bluuebunny/crossref_metadata_2025_split huggingface dataset:
A randomized, double‐blind, placebo‐controlled study of cd4 monoclonal antibody therapy in early rheumatoid arthritis
Authors: Van Der Lubbe Peter A. , Dijkmans Ben A. C. , Markusse Hendrik M. , Nässander Ulla , Breedveld Ferdinand C. 
Published: February 2007

AbstractObjective. To assess the efficacy of the CD4 monoclonal antibody (MAb) cM‐T412 in the treatment of early rheumatoid arthritis (RA).Methods. Sixty patients were enrolled in a 6‐week randomized, double‐blind, placebo‐controlled study investigating multiple dose regimens of cM‐T412. Thirty patients subsequently were enrolled in a 9‐month randomized, double‐blind, placebo‐controlled study investigating monthly single‐dose administrations of cM‐T412.Results. Analysis of clinical parameters revealed no changes in arthritis activity in the groups that received CD4 MAb or the placebo group, and no difference between the groups, in either in the first or the second part of the study. The number of circulating CD4+ cells decreased substantially in the patients treated with CD4 MAb.Conclusion. CD4 MAb treatment of patients with early RA induced no therapeutic effect.
Development of an observation method for assessing pain behaviors in children with juvenile rheumatoid arthritis
Authors: Jaworski Theresa M. , Bradley Laurence A. , Heck Louis W. , Roca Alex , Alarcön Graciela S. 
Published: February 2007

AbstractObjective. To develop an observation method for assessing pain behaviors in children with juvenile rheumatoid arthritis (JRA).Methods. Thirty children with JRA performed a standardized sequence of activities for video recording, and correlations between the pain behaviors observed on the videotapes and established measures of pain, depression, and functional disability were determined.Results. Pain behaviors were reliably observed (kappa coefficients 0.53‐0.79). Total pain behaviors were significantly correlated with subjective reports of pain (r = 0.50) and disability levels (r = 0.64). These behaviors were not significantly associated with children's depression ratings (r = 23).Conclusion. The results indicate that the behavioral observation method provides a reliable and valid measure of pain associated with JRA. Measurement of pain behaviors may be especially useful in treatment outcome studies because these behaviors are relatively independent of depression.
Lyme disease in a 74‐year‐old forest owner with symptoms of dermatomyositis
Authors: Hoffmann Jörg C. , Stichtenoth Dirk O. , Zeidler Henning , Follmann Markus , Brandis Almuth , Stanek Gerold , Wollenhaupt Jürgen 
Published: February 2007

AbstractWe describe a 73‐year‐old forest owner with widespread erythema, myalgia, and proximal muscle weakness. The clinical signs and the results of electro‐myography, magnetic resonance imaging, and a muscle biopsy were consistent with dermatomyositis. However, serology was positive for Borrelia burgdorferi. More importantly, B burgdorferi DNA was detected in skin by polymerase chain reaction techniques, and spirochete‐like organisms were detected in the muscle by silver staining. Lyme disease with muscle involvement can mimic or trigger dermatomyositis and should be considered in the differential diagnosis of dermatomyositis.
Degenerative lumbar spinal stenosis diagnostic value of the history and physical examination
Authors: Katz Jeffrey N. , Dalgas Marianne , Stucki Gerold , Katz Nathaniel P. , Bayley James , Fossel Anne H. , Chang Lily C. , Lipson Stephen J. 
Published: February 2007

AbstractObjective. To assess the value of the history and physical examination findings in the diagnosis of symptomatic degenerative lumbar spinal stenosis (LSS).Methods. The study was performed in 3 specialty clinics, and included patients with low back pain who were at least age 40. Findings from a standardized history and physical examination were compared with the diagnostic impression of expert attending clinicians. Imaging studies were available in 88% of those with LSS, and the findings further supported the diagnosis of LSS in each case. The sensitivity, specificity, and likelihood ratio associated with each history and physical examination finding were calculated in bivariate analyses, and independent correlates of LSS were identified with multivariate analyses.Results. Ninety‐three patients were evaluated. History findings most strongly associated with the diagnosis of LSS (likelihood ratio ≥2) were greater age, severe lower‐extremity pain, and absence of pain when seated. Physical examination findings most strongly associated with the diagnosis were wide‐based gait, abnormal Romberg test result, thigh pain following 30 seconds of lumbar extension, and neuromuscular deficits. Independent correlates of LSS included advanced age (P = 0.0001), absence of pain when seated (P = 0.006), wide‐based gait (P = 0.013), and thigh pain following 30 seconds of lumbar extension (P = 0.002).Conclusion. Specific history and physical examination findings are useful in the diagnosis of LSS and should be ascertained routinely in older patients with low back pain.
klebsiella pneumoniae‐reactive t cells in blood and synovial fluid of patients with ankylosing spondylitis comparison with hla–b27 + healthy control subjects in a limiting dilution study and determination of the specificity of synovial fluid t cell clones
Authors: Hermann Elisabeth , Sucké Bernd , Droste Ulf , zum Büschenfelde Karl‐Hermann Meyer 
Published: February 2007

AbstractObjective. To study the frequency of Klebsiella pneumoniae–responsive T cells in the peripheral blood (PB) of ankylosing spondylitis (AS) patients compared with that in healthy HLA–B27+ donors, and to examine T lymphocyte clones (TLC) derived from AS patient synovial fluid (SF) for the presence of Klebsiella reactivity.Methods. Limiting dilution analysis of PB T cells in 8 patients with active AS and in 8 HLA–B27+ healthy subjects was used to determine the frequency of PB T cells responsive to K pneumoniae and Escherichia coli GroEL. SF T cells from a patient with active AS were cloned, and 125 TLC were characterized in proliferation assays.Results. There were fewer T cells in the PB of AS patients that reacted with K pneumoniae than in the PB of healthy HLA–B27+ subjects. The frequencies of E coli GroEL–responsive T cells were ∼5–10 times lower in all subjects tested (healthy donors and AS patients), but without significant differences between the 2 groups. Two CD4+ TLC that recognized K pneumoniae (1 cross‐reactive with E coli) as well as 3 TLC that recognized GroEL (2 CD4+, 1 T cell receptor γ/δ+) were isolated from the SF of a patient with active AS.Conclusion. Our results indicate that there is a quantitative reduction of K pneumoniae‐responsive T cells in the PB of AS patients as compared with healthy controls. This may reflect a defective peripheral T cell defense in the immune response to Klebsiella and may allow bacterial antigens to reach the synovium, where they initiate specific T cell responses.
Quantitative bone scintigraphy in the management of monostotic paget's disease of bone
Authors: Patel Sanjeev , Pearson Derek , Hosking David J. 
Published: February 2007

AbstractObjective. To assess the use of quantitative bone scanning (QBS) in the monitoring of patients with intravenous pamidronate–treated symptomatic mono‐stotic Paget's disease of bone in whom biochemical markers of bone turnover are relatively normal.Methods. QBS was performed in 9 patients and the results were expressed as a ratio, obtained by comparing isotope uptake at an affected and a control (unaffected) site.Results. Serum alkaline phosphatase levels were normal in 7 of the 9 patients and changed minimally with treatment. The median QBS ratio was 2.72 (range 1.69–24.6) at baseline and 1.49 (range 0.63–4.18) post‐ treatment (P = 0.008). The median symptom score decreased with treatment, but QBS ratios provided the only objective measure of disease activity by which response to pamidronate therapy could be judged.Conclusion. QBS may be a useful technique for evaluating the effects of treatment in patients with Paget's disease of bone.
Adult respiratory distress syndrome in polymyositis patients with the anti–jo‐1 antibody
Authors: Clawson Kevin , Oddis Chester V. 
Published: February 2007

AbstractWe report 3 patients with polymyositis and the anti–Jo‐1 antibody who developed fatal adult respiratory distress syndrome (ARDS). Other than the presence of the anti–Jo‐1 antibody, there were no other consistent clinical features at the onset of disease that were predictive of ARDS development.
Campath‐1h, a humanized monoclonal antibody, in refractory rheumatoid arthritis
Authors: Weinblatt Michael E. , Maddison Peter J. , Bulpitt Ken J. , Hazleman Brian L. , Urowitz Murray B. , Sturrock Roger D. , Coblyn Jonathan S. , Maier Agnes L. , Spreen William R. , Manna Vasant K. , Johnston Jeffrey M. 
Published: February 2007

AbstractObjective. To evaluate the biologic response, tolerability, and potential clinical effect of a humanized antilymphocyte monoclonal antibody, CAMPATH‐1H, in patients with rheumatoid arthritis (RA).Methods. Forty adult patients with active, refractory RA were treated with CAMPATH‐1H, given intravenously, in a multicenter, open, single‐dose‐escalation study. Patients were assigned to dose groups of 1, 3, 10, 30, 60, and 100 mg CAMPATH‐1H.Results. There was a profound, immediate, and sustained reduction of the peripheral lymphocyte count; the most susceptible were the levels of CD4+ and CD8+ cells, which remained depressed during the study period. Sixty‐three percent of patients developed antibodies to CAMPATH‐1H. Side effects occurred frequently throughout the first 24 hours following infusion, and included fever, headache, nausea, vomiting, and hypotension. All of the immediate drug toxicities resolved within the initial 24‐hour postdosing period. One patient developed a reactivation of Mycobacterium xenopi infection 10 weeks following infusion. Sixty‐five percent of patients developed a clinical response; the mean duration of response was 2 weeks.Conclusion. CAMPATH‐1H is a lymphocytedepleting antibody that is biologically potent even after single‐dose therapy. There was no correlation between biologic effect and clinical response. Sustained lymphocyte suppression was observed. Acute infusion toxicities were observed in most patients. The role of depleting monoclonal antibodies in the treatment of RA should be reevaluated.
Oral 2‐chlorodeoxyadenosine in psoriatic
Authors: Eibschutz Barry , Baird Stephen M. , Weisman Michael H. , Amox Diane G. , Spellman Mary , Piacquadio Daniel , Carrera Carlos J. , Carson Dennis A. 
Published: February 2007

AbstractObjective. To determine if weekly oral 2‐chlorodeoxyadenosine (2‐CdA) can induce selective lymphocytopenia, and reduce inflammation, in patients with refractory psoriatic arthritis.Methods. Seven patients with psoriatic arthritis were treated with oral 2‐CdA at weekly dosages of 0.3 mg/kg to 0.45 mg/kg for 12 weeks, followed by monthly maintenance therapy. The patients were evaluated after 6 months.Results. The drug treatment produced selective lymphocytopenia, and reduced lymphocyte infiltration into involved skin. One patient did not complete 12 weeks of therapy because of perceived lack of efficacy. Four of the 6 remaining patients had improved joint disease, and 5 of 6 had improved psoriasis.Conclusion. Weekly oral 2‐CdA appears to be a well‐tolerated regimen for the inducement of peripheral lymphocytopenia in patients with psoriatic arthritis. Larger‐scale, controlled trials may be warranted.
In vivo effects of stromelysin on the composition and physical properties of rabbit articular cartilage in the presence and absence of a synthetic inhibitor
Authors: Bonassar Lawrence J. , Jeffries Kimberly A. , Frank Eliot H. , Moore Vernon L. , Lark Michael W. , Bayne Ellen K. , Mcdonnell Joseph , Olszewski Julie , Hagmann William , Chapman Kevin , Grodzinsky Alan J. 
Published: February 2007

AbstractObjective. To characterize the effects of intra‐articular injection of recombinant human stromelysin (SLN) on the matrix composition and physical properties of cartilage from lapine stifle joints and the modulation of these effects by the systemic administration of an N‐carboxyalkyl synthetic matrix metalloproteinase inhibitor, L‐696,418.Methods. Female 6–8‐week‐old New Zealand white rabbits received an intraarticular injection of 100 μg activated SLN in 1 stifle joint and buffer in the contralateral control knee; these animals were killed after 1 hour. A separate group of animals received an intravenous injection of either 30 mg/kg L‐696,418 or buffer prior to intraarticular injection of SLN. Joints were dissected and analyzed for proteoglycan (PG) loss into joint fluid, tissue biochemical composition, and histology by toluidine blue or anti‐VDIPEN antibody staining, or were frozen for physical property analysis. Disks of femoropatellar groove cartilage were harvested from the stifle joint and tested in uniaxially confined compression for determination of electromechanical and mechanical properties.Results. Lapine stifle joints that received injection of SLN without systemic administration of L‐696,418 showed a 13‐fold increase in loss of PG into synovial fluid. Cartilage from these joints showed significant decreases in streaming potential at 1 Hz and electrokinetic coupling coefficient, but no change in equilibrium modulus, dynamic stiffness, or hydraulic permeability. Systemic treatment with L‐696,418 resulted in a significant decrease in loss of PG into joint fluid and elimination of changes in cartilage highfrequency streaming potential and coupling coefficient in joints that were injected with SLN.Conclusion. The 1‐hour exposure to SLN in vivo resulted in loss of PG and exposure of the VDIPEN epitope of the aggrecan core protein in the superficial region of the tissue near the articular surface. This highly localized degradation resulted in electromechanical behavior changes, but little or no change occurred in mechanical properties. Systemic administration of L‐696,418 significantly decreased loss of PG from cartilage and prevented the highly localized tissue degradation and the resultant changes in electromechanical behavior caused by intraarticular SLN injection.
Somatostatin‐induced modulation of inflammation in experimental arthritis
Authors: Matucci‐Cerinic Marco , Borrelli Francesco , Generini Sergio , Cantelmo Alfredo , Marcucci Isabella , Martelli Fabrizio , Romagnoli Paolo , Bacci Stefano , Conz Angelo , Marinelli Paolo , Marabini Simone 
Published: February 2007

AbstractObjective. To study the antiinflammatory effect of different doses of intraarticular somatostatin in experimental arthritis in rabbits.Methods. Chronic arthritis was induced by a single injection of fibrin into the knee joint of rabbits previously sensitized to this antigen. The effects of sequential intraarticular injections of somatostatin into the rabbit knee, at doses of 500, 750, and 1,000 μg, were monitored by measuringknee joint circumferences and hematologic parameters. The measurements were compared with those obtained following use of triamcinolone acetonide and placebo. At the end of the experiments, the knee joints were examined histologically.Results. Somatostatin treatment induced a statistically significant and dose‐related reduction of knee joint swelling. This effect was shorter than that produced by triamcinolone acetonide; however, the antiinflammatory activity elicited by successive doses of triamcinolone acetonide declined both in extent and duration, while the effects of somatostatin remained unchanged at each successive treatment. Histopatho‐logic observations showed that both somatostatin and triamcinolone acetonide reduced the inflammatory signs in the joint structures, although triamcinolone acetonide appeared to be more effective.Conclusion. These findings suggest that somatostatin exerts an antiinflammatory effect in this model of experimental arthritis and may represent a valid and safer alternative to corticosteroids for intraarticular therapy of arthritis.
A patient with antineutrophil cytoplasmic antibody–negative pulmonary capillaritis and circulating primed neutrophils
Authors: Nierman David M. , Kalb Thomas H. , Ornstein Matthew H. , Gil Joan 
Published: February 2007

AbstractWe describe an antineutrophil cytoplasmic antibody–negative patient with capillaritis, acute respiratory failure, and primed neutrophils circulating systemically. Thoracoscopic lung biopsy showed capillary destruction, with neutrophils infiltrating the lung interstitium and air spaces but no alveolar damage or hemorrhage. We suggest that this atypical, limited form of pulmonary injury may occur when circulating neutrophils are primed, but, in the absence of an activating factor, not fully activated.
AI/learn/rheumatology. A computer‐assisted educational system for teaching about rheumatic diseases
Authors: Bridges Alan J. , Dansdill David , Anderson James , Reid John , Hazelwood Susan , Cutts James H. , Gall Eric P. , Sharp Gordon , Mitchell Joyce A. 
Published: February 2007

AbstractEducation of health professionals about the rheumatic diseases is in need of improvement. The computer is an instrument that can be used efficiently to educate large numbers of users. With specific educational principles in mind, we developed Al/LEARN/RHEUMATOLOGY, a computer‐assisted interactive videodisc system for teaching the rheumatic diseases. While interacting with the user, it conveys knowledge using visual and problem‐solving techniques. The system is efficient, enjoyable to use, and useful for small groups and independent study. It is applicable for teaching medical and allied health professional students, postgraduate trainees, and primary care physicians.
Changing patterns of hospital use for patients with musculoskeletal diseases in Michigan, 1980 to 1987
Authors: McMahon Laurence F. , Petroni Gina R. , Tedeschi Philip J. , McLaughlin Catherine G. 
Published: February 2007

AbstractOver the past 10 years there have been dramatic changes in health care financing in the United States, such as Medicare's Prospective Payment System for hospitalized Medicare beneficiaries, and in health services delivery, such as the growth in health maintenance organizations and other forms of managed care. These changes have occurred largely in response to payors' concerns about the rising cost of health care. A study of such changes in financing and delivery, and how specific groups of patients are affected is necessary so that the effects of these changes on patients' health can be determined.We examined the hospitalization rates for patients with musculoskeletal diseases in Michigan from 1980 through 1987. During this period, the overall ageadjusted hospitalization rates decreased 7.0% per year (p = 0.001). The decrease occurred less for surgical discharges (6.0% per year) than for medical discharges (8.6% per year) (p < 0.001). While these overall trends are of interest, they obscure disease‐specific trends that vary significantly from both the overall, and the medical and surgical trends. For example, while surgical discharges, in general declined, procedures related to major joint and limb reattachment (DRG # 209) increased at a rate of 6.3% per year. And while medical discharges in general decreased over this period, discharges for osteomyelitis increased 5.4% per year. The patterns of diseasespecific trends offers insight into the possible causes for these changes. Finally, it is important to understand the epidemiology of hospital use to evaluate the effects of new medical care delivery and payment systems on the care of subsets of patients.
Medical and psychosocial predictors of sexual outcome among women with systemic lupus Erythematosus
Authors: Curry Sandra L , Levine Stephen B. , Jones Paul K. , Kurit Doris M. 
Published: February 2007

AbstractThe influence of medical and psychosocial variables on sexual outcome in 100 women with systemic lupus erythematosus was examined. Subjects were administered a sexual adjustment interview and scales assessing depression, body image, and relationship qualilty. Medical data were obtained from patients and physicians. Key predictors of sexual outcome were disease severity (P < 0.001), premorbid sexual adjustment (P < 0.05), and relationship quality (P < 0.05). Results suggest that the impact of systemic lupus erythematosus on sexual response may best be understood by considering a combination of interpersonal, psychological, and medical conditions in a patient's life.
Cognitive‐behavioral approaches to pain management in rheumatoid arthritis
Authors: Parker Jerry C , Iverson Grant L , Smarr Karen L , Stucky‐ropp Renée C 
Published: February 2007

AbstractThe purpose of this article is to review the literature on the topic of cognitive‐behavioral approaches to pain management for persons with rheumatoid arthritis. Existing studies offer support for the usefulness of cognitive‐behavioral techniques, but methodologic limitations were identified. Although the core element in rheumatoid arthritis pain management is optimal rheumatologic care, an important role also exists for strategies that seek to reduce the cognitive‐evaluative aspects of arthritis pain.
Pain behavior of rheumatoid arthritis patients enrolled in experimental drug trials
Authors: Anderson Karen O. , Bradley Laurence A. , Turner Robert A. , Agudelo Carlos A. , Pisko Edward J. 
Published: February 2007

AbstractObjective. This study examined the sensitivity of a behavioral observation method for the assessment of arthritis pain as an outcome measure in clinical drug trials.Methods. The subjects were 33 rheumatoid arthritis patients who were receiving either an active experimental drug or a placebo. Disease activity measures, self‐reports of pain, and pain behavior observations were completed for each subject prior to drug initiation, 6 weeks after drug initiation, and 12 weeks after drug initiation.Results. Significant reductions in measures of disease activity and self‐report of pain were found for the subjects who received an active drug, relative to those who received the placebo. The pain behavior scores produced by both groups of subjects remained relatively stable during the study.Conclusion. The lack of change in pain behavior suggests that arthritis pain behavior may lack sensitivity to short‐term changes accompanying drug therapy.
Life activities of persons with rheumatoid arthritis with and without depressive symptoms
Authors: Katz Patricia P. , Yelin Edward H. 
Published: February 2007

AbstractObjective. Persons with rheumatoid arthritis (RA) report more activity losses than persons without RA. Persons with RA who report depressive symptoms experience lower levels of functioning. We integrated these findings and examined the association of depressive symptoms with the activities in which persons with RA participate.Methods. We surveyed 726 persons with RA and 192 matched controls. Within each group, we examined the perceived importance and actual performance of 65 life activities by individuals with and without depressive symptoms.Results. Significantly more individuals with RA reported depressive symptoms. Among persons with RA, those who had depressive symptoms performed fewer activities, particularly fewer valued activities. In contrast, among controls, those who were depressed rated fewer activities as important, but exhibited few significant differences in the performance of activities.Conclusions. Depressive symptoms and life activities are associated differently among persons with RA and controls. The higher rate of depression among persons with RA may be partially due to the inability to perform valued activities.