bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serum hyaluronic acid level as a predictor of disease progression in osteoarthritis of the knee
Authors: Sharif Mohammed , George Emmanuel , Shepstone Lee , Knudson Warren , Thonar EUGENE J.‐M. A. , Cushnaghan Janet , Dieppe Paul 
Published: February 2007

AbstractObjective. To investigate the prognostic value of serum hyaluronic acid (HA) and keratan sulfate (KS) levels in relation to tibiofemoral osteoarthritis (OA) of the knee.Methods. Clinical and demographic data were collected on 94 patients. Radiographs were obtained at study entry and at 5‐year followup. Disease progression was defined as 2 mm of joint space narrowing of any tibiofemoral compartment, and/or knee joint surgery during the study period. Serum HA and KS were measured and levels were correlated with entry data and disease progression.Results. At entry, HA levels were significantly related to disease duration (P = 0.036), minimum joint space (P = 0.049), and previous surgery (P = 0.001). After these variables were taken into account, patients whose disease had progressed were shown to have had significantly higher levels of HA at baseline compared with those whose disease had not progressed (P = 0.019). However, there were no significant differences in levels of serum KS between those with and those without disease progression, at entry (P = 0.779) or at subsequent visits.Conclusion. These results suggest that serum HA levels predict disease outcome in OA of the knee and confirm that a single measurement of the serum level of KS is not useful as a prognostic marker in OA.
Finger tendon involvement in rheumatoid arthritis
Authors: Grassi Walter , Tittarelli Egidio , Blasetti Patrizia , Pirani Osvaldo , Cervini Claudio 
Published: February 2007

AbstractObjective. To characterize finger tendon involvement in patients with rheumatoid arthritis (RA).Methods. The finger tendons of 20 RA patients were studied by ultrasonography using a high‐frequency (13‐MHz) transducer.Results. Eighteen patients (90%) showed finger tendon abnormalities: widening of the flexor tendon sheath (80%), loss of the normal fibrillar echotexture (60%), irregularity of the extensor (30%) and flexor (50%) tendon margins, tendon tear (10%), synovial cyst (20%).Conclusion. High‐frequency sonography is helpful in assessing even minimal finger tendon lesions in RA patients.
A self‐administered rheumatoid arthritis disease activity index (RADAI) for epidemiologic research
Authors: Stucki Gerold , Liang Matthew H. , Stucki Susanne , Brühlmann Pius , Michel Beat A. 
Published: February 2007

AbstractObjective. To examine the psychometric properties and construct validity of a self‐administered Rheumatoid Arthritis Disease Activity Index (RADAI).Methods. Five items of the Rapid Assessment of Disease Activity in Rheumatology (RADAR) questionnaire were aggregated into the RADAI and assessed for their factor loading, internal consistency, and construct validity.Results. In 55 patients with RA, the RADAI had a high internal consistency (Cronbach's alpha = 0.91) and correlated with physician's assessment of disease activity (r = 0.54, P < 0.01), the swollen joint count (r = 0.54, P < 0.01), and the C‐reactive protein value (r = 0.43, P < 0.01).Conclusion. The RADAI is a highly reliable and valid self‐administered measure of disease activity for clinical, health services, and epidemiologic research. Its sensitivity to change in longitudinal studies needs further study.
Cardiovascular fitness and health in patients with end‐stage osteoarthritis
Authors: Philbin Edward F. , Groff Gerald D. , Ries Michael D. , Miller Thomas E. 
Published: February 2007

AbstractObjective. To evaluate the cardiovascular fitness of a group of patients with severe osteoarthritis (OA).Methods. Thirty‐seven patients with end‐stage OA were evaluated just before hip or knee replacement surgery. Severity of arthritis was evaluated using standardized techniques. Patients and age‐ and sex‐matched controls underwent a single, maximal, symptomlimited, cardiopulmonary exercise test using arm or leg ergometry and a metabolic cart to measure expired respiratory gases.Results. Severe musculoskeletal disability and deformity was confirmed in the OA patient group. During exercise testing, OA patients were able to perform physiologically maximal cardiopulmonary exercise. Arthritis patients were noted to be severely deconditioned, with reduced peak oxygen consumption (OA hips mean ± SD 14.9 ± 4.2 versus control hips 19.0 ± 4.6, P < 0.0001; OA knees 12.8 ± 3.7 versus control knees 17.6 ± 5.2 ml/kg/minute, P < 0.0005). A trend for more frequent manifestations of coronary heart disease in OA patients than in controls (27% versus 13%; P > 0.05) was also noted.Conclusion. Patients with end‐stage lower extremity OA are severely deconditioned. This may place them at incremental risk for the development of coronary heart disease.
Osteoporosis in rheumatoid arthritis
Authors: Sambrook Philip N. , Spector Timothy D. , Seeman Ego , Bellamy Nicholas , Buchanan Russell R. C. , Duffy David L. , Martin Nicholas G. , Prince Richard , Owen Evan , Silman Alan J. , Eisman John A. 
Published: February 2007

AbstractObjective. To quantify the magnitude and distribution of osteoporosis in rheumatoid arthritis (RA).Methods. Bone mineral density (BMD) was measured by dual x‐ray absorptiometry, in a monozygotic co‐twin control study.Results. BMD was reduced at most skeletal sites in the twin with RA compared with the co‐twin (lumbar spine 4.6%, femoral neck 9.7%, total body 5.7%). Differences in lean soft tissue (5.6% for total body) correlated with differences in BMD between twins at multiple sites.Conclusion. Osteoporosis in RA is generalized and may be related to loss of mobility or muscle mass associated with the disease.
Spin‐spin relaxation of brain tissues in systemic lupus erythematosus
Authors: Sibbitt Wilmer L. , Brooks William M. , Haseler Luke J. , Griffey Richard H. , Frank Loren M. , Hart Blaine L. , Sibbitt Randy R. 
Published: February 2007

AbstractObjective. To correlate the spin‐spin relaxation time (T2) of brain tissue in neuropsychiatric systemic lupus erythematosus (NPSLE) with the patient's clinical condition.Methods. T2 values were determined in 54 SLE patients and 45 non‐SLE controls at 1.5 Tesla, using intensity from multi‐echo magnetic resonance (MR) images fitted to an exponential decay curve with rateconstant T2.Results. The T2 of white matter was increased in SLE patients compared with controls (P = 0.01) and was increased in those patients who had previously experienced major NPSLE. Patients with acute diffuse neurologic manifestations (seizures, psychosis, coma) demonstrated a longer T2 of the gray matter (mean ± SD 92.75 ± 6.35 ms, n = 10) than did other SLE patients (mean ± SD 79.61 ± 5.04 ms, n = 44) (P = 0.02 by t‐test), which suggests acute cerebral edema. The mean T2 values of reversible and nonreversible focal lesions were significantly different (P < 0.02), indicating different microenvironments and micropathology.Conclusion. Quantitative T2 measurement extends the utility and sensitivity of conventional MR imaging for evaluating NPSLE.
Use of magnetic resonance imaging and positron emission tomography in the assessment of synovial volume and glucose metabolism in patients with rheumatoid arthritis
Authors: Polisson Richard P. , Schoenberg Oded I. , Fischman Alan , Rubin Robert , Simon Lee S. , Rosenthal Daniel , Palmer William E. 
Published: February 2007

AbstractObjective. To measure the anatomic and physiologic changes in the synovium of patients with active rheumatoid arthritis (RA) before and after the initiation of treatment with low‐dose systemic glucocorticoids and methotrexate (MTX).Methods. Two patients with RA with active synovitis involving the carpus were evaluated by imaging parameters at baseline and again after 14 weeks (of treatment with low‐dose prednisone and MTX). Standard clinical parameters, laboratory measurements, and contrast‐enhanced magnetic resonance imaging (MRI) (synovial volume estimate) and positron emission tomography (PET) with 18F‐fluoro‐2‐deoxyglucose (18‐FDG) (synovial metabolism estimate) were performed.Results. Compared with baseline, standard clinical parameters (i.e., joint count, joint index, morning stiffness, global assessments of arthritis activity, and erythrocyte sedimentation rate) improved dramatically in both patients after treatment with low‐dose prednisone and MTX. In concert with this trend, the synovial volume of the affected wrist was reduced by 60%, and 76% and the metabolism of 18‐FDG was reduced by 66% and 69% in the 2 patients.Conclusion. These preliminary observations indicate that a volumetric estimate of inflamed synovium (using contrast‐enhanced MRI) and quantification of synovial deoxyglucose metabolism (using PET) are technically feasible and, in the 2 reported cases, correlate well with standard outcome measures. These imaging modalities may provide new objective parameters to determine RA disease activity and effectiveness of antirheumatic medications; however, the potential clinical utility of these measures remains to be defined.
The contributions of disease activity, sleep patterns, and depression to fatigue in systemic lupus erythematosus
Authors: Mckinley Paula S. , Ouellette Suzanne C. , Winkel Gary H. 
Published: February 2007

AbstractObjective. This study describes lupus fatigue multidimensionally and introduces a multivariate model: Sleep problems and depression, through reciprocal effects on each other, act as mediators through which lupus disease activity increases fatigue.Methods. Self‐reported sleep patterns, depression, and fatigue were assessed in 48 women with systemic lupus erythematosus (SLE) and 27 women from the general population. Rheumatologists rated current lupus disease activity.Results. The SLE group reported greater overall fatigue than did the controls. Temporal and affective dimensions of fatigue were more differentiating than sensory or severity dimensions. The SLE group also reported longer sleep latency and total sleep time, but not higher depression. Using 2‐stage regression, a form of structural equation modeling, the proposed lupus fatigue model was supported.Conclusion. These preliminary results describe fatigue as a multidimensional phenomenon arising out of several contributing factors. They suggest that fatigue treatment strategies should address mediating processes such as sleep and depression, in addition to disease activity.
The early clinical recognition of juvenile‐onset ankylosing spondylitis and its differentiation from juvenile rheumatoid arthritis
Authors: Burgos‐Vargas Rubén , Zquez‐Mellado Janitzia VÁ 
Published: February 2007

AbstractObjective. To determine which early clinical data differentiate juvenile‐onset ankylosing spondylitis (AS) from juvenile rheumatoid arthritis (JRA).Methods. Medical records of 35 patients with juvenile‐onset AS and 75 with JRA (excluding type II pauciarticular JRA), all of whom had disease onset at age ≤16 years, disease duration of ≤2½ years at the initial visit to the rheumatology clinic, and followup of ≥ 10 years, were analyzed retrospectively with regard to features of disease found 6 months, 12 months, and 10 years after onset.Results. At 6 months, various features appeared more frequently in the juvenile‐onset AS group than in the JRA group, i.e., pauciarthritis (54.3% versus 30.7%; P = 0.03, odds ratio [OR] = 2.7), enthesopathy (82.9% versus 0%; P < 0.0001, OR = 321.4), tarsal disease (71.4% versus 1.3%; P < 0.0001, OR = 185.0), and lumbar/sacroiliac symptoms (11.4% versus 0%; P = 0.02, OR = 11.9). At 12 months, the features found more frequently among juvenile‐onset AS patients than JRA patients were enthesopathy (88.6% versus 4.0%; P < 0.0001, OR = 186.0), tarsal disease (85.7% versus 10.7%; P < 0.0001, OR = 50.3), and knee disease (100.0% versus 82.7%; P = 0.04, OR = 8.0). Involvement of the upper extremities (especially the hands) was found in significantly fewer juvenile‐onset AS patients compared with the JRA group. Definite involvement of the spine and sacroiliitis in juvenile‐onset AS occurred after a mean ± SD of 7.3 ± 2.0 years.Conclusion. Regardless of axial disease, enthes opathy and tarsal disease in children who have arthritis of the lower, but not of the upper extremities differentiate juvenile‐onset AS from JRA within 1 year of symptoms. The discriminative value of these parameters approaches that of axial disease (the gold standard) throughout the followup period.
Comparative prospective, double‐blind, multicenter study of the efficacy of tiludronate and etidronate in the treatment of paget's disease of bone
Authors: Roux C. , Gennari C. , Farrerons J. , Devogelaer J. P. , Mulder H. , Kruse H. P. , Picot C. , Titeux L. , Reginster J. Y. , Dougados M. 
Published: February 2007

AbstractObjective. To compare the efficacy and safety of tiludronate and etidronate at the same dosage (400 mg/day) for the treatment of active Paget's disease of bone.Methods. We studied 234 patients with radiologic lesions characteristic of Paget's disease of bone and serum alkaline phosphatase (AP) concentrations at least twice the upper limit of normal, in a prospective, randomized, double‐blind, multicenter clinical trial lasting 6 months. Patients were randomly allocated into 1 of 3 treatment groups: tiludronate for 3 months followed by placebo for 3 months, tiludronate for 6 months, or etidronate for 6 months. Serum AP levels and urinary hydroxyproline excretion were measured at baseline and after 3 months and 6 months. Patients with a reduction of at least 50% in the serum AP concentration were considered to be responders.Results. After 3 months, the proportion of responders was higher in the tiludronate group (57.4%) than in the etidronate group (13.9%) (P < 0.0001). In the etidronate group, this percentage was lower among patients who had received previous treatment with a bisphosphonate (2.3%) than among those who had not (28.6%) (P < 0.01). Previous bisphosphonate treatment was not associated with response in the tiludronate group. After 6 months, the proportion of responders did not differ between the 2 tiludronate groups (60.3% and 70.1%), but was lower in the etidronate group (25.3%) (P < 0.0001). There was a higher proportion of patients with treatment‐resistant disease ( < 25% reduction of serum AP) in the etidronate group (51.9%) than in the tiludronate 3‐month group (17.9%) or the tiludronate 6‐month group (19.5%) (P < 0.0001). Gastrointestinal disturbances were more common, and occurred earlier, with tiludronate, but they were mostly mild, requiring no treatment.Conclusion. Tiludronate at 400 mg/day for 3 months or 6 months is more effective than the same dosage of etidronate for 6 months in the treatment of Paget's disease.
Markers of bone metabolism in postmenopausal women with rheumatoid arthritis
Authors: Hall G. M. , Spector T. D. , Delmas P. D. 
Published: February 2007

AbstractObjective. To investigate bone metabolism in postmenopausal women with rheumatoid arthritis (RA) treated with or not treated with corticosteroids, and the response to hormone replacement therapy (HRT).Methods. One hundred six RA patients were divided into those taking low‐dose steroids (RA+; n = 35) and those not (RA–; n = 71) and randomly allocated to receive HRT or calcium for 2 years. Bone formation markers included serum osteocalcin (OC) and bone‐specific alkaline phosphatase, and resorption markers included urinary deoxypyridinoline (DPyr) and CrossLaps (XL). Bone mineral density (BMD) was measured annually using dual x‐ray absorptiometry.Results. OC levels were significantly lower in both the RA+ and RA– groups compared with 112 healthy control subjects (P < 0.01 and P < 0.05, respectively), but were similar in the 2 RA groups. DPyr and XL levels were elevated in the RA+ group compared with the RA– group (P < 0.05) but were similar between the RA– group and controls. OC was negatively correlated with parameters of disease activity (P < 0.05). After HRT, XL excretion decreased significantly in the overall RA group. Three‐month changes in XL correlated with 2‐year changes in spinal BMD (P < 0.01).Conclusion. Bone metabolism may be uncoupled in chronic RA. Bone formation appears to be reduced, partly reflecting disease activity, whereas resorption increased only in steroid users. HRT reduces resorption in RA irrespective of steroid usage, emphasizing its value in the treatment of postmenopausal women with RA.
Radiographic osteoarthritis of the hip and bone mineral density
Authors: Nevitt Michael C. , Lane Nancy E. , Scott Jean C. , Hochberg Marc C. , Pressman Alice R. , Genant Harry K. , Cummings Steven R. 
Published: February 2007

AbstractObjective. To examine the cross‐sectional association between radiographic features of hip osteoarthritis (OA) and bone mineral density (BMD) of the hip, spine, and appendicular skeleton among Caucasian women ages 65 and older who were participating in the Study of Osteoporotic Fractures.Methods. Pelvis radiographs of 4,855 subjects were assessed for individual radiographic features of hip OA: osteophytes, joint space narrowing, subchondral sclerosis, cysts, and femoral head deformity. Hips were graded on a summary scale of 0 (no OA) to 4 (severe OA) based on the number of radiographic features present. Appendicular BMD was measured in all subjects, and hip and spine BMD in 84% of the group. We used linear regression to examine the association of BMD with hip OA, and to adjust for age, weight, and other determinants of bone mass.Results. Three hundred fifty‐one women (7.2%) had mild (grade 2) and 228 (4.7%) had moderate to severe (grade 3–4) radiographic evidence of hip OA. Women with grade 3–4 hip OA had a higher age‐adjusted BMD at the femoral neck and Ward's triangle (9–10%; P < 0.0001), trochanter (4%; P < 0.01), lumbar spine (8%; P < 0.0001), and distal radius and calcaneus (5%; P < 0.0001 [for each comparison]) compared with those with grade 0–1 OA in the worse hip. Elevations in BMD were greatest in the femoral neck of hips with OA, in women with bilateral hip OA, and in women with hip osteophytes. These findings were essentially unchanged by adjustment for determinants of bone mass.Conclusion. Elderly Caucasian women with moderate to severe radiographic hip OA had higher BMD in the hip, spine, and appendicular skeleton than did women without hip OA. Our findings are consistent with a role of elevated BMD in the pathogenesis of hip OA.
Compartment‐directed physical examination of the knee can predict articular cartilage abnormalities disclosed by needle arthroscopy
Authors: Ike Robert W. , O'Rourke Kenneth S. 
Published: February 2007

AbstractObjective. To determine whether physical examination maneuvers that focus on each knee compartment and assess crepitus at several distinct sites can specifically disclose articular cartilage abnormalities in the compartment being assessed.Methods. Twenty patients with knee pain were examined before needle arthroscopy. Crepitus was sought from the patellofemoral compartment, medial tibiofemoral compartment, and lateral tibiofemoral compartment. Any crepitus felt in the distal tibia during a tibiofemoral stress maneuver was recorded as transmitted bony crepitus (TBC). Needle arthroscopy assessed articular cartilage (5 sites) and both menisci in each knee.Results. Crepitus by conventional assessment revealed patellar cartilage disruption (69% sensitive, 50% specific) and abnormalities of tibiofemoral cartilage (67% sensitive, 40% specific) but could not indicate their location. Tibiofemoral crepitus found cartilage disruption in the compartment at a sensitivity of 22% and a specificity of 100%, and with added tibiofemoral stress, a sensitivity of 65% and a specificity of 94% (the one “false positive” had bare bone in the other compartment). TBC was detected in 7 compartments, all of which had focal bare bone on tibial and femoral surfaces; 6 other compartments had tibial bare bone without TBC. Thus, TBC was 54% sensitive and 100% specific for tibial bare bone, and 88% sensitive and 100% specific for bone‐on‐bone.Conclusion. Compartment‐directed physical examination of the painful knee can locate and assess the severity of certain articular cartilage abnormalities that are not reliably found by conventional methods. Transmitted bony crepitus is a specific finding for bone‐on‐bone in the compartment being assessed.
Elevated levels of eosinophil major basic protein in the sera of patients with systemic sclerosis
Authors: Cox Darrin , Earle Linda , Jimenez Sergio A. , Leiferman Kristin M. , Gleich Gerald J. , Varga John 
Published: February 2007

AbstractObjective. To examine eosinophil activation, as reflected by evidence of eosinophil degranulation in the blood and affected tissues, in patients with diffuse and limited cutaneous forms of systemic sclerosis (SSc).Methods. Levels of the eosinophil‐derived major basic protein (MBP), a marker of eosinophil degranulation, were determined in sera from 46 SSc patients, from patients with rheumatoid arthritis and giant cell arteritis, and from healthy volunteers, and in bronchoalveolar lavage fluid from 4 SSc patients. Extracellular tissue deposition of MBP was evaluated in biopsy specimens from affected skin or lung of 11 SSc patients.Results. Patients with diffuse cutaneous SSc (dcSSc) had elevated serum MBP levels compared with normal individuals (mean ± SD 762 ± 271 ng/ml versus 534 ± 144 ng/ml; P = 0.0004). MBP levels were positively correlated with the extent of cutaneous involvement, and negatively correlated with pulmonary function and duration of disease (r = –0.20). By immunohistochemical analysis, modest extracellular MBP deposition could be demonstrated in involved skin in 7 of 10 biopsy specimens, and MBP staining was prominent in affected lung tissues in 2 patients.Conclusion. Eosinophil degranulation appears to be increased in some patients with dcSSc, as indicated by elevated serum levels of MBP and extracellular accumulation of MBP in the lung. Eosinophil granule proteins may contribute to the development of cutaneous and pulmonary fibrosis in SSc.
Changes in glycosaminoglycan epitope levels in knee joint fluid following injury
Authors: Hazell Paula K. , Dent Colin , Fairclough John A. , Bayliss Michael T. , Hardingham Tim E. 
Published: February 2007

AbstractObjective. To measure the levels of epitopes on the chondroitin sulfate (CS) and keratan sulfate (KS) chains of proteoglycan fragments in synovial fluids from injured and contralateral uninjured knees of patients with traumatic cruciate ligament and/or meniscus damage.Methods. Enzyme‐linked immunosorbent assays were used to determine the levels of monoclonal antibody epitopes 3‐B‐3 and 7‐D‐4 (CS), and 5‐D‐4 (KS), in paired joint fluids from the injured and uninjured knees of trauma patients.Results. Levels of the CS epitopes were increased in the trauma joint fluids from most patients, with higher levels of 3‐B‐3 epitope in 12 of the 16 patients, but the difference did not achieve significance; however, 7‐D‐4 levels were higher in 15 patients, and the difference was highly significant (P = 0.0005). In contrast, the KS epitope detected by 5‐D‐4 was decreased in 13 of 15 patients, and the difference was significant (P = 0.0074).Conclusion. The increased level of 7‐D‐4 epitope on proteoglycans in joint fluid from injured knees may reflect the response of the articular cartilage to acute trauma resulting in altered expression of specific CS epitopes on cartilage proteoglycans. The fall in KS epitope levels may reflect the synthesis of proteoglycans that have lower KS content.