bluuebunny/crossref_metadata_2025_split huggingface dataset:
Catastrophic antiphospholipid syndrome. Response to repeated plasmapheresis over three years
Authors: Neuwelt C. Michael , Daikh David I. , Linfoot John A. , Pfister David A. , Young Robyn G. , Webb Ronald L. , London Stuart S. , Asherson Ronald A. 
Published: February 2007

AbstractThe catastrophic antiphospholipid syndrome (CAPS) is rare and usually fatal. In this report, we describe an unusual patient who, 31 years after experiencing an atypical preeclampsia‐eclampsia presentation known today as the HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets), developed CAPS, which seemed to complicate a diagnosis of primary antiphospholipid syndrome. She responded to repeated plasmapheresis over 3 years. Anticoagulants, corticosteroids, intravenous gamma globulin, and intravenous cyclophosphamide had all failed to halt the progression of CAPS, but repeated plasmapheresis not only halted the condition, but it led to the reversal of a leukoencephalopathy. The relationship between HELLP syndrome and CAPS is discussed, and possible patho‐genetic mechanisms that explain the efficacy of repeated plasmapheresis in this setting are suggested. It is postulated that perhaps plasmapheresis, through removal of cytokines or other mediators, disrupts the interaction between phospholipid‐protein complexes and endothelial cells. Repeated plasmapheresis should be considered in the most refractory cases of CAPS when more conventional treatment regimens have failed.
Sensitivity and positive predictive value of medicare part B physician claims for rheumatologic diagnoses and procedures
Authors: Katz Jeffrey N. , Barrett Jane , Liang Matthew H. , Bacon Aane M. , Kaplan Herbert , Kieval Raphael I. , Lindsey Stephen M. , Roberts W. Neal , Sheff Daniel M. , Spencer Robert T. , Weaver Arthur L. , Baron John A. 
Published: February 2007

AbstractObjective. To examine the sensitivity and positive predictive value of Medicare physician claims for select rheumatic conditions managed in rheumatology specialty practices.Methods. Eight rheumatologists in 3 states abstracted 378 patient office records to obtain information on diagnosis and office procedures. The Medicare Part B physician claims for these patient visits were obtained from the Health Care Financing Administration. The sensitivity of the claims data for a specific diagnosis was calculated as the proportion of all patients whose office records for a particular visit documented that diagnosis and who also had physician claims for that visit which identified that diagnosis. The positive predictive value was evaluated in a separate sample of 331 patient visits identified in Medicare physician claims. The positive predictive value of the claims data for a specific diagnosis was calculated as the proportion of patients with that diagnosis coded in the claims for a particular visit who also had the diagnosis documented in the medical record for that visit.Results. Ninety percent of abstracted office medical records were matched successfully with Medicare physician claims. The sensitivity of the Medicare physician claims was 0.90 (95% confidence interval [CI] 0.85–0.95) for rheumatoid arthritis (RA), 0.85 (95% CI 0.73–0.97) for systemic lupus erythematosus (SLE), and 0.85 (95% CI 0.78–1.0) for aspiration or injection procedures. The sensitivity for osteoarthritis (OA) of the hip or knee was ≤0.50 if 5‐digit codes specifying anatomic site were required. The sensitivity for fibromyalgia (FM) was 0.48 (95% Cl 0.28–0.68). The positive predictive values were at least 0.90 for RA, SLE, and aspiration or injection procedures. Positive predictive values for FM and the 5‐digit site‐specific codes for OA of the knee were 0.83 (95% CI 0.66–1.0) and 0.88 (95% CI 0.75–1.0), respectively, while the positive predictive value of the 5‐digit site‐specific codes for OA of the hip was zero (95% CI 0–0.26). The positive predictive value of OA at any site was 0.83 (95% CI 0.76–0.90).Conclusion. In specialty practice, Medicare physician claims had high sensitivity and positive predictive value for RA, SLE, OA without specification of anatomic site, and injection or aspiration procedures. The claims had lower sensitivity and predictive value for FM and for OA of the hip. The accuracy of Medicare physician claims for other conditions and in the primary care setting requires further investigation.
Heterotopic ossification in the setting of neuromuscular blockade
Authors: Goodman Thomas A. , Merkel Peter A. , Perlmutter Gary , Doyle Mittie Kelleher , Krane Stephen M. , Polisson Richard P. 
Published: February 2007

AbstractObjective. Heterotopic ossification (HO) is a disorder characterized by the formation of new bone in tissue that does not ossify under normal conditions. We report a series of 6 cases in which HO occurred in the setting of adult respiratory distress syndrome (ARDS). We wished to show that HO can occur after neuromuscular blockade and that these cases might provide additional evidence that HO is influenced by neural mechanisms.Methods. Cases of HO were selected from the consultation services at the Massachusetts General Hospital and the Brigham and Women's Hospital. Affected patients all had ARDS and had been treated with a neuromuscular blocking agent. Patients with a history of stroke, burn, head trauma, spinal cord injury, or joint replacement were excluded from this study.Results. Heterotopic bone appeared around large joints in a pattern identical to that seen in patients with paralysis, traumatic brain injury, severe burns, or trauma. New bone formation was self‐limited over a period of 1–2 years. Alkaline phosphatase and technetium bone scan were sensitive ways of detecting early disease and monitoring disease activity. Medical therapies had limited benefit. Surgical excision of mature new bone appeared to be the only definitive therapy.Conclusion. Neuromuscular blockade in the setting of ARDS appears to be an important risk factor for the development of HO. The similarity of these cases of HO occurring in patients with brain or spinal cord injury raises the possibility that neural mechanisms may be important in the pathogenesis of this disease. Whether the type of neuromuscular blocking agent and the duration of use are important determinants of disease severity remains to be determined.
Deficient Fas ligand expression by synovial lymphocytes from patients with rheumatoid arthritis
Authors: Cantwell Mark J. , Hua Tinh , Zvaifler Nathan J. , Kipps Thomas J. 
Published: February 2007

AbstractObjective. To examine the expression and function of CD95 (Fas) and its ligand in rheumatoid arthritis (RA).Methods. We used flow cytometry and reverse transcriptase‐polymerase chain reaction methods to assess lymphocyte expression of CD95 and its ligand. We also examined whether lymphocytes could undergo Fas‐mediated apoptosis with anti‐CD95 monoclonal antibody (MAb) or human Fas ligand‐expressing fibroblasts, and if synovial fluid contained a soluble factor(s) that could inhibit such interactions. Finally, we determined whether anti‐CD3 MAb could induce synovial T cells to express the Fas ligand in vitro.Results. Nearly all RA synovial fluid or synovial tissue lymphocytes expressed CD95 and could be induced to undergo apoptosis by CD95 crosslinking. We did not detect a soluble inhibitor in RA synovial fluid that could account for the survival of CD95+ synovial cells in vivo. Instead, we detected little or no expression of Fas ligand by RA synovial lymphocytes. However, we could induce such cells to express Fas ligand with anti‐CD3 MAb or phorbol ester and ionomycin in vitro.Conclusion. There is ineffective clearance of activated cells in the RA joint due to deficient expression of the Fas ligand.
Suppression of collagen‐induced arthritis through adenovirus‐mediated transfer of a modified tumor necrosis factor α receptor gene
Authors: Le Christine H. , Nicolson A. Graham , Morales Alejandro , Sewell K. Lea 
Published: February 2007

AbstractObjective. To evaluate the efficacy of systemic and intraarticular adenoviral transfer of a modified tumor necrosis factor α receptor (TNFαR) gene and its expression in rat collagen‐induced arthritis (CIA).Methods. Rats with CIA received injections of replication‐deficient adenovirus containing either a TNFα inhibitor (TNFI) gene or a control β galactosidase (β‐gal) gene. The TNFI gene codes for a fusion protein consisting of the human 55‐kd TNFαR and a mouse IgG heavy chain. Successful gene transfer was determined by serum TNFαR measurements and by histologic examination of injected joints with in situ blue staining.Results. Serum TNFαR levels were detectable for 8 days following systemic TNFI gene transfer. CIA severity was significantly suppressed by TNFI gene transfer, both prior to and following arthritis onset (P = 0.0001, by repeated‐measures 2‐factor analysis of variance). Direct synovial TNFI gene transfer was successful, but induced an inflammatory response without any net TNFI benefit.Conclusion. Systemic adenoviral‐mediated transfer of the TNFI gene suppressed CIA during its transitory expression. Intraarticular gene transfer was limited by an adenoviral synovitis that was not overcome by delivery of the TNFI gene. TNFI is an excellent protein candidate for further therapeutic study.
Complexed plasma elastase as an in vivo marker for leukocyte activation in antineutrophil cytoplasmic antibody‐associated vasculitis
Authors: Haubitz M. , Schulzeck P. , Schellong S. , Schulze M. , Koch K. M. , Brunkhorst R. 
Published: February 2007

AbstractObjective. It has been postulated that antineutrophil cytoplasmic antibody (ANCA)‐induced degranulation of primed granulocytes and monocytes is involved in the pathogenesis of ANCA‐associated vasculitis. Since elastase is the major lysosomal protein released during leukocyte degranulation, we investigated cell activation in vivo in patients with ANCA‐associated vasculitis by determining complexed plasma elastase levels.Methods. Plasma elastase complexed with α1‐antitrypsin was measured in 20 patients with ANCAassociated vasculitis, using an immunoactivation assay. In parallel, C‐reactive protein (CRP) and ANCA levels were determined and clinical disease activity was assessed.Results. Complexed elastase levels were significantly elevated in patients with ANCA‐associated vasculitis who had not received immunosuppressive therapy (mean ± SD 71.5 ± 22.6 μg/liter), compared with healthy volunteers (12.2 ± 11.4 μg/liter; P < 0.001). Elastase decreased significantly after 2 weeks (46.5 ± 26.8 μg/liter; P < 0.01) and further after 8–10 weeks of immunosuppressive treatment (28.1 ± 13.4 μg/liter; P < 0.02), in correlation with decreasing vasculitis activity. Concomitantly, ANCA titers and CRP levels decreased.Conclusion. These data support the theory that, by the release of lysosomal proteinases, leukocyte activation may be involved in the pathogenesis of ANCAassociated vasculitis. In addition, plasma elastase may be used as a marker for disease activity.
Investigation of the association of the CRTM and CRTL1 genes with radiographically evident osteoarthritis in subjects from the rotterdam study
Authors: Meulenbelt I. , Bijkerk C. , De Wildt S. C. M. , Miedema H. S. , Valkenburg H. A. , Breedveld F. C. , Pols H. A. P. , Te Koppele J. M. , Sloos V. F. G. , Hofman A. , Slagboom P. E. , Van Duijn C. M. 
Published: February 2007

AbstractObjective. To investigate whether radiographically evident osteoarthritis (ROA) in 55–65‐year‐old men and women is associated with specific alleles or genotypes of the cartilage matrix protein (CRTM) and cartilage link protein (CRTLl) genes.Methods. Cases were selected from a populationbased study on the presence of ROA of the knee or hip. Further radiographic analysis included scoring for spine and hand ROA. Controls, selected from the same population, were free of ROA in all joints.Results. The CRTM locus was significantly associated with hip ROA in men (odds ratio 0.50, 95% confidence interval 0.26–0.95). A significant association between ROA and the CRTLl gene was not observed.Conclusion. These results suggest that the CRTM locus may play a role in the sex‐ and joint site‐specific pattern of ROA development.
Magnetic resonance imaging‐determined synovial membrane and joint effusion volumes in rheumatoid arthritis and osteoarthritis. Comparison with the macroscopic and microscopic appearance of the synovium
Authors: Østergaard Mikkel , Stoltenberg Michael , Løvgreen‐Nielsen Preben , Volck Birgitte , Jensen Claus Hjorth , Lorenzen Ib 
Published: February 2007

AbstractObjective. To evaluate the relationship between synovial membrane and joint effusion volumes determined by magnetic resonance imaging (MRI) and macroscopic and microscopic synovial pathologic findings in patients with rheumatoid arthritis (RA) and osteoarthritis (OA).Methods. Synovial biopsies were performed, and macroscopic grades of synovitis assigned, at preselected knee sites during arthroscopy or arthrotomy in 17 knees with RA and 25 with OA. Synovial inflammation and 9 separate tissue characteristics were graded histologically. Synovial membrane and joint effusion volumes were determined by preoperative MRI, enhanced with intravenous gadopentetate dimeglumine.Results. MRI‐determined synovial membrane volumes were correlated with the overall histologic assessment of synovial inflammation (Spearman's σ = 0.55, P < 0.001), with fibrin deposition, with subsynovial mononuclear and polymorphonuclear leukocyte infiltration (σ = 0.51‐0.59), and less significantly with macroscopic synovitis, vessel proliferation, and granulation tissue formation (σ = 0.40‐0.42). No correlation with synovial lining multiplication, perivascular edema, villous formation, or fibrosis was found (σ < 0.30).Conclusion. MRI‐determined synovial volumes are correlated with synovial inflammatory activity. Synovial volumes probably mainly reflect the mass of cell‐infiltrated, vascularized subsynovial tissue, but may also be influenced by the cumulative synovial proliferative activity. MRI‐determined synovial membrane and effusion volumes may be sensitive markers and/or predictors of disease activity and treatment outcome in RA.
Systemic lupus erythematosus with membranous glomerulonephritis and transverse myelitis associated with anabolic steroid use
Authors: Radis Charles D. , Callis Kristina P. 
Published: February 2007

AbstractThis report describes a 29‐year‐old bodybuilder taking anabolic steroids who presented with urinary retention, arthralgias, and peripheral edema, subsequently developed acute lower‐extremity paralysis, and was diagnosed as having transverse myelitis and membranous glomerulonephritis secondary to systemic lupus erythematosus (SLE). The association of anabolic steroid use and hyperprolactinemia, and their possible link to the development of SLE, are reviewed.
Lack of association of hla‐drb1 genotype with radiologic progression in japanese patients with early rheumatoid arthritis
Authors: Higami Kenshi , Hakoda Masayuki , Matsuda Yuko , Ueda Hiroyuki , Kashiwazaki Sadao 
Published: February 2007

AbstractObjective. To evaluate the role of HLA‐DRB1 genotypes in the development and progression of the rheumatoid arthritis (RA) disease process.Methods. Patients with polyarthritis of <1 year in duration were consecutively enrolled in the study. Other inclusion criteria were no diagnosis of inflammatory diseases other than RA, and no history of taking disease‐modifying antirheumatic drugs or steroids. Patients were evaluated every 4 weeks, and radiographs of the hands/wrists and feet were taken at presentation and 1 year later. HLA‐DRB1 genotypes were determined by polymerase chain reaction and restriction fragment length polymorphism methods.Results. We enrolled 198 patients (median disease duration 5.0 months) and 150 controls. The frequency of individuals with DRB1*0405 and *0410 was significantly higher in the patients than in the controls. Homozygous states for DRB1 alleles with the RArelated shared epitope (SE) were associated with increased susceptibility for the development of polyarthritis (odds ratio 3.4, 95% confidence interval 1.5–7.7). None of the DRB1 alleles or SE genotypes correlated with the presence of bone erosion at presentation or 1 year later.Conclusion. DRB1 alleles with SEs were associated with the development of polyarthritis but not with early radiographic progression of the disease process.
Evaluation of a computer‐based education lesson for patients with systemic lupus erythematosus
Authors: Wetstone Scott L. , Pfeiffer Carol A. , Rippey Robert M. 
Published: February 2007

AbstractA computer‐based education (CBE) lesson for patients with systemic lupus erythematosus (SLE) was developed to supplement one‐on‐one teaching by physicians and other health professionals. It was evaluated using a pretest—posttest experimental design. Fifty‐three patients were randomly divided into control and CBE groups. All subjects found the lesson easy to use and responded favorably to this form of education. Results after matching for initial knowledge demonstrated significant increase in knowledge (from 62% to 77% correct, P < 0.01) as well as increased hopefulness of a good prognosis (P < 0.05) for the CBE group. Knowledge gain was correlated with low initial positive affect (r = −0.51, P < 0.01), high initial negative affect (r = 0.38, P < 0.03), and low initial internal health locus of control (r = 0.35, P < 0.04). Subjects with previous computer experience benefited more than those without such experience (23.5% vs 8.9% additional correct, P = 0.01). The data suggest that CBE is successful in the education of patients with this complex multisystemic disease.
Attacking the sacred cows
Authors: Moncur Carolee 
Published: February 2007

AbstractThe time has come to review the traditional methods of prescribing exercise programs for persons who have arthritis. For years, we as health care providers have based our decisions on early research, a small number of subjects, and anecdotal experience. Evolution of technical advances and scientific thought now enables us to investigate old traditions or sacred cows to determine if they should continue to exist. The author discusses several of the beliefs that are prevalent among today's practitioners.
Educational and psychosocial needs of patients with chronic disease: A survey of preferences of patients with rheumatoid arthritis
Authors: Buckley Lenore M. , Vacek Pamela , Cooper Sheldon M. 
Published: February 2007

AbstractThere is increasing interest in better defining and meeting the nonmedical needs of patients with chronic diseases, such as rheumatoid arthritis (RA). We surveyed patients with RA about the importance of eight psyche‐social and eight educational issues, and asked patients from what source they preferred to get help with these issues and which sources they would not use. We also looked at individual variables, including sex, age, disease duration, and disease severity, to see if they affected patients' choices. The issues rated most important by patients included communicating with the doctor, understanding medication, dealing with pain, and the effects of arthritis on energy level, the future, and work. Most patients preferred to seek help from their physicians, although up to 75% were willing to attend groups, and 68% were willing to see individual counselors for some issues.
The role of expectations and preferences in health care satisfaction of patients with arthritis
Authors: Ross Caroline K. , Sinacore James M. , Stiers William , Budiman‐Mak Elly 
Published: February 2007

AbstractStudies of patient satisfaction have typically been conducted in general patient populations with little attention to patients suffering from specific illnesses. The purpose of this article is to review literature and raise issues relevant to the satisfaction of patients with chronic arthritis. Individuals suffering from a chronic illness such as arthritis may be different from others who seek medical care in their expectations, what they expect from care, and preferences, what they want from care. These differences may occur because patients with chronic arthritis have greater experience with care seeking and increasing recognition of the potential for poor disease outcomes in spite of adequate care. Literature from marketing research and health care which suggests that both expectations and preferences influence satisfaction with care will be reviewed. Then specific hypotheses about expectations and preferences of patients with chronic arthritis will be proposed. Recommendations for future studies of arthritis patient expectations and preferences will be made.
Rheumatology nursing: Evolution of the role and functions of a subspecialty
Authors: Pigg Janice Smith 
Published: February 2007

AbstractThis article traces the evolution and historical background of rheumatology nursing through the contribution of those who were a part of the process. The role and functions of the rheumatology nurse are revealed in the literature and the activities in which rheumatology nurses have been involved. Rheumatology nursing as aspecialty in itself or as a subspecialty of rehabilitation, orthopedic, or medical/surgical nursing is described.
Self‐reported fatigue in rheumatoid arthritis a pilot study
Authors: Tack Basia Belza 
Published: February 2007

AbstractThe purpose of this pilot study was to examine the symptom of fatigue in rheumatoid arthritis. The instruments used included the Profile of Mood States, fatigue and pain visual analog scales, and an interviewer's assessment of respondent fatigue. The results indicated that fatigue was a significant problem in this sample;fatigue was positively associated with depression, pain, and poorer overall mood state; and the three measures of fatigue produced congruent reports of fatigue.
Point patient control of treatment is essential
Authors: Brady Teresa J. 
Published: February 2007

AbstractWho is in control of treatment is an issue clinicians address on a daily basis. This represents an ethical dilemma, which sets the principle of autonomy in direct conflict with the principle of beneficence. This article advocates giving autonomy precedence over beneficence to achieve patient control of treatment. Patient control of treatment is essential in chronic disease because the patient is the expert in his or her own goals and values, the sick role is inappropriate in chronic disease and may have devastating emotional consequences, and in actuality the patient is the health care provider.
The modified health assessment questionnaire difficulty scale. A health status measure revisited
Authors: Blalock Susan J. , Sauter Suzanne Van H. , Devellis Robert F. 
Published: February 2007

AbstractThis study examined the equivalency of disability estimates obtained from the health assessment questionnaire (HAQ) and the modified HAQ (MHAQ). We found that although the MHAQ and HAQ scores were highly correlated, MHAQ scores were significantly lower than HAQ scores, were not normally distributed, and exhibited a restricted range. Implications of these findings are discussed.