JOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, Issue 1 2000
C. Di Girolamo
Immunological studies document the role of HLA in psoriasis and the correlation between neuropeptides, psoriasis, and related arthritis. Some anecdotal case reports, moreover, describe a noncasual association between peripheral neuropathy and psoriatic manifestations. To verify a possible subclinical peripheral nerve involvement in this disimmune pathology, we started a pilot study in twenty patients with psoriatic arthritis and in whom other common causes of peripheral neuropathies had been ruled out. We performed a complete clinical neurological examination and a neurophysiological examination (orthodromic sensory and motor nerve conduction velocity in median and tibial nerves; antidromic sensory nerve conduction velocity in sural nerve). In 40% of the patients there was a mild but definite "glove-stocking" hypoesthesia, while hypopallesthesia was detected in only 20%. Electrophysiologic examinations were less informative borderline distal conduction velocities in 30% of patients. These preliminary data suggest a peripheral nerve involvement in this pathology, mainly affecting the small nerve fibres. [source]

Perioperative Management of Medications for Psoriasis and Psoriatic Arthritis: A Review for the Dermasurgeon

DERMATOLOGIC SURGERY, Issue 4 2008
CLAUDIA HERNANDEZ MD
BACKGROUND Psoriasis affects an estimated 3% of the world's population. Many are on chronic immunosuppressive therapy for the cutaneous and joint manifestations of this disorder. The management of these medications in the perioperative period is controversial. Psoriasis and psoriatic arthritis medications can affect wound healing, hemostasis, and infection risk during cutaneous surgery. OBJECTIVES The objective of this article is to provide a critical review of various medications used for care of the psoriatic patient and their potential effect on cutaneous surgical procedures. CONCLUSIONS This review summarizes current understanding of wound healing, hemostatic effects, and infectious risks regarding many psoriasis medications including nonsteroidal anti-inflammatory drugs, cyclooxygenase inhibitors, corticosteroids, various immunosuppressants, and biologic response modifiers. Recommendations vary depending on the agent in question, type of procedure, and comorbid conditions in the patient. Caution is advised when using many of the medications reviewed due to lack of human data of their effects in the perioperative period. [source]

Is it possible to identify early predictors of the future cost of chronic arthritis?

FUNDAMENTAL & CLINICAL PHARMACOLOGY, Issue 1 2009
The VErA project
Abstract This study was conducted to identify early predictors of the total cost of inflammatory arthritis (IA). One hundred and eighty patients affected by undifferentiated arthritis (UA) or rheumatoid arthritis (RA) were included in the French Very Early rheumatoid Arthritis (VErA) cohort between 1998 and 2001. Health economic data for 2003 were collected using a patient self-questionnaire. Results were analysed in terms of direct, indirect and total costs in 2003 euros (2003,) for the population as a whole and in diagnostic subgroups. A payor perspective (the French National Health Insurance, in this case) was adopted. Multiple linear regression models were used to identify predictors of total cost from among the criteria assessed on recruitment. Results of the study showed that for the study population as a whole, the mean total cost was ,4700 per patient. The costs attributable to the RA and UA sub-groups were ,5928 and ,2424 per patient, respectively. In a univariate analysis, certain parameters were significantly correlated with a higher cost of illness. In the multivariate analysis, some of these parameters were further identified as being predictive of higher cost. Two strong significant, early predictors of total cost were identified: higher pain (P = 0.002) and the presence of rheumatoid factor (P = 0.004). In the RA sub-group, lower grip strength of the dominant hand (P = 0.039) was another predictor of the illness's subsequent economic impact. In conclusion, our data show that simple clinical and laboratory parameters can be used early in the course of IA to predict the condition's impact on healthcare budgets. [source]

Efficiency of combined methotrexate/chloroquine therapy in adjuvant-induced arthritis

FUNDAMENTAL & CLINICAL PHARMACOLOGY, Issue 4 2005
M.A.R.C.P. Silva
Abstract The present study evaluates the effects of methotrexate (MTX) and chloroquine (CQ), and of combined MTX + CQ treatment, on the inflammatory response and on plasma and liver phosphatase and transaminase activities, employing an adjuvant-induced arthritis model in rats. Arthritis was induced by the intradermal injection of a suspension of Mycobacterium tuberculosis in mineral oil into the plantar surface of the hind paws. Development of the inflammatory response was assessed over a 21-day period. Animal groups received either: (i) MTX, administered i.p., weekly, in 0.15, 1.5, 3, 6 or 12 mg/kg doses; (ii) CQ, given intragastrically, in daily 25 or 50 mg/kg doses; or (iii) MTX + CQ, administered in two combinations (MTX1.5 mg/kg + CQ50 mg/kg, or MTX6 mg/kg + CQ50 mg/kg). At the end of the experimental period, the animals were anesthetized and killed, blood and liver samples were collected and prepared for measurement of acid and alkaline phosphatase (AP, ALP), and aspartate (AST) and alanine aminotransferase (ALT) activities. MTX at 6 and 12 mg/kg reduced the inflammatory response while CQ had no effect. MTX6 mg/kg + CQ50 mg/kg reduced the inflammatory response similar to MTX12 mg/kg, without affecting the bone marrow. Plasma AP and liver ALP activities were very elevated in the arthritic rats. While MTX treatment partially reduced both plasma AP and liver ALP activities at all doses used in the arthritic rats, CQ treatment reduced plasma AP, but increased liver AP activity. MTX + CQ treatment decreased plasma AP and liver ALP activities in the arthritic rats to control values. Plasma and liver AST activities were unaltered in the arthritic rats, and were unaffected by treatment. However, plasma and liver ALT activities were significantly reduced in the arthritic rats. While MTX or CQ treatment did not alter plasma transaminase activity in the arthritic rats, after MTX + CQ treatment, plasma ALT activity returned to normal values. In conclusion, the present data suggest that MTX + CQ treatment provides more effective anti-inflammatory protection against adjuvant-induced arthritis than does MTX alone, reverting the alterations in enzyme activities induced by this inflammatory disease in rats. [source]

Assessing functional health status in adults with haemophilia: towards a preliminary core set of clinimetric instruments based on a literature search in Rheumatoid Arthritis and Osteoarthritis

HAEMOPHILIA, Issue 4 2005
P. De Kleijn
Summary., People with haemophilia experience a progressive deterioration of their functional health status. Regular clinical assessment of functional health status provides insight into their process of disablement. As such, the development of a core-set of measurement tools is warranted. The aim of this study was to gather data to prepare a (preliminary) core set of clinically relevant and feasible instruments to assess the functional health status of adults with haemophilia, and to indicate their psychometric qualities. Therefore, clinimetric instruments frequently used in two haemophilia-resembling diseases (Rheumatoid Arthritis and Osteoarthritis) were reviewed from the literature. An extensive search in Medline yielded 13 relevant review articles, incorporating a total of 182 instruments, of which 40 were appropriate for haemophilia. Of these 40 instruments 3 measure body structures, 13 body functions, 19 activities (of which 5 are performance based and 14 self-report based), and 3 measure participation. This classification is based on the International Classification of Functioning, Disability and Health. Detailed information regarding the psychometrics (reliability, validity and responsiveness) of four instruments is described fully in the literature, whereas the psychometrics of the majority of the other instruments are only partly described. The results of this literature study may contribute to the formation of a (preliminary) core set of clinimetric instruments to assess the functional health status of adults with haemophilia. Decisions on the final core set should be held within the Musculoskeletal Committee of the World Federation of Haemophilia. [source]

Arthritis induced in rats with non-immunogenic adjuvants as models for rheumatoid arthritis

IMMUNOLOGICAL REVIEWS, Issue 1 2001
Rikard Holmdahl
Summary: Rat models are useful for studies of the pathogenesis of rheumatoid arthritis (RA) since rats are extraordinarily sensitive to induction of arthritis with adjuvants. Injection of not only the classical complete Freund's adjuvant but also mineral oil without mycobacteria and pure adjuvants such as pristane and squalene, induce severe arthritis in many rat strains. Models like pristane-induced arthritis in rats are optimal models for RA since they fulfill the RA criteria including a chronic relapsing disease course. Arthritogenic adjuvants like pristane, avridine, squalene and mineral oil are not immunogenic since they do not contain major histocompatibility complex (MHC) binding peptides. Nevertheless, the diseases are MHC-associated and dependent on the activation of ,,TCR (T-cell receptor)-expressing T cells. However, it has not been possible to link the immune response to joint antigens or other endogenous components although immunization with various cartilage proteins induce arthritis but with different pathogeneses. To unravel the mechanisms behind adjuvant-induced arthritis, a disease-oriented genetic approach is optimal. Several loci that control onset of arthritis, severity and chronicity of the disease have been identified in genetic crosses and most of these have been confirmed in congenic strains. In addition, many of these loci are found in other autoimmune models in the rat as well as associated with arthritis in mice and humans. [source]

Mucocutaneous manifestations in inflammatory bowel disease

INFLAMMATORY BOWEL DISEASES, Issue 4 2009
lhami Yüksel MD
Abstract Background: The aim of this study was to evaluate the prevalence and features of the major cutaneous manifestations (erythema nodosum [EN] and pyoderma gangrenosum [PG]) and to determine the associations between cutaneous manifestations and other extraintestinal manifestations in patients with inflammatory bowel disease (IBD). Methods: The mucocutaneous manifestations of patients with IBD were studied between December 2002 and June 2007. All patients underwent a detailed whole body examination by a gastroenterologist and dermatologist. Results: In all, 352 patients were included in this study; 34 patients (9.3%) presented with at least 1 major cutaneous manifestation. The prevalence of EN (26 patients) and PG (8 patients) in IBD was 7.4% and 2.3%, respectively. EN was more common in Crohn's disease (16/118) than ulcerative colitis (10/234) (P = 0.002). EN was found to be related to disease activity of the bowel (P = 0.026). The prevalence of arthritis was significantly higher in the IBD patients with EN (11/26) than in IBD patients without EN (53/326) (P = 0.006). Arthritis was more common in IBD patients with PG (7/8) than in IBD patients without PG (57/344) (P = 0.00). IBD patients with PG were significantly more likely to have uveitis (1/8) compared with IBD patients without PG (5/344) (P = 0.017). Conclusions: We found the prevalence of 2 important cutaneous manifestations to be 9.3% in IBD in Turkish patients. EN was found to be more common in Crohn's disease and is associated with an active episode of bowel disease and peripheral arthritis. In addition, PG was connected with uveitis and peripheral arthritis. (Inflamm Bowel Dis 2009) [source]

Symposium on Arthritis in Developing Countries: Problems and Prospects , ACR Conference, San Diego, US, November 17, 2005

INTERNATIONAL JOURNAL OF RHEUMATIC DISEASES, Issue 1 2006
Prakash PISPATI
No abstract is available for this article. [source]

Certain Aspects of ACTH and Cortisone Therapy in Older Patients with Rheumatoid Arthritis

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2002
Max M. Montgomery MD
First page of article [source]

Osteoblast Function Is Compromised at Sites of Focal Bone Erosion in Inflammatory Arthritis,,

JOURNAL OF BONE AND MINERAL RESEARCH, Issue 9 2009
Nicole C Walsh PhD
Abstract In rheumatoid arthritis (RA), synovial inflammation results in focal erosion of articular bone. Despite treatment attenuating inflammation, repair of erosions with adequate formation of new bone is uncommon in RA, suggesting that bone formation may be compromised at these sites. Dynamic bone histomorphometry was used in a murine model of RA to determine the impact of inflammation on osteoblast function within eroded arthritic bone. Bone formation rates at bone surfaces adjacent to inflammation were similar to those observed in nonarthritic bone; therefore, osteoblast activity is unlikely to compensate for the increased bone resorption at these sites. Within arthritic bone, the extent of actively mineralizing surface was reduced at bone surfaces adjacent to inflammation compared with bone surfaces adjacent to normal marrow. Consistent with the reduction in mineralized bone formation, there was a notable paucity of cells expressing the mid- to late stage osteoblast lineage marker alkaline phosphatase, despite a clear presence of cells expressing the early osteoblast lineage marker Runx2. In addition, several members of the Dickkopf and secreted Frizzled-related protein families of Wnt signaling antagonists were upregulated in arthritic synovial tissues, suggesting that inhibition of Wnt signaling could be one mechanism contributing to impaired osteoblast function within arthritic bone. Together, these data indicate that the presence of inflammation within arthritic bone impairs osteoblast capacity to form adequate mineralized bone, thus contributing to the net loss of bone and failure of bone repair at sites of focal bone erosion in RA. [source]

Early Prosthetic Valve Failure in a Patient with Rheumatoid Arthritis

JOURNAL OF CARDIAC SURGERY, Issue 1 2009
Sanjay Asopa M.R.C.S.
Most patients do not require cardiac surgical intervention unless they develop complications such as significant valvular regurgitation. Patients with RA often require orthopedic operations and therefore a bioprosthetic valve replacement is normally advocated to avoid problems related to anticoagulation. We report a case of a 64-year-old woman with seropositive RA who had undergone bioprosthetic aortic valve replacement three years previously. She re-presented with early prosthetic valve failure due to accelerated degeneration and calcification. This was treated successfully with redo replacement with a mechanical prosthesis. Here, we discuss our experience and debate the various valve choices available that should be considered in patients with rheumatoid disease. [source]

Inter-relationships between rheumatoid arthritis and periodontal disease

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2003
A review
Abstract This review considers the considerable similarities between periodontal disease and rheumatoid arthritis (RA). While the etiology of these two diseases may differ, the underlying pathogenic mechanisms are remarkably similar and it is possible that individuals manifesting both periodontitis and RA may suffer from a unifying underlying systemic dysregulation of the inflammatory response. In light of these findings, the implications for the use of disease-modifying medications in the management of these two chronic inflammatory conditions is apparent. Further longitudinal studies and medication-based intervention studies are required to determine just how closely these two conditions are allied. Zusammenfassung Diese Übersicht berücksichtigt die beträchtlichen Ähnlichkeiten zwischen einer Parodontalerkrankung und der rheumatoiden Arthritis. Während die Ätiologie dieser zwei Erkrankungen sich unterscheiden kann, sind die zugrundeliegenden Pathogenitätsmechanismen bemer-kenswert ähnlich. Und es ist möglich, dass Personen bei denen sich sowohl eine Parodontitis als auch eine rheumatoide Arthritis manifestiert hat, an einer verbindenden zugrundeliegenden systemischen Dysregulation der Entzündungsreaktion leiden könnten. Unter Berücksichtigung dieser Ergebnisse ist es offensichtlich, dass, bei der Beherrschung dieser zwei chronischen entzündlichen Zustände, die Verwendung von die Erkrankung modifizierenden Medikamenten, indiziert ist. Weitere Longitudinalstudien und Interventionsstudien mit Medikamenten sind notwendig, um zu bestimmen, wie nahe diese zwei Zustände verwandt sind. Résumé Cette revue considère les similarités considérables qui existent entre la maladie parodontale et l'arthrite rhumatoïde. Tandis que l'étiologie de ces deux maladies peut être différente, les mécanismes pathogéniques sous-jacents sont remarquablement semblables et il est possible que les individus avec arthrite rhumatoïde puissent souffrir d'une dérégularisation systémique sous-jacente unifiée de la réponse inflammatoire. A la lumière de ces découvertes, les implications de l'utilisation de médicaments modifiant la maladie dans le traitement de ces deux conditions inflammatoires chroniques est apparent. Davantage d'études longitudinales et d'études où il y a une intervention médicamenteuse sont requises pour déterminer le proportion de proximité de ces deux conditions. [source]

The Inhibition of Inducible Nitric Oxide Synthase Reverts Arthritic-Induced Decrease in Pituitary Growth Hormone mRNA But Not in Liver Insulin-Like Growth Factor I mRNA Expression

JOURNAL OF NEUROENDOCRINOLOGY, Issue 12 2003
I. Ibáñez De Cáceres
Abstract Experimental arthritis induced by Freund-adjuvant administration is a model of chronic inflammation and rheumatoid arthritis associated with a decrease in pituitary growth hormone (GH) and hepatic insulin-like growth factor I (IGF-I) gene expression. Excessive nitric oxide (NO) synthesis by inducible NO synthase (iNOS) has been implicated in the pathogenesis of inflammatory illness. Moreover, NO participates in the regulation of GH secretion at both the hypothalamus and the pituitary. We have examined the role of iNOS activation in producing the changes in the GH-IGF-I axis in arthritic rats. Adult male Wistar rats received aminoguanidine or vehicle from day 20, after adjuvant or vehicle injection, until day 28. Two hours and 30 min after the last aminoguanidine injection, all rats were killed by decapitation. Arthritis increased hypothalamic expression of somatostatin mRNA while it decreased pituitary GH mRNA expression, and both effects were prevented by aminoguanidine administration. In arthritic rats, the parallel decrease in serum IGF-I, and in hepatic IGF-I content and mRNA expression, correlates with the decrease in circulating GH concentrations. Aminoguanidine administration to arthritic rats did not modify either serum GH or serum IGF-I concentrations, or hepatic IGF-I mRNA expression. However, aminoguanidine administration to control rats resulted in a decrease in serum GH concentrations and in a decrease in both hepatic IGF-I mRNA expression and serum IGF-I concentrations. These data suggest that NO mediates the arthritis-induced decrease in GH mRNA expression by acting at a hypothalamic level, but it is not involved in the decrease in hepatic IGF-I mRNA expression. [source]

Unmitigated Communion, Social Constraints, and Psychological Distress Among Women With Rheumatoid Arthritis

JOURNAL OF PERSONALITY, Issue 1 2004
Sharon Danoff-Burg
This longitudinal study is the first to examine the influence of unmitigated communion on adaptation to a chronic illness that affects a much greater proportion of women to men. Women with rheumatoid arthritis completed measures of unmitigated communion, social constraints, and psychological distress at study entry and repeated the distress measure one year later. As expected, unmitigated communion was associated with psychological distress. Cross-sectional moderation analyses indicated that low social constraints buffered the negative effects of unmitigated communion. [source]

Guidelines for the Management of Rheumatoid Arthritis 2002 Update

JOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 10 2002
APRN-C, Mary Jo Goolsby EdD
Rheumatoid arthritis (RA) is a progressive polyarthritis that is responsible for over nine million office visits annually. It is likely that most nurse practitioners will care for one or more patients with RA because approximately 1% of the adult population is affected by this disabling disorder. The guideline reviewed in this month's column describes the recommended care of patients who have been previously diagnosed with RA. [source]

Reiter's Syndrome (Reactive Arthritis) and Travelers' Diarrhea

JOURNAL OF TRAVEL MEDICINE, Issue 1 2006
DTM&H, Johnnie A. Yates MD
Reiter's syndrome [also called reactive arthritis (ReA)] is the triad of arthritis, urethritis, and conjunctivitis. Two cases of Reiter's syndrome triggered by travelers' diarrhea are presented. Health care providers should suspect ReA in travelers with joint symptoms and antecedent diarrheal disease. [source]

Synovial fluid at microwave frequencies

MICROWAVE AND OPTICAL TECHNOLOGY LETTERS, Issue 7 2007
Anil Lonappan
Abstract Arthritis is one of the most pervasive diseases that causes of disability. For most people arthritis pain and inflammation cannot be avoided as the body ages. The present communication reports the study on the synovial fluid has the main lubricant in joints collected from normal persons and those ailing from arthritis are subjected to the microwave study and the variations of the dielectric parameters are investigated. The in vitro measurements of synovial fluid samples are done using cavity perturbation technique in the frequency range of 2,3 GHz. It is observed that in this band, the dielectric constant of normal samples are higher than those of arthritis affected ones and conductivity of is higher in normal samples, which finds application in detecting arthritis using microwaves. © 2007 Wiley Periodicals, Inc. Microwave Opt Technol Lett 49: 1700,1702, 2007; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/mop.22552 [source]

Patients' conceptions of the cause of their rheumatoid arthritis: A qualitative study

MUSCULOSKELETAL CARE, Issue 4 2009
MScN, Ulrika Bergsten RN
Abstract Background:,Patients' perspective of the causes and consequences of rheumatoid arthritis (RA) can conflict with that of healthcare professionals and lead to misunderstanding, difficulties in management and a poorer outcome. Objectives:,The aim of this study was to describe the variation in how patients' conceive the cause of their RA. Methods:,An open written question from the Epidemiological Investigation of Rheumatoid Arthritis (EIRA) study, aimed at patients recently diagnosed with RA, was answered by 38 strategically selected patients during 2003 and analysed using the phenomenographic approach. Results:,Two descriptive categories and six concepts emerged: the category ,consequences beyond personal control' comprised not having a clue, being exposed to climatic change, being genetically exposed and unexpected effects of events; the category ,overloaded circumstances' involved work and family-related strain. Consequences beyond personal control implied that the patients could not prevent the disease and expressed their lack of understanding as to why they contracted it. Overloaded circumstances were described as strained situations that were both work and family related and could be influenced by the patient. Conclusions:,The patient's perspective of the cause of their RA includes aspects that complement the current pathogenetic models and should therefore be considered in the management of the disease. When dealing with rheumatic diseases, it is necessary to be aware of the patient's perspectives in order to new management strategies. In addition to epidemiological studies, further studies of patients' own experience are needed in order to achieve a more tailored care model. Copyright © 2009 John Wiley & Sons, Ltd [source]

Novel recombinant congenic mouse strain developing arthritis with enthesopathy

PATHOLOGY INTERNATIONAL, Issue 7 2008
Shiro Mori
Based on the hypothesis that the complex pathological and immunological manifestations of rheumatoid arthritis (RA) and the related diseases are under the control of multiple gene loci with allelic polymorphism, a recombinant congenic mouse strain was prepared between an MRL/Mp- lpr/lpr (MRL/lpr) strain, which develops arthritis resembling RA, and a non-arthritic strain C3H/HeJ- lpr/lpr (C3H/lpr). In MRL/lpr × (MRL/lpr × C3H/lpr) F1 mice, the mice developing severe arthritis were selected based on joint swelling to further continue intercrosses, and then an McH- lpr/lpr -RA1 (McH/lpr-RA1) strain was established and its histopathological phenotypes of joints and autoimmune traits were analyzed. Arthritis in McH/lpr-RA1 mice developed at a higher incidence by 20 weeks of age, compared with that in the MRL/lpr mice, who had severe synovitis (ankle, 60.3%; knee, 65.1%), and also fibrous and fibrocartilaginous lesions of articular ligamenta resembling enthesopathy (ankle, 79.4%; knee, 38.1%), resulting in ankylosis. The lymphoproliferative disorder was less, and serum levels of IgG and IgG autoantibodies including anti-dsDNA and rheumatoid factor were lower than those of both MRL/lpr and C3H/lpr strains. McH/lpr-RA1 mice may provide a new insight into the study of RA regarding the common genomic spectrum of seronegative RA and enthesopathy. [source]

Harlequin Ichthyosis in Association with Hypothyroidism and Juvenile Rheumatoid Arthritis

PEDIATRIC DERMATOLOGY, Issue 5 2003
Yuin-Chew Chan M.D.
Two Chinese children, a 2-year-old boy and an 11-year-old girl, presented with these classic features as well as alopecia and loss of eyebrows and eyelashes. The boy was small for his age and was found to have hypothyroidism at the age of 18 months; he is currently on thyroxine replacement therapy. At 6 years of age, the girl developed symmetrical polyarthritis associated with positive rheumatoid factor and radiologic evidence of erosive arthritis, suggestive of juvenile rheumatoid arthritis. She received prednisolone, nonsteroidal anti-inflammatory drugs (NSAIDs), and subsequently methotrexate for her arthritis, with clinical and radiologic improvement. Early therapy with oral retinoids in both children accelerated shedding of the hyperkeratotic plates as well as improved ectropion and eclabium. There was no major adverse reaction to oral retinoids. The development of juvenile rheumatoid arthritis in survivors with harlequin ichthyosis has not been previously described. The use of prednisolone and NSAIDs in the girl did not affect the skin condition, but the addition of methotrexate led to a decrease in erythema. The association with autoimmune disease is probably coincidental. The psychosocial impact of this severe lifelong disease on the two families was enormous. Early retinoid therapy may improve the disorder and help increase survival rates. A multidisciplinary approach, including psychosocial support of the affected families, is vital in the management of this lifelong disease. [source]

Pseudoporphyria and Nonsteroidal Antiinflammatory Agents in Children with Juvenile Idiopathic Arthritis

PEDIATRIC DERMATOLOGY, Issue 6 2000
Bernadette De Silva M.R.C.P.
Nonsteroidal antiinflammatory drugs (NSAIDs) are implicated in the etiology of this condition. In a 1-year prospective study of children attending the pediatric rheumatology clinic in Edinburgh we found a prevalence of pseudoporphyria of 10.9% in children taking NSAIDs for juvenile idiopathic arthritis. Naproxen was the most commonly implicated NSAID, independent of dosage. Blue/gray eye color was an independent risk factor for the development of pseudoporphyria. We would advise caution in prescribing naproxen in these children to prevent disfiguring facial scarring. [source]

Methicillin-resistenter Staphylococcus aureus: ,-Lactam-Resistenz "trifft" Virulenz

PHARMAZIE IN UNSERER ZEIT (PHARMUZ), Issue 5 2006
Hans-Jörg Linde PD Dr.
CA-MRSA sind weltweit ein emerging pathogen außerhalb von medizinischen Einrichtungen. Sie betreffen Patienten ohne Risikofaktoren, insbesondere auch Kinder und Erwachsene im jüngeren Alter. Typischerweise kommt es zu Haut- und Weichteilinfektionen, die häufig mit Komplikationen verlaufen (multipel, rezidivierend, seltener Endokarditis, Osteomyelitis, septische Arthritis). Seltene schwere Komplikationen sind nekrotisierende Pneumonien, nekrotisierende Fasziitis, Purpura fulminans und Waterhouse-Friderichsen-Syndrom. Als besonderen Virulenzfaktor weisen CA-MRSA u.a. das Panton-Valentine-Leukozidin auf. Die Stämme sind resistent gegen alle , -Lactam-Antibiotika. Zur Therapie sind Clindamycin, Doxycyclin, Moxifloxacin, Co-Trimoxazol, Linezolid, Glykopeptide und Daptomycin geeignet. Die Sanierung des Trägerstatus ist aufwändig und verlangt eine sorgfältige Planung. Um eine weitere Verbreitung zu verhindern, sind verbesserte diagnostische, therapeutische und hygienische Maßnahmen bei niedergelassenen Ärzten und in Krankenhäusern nötig. [source]

Adalimumab verlangsamt die Progression der Rheumatoiden Arthritis

PHARMAZIE IN UNSERER ZEIT (PHARMUZ), Issue 1 2003
Article first published online: 13 JAN 200
Der rein humane monoklonale Antikörper D2E7 (Adalimumab) von Abbott Laboratories zur Behandlung der rheumatoiden Arthritis (RA) verzögert die Progression der strukturellen Gelenkschäden und zeigt eine anhaltende Wirksamkeit über einen Zeitraum von drei Jahren. Dies belegen Daten einer Phase-III-Kernstudie zum Sicherheits- und Wirksamkeitsprofil von D2E7 bei einer zweiwöchentlichen Dosierung, die im Rahmen des Jahresmeetings des American College of Rheumatology in New Orleans vorgestellt wurden. [source]

The Observational Evaluation of Subjective Well-Being in Patients with Rheumatoid Arthritis

APPLIED PSYCHOLOGY: HEALTH AND WELL-BEING, Issue 1 2009
Afton L. Hassett
An important aspect of general health is subjective well-being (SWB), which is defined as happiness and overall satisfaction with life. Herein we examined the reliability and validity of observation-based ratings of SWB in patients with rheumatoid arthritis (RA). Ten RA patients experiencing a disease flare (period of increased symptoms) completed two semi-structured interviews (baseline and 4 weeks later) that were digitally recorded. Twelve healthcare professionals watched the 20 brief videos in random order and scored them using the Well-Being Coding System (WBCS) for observer-reported SWB. Patient-reported SWB scores and scores from the Medical Outcomes Study: 36-Item Short Form Survey (SF-36) were compared to observer-reported scores for SWB. We found inter-rater reliability to be extremely high and a significant relationship between observer SWB composite scores and patient SWB composite scores. Observer SWB composite scores and other scores associated with SWB from the SF-36 were also related significantly. There was also some evidence supporting the ability of observers to detect change in SWB. Taken together, we found preliminary evidence suggesting that when using information gleaned from brief patient interviews clinicians can make reliable and valid evaluations of patients' SWB. [source]

Indocyanine green,enhanced imaging of antigen-induced arthritis with an integrated optical imaging/radiography system,

ARTHRITIS & RHEUMATISM, Issue 8 2010
Reinhard Meier
Objective To evaluate a combined indocyanine green,enhanced optical imaging/radiography system for the detection of arthritic joints in a rat model of antigen-induced arthritis. Methods Arthritis of the knee and ankle joints was induced in 6 Harlan rats, using peptidoglycan,polysaccharide polymers. Three rats served as untreated controls. Optical imaging of the knee and ankle joints was done with an integrated optical imaging/radiography system before and up to 24 hours following intravenous injection of 10 mg/kg indocyanine green. The fluorescence signal intensities of arthritic and normal joints were compared for significant differences, using generalized estimating equation models. Specimens of knee and ankle joints were further processed and evaluated by histology. Results Immediately after administration, indocyanine green provided a significant increase in the fluorescence signal of arthritic joints compared with baseline values (P < 0.05). The fluorescence signal of arthritic joints was significantly higher compared with that of nonarthritic control joints at 1,720 minutes after intravenous injection (P < 0.05). Fusion of indocyanine green,enhanced optical imaging and radiography allowed for anatomic coregistration of the inflamed tissue with the associated joint. Hematoxylin and eosin staining confirmed marked synovial inflammation of arthritic joints and the absence of inflammation in control joints. Conclusion Indocyanine green,enhanced optical imaging is a clinically applicable tool for detection of arthritic tissue. Using relatively high doses of indocyanine green, long-term enhanced fluorescence of arthritic joints can be achieved. This may facilitate simultaneous evaluations of multiple joints in a clinical setting. Fusion of indocyanine green,enhanced optical imaging scans with radiography increases anatomic resolution. [source]

Introducing the New Editor of Arthritis & Rheumatism, Joan M. Bathon, MD

ARTHRITIS & RHEUMATISM, Issue 7 2010
Stanley B. Cohen MD President
No abstract is available for this article. [source]