bluuebunny/crossref_metadata_2025_split huggingface dataset:
Circulating hyaluronic acid levels vary with physical activity in healthy subjects and in rheumatoid arthritis patients. relationship to synovitis mass and morning stiffness
Authors: Engströum‐Laurent, Anna , Hällgren Roger 
Published: February 2007

AbstractWe evaluated the possible influence of physical activity on serum levels of hyaluronic acid (HA), plasma levels of elastase, and serum levels of procollagen III peptide. In 15 healthy individuals, HA increased from 26 ± 9 m̈g/liter (mean ± SD) before arising from a night'S sleep to 54 ± 24 m̈g/liter 1 hour after arising and performance of normal morning activities (P < 0.001). HA in 14 patients who had inflammatory arthritis increased from 124 ± 104 m̈g/liter to 402 ± 232 m̈g/liter under the same conditions (P < 0.001). The elevation due to physical activity was significantly (P < 0.001) higher in patients with rheumatoid arthritis (RA) than that found in controls. A slight increase of HA in the afternoon was also observed in healthy subjects who performed heavy exercise, but a marked increase was seen in RA patients who performed moderate exercise. In another group of 24 RA patients, a more standardized blood sampling was performed before arising and during normal morning activities. An increase in HA was significantly (P < 0.001) correlated to the synovitis mass, estimated by the Ritchie articular index. Maximum increases of HA were seen 30 and 60 minutes after arising; thereafter, levels decreased to those measured at rest. During the morning activities, procollagen III peptide remained stable, while plasma elastase tended to increase. It is proposed that HA, produced in the joint tissue structures and accumulated at rest, is carried by the lymph vessels to the general circulation during physical activity. In RA, the more pronounced HA outflow is probably due to enhanced synthesis, and thus accumulation, of HA in the inflamed joint tissue. This may be a cause of morning stiffness, because HA that has excessively accumulated in the joint tissue could immobilize water and mechanically hinder joint movements. This hypothesis was supported by the observed relationship between the transient increase of HA and duration of morning stiffness.
Folate status of rheumatoid arthritis patients receiving long‐term, low‐dose methotrexate therapy
Authors: Morgan Sarah L. , Baggott Joseph E. , Altz‐Smith Mary 
Published: February 2007

AbstractThe folate status of 29 healthy control subjects, 16 rheumatoid arthritis (RA) patients taking methotrexate (MTX), and 20 RA patients who were not being treated with MTX was estimated by an assay of the folate‐dependent enzymatic synthesis of serine from formate and glycine, which is termed the C1 index. Analysis of variance demonstrated that the specific activity of the enzyme system in lymphocytes was significantly lower in the MTX‐treated group, with an activity approximately one‐half that of the control and the non—MTX‐treated groups. Since the C1 index is one of the first biochemical parameters found to be different between MTX‐treated and non—MTX‐treated groups, alterations in folate‐mediated amino acid metabolism may be involved in the mechanism of response to MTX therapy. Use of the C1 index may assist in the development of protocols which preserve the efficacy of MTX therapy while minimizing toxicity.
Quantitative defect of CD4+2H4+ cells in systemic lupus erythematosus and sjögren'S syndrome
Authors: Sato Kazuto , Miyasaka Nobuyuki , Yamaoka Kunio , Okuda Masaharu , Yata Junichi , Nishioka Kusuki 
Published: February 2007

AbstractSurface antigens of T lymphocytes in peripheral blood mononuclear cells from 19 patients with systemic lupus erythematosus (SLE), 14 patients with Sjögren'S syndrome (SS), and 14 healthy control subjects were studied by 2‐color analysis. The proportion of CD4+2H4+ cells, which correspond to a suppressor/inducer subset, was decreased significantly in both SLE and SS. In contrast, the percentage of CD4+4B4+ cells, which define a helper/inducer subset, showed no significant difference among the patient groups. These data suggest that quantitative defect of suppressor/inducer cells may play an important role in the immunoregulatory disturbance in SLE and SS.
Hypermobility: features and differential incidence between the sexes
Authors: Larsson Lars‐Goran , Baum John , Mudholkar Govind S. 
Published: February 2007

AbstractSix hundred sixty individuals from a music school were studied to determine the frequency of incidence and the nature of their hypermobility. They were interviewed and examined for the 5 recognized features of hypermobility (laxity of the thumbs, fingers, elbows, spine, and knees). The incidence of hypermobility, according to the number of joints involved, followed an empiric geometric law. Approximately 27% of the individuals had 1 lax joint, whereas only 3% possessed all 5 features. Specific features were present at different frequencies in the 2 sexes. The ratio of the occurrence of 2 features in women compared with the occurrence in men was 2:1. Ratios for the occurrence of 3, 4, and 5 features were 4:1, 8:1, and 3:1, respectively. Thus, hypermobility was a predominantly female characteristic. Joint laxity declined with age, although not to a statistically significant degree. In men, the decline started when they were in their mid‐twenties; however, in women, joint laxity continued through the mid‐forties.
Characteristics of responders and nonresponders to slow‐acting antirheumatic drugs in juvenile rheumatoid arthritis
Authors: Giannini Edward H. , Brewer Earl J. , Kuzmina Nina , Alekseev Lev , Shokh Boris P. 
Published: February 2007

AbstractA 12‐month double‐blind, parallel, randomized, placebo‐controlled multicenter trial of D‐penicillamine and hydroxychloroquine was conducted in 162 children with juvenile rheumatoid arthritis in the United States and in the Union of Soviet Socialist Republics. No statistically significant intergroup differences were detected in primary outcome variables. We investigated the possible existence of select subgroups of patients who have a higher likelihood of response to active drugs than to placebo. Using previously published criteria, each patient was classified as a responder or nonresponder, and their demographic and disease characteristics at baseline were compared. We were unable to identify a subgroup of individuals who were more likely to respond to D‐penicillamine or hydroxychloroquine than to placebo.
Antioxidant activity of synovial fluid, hyaluronic acid, and two subcomponents of hyaluronic acid. synovial fluid scavenging effect is enhanced in rheumatoid arthritis patients
Authors: Sato Hideki , Takahashi Terumi , Ide Hirotsugu , Fukushima Toshiyuki , Tabata Minoru , Sekine Fusao , Kobayashi Kazuo , Negishi Masao , Niwa Yukie 
Published: February 2007

AbstractTo test the scavenging of reactive oxygen species (ROS), we added synovial fluids from patients with rheumatoid arthritis (RA) and osteoarthritis, as well as hyaluronic acid (HA) and its 2 subcomponents, D‐glucuronic acid and N‐acetyl‐D‐glucosamine, to 2 ROS‐generating systems, activated neutrophils and xanthine‐xanthine oxidase. Synovial fluid from RA patients, HA, and D‐glucuronic acid markedly decreased the O2‐, H2O2, OH‐, and chemiluminescence measured in both systems. HA and synovial fluid, which are known to be susceptible to degradation by excessive ROS in RA patients, also seem to play an active role in protecting articular tissues from oxidative damage.
Identification of brain lesions in neuropsychiatric systemic lupus erythematosus by magnetic resonance scanning
Authors: Mccune W. Joseph , Macguire Anne , Aisen Alex , Gebarski Stephen 
Published: February 2007

AbstractCranial magnetic resonance imaging in 28 systemic lupus erythematosus patients who had experienced 30 acute neuropsychiatric events showed focal brain lesions in 16 of 30 events (53%) and low brain volume (atrophy) in 20 of 30 events (67%). Definite focal lesions were significantly more frequent in patients with clinically localized neurologic deficits (8 of 8, 100%), or seizures (5 of 6, 83%) than in patients without such localizing signs (3 of 16, 19%). Many of these lesions were occult on intravenous contrast‐enhanced x‐ray computed tomography. In 2 patients, lesions in gray matter resolved within 2 or 3 weeks, in association with clinical improvement. Magnetic resonance imaging is an important technique for detecting the extent of brain injury in cerebral lupus.
Long‐term prospective trial of low‐dose methotrexate in rheumatoid arthritis
Authors: Weinblatt Michael E. , Trentham David E. , Fraser Patricia A. , Holdsworth Donald E. , Falchuk Kenneth R. , Weissman Barbara N. , Coblyn Jonathan S. 
Published: February 2007

AbstractTwenty‐six patients with severe rheumatoid arthritis who had completed a randomized crossover trial of methotrexate elected to continue to receive the drug in a long‐term prospective study. At 36 months, 16 patients remained in the study. Over this period of time, significant improvement was noted in the number of painful and swollen joints, physician and patient global assessments, erythrocyte sedimentation rate, and prednisone dose. Adverse reactions occurred in 16 patients (62%), including nausea, alopecia, headache, stomatitis, herpes zoster, and diarrhea. Mild leukopenia (3 patients), thrombocytopenia (3 patients), and elevated transaminase levels (8 patients) resolved with temporary drug discontinuation. No patient withdrew due to drug toxicity. Liver biopsy specimens in 17 patients after 24 months of treatment showed no evidence of fibrosis or cirrhosis. A significant increase in the percentage of T3 and T4 blood cells and increases in lymphocyte proliferation to concanavalin A and purified protein derivative of tuberculin were found after 2 years of therapy. Our findings indicate that methotrexate has remained effective over 36 months of therapy, with acceptable toxicity levels and no evidence of systemic immunosuppression.
Tenderness in 75 anatomic sites. distinguishing fibromyalgia patients from controls
Authors: Simms Robert W. , Goldenberg Don L. , Felson David T. , Mason John H. 
Published: February 2007

AbstractWe studied tenderness at 75 unilateral anatomic locations in 10 fibromyalgia patients and 10 normal control subjects to determine which sites best identified patients with fibromyalgia. Using a dolorimeter, the mean amount of pressure required to elicit tenderness was significantly lower in patients than in controls at 19 sites (P < 0.001). Of the previously proposed tender points, only 2 were included in those 19 best discriminating points. Fifteen of the 19 best discriminating points were clustered in regions around the anterior shoulder, anterior chest, posterior scapula, and medial knee. The 19 sites that we have identified best separate patients with fibromyalgia from controls, although the discriminating power of these sites in other chronic pain syndromes will require further study. Examination of specific regions may be more useful clinically than the exact anatomic sites within these regions.
Stability of normal joint findings in persistent classic rheumatoid arthritis
Authors: Roberts W. Neal , Daltroy Lawren H. , Anderson Ronald J. 
Published: February 2007

AbstractWe reviewed the records of 44 patients, retrospectively selected because they had had persistently active rheumatoid arthritis for more than 5 years (mean ± SD followup 9.8 ± 2.6 years) and because they met the American Rheumatism Association criteria for classic disease, to determine the change in extent of the anatomic distribution of joint involvement over time. The positive predictive value of a lack of inflammation in a joint during the first year for the lack of involvement over the ensuing 4 years was 87%. Thirty‐eight of the 43 joints that required replacement were inflamed in the first year of disease.
The american rheumatism association 1987 revised criteria for the classification of rheumatoid arthritis
Authors: Arnett Frank C. , Edworthy Steven M. , Bloch Daniel A. , Mcshane Dennis J. , Fries James F. , Cooper Norman S. , Healey Louis A. , Kaplan Stephen R. , Liang Matthew H. , Luthra Harvinder S. , Medsger Thomas A. , Mitchell Donald M. , Neustadt David H. , Pinals Robert S. , Schaller Jane G. , Sharp John T. , Wilder Ronald L. , Hunder Gene G. 
Published: February 2007

AbstractThe revised criteria for the classification of rheumatoid arthritis (RA) were formulated from a computerized analysis of 262 contemporary, consecutively studied patients with RA and 262 control subjects with rheumatic diseases other than RA (non‐RA). The new criteria are as follows: 1) morning stiffness in and around joints lasting at least 1 hour before maximal improvement; 2) soft tissue swelling (arthritis) of 3 or more joint areas observed by a physician; 3) swelling (arthritis) of the proximal interphalangeal, metacarpophalangeal, or wrist joints; 4) symmetric swelling (arthritis); 5) rheumatoid nodules; 6) the presence of rheumatoid factor; and 7) radiographic erosions and/or periarticular osteopenia in hand and/or wrist joints. Criteria 1 through 4 must have been present for at least 6 weeks. Rheumatoid arthritis is defined by the presence of 4 or more criteria, and no further qualifications (classic, definite, or probable) or list of exclusions are required. In addition, a “classification tree” schema is presented which performs equally as well as the traditional (4 of 7) format. The new criteria demonstrated 91–94% sensitivity and 89% specificity for RA when compared with non‐RA rheumatic disease control subjects.
Lupus pregnancy. a prospective study of placental changes
Authors: Hanly John G. , Gladman Dafna D. , Rose Toby H. , Laskin Carl A. , Urowitz Murray B. 
Published: February 2007

AbstractEleven patients with systemic lupus erythematosus (SLE) were monitored prospectively during pregnancy. Clinical and serologic features of disease activity were recorded, and after delivery, a careful search for pathologic changes in the placenta was carried out. Seven patients delivered live infants, and 4 patients had unsuccessful pregnancies, with fetal loss occurring between 12 and 27 weeks of gestation. One of these 4 patients had active SLE at delivery, and all had circulating lupus anticoagulant and thrombocytopenia. Other serologic abnormalities, including anticardiolipin and anti‐Ro antibodies, were not associated with fetal loss. The overall placental size was reduced in SLE patients compared with that in healthy controls and in diabetic controls. A variety of pathologic changes were noted, including placental infarction, intraplacental hematoma, deposition of immunoglobulin and complement, and thickening of the trophoblast basement membrane. The reduction in placental size appeared to enhance the clinical significance of these pathologic changes.
Synovial fluid inorganic pyrophosphate concentration and nucleotide pyrophosphohydrolase activity in basic calcium phosphate deposition arthropathy and milwaukee shoulder syndrome
Authors: Rachow John W. , Ryan Lawrence M. , Mccarty Daniel J. , Halverson Paul C. 
Published: February 2007

AbstractSynovial fluid (SF) inorganic pyrophosphate (PPi) concentration is elevated in calcium pyrophosphate dihydrate (CPPD) crystal deposition arthropathy. Since CPPD and basic calcium phosphate (BCP) crystals often are present in the same joints, we determined [PPi] and activity of the PPi‐generating enzyme, nucleotide pyrophosphohydrolase (NPPH), in SF from the joints of patients with various arthropathies, including those with BCP crystals. We found elevated SF [PPi] in joints with BCP crystals, as well as in joints with CPPD crystals. The presence of BCP crystals in synovial fluids was also predictive of elevated NPPH activity.
The relationship of socioeconomic status to subsequent health status in systemic lupus erythematosus
Authors: Esdaile John M. , Sampalis John S. , Lacaille Diane , Danoff Deborah 
Published: February 2007

AbstractWe examined the relationship of socioeconomic status to health status, as determined by the Arthritis Impact Measurement Scales, in 78 systemic lupus ery‐thematosus patients who had been entered into a prospective study. After controlling for age, disease duration, and disease severity, a significant relationship between socioeconomic status and outcome was not demonstrated. All study subjects had health insurance for medical services. The results have potential implications for health care policy.
Tibialis posterior tendon rupture: a cause of rheumatoid flat foot
Authors: Downey Daniel J. , Simkin Peter A. , Mack Laurence A. , Richardson Michael L. , Kilcoyne Ray F. , Hansen Sigvard T. 
Published: February 2007

AbstractFlat foot, a major cause of foot pain and disability, may result from rupture of the tibialis posterior tendon. We describe 2 patients with rheumatoid arthritis who developed flat feet secondary to surgically confirmed tendon rupture, and we discuss the anatomy and diagnosis of this condition. In the second patient, we also present the results of tendon imaging with both magnetic resonance and ultrasound.
Spinal cord compression by epidural lipomatosis in juvenile rheumatoid arthritis
Authors: Arroyo Ivonne L. , Barron Karyl S. , Brewer Earl J. 
Published: February 2007

AbstractTwo cases of spinal cord compression secondary to steroid‐induced epidural lipomatosis in systemic juvenile rheumatoid arthritis (JRA) patients are reported. This complication of prolonged corticosteroid therapy has not been described previously in children with JRA. Epidural lipomatosis should be considered in the differential diagnosis of JRA patients receiving high‐dose and/or prolonged corticosteroid therapy who present with neurologic signs and symptoms referable to the spinal cord.
Team versus non‐team outpatient care in rheumatoid arthritis
Authors: Ahlmen Monica , Sullivan Marianne , Bjelle Anders 
Published: February 2007

AbstractIn a rheumatology department, 2 randomized groups of female outpatients with rheumatoid arthritis were studied prospectively for 1 year. The outcome of multidisciplinary team care (T group, 31 patients) was compared with that of regular outpatient clinic care (NT group, 28 patients). Pharmacologic treatment and orthopedic specialist consultations were similar in both groups, but use of paramedical care was higher in the T group. Outcome measures of disease activity, specific joint function, and self‐rated physical discomfort disclosed no significant differences between the 2 groups. Mental well‐being increased in the T group. Overall health, measured by the Sickness Impact Profile, improved significantly only in the T group. This improvement was also significant compared with the NT group.
Spirochetal antigens and lymphoid cell surface markers in lyme synovitis
Authors: Steere Allen C. , Duray Paul H. , Butcher Eugene C. 
Published: February 2007

AbstractUsing monoclonal antibodies to spirochetal antigens and lymphoid cell surface markers, we examined the synovial lesions of 12 patients with Lyme disease, and compared them with rheumatoid synovium and tonsillar lymphoid tissue. The synovial lesions of Lyme disease patients and rheumatoid arthritis patients were similar and often consisted of the elements found in normal organized lymphoid tissue. In both diseases, T cells, predominantly of the helper/inducer subset, were distributed diffusely in subsynovial lining areas, often with nodular aggregates of tightly intermixed T and B cells. IgD‐bearing B cells were scattered within the aggregates, and a few follicular dendritic cells and activated germinal center B cells were sometimes present. Outside the aggregates, many plasma cells, high endothelial venules, scattered macrophages, and a few dendritic macrophages were found. HLA–DR and DQ expression was intense throughout the lesions. In 6 of the 12 patients with Lyme arthritis, but in none of those with rheumatoid arthritis, a few spirochetes and globular antigen deposits were seen in and around blood vessels in areas of lymphocytic infiltration. Thus, in Lyme arthritis, a small number of spirochetes are probably the antigenic stimulus for chronic synovial inflammation.
Effects of warming up on reliability of anthropometric techniques in ankylosing spondylitis
Authors: Neal Roberts W. , Liang Matthew H. , Pallozzi Lorna M. , Daltroy Lawren H. 
Published: February 2007

AbstractTo determine the effect of warm‐up on anthropometric measures, 10 patients with ankylosing spondylitis and 10 normal control subjects were measured over a 1‐hour period by one therapist. A series of 4 measures–a modified Schober's test, finger‐to‐floor with the subject standing on a 23‐cm stool, chest expansion, and cervical rotation using an arthrodial protractor—were repeated completely 4 times. Subjects exercised between each series (except between the third and fourth series). Intra‐rater reliability was determined by comparing measurement 3 with measurement 4, and the warm‐up effect was determined by comparing measurement 1 with measurement 3. The Schober's test and chest expansion are stable measures and are not affected by warm‐up. However, the finger‐to‐floor and cervical rotation exercises require warm‐up to ensure stable values for clinical or research followup of spondylitis.
A long‐term prospective study of the use of methotrexate in rheumatoid arthritis
Authors: Kremer Joel M. , Lee Joong K. 
Published: February 2007

AbstractTwenty‐five patients have completed a mean of 53 months of treatment with methotrexate (MTX) as part of a prospective study of the long‐term safety and efficacy of the drug. Since the times of the last report (at a mean of 29 months), the mean dosage of MTX has increased from 12.4 mg/week to 14.6 mg/week, whereas the mean prednisone dosage has decreased from a baseline of 7.1 mg/day to 1.9 mg/day. A significant improvement from baseline in all clinical parameters tested was maintained, and response to therapy did not vary significantly between the assessment at 29 months and that at 53 months. Toxic reactions were as common during months 30–53 as during the first 29 months of the study, with patterns of toxic reactions remaining consistent within each patient. Radiologic evidence of disease progression was not seen before 24 months of MTX treatment, but after this time, it was observed in some patients. We conclude that many clinical features of long‐term MTX therapy are distinctly different from what might have been expected after the short‐term trials.
Effects of fasting on disease activity, neutrophil function, fatty acid composition, and leukotriene biosynthesis in patients with rheumatoid arthritis
Authors: Hafström Ingiäld , Ringertz Bo , Gyllenhammar Hans , Palmblad Jan , Harms‐Ringdahl Mats 
Published: February 2007

AbstractFourteen patients with rheumatoid arthritis (RA) were studied before, during, and after a 1‐week total fast. Disease activity decreased, as did the neutrophil release of lysozyme induced by the ionophore A23187. The ability of zymosan‐activated RA patient serum to aggregate control neutrophils was reduced, together with serum concentrations of C3. The relative contents of arachidonic acid and eicosapentaenoic acid were increased in serum, platelets, and neutrophils, whereas levels of linoleic acid and linolenic acid were unchanged. Fasting also reduced the release of leukotriene B4 from neutrophils. We thus conclude that a reduced ability to generate cytotaxins, reduced release of enzyme, and reduced leukotriene formation from RA neutrophils, together with an altered fatty acid composition of membrane phospholipids, may be mechanisms for the decrease of inflammatory symptoms that results from fasting.