to render diagnosis as lymphoma can mimic infection, synovial hypertrophic processes, and depositional arthropathy. (orig.)

  3. Therapeutic exercises in the combination therapy of patients with juvenile chronic arthritis

    Directory of Open Access Journals (Sweden)

    Tatyana Andreyevna Shelepina

    2013-01-01

    Full Text Available The paper analyzes the role of therapeutic exercises in the therapy of patients with juvenile chronic arthritis. The author discusses the time of, indications for, and contraindications to their use and states her belief that it is advisable for a rheumatologist to prescribe this therapy option. The data available in the literature and the author’s data on the efficiency of this therapy are given.

  4. Success rates of first-line antibiotics for culture-negative sub-acute and chronic septic arthritis.

    Science.gov (United States)

    Chuckpaiwong, Bavornrit; Phoompoung, Saravut

    2014-09-01

    A combination of surgical and medical treatment is normally required for patients with septic arthritis. Antibiotics selected for use on these patients are normally based on tissue culture results. However, in sub-acute and chronic septic arthritis cases, the results of the culture are usually negative as a result of prior treatment. The present study will investigate the incidence of culture-negative septic arthritis and the outcomes based on the use of first-line drug antibiotics for the treatment of sub-acute and chronic septic arthritis. For the present study, the authors retrospectively reviewed medical records of surgically treated septic arthritis cases over the past 10 years at Siriraj Hospital. The patient culture results, the antibiotics used, and the results of treatment were all recorded and analyzed. One hundredfifty-three septic arthritis patients were reviewed. Sixty-two patients were classified as having been diagnosed with either sub-acute or chronic septic arthritis. Thirty-six of 62 patients (58.1%) had a negative culture result. In the culture-positive patients, 42.3% had Streptococcus, 26.9% had Staphylococcus aureus, 11.5% had other gram positive bacteria, 15.4% had gram-negative bacteria, and 3.8% had tuberculus infection. In the culture-negative sub-acute and chronic group (36 of 62), 23 patients received Cefazolin, nine patients received Cloxacillin, and four patients received Clindamycin. Successful results were 69.9%, 66.7% and 75%, respectively. The present study reflects that the incidence ofculture-negative, sub-acute and chronic septic arthritis is approximately 58.1%. The first-line class of antibiotics remains the appropriate antibiotic choice for these patients because they are still effective for treatment of septic arthritis in up to 70% of all cases.

  5. Effect of Electro-acupuncture on Rat Joint Patho-morphology of Chronic Adjuvant Arthritis Model

    Institute of Scientific and Technical Information of China (English)

    张幼美; 胡玲; 唐纯志; 曹伟

    2003-01-01

    Objective:To study the effect of electro-acupuncture (EA) on pathomorphological changes of joints in rat model of chronic adjuvant arthritis. Methods: The rat chronic adjuvant arthritis model was established by subcutaneous injection of 0.1 ml of complete Freund's adjuvant to the left hind sole. Forty Wistar rats were randomly divided into the model group, the low frequency (2 Hz) EA group, the high frequency EA (100 Hz) group and the body acupuncture group. After being modeled except the model group, the other three groups were treated with EA or body acupuncture in Yanglingquan points (bilateral) for 3 weeks, the left ankle joints and metatarsal joints of rats were taken for pathological examination by fixing with 10% formalin and embedding in paraffin, sectioning and staining with HE. Results: Obvious inflammatory cell infiltration, loosened synovial tissue, damage of articular cartilage and proliferation of synovial cells and granulation tissue were observed in the sections of joints in model rats. These pathological changes were significantly improved after treatment, and the effect in the high frequency EA group were significantly superior to that in the low frequency EA and body acupuncture group. Conclusion: High frequency EA could significantly improve the pathomorphological changes of joints in chronic adjuvant arthritis rat models.

  6. Effect of Electro—acupuncture on Rat Joint Pathomorphology of Chronic Adjuvant Arthritis Model

    Institute of Scientific and Technical Information of China (English)

    ZHANGYou-mei; HULing; 等

    2003-01-01

    Objective:To study the effect of electro-acupuncture(EA) on pathomorphological changes of joints in rat model of chronic adjuvant arthritis.Methods:The rat chronic adjuvant arthritis model was established by subcutaneous injection of 0.1 ml of complete Freunds adjuvant to the left hind sole.Forty Wistar rats were randomly divided into the model group,the low frequency(2Hz) EA group,the high frequency EA(100Hz)group and the body acupuncture group.After being modeled except the model group,the other three groups were treated with EA or body acupuncture in Yanglingquan points(bilater-al)for 3weeks,the left ankle joints and metatarsal joints of rats were taken for pathological examination by fixing with 10% formalin and embedding in paraffin,sectioning and staining with HE.Results:Obvious inflammatory cell infiltration,loosened synovial tissue,damage of articular cartilage and proliferation of synovial cells and granulation tissue were observed in the sections of joints in model rats.These pathologi-cal changes were significantly improved after treatment,and the effect in the high frequency EA group were significantly superior to that in the low frequency EA and body acupuncture group.Conclusion:High frequency EA could significantly improve the pathomorphological changes of joints in chronic adjuvant ar-thritis rat models.

  7. FEATURES OF THE CHRONIC PAIN SYNDROME IN PATIENTS WITH RHEUMATOID ARTHRITIS AND MEDICAL DIAGNOSTIC TACTICS

    Directory of Open Access Journals (Sweden)

    M. A. Gromova

    2016-01-01

    Full Text Available Objective: to establish features of a chronic pain syndrome disorders in patients with rheumatoid arthritis, to reveal correlation with psychoemotional disorders and to develop the differential approach to maintaining patients. Materials and methods. 101 patients at the age of 60.6 ± 11.8 years, 92 % of women, with reliable rheumatoid arthritis (American College of Rheumatology – ACR, 1987, were examined. The visual analog scale was used for an assessment of pain strength at the moment; the Van Korff’s questionnaire – for determination of pain strength at the moment and retrospectively for the last half a year with an assessment of disadaptation level and disability, ranging of a chronic pain syndrome on classes; the McGill Pain Questionnaire – for the characteristic of touchsensitive and emotional components of pain. Neuropathic pain was revealed by DN4 questionnaire. Anxiety and depression were determined by the Hospital Anxiety and Depression Scale (HADS. Fibromyalgia diagnosed by criteria of ACR, (1990. Results. Pain estimated by various scales and questionnaires varied from moderated to intensive. According to Van Korff’s questionnaire it was characterized by average level of disadaptation and easy disability that corresponded to the second class of chronic pain. The Rank pain index of the McGill Pain Questionnaire touch scale testified that pain was described by a smaller number of definitions on a touch scale than on emotional. This indicates a moderate impact of pain syndrome on a state of mind. Neuropathic pain is diagnosed for 37.3 % of patients with tunnel syndrome, mononeuritis and touch polyneuropathy. The secondary fibromyalgia is revealed for 2 % of patients with early rheumatoid arthritis of high activity. According to HADS anxiety and depression was revealed for 58 and 59 % of patients correspondingly. This demanded psychotherapeutic consultation and additional correction. We proposed the algorithm of diagnostic and

  8. Artrite crônica e periodontite Chronic arthritis and periodontitis

    Directory of Open Access Journals (Sweden)

    Flávia Silva Farah Ferreira Braga

    2007-08-01

    Full Text Available Como parecem existir similaridades entre os mecanismos patogenéticos de doenças reumatológicas, como a artrite reumatóide e a artrite idiopática juvenil com a periodontite, alguns estudos têm sido publicados com o objetivo de levantar evidências de uma possível inter-relação entre essas condições. A artrite reumatóide parece modular a resposta imune do hospedeiro, podendo aumentar a suscetibilidade à doença periodontal destrutiva em adultos. Recentemente, evidenciou-se que também pacientes com artrite idiopática juvenil possuíam maior suscetibilidade à doença periodontal destrutiva comparados a indivíduos saudáveis da mesma idade. No entanto, ainda se desconhecem os mecanismos que justificariam uma hipótese de associação entre essas condições crônicas inflamatórias. Sendo assim, o objetivo deste trabalho foi promover uma revisão da literatura sobre uma possível relação entre artrite crônica e periodontite.As similarities between pathogenetic mechanisms concerning rheumatic diseases, such as rheumatoid arthritis and juvenile idiopathic arthritis, with periodontitis may exhist, some studies have been published with the objective of showing evidences of a possible relationship between these conditions. Rheumatoid arthritis seems to modulate the host's immune mechanisms and may increase the susceptibility of adults to destructive periodontal disease. Recently evidences showed that also patients with juvenile idiopathic arthritis had an increased susceptibility to destructive periodontal disease compared to healthy individuals of the same age. Nevertheless the mechanisms of association of these chronic inflammatory conditions remain unclear. So, this study aims to review literature concerning a possible relationship between chronic arthritis and periodontitis.

  9. 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 ...

  10. 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 ...

  11. Association between chronic periodontitis and rheumatoid arthritis: a hospital-based case-control study.

    Science.gov (United States)

    Joseph, Rosamma; Rajappan, Sreeraj; Nath, Sameera G; Paul, Binoy J

    2013-01-01

    Rheumatoid arthritis (RA) and chronic periodontitis are the most common chronic inflammatory diseases with remarkable pathological and clinical similarities. A lot of similarities exist between RA and periodontitis at cellular and molecular levels. The relationship between these two chronic inflammatory diseases is still unclear. This case-control study was undertaken to determine the possible association between chronic inflammatory diseases like RA and periodontitis. The case group consisted of 100 patients attending the Rheumatology clinic who have rheumatoid arthritis (RA group). Age- and gender-matched 112 patients without RA attending the Outpatient wing of Department of General Medicine formed the control group (NRA group). The number of missing teeth, gingival index (GI), oral hygiene index-simplified (OHI-S), probing pocket depth (PPD) and clinical attachment levels (CAL) were evaluated in both the groups. Rheumatoid disease activity was assessed by DAS-28 score system. Systemic markers of inflammation like erythrocytic sedimentation rate (ESR) and serum levels of C-reactive protein (CRP) were assessed. There was a statistically significant difference in GI, OHI-S, PPD, CAL, ESR and CRP levels between cases (RA group) and controls (NRA group) (P < 0.05). Among subjects with RA, there was no association between the rheumatoid disease activity and the severity of periodontal disease. The occurrence and severity of periodontitis was found to be higher in RA subjects as compared to subjects without RA, suggesting a positive relation between these two chronic inflammatory diseases.

  12. Treatment of knee flexion contracture in patients with chronic juvenile arthritis: A case report

    Directory of Open Access Journals (Sweden)

    Matijević Radmila

    2006-01-01

    Full Text Available Introduction. Knee flexion contractures are common after-effects of juvenile arthritis. Treatment is usually conservative and may include physical therapy and kinesitherapy. Surgical treatment, particularly of the soft parts, indicated for contractures resistant to conservative treatment, helps to correct the deformity, maintain movements, and relieves pain. Intensive postoperative physiotherapy is of special importance. Case report. A 23-year-old female patient with chronic juvenile arthritis since the age of one was admitted for treatment of flexion con­tractures in both knees, muscle hypotrophy, loss of strength and gait disability. The patient underwent arthroscopic synovectomy. The operation was first performed on the right and after 3 mouths on the left knee. The pre operative range of motion in the rigth knee was 30°-70° and in the left 40°-80°. The patient underwent intensive physical therapy to reduce postoperative swelling of knees and firstly passive and then active kinesitherapy. Nine months after the first surgery and six months after the second, the range of motion in the right knee was 0°-100° and in the left 0°-105°. The strength of tested muscles was increased and gait was improved. Conclusion. Management and rehabilitation of patients with chronic juvenile arthritis include maintenance or improvement in position and function of joints that is achieved with synovectomy. The results depend on combined interdisciplinary rehabilitation, well-experienced staff, and pre- and post-operative physiotherapy as well as kinesitherapy. Arthroscopic synovectomy has many advantages and we believe that it was a better solution than open capsulosynovectomy in this patient with chronic juvenile arthritis of the knee. .

  13. Does gamma-aminobutyric acid (GABA influence the development of chronic inflammation in rheumatoid arthritis?

    Directory of Open Access Journals (Sweden)

    Bridges S Louis

    2008-01-01

    Full Text Available Abstract Background Recent studies have demonstrated a role for spinal p38 MAP kinase (MAPK in the development of chronic inflammation and peripheral arthritis and a role for GABA in the inhibition of p38 MAPK mediated effects. Integrating these data suggests that GABA may play a role in downregulating mechanisms that lead to the production of proinflammatory agents such as interleukin-1, interleukin-6, and matrix metalloproteinase 3 – agents implicated in the pathogenesis of rheumatoid arthritis (RA. Genetic studies have also associated RA with members of the p38 MAPK pathway. Hypothesis We propose a hypothesis for an inefficient GABA signaling system that results in unchecked proinflammatory cytokine production via the p38 MAPK pathway. This model also supports the need for increasing research in the integration of immunology and neuroscience.

  14. QUALITY OF LIFE, PERCEIVED STIGMA, ACTIVITY AND PARTICIPATION OF PEOPLE WITH LEPROSY-RELATED DISABILITIES IN SOUTH-EAST NEPAL

    Directory of Open Access Journals (Sweden)

    Huib Cornielje

    2011-05-01

    Full Text Available In Nepal, many people live with leprosy-related disabilities. The objective of this study was to evaluate differences in socio-economic characteristics, quality of life (QOL, perceived stigma, activity and participation among people affected by leprosy as a group and between this group and the general population, and to identify prime determinants of QOL among the leprosy-affected people. People with leprosy-related disabilities (N=100; 54DGI/46DGII and community controls (N=100 were selected from Morang district, South-East Nepal, using quota sampling. QOL, perceived stigma and participation and activity limitations were measured using the Nepali abbreviated version of the World Health Organisation Quality of Life (WHOQOL assessment and the Nepali versions of the Jacoby Scale, Participation Scale and Green Pastures Activity Scale (GPAS, respectively. Total QOL, participation and activity levels of people affected by leprosy were worse than those of the general population. Regression analysis showed that the ability to maintain a family, satisfaction with health, vocational training, sex, activity and participation limitations (the latter for QOL only, perceived stigma and living situation (i.e. joint family, type of house were significantly associated with a deterioration in QOL and higher participation restriction in one or both of the grading groups. There is an urgent need for interventions focused on quick referral of people with leprosy, to minimize the development of visible impairments, and social rehabilitation. The latter can be achieved by creating more public awareness, providing (financial support for income generating projects and /or vocational training to leprosy- affected people, and by encouraging them to be involved in all community development activities. The current results indicate that such measures would help improve the quality of life of people with leprosy-related disabilities.DOI 10.5463/DCID.v22i1.15

  15. Cartilage oligomeric matrix protein deficiency promotes early onset and the chronic development of collagen-induced arthritis

    DEFF Research Database (Denmark)

    Geng, Hui; Carlsen, Stefan; Nandakumar, Kutty;

    2008-01-01

    ABSTRACT: INTRODUCTION: Cartilage oligomeric matrix protein (COMP) is a homopentameric protein in cartilage. The development of arthritis, like collagen-induced arthritis (CIA), involves cartilage as a target tissue. We have investigated the development of CIA in COMP-deficient mice. METHODS: COMP......-deficient mice in the 129/Sv background were backcrossed for 10 generations against B10.Q mice, which are susceptible to chronic CIA. COMP-deficient and wild-type mice were tested for onset, incidence, and severity of arthritis in both the collagen and collagen antibody-induced arthritis models. Serum anti......-collagen II and anti-COMP antibodies as well as serum COMP levels in arthritic and wild-type mice were measured by enzyme-linked immunosorbent assay. RESULTS: COMP-deficient mice showed a significant early onset and increase in the severity of CIA in the chronic phase, whereas collagen II-antibody titers were...

  16. Physical fitness and its relationship to other indices of health status in children with chronic arthritis.

    Science.gov (United States)

    Malleson, P N; Bennett, S M; MacKinnon, M; Jespersen, D K; Coutts, K D; Turner, S P; McKenzie, D C

    1996-06-01

    To compare aerobic and anaerobic fitness of a group of children w-th chronic arthritis with that of healthy controls, and to explore the relationship between physical fitness and other indices of health status in these children. Thirty-one children aged 8 to 17 years with chronic arthritis of varying type and severity and 16 physically healthy controls participated in the study. Using a cycle ergometer, aerobic fitness was assessed by measuring peak oxygen uptake achieved in a 15 s period during exercise to volitional fatigue. Anaerobic fitness was assessed by measuring peak power in the legs in a 5 s period and total work completed (Wingate test). Joint pain experienced over the week before testing and during testing was measured using a 10 cm visual analog scale. Self-esteem was measured using the Self Perception Profile for Children Questionnaire. There were no significant differences between mean peak O2 uptake or mean peak anaerobic power for patients and controls; however, the mean values for both controls and patients were significantly lower than reported values for healthy children. Peak O2 uptake controlled for age, sex, and sum of skinfolds was negatively associated with disease severity, measured by physician global assessment (p = 0.04), but peak power was not. Neither aerobic nor anaerobic fitness were associated with disease activity measured by physician global assessment or active joint count, or with disease duration. There was a tendency for children with active arthritis to experience less pain during fitness testing than over the previous week (p = 0.06). Testing did not seem to exacerbate joint symptoms. Self-ratings of athletic competence were significantly correlated with peak O2 uptake achieved for children with arthritis (r = 0.43, p = 0.02), but not for controls. Global self-esteem was moderately correlated with self-rated athletic competence in controls (r = 0.49, p = 0.09), but was not in children with arthritis. In this sample of

  17. Activity of lysosomal exoglycosidases in serum and synovial fluid in patients with chronic Lyme and rheumatoid arthritis.

    Science.gov (United States)

    Pancewicz, Slawomir; Popko, Janusz; Rutkowski, Ryszard; Knaś, Malgorzata; Grygorczuk, Sambor; Guszczyn, Tomasz; Bruczko, Marta; Szajda, Slawomir; Zajkowska, Joanna; Kondrusik, Maciej; Sierakowski, Stanislaw; Zwierz, Krzysztof

    2009-01-01

    Lysosomal exoglycosidases participate in the destruction of the articular cartilage by cleaving glycoside bonds in glycoproteins and proteoglycans. The aim of the study was to determine the activity of exoglycosidases: hexosaminidase, beta-glucuronidase, beta-galactosidase, alpha-mannosidase and alpha-fucosidase in serum and synovial fluid of patients with Lyme and rheumatoid arthritis. The study group consisted of 10 patients with chronic Lyme arthritis (age 18 - 74 y), 13 with rheumatoid arthritis (age 32 - 70 y) and 10 with juvenile idiopathic arthritis (age 8 - 17 y). The control group consisted of 9 healthy volunteers (age 24 - 62 y). The activity of the exoglycosidases was determined with the p-nitrophenyl derivatives of sugars as substrates. A significant increase of the activity of all the exoglycosidases in serum and in synovial fluid of the patients with different forms of arthritis was found. The ratio of synovial fluid/serum activity of exoglycosidases was above 2.0 in LA but not in JIA and RA patients. As the main source of exoglycosidases in the joint is the synovial membrane, this result supports the appropriateness of therapeutic synovectomy in chronic Lyme arthritis with knee effusion. The serum activity of hexosaminidase may be used in monitoring the course of Lyme arthritis and the efficiency of treatment.

  18. Chronic gonococcal arthritis with C5 deficiency presenting with brief flare-ups: case study and literature review.

    Science.gov (United States)

    Davido, B; Dinh, A; Lagrange, A; Mellon, G; de Truchis, P; Perronne, C; Cremieux, A C

    2014-09-01

    Gonococcal arthritis is typically acute and appears within 3 weeks after initial infection. Chronic gonococcal arthritis is now exceptionally rare, since the advent of the antibiotic era. Numerous host factors are involved in gonococcal dissemination, such as complement deficiency, HIV and gonococcus strain characteristics. Gonococcal arthritis shares the same risk factors. In this instance, our patient was a 16-year-old girl suffering from persistent polyarthralgia with joint swelling presenting with brief flare-ups for a period of 1 year. She disclosed a single episode of unprotected sexual intercourse 1 year ago, i.e. just before developing her first rheumatological symptoms. Therefore, we performed a joint aspiration (arthrocentesis), and synovial fluid was inoculated directly into aerobic and anaerobic blood culture bottles, which tested positive for Neisseria gonorrhoeae within 24 h. Clinical presentation was consistent with previous reports of chronic gonococcal arthritis. Further investigation revealed a C5 complement deficiency, which might explain the chronic Neisseria process. A favourable outcome was reached after a ten-day course of IV ceftriaxone, with no apparent sequelae found during follow-up 6 weeks later. This case demonstrates an unusual gonococcal arthritis with brief flare-ups for the course of a year, followed by a subacute form. N. meningitidis infections, similar to N. gonorrhoeae, are typically acute and may sometimes be involved in chronic processes. However, this characteristic appears to be rare in the case of N. gonorrhoeae. Risk factors for this chronic process will be discussed with a review of the literature.

  19. THE USE OF PREPARATIONS BASED ON BACTERIAL LYSATES IN THE TREATMENT OF CHRONIC TONSILLITIS IN PATIENTS WITH RHEUMATOID ARTHRITIS

    OpenAIRE

    Kolyada T.І.; Tupotіlov A.V.; Vdovіchenko N.І; Litvinenko O.Y.

    2014-01-01

    In the therapy of decompensated form of chronic tonsillitis (CT) were used as immunomodulatory agents IRS and Ismigen. These bacterial lysates differ in the bacterial setting, the method of preparation (chemical, mechanical) and the method of application.Rheumatoid arthritis (RA) is one of the important factors that could significantly complicate the therapy of chronic tonsillitis. RA is a chronic immune inflammatory disease that progressively affects connective tissue...

  20. Assessment of bone mineral density in adults with a history of juvenile chronic arthritis: a cross-sectional long-term followup study

    DEFF Research Database (Denmark)

    Zak, M; Hassager, C; Lovell, D J

    1999-01-01

    To assess bone mineral density (BMD) and bone turnover in adults with a history of juvenile chronic arthritis (JCA) or persistent JCA, and to identify predictors of reduced BMD.......To assess bone mineral density (BMD) and bone turnover in adults with a history of juvenile chronic arthritis (JCA) or persistent JCA, and to identify predictors of reduced BMD....

  1. Effects of TGFbeta1 and extracts from Cervus korean TEMMINCK var. mantchuricus Swinhoe on acute and chronic arthritis in rats.

    Science.gov (United States)

    Kim, Kyung-Woon; Song, Kwon-Ho; Lee, Ji-Min; Kim, Kap-Sung; Kim, Sung-Il; Moon, Sung-Kwon; Kang, Bong-Seok; Kim, Dong-Soo; Chung, Kang-Hyun; Chang, Young-Chae; Kim, Cheorl-Ho

    2008-07-23

    To elucidate the pharmacological activities of deer antler acupuncture and TGF61538;1 on the acute and chronic phases of rheumatoid arthritis diseases. Polyarthritis rats were administered with TGF61538;1 and water extract of deer antler acupunture (DAA), prepared from the pilose antler of Cervus korean TEMMINCK var. mantchuricus Swinhoe. TGF61538; (0.1 to 2 61549;g/animal) and DAA (5-100 61549;g/kg animal) were initiated 1 day before an arthritogenic dose of streptococcal cell wall fragments to see the effects on the joint swelling and distortion during the acute phase and the chronic phase of the disease. Arthritic index suppression of rat arthritis model was examined by TGF61538; and DAA administrations. TGF61538;1 and DAA diminished the polyarthritis development in rats. TGF61538; and DAA eliminated the joint swelling and distortion observed during the acute phase and the chronic phase of the disease. The TGF61538; and DAA suppressed the arthritis progress when administration was begun after acute phase of arthritis. Consistent with the inhibition of inflammatory cell recruitment into the synovium, TGF61538;1 and DAA reversed the leukocytosis associated with the chronic phase of the arthritis, respectively.

  2. Rheumatoid Arthritis Educational Video Series

    Medline Plus

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

  3. Evaluation of the therapeutic effect of hydroxyapatite particles labeled with Ho sub 1 sub 6 sub 6 in rats with acute and chronic arthritis

    CERN Document Server

    Mendoza-Lopez, P

    2002-01-01

    with significantly statistical values (p<=0,01). This therapeutic effect was evident too when evaluating the measure of the articular perimeter in acute and chronic arthritis groups through the time with significantly statistical values (p<=0,01). In conclusion the hydroxyapatite particles labeled with Holmium-166 are biologically stable in vivo and have a therapeutic effect in the treatment of acute and chronic arthritis in rats. The therapeutic effect of an intraarticular injection of hydroxyapatite particles labeled with Holmium-166 ( Ho sub 1 sub 6 sub 6 HA) was evaluated. For this evaluation 72 antigen-induced arthritis rats; the arthritis was induced by an intraarticular injection of a suspension of ovoalbumin and Freund's adjuvant complete. The 72 rats were divided in three groups: control group, acute arthritis group and chronic arthritis group. The evaluation of the therapeutic effect was achieved by the measuring of the perimeter of the arthritic knee joint in different days after the intraart...

  4. A biopsychosocial investigation of pediatric chronic pain with special focus on juvenile idiopathic arthritis

    DEFF Research Database (Denmark)

    Lomholt, Johanne Jeppesen

    Our understanding and management of pediatric chronic pain have advanced markedly over the last half century. Chronic pain is pain that persists for a usually more than three months and is highly prevalent in children and adolescents. Juvenile idiopathic arthritis (JIA) can be characterized...... increased quality of life, reductions in anxiety levels and pain catastrophizing, and improvements in adaptive pain cognitions; the latter were expressed as strengthened beliefs in the ability to control pain and self-efficacy. After controlling for disease activity, no differences between the intervention...... and waitlist condition were found in measures of pain and functional disability. The feasibility of the CBT program was supported by a low drop-out rate, and high levels of reported intervention credibility and satisfaction with the treatment. In study 4 differences in pain and health complaints was examined...

  5. Sulfasalazine in the treatment of juvenile chronic arthritis - A randomized, double-blind, placebo-controlled, multicenter study

    NARCIS (Netherlands)

    Fiselier, TJW; Franssen, MJAM; Zwinderman, AH; ten Cate, R; van Suijlekom-Smit, LWA; van Luijk, WHJ; van Soesbergen, RM; Wulffraat, NM; Oostveen, JCM; Kuis, W; Dijkstra, PF; van Ede, CFP; Dijkmans, BAC

    1998-01-01

    Objective. To assess the efficacy, tolerability, and safety of sulfasalazine (SSZ) in the treatment of juvenile chronic arthritis (JCA). Methods. we conducted a 24-week randomized, placebo-controlled, double-blind, multicenter study of patients with active JCA of both oligoarticular and polyarticula

  6. Interleukin-1 receptor antagonist in neonates, children and adults, and in patients with pauci- and polyarticular onset juvenile chronic arthritis

    DEFF Research Database (Denmark)

    Müller, K; Zak, M; Nielsen, S;

    2011-01-01

    patients with juvenile chronic arthritis (JCA) of the pauci- or polyarticular onset type. RESULTS: IL-1ra serum levels were found to differ significantly between the three age groups, being higher in neonates (569 pg/ml) than in children (70 pg/ml) and adults (177 pg/ml). IL-1ra production in E. coli...

  7. Autoantibodies to IL-1 alpha in sera from umbilical cords, children, and adults, and from patients with juvenile chronic arthritis

    DEFF Research Database (Denmark)

    Müller, K; Hansen, M B; Zak, M;

    1996-01-01

    umbilical cords (n = 11), children (n = 45), and adults (n = 20), as well as in 51 patients with juvenile chronic arthritis (JCA) of pauciarticular (n = 34), polyarticular (n = 8), or systemic onset type (n = 9). RESULTS. The frequency of positive sera was significantly lower in children than in cord blood...

  8. [Preference for etanercept pen versus syringe in patients with chronic arthritis. Nurse education workshop].

    Science.gov (United States)

    Garcia-Diaz, Silvia; Girabent-Farrés, Montserrat; Roig-Vilaseca, Daniel; Reina, Delia; Cerdà, Dacia; González, Marina; Torrente-Segarra, Vicenç; Fíguls, Ramon; Corominas, Hèctor

    2013-01-01

    The aims of this study are to evaluate the level of fear of post-injection pain prior to the administration, the difficulty in handling the device, and the level of satisfaction of patients using a pre-filled syringe versus an etanercept pen, as well as to evaluate the usefulness of the training given by nursing staff prior to starting with the pen, and the preferences of patients after using both devices. A prospective study was designed to follow-up a cohort of patients during a 6 months period. The data was collected using questionnaires and analyzed with SPSS 18.00. Rank and McNemar tests were performed. Statistical significance was pre-set at an α level of 0.05. A total of 29 patients were included, of whom 69% female, and with a mean age 52.5±10.9 years. Of these, 48% had rheumatoid arthritis, 28% psoriatic arthritis, 21% ankylosing spondylitis, and 3% undifferentiated spondyloarthropathy. There were no statistically significant differences either with the fear or pain or handling of the device between the syringe and the pen (P=.469; P=.812; P=.169 respectively). At 6 months, 59% of patients referred to being satisfied or very satisfied with the pen. Almost all (93%) found useful or very useful the training given by nursing staff prior to using the pen, and 55% preferred the pen over the pre-filled syringe. The etanercept pen is another subcutaneous device option for patients with chronic arthritis. According to the present study, nursing educational workshops before starting this therapy are recommended. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  9. Analgesic effects of intra-articular botulinum toxin Type B in a murine model of chronic degenerative knee arthritis pain

    Directory of Open Access Journals (Sweden)

    Stephanie Anderson

    2010-09-01

    Full Text Available Stephanie Anderson1,2, Hollis Krug1,2, Christopher Dorman1, Pari McGarraugh1, Sandra Frizelle1, Maren Mahowald1,21Rheumatology Section, Veteran’s Affairs Medical Center, Minneapolis, Minnesota; 2Division of Rheumatology and Autoimmune Diseases, University of Minnesota Medical School, Minneapolis, Minnesota, USAObjective: To evaluate the analgesic effectiveness of intra-articular botulinum toxin Type B (BoNT/B in a murine model of chronic degenerative arthritis pain.Methods and materials: Chronic arthritis was produced in adult C57Bl6 mice by intra-articular injection of Type IV collagenase into the left knee. Following induction of arthritis, the treatment group received intra-articular BoNT/B. Arthritic control groups were treated with intra-articular normal saline or sham injections. Pain behavior testing was performed prior to arthritis, after induction of arthritis, and following treatments. Pain behavior measures included analysis of gait impairment (spontaneous pain behavior and joint tenderness evaluation (evoked pain response. Strength was measured as ability to grasp and cling.Results: Visual gait analysis showed significant impairment of gait in arthritic mice that improved 43% after intra-articular BoNT/B, demonstrating a substantial articular analgesic effect. Joint tenderness, measured with evoked pain response scores, increased with arthritis induction and decreased 49.5% after intra-articular BoNT/B treatment. No improvement in visual gait scores or decrease in evoked pain response scores were found in the control groups receiving intra-articular normal saline or sham injections. Intra-articular BoNT/B was safe, and no systemic effects or limb weakness was noted.Conclusions: This study is the first report of intra-articular BoNT/B for analgesia in a murine model of arthritis pain. The results of this study validate prior work using intra-articular neurotoxins in murine models. Our findings show chronic degenerative arthritis

  10. Diagnosis and treatment of heel pain in chronic inflammatory arthritis using ultrasound.

    Science.gov (United States)

    Cunnane, G; Brophy, D P; Gibney, R G; FitzGerald, O

    1996-06-01

    The authors examined the role of ultrasound (US) in diagnosis and management of heel pain in chronic inflammatory arthritis. Nineteen patients underwent US examination. Eight patients (2 with previously unsuccessful nonguided injections), had 11 US-guided corticosteroid injections for treatment of retrocalcaneal bursitis (n = 6), plantar fasciitis (n = 3), and posterior tibial tenosynovitis (n = 2). US-demonstrated Achilles tendon rupture (n = 2), Achilles tendinitis (n = 8), posterior tibial tenosynovitis (n = 6), peroneus longus tenosynovitis (n = 2), retrocalcaneal bursitis (n = 13), and plantar fasciitis (n = 4). Loss of smooth bone contour (n = 13) correlated with bone erosions on plain radiographs in all but one case. Ten of 11 guided injections resulted in full resolution of heel pain. The diverse causes of heel pain are highlighted, and the ability of US to provide information with management implications is confirmed. US-guided corticosteroid injection is beneficial, especially after failure of nonguided injection.

  11. The Mechanisms Underlying Chronic Inflammation in Rheumatoid Arthritis from the Perspective of the Epigenetic Landscape

    Directory of Open Access Journals (Sweden)

    Yasuto Araki

    2016-01-01

    Full Text Available Rheumatoid arthritis (RA is a chronic inflammatory autoimmune disease that is characterized by synovial hyperplasia and progressive joint destruction. The activation of RA synovial fibroblasts (SFs, also called fibroblast-like synoviocytes (FLS, contributes significantly to perpetuation of the disease. Genetic and environmental factors have been reported to be involved in the etiology of RA but are insufficient to explain it. In recent years, accumulating results have shown the potential role of epigenetic mechanisms, including histone modifications, DNA methylation, and microRNAs, in the development of RA. Epigenetic mechanisms regulate chromatin state and gene transcription without any change in DNA sequence, resulting in the alteration of phenotypes in several cell types, especially RASFs. Epigenetic changes possibly provide RASFs with an activated phenotype. In this paper, we review the roles of epigenetic mechanisms relevant for the progression of RA.

  12. Determination of salicylic acid by HPLC in plasma and saliva from children with juvenile chronic arthritis.

    Science.gov (United States)

    Legaz, M E; Acitores, E; Valverde, F

    1992-12-01

    A high performance liquid chromatography (HPLC) method has been developed for measuring salicylic acid in the plasma and saliva of children with juvenile chronic arthritis (JCA). Samples were extracted with diethyl ether and, after drying, redissolved in methanol to be chromatographed. Quantitation of salicylic acid was performed by reverse phase HPLC on a spherisorb ODS-2 column, using methanol: water: acetic acid as mobile phase. Phenolic was monitored by absorbance at 237 nm. Linearity between the amount of mass injected and the response in the detector was determined. This method was applied to compare concentrations of salivary and plasma salicylic acid. The method also permitted the quantitation of salivary salicylate as a non-invasive, indirect method for monitoring the concentration of plasma salicylate in patients with JCA.

  13. Monoarticular Arthritis.

    Science.gov (United States)

    Singh, Namrata; Vogelgesang, Scott A

    2017-05-01

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

  14. Chronic calcium pyrophosphate crystal inflammatory arthritis induced by extreme hypomagnesemia in short bowel syndrome

    Directory of Open Access Journals (Sweden)

    Hahn Markus

    2012-09-01

    Full Text Available Abstract Background Short bowel syndrome (SBS may induce a plethora of clinical symptoms ranging from underweight to nutrient-, vitamin- and electrolyte deficiencies. The objective of this case report is to illustrate how demanding the management of a 60 year old patient with SBS and recurrent joint attacks was for different medical disciplines. Case presentation The patient with SBS presented with a body mass index of 16.5 kg/m2 after partial jejunoileal resection of the small intestine with a six year long history of recurrent pain attacks in multiple peripheral joints, chronic diarrhoea and food intolerances. Pain attacks occurred 4–5 times a week with a median consumption of 15 mg prednisone per day. The interdisciplinary workup after several gastroenterologic, rheumatologic, radiologic, psychiatric and orthopedic consultations is shown including successful treatment steps. Clinical diagnosis revealed no systemic inflammatory disease, but confirmed extreme hypomagnesemia (0.2 mmol/l after reproducible pathological magnesium resorption tests as causative for chronic calcium pyrophosphate crystal inflammatory arthritis (pseudogout, chondrocalcinosis. Multidisciplinary treatment included application of colchicines, parenteral nutrition and magnesium substitution, antiperistaltic agents and avoidance of intolerant foods. Normalization of magnesium levels and a marked remission of joint attacks were achieved after six months with significant reduction of prednisone to 1.5 mg/day. Conclusion Despite the rarity of this condition, it is important to know that hypomagnesaemia may be associated with calcium pyrophosphate crystal inflammatory arthritis (chondrocalcinosis and that SBS patients may be prone to develop extreme hypomagnesaemia causing recurrent joint attacks without systemic inflammation.

  15. High molecular weight hyaluronan for treatment of chronic shoulder pain associated with glenohumeral arthritis

    Directory of Open Access Journals (Sweden)

    Weil AJ

    2011-07-01

    Full Text Available Arnold J WeilNon-Surgical Orthopedics PC, Marietta, GA, USABackground: There is insufficient evidence to determine whether intra-articular injections may be effective for treatment of glenohumeral osteoarthritis. Euflexxa® (high molecular weight hyaluronate, a bioengineered high molecular weight hyaluronan, has been shown to be a safe and effective treatment for patients with knee osteoarthritis. There is also support for the use of hyaluronate injection for the treatment of chronic shoulder pain associated with osteoarthritis or rotator cuff damage. This small-scale exploratory study was conducted to evaluate the safety and efficacy of high molecular weight hyaluronate for the treatment of chronic shoulder pain associated with osteoarthritis.Methods: Subjects with glenohumeral osteoarthritis and chronic pain (n = 27 received one injection per week for 3 weeks of high molecular weight hyaluronate and were assessed for changes in pain (100 mm visual analog scale [VAS], range of motion, and the subject’s and physician’s global assessment over 26 weeks. Subjects were also assessed for pain, stiffness, and physical functioning using the Western Ontario and McMaster Universities Arthritis Index (WOMAC. Finally, responses were evaluated using modified Outcome Measures in Rheumatoid Arthritis Clinical Trials (OMERACT-Osteoarthritis Research Society International (OARSI Proposition D criteria. Safety was assessed by recording adverse events.Results: High molecular weight hyaluronate significantly improved pain (VAS, WOMAC, range of motion, stiffness, and physical functioning scores; 77.8% of subjects were rated as having an OMERACT-OARSI Proposition D high response. There were no serious adverse events, and none were considered to be related to treatment.Conclusion: Treatment with high molecular weight hyaluronate improves pain, stiffness, and range of motion, and may have an acceptable safety and tolerability profile. A randomized, double

  16. Effect of chronic periodontitis on oxidative status in patients with rheumatoid arthritis.

    Science.gov (United States)

    Sezer, Ufuk; Erciyas, Kamile; Ustün, Kemal; Pehlivan, Yavuz; Şenyurt, Süleyman Ziya; Aksoy, Nurten; Tarakçıoğlu, Mehmet; Taysı, Seyithan; Onat, Ahmet Mesut

    2013-06-01

    Rheumatoid arthritis (RA) and chronic periodontitis (CP) are the most common chronic inflammatory diseases and have remarkable similar pathologies. The aim of this study is to investigate the impact of periodontal status on oxidative stress in patients with RA by evaluating serum oxidative parameters and prolidase levels. For this cross-sectional comparative study, the following four groups were composed of 20 individuals each (80 individuals total): 1) RA with CP (RA-CP group); 2) RA but periodontally healthy (RA-C group); 3) systemically healthy with CP (CP group); and 4) systemically and periodontally healthy (C group). Demographic, periodontal, rheumatological, and serum oxidative parameters as determined by serum total antioxidant status, total oxidant status, oxidative stress index (OSI), lipid hydroperoxide levels, paraoxonase, arylesterase, and ceruloplasmin activity, prolidase level, and total sulfhydryl groups were evaluated. The OSI values of the RA-CP group were statistically significantly higher than those of the C group (P <0.05). The prolidase levels of the RA-C, RA-CP groups and the CP group were statistically higher than those of the C group (P = 0.001, P = 0.007, and P = 0.001, respectively). Although CP and RA each increase oxidative stress, in a small sample size these effects are only significant when both CP and RA are combined relative to neither exposure. In addition, increased prolidase levels in patients with RA and CP may be related to increased oxidative tissue damage.

  17. Psychological Distress in Out-Patients Assessed for Chronic Pain Compared to Those with Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    D. Rice

    2016-01-01

    Full Text Available Background. Patients diagnosed with chronic pain (CP and rheumatoid arthritis (RA represent two samples with overlapping symptoms, such as experiencing significant pain. Objectives. To compare the level of psychological distress among patients diagnosed CP attending a specialist pain clinic with those attending a specialist RA clinic. Measures. A cross-sectional study was conducted at an academic specialist chronic pain and rheumatology clinic. Participants. 330 participants included a CP group (n=167 and a RA group (n=163 completed a booklet of questionnaires regarding demographic characteristics, duration, and severity of their pain. Psychological and personality variables were compared between the CP and RA participants using a Multivariate Analysis of Covariance (MANCOVA. Results. Level of psychological distress based on the subscales of the DASS (depression, anxiety, and stress, PASS (escape avoidance, cognitive anxiety, fear of pain, and physiological anxiety, and PCS (rumination, magnification, and helplessness was significantly higher in the CP group compared to the RA group. Categorization of individuals based on DASS severity resulted in significant differences in rates of depression and anxiety symptoms between groups, with a greater number of CP participants displaying more severe depressive and anxiety symptoms. Discussion and Conclusions. This study found greater levels of psychological distress among CP individuals referred to an academic pain clinic when compared to RA patients referred to an academic rheumatology clinic.

  18. 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 ...

  19. Septic arthritis in patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Al-Ahaideb Abdulaziz

    2008-07-01

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

  20. 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.

  1. Patients with Rheumatoid Arthritis and Chronic Pain Display Enhanced Alpha Power Density at Rest.

    Science.gov (United States)

    Meneses, Francisco M; Queirós, Fernanda C; Montoya, Pedro; Miranda, José G V; Dubois-Mendes, Selena M; Sá, Katia N; Luz-Santos, Cleber; Baptista, Abrahão F

    2016-01-01

    Patients with chronic pain due to neuropathy or musculoskeletal injury frequently exhibit reduced alpha and increased theta power densities. However, little is known about electrical brain activity and chronic pain in patients with rheumatoid arthritis (RA). For this purpose, we evaluated power densities of spontaneous electroencephalogram (EEG) band frequencies (delta, theta, alpha, and beta) in females with persistent pain due to RA. This was a cross-sectional study of 21 participants with RA and 21 healthy controls (mean age = 47.20; SD = 10.40). EEG was recorded at rest over 5 min with participant's eyes closed. Twenty electrodes were placed over five brain regions (frontal, central, parietal, temporal, and occipital). Significant differences were observed in depression and anxiety with higher scores in RA participants than healthy controls (p = 0.002). Participants with RA exhibited increased average absolute alpha power density in all brain regions when compared to controls [F (1.39) = 6.39, p = 0.016], as well as increased average relative alpha power density [F (1.39) = 5.82, p = 0.021] in all regions, except the frontal region, controlling for depression/anxiety. Absolute theta power density also increased in the frontal, central, and parietal regions for participants with RA when compared to controls [F (1, 39) = 4.51, p = 0.040], controlling for depression/anxiety. Differences were not exhibited on beta and delta absolute and relative power densities. The diffuse increased alpha may suggest a possible neurogenic mechanism for chronic pain in individuals with RA.

  2. Patients with Rheumatoid Arthritis and Chronic Pain Display Enhanced Alpha Power Density at Rest

    Science.gov (United States)

    Meneses, Francisco M.; Queirós, Fernanda C.; Montoya, Pedro; Miranda, José G. V.; Dubois-Mendes, Selena M.; Sá, Katia N.; Luz-Santos, Cleber; Baptista, Abrahão F.

    2016-01-01

    Patients with chronic pain due to neuropathy or musculoskeletal injury frequently exhibit reduced alpha and increased theta power densities. However, little is known about electrical brain activity and chronic pain in patients with rheumatoid arthritis (RA). For this purpose, we evaluated power densities of spontaneous electroencephalogram (EEG) band frequencies (delta, theta, alpha, and beta) in females with persistent pain due to RA. This was a cross-sectional study of 21 participants with RA and 21 healthy controls (mean age = 47.20; SD = 10.40). EEG was recorded at rest over 5 min with participant's eyes closed. Twenty electrodes were placed over five brain regions (frontal, central, parietal, temporal, and occipital). Significant differences were observed in depression and anxiety with higher scores in RA participants than healthy controls (p = 0.002). Participants with RA exhibited increased average absolute alpha power density in all brain regions when compared to controls [F(1.39) = 6.39, p = 0.016], as well as increased average relative alpha power density [F(1.39) = 5.82, p = 0.021] in all regions, except the frontal region, controlling for depression/anxiety. Absolute theta power density also increased in the frontal, central, and parietal regions for participants with RA when compared to controls [F(1, 39) = 4.51, p = 0.040], controlling for depression/anxiety. Differences were not exhibited on beta and delta absolute and relative power densities. The diffuse increased alpha may suggest a possible neurogenic mechanism for chronic pain in individuals with RA. PMID:27540360

  3. Gratitude uniquely predicts lower depression in chronic illness populations: A longitudinal study of inflammatory bowel disease and arthritis.

    Science.gov (United States)

    Sirois, Fuschia M; Wood, Alex M

    2017-02-01

    Although gratitude has been identified as a key clinically relevant trait for improving well-being, it is understudied within medical populations. The current study addressed this gap and extended previous and limited cross-sectional research by examining the longitudinal associations of gratitude to depression in 2 chronic illness samples, arthritis and inflammatory bowel disease (IBD). Two chronic illness samples, arthritis (N = 423) and IBD (N = 427), completed online surveys at Time 1 (T1). One hundred sixty-three people with arthritis and 144 people with IBD completed the 6-month follow-up survey (T2). Depression, gratitude, illness cognitions, perceived stress, social support, and disease-related variables were assessed at T1 and T2. At T2, 57.2% of the arthritis sample and 53.4% of the IBD sample met the cut off scores for significant depression. T1 gratitude was negatively associated with depressive symptoms at T1 and T2 in both samples (rs from -.43 to -.50). Regression analyses revealed that T1 gratitude remained a significant and unique predictor of lower T2 depression after controlling for T1 depression, relevant demographic variables, illness cognitions, changes in illness-relevant variables, and another positive psychological construct, thriving, in both samples. As the first investigation of the longitudinal associations of gratitude to psychological well-being in the context of chronic illness, the current study provides important evidence for the relevance of gratitude for health-related clinical populations. Further intervention-based research is warranted to more fully understand the potential benefits of gratitude for adjustment to chronic illness. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  4. Artrite da gota tofácea crônica mimetizando artrite reumatoide Chronic tophaceous gout mimicking rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Juliana F. Sarmento

    2009-12-01

    Full Text Available A gota é um distúrbio no metabolismo das purinas, usualmente associado à ocorrência de crises recorrentes de artrite nas articulações dos membros inferiores em homens entre 40-50 anos, e com o desenvolvimento de tofos subcutâneos nos pacientes com doença de longa evolução. Casos de pacientes com artrite gotosa crônica que mimetizam quadros de artrite reumatoide e vice-versa são raros. Descrevemos o caso de um paciente de 56 anos, com quadro de artrite poliarticular, simétrica e deformante, comprometendo principalmente as articulações de mãos e punhos, com nódulos subcutâneos difusos pelo corpo, alterações radiográficas atípicas e urolitíase, que, após avaliação clínica e dos exames complementares, recebeu diagnóstico de gota tofácea crônica mutilante mimetizando artrite reumatoide.Gout is a disorder of purine metabolism, usually associated with recurrent bouts of arthritis in the joints of the lower limbs, affecting men 40 to 50 years of age, which leads to the development of subcutaneous tophi in patients with long-lasting disease. Cases of patients with chronic gouty arthritis mimicking rheumatoid arthritis, and vice-versa, are rare. This report describes the case of a 56-year old male with symmetric, deforming, and polyarticular arthritis affecting, specially, the joints of the hands and wrists, with diffuse subcutaneous nodules throughout his body, atypical radiographic findings, and urolithiasis. Following clinical evaluation and additional tests, this patient received a diagnosis of chronic tophaceous gout mimicking mutilating rheumatoid arthritis.

  5. Association of treatment-resistant chronic Lyme arthritis with HLA-DR4 and antibody reactivity to OspA and OspB of Borrelia burgdorferi.

    Science.gov (United States)

    Kalish, R A; Leong, J M; Steere, A C

    1993-01-01

    Chronic Lyme arthritis that is unresponsive to antibiotic therapy is associated with an increased frequency of the HLA-DR4 specificity. To determine whether the immune response to a particular polypeptide of Borrelia burgdorferi may be associated with treatment-resistant chronic Lyme arthritis, we correlated the clinical courses and HLA-DR specificities of 128 patients with Lyme disease with their antibody responses to spirochetal polypeptides. Antibody reactivity was determined by Western blotting (immunoblotting) with sonicated whole B. burgdorferi and recombinant forms of its outer surface proteins, OspA and OspB, as the antigen preparations. Of 15 patients monitored for 4 to 12 years, 11 (73%) developed strong immunoglobulin G responses to both OspA and OspB near the beginning of prolonged episodes of arthritis, from 5 months to 7 years after disease onset. When single serum samples from 80 patients with Lyme arthritis, were tested, 57 (71%) showed antibody reactivity to recombinant Osp proteins; in contrast, none of 43 patients who had erythema migrans or Lyme meningitis (P < 0.00001) and 1 of 5 patients who had chronic neuroborreliosis but who never had arthritis (P = 0.03) showed antibody reactivity to these proteins. Among the 60 antibiotic-treated patients with Lyme arthritis, those with the HLA-DR4 specificity and Osp reactivity had arthritis for a significantly longer time after treatment than those who lacked Osp reactivity (median duration, 9.5 versus 4 months; P = 0.009); a similar trend was found for the HLA-DR2 specificity. For other HLA-DR specificities, arthritis resolved within a median duration of 2 months in both Osp-reactive and nonreactive patients. We conclude that the combination of the HLA-DR4 specificity and OspA or OspB reactivity is associated with chronic arthritis and the lack of a response to antibiotic therapy. Images PMID:7685738

  6. A Rare Case of Cardiac Tamponade Induced by Chronic Rheumatoid Arthritis.

    Science.gov (United States)

    Yousuf, Tariq; Kramer, Jason; Kopiec, Adam; Bulwa, Zachary; Sanyal, Shuvani; Ziffra, Jeffrey

    2015-09-01

    Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease primarily involving the joint synovium. RA is a systemic disease which has many known extra-articular manifestations. We present a unique case of a patient with long standing RA who presented with a primary complaint of chest and back pain. Echocardiography revealed borderline normal left ventricular function and a large pericardial effusion with the finding of elevated intrapericardial pressure suspicious for cardiac tamponade. Infectious workup was all found to be negative. The presence and elevation of anti-cyclic citrullinated peptide antibody, rheumatoid factor and C-reactive protein (CRP) confirmed the patient was having an active flare-up of RA. It was determined that this flare-up was the cause of the cardiac tamponade. A pericardiocentesis was performed and 850 mL of bloody fluid was drained. The patient remained stable following the pericardiocentesis. At his follow-up visit, repeat echocardiogram showed no signs for pericardial effusion. Although there has been extensive study of RA, there are only a few documented cases noting the occurrence of cardiac tamponade in these patients. Therefore, it is important for the clinician to be aware of and recognize this potentially serious cardiac outcome associated with a common rheumatologic condition.

  7. Homeopathic drug therapy. Homeopathy in Chikungunya Fever and Post-Chikungunya Chronic Arthritis: an observational study.

    Science.gov (United States)

    Wadhwani, Gyandas G

    2013-07-01

    To observe the effect of homeopathic therapy in Chikungunya Fever (CF) and in Post-Chikungunya Chronic Arthritis (PCCA) in a primary health care setting. A prospective observational study was conducted at Delhi Government Homeopathic Dispensary, Aali Village, New Delhi, India, for a period of 6 months, from 1st October 2010 to 31st March 2011. 126 patients (75 CF, 51 PCCA) were enrolled based on predefined inclusion criteria. A single homeopathic medicine was prescribed for each patient after case taking with the help of Materia Medica and/or Repertory. Results were evaluated on the basis of visual analogue scale and symptom scores. Complete recovery was seen in 84.5% CF cases in a mean time of 6.8 days. 90% cases of PCCA recovered completely in a mean time of 32.5 days. Homeopathic therapy may be effective in CF and PCCA. A randomized controlled trial should be considered. Copyright © 2013 The Faculty of Homeopathy. Published by Elsevier Ltd. All rights reserved.

  8. The extent of leprosy-related disabilities in Istanbul Leprosy Hospital, Turkey.

    Science.gov (United States)

    Cakiner, T; Yüksel, A; Eğït, A S; Cağri, G; Karaçorlu, M; Kültür, A

    1997-03-01

    This study was carried out between January and December 1992 at the Istanbul Leprosy Hospital. Seven hundred and eleven leprosy patients were evaluated according to their age, gender and type of disease and disability according to the WHO disability grading system (1980). There were 527 males (74.2%) and 184 females (25.8%) in the group. The average age was 50.0 +/- 13.5 years and the average duration of disease was 25.9 +/- 13.2 years. Six hundred and seventy-eight patients (95.4%) were in borderline (BL) and lepromatous (LL) leprosy. The extent of disabilities was very high in 711 leprosy patients. It was found that 539 of the patients (75.8%) had eye disabilities, 511 of them (71.8%) had hand disabilities, 521 of them (73.3%) had foot disabilities. The most frequent eye, hand and foot disabilities were a decrease of vision (52.7), acute or chronic iridocyclitis (48.8%), slightly-marked corneal sensory loss (43.2%), mobile claw hand (33.3%), palmar insensitivity (16.3%), plantar ulcer (37.2%) and plantar insensitivity (19.8%). Eye deformities were the most common of the three affected areas in this study.

  9. DISEASE COPING STYLES IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE OR RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    Y. K. Galetskayte

    2013-01-01

    Full Text Available Objective: to study the types of response to illness in patients with chronic obstructive pulmonary disease (COPD or rheumatoid arthritis (RA.Subjects and methods. The sample consisted of 100 patients (mean age 59.2 ± 14.4 years from University Clinical Hospital One, I.M. Seche nov First Moscow State Medical University, 57 of whom were treated for RA and 43 were for COPD. All the patients were examined by a psychiatrist, a psychologist, and a therapist. The Beck Depression Inventory, SF-36 quality of life questionnaire, and projective psychological tests were also used.Results. Three main types of response to illness were identified. The features of aberrant hypochondria were most common in the patientswith COPD (53.3 % (23/43. In RA, hypochondriacal development as a confrontation with illness was intrinsic to a considerable proportion of patients (42.1 % (24/57. The common response was hypochondriacal neurosis (health anxiety, organ neurotic and omatoautonomic disorders that was encountered in 27 % (27/100 in the patients with COPD or RA and more common in those with RA (29.8 % (17/57. The examination revealed nosogenic depressive reactions in 19.2 % (11/57 of the patients with RA and in 9.3 % (4/43 of those with COPD.Conclusion. The main types of response to somatic illness in the two chronic diseases similar in their impact on quality of life have been investigated, which may be further used to manage this category of patients.

  10. DISEASE COPING STYLES IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE OR RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    Y. K. Galetskayte

    2014-07-01

    Full Text Available Objective: to study the types of response to illness in patients with chronic obstructive pulmonary disease (COPD or rheumatoid arthritis (RA.Subjects and methods. The sample consisted of 100 patients (mean age 59.2 ± 14.4 years from University Clinical Hospital One, I.M. Seche nov First Moscow State Medical University, 57 of whom were treated for RA and 43 were for COPD. All the patients were examined by a psychiatrist, a psychologist, and a therapist. The Beck Depression Inventory, SF-36 quality of life questionnaire, and projective psychological tests were also used.Results. Three main types of response to illness were identified. The features of aberrant hypochondria were most common in the patientswith COPD (53.3 % (23/43. In RA, hypochondriacal development as a confrontation with illness was intrinsic to a considerable proportion of patients (42.1 % (24/57. The common response was hypochondriacal neurosis (health anxiety, organ neurotic and omatoautonomic disorders that was encountered in 27 % (27/100 in the patients with COPD or RA and more common in those with RA (29.8 % (17/57. The examination revealed nosogenic depressive reactions in 19.2 % (11/57 of the patients with RA and in 9.3 % (4/43 of those with COPD.Conclusion. The main types of response to somatic illness in the two chronic diseases similar in their impact on quality of life have been investigated, which may be further used to manage this category of patients.

  11. Blood cell gene expression profiling in subjects with aggressive periodontitis and chronic arthritis

    DEFF Research Database (Denmark)

    Sørensen, Lars K; Poulsen, Anne Havemose; Sønder, Søren U

    2008-01-01

    with untreated localized aggressive periodontitis (LAgP) or generalized aggressive periodontitis (GAgP). Differentially expressed genes were validated in groups of subjects with LAgP, GAgP, juvenile idiopathic arthritis (JIA), or rheumatoid arthritis (RA) and controls. METHODS: Candidate genes were identified...

  12. A case of septic arthritis caused by a Mycoplasma salivarium strain resistant towards Ciprofloxacin and Clarithromycin in a patient with chronic lymphatic leukemia.

    Science.gov (United States)

    Büchsel, Martin; Pletschen, Lars; Fleiner, Michael; Häcker, Georg; Serr, Annerose

    2016-09-01

    Mycoplasma salivarium is a rare agent of septic arthritis in immunocompromised patients. We report a case of septic arthritis due to Mycoplasma salivarium in a patient with B-cell chronic lymphocytic leukemia who underwent chemotherapy with rituximab and bendamustin. Therapy of arthritis due to Mycoplasma salivarium is difficult because there are almost no susceptibility data available. The present case illustrates that antimicrobial susceptibility of Mycoplasma strains is not necessarily predictable and that antibiotic therapy should therefore be guided by in vitro susceptibility testing. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Hypouricemic and arthritis relapse-reducing effects of compound tufuling oral-liquid in intercritical and chronic gout

    Science.gov (United States)

    Xie, Zhijun; Wu, Huaxiang; Jing, Xiaoqing; Li, Xiuyang; Li, Yasong; Han, Yongmei; Gao, Xiangfu; Tang, Xiaopo; Sun, Jing; Fan, Yongshen; Wen, Chengping

    2017-01-01

    Abstract Trial Design: In the double-blind, randomized, controlled trial, we aimed to evaluate the effects of compound tufuling oral liquid (CoTOL) on serum uric acid (sUA) levels and recurrence of acute gouty arthritis in intercritical and chronic gout treatment. Methods: A total of 210 patients with gout were screened from 8 hospitals to observe the sUA and acute gouty arthritis recurrence rate-reducing effects of CoTOL in intercritical and chronic gout during a 12-week treatment. We treated 139 and 71 patients with CoTOL and the placebo, respectively, and evaluated their sUA levels, acute gouty arthritis recurrence rate, and adverse events at week 0, 6, and 12. Results: Twenty-five and 12 patients in the treatment and control groups, respectively, had interrupted treatments, whereas 114 and 59 cases, respectively, completed their treatments. At the end of the 12-week treatment, the average decrease in sUA was 74.26 (95% confidence interval [CI]: 56.74–91.77 μmol/L) and 28.81 μmol/L (95% CI: 4.91–52.71 μmol/L) in the treatment and control groups, respectively (P = 0.004). The average decrease rate of sUA was 12.76% (95% CI: 9.82%–15.70%) and 4.57% (95% CI: 0.42%–8.71%) in the treatment and control groups, respectively (P = 0.004), and the gouty arthritis recurrence rate of the treatment group was lower than that of the control group (from week 6 to 12, 21.93% and 50.88% in the treatment and control group, respectively, P leucopenia incidences were observed in the treatment group than those in the control group (3/139 vs. 7/71, respectively, P = 0.033). Conclusion: CoTOL reduced sUA levels and effectively prevented acute arthritis recurrence in intercritical and chronic gout without serious adverse events. PMID:28296744

  14. Periodontitis in early and chronic rheumatoid arthritis: a prospective follow-up study in Finnish population

    Science.gov (United States)

    Äyräväinen, Leena; Leirisalo-Repo, Marjatta; Kuuliala, Antti; Ahola, Kirsi; Koivuniemi, Riitta; Meurman, Jukka H; Heikkinen, Anna Maria

    2017-01-01

    Objectives To investigate the association between rheumatoid arthritis (RA) and periodontitis with special emphasis on the role of antirheumatic drugs in periodontal health. Design Prospective follow-up study. Patients with early untreated RA and chronic active RA were examined at baseline and 16 months later. Controls were examined once. Settings and participants The study was conducted in Finland from September 2005 to May 2014 at the Helsinki University Hospital. Overall, 124 participants were recruited for dental and medical examinations: 53 were patients with early disease-modifying antirheumatic drug (DMARD) naїve RA (ERA), 28 were patients with chronic RA (CRA) with insufficient response to conventional DMARDs. After baseline examination, patients with ERA started treatment with synthetic DMARDs and patients with CRA with biological DMARDs. Controls were 43 age-matched, gender-matched and community-matched participants. Outcome measures Degree of periodontitis (defined according to the Center for Disease Control and Prevention and the American Academy of Periodontology). Prevalence of periodontal bacteria (analysed from plaque samples), clinical rheumatological status by Disease Activity Score, 28-joint count (DAS28), function by Health Assessment Questionnaire (HAQ) and treatment response by European League Against Rheumatism (EULAR) criteria. Results Moderate periodontitis was present in 67.3% of patients with ERA, 64.3% of patients with CRA and 39.5% of control participants (p=0.001). Further, patients with RA had significantly more periodontal findings compared with controls, recorded with common periodontal indexes. In the re-examination, patients with RA still showed poor periodontal health in spite of treatment with DMARDs after baseline examination. The prevalence of Porphyromonas gingivalis was higher in patients with ERA with periodontal probing depth ≥4 mm compared with patients with CRA and controls. Antirheumatic medication did not seem

  15. Periodontitis in early and chronic rheumatoid arthritis: a prospective follow-up study in Finnish population.

    Science.gov (United States)

    Äyräväinen, Leena; Leirisalo-Repo, Marjatta; Kuuliala, Antti; Ahola, Kirsi; Koivuniemi, Riitta; Meurman, Jukka H; Heikkinen, Anna Maria

    2017-01-31

    To investigate the association between rheumatoid arthritis (RA) and periodontitis with special emphasis on the role of antirheumatic drugs in periodontal health. Prospective follow-up study. Patients with early untreated RA and chronic active RA were examined at baseline and 16 months later. Controls were examined once. The study was conducted in Finland from September 2005 to May 2014 at the Helsinki University Hospital. Overall, 124 participants were recruited for dental and medical examinations: 53 were patients with early disease-modifying antirheumatic drug (DMARD) naїve RA (ERA), 28 were patients with chronic RA (CRA) with insufficient response to conventional DMARDs. After baseline examination, patients with ERA started treatment with synthetic DMARDs and patients with CRA with biological DMARDs. Controls were 43 age-matched, gender-matched and community-matched participants. Degree of periodontitis (defined according to the Center for Disease Control and Prevention and the American Academy of Periodontology). Prevalence of periodontal bacteria (analysed from plaque samples), clinical rheumatological status by Disease Activity Score, 28-joint count (DAS28), function by Health Assessment Questionnaire (HAQ) and treatment response by European League Against Rheumatism (EULAR) criteria. Moderate periodontitis was present in 67.3% of patients with ERA, 64.3% of patients with CRA and 39.5% of control participants (p=0.001). Further, patients with RA had significantly more periodontal findings compared with controls, recorded with common periodontal indexes. In the re-examination, patients with RA still showed poor periodontal health in spite of treatment with DMARDs after baseline examination. The prevalence of Porphyromonas gingivalis was higher in patients with ERA with periodontal probing depth ≥4 mm compared with patients with CRA and controls. Antirheumatic medication did not seem to affect the results. Moderate periodontitis was more frequent in

  16. Association of Toll-like receptor 4 (TLR4) with chronic plaque type psoriasis and psoriatic arthritis.

    Science.gov (United States)

    Smith, Rh Ll; Hébert, H L; Massey, J; Bowes, J; Marzo-Ortega, H; Ho, P; McHugh, N J; Worthington, J; Barton, A; Griffiths, C E M; Warren, R B

    2016-04-01

    Family studies have provided overwhelming evidence for an underlying genetic component to psoriasis. Toll-like receptors (TLRs) are key transmembrane proteins in both the innate and adaptive immune responses which are known to be integral processes in psoriasis. Recent functional studies support this notion having suggested a role for TLR4 in the pathogenesis of psoriasis. Furthermore a missense polymorphism in the TLR4 gene has been associated with a number of autoimmune conditions, including Crohn diseases, making TLR4 a viable candidate gene for investigation. The aim of this study was to investigate polymorphisms across the TLR4 region with a high-density single nucleotide polymorphism (SNP) panel in a large cohort of patients with chronic plaque type psoriasis. Twenty SNPs were successfully genotyped using Sequenom iPLEX Gold platform in 2826 UK chronic plaque type psoriasis patients including subgroup data on presence of confirmed psoriatic arthritis (n = 1839) and early-onset psoriasis (n = 1466) was available. Allele frequencies for psoriasis patients were compared against imputed Wellcome Trust Case Control Consortium controls (n = 4861). Significant association was observed between a missense variant rs4986790 of TLR4 (Asp229Gly) and plaque type psoriasis (p = 2 × 10(-4)) which was also notable in those with psoriatic arthritis (p = 2 × 10(-4)) and early-onset psoriasis (p = 8 × 10(-4)). We present data suggestive of an association between a functional variant and an intronic variant of TLR4 and chronic plaque type psoriasis and psoriatic arthritis. However, validation of this association in independent cohorts will be necessary.

  17. Transferrin microheterogeneity in rheumatoid arthritis - Relation with disease activity and anemia of chronic disease

    NARCIS (Netherlands)

    R.A. Feelders (Richard); G. Vreugdenhil (Gerard); G. de Jong (G.); A.J.G. Swaak (Antonius); H.G. van Eijk (Henk)

    1992-01-01

    textabstractWe studied the relation between disease activity in rheumatoid arthritis (RA) and the microheterogeneity of transferrin. Using crossed immuno isoelectric focusing, transferrin microheterogeneity patterns were analyzed in sera of healthy individuals, nonanemic RA patients, iron deficient

  18. Rheumatoid Arthritis: Can It Affect the Eyes?

    Science.gov (United States)

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

  19. Influence of physical treatment on disease activity and health status of patients with chronic arthritis

    Directory of Open Access Journals (Sweden)

    Mustur Dušan

    2008-01-01

    Full Text Available Introduction This is an open uncontrolled study about effects of physical treatment on disease activity parameters of patients with rheumatoid arthritis and psoriatic arthritis. Objective The aim of the study was to establish if there was any improvement of disease activity parameters after four weeks of physical and spa treatment. METHOD We compared morning stiffness, tender and swollen joint count, body pain level and Disease Activity Score 28 (DAS-28 in patients with rheumatoid and psoriatic arthritis, and assessed the effect of physical and spa treatment on those parameters. The research encompassed 109 patients: 69 with rheumatoid arthritis (RA group and 40 with psoriatic arthritis (PA group. They were from Norway, staying for four weeks in June-September 2003. The groups served as their own controls - "one group pre-test post test" study. Disease activity measurement was made twice: at the beginning and at the end of treatment. The therapeutic set consisted of mud applications, kinesitherapy, mineral water pool and electrotherapy. Results At the beginning there was no significant difference in observed disease activity parameters between patients with rheumatoid and psoriatic arthritis (p>0.05. After four weeks of physical and spa treatment disease activity was significantly reduced in all observed parameters in both groups: morning stiffness (p<0.001 RA+PA, tender joint count (p<0.01 RA+PA, swollen joint count (p<0.01 RA; p<0.05 PA, body pain (p<0.01 RA+PA and DAS-28 score (p<0.01 RA+PA. Conclusion Physical and spa treatment, together with climatic factors in Igalo, lead to a significant reduction of disease activity parameters of patients suffering from rheumatoid arthritis and psoriatic arthritis. .

  20. A Review of Persuasive Principles in Mobile Apps for Chronic Arthritis Patients: Opportunities for Improvement.

    Science.gov (United States)

    Geuens, Jonas; Swinnen, Thijs Willem; Westhovens, Rene; de Vlam, Kurt; Geurts, Luc; Vanden Abeele, Vero

    2016-10-13

    Chronic arthritis (CA), an umbrella term for inflammatory rheumatic and other musculoskeletal diseases, is highly prevalent. Effective disease-modifying antirheumatic drugs for CA are available, with the exception of osteoarthritis, but require a long-term commitment of patients to comply with the medication regimen and management program as well as a tight follow-up by the treating physician and health professionals. Additionally, patients are advised to participate in physical exercise programs. Adherence to exercises and physical activity programs is often very low. Patients would benefit from support to increase medication compliance as well as compliance to the physical exercise programs. To address these shortcomings, health apps for CA patients have been created. These mobile apps assist patients in self-management of overall health measures, health prevention, and disease management. By including persuasive principles designed to reinforce, change, or shape attitudes or behaviors, health apps can transform into support tools that motivate and stimulate users to achieve or keep up with target behavior, also called persuasive systems. However, the extent to which health apps for CA patients consciously and successfully employ such persuasive principles remains unknown. The objective of this study was to evaluate the number and type of persuasive principles present in current health apps for CA patients. A review of apps for arthritis patients was conducted across the three major app stores (Google Play, Apple App Store, and Windows Phone Store). Collected apps were coded according to 37 persuasive principles, based on an altered version of the Persuasive System Design taxonomy of Oinas-Kukkonen and Harjuma and the taxonomy of Behavior Change Techniques of Michie and Abraham. In addition, user ratings, number of installs, and price of the apps were also coded. We coded 28 apps. On average, 5.8 out of 37 persuasive principles were used in each app. The most

  1. Evidence for chronic, peripheral activation of neutrophils in polyarticular juvenile rheumatoid arthritis.

    Science.gov (United States)

    Jarvis, James N; Petty, Howard R; Tang, Yuhong; Frank, Mark Barton; Tessier, Philippe A; Dozmorov, Igor; Jiang, Kaiyu; Kindzelski, Andrei; Chen, Yanmin; Cadwell, Craig; Turner, Mary; Szodoray, Peter; McGhee, Julie L; Centola, Michael

    2006-01-01

    Although strong epidemiologic evidence suggests an important role for adaptive immunity in the pathogenesis of polyarticular juvenile rheumatoid arthritis (JRA), there remain many aspects of the disease that suggest equally important contributions of the innate immune system. We used gene expression arrays and computer modeling to examine the function in neutrophils of 25 children with polyarticular JRA. Computer analysis identified 712 genes that were differentially expressed between patients and healthy controls. Computer-assisted analysis of the differentially expressed genes demonstrated functional connections linked to both interleukin (IL)-8- and interferon-gamma (IFN-gamma)-regulated processes. Of special note is that the gene expression fingerprint of children with active JRA remained essentially unchanged even after they had responded to therapy. This result differed markedly from our previously reported work, in which gene expression profiles in buffy coats of children with polyarticular JRA reverted to normal after disease control was achieved pharmacologically. These findings suggest that JRA neutrophils remain in an activated state even during disease quiescence. Computer modeling of array data further demonstrated disruption of gene regulatory networks in clusters of genes modulated by IFN-gamma and IL-8. These cytokines have previously been shown to independently regulate the frequency (IFN-gamma) and amplitude (IL-8) of the oscillations of key metabolites in neutrophils, including nicotinamide adenine dinucleotide (phosphate) (NAD(P)H) and superoxide ion. Using real-time, high-speed, single-cell photoimaging, we observed that 6/6 JRA patients displayed a characteristic defect in 12% to 23% of the neutrophils tested. Reagents known to induce only frequency fluctuations of NAD(P)H and superoxide ion induced both frequency and amplitude fluctuations in JRA neutrophils. This is a novel finding that was observed in children with both active (n = 4) and

  2. Juvenile chronic arthritis. Dentofacial morphology, growth, mandibular function and orthodontic treatment.

    Science.gov (United States)

    Kjellberg, H

    1995-01-01

    In children with Juvenile Chronic arthritis (JCA), temporomandibular joint involvement may lead to disturbances in dentofacial growth and mandibular function. The aim of this thesis was to study the dentofacial morphology, temporomandibular joint destruction and mandibular function in JCA children, and the relation between these factors. The intention was also to make a longitudinal study of the changes in facial morphology during growth and during treatment with functional appliances. Thirty-five JCA children, 12 boys and 23 girls, aged 7-16 years (mean 11.2 years), and the control groups, with either normal or distal occlusion, were studied by means of panoramic radiographs, lateral cephalograms, study casts, recordings of signs and symptoms of temporomandibular disorders (TMD), bite force and chewing characteristics. A method to evaluate the condylar height on panoramic radiographs was developed. Panoramic radiographs are found to be reliable for evaluation of the condylar height, provided the same panoramic machine is used. The dentofacial morphology in JCA children is characterized by a smaller, more retrognathic and steeper inclined mandible compared to that of healthy children with ideal occlusion. Compared to healthy children with distal occlusion, no difference in mandibular retrognathia could be demonstrated but the JCA children showed a smaller, more steeply inclined mandible. The presence and extent of condylar lesions play a significant role in the development of the facial morphology and also contribute to the facial heterogeneity among JCA children. During growth the JCA children without radiographically visible condylar lesions showed a growth pattern resembling that of healthy children with normal occlusion, while children with condylar lesions showed aggravation of the mandibular retrognathia and a tendency towards a backward-rotating growth pattern. The chewing movements in JCA children are restricted by the disease and by the presence of

  3. Successfully living with chronic arthritis : the role of the allied health professionals

    NARCIS (Netherlands)

    Taal, E.; Bobiatynska, E.; Lloyd, J.; Veehof, M.M.; Rasker, W.J.; Oosterveld, F.G.J.; Rasker, J.J.

    2006-01-01

    The treatment and care of patients with rheumatoid arthritis (RA) is complex and various health professionals with different areas of expertise may be involved. The objective of this article is to review the treatments and their efficacy as provided by health care professionals in RA care. The requi

  4. 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. ...

  5. IgA nephropathy and psoriatic arthritis that improved with steroid pulse therapy and mizoribine in combination with treatment for chronic tonsillitis and epipharyngitis.

    Science.gov (United States)

    Kaneko, Tomohiro; Mii, Akiko; Fukui, Megumi; Nagahama, Kiyotaka; Shimizu, Akira; Tsuruoka, Shuichi

    2015-01-01

    A 65-year-old man was admitted to our hospital with edema and renal dysfunction. He had received a diagnosis of psoriatic arthritis at 50 years of age. As a renal biopsy showed IgA nephropathy (IgAN), bilateral tonsillectomy was performed, and one course of steroid pulse therapy with an oral steroid and mizoribine were subsequently administered. The patient's proteinuria gradually reduced in association with an improvement in the renal function. In addition, the rash and arthralgia were ameliorated. In this case, adding treatment for chronic epipharyngitis accelerated the curative effects, and focal infection therapy consisting of immunosuppressive drugs was effective for both IgAN and psoriatic arthritis.

  6. Placement of a collagen glaucoma drainage device to control intraocular pressure and chronic iritis secondary to juvenile rheumatoid arthritis.

    Science.gov (United States)

    Price, Francis W; Ziemba, Steven L

    2002-01-01

    A patient with juvenile rheumatoid arthritis and chronic iritis is reported with intraocular pressure near 30 mm Hg and previous episodes of intraocular pressure as high as 50 mm Hg despite maximally tolerated medical therapy. Because of the potential risk involved with a full-thickness filtration procedure, it was decided that a nonpenetrating deep sclerectomy would be appropriate, followed by placement of a collagen glaucoma drainage device to maintain aqueous outflow. Immediately postoperatively, intraocular pressure was stabilized. At 24 months postoperatively, intraocular pressure was well controlled at 15 mm Hg with patient receiving only Lotemax. No significant complications were noted at any point in the postoperative course. Because of the patient's predisposition for serious complications frequently associated with trabeculectomy, nonpenetrating deep sclerectomy with the collagen glaucoma drainage device was an effective alternative for this patient.

  7. [Chosen problems of mental functioning in patients with chronic systemic connective tissue diseases base on example of rheumatoid arthritis].

    Science.gov (United States)

    Nasiłowska-Barud, Alicja; Żuk, Mariola

    2015-01-01

    Disorders in mental functioning are indicated as the cause of all connective tissue diseases and also as their consequences. That is why psychologist's help may be very important for patients with rheumatoid arthritis. Psychological observations of patients with chronic systemic connective tissue diseases show a number of negative emotional states such as fear, anxiety, insecurity, depressed mood, depression, impatience, anger and a sense of loss These patients constantly experience pain of varying intensity and location. In many of them progressive disease leads to the advancement of mental crisis. Methods of psychological therapy must be focused on strenghtening mental resilience and helping in surviving mental crisis. Psychological therapy should concentrate on raising self-esteem, training interpersonal skills and teaching relaxation techniques to cope better with pain and suffering. Psychological therapy should support the patient in struggling with the problems caused by the disease and developing ways of adapting to life with the disease.

  8. Population Pharmacokinetics of Ofatumumab in Patients With Chronic Lymphocytic Leukemia, Follicular Lymphoma, and Rheumatoid Arthritis

    DEFF Research Database (Denmark)

    Struemper, Herbert; Sale, Mark; Patel, Bela R;

    2014-01-01

    Ofatumumab is a human monoclonal antibody directed at CD20 approved for treatment of chronic lymphocytic leukemia. The population pharmacokinetics of intravenous ofatumumab were characterized in patients with relapsed/refractory chronic lymphocytic leukemia, relapsed/refractory follicular lymphoma...

  9. Periodontal therapy in chronic periodontitis lowers gingival crevicular fluid interleukin-1beta and DAS28 in rheumatoid arthritis patients.

    Science.gov (United States)

    Bıyıkoğlu, Başak; Buduneli, Nurcan; Aksu, Kenan; Nalbantsoy, Ayşe; Lappin, David F; Evrenosoğlu, Evren; Kinane, Denis F

    2013-10-01

    To evaluate clinical outcomes and effects of non-surgical periodontal therapy on serum, gingival crevicular fluid (GCF) interleukin-1beta (IL-1β) and tumor necrosis factor-alpha (TNF-α) levels in chronic periodontitis patients with/without rheumatoid arthritis (RA), fifteen RA patients with chronic periodontitis (RA-P) and 15 systemically healthy non-RA chronic periodontitis patients (H-P) were recruited. Clinical periodontal recordings, GCF, and blood samples were obtained at baseline, 1, 3, and 6 months after periodontal treatment. GCF, serum IL-1β, TNF-α levels were analyzed by ELISA. Disease activity score 28 (DAS28) was used to assess RA clinical morbidity. Study groups were compared by Mann-Whitney U test. Wilcoxon test was used to compare the data at baseline, 1, 3, and 6 months after periodontal therapy within the same group. DAS28 decreased significantly after periodontal therapy in RA-P group (p periodontal therapy. GCF IL-1β amounts decreased significantly in both groups following treatment (p periodontal indices (p periodontal treatment suggest that periodontal therapy synergizes with systemic RA therapy to improve RA status.

  10. Characterization of chronic arthritis in a multicenter study of 852 childhood-onset systemic lupus erythematosus patients.

    Science.gov (United States)

    Sakamoto, Ana Paula; Silva, Clovis Artur; Ferriani, Mariana Paes Leme; Pereira, Rosa Maria Rodrigues; Bonfá, Eloisa; Saad-Magalhães, Claudia; Okuda, Eunice; Appenzeller, Simone; Gomes, Francisco Hugo; Cunha, Ana Luiza Garcia; Salume, Mirna Henriques Tomich; Piotto, Daniela Petry; Terreri, Maria Teresa

    2016-12-01

    Chronic arthritis (CA) is an unusual condition in childhood-onset systemic lupus erythematosus (cSLE) and data in children is very limited. The aim of the study is to assess CA in a large population of cSLE patients, in a multicenter cross-sectional study including 852 cSLE patients followed in ten Pediatric Rheumatology referral services in state of São Paulo, Brazil. CA was observed in 32/852 (3.7 %) cSLE patients mostly in hands and ankles. Chronic monoarthritis was diagnosed in four cSLE patients, oligoarthritis in nine and polyarthritis in 19. In the latter group, six had rhupus syndrome. Two oligoarticular patients had Jaccoud's arthropathy. CA was an isolated manifestation observed at disease onset in 13/32 (41 %) cSLE patients, and juvenile idiopathic arthritis (JIA) was the first diagnosis in 18/32 (56 %). The comparison of last visit of patients with CA and without this manifestation revealed higher frequency of splenomegaly (28 vs. 11 %, p = 0.002). The median of SLICC/ACR-DI score [1(0-9) vs. 0(0-7), p = 0.003] was significantly higher in CA patients compared to patients without this manifestation, likewise the frequency of musculoskeletal damage (31 vs. 9 % p = 0.001). Frequencies of treatment with nonsteroidal anti-inflammatory drugs (75 vs. 26 %, p < 0.0001), hydroxychloroquine sulfate (87 vs. 59 %, p = 0.001) and methotrexate (47 vs. 22 %, p = 0.001) were significantly higher in CA patients. This large multicenter study allowed us to characterize CA as a rare and early manifestation of cSLE, frequently mimicking JIA at disease onset. It is predominantly polyarticular, involving more often hands and ankles and it is associated with significant musculoskeletal accrual damage.

  11. Identification of NURR1 as a mediator of MIF signaling during chronic arthritis: effects on glucocorticoid-induced MKP1.

    Science.gov (United States)

    Ralph, Jennifer A; Ahmed, Afsar U; Santos, Leilani L; Clark, Andrew R; McMorrow, Jason; Murphy, Evelyn P; Morand, Eric F

    2010-11-01

    Elucidation of factors regulating glucocorticoid (GC) sensitivity is required for the development of "steroid-sparing" therapies for chronic inflammatory diseases, including rheumatoid arthritis (RA). Accumulating evidence suggests that macrophage migration inhibitory factor (MIF) counterregulates the GC-induction of anti-inflammatory mediators, including mitogen-activated protein kinase phosphatase 1 (MKP1), a critical mitogen-activated protein kinase signaling inhibitor. This observation has yet to be extended to human disease; the molecular mechanisms remain unknown. We investigated NURR1, a GC-responsive transcription factor overexpressed in RA, as a MIF signaling target. We reveal abrogation by recombinant MIF (rMIF) of GC-induced MKP1 expression in RA fibroblast-like synoviocytes (FLS). rMIF enhanced NURR1 expression, artificial NBRE (orphan receptor DNA-binding site) reporter transactivation, and reversed GC-inhibition of NURR1. NURR1 expression was reduced during experimental arthritis in MIF-/- synovium, and silencing MIF reduced RA FLS NURR1 mRNA. Consistent with NBRE identification on the MKP1 gene, MKP1 mRNA was reduced in FLS that ectopically express NURR1, and silencing NURR1 enhanced MKP1 mRNA in RA FLS. rMIF enhanced NBRE binding on the MKP1 gene, and the absence of the NBRE prevented NURR1-repressive effects on basal and GC-induced MKP1 transactivation. This study defines NURR1 as a novel MIF target in chronic inflammation and demonstrates a role for NURR1 in regulating the anti-inflammatory mediator, MKP1. We propose a MIF-NURR1 signaling axis as a regulator of the GC sensitivity of MKP1.

  12. Weight-bearing physical activity, calcium intake, systemic glucocorticoids, chronic inflammation, and body constitution as determinants of lumbar and femoral bone mineral in juvenile chronic arthritis.

    Science.gov (United States)

    Kotaniemi, A; Savolainen, A; Kröger, H; Kautiainen, H; Isomäki, H

    1999-01-01

    The associations between the lumbar and femoral bone mineral and several body constitutional, lifestyle, and disease related variables were studied in 111 children with juvenile chronic arthritis (JCA) by factor and multiple linear regression analyses. In addition to the measurement of bone mineral density (BMD), bone width and bone mineral volumetric density (BMDvol) were determined by dual-x-ray absorptiometry (DXA). Factor analysis of 13 explanatory variables yielded six non-correlating factors, named as body size, physical activity, calcium intake, glucocorticoids, disease duration, and disease activity. These six factors were used as new variables to explain BMD, BMDvol, and bone width by multiple linear regression analyses. These showed body size, physical activity, and calcium intake as significant positive and disease activity and glucocorticoids as significant negative determinants of BMD in JCA. The analyses revealed also considerable differences in the relationships between factors and BM Dvol or bone width.

  13. Infections and arthritis.

    Science.gov (United States)

    Mathew, Ashish Jacob; Ravindran, Vinod

    2014-12-01

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

  14. Short-term glucocorticoid administration in patients with protracted and chronic gout arthritis. Part 2 — comparison of different medication forms efficacy

    Directory of Open Access Journals (Sweden)

    A A Fedorova

    2008-01-01

    Full Text Available Objective. To compare efficacy of different glucocorticoid (GC medication forms in protracted and chronic gout arthritis. Material and methods. 59 pts with tophaceous gout (crystal-verified diagnosis and arthritis of three and more joints lasting more than a months in spite of treatment with sufficient doses of nonsteroidal anti-inflammatory drugs were included. Median age of pts was 56 [48;63], median disease duration — 15,2 years [7,4;20], median swollen joint count at the examination — 8 [5; 11]. The patients were randomized into 2 groups. Methylprednisolone (MP 500 mg/day iv during 2 days and placebo im once was administered in one of them, betamethasone (BM 7 mg im once and placebo iv twice — in the other. Results. Number of pts with full resolution of arthritis, recurrent exacerbation, insufficient arthritis resolution or clinically insignificant response was comparable in both groups. More rapid decrease of pain at moving was achieved during the first 2-3 days after GC administration in pts with full resolution of arthritis (p=0,03 in group receiving MP in comparison with BM. At day 14 joint damage measures did not differ between groups. Conclusion. Efficacy of short-term glucocorticoid administration does not depend on mode of administration and GC medication form (methylprednisolone 500 mg/day iv during 2 days or betamethasone 7 mg im once.

  15. 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.

  16. ANALYSIS OF THE PATHOGENETIC MECHANISMS OF CHRONIC JOINT PAIN IN PATIENTS WITH RHEUMATOID ARTHRITIS AND KNEE OSTEOARTHRITIS

    Directory of Open Access Journals (Sweden)

    E. S. Filatova

    2014-01-01

    Full Text Available Objective: to reveal neurogenic mechanisms in the pathogenesis of chronic pain syndrome in rheumatoid arthritis (RA and knee osteoarthritis (OA in order to develop individualized pharmacotherapy.Subjects and methods. One hundred and eighty-three patients with RA and 80 with knee OA were examined. By using the neuropathic pain diagnostic questionnaire (DN4, all the patients were divided into 2 groups with and without a neuropathic pain component (NPC.Results. NPC was found in 43% of the patients with RA and it was connected with involvement of the peripheral somatosensory system. In RA, NPC was common in older patients with longer disease duration, higher X-ray stage, and severe functional insufficiency. 30% of patients with knee OA also had NPC, however the signs of nervous system involvement were absent. In OA, NPC was associated with hyperalgesia, higher pain intensity, more marked joint dysfunction on the WOMAC, and anxiety.Discussion. This investigation revealed a mixed pattern of chronic pain syndrome in patients with RA and knee OA; some patients were found to have a NPC in the presence of predominantly a nociceptive component

  17. Arthritis in Children

    Science.gov (United States)

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

  18. Fungal arthritis simulating juvenile rheumatoid arthritis.

    OpenAIRE

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

    1982-01-01

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

  19. Rheumatic patients at work : a study of labour force participations and its determinants in rheumatoid arthritis, ankylosing spondylitis, and juvenile chronic arthritis

    NARCIS (Netherlands)

    Chorus, A.M.J.

    2004-01-01

    This thesis at the University of Maastricht, defended at May 7, 2004, yields several important and new findings with regard to work related quality of life, participation in the labour force and its determinants of patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and juvenile chr

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

    Science.gov (United States)

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

    2017-03-01

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

  1. Successfully living with chronic arthritis. The role of the allied health professionals.

    Science.gov (United States)

    Taal, Erik; Bobietinska, Elzbieta; Lloyd, Jill; Veehof, Martine; Rasker, Wietske Jm; Oosterveld, F G J Frits; Rasker, J J Hans

    2006-03-01

    The treatment and care of patients with rheumatoid arthritis (RA) is complex and various health professionals with different areas of expertise may be involved. The objective of this article is to review the treatments and their efficacy as provided by health care professionals in RA care. The requirements for further research in this area are formulated. To achieve better effects of treatment it is necessary to improve the coordination of services as provided by the different specialists. The important roles of the patients themselves in the care and management of the disease are emphasized, as well as the roles of the informal caregivers such as a spouse or other family members and friends and the role of patient societies. The possible role of the International Classification of Functioning, Disability and Health (ICF) to improve the communication and facilitate the coordination among health professionals and between patients and health professionals is mentioned. The topics presented in this article may encourage further discussion and research, particularly concerning the effects of the treatments as provided by allied health professionals. Health professionals play an important role in the life of patients with rheumatic disorders, in all the domains of the ICF: body functions and structure, activities (action by an individual) and participation (involvement in a life situation). Health professionals in rheumatology can make the difference in the lives of RA patients and their families.

  2. Bilateral periprosthetic stress fractures in a juvenile chronic arthritis patient secondary to bilateral genu valgum.

    Science.gov (United States)

    Al-Khateeb, H; Meir, A; Singer, G C

    2007-01-01

    Lateral insufficiency fractures following total hip replacement have been reported with the femoral stems positioned in varus, together with osteopenia of the lateral femoral cortex. Any abnormal alignment of the lower limbs, such as genu valgum, will alter the load distribution across the femoral cortices, and repetitive loading during walking will predispose the bones to stress fractures at any stress riser point, such as the tip of a femoral component. Bilateral femoral stress fractures post total hip replacements have not been previously described. We present a 55-year-old woman, diagnosed with juvenile idiopathic arthritis, who had undergone bilateral total hip replacements and bilateral knee replacements. The knees 15 years postoperatively were in valgus and the left knee was extremely stiff, flexing to just 5. The patient presented with bilateral thigh pain, with plain radiographs confirming bilateral periprosthetic fractures of the femur at the tip of well-fixed femoral components. There was no history of injury and her hips were functioning well up to this time. The patient required revision of both hips to long-stem uncemented components, bypassing the fractures, and revision of both knees to stemmed semi-constrained implants, thereby correcting the alignment of both lower limbs. Both fractures healed and the patient is currently pain-free and mobile with walking aids. Surgeons must remain aware that when implants are in situ, abnormal alignments will lead to abnormal forces, and stress fractures are likely to occur at any stress riser around the implant. Avoiding malalignment will avoid this complication.

  3. The negative bone effects of the disease and of chronic corticosteroid treatment in premenopausal women affected by rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    A. Fassio

    2016-09-01

    Full Text Available Osteoporosis is a well-known extra-articular complication in rheumatoid arthritis (RA. The chronic corticosteroid treatment, the functional impairment associated with RA and the disease itself appear to be the most relevant determinants. Most of the previous studies involved postmenopausal women, in whom the estrogenic deficiency might amplify the negative effect towards bone of both RA and corticosteroid therapy. We decided to evaluate bone health in a cohort of premenopausal RA patients. The study population includes 47 premenopausal women attending our outpatient clinic for RA and twice as many healthy age-matched control women selected from the hospital personnel. The bone density at the spine and femoral neck were significantly lower in patients with RA as compared with controls. When spine bone mineral density (BMD values were adjusted for the cumulative glucocorticoid (GC dose alone and for the cumulative GC dose plus body mass index (BMI the mean differences between two groups decreased but they remained statistically significant. We found no difference when the spine BMD was adjusted for cumulative GC dose, BMI and health assessment questionnaire. The difference in femoral neck BMD remained statistically significant also after all the same adjustments. In conclusion, our study shows that a BMD deficiency is frequent also in premenopausal women affected by RA, especially at femoral site and that the main determinants of this bone loss are not only the disease-related weight loss, corticosteroid therapy and functional impairment, but also the systemic effects of the disease itself.

  4. Circulating anti-cyclic citrullinated peptide antibody in patients with rheumatoid arthritis and chronic obstructive pulmonary disease.

    Science.gov (United States)

    Yang, Deng-Ho; Tu, Chuan-Chou; Wang, Shou-Cheng; Wei, Cheng-Chung; Cheng, Ya-Wen

    2014-07-01

    Anti-cyclic citrullinated peptide (anti-CCP) antibody is highly specific for diagnosing rheumatoid arthritis (RA). Cigarette smoking is a lifestyle and environmental factor associated with anti-CCP production and is strongly associated with chronic obstructive pulmonary disease (COPD). This study assessed levels of anti-CCP antibodies and rheumatoid factor (RF) among patients with RA and COPD. The study sample comprised 63 patients with RA and 70 patients with COPD, all of whom underwent assessment of anti-CCP antibody and RF levels. Testing revealed that 54.2% of RA patients and 0% of COPD patients were positive for anti-CCP antibodies. Additionally, 82.5% of RA patients and 42% of COPD patients were positive for RF. Among RA patients, levels of anti-CCP antibodies were higher among smokers than among nonsmokers (242.7 ± 128.3 vs. 68.1 ± 112.1, P < 0.001). COPD patients had low titers of RF but were negative for anti-CCP antibodies. The presence of anti-CCP antibodies was a reliable serologic marker in RA diagnosis and was associated with cigarette smoking.

  5. Assessment of interleukin-6 receptor inhibition therapy on periodontal condition in patients with rheumatoid arthritis and chronic periodontitis.

    Science.gov (United States)

    Kobayashi, Tetsuo; Okada, Moe; Ito, Satoshi; Kobayashi, Daisuke; Ishida, Kohei; Kojima, Anri; Narita, Ichiei; Murasawa, Akira; Yoshie, Hiromasa

    2014-01-01

    Overproduction of interleukin (IL)-6 may play a pathologic role in rheumatoid arthritis (RA) and chronic periodontitis (CP). The present study assesses IL-6 receptor (IL-6R) inhibition therapy on the periodontal condition of patients with RA and CP. The study participants were 28 patients with RA and CP during treatment with IL-6R inhibitor, and 27 patients with RA and CP during treatment without IL-6R inhibitor. Periodontal and rheumatologic parameters and serum levels of cytokine and inflammatory markers and immunoglobulin G against periodontopathic bacteria were examined after medication with IL-6R inhibitor for 20.3 months on average (T1) and again 8 weeks later (T2). No differences were observed between the groups in any parameter values at T1, except for serum IL-6 levels. The anti-IL-6R group showed a significantly greater decrease in gingival index, bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), and serum levels of IL-6 and matrix metalloproteinase (MMP)-3 from T1 to T2 than the control group (P periodontal and serum parameter values were different between the patients with RA and CP during treatment with and without IL-6R inhibitor.

  6. Self-perceived oral health and periodontal parameters in chronic periodontitis patients with and without rheumatoid arthritis.

    Science.gov (United States)

    Javed, Fawad; Ahmed, Hameeda Bashir; Mehmood, Abid; Mikami, Toshinari; Malmstrom, Hans; Romanos, Georgios E

    2016-02-01

    It is hypothesized that self-perceived oral health and periodontal status are worse in chronic periodontitis (CP) patients with rheumatoid arthritis (RA) compared to CP patients without RA. The aim of the present study was to assess self-perceived oral health and periodontal parameters in CP patients with and without RA. Fifty CP patients with RA and 50 CP patients without RA were included. Information regarding sociodemographic characteristics and self-perceived oral symptoms were collected using a questionnaire. Periodontal parameters (plaque index, bleeding on probing, probing depth, clinical attachment loss, number of missing teeth, and marginal bone loss) were recorded. There was no significant difference in socioeconomic status, education status, self-perceived oral symptoms, and periodontal parameters among CP patients with and without RA. Self-perceived oral health and periodontal parameters are mainly governed by the intensity of CP, and the role of RA in this context seems to be rather secondary. © 2014 Wiley Publishing Asia Pty Ltd.

  7. Rheumatoid arthritis.

    Science.gov (United States)

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

    2016-10-22

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

  8. Gadolinium-enhanced MRI features of acute gouty arthritis on top of chronic gouty involvement in different joints.

    Science.gov (United States)

    Emad, Yasser; Ragab, Yasser; El-Naggar, Ahmed; El-Shaarawy, Nashwa; Abd-Allah, Mayada A; Gamal, Rania M; Fathy, Ahmed; Hawass, Mona; Rasker, Johannes J

    2015-11-01

    The aims of the current study are to describe gadolinium-enhanced MRI features of an acute flare of established gouty arthritis in different joints and to examine a possible association between serum uric acid and MRI signs indicative of ongoing inflammation and/or structural joint damage as well as association with disease characteristics and laboratory findings. Twenty-seven male patients with established chronic gout agreed to participate, mean age 47.6 years, and mean disease duration in months 43.2 (±31.8). For all patients, detailed demographic, disease characteristics, and laboratory findings were obtained and correlated with MRI findings. In 27 patients with established gout, a total of 50 MRI studies were performed of the following joints: feet joints (n = 23), ankles (n = 18), knees (n = 5), and hand and wrist joints (n = 4). MRI revealed capsular thickening in 19 patients, bone marrow edema (BME) in 15, soft tissue edema (STE) in 20, joint effusion in 21, bone erosions in 17, cartilaginous erosions in 4, and tenosynovitis in 9 cases. In 17 cases, tophaceous lesions were found. Post contrast MRI showed synovial thickening in seven cases. Positive correlations were observed between serum uric acid levels and the following MRI findings: capsular thickening (r = 0.552, p = 0.003), BME (r = 0.668, p ≤ 0.0001), STE (r = 0.559, p = 0.002), and tenosynovitis (r = 0.513, p = 0.006). Using MRI in chronic gout, important features can be detected like BME, minute cartilaginous erosions, and hypertrophic synovial inflammation in post contrast MR images. Serum uric acid (SUA) was positively correlated with capsular thickening, BME, STE, and tenosynovitis.

  9. Increased Risk of Chronic Kidney Disease in Rheumatoid Arthritis Associated with Cardiovascular Complications - A National Population-Based Cohort Study.

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    Hsien-Yi Chiu

    Full Text Available There have been few large population-based studies of the association between rheumatoid arthritis (RA and chronic kidney disease (CKD and glomerulonephritis. This nationwide cohort study investigated the risks of developing CKD and glomerulonephritis in patients with RA, and the associated risks for cardiovascular complications.From the Taiwan National Health Insurance Research Database, we identified a study cohort of 12,579 patients with RA and randomly selected 37,737 subjects without RA as a control cohort. Each subject was individually followed for up for 5 years, and the risk of CKD was analyzed using Cox proportional hazards regression models.During the follow-up period, after adjusting for traditional cardiovascular risk factors RA was independently associated with a significantly increased risk of CKD (adjusted hazard ratio [aHR] 1.31; 95% confidence interval [CI] 1.23-1.40 and glomerulonephritis (aHR 1.55; 95% CI 1.37-1.76. Increased risk of CKD was also associated with the use of non-steroidal anti-inflammatory drugs, cyclosporine, glucocorticoids, mycophenolate mofetil, and cyclophosphamide. Patients with comorbidities had even greater increased risk of CKD. Moreover, RA patients with concurrent CKD had significantly higher likelihood of developing ischemic heart disease and stroke.RA patients had higher risk of developing CKD and glomerulonephritis, independent of traditional cardiovascular risk factors. Their increased risk of CKD may be attributed to glomerulonephritis, chronic inflammation, comorbidities, and renal toxicity of antirheumatic drugs. Careful monitoring of renal function in RA patients and tight control of their comorbid diseases and cardiovascular risk factors are warranted.

  10. THE USE OF PREPARATIONS BASED ON BACTERIAL LYSATES IN THE TREATMENT OF CHRONIC TONSILLITIS IN PATIENTS WITH RHEUMATOID ARTHRITIS

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    Kolyada T.І.

    2014-12-01

    Full Text Available In the therapy of decompensated form of chronic tonsillitis (CT were used as immunomodulatory agents IRS and Ismigen. These bacterial lysates differ in the bacterial setting, the method of preparation (chemical, mechanical and the method of application.Rheumatoid arthritis (RA is one of the important factors that could significantly complicate the therapy of chronic tonsillitis. RA is a chronic immune inflammatory disease that progressively affects connective tissue mostly of the peripheral joints and it has a wide range of extra-articular manifestations. The aim of our study was to explore the dynamics of immunologic indicators during the active disease and treatments in patients with decompensate form of chronic tonsillitis, including tonsillitis complicated with RA. Materials and methods. 33 patients with decompensate form of chronic tonsillitis in active period of disease observed during the study. Patients were divided into the following groups: 24 persons with the decompensate form of CT, 9 persons with the rheumatoid arthritis and 9 persons with the decompensate form of CT complicated with RA in remission stage. The control group consisted of 15 apparently healthy persons. Concentrations of serum IgA, IgM, IgG were determined by the method of radial immune diffusion by Manchini. Levels of sIgA, IFN – γ and rheumatoid factor in the blood serum of patients were evaluated using ELISA test systems of "Vector-best". Patients of group CTD (with decompensate form of chronic tonsillitis were divided into subgroups CTD1 and CTD2, depending on the applied treatment. Both subgroups treated with standard therapy for two weeks and received Derynat during 1 month by 2 drops in each nostril twice a day. After 30 days of the standard therapy beginning the subgroup CTD1 patients received IRS 19 during two weeks, one intranasal inhalation in each nostril 3 times a day. Patients subgroup CTD2 and CTD+RA instead IRS 19 received Ismigen after 30 days of

  11. Psychosocial management of chronic pain in patients with rheumatoid arthritis: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Sharpe L

    2016-03-01

    Full Text Available Louise SharpeSchool of Psychology, The University of Sydney, Sydney, NSW, AustraliaAbstract: There are numerous reviews and meta-analyses that confirm that psychological therapy is efficacious for patients with rheumatoid arthritis (RA in terms of managing pain. Therefore, the literature has moved on to answer additional questions: 1 What types of interventions are most strongly supported by the current evidence? 2 Do different patients benefit from different approaches? 3 When is it best to intervene? 4 What modalities are best for administering the intervention? 5 What model of care should we be proposing that will result in widespread implementation and will ensure access for patients with RA? This review concludes that cognitive behavioral therapy (CBT is the most efficacious treatment for pain management in RA; however, there are indications that mindfulness may have particular benefits for patients with a history of depression. CBT is most effective when administered early in the course of the disease. However, there is at present little evidence to confirm whether or not psychosocial interventions are effective for patients with comorbid psychological disorders. One of the major challenges is ensuring access to effective interventions for patients, particularly early on in the course of the disease, with a view to preventing physical and psychological morbidity. A stepped-care model is proposed; however, we urgently need more, better-quality trials of minimal interventions, particularly in Internet-delivered CBT, which appears promising and may form the cornerstone of future stepped-care models for providing psychosocial care to patients with RA.Keywords: pain, pain management, cognitive behavioral therapy, psychosocial treatment, coping, psychosocial, psychotherapy

  12. Short term administration of glucocorticoids in patients with protracted and chronic gout arthritis. Part III – frequency of adverse events

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    A A Fedorova

    2009-01-01

    Full Text Available Objective. To assess frequency of adverse events during short term administration of gluco- corticoid (GC in protracted and chronic gout arthritis. Material and methods. 59 pts with tophaceous gout (crystal-verified diagnosis and arthritis of three and more joints lasting more than a months in spite of treatment with sufficient doses of nonsteroidal anti-inflammatory drugs were included. Median age of pts was 56 [48;63], median disease duration – 15,2 years [7,4;20], median swollen joint count at the examination – 8 [5;11]. The patients were randomized into 2 groups. Methylprednisolone (MP 500 mg/day iv during 2 days and placebo im once was administered in one of them, betamethasone (BM 7 mg im once and placebo iv twice – in the other. Clinical evaluation of inflamed joints was performed every day. Standard laboratory examination and ECG were done before drug administration, at 3rd, 7th, and 14th day of follow up. Immunoreactive insulin level was evaluated before drug administration and at day 14. Blood pressure (BP was measured every day. Results. After first GC administration BP elevated in 28 (47% pts. In pts not having appropriate BP values BP elevated in 73% of cases. Pts with appropriate BP values showed less frequent BP elevation – 38% (p=0,02. In 8 (13% pts at day 3 after GC administration ECG signs of myocardial blood supply deterioration were revealed. Glucose level elevated in 10 (17% pts and after the second BM administration – in 5 (8% pts. Cholesterol level did not significantly change after 14 days of follow up but in 28 (47% pts it increased in comparison with baseline. Trigliceride level significantly decreased at day 14 from 149 [106; 187] to 108 [66,5; 172] mg/dl (p=0,02. 26 (44% pts had face hyperemia, 4 (7% –42 palpitation and 2 (3,4% – bitter taste. Conclusion. Administration of short course of GC in pts with gout requires monitoring of possible adverse events. Antihypertensive therapy providing appropriate BP

  13. High molecular weight hyaluronan for treatment of chronic shoulder pain associated with glenohumeral arthritis

    OpenAIRE

    Weil AJ

    2011-01-01

    Arnold J WeilNon-Surgical Orthopedics PC, Marietta, GA, USABackground: There is insufficient evidence to determine whether intra-articular injections may be effective for treatment of glenohumeral osteoarthritis. Euflexxa® (high molecular weight hyaluronate), a bioengineered high molecular weight hyaluronan, has been shown to be a safe and effective treatment for patients with knee osteoarthritis. There is also support for the use of hyaluronate injection for the treatment of chronic ...

  14. The skin tissue is adversely affected by TNF-alpha blockers in patients with chronic inflammatory arthritis: a 5-year prospective analysis

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    Natalia P. Machado

    2013-09-01

    Full Text Available OBJECTIVE: We evaluated the incidence of and the main risk factors associated with cutaneous adverse events in patients with chronic inflammatory arthritis following anti-TNF-α therapy. METHODS: A total of 257 patients with active arthritis who were taking TNF-α blockers, including 158 patients with rheumatoid arthritis, 87 with ankylosing spondylitis and 12 with psoriatic arthritis, were enrolled in a 5-year prospective analysis. Patients with overlapping or other rheumatic diseases were excluded. Anthropometric, socioeconomic, demographic and clinical data were evaluated, including the Disease Activity Score-28, Bath Ankylosing Spondylitis Disease Activity Index and Psoriasis Area Severity Index. Skin conditions were evaluated by two dermatology experts, and in doubtful cases, skin lesion biopsies were performed. Associations between adverse cutaneous events and clinical, demographic and epidemiological variables were determined using the chi-square test, and logistic regression analyses were performed to identify risk factors. The significance level was set at p<0.05. RESULTS: After 60 months of follow-up, 71 adverse events (73.85/1000 patient-years were observed, of which allergic and immune-mediated phenomena were the most frequent events, followed by infectious conditions involving bacterial (47.1%, parasitic (23.5%, fungal (20.6% and viral (8.8% agents. CONCLUSION: The skin is significantly affected by adverse reactions resulting from the use of TNF-α blockers, and the main risk factors for cutaneous events were advanced age, female sex, a diagnosis of rheumatoid arthritis, disease activity and the use of infliximab.

  15. Incidence of chronic persistent rheumatoid arthritis and the impact of smoking

    DEFF Research Database (Denmark)

    Svendsen, Anders J; Junker, Peter; Houen, Gunnar;

    2017-01-01

    %). Information on smoking was obtained by questionnaire and interview. A mixed effect Poisson regression model was used to estimate incidence rate ratios with age, sex, smoking duration and smoking intensity as covariates. We used the SplitLexis procedure in the Epi R package to study a possible effect of period...... or cohort in addition to age on the variation of the incidence. RESULTS: The annual incidence of chronic persistent RA was 18.8 per 100,000 person years aged 15-73 years (females 25.2, males 12.0), increasing with age to a maximum at sixty years in females and seventy years in males. The incidence rate...

  16. Significance of Circulating and Crevicular Matrix Metalloproteinase-9 in Rheumatoid Arthritis-Chronic Periodontitis Association

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    Isabela Silosi

    2015-01-01

    periodontal disease have been identified. Emerging as a chronic inflammatory joint disease, RA displays various features and pathogenetic events similar to chronic periodontitis (CP. The purpose of this study was to evaluate the utility of determining systemic and crevicular levels of metalloproteinase-9 (MMP-9 as potential biomarkers for association between RA and CP. A total of fifty-six patients were included in the study. The subjects were categorized into four groups as follows: healthy-control (n=21, active RA (n=16, CP (n=14, and RA-CP association (n=12. Assessment of serum and crevicular concentrations of total MMP-9 (active and pro-MMP-9 was based on ELISA technique. The results of this study showed statistically significant differences of serum MMP-9 between patients groups and control. Serum levels of MMP-9 were similar in RA and RA-CP associated patients. Gingival crevicular fluid (GCF recorded increased MMP-9 levels in RA-CP association subjects as compared to CP. Considering that RA-CP association is characterized by a disregulation of the inflammatory response, MMP-9 may play a role in the pathogenesis of RA-CP association. MMP-9 is therefore a sensitive tool in the diagnosis and management of patients affected by this binomial association.

  17. Hypouricemic and arthritis relapse-reducing effects of compound tufuling oral-liquid in intercritical and chronic gout: A double-blind, placebo-controlled, multicenter randomized trial.

    Science.gov (United States)

    Xie, Zhijun; Wu, Huaxiang; Jing, Xiaoqing; Li, Xiuyang; Li, Yasong; Han, Yongmei; Gao, Xiangfu; Tang, Xiaopo; Sun, Jing; Fan, Yongshen; Wen, Chengping

    2017-03-01

    In the double-blind, randomized, controlled trial, we aimed to evaluate the effects of compound tufuling oral liquid (CoTOL) on serum uric acid (sUA) levels and recurrence of acute gouty arthritis in intercritical and chronic gout treatment. A total of 210 patients with gout were screened from 8 hospitals to observe the sUA and acute gouty arthritis recurrence rate-reducing effects of CoTOL in intercritical and chronic gout during a 12-week treatment. We treated 139 and 71 patients with CoTOL and the placebo, respectively, and evaluated their sUA levels, acute gouty arthritis recurrence rate, and adverse events at week 0, 6, and 12. Twenty-five and 12 patients in the treatment and control groups, respectively, had interrupted treatments, whereas 114 and 59 cases, respectively, completed their treatments. At the end of the 12-week treatment, the average decrease in sUA was 74.26 (95% confidence interval [CI]: 56.74-91.77 μmol/L) and 28.81 μmol/L (95% CI: 4.91-52.71 μmol/L) in the treatment and control groups, respectively (P = 0.004). The average decrease rate of sUA was 12.76% (95% CI: 9.82%-15.70%) and 4.57% (95% CI: 0.42%-8.71%) in the treatment and control groups, respectively (P = 0.004), and the gouty arthritis recurrence rate of the treatment group was lower than that of the control group (from week 6 to 12, 21.93% and 50.88% in the treatment and control group, respectively, P treatment group than those in the control group (3/139 vs. 7/71, respectively, P = 0.033). CoTOL reduced sUA levels and effectively prevented acute arthritis recurrence in intercritical and chronic gout without serious adverse events.

  18. PHARMACOECONOMIC ASPECTS OF TREATMENT WITH THE INHIBITORS OF TUMOR NECROSIS FACTOR OF THE CHRONIC UVEITIS REFRACTORY TO THE BASIC THERAPY (INCLUDING AN ASSOCIATED WITH JUVENILE IDIOPATHIC ARTHRITIS

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    A.V. Rudakova

    2011-01-01

    Full Text Available Therapy of chronic uveitis refractory to the basic treatment, in juvenile idiopathic arthritis (JIA is a very complex problem in pediatrics. Substantial progress in this area resulted after the implementation in practice of inhibitors of tumor necrosis factor (TNF, as the most effective in such clinical situation drugs adalimumab and infliximab are considered (although infliximab was not officially approved in JIA. Objective. To estimate the cost effectiveness of TNF inhibitors — adalimumab, and infliximab in chronic uveitis, refractory to the basic therapy (including associated with juvenile rheumatoid arthritis. Methods. A modeling on the basis of a comparative prospective cohort clinical study was carried out. The analysis was performed by the method «cost–effectiveness» from a position of health and social accounting perspective. Results. It was shown that the frequency and time of remission did not differ when treatment with infliximab (5 mg/kg at 0–2–6 weeks and further once in 6–8 weeks and adalimumab (24 mg/m2 once in 2 weeks. Adalimumab provides a long-term maintenance of remission (no recurrence in 60% of patients within 40 months of observation, whereas 1 year after the treatment with infliximab the frequency of exacerbations was returned to that observed before therapy. The proportion of patients without relapse in the treatment with infliximab for 40 months was 18.8%. Similar results were obtained in a subset of patients with chronic uveitis associated with JIA (with follow-up of 20 months of in a group of infliximab number patients without relapse was 11.1%, with adalimumab therapy — 63.6%. In the general population of patients with refractory chronic uveitis the factor «cost–effectiveness» calculated for a patient with the maintenance of remission for 3 years with adalimumab therapy was in 2,1–2,8 times less than in the treatment with infliximab. In chronic uveitis associated with JIA, the coefficient of

  19. Gonococcal arthritis

    Science.gov (United States)

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

  20. 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.

  1. Rheumatoid Arthritis

    Science.gov (United States)

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

  2. Effects of anti-tumor necrosis factor agents for familial mediterranean fever patients with chronic arthritis and/or sacroiliitis who were resistant to colchicine treatment.

    Science.gov (United States)

    Bilgen, Sule Apras; Kilic, Levent; Akdogan, Ali; Kiraz, Sedat; Kalyoncu, Umut; Karadag, Omer; Ertenli, Ihsan; Dogan, Ismail; Calguneri, Meral

    2011-10-01

    Effectiveness of anti-tumor necrosis factor (anti-TNF) agents in colchicine-resistant familial Mediterranean fever (FMF) patients has attracted attention in recent years. We analyzed the effect of anti-TNF agents on clinical findings of colchicine-resistant FMF patients with chronic arthritis and/or sacroiliitis. Data from 10 FMF patients (5 male and 5 female patients: mean age, 30.1 [SD, 8.5] years) with chronic arthritis and/or sacroiliitis who were on anti-TNF agents are reviewed. Frequency of FMF attacks before and after treatment with anti-TNF agents was recorded from hospital files. The effects of the anti-TNF treatment were determined by using the number of tender and/or swollen joints, serum acute phase reactant levels, and Bath Ankylosing Spondylitis Disease Activity Index scores. Change in urine protein loss was also evaluated in patients with amyloidosis. In 6 patients, FMF attacks had been considered to be unresponsive to colchicine, and 4 patients were partial responders before treatment with anti-TNF agents. Mean attack frequency of the patients in the 3 months' period before anti-TNF agent treatment was 3.8 (SD, 3.1). After anti-TNF treatment, in 3 patients, FMF attack frequency decreased, and in the remaining 7 patients, no attack occurred. Serum acute phase reactant levels were decreased significantly at 3 and 6 months after anti-TNF treatment (P treatment Bath Ankylosing Spondylitis Disease Activity Index scores were also decreased significantly (6.2 [SD], 1.7 vs. 2.1 [SD], 1.7; P = 0.012). In all 3 patients with amyloidosis, urine protein loss decreased without any increase in serum creatinine levels. Anti-TNF treatment can have beneficial effects for controlling FMF attacks in FMF patients with chronic arthritis and/or sacroiliitis.

  3. "I know I have arthritis but I don't know what type". Understanding and knowledge of this chronic condition

    Directory of Open Access Journals (Sweden)

    Broderick Danny

    2010-08-01

    Full Text Available Abstract Background "Arthritis" is a common musculoskeletal condition but the knowledge of what type of arthritis people have, may be limited but may have changed over time in response to campaigns, increased awareness and improved health literacy. This paper describes people who did not know what type of arthritis they had, by a range of relevant demographic and socioeconomic variables, and assesses changes over time in the proportion of people who report having arthritis but do not know what type, using representative population surveillance data. Methods Data were collected using the South Australian Monitoring and Surveillance System (SAMSS, a risk factor surveillance system where each month, a representative random sample of South Australians is selected from the Electronic White Pages, with interviews conducted using computer assisted telephone interviewing (CATI. Data were used for the period January 2006 to December 2008 (n = 16465 for respondents aged 18 years and over. Results Overall, the proportion of respondents who did not know what type of arthritis they had, among people aged 18 years and over, for 2006 to 2008 was 6.5% (95% CI 6.1-6.9. When considering only those respondents reporting that they had been told by a doctor that they had arthritis, 30.1% did not know what type of arthritis they had. Multivariate analysis indicated that males, those with have a trade, certificate or diploma or secondary level of education, who spoke a language other than English at home, were widowed and earned $20,001 to $60,000, more than $80,000 or did not state their income were more likely to maintain that they did not know what type of arthritis they had. Conclusions Population ageing and an increase in arthritis prevalence in the future will further increase the burden of arthritis. These increases in prevalence are not inevitable, especially if investments are made in public health prevention programs, particularly those addressing cultural

  4. Incidence of active mycobacterial infections in Brazilian patients with chronic inflammatory arthritis and negative evaluation for latent tuberculosis infection at baseline - A longitudinal analysis after using TNFα blockers

    Science.gov (United States)

    Gomes, Carina Mori Frade; Terreri, Maria Teresa; de Moraes-Pinto, Maria Isabel; Barbosa, Cássia; Machado, Natália Pereira; Melo, Maria Roberta; Pinheiro, Marcelo Medeiros

    2015-01-01

    Several studies point to the increased risk of reactivation of latent tuberculosis infection (LTBI) in patients with chronic inflammatory arthritis (CIAs) after using tumour necrosis factor (TNF)α blockers. To study the incidence of active mycobacterial infections (aMI) in patients starting TNF α blockers, 262 patients were included in this study: 109 with rheumatoid arthritis (RA), 93 with ankylosing spondylitis (AS), 44 with juvenile idiopathic arthritis (JIA) and 16 with psoriatic arthritis (PsA). All patients had indication for anti-TNF α therapy. Epidemiologic and clinical data were evaluated and a simple X-ray and tuberculin skin test (TST) were performed. The control group included 215 healthy individuals. The follow-up was 48 months to identify cases of aMI. TST positivity was higher in patients with AS (37.6%) than in RA (12.8%), PsA (18.8%) and JIA (6.8%) (p < 0.001). In the control group, TST positivity was 32.7%. Nine (3.43%) patients were diagnosed with aMI. The overall incidence rate of aMI was 86.93/100,000 person-years [95% confidence interval (CI) 23.6-217.9] for patients and 35.79/100,000 person-years (95% CI 12.4-69.6) for control group (p < 0.001). All patients who developed aMI had no evidence of LTBI at the baseline evaluation. Patients with CIA starting TNF α blockers and no evidence of LTBI at baseline, particularly with nonreactive TST, may have higher risk of aMI. PMID:26560983

  5. Plasma adiponectin in patients with active, early, and chronic rheumatoid arthritis who are steroid- and disease-modifying antirheumatic drug-naive compared with patients with osteoarthritis and controls

    DEFF Research Database (Denmark)

    Laurberg, Trine Bay; Frystyk, Jan; Ellingsen, Torkell;

    2009-01-01

    OBJECTIVE: Rheumatoid arthritis (RA) is a systemic chronic inflammatory joint disease, whereas osteoarthritis (OA) is a local joint disease with low-level inflammatory activity. The pathogenic role of the adipocytokine adiponectin is largely unknown in these diseases. We hypothesized (1) that pla......OBJECTIVE: Rheumatoid arthritis (RA) is a systemic chronic inflammatory joint disease, whereas osteoarthritis (OA) is a local joint disease with low-level inflammatory activity. The pathogenic role of the adipocytokine adiponectin is largely unknown in these diseases. We hypothesized (1...

  6. Limitations of clinical trials in chronic diseases: is the efficacy of methotrexate (MTX) underestimated in polyarticular psoriatic arthritis on the basis of limitations of clinical trials more than on limitations of MTX, as was seen in rheumatoid arthritis?

    Science.gov (United States)

    Pincus, Theodore; Bergman, Martin J; Yazici, Yusuf

    2015-01-01

    Clinical trials are the optimal method to establish efficacy of a drug versus placebo or another drug. Nonetheless, important limitations are seen, particularly in chronic diseases over long periods, although most are ignored. Pragmatic limitations of clinical trials include a relatively short observation period, suboptimal dosage schedules, suboptimal surrogate markers for long-term outcomes, statistically significant results which may not be clinically unimportant and vice versa. Even ideal clinical trials have intrinsic limitations, including the influence of design on results, data reported in groups which ignore individual variation, non-standard observer-dependent interpretation of a balance of efficacy and toxicity, and distortion of a "placebo effect." Limitations are seen in many clinical trials of methotrexate (MTX) in rheumatoid arthritis (RA) and psoriatic arthritis (PsA). The first MTX clinical trial in rheumatology documented excellent efficacy in PsA, but frequent adverse events in 1964, explained by intravenous doses up to 150 kg. MTX was abandoned until the 1980s for RA, while gold salts and penicillamine were termed "remission-inducing," on the basis limitations of clinical trials. In the most recent MTX in PsA (MIPA) trial, all outcomes favoured MTX, but only patient and physician global estimates met the pclinical trials than from limitations of MTX.

  7. Chronic Pain

    Science.gov (United States)

    ... a problem you need to take care of. Chronic pain is different. The pain signals go on ... there is no clear cause. Problems that cause chronic pain include Headache Low back strain Cancer Arthritis ...

  8. Differential effect of methotrexate on the increased CCR2 density on circulating CD4 T lymphocytes and monocytes in active chronic rheumatoid arthritis, with a down regulation only on monocytes in responders

    DEFF Research Database (Denmark)

    Ellingsen, T; Hornung, N; Møller, B K;

    2007-01-01

    arthritis. METHODS: All 34 patients with rheumatoid arthritis fulfilled the 1987 American Rheumatism Association criteria and were followed for 16 weeks after starting MTX. Peripheral blood mononuclear cells were analysed for CCR2 and CXCR3 density by three-colour flow cytometry before initiation of MTX...... and at week 12. RESULTS: 22 (65%) patients were non-responders, 12 (35%) patients responded to MTX by American College of Rheumatology (ACR)20% criteria, and 8 (24%) of these patients responded by ACR50%. In patients with active rheumatoid arthritis before starting MTX, CCR2 density on circulating monocytes......: Active chronic rheumatoid arthritis is characterised by enhanced CCR2 density on circulating monocytes and CD4(+) CXCR3(+) and CD4(+) CXCR3(-) T lymphocytes. During MTX treatment, a decrease in CCR2 density on monocytes in the ACR50% responder group was associated with decreased disease activity...

  9. Differential effect of methotrexate on the increased CCR2 density on circulating CD4 T lymphocytes and monocytes in active chronic rheumatoid arthritis, with a down regulation only on monocytes in responders

    DEFF Research Database (Denmark)

    Ellingsen, T; Hornung, N; Møller, B K

    2007-01-01

    : Active chronic rheumatoid arthritis is characterised by enhanced CCR2 density on circulating monocytes and CD4(+) CXCR3(+) and CD4(+) CXCR3(-) T lymphocytes. During MTX treatment, a decrease in CCR2 density on monocytes in the ACR50% responder group was associated with decreased disease activity...... arthritis. METHODS: All 34 patients with rheumatoid arthritis fulfilled the 1987 American Rheumatism Association criteria and were followed for 16 weeks after starting MTX. Peripheral blood mononuclear cells were analysed for CCR2 and CXCR3 density by three-colour flow cytometry before initiation of MTX...... and at week 12. RESULTS: 22 (65%) patients were non-responders, 12 (35%) patients responded to MTX by American College of Rheumatology (ACR)20% criteria, and 8 (24%) of these patients responded by ACR50%. In patients with active rheumatoid arthritis before starting MTX, CCR2 density on circulating monocytes...

  10. 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 ...

  11. Kartagener syndrome and rheumatoid arthritis.

    Science.gov (United States)

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

    2006-02-01

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

  12. Clinical experience with the interleukin-1β blocker canakinumab in patients with chronic tophaceous gout: abolishment of arthritis and prevention of exacerbations when allopurinol is used

    Directory of Open Access Journals (Sweden)

    M. S. Eliseev

    2015-01-01

    Full Text Available The interleukin (IL-1β inhibitor canakinumab may be effective in relieving an acute gout attack and in preventing an arthritis exacerbation. However, there are insufficient data on the use of this agent to abolish and prevent arthritis in patients who are resistant to another anti-inflammatory therapy.Objective: to evaluate the efficacy of the interleukin (IL-1β inhibitor canakinumab in patients with chronic tophaceous gout, who are resistant to traditional anti-inflammatory therapy, in order to abolish arthritis and to prevent its exacerbations when adjusting the optimal dose of allopurinol.Subjects and methods. An open-labeled prospective study was conducted in 20 patients (mean age, 54.5±12.7 years with chronic tophaceous gout. Serum uric acid (UA levels were 486.3±135.2 μmol/l. The inclusion criteria were crystal-verified gout; arthritis affecting more than 5 joints; inefficacy of non-steroidal anti-inflammatory drugs (NSAIDs, glucocorticoids (GCs, or colchicine when used for over a month; more than 4 arthritis attacks during year. The exclusion criteria were Stage ≥3 chronic kidney disease, infectious diseases. All the patents received a single subcutaneous injection of canakinumab 150 mg. NSAIDs and/or colchicine was discontinued a day before the injection. The number of swollen and tender joints and visual analogue scale (VAS pain intensity were estimated before and 14 and 120 days after the injection; SF-36v1 and HAQ changes were assessed before and 120 days after the injection. 14 days after the injection, all the patients were given allopurinol, the dosage of which was individually adjusted, by starting on 100 mg/day and subsequently increasing by 100 mg/dayevery 2 weeks (not more than 800 mg/day until the goal UA level (<360 μmol/l was reached.Results. 14 days after canakinumab injection, arthritis was abolished in 8 (40% patients and 3 patients needed to continue NSAID therapy. Following 14 days of the injection

  13. Fetal Programming in Rheumatoid Arthritis

    NARCIS (Netherlands)

    F.D.O. de Steenwinkel (Florentien)

    2013-01-01

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

  14. Gadolinium-enhanced MRI features of acute gouty arthritis on top of chronic gouty involvement in different joints

    NARCIS (Netherlands)

    Emad, Yasser; Ragab, Yasser; El-Naggar, Ahmed; El-Shaarawy, Nashwa; Abd-Allah, Mayada A.; Gamal, Rania M.; Fathy, Ahmed; Hawass, Mona; Rasker, Hans

    2015-01-01

    The aims of the current study are to describe gadolinium-enhanced MRI features of an acute flare of established gouty arthritis in different joints and to examine a possible association between serum uric acid and MRI signs indicative of ongoing inflammation and/or structural joint damage as well as

  15. Application of urinary indicator proteins in the non-invasive assessment of glomerulo-tubular lesions in patients with chronic glomerulonephritis and rheumatoid arthritis.

    Science.gov (United States)

    Weber, M H; Verwiebe, R; Janning, G; Scheler, F

    1989-01-01

    As the semiautomated electrophoretic analysis of proteinuria still needs technical experience, interest was focused on easy-to-perform methods of urinary protein measurement. SRID-tests for albumin, transferrin, IgG, alpha-1-microglobulin and a spectrophotometrical test for beta-NAG were carried out in 50 normal controls and compared to PCI/ECI-values of patients suffering from rheumatoid arthritis (n = 52) and various types of chronic glomerulonephritis (n = 41). Elevated levels of alpha-1-M and beta-NAG in chronic glomerulonephritis were interpreted as indicative for tubulointerstitial involvement in the chronic inflammatory process. PCI/ECI elevation in individual RA-samples may be caused by functional impairment of tubular protein handling due to chronic ingestion of non-steroid analgesics. The serum assays for transferrin (TF) and IgG based on SRID technique turned out to be too insensitive for the application on unconcentrated urine of normal control persons. In renal patients, however, TF-PCI values above 30 mg/g crea and IgG-PCI values above 50 mg/g crea have to be interpreted as pathologic indicating damage of the glomerular basement membrane. To elucidate TF- and IgG-values in urines with low protein content, highly sensitive nephelometric methods should be used. Concentration of urinary proteins using membrane filters may lead to protein losses, resulting in miscalculation of PC-indices.

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

    Science.gov (United States)

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

    2017-09-01

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

  17. Anti-cyclic citrullinated peptide (CCP) antibody in patients with wood-smoke-induced chronic obstructive pulmonary disease (COPD) without rheumatoid arthritis.

    Science.gov (United States)

    Sigari, Naseh; Moghimi, Nasrin; Shahraki, Farhad Saber; Mohammadi, Shilan; Roshani, Daem

    2015-01-01

    Citrullination, a post-translational modification of proteins, is increased in inflammatory processes and is known to occur in smokers. It can induce anti-cyclic citrullinated peptide (CCP) antibodies, the most specific serologic marker for rheumatoid arthritis. Thus far, the incidence of autoimmunity in patients with wood-smoke-induced chronic obstructive pulmonary disease (COPD) resulting in anti-CCP production has not been examined. We hypothesise that anti-CCP antibody level in these patients should be higher than that in healthy subjects. A total of 112 non-rheumatoid arthritis patients, including 56 patients with wood-smoke-induced COPD and 56 patients with tobacco-induced COPD, and 56 healthy non-smoker controls were included. The serum anti-CCP antibody levels were measured and compared between the groups and against smoke exposure and clinical characteristics. The mean anti-CCP antibody levels in wood-smoke-induced COPD group were significantly higher than those in tobacco-induced COPD group (p = 0.03) and controls (p = 0.004). Furthermore, 8 (14.2 %) patients with wood-smoke-induced COPD, 4 (7.14 %) with tobacco-induced COPD and 2 (3.57 %) controls exceeded the conventional cut-off of anti-CCP antibody positivity. No relationship was found between the anti-CCP antibody level and age, gender, duration of disease, Pack-years of smoking, and duration of exposure to wood smoke. Moreover, correlations between anti-CCP antibodies and severity of airflow limitation, CAT scores, mMRC scores of dyspnoea, and GOLD staging of COPD severity were not significant. Wood-smoke-induced COPD could significantly increase the anti-CCP antibody level in non-rheumatoid arthritis patients when compared with that in patients with tobacco-induced COPD and healthy controls.

  18. Survey on attitudes regarding EULAR recommendations for the role of nurses involved in medical care of patients with chronic inflammatory arthritis in Japan.

    Science.gov (United States)

    Fusama, Mie; Nakahara, Hideko; van Eijk-Hustings, Yvonne; Oliver, Susan; Takeuchi, Tsutomu

    2017-09-01

    We seek to evaluate the opinions of nurses and doctors in Japan regarding EULAR recommendations for nurses' roles in the management of chronic inflammatory arthritis. This is a cross-sectional survey within Japan. We randomly selected nurses and doctors engaged in consultation of patients with rheumatoid arthritis (RA) and assessed their agreement and opinions on the feasibility of implementing EULAR recommendations, including potential barriers. 431 nurses and 128 doctors completed the questionnaire. For both nurses and doctors, levels of feasibility showed statistically significant lower results compared with those of agreement for all items. When compared between nurses and doctors, agreement showed no statistically significant differences, while nurses' answers were statistically significant lower for feasibility. Insufficient time, staff and knowledge, lack of established procedures and facilities, and lack of an education system for nurses were cited as barriers to the feasibility of implementing EULAR recommendations. This is the first survey within Japan evaluating opinions regarding EULAR recommendations for nurses' roles. We found that while agreement was high, feasibility was generally believed to be low. We recommend further research and collaboration between medical professionals in order to implement these recommendations in Japan.

  19. Chronic inflammation and low-dose glucocorticoid effects on glucose metabolism in premenopausal females with rheumatoid arthritis free of conventional metabolic risk factors.

    Science.gov (United States)

    Penesová, A; Rádiková, Z; Vlček, M; Kerlik, J; Lukáč, J; Rovenský, J; Imrich, R

    2013-01-01

    Chronic systemic inflammation is associated with increased cardiovascular mortality in patients with rheumatoid arthritis (RA). The aim of our study was to investigate association of glucose metabolism and inflammatory markers in a group of patients with rheumatoid arthritis free of other metabolic risk factors. Twenty-two premenopausal RA females (11 patients on low-dose GC (glucocorticoid therapy) and 15 age- and BMI-matched healthy females underwent the oral glucose tolerance test. The insulin sensitivity indices according Matsuda (ISI(MAT)) and Cederholm (ISI(CED)) as well as HOMA2 %S were calculated. Cytokines, lipid profile, non-esterified fatty acids (NEFA) and plasminogen activator inhibitor-1 (PAI-1) were measured in baseline blood samples. Despite elevated interleukin IL-6 and TNF alpha, glucose, insulin and C-peptide responses to oral glucose load as well as ISI(MAT), ISI(CED), PAI-1 and NEFA were comparable in both RA groups and healthy controls. HOMA2 %S correlated with disease activity. In conclusions, low-dose glucocorticoid treatment does not lead to glucose metabolism impairment in RA patients without other metabolic risk factors. Increased cardiovascular mortality and morbidity is probably due to a direct effect of systemic inflammation on myocardium and/or blood vessels.

  20. [Two cases with SLE and MCTD developed after a long period of chronic arthritis that was initially diagnosed as JRA].

    Science.gov (United States)

    Takei, S; Maeno, N; Shigemori, M; Nakae, Y; Mori, H; Nerome, Y; Imanaka, H; Hokonohara, M; Miyata, K

    1997-10-01

    In order to discuss the diversity of clinical features and the difficulty in diagnosis of children with juvenile rheumatoid arthritis (JRA), we present two cases who have documented the development of systemic lupus erythematosus (SLE) and mixed connective tissue disease (MCTD) after a long period of disease characterized only by arthritis that was initially diagnosed as JRA. The first case was a girl diagnosed for her arthritic joints as polyarticular JRA at 15 years of age. At onset, she had Raynaud phenomenon but autoantibodies such as anti-nuclear antibody (ANA), anti-DNA antibody, and rheumatoid factor were negative. Five years after onset, she became ANA positive and 3 years later she became pregnant. During her pregnancy, she became positive for anti-DNA antibody without any signs of nephritis. One month after the delivery, however, she developed butterfly rash, carditis, nephritis, and was diagnosed as SLE. No destructive changes were observed in her joints though arthritis continued for 8 years form onset to pregnancy. The second case was a 3 years old girl who was diagnosed as polyarticular JRA. Treatment by aspirin induced complate remission after one year from the onset. However, 10 years after that remission, she developed Raynaud phenomenon and arthralgia in her knees and hip joints. Her laboratory findings showed hypergammaglobulinemia, positive ANA, positive anti-DNA antibody, positive anti-RNP antibody. She was eventually diagnosed as MCTD when she was found to have polymyositis by EMG and serum CK. In the present paper, two cases imply the difficulty in diagnosing JRA and diversity of rheumatic diseases such as JRA, SLE and MCTD. Closer and longer period of observation is essential for the JRA patients with nondestructive arthritis.

  1. 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 ...

  2. 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 ...

  3. Thumb Arthritis

    Science.gov (United States)

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

  4. Fungal arthritis

    Science.gov (United States)

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

  5. Sporotrichal arthritis.

    OpenAIRE

    1991-01-01

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

  6. Psoriatic Arthritis

    Science.gov (United States)

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

  7. 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.

  8. MR-morphological changes of the metacarpophalangeal joints in patients with rheumatoid arthritis: comparison of early and chronical stages; MR-morphologische Veraenderungen der Metacarpophalangealgelenke bei Rheumatoider Arthritis: Vergleich frueher und spaeter Stadien

    Energy Technology Data Exchange (ETDEWEB)

    Scherer, A.; Engelbrecht, V.; Poll, L.W.; Peters, R.; Moedder, U. [Duesseldorf Univ. (Germany). Inst. fuer Diagnostische Radiologie; Ostendorf, B.; Becker, A.; Dann, P.; Schneider, M. [Zentrum fuer Rheumatologie, Klinik fuer Nephrologie und Rheumatologie, Heinrich-Heine-Univ., Duesseldorf (Germany)

    2001-10-01

    Purpose: Evaluation of MRI findings in the metacarpophalangeal (MCP) joints in patients with early (eRA) and chronical rheumatoid arthritis (cRA). Material and Methods: In 22 RA patients (9 with disease duration {<=} 1.5 years = eRA) the dominant hands were examined by MRI in coronal T{sub 2} weighted turbo-spin-echo (TSE). T{sub 1} weighted spin-echo (SE) sequences before and after injection of Gd-DTPA and fat-suppressed short tau inversion recovery (STIR) sequences, followed by miniarthroscopy (MA) of the MCP II joint after an interval of 24 hours. MRI and MA findings were assessed using standardised semiquantitative items of synovial and bony pathologies and a statistical comparison between eRA and cRA patients was performed. Results: In MRI synovial proliferation was detected in 13/13 cRA and 8/9 eRA patients. It was statistically not significant; the degree of synovial proliferation was however lower in the eRA group. All eRA patients with synovial changes showed enhancement after administration of contrast medium, a marker which correlated with the clinical activity. In 2/13 cRA patients no uptake of contrast medium was evident. Bony erosions and strongly narrowing joint space correlated with disease duration and were documented significantly rarer in the eRA patients (1/9, 2/9) than in the cRA patients (9/13, 10/13). Conclusion: In RA patients, MRI of the metacarpophalangeal joints can detect specific pathological changes which are observed significantly more often in either early or chronic stages and which are associated with disease activity and duration. (orig.) [German] Ziel: Evaluation MR-morphologischer Veraenderungen im Bereich der Metacarpophalangealgelenke (MCP) bei Patienten mit frueher (fRA) und chronischer rheumatoider arthritis (cRA). Material und Methode: Bei 22 Patienten mit rheumatoider arthritis (RA) (davon 9 mit einer Krankheitsdauer {<=} 1,5 Jahre = fRA) wurde die klinisch fuehrende Hand in der MRT untersucht. Das Protokoll umfasste T

  9. 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.

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

    Science.gov (United States)

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

    2012-06-01

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

  11. Occupational therapy for patients with chronic diseases: CVA, rheumatoid arthritis and progressive diseases of the central nervous system.

    NARCIS (Netherlands)

    Driessen, M.J.; Dekker, J.; Lankhorst, G.; Zee, J. van der

    1997-01-01

    A substantial proportion of the patients treated by occupational therapists have a chronic disease. The aim of this study was to describe the outlines of occupational therapy treatment for three specific groups of chronic diseases: progressive neurological diseases, cerebrovascular accident and rh

  12. Occupational therapy for patients with chronic diseases: CVA, rheumatoid arthritis and progressive diseases of the central nervous system.

    NARCIS (Netherlands)

    Driessen, M.J.; Dekker, J.; Lankhorst, G.; Zee, J. van der

    1997-01-01

    A substantial proportion of the patients treated by occupational therapists have a chronic disease. The aim of this study was to describe the outlines of occupational therapy treatment for three specific groups of chronic diseases: progressive neurological diseases, cerebrovascular accident and

  13. 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 ...

  14. Sex and Arthritis

    Science.gov (United States)

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

  15. Role of tachykinin 1 and 4 gene-derived neuropeptides and the neurokinin 1 receptor in adjuvant-induced chronic arthritis of the mouse.

    Directory of Open Access Journals (Sweden)

    Eva Borbély

    Full Text Available OBJECTIVE: Substance P, encoded by the Tac1 gene, is involved in neurogenic inflammation and hyperalgesia via neurokinin 1 (NK1 receptor activation. Its non-neuronal counterpart, hemokinin-1, which is derived from the Tac4 gene, is also a potent NK1 agonist. Although hemokinin-1 has been described as a tachykinin of distinct origin and function compared to SP, its role in inflammatory and pain processes has not yet been elucidated in such detail. In this study, we analysed the involvement of tachykinins derived from the Tac1 and Tac4 genes, as well as the NK1 receptor in chronic arthritis of the mouse. METHODS: Complete Freund's Adjuvant was injected intraplantarly and into the tail of Tac1(-/-, Tac4(-/-, Tacr1(-/- (NK1 receptor deficient and Tac1(-/-/Tac4(-/- mice. Paw volume was measured by plethysmometry and mechanosensitivity using dynamic plantar aesthesiometry over a time period of 21 days. Semiquantitative histopathological scoring and ELISA measurement of IL-1β concentrations of the tibiotarsal joints were performed. RESULTS: Mechanical hyperalgesia was significantly reduced from day 11 in Tac4(-/- and Tacr1(-/- animals, while paw swelling was not altered in any strain. Inflammatory histopathological alterations (synovial swelling, leukocyte infiltration, cartilage destruction, bone damage and IL-1β concentration in the joint homogenates were significantly smaller in Tac4(-/- and Tac1(-/-/Tac4(-/- mice. CONCLUSIONS: Hemokinin-1, but not substance P increases inflammation and hyperalgesia in the late phase of adjuvant-induced arthritis. While NK1 receptors mediate its antihyperalgesic actions, the involvement of another receptor in histopathological changes and IL-1β production is suggested.

  16. [Arthritis and clinical history].

    Science.gov (United States)

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

    2011-01-01

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

  17. 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

  18. Modulation of SERCA in the chronic phase of adjuvant arthritis as a possible adaptation mechanism of redox imbalance.

    Science.gov (United States)

    Strosova, Miriam; Karlovska, Jana; Spickett, Corinne M; Orszagova, Zuzana; Ponist, Silvester; Bauerova, Katarina; Mihalova, Danica; Horakova, Lubica

    2009-09-01

    Adjuvant arthritis (AA) is a condition that involves systemic oxidative stress. Unexpectedly, it was found that sarcoplasmic reticulum Ca(2 +)-ATPase (SERCA) activity was elevated in muscles of rats with AA compared to controls, suggesting possible conformational changes in the enzyme. There was no alteration in the nucleotide binding site but rather in the transmembrane domain according to the tryptophan polar/non-polar fluorescence ratio. Higher relative expression of SERCA, higher content of nitrotyrosine but no increase in phospholipid oxidation in AA SR was found. In vitro treatments of SR with HOCl showed that in AA animals SERCA activity was more susceptible to oxidative stress, but SR phospholipids were more resistant and SERCA could also be activated by phosphatidic acid. It was concluded that increased SERCA activity in AA was due to increased levels of SERCA protein and structural changes to the protein, probably induced by direct and specific oxidation involving reactive nitrogen species.

  19. Arthritis in America PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2017-03-07

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

  20. 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.

  1. The effect of TNFalpha blockade on the antinuclear antibody profile in patients with chronic arthritis: biological and clinical implications.

    Science.gov (United States)

    De Rycke, L; Baeten, D; Kruithof, E; Van den Bosch, F; Veys, E M; De Keyser, F

    2005-01-01

    Since the first proof of efficacy of TNFalpha blockade, both the number of patients treated worldwide and the number of indications for treatment with TNFalpha blockers have grown steadily. Surprisingly, the profound immunomodulation induced by anti-TNFalpha therapy is associated with a relatively low incidence of immune-related complications such as lupus-like syndromes and demyelinating disease. This contrasts sharply with the prominent induction of autoantibodies such as antinuclear antibodies (ANA) and anti-dsDNA antibodies during TNFalpha blockade. Although this phenomenon has been recognized for several years, the clinical and biological implications are not yet fully understood. In this review, recent studies analysing the effect of TNFalpha blockade (infliximab and etanercept) on the ANA profile in autoimmune arthritis will be discussed. Taken together, these reports indicate that the prominent ANA and anti-dsDNA autoantibody response is 1) not a pure class effect of TNFalpha blockers, 2) independent of the disease background, 3) largely restricted to the induction of short-term IgM anti-dsDNA antibodies, and 4) not associated with other serological or clinically relevant signs of lupus. Nevertheless, a careful follow-up of patients treated with TNFalpha blockers remains mandatory, including monitoring for lupus-like characteristics.

  2. Behavioral Problems in Juvenile Idiopathic Arthritis: A Controlled Study to Examine the Risk of Psychopathology in a Chronic Pediatric Disorder

    Science.gov (United States)

    Chamanara, Elham; Raeeskarami, Seyed-Reza

    2016-01-01

    Children with juvenile idiopathic arthritis (JIA) are prone to the problems that can delay their psychosocial development; however, the existing literature has not reached a consensus on the psychological problems related to JIA. A total of 51 children and adolescents with JIA and 75 healthy controls aged 6 to 18 years were examined using the Child Behavioral Checklist (CBCL). Our results represented that 70 percent of JIA group reached “borderline clinical” range or “clinical” range in internalizing problems, while this percentage in the control group was 18 percent. In addition, our results indicated that JIA group has gotten significantly higher scores (more than twofold) in externalizing behaviors compared to control group. Furthermore, children with JIA showed higher rate of anxiety/depression, withdrawal/depression, somatic complaints, rule breaking behaviors, and aggressive behaviors as well as thought and social problems compared to control group (p < 0.001). As a conclusion, children and adolescents with JIA compared to healthy controls may show higher rate of both internalizing and externalizing problems. Furthermore, our novel findings on externalizing, social, and thought problems in JIA warrant further investigation on affected children who may be at greater risk of future psychopathologies. PMID:27656678

  3. Autoimmune correlation of rheumatoid arthritis and periodontitis

    OpenAIRE

    Lalitha Tanjore Arunachalam

    2014-01-01

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

  4. Vital Signs: Prevalence of Doctor-Diagnosed Arthritis and Arthritis-Attributable Activity Limitation - United States, 2013-2015.

    Science.gov (United States)

    Barbour, Kamil E; Helmick, Charles G; Boring, Michael; Brady, Teresa J

    2017-03-10

    In the United States, doctor-diagnosed arthritis is a common and disabling chronic condition. Arthritis can lead to severe joint pain and poor physical function, and it can negatively affect quality of life. CDC analyzed 2013-2015 data from the National Health Interview Survey, an annual, nationally representative, in-person interview survey of the health status and behaviors of the noninstitutionalized civilian U.S. adult population, to update previous prevalence estimates of arthritis and arthritis-attributable activity limitations. On average, during 2013-2015, 54.4 million (22.7%) adults had doctor-diagnosed arthritis, and 23.7 million (43.5% of those with arthritis) had arthritis-attributable activity limitations (an age-adjusted increase of approximately 20% in the proportion of adults with arthritis reporting activity limitations since 2002 [p-trend arthritis were 49.3%, 47.1%, and 30.6%, respectively; the prevalences of arthritis-attributable activity limitations among adults with these conditions and arthritis were 54.5% (heart disease), 54.0% (diabetes), and 49.0% (obesity). The prevalence of arthritis is high, particularly among adults with comorbid conditions, such as heart disease, diabetes, and obesity. Furthermore, the prevalence of arthritis-attributable activity limitations is high and increasing over time. Approximately half of adults with arthritis and heart disease, arthritis and diabetes, or arthritis and obesity are limited by their arthritis. Greater use of evidence-based physical activity and self-management education interventions can reduce pain and improve function and quality of life for adults with arthritis and also for adults with other chronic conditions who might be limited by their arthritis.

  5. Australian Paediatric Rheumatology Group standards of care for the management of juvenile idiopathic arthritis.

    Science.gov (United States)

    Munro, Jane; Murray, Kevin; Boros, Christina; Chaitow, Jeffrey; Allen, Roger C; Akikusa, Jonathan; Adib, Navid; Piper, Susan E; Singh-Grewal, Davinder

    2014-09-01

    This standards document outlines accepted standards of management for children, adolescents and young adults with juvenile idiopathic arthritis (JIA) in Australia. This document acknowledges that the chronic inflammatory arthritis conditions (JIA) in childhood are different diseases from inflammatory arthritis in adults and that specific expertise is required in the care of children with arthritis.

  6. Intrinsic brain connectivity in chronic pain: A resting-state fMRI study in patients with rheumatoid arthritis.

    Directory of Open Access Journals (Sweden)

    Pär eFlodin

    2016-03-01

    Full Text Available AbstractBackground. Rheumatoid arthritis (RA is commonly accompanied by pain that is discordant with the degree of peripheral pathology. Very little is known about the cerebral processes involved in pain processing in RA. Here we investigated resting-state brain connectivity associated with prolonged pain in RA. Methods. 24 RA subjects and 19 matched controls were compared with regard to both behavioral measures of pain perception and resting-resting state fMRI data acquired subsequently to fMRI sessions involving pain stimuli. The resting-state fMRI brain connectivity was investigated using 159 seed regions located in cardinal pain processing brain regions. Additional principal component based multivariate pattern analysis of the whole brain connectivity pattern was carried out in a data driven analysis to localize group differences in functional connectivity. Results. When RA patients were compared to controls, we observed significantly lower pain resilience for pressure on the affected finger joints (i.e. P50-joint and an overall heightened level of perceived global pain in RA patients. Relative to controls, RA patients displayed increased brain connectivity predominately for the supplementary motor areas, mid-cingulate cortex and the primary sensorimotor cortex. Additionally, we observed an increase in brain connectivity between the insula and prefrontal cortex as well as between anterior cingulate cortex and occipital areas for RA patients. None of the group differences in brain connectivity were significantly correlated with behavioral parameters.Conclusion. Our study provides experimental evidence of increased connectivity between frontal midline regions that are implicated in affective pain processing and bilateral sensorimotor regions in RA patients.

  7. The synovial prostaglandin system in chronic inflammatory arthritis: differential effects of steroidal and nonsteroidal anti-inflammatory drugs

    Science.gov (United States)

    Bombardieri, S.; Cattani, P.; Ciabattoni, G.; Di Munno, O.; Pasero, G.; Patrono, C.; Pinca, E.; Pugliese, F.

    1981-01-01

    1 The present study was undertaken to characterize the spectrum of arachidonic acid metabolites present in synovial effusions of patients with rheumatoid or psoriatic arthritis, and to compare changes in their concentration following a short-term treatment with 6α-methyl-prednisolone (6-MeP: 4-8 mg/day) or indoprofen (1.2 g/day), a nonsteroidal anti-inflammatory agent with proven synovial prostaglandin inhibitory effect. 2 Measurements of prostaglandin E2 (PGE2), thromboxane (TX) B2, 6-keto-PGF1α and PGF2α were performed by radioimmunoassay techniques in synovial effusions obtained from 23 patients, and validated by thin-layer chromatographic analysis of the extracted immunoreactivity. 3 PGE2 and TXB2 accounted for more than 60% of the total immunoreactivity in untreated patients. The absence of any constant ratio between the different arachidonic acid metabolites detected in synovial fluid is consistent with a heterogeneous cellular origin of these compounds. 4 Indoprofen treatment was associated with a consistent reduction of synovial prostaglandin and thromboxane concentrations, ranging from 36% in the case of 6-keto-PGF1α to 90% in the case of PGE2. 5 In contrast, 6-MeP caused opposite changes on different metabolites originating via the cyclo-oxygenase pathway. Thus, 6-keto-PGF1α concentrations were reduced by 35%, PGF2α concentrations were increased by 30%, while PGE2 and TXB2 were unchanged following 6-MeP. 6 Although the mechanism(s) underlying the failure of 6-MeP to reduce synovial PGE2 and TXB2 levels are uncertain, the results of the present study clearly indicate that therapeutic doses of steroidal and nonsteroidal anti-inflammatory drugs cause quite distinct changes in arachidonic acid metabolism, which might be relevant to their specific therapeutic actions and side-effects. PMID:6895043

  8. APLAR rheumatoid arthritis treatment recommendations.

    Science.gov (United States)

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

    2015-09-01

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

  9. Rheumatoid Arthritis and Periodontal Disease. An Update

    National Research Council Canada - National Science Library

    Venkataraman, Archana; Almas, Khalid

    2015-01-01

    ...: rheumatoid arthritis (RA) and periodontal disease (PD). RA is a chronic inflammatory disease of the joints, characterized by loss of connective tissue and mineralized structures, the so-called "synovial membrane...

  10. 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 ...

  11. Juvenile arthritis and uveitis.

    Science.gov (United States)

    Kanski, J J

    1990-01-01

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

  12. Pathogenesis and early detection of inflammatory arthritis: the role of musculoskeletal symptoms, infections and arthritis-related comorbidities in primary care.

    NARCIS (Netherlands)

    Nielen, M.; Beers-Tas, M. van; Korevaar, J.; Schaardenburg, D. van

    2016-01-01

    Background & Aim: Rheumatoid arthritis is a chronic systemic autoimmune disease characterized by clinically apparent inflammatory arthritis (IA). A preclinical phase has been recognized in which symptoms arise and ambulatory care utilization increases. However, information on location and timing of

  13. Juvenile Arthritis

    Science.gov (United States)

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

  14. Rheumatoid arthritis

    African Journals Online (AJOL)

    Mahmood Ally

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

  15. 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 ...

  16. Posttraumatic Arthritis

    OpenAIRE

    Pickering, Robert D.

    1984-01-01

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

  17. Proinflammatory and anti-inflammatory cytokines in gingival crevicular fluid and serum of patients with rheumatoid arthritis and patients with chronic periodontitis.

    Science.gov (United States)

    Cetinkaya, Burcu; Guzeldemir, Esra; Ogus, Ersin; Bulut, Sule

    2013-01-01

    The aim of this study is to evaluate proinflammatory and anti-inflammatory cytokine levels in gingival crevicular fluid (GCF) and serum of rheumatoid arthritis (RA) and chronic periodontitis (CP) patients to assess whether cytokine profiles distinguish patients with RA and patients with CP while using healthy patients as background controls. A total of 49 patients, 17 patients with RA (three males and 14 females; mean age: 47.82 ± 10.74 years), 16 patients with CP (10 males and six females; mean age: 44.00 ± 7.00 years), and 16 controls (eight males and eight females; mean age: 28.06 ± 6.18 years) were enrolled. Patients with RA were under the supervision of rheumatologists; 15 of the patients with RA were being treated with methotrexate-sulfasalazine combined therapy, and two of the patients were being treated with leflunomid therapy. Periodontal parameters (plaque index, gingival index, probing depth, and clinical attachment level) were recorded. Interleukin (IL)-1β, IL-4, IL-10, and tumor necrosis factor-α (TNF-α) were determined in GCF and IL-1β and IL-10 in serum by enzyme-linked immunosorbent assay. There were significant differences found among RA, CP, and control groups for all periodontal parameters (P 0.05). Although the total amount and concentration of serum IL-10 was not significantly different among the groups (P >0.05), serum IL-1β was significantly lower in the RA group compared to CP patients and controls and was higher in GCF of the RA group compared to the CP group. Although clinical periodontal disease parameters indicated more severe periodontal disease in CP compared to RA patients, immunologic evaluation did not reveal consistent results regarding proinflammatory and anti-inflammatory cytokine levels. This might be a result of the use of non-steroidal anti-inflammatory drugs and rheumatoid agents by patients with RA.

  18. Pregnancy and infant outcomes including major congenital malformations among women with chronic inflammatory arthritis or psoriasis, with and without etanercept use.

    Science.gov (United States)

    Carman, Wendy J; Accortt, Neil A; Anthony, Mary S; Iles, Janet; Enger, Cheryl

    2017-09-01

    Objectives were to quantify prevalence estimates of pregnancy and infant outcomes including major congenital malformations (MCMs) by etanercept (ETN) exposure among infants born to women with chronic inflammatory arthritis (cIA) or psoriasis (PsO). Claims-based data delineated pregnancy exposures and outcomes of live or nonlive births among women with cIA and PsO (ETN exposed, unexposed) and general population (GP) comparators. Infant outcomes were determined for live-born infants covered by the mother's insurer. Medical records were obtained from all accessible mother-infant pairs with claims for MCMs and a random sample of mothers. Multivariable logistic regression estimated the odds ratios (ORs) of having at least one algorithm-defined MCM in the ETN-exposed cohorts versus unexposed comparators. Prevalence estimates for pregnancy outcomes were comparable across cIA and PsO cohorts. Algorithm-defined prevalence estimates of having at least one MCM were 6.1% (ETN exposed), 5.5% (unexposed), and 5.7% (GP cohort) for the cIA cohort; PsO cohort estimates were 2.0%, 4.2%, and 4.7%, respectively. The ETN-exposure ORs for having at least one algorithm-defined MCM among infants of cIA mothers was 1.03 (95%CI: 0.51-2.10) and 0.39 (95%CI: 0.05-2.98) among infants of PsO mothers. Logistic regression with inverse probability of treatment weighting that included disease state resulted in an OR of 0.65 (0.24, 1.72). Overall, this study did not identify any new safety concerns associated with the use of etanercept during pregnancy. Etanercept, along with the other TNFis, remains a treatment without well-controlled clinical trials in pregnant women. Patients should continue to consult their doctor regarding benefit risk decisions of TNFi therapy during pregnancy. Copyright © 2017 John Wiley & Sons, Ltd.

  19. Rheumatoid arthritis and periodontitis; a possible link via citrullination

    NARCIS (Netherlands)

    de Smit, M J; Tonckens-Brouwer, Elisabeth; Vissink, A; van Winkelhoff, A J

    2011-01-01

    Rheumatoid Arthritis (RA) and chronic and aggressive periodontitis are chronic inflammatory disorders characterized by deregulation of the host inflammatory response. Increased secretion of pro-inflammatory mediators results in soft and hard tissue destruction of the synovium and periodontium respec

  20. Rheumatoid arthritis and periodontitis; a possible link via citrullination

    NARCIS (Netherlands)

    de Smit, M J; Tonckens-Brouwer, Elisabeth; Vissink, A; van Winkelhoff, A J

    2011-01-01

    Rheumatoid Arthritis (RA) and chronic and aggressive periodontitis are chronic inflammatory disorders characterized by deregulation of the host inflammatory response. Increased secretion of pro-inflammatory mediators results in soft and hard tissue destruction of the synovium and periodontium respec

  1. Rheumatoid Arthritis Educational Video Series

    Medline Plus

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

  2. 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 ...

  3. Rheumatoid Arthritis Educational Video Series

    Medline Plus

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

  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. Report - Recurrent hip arthritis diagnosed as juvenile idiopathic arthritis: A case report.

    Science.gov (United States)

    Chang, Tung-Ming; Yang, Kuender D; Yong, Su-Boon

    2016-05-01

    Juvenile idiopathic arthritis is the most common rheumatic disease in childhood. It is a chronic inflammatory disease associated with arthritis of unknown etiology that begins before the age of 16 and persists for longer than 6 weeks. In this report, the case of a child who suffered recurrent alternative hip arthritis with bilateral hip arthritis is examined, in which he was finally diagnosed as suffering from Juvenile idiopathic arthritis. A 14-year-old boy of Taiwanese origin presented with a normal birth and developmental history. At the age of 10, right-side hip joint pain was experienced, which later migrated to the left side. On further inspection, synovium hypertrophy, cartilage erosion and hip turbid fluid accumulation were found and aseptic arthritis was presumed to be the primary cause. However, after re-examining both his clinical history and presentation, Juvenile idiopathic arthritis was the final diagnosis. Any child presenting with repeat joint swelling are at risk of Juvenile idiopathic arthritis. This is still to be the case if symptoms recede or heal and no initial diagnosis is made. Therefore, a better understanding of the risk of recurrent arthritis is needed. It cannot be emphasized strongly enough that Juvenile idiopathic arthritis should be suspected at all times when a child suffers from recurrent aseptic arthritis of the hip joint.

  6. Imaging of the temporomandibular joint in juvenile idiopathic arthritis.

    Science.gov (United States)

    Vaid, Yoginder N; Dunnavant, F Daniel; Royal, Stuart A; Beukelman, Timothy; Stoll, Matthew L; Cron, Randy Q

    2014-01-01

    Temporomandibular joint (TMJ) arthritis in children with juvenile idiopathic arthritis (JIA) is extremely common but frequently asymptomatic. Magnetic resonance imaging (MRI) with contrast remains the gold standard for identifying TMJ arthritis in JIA. A reliable scoring system with published MRI examples of typical acute and chronic TMJ arthritis changes will be invaluable for future prospective treatment trials of TMJ arthritis in JIA. MRIs were collected from routine clinical studies assessing TMJ arthritis in JIA. Representative images were selected for publication to depict acute (synovial fluid, bone marrow edema, and synovial enhancement) and chronic (pannus, disc derangement, and condylar head flattening and erosions) TMJ arthritis findings. A preliminary MRI-based scoring system for assessing degrees of acute and chronic TMJ arthritis was developed and tested for inter- and intrareader reliability. TMJ MRIs representative of acute and chronic TMJ arthritis in JIA were selected from among thousands taken (>500 TMJ MRI studies annually at Children's of Alabama) since September 2007. Moreover, computed tomography scans depicting select bony changes (osteophyte formation, micrognathia) were chosen for publication. A description of the MRI protocol for assessing TMJ arthritis is included. A preliminary scoring system weighted for degree of acute and chronic TMJ arthritis MRI findings was found to have substantial inter- and intrareader reliability. A published set of MRIs depicting representative acute and chronic changes will help establish a standardized scoring system to assess TMJ arthritis in children with JIA. Future validation will aid in assessing improvement during treatment trials of TMJ arthritis. Copyright © 2014 by the American College of Rheumatology.

  7. Vagal influences in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Rasmussen, S E; Pfeiffer-Jensen, M; Drewes, A M

    2017-01-01

    Rheumatoid arthritis (RA) is a chronic immune-mediated inflammatory disease with a prevalence of 0.5-1% in Western populations. Conventionally, it is treated with therapeutic interventions that include corticosteroids, disease-modifying anti-rheumatic drugs, and biological agents. RA exerts...

  8. Subacromial bursitis with giant rice bodies as initial presentation of rheumatoid arthritis.

    Science.gov (United States)

    Subramaniam, Ramesh; Tan, Justina Wei Lyn; Chau, Cora Yuk Ping; Lee, Keng Thiam

    2012-10-01

    Rice body formation is a nonspecific response to chronic synovial inflammation associated with tuberculous arthritis, rheumatoid arthritis, juvenile rheumatoid arthritis, seronegative inflammatory arthritis, and even osteoarthritis. Such bodies were termed rice bodies because of their close resemblance to grains of polished white rice. We present a case report of a middle-aged woman with right shoulder subacromial/subdeltoid bursitis with giant rice body formation as her initial presentation of rheumatoid arthritis. Her right shoulder symptoms resolved after subacromial and subdeltoid bursectomy and removal of the rice bodies. She subsequently developed inflammatory arthritis of other joints, met the criteria for rheumatoid arthritis, and has been treated medically.

  9. Gouty arthritis

    Energy Technology Data Exchange (ETDEWEB)

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

    1984-01-01

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

  10. 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.

  11. Systemic application of rhenium-186 hydroxyethylidenediphosphonate ({sup 186}Re HEDP) as an option for the treatment of chronic arthritis and arthropathy[Radiosynoviorthesis]; Systemische Applikation von Rhenium-186 Hydroxyethylidendiphosphonat ({sup 186}Re HEDP) als Therapieoption bei chronischen Arthritiden und Arthropathien

    Energy Technology Data Exchange (ETDEWEB)

    Bucerius, J.; Biersack, H.J.; Palmedo, H. [Klinik und Poliklinik fuer Nuklearmedizin, Universitaetsklinikum Bonn (Germany); Wallny, T. [Orthopaedische Klinik l, Klinik fuer Orthopaedische Chirurgie, St. Bernhard-Hospital Kamp-Lintfort (Germany); Klinik und Poliklinik fuer Orthopaedie, Universitaetsklinikum Bonn (Germany); Brackmann, H.H. [Inst. fuer experimentelle Haematologie und Transfusionsmedizin, Universitaetsklinikum Bonn (Germany)

    2006-03-15

    Chronic arthritis is very common and is associated with a variety of systemic diseases whereas hemophilic arthropathy is one of the most common clinical manifestations of hemophilia, mainly of hemophilia type A. All of these polyarticular diseases are associated with progressive pain and increasing lack of mobility. Therapy is based on conservative treatment such as medication with non-steroidal anti-inflammatory drugs, selective therapy strategies such as intraarticular injections of e.g. radioactive substances (radiosynoviorthesis) or surgical interventions. However, in some cases, the disease does not respond to one of these treatment options or cannot be continued due to important side-effects. Systemic application of radioisotopes like {sup 186}Re HEDP has been successfully administered for pain palliation of osseous metastases. Today, only few data exist for systemic therapy with {sup 186}Re HEDP in patients suffering from benign polyarticular disease. In a prospective study with patients suffering from chronic arthritis a single systemic application of {sup 186}Re HEDP led to a reduction of disease activity in six of eight and to a reduction of the number of painful or swollen joints in five of eight included patients. In a further prospective study with 12 patients with hemophilic arthropathy, 19 of 36 (52.7%) most painful joints could be successfully treated with one systemic {sup 186}Re HEDP therapy. Furthermore, a reduction of global pain could be observed in those patients. However, further randomized studies with larger study populations are necessary in order to confirm this promising results. (orig.)

  12. Biomarkers for rheumatoid and psoriatic arthritis.

    Science.gov (United States)

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

    2015-11-01

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

  13. Calcium pyrophosphate arthritis

    Science.gov (United States)

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

  14. Arthritis in America

    Science.gov (United States)

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

  15. Arthritis: Frequently Asked Questions

    Science.gov (United States)

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

  16. Juvenil idiopatisk arthritis

    DEFF Research Database (Denmark)

    Herlin, Troels

    2002-01-01

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

  17. Arthritis of the Hand

    Science.gov (United States)

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

  18. Incorporation of n-3 PUFA and γ-linolenic acid in blood lipids and red blood cell lipids together with their influence on disease activity in patients with chronic inflammatory arthritis - a randomized controlled human intervention trial

    Directory of Open Access Journals (Sweden)

    Springer Monika

    2011-08-01

    Full Text Available Abstract Background and aim Marine n-3 fatty acids and γ-linolenic acid both have anti-inflammatory effects and may be useful to help treat inflammatory diseases. The effects of these alone or combined were examined in patients with arthritis in a randomized controlled trial. Design Patients with rheumatoid arthritis or psoriatic arthritis were randomized into four groups in a double-blind, placebo-controlled parallel designed study. Patients received the respective capsules (1: 3.0 g n-3 LC-PUFA/d; 2: 3.2 g γ-linolenic acid/d; 3: 1.6 g n-3 LC-PUFA + 1.8 g γ-linolenic acid/d; 4: 3.0 g olive oil for a twelve week period. Clinical status was evaluated and blood samples were taken at the beginning and at the end of the period. Differences before and after intervention were tested with paired t-test or with Wilcoxon test for non-normal data distribution. Results 60 patients (54 rheumatoid arthritis, 6 psoriatic arthritis were randomised, 47 finished per protocol. In group 1, the ratio of arachidonic acid (AA/eicosapentaenoic acid (EPA decreased from 6.5 ± 3.7 to 2.7 ± 2.1 in plasma lipids and from 25.1 ± 10.1 to 7.2 ± 4.7 in erythrocyte membranes (p ≤ 0.001. There was no significant influence on AA/EPA ratio due to interventions in group 2-4. In group 2, the intake of γ-linolenic acid resulted in a strong rise of γ-linolenic acid and dihomo-γ-linolenic acid concentrations in plasma lipids, cholesteryl esters, and erythrocyte membranes. The combination of n-3 LC-PUFA and γ-linolenic acid (group 3 led to an increase of γ-linolenic acid and dihomo-γ-linolenic acid concentrations in plasma lipids, cholesteryl esters, and erythrocyte mem-branes. This increase was only half of that in group 2. Conclusions Incorporation of eicosanoid precursor FAs was influenced by an intake of n-3 LC-PUFA and γ-linolenic acid suggesting a possible benefit for therapy of chronic inflammatory diseases. Trial Registration ClinicalTrials NCT01179971

  19. Therapeutical approach to rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Paraskevi Gourni

    2008-10-01

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

  20. CD1d-dependent NKT cells play a protective role in acute and chronic arthritis models by ameliorating antigen-specific Th1 responses

    DEFF Research Database (Denmark)

    Teige, Anna; Bockermann, Robert; Hasan, Maruf

    2010-01-01

    A protective and anti-inflammatory role for CD1d-dependent NKT cells (NKTs) has been reported in experimental and human autoimmune diseases. However, their role in arthritis has been unclear, with conflicting reports of CD1d-dependent NKTs acting both as regulatory and disease-promoting cells...

  1. Juvenile idiopathic arthritis

    Directory of Open Access Journals (Sweden)

    Krupa H Bhatt

    2014-01-01

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

  2. 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.

  3. 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.

  4. Metabolite Space of Rheumatoid Arthritis

    OpenAIRE

    van Wietmarschen, Herman; van der Greef, Jan

    2012-01-01

    Metabolites play numerous roles in the healthy and diseased body, ranging from regulating physiological processes to providing building blocks for the body. Therefore, understanding the role of metabolites is important in elucidating the etiology and pathology of diseases and finding targets for new treatment options. Rheumatoid arthritis is a complex chronic disease for which new disease management strategies are needed. The aim of this review is to bring together and integrate information a...

  5. Which patients improve the most from arthritis rehabilitation?

    DEFF Research Database (Denmark)

    Hagel, Sofia; Lindqvist, Elisabet; Petersson, Ingemar F

    2014-01-01

    Objective: To study health-related quality of life (HRQoL) in arthritis rehabilitation performed by multidisciplinary teams in patients with chronic inflammatory arthritis. Predictors of change in health-related quality of life and the proportion of patients with clinical improvement were investi...

  6. CDC Vital Signs–Arthritis in America

    Centers for Disease Control (CDC) Podcasts

    2017-03-07

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

  7. Arthritis Awareness (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2016-05-19

    As the U.S. population ages, so does the frequency of certain chronic diseases, such as arthritis. In this podcast, Dr. Kamil Barbour discusses ways to manage arthritis.  Created: 5/19/2016 by MMWR.   Date Released: 5/19/2016.

  8. Autoantibodies to cyclic citrullinated peptides predict progression to rheumatoid arthritis in patients with undifferentiated arthritis - A prospective cohort study

    NARCIS (Netherlands)

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

    2004-01-01

    Objective. Rheumatoid arthritis (RA) is a common, severe, chronic inflammatory joint disease. Since the disease may initially be indistinguishable from other forms of arthritis, early diagnosis can be difficult. Autoantibodies seen in RA can be detected years before clinical symptoms develop. In an

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

    NARCIS (Netherlands)

    Gaalen, van FA; Linn-Rasker, SP; Venrooij, W.J.; Jong, B.A.; Breedveld, F.C.; Verweij, C.L.; Toes, RE; Huizinga, T.W.

    2004-01-01

    OBJECTIVE: Rheumatoid arthritis (RA) is a common, severe, chronic inflammatory joint disease. Since the disease may initially be indistinguishable from other forms of arthritis, early diagnosis can be difficult. Autoantibodies seen in RA can be detected years before clinical symptoms develop. In an

  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.

  11. Midcarpal and STT Arthritis in Patients With CMC Arthritis

    National Research Council Canada - National Science Library

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

    2016-01-01

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

  12. [Rheumatoid arthritis].

    Science.gov (United States)

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

    2005-07-29

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

  13. Can Depression Up Odds for Arthritis Linked to Psoriasis?

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_163780.html Can Depression Up Odds for Arthritis Linked to Psoriasis? Mood ... 24, 2017 FRIDAY, Feb. 24, 2017 (HealthDay News) -- Depression in people with the chronic inflammatory skin disease ...

  14. 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.

  15. Physiotherapy in rheumatoid arthritis.

    Science.gov (United States)

    Kavuncu, Vural; Evcik, Deniz

    2004-05-17

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

  16. Diagnosis and treatment of enthesitis-related arthritis

    Directory of Open Access Journals (Sweden)

    Weiss PF

    2012-06-01

    Full Text Available Pamela F WeissDivision of Rheumatology and Center for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia, Departments of Pediatrics and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, PA, USAAbstract: Juvenile idiopathic arthritis (JIA is a chronic, inflammatory disease of unknown etiology. The enthesitis-related arthritis (ERA JIA category describes a clinically heterogeneous group of children including some who have predominately enthesitis, enthesitis and arthritis, juvenile ankylosing spondylitis, or inflammatory bowel disease-associated arthropathy. ERA accounts for 10%–20% of JIA. Common clinical manifestations of ERA include arthritis, enthesitis, and acute anterior uveitis. Axial disease is also common in children with established ERA. Treatment regimens for ERA, many of them based on adults with rheumatoid arthritis and ankylosing spondylitis, include the use of nonsteroidal anti-inflammatory drugs, disease-modifying antirheumatic drugs, and biologic agents either individually or in combination.Keywords: juvenile arthritis, enthesitis, sacroillitis, epidemiology, therapy

  17. Physical bone changes in carragheenin-induced arthritis evaluated by quantitative computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Soeballe, K.; Hansen, E.S. (Aarhus Univ. (Denmark). Biomechanics Lab. Aarhus Univ. (Denmark). Inst. of Experimental Clinical Research); Pedersen, C.M. (Aarhus Kommunehospital (Denmark). Dept. of Diagnostic Radiology); Odgaard, A.; Hvid, I.; Buenger, C. (Aarhus Univ. (Denmark). Biomechanics Lab.); Juhl, G.I. (Aarhus Univ. (Denmark). Inst. of Experimental Clinical Research); Rasmussen, H.B. (Aarhus Amtssygehus (Denmark). Inst. of Pathology)

    1991-07-01

    Repeated non-invasive measurements were performed in dogs to trabecular bone density (TBD), low density bone area (LDBA), and high density bone area (HDBA) in chronic arthritis using quantitative computed tomography (QCT). Unilateral chronic arthritis of the knee had been induced by weekly instillation of 2 ml carragheenin into the right knee joint for 12 weeks with the left knee serving as a control. CT scanning of the distal femoral condyles was performed in 12 mature dogs with chronic arthritis. Another 6 dogs underwent a longitudinal CT study starting immediately prior to induction of arthritis. Indentation test and histomorphometric analyses confirmed the bone density changes as measured by CT. (orig./GDG).

  18. Endomorphins in rheumatoid arthritis, osteoarthritis, and experimental arthritis.

    Science.gov (United States)

    Jessop, David S; Fassold, Alexander; Wolff, Christine; Hofbauer, Rafael; Chover-Gonzalez, Antonio; Richards, Louise J; Straub, Rainer H

    2010-04-01

    The opioid tetrapeptides endomorphins (EM)-1 and EM-2 are widely expressed in central nervous system and immune tissues of rats and humans. Their analgesic properties are well characterized but they also have anti-inflammatory properties. EM-1 significantly attenuated the onset of hindpaw inflammation in adjuvant-induced arthritis in rats. Immunohistochemical staining demonstrated the presence of EMs in T cells, macrophages, and fibroblasts in synovial tissues from patients with osteo- or rheumatoid arthritis (RA). In an ex vivo superfusion system, EM-1 potently inhibited the release of proinflammatory cytokines interleukin (IL)-6 and IL-8 from synovial tissues from patients with osteo- or RA. These results demonstrate that EMs are endogenously synthesized within human immune cells and have the potential to act as potent therapeutic agents in the treatment of chronic inflammatory disease. We discuss the clinical potential for EM analogues chemically modified to resist proteolytic degradation and identify modified protease-resistant analogues with enhanced bioactivity.

  19. Methotrexate-loaded lipid-core nanocapsules are highly effective in the control of inflammation in synovial cells and a chronic arthritis model

    Directory of Open Access Journals (Sweden)

    Boechat AL

    2015-10-01

    Full Text Available Antônio Luiz Boechat,1,2,* Catiúscia Padilha de Oliveira,3,* Andrea Monteiro Tarragô,2 Allyson Guimarães da Costa,2 Adriana Malheiro,1,2 Silvia Stanisçuaski Guterres,3 Adriana Raffin Pohlmann3,41Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal do Amazonas, Manaus, 2Programa de Pós-Graduação e Imunologia Básica e Aplicada, Universidade Federal do Amazonas, Manaus, 3Programa de Pós-Graduação em Ciências Farmacêuticas, Faculdade de Farmácia, 4Departamento de Química Orgânica, Instituto de Química, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil*These authors contributed equally to this workBackground: Rheumatoid arthritis (RA is the most common autoimmune disease in the word, affecting 1% of the population. Long-term prognosis in RA was greatly improved following the introduction of highly effective medications such as methotrexate (MTX. Despite the importance of this drug in RA, 8%–16% of patients must discontinue the treatment because of adverse effects. Last decade, we developed a promising new nanocarrier as a drug-delivery system, lipid-core nanocapsules.Objective: The aim of the investigation reported here was to evaluate if methotrexate-loaded lipid-core nanocapsules (MTX-LNC reduce proinflammatory and T-cell-derived cytokines in activated mononuclear cells derived from RA patients and even in functional MTX-resistant conditions. We also aimed to find out if MTX-LNC would reduce inflammation in experimentally inflammatory arthritis at lower doses than MTX solution.Methods: Formulations were prepared by self-assembling methodology. The adjuvant arthritis was induced in Lewis rats (AIA and the effect on edema formation, TNF-a levels, and interleukin-1 beta levels after treatment was evaluated. Mononuclear cells obtained from the synovial fluid of RA patients during articular infiltration procedures were treated with MTX solution and MTX-LNC. For in vitro experiments

  20. Histone Deacetylase Inhibitors Suppress Inflammatory Activation of Rheumatoid Arthritis Patient Synovial Macrophages and Tissue

    NARCIS (Netherlands)

    A.M. Grabiec; S. Krausz; W. de Jager; T. Burakowski; D. de Groot; M.E. Sanders; B.J. Prakken; W. Maslinski; E. Eldering; P.P. Tak; K.A. Reedquist

    2010-01-01

    Macrophages contribute significantly to the pathology of many chronic inflammatory diseases, including rheumatoid arthritis (RA), asthma, and chronic obstructive pulmonary disease. Macrophage activation and survival are tightly regulated by reversible acetylation and deacetylation of histones, trans

  1. Nanomedicine delivers promising treatments for rheumatoid arthritis.

    Science.gov (United States)

    Prasad, Leena Kumari; O'Mary, Hannah; Cui, Zhengrong

    2015-01-01

    An increased understanding in the pathophysiology of chronic inflammatory diseases, such as rheumatoid arthritis, reveals that the diseased tissue and the increased presence of macrophages and other overexpressed molecules within the tissue can be exploited to enhance the delivery of nanomedicine. Nanomedicine can passively accumulate into chronic inflammatory tissues via the enhanced permeability and retention phenomenon, or be surface conjugated with a ligand to actively bind to receptors overexpressed by cells within chronic inflammatory tissues, leading to increased efficacy and reduced systemic side-effects. This review highlights the research conducted over the past decade on using nanomedicine for potential treatment of rheumatoid arthritis and summarizes some of the major findings and promising opportunities on using nanomedicine to treat this prevalent and chronic disease.

  2. 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.

  3. Nutritional considerations in rheumatoid arthritis.

    Science.gov (United States)

    Touger-Decker, R

    1988-03-01

    Rheumatoid arthritis is a chronic, systemic, inflammatory disorder of unknown etiology. The severity of the disease process adversely affects nutritional status. Articular changes, such as small joint deformities and temporomandibular joint syndrome, alter the ability to self-feed. The inflammatory process may increase metabolic rate. Ingestion, digestion, absorption, and excretion may be compromised by secondary manifestations of the disease. Comprehensive nutrition assessment incorporates evaluation of disease and treatment-specific factors, along with the usual assessment parameters. Abnormal values for certain assessment parameters do not necessarily reflect nutritional status. Treatment methods, including medications, may have an impact on nutritional status, assessment tools, and self-feeding. Nutrition management goals focus on identification and implementation of feeding strategies. Evaluation of the ability to feed oneself includes consideration of functional status, secondary manifestations, and medical treatment. Multiple feeding modalities may be required. Oral supplements, tube feedings, and parenteral nutrition may be employed to meet the nutrition needs of the individual with rheumatoid arthritis.

  4. What Is Juvenile Arthritis?

    Science.gov (United States)

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

  5. MP Joint Arthritis

    Science.gov (United States)

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

  6. 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 ...

  7. 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...

  8. Rheumatoid arthritis (image)

    Science.gov (United States)

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

  9. Sex and Arthritis

    Science.gov (United States)

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

  10. Mineral Oil Aspiration Related Juvenile Idiopathic Arthritis

    OpenAIRE

    Nelson, Andrew D.; Fischer, Philip R.; Reed, Ann M.; Wylam, Mark E.

    2015-01-01

    We describe the development of rheumatoid factor-positive migratory polyarthritis in a 5-year-old male who had been administered bidaily oral mineral oil as a laxative since birth. Minor respiratory symptoms, radiographic and bronchoscopic findings were consistent with chronic lipoid pneumonia. We speculate that immune sensitization to mineral oil promoted the clinical syndrome of juvenile idiopathic arthritis.

  11. Candidate gene studies in rheumatoid arthritis

    NARCIS (Netherlands)

    Daha, Nina Ashira

    2015-01-01

    Rheumatoid arthritis is a chronic auto-immune disorder, of which persistent synovitis, bone erosions and auto-antibody formation are characteristic features. Although the etiology of the disease remains largely unknown, it is established that genetic risk factors play a pivotal role in disease patho

  12. Nanomedicine delivers promising treatments for rheumatoid arthritis

    OpenAIRE

    Prasad, Leena Kumari; O’Mary, Hannah; Cui, Zhengrong

    2015-01-01

    An increased understanding in the pathophysiology of chronic inflammatory diseases, such as rheumatoid arthritis, reveals that the diseased tissue and the increased presence of macrophages and other overexpressed molecules within the tissue can be exploited to enhance the delivery of nanomedicine. Nanomedicine can passively accumulate into chronic inflammatory tissues via the enhanced permeability and retention phenomenon, or be surface conjugated with a ligand to actively bind to receptors o...

  13. Radioisotopic synovectomy using ferric hydroxide macroaggregated for chronic arthritis treatment; Sinovectomia radioisotopica atraves do macroagregado de hidroxido ferrico para tratamento da artrite cronica

    Energy Technology Data Exchange (ETDEWEB)

    Lima, Carla Flavia; Campos, Tarcisio P.R. [Minas Gerais Univ., Belo Horizonte, MG (Brazil). Dept. de Ciencias e Tecnicas Nucleares] E-mail: campos@nuclear.ufmg.br

    2002-07-01

    Synovectomy radioisotopic is an arthritis treatment used in specific clinical conditions whose main goal is to sterilized the synovia. This treatment has specific and precise indications and it is considered to have an adequate response. The present work presents a modeling of an articulation (joint) based on its real geometric anatomy and chemical constitution. The internal dosimetry is evaluated by the Monte Carlo Code. The majority of the radionuclides were considered in the simulations. The syntheses of the ferric hydroxide macroaggregates with dysprosium and samarium have been prepared (Dy{sup 165}-MHF and Sm{sup 153}-MHF). Obtaining the cintilographic images of rabbits in which Dy{sup 165}-MHF is injected is in progress. Biodistribution studies in addition with the internal dosimetry will certify the dose in the membrane of the synovia. (author)

  14. 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.

  15. X-linked agammaglobulinemia combined with juvenile idiopathic arthritis and invasive Klebsiella pneumoniae polyarticular septic arthritis.

    Science.gov (United States)

    Zhu, Zaihua; Kang, Yuli; Lin, Zhenlang; Huang, Yanjing; Lv, Huoyang; Li, Yasong

    2015-02-01

    X-linked agammaglobulinemia (XLA) is a primary immunodeficiency disease caused by mutations in the Bruton's tyrosine kinase (BTK) gene. XLA can also present in combination with juvenile idiopathic arthritis (JIA), the major chronic rheumatologic disease in children. We report herein the first known case of a juvenile patient diagnosed with XLA combined with JIA that later developed into invasive Klebsiella pneumoniae polyarticular septic polyarthritis. An additional comprehensive review of XLA combined with JIA and invasive K. pneumoniae septic arthritis is also presented. XLA was identified by the detection of BTK mutations while the diagnosis of JIA was established by clinical and laboratory assessments. Septic arthritis caused by invasive K. pneumoniae was confirmed by culturing of the synovia and gene detection of the isolates. Invasive K. pneumoniae infections can not only result in liver abscesses but also septic arthritis, although this is rare. XLA combined with JIA may contribute to invasive K. pneumoniae infection.

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

    Science.gov (United States)

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

    2001-01-01

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

  17. Effects of chronic therapy with non-steroideal antinflammatory drugs on gastric permeability of sucrose: A study on 71 patients with rheumatoid arthritis

    Institute of Scientific and Technical Information of China (English)

    Marta Maino; Angelo Franzè; Francesco Di Mario; Nicola Mantovani; Roberta Merli; Giulia Martina Cavestro; Gioacchino Leandro; Lucas Giovanni Cavallaro; Vincenzo Corrente; Veronica Iori; Alberto Pilotto

    2006-01-01

    AIM: To evaluate the gastric permeability after both acute and chronic use of non-steroidal anti-inflammatory drugs (NSAIDs) and to assess the clinical usefulness of sucrose test in detecting and following NSAIDs- induced gastric damage mainly in asymptomatic patients and the efficacy of a single pantoprazole dose in chronic users.METHODS: Seventy-one consecutive patients on chronic therapy with NSAIDs were enrolled in the study and divided into groups A and B (group A receiving 40 mg pantoprazole daily, group B only receiving NSAIDs). Sucrose test was performed at baseline and after 2, 4 and 12 wk,respectively. The symptoms in the upper gastrointestinal tract were recorded.RESULTS: The patients treated with pantoprazole had sucrose excretion under the limit during the entire follow-up period. The patients without gastroprotection had sucrose excretion above the limit after 2 wk, with an increasing trend in the following weeks (P = 0.000). A number of patients in this group revealed a significantly altered gastric permeability although they were asymptomatic during the follow-up period.CONCLUSION: Sucrose test can be proposed as a valid tool for the clinical evaluation of NSAIDs- induced gastric damage in both acute and chronic therapy. This tecnique helps to identify patients with clinically silent gastric damages. Pantoprazole (40 mg daily) is effective and well tolerated in chronic NSAID users.

  18. Review paper The role of physiological elements in the future therapies of rheumatoid arthritis. II. The relevance of energy redistribution in the process of chronic inflammation

    Directory of Open Access Journals (Sweden)

    Michał Gajewski

    2015-04-01

    Full Text Available The reasons for development of chronic inflammation are complex and not fully understood. One of the factors affecting the prolongation of inflammation is changes in cell metabolism, occurring at the center of the inflammatory process. In chronic inflammation there is an imbalance between the processes of storage and consumption of energy reserves. Hypoxia that is a consequence of edema results in transition of white blood cells to anaerobic metabolism. Neutrophils, lymphocytes and macrophages produce active oxygen metabolites which on one hand facilitate the elimination of pathogens, and on the other hand, can cause damage to healthy cells located in the inflamed tissue. In this paper, we discuss the importance of disturbed redistribution of energy as one of the main reasons for transformation of the acute inflammatory process into the chronic one.

  19. The role of physiological elements in the future therapies of rheumatoid arthritis. II. The relevance of energy redistribution in the process of chronic inflammation.

    Science.gov (United States)

    Gajewski, Michał; Rzodkiewicz, Przemysław; Wojtecka-Łukasik, Elżbieta

    2015-01-01

    The reasons for development of chronic inflammation are complex and not fully understood. One of the factors affecting the prolongation of inflammation is changes in cell metabolism, occurring at the center of the inflammatory process. In chronic inflammation there is an imbalance between the processes of storage and consumption of energy reserves. Hypoxia that is a consequence of edema results in transition of white blood cells to anaerobic metabolism. Neutrophils, lymphocytes and macrophages produce active oxygen metabolites which on one hand facilitate the elimination of pathogens, and on the other hand, can cause damage to healthy cells located in the inflamed tissue. In this paper, we discuss the importance of disturbed redistribution of energy as one of the main reasons for transformation of the acute inflammatory process into the chronic one.

  20. Psoriatic arthritis: genetics and pathogenesis

    Directory of Open Access Journals (Sweden)

    A. Mathieu

    2012-06-01

    Full Text Available Psoriatic arthritis is a complex disease affecting primarily peripheral and axial joints and entheses together with the skin. The pathogenesis is characterized by a genetic background and by inflammatory mechanisms which may be triggered by environmental factors. Several susceptibility genes have been investigated; they include HLA genes, genes within the HLA region and genes outside the HLA region. T cells, including the recently described subset Th17, are thought to play an important role in the acute and chronic phases of the disease. Some of these findings allowed novel therapeutic interventions or opened new promising approaches in treatment. The most relevant data of the literature are summarized and discussed.

  1. Glucocorticoids in juvenile idiopathic arthritis.

    Science.gov (United States)

    Malattia, Clara; Martini, Alberto

    2014-05-01

    Although the use of corticosteroids in juvenile idiopathic arthritis (JIA) is now much more limited owing to the availability of methotrexate and biological agents, there are clinical scenarios where it is still indicated. For example, corticosteroids may be indicated for intraarticular injections to prevent joint deformities, as a "bridge" drug to relieve symptoms in polyarticular disease while waiting for methotrexate and biologics to exert their full therapeutic effects, and in the treatment of chronic iridocyclitis, macrophage activation syndrome, and systemic JIA, although the advent of interleukin (IL)-1 and IL-6 blockers has greatly reduced the latter indication.

  2. Atherosclerosis in Juvenile Idiopathic Arthritis

    Directory of Open Access Journals (Sweden)

    Ewa Jednacz

    2012-01-01

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

  3. Prevalence of Arthritis and Arthritis-Attributable Activity Limitation by Urban-Rural County Classification - United States, 2015.

    Science.gov (United States)

    Boring, Michael A; Hootman, Jennifer M; Liu, Yong; Theis, Kristina A; Murphy, Louise B; Barbour, Kamil E; Helmick, Charles G; Brady, Terry J; Croft, Janet B

    2017-05-26

    Rural populations in the United States have well documented health disparities, including higher prevalences of chronic health conditions (1,2). Doctor-diagnosed arthritis is one of the most prevalent health conditions (22.7%) in the United States, affecting approximately 54.4 million adults (3). The impact of arthritis is considerable: an estimated 23.7 million adults have arthritis-attributable activity limitation (AAAL). The age-standardized prevalence of AAAL increased nearly 20% from 2002 to 2015 (3). Arthritis prevalence varies widely by state (range = 19%-36%) and county (range = 16%-39%) (4). Despite what is known about arthritis prevalence at the national, state, and county levels and the substantial impact of arthritis, little is known about the prevalence of arthritis and AAAL across urban-rural areas overall and among selected subgroups. To estimate the prevalence of arthritis and AAAL by urban-rural categories CDC analyzed data from the 2015 Behavioral Risk Factor Surveillance System (BRFSS). The unadjusted prevalence of arthritis in the most rural areas was 31.8% (95% confidence intervals [CI] = 31.0%-32.5%) and in the most urban, was 20.5% (95% CI = 20.1%-21.0%). The unadjusted AAAL prevalence among adults with arthritis was 55.3% in the most rural areas and 49.7% in the most urban. Approximately 1 in 3 adults in the most rural areas have arthritis and over half of these adults have AAAL. Wider use of evidence-based interventions including physical activity and self-management education in rural areas might help reduce the impact of arthritis and AAAL.

  4. Optimism and adaptation to chronic disease: the role of optimism in relation to self-care options of type I diabetes mellitus, rheumatoid arthritis and multiple sclerosis.

    NARCIS (Netherlands)

    Fournier, M.; Ridder, D. de; Bensing, J.

    2002-01-01

    OBJECTIVES: To determine the role of optimistic beliefs in adaptation processes of three chronic diseases different in controllability by self-care. It was expected that optimism towards the future would relate to adaptation independently of the controllability of disease. Optimism regarding one's c

  5. The psychophysiological stress response in psoriasis and rheumatoid arthritis

    NARCIS (Netherlands)

    Brouwer, S.J.M. de; Middendorp, H. van; Stormink, C.; Kraaimaat, F.W.; Sweep, F.C.; Jong, E.M.G.J. de; Schalkwijk, J.; Eijsbouts, A.M.M.; Donders, A.R.T.; Kerkhof, P.C.M. van de; Riel, P.L.C.M. van; Evers, A.W.M.

    2014-01-01

    BACKGROUND: Psychosocial stress can be a risk factor for the maintenance and exacerbation of chronic inflammatory diseases, such as psoriasis and rheumatoid arthritis (RA). OBJECTIVES: To gain insight into the specificity of the psychophysiological stress response during chronic inflammation, we ass

  6. Anterior uveitis in juvenile rheumatoid arthritis.

    Science.gov (United States)

    Kanski, J J

    1977-10-01

    The ocular and systemic characteristics of 160 patients with anterior uveitis and seronegative juvenile rheumatoid arthritis are reviewed. Chronic uveitis occurred in 131 patients, 76% of whom were girls. Both eyes were involved in 70% of the cases. Band keratopathy occurred in 41% of the eyes, cataract in 42%, and secondary glaucoma in 19%. Only 11 patients had uveitis before the onset of arthritis. Notable correlations included a pauciarticular onset of arthritis in 95% of the patients, and positive tests for antinuclear antibody in 82%. Of 29 patients with acute anterior uveitis, 27 were boys. The inflammation responded well to therapy, and serious complications did not occur. At follow-up 21 patients had typical ankylosing spondylitis, and five had sacroiliitis. The incidence of positive results of tests for HLA-B27 antigen was 94%.

  7. Arthritis of the hand - Rheumatoid

    Science.gov (United States)

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

  8. 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 ...

  9. Rheumatoid Arthritis Educational Video Series

    Medline Plus

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

  10. Rheumatoid Arthritis Educational Video Series

    Medline Plus

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

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

  13. 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...

  14. Prevalence and occupational impact of arthritis in Saskatchewan farmers.

    Science.gov (United States)

    Taylor-Gjevre, Regina M; Trask, Catherine; King, Nathan; Koehncke, Niels

    2015-01-01

    Agricultural workers have physically demanding occupations. In this study of Saskatchewan farmers, the authors examined (1) self-reported prevalence of physician-diagnosed rheumatoid arthritis and osteoarthritis; and (2) the impact of these chronic arthridities on engagement in physical tasks related to farming. This study was conducted through a cross-sectional analysis of baseline data from the Saskatchewan Farm Injury Cohort Study in which 2,473 adult residents upon 1,216 farms participated. Collected survey data included demographic and health information; regional musculoskeletal symptoms for each participant assessed via the Standard Nordic Questionnaire; and engagement in various specific physical tasks or activities associated with mixed farming practices. Of the 2,473 respondents, 13% reported chronic arthritic diagnoses (10% osteoarthritis, 4% rheumatoid arthritis, with 1% from each category overlapping with both forms of arthritis). Participants reporting arthritis were more likely to also report disabling musculoskeletal symptoms involving their shoulders, elbows, hands, lower back, hips, knees, and ankles. Farmers with arthritis reported less participation in all physical farming activities studied, including various machinery operations, herd maintenance and veterinary activities, overhead work, shoveling/pitchfork work, and lifting/carrying. When adjusted for age, gender, and comorbidities, operation of combines and shoveling/pitchfork work continued to be significantly less engaged in by farmers with arthritis. The overall prevalence of arthritis was consistent with general population prevalence, although the category of rheumatoid arthritis was overrepresented. Farmers with arthritis were significantly less likely to participate in combine operation and shoveling/pitchfork chores compared with their counterparts without arthritis.

  15. Is air pollution a risk factor for rheumatoid arthritis?

    Science.gov (United States)

    Essouma, Mickael; Noubiap, Jean Jacques N

    2015-01-01

    Rheumatoid arthritis is a chronic inflammatory debilitating disease triggered by a complex interaction involving genetic and environmental factors. Active smoking and occupational exposures such as silica increase its risk, suggesting that initial inflammation and generation of rheumatoid arthritis-related autoantibodies in the lungs may precede the clinical disease. This hypothesis paved the way to epidemiological studies investigating air pollution as a potential determinant of rheumatoid arthritis. Studies designed for epidemiology of rheumatoid arthritis found a link between traffic, a surrogate of air pollution, and this disease. Furthermore, a small case-control study recently found an association between wood smoke exposure and anticyclic citrullinated protein/peptide antibody in sera of patients presenting wood-smoke-related chronic obstructive pulmonary disease. However, reports addressing impact of specific pollutants on rheumatoid arthritis incidence and severity across populations are somewhat conflicting. In addition to the link reported between other systemic autoimmune rheumatic diseases and particulate matters/gaseous pollutants, experimental observation of exacerbated rheumatoid arthritis incidence and severity in mice models of collagen-induced arthritis after diesel exhaust particles exposure as well as hypovitaminosis D-related autoimmunity can help understand the role of air pollution in rheumatoid arthritis. All these considerations highlight the necessity to extend high quality epidemiological researches investigating different sources of atmospheric pollution across populations and particularly in low-and-middle countries, in order to further explore the biological plausibility of air pollution's effect in the pathogenesis of rheumatoid arthritis. This should be attempted to better inform policies aiming to reduce the burden of rheumatoid arthritis.

  16. Normal luminal bacteria, especially Bacteroides species, mediate chronic colitis, gastritis, and arthritis in HLA-B27/human beta2 microglobulin transgenic rats.

    OpenAIRE

    Rath, H. C.; Herfarth, H H; Ikeda, J S; Grenther, W B; Hamm, T. E.; Balish, E.; Taurog, J D; Hammer, R. E.; Wilson, K. H.; Sartor, R B

    1996-01-01

    Genetic and environmental factors are important in the pathogenesis of clinical and experimental chronic intestinal inflammation. We investigated the influence of normal luminal bacteria and several groups of selected bacterial strains on spontaneous gastrointestinal and systemic inflammation in HLA-B27 transgenic rats. Rats maintained germfree for 3-9 mo were compared with littermates conventionalized with specific pathogen-free bacteria. Subsequently, germfree transgenic rats were colonized...

  17. The pathogenesis of bone erosions in gouty arthritis.

    Science.gov (United States)

    Schlesinger, Naomi; Thiele, Ralf G

    2010-11-01

    The characteristic radiographic hallmarks of chronic gouty arthritis are the presence of macroscopic tophi and erosions with overhanging edges and relative preservation of the joint space. In recent years there has been more insight into the processes underlying the development of bone erosions in gouty arthritis. This review discusses the mechanical, pathological, cellular and immunological factors that may have a role in the pathogenesis of bone erosions in gouty arthritis. It highlights the evidence suggesting that monosodium urate crystal deposition is associated with the presence of underlying osteoarthritis and the important role of osteoclasts and the receptor for activation of nuclear factor κ B (RANK) and RANK ligand (RANK-RANKL) pathway in the pathogenesis of gouty erosions. Gouty arthritis is primarily driven by interleukin 1β (IL-1β). IL-1β has been implicated in bone destruction and erosions in other inflammatory arthridities. Thus, future IL-1 inhibitors may prevent and treat erosion formation due to tophaceous gouty arthritis. This review discusses imaging modalities and highlights ultrasongraphic evidence suggesting a significant relationship between the presence of the gouty tophus and bone erosions as well as the frequent presence of persistent low-grade inflammation in asymptomatic chronic tophaceous gouty arthritis on high-resolution ultrasonography. It is the tophus eroding the underlying bone that is pivotal for the development of bone erosions in gouty arthritis.

  18. Rheumatoid Arthritis Educational Video Series

    Medline Plus

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

  19. Lyme disease in the differential diagnosis of rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Ahmet Karadağ

    2016-03-01

    Full Text Available Clinically, there are some differences between rheumatoid arthritis (RA and Lyme disease. Although Lyme arthritis exhibits marked differences from RA, it can cause erosion at joint due to chronic proliferative synovitis as similar to RA. In the literature, a case was reported where both entities were seen together. In this manuscript, we aimed to present a case with symmetric arthritis at small hand joints and arthralgia at wrist that mimicked RA but diagnosed as Lyme disease by history, clinical presentation and laboratory findings, and successfully treated.

  20. Update on Therapeutic Approaches for Rheumatoid Arthritis.

    Science.gov (United States)

    Nogueira, Eugénia; Gomes, Andreia; Preto, Ana; Cavaco-Paulo, Artur

    2016-01-01

    Rheumatoid arthritis is a common chronic inflammatory and destructive arthropathy that consumes considerable personal, social and economic costs. It consists of a syndrome of pain, stiffness and symmetrical inflammation of the synovial membrane (synovitis) of freely moveable joints such as the knee (diarthrodial joints). Although the etiology of rheumatoid arthritis is unclear, the disease is characterized by inflammation of the synovial lining of diarthrodial joints, high synovial proliferation and an influx of inflammatory cells, macrophages and lymphocytes through angiogenic blood vessels. Diseasemodifying antirheumatic drugs slow disease progression and can induce disease remission in some patients. Methotrexate is the first line therapy, but if patients become intolerant to this drug, biologic agents should be used. The development of biological substances for the treatment of rheumatic conditions has been accompanied by ongoing health economic discussions regarding the implementation of these highly effective, but accordingly, highly priced drugs are the standard treatment guidelines of rheumatic diseases. In this way, more efficient strategies have to be identified. Despite numerous reviews in rheumatoid arthritis in the last years, this area is in constant development and updates are an urgent need to incorporate new advances in rheumatoid arthritis research. This review highlights the immunopathogenesis rationale for the current therapeutic strategies in rheumatoid arthritis.

  1. Controlling Arthritis (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2013-11-14

    Arthritis affects more than one in five adults and is the most common cause of disability in the U.S. It occurs often in people with chronic conditions, such as heart disease and diabetes, as well as those who are obese. This podcast discusses arthritis symptoms and how to control the condition.  Created: 11/14/2013 by MMWR.   Date Released: 11/14/2013.

  2. Controlling Arthritis (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2013-11-14

    Arthritis affects more than one in five adults and is the most common cause of disability in the United States. It occurs often in people with chronic conditions, such as heart disease and diabetes, as well as those who are obese. In this podcast, Dr. Kamil Barbour discusses ways to control arthritis.  Created: 11/14/2013 by MMWR.   Date Released: 11/14/2013.

  3. Bacillus pumilus Septic Arthritis in a Healthy Child.

    Science.gov (United States)

    Shivamurthy, V M; Gantt, Soren; Reilly, Christopher; Tilley, Peter; Guzman, Jaime; Tucker, Lori

    2016-01-01

    We report a case of septic arthritis caused by a Bacillus species, B. pumilus, occurring in a healthy child. This organism rarely causes serious infections and has only been described in newborns and immunocompromised individuals or as a skin infection. This child developed an indolent joint swelling after a minor skin injury, and symptoms were initially thought most consistent with chronic arthritis. The case demonstrates that clinicians should consider joint infection in children presenting with acute monoarticular swelling, even without prominent systemic features.

  4. Ultrasound in Arthritis.

    Science.gov (United States)

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

    2017-09-01

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

  5. Gender and the treatment of immune-mediated chronic inflammatory diseases: rheumatoid arthritis, inflammatory bowel disease and psoriasis: an observational study

    Directory of Open Access Journals (Sweden)

    Lesuis Nienke

    2012-08-01

    Full Text Available Abstract Background Rheumatoid arthritis (RA, inflammatory bowel disease (IBD, and psoriasis are immune-mediated inflammatory diseases with similarities in pathophysiology, and all can be treated with similar biological agents. Previous studies have shown that there are gender differences with regard to disease characteristics in RA and IBD, with women generally having worse scores on pain and quality of life measurements. The relationship is less clear for psoriasis. Because treatment differences between men and women could explain the dissimilarities, we investigated gender differences in the disease characteristics before treatment initiation and in the biologic treatment prescribed. Methods Data on patients with RA or IBD were collected from two registries in which patients treated with biologic medication were enrolled. Basic demographic data and disease activity parameters were collected from a time point just before the initiation of the biologic treatment. For patients with psoriasis, the data were taken from the 2010 annual report of the Swedish Psoriasis Register for systemic treatment, which included also non-biologic treatment. For all three diseases, the prescribed treatment and disease characteristics were compared between men and women. Results In total, 4493 adult patients were included in the study (1912 with RA, 131 with IBD, and 2450 with psoriasis. Most of the treated patients with RA were women, whereas most of the patients with IBD or psoriasis were men. There were no significant differences between men and women in the choice of biologics. At treatment start, significant gender differences were seen in the subjective disease measurements for both RA and psoriasis, with women having higher (that is, worse scores than men. No differences in objective measurements were found for RA, but for psoriasis men had higher (that is, worse scores for objective disease activity measures. A similar trend to RA was seen in IBD

  6. 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.

  7. Kinesiotherapy for quality of life, pain and muscle strength of rheumatoid arthritis and systemic lupus erythematosus patient. Case report

    OpenAIRE

    Myra,Rafaela Simon; DeMarco,Mariângela; Zanin, Caroline; Wibelinger, Lia Mara

    2015-01-01

    ABSTRACT BACKGROUND AND OBJECTIVES: Rheumatoid arthritis is an inflammatory, chronic and progressive disease. It impairs joint synovial membranes and may induce bone and cartilage destruction. Many diseases may follow rheumatoid arthritis, including systemic lupus erythematosus, an inflammatory, chronic autoimmune disease with multisystemic manifestations, with periods of remission and exacerbation. This study aimed at reporting kinesiotherapy intervention for quality of life, pain and muscle...

  8. Changes in Soluble CD18 in Murine Autoimmune Arthritis and Rheumatoid Arthritis Reflect Disease Establishment and Treatment Response

    DEFF Research Database (Denmark)

    Kragstrup, Tue Wenzel; Jalilian, Babak; Keller, Kresten Krarup;

    2016-01-01

    in murine models of rheumatoid arthritis. METHODS: The level of sCD18 was analyzed with a time-resolved immunoflourometric assay in 1) plasma from early treatment naïve RA patients during a treat-to-target strategy (the OPERA cohort), 2) plasma from chronic RA patients, 3) serum from SKG and CIA mice...... associated with radiographic progression. Correspondingly, the serum level of sCD18 was decreased in SKG mice 6 weeks after arthritis induction compared with healthy littermates. The sCD18 levels in both SKG and CIA mice exhibited a biphasic course after arthritis induction with an initial increase above...

  9. {sup 166}Ho-chitosan as a radiation synovectomy agent - antigen-induced arthritis in rabbits

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sug Jun; Lee, Soo Yong; Jeon, Dae Geun; Lee, Jong Seok [Korea Cancer Center Hospital, Seoul (Korea, Republic of)

    1998-01-01

    Radiation synovectomy is a noninvasive therapy that has been investigated as an alternative to surgical synovectomy. It has been successfully employed in the treatment of synovitis in rheumatoid arthritis and other inflammatory arthropathies. In this study, we developed experimental animal model for radiation synovectomy. A model system in which a single injection of ovalbumin into the knee joints of previously sensitized rabbits consistently produced a chronic arthritis which was histologically similiar to human rheumatoid arthritis. (author). 8 refs., 8 figs

  10. Evaluation of quality of life in chronic, progressing rheumatic diseases based on the example of osteoarthritis and rheumatoid arthritis 

    Directory of Open Access Journals (Sweden)

    Wysocka-Skurska I

    2016-11-01

    Full Text Available Izabela Wysocka-Skurska,1 Matylda Sierakowska,2 Wojciech Kułak3 1Department of Rheumatology and Internal Diseases, University Hospital in Bialystok, 2Department of Integrated Medical Care, Medical University of Bialystok, 3Clinic Rehabilitation Center for Children with Early Help Disabled Children “Give a Chance”, Medical University of Bialystok, Bialystok, Poland Background: Rheumatic diseases, irrespective of etiology and clinical course, influence different areas of a patient’s life. Adapting to disability and limitations caused by an illness is very difficult for many patients. The main goal of a therapeutic procedure should be improvement of health-related quality of life (QoL.Objective: Evaluation of the factors that influence the QoL that are conditioned by the state of health of patients with osteoarthritis (OA and rheumatoid arthritis (RA.Methods: The study group consisted of 198 patients diagnosed with OA, according to the American College of Rheumatology criteria (1988, and 100 patients diagnosed with RA, according to the American College of Rheumatology criteria (2010. A diagnostic survey using visual analog scale of pain, health assessment questionnaire disability index, and 36-item short form health survey were used in this study.Results: The average age of patients with OA was 59.16 (±15.87 years and patients with RA was 55.22 (±14.87 years. The average duration of illness examined for OA was 5.5 (±4.32 years, whereas for RA, it was slightly more at 6.8 (±5.21 years. Overall the QoL in both study groups was of medium level. Among patients with OA and RA, lower evaluation of QoL was mainly affected by age (OA – physical sphere [PCS] rs=-0.177, P<0.012; MCS rs=-0.185,  P=0.008; RA – PCS rs=-0.234,  P=0.019; MCS rs=-0.208,  P=0.038, the level of physical disability (OA – PCS rp=-0.532,  P<0.001; MCS rs=-0.467,  P<0.001; RA – PCS rp=-0.326, P<0.001; MCS rs=-0.229, P<0.001, and pain (OA – PCS rp=-0

  11. Dual diagnosis: rheumatoid arthritis and multiple sclerosis.

    Science.gov (United States)

    Ozsahin, Mustafa; Dikici, Suber; Kocaman, Gülsen; Besir, Fahri Halit; Baltaci, Davut; Ataoglu, Safinaz

    2014-01-01

    Juvenile rheumatoid arthritis (JRA) is the most common rheumatologic disease in children. Moreover, multiple sclerosis (MS) is the most frequent demyelinating disease and has been associated with various chronic inflammatory diseases. However, its association with JRA has not been frequently described. Autoimmunity in both JRA and MS has been documented in the scientific literature, although there has been no definitive finding that patients with JRA are prone to the development of MS. An increasing frequency of MS resulting from an increased use of antitumor necrosis factor agents in the treatment of rheumatoid arthritis and other chronic inflammatory diseases has been reported recently. In this study, we report on the development of MS in a patient with JRA who did not have a history of antitumor necrosis factor use.

  12. What Is Rheumatoid Arthritis?

    Science.gov (United States)

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

  13. Juvenile idiopathic arthritis

    NARCIS (Netherlands)

    Prakken, Berent; Albani, Salvatore; Martini, Alberto

    2011-01-01

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

  14. A rare cause of septic arthritis: melioidosis.

    Science.gov (United States)

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

    2013-10-01

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

  15. Childhood psychosocial stressors and adult onset arthritis : Broad spectrum risk factors and allostatic load

    NARCIS (Netherlands)

    Von Korff, Michael; Alonso, Jordi; Ormel, Johan; Angermeyer, Matthais; Bruffaerts, Ronny; Fleiz, Clara; de Girolamo, Giovanni; Kessler, Ronald C.; Kovess-Masfety, Viviane; Posada-Villa, Jose; Scott, Kate M.; Uda, Hidenori

    2009-01-01

    Neural, endocrine, and immune stress mediators are hypothesized to increase risks of diverse chronic diseases, including arthritis. Retrospective data from the World Mental Health Surveys (N = 18,309) were employed to assess whether adult onset of arthritis was associated with childhood adversities

  16. Systems biology guided by Chinese medicine reveals new markers for sub-typing rheumatoid arthritis patients

    NARCIS (Netherlands)

    Wietmarschen, H. van; Yuan, K.; Lu, C.; Gao, P.; Wang, J.; Xiao, C.; Yan, X.; Wang, M.; Schroën, J.; Lu, A.; Xu, G.; Greef, J. van der

    2009-01-01

    BACKGROUND: Complex chronic diseases such as rheumatoid arthritis have become a major challenge in medicine and for the pharmaceutical industry. New impulses for drug development are needed. OBJECTIVE: A systems biology approach is explored to find subtypes of rheumatoid arthritis patients enabling

  17. Use of technetium-99m methylene diphosphonate and gallium-67 citrate scans after intraarticular injection of Staphylococcus aureus into knee joints of rabbits with chronic antigen-induced arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Mahowald, M.L.; Raskind, J.R.; Peterson, L.; Gerding, D.; Raddatz, D.A.; Shafer, R.

    1986-08-01

    Numerous clinical studies have questioned the ability of radionuclide scans to differentiate septic from aseptic joint inflammation. A clinical study may not be able to document an underlying disease process or duration of infection and, thus, may make conclusions about the accuracy of scan interpretations open to debate. In this study, the Dumonde-Glynn model of antigen-induced arthritis in rabbits was used as the experimental model to study technetium and gallium scans in Staphylococcus aureus infection of arthritic and normal joints. Gallium scans were negative in normal rabbits, usually negative in antigen-induced arthritis, but positive in septic arthritis. The bone scan was usually negative in early infection but positive in late septic arthritis, a finding reflecting greater penetration of bacteria into subchondral bone because of the underlying inflammatory process.

  18. 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

  19. 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

  20. Radiosynovectomy of the knee joint in chronic arthritis; An easy and useful treatment. Radiosynoviectomie van de knie bij chronische artritis; Een eenvoudige en zinvolle behandeling

    Energy Technology Data Exchange (ETDEWEB)

    Boerbooms, A.M.T.; Putte, L.B.A. van de (Academisch Ziekenhuis St. Radboud, Nijmegen (Nteherlands). Afdeling Reumatologie); Corstens, F.H.M.; Buijs, W.C.A.M. (Academisch Ziekenhuis St. Radboud, Nijmegen (Netherlands). Afdeling Nucleaire Geneeskunde); Bruyn, G.A.W. (Medisch Centrum, Leeuwarden (Netherlands). Afdeling Reumatologie)

    1992-05-09

    185 MBq (5 mCi) colloidal 198-aurothioglucose ({sup 198}Au) or colloidal yttrium-90-silicate ({sup 90}Y) in 10 ml 0.9% NaCl was injected into knee joint cavity after aspiration of joint fluid. After that the patient stayed in bed for 3 days. Clinical examination, erythrocyte sedimentation rate, {sup 99m}Tc-pertechnetate uptake measurements and radiographs of the knee joints were performed at baseline and during follow-up. Main results, group 1. evaluation after 6 months and after 3 years showed significantly better results in the group of knee joints with no minimal pre-existing radiological abnormalities compared with the group of knee joints with moderate or severe radiological abnormalities (p<0.05). Group 2. 24 months (mean) after treatment with {sup 90}Y, 50% of the treated knees showed clinical improvement of the synovitis. Group 3. a significant reduction of haemarthrotic episodes of all 6 joints treated and a reduction of pain in 4 during a follow-up of 2.5 years.It is concluded that radiosynovectomy is a valuable and simple form of treatment for therapy-resistant chronic synovitis. (author). 20 refs.; 3 tabs.

  1. Cardiovascular comorbidity in rheumatoid arthritis

    OpenAIRE

    Holmqvist, Marie E

    2010-01-01

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

  2. Cardiovascular involvement in psoriatic arthritis

    Directory of Open Access Journals (Sweden)

    V. De Gennaro Colonna

    2011-11-01

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

  3. Health status of adults with Short Stature: A comparison with the normal population and one well-known chronic disease (Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Naess Eva E

    2007-02-01

    Full Text Available Abstract Background To examine the subjective health status of adults with short stature (ShSt and compare with the general population (GP and one well-known chronic disease, rheumatoid artritis (RA. In addition, to explore the association between age, gender, height, educational level and different aspects of health status of adults with short stature. Methods A questionnaire was mailed to 72 subjects with short stature registered in the database of a Norwegian resource centre for rare disorders, response rate 61% (n = 44, age 16–61. Health status was assessed with SF-36 version 2. Comparison was done with age and gender matched samples from the general population in Norway (n = 264 and from subjects with RA (n = 88. Results The ShSt sample reported statistically significant impaired health status in all SF-36 subscales compared with the GP sample, most in the physical functioning, Mean Difference (MD 34 (95% Confidence Interval (CI 25–44. The ShSt reported poorer health status in mental health, MD 11 (95% CI 4–18 and social functioning, MD 11 (95% CI 2–20 but better in role physical MD 13 (95% CI 1–25 than the RA sample. On the other subscales there were minor difference between the ShSt and the RA sample. Within the short stature group there was a significant association between age and all SF-36 physical subcales, height was significantly associated with physical functioning while level of education was significantly associated with mental health. Conclusion People with short stature reported impaired health status in all SF-36 subscales indicating that they have health problems that influence their daily living. Health status seems to decline with increasing age, and earlier than in the general population.

  4. A new arthritis therapy with oxidative burst inducers.

    Directory of Open Access Journals (Sweden)

    Malin Hultqvist

    2006-09-01

    Full Text Available BACKGROUND: Despite recent successes with biological agents as therapy for autoimmune inflammatory diseases such as rheumatoid arthritis (RA, many patients fail to respond adequately to these treatments, making a continued search for new therapies extremely important. Recently, the prevailing hypothesis that reactive oxygen species (ROS promote inflammation was challenged when polymorphisms in Ncf1, that decrease oxidative burst, were shown to increase disease severity in mouse and rat arthritis models. Based on these findings we developed a new therapy for arthritis using oxidative burst-inducing substances. METHODS AND FINDINGS: Treatment of rats with phytol (3,7,11,15-tetramethyl-2-hexadecene-1-ol increased oxidative burst in vivo and thereby corrected the effect of the genetic polymorphism in arthritis-prone Ncf1(DA rats. Importantly, phytol treatment also decreased the autoimmune response and ameliorated both the acute and chronic phases of arthritis. When compared to standard therapies for RA, anti-tumour necrosis factor-alpha and methotrexate, phytol showed equally good or better therapeutic properties. Finally, phytol mediated its effect within hours of administration and involved modulation of T cell activation, as injection prevented adoptive transfer of disease with arthritogenic T cells. CONCLUSIONS: Treatment of arthritis with ROS-promoting substances such as phytol targets a newly discovered pathway leading to autoimmune inflammatory disease and introduces a novel class of therapeutics for treatment of RA and possibly other chronic inflammatory diseases.

  5. DRD1-DRD5 EXPRESSION PROFILES IN ARTHRITIS RHEUMATOID

    Directory of Open Access Journals (Sweden)

    M.T. SADEGHI KOUPAEI

    2010-01-01

    Full Text Available ObjectivesThe cause of rheumatoid arthritis (RA as a chronic inflammatory autoimmune disease is still unknown. It appears that both genetic and environmental factors play a role in its pathogenesis. Recent studies reveal that in addition to the CNS, immune cells synthesis neurotransmitters so that these catecholamines can regulate immune functions. The aim of this study is to evaluate the dopamine receptor gene expression profiles on peripheral blood mononuclear cells of rheumatoid arthritis patients in comparison with normal individuals.Material & MethodsIn the present study, we investigated dopamine receptor gene expression in PBMCs of 40 RA patients and 40 healthy individuals using Real Time-PCR.The specificities of the obtained Real time PCR products for the respective dopamine receptors fragments were confirmed by sequenced analysis capillary systemResultsWe found that DRD1-DRD5 types of dopamine receptors genes expression profiles of rheumatoid arthritis patients differ compared to healthy individuals. Moreover, a significant difference of DR2 and DR4 gene expression was seen in rheumatoid arthritis patients.ConclusionThis study showed that some types of dopamine receptors genes expression profiles alter in rheumatoid arthritis patients with comparison to healthy individuals Moreover, this alteration possibly could result in dysfunction of dopaminergic system in immune cells and finally lead to rheumatoid arthritis.Keywords: Rheumatoid arthritis, Dopamine receptor, Gene expression, Human peripheral blood lymphocytes, Real Time- Polymerase Chain Reaction

  6. Hamster and Murine Models of Severe Destructive Lyme Arthritis

    Directory of Open Access Journals (Sweden)

    Erik Munson

    2012-01-01

    Full Text Available Arthritis is a frequent complication of infection in humans with Borrelia burgdorferi. Weeks to months following the onset of Lyme borreliosis, a histopathological reaction characteristic of synovitis including bone, joint, muscle, or tendon pain may occur. A subpopulation of patients may progress to a chronic, debilitating arthritis months to years after infection which has been classified as severe destructive Lyme arthritis. This arthritis involves focal bone erosion and destruction of articular cartilage. Hamsters and mice are animal models that have been utilized to study articular manifestations of Lyme borreliosis. Infection of immunocompetent LSH hamsters or C3H mice results in a transient synovitis. However, severe destructive Lyme arthritis can be induced by infecting irradiated hamsters or mice and immunocompetent Borrelia-vaccinated hamsters, mice, and interferon-gamma- (IFN-γ- deficient mice with viable B. burgdorferi. The hamster model of severe destructive Lyme arthritis facilitates easy assessment of Lyme borreliosis vaccine preparations for deleterious effects while murine models of severe destructive Lyme arthritis allow for investigation of mechanisms of immunopathology.

  7. Agmatine ameliorates adjuvant induced arthritis and inflammatory cachexia in rats.

    Science.gov (United States)

    Taksande, Brijesh G; Gawande, Dinesh Y; Chopde, Chandrabhan T; Umekar, Milind J; Kotagale, Nandkishor R

    2017-02-01

    The present study investigated the pharmacological effect of agmatine in Complete Freud Adjuvant (CFA) induced arthritis and cachexia in rats. The rats were injected with CFA (0.1ml/rat) to induced symptoms of arthritis. Day 8 onwards of CFA administration, rats were injected daily with agmatine for next 7days, and arthritis score, body weights and food intake were monitored daily (g). Since cachexia is known to produce severe inflammation, malnutrition and inhibition of albumin gene expression, we have also monitored the total proteins, albumin, TNF-α and IL-6 levels in arthritic rats and its modulation by agmatine. In the present study, CFA treated rats showed a progressive reduction in both food intake and body weight. In addition analysis of blood serum of arthritis animals showed a significant reduction in proteins and albumin and significant elevation in tumor necrosis factor (TNF)-α and Interleukins (IL)-6. Chronic agmatine (20-40mg/kg, ip) treatment not only attenuated the signs of arthritis but also reverses anorexia and body weight loss in CFA treated rats. In addition, agmatine restored total protein and albumin and reduces TNF-α and IL-6 levels in arthritis rats. These results suggest that agmatine administration can prevent the body weights loss and symptoms of arthritis via inhibition of inflammatory cytokines.

  8. IFN-αα induced psoriatic arthritis and HCV-related liver cirrhosis. Therapeutic options and patient’s opinion

    Directory of Open Access Journals (Sweden)

    M. Piga

    2011-09-01

    Full Text Available Hepatitis C virus (HCV infection in the setting of Psoriatic Arthritis is an additional variable to be considered in the therapeutic approach to the disease because of the complications of an immunosuppressive treatment in the course of a chronic infection and the possible hepatotoxicity of many drugs conventionally used to treat psoriatic arthritis. The case reported explores the therapeutic options in a patient with IFN-α induced psoriatic arthritis, characterised by severe arthritis and psoriasis but also the concomitant presence of HCV chronic hepatitis, in light of the patient’s concerns

  9. [Pathogenesis of rheumatoid arthritis].

    Science.gov (United States)

    Branimir Anić; Miroslav Mayer

    2014-01-01

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

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

    NARCIS (Netherlands)

    J.M.W. Hazes (Mieke)

    2003-01-01

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

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

    NARCIS (Netherlands)

    J.M.W. Hazes (Mieke)

    2003-01-01

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

  12. [Septic arthritis and spondylitis].

    Science.gov (United States)

    Fujikawa, Yosuke

    2014-10-01

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

  13. 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.

  14. Treatment in juvenile rheumatoid arthritis and new treatment options.

    Science.gov (United States)

    Kasapçopur, Özgür; Barut, Kenan

    2015-03-01

    Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease of the childhood with the highest risk of disability. Active disease persists in the adulthood in a significant portion of children with juvenile rheumatoid arthritis despite many developments in the diagnosis and treatment. Therefore, initiation of efficient treatment in the early period of the disease may provide faster control of the inflammation and prevention of long-term harms. In recent years, treatment options have also increased in children with juvenile idiopathic arthritis owing to biological medications. All biological medications used in children have been produced to target the etiopathogenesis leading to disease including anti-tumor necrosis factor, anti-interleukin 1 and anti-interleukin 6 drugs. In this review, scientific data about biological medications used in the treatment of rheumatoid arthritis and new treatment options will be discussed.

  15. Treatment in juvenile rheumatoid arthritis and new treatment options

    Science.gov (United States)

    Kasapçopur, Özgür; Barut, Kenan

    2015-01-01

    Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease of the childhood with the highest risk of disability. Active disease persists in the adulthood in a significant portion of children with juvenile rheumatoid arthritis despite many developments in the diagnosis and treatment. Therefore, initiation of efficient treatment in the early period of the disease may provide faster control of the inflammation and prevention of long-term harms. In recent years, treatment options have also increased in children with juvenile idiopathic arthritis owing to biological medications. All biological medications used in children have been produced to target the etiopathogenesis leading to disease including anti-tumor necrosis factor, anti-interleukin 1 and anti-interleukin 6 drugs. In this review, scientific data about biological medications used in the treatment of rheumatoid arthritis and new treatment options will be discussed. PMID:26078691

  16. Diagnosis of arthritis through fuzzy inference system.

    Science.gov (United States)

    Singh, Sachidanand; Kumar, Atul; Panneerselvam, K; Vennila, J Jannet

    2012-06-01

    Expert or knowledge-based systems are the most common type of AIM (artificial intelligence in medicine) system in routine clinical use. They contain medical knowledge, usually about a very specifically defined task, and are able to reason with data from individual patients to come up with reasoned conclusion. Although there are many variations, the knowledge within an expert system is typically represented in the form of a set of rules. Arthritis is a chronic disease and about three fourth of the patients are suffering from osteoarthritis and rheumatoid arthritis which are undiagnosed and the delay of detection may cause the severity of the disease at higher risk. Thus, earlier detection of arthritis and treatment of its type of arthritis and related locomotry abnormalities is of vital importance. Thus the work was aimed to design a system for the diagnosis of Arthitis using fuzzy logic controller (FLC) which is, a successful application of Zadeh's fuzzy set theory. It is a potential tool for dealing with uncertainty and imprecision. Thus, the knowledge of a doctor can be modelled using an FLC. The performance of an FLC depends on its knowledge base which consists of a data base and a rule base. It is observed that the performance of an FLC mainly depends on its rule base, and optimizing the membership function distributions stored in the data base is a fine tuning process.

  17. Systemic-onset juvenile idiopathic arthritis.

    Science.gov (United States)

    Cimaz, Rolando

    2016-09-01

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

  18. An Evaluation of Non-Surgical Periodontal Therapy in Patients with Rheumatoid Arthritis

    OpenAIRE

    Roman-Torres, Caio V.G; Neto, José S; Souza, Marcio A; Schwartz-Filho, Humberto O; Brandt, William C; Diniz, Ricardo E.A.S

    2015-01-01

    aim of this study was to evaluate the efficacy of periodontal scaling and oral hygiene instruction for patients with mild chronic periodontitis and rheumatoid arthritis through clinical periodontal parameters and laboratory tests for CRP (C- reactive protein) and ESR (erythrocyte sedimentation rate). Twelve individuals with rheumatoid arthritis and 12 healthy individuals were evaluated, with a mean age of 45.38 and 46.75 respectively, all female and with mild, chronic periodontitis. The parti...

  19. The Role of IL-17 in the Angiogenesis of Rheumatoid Arthritis

    Science.gov (United States)

    2013-07-01

    induced by the homeostatic chemokines CCL19 and CCL21 in B-cell chronic lymphocytic leukemia . Exp Hematol 38:756-764, 764 e751-754. 12. Scandella, E...Jackson. 2010. Inflammation-induced secretion of CCL21 in lymphatic endothelium is a key regulator of integrin-mediated dendritic cell transmigration...dependency in the erosive stage of chronic streptococcal cell wall arthritis coincident with TLR-4–medi- ated interleukin-17 production. Arthritis Rheum. 58

  20. Rheumatoid arthritis affecting temporomandibular joint.

    Science.gov (United States)

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

    2015-01-01

    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.

  1. Collagen Biomarkers for Arthritis Applications

    Directory of Open Access Journals (Sweden)

    James D. Birmingham

    2006-01-01

    Full Text Available The most common form of chronic arthritis is osteoarthritis (OA with prevalence as high as 80% after age 75 (Arden and Nevitt, 2006. The incidence of OA is expected to increase as the population ages, increasing the socioeconomic burden of OA. Despite the signifi cant burden of this disease, no drug has been identifi ed that can effectively modify disease progression (Moskowitz and Hooper, 2005; Abadie et al. 2004. However, slowing disease progress and improvement in quality of life may be achieved by behavioral modifi cations, such as weight loss and exercise. Many patients with early OA will progress to disability and joint replacement. Physical examination and radiographic studies are relatively poor means for detecting disease early or predicting progression. Therefore, identifi cation of factors to facilitate early OA diagnosis and prognosis is a major focus of current OA research (Lohmander and Felson, 2004; Lohmander, 2004; Garnero and Delmas, 2003.

  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. [Pulmonary manifestations in rheumatoid arthritis].

    Science.gov (United States)

    Morawska, Justyna; Domysławska, Izabela; Bagrowska, Magdalena; Sierakowski, Stanislaw

    2015-01-01

    Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by destructive cartilages, bones and other structures formed joints. RA belongs to connective tissue diseases represented by systemic nature, internal illness, extra-articular features and rapidly progress of atherosceirosis. The extra-articular complications cause the reduction of patient longevity. The frequency of symptoms in patient with RA and respiratory disorders occur in 10-20% of cases. Pulmonary complications are the second most common cause of premature of patient deaths. Respiratory disorders associated with RA are devided into 3 groups: infection, lung disease caused by drugs and pulmonary manifestation connected by RA. These last affect interstitial tissue, bronchioli, pulmonary vessels, pleura, also are presented by pulmonary rheumatoid nodules and pulmonary hypertension.

  4. [New therapies for rheumatoid arthritis].

    Science.gov (United States)

    Salgado, Eva; Maneiro, José Ramón

    2014-11-18

    Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease characterized by inflammation of the synovial membrane and progressive destruction of the articular cartilage and bone. Advances in the knowledge of disease pathogenesis allowed the identification of novel therapeutic targets such as tumor necrosis factor (TNF), interleukin (IL)-1, IL-6 or the system JAK/STAT phosphorylation. At present there are 5 TNF antagonists approved for RA. Tocilizumab blocks the pathway of IL-6 and is the only biological with proven efficacy in monotherapy. Rituximab modulates B cell response in RA. Abatacept provided new data on T cell involvement in the pathogenesis of RA. Tofacitinib is the first kinase inhibitor approved for this disease. Biologic drugs have proven efficacy, almost always in combination with methotrexate, and even halt radiographic progression. Monitoring infection is the main precaution in handling these patients. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  5. Recommendations for the coordinated management of psoriatic arthritis by rheumatologists and dermatologists: a Delphi study.

    Science.gov (United States)

    Cañete, J D; Daudén, E; Queiro, R; Aguilar, M D; Sánchez-Carazo, J L; Carrascosa, J M; Carretero, G; García-Vivar, M L; Lázaro, P; López-Estebaranz, J L; Montilla, C; Ramírez, J; Rodríguez-Moreno, J; Puig, L

    2014-04-01

    Psoriatic arthritis, a chronic inflammatory musculoskeletal disease that is associated with psoriasis, causes joint erosions, accompanied by loss of function and quality-of-life. The clinical presentation is variable, with extreme phenotypes that can mimic rheumatoid arthritis or ankylosing spondylitis. Because psoriasis usually presents before psoriatic arthritis, the dermatologist plays a key role in early detection of the latter. As many treatments used in psoriasis are also used in psoriatic arthritis, treatment recommendations should take into consideration the type and severity of both conditions. This consensus paper presents guidelines for the coordinated management of psoriatic arthritis by rheumatologists and dermatologists. The paper was drafted by a multidisciplinary group (6rheumatologists, 6dermatologists, and 2epidemiologists) using the Delphi method and contains recommendations, tables, and algorithms for the diagnosis, referral, and treatment of patients with psoriatic arthritis. Copyright © 2013 Elsevier España, S.L. and AEDV. All rights reserved.

  6. Arthritis and IBD

    Science.gov (United States)

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

  7. A nurse-led rheumatology clinic versus rheumatologist-led clinic in monitoring of patients with chronic inflammatory arthritis undergoing biological therapy: a cost comparison study in a randomised controlled trial.

    Science.gov (United States)

    Larsson, Ingrid; Fridlund, Bengt; Arvidsson, Barbro; Teleman, Annika; Svedberg, Petra; Bergman, Stefan

    2015-11-16

    Recommendations for rheumatology nursing management of chronic inflammatory arthritis (CIA) from European League Against Rheumatism (EULAR) states that nurses should take part in the monitoring patients' disease and therapy in order to achieve cost savings. The aim of the study was to compare the costs of rheumatology care between a nurse-led rheumatology clinic (NLC), based on person-centred care (PCC), versus a rheumatologist-led clinic (RLC), in monitoring of patients with CIA undergoing biological therapy. Patients with CIA undergoing biological therapy (n = 107) and a Disease Activity Score of 28 ≤ 3.2 were randomised to follow-up by either NLC or RLC. All patients met the rheumatologist at inclusion and after 12 months. In the intervention one of two annual monitoring visits in an RLC was replaced by a visit to an NLC. The primary outcome was total annual cost of rheumatology care. A total of 97 patients completed the RCT at the 12 month follow-up. Replacing one of the two annual rheumatologist monitoring visits by a nurse-led monitoring visit, resulted in no additional contacts to the rheumatology clinic, but rather a decrease in the use of resources and a reduction of costs. The total annual rheumatology care costs including fixed monitoring, variable monitoring, rehabilitation, specialist consultations, radiography, and pharmacological therapy, generated € 14107.7 per patient in the NLC compared with € 16274.9 in the RCL (p = 0.004), giving a € 2167.2 (13 %) lower annual cost for the NLC. Patients with CIA and low disease activity or in remission undergoing biological therapy can be monitored with a reduced resource use and at a lower annual cost by an NLC, based on PCC with no difference in clinical outcomes. This could free resources for more intensive monitoring of patients early in the disease or patients with high disease activity. The trial is registered as a clinical trial at the ClinicalTrials.gov (NCT01071447). Registration date: October 8

  8. Prevalence of Doctor-Diagnosed Arthritis at State and County Levels - United States, 2014.

    Science.gov (United States)

    Barbour, Kamil E; Helmick, Charles G; Boring, Michael; Zhang, Xingyou; Lu, Hua; Holt, James B

    2016-05-20

    Doctor-diagnosed arthritis is a common chronic condition that affects approximately 52.5 million (22.7%) adults in the United States and is a leading cause of disability (1,2). The prevalence of doctor-diagnosed arthritis has been well documented at the national level (1), but little has been published at the state level and the county level, where interventions are carried out and can have their greatest effect. To estimate the prevalence of doctor-diagnosed arthritis among adults at the state and county levels, CDC analyzed data from the 2014 Behavioral Risk Factor Surveillance System (BRFSS). This report summarizes the results of that analysis, which found that, for all 50 states and the District of Columbia (DC) overall, the age-standardized median prevalence of doctor-diagnosed arthritis was 24% (range = 18.8%-35.5%). The age-standardized model-predicted prevalence of doctor-diagnosed arthritis varied substantially by county, with estimates ranging from 15.8% to 38.6%. The high prevalence of arthritis in all counties, and the high frequency of arthritis-attributable limitations (1) among adults with arthritis, suggests that states and counties might benefit from expanding underused, evidence-based interventions for arthritis that can reduce arthritis symptoms and improve self-management.

  9. Diagnosis and classification of juvenile idiopathic arthritis.

    Science.gov (United States)

    Eisenstein, Eli M; Berkun, Yackov

    2014-01-01

    In recent years, it has become increasingly clear that the term Juvenile Idiopathic Arthritis (JIA) comprises not one disease but several. Moreover, recent studies strongly suggest that some of these clinico-pathophysiologic entities appear to cross current diagnostic categories. The ultimate goal of the JIA classification is to facilitate development of better, more specific therapy for different forms of disease though improved understanding of pathophysiology. The past two decades have witnessed significant advances in treatment and improved outcomes for many children with chronic arthritis. However, understanding of the basic biologic processes underlying these diseases remains far from complete. As a result, even the best biologic agents of today represent "halfway technologies". Because they do not treat fundamental biologic processes, they are inherently expensive, need to be given for a long time in order to ameliorate the adverse effects of chronic inflammation, and do not cure the disease. Pediatric rheumatology is now entering an era in which diagnostic categories may need to change to keep up with discovery. A more precise, biologically based classification is likely to contribute to development of more specific and improved treatments for the various forms of childhood arthritis. In this review, we discuss how genetic, gene expression, and immunologic findings have begun to influence how these diseases are understood and classified.

  10. HOW TO LIVE WITH RHEUMATOID ARTHRITIS???

    Directory of Open Access Journals (Sweden)

    Parle Milind

    2012-03-01

    Full Text Available Rheumatoid Arthritis (RA is a chronic auto-immune disease characterized by painful inflammation of the joints and surrounding tissues, leading to long term disability. Rheumatoid arthritis can begin at any age but has its peak between 35 to 55 years of age. RA shows hereditary linkage. Women and smokers are most often affected. The patient doesn’t feel any symptoms during inactive state of the disease. RA progresses in a symmetrical pattern involving both the sides of the body. Once rheumatoid arthritis is confirmed by diagnosis, treatment should start as early as possible. The treatment for rheumatoid arthritis focuses initially on reducing the joint inflammation and pain with the use of analgesics and anti-inflammatory agents. In the next stage, joint function is restored by administering Disease Modifying Anti-rheumatic Drugs (DMARDs thus preventing joint deformity. Treatment is generally based on the degree of severity of RA. Patients with mild RA are advised to take rest and are prescribed analgesics and anti-inflammatory medicines, which include fast acting drugs like NSAIDs. Slow acting drugs like (DMARDs such as methotrexate, sulfasalazine, lelflunomide etc., and Body’s reaction modifiers (BRMs such as rituximab, anankinra, infliximab etc., are reserved for patients suffering from moderate to severe RA. The patient is advised to undertake regular exercises like walking, stretching, swimming or cycling, which are aimed at reducing body weight. The patient suffering from arthritis can carry out his normal day-to-day activities with the help of proper medication and regular exercise.

  11. Histopathology of Lyme arthritis in LSH hamsters

    Energy Technology Data Exchange (ETDEWEB)

    Hejka, A.; Schmitz, J.L.; England, D.M.; Callister, S.M.; Schell, R.F.

    1989-05-01

    The authors studied the histopathologic evolution of arthritis in nonirradiated and irradiated hamsters infected with Borrelia burgdorferi. Nonirradiated hamsters injected in the hind paws with B. burgdorferi developed an acute inflammatory reaction involving the synovium, periarticular soft tissues, and dermis. This acute inflammatory reaction was short-lived and was replaced by a mild chronic synovitis as the number of detectable spirochetes in the synovium, periarticular soft tissues, and perineurovascular areas diminished. Exposing hamsters to radiation before inoculation with B. burgdorferi exacerbated and prolonged the acute inflammatory phase. Spirochetes also persisted longer in the periarticular soft tissues. A major histopathologic finding was destructive and erosive bone changes of the hind paws, which resulted in deformation of the joints. These studies should be helpful in defining the immune mechanism participating in the onset, progression, and resolution of Lyme arthritis.

  12. Osteoporosis diagnostics in patients with rheumatoid arthritis.

    Science.gov (United States)

    Węgierska, Małgorzata; Dura, Marta; Blumfield, Einat; Żuchowski, Paweł; Waszczak, Marzena; Jeka, Sławomir

    2016-01-01

    Rheumatoid arthritis (RA) is a chronic systemic connective tissue disease. The development of comorbidities often occurs in the course of RA. One of them is osteoporosis, which has serious social and economic effects and may contribute to the increase in the degree of disability and premature death of the patient. Due to the young age in which RA disease occurs, densitometry (DXA) of the lumbar spine is the basic examination in osteoporosis diagnostics. In the course of RA, much more frequently than in healthy persons of the same age, osteoporotic fractures of vertebral bodies occur, which hinder a correct assessment in the DXA test. Rheumatoid arthritis patients often undergo computed tomography (CT) examination of the abdominal cavity for other medical indications than suspected spinal injury. Then, CT examination may also serve for the assessment of bone density, especially in patients with osteoporotic fractures.

  13. GANGGUAN PERTUMBUHAN MANDIBULA PADA JUVENILE RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    Ria Puspitawati

    2015-08-01

    Full Text Available 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: congenital, the disease's direct effect on the condyle, functional deficiency of the temporomandibular joint, duration, age of disease onset and type of the JRA and corticosteroid therapy. However, the mechanism for the mandibulofacial growth and developmental aberrations due to JRA are not fully understood. This literature review will discuss the hypotheses concerning mechanisms of those growth and developmental disturbances, especially based on clinical and radiographic studies on JRA cases.

  14. Understanding Rheumatoid Arthritis (RA): Research

    Science.gov (United States)

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

  15. 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 ...

  16. Handout on Health: Rheumatoid Arthritis

    Science.gov (United States)

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

  17. Rheumatoid Arthritis Educational Video Series

    Medline Plus

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

  18. Rheumatoid Arthritis Educational Video Series

    Medline Plus

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

  19. Rheumatoid Arthritis Educational Video Series

    Medline Plus

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

  20. Rheumatoid Arthritis Educational Video Series

    Medline Plus

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

  1. Rheumatoid Arthritis Educational Video Series

    Medline Plus

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

  2. Rheumatoid Arthritis Educational Video Series

    Medline Plus

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

  3. The Role of Health Literacy and Social Networks in Arthritis Patients' Health Information-Seeking Behavior: A Qualitative Study

    OpenAIRE

    Janette Ellis; Judy Mullan; Anthony Worsley; Nagesh Pai

    2012-01-01

    Background. Patients engage in health information-seeking behaviour to maintain their wellbeing and to manage chronic diseases such as arthritis. Health literacy allows patients to understand available treatments and to critically appraise information they obtain from a wide range of sources. Aims. To explore how arthritis patients' health literacy affects engagement in arthritis-focused health information-seeking behaviour and the selection of sources of health information available through ...

  4. Native type II collagen-induced arthritis in the rat. I. Incidence and humoral response to collagen.

    OpenAIRE

    Morgan, K; Clague, R B; Shaw, M J; Holt, P J

    1980-01-01

    An acute inflammatory arthritis has been induced in 76% of rats injected intradermally with native bovine type II collagen emulsified in Freund's complete (CFA) or incomplete (ICFA) adjuvant. The arthritis became chronic in 14 out of 31 rats, and ear and tail lesions were noted in some rats. No arthritis was induced by native type I collagen, denatured type II collagen, rabbit IgG, or buffer alone injected intradermally with adjuvant. Using a solid-phase radioimmunoassay for serum antibodies ...

  5. Systemic immune markers characterizing early stages of rheumatoid arthritis

    NARCIS (Netherlands)

    Chalan, Paulina Luiza

    2016-01-01

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

  6. Pain Sensitisation in Women with Active Rheumatoid Arthritis

    DEFF Research Database (Denmark)

    Vladimirova, Nora; Jespersen, Anders; Bartels, Else Marie

    2015-01-01

    Objectives. In some rheumatoid arthritis (RA) patients, joint pain persists without signs of inflammation. This indicates that central pain sensitisation may play a role in the generation of chronic pain in a subgroup of RA. Our aim was to assess the degree of peripheral and central pain...... of patients may be of importance when considering treatment strategies....

  7. The adolescent experience in Juvenile Idiopathic Arthritis: A narrative approach

    NARCIS (Netherlands)

    Fuchs, C.E.|info:eu-repo/dai/nl/304820369

    2013-01-01

    This dissertation focused on the self-experience of adolescents with juvenile idiopathic arthritis (JIA) or chronic fatigue syndrome (CFS). Although the etiology and nosology of JIA and CFS are fundamentally different, some commonalities in the emotional experience of adolescents dealing with these

  8. Chondrocyte activity is increased in psoriatic arthritis and axial spondyloarthritis

    DEFF Research Database (Denmark)

    Gudmann, Natasja Stæhr; Munk, Heidi Lausten; Christensen, Anne Friesgaard

    2016-01-01

    BACKGROUND: Psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) are chronic inflammatory rheumatic diseases with complex origins. Both are characterized by altered extracellular matrix remodeling in joints and entheses that results in destructive and osteochondral proliferative lesions...

  9. Successful total knee arthroplasty in the presence of sporotrichal arthritis.

    NARCIS (Netherlands)

    Koeter, S.; Jackson, R.W.

    2006-01-01

    Articular sporotrichosis, a chronic granulomatous fungal infection, is a rare entity but when present may lead to significant joint destruction. Severe knee arthrosis due to sporotrichal arthritis has traditionally been treated with arthrodesis. Total knee arthroplasty in the presence of sporotricha

  10. Rheumatoid arthritis and periodontitis; a possible link via citrullination

    OpenAIRE

    Smit, M. J.; Tonckens-Brouwer, Elisabeth; Vissink, A; van Winkelhoff, A J

    2011-01-01

    Rheumatoid Arthritis (RA) and chronic and aggressive periodontitis are chronic inflammatory disorders characterized by deregulation of the host inflammatory response. Increased secretion of pro-inflammatory mediators results in soft and hard tissue destruction of the synovium and periodontium respectively. Both diseases share risk factors and have pathological pathways in common, resulting in loss of function and disability as a final clinical outcome. This article discusses possible interact...

  11. Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 2. Psoriatic arthritis: overview and guidelines of care for treatment with an emphasis on the biologics.

    Science.gov (United States)

    Gottlieb, Alice; Korman, Neil J; Gordon, Kenneth B; Feldman, Steven R; Lebwohl, Mark; Koo, John Y M; Van Voorhees, Abby S; Elmets, Craig A; Leonardi, Craig L; Beutner, Karl R; Bhushan, Reva; Menter, Alan

    2008-05-01

    Psoriasis is a common, chronic, inflammatory, multisystem disease with predominantly skin and joint manifestations affecting approximately 2% of the population. In this second of 5 sections of the guidelines of care for psoriasis, we give an overview of psoriatic arthritis including its cardinal clinical features, pathogenesis, prognosis, classification, assessment tools used to evaluate psoriatic arthritis, and the approach to treatment. Although patients with mild to moderate psoriatic arthritis may be treated with nonsteroidal anti-inflammatory drugs and/or intra-articular steroid injections, the use of disease-modifying antirheumatic drugs, particularly methotrexate, along with the biologic agents, are considered the standard of care in patients with more significant psoriatic arthritis. We will discuss the use of disease-modifying antirheumatic drugs and the biologic therapies in the treatment of patients with moderate to severe psoriatic arthritis.

  12. Rheumatoid Arthritis Educational Video Series

    Medline Plus

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

  13. Th17 cytokines and arthritis

    NARCIS (Netherlands)

    E.W. Lubberts (Erik)

    2010-01-01

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

  14. Pain syndrome in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Ekaterina Sergeyevna Filatova

    2011-01-01

    Full Text Available Subjects and methods. One hundred and eighty-three patients with valid rheumatoid arthritis (RA were examined to study the specific fea tures of chronic pain syndrome. The DN4 neuropathic pain diagnostic questionnaire was used to divide all the patients into 2 groups: 1 78 patients with the neuropathic component of pain (NCP and 2 105 patients without the latter. Results. A clinical neurological examination could reveal peripheral nervous system lesion in 96% of Group 1 patients and in 4% of Group 2 ones. The patients with NCP were ascertained to be older, they were longer ill with RA, had higher clinical, X-ray stages and functional class, as well as higher pain intensity. However, no differences were found between the two groups in the values of disease activity (DAS 28 and erythrocyte sedimentation rate. There was a high rate (71% of depressive disorders, the prevalence and degree of which in RA patients were determined by the characteristics of disease severity and did not depend on the presence of NCP. Discussion. The performed study demonstrated that, along with an obligate nociceptive mechanism, the patients with RA had neurogenic and psychogenic components of pain in 43 and 71% of cases, respectively. Consequently, chronic pain syndrome in RA is commonly mixed and both the activity of the inflammatory process and the magnitude of neurogenic and psychogenic components should be borne in mind for optimal pain control.

  15. [Juvenile idiopathic arthritis].

    Science.gov (United States)

    Herlin, Troels

    2002-08-19

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

  16. Dermatoglyphics in rheumatoid arthritis.

    Directory of Open Access Journals (Sweden)

    Ravindranath R

    2003-10-01

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

  17. Neonatal Candida arthritis

    Directory of Open Access Journals (Sweden)

    Saurabh Sharma

    2014-01-01

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

  18. Psoriatic Arthritis Registries.

    Science.gov (United States)

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

    2015-11-01

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

  19. Vasculitis and inflammatory arthritis.

    Science.gov (United States)

    Watts, Richard A; Scott, David G I

    2016-10-01

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

  20. The role of exercise in the management of rheumatoid arthritis.

    Science.gov (United States)

    Metsios, George S; Stavropoulos-Kalinoglou, Antonis; Kitas, George D

    2015-01-01

    Rheumatoid arthritis (RA) is a chronic inflammatory disease associated with significant functional impairment and increased risk for cardiovascular disease. Along with pharmacological therapy, exercise seems to be a very promising intervention to improve disease-related outcomes, including functional ability and systemic manifestations, such as the increased cardiovascular risk. In this review, we discuss the physiological mechanisms by which exercise improves inflammation, cardiovascular risk and psychological health in patients with rheumatoid arthritis (RA) and describe in detail how exercise can be incorporated in the management of this disease using real examples from our clinical practice.

  1. Cicatricial Pemphigoid in Accompany with Rheumatoid Arthritis: a Case Report

    Institute of Scientific and Technical Information of China (English)

    Di Wu; Li-ming Zhang; Ying Jiang

    2010-01-01

    @@ CICATRICIAL pemphigoid (CP, also known as benign mucous membrane pemphigoid) is a rare chronic autoimmune subepithelial blister-ing disease, with an incidence of 1 per million, characterized by erosive lesions of mucous membranes and skin that result in scarring.1,2 Rheumatoid arthritis (RA) is a symmetric inflammatory arthritis that mainly affects the small joints of hands and feet, with a prevalence of 0.3% in China. In this case report we described the diagnosis of and treatment for a patient developing CP 18 years after the onset of RA, a combination rarely en-countered or reported so far.

  2. Bacillus pumilus Septic Arthritis in a Healthy Child

    Directory of Open Access Journals (Sweden)

    V. M. Shivamurthy

    2016-01-01

    Full Text Available We report a case of septic arthritis caused by a Bacillus species, B. pumilus, occurring in a healthy child. This organism rarely causes serious infections and has only been described in newborns and immunocompromised individuals or as a skin infection. This child developed an indolent joint swelling after a minor skin injury, and symptoms were initially thought most consistent with chronic arthritis. The case demonstrates that clinicians should consider joint infection in children presenting with acute monoarticular swelling, even without prominent systemic features.

  3. Physiotherapy in pauciarticular juvenile idiopathic arthritis. Case study.

    Science.gov (United States)

    Zuk, Beata; Kaczor, Zofia; Zuk-Drążyk, Berenika; Księżopolska-Orłowska, Krystyna

    2014-01-01

    Juvenile idiopathic arthritis (JIA) is the most common arthropathy of childhood and adolescence. This term encompasses a group of chronic systemic inflammatory diseases of the connective tissue which cause arthritis in patients under 16 years of age lasting at least 6 weeks. The authors presented the characteristic features of physiotherapy based on functional examination results on the basis of two cases of girls with pauciarticular JIA treated according to an established pharmacological regimen. Physiotherapy should be introduced at an early stage of the disease. Kinesiotherapy preceded by history-taking and a functional examination of the patient, has to focus on both primary and secondary joint lesions.

  4. Associations Between Arthritis and Change in Physical Function in U.S. Retirees.

    Science.gov (United States)

    Baker, Nancy A; Barbour, Kamil E; Helmick, Charles G; Zack, Matthew M; Al Snih, Soham

    2017-01-01

    The aims of this study were to determine among retirees: the associations of arthritis with limitations in physical functions, and whether these associations changed differently with age for those with arthritis versus without arthritis. We identified retirees from the Health and Retirement Study, a nationally representative longitudinal panel study of U.S. adults ≥51 years old. We calculated incidence density ratios (IDRs) using Poisson regression modeling with generalized estimating equations to estimate the associations between arthritis and limitations in four physical function measures (large muscle tasks, mobility, activities of daily living, and instrumental activities of daily living) adjusting for age, sex, race/ethnicity, marital status, education, total household income, depression, obesity, smoking, chronic conditions, physical activity, and cohort status. We examined interaction effects between arthritis and age to determine if the rate of change in physical function differed by arthritis status across age. Over 8 years (2004-2012), significantly more retirees with arthritis had limitations with large muscle tasks (IDR 2.1: 95% confidence interval 1.6, 2.8), mobility (IDR 1.6: 1.2, 2.2), activities of daily living (IDR 2.2: 1.0, 4.7), and instrumental activities of daily living (IDR 3.7: 1.9, 7.4) than retirees without arthritis. Retirees with arthritis did not develop limitations in mobility, activities of daily living, and instrumental activities of daily living at a different rate as they aged compared to those without arthritis. Arthritis was associated with a greater prevalence of physical function limitations. Preventing limitations caused by arthritis is a key strategy to prevent disability in retirees. Published by Oxford University Press on behalf of The Gerontological Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  5. Comparison of Two Assays to Determine Anti-Citrullinated Peptide Antibodies in Rheumatoid Arthritis in relation to Other Chronic Inflammatory Rheumatic Diseases: Assaying Anti-Modified Citrullinated Vimentin Antibodies Adds Value to Second-Generation Anti-Citrullinated Cyclic Peptides Testing

    Directory of Open Access Journals (Sweden)

    Miriam Lizette Díaz-Toscano

    2014-01-01

    Full Text Available Determination of anti-citrullinated peptide antibodies (ACPA plays a relevant role in the diagnosis of rheumatoid arthritis (RA. To date, it is still unclear if the use of several tests for these autoantibodies in the same patient offers additional value as compared to performing only one test. Therefore, we evaluated the performance of using two assays for ACPA: second-generation anti-citrullinated cyclic peptides antibodies (anti-CCP2 and anti-mutated citrullinated vimentin (anti-MCV antibodies for the diagnosis of RA. We compared three groups: RA (n=142, chronic inflammatory disease (CIRD, n=86, and clinically healthy subjects (CHS, n=56 to evaluate sensitivity, specificity, predictive values, and likelihood ratios (LR of these two assays for the presence of RA. A lower frequency of positivity for anti-CCP2 was found in RA (66.2% as compared with anti-MCV (81.0%. When comparing RA versus other CIRD, sensitivity increased when both assays were performed. This strategy of testing both assays had high specificity and LR+. We conclude that adding the assay of anti-MCV antibodies to the determination of anti-CCP2 increases the sensitivity for detecting seropositive RA. Therefore, we propose the use of both assays in the initial screening of RA in longitudinal studies, including early onset of undifferentiated arthritis.

  6. Comparison of Two Assays to Determine Anti-Citrullinated Peptide Antibodies in Rheumatoid Arthritis in relation to Other Chronic Inflammatory Rheumatic Diseases: Assaying Anti-Modified Citrullinated Vimentin Antibodies Adds Value to Second-Generation Anti-Citrullinated Cyclic Peptides Testing

    Science.gov (United States)

    Díaz-Toscano, Miriam Lizette; Olivas-Flores, Eva Maria; Zavaleta-Muñiz, Soraya Amali; Gamez-Nava, Jorge Ivan; Cardona-Muñoz, Ernesto German; Ponce-Guarneros, Manuel; Castro-Contreras, Uriel; Nava, Arnulfo; Salazar-Paramo, Mario; Celis, Alfredo; Fajardo-Robledo, Nicte Selene; Corona-Sanchez, Esther Guadalupe; Gonzalez-Lopez, Laura

    2014-01-01

    Determination of anti-citrullinated peptide antibodies (ACPA) plays a relevant role in the diagnosis of rheumatoid arthritis (RA). To date, it is still unclear if the use of several tests for these autoantibodies in the same patient offers additional value as compared to performing only one test. Therefore, we evaluated the performance of using two assays for ACPA: second-generation anti-citrullinated cyclic peptides antibodies (anti-CCP2) and anti-mutated citrullinated vimentin (anti-MCV) antibodies for the diagnosis of RA. We compared three groups: RA (n = 142), chronic inflammatory disease (CIRD, n = 86), and clinically healthy subjects (CHS, n = 56) to evaluate sensitivity, specificity, predictive values, and likelihood ratios (LR) of these two assays for the presence of RA. A lower frequency of positivity for anti-CCP2 was found in RA (66.2%) as compared with anti-MCV (81.0%). When comparing RA versus other CIRD, sensitivity increased when both assays were performed. This strategy of testing both assays had high specificity and LR+. We conclude that adding the assay of anti-MCV antibodies to the determination of anti-CCP2 increases the sensitivity for detecting seropositive RA. Therefore, we propose the use of both assays in the initial screening of RA in longitudinal studies, including early onset of undifferentiated arthritis. PMID:25025037

  7. Juvenile idiopathic arthritis: a clinical overview

    Energy Technology Data Exchange (ETDEWEB)

    Davidson, J

    2000-02-01

    The chronic arthritides in childhood remain a poorly understood group of conditions. Their classification has been a source of much confusion over the years with differences in terminology between Europe and North America. A significant step forward in paediatric rheumatology has been the recent development of an internationally agreed classification system which uses the overall term juvenile idiopathic arthritis (JIA). The various subtypes of JIA and their clinical features are described, together with an overview of their differential diagnosis, complications and outcomes. An outline of current management strategies is given and potential future developments highlighted.

  8. [Physiotherapy in rheumatoid arthritis and ankylosing spondylitis].

    Science.gov (United States)

    Mariacher-Gehler, S; Wyss-Näther, A; Aeschlimann, A G

    2001-08-01

    Both Rheumatoid Arthritis (RA) and Ankylosing Spondylitis (AS) are chronic, inflammatory systemic diseases. RA predominantly manifests itself in the peripheral joints, whereas AS most prominently in the spine. As time progresses the roles of active and physical therapy become increasingly important. The aims of intensive and dynamic exercise for patients with RA and AS are formulated following the ICIDH-2. Thus, the aims are a direct equation of body function, activities and participation. The benefits of exercise therapy are increased joint mobility, increased muscle strength, improved functional ability and better cardiorespiratory function without incurring a flare of the disease.

  9. Linkage Between Periodontal Disease and Rheumatoid Arthritis

    DEFF Research Database (Denmark)

    Holmstrup, Palle; Nielsen, Claus Henrik

    2016-01-01

    The past decades have significantly widened the perspectives of the chronic oral infectious disease known as periodontitis. The disease is regarded as a bacterial infection resulting in low-grade inflammation of the periodontal tissues, and both the associated release of pro-inflammatory mediators...... and the presence of bacteria in the periodontal pockets, which, as the result of daily procedures, may spread after penetration of the vasculature, are possible mediators of systemic consequences. The present chapter deals with the possible association of periodontitis with rheumatoid arthritis, which may possess...

  10. Polymorphisms within the IL-1 gene cluster: effects on cytokine profiles in peripheral blood and whole blood cell cultures of patients with aggressive periodontitis, juvenile idiopathic arthritis, and rheumatoid arthritis

    DEFF Research Database (Denmark)

    Poulsen, Anne Havemose; Sørensen, Lars Korsbaek; Bendtzen, Klaus

    2007-01-01

    Genetic polymorphisms of cytokines have been associated with the susceptibility, severity, and clinical outcome of inflammatory diseases, such as periodontitis and chronic arthritis. An important question to address is how interleukin (IL)-1 polymorphisms affect the cytokine profiles of patients...

  11. A case of juvenile idiopathic polyarticular arthritis complicated by IgA deficiency in 22q11 deletion syndrome.

    Science.gov (United States)

    Sato, Satoshi; Kawashima, Hisashi; Suzuki, Kazunori; Nagao, Ryuhei; Tsuyuki, Kazumitsu; Hoshika, Akinori

    2011-08-01

    Chronic arthritis may occur in association with antibody deficiency and chromosomal aberrations. This report presents the case of a 6-year-old girl with chromosome 22q11 deletion syndrome and chronic arthritis. The onset of arthritis occurred at 4 years of age. The chronic arthritis course has been the polyarticular type. Neither antinuclear antibody nor rheumatoid factor was detected. Serum IgA was extremely low. She was diagnosed with juvenile idiopathic polyarticular arthritis (JIA) complicated by IgA deficiency in the 22q11 deletion syndrome. There is an increased prevalence of chronic arthritis in association with 22q11 deletion syndrome with IgA deficiency, but the reasons for this association are unknown. This study evaluated the possible correlation between cytokines and the susceptibility to chronic arthritis in the 22q11 deletion syndrome with IgA deficiency. The expression of pro-inflammatory cytokines such as IL-8, IL-6, MIP-1β, and MCP-1 suggests that T and B cells, macrophages and neutrophils modulate joint inflammation by an immune response. And the presence of IL-10 and IL-5 might suggest that the synovitis is associated with JIA and IgA deficiency.

  12. Substance P and Chronic Pain in Patients with Chronic Inflammation of Connective Tissue.

    Directory of Open Access Journals (Sweden)

    Barbara Lisowska

    Full Text Available Evidence suggests that substance P (SP is involved in chronic joint inflammation, such as the pathogenesis of rheumatoid arthritis and osteoarthritis. The goal of the research was to evaluate the correlation between chronic pain and changes in the SP level in patients with chronic inflammation of the connective tissue.Patients with osteoarthritis and rheumatoid arthritis were enrolled in this study. The relationship between chronic pain intensity and the serum SP concentration was evaluated in these groups of patients with osteoarthritis and rheumatoid arthritis.The results showed a positive correlation between the serum SP concentrations and chronic pain intensity.1. The SP serum concentration was significantly different between the groups of patients with OA and RA. 2. There was a positive correlation between the serum SP concentration and chronic pain intensity in OA and RA patients.

  13. Modulation of IL-17 and Foxp3 expression in the prevention of autoimmune arthritis in mice.

    Directory of Open Access Journals (Sweden)

    Joana Duarte

    Full Text Available BACKGROUND: Rheumatoid Arthritis (RA is a chronic immune mediated disease associated with deregulation of many cell types. It has been reported that different T cell subsets have opposite effects in disease pathogenesis, in particular Th17 and Treg cells. METHODOLOGY AND FINDINGS: We investigated whether non-depleting anti-CD4 monoclonal antibodies, which have been reported as pro-tolerogenic, can lead to protection from chronic autoimmune arthritis in SKG mice--a recently described animal model of RA--by influencing the Th17/Treg balance. We found that non-depleting anti-CD4 prevented the onset of chronic autoimmune arthritis in SKG mice. Moreover, treated mice were protected from the induction of arthritis up to 60 days following anti-CD4 treatment, while remaining able to mount CD4-dependent immune responses to unrelated antigens. The antibody treatment also prevented disease progression in arthritic mice, although without leading to remission. Protection from arthritis was associated with an increased ratio of Foxp3, and decreased IL-17 producing T cells in the synovia. In vitro assays under Th17-polarizing conditions showed CD4-blockade prevents Th17 polarization, while favoring Foxp3 induction. CONCLUSIONS: Non-depleting anti-CD4 can therefore induce long-term protection from chronic autoimmune arthritis in SKG mice through reciprocal changes in the frequency of Treg and Th17 cells in peripheral tissues, thus shifting the balance towards immune tolerance.

  14. Monitoring rheumatoid arthritis

    NARCIS (Netherlands)

    Gvozdenovic, Emilia

    2016-01-01

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

  15. Neonatal septic arthritis.

    Science.gov (United States)

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

    1996-09-01

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

  16. The Ras guanine nucleotide exchange factor RasGRF1 promotes matrix metalloproteinase-3 production in rheumatoid arthritis synovial tissue

    NARCIS (Netherlands)

    de Abreu, J.R.F.; de Launay, D.; Sanders, M.E.; Grabiec, A.M.; van de Sande, M.G.; Tak, P.P.; Reedquist, K.A.

    2009-01-01

    Introduction Fibroblast-like synoviocytes (FLS) from rheumatoid arthritis ( RA) patients share many similarities with transformed cancer cells, including spontaneous production of matrix metalloproteinases ( MMPs). Altered or chronic activation of proto-oncogenic Ras family GTPases is thought to

  17. Anti-cyclic citrullinated peptide positivity in non-rheumatoid arthritis disease samples: citrulline-dependent or not?

    NARCIS (Netherlands)

    Nini, A. van; Cheung, K.; Fusconi, M.; Stammen-Vogelzangs, J.; Drenth, J.P.H.; Dall'aglio, A.C.; Bianchi, F.B.; Bakker-Jonges, L.E.; Venrooij, W.J.W. van; Pruijn, G.J.M.; Zendman, A.J.W.

    2007-01-01

    BACKGROUND: Antibodies directed against citrullinated proteins (eg anti-cyclic citrullinated peptide (CCP)) have excellent diagnostic and good prognostic potential for rheumatoid arthritis. Type 1 autoimmune hepatitis (AIH-1) is a chronic liver disease characterised by a variety of serum

  18. EXTRACORPOREAL PHOTOCHEMOTHERAPY IN PSORIASIS AND PSORIATIC ARTHRITIS

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    E. S. Yakubovskaya

    2016-01-01

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

  19. IMAGING OF PSORIATIC ARTHRITIS

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    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

  20. Juvenile rheumatoid arthritis: therapeutic perspectives.

    Science.gov (United States)

    Chikanza, Ian C

    2002-01-01

    Juvenile rheumatoid arthritis (JRA) is the most common childhood chronic systemic autoimmune inflammatory disease. The therapeutic approach to JRA has, to date, been casual and based on extensions of clinical experiences gained in the management of adult rheumatoid arthritis (RA). The physiology of inflammation has been systemically studied and this has led to the identification of specific therapeutic targets and the development of novel approaches to the management of JRA. The classical treatments of the disease such as methotrexate, sodium aurothiomalate and sulfasalazine, are not always effective in controlling RA and JRA. This has necessitated the development of novel agents for treating RA, most of which are biological in nature and are targeted at specific sites of the inflammatory cascades. These biological therapeutic strategies in RA have proved successful and are being applied in the management of JRA. These developments have been facilitated by the advances in molecular biology which have heralded the advent of biodrugs (recombinant proteins) and gene therapy, in which specific genes can be introduced locally to enhance in vivo gene expression or suppress gene(s) of interest with a view to down-regulating inflammation. Some of these biodrugs, such as anti-tumor necrosis factor alpha (anti-TNFalpha), monoclonal antibodies (infliximab, adalimumab), TNF soluble receptor constructs (etanercept) and interleukin-1 receptor antagonist (IL-1Ra) have been tested and shown to be effective in RA. Etanercept has now been licensed for JRA. Clinical trials of infliximab in JRA are planned. Studies show that the clinical effects are transient, necessitating repeated treatments and the risk of vaccination effects. Anti-inflammatory cytokines such as IL-4, IL-10, transforming growth factor-beta and interferon-beta (IFN-beta) are undergoing clinical trials. Many of these agents have to be administered parenterally and production costs are very high; thus, there is a need

  1. The Impact of Imagery Therapy on Rheumatoid Arthritis Patients

    Directory of Open Access Journals (Sweden)

    Wadee Alhalabi

    2012-09-01

    Full Text Available This paper concerns computer applications in medicine that exploit the potentially powerful interconnection between psychology and physiology. An important class of applications involve patients who suffer chronic pain caused by rheumatoid arthritis; these patients look for any kind of therapeutic technique to use in addition to traditional medicine in order to alleviate pain, reduce physical disabilities caused by the disease or delay disease progress and improve their lifestyle. This paper focuses on a particular class of therapeutic techniques that provide imagery therapy using virtual reality in the treatment of rheumatoid arthritis. We describe imagery therapy involving guided imagery and illustrate its effects. We particularly describe the application of VR and IT in the treatment of rheumatoid arthritis. A brief introduction to our system and the research we have done in this field is presented, showing some preliminary results that support our hypothesis.

  2. Genetics Home Reference: juvenile idiopathic arthritis

    Science.gov (United States)

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

  3. 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 ...

  4. Accommodation and Compliance Series: Employees with Arthritis

    Science.gov (United States)

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

  5. Rheumatoid Arthritis: Can It Affect the Lungs?

    Science.gov (United States)

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

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

    Directory of Open Access Journals (Sweden)

    Abhinav Agrawal

    2015-01-01

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

  7. Clinical management of septic arthritis.

    Science.gov (United States)

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

    2013-06-01

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

  8. Mimicry of lyme arthritis by synovial hemangioma.

    Science.gov (United States)

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

    2011-12-01

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

  9. Cable television and health promotion: a feasibility study with arthritis patients.

    Science.gov (United States)

    Katz, D

    1985-01-01

    Community access cable television channels can be used to provide low-cost health programming in many communities. This article describes a study undertaken to ascertain the extent to which arthritis patients could be targeted by arthritis-related programming over a local cable system. A number of publicity sources were used to advertise the programs to a preidentified group and the public at large. Telephone and written surveys revealed that the programming garnered a moderate viewing audience composed preponderantly of arthritis patients. Some conceptual and practical issues involved in targeting chronic patient groups for health programming are discussed.

  10. Rheumatoid arthritis: identifying and characterising polymorphisms using rat models

    Science.gov (United States)

    2016-01-01

    ABSTRACT Rheumatoid arthritis is a chronic inflammatory joint disorder characterised by erosive inflammation of the articular cartilage and by destruction of the synovial joints. It is regulated by both genetic and environmental factors, and, currently, there is no preventative treatment or cure for this disease. Genome-wide association studies have identified ∼100 new loci associated with rheumatoid arthritis, in addition to the already known locus within the major histocompatibility complex II region. However, together, these loci account for only a modest fraction of the genetic variance associated with this disease and very little is known about the pathogenic roles of most of the risk loci identified. Here, we discuss how rat models of rheumatoid arthritis are being used to detect quantitative trait loci that regulate different arthritic traits by genetic linkage analysis and to positionally clone the underlying causative genes using congenic strains. By isolating specific loci on a fixed genetic background, congenic strains overcome the challenges of genetic heterogeneity and environmental interactions associated with human studies. Most importantly, congenic strains allow functional experimental studies be performed to investigate the pathological consequences of natural genetic polymorphisms, as illustrated by the discovery of several major disease genes that contribute to arthritis in rats. We discuss how these advances have provided new biological insights into arthritis in humans. PMID:27736747

  11. INVESTIGATION OF CYTOKINE PROFILE IN PATIENTS WITH REACTIVE ARTHRITIS

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    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.

  12. IMMUNOPATHOGENESIS OF PSORIASIS AND PSORIATIC ARTHRITIS AND PHARMACOLOGICAL PERSPECTIVES

    Directory of Open Access Journals (Sweden)

    A. Genovese

    2011-09-01

    Full Text Available Psoriasis and psoriatic arthritis are chronic inflammatory disorders resulting from a combination of genetic and environmental factors, though the precise causal agents have not yet been identified. The immune system has a major role in their development and the possibility exists that self antigens or antigens from microbial agents, or microbial superantigens initiate a vigorous immune response. Different subsets of T-lymphocytes and dendritic cells, mast cells and granulocytes participate in the pathogenesis and several cytokines and chemokines have been identified in tissue lesions. TNF-α is a key proinflammatory cytokine with important pathogenetic role in psoriasis and psoriatic arthritis. Evidence from clinical trials targeting the TNF-α–TNF-α-receptor supports a central role for this cytokine in the pathogenesis of psoriasis and psoriatic arthritis. Angiogenesis is a prominent early event in lesional psoriatic skin and in synovial membrane psoriatic arthritis. Future potential targets in the treatment of these disorders include biologic agents aimed at blockade of other cytokines, chemokines and angiogenic factors. Key words: Psoriasis, psoriatic arthritis, immunity

  13. Alternative for anti-TNF antibodies for arthritis treatment.

    Science.gov (United States)

    Paquet, Joseph; Henrionnet, Christel; Pinzano, Astrid; Vincourt, Jean-Baptiste; Gillet, Pierre; Netter, Patrick; Chary-Valckenaere, Isabelle; Loeuille, Damien; Pourel, Jacques; Grossin, Laurent

    2011-10-01

    Tumor necrosis factor-α (TNF-α), a proinflammatory cytokine, plays a key role in the pathogenesis of many inflammatory diseases, including arthritis. Neutralization of this cytokine by anti-TNF-α antibodies has shown its efficacy in rheumatoid arthritis (RA) and is now widely used. Nevertheless, some patients currently treated with anti-TNF-α remain refractory or become nonresponder to these treatments. In this context, there is a need for new or complementary therapeutic strategies. In this study, we investigated in vitro and in vivo anti-inflammatory potentialities of an anti-TNF-α triplex-forming oligonucleotide (TFO), as judged from effects on two rat arthritis models. The inhibitory activity of this TFO on articular cells (synoviocytes and chondrocytes) was verified and compared to that of small interfering RNA (siRNA) in vitro. The use of the anti-TNF-α TFO as a preventive and local treatment in both acute and chronic arthritis models significantly reduced disease development. Furthermore, the TFO efficiently blocked synovitis and cartilage and bone destruction in the joints. The results presented here provide the first evidence that gene targeting by anti-TNF-α TFO modulates arthritis in vivo, thus providing proof-of-concept that it could be used as therapeutic tool for TNF-α-dependent inflammatory disorders.

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

    OpenAIRE

    de Smit, Menke

    2015-01-01

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

  15. Scabies in a Patient with Rheumatoid Arthritis Treated with Adalimumab – A Case Report

    OpenAIRE

    Ivan Marković; Silva Pukšić; Ana Gudelj Gračanin; Melanie Ivana Čulo; Joško Mitrović; Jadranka Morović-Vergles

    2015-01-01

    Rheumatoid arthritis is a chronic systemic inflammatory disease characterized by synovitis, erosions, and destruction of affected joints. If untreated, it leads to severe disability and premature mortality. Tumor necrosis factor alpha (TNF-α) inhibitors are biological drugs used in treatment of rheumatoid arthritis. Possible side effects include skin allergic reactions, which, if generalized, are the reason for discontinuation of the drug. We report the case of a 46-year-old female patient wi...

  16. Severe Osteomyelitis and Septic Arthritis due to Serratia marcescens in an Immunocompetent Patient

    Directory of Open Access Journals (Sweden)

    Hiba Hadid

    2015-01-01

    Full Text Available Septic arthritis and osteomyelitis due to Serratia marcescens in immunocompetent patients without risk factors are extremely rare. Here, we report a case of septic arthritis and severe adjacent osteomyelitis of the tibia due to Serratia marcescens in a diabetic community-dweller patient. The patient had no contact with healthcare workers or facilities and had no chronic disease except for poorly controlled diabetes. Without predisposing risk factors, this type of infection is extremely rare, even in diabetics.

  17. Long term efficacy and safety of etanercept in the treatment of psoriasis and psoriatic arthritis

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    Kivelevitch D

    2014-04-01

    Full Text Available Dario Kivelevitch, Bobbak Mansouri, Alan Menter Department of Dermatology, Baylor University Medical Center, Dallas, TX, USA Abstract: Psoriasis is a chronic, immune-mediated inflammatory disease affecting both the skin and joints. Approximately 20% of patients suffer a moderate to severe form of skin disease and up to 30% have joint involvement. Standard therapies for psoriasis include topical medications, phototherapy, and both oral systemic and biological therapies whereas therapies for psoriatic arthritis include nonsteroidal anti-inflammatory drugs followed by disease modifying antirheumatic drugs and/or tumor necrosis factor (TNF-α inhibitors and interleukin-12/23p40 inhibitors. Treatment of both diseases is typically driven by disease severity. In the past decade, major advances in the understanding of the immunopathogenesis of psoriasis and psoriatic arthritis have led to the development of numerous biological therapies, which have revolutionized the treatment for moderate to severe plaque psoriasis and psoriatic arthritis. Anti-TNF-α agents are currently considered as first line biological therapies for the treatment of moderate to severe psoriasis and psoriatic arthritis. Currently approved anti-TNF-α agents include etanercept, adalimumab, and infliximab for psoriasis and psoriatic arthritis as well as golimumab and certolizumab for psoriatic arthritis. In this article, we aim to evaluate the long term safety and efficacy of etanercept in psoriasis and psoriatic arthritis. Keywords: psoriasis, psoriatic arthritis, etanercept, biological therapy, tumor necrosis factor, safety

  18. Rheumatoid Arthritis and Periodontal Disease. An Update.

    Science.gov (United States)

    Venkataraman, Archana; Almas, Khalid

    2015-01-01

    A review of the epidemiological, pathological and immunological relationships between two chronic inflammatory diseases: rheumatoid arthritis (RA) and periodontal disease (PD). RA is a chronic inflammatory disease of the joints, characterized by loss of connective tissue and mineralized structures, the so-called "synovial membrane." Periodontitis is the inflammatory destruction of the periodontal attachment and alveolar bone. While the etiology of these two diseases may differ, the underlying pathogenic mechanisms are similar. And it is possible that individuals manifesting both PD and RA may suffer from a unifying underlying systemic deregulation of the inflammatory response. There is an overproduction of a variety of cytokines and MMPs that appears to be common in both diseases. Oral health parameters should be more closely monitored in patients with RA, an autoimmune disease. Data suggest that periodontal therapies combined with routine RA treatments further improve RA status. Interventions to prevent, minimize or treat periodontitis in arthritis patients will definitely promise a better quality of life for these patients.

  19. Cardiac involvement in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    V. De Gennaro Colonna

    2011-06-01

    Full Text Available Rheumatoid arthritis (RA is a systemic disease of unknown etiology characterized by a chronic inflammatory process mainly leading to destruction of synovial membrane of small and major diarthrodial joints. The prevalence of RA within the general adult population is about 1% and female subjects in fertile age result mostly involved. It’s an invalidating disease, associated with changes in life quality and a reduced life expectancy. Moreover, we can observe an increased mortality rate in this population early after the onset of the disease. The mortality excess can be partially due to infective, gastrointestinal, renal or pulmonary complications and malignancy (mainly lung cancer and non- Hodgkin lymphoma. Among extra-articular complications, cardiovascular (CV involvement represents one of the leading causes of morbidity and mortality. Every cardiac structure can be affected by different pathogenic pathways: heart valves, conduction system, myocardium, endocardium, pericardium and coronary arteries. Consequently, different clinical manifestations can be detected, including: pericarditis, myocarditis, myocardial fibrosis, arrhythmias, alterations of conduction system, coronaropathies and ischemic cardiopathy, valvular disease, pulmonary hypertension and heart failure. Considering that early cardiac involvement negatively affects the prognosis, it is mandatory to identify high CV risk RA patients to better define long-term management of this population.

  20. Gender differences in functional limitations among Canadians with arthritis: the role of disease duration and comorbidity.

    Science.gov (United States)

    Omariba, D Walter Rasugu

    2011-12-01

    Mechanisms underlying gender disparities in functional limitations among people with arthritis remain unclear. This study examined gender differences in the relationship between disease duration and comorbidity and functional limitations among people with arthritis. Data were from the arthritis component of the 2009 Survey on Living with Chronic Diseases in Canada. People were considered to have functional limitations if they reported that arthritis limits them "a lot" in activities of daily living. Those with no functional limitations were the reference group. Gender-stratified weighted multivariate binary logistic regression analyses were conducted. In a fully adjusted multivariate analysis, only among women was time elapsed since the arthritis diagnosis associated with functional limitations. Disabling and life-threatening chronic conditions were associated with functional limitations in both genders. Among men, obesity and low household income were associated with higher odds of functional limitations, while living in British Columbia was associated with decreased odds. For women, smoking, not engaging in physical activity, residing in a non-Atlantic province, and having excess weight increased the odds of functional limitations, while habitual alcohol drinking decreased the odds. Gender differences in the risks of reporting functional limitations were significant. These differences appear to be driven by duration of having arthritis, and disparities in health behavioural factors, household income and region of residence. The association between chronic conditions and functional limitations was similar for men and women.

  1. [Sport and rheumatoid arthritis].

    Science.gov (United States)

    Proschek, D; Rehart, S

    2014-06-01

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

  2. 慢性痛风性关节炎患者健康相关生命质量及影响因素分析%Health-related quality of life and influencing factors in patients with chronic gouty arthritis

    Institute of Scientific and Technical Information of China (English)

    包可久; 刘颖; 周丽娜; 陈兵

    2016-01-01

    Objective To analyze the health-related quality of life (HRQOL) in patients with chronic gouty arthritis (CGA), and to study the influencing factors of HRQOL. Methods A total of 157 patients with CGA who were treated in Departments of Endocrinology of Southwest Hospital, Third Military Medical University from June 2012 to June 2015 were selected as research subjects. Self-rating Depression Scale (SDS) was used to assess degree of depression in patients with CGA, and 36-Item Short Form Health Survey (SF-36) was applied to assess the HRQOL of these patients. One-way ANOVA and stepwise regression analysis were used to study the influence factors of HRQOL. Results SDS scores showed that there were 82 patients with depressive symptoms (52.3%), including 54 (34.4%) patients of mild depression, 18 patients (11.5%) of moderate depression, 10 patients (6.4%) of severe depres-sion. Stepwise regression analysis showed that SDS score, age, sex, treatment, physical exercise, health insurance, alco-hol consumption, diet control and sleep quality influenced the HRQOL scores of patients, and treatment, diet control, physical exercise, SDS score and age were the main influencing factors, with the unstandardized coefficients of 17.14, 16.33, 15.75,-14.24,-13.96. Conclusion Most of patients with CGA suffer from depressive symptoms, and the HRQOL scores of them is not optimistic. More attention must be paid to the elderly and male patients. Diet control, quit-ting drinking, receiving treatment, psychological treatment, strengthen exercise, improving sleep quality and expanding the scope of medical insurance all can improve patients' quality of life.%目的 调查慢性痛风性关节炎(CGA)患者健康相关生命质量(HRQOL),并探讨其影响因素.方法 选取2012年6月至2015年6月第三军医大学西南医院内分泌科收治的157例CGA患者进行调查,使用抑郁自评量表(SDS)评估CGA患者抑郁状况,使用简明健康调查问卷(SF-36)测量患者的HRQOL

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

    OpenAIRE

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

    2016-01-01

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

  4. Children, Sports, and Chronic Disease.

    Science.gov (United States)

    Goldberg, Barry

    1990-01-01

    Discusses four chronic diseases (cystic fibrosis, congenital heart disease, rheumatoid arthritis, and asthma) that affect American children. Many have their physical activities unnecessarily restricted, though sports and exercise can actually alleviate symptoms and improve their psychosocial development. Physicians are encouraged to prescribe…

  5. Pandigital and subcutaneous chronic tophaceous gout with acute renal failure

    Directory of Open Access Journals (Sweden)

    J Shashibhushan

    2015-01-01

    Full Text Available Gout (Podagra is a disorder of purine metabolism characterized by the deposition of monosodium urate crystals in joints and connective tissue and risk of deposition in kidney interstitium. Although acute gouty arthritis is familiar for most physicians, chronic gouty arthritis, which affects small joints of the hands can be difficult to distinguish from other common interphalangeal arthropathies such as rheumatoid arthritis (RA, psoriatic arthritis, and erosive osteoarthritis because of very similar presentations. Here we describe a 60-year-old male diabetic patient with pandigital, extensive subcutaneous tophaceous gout presented with uremic encephalopathy and joint deformities. He had been treated mistakenly as RA for 10 years.

  6. Rheumatoid arthritis is an autoimmune disease caused by periodontal pathogens

    Directory of Open Access Journals (Sweden)

    Ogrendik M

    2013-05-01

    Full Text Available Mesut OgrendikDivision of Physical Therapy and Rheumatology, Nazilli State Hospital, Nazilli, TurkeyAbstract: A statistically significant association between periodontal disease (PD and systemic diseases has been identified. Rheumatoid arthritis (RA, which is a chronic inflammatory joint disease, exhibits similar characteristics and pathogenesis to PD. The association between RA and PD has been investigated, and numerous publications on this subject exist. Approximately 20 bacterial species have been identified as periodontal pathogens, and these organisms are linked to various types of PD. The most analyzed species of periodontopathic bacteria are Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, and Aggregatibacter actinomycetemcomitans. Antibodies and DNA from these oral pathogens have been isolated from the sera and synovial fluids of RA patients. This rapid communication describes the role of periodontal pathogens in the etiopathogenesis of RA.Keywords: etiopathogenesis, chronic arthritis, periodontitis, Porphyromonas gingivalis, systemic disease, animal models, antibiotics

  7. Deficiências após a alta medicamentosa da hanseníase: prevalência e distribuição espacial Deficiencias posteriores a alta medicamentosa de hanseniasis: prevalencia y distribución espacial Leprosy-related disabilities after release from multidrug treatment: prevalence and spatial distribution

    Directory of Open Access Journals (Sweden)

    Susilene Maria Tonelli Nardi

    2012-12-01

    -OMS y por el EHF alcanzaron 32% de los ex -pacientes La presencia de deficiencias fue mayor con el aumento de la edad (p=0,029, en casos multibacilares (p=0,005 y con diagnóstico equivocado del paciente sobre su salud física (p?0,001. Los que necesitaban de prevención/rehabilitación recorrieron distancia promedio de 5,5km hasta el servicio de rehabilitación. Las personas con deficiencia física estaban distribuidas en todo el municipio, pero se concentraban en el área más populosa y de mayor carencia socioeconómica. CONCLUSIONES: La frecuencia de deficiencias es elevada posterior al alta medicamentosa. Los ex -pacientes más viejos, los que tuvieron formas multibacilares de la enfermedad, los de baja escolaridad y los que presentaron diagnóstico equivocado de la propia salud física merecen atención especial para la prevención y rehabilitación de deficiencias. La distancia entre los servicios de rehabilitación y las residencias de los pacientes requiere reorganización de la red de atención en el municipio.OBJECTIVE: To estimate the frequency of people with leprosy-related physical disabilities after release from multidrug treatment and to analyze their spatial distribution. METHODS: Descriptive cross-sectional study with 232 leprosy patients treated between 1998 and 2006. Physical disabilities were assessed using the World Health Organization disability grading and the eye-hand-foot (EHF sum score. The residential address of patients and rehabilitation centers were geocoded. It was estimated the overall frequency of physical disability and frequency by disability grade (grade 0, grade 1, and grade 2 according to the WHO disability grading taking into consideration clinical and sociodemographic variables in the descriptive analysis. Student's t-test, chi-square test (χ2, and Fisher's test were used as appropriate at a 5% significance level. RESULTS: Of the patients studied, 51.6% were female, mean age 54 years old (SD 15.7, 30.5% had less than 2 years of

  8. Septic arthritis in adult horses.

    Science.gov (United States)

    Carstanjen, B; Boehart, S; Cislakova, M

    2010-01-01

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

  9. 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

  10. Rheumatoid Arthritis Educational Video Series

    Medline Plus

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

  11. Management of rheumatoid arthritis: Impact and risks of various therapeutic approaches

    OpenAIRE

    NEGREI, CAROLINA; BOJINCA, VIOLETA; Balanescu, Andra; BOJINCA, MIHAI; BACONI, DANIELA; SPANDIDOS, DEMETRIOS A.; Tsatsakis, Aristidis M; Stan, Miriana

    2016-01-01

    Rheumatic diseases are highly prevalent chronic disorders and the leading cause of physical disability worldwide, with a marked socio-economic impact. Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease of unknown etiology with an autoimmune pathogenesis, characterised by arthropathy with chronic, deforming, destructive evolution and multiple systemic manifestations. The management of RA has undergone significant changes as far as objectives and approaches are concerned, endi...

  12. Evaluation of the Arthritis Foundation's Camine Con Gusto Program for Hispanic Adults With Arthritis.

    Science.gov (United States)

    Callahan, Leigh F; Rivadeneira, Alfredo; Altpeter, Mary; Vilen, Leigha; Cleveland, Rebecca J; Sepulveda, Victoria E; Hackney, Betsy; Reuland, Daniel S; Rojas, Claudia

    2016-09-01

    Camine Con Gusto (CCG) is the Hispanic version of an evidence-based walking program for people with arthritis. This study examined CCG outcomes, feasibility, tolerability, safety, and acceptability and potential tailoring. A pre and post 6-week evaluation was conducted in Hispanic people with arthritis. Outcomes included pain, stiffness, fatigue, functional capacity, helplessness, and self-efficacy. A formative evaluation with program participants and key stakeholders explored program tailoring. Participants' mean age was 46.9 years, 44.4% had a high school degree or less, 2.5% were born in United States, 60.1% spoke only Spanish, and 74.7% were female. Moderate effect sizes were found: 0.50 for pain, 0.75 for fatigue, 0.49 for stiffness, 0.33 for function, 0.26 for helplessness, and 0.24 for self-efficacy. There were 285 participants recruited with an 82% 6-week retention (feasibility), no adverse events were reported (safety), and 98% reported program satisfaction (acceptability). Recommended adaptations included simpler language, more pictures and content addressing nutrition and chronic conditions, shortened materials, and inclusion of motivational strategies. CCG showed improvement in outcomes in Hispanic individuals comparable to those noted in non-Hispanic White and Black individuals with arthritis. © The Author(s) 2016.

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

    Science.gov (United States)

    Havemose-Poulsen, Anne; Westergaard, Jytte; Stoltze, Kaj; Skjødt, Henrik; Danneskiold-Samsøe, Bente; Locht, Henning; Bendtzen, Klaus; Holmstrup, Palle

    2006-02-01

    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. The study population consisted of white adults (rheumatoid factors (RFs), and antibodies to cyclic citrullinated peptides. RA patients had a higher percentage of sites with PD>or=4 mm, CAL>or=2 mm, and ABL>or=2 mm compared to controls. The percentage of sites with CAL>or=2 mm significantly correlated with the levels of IgM-RF and IgA-RF. Missing teeth in JIA and RA patients were not lost due to periodontitis. Patients with GAgP showed higher levels of leukocytes, including neutrophils, and CRP compared to controls. In part, JIA and RA patients showed similar results. Young adults with RA may develop periodontal destruction, and these patients require professional attention. Both differences and similarities in periodontal and hematological variables were seen in individuals with periodontitis, JIA, and RA.

  14. 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.

  15. Rheumatoid arthritis – an update for general dental practitioners

    OpenAIRE

    de Souza, Savia; Bansal, Rupinder k.; Galloway, James

    2016-01-01

    Rheumatoid arthritis (RA) is a common chronic inflammatory autoimmune disorder which significantly impacts patients’ lives and can lead to permanent disability. Inflammation in RA not only affects joints; but can affect organs including the heart and lungs. Early diagnosis, initiation of intensive drug therapy, and a multidisciplinary care approach have vastly improved the long-term prognosis for those living with the condition. However, RA patients often present with co-morbidities which add...

  16. Management of rheumatoid arthritis during pregnancy: challenges and solutions

    OpenAIRE

    Krause ML; Makol A

    2016-01-01

    Megan L Krause, Ashima Makol Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, MN, USA Abstract: Rheumatoid arthritis, a chronic inflammatory autoimmune disease with significant physical disability, affects women three times more frequently than men, often in their childbearing years. Parenthood decisions can be challenging, often affected by perceptions of their disease state, health care needs, and complex pharmacological treatments. Many women struggle to find adequa...

  17. Rheumatoid arthritis is an autoimmune disease caused by periodontal pathogens

    OpenAIRE

    2013-01-01

    Mesut OgrendikDivision of Physical Therapy and Rheumatology, Nazilli State Hospital, Nazilli, TurkeyAbstract: A statistically significant association between periodontal disease (PD) and systemic diseases has been identified. Rheumatoid arthritis (RA), which is a chronic inflammatory joint disease, exhibits similar characteristics and pathogenesis to PD. The association between RA and PD has been investigated, and numerous publications on this subject exist. Approximately 20 bacterial species...

  18. Psoriatic arthritis: latest treatments and their place in therapy

    OpenAIRE

    Kang, Eun Jin; Kavanaugh, Arthur

    2015-01-01

    Psoriatic arthritis (PsA) is a heterogeneous chronic inflammatory disease that may affect peripheral and axial joints, entheses, skin and nails, and other organs. Treatment with nonsteroidal anti-inflammatory drugs, steroid and disease-modifying antirheumatic drugs had been the backbone of traditional management of PsA for many years. However, improvement in our understanding of immunopathogenesis of PsA has led to new immunomodulatory therapies. Introduction of novel agents has raised the ba...

  19. Overinfection by Paracoccidioides brasiliensis in Gouty Crystal Arthritis

    Directory of Open Access Journals (Sweden)

    F. Bonilla-Abadía

    2012-01-01

    Full Text Available Paracoccidioidomycosis is an endemic South American systemic mycosis caused by the dimorphic fungus Paracoccidioides brasiliensis (P. brasiliensis. The main clinical form of disease is pulmonary, but all organs may be involved. We report a case of overinfection by P. brasiliensis in chronic gouty arthritis affecting the proximal phalanx of the right hallux. The patient required proximal amputation and long-term antifungal therapy.

  20. Local administration of glucocorticoids decreases synovial citrullination in rheumatoid arthritis

    OpenAIRE

    2012-01-01

    Introduction Protein citrullination is present in the rheumatoid synovium, presumably contributing to the perpetuation of chronic inflammation, in the presence of specific autoimmunity. As a result, the present study examined the possibility that effective antirheumatic treatment will decrease the level of synovial citrullination. Methods Synovial biopsies were obtained from 11 rheumatoid arthritis (RA) patients before and after 8 weeks of treatment with 20 mg methotrexate weekly, 15 RA patie...

  1. Rheumatoid arthritis and the role of oral bacteria

    OpenAIRE

    Loyola-Rodriguez, Juan Pablo; Martinez-Martinez, Rita Elizabeth; Abud-Mendoza, Carlos; Patiño-Marin, Nuria; Gregory J. Seymour

    2010-01-01

    Rheumatoid arthritis (RA) and periodontal disease (PD) have shown similar physiopathologic mechanisms such as chronic inflammation with adjacent bone resorption in an immunogenetically susceptible host; however, PD has a well-recognized bacterial etiology while the cause of RA is unclear. Some reports have indicated that an infectious agent in a susceptible host could be one possible trigger factor for RA, and it has been suggested that oral microorganisms, specialty periodontal bacteria coul...

  2. Hepatitis C Virus-related Arthritis: Bone Scintigraphic Appearances

    Science.gov (United States)

    Aktas, Gul Ege; Sarikaya, Ali; Kandemir, Ozan

    2017-01-01

    A symptomatic joint involvement and arthralgia are frequent in patients with chronic hepatitis C virus (HCV) infection. However, HCV infection-related arthritis (HCVrA) affects up to 4-11% of the subjects suffering from disease. We reported a patient with HCVrA presented with the commonly accepted diagnostic clinical signs and laboratory parameters. The painful joints distinctly demonstrated increased uptake of Tc-99 m methylene diphosphonate in scintigraphy and normal findings in radiography.

  3. Prevalence of acute and chronic viral seropositivity and characteristics of disease in patients with psoriatic arthritis treated with cyclosporine: a post hoc analysis from a sex point of view on the observational study of infectious events in psoriasis complicated by active psoriatic arthritis

    Directory of Open Access Journals (Sweden)

    Colombo D

    2015-12-01

    Full Text Available Delia Colombo,1 Sergio Chimenti,2 Paolo Antonio Grossi,3 Antonio Marchesoni,4 Federico Bardazzi,5 Fabio Ayala,6 Lucia Simoni,7 Donatella Vassellatti,1 Gilberto Bellia1 On behalf of SYNERGY Study Group 1Novartis Farma Italia, Origgio (VA, 2Tor Vergata Polyclinic Rome, 3Macchi Hospital and Foundation, Varese, 4Orthopaedic Institute Pini, Milan, 5S Orsola-Malpighi Polyclinic, Bologna, 6University Federico II Naples, 7MediData srl, Modena, Italy Background: Sex medicine studies have shown that there are sex differences with regard to disease characteristics in immune-mediated inflammatory diseases, including psoriasis, in immune response and susceptibility to viral infections. We performed a post hoc analysis of the Observational Study of infectious events in psoriasis complicated by active psoriatic arthritis (SYNERGY study in patients with psoriatic arthritis (PsA treated with immunosuppressive regimens including cyclosporine, in order to evaluate potential between-sex differences in severity of disease and prevalence of viral infections.Methods: SYNERGY was an observational study conducted in 24 Italian dermatology clinics, which included 238 consecutively enrolled patients with PsA, under treatment with immunosuppressant regimens including cyclosporin A. In this post hoc analysis, patients' demographical data and clinical characteristics of psoriasis, severity and activity of PsA, prevalence of seropositivity for at least one viral infection, and treatments administered for PsA and infections were compared between sexes.Results: A total of 225 patients were evaluated in this post hoc analysis, and 121 (54% were males. Demographic characteristics and concomitant diseases were comparable between sexes. Statistically significant sex differences were observed at baseline in Psoriasis Area and Severity Index score (higher in males, mean number of painful joints, Bath Ankylosing Spondylitis Disease Activity Index, and the global activity of disease

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

    Directory of Open Access Journals (Sweden)

    Atkinson Mark A

    2011-02-01

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

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  6. The Role of Health Literacy and Social Networks in Arthritis Patients' Health Information-Seeking Behavior: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Janette Ellis

    2012-01-01

    Full Text Available Background. Patients engage in health information-seeking behaviour to maintain their wellbeing and to manage chronic diseases such as arthritis. Health literacy allows patients to understand available treatments and to critically appraise information they obtain from a wide range of sources. Aims. To explore how arthritis patients' health literacy affects engagement in arthritis-focused health information-seeking behaviour and the selection of sources of health information available through their informal social network. Methods. An exploratory, qualitative study consisting of one-on-one semi-structured interviews. Twenty participants with arthritis were recruited from community organizations. The interviews were designed to elicit participants' understanding about their arthritis and arthritis medication and to determine how the participants' health literacy informed selection of where they found information about their arthritis and pain medication. Results. Participants with low health literacy were less likely to be engaged with health information-seeking behaviour. Participants with intermediate health literacy were more likely to source arthritis-focused health information from newspapers, television, and within their informal social network. Those with high health literacy sourced information from the internet and specialist health sources and were providers of information within their informal social network. Conclusion. Health professionals need to be aware that levels of engagement in health information-seeking behaviour and sources of arthritis-focused health information may be related to their patients' health literacy.

  7. The role of health literacy and social networks in arthritis patients' health information-seeking behavior: a qualitative study.

    Science.gov (United States)

    Ellis, Janette; Mullan, Judy; Worsley, Anthony; Pai, Nagesh

    2012-01-01

    Background. Patients engage in health information-seeking behaviour to maintain their wellbeing and to manage chronic diseases such as arthritis. Health literacy allows patients to understand available treatments and to critically appraise information they obtain from a wide range of sources. Aims. To explore how arthritis patients' health literacy affects engagement in arthritis-focused health information-seeking behaviour and the selection of sources of health information available through their informal social network. Methods. An exploratory, qualitative study consisting of one-on-one semi-structured interviews. Twenty participants with arthritis were recruited from community organizations. The interviews were designed to elicit participants' understanding about their arthritis and arthritis medication and to determine how the participants' health literacy informed selection of where they found information about their arthritis and pain medication. Results. Participants with low health literacy were less likely to be engaged with health information-seeking behaviour. Participants with intermediate health literacy were more likely to source arthritis-focused health information from newspapers, television, and within their informal social network. Those with high health literacy sourced information from the internet and specialist health sources and were providers of information within their informal social network. Conclusion. Health professionals need to be aware that levels of engagement in health information-seeking behaviour and sources of arthritis-focused health information may be related to their patients' health literacy.

  8. Bone pathology inpsoriatic arthritis

    Directory of Open Access Journals (Sweden)

    V. V. Badokin

    2007-01-01

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

  9. Prevalence of acute and chronic viral seropositivity and characteristics of disease in patients with psoriatic arthritis treated with cyclosporine: a post hoc analysis from a sex point of view on the observational study of infectious events in psoriasis complicated by active psoriatic arthritis

    Science.gov (United States)

    Colombo, Delia; Chimenti, Sergio; Grossi, Paolo Antonio; Marchesoni, Antonio; Bardazzi, Federico; Ayala, Fabio; Simoni, Lucia; Vassellatti, Donatella; Bellia, Gilberto

    2016-01-01

    Background Sex medicine studies have shown that there are sex differences with regard to disease characteristics in immune-mediated inflammatory diseases, including psoriasis, in immune response and susceptibility to viral infections. We performed a post hoc analysis of the Observational Study of infectious events in psoriasis complicated by active psoriatic arthritis (SYNERGY) study in patients with psoriatic arthritis (PsA) treated with immunosuppressive regimens including cyclosporine, in order to evaluate potential between-sex differences in severity of disease and prevalence of viral infections. Methods SYNERGY was an observational study conducted in 24 Italian dermatology clinics, which included 238 consecutively enrolled patients with PsA, under treatment with immunosuppressant regimens including cyclosporin A. In this post hoc analysis, patients’ demographical data and clinical characteristics of psoriasis, severity and activity of PsA, prevalence of seropositivity for at least one viral infection, and treatments administered for PsA and infections were compared between sexes. Results A total of 225 patients were evaluated in this post hoc analysis, and 121 (54%) were males. Demographic characteristics and concomitant diseases were comparable between sexes. Statistically significant sex differences were observed at baseline in Psoriasis Area and Severity Index score (higher in males), mean number of painful joints, Bath Ankylosing Spondylitis Disease Activity Index, and the global activity of disease assessed by patients (all higher in females). The percentage of patients with at least one seropositivity detected at baseline, indicative of concomitant or former viral infection, was significantly higher among women than among men. No between-sex differences were detected in other measures, at other time points, and in treatments. Patients developed no hepatitis B virus or hepatitis C virus reactivation during cyclosporine treatment. Conclusion Our post hoc

  10. Fungal arthritis and osteomyelitis.

    Science.gov (United States)

    Kohli, Rakhi; Hadley, Susan

    2005-12-01

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

  11. Prevalence of anemia in chronic obstructive pulmonary disease: Comparison to other chronic diseases

    National Research Council Canada - National Science Library

    John, Matthias; Lange, Andre; Hoernig, Soeren; Witt, Christian; Anker, Stefan D

    2006-01-01

    ... in better definition of prognosis but could also potentially provide opportunities for novel therapeutic strategies in these patients. Although anemia is a well-recognized comorbidity in a variety of conditions commonly associated with chronic illnesses such as heart failure, inflammatory diseases (like rheumatoid arthritis), chronic infectious disorde...

  12. Rheumatoid arthritis: a review and dental care considerations.

    Science.gov (United States)

    Grover, H S; Gaba, N; Gupta, A; Marya, C M

    2011-06-01

    Rheumatoid arthritis (RA), is a chronic multisystem disease of presumed autoimmune etiology. Medical complications due to RA and its treatment may affect the provision of oral health care. Associated syndromes may contribute to a patient's susceptibility to infections and impaired hemostasis. Therefore oral health care providers need to recognize and identify modificationsof dental care based on the medical status of patients with RA. As with many other chronic conditions, early intervention can reduce the severity of the disease. Furthermore, oral health care providers play an important role in the overall care of these patients as it relates to early recognition, as well as control of the disease.

  13. Arterial stiffness is not increased in patients with short duration rheumatoid arthritis and ankylosing spondylitis.

    Science.gov (United States)

    Dzieża-Grudnik, Anna; Sulicka, Joanna; Strach, Magdalena; Siga, Olga; Klimek, Ewa; Korkosz, Mariusz; Grodzicki, Tomasz

    2017-04-01

    Patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) have increased cardiovascular (CV) morbidity and mortality. Arterial stiffness is an independent predictor of CV events. The aim of the study was to assess arterial stiffness and inflammatory markers in patients with short duration chronic arthritis. We assessed carotid-femoral pulse wave velocity (PWV), augmentation index (AIx), traditional CV risk factors and inflammatory and endothelial markers in 71 chronic arthritis patients (RA and AS) and in 29 healthy controls. We did not find differences in PWV (for RA, AS and controls, respectively: 10 [8.8-10.9] versus 10.7 [9.1-11.8] versus 9.2 [8.3-11.4] m/s; p = .14) and AIx (for RA, AS and controls, respectively: 24.3 ± 11.5 versus 5.7 ± 12.4 versus 10 ± 12.8%; p = .22). Both groups of arthritis patients had active disease with significantly elevated inflammatory markers compared to controls. There were no correlations between endothelial and inflammatory markers and parameters of arterial stiffness in arthritis patients. When analyzing arthritis patients according to median of PVW, there were no significant differences in inflammatory and endothelial markers. We found that in patients with short duration active RA and AS arterial stiffness was not increased and furthermore, there was no association between markers of systemic inflammation and arterial stiffness.

  14. The effect of resveratrol on the recurrent attacks of gouty arthritis.

    Science.gov (United States)

    Chen, Haiyan; Zheng, Shucong; Wang, Yuankai; Zhu, Huiqing; Liu, Qiong; Xue, Yu; Qiu, Jianhua; Zou, Hejian; Zhu, Xiaoxia

    2016-05-01

    Gouty arthritis is characterized by inflammation induced by monosodium urate (MSU) crystal deposition, which is resulted by an increase of serum urate concentration. The management of gout, especially the recurrent acute attacks of chronic gouty arthritis, is still a problem to be resolved. In this study, we aimed to develop the preventive and therapeutic effect of resveratrol on gouty arthritis. MSU was used to induce gouty arthritis in the foot pad of C57BL/6 mice. Yeast polysaccharide and potassium oxonate were used to induce hyperuricemia in Kunming mice. Resveratrol was intraperitoneal injected to the mice in the treatment group. The pad inflammation and the level of serum uric acid were investigated to estimate the effect of resveratrol in gouty arthritis. Hyperuricemia was significantly detected in the mice treated with yeast polysaccharide and potassium oxonate, and gouty arthritis was successfully induced with MSU in mice. We further identified that resveratrol inhibited pad swelling and pad 99mTc uptake in gouty mice. Moreover, serum uric acid level was also decreased by resveratrol in hyperuricemia mice. This study highlighted that resveratrol might be applied to prevent the recurrent acute attack of gouty arthritis because of its inhibition of articular inflammation and down-regulation of serum uric acid.

  15. Cost of arthritis: a systematic review of methodologies used for direct costs.

    Science.gov (United States)

    Lo, T K T; Parkinson, Lynne; Cunich, Michelle; Byles, Julie

    2016-01-01

    A substantial amount of healthcare and costs are attributable to arthritis, which is a very common chronic disease. This paper presents the results of a systematic review of arthritis cost studies published from 2008 to 2013. MEDLINE, Embase, EconLit databases were searched, as well as governmental and nongovernmental organization websites. Seventy-one reports met the inclusion/exclusion criteria, and 24 studies were included in the review. Among these studies, common methods included the use of individual-level data, bottom-up costing approach, use of both an arthritis group and a control group to enable incremental cost computation of the disease, and use of regression methods such as generalized linear models and ordinary least squares regression to control for confounding variables. Estimates of the healthcare cost of arthritis varied considerably across the studies depending on the study methods, the form of arthritis and the population studied. In the USA, for example, the estimated healthcare cost of arthritis ranged from $1862 to $14,021 per person, per year. The reviewed study methods have strengths, weaknesses and potential improvements in relation to estimating the cost of disease, which are outlined in this paper. Caution must be exercised when these methods are applied to cost estimation and monitoring of the economic burden of arthritis.

  16. Self-Management Education Participation Among US Adults With Arthritis: Who's Attending?

    Science.gov (United States)

    Murphy, Louise B; Brady, Teresa J; Boring, Michael A; Theis, Kristina A; Barbour, Kamil E; Qin, Jin; Helmick, Charles G

    2017-09-01

    Self-management education (SME) programs teach people with chronic conditions skills to manage their health conditions. We examined patterns in SME program participation among US adults with arthritis ages ≥18 years. Respondents with arthritis were those who reported ever being diagnosed with arthritis by a doctor or health care provider. We analyzed 2014 National Health Interview Survey data to estimate the percentage (unadjusted and age-standardized) who ever attended an SME program overall and for selected subgroups, representativeness of SME participants relative to all adults with arthritis, and trends in SME course participation. In 2014, 1 in 9 US adults with arthritis (11.3% [95% confidence interval (95% CI) 10.4-12.3]; age-standardized 11.4% [95% CI 10.0-12.9]) had ever participated in an SME program. SME participation (age-standardized) was highest among those with ≥8 health care provider visits in the past 12 months (16.0% [95% CI 13.1-19.4]). Since 2002, the number of adults with arthritis who have ever participated in SME has increased by 1.7 million, but the percentage has remained constant. Despite its many benefits, SME participation among US adults with arthritis remains persistently low. By recommending that their patients attend SME programs, health care providers can increase the likelihood that their patients experience SME program benefits. © 2016, American College of Rheumatology.

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

    Science.gov (United States)

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

    2017-04-01

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

  18. Serotonin Is Involved in Autoimmune Arthritis through Th17 Immunity and Bone Resorption.

    Science.gov (United States)

    Chabbi-Achengli, Yasmine; Coman, Tereza; Collet, Corinne; Callebert, Jacques; Corcelli, Michelangelo; Lin, Hilène; Rignault, Rachel; Dy, Michel; de Vernejoul, Marie-Christine; Côté, Francine

    2016-04-01

    Rheumatoid arthritis is a chronic disease that results in a disabling and painful condition as it progresses to destruction of the articular cartilage and ankylosis of the joints. Although the cause of the disease is still unknown, evidence argues that autoimmunity plays an important part. There are increasing but contradictory views regarding serotonin being associated with activation of immunoinflammatory pathways and the onset of autoimmune reactions. We studied serotonin's involvement during collagen-induced arthritis in wild-type and Tph1(-/-) mice, which have markedly reduced peripheral serotonin levels. In wild-type mice, induction of arthritis triggered a robust increase in serotonin content in the paws combined with less inflammation. In Tph1(-/-) mice with arthritis, a marked increase in the clinical and pathologic arthritis scores was noticed. Specifically, in Tph1(-/-) mice with arthritis, a significant increase in osteoclast differentiation and bone resorption was observed with an increase in IL-17 levels in the paws and in Th17 lymphocytes in the draining lymph nodes, whereas T-regulatory cells were dampened. Ex vivo serotonin and agonists of the 5-HT2A and 5-HT2B receptors restored IL-17 secretion from splenocytes and Th17 cell differentiation in Tph1(-/-) mice. These findings indicate that serotonin plays a fundamental role in arthritis through the regulation of the Th17/T-regulatory cell balance and osteoclastogenesis.

  19. Kidney involvement in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    P. Lazzarini

    2011-09-01

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

  20. Immunological markers of rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Agnieszka Matuszewska

    2016-03-01

    Full Text Available Rheumatoid arthritis (RA is the most common connective tissue disease of autoimmune origin. The disease is characterized by chronic inflammation leading to bone erosions and organ involvement. RA is a progressive disease. It affects the quality of life, leading to disability and death mainly due to premature cardiovascular disease. Early diagnosis and appropriate treatment are essential for prognosis and quality of life improvement. In 2010 the American College of Rheumatology (ACR and The European League Against Rheumatism (EULAR established new RA classification criteria. Besides clinical symptoms it includes two immunologic criteria: rheumatoid factor (RF and anti-citrullinated protein antibodies (anti-CCP antibodies. RF is the first well-known RA immunologic marker. It is observed in 80-85% of patients with RA. Elevated serum level of RF has been associated with increased disease activity, radiographic progression, and the presence of extraarticular manifestations. The sensitivity of RF is 50-90%, and specificity is 50-95%. Anti-CCP antibodies appear to be a more specific marker than RF. They are often present at the very beginning of the disease, or even years before the first symptoms. The prognostic value of anti-CCP antibodies is well established. High serum level of anti-CCP correlates with poor prognosis and early erosions of the joints. The sensitivity of anti-CCP2 is 48-80%, and specificity is 96-98%. New immunologic markers include anti-carbamylated protein antibodies (anti-CarP and antibodies against heterogeneous nuclear ribonucleoproteins (anti-hnRNP A2/B1, RA33. Scientists aim to identify a highly sensitive and specific biomarker of the disease that not only has diagnostic and prognostic value but also may predict the response to treatment.

  1. [Immunological markers of rheumatoid arthritis].

    Science.gov (United States)

    Matuszewska, Agnieszka; Madej, Marta; Wiland, Piotr

    2016-03-25

    Rheumatoid arthritis (RA) is the most common connective tissue disease of autoimmune origin. The disease is characterized by chronic inflammation leading to bone erosions and organ involvement. RA is a progressive disease. It affects the quality of life, leading to disability and death mainly due to premature cardiovascular disease. Early diagnosis and appropriate treatment are essential for prognosis and quality of life improvement. In 2010 the American College of Rheumatology (ACR) and The European League Against Rheumatism (EULAR) established new RA classification criteria. Besides clinical symptoms it includes two immunologic criteria: rheumatoid factor (RF) and anti-citrullinated protein antibodies (anti-CCP antibodies). RF is the first well-known RA immunologic marker. It is observed in 80-85% of patients with RA. Elevated serum level of RF has been associated with increased disease activity, radiographic progression, and the presence of extraarticular manifestations. The sensitivity of RF is 50-90%, and specificity is 50-95%. Anti-CCP antibodies appear to be a more specific marker than RF. They are often present at the very beginning of the disease, or even years before the first symptoms. The prognostic value of anti-CCP antibodies is well established. High serum level of anti-CCP correlates with poor prognosis and early erosions of the joints. The sensitivity of anti-CCP2 is 48-80%, and specificity is 96-98%. New immunologic markers include anti-carbamylated protein antibodies (anti-CarP) and antibodies against heterogeneous nuclear ribonucleoproteins (anti-hnRNP A2/B1, RA33). Scientists aim to identify a highly sensitive and specific biomarker of the disease that not only has diagnostic and prognostic value but also may predict the response to treatment.

  2. Immunological markers of rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Agnieszka Matuszewska

    2016-03-01

    Full Text Available Rheumatoid arthritis (RA is the most common connective tissue disease of autoimmune origin. The disease is characterized by chronic inflammation leading to bone erosions and organ involvement. RA is a progressive disease. It affects the quality of life, leading to disability and death mainly due to premature cardiovascular disease. Early diagnosis and appropriate treatment are essential for prognosis and quality of life improvement.In 2010 the American College of Rheumatology (ACR and The European League Against Rheumatism (EULAR established new RA classification criteria. Besides clinical symptoms it includes two immunologic criteria: rheumatoid factor (RF and anti-citrullinated protein antibodies (anti-CCP antibodies. RF is the first well-known RA immunologic marker. It is observed in 80-85% of patients with RA. Elevated serum level of RF has been associated with increased disease activity, radiographic progression, and the presence of extraarticular manifestations. The sensitivity of RF is 50-90%, and specificity is 50-95%. Anti-CCP antibodies appear to be a more specific marker than RF. They are often present at the very beginning of the disease, or even years before the first symptoms. The prognostic value of anti-CCP antibodies is well established. High serum level of anti-CCP correlates with poor prognosis and early erosions of the joints. The sensitivity of anti-CCP2 is 48-80%, and specificity is 96-98%.New immunologic markers include anti-carbamylated protein antibodies (anti-CarP and antibodies against heterogeneous nuclear ribonucleoproteins (anti-hnRNP A2/B1, RA33. Scientists aim to identify a highly sensitive and specific biomarker of the disease that not only has diagnostic and prognostic value but also may predict the response to treatment.

  3. Tumour necrosis factor-alpha antagonists in the management of rheumatoid arthritis in the elderly: a review of their efficacy and safety.

    NARCIS (Netherlands)

    Radovits, B.J.; Kievit, W.; Laan, R.F.J.M.

    2009-01-01

    Rheumatoid arthritis (RA) is a chronic inflammatory disease that frequently affects people aged >or=65 years, causing significant impairment with pain and functional disability. Elderly RA patients have specific problems, including co-morbid diseases, numerous concomitant medications, greater num

  4. Efficacy of cyclo-oxygenase-2 inhibition by etoricoxib and naproxen on the axial manifestations of ankylosing spondylitis in the presence of peripheral arthritis

    OpenAIRE

    Gossec, L; van der Heijde, D.; Melian, A; Krupa, D.; James, M.; Cavanaugh, P; Reicin, A; Dougados, M.

    2005-01-01

    Objective: The combined efficacy of selective and non-selective cyclo-oxygenase-2 (COX-2) inhibition on the axial manifestations of ankylosing spondylitis (AS) in the presence or absence of chronic peripheral arthritis was evaluated.

  5. Radiological aspects of rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Schacherl, M.

    1985-09-23

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

  6. Interstitial lung involvement in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    David Vladimirovich Bestaev

    2014-01-01

    Full Text Available Rheumatoid arthritis (RA is a systemic autoimmune rheumatic disease of unknown etiology, characterized by chronic erosive arthritis and extraarticular manifestations. Pulmonary involvement is one of the common extraarticular manifestations of RA and may show itself as bronchial tree lesions, rheumatoid nodules, Caplan's syndrome, and lesions in the pleura or pulmonary interstitium (interstitial lung involvement (ILI. High-resolution computed tomography allows the diagnosis of ILI in RA in nearly 70% of cases although the incidence of ILI may be lower (4 to 30% depending on diagnostic methods and patient selection criteria. There are several histopathological types of ILI, the differential diagnosis of which can be troublesome. Usual interstitial pneumonia (UIP and nonspecific interstitial pneumonia are major types of RA-associated ILI. UIP-pattern ILI has a more severe course than ILI with other histological patterns. The clinical presentation of ILI may be complicated by the likely toxic effect of a number of disease-modifying antirheumatic drugs (DMARDs used to treat RA, such as methotrexate and leflunomide, and biological agents (BAs, tumor necrosis factor-α (TNF-α inhibitors. The pathogenesis of pulmonary involvement in RA and the role of synthetic DMARDs and BAs in the development of ILI call for further investigations.An extraarticular manifestation, such as ILI, affects the choice of treatment policy in patients with RA.The relevance of a study of ILI is beyond question. The paper discusses the state-of-the-art of investigations in this area.

  7. 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.

  8. [Optic neuritis in juvenile idiopathic arthritis patient].

    Science.gov (United States)

    Lourenço, Daniela M R; Buscatti, Izabel M; Lourenço, Benito; Monti, Fernanda C; Paz, José Albino; Silva, Clovis A

    2014-01-01

    Optic neuritis (ON) was rarely reported in juvenile idiopathic arthritis (JIA) patients, particularly in those under anti-tumor necrosis factor alpha blockage. However, to our knowledge, the prevalence of ON in JIA population has not been studied. Therefore, 5,793 patients were followed up at our University Hospital and 630 (11%) had JIA. One patient (0.15%) had ON and was reported herein. A 6-year-old male was diagnosed with extended oligoarticular JIA, and received naproxen and methotrexate subsequently replaced by leflunomide. At 11 years old, he was diagnosed with aseptic meningitis, followed by a partial motor seizure with secondary generalization. Brain magnetic resonance imaging (MRI) and electroencephalogram showed diffuse disorganization of the brain electric activity and leflunomide was suspended. Seven days later, the patient presented acute ocular pain, loss of acuity for color, blurred vision, photophobia, redness and short progressive visual loss in the right eye. A fundoscopic exam detected unilateral papilledema without retinal exudates. Orbital MRI suggested right ON. The anti-aquaporin 4 (anti-AQP4) antibody was negative. Pulse therapy with methylprednisolone was administered for five days, and subsequently with prednisone, he had clinical and laboratory improvement. In conclusion, a low prevalence of ON was observed in our JIA population. The absence of anti-AQP4 antibody and the normal brain MRI do not exclude the possibility of demyelinating disease associated with chronic arthritis. Therefore, rigorous follow up is required.

  9. Managing juvenile idiopathic arthritis-associated uveitis.

    Science.gov (United States)

    Hawkins, Madeleine J; Dick, Andrew D; Lee, Richard J W; Ramanan, Athimalaipet V; Carreño, Ester; Guly, Catherine M; Ross, Adam H

    2016-01-01

    Bilateral chronic anterior uveitis is an extra-articular feature of juvenile idiopathic arthritis. Although figures vary, uveitis occurs in approximately 11%-13% of patients with this disease and is most commonly associated with the female gender, oligoarthritis, and presence of antinuclear antibodies. The disease has an insidious onset and is often asymptomatic. Managing patients with juvenile idiopathic arthritis-associated uveitis remains challenging as the disease may prove to be refractory to traditional treatment regimens. Stepwise immunomodulatory therapy is indicated, with new biologic drugs being used last in cases of refractory uveitis. Small scale studies and practice have provided the evidence to undertake randomized control trials to evaluate the efficacy, safety, and cost-effectiveness of anti-tumor necrosis factor-α therapies, such as infliximab and adalimumab. These have demonstrated promising results, with further data awaited from ongoing trials for adalimumab (as SYCAMORE and ADJUVITE trials). Lower grade evidence is supporting the use of newer biologics such as rituximab, daclizumab, tocilizumab, and abatacept in those cases refractory to anti-tumor necrosis factor-α therapy.

  10. Progressive subretinal fibrosis in patients with rheumatoid arthritis and renal dysfunction.

    Science.gov (United States)

    Matsuo, T; Matsuo, N

    1998-01-01

    We present two patients (56-year-old and 71-year-old women) who developed subretinal fibrosis in parallel with exacerbation of rheumatoid arthritis and deteriorated renal function. The first patient developed subretinal fibrosis in the right eye, coupled with multifocal choroiditis and serous retinal detachment in both eyes, in the course of rapidly progressive glomerulonephritis complicated with rheumatoid arthritis. Antineutrophil cytoplasmic antibody was positive in a perinuclear pattern (pANCA) and the increased dose of prednisolone to 40 mg/day resulted in subsidence of the subretinal inflammation. The second patient developed subretinal fibrosis in the left eye with mottled retinal pigment epithelium of both eyes, in the course of rheumatoid arthritis and stable chronic renal failure. Although the manifestations of subretinal fibrosis and concurrent renal dysfunction were different between these two patients, subretinal fibrosis might be noted as a complication of rheumatoid arthritis and renal dysfunction.

  11. Capillaroscopy in Psoriatic and Rheumatoid Arthritis: A Useful Tool for Differential Diagnosis

    Directory of Open Access Journals (Sweden)

    Dario Graceffa

    2013-01-01

    Full Text Available Impairment of capillaries permeability and changes of microcirculation are associated with inflammatory arthritis. In order to demonstrate microvascular differences between psoriatic arthritis (PsA and rheumatoid arthritis (RA we analyzed capillaroscopic abnormalities such as megacapillaries, haemorrhages, ramifications, and avascular areas in patients affected by these two rheumatic disorders. Moreover to identify specific capillaroscopy patterns we analyzed the following parameters: venous limb diameter, arterial limb diameter, capillary loop diameter, amplitude of the capillary loop, linear density of capillaries (on 2 mm, and number of twisted capillaries (on 4 mm. Through a comparative morphometric analysis of capillaroscopy, our study demonstrated the presence of specific microvascular differences between PsA and RA providing an additional diagnostic tool for the differential diagnosis. We also suggest that capillaries structural abnormalities might reflect endothelial injury due to systemic inflammation during chronic arthritis.

  12. [Presence of riziform bodies in a patient with juvenile idiopathic arthritis: case report and literature review.

    Science.gov (United States)

    Campos, Leonardo Rodrigues; Sztajnbok, Fernanda Cardoso das Neves; Galvão, Stélio; Lessa, Marise de Araújo; Aymoré, Ierecê Lins; Sztajnbok, Flavio

    2014-10-23

    Riziform bodies are structures formed by fibrin and cells that can be found in the synovial fluid or attached to the synovium, and have this denomination due to its rice grain-like appearance. They have already been described in several diseases such as tuberculous arthritis, rheumatoid arthritis, and rarely in juvenile idiopathic arthritis (JIA). This is the case of a boy with a 4-month course of chronic monoarthritis of the left knee, with family history of sarcoidosis in which diagnostic investigation showed the presence of these riziform bodies in the synovial biopsy. Diagnostic investigation ruled out sarcoidosis, tuberculosis and malignancies, establishing the diagnosis of JIA. Our objective was to describe what we believe is the 9th case reported on the presence of riziform bodies in JIA, which are probably underdiagnosed, and should be considered mainly in cases of severe arthritis of difficult medical treatment.

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

    Science.gov (United States)

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

  14. Risk of periodontitis in patients with psoriasis and psoriatic arthritis.

    Science.gov (United States)

    Egeberg, A; Mallbris, L; Gislason, G; Hansen, P R; Mrowietz, U

    2017-02-01

    Psoriasis and periodontitis are chronic inflammatory disorders with overlapping inflammatory pathways, but data on risk of periodontitis in psoriasis are scarce and a possible pathogenic link is poorly understood. We investigated the association between psoriasis and periodontitis in a nationwide cohort study. All Danish individuals aged ≥18 years between 1 January 1997 and 31 December 2011 (n = 5,470,428), including 54 210 and 6988 patients with mild and severe psoriasis, and 6428 with psoriatic arthritis, were linked through administrative registers. Incidence rate ratios (IRRs) were estimated by Poisson regression. Incidence rates of periodontitis per 10 000 person-years were 3.07 (3.03-3.12), 5.89 (1.07-6.84), 8.27 (5.50-12.45) and 11.12 (7.87-15.73) for the reference population, mild psoriasis, severe psoriasis and psoriatic arthritis respectively. Adjusted IRRs were (1.66; 1.43-1.94) for mild psoriasis, (2.24; 1.46-3.44) for severe psoriasis and (3.48; 2.46-4.92) for psoriatic arthritis. Similar results were found when a case-control design was applied. We found a significant psoriasis-associated increased risk of periodontitis, which was highest in patients with severe psoriasis and psoriatic arthritis. © 2016 European Academy of Dermatology and Venereology.

  15. Rheumatoid arthritis and salivary biomarkers of periodontal disease.

    Science.gov (United States)

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

    2010-12-01

    To test the hypothesis that rheumatoid arthritis (RA) influenced levels of salivary biomarkers of periodontal disease. Medical assessments, periodontal examinations and pain ratings were obtained from 35 RA, 35 chronic periodontitis and 35 age- and gender-matched healthy controls in a cross-sectional, case-controlled study. Unstimulated whole saliva samples were analysed for interleukin-1β (IL-1β), matrix metalloproteinase-8 (MMP-8) and tumour necrosis factor-α (TNF-α) concentrations. The arthritis and healthy groups had significantly less oral disease than the periodontitis group (Parthritis group having significantly more sites bleeding on probing (BOP) than matched controls (P=0.012). Salivary levels of MMP-8 and IL-1β were significantly elevated in the periodontal disease group (Parthritis group compared with controls (P=0.002). Arthritis patients receiving anti-TNF-α antibody therapy had significantly lower IL-1β and TNF-α levels compared with arthritis patients not on anti-TNF-α therapy (P=0.016, 0.024) and healthy controls (Pperiodontal inflammation than healthy controls, i.e., an increased BOP. Systemic inflammation appears to influence levels of select salivary biomarkers of periodontal disease, and anti-TNF-α antibody-based disease-modifying therapy significantly lowers salivary IL-1β and TNF-α levels in RA. © 2010 John Wiley & Sons A/S.

  16. Periodontal disease and rheumatoid arthritis: a systematic review.

    Science.gov (United States)

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

    2013-05-01

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

  17. Autoimmune/Inflammatory Arthritis Associated Lymphomas: Who Is at Risk?

    Science.gov (United States)

    Yadlapati, Sujani; Efthimiou, Petros

    2016-01-01

    Specific autoimmune and inflammatory rheumatic diseases have been associated with an increased risk of malignant lymphomas. Conditions such as rheumatoid arthritis (RA), primary Sjögren's syndrome (pSS), systemic lupus erythematosus (SLE), dermatomyositis, and celiac disease have been consistently linked to malignant lymphomas. Isolated cases of lymphomas associated with spondyloarthropathies and autoinflammatory diseases have also been reported. Direct association between autoimmunity and lymphomagenesis has been reinforced by large epidemiological studies. It is still uncertain whether disease specific determinants or phenotypic or treatment related characteristics increase likelihood of lymphomagenesis in these patients. For example, recent literature has indicated a positive correlation between severity of inflammation and risk of lymphomas among RA and Sjögren's syndrome patients. It is also debated whether specific lymphoma variants are more commonly seen in accordance with certain chronic autoimmune arthritis. Previous studies have revealed a higher incidence of diffuse large B-cell lymphomas in RA and SLE patients, whereas pSS has been linked with increased risk of mucosa-associated lymphoid tissue lymphoma. This review summarizes recent literature evaluating risk of lymphomas in arthritis patients and disease specific risk determinants. We also elaborate on the association of autoimmune arthritis with specific lymphoma variants along with genetic, environmental, and therapeutic risk factors.

  18. Autoimmune/Inflammatory Arthritis Associated Lymphomas: Who Is at Risk?

    Directory of Open Access Journals (Sweden)

    Sujani Yadlapati

    2016-01-01

    Full Text Available Specific autoimmune and inflammatory rheumatic diseases have been associated with an increased risk of malignant lymphomas. Conditions such as rheumatoid arthritis (RA, primary Sjögren’s syndrome (pSS, systemic lupus erythematosus (SLE, dermatomyositis, and celiac disease have been consistently linked to malignant lymphomas. Isolated cases of lymphomas associated with spondyloarthropathies and autoinflammatory diseases have also been reported. Direct association between autoimmunity and lymphomagenesis has been reinforced by large epidemiological studies. It is still uncertain whether disease specific determinants or phenotypic or treatment related characteristics increase likelihood of lymphomagenesis in these patients. For example, recent literature has indicated a positive correlation between severity of inflammation and risk of lymphomas among RA and Sjögren’s syndrome patients. It is also debated whether specific lymphoma variants are more commonly seen in accordance with certain chronic autoimmune arthritis. Previous studies have revealed a higher incidence of diffuse large B-cell lymphomas in RA and SLE patients, whereas pSS has been linked with increased risk of mucosa-associated lymphoid tissue lymphoma. This review summarizes recent literature evaluating risk of lymphomas in arthritis patients and disease specific risk determinants. We also elaborate on the association of autoimmune arthritis with specific lymphoma variants along with genetic, environmental, and therapeutic risk factors.

  19. Adipokines as Potential Biomarkers in Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Annalisa Del Prete

    2014-01-01

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

  20. Rheumatoid arthritis susceptibility genes: An overview.

    Science.gov (United States)

    Korczowska, Izabela

    2014-09-18

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

  1. Coexistence of rheumatoid arthritis and ankylosing spondylitis.

    Science.gov (United States)

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

    2015-01-01

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

  2. Characteristics of resistin in rheumatoid arthritis angiogenesis.

    Science.gov (United States)

    Su, Chen-Ming; Huang, Chun-Yin; Tang, Chih-Hsin

    2016-06-01

    Adipokines have been reported to be involved in the regulation of various physiological processes, including the immune response. Rheumatoid arthritis (RA) is an example of a systemic immune disease that causes chronic inflammation of the synovium and bone destruction in the joint. Recent therapeutic strategies based on the understanding of the role of cytokines and cellular mechanisms in RA have improved our understanding of angiogenesis. On the other hand, endogenous endothelial progenitor cells, which are a population isolated from peripheral blood monocytes have recently been identified as a homing target for pro-angiogeneic factor and vessel formation. In this review, we summarize the effects of common adipokines, such as adiponectin, leptin and resistin in RA pathogenesis and discuss other potential mechanisms of relevance for the therapeutic treatment of RA.

  3. Treatment strategies in surgery for rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-08-15

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

  4. Benefits of Exercise in Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Jennifer K. Cooney

    2011-01-01

    Full Text Available This paper aims to highlight the importance of exercise in patients with rheumatoid arthritis (RA and to demonstrate the multitude of beneficial effects that properly designed exercise training has in this population. RA is a chronic, systemic, autoimmune disease characterised by decrements to joint health including joint pain and inflammation, fatigue, increased incidence and progression of cardiovascular disease, and accelerated loss of muscle mass, that is, “rheumatoid cachexia”. These factors contribute to functional limitation, disability, comorbidities, and reduced quality of life. Exercise training for RA patients has been shown to be efficacious in reversing cachexia and substantially improving function without exacerbating disease activity and is likely to reduce cardiovascular risk. Thus, all RA patients should be encouraged to include aerobic and resistance exercise training as part of routine care. Understanding the perceptions of RA patients and health professionals to exercise is key to patients initiating and adhering to effective exercise training.

  5. Dermatitis herpetiformis and rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Singal Archana

    2002-01-01

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

  6. Rheumatoid Arthritis Educational Video Series

    Medline Plus

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

  7. Genetics Home Reference: rheumatoid arthritis

    Science.gov (United States)

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

  8. Therapy strategies in psoriatic arthritis.

    Science.gov (United States)

    Coates, Laura C

    2015-01-01

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

  9. Rheumatoid Arthritis Educational Video Series

    Medline Plus

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

  10. Rheumatoid Arthritis Educational Video Series

    Medline Plus

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

  11. Rheumatoid Arthritis Educational Video Series

    Medline Plus

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

  12. Rheumatoid Arthritis Educational Video Series

    Medline Plus

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

  13. Rheumatoid Arthritis Educational Video Series

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

  14. The Immunoglobulin (IgG) Antibody Response to OspA and OspB Correlates with Severe and Prolonged Lyme Arthritis and the IgG Response to P35 Correlates with Mild and Brief Arthritis

    Science.gov (United States)

    Akin, Evren; McHugh, Gail L.; Flavell, Richard A.; Fikrig, Erol; Steere, Allen C.

    1999-01-01

    In an effort to implicate immune responses to specific Borrelia burgdorferi proteins that may have a role in chronic Lyme arthritis, we studied the natural history of the antibody response to B. burgdorferi in serial serum samples from 25 patients monitored throughout the course of Lyme disease. In these patients, the immunoglobulin G (IgM) and IgG antibody responses to 10 recombinant B. burgdorferi proteins, determined during early infection, early arthritis, and maximal arthritis, were correlated with the severity and duration of maximal arthritis. The earliest responses were usually to outer surface protein C (OspC), P35, P37, and P41; reactivity with OspE, OspF, P39, and P93 often developed weeks later; and months to years later, 64% of patients had responses to OspA and OspB. During early infection and early arthritis, the levels of IgG antibody to P35 correlated inversely with the subsequent severity or duration of maximal arthritis. In contrast, during periods of maximal arthritis, the levels of IgG antibody to OspA and OspB, especially to a C-terminal epitope of OspA, correlated directly with the severity and duration of arthritis. Thus, the higher the IgG antibody response to P35 earlier in the infection, the milder and briefer the subsequent arthritis, whereas during maximal arthritis, the higher the IgG response to OspA and OspB, the more severe and prolonged the arthritis. PMID:9864212

  15. Fatigue in Rheumatoid Arthritis.

    Science.gov (United States)

    Katz, Patricia

    2017-05-01

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

  16. 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.

  17. Niki de Saint Phalle's lifelong dialogue between art and diseases: psychological trauma of sexual abuse, transient selective IgA deficiency, occupational exposure to toxic plastic material, chronic lung disease, rheumatoid arthritis.

    Science.gov (United States)

    Zeidler, Henning

    2013-05-01

    The French artist Niki de Saint Phalle (1930-2002) is one of the most famous female painter and sculptor of the 20th century. Her eventful live was full of emotional and physical burdens such as abuse by the father as a adolescent, early separation from family, nervous collapse, turbulent relationship with the artist Jean Tinguely, and last not least serious diseases. The psychological trauma of sexual abuse together with a "nervous breakdown" years later was the start of a life as an artist and is also a key to her art of the early years. She was affected from rheumatoid arthritis (RA) and was treated over 20 years with prednisolone and antimalarials leading to a good functional outcome and limited erosions of the wrist joint. Additionally, she had lifelong pulmonary disorders finally leading to death, which she attributed to polyester, the material used for her sculptures. An analysis of medical documents collected by her and provided by treating physicians gives another surprising explanation: selective IgA deficiency with multiple recurrent respiratory infections, asthma, milk intolerance, autoimmune thyroiditis, and RA compatible with hypogammaglobulinemia. Very unique in case of Niki de Saint Phalle is that IgA deficiency was transient. Nevertheless, it may be possible that the occupational exposure with art materials (polystyrene, polyester) has contributed in part or temporarily to her health problems. Altogether, her enormous artistic productivity represents an outstanding example of creative coping with RA and other lifelong health problems.

  18. The Unique Macroscopic Appearance of Gouty Arthritis of the Knee.

    Science.gov (United States)

    Mittl, Gregory S; Zuckerman, Joseph D

    2015-07-01

    Patients with significant gouty arthritis can develop disabling joint pain secondary to monosodium urate (MSU) articular deposition. We report a case of white, chalky MSU crystal deposition covering the articular surfaces of the knee as discovered by total knee arthroplasty. A 65-year-old male with a history of gout presented with bilateral knee pain. His radiographic imaging was negative for gouty tophi, and he elected to undergo left total knee arthroplasty. Intraoperatively a distinct chalky, white paste consistent with MSU deposition was observed covering the articular surfaces of the knee consistent with the diagnosis of gouty arthritis. Gout is the most common inflammatory arthritis affecting more than 3 million people in the USA. The inflammation results from the phagocytosis of monosodium urate crystals (MSU) and the release of inflammatory cytokines within the joint. Gout progresses from acute to chronic over many years and frequently causes chronic arthropathy. When significant knee pain and disability is associated with gouty arthropathy, total knee arthroplasty is certainly an option. The pathological appearance of gouty joints is characteristic. Macroscopic examination of joints affected by gout reveals a nodular, white, chalky appearance. Polarized microscopy of gout demonstrates negative birefringent needle-shaped MSU crystals. In this case report, we describe the characteristic chalky, white MSU deposit that covers the articular surfaces of a knee joint in a patient with a history of gout undergoing total knee arthroplasty. The investigators have obtained the patient's informed written consent for print and electronic publication of the case report.

  19. Physiotherapeutic procedures in patients with rheumatoid arthritis with maximum difficulties in the joints of the hand area

    OpenAIRE

    LEDVINOVÁ, Eva

    2014-01-01

    This bachelor thesis is focused on physiotherapeutic methods used in patients with rheumatoid arthritis whose difficulties are mainly in the joints of their hand. Rheumatoid arthritis is a chronic inflammatory joint disease in most cases with a protracted course and it may cause joint deformations. These lead to handling issues which complicate normal daily activities of the patients. Thus this disease causes both physical disability of the patient and as well significantly disrupts their soc...

  20. The nonpsychoactive cannabis constituent cannabidiol is an oral anti-arthritic therapeutic in murine collagen-induced arthritis

    OpenAIRE

    Malfait, A. M.; Gallily, R; Sumariwalla, P. F.; Malik, A. S.; Andreakos, E; Mechoulam, R.; Feldmann, M

    2000-01-01

    The therapeutic potential of cannabidiol (CBD), the major nonpsychoactive component of cannabis, was explored in murine collagen-induced arthritis (CIA). CIA was elicited by immunizing DBA/1 mice with type II collagen (CII) in complete Freund's adjuvant. The CII used was either bovine or murine, resulting in classical acute CIA or in chronic relapsing CIA, respectively. CBD was administered after onset of clinical symptoms, and in both models of arthritis the treatment effectively blocked pro...