British journal of rheumatology最新文献

{"title":"Pogosta disease: clinical observations during an outbreak in the province of North Karelia, Finland.","authors":"M Turunen,&nbsp;P Kuusisto,&nbsp;P E Uggeldahl,&nbsp;A Toivanen","doi":"10.1093/rheumatology/37.11.1177","DOIUrl":"https://doi.org/10.1093/rheumatology/37.11.1177","url":null,"abstract":"<p><strong>Objective: </strong>To characterize the clinical picture of Pogosta disease.</p><p><strong>Method: </strong>The data of 73 patients who had had Pogosta disease in 1981 and who then had been seen by a local physician in North Karelia were analysed.</p><p><strong>Results: </strong>The main manifestations were fever (23%), rash (88%) and joint symptoms (93%). The joint symptoms in some patients lasted for several months and were severe enough to cause immobilization. The clinical picture was identical in those patients who had a definite serological diagnosis and those who did not have a detectable antibody response.</p><p><strong>Conclusion: </strong>The symptoms of Sindbis virus-induced Pogosta discase consist of fever, rash and joint symptoms, whic may be severe and prolonged.</p>","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 11","pages":"1177-80"},"PeriodicalIF":0.0,"publicationDate":"1998-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.11.1177","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20760213","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":"Can collagen type II sustain a methotrexate-induced therapeutic effect in patients with long-standing rheumatoid arthritis? A double-blind, randomized trial.","authors":"H. Häuselmann, M. Caravatti, B. Seifert, K. Wang, P. Bruckner, G. Stucki, B. Michel","doi":"10.1093/RHEUMATOLOGY/37.10.1110","DOIUrl":"https://doi.org/10.1093/RHEUMATOLOGY/37.10.1110","url":null,"abstract":"OBJECTIVE\u0000Based on the results of two recently published, randomized, double-blind and placebo-controlled studies, a possible improvement in rheumatoid arthritis disease activity after oral tolerization with triple helical collagen type II has been suggested. The goal of this study was to go one step further and ask the question whether collagen type II can sustain the therapeutic effect induced by methotrexate, the most widely accepted disease-modifying anti-rheumatic drug in patients with long-standing rheumatoid arthritis.\u0000\u0000\u0000METHODS\u0000Ninety-two patients with rheumatoid arthritis on stable therapy with methotrexate were enrolled in a 3 month double-blind, randomized and comparative study to examine the efficacy of oral triple helical collagen type II as compared to continuing methotrexate. The dose of methotrexate (or the respective placebo drug) and of concomitant corticosteroids was not changed and intra-articular corticosteroids were not allowed during the 3 months. The primary study endpoint was disease activity as measured by physician and patients.\u0000\u0000\u0000RESULTS\u0000While patients under ongoing therapy with methotrexate had, as expected, no change in disease activity, almost all parameters of disease activity and outcome in patients under a daily oral dose of 0.5 mg triple helical collagen type II worsened significantly (highly significant difference in swollen joints, between the two groups, P < 0.0001). No significant differences in side-effects between the two groups during the study period could be demonstrated.\u0000\u0000\u0000CONCLUSIONS\u0000Substitution of methotrexate with daily 0.5 mg of triple helical collagen type II in patients with rheumatoid arthritis leads to a significant increase in disease activity, suggesting that oral collagen type II at the given dose is not capable of sustaining the methotrexate-induced anti-inflammatory effect in patients with long-standing rheumatoid arthritis.","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"378 1","pages":"1110-7"},"PeriodicalIF":0.0,"publicationDate":"1998-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75861259","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":"Cost-effectiveness and cost-utility of combination therapy in early rheumatoid arthritis: randomized comparison of combined step-down prednisolone, methotrexate and sulphasalazine with sulphasalazine alone. COBRA Trial Group. Combinatietherapie Bij Reumatoïde Artritis.","authors":"A C Verhoeven,&nbsp;J C Bibo,&nbsp;M Boers,&nbsp;G L Engel,&nbsp;S van der Linden","doi":"10.1093/rheumatology/37.10.1102","DOIUrl":"https://doi.org/10.1093/rheumatology/37.10.1102","url":null,"abstract":"<p><strong>Objective: </strong>Assessment of the cost-effectiveness and cost-utility of early intervention in rheumatoid arthritis (RA) patients, with combined step-down prednisolone, methotrexate and sulphasalazine, compared to sulphasalazine alone.</p><p><strong>Methods: </strong>Multicentre 56 week randomized double-blind trial with full economic analysis of direct costs and utility analysis with rating scale and standard gamble measurement techniques.</p><p><strong>Results: </strong>The combined-treatment group included 76 patients and the sulphasalazine group 78 patients. The mean total costs per patient in the first 56 weeks of follow-up were $5519 for combined treatment and $6511 for treatment with sulphasalazine alone (P = 0.37). Out-patient care, in-patient care and non-health care each contributed about one-third to the total costs. The combined-treatment group appeared to generate savings in the length of hospital stay for RA, non-protocol drugs and costs of home help, but comparisons were not statistically significant. Protocol drugs and monitoring were slightly more expensive in the combined-treatment group. Clinical, radiographic and functional outcomes significantly favoured combined treatment at week 28 (radiography also at week 56). Utility scores also favoured combined treatment.</p><p><strong>Conclusion: </strong>Combined treatment is cost-effective due to enhanced efficacy at lower or equal direct costs.</p>","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 10","pages":"1102-9"},"PeriodicalIF":0.0,"publicationDate":"1998-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.10.1102","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20736898","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":"Chronic neck pain: a comparison of acupuncture treatment and physiotherapy.","authors":"J David,&nbsp;S Modi,&nbsp;A A Aluko,&nbsp;C Robertshaw,&nbsp;J Farebrother","doi":"10.1093/rheumatology/37.10.1118","DOIUrl":"https://doi.org/10.1093/rheumatology/37.10.1118","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of acupuncture, as compared with physiotherapy, in the management of chronic neck pain.</p><p><strong>Design: </strong>Seventy adult patients with non-inflammatory neck pain of >6 weeks duration and with no abnormal neurology were randomly assigned to receive either of the treatments. Thirty-five patients were included in each group.</p><p><strong>Outcome measures: </strong>Pain by visual analogue scale and neck pain questionnaire, improvement in range of movement of neck relative to baseline, and well-being (general health questionnaire). Measurements were recorded at the start of treatment, at 6 weeks and at 6 months.</p><p><strong>Results: </strong>Both treatment groups improved in all criteria. Acupuncture was slightly more effective in patients who had higher baseline pain scores.</p><p><strong>Conclusions: </strong>Both acupuncture and physiotherapy are effective forms of treatment. Since an untreated control group was not part of the study design, the magnitude of this improvement cannot be quantified.</p>","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 10","pages":"1118-22"},"PeriodicalIF":0.0,"publicationDate":"1998-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.10.1118","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20736900","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":"Shared epitope homozygosity' is strongly associated with rheumatoid arthritis in Turkey. Istanbul Rheumatology Study Group.","authors":"G Saruhan-Direskeneli","doi":"10.1093/rheumatology/37.10.1126","DOIUrl":"https://doi.org/10.1093/rheumatology/37.10.1126","url":null,"abstract":"<p><strong>Objective: </strong>Associations with HLA-DRB alleles, implicated in the aetiopathogenesis of rheumatoid arthritis (RA), are found to be different in various ethnic groups. This study aimed to investigate DRB1 alleles in RA patients in Turkey.</p><p><strong>Methods: </strong>The DRB region of the MHC was screened by polymerase chain reaction/sequence-specific oligonucleotide (PCR/SSO) hybridizations in 101 seropositive RA patients and compared with 101 healthy controls.</p><p><strong>Results: </strong>Significant differences were in the frequencies of DRB1*0404 (12 vs 1, P = 0.003, OR = 13.5), *0401 (19 vs 4, P = 0.001, OR = 5.6) and *0408 (5 vs 0, P = 0.06, OR = 11.6) between RA patients and controls. The shared epitope (SE) was present in 70.2% of RA patients compared to 31.6% of controls (P < 0.0001, OR = 5.1). A double dose of SE was considerably more frequent in the RA group (21 vs 1, P < 0.0001, OR = 26.5).</p><p><strong>Conclusion: </strong>These results support the reported positive association of RA with SE in seropositive patients in Turkey, and emphasize 'SE homozygosity' as the most strongly associated genetic susceptibility marker for RA.</p>","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 10","pages":"1126-8"},"PeriodicalIF":0.0,"publicationDate":"1998-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.10.1126","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20736902","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":"Neuropsychiatric systemic lupus erythematosus and the syndrome of inappropriate secretion of antidiuretic hormone: a case report with very late onset systemic lupus erythematosus.","authors":"S M Mirsattari,&nbsp;C Power,&nbsp;A Fine,&nbsp;G S McGinn,&nbsp;S Ludwick,&nbsp;J M Canvin","doi":"10.1093/rheumatology/37.10.1132","DOIUrl":"https://doi.org/10.1093/rheumatology/37.10.1132","url":null,"abstract":"<p><p>The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) associated with neuropsychiatric lupus (NP-SLE) is rare. We report a case of SIADH associated with the new onset of SLE in an 88-yr-old female. The unique features of this case include the extreme age of onset of SLE presenting with neuropsychiatric manifestations and positive antiribosomal P antibody titres. Both the NP manifestations of SLE and SIADH were highly correlated with the SLE disease activity. This case illustrates a novel presentation of NP-SLE with SIADH which may develop due to antibody-mediated hypothalamic dysfunction.</p>","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 10","pages":"1132-4"},"PeriodicalIF":0.0,"publicationDate":"1998-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.10.1132","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20736904","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":"Binding feet, the living legacy of the Ching Dynasty (1644-1912), China.","authors":"S K Ming","doi":"10.1093/rheumatology/37.10.1140","DOIUrl":"https://doi.org/10.1093/rheumatology/37.10.1140","url":null,"abstract":"","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 10","pages":"1140-1"},"PeriodicalIF":0.0,"publicationDate":"1998-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.10.1140","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20736909","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":"Diagnosis and course of early-onset arthritis: results of a special early arthritis clinic compared to routine patient care.","authors":"I E van der Horst-Bruinsma,&nbsp;I Speyer,&nbsp;H Visser,&nbsp;F C Breedveld,&nbsp;J M Hazes","doi":"10.1093/rheumatology/37.10.1084","DOIUrl":"https://doi.org/10.1093/rheumatology/37.10.1084","url":null,"abstract":"<p><strong>Objective: </strong>Early arthritis patients referred to an Early Arthritis Clinic (EAC) (n = 233) were compared to 241 patients from the routine out-patient clinic with respect to lag time between the onset of symptoms and the visit to the rheumatologist, clinical presentation and the consistency of the diagnosis after 1 yr.</p><p><strong>Results: </strong>The reduction in median lag time for the EAC patients was at least 3 months. An insidious onset of symptoms was found more often in the rheumatoid arthritis (RA) patients in the routine clinic. In 70% of all cases, a diagnosis could be made after 2 weeks and, if the clinical diagnosis was definite RA, this hardly changed during the following year. Early erosions were seen in 25% of RA patients and were associated with a positive rheumatoid factor (OR 2.08, 95% CI 0.95 4.59).</p><p><strong>Conclusion: </strong>An early diagnosis of RA at the EAC is possible and reliable; the high frequency of erosions illustrates the need for early treatment.</p>","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 10","pages":"1084-8"},"PeriodicalIF":0.0,"publicationDate":"1998-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.10.1084","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20736971","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":"Sjögren's syndrome: a community-based study of prevalence and impact.","authors":"E Thomas,&nbsp;E M Hay,&nbsp;A Hajeer,&nbsp;A J Silman","doi":"10.1093/rheumatology/37.10.1069","DOIUrl":"https://doi.org/10.1093/rheumatology/37.10.1069","url":null,"abstract":"<p><strong>Objective: </strong>Using the European Community (EC) criteria for classification Vitali et al. Arthritis Rheum 1993;36:340 7, we report the prevalence estimates of Sjogren's syndrome (SS) from a general population and present the first population data to assess the impact of the syndrome.</p><p><strong>Methods: </strong>A cross-sectional population-based survey performed on 1000 adults, aged 18-75 yr, randomly selected from a population register. Responders to the initial postal phase were invited for an interview. The five criteria measured at interview were: (1) the reporting of subjective oral symptoms lasting for > 3 months; (2) the reporting of subjective ocular symptoms lasting for >3 months; (3) Schirmer-I test; (4) unstimulated salivary flow; (5) autoantibodies [Ro (SS-A), La (SS-B), rheumatoid factor (RF), antinuclear antibodies (ANA)]. SS was diagnosed if at least four of these five criteria were positive. The MOS Short-form 36 (SF-36), General Health Questionnaire (GHQ) and the Health and Fatigue Questionnaire (HFQ) were completed by subjects after the interview, and scores were compared between those with and without a diagnosis of SS.</p><p><strong>Results: </strong>A total of 341 subjects completed both the postal questionnaire and home visit. A diagnosis of SS could be given to 13 subjects. After adjusting for the presence of possible bias due to non-response, our best estimate of the prevalence of SS in the study population was 33 per 1000 subjects (95% CI 22 44). The prevalence of the disorder was higher in females (38; 95% CI 27-52) and for those subjects aged > or = 55 yr (46; 95% CI 34-61). Those subjects diagnosed positively were more impaired for each of the eight dimensions of the SF-36 than those without a diagnosis, and also suffered from higher levels of depression and fatigue.</p><p><strong>Conclusions: </strong>SS affects approximately 3-4% of adults and in the general population appears to be associated with a clinically significant impairment of a subject's health and well-being.</p>","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"37 10","pages":"1069-76"},"PeriodicalIF":0.0,"publicationDate":"1998-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/rheumatology/37.10.1069","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20736969","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":"Histological and biochemical assessment of mitochondrial function in dermatomyositis.","authors":"Ò. Miró, J. Casademont, J. Grau, D. Jarreta, A. Urbano-Márquez, F. Cardellach","doi":"10.1093/RHEUMATOLOGY/37.10.1047","DOIUrl":"https://doi.org/10.1093/RHEUMATOLOGY/37.10.1047","url":null,"abstract":"OBJECTIVE\u0000Mitochondrial dysfunction in idiopathic inflammatory myopathies (IIM) remains a controversial issue. The aim of the present study was to investigate the correlation between histological abnormalities and the biochemical function of the skeletal muscle mitochondria from patients with dermatomyositis (DM).\u0000\u0000\u0000METHOD\u0000We evaluated 10 patients with a new diagnosis of DM and 15 healthy individuals, matched by age and gender. Muscle biopsy was routinely processed for histochemical studies and biochemical analysis of pure mitochondria. The percentages of ragged-red fibres (RRF), cytochrome c oxidase (COX)-negative fibres and succinic dehydrogenase (SDH) hyper-reactive fibres were calculated, oxygen utilization using different substrates was assessed polarographically, and enzymatic activity of individual complexes of the electron transport chain (ETC) and ATPase was measured spectrophotometrically.\u0000\u0000\u0000RESULTS\u0000We found an increased percentage of COX-negative and SDH hyper-reactive fibres in DM patients (0.82 and 1.82%, respectively) compared to controls (0.26 and 0.22%; P < 0.05 and P = 0.001, respectively); however, oxidation rates of different substrates and enzymatic activities of ETC and ATPase did not differ significantly between both groups.\u0000\u0000\u0000CONCLUSION\u0000The overall function of ETC from skeletal muscle mitochondria is not affected in DM.","PeriodicalId":9307,"journal":{"name":"British journal of rheumatology","volume":"51 1","pages":"1047-53"},"PeriodicalIF":0.0,"publicationDate":"1998-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90920603","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}