bluuebunny/crossref_metadata_2025_split huggingface dataset:
Central nervous system toxicity associated with weekly low‐dose methotrexate treatment
Authors: Wernick Richard , Smith David L. 
Published: February 2007

AbstractCentral nervous system (CNS) toxicity from low‐dose methotrexate (MTX) has been reported rarely, and reported symptoms consist primarily of dizziness and headache. We reviewed the records of 25 consecutive patients treated with low‐dose MTX, and found 5 who had spontaneously reported unpleasant cranial sensations, mood alteration, or memory impairment. Rechallenge with MTX on 5 occasions in 3 patients led to recurrent CNS symptoms in all cases. CNS toxicity was the sole reason for discontinuation of MTX in 2 patients. These 5 patients differed from the 20 without CNS toxicity in age (mean 68 versus 50) and baseline serum creatinine level (1.3 mg/dl versus 0.9 mg/dl), but not in weekly dosage of MTX (12 mg versus 16 mg). These results suggest that CNS toxicity is more common than previously reported, particularly in older patients with mild renal insufficiency.
Sleep fragmentation in rheumatoid arthritis
Authors: Mahowald Mark W. , Mahowald Maren L. , Bundlie Scott R. , Ytterberg Steven R. 
Published: February 2007

AbstractFatigue is commonly reported by patients with rheumatoid arthritis (RA), and it is frequently used to evaluate disease activity and response to therapy. We theorized that the feeling of fatigue in patients with RA may be a manifestation of disturbance of sleep. Sixteen patients with chronic, active RA, who were selected for early onset of fatigue (<6 hours after morning awakening), were extensively evaluated by formal all‐night polysomnographic recording and multiple sleep latency testing (MSLT). Although no sleep deprivation was found, all patients had some type of marked disturbances of sleep, including unanticipated sleep apnea (2 patients), frequent movement of extremities (all 16 patients), and frequent arousal (all 16 patients). The alpha‐delta sleep pattern was present in 13 patients, and 7 were found by MSLT to be hypersomnolent. None of the patients accurately recognized the degree of their sleep disruption. Our findings from the MSLT indicate that fatigue in patients with RA may be a manifestation of sleep fragmentation, rather than a nonspecific constitutional symptom.
Psoriatic arthritis in children
Authors: Southwood Taunton R. , Petty Ross E. , Malleson Peter N. , Delgado Egle A. , Hunt David W. C. , Wood Betty , Schroeder Maria‐Louise 
Published: February 2007

AbstractA proposed definition of juvenile psoriatic arthritis (JPsA) was used to identify definite or probable JPsA in 35 children. Definite JPsA (24 patients) was defined as arthritis associated, but not necessarily coincident, with a typical psoriatic rash, or arthritis plus at least 3 of 4 minor criteria: dactylitis, nail pitting, psoriasis‐like rash, or family history of psoriasis. Probable JPsA (11 patients) was defined as arthritis plus 2 of the minor criteria. In 33 of 35 patients, the onset of arthritis was pauciarticular, but the disease followed a polyarticular course in 23 of 35. Chronic anterior uveitis (6 of 35), antinuclear antibodies (22 of 35), anticollagen antibodies (10 of 35), HLA‐DR4 (2 of 28), and HLA‐DR8 (5 of 28) occurred with frequencies similar to those seen in patients with juvenile rheumatoid arthritis. JPsA may have more in common with juvenile rheumatoid arthritis than with the seronegative spondylarthropathies with which it is traditionally associated.
Inhibition of in vitro vascular endothelial cell proliferation and in vivo neovascularization by low‐dose methotrexate
Authors: Hirata S. , Matsubara T. , Saura R. , Hirohata K. , Tateishi H. 
Published: February 2007

AbstractNeovascularization in the rheumatoid synovium plays an important role in the propagation of rheumatoid synovitis because the emigration of mononuclear cells and the growth of pannus are critically dependent on the development of small blood vessels. Inhibition of local vascular endothelial cell (EC) proliferation, which is essential for growth of these vessels, therefore, would have the potential to suppress rheumatoid inflammation. We investigated the effects of methotrexate (MTX), low doses of which are commonly administered to rheumatoid arthritis patients, on DNA synthesis by human umbilical vein EC in vitro and on rabbit corneal neovascularization in vivo. MTX inhibited both basal and EC growth factor–stimulated tritiated deoxyuridine (3H‐UdR) incorporation into EC in a dose‐dependent manner. Significant inhibition was observed at a concentration of 5 × 10−9M, which is that attained in the serum of treated patients. Neovascularization in vivo was also suppressed by low‐dose intramuscular injections. These results suggest that MTX has an antiangiogenic effect, and may suppress rheumatoid inflammation through the reduction of synovial small blood vessels responsible for mononuclear cell infiltration and proliferation of synovial tissue.
Normotensive renal failure in systemic sclerosis
Authors: Helfrich David J. , Banner Barbara , Steen Virginia D. , Medsger Thomas A. 
Published: February 2007

AbstractOf 140 patients with “scleroderma renal crisis” encountered during a 33‐year period, 15 of 131 (11%) whose blood pressures were recorded were normotensive during this complication. In comparison with 116 patients with hypertension, the normotensive patients significantly more often had microangiopathic hemolytic anemia (90% versus 38%) and thrombocytopenia (83% versus 21%). Pulmonary hemorrhage occurred in 6 normotensive patients. More normotensive patients had received high doses of corticosteroids (prednisone gE;30 mg/day) during the 2 months immediately preceding renal crisis (64% versus 16%). A role for corticosteroids in precipitating renal crisis is suggested. The 12‐month survival was significantly reduced in the normotensive patients (13% versus 35%).
The presence of antibodies to lymphotoxin and tumor necrosis factor in normal serum
Authors: Jeffes Edward W. B. , Ininns Elizabeth K. , Schmitz Kristen L. , Yamamoto Robert S. , Dett Carmen A. , Granger Gale A. 
Published: February 2007

AbstractLymphotoxin (LT) and tumor necrosis factor (TNF) are cytokines that probably play a role in several autoimmune diseases. In this report, we describe the detection, in normal nonimmune serum, of naturally occurring antibodies that bind to recombinant human LT and TNF. The naturally occurring antibodies that bind to LT and TNF could explain why normal immunoglobulin is effective therapy in idiopathic thrombocytopenic purpura and Kawasaki syndrome.
Development and initial validation of a dual‐language english–spanish format for the arthritis impact measurement scales
Authors: Hendricson William D. , Jon Russell I. , Prihoda Thomas J. , Jacobson James M. , Rogan Alice , Bishop George D. , Castillo Richard 
Published: February 2007

AbstractLanguage, cultural, and educational barriers complicate efforts to validate health status questionnaires that have been translated into Spanish. To overcome these problems, a prototype dual‐language format was developed for the Arthritis Impact Measurement Scales. Validity testing with 72 patients diagnosed as having rheumatoid arthritis indicated high levels of test‐retest reliability, item‐to‐scale internal consistency, and construct validity for both Anglo and Hispanic subjects. A technique for developing and pilot‐testing a questionnaire written in a regional Spanish dialect is described. Linguistic considerations, questionnaire design, and other applications are discussed in light of the results obtained.
Autoantibodies to the major nucleolar phosphoprotein B23 define a novel subset of patients with anticardiolipin antibodies
Authors: Li Xiaozhou , Jane Mcneilage L. , Whittingham Senga 
Published: February 2007

AbstractOf 164 sera with antinucleolar antibodies, 7 (4.3%) were shown by Western blotting to react with a 37‐kd polypeptide in a nuclear extract of HeLa cells and with the recombinant protein expressed by a complementary DNA clone encoding the major nucleolar protein B23. Six of the 7 sera (86%) had antibodies to cardiolipin (aCL), and the sample that was negative for aCL had had lupus anticoagulant on previous testing. All 7 patients had either systemic lupus erythematosus (SLE) or a variant of SLE, suggesting that anti‐B23 identifies a subset of patients with SLE associated with a high frequency of aCL.
High‐grade atrioventricular heart block in an adult with systemic lupus erythematosus: The association of nuclear RNP (U1 RNP) antibodies, a case report, and review of the literature
Authors: Bilazarian Seth D. , Taylor Allen J. , Brezinski Damian , Hochberg Marc C. , Guarnieri Thomas , Provost Thomas T. 
Published: February 2007

AbstractHigh‐grade atrioventricular heart block (HGAVB) occurring as a manifestation of systemic lupus erythematosus is an exceedingly rare event. We describe a patient with HGAVB who had myositis and antibodies to nuclear RNP (previously associated with myocarditis). A review of the literature on HGAVB associated with systemic lupus erythematosus is also presented.
Destructive arthritis, rheumatoid factor, and HLA–DR4. Susceptibility versus severity, a case–control study
Authors: Calin Andrei , Elswood Judith , Klouda Peter T. 
Published: February 2007

AbstractIn response to the continuing debate as to whether seronegative rheumatoid arthritis (RA) and seropositive RA are part of the same disease spectrum or are distinct disorders, we evaluated 720 patients with definite and classic RA, of whom 53 subjects had definite persistently seronegative destructive disease. For all but 1 seronegative RA patient, a seropositive RA case control was identified and matched for age, disease duration, degree of destruction on hand radiographs, and disease‐modifying drug therapy. DR typing was undertaken on these 105 patients, together with scoring of hand radiographs. The frequency of DR4 was 69% in seropositive RA patients and 60% in seronegative RA patients (P = 0.22), versus 36% in 318 healthy controls (P = 0.008 and P = 0.007 versus seropositive and seronegative RA, respectively). Patients were matched and rematched with different controls in a series of subanalyses in order to make comparisons of hand radiograph scores. We found that HLA–DR4 was associated with destructive RA in both seropositive and seronegative RA patients. In general, DR4+ patients had more severe disease by radiologic criteria than did DR4– patients. Thus, HLA–DR4 may be an additive factor to the serologic status and may be more closely related to disease severity than to disease susceptibility.
The clinical significance of iC3b neoantigen expression in plasma from patients with systemic lupus erythematosus
Authors: Negoro Nobuo , Okamura Mikio , Takeda Tadanao , Koda Shinichi , Amatsu Koji , Inoue Takatoshi , Curd John G. , Kanayama Yoshiharu 
Published: February 2007

AbstractWe studied the expression of an iC3b neoantigen (iC3b‐NEO) in plasma from patients with systemic lupus erythematosus (SLE), by using a monoclonal antibody specific for iC3b/C3dg/C3d, to investigate the activation of the third component of complement in SLE. The plasma iC3b‐NEO level in 40 untreated patients with active SLE was significantly higher than that in 36 normal subjects (mean ± SD 31.5 ± 13.9 μg/ml versus 12.3 ± 3.3 μg/ml; P < 0.001). The plasma iC3b‐NEO level was highly correlated with clinical disease activity (τ = 0.62, P < 0.0001), and it was the parameter most closely correlated with renal histologic activity in lupus nephritis (τ = 0.52, P < 0.0001). Also, patients with diffuse proliferative lupus nephritis had the highest levels of plasma iC3b‐NEO among all World Health Organization classes of lupus nephritis (P < 0.01). We conclude that the plasma iC3b‐NEO level is strongly associated with clinical disease activity and renal histologic activity in patients with SLE, and that plasma iC3b‐NEO may be a sensitive and useful measure of complement activation in SLE.
Antiribosomal S10 antibodies in humans and MRL/lpr mice with systemic lupus erythematosus
Authors: Bonfa E. , Parnassa A. P. , Rhoads D. D. , Roufa D. J. , Wool I. G. , Elkon K. B. 
Published: February 2007

AbstractAutoantibodies directed against a ribosomal small subunit protein of 20,000 molecular weight were found in sera from 5 of 44 patients with systemic lupus erythematosus (11%) and 5 of 48 MRL/lpr mice (10%). This ribosomal protein was identified as S10 on the basis of two‐dimensional gel electrophoresis and immunoblotting, as well as immunoblots of the purified S10 protein. The S10 protein antigen was readily extracted from ribosomes at low salt (300 mM KCI) and low magnesium (0.5 mM) concentrations, consistent with the highly exposed location proposed for this protein on the 40S subunit. Anti‐S10 antibodies were observed significantly more frequently in lupus sera containing both anti‐Sm and antiribosomal P protein antibodies and in MRL/lpr sera with anti‐Sm activity, suggesting a linked pattern of autoantibody response. Together with anti‐Sm and antiribosomal P protein antibodies, anti‐S10 represents a third autoantibody highly specific for lupus in humans and MLR/lpr mice.
Activation of the complement system in systemic sclerosis. Relationship to clinical severity
Authors: Senaldi Giorgio , Lupoli Salvatore , Vergani Diego , Black Carol M. 
Published: February 2007

AbstractUsing newly developed techniques, we investigated the complement pathways and the extent of their activation in patients with systemic sclerosis (SSc) of both the diffuse cutaneous and limited cutaneous types. Plasma levels of the fragments C3d, C4d, and Ba were measured in patients with SSc and in matched control subjects. All fragments and ratios were higher in SSc patients than in controls (P < 0.05), demonstrating that complement activation occurs in SSc. Levels of C3d, C3d:C3, Ba, and Ba:factor B were higher in patients with diffuse cutaneous SSc than in those with limited SSc (P < 0.01). All fragments and ratios were higher in diffuse cutaneous SSc patients than in controls (P < 0.01). C3d, C3d:C3, C4d, and C4d:C4 levels were also higher in patients with limited cutaneous SSc than in controls (P < 0.05). These results show that complement activation occurs in SSc patients and that it reflects clinical severity. Complement activation may therefore have a pathogenetic role in SSc, and its measurement may prove useful in monitoring the disease.
Suppression of human synovial cell proliferation by dihomo‐γ‐linolenic acid
Authors: Baker Daniel G. , Krakauer Kathrin A. , Tate Guillermo , Laposata Michael , Zurier Robert B. 
Published: February 2007

AbstractProstaglandin E1 (PGE1) and oils enriched in its precursor fatty acids suppress inflammation and joint tissue injury in several animal models. Since synovial cell proliferation is a hallmark of rheumatoid arthritis, we studied the effect of dihomo‐γ‐linolenic acid (DGLA), an immediate precursor of PGE1, on the growth of human adherent synovial cells (ASC) in tissue culture. When stimulated by appropriate concentrations of recombinant interleukin‐1β (rIL‐1β), ASC proliferate and produce PGE. DGLA‐enriched medium suppressed both baseline and rIL‐1β–stimulated ASC growth fivefold, compared with medium supplemented with arachidonic acid. Indomethacin reduced the effect of the DGLA. Synovial cells incorporated the DGLA, and rIL‐1β–stimulated cells that were incubated with DGLA exhibited a 14‐fold increase in PGE1 (to 25.2 ± 6.0 ng/ml, mean ± SD) and a 70% decrease in PGE2 (to 25.2 ± 4.2 ng/ml) compared with cells in control medium. At equivalent concentrations (5 × 10−7M), PGE1 increased the level of cellular cAMP to a greater extent than did PGE2 (16.8 ± 2.0 pmoles versus 4.3 ± 1.9 pmoles, mean ± SEM). Exogenous PGE1 was also a more effective inhibitor of cell growth. Similarly, cAMP concentrations in cells exposed to DGLA for 6 hours were greater than concentrations in arachidonic acidenriched cultures (17.8 ± 3.3 pmoles versus 2.1 ± 2.0 pmoles). These observations suggest that DGLA can restrain ASC growth, an effect which may be due to its capacity to increase PGE1 production and subsequent cellular cAMP concentration.
Isotype analysis of the anti–CENP‐B anticentromere autoantibody: Evidence for restricted clonality
Authors: Eisenberg Robert A. , Earnshaw William C. , Bordwell Bonnie J. , Craven Sylvia Y. , Cheek Robert , Rothfield Naomi F. 
Published: February 2007

AbstractUtilizing the centromere B fusion protein (CENP‐B) and specific, matched monoclonal antiisotype reagents in an enzyme‐linked immunosorbent assay, we found that anti–CENP‐B autoantibodies were skewed to the IgG1 isotype. The overall k:λ light chain ratio was 2:1, although several individual sera showed a strong predominance of one of the light chains. Isoelectric focusing of light chain–skewed sera showed polyclonal patterns. Our findings are consistent with the anti–CENP‐B autoantibody response being a chronic, antigen‐driven response.
Antihistone antibodies in rheumatoid arthritis and Felty's syndrome
Authors: Cohen Michael G. , Webb John 
Published: February 2007

AbstractAlthough antihistone antibodies are frequently detected in patients with systemic lupus erythematosus, they appear to be uncommon or present only at low levels in rheumatoid arthritis (RA) patients. We used an enzyme‐linked immunosorbent assay to study sera from 42 patients with RA, and we confirmed that antihistone antibodies mainly occurred at low levels in these patients. In contrast, 83% of 24 patients with Felty's syndrome had antihistone antibodies, often at high levels. Thus, antihistone antibodies may be a common autoimmune abnormality in patients with Felty's syndrome but not in other patients with RA. In addition, we demonstrated that some rheumatoid factors have cross‐reactive antihistone antibody activity.
Development of a disability measurement tool for juvenile rheumatoid arthritis. The juvenile arthritis functional assessment scale
Authors: Lovell Daniel J. , Shear Edith , Hartner Sandra , McGirr Gerri , Schulte Marion , Levinson Joseph , Howe Steven 
Published: February 2007

AbstractA disability assessment tool, the Juvenile Arthritis Functional Assessment Scale, was developed for, and validated in, patients with juvenile rheumatoid arthritis (JRA). Standards for this 10‐item tool were developed using the scores of 63 normal school children as controls and comparing these results with those of 71 age‐matched JRA patients (age 7–16 years). The JRA patients scored statistically significantly higher on the scale, which also demonstrated excellent internal and convergent validity and internal reliability. The test is easily administered in 10 minutes by a physical or occupational therapist in a clinical or office setting. This tool represents the first normalized disability assessment tool developed for JRA patients.
Efficacy of physical conditioning exercise in patients with rheumatoid arthritis and osteoarthritis
Authors: Minor Marian A. , Webel Richard R. , Kay Donald R. , Hewett John E. , Anderson Sharon K. 
Published: February 2007

AbstractA group of 120 patients with rheumatoid arthritis or osteoarthritis volunteered to be subjects for this study of aerobic versus nonaerobic exercise. Patients were stratified by diagnosis and randomized into an exercise program of aerobic walking, aerobic aquatics, or non‐aerobic range of motion (controls). The retention rate for the 12‐week program was 83%. Exercise tolerance, disease‐related measures, and self‐reported health status were assessed. The aquatics and walking exercise groups showed significant improvement over the control group in aerobic capacity, 50‐foot walking time, depression, anxiety, and physical activity after the 12‐week exercise program. There were no significant between‐group differences in the change scores for flexibility, number of clinically active joints, duration of morning stiffness, or grip strength. Our findings document the feasibility and efficacy of conditioning exercise for people who have rheumatoid arthritis or osteoarthritis.
Differences in the fine specificity of ANTI–Ro (SS‐A) in relation to the presence of other precipitating autoantibodies
Authors: Rader Michael D. , Codding Chris , Reichlin Morris 
Published: February 2007

AbstractIn sera from patients with systemic lupus erythematosus or Sjögren's syndrome, we determined the fraction of antibody that remained reactive with human Ro (SS‐A) after absorption with bovine spleen extract, and the reactivity with the 60‐kd and 54‐kd red blood cell Ro (SS‐A) bands by Western blot. Of the 3 groups of sera studied, those containing anti–Ro (SS‐A) alone had the highest degree of reactivity with human Ro (SS‐A) after absorption with bovine spleen extract, followed, in descending order, by sera containing anti–Ro (SS‐A) and anti–La (SS‐B), and sera containing anti–Ro (SS‐A) and anti–nuclear RNP. The groups of sera could be distinguished on this basis. Sera with anti–Ro (SS‐A) and anti–nuclear RNP could also be distinguished from the other 2 types of sera by their uniform and preferential reactivity with the 60‐kd red blood cell Ro (SS‐A), by Western blot analysis. These findings indicate that there are both qualitative and quantitative differences, associated with the presence of other autoantibodies, in the fine specificity of anti–Ro (SS‐A) sera.
New radiographic grading scales for osteoarthritis of the hand. Reliability for determining prevalence and progression
Authors: Kallman Douglas A. , Wigley Fredrick M. , Scott William W. , Hochberg Marc C. , Tobin Jordan D. 
Published: February 2007

AbstractWe developed and evaluated scales for grading the prevalence and progression of the individual radiographic features of osteoarthritis (OA) of the hand. Four equally time‐spaced hand radiographs from 50 participants in the Baltimore Longitudinal Study of Aging, who were followed for at least 20 years, were read separately and „blindly”︁ by 4 experienced, trained readers. Eleven hand joints were individually assessed for the presence of osteophytes, joint space narrowing, subchondral cysts, subchondral sclerosis, lateral deformity, and cortical collapse, and were also graded using the Kellgren/Lawrence scale, a global estimate of OA. The intraclass correlation coefficient was used to determine cross‐sectional inter‐ and intrareader reliability. Interreader agreement on OA progression was evaluated using life‐table analysis. Each of the grading scales for the individual radiographic features of OA of the hand, except for cysts, were cross‐sectionally reliable between readers. Each reader was able to reproduce his original scores almost perfectly when grading the radiographs a second time. Using these scales, the different readers agreed on all the features of longitudinal progression of OA of the hand, except cysts. We believe that this method for grading hand radiographs for OA has proved to be reliable for both cross‐sectional and longitudinal studies.
Elevated mean corpuscular volume as a predictor of hematologic toxicity due to methotrexate therapy
Authors: Weinblatt Michael E. , Fraser Patricia 
Published: February 2007

AbstractRetrospective analysis of 23 rheumatoid arthritis patients receiving low‐dose methotrexate (MTX) demonstrated an association between the mean corpuscular volume (MCV) and hematologic toxicity. All 6 patients who developed hematologic toxicity were folate deficient, and 4 of 6 had marked macrocytosis. Furthermore, the mean MCV of the patients who developed toxicity was significantly higher than that of the controls without toxicity (P < 0.02). This difference in MCV was associated with an increased probability of developing toxicity with time (P < 0.005). These results suggest that sustained elevation in the MCV may be a predictor of impending hematologic toxicity due to folate depletion.