British journal of rheumatology最新文献

{"title":"Glucocorticosteroids in rheumatoid arthritis: lessons for the future.","authors":"D E Yocum","doi":"10.1093/rheumatology/37.11.1145","DOIUrl":"https://doi.org/10.1093/rheumatology/37.11.1145","url":null,"abstract":"","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 11","pages":"1145-7"},"PeriodicalIF":0.0,"publicationDate":"1998-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.11.1145","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20760901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From criticism to creativity: the genesis of the ARC/BSR Clinical Trials Group.","authors":"D R Blake, B Hazleman, C Cooper, D Isenberg, R L Edwards","doi":"10.1093/rheumatology/37.11.1146","DOIUrl":"https://doi.org/10.1093/rheumatology/37.11.1146","url":null,"abstract":"","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 11","pages":"1146-7"},"PeriodicalIF":0.0,"publicationDate":"1998-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.11.1146","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20760903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hormone replacement therapy, other reproductive variables and symptomatic hip osteoarthritis in elderly white women: a case-control study.","authors":"E M Dennison,&nbsp;N K Arden,&nbsp;S Kellingray,&nbsp;P Croft,&nbsp;D Coggon,&nbsp;C Cooper","doi":"10.1093/rheumatology/37.11.1198","DOIUrl":"https://doi.org/10.1093/rheumatology/37.11.1198","url":null,"abstract":"<p><strong>Background: </strong>Recent epidemiological studies suggest that post-menopausal hormone replacement therapy might reduce the risk of hip osteoarthritis (OA) in women. However, the association of the disorder with other reproductive variables is controversial. We addressed this issue in a population-based case control study among 413 female cases and 413 age- and sex-matched controls.</p><p><strong>Methods: </strong>A total of 413 women listed for hip replacement because of primary OA over an 18 month period were compared with an equal number of controls selected from the general population and individually matched for age and general practice. Information about reproductive variables was obtained by questionnaire administered at interview.</p><p><strong>Results: </strong>The risk of hip OA was significantly elevated among women who had had an oophorectomy (OR = 1.9, 95% CI 1.0-3.7). After adjustment for body mass index, the presence of Heberden's nodes, previous hip injury and past leisure sporting activity (all independent risk factors for hip OA), and for other reproductive variables, there was a non-significant, protective effect of long-term hormone replacement therapy, such that > or =5 yr of use was associated with a 40% reduction in risk (OR = 0.6, 95% CI 0.2-1.8). Paradoxically, short-term HRT use (up to 5 yr duration) was associated with an excess risk of hip OA (OR = 1.7, 95% CI 0.9-3.3). There was no association between the risk of hip OA and use of oral contraceptives, parity or hysterectomy.</p><p><strong>Conclusions: </strong>These data are consistent with previous studies suggesting a protective effect of long-term hormone replacement therapy on the risk of hip OA. By contrast, an elevation of risk in short-term users was demonstrated. Our results also suggest that risk is increased among women who have undergone unilateral or bilateral oophorectomy. Studies are required to investigate the mechanisms underlying these associations.</p>","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 11","pages":"1198-202"},"PeriodicalIF":0.0,"publicationDate":"1998-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.11.1198","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20759468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Referral and diagnosis of common rheumatic diseases by primary care physicians.","authors":"J I Gamez-Nava,&nbsp;L Gonzalez-Lopez,&nbsp;P Davis,&nbsp;M E Suarez-Almazor","doi":"10.1093/rheumatology/37.11.1215","DOIUrl":"https://doi.org/10.1093/rheumatology/37.11.1215","url":null,"abstract":"<p><strong>Objective: </strong>To describe primary care patterns of referral and diagnoses of patients with rheumatic diseases referred to rheumatologists.</p><p><strong>Methods: </strong>The medical records of all consecutive patients referred in 1994 by >300 primary care physicians to two rheumatologists at an academic centre were reviewed. The referring physician diagnosis was compared with the rheumatologist's diagnosis. Sensitivity, specificity and predictive values of primary care diagnoses were estimated using the rheumatologist diagnosis as the 'gold standard'.</p><p><strong>Setting: </strong>University-based rheumatology out-patient clinic.</p><p><strong>Results: </strong>Over half of the patients referred had a rheumatologist diagnosis of soft-tissue rheumatism or a spinal pain syndrome. Three hundred and forty-seven patients (49%) had a primary care diagnosis of a defined rheumatic disease. Of these, 142 (41%) of the primary care diagnoses were subsequently modified by the rheumatologist. The highest agreement between primary care physician and rheumatologist was observed for crystal-induced arthritis (kappa = 0.86), and the lowest agreement for polymyalgia rheumatica (kappa = 0.39) and systemic lupus (kappa = 0.46). Sensitivity was lowest for a primary care diagnosis of fibromyalgia (48%) and highest for ankylosing spondylitis (94%). Positive predictive values were generally low, in particular for systemic lupus erythematosus (33%) and polymyalgia rheumatica (30%).</p><p><strong>Conclusion: </strong>Most patients referred to an academic rheumatology centre had soft-tissue rheumatism or other pain syndromes. In general, diagnostic agreement between rheumatologists and primary care physicians was low. Increased emphasis on musculoskeletal disorders should be encouraged in medical education to increase the efficiency of rheumatology referrals.</p>","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 11","pages":"1215-9"},"PeriodicalIF":0.0,"publicationDate":"1998-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.11.1215","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20759471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progression in early erosive rheumatoid arthritis: 12 month results from a randomized controlled trial comparing methotrexate and gold sodium thiomalate.","authors":"R Rau,&nbsp;G Herborn,&nbsp;H Menninger,&nbsp;O Sangha","doi":"10.1093/rheumatology/37.11.1220","DOIUrl":"https://doi.org/10.1093/rheumatology/37.11.1220","url":null,"abstract":"<p><strong>Objective: </strong>To compare radiographic outcomes in patients with active early erosive rheumatoid arthritis (RA) who were treated with methotrexate (MTX) and gold sodium thiomalate (GSTM).</p><p><strong>Methods: </strong>A total of 174 patients from two centres were randomly assigned to receive weekly i.m. injections for 12 months of either 15 mg MTX or 50 mg GSTM in a double-blind fashion. Radiographic evaluations including standardized scoring of 38 joints of the hands, wrists and forefeet, and count of eroded joints, were carried out at baseline and after 6 and 12 months in all patients, including withdrawals.</p><p><strong>Results: </strong>An intention-to-treat analysis revealed no statistically significant difference in the progression of radiographic scores between treatment groups after 6 months (3.4 with MTX vs 2.6 with GSTM, P = 0.66) and after 12 months (6.0 vs 4.8, P = 0.44). A similar pattern was observed for the number of joints with erosions. The slope of radiographic progression was significantly reduced in the second half-year compared to the first 6 months in both groups. Erythrocyte sedimentation rate and C-reactive protein at baseline, and the presence of rheumatoid factor (RF), were the main predictors of progression in bivariate analysis. RF remained as the only predictor for radiographic outcome in multivariable analysis.</p><p><strong>Conclusion: </strong>In parallel to clinical improvement, both GSTM and MTX reduce the slope of radiographic progression in patients with active erosive RA.</p>","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 11","pages":"1220-6"},"PeriodicalIF":0.0,"publicationDate":"1998-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.11.1220","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20759472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of intravenous pulsed methylprednisolone in the treatment of systemic-onset juvenile chronic arthritis.","authors":"A O Adebajo,&nbsp;M A Hall","doi":"10.1093/rheumatology/37.11.1240","DOIUrl":"https://doi.org/10.1093/rheumatology/37.11.1240","url":null,"abstract":"<p><p>An open prospective study using i.v. methylprednisolone in children with juvenile chronic arthritis (JCA) who had had a systemic exacerbation of disease is described. Eighteen children aged from 3 to 14 yr and 9 months (mean 9.7 yr) were treated. Ten patients (55%) had a loss of all systemic features 1 month after the pulse, and eight (45%) had a reduction in the active joint count. At this time, five of the patients on oral prednisolone had achieved a reduction in dosage. Also at 1 month, a reduction in erythrocyte sedimentation rate was observed in 11 patients (61%) and of C-reactive protein in 11 of 16 (72%). Altogether, 13 patients (72%) had a good response, while a further three (16%) went into remission. Our conclusions are that pulse methylprednisolone provides good short-term benefit in patients with systemic-onset JCA; no serious side-effects were noted. Further long-term studies are warranted.</p>","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 11","pages":"1240-2"},"PeriodicalIF":0.0,"publicationDate":"1998-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.11.1240","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20760051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for thrombotic events in giant cell arteritis and polymyalgia rheumatica.","authors":"B Seriolo,&nbsp;M Cutolo,&nbsp;A Garnero,&nbsp;S Accardo","doi":"10.1093/rheumatology/37.11.1251","DOIUrl":"https://doi.org/10.1093/rheumatology/37.11.1251","url":null,"abstract":"","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 11","pages":"1251-3"},"PeriodicalIF":0.0,"publicationDate":"1998-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.11.1251","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20760057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An insight into rheumatology resources available on the World Wide Web.","authors":"C M Tench,&nbsp;G P Clunie,&nbsp;J Dacre,&nbsp;A Peacock","doi":"10.1093/rheumatology/37.11.1233","DOIUrl":"https://doi.org/10.1093/rheumatology/37.11.1233","url":null,"abstract":"<p><p>The aim of this study was to gain an overview of rheumatology resources on the World Wide Web (WWW). A list of websites was generated using a commercial search engine and 'rheumatology' as a key word. A total of 154 websites were then evaluated with respect to origin and likely target audience; 43% of this initial group were either not accessible, repeats, or in a language other than English. Of the 87 websites we were able to analyse, we found that 67% originated from medical organizations and 51% were interpreted to be directed specifically at rheumatologists. Only 16% of websites were directed at patients only. The remainder were felt to contain information useful to both groups. Over half the websites felt to be of interest to patients contained advertisements. Although there is a lot of information relating to rheumatology on the WWW, it was invariably time consuming to access and there was little directed solely at patient education.</p>","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 11","pages":"1233-5"},"PeriodicalIF":0.0,"publicationDate":"1998-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.11.1233","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20759475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic sclerosis complicated by procainamide-induced lupus and antiphospholipid syndrome.","authors":"H Kameda,&nbsp;T Mimori,&nbsp;J Kaburaki,&nbsp;T Fujii,&nbsp;T Takahashi,&nbsp;M Akaishi,&nbsp;Y Ikeda","doi":"10.1093/rheumatology/37.11.1236","DOIUrl":"https://doi.org/10.1093/rheumatology/37.11.1236","url":null,"abstract":"","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 11","pages":"1236-9"},"PeriodicalIF":0.0,"publicationDate":"1998-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.11.1236","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20759476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum dehydroepiandrosterone sulphate levels in patients with early rheumatoid arthritis: positive association with C-reactive protein, but not with HLA-DR genotype.","authors":"E J Giltay,&nbsp;A C Verhoeven,&nbsp;D van Schaardenburg,&nbsp;C Popp-Snijders,&nbsp;M Boers,&nbsp;L J Gooren,&nbsp;B A Dijkmans","doi":"10.1093/rheumatology/37.11.1254","DOIUrl":"https://doi.org/10.1093/rheumatology/37.11.1254","url":null,"abstract":"","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 11","pages":"1254-6"},"PeriodicalIF":0.0,"publicationDate":"1998-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.11.1254","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20760059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}