bluuebunny/crossref_metadata_2025_split huggingface dataset:
Crucial role of interleukin‐10/interleukin‐12 balance in the regulation of the type 2 T helper cytokine response in reactive arthritis
Authors: Yin Zhinan , Braun Jürgen , Neure Lucia , Wu Peihua , Liu Lanzhen , Eggens Ulrich , Sieper Joachim 
Published: February 2007

AbstractObjective. To investigate whether a predominant type 1 T helper (Thl) or Th2 cytokine pattern is present in the joints of patients with reactive arthritis (ReA), and whether the cytokine pattern can be modulated by cytokines or anticytokines.Methods. Eleven patients with ReA following infection with either Chlamydia trachomatis, Yersinia enterocolitica, or Salmonella enteritidis were investigated for the presence of Th1/Th2 cytokines in the joints. Release of the bacteria‐specific cytokines interferon‐γ (IFNγ), tumor necrosis factor α (TNFα), interleukin‐10 (IL‐10), and IL‐4 was measured in synovial fluid mononuclear cells (SFMC) using enzyme‐linked immunosorbent assay and polymerase chain reaction. In the synovial membrane, secretion of IFNγ and IL‐4 was determined by immunohistologic analysis. Cytokine regulation was studied by adding cytokines and anticytokines to the cultures.Results. Upon stimulation with specific bacteria, SFMC secreted low amounts of IFNγ and TNFα, but high amounts of IL‐10. IL‐10 was responsible for the suppression of IFNγ and TNFα, as judged by the effect of adding either anti‐IL‐10 antibodies or exogenous IL‐10 to these cultures. The addition of neutralizing anti‐IL‐12 to the cultures completely abolished the effects of anti‐IL‐10, suggesting that inhibition of the Th1‐like cytokines by IL‐10 is mediated through suppression of IL‐12 synthesis. Exogenous IL‐12 clearly enhanced IFNγ and TNFα secretion. In the synovial membrane, a higher number of cells were positive for the Th2 cytokine IL‐4, compared with the amount of IFNγ‐secreting cells.Conclusion. These data indicate that a Th2 cytokine pattern predominates in the joints of patients with ReA. Since Thl cytokines are necessary for the elimination of ReA‐associated bacteria, Th2 cytokines might contribute to bacterial persistence in the joint. Therefore, the IL‐10/IL‐12 balance appears to be crucial for regulation of the cytokine pattern in the joints of patients with ReA.
Mortality studies in psoriatic arthritis. Results from a single outpatient clinic. I. Causes and risk of death
Authors: Wong Katy , Gladman Dafna D. , Husted Janice , Long Jennifer A. , Farewell Vernon T. , Long Jennifer A. 
Published: February 2007

AbstractObjective. To identify the causes of death and mortality risk in patients with psoriatic arthritis (PsA) who were being followed up at a single outpatient clinic in Toronto, Ontario, Canada.Methods. Patients enrolled in the PsA Clinic between 1978 and 1993 were compared with the general population of Ontario. Deaths were identified from the clinic database and through linkage with the provincial mortality database, and causes were confirmed by death certificates. A standardized mortality ratio (SMR) was computed, based on the assumption that patients lost to followup were alive at the end of the study.Results. Of the 428 patients with PsA (194 women and 234 men), 53 (26 women and 27 men) died. The 4 leading causes of death were diseases of the circulatory (36.2%) or respiratory (21.3%) system, malignant neoplasms (17.0%), and injuries/poisoning (14.9%). The SMR for the female cohort was 1.59, and for the men, it was 1.65, indicating a 59% and 65% increase in the death rate, respectively. Deaths due to respiratory causes were particularly increased in these patients.Conclusion. The results suggest that this PsA Clinic outpatient population had an increased mortality risk.
Adverse outcomes of antiinflammatory therapy among patients with polymyalgia rheumatica
Authors: Gabriel Sherine E. , Sunku Jayasimha , Salvarani Carlo , O'Fallon W. Michael , Hunder Gene G. 
Published: February 2007

AbstractObjective. To evaluate the incidence and risks of adverse events associated with therapy (both corticosteroids [CS] and nonsteroidal antiinflammatory drugs [NSAIDs]) among a previously identified, populationbased cohort of patients first diagnosed with polymyalgia rheumatica (PMR) between 1970 and 1991 who were followed up over the long term.Methods. Information on demographics, PMR diagnosis, disease course, and drug therapy, in addition to data on adverse events commonly associated with CS and NSAID treatment, was obtained from the Rochester Epidemiology Project database. Cox proportional hazards and regression analysis models were used to evaluate the relationship between the occurrence of these events and therapy.Results. Of the 232 patients (69 male, 163 female) included in the study, the mean age at PMR diagnosis was 72.9 years, the average followup was 8.0 years, and 30 patients were also diagnosed with giant cell (temporal) arteritis. Among the 175 patients (49 male, 126 female) treated with CS, the mean duration of CS therapy was 2.4 years, the average daily dose was 9.6 mg, and the mean cumulative dose was 8.4 gm. In total, 65% of the 124 patients treated with CS alone experienced at least 1 adverse event, compared with 67% of the 57 patients treated with NSAIDs alone and 80% of the 51 patients treated with CS and NSAIDs. The average time from initiation of therapy to the first adverse event was 1.6 years (n = 160). Proportional hazards modeling identified 3 variables that independently increased the risk of adverse events: age at PMR diagnosis, a cumulative dose of prednisone ≥1,800 mg, and female sex. Person‐year analysis revealed that the risks of diabetes mellitus, vertebral fractures, femoral neck fractures, and hip fractures were 2–5 times greater among PMR patients compared with age‐ and sex‐matched individuals from the same population. Medical care or consultation by a rheumatologist was a highly significant predictor of a lower initial CS dose.Conclusion. The use of CS and NSAIDs in the treatment of PMR is associated with important longterm morbidity.
Criteria for the diagnosis of familial mediterranean fever
Authors: Livneh Avi , Langevitz Pnina , Zemer Deborah , Zaks Nurit , Kees Salim , Lidar Tzvi , Migdal Amiel , Padeh Shai , Pras Mordechai 
Published: February 2007

AbstractObjective. To establish a new set of criteria for the diagnosis of familial Mediterranean fever (FMF).Methods. Twenty‐seven features and manifestations typical of FMF were studied to determine their prevalence in 105 patients with FMF and 106 controls. Diagnosis of FMF in the study group was based on clinical judgment. Controls were patients with a variety of other diseases who presented to the emergency room or outpatient clinics with recurrent episodes of pain in body sites usually involved in FMF attacks. Manifestations observed to be significantly more common in FMF patients than in controls were incorporated into the rule proposed for diagnosis of FMF, based on a model of major, minor, and supportive criteria.Results. Two sets of diagnostic criteria were established. A conservative criteria set for diagnosis of FMF was based on the presence of 1 major or 2 minor criteria, or 1 minor plus 5 supportive criteria, and a simple criteria set for diagnosis of FMF required 1 major or 2 minor criteria. The sensitivity and specificity of these 2 criteria sets were >95% and >97%, respectively.Conclusion. The proposed new sets of criteria were highly sensitive and specific, and could be used to readily diagnose FMF and to distinguish FMF from other periodic febrile diseases.
Symptomatic spinal calcinosis in systemic sclerosis (scleroderma)
Authors: Ward Mark , Curé Joel , Schabel Stephen , Smith Edwin A. , Schumacher H. Ralph , Silver Richard M. 
Published: February 2007

AbstractTwo patients with diffuse cutaneous systemic sclerosis and spinal calcification, involving the lumbar spine in one and the cervical spine in the other, are described. Computed tomography‐guided aspiration of the calcific masses was performed, and material aspirated from one patient was shown to be apatite, Ca5(PO4)3OH. One patient showed improvement following lumbar laminotomy, hemilaminectomy, and diskectomy.
Juvenile rheumatoid arthritis in affected sibpairs
Authors: Moroldo Marta B. , Tague B. Link , Shear Edith S. , Glass David N. , Giannini Edward H. 
Published: February 2007

AbstractObjective. To describe the demographics and clinical disease in affected sibpairs (ASPs) with juvenile rheumatoid arthritis (JRA), and to compare JRA as it occurs in ASPs with that from non‐ASP JRA populations described in the literature.Methods. A rare disease research registry was established with a focus on JRA ASPs to facilitate accrual of patients for genetic, epidemiologic, and clinical studies. Physicians likely to care for patients with JRA were made aware of the registry and its goals by a variety of methods and asked to refer patients for entry.Results. To date, 71 ASPs have been registered and complete information has been obtained. These affected sibs differed in age by a mean of 4.1 years (SD 3.4) and in age at disease onset by 2.8 years (SD 3.0). The actual time difference between onset in sib 1 versus sib 2 averaged 4.4 years (SD 4.2). Sixty‐three percent of the sibpairs were concordant for sex, and 76% for JRA.Onset type within sibpairs did not appear to be random, based upon comparisons with non‐ASP populations. Greater than expected concordance was seen among those with pauciarticular‐onset and polyarticular‐onset JRA. Seventy‐nine percent of the pairs were concordant for course type. Seven sets of twins were included (∼10% of the total), all were concordant for onset and course type (6 sets with pauciarticular, 1 set with polyarticular), and disease onset was separated by a mean of only 3.3 months. Within the onset and course types, the clinical disease, such as the female:male ratio, age at onset, and serologic findings, in ASPs resembled that which has been described in the literature.Conclusion. A higher than expected degree of concordance for onset type of JRA exists between sibpairs, indicating that genetic influences play a role. Affected sibs do not tend to develop their disease at approximately the same point in time, except for the twin sets. Clinical features of the disease within the various subtypes appear similar to those in non‐ASP populations.
HLA‐B27‐derived peptides as autoantigens for T lymphocytes in ankylosing spondylitis
Authors: Märker‐Hermann Elisabeth , Büschenfelde Karl‐Hermann Meyer Zum , Wildner Gerhild 
Published: February 2007

AbstractObjective.To study whether peptides derived from the HLA‐B27 molecule sequence can stimulate peripheral blood T lymphocytes (PBL) from patients with HLA‐B27‐associated spondylarthropathies.Methods.PBL from 55 HLA‐B27+ patients with ankylosing spondylitis (AS), 28 HLA‐B27+ patients with other spondylarthropathies, 7 rheumatoid arthritis patients, and 30 HLA‐B27+ and 22 HLA‐B27‐ healthy controls were tested in lymphocyte proliferation assays with 4 synthetic peptides derived from the HLA‐B*2705 molecule.Results. A 13‐mer peptide (B27PA) induced significant proliferative responses in 17 of the 55 AS patients (stimulation index [SI] 2.5–17.5), as well as in 3 of the HLA‐B27+ healthy controls (SI 2.5–9.8). Another 13‐mer peptide (B27PC) induced PBL proliferation (SI 2.7–5.5) in 10 AS patients and in some donors of the control groups. In B27PA‐specific T cell lines, an expansion of cells positive for the γ/δ T cell receptor could be demonstrated.Conclusion. These results indicate that HLA‐B27‐derived peptides can be recognized as autoantigens by PBL of HLA‐B27+ AS patients and B27+ healthy controls. Recent infections preceding the manifestation of AS may be involved in this process of anti‐self major histocompatibility complex reactivity.
Effects of pulse methylprednisolone on bone and marrow tissues. Corticosteroid‐induced osteonecrosis in rabbits
Authors: Yamamoto Takuaki , Irisa Takahiko , Sugioka Yoichi , Sueishi Katsuo , Yamamoto Takuaki , Irisa Takahiko , Sugioka Yoichi , Sueishi Katsuo 
Published: February 2007

AbstractObjective. To investigate the effects of pulse methylprednisolone acetate on bone and bone marrow tissues and to clarify the causal factors of corticosteroidinduced osteonecrosis (ON) by using an experimental animal model.Methods. Male adult Japanese white rabbits were injected once with 20 mg/kg of methylprednisolone into the right gluteus medius muscle. Seven rabbits were killed at 4 weeks, 4 at 6 weeks, 4 at 8 weeks, and 6 at 10 weeks. Both histopathologic and hematologic studies were performed every week.Results. By 4 weeks after the steroid injection, 43% of the rabbits studied had developed multifocal ON lesions in the femur and/or humerus. In 1 rabbit, a thrombus was detected in an arteriole adjacent to the necrotic area at 4 weeks. After 6 weeks, there was also progressive histologic evidence of revascularization, with granulation tissue, and osteoblastic repair, with appositional bone formation. Hyperlipemia, fatty liver, and intraosseous fat embolism were observed in conjunction with thrombocytopenia and hypofibrinogenemia.Conclusion. A single injection of high‐dose corticosteroids was found to be capable of inducing thrombocytopenia, hypofibrinogenemia, and hyperlipemia with multifocal ON in several bones.
Circulating plasma levels of nucleosomes in patients with systemic lupus erythematosus. Correlation with serum antinucleosome antibody titers and absence of clear association with disease activity
Authors: Amoura Zahir , Piette Jean‐Charles , Chabre Henri , Cacoub Patrice , Papo Thomas , Wechsler Bertrand , Bach Jean‐François , Koutouzov Sophie 
Published: February 2007

AbstractObjective. To assess nucleosome plasma levels in patients with systemic lupus erythematosus (SLE) and to study the correlations with serum antinucleosome, anti‐double‐stranded DNA (anti‐dsDNA), and antihistone antibody activities, as well as with disease activity (by the SLE Disease Activity Index [SLEDAI]).Methods. In a cross‐sectional study, we assessed 58 SLE patients for their plasma nucleosome levels. Plasma nucleosome levels as well as serum antinucleosome, anti‐double‐stranded DNA, and antihistone antibody activities were assessed by enzyme‐linked immunosorbent assay. SLE activity was evaluated using the SLEDAI.Results. The mean (± SD) plasma nucleosome concentration in SLE patients was 52 ± 159 ng/ml (range 5–1,180), and was significantly higher than that of the controls (16 ± 8.8 ng/ml, range 8–52; P = 0.03). Thirteen of the 58 lupus patients had levels over the range of normal (defined as the control mean + 3 SD, or 42 ng/ml). An inverse correlation was found between nucleosome plasma levels and serum antinucleosome antibody activity in the entire group of SLE patients, those with active disease, and those with inactive disease, respectively. No correlation was found between the SLEDAI and nucleosome plasma concentrations.Conclusion. Nucleosome plasma levels may be normal or increased in SLE, and found in patients with active or inactive SLE. Longitudinal studies are needed to further establish whether high levels of circulating nucleosomes may predict the occurrence of an SLE flare.
Esophageal dysfunction in scleroderma. Relationship with disease subsets
Authors: Bassotti Gabrio , Battaglia Edda , Debernardi Valeria , Quiriconi Fabrizio , Dughera Luca , Buonafede Giuseppina , Puiatti Paolo , Mioli Pier Roberto , Emanuelli Giorgio , Germani Ugo , Morelli Antonio , Spinozzi Fabrizio 
Published: February 2007

AbstractObjective. To investigate the relationship between esophageal function and the extent of disease in a nonselected group of scleroderma patients, and to study gastric and small bowel motility in a group of scleroderma patients with more severe clinical manifestations.Methods. Esophageal function in 125 scleroderma patients was investigated by radiologic, endoscopic, manometric, and pH‐metric techniques. Ten patients also underwent gastrointestinal (GI) manometric recording, both during fasting and after a standard meal.Results. Radiologic abnormalities of the esophagus were found in 55 of 81 patients (68%) and esophagitis in 45 of 125 (36%). No significant relationship was disclosed between GI symptoms, radiologic abnormalities, esophagitis grade, and the various disease subsets. However, the overall incidence of endoscopic esophagitis (irrespective of the degree) was significantly (P < 0.05) correlated with the patient subgroups, with 100% incidence of esophagitis in those having the more severe cutaneous involvement (type III). Manometric abnormalities were documented in 80% of patients, and pathologic reflux in 78%. The severity of esophageal abnormalities on manometry significantly correlated with the severity of the disease, whereas no correlations were found with pH‐metric data. Ninety percent of the 10 female patients undergoing antroduodenal manometry displayed abnormal findings; of these, 60% showed neuropathic, and 30% myopathic, patterns. The latter were recorded in patients with a more severe stage of the disease (type III).Conclusion. A direct relationship was observed between scleroderma subsets and the severity of esophageal (and, probably, more distal gut) motor involvement. Since no correlation was found between esophageal symptoms and the severity of manometric abnormalities, manometry should be considered the single most important GI test to document the severity of the “esophageal” disease. Gastric and small bowel manometry may also offer evidence of widespread gut involvement, and provide a rationale for a more targeted therapeutic approach.
A case of spontaneous femoral neck fracture associated with multicentric reticulohistiocytosis. Oversecretion of interleukin‐1β, interleukin‐6, and tumor necrosis factor α by affected synovial cells
Authors: Nakamura Hiroshi , Yoshino Shinichi , Shiga Hiroo , Tanaka Hidekazu , Katsumata Shinichi 
Published: February 2007

AbstractWe describe a case of left femoral neck fracture associated with multicentric reticulohistiocytosis (MR). Biopsy specimens from a skin nodule and from synovial tissue showed histiocytic multinucleated giant cells (MR cells) that are characteristic of MR. A surgical specimen from the resected femoral head revealed that multinucleated giant cells and mononuclear cells invaded the marginal subchondral bone, without evident pannus. These cells also infiltrated into the fracture site, with bone resorption by activated osteoclasts. Immunohistochemical studies of synovium from the left hip joint showed positive staining for interleukin‐1β (IL‐1β), IL‐6, and tumor necrosis factor α, and abundant cytokine production by cultured synovial cells was demonstrated. These findings suggest that the subchondral invasion and intramedullary infiltration by MR cells caused articular destruction and/or fracture as a result of oversecretion of the cytokines.
Functional ability and work status in patients with fibromyalgia
Authors: Cathey Mary Ann , Wolfe Frederick , Kleinheksel Sue M. 
Published: February 2007

AbstractTo assess functional ability in fibromyalgia patients, we examined 28 patients during the performance of five standardized work tasks (SWT), and compared their performance to 26 RA patients and 11 healthy community controls. Fibromyalgia patients performed 58.6% and RA patients 62.1% of the work done by normals. Work performance was strongly associated with pretest Stanford Health Assessment Disability Index (HAQ) scores (r = 0.705), but also with pain, global severity, and psychologic status in both RA and fibromyalgia groups. We also examined work status in 176 fibromyalgia patients. Sixty percent were employed, 9.6% considered themselves disabled, but only 6.2% received disability payments (none for the specific diagnosis of fibromyalgia). Thirty percent of patients had changed jobs because of this illness. Functional ability is impaired in Fibromyalgia. SWT and the HAQ disability instrument may be effective in the clinical assessment of fibromyalgia.
Static wrist splint: Its effect on hand function in three women with rheumatoid arthritis
Authors: Backman Catherine L. , Deitz Jean C. 
Published: February 2007

AbstractThe effect of a static wrist splint on strength (grip and pinch), applied strength (pouring water, lifting groceries), and applied dexterity (writing, manipulating coins) was examined using a single‐subject, alternating‐treatments design. A aseline phase was followed by an intervention phase in which splint and no‐splint conditions were alternated and counterbalanced. Three women with rheumatoid arthritis (RA) entered the study. Data for each subject on each measure of hand function were plotted on graphs and analyzed visually for changes in level, trend, and variability. The results suggested that for women with RA a static wrist splint is useful in improving hand strength, but may hinder the wearer's ability to perform some fine motor tasks.
Effect of iontophoretically delivered dexamethasone on muscle performance in a rheumatoid arthritic joint. A case study
Authors: Hasson Scott M. , English Susan E. , Daniels Jerry C. , Reich Miles 
Published: February 2007

AbstractDexamethasone is a corticosteroid that has been used to decrease inflammation and pain in inflammed joints. The method of delivery has conventionally been through joint injection. The subject (female, age 36) in this investigation, has a 2‐year history of rheumatoid arthritis in the wrists, knees, ankles, and feet. The joints treated in this study were the knees, and a double‐blind procedure was utilized to determine the experimental (E) (dexamethasone and lidocaine) left; versus the control (C) (lidocaine only) right. Treatment consisted of iontophoresis onto the knee joint; and then repeated on the other knee joint, three times a week over an 8‐week period. Prior to the initial treatment session baseline data were collected for peak torque (knee extension [KE] at high omnikinetic resistance (PT); KE angular velocity at low resistance (AV); and total KE work at low resistance (20 repetitions). The subject was subsequently reassessed at 2 weeks, 4 weeks, 6 weeks and 8 weeks. The results, (E vs. C, percentage change from baseline to 8 weeks): PT (20.8% vs. −6.7%); AV (22.3% vs. 13.4%); and TW (54.0% vs. 17.2%). The results indicate that delivery of dexamethasone via electrical current may be effective in improving muscle/joint performance in a patient with rheumatoid arthritis.
Rheumatoid arthritis patients and clinical drug trials A case‐control study
Authors: Austin Janet S. , Ambros Richard F. , Young Peggy K. , Moreland Larry W. , Anthony Saway P. , Alarcón Graciela S. 
Published: February 2007

AbstractIn order to understand better why patients do or do not participate in clinical drug trials, we sent questionnaires to 100 patients with rheumatoid arthritis (RA) who participated in clinical drug trials at our center and to 100 RA patients with similar disease durations who did not participate in clinical drug trials at our center. We compared demographic, so‐cioeconomic, and clinical characteristics of respondents. Those who participated and those who did not participate in clinical drug trials selected similar rank‐order preferences of potential reasons for doing so. The most frequent reasons cited by participants and nonparticipants were physician recommendation (50% and 56%) and benefit to society (25% and 17%). Participants and nonparticipants were similar in reference to their age, sex, educational level, reported income per household, employment status, distance from the medical center, disease duration, number of tender joints, American Rheumatism Association functional class, and mean erythrocyte sedimentation rate variables. There were two differences between the groups: participants included a lower percentage of blacks and had a greater number of swollen joints. Even with those exceptions, we concluded that participants in clinical trials appear to be comparable to the general population of RA patients followed at our outpatient department.