bluuebunny/crossref_metadata_2025_split huggingface dataset:
Polymyalgia rheumatica in patients with a normal erythrocyte sedimentation rate
Authors: Helfgott Simon M. , Kieval Raphael I. 
Published: February 2007

AbstractObjective. To ascertain the frequency of polymyalgia rheumatica (PMR) with a normal erythrocyte sedimentation rate (ESR; ≤30 mm/hour) and to determine any defining clinical characteristics.Methods. A retrospective chart review study of all patients meeting the clinical criteria for PMR seen over a 5‐year period in a hospital and an office‐based rheumatology practice.Results. We evaluated 117 patients; 26 (22.2%) had a pretreatment ESR of ⩽30 mm/hour (mean ± SD 19.8 ± 7.5 versus 74.4 ± 30.3 mm/hour for elevated ESR group; P < 0.0001). Of the 26 normal ESR patients, 15 (58%) were female compared with 74 of the 91 elevated ESR patients (81%) (P < 0.02, by Fisher's exact test). The mean hemoglobin concentration was significantly lower in the elevated ESR population (mean ± SD 1.23 ± 0.15 gm/liter versus 1.38 ± 0.11 gm/liter; P < 0.0001). The duration of symptoms prior to treatment with prednisone was significantly longer for patients with a normal ESR (149 ± 95 days versus 103 ± 95 days for elevated ESR patients; P <0.04).Conclusion. In our series, PMR with a normal ESR accounted for approximately one‐fifth of all PMR patients, more commonly in men. The lack of characteristically abnormal laboratory findings may result in a delay in the proper diagnosis and management of this condition.
Methotrexate‐associated lymphoma in patients with rheumatoid arthritis. Report of two cases
Authors: Bachman Teresa R. , Sawitzke Allen D. , Perkins Sherrie L. , Ward John H. , Cannon Grant W. 
Published: February 2007

AbstractThis report describes 2 patients with longstanding seropositive rheumatoid arthritis (RA) treated with oral methotrexate (MTX) who developed large cell lymphoma of B cell phenotype. In situ hybridization studies showed nuclear staining for Epstein‐Barr virus (EBV) within the malignant lymphoid cells. In both cases, the lymphoma was undetectable several weeks after diagnostic biopsy followed by discontinuation of MTX. These observations suggest that, in patients with RA who develop an EBV‐associated lymphoproliferative disorder, a trial of discontinuation of immunosuppressive agents may be warranted before chemotherapy is considered. In addition, there is a need for a heightened awareness of the development of lymphoma in this patient population.
Multiple myeloma–associated systemic vasculopathy due to crystalglobulin or polyarteritis nodosa
Authors: Hasegawa Hisashi , Ozawa Tetsuo , Tada Noriyoshi , Taguchi Youko , Ohno Koichiro , Chou Takaaki , Watanabe Takeshi , Kuroda Takeshi , Nakano Masaaki , Usuda Hiroyuki , Emura Iwao , Arakawa Masaaki 
Published: February 2007

AbstractSystemic vasculopathy is a rare complication of multiple myeloma (MM). We describe a patient diagnosed with MM who developed clinical features of systemic vasculopathy including gangrene, livedo reticularis, hypertension, renal failure, and perforation of the small intestine. Histopathologic examination of the small intestine revealed necrotizing vasculitis in the small arteries, along with crystalline deposits in the small vessels. To our knowledge, previously reported cases of systemic vasculopathy associated with MM include at least 9 cases due to crystalglobulin deposition in vessels and 2 due to polyarteritis nodosa. Deposits of crystalglobulin may have induced systemic necrotizing vasculitis in our patient.
Gastric antral vascular ectasia (watermelon stomach) in patients with systemic sclerosis
Authors: Watson Maria , Hally Robert J. , McCue Peter A. , Varga John , Jiménez Sergio A. 
Published: February 2007

AbstractThis report describes 5 patients with systemic sclerosis (SSc) who developed severe, recurrent upper gastrointestinal (GI) bleeding due to gastric antral vascular ectasia (GAVE). The clinical records, the endoscopic findings, and the histologic appearance of biopsy specimens and surgically resected gastric tissue from the patients were reviewed. All 5 patients developed severe and recurrent episodes of upper GI bleeding leading to severe anemia requiring multiple transfusions. The cutaneous involvement was diffuse in 3 patients and limited in 2. All but 1 had cutaneous telangiectasias. The diagnosis of GAVE was established by endoscopy within 3 years of the diagnosis of SSc in all cases. One patient required heater probe cautery, 2 required laser coagulation, and 2 underwent surgical resection of the gastric antrum for control of the GI bleeding. The possibility of GAVE should be considered in SSc patients who have recurrent upper GI bleeding. It is suggested that the antral vascular lesions in these patients may represent a component of the spectrum of vascular alterations of SSc.
The development and initial validation of the systemic lupus international collaborating clinics/American college of rheumatology damage index for systemic lupus erythematosus
Authors: Gladman Dafna , Ginzler Ellen , Goldsmith Charles , Fortin Paul , Liang Matthew , Sanchez‐Guerrero Jorge , Urowitz Murray , Bacon Paul , Bombardieri Stefano , Hanly John , Jones John , Hay Elaine , Symmons Deborah , Isenberg David , Kalunion Kenneth , Maddison Peter , Nived Ola , Sturfelt Gunnar , Petri Michelle , Richter Martin , Snaith Michael , Zoma Asad 
Published: February 2007

AbstractObjective. To develop and perform an initial validation of a damage index for systemic lupus erythematosus (SLE).Methods. A list of items considered to reflect damage in SLE was generated through a nominal group process. A consensus as to which items to be included in an index was reached, together with rules for ascertainment. Each center submitted 2 assessments, 5 years apart, on 2 patients with active and 2 with inactive disease, of whom 1 had increased damage and the other had stable disease. Analysis of variance was used to test the factors physician, time, amount of damage, and activity status.Results. Nineteen physicians completed the damage index on 42 case scenarios. The analysis revealed that the damage index could identify changes in damage seen in patients with both active and inactive disease. Patients who had active disease at both time points had a higher increase in damage. There was good agreement among the physicians on the assessment of damage in these patients.Conclusion. This damage index for SLE records damage occurring in patients with SLE regardless of its cause. The index was demonstrated to have content, face, criterion, and discriminant validity.
Disease severity in patients with systemic lupus erythematosus correlates with an increased ratio of interleukin‐10: Interferon‐γ–secreting cells in the peripheral blood
Authors: Hagiwara Eri , Gourley Mark F. , Lee Susie , Klinman Dennis M. 
Published: February 2007

AbstractObjective. To compare the phenotype and frequency of cells that actively secrete type 1 and type 2 cytokines in systemic lupus erythematosus (SLE) patients (n = 46), versus normal controls (n = 60).Methods. ELISPOT analysis of freshly isolated peripheral blood mononuclear cells (PBMC).Results. T cells were the major source of interleukin‐2 (IL‐2), IL‐4, and interferon‐γ (IFNγ), whereas monocytes were the primary source of IL‐6 and IL‐10 in the PB of lupus patients. Significantly fewer PBMC spontaneously secreted IFNγ and IL‐2 (P ⩽ 0.03), while significantly more PBMC produced IL‐6 and IL‐10 (P < 0.001), in lupus patients versus controls. Disease severity in lupus patients correlated with an elevated ratio of IL‐10:IFNγ‐secreting cells (P < 0.001).Conclusion. SLE is characterized by an imbalance in the ratio of type 1:type 2 cytokine‐secreting PBMC.
Increased bone mass with pamidronate treatment in rheumatoid arthritis. Results of a three‐year randomized, double‐blind trial
Authors: Eggelmeijer Frank , Papapoulos Socrates E. , van Paassen Henk C. , Dijkmans Ben A. C. , Valkema Roelf , Westedt Marie Louise , Landman Jan‐Otto , Pauwels Ernest K. J. , Breedveld Ferdinand C. 
Published: February 2007

AbstractObjective. Osteoporosis is a frequent complication of rheumatoid arthritis (RA). We therefore investigated the effect of oral pamidronate therapy as a specific bone‐sparing agent in RA.Methods. The study design was a 3‐year randomized, double‐blind trial of 300 mg oral pamidronate/day compared with placebo in 105 RA patients. Bone mineral density (BMD) measured at 12‐month intervals was the primary efficacy parameter.Results. In 3 years, lumbar spine and forearm BMD increased significantly in the pamidronate‐treated group (by 8.4 ± 6.9% [mean ± SEM] [P < 0.0001] and 5.2 ± 6.5% [P < 0.005], respectively), compared with nonsignificant changes in the placebo‐treated patients (increase of 0.6 ± 5.2% and decrease of 1.2 ± 5.8%, respectively). Femoral neck BMD increased in the pamidronate‐treated group (by 2.6 ± 8.6%) and decreased significantly in the placebo‐treated group (by 4.0 ± 1.3% [P < 0.005]). The changes in BMD with time at all 3 measurement sites were significantly different between the treatment groups (P < 0.0001). Changes in radiographic signs of joint damage and in disease activity were similar in the 2 groups.Conclusion. The present study provides the first evidence that long‐term treatment with an orally administered bisphosphonate overcomes bone loss and increases bone mass when compared with placebo. This finding may have significance with regard to the treatment of patients with RA.
Gender, paid work, and symptoms of emotional distress in rheumatoid arthritis patients
Authors: Fifield Judith , Reisine Susan , Sheehan T. Joseph , McQuillan Julia 
Published: February 2007

AbstractObjective. To evaluate the relative contribution of gender‐related work conditions, gender‐related socialization practices, and disease characteristics to the explanation of emotional distress in men and women with rheumatoid arthritis (RA).Methods. Three hundred sixty‐nine RA patients who were employed outside the home were recruited from a national randomized sample of rheumatology practices. Data on paid work and disease characteristics were obtained by telephone interview. Emotional distress was measured by the Center for Epidemiological Studies Depression (CES‐D) scale. Hierarchical ordinary least‐squares regression was used to assess the relationship of sex, class, work characteristics, and disease characteristics to both the CES‐D summary scale and the CES‐D factor structure.Results. Differences in emotional distress were explained best by functional ability and pain and secondarily by the characteristics of paid work, with no independent effect for sex. Distress increased with decreasing functional ability, increasing pain, and exposure to such work characteristics as low autonomy, low income, and high demands. No sex differences in any of the CES‐D subscales remained after controlling for disease and work variables.Conclusion. Among employed RA patients with high levels of functional disability and exposure to stressful work characteristics, men and women are at equal risk of experiencing emotional distress.
Psychiatric diagnoses in patients with fibromyalgia are related to health care–seeking behavior rather than to illness
Authors: Aaron Leslie A. , Bradley Laurence A. , Alarcón Graciela S. , Alexander Ronald W. , Triana‐Alexander Mireya , Martin Michelle Y. , Alberts Kristin R. 
Published: February 2007

AbstractObjective. To compare the frequency of lifetime psychiatric disorders among 3 groups of subjects: patients with fibromyalgia syndrome (FMS) from a tertiary care setting, community residents with FMS who had not sought medical care for their FMS symptoms (“FMS nonpatients”), and healthy controls.Methods. We used the Computerized Diagnostic Interview Schedule to assess lifetime psychiatric diagnoses, as well as the Center for Epidemiological Studies Depression scale and the Trait Anxiety Inventory to assess current psychological distress, among 64 patients with FMS, 28 FMS nonpatients, and 23 healthy individuals.Results. Patients with FMS, relative to FMS nonpatients and healthy controls, were characterized by a significantly greater number of lifetime psychiatric diagnoses (P = 0.002). Nonpatients did not differ from controls in psychiatric diagnoses. Patients also exhibited higher psychological distress levels than nonpatients, and nonpatients showed greater distress than controls. Differences in psychological distress between patients and nonpatients were eliminated after controlling for pain threshold and fatigue ratings.Conclusion. Psychiatric disorders are not intrinsically related to the FMS syndrome. Instead, multiple lifetime psychiatric diagnoses may contribute to the decision to seek medical care for FMS in tertiary care settings.
Regulation of adhesion molecule expression by human synovial microvascular endothelial cells in vitro
Authors: To Shing S. T. , Newman Peter M. , Hyland Valentine J. , Robinson Bruce G. , Schrieber Leslie 
Published: February 2007

AbstractObjective. To examine the in vitro expression of E‐selectin, P‐selectin, intercellular adhesion molecule 1 (ICAM‐1), ICAM‐2, vascular cell adhesion molecule 1 (VCAM‐1), and platelet–endothelial cell adhesion molecule 1 (PECAM‐1) by synovial microvascular endothelial cells (SMEC) in comparison with microvascular neonatal foreskin endothelial cells (FSE) and macrovascular human umbilical vein endothelial cells (HUVE).Methods. Cultured endothelial cells were treated for 4 hours with medium alone or tumor necrosis factor α (TNF α). The expression of endothelial adhesion molecules was evaluated by flow cytometry, cell enzyme‐linked immunosorbent assay, and Northern blot analysis.Results. SMEC continuously expressed E‐selectin under basal culture conditions, whereas FSE and HUVE did not. TNF α treatment of rheumatoid arthritis (RA) SMEC resulted in sustained peak expression of E‐selectin for up to 24 hours, which subsequently declined but remained elevated even at 72 hours. In contrast, peak E‐selectin expression in FSE and HUVE occurred between 4 hours and 16 hours after TNF α treatment and then declined to near basal levels by 24–48 hours. SMEC expressed significantly higher levels of ICAM‐1 compared with HUVE under basal culture conditions. There was no difference between SMEC, FSE, and HUVE in the expression of P‐selectin, VCAM‐1, ICAM‐2, or PECAM‐1. Northern blot analysis demonstrated that the levels of E‐selectin expression by TNF α‐stimulated endothelial cells correlated with their respective messenger RNA levels.Conclusion. Regulation of E‐selectin and ICAM‐1 expression in RA synovial endothelium is different from that in neonatal foreskin and human umbilical vein endothelium. The augmented expression of adhesion molecules in RA synovial endothelium may facilitate the recruitment of leukocytes to this site.
The superficial layer of human articular cartilage is more susceptible to interleukin‐1–induced damage than the deeper layers
Authors: Häuselmann H. J. , Flechtenmacher J. , Michal L. , Thonar E. J‐M. A. , Shinmei M. , Kuettner K. E. , Aydelotte M. B. 
Published: February 2007

AbstractObjective. To compare the responses of chondrocytes from superficial and deep layers of normal human articular cartilage to interleukin‐1 (IL‐1) and IL‐1 receptor antagonist protein (IRAP), and to evaluate the binding sites for IL‐1 on these cells.Methods. Cartilage and chondrocytes from superficial and deeper layers of human femoral condyles were cultured with and without IL‐1 in the presence and absence of IRAP. The effect of these agents on 35S‐proteoglycan synthesis and catabolism and production of stromelysin and tissue inhibitor of metalloproteinases 1 (TIMP‐1) were measured by biochemical and immunologic assays. Receptor binding was evaluated using 125I‐labeled IL‐1.Results. IL‐1 induced more severe inhibition of proteoglycan synthesis and a lower ratio of secreted TIMP‐1:stromelysin in chondrocytes from superficial cartilage than those from deeper cartilage. IRAP blocked responses to IL‐1 more effectively in chondrocytes from deep cartilage than those from superficial cartilage. Chondrocytes from the articular surface showed approximately twice the number of high‐affinity binding sites for IL‐1 as did cells from deep cartilage.Conclusion. Chondrocytes from the surface of articular cartilage show a greater vulnerability to the harmful effects of IL‐1 and are less responsive to the potential therapeutic effects of IRAP than cells in the deeper layers of the tissue.
Disease‐modifying activity of SK&F 106615 in rat adjuvant‐induced arthritis. Multiparameter analysis of disease including magnetic resonance imaging and bone mineral density measurements
Authors: Bradbeer Jeremy N. , Kapadia Rasesh D. , Sarkar Susanta K. , Zhao Hugh , Stroup George B. , Swift Barbara A. , Rieman David J. , Badger Alison M. 
Published: February 2007

AbstractObjective. To evaluate the effect of SK&F 106615 on joint integrity in rats with adjuvant‐induced arthritis (AIA).Methods. AIA was induced in Lewis rats on day 0, and the animals were treated either prophylactically (days 0–16 or days 0–23) or therapeutically (days 10–23) with SK&F 106615. Efficacy was determined by measurements of paw inflammation, bone mineral density (BMD) using dual x‐ray absorptiometry, and magnetic resonance imaging (MRI). Joint integrity was also determined histologically, and serum interleukin‐6 (IL‐6) levels were measured as a marker of the antiinflammatory effects of the compound.Results. Prophylactic treatment (days 0–16) of AIA rats with SK&F 106615 significantly inhibited paw volume at doses of 5–45 mg/kg/day given orally on 5 days each week. Extensive evaluation of joint integrity in rats treated with SK&F 106615 20 mg/kg/day orally for 23 days showed inhibition of paw volume, normalization of BMD, and significant improvement in disease by MRI and histologic assessment compared with the AIA controls. Elevated levels of serum IL‐6 in AIA rats were reduced dramatically by SK&F 106615. Therapeutic treatment (days 10–23) resulted in similar protective effects measured by paw inflammation, BMD, and MRI. In the therapeutic protocol, serum IL‐6 appeared to be a more sensitive marker of antiinflammatory activity than paw edema.Conclusion. Symptoms of AIA in rats are significantly reduced by prophylactic and therapeutic treatment with SK&F 106615. Of particular note, this compound appears to exert a protective effect on joint integrity and to have disease‐modifying properties.
Some autoantibodies to Ro/SS‐A and La/SS‐B are antiidiotypes to anti–double‐stranded DNA
Authors: Zhang Wei , Reichlin Morris 
Published: February 2007

AbstractObjective. To determine the relationship of anti–Ro/SS‐A and anti–La/SS‐B antibodies to anti–double‐stranded DNA (anti‐dsDNA) in sera from patients with systemic lupus erythematosus.Methods. Sera with anti–Ro/SS‐A alone (n = 5) or those with anti–Ro/SS‐A and anti–La/SS‐B (n = 7) were absorbed with purified Ro/SS‐A and La/SS‐B, respectively. The absorbed sera were then tested for reactivity with MOLT‐4 extract by Western blot and dsDNA by enzyme‐linked immunosorbent assay (ELISA). With selected sera, anti‐dsDNA was isolated on DNA cellulose columns and anti–Ro/SS‐A and anti–La/SS‐B were isolated on antigen‐affinity columns. Reactivity between anti‐dsDNA and autologous anti–Ro/SS‐A or anti–La/SS‐B, as well as inhibition by cognate antigens, was studied.Results. After absorption, all sera showed reactivity with small nuclear RNP A and D bands in Western blots, and some showed reactivity with dsDNA by ELISA. Anti‐dsDNA populations (n = 4) were purified on dsDNA cellulose columns. Anti–Ro/SS‐A (n = 1) and anti–La/SS‐B (n = 3) were affinity purified from the same sera as the anti‐dsDNA. In all cases, anti‐dsDNA bound autologous anti–Ro/SS‐A and anti–La/SS‐B much more strongly than it bound normal pooled IgG. Moreover, dsDNA, but not RNA, blocked these interactions. In addition, Ro/SS‐A blocked anti–Ro/SS‐A and La/SS‐B blocked anti–La/SS‐B in these same interactions.Conclusion. In sera with anti–Ro/SS‐A and anti–La/SS‐B, there are subpopulations of these antibodies that bind and mask anti‐dsDNA. We hypothesize that these anti–Ro/SS‐A and anti–La/SS‐B antibodies are antiidiotypes to idiotypes on anti‐dsDNA and that they both mask and down‐regulate these anti‐dsDNA antibodies.
Enhancement of sparc (osteonectin) synthesis in arthritic cartilage: Increased levels in synovial fluids from patients with rheumatoid arthritis and regulation by growth factors and cytokines in chondrocyte cultures
Authors: Nakamura Shigeo , Kamihagi Kyoko , Satakeda Hisashi , Katayama Masahiko , Pan Haiou , Okamoto Hiroshi , Noshiro Mitsuhide , Takahashi Koichiro , Yoshihara Yasuo , Shimmei Masayuki , Okada Yasunori , Kato Yukio 
Published: February 2007

AbstractObjective. To investigate the roles of SPARC (secreted protein, acidic and rich in cysteine) (osteonectin) in arthritis, using cartilage and synovium specimens and synovial fluids (SF) from patients with rheumatoid arthritis (RA) or osteoarthritis (OA), and to examine the effects of cytokines, growth factors, and hormones on SPARC synthesis by chondrocytes in culture.Methods. SPARC in cartilage and synovium was immunostained with monoclonal antibodies. SPARC synthesis by cultured chondrocytes was measured by Northern blot analysis, immunoblotting, and sandwich enzyme‐linked immunosorbent assay.Results. SPARC was identified in numerous chondrocytes in the superficial and middle zones and in regenerating chondrocytes of RA and OA joints, whereas such staining was absent in these zones of normal cartilage, except for weak signals from a few chondrocytes in the deep zone. In addition, SPARC synthesis was enhanced in synovial cells of RA and OA joints. The average SPARC level in SF was 10‐fold higher in the RA than in the OA population. In rabbit articular chondrocyte cultures, administration of transforming growth factor β1 (TGFβ1) and bone morphogenetic protein 2 increased SPARC levels at 24–48 hours, whereas interleukin‐1β (IL‐1β), IL‐1α, tumor necrosis factor α, lipopolysaccharide, phorbol myristate acetate, basic fibroblast growth factor, and dexamethasone decreased SPARC levels at 24–72 hours. TGFβ increased SPARC messenger RNA (mRNA) levels at 24 hours, whereas IL‐1β caused a marked decrease in SPARC mRNA levels at 24 hours. Furthermore, IL‐1 decreased the glycosylation of SPARC.Conclusion. These findings suggest that various growth factors and cytokines, including TGFβ1 and IL‐1β, regulate the production of SPARC by chondrocytes at pre‐ and posttranslational levels, and that SPARC synthesis is markedly enhanced in arthritic joints.