bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health‐related quality of life of patients with juvenile dermatomyositis: Results from the paediatric rheumatology international trials organisation multinational quality of life cohort study
Authors: Apaz Maria Teresa , Saad‐Magalhães Claudia , Pistorio Angela , Ravelli Angelo , de Oliveira sato Juliana , Marcantoni Maria Beatriz , Meiorin Silvia , Filocamo Giovanni , Pilkington Clarissa , Maillard Susan , Al‐Mayouf Sulaiman , Prahalad Sampath , Fasth Anders , Joos Rik , Schikler Kenneth , Mozolova Dagmar , Landgraf Jeanne M. , Martini Alberto , Ruperto Nicolino 
Published: March 2009

AbstractObjectiveTo investigate the health‐related quality of life (HRQOL) change over time, as measured by the Child Health Questionnaire (CHQ), and its determinants in patients with active juvenile dermatomyositis (DM).MethodsWe assessed patients with juvenile DM at both baseline and 6 months of followup, and healthy children age ≤18 years. Potential determinants of poor HRQOL included demographic data, physician's and parent's global assessments, muscle strength, functional ability as measured by the Childhood Health Assessment Questionnaire (C‐HAQ), global disease activity assessments, and laboratory markers.ResultsA total of 272 children with juvenile DM and 2,288 healthy children were enrolled from 37 countries. The mean ± SD CHQ physical and psychosocial summary scores were significantly lower in children with juvenile DM (33.7 ± 11.7 versus 54.6 ± 4.1) than in healthy children (45.1 ± 9.0 versus 52 ± 7.2), with physical well‐being domains being the most impaired. HRQOL improved over time in responders to treatment and remained unchanged or worsened in nonresponders. Both physical and psychosocial summary scores decreased with increasing levels of disease activity, muscle strength, and parent's evaluation of the child's overall well‐being. A C‐HAQ score >1.6 (odds ratio [OR] 5.06, 95% confidence interval [95% CI] 2.03–12.59), child's overall well‐being score >6.2 (OR 5.24, 95% CI 2.27–12.10), and to a lesser extent muscle strength and alanine aminotransferase level were the strongest determinants of poor physical well‐being at baseline. Baseline disability and longer disease duration were the major determinants for poor physical well‐being at followup.ConclusionWe found that patients with juvenile DM have a significant impairment in their HRQOL compared with healthy peers, particularly in the physical domain. Physical well‐being was mostly affected by the level of functional impairment.
Association of physical performance with muscle strength and hip range of motion in hip osteoarthritis
Authors: Pua Yong‐Hao , Wrigley Tim V. , Collins Marnie , Cowan Sallie M. , Bennell Kim L. 
Published: March 2009

AbstractObjectiveTo examine whether the associations of physical performance with isometric hip and knee extensors strength and passive hip flexion and internal rotation range of motion (ROM) are nonlinear in community‐dwelling adults with hip osteoarthritis (OA).MethodsParticipants were 100 adults (mean age 62 years) with radiographically confirmed hip OA. Physical performance measures included gait speed test and timed stair tests. Piecewise regression models of muscle strength and hip ROM on physical performance measures were used to identify possible breakpoints. Receiver operating characteristic (ROC) curve analysis was used to identify participants with functionally inadequate (≤1.0 meters/second) gait speed and optimal cut points were identified.ResultsMuscle strength and hip ROM were nonlinearly associated with stair measures but not with gait speed measures. The optimal breakpoints and ROC‐derived cut points were 1.8–2.5Nm/kg for knee extensors, 1.5–2.1Nm/kg for hip extensors, 25–26° for hip internal rotation ROM, and 109–115° for hip flexion ROM. Muscle strength breakpoints increased monotonically with increasing movement demand.ConclusionIn individuals with hip OA, the associations between physical performance and measures of muscle strength and hip ROM are less straightforward than previously assumed. These breakpoints and ROC‐derived cut points may be useful in identifying individuals for whom interventions that improve muscle strength or hip ROM would be most beneficial.
Effect of fluvastatin on cardiac outcomes in kidney transplant patients with systemic lupus erythematosus: A randomized placebo‐controlled study
Authors: Norby Gudrun E. , Holme Ingar , Fellström Bengt , Jardine Alan , Cole Edward , Abedini Sadollah , Holdaas Hallvard 
Published: March 2009

AbstractObjectivePatients with systemic lupus erythematosus (SLE), with or without end‐stage renal failure, are at increased risk of premature cardiovascular disease. Although statin therapy has been found to reduce cardiovascular risk in the general population, its effectiveness in kidney transplant recipients with SLE has not been examined. This study was undertaken to investigate the effect of fluvastatin on cardiac end points in a randomized controlled trial of renal transplant patients with SLE.MethodsPatients with SLE were identified from among participants in the Assessment of Lescol in Renal Transplantation trial, a randomized, double‐blind, placebo‐controlled study of the effect of fluvastatin (40–80 mg/day) on cardiovascular outcomes in renal transplant recipients. Patients were randomized to either a group receiving fluvastatin or a placebo group for the duration of the 5–6‐year trial, and then invited to continue in a 2‐year open‐label extension during which all participants, regardless of original group, received fluvastatin. Patients were followed up for a total of 7–8 years for assessment of the primary end point of major cardiac events, comprising nonfatal myocardial infarction, cardiac death, and coronary intervention procedures.ResultsFluvastatin reduced low‐density lipoprotein cholesterol levels by 29.2% (95% confidence interval [95% CI] 18.3–40%), from a mean ± SD of 4.0 ± 0.9 mmoles/liter to 2.8 ± 1.1 mmoles/liter, and total cholesterol by 19.6% (95% CI 11.7–27.5%), from 6.4 ± 0.9 mmoles/liter to 5.1 ± 1.1 mmoles/liter. Compared with placebo‐treated patients, patients randomized to receive fluvastatin exhibited a 73.4% reduction in the risk of major cardiac events (relative risk 26.6 [95% CI 5.9–119.4], P = 0.064).ConclusionOur results indicate that the effect of fluvastatin on cardiac events in renal transplant recipients with SLE is similar to that observed with statin therapy in the renal transplant population as a whole.
Recombinant human relaxin in the treatment of systemic sclerosis with diffuse cutaneous involvement: A randomized, double‐blind, placebo‐controlled trial
Authors: Khanna Dinesh , Clements Philip J. , Furst Daniel E. , Korn Joseph H. , Ellman Michael , Rothfield Naomi , Wigley Fredrick M. , Moreland Larry W. , Silver Richard , Kim Youn H. , Steen Virginia D. , Firestein Gary S. , Kavanaugh Arthur F. , Weisman Michael , Mayes Maureen D. , Collier David , Csuka Mary E. , Simms Robert , Merkel Peter A. , Medsger Thomas A. , Sanders Martin E. , Maranian Paul , Seibold James R. 
Published: March 2009

AbstractObjectiveA phase II randomized controlled trial of recombinant human relaxin suggested that a dosage of 25 μg/kg/day was safe and clinically effective in improving skin disease and reducing functional disability in scleroderma (systemic sclerosis; SSc). We undertook a large randomized, double‐blind, placebo‐controlled clinical trial to compare placebo with 10 μg/kg/day and 25 μg/kg/day recombinant human relaxin, given for 24 weeks in patients with stable, diffuse, moderate‐to‐severe SSc.MethodsMen and women ages 18–70 years with diffuse cutaneous SSc (dcSSc) were administered recombinant human relaxin (10 μg/kg/day or 25 μg/kg/day) or placebo for 24 weeks as a continuous subcutaneous infusion. There was a followup safety visit at week 28.ResultsThe primary outcome measure, the modified Rodnan skin thickness score, was similar among the 3 groups at baseline and at weeks 4, 12, and 24. Secondary outcomes such as functional disability were similar in all 3 groups, while the forced vital capacity decreased significantly in the relaxin groups. The discontinuation of both doses of relaxin at week 24 led to statistically significant declines in creatinine clearance and serious renal adverse events (defined as doubling of serum creatinine, renal crisis, or grade 3 or 4 essential hypertension) in 7 patients who had received relaxin therapy but in none who had received placebo.ConclusionRecombinant relaxin was not significantly better than placebo in improving the total skin score or pulmonary function or in reducing functional disability in patients with dcSSc. In addition, relaxin was associated with serious renal adverse events, the majority of which occurred after stopping the infusion. If relaxin is used therapeutically for any conditions other than scleroderma, close monitoring of blood pressure and renal function must be performed.
Increased morbidity from ischemic heart disease in patients with Wegener's granulomatosis
Authors: Faurschou Mikkel , Mellemkjaer Lene , Sorensen Inge Juul , Svalgaard Thomsen Bjarne , Dreyer Lene , Baslund Bo 
Published: March 2009

AbstractObjectiveExperimental studies indicate that patients with Wegener's granulomatosis (WG) experience accelerated atherosclerosis. The purpose of this study was to investigate whether the occurrence of overt ischemic heart disease (IHD) is increased in WG.MethodsA total of 293 WG patients were included in the study. Information on all hospitalizations for IHD in Denmark from 1977 to 2006 was obtained from the Danish National Hospital Register. The WG patients were compared with the Danish background population with respect to rates of hospitalization for clinical manifestations of IHD after the date of vasculitis diagnosis by calculating standardized ratios of observed to expected (O:E) events.ResultsSixty‐three first IHD events were registered in the WG group during the 2,482 patient‐years of followup, corresponding to a significantly increased O:E ratio for IHD of 1.9 (95% confidence interval [95% CI] 1.4–2.4). A significantly increased risk was found for acute myocardial infarction (MI) (O:E ratio 2.5 [95% CI 1.6–3.7]), but not for angina pectoris (O:E ratio 1.3 [95% CI 0.7–2.1]). In analyses stratified according to the time between the diagnosis of vasculitis and the cardiovascular event, increased O:E ratios were found for IHD and acute MI occurring <5.0 years after WG diagnosis (2.1 [95% CI 1.4–3.0] for IHD and 3.6 [95% CI 2.0–5.9] for acute MI) and for IHD occurring ≥10.0 years after WG diagnosis (2.2 [95% CI 1.3–3.4]). Significantly increased O:E ratios for IHD and acute MI were found in patients who were ≥50.0 years of age at the time of diagnosis of WG, in male patients, and in patients who received high cumulative doses of cyclophosphamide.ConclusionCompared with the background population, WG patients seem to experience an increased number of both early and late cardiovascular events due to IHD.
Association between anti–cyclic citrullinated peptide antibodies and ischemic heart disease in patients with rheumatoid arthritis
Authors: López‐Longo Francisco Javier , Oliver‐Miñarro Desamparados , de la Torre Inmaculada , González‐Díaz de Rábago Eugenia , Sánchez‐Ramón Silvia , Rodríguez‐Mahou Margarita , Paravisini Alexandra , Monteagudo Indalecio , González Carlos‐Manuel , GarCía‐Castro Marta , Casas María Dolores , Carreño Luis 
Published: March 2009

AbstractObjectivePatients with rheumatoid arthritis (RA) have an increased risk of cardiovascular disease that may not always be related to the presence of traditional cardiovascular risk factors. The aim of this study was to determine if anti–cyclic citrullinated peptide (anti‐CCP) antibodies are associated with cardiovascular disease in patients with RA.MethodsAnti‐CCP antibodies were determined by enzyme‐linked immunosorbent assay in the earliest serum sample available from 937 patients with a diagnosis of RA. We studied the relationship between anti‐CCP antibodies with traditional cardiovascular risk factors and cardiovascular events.ResultsWe found positive anti‐CCP antibodies (>25 units/ml) in 672 patients (71.7%). There was no association between the anti‐CCP antibodies and cardiovascular risk factors such as smoking, hypertension, dyslipidemia, being overweight, or diabetes mellitus. However, patients who had positive anti‐CCP antibodies experienced more frequent ischemic heart disease (6.5% versus 2.6%; odds ratio [OR] 2.58, 95% confidence interval [95% CI] 1.17–5.65) and had higher mortality rates (11.2% versus 6.8%; OR 1.72, 95% CI 1.01–2.91). Similar results were obtained when we considered anti‐CCP titers 20‐fold higher (>500 units/ml). Multivariable analysis showed that ischemic heart disease is independently associated with positive anti‐CCP antibodies (OR 2.8, 95% CI 1.19–6.56; P = 0.009).ConclusionAnti‐CCP antibodies in patients with RA are independently associated with the development of ischemic heart disease.
Clinical and imaging efficacy of infliximab in HLA–B27–Positive patients with magnetic resonance imaging–determined early sacroiliitis
Authors: Barkham Nick , Keen Helen I. , Coates Laura C. , O'Connor Philip , Hensor Elizabeth , Fraser Alexander D. , Cawkwell Lorna S. , Bennett Alexander , McGonagle Dennis , Emery Paul 
Published: March 2009

AbstractObjectiveTo evaluate the efficacy of infliximab in HLA–B27–positive patients with magnetic resonance imaging (MRI)–determined early sacroiliitis, using both clinical and MRI assessments.MethodsForty patients with recent‐onset inflammatory back pain, as assessed by the Calin criteria, HLA–B27 positivity, clinical disease activity as measured by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), pain and morning stiffness, and magnetic resonance imaging (MRI)–determined sacroiliac joint bone edema were randomized in a double‐blind manner to receive infliximab 5 mg/kg or placebo at 0, 2, 6, and 12 weeks. MRI scans were performed at baseline and 16 weeks and scored by 2 observers (blinded to both the order of the scans and to treatment group), using the Leeds scoring system. Clinical assessments included the BASDAI, the Bath Ankylosing Spondylitis Functional Index (BASFI), the Ankylosing Spondylitis Quality of Life (ASQoL) instrument, the ASsessment in Ankylosing Spondylitis International Working Group criteria (ASAS) for improvement, and markers of inflammation.ResultsThe mean reduction in the total MRI score from week 0 to week 16 was significantly greater in infliximab‐treated patients compared with placebo‐treated patients (P = 0.033). On average, significantly more lesions resolved in the infliximab group (P < 0.001), while significantly more new lesions developed in the placebo group (P = 0.004). Significantly greater improvement in the infliximab group versus the placebo group was also observed for changes from week 0 to week 16 in the BASDAI (P = 0.002), BASFI (P = 0.004), and ASQoL (P = 0.007) scores. Responses according to the ASAS criteria for 40% improvement, the ASAS criteria for 20% improvement in 5 of 6 domains, and ASAS partial remission were achieved by 61%, 44%, and 56% of infliximab‐treated patients, respectively. Infliximab was well tolerated, and no serious adverse events were observed.ConclusionInfliximab was an effective therapy for early sacroiliitis, providing a reduction in disease activity by week 16. This study is the first to show that infliximab is effective for reducing clinical and imaging evidence of disease activity in patients with MRI‐determined early axial spondylarthritis.
Opposing effects of HLA–DRB1*13 alleles on the risk of developing anti–citrullinated protein antibody–positive and anti–citrullinated protein antibody–negative rheumatoid arthritis
Authors: Lundström Emeli , Källberg Henrik , Smolnikova Marina , Ding Bo , Rönnelid Johan , Alfredsson Lars , Klareskog Lars , Padyukov Leonid 
Published: March 2009

AbstractObjectiveThe effect of non–shared epitope HLA–DRB1 alleles on rheumatoid arthritis (RA) is poorly understood. This study was undertaken to investigate the effects of several HLA–DRB1 alleles, independent of the shared epitope, on the risk of developing anti–citrullinated protein antibody (ACPA)–positive or ACPA‐negative RA in a large case–control study.MethodsHLA typing for the DRB1 gene was performed in 1,352 patients with RA and 922 controls from the Swedish Epidemiological Investigation of Rheumatoid Arthritis study. Relative risks (RRs) and 95% confidence intervals (95% CIs) were calculated.ResultsDRB1*13 was found to protect against ACPA‐positive RA when stratifying for the shared epitope and using a dominant genetic model (RR 0.41 [95% CI 0.26–0.64]). Furthermore, DRB1*13 neutralized the effect of the shared epitope in ACPA‐positive RA (RR 3.91 [95% CI 3.04–5.02] in patients who had the shared epitope but not DRB1*13, and RR 1.22 [95% CI 0.81–1.83] in patients with both the shared epitope and DRB1*13, as compared with patients negative for both the shared epitope and DRB1*13). However, we did not replicate the previous published risk of ACPA‐negative RA conferred by DRB1*03 when a dominant genetic model was used (RR 1.29 [95% CI 0.91–1.82]). Similarly, no significant effect of DRB1*03 on RR for ACPA‐negative RA was seen using the recessive genetic model (RR 1.18 [95% CI 0.6–2.4]). In contrast, the combination of DRB1*03 and DRB1*13 was significantly associated with increased risk of developing ACPA‐negative RA (RR 2.07 [95% CI 1.17–3.67]).ConclusionOur findings indicate that the DRB1*13 allele plays a dual role in the development of RA, by protecting against ACPA‐positive RA but, in combination with DRB1*03, increasing the risk of ACPA‐negative RA.
In vitro spontaneous osteoclastogenesis of human peripheral blood mononuclear cells is not crucially dependent on T lymphocytes
Authors: Vandooren Bernard , Melis Lode , Veys Eric M. , Tak Paul P. , Baeten Dominique 
Published: March 2009

AbstractObjectiveIn vitro spontaneous osteoclastogenesis from peripheral blood mononuclear cells (PBMCs) is increased in diseases with excessive bone loss. The purpose of this study was to reassess the role of T lymphocytes in this process.MethodsFresh or cryopreserved PBMCs obtained from healthy subjects and from patients with rheumatoid arthritis, psoriatic arthritis, and non‐psoriatic spondylarthritis were cultured at high density and stained for tartrate‐resistant acid phosphatase (TRAP). Resorption of mineralized matrix was assessed by a dentin disc assay. CD14+ monocytes and CD3+ T cells were selected using magnetically labeled antibodies.ResultsNumerous multinucleated, TRAP+, dentin‐resorbing osteoclasts developed spontaneously from fresh PBMCs from healthy individuals. This process was abrogated by T cell depletion and was restored by exogenous macrophage colony‐stimulating factor (M‐CSF) and RANKL, indicating the important role of T cells in spontaneous osteoclastogenesis in vitro. Using physiologic freezing and thawing as a model for the activation of PBMCs, spontaneous osteoclastogenesis was significantly increased in cryopreserved versus fresh cells. Under these conditions, spontaneous osteoclastogenesis was not dependent on T lymphocytes, since it was not influenced by T cell depletion and persisted in purified CD14+ cell cultures supplemented with M‐CSF and RANKL. In contrast to studies with fresh PBMCs, spontaneous osteoclastogenesis under these conditions did not appear to be clearly different between healthy subjects and patients with arthritis.ConclusionSpontaneous osteoclastogenesis in vitro is dependent on T lymphocytes or on the direct activation of monocytic cells, depending on the test conditions. This variability warrants better validation of the relevance of this functional test for in vivo osteoclastogenesis.
Measuring finger joint cartilage by ultrasound as a promising alternative to conventional radiograph imaging
Authors: Möller Burkhard , Bonel Harald , Rotzetter Marianne , Villiger Peter M. , Ziswiler Hans‐rudolf 
Published: March 2009

AbstractObjectiveTo evaluate the reliability and validity of a novel ultrasound (US) imaging method to measure metacarpophalangeal (MCP) and proximal interphalangeal (PIP) finger joint cartilage.MethodsWe examined 48 patients with rheumatoid arthritis (RA), 18 patients with osteoarthritis (OA), 24 patients with unclassified arthritis of the finger joints, and 34 healthy volunteers. The proximal cartilage layer of MCP and PIP joints for fingers 2–5 was bilaterally visualized from a posterior view, with joints in ∼90° flexion. Cartilage thickness was measured with integrated tools on static images. External validity was assessed by measuring radiologic joint space width (JSW) and a numeric joint space narrowing (JSN) score in patients with RA.ResultsPrecise measurement was possible for 97.5% of MCP and 94.2% of PIP joints. Intraclass correlation coefficients for bilateral total joint US scores were 0.844 (95% confidence interval [95% CI] 0.648–0.935) for interobserver comparisons and 0.928 (95% CI 0.826–0.971) for intraobserver comparisons (using different US devices). The US score correlated with JSN for both hands (adjusted R2 = 0.513, P < 0.001) and JSW of the same finger joints (adjusted R2 = 0.635, P < 0.001). Reduced cartilage shown by US allowed discrimination of early symptomatic OA versus early RA and healthy joints. In patients with RA, US scores correlated with duration of treatment‐resistant, progressive RA.ConclusionThe US method of direct visualization and quantification of cartilage in MCP and PIP joints is objective, reliable, valid, and can be useful for diagnostic purposes in patients with arthritis.