MedWorm: Rheumatology

Reumatologia 2008

Revista Brasileira de Reumatologia — Sat, 05 Jul 2008 15:34:14 +0100

(Source: Revista Brasileira de Reumatologia)

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Who cares wins: medical journalists vote arthritis care health charity of the year, uk

Arthritis News From Medical News Today — Fri, 04 Jul 2008 09:00:00 +0100

The UK's leading organisation supporting and representing the interests of people with any of the 200 forms of arthritis was last night voted Health Charity of the Year by members of the Medical Journalists' Association. The user-led charity, which celebrated its diamond jubilee in 2007 and pre-dates the NHS by one year, beat a distinguished field to scoop the coveted award. (Source: Arthritis News From Medical News Today)

The presence and utility of iga class antibodies to cyclic citrullinated peptides in early rheumatoid arthritis (the swedish tira project)

Arthritis Research and Therapy — Fri, 04 Jul 2008 04:00:00 +0100

IntroductionThe present study was done to assess whether IgA class antibodies against cyclic citrullinated peptides (IgA anti-CCP) in recent-onset rheumatoid arthritis (RA) adds diagnostic and/or prognostic information to IgG anti-CCP analysis. Methods: Serum samples were obtained from 228 patients with recent-onset ( (Source: Arthritis Research and Therapy)

Tnf-alpha assay shows cytokine response to methotrexate in ra patients

Medscape Rheumatology Headlines — Fri, 04 Jul 2008 02:05:07 +0100

An investigational in vitro tumor necrosis factor (TNF)-alpha assay may be useful in predicting treatment response in patients with rheumatoid arthritis (RA) who are starting methotrexate therapy. Reuters Health Information (Source: Medscape Rheumatology Headlines)

Fatigue in osteoarthritis: a qualitative study

Medscape Rheumatology Headlines — Thu, 03 Jul 2008 18:36:19 +0100

Fatigue in osteoarthritis is not routinely evaluated. What characterizes the fatigue experience in community-dwelling persons with osteoarthritis of the hip and knee? BMC Musculoskeletal Disorders (Source: Medscape Rheumatology Headlines)

Technology insight: adult mesenchymal stem cells for osteoarthritis therapy

Medscape Rheumatology Headlines — Thu, 03 Jul 2008 16:18:38 +0100

In this review, the authors outline the potential use of strategies based on mesenchymal stem cells, which can differentiate into cells of the chondrogenic lineage, in the regeneration and maintenance of damaged articular cartilage. Nature Clinical Practice Rheumatology (Source: Medscape Rheumatology Headlines)

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Phase ii results for low-dose oral immune tolerance therapy (arg201) in systemic scleroderma published

Arthritis News From Medical News Today — Thu, 03 Jul 2008 11:00:00 +0100

arGentis Pharmaceuticals, LLC announced that the Phase II results using highly purified type 1 bovine collagen orally (now known as ARG201) in the treatment of diffuse cutaneous systemic sclerosis (scleroderma - SSc) have been published in the June issue of Arthritis & Rheumatism, a major peer-reviewed rheumatology research journal. (Source: Arthritis News From Medical News Today)

Recurrent meningitis revealing a behçet’s disease

Rheumatology International — Thu, 03 Jul 2008 08:16:03 +0100

Abstract The aim of the present study was to describe a case of Behçet’s disease revealed by a recurrent meningitis and to review literature on these two conditions. We describe the case of a 25-year-old man who presented four episodes of recurrent meningitis without any locoregional cause and developed oral and genital ulcerations few months later. Behçet’s disease is a chronic, multisystemic disorder with variable prevalence in different geographical areas. Its neurological manifestations are well recognized. Both central and peripheral nervous systems can be involved. Recurrent meningitis in Behçet’s disease is exceptional. To our knowledge, only two cases reported recurrent meningitis as initial manifestation of Behçet’s disease. This case report underscores another facet of neurological manifestations of Behçet’s disease. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s00296-008-0643-3Authors Laïla Benjilali, Ibn Sina Hospital Internal Medicine Department Rabat MoroccoHicham Harmouche, Ibn Sina Hospital Internal Medicine Department Rabat MoroccoSiham El Bied, Ibn Sina Hospital Internal Medicine Department Rabat MoroccoJihan Raffali, Ibn Sina Hospital Internal Medicine Department Rabat MoroccoZoubida Tazi Mezalek, Ibn Sina Hospital Internal Medicine Department Rabat MoroccoMohamed Adnaoui, Ibn Sina Hospital Internal Medicine Department Rabat MoroccoMohamed Aouni, Ibn Sina Hospital Internal Medicine Department Rabat MoroccoAbdelaziz Maaouni, Ibn Sina Hospital Internal Medicine Department Rabat Morocco Journal Rheumatology InternationalOnline ISSN 1437-160XPrint ISSN 0172-8172 (Source: Rheumatology International)

The rate and significance of mediterranean fever gene mutations in patients with ankylosing spondylitis: a three-month, longitudinal clinical study

Rheumatology International — Thu, 03 Jul 2008 08:16:02 +0100

Abstract In this study, our aim was to investigate the prevalence of Mediterranean fever (MEFV) gene mutations in patients with ankylosing spondylitis (AS) and assessing their clinical significance. Ninety-five consecutive patients (12 women, 83 men) with active AS were included to the study. All patient’s relevant clinical data were recorded at the beginning and patient assessment measures were performed. The frequency of the eight most common MEFV mutations: M694V, V726A, E148Q, M680I, M694I, P369S, F479L, and the R761H were determined. Genetic analysis was carried out by the NanoChip® Molecular Genetics Workstation. NSAIDs were given to patients for treatment. The rate of MEFV mutations and their clinical significance were assessed. With regard to the MEFV mutation analysis, 30.5% of AS patients were found to have at least one mutation. The response rate to the NSAIDs (P = 0.825) or frequency of patients having active disease (P = 0.066) after the treatment, were not found different between the patients those have MEFV mutations and the patients those were non-carriers. Furthermore, no clinical and laboratory difference between MEFV mutation carriers and non-carriers were found. We think that although prevalence of MEFV mutations is significantly high in AS patients without clinical features of familial Mediterranean fever, its influence to the prognosis is less likely. Further investigations are needed to define the impact of MEFV mutations on the disease course of ankylosing spondylitis. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00296-008-0637-1Authors Muhammet Cinar, Gülhane Askeri Tıp Akademisi Romatoloji Bilim Dalı Department of Internal Medicine Etlik Ankara 06010 TurkeyAyhan Dinc, Gülhane Askeri Tıp Akademisi Romatoloji Bilim Dalı Rheumatology Division Etlik Ankara 06010 TurkeyIsmail Simsek, Gülhane Askeri Tıp Akademisi Romatoloji Bilim Dalı Rheumatology Division Etlik Ankara 06010 TurkeyHakan Erdem, Gülhane Askeri Tıp Akademisi Romatoloji Bilim Dalı Rheumatology Division Etlik Ankara 06010 TurkeyBayram Koc, Gülhane Askeri Tıp Akademisi Romatoloji Bilim Dalı Department of Internal Medicine Etlik Ankara 06010 TurkeySalih Pay, Gülhane Askeri Tıp Akademisi Romatoloji Bilim Dalı Rheumatology Division Etlik Ankara 06010 TurkeyYusuf Tunca, Gülhane Askeri Tıp Akademisi Romatoloji Bilim Dalı Department of Medical Genetics Etlik Ankara 06010 TurkeySelim Kilic, Gülhane Askeri Tıp Akademisi Romatoloji Bilim Dalı Department of Epidemiology Etlik Ankara 06010 TurkeyDavud Gul, Gülhane Askeri Tıp Akademisi Romatoloji Bilim Dalı Department of Medical Genetics Etlik Ankara 06010 Turkey Journal Rheumatology InternationalOnline ISSN 1437-160XPrint ISSN 0172-8172 (Source: Rheumatology International)

Associations with subregional bmd-measurements in patients with rheumatoid arthritis

Rheumatology International — Thu, 03 Jul 2008 08:16:02 +0100

Abstract Patients with rheumatoid arthritis (RA) have bone loss to various degrees at different skeletal sites. The subregional bone mineral density (BMD) of the hand and the correlation of BMD to other regional bone losses, parameters of inflammation or bone resorption was evaluated in 421 patients with RA and controls. RA patients had significantly (P < 0.01) lower BMD values in the carpus (0.405 ± 0.004 g/cm2), metacarpal joint II (0.318 ± 0.036 g/cm2) and metacarpal joint III (0.326 ± 0.022 g/cm2) compared to controls. There was no difference in bone density at the lumbar spine or hip. Significant (P < 0.001) correlations were found between BMD total of the hand, its subregions, the forearm and hip. Parameters of inflammation correlated significantly (P < 0.001) with pyridinolines (r = 0.378), desoxypyridinolines (r = 0.183), forearm (r = −10, P < 0.05), MCP II (r = −0.190, P < 0.001), MCP III (r = 0.204, P < 0.001) and carpus (r = 0.191, P < 0.001). Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00296-008-0638-0Authors H. Franck, Schwerpunktspraxis für Rheumatologie/Endokrinologie Godesbergerallee 90 52175 Bonn GermanyJ. Gottwalt, Rheumazentrum Oberammergau Hubertusstr. 40 82487 Oberammergau Germany Journal Rheumatology InternationalOnline ISSN 1437-160XPrint ISSN 0172-8172 (Source: Rheumatology International)

Expression of mmp-1 in cartilage and synovium of experimentally induced rabbit aclt traumatic osteoarthritis: immunohistochemical study

Rheumatology International — Thu, 03 Jul 2008 08:16:01 +0100

Abstract To observe the level and the distribution of MMP-1 in cartilage and synovium over the progression of OA in rabbit ACLT model, and to explore the relationship between the amount of MMP-1 expression and the degree of OA cartilage degradation. OA was induced in 20 rabbits by anterior cruciate ligament transection (ACLT) and ten rabbits were killed at 4 and 8 weeks after the operation, respectively. A further ten rabbits received unilateral knee arthrotomy as controls. Cartilage degradation was observed under dissecting microscope, immunohistochemical, and morphometric analysis were adopted to record the tissue level and distribution of MMP-1 in cartilage and synovium. Cartilage degradation in both ACLT groups was more severe than that in control group, and the degradation in 8-week ACLT group was more severe than that in 4-week ACLT group. MMP-1 was expressed predominantly in the superficial and upper intermediate layers of cartilage and in the lining layer of synovium. Its expression was increased steadily over the progression of OA both in cartilage and in synovium, but there was a little difference in the increase pattern between them: increase of MMP-1 in synovium lagged behind that in cartilage in early stage of OA. Conclusion: MMP-1 was involved in OA development in rabbit ACLT model and the amount of its expression was related with the degree of cartilage degradation. The increase of MMP-1 expression in synovium lagged behind that in cartilage, suggesting OA pathology was originated from cartilage, but synovitis may also paticipate in cartilage degradation, especially in middle and late stage of OA. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00296-008-0636-2Authors Hongbin Wu, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology Wuhan ChinaJingyuan Du, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology Wuhan ChinaQixin Zheng, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology Wuhan China Journal Rheumatology InternationalOnline ISSN 1437-160XPrint ISSN 0172-8172 (Source: Rheumatology International)

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Increase levels of apo-a1 and apo b are associated in knee osteoarthritis: lack of association with vegf -460 t/c and +405 c/g polymorphisms

Rheumatology International — Thu, 03 Jul 2008 08:15:58 +0100

Abstract To investigate the genotype and allele frequency of vascular endothelial growth factor gene polymorphisms in knee osteoarthritis (OA) and their relationship with disease activity and lipid profile, we enrolled 49 knee OA patients and 75 healthy subjects (HS) as a control group. Body mass index (BMI), laboratorial assessment and genotyped by polymerase chain reaction–restriction fragment length polymorphisms (PCR–RFLP) were studied in both groups. Disease activity was determined using Lequesne and WOMAC indexes; a P value < 0.05 was considered significant. The −460 and +405 VEGF polymorphisms did not shown significant association between OA patients and HS. However, between OA patients and HS a significant differences were observed in BMI, age, apo A-I and apo B, independently of both polymorphisms studied (P < 0.05). In conclusion, increased apo A-1 and apo B levels are associated in knee OA, but the −460 T/C and +405 C/G VEGF polymorphisms are not associated with knee OA susceptibility. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00296-008-0633-5Authors Sergio Sánchez-Enríquez, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara Instituto de Investigación en Reumatología y del Sistema Músculo Esquelético Guadalajara Jalisco MexicoNora Magdalena Torres-Carrillo, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara Instituto de Investigación en Reumatología y del Sistema Músculo Esquelético Guadalajara Jalisco MexicoMónica Vázquez-Del Mercado, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara Instituto de Investigación en Reumatología y del Sistema Músculo Esquelético Guadalajara Jalisco MexicoLorenzo Salgado-Goytia, Universidad Autónoma de Guerrero Unidad Académica de Ciencias Químico-Biológicas Guadalajara MexicoHéctor Rangel-Villalobos, Centro Universitario de la Ciénega, Universidad de Guadalajara Instituto de Genética Humana Guadalajara MexicoJosé Francisco Muñoz-Valle, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara Instituto de Investigación en Reumatología y del Sistema Músculo Esquelético Guadalajara Jalisco Mexico Journal Rheumatology InternationalOnline ISSN 1437-160XPrint ISSN 0172-8172 (Source: Rheumatology International)

Meditation, yoga might switch off stress genes

MedicineNet Rheumatoid Arthritis General — Thu, 03 Jul 2008 07:00:00 +0100

Title: Meditation, Yoga Might Switch Off Stress GenesCategory: Health NewsCreated: 7/3/2008 2:00:00 AMLast Editorial Review: 7/3/2008 (Source: MedicineNet Rheumatoid Arthritis General)

Lung infections cost hospitals more than $10b in 2006

MedicineNet Rheumatoid Arthritis General — Thu, 03 Jul 2008 07:00:00 +0100

Title: Lung Infections Cost Hospitals More Than $10B in 2006Category: Health NewsCreated: 7/3/2008 2:00:00 AMLast Editorial Review: 7/3/2008 (Source: MedicineNet Rheumatoid Arthritis General)

Vitamins, minerals & nutritional supplements

MedicineNet Rheumatoid Arthritis General — Thu, 03 Jul 2008 07:00:00 +0100

Title: Vitamins, Minerals & Nutritional SupplementsCategory: Health and LivingCreated: 9/2/2005Last Editorial Review: 7/3/2008 (Source: MedicineNet Rheumatoid Arthritis General)

Human infrapatellar fat pad derived stem cells express the pericyte marker 3g5 and show enhanced chondrogenesis after expansion in fibroblast growth factor-2

Arthritis Research and Therapy — Thu, 03 Jul 2008 04:00:00 +0100

IntroductionInfrapatellar fat pad (IPFP) is a possible source of stem cells for the repair of articular cartilage defects. In this study adherent proliferative cells were isolated from digests of IPFP tissue. The effects of the expansion of these cells in FGF-2 were tested on their proliferation, characterisation and chondrogenic potential. Methods: IPFP tissue was obtained from six patients undergoing total knee replacement and sections were stained with 3G5, SMA and vWF to identify different cell types in the vasculature. Cells were isolated from IPFP, and both mixed populations and clonal lines derived from them were characterised for cell surface epitopes including 3G5. Cells were expanded with and without FGF-2 and were tested for chondrogenic differentiation in cell aggregate cultures. Results: 3G5 positive cells were present in perivascular regions in tissue section of the IPFP and proliferative adherent cells isolated from the IPFP were also 3G5 positive. However, 3G5 expression was only on a small proportion of cells in all populations and at all passages, including the clonally expanded cells. The cells showed cell surface epitope expression similar to adult stem cells. They stained strongly for CD13, CD29, CD44, CD90 and CD105 and were negative for CD34 and CD56, but also negative for LNGFR and STRO1. The IPFP derived cells showed chondrogenic differentiation in cell aggregate cultures and prior expansion with FGF-2 enhanced chondrogenesis. Expansion in FGF-2 resulted in greater down-regulation of many cartilage-associated genes, but on subsequent chondrogenic differentiation they showed stronger up-regulation of these genes and this resulted in greater matrix production per cell. Conclusions: These results show that these cells express mesenchymal stem cell markers but further work is needed to determine the true origin of these cells. These results suggest that expansion of these cells with FGF-2 has important consequences for facilitating their chondrogenic differentiation. (Source: Arthritis Research and Therapy)

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Multitargeted immune therapy scores well for severe lupus nephritis

MedPage Today Rheumatology — Wed, 02 Jul 2008 19:18:56 +0100

NANJING, China -- In patients with severe combined lupus nephritis, multitargeted immune therapy led to more than a six-fold increase in the rate of complete remissions compared with intravenous cyclophosphamide, investigators here reported. (Source: MedPage Today Rheumatology)

Cimzia(r) filed with emea for treatment of rheumatoid arthritis, europe

Arthritis News From Medical News Today — Wed, 02 Jul 2008 09:00:00 +0100

UCB announced that a Marketing Authorisation Application (MAA) has been submitted to the European Medicines Agency (EMEA) requesting the approval of Cimzia® (certolizumab pegol) as a subcutaneous treatment for adults with moderate to severe active rheumatoid arthritis (RA) and has been accepted for review. Subject to approval, Cimzia® will be the first and only PEGylated, Fc-Free anti-TNF (Tumour Necrosis Factor alpha) biologic therapy available in Europe for the treatment of RA. (Source: Arthritis News From Medical News Today)

Extreme heat a deadly risk for older adults

MedicineNet Rheumatoid Arthritis General — Wed, 02 Jul 2008 07:00:00 +0100

Title: Extreme Heat a Deadly Risk for Older AdultsCategory: Health NewsCreated: 7/2/2008 2:00:00 AMLast Editorial Review: 7/2/2008 (Source: MedicineNet Rheumatoid Arthritis General)

Health tip: stop smoking, save your bones

MedicineNet Rheumatoid Arthritis General — Wed, 02 Jul 2008 07:00:00 +0100

Title: Health Tip: Stop Smoking, Save Your BonesCategory: Health NewsCreated: 7/2/2008 2:00:00 AMLast Editorial Review: 7/2/2008 (Source: MedicineNet Rheumatoid Arthritis General)

Eleven tips for a safe fourth of july

MedicineNet Rheumatoid Arthritis General — Wed, 02 Jul 2008 07:00:00 +0100

Title: Eleven Tips for a Safe Fourth of JulyCategory: Doctor's ViewsCreated: 6/26/2007Last Editorial Review: 7/2/2008 (Source: MedicineNet Rheumatoid Arthritis General)

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Could caffeine stop ms in its tracks?

MedicineNet Rheumatoid Arthritis General — Tue, 01 Jul 2008 07:00:00 +0100

Title: Could Caffeine Stop MS in Its Tracks?Category: Health NewsCreated: 7/1/2008Last Editorial Review: 7/1/2008 (Source: MedicineNet Rheumatoid Arthritis General)

Abdominal pain

MedicineNet Rheumatoid Arthritis General — Tue, 01 Jul 2008 07:00:00 +0100

Title: Abdominal PainCategory: Diseases and ConditionsCreated: 12/31/1997Last Editorial Review: 7/1/2008 (Source: MedicineNet Rheumatoid Arthritis General)

Females with high birth weight more likely to develop rheumatoid arthritis

Body Aches News From Medical News Today — Tue, 01 Jul 2008 07:00:00 +0100

A new study published in the Annals of the Rheumatic Diseases finds that compared to females born with average birth weight, those born with heavy birth weight are two times as likely to develop rheumatoid arthritis when they become adults. Rheumatoid arthritis is a condition that occurs when the immune system attacks the joints, lungs or skin and results in inflammation, pain, and loss of functioning mobility. (Source: Body Aches News From Medical News Today)

High birth weight doubles risk of rheumatoid arthritis

MedicineNet Rheumatoid Arthritis General — Tue, 01 Jul 2008 07:00:00 +0100

Title: High Birth Weight Doubles Risk of Rheumatoid ArthritisCategory: Health NewsCreated: 7/1/2008 2:00:00 AMLast Editorial Review: 7/1/2008 (Source: MedicineNet Rheumatoid Arthritis General)

Scientists id new genes tied to crohn's disease

MedicineNet Rheumatoid Arthritis General — Tue, 01 Jul 2008 07:00:00 +0100

Title: Scientists ID New Genes Tied to Crohn's DiseaseCategory: Health NewsCreated: 7/1/2008 2:00:00 AMLast Editorial Review: 7/1/2008 (Source: MedicineNet Rheumatoid Arthritis General)

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Herniated disc - epidural cortisone injections

MedicineNet Rheumatoid Arthritis General — Tue, 01 Jul 2008 07:00:00 +0100

Title: Herniated Disc - Epidural Cortisone InjectionsCategory: Doctor's ViewsCreated: 12/31/1997Last Editorial Review: 7/1/2008 (Source: MedicineNet Rheumatoid Arthritis General)

Successful cyclophosphamide therapy with complete resolution of pulmonary artery aneurysm in hughes–stovin syndrome patient

Clinical Rheumatology — Tue, 01 Jul 2008 06:05:14 +0100

Abstract Hughes–Stovin syndrome is an exceedingly rare disorder of unknown etiology, and it is characterized by multiple pulmonary artery aneurysms and peripheral venous thrombosis. We report a case of Hughes–Stovin syndrome with complete resolution of pulmonary artery aneurysm after treatment with cyclophosphamide. A 48-year-old man presented with massive hemoptysis, fever, and weight loss of 4-month duration. Computed tomography angiography revealed multiple pulmonary arterial aneurysms of variable sizes in both lung fields. Inferior vena caval thrombosis was also noted. Despite multiple surgical procedures including embolectomy and lobectomy combined with steroid therapy, new aneurysms continued to appear with persistent hemoptysis. Thorough history and physical examination did not suggest any evidence of Behcet’s disease. Hughes–Stovin syndrome was subsequently diagnosed. High-dose prednisolone combined with oral cyclophosphamide therapy was initiated. Chest radiography follow-up in 3 months revealed complete resolution of pulmonary aneurysm. No new aneurysm was detected at 15 months of follow-up. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s10067-008-0951-8Authors Jaejoon Lee, Sungkyunkwan University School of Medicine Department of Medicine, Samsung Medical Center 50 Ilwon-dong, Gangnam-gu Seoul 135-710 Republic of KoreaJung-Won Noh, Sungkyunkwan University School of Medicine Department of Medicine, Samsung Medical Center 50 Ilwon-dong, Gangnam-gu Seoul 135-710 Republic of KoreaJi Won Hwang, Sungkyunkwan University School of Medicine Department of Medicine, Samsung Medical Center 50 Ilwon-dong, Gangnam-gu Seoul 135-710 Republic of KoreaHyungjin Kim, Sungkyunkwan University School of Medicine Department of Medicine, Samsung Medical Center 50 Ilwon-dong, Gangnam-gu Seoul 135-710 Republic of KoreaJoong Kyong Ahn, Sungkyunkwan University School of Medicine Department of Medicine, Samsung Medical Center 50 Ilwon-dong, Gangnam-gu Seoul 135-710 Republic of KoreaEun-Mi Koh, Sungkyunkwan University School of Medicine Department of Medicine, Samsung Medical Center 50 Ilwon-dong, Gangnam-gu Seoul 135-710 Republic of KoreaHoon-Suk Cha, Sungkyunkwan University School of Medicine Department of Medicine, Samsung Medical Center 50 Ilwon-dong, Gangnam-gu Seoul 135-710 Republic of Korea Journal Clinical RheumatologyOnline ISSN 1434-9949Print ISSN 0770-3198 (Source: Clinical Rheumatology)

Steroid-refractory severe hepatic failure in adult onset still’s disease responding to cyclosporine

Clinical Rheumatology — Tue, 01 Jul 2008 06:05:14 +0100

Abstract We report two Japanese women with severe hepatic dysfunction and adult onset Still’s disease. A 51-year-old woman had been diagnosed with adult onset Still’s disease 3 years earlier. She relapsed while on maintenance therapy with prednisolone and methotrexate. After induction of remission with methylprednisolone pulse therapy, indomethacin, and methotrexate, severe hepatic failure occurred. This patient lacked the typical symptoms of adult onset Still’s disease. The second patient was a 32-year-old woman with typical adult onset Still’s disease. Remission was induced by high-dose prednisolone and methylprednisolone pulse therapy plus cyclosporine. After she stopped cyclosporine, severe liver dysfunction occurred. In both patients, liver dysfunction occurred during high-dose steroid therapy, and oral cyclosporine (3 mg/kg per day) dramatically improved their liver function. When steroid-resistant severe hepatic failure occurs in patients with adult onset Still’s disease, cyclosporine may be the immunosuppressant of choice. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s10067-008-0950-9Authors Takao Nagashima, Jichi Medical University Division of Rheumatology and Clinical Immunology Yakushiji 3311-1 Shimotsuke-shi Tochigi 329-0498 JapanYoko Aoki, Jichi Medical University Division of Rheumatology and Clinical Immunology Yakushiji 3311-1 Shimotsuke-shi Tochigi 329-0498 JapanSachiko Onishi, Jichi Medical University Division of Rheumatology and Clinical Immunology Yakushiji 3311-1 Shimotsuke-shi Tochigi 329-0498 JapanMasahiro Iwamoto, Jichi Medical University Division of Rheumatology and Clinical Immunology Yakushiji 3311-1 Shimotsuke-shi Tochigi 329-0498 JapanHitoaki Okazaki, Jichi Medical University Division of Rheumatology and Clinical Immunology Yakushiji 3311-1 Shimotsuke-shi Tochigi 329-0498 JapanSeiji Minota, Jichi Medical University Division of Rheumatology and Clinical Immunology Yakushiji 3311-1 Shimotsuke-shi Tochigi 329-0498 Japan Journal Clinical RheumatologyOnline ISSN 1434-9949Print ISSN 0770-3198 (Source: Clinical Rheumatology)

Rare association of antisynthetase syndrome and kennedy’s disease

Clinical Rheumatology — Tue, 01 Jul 2008 06:05:11 +0100

Abstract Antisynthetase syndrome is a type of Idiopathic Inflammatory Myopathy (IIM) associated with anti-Jo1 antibody. Kennedy’s disease or X-linked spinal and bulbar muscular atrophy (SBMA) is a rare neuromuscular disease. We describe the case report of a 53-year-old man who presented with proximal muscle weakness and a history of bilateral hand tremor. Initial physical examination demonstrated “mechanic’s hands”, Raynaud’s phenomenon, having elevated creatine kinase and lactate dehydrogenase levels and anti-Jo1 antibody positivity. His muscle biopsy demonstrated inflammatory infiltrate characteristic of IIM. Considering these findings, we reached the diagnosis of antisynthetase syndrome and commenced immunosuppressive therapy. On follow-up examination, he had developed dysphagia, and his tremor had worsened. His electroneurogram result was characteristic of Kennedy’s disease, and the genetic test result showed an allele with 44 CAG repeat expansion in the androgen receptor gene of the X chromosome. This confirmed that in addition to antisynthetase syndrome, he also had Kennedy’s disease. This patient now receives immunology and neurology follow-up. His symptoms have improved with low dose corticosteroids, propranolol for tremor, vitamin B supplementation, and physiotherapy. This article presents a rare case report of a patient with concurrent antisynthetase syndrome and Kennedy’s disease, both of which lead to elevated creatine kinase levels and muscle weakness, thus, underpinning the importance of careful follow-up of patients with IIM and maintaining an open mind to other diagnoses when faced with refractory and/or new symptoms. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s10067-008-0946-5Authors Nora Szabo, University of Debrecen Medical and Health Science Centre Division of Clinical Immunology, Third Department of Internal Medicine, Institute of Internal Medicine Moricz Zs. str 22 4004 Debrecen HungarySzilveszter Lukacs, Spire Portsmouth Hospital Portsomouth UKWiranthi Gunasekera, Spire Portsmouth Hospital Portsomouth UKKatalin Danko, University of Debrecen Medical and Health Science Centre Division of Clinical Immunology, Third Department of Internal Medicine, Institute of Internal Medicine Moricz Zs. str 22 4004 Debrecen Hungary Journal Clinical RheumatologyOnline ISSN 1434-9949Print ISSN 0770-3198 (Source: Clinical Rheumatology)

Intramuscular gold for the treatment of seronegative spondyloarthropathy associated with familial mediterranean fever

Rheumatology International — Tue, 01 Jul 2008 05:53:57 +0100

Abstract Articular attack is a common feature of familial Mediterranean fever (FMF). FMF arthritis commonly resolves without any sequale within a few weeks. However, approximately 10% of the patients develop protracted arthritis persisting for months to years. Treatment with colchicine may not be effective and nonsteroidal antiinflammatory drugs or second line agents may be needed for the management of protracted arthritis. In this paper, we describe a 22-year-old patient with FMF who was complicated with protracted arthritis in the knee and shoulder joints and bilateral sacroiliitis. He was successfully treated by intramuscular gold 50 mg weekly. However, gold treatment was discontinued 8 months later because of the development of asymptomatic proteinuria. In conclusion, FMF should be considered in the evaluation of peripheric oligoarthritis, particularly in patients with Mediterranean origin. Intramuscular gold might be an effective agent. However, care should be taken regarding the development of proteinuria. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s00296-008-0631-7Authors Mehmet D. Demirag, Gazi University, School of Medicine Department of Internal Medicine, Section of Rheumatology Demetgül Mah. 6. sokak No:15/16, Yenimahalle 06200 Ankara TurkeyMehmet A. Ozturk, Gazi University, School of Medicine Department of Internal Medicine, Section of Rheumatology Demetgül Mah. 6. sokak No:15/16, Yenimahalle 06200 Ankara TurkeyBerna Goker, Gazi University, School of Medicine Department of Internal Medicine, Section of Rheumatology Demetgül Mah. 6. sokak No:15/16, Yenimahalle 06200 Ankara TurkeySeminur Haznedaroglu, Gazi University, School of Medicine Department of Internal Medicine, Section of Rheumatology Demetgül Mah. 6. sokak No:15/16, Yenimahalle 06200 Ankara Turkey Journal Rheumatology InternationalOnline ISSN 1437-160XPrint ISSN 0172-8172 (Source: Rheumatology International)

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Prevalence and risk factors of osteoporosis in patients with parkinson’s disease

Rheumatology International — Tue, 01 Jul 2008 05:53:56 +0100

Abstract Parkinson’s disease (PD) is the most common cause of disability in the elderly. It is currently recognized as a cause of secondary osteoporosis. To evaluate the prevalence of osteoporosis in PD and detect its risk factors, 52 patients with PD (36 men/16 women) and 52 controls paired for age and sex were recruited. Clinical data including demography, disease duration and disease severity were collected. All subjects had bone mineral density (BMD) measured by dual energy X-ray absorptiometry, dorsal and lumbar spine X-ray, and biological exams (osteocalcin, CTX, parathormon). The mean age of the patients was 60.0 ± 9.25 years [30–77], and the mean disease duration was 4.9 ± 4.5 years [0.2–17]. Nine patients (17.3%) were osteoporotic and 28 (53.8%) osteopenic. BMD at the lumbar spine and the hip was lower among patients than controls (spine: 1.031 vs. 1.175 g/cm2; P < 0.001; hip: 0.968 vs. 1.054; P = 0.02). PD patients with low BMD presented a more severe disease and an insufficient sun exposure and calcium intake. There was a positive statistically significant correlation between patients BMD and body mass index and negative correlation with age, severity of PD, and osteocalcin levels. The prevalence of osteoporosis/osteopenia is high in PD patients and seems related to the severity of the disease, an insufficient sun exposure and calcium intake. This osteoporosis constitutes with falls the major risk factors of fracture in PD patients. Content Type Journal ArticleCategory Original PaperDOI 10.1007/s00296-008-0632-6Authors A. Bezza, Military Hospital Mohammed V Rheumatology and Physical Rehabilitation Centre PO Box: 1018 Rabat MoroccoZ. Ouzzif, Military Hospital Mohammed V Biochemistry Department PO Box: 1018 Rabat MoroccoH. Naji, Military Hospital Mohammed V Rheumatology and Physical Rehabilitation Centre PO Box: 1018 Rabat MoroccoL. Achemlal, Military Hospital Mohammed V Rheumatology and Physical Rehabilitation Centre PO Box: 1018 Rabat MoroccoA. Mounach, Military Hospital Mohammed V Rheumatology and Physical Rehabilitation Centre PO Box: 1018 Rabat MoroccoM. Nouijai, Military Hospital Mohammed V Rheumatology and Physical Rehabilitation Centre PO Box: 1018 Rabat MoroccoA. Bourazza, Military Hospital Mohammed V Neurology Department PO Box: 1018 Rabat MoroccoR. Mossadeq, Military Hospital Mohammed V Neurology Department PO Box: 1018 Rabat MoroccoA. El Maghraoui, Military Hospital Mohammed V Rheumatology and Physical Rehabilitation Centre PO Box: 1018 Rabat Morocco Journal Rheumatology InternationalOnline ISSN 1437-160XPrint ISSN 0172-8172 (Source: Rheumatology International)

Bronchus-associated lymphoid tissue lymphoma in a patient with primary sjögren’s syndrome

Rheumatology International — Tue, 01 Jul 2008 05:53:54 +0100

Abstract Despite its infrequent occurrence, the possible development of lymphoma or lymphoid lung disease in patients with Sjögren’s syndrome should always be borne in mind. We describe a case of bronchus-associated lymphoid tissue (BALT) lymphoma in a patient with Sjögren’s syndrome that clearly exemplifies the wide-ranging problems of diagnosing, treating and following such patients. This difficulty is due to the fact that the clinical and radiological findings suggest interstitial lung disease, and histological assays are required for a correct diagnosis. A precise knowledge of the various histological and radiological patterns of lung involvement can aid patient management. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s00296-008-0645-1Authors Francesca Ingegnoli, Istituto Gaetano Pini, Chair of Rheumatology, University of Milan Department of Rheumatology Piazza Cardinal Ferrari 1 20122 Milan ItalyAlba Sciascera, Azienda Ospedaliera S. Anna Department of Internal Medicine Como ItalyValentina Galbiati, Istituto Gaetano Pini, Chair of Rheumatology, University of Milan Department of Rheumatology Piazza Cardinal Ferrari 1 20122 Milan ItalyVincenzo Corbelli, Azienda Ospedaliera S. Anna Department of Internal Medicine Como ItalyEnzo D’Ingianna, Azienda Ospedaliera S. Anna Department of Internal Medicine Como ItalyFlavio Fantini, Istituto Gaetano Pini, Chair of Rheumatology, University of Milan Department of Rheumatology Piazza Cardinal Ferrari 1 20122 Milan Italy Journal Rheumatology InternationalOnline ISSN 1437-160XPrint ISSN 0172-8172 (Source: Rheumatology International)

Paget’s disease of bone: a review

Rheumatology International — Tue, 01 Jul 2008 05:53:53 +0100

Abstract Paget’s disease of bone (PDB) is a condition of unknown etiology characterized by excessive and abnormal bone remodeling. It may be localized to one or several skeletal segments. The disease seldom appears before the age of 40 years, but its prevalence tends to double each decade from the age of 50 onwards, reaching about 10% after ninth decade. PDB may virtually affect every bone in the skeleton. Affected bones are involved right away with no new involvement during the evolution. The basic symptom of the disease is bone pain, while complications depend on skeletal sites involved and range from secondary osteoarthritis to malignant degeneration. Diagnosis is usually based upon clinical features, imaging, and laboratory analyses. Therapeutic approach is currently based on second-generation bisphosphonates. Their use is recommended when bone alkaline phosphatase is high and/or when the disease localizations are highly suspected for determining complications. Content Type Journal ArticleCategory ReviewDOI 10.1007/s00296-008-0640-6Authors Matteo Colina, Ferrara ItalyRenato La Corte, Ferrara ItalyFrancesco De Leonardis, Ferrara ItalyFrancesco Trotta, Ferrara Italy Journal Rheumatology InternationalOnline ISSN 1437-160XPrint ISSN 0172-8172 (Source: Rheumatology International)

5-ht3 receptor antagonist for the treatment of tendinopathy.

Nature Clinical Practice. Rheumatology. — Tue, 01 Jul 2008 04:00:00 +0100

5-HT3 receptor antagonist for the treatment of tendinopathy.

Nat Clin Pract Rheumatol. 2008 Jul;4(7):E4

Authors: Mousavizadeh K, Stratz T, Mueller W, Fiebich BL

PMID: 18597984 [PubMed - in process]

(Source: Nature Clinical Practice. Rheumatology.)

Cryopreserved and frozen hyaline cartilage imaged by environmental scanning electron microscope. an experimental and prospective study.

J Rheumatol — Tue, 01 Jul 2008 04:00:00 +0100

Cryopreserved and Frozen Hyaline Cartilage Imaged by Environmental Scanning Electron Microscope. An Experimental and Prospective Study.

J Rheumatol. 2008 Jul 1;

Authors: Sastre S, Suso S, Segur JM, Bori G, Carbonell JA, Agustí E, Nuñez M

OBJECTIVE: To obtain images of the articular surface of osteochondral grafts (fresh, frozen, and cryopreserved in RPMI) using an environmental scanning electron microscope (ESEM). To evaluate and compare the main morphological aspects of the chondral surface of the fresh, frozen, and cryopreserved grafts as visualized via ESEM. METHODS: The study was based on osteochondral fragments from the internal condyle of the knee joint of New Zealand rabbits, corresponding to the chondral surface from fresh, frozen, and cryopreserved samples. One hundred ESEM images were obtained from each group and then classified according to a validated system. The kappa index and the corresponding concordance index were calculated, and the groups were compared by Pearson's chi-squared test (p < 0.05). RESULTS: The articular surface of cryopreserved osteochondral grafts had fewer even surfaces and filled lacunae and a higher number of empty lacunae as compared to fresh samples; these differences correspond to images of cell membrane lesions that lead to destruction of the chondrocyte. Frozen grafts showed more hillocky and knobby surfaces than did fresh grafts; they also had a greater number of empty chondrocyte lacunae. CONCLUSION: ESEM is useful for obtaining images of the surface of osteochondral grafts. When compared to fresh samples, cryopreservation in RPMI medium produces changes in the surface of hyaline cartilage, but to a lesser extent than those produced by freezing.

PMID: 18597396 [PubMed - as supplied by publisher]

(Source: J Rheumatol)

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Occupation-related squatting, kneeling, and heavy lifting and the knee joint: a magnetic resonance imaging-based study in men.

J Rheumatol — Tue, 01 Jul 2008 04:00:00 +0100

Occupation-Related Squatting, Kneeling, and Heavy Lifting and the Knee Joint: A Magnetic Resonance Imaging-Based Study in Men.

J Rheumatol. 2008 Jul 1;

Authors: Amin S, Goggins J, Niu J, Guermazi A, Grigoryan M, Hunter DJ, Genant HK, Felson DT

OBJECTIVE: We examined the relation between occupational exposures to frequent squatting/kneeling and/or heavy lifting with cartilage morphology, based on magnetic resonance imaging (MRI), at the tibiofemoral and patellofemoral joints in men and determined which compartments are most affected. METHODS: We evaluated 192 men with symptomatic knee osteoarthritis (OA). The more symptomatic knee was imaged using MRI. Cartilage was scored using the Whole Organ MRI Score semiquantitative method at the medial and lateral tibiofemoral joint and patellofemoral joint. Occupational exposures to frequent squatting, kneeling, and/or heavy lifting were assessed using a validated questionnaire. RESULTS: Among the 192 men [mean (+/- standard deviation) age 69 +/- 9 yrs, body mass index (BMI) 30.8 +/- 4.7 kg/m(2)], those reporting occupational exposure to squatting/kneeling alone, heavy lifting alone, both squatting/kneeling and heavy lifting, or none of these activities numbered 7, 40, 47, and 98, respectively. Compared with men with no occupational exposure to these activities, and following adjustment for age, BMI, and history of knee injury or surgery, we found that men reporting occupational exposures to both squatting/kneeling and heavy lifting had a modest increased risk for worse cartilage morphology scores at the patellofemoral joint [odds ratio (OR) 1.8, 95% confidence interval (CI) 1.1 to 3.2] and medial tibiofemoral joint (OR 1.6, 95% CI 0.9, 3.0), although the latter did not reach statistical significance. CONCLUSION: Men with frequent occupational squatting/kneeling and heavy lifting have a greater likelihood for worse cartilage morphology scores at the patellofemoral joint. These findings add support to the important role of biomechanical loading on the pathogenesis of knee OA, particularly patellofemoral OA.

PMID: 18597397 [PubMed - as supplied by publisher]

(Source: J Rheumatol)

A high interleukin 1 receptor antagonist/il-1beta ratio occurs naturally in knee osteoarthritis.

J Rheumatol — Tue, 01 Jul 2008 04:00:00 +0100

A High Interleukin 1 Receptor Antagonist/IL-1beta Ratio Occurs Naturally in Knee Osteoarthritis.

J Rheumatol. 2008 Jul 1;

Authors: Richette P, François M, Vicaut E, Fitting C, Bardin T, Corvol M, Savouret JF, Rannou F

OBJECTIVE: To assess the interleukin 1 receptor antagonist (IL-1Ra)/IL-1ss ratio in synovial fluid (SF) of patients with knee osteoarthritis (OA) or rheumatoid arthritis (RA) to determine a possible relation between cytokine level and disease activity. METHODS: IL-1ss and IL-1Ra concentrations were measured by ELISA in knee SF from patients with OA (n = 42) or RA (n = 11). For OA patients, pain and disability were assessed by a visual analog scale (VAS) and the Lequesne index. RA disease activity was assessed using the Disease Activity Score 28 Joint Count (DAS28). RESULTS: Patients with OA showed lower median levels of IL-1ss and IL-1Ra in SF than patients with RA (p < 0.001) but a higher IL-1Ra/IL-1ss ratio: 1793 (584-6221) versus 773.5 (187.64-1570.5) (p = 0.05). For patients with OA, the IL-1Ra/IL-1ss ratio was not associated with pain or disability. For patients with RA, the IL-1Ra/IL-1ss ratio and IL-1Ra and IL-1ss levels were related to SF white blood cell count. CONCLUSION: High endogenous IL-1Ra/IL-1ss ratio occurs in SF from knee OA and does not correlate with pain or Lequesne index. Our results suggest that intraarticular injection of IL-1Ra might be self-limited in patients with knee OA and a naturally high SF ratio.

PMID: 18597398 [PubMed - as supplied by publisher]

(Source: J Rheumatol)

Comparison of 4 functional indexes in psoriatic arthritis with axial or peripheral disease subgroups using rasch analyses.

J Rheumatol — Tue, 01 Jul 2008 04:00:00 +0100

Comparison of 4 Functional Indexes in Psoriatic Arthritis with Axial or Peripheral Disease Subgroups Using Rasch Analyses.

J Rheumatol. 2008 Jul 1;

Authors: Leung YY, Tam LS, Kun EW, Ho KW, Li EK

OBJECTIVE: Rasch item response theory analysis is essential in evaluating measurement tools in specific disease cohorts. We compared the performance of 4 functional indexes in patients with psoriatic arthritis (PsA) in axial or peripheral disease subgroups. METHODS: A cross-sectional study was performed in a single center. Functional outcomes assessed by the Health Assessment Questionnaire (HAQ), Bath Ankylosing Spondylitis Functional Index (BASFI), Dougados Functional Index (FI), and the physical functioning scale of the Medical Outcome Study Short-form 36 (SF-36-PF) were analyzed by the Rasch model for item fit, item separation, measurement span, and distribution properties. Patient subgroups with axial or peripheral disease were analyzed for differential item functioning (DIF). RESULTS: One hundred eight patients with PsA were assessed. The 4 functional indexes were highly correlated with each other and moderately correlated with patients' perception of health and pain scores. Floor effects were less marked in SF-36-PF. The 4 indexes satisfied the unidimensionality assumption of the Rasch model. HAQ and SF-36-PF had better information-weighted fit statistics (INFIT) and outlier-sensitive (OUTFIT) statistics. HAQ had the poorest item separation. SF-36-PF had the highest item separation (6.99), reliability (0.85), and the longest span of item threshold (9.03 logits). Only 1 and 2 items in BASFI and Dougados-FI had DIF in patients with sacroiliitis. CONCLUSION: HAQ, BASFI, Dougados-FI, and SF-36-PF provide unidimensional measures of functional disability in PsA. SF-36-PF was the best in terms of less floor effect, highest item separation, longest span of item threshold, and better distributional properties. BASFI and Dougados-FI behaved similarly in patients with and without sacroiliitis and conferred no superiority in patients with axial disease.

PMID: 18597399 [PubMed - as supplied by publisher]

(Source: J Rheumatol)

Prognostic factors for survival in scleroderma associated pulmonary arterial hypertension.

J Rheumatol — Tue, 01 Jul 2008 04:00:00 +0100

Prognostic Factors for Survival in Scleroderma Associated Pulmonary Arterial Hypertension.

J Rheumatol. 2008 Jul 1;

Authors: Johnson SR, Swinton JR, Granton JT

OBJECTIVE: Identification of prognostic factors for survival in systemic sclerosis-associated pulmonary arterial hypertension (SSc-PAH) is necessary for appropriate monitoring, interventions, and timely referral for lung transplantation. Our objectives were (1) to identify factors associated with survival in SSc-PAH and (2) to evaluate the methodologic quality of prognostic studies against current standards. METHODS: A systematic review was performed to identify studies evaluating factors associated with survival in SSc-PAH. The methodologic quality of each study was evaluated using a methodologic quality index. RESULTS: HLA-DRw6 (RR 54.52, p = 0.01), HLA-DRw52 (RR not reported, p = 0.02), initial systolic pulmonary artery pressure (sPAP) > 60 mmHg (HR 3.60, 95% CI 1.42, 9.15), elevated mean right atrial pressure (mRAP) (HR 20.7, p = 0.0001), and shorter time between SSc onset and observed PAH (5.24 vs 9.93 yrs, p < 0.01) were associated with decreased survival. Age > 50 years (HR 2.34, 95% CI 0.54, 10.2), male sex (HR 2.02, 95% CI 0.65, 6.20), limited subtype (HR 2.37, 95% CI 0.68, 8.20), pulmonary fibrosis [Kaplan-Meier (KM) curves, p = 0.3], change in pulmonary vascular resistance (KM curves, p = 0.8), anti-centromere (HR 1.67, 95% CI 0.66, 4.26) and anti-ScL-70 (HR 0.28, 95% CI 0.03, 1.99) antibodies were not definitively associated with survival. Attributes of participants, prognostic factors, and outcome measures were well reported. Study attrition, confounding, and analysis were not well reported. CONCLUSION: HLA-DRw52 and -DRw6, initial sPAP > 60 mmHg, mRAP, and shorter time between SSc onset and observed PAH were associated with decreased survival; however, methodologic quality of study reporting was variable. Prognostic factor research is needed using current methodologic standards.

PMID: 18597400 [PubMed - as supplied by publisher]

(Source: J Rheumatol)

Control of autoimmune diseases by the vitamin d endocrine system.

Nature Clinical Practice. Rheumatology. — Tue, 01 Jul 2008 04:00:00 +0100

Control of autoimmune diseases by the vitamin D endocrine system.

Nat Clin Pract Rheumatol. 2008 Jul 1;

Authors: Adorini L, Penna G

1,25-Dihydroxyvitamin D(3) [1,25(OH)(2)D(3)], the biologically active form of vitamin D(3), is a secosteroid hormone essential for bone and mineral homeostasis. It regulates the growth and differentiation of multiple cell types, and displays immunoregulatory and anti-inflammatory properties. Cells involved in innate and adaptive immune responses-including macrophages, dendritic cells, T cells and B cells-express the vitamin D receptor (VDR), and can both produce and respond to 1,25(OH)(2)D(3). The net effect of the vitamin D system on the immune response is an enhancement of innate immunity coupled with multifaceted regulation of adaptive immunity. Epidemiological evidence indicates a significant association between vitamin D deficiency and an increased incidence of several autoimmune diseases, and clarification of the physiological role of endogenous VDR agonists in the regulation of autoimmune responses will guide the development of pharmacological VDR agonists for use in the clinic. The antiproliferative, prodifferentiative, antibacterial, immunomodulatory and anti-inflammatory properties of synthetic VDR agonists could be exploited to treat a variety of autoimmune diseases, from rheumatoid arthritis to systemic lupus erythematosus, and possibly also multiple sclerosis, type 1 diabetes, inflammatory bowel diseases, and autoimmune prostatitis.

PMID: 18594491 [PubMed - as supplied by publisher]

(Source: Nature Clinical Practice. Rheumatology.)

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Are intra-articular injections of hylan more effective than injections of hyaluronic acid for knee osteoarthritis?

Nature Clinical Practice. Rheumatology. — Tue, 01 Jul 2008 04:00:00 +0100

Are intra-articular injections of hylan more effective than injections of hyaluronic acid for knee osteoarthritis?

Nat Clin Pract Rheumatol. 2008 Jul 1;

Authors: Williams FM, Spector TD

PMID: 18594492 [PubMed - as supplied by publisher]

(Source: Nature Clinical Practice. Rheumatology.)

Focal and generalized bone loss in rheumatoid arthritis: separate or similar concepts?

Nature Clinical Practice. Rheumatology. — Tue, 01 Jul 2008 04:00:00 +0100

Focal and generalized bone loss in rheumatoid arthritis: separate or similar concepts?

Nat Clin Pract Rheumatol. 2008 Jul 1;

Authors: Haugeberg G

PMID: 18594493 [PubMed - as supplied by publisher]

(Source: Nature Clinical Practice. Rheumatology.)

Clinical studies can be performed in an ethical manner.

Nature Clinical Practice. Rheumatology. — Tue, 01 Jul 2008 04:00:00 +0100

Clinical studies can be performed in an ethical manner.

Nat Clin Pract Rheumatol. 2008 Jul;4(7):E5

Authors: Fleischmann R

PMID: 18587427 [PubMed - in process]

(Source: Nature Clinical Practice. Rheumatology.)

Author response to "clinical studies can be performed in an ethical manner".

Nature Clinical Practice. Rheumatology. — Tue, 01 Jul 2008 04:00:00 +0100

Author response to "Clinical studies can be performed in an ethical manner".

Nat Clin Pract Rheumatol. 2008 Jul;4(7):E6

Authors: Romain PL

PMID: 18587428 [PubMed - in process]

(Source: Nature Clinical Practice. Rheumatology.)

The future of specialty care in the us.

Nature Clinical Practice. Rheumatology. — Tue, 01 Jul 2008 04:00:00 +0100

The future of specialty care in the US.

Nat Clin Pract Rheumatol. 2008 Jul;4(7):333

Authors: Cooper RA

PMID: 18587429 [PubMed - in process]

(Source: Nature Clinical Practice. Rheumatology.)

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Novel splice variants derived from the receptor tyrosine kinase superfamily are potential therapeutics for rheumatoid arthritis

Arthritis Research and Therapy — Tue, 01 Jul 2008 04:00:00 +0100

IntroductionDespite the advent of biological therapies for treatment of rheumatoid arthritis (RA), there is a compelling need to develop alternative therapeutic targets for non-responders to existing treatments. Soluble receptors occur naturally in vivo, such as the splice variant of the cell surface receptor for vascular endothelial growth factor (VEGF), a key regulator of angiogenesis in RA. Bioinformatics analyses predict that the majority of human genes undergo alternative splicing, generating proteins, many of which may have regulatory functions. The goal of this study was to identify alternative splice variants (ASV) from cell surface receptor genes, and to determine whether the novel proteins encoded exert therapeutic activity in an in vivo model of arthritis. Methods: To identify novel splice variants, we performed RT-PCR using an mRNA pool representing major human tissue types and tumors. Novel ASV were identified by alignment of each cloned sequence to its respective genomic sequence in comparison with full-length transcripts. To test whether these ASV have biologic activity, we characterized a subset of them for ligand binding, and for efficacy in an animal model of arthritis. The in vivo study was accomplished using adenoviruses expressing secreted ASV. Results: We cloned 60 novel human ASV from 21 genes, encoding cell surface receptors, many of which are known to be important in the regulation of angiogenesis. The ASV were characterized by exon extension, intron retention and alternative exon utilization. Efficient expression and secretion of selected ASV - corresponding to VEGFR1, VEGFR2, VEGFR3, angiopoietin receptor Tie1, Met (receptor for hepatocyte growth factor), colony stimulating factor (CSF)1R, platelet-derived growth factor (PDGF)R, fibroblast growth factor (FGF)R1, Kit and RAGE - was demonstrated, together with binding to their cognate ligands. Importantly, ASV derived from VEGFR1 and Tie1, and to a lesser extent from VEGFR2 and FGFR1, reduced clinical signs of arthritis in vivo. The reduction was paralleled by decreased joint inflammation and destruction. Conclusions: Our study shows that unique ASV derived from receptors which play key roles in angiogenesis - namely VEGFR1 and, for the first time, Tie1 - can markedly reduce arthritis severity. More broadly, our results demonstrate that ASV are a source of novel proteins with therapeutic potential, in diseases in which angiogenesis and cellular hyperplasia play a central role, such as RA. (Source: Arthritis Research and Therapy)

Excellent results with early, aggressive treatment in ra

Medscape Rheumatology Headlines — Tue, 01 Jul 2008 02:53:47 +0100

Continuous methotrexate and intra-articular corticosteroids can achieve "excellent clinical response and disease control after 2 years" in patients with early rheumatoid arthritis (RA), Danish investigators report in the June issue of the Annals of Rheumatic Diseases. Reuters Health Information (Source: Medscape Rheumatology Headlines)

Role of fda's drug information centers

Medscape Rheumatology Headlines — Mon, 30 Jun 2008 21:22:53 +0100

Who do the government DICs serve, and what exactly do they do? American Journal of Health-System Pharmacy (Source: Medscape Rheumatology Headlines)

The acr-eular collaboration: an expert interview with ferdinand c. breedveld, md, phd

Medscape Rheumatology Headlines — Mon, 30 Jun 2008 21:22:04 +0100

Ferdinand C. Breedveld, MD, PhD, President, EULAR, provides expert commentary to Medscape on the new collaborative initiative between the ACR and EULAR. Medscape Rheumatology (Source: Medscape Rheumatology Headlines)