bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increased enthesopathy among Behçet's syndrome patients with acne and arthritis: An ultrasonography study
Authors: Hatemi Gulen , Fresko Izzet , Tascilar Koray , Yazici Hasan 
Published: April 2008

AbstractObjectiveBehçet's syndrome is characterized by clusters of disease expression, one of which is the coexistence of acne and arthritis. The aim of this study was to test the hypothesis that enthesopathy is increased in this cluster, having features reminiscent of acne‐associated arthritis.MethodsThe study group comprised 35 patients with Behçet's syndrome who had acne and arthritis (BS‐AA), 38 patients with Behçet's syndrome who did not have arthritis (BS‐WA), 37 patients with ankylosing spondylitis (AS), 25 patients with rheumatoid arthritis (RA), and 25 healthy control subjects. Five entheseal sites (the superior and inferior poles of the patella, the tibial tuberosity, and the superior and inferior poles of the calcaneus) on both lower extremities were examined by 2 independent observers, using ultrasonography. A previously validated composite score was calculated for each patient. The numbers of entheseal sites giving a positive power Doppler signal in each group were also compared.ResultsPatients with AS had the highest enthesopathy score (mean ± SD 4.1 ± 2.4; F [4df] = 8.43, P < 0.001) followed by BS‐AA patients (3.0 ± 1.9; F [3df] = 3.63, P = 0.015). The mean ± SD enthesopathy scores among the remaining 3 groups were similar (for BS‐WA, 1.8 ± 1.4; for RA, 2.2 ± 1.6; for healthy controls, 2.0 ± 1.5 [F (2df) = 0.65, P = 0.53]). Power Doppler scores were highest for the BS‐AA group (mean ± SD 3.0 ± 1.5; F [4df] = 15.54, P < 0.001) followed by the AS group (2.7 ± 1.8; F [3df] = 14.38, P < 0.001), the RA group (2.6 ± 1.8; F [2df] = 13.88, P < 0.001), the BS‐WA group (1.2 ± 1.3; F [1df] = 4.48, P = 0.038), and the control group (0.5 ± 1.1). There was 87% agreement between the 2 observers (κ = 0.55, intraclass correlation coefficient 0.71).ConclusionThe increased presence of enthesopathy among BS‐AA patients compared with that among BS‐WA patients further supports the hypothesis that patients with Behçet's syndrome who also have arthritis and acne form a distinct cluster.
Combined analysis of monocyte and lymphocyte messenger RNA expression with serum protein profiles in patients with scleroderma
Authors: Duan Hangjun , Fleming Jo , Pritchard David K. , Amon Lynn M. , Xue Jun , Arnett Heather A. , Chen Guang , Breen Patricia , Buckner Jane H. , Molitor Jerry A. , Elkon Keith B. , Schwartz Stephen M. 
Published: April 2008

AbstractObjectiveWe attempted to elucidate possible pathogenetic mechanisms in scleroderma by analysis of gene expression patterns of purified monocytes and lymphocytes, as well as protein profiles of cytokines and growth factors.MethodsExpression analysis was performed on messenger RNA (mRNA) from cells that had been purified with magnetic beads. Plasma samples from the same patients were used for multiplex cytokine analysis. Potential sources of proteins were also examined by in situ hybridization of skin specimens.ResultsA total of 1,800 genes from monocytes and 863 genes from CD4+ T cells were differentially expressed in scleroderma patients. As observed by other investigators using unfractionated peripheral blood cells from patients with autoimmune connective tissue diseases, the cell type–specific analyses of our scleroderma samples showed expression of genes suggesting the presence of interferon‐α (IFNα), despite the apparent absence of this cytokine in plasma. IFNα RNA was, however, expressed at enhanced levels in vascular and perivascular cells in scleroderma skin samples. While levels of interleukin‐1α (IL‐1α) and IL‐16 were among 10 proteins found to be significantly elevated in scleroderma patients, none of the large panel of plasma cytokines we analyzed correlated with the expression levels of putative IFN response genes.ConclusionThe pattern of up‐regulation of mRNA in both the monocytes and CD4 lymphocytes of scleroderma patients, together with the detection of IFNα RNA in the microvasculature, suggests that leukocytes respond to this cytokine locally in the vessels. Detection of high levels of IL‐1α and IL‐16 in plasma and the independence of these protein levels from the IFN signature, implicates an independent contribution of other cytokines to immune activation and/or inflammation in scleroderma.
Correlation of magnetization transfer ratio histogram parameters with neuropsychiatric systemic lupus erythematosus criteria and proton magnetic resonance spectroscopy: Association of magnetization transfer ratio peak height with neuronal and cognitive dysfunction
Authors: Emmer B. J. , Steup‐Beekman G. M. , Steens S. C. A. , Huizinga T. W. J. , van Buchem M. A. , van der Grond J. 
Published: April 2008

AbstractObjectiveTo investigate whether, in neuropsychiatric systemic lupus erythematosus (NPSLE) patients, magnetization transfer ratio (MTR) histogram parameters are related to neurochemical findings obtained using proton magnetic resonance spectroscopy (1H‐MRS) and to determine whether MTR histogram changes are linked to specific SLE and NPSLE characteristics.MethodsEighteen SLE patients (15 female, 3 male; mean ± SD age 42.8 ± 12.8 years), 34 NPSLE patients (32 female, 2 male; mean ± SD age 35.9 ± 12.2 years), and 15 healthy controls (14 female, 1 male; mean ± SD age 44.7 ± 9.6 years) underwent magnetization transfer imaging and 1H‐MRS. Whole‐brain MTR histogram parameters were associated with 1H‐MRS metabolite ratios, certain SLE criteria, and neuropsychiatric syndromes.ResultsNo differences were found in the MTR histogram parameters between SLE patients and NPSLE patients. NPSLE patients had a lower MTR histogram peak height than did the healthy controls. The MTR histogram peak height and the mean height were significantly associated with the N‐acetylaspartate to creatinine ratio, suggesting neuronal dysfunction. Of all SLE criteria, renal dysfunction and arthritis were associated with MTR histogram parameters. After corrections for age, sex, and these SLE criteria, of the various neuropsychiatric syndromes only cognitive dysfunction was associated with the MTR histogram peak height.ConclusionThe MTR peak height is lower in NPSLE patients than in healthy controls. MTR peak height reflects neuronal dysfunction, as detected by 1H‐MRS. Furthermore, the MTR peak height is associated with cognitive dysfunction but not with the other neuropsychiatric syndromes evaluated in our study.
Functional characterization of antineutrophil cytoplasmic antibodies in patients with cocaine‐induced midline destructive lesions
Authors: Peikert Tobias , Finkielman Javier D. , Hummel Amber M. , McKenney Maureen E. , Gregorini Gina , Trimarchi Matteo , Specks Ulrich 
Published: April 2008

AbstractObjectiveAntineutrophil cytoplasmic antibodies (ANCA) binding to neutrophil elastase (NE) and proteinase 3 (PR3) are detectable in most patients with cocaine‐induced midline destructive lesions (CIMDL), but the pathogenic role and antigen specificity of these antibodies are unknown. This study was undertaken to assess the effects of NE ANCA on the enzymatic activity of NE, to determine whether these antibodies interfere with the physiologic effect of secretory leukoprotease inhibitor (SLPI), and to investigate the antigen specificity of both NE and PR3 ANCA in patients with CIMDL. We also compared the binding of PR3 ANCA in patients with CIMDL with that in patients with Wegener's granulomatosis (WG).MethodsPR3 ANCA and NE ANCA were detected by capture enzyme‐linked immunosorbent assays (ELISAs) and by indirect immunofluorescence. IgG was purified from the patients' sera, and the influence of NE ANCA on the enzymatic activity of NE and on the inhibitory activity of SLPI was investigated by determining the hydrolysis of N‐methoxysuccinyl‐Ala‐Ala‐Pro‐Val p‐nitroanilide by NE.ResultsIgG from NE ANCA–positive sera of patients with CIMDL inhibited the enzymatic activity of NE and did not interfere with the activity of SLPI. In contrast to the findings in WG sera, measurement of PR3 ANCA in CIMDL sera showed only fair to moderate concordance between the 2 different capture ELISAs. Cross‐inhibition experiments demonstrated that NE ANCA and PR3 ANCA represent distinct autoantibodies in patients with CIMDL.ConclusionThe functional effects of NE ANCA on the enzymatic activity of NE or on the activity of SLPI cannot be implicated in the pathogenesis of CIMDL. The autoimmune reaction that targets neutrophil serine proteases in patients with CIMDL is frequently directed against more than one antigen. The ANCA response, including the reactivity of PR3 ANCA, in patients with CIMDL differs from what has been described in patients with WG.
A paradigm of diagnostic criteria for polyarteritis nodosa: Analysis of a series of 949 patients with vasculitides
Authors: Henegar Corneliu , Pagnoux Christian , Puéchal Xavier , Zucker Jean‐Daniel , Bar‐Hen Avner , Guern Véronique Le , Saba Mona , Bagnères Denis , Meyer Olivier , Guillevin Loïc ,   French Vasculitis Study Group
Published: April 2008

AbstractObjectiveTo establish a set of clinical and paraclinical criteria potentially useful as a diagnostic screening tool for polyarteritis nodosa (PAN).MethodsThe abilities of individual descriptive items to predict a diagnosis of PAN were evaluated by screening available data from 949 patients from the French Vasculitis Study Group database, including 262 with PAN and 687 with control vasculitides. Selected items were tested in a logistic regression model to establish a minimal set of nonredundant PAN‐predictive criteria. The discriminative accuracy of these items and of the American College of Rheumatology (ACR) 1990 criteria were assessed by reapplying them to the initial patient sample and a subgroup restricted to PAN and microscopic polyangiitis (MPA) patients. A computer simulation procedure was conducted on artificially generated patient data to evaluate the usefulness of these criteria in predicting a diagnosis of PAN.ResultsThe analysis resulted in the retention of 3 positive predictive parameters (hepatitis B virus antigen and/or DNA in serum, arteriographic anomalies, and mononeuropathy or polyneuropathy) and 5 negative predictive parameters (indirect immunofluorescence detection of antineutrophil cytoplasmic antibody; asthma; ear, nose, and throat signs; glomerulopathy; and cryoglobulinemia) for the criteria set. These criteria yielded 70.6% sensitivity for all control vasculitides and 89.7% for MPA controls, with 92.3% specificity for all controls and 83.1% for MPA controls. The discriminant abilities of this set of items outperformed the ACR 1990 criteria in all analytical situations, showing better robustness to variations in the prevalence of individual vasculitides.ConclusionThe use of positive and negative discriminant criteria could constitute a sound basis for developing a diagnostic tool for PAN to be used by clinicians. Further prospective analyses and validations in different populations are needed to confirm these items as satisfactory diagnostic criteria.
Radiographic progression of ankylosing spondylitis after up to two years of treatment with etanercept
Authors: van der Heijde D. , Landewé R. , Einstein S. , Ory P. , Vosse D. , Ni L. , Lin S.‐L. , Tsuji W. , Davis J. C. 
Published: April 2008

AbstractObjectiveTo investigate the effect of etanercept therapy on radiographic progression in patients with ankylosing spondylitis (AS).MethodsPatients with AS who had previously participated in a 24‐week randomized, double‐blind, placebo‐controlled trial of etanercept therapy were enrolled in a 72‐week open‐label extension. Radiographs of the cervical and lumbar spine from patients who received etanercept (25 mg twice weekly) for up to 96 weeks were compared with radiographs from patients in a large prevalence cohort (Outcome Assessments in Ankylosing Spondylitis International Study [OASIS]) who had not been treated with anti–tumor necrosis factor α (anti‐TNFα) agents. Radiographs obtained at 2 time points up to 96 weeks apart from patients in both study populations were digitized and read by 2 independent readers who were blinded with regard to patient group and sequence. The primary end point was the 96‐week change in the modified Stoke AS Spine Score (mSASSS).ResultsA total of 257 patients treated with etanercept were compared with 175 unselected patients from the OASIS study. There was no significant difference in the change in the mSASSS from baseline among patients who received etanercept (mean ± SD 0.91 ± 2.45) versus those from the OASIS group (0.95 ± 3.18).ConclusionUnlike other inflammatory rheumatic diseases such as rheumatoid arthritis and psoriatic arthritis, structural progression in AS seems to be independent of TNF, despite the fact that TNF is responsible for the signs and symptoms due to inflammation in this disease.
Persistent efficacy of anakinra in patients with tumor necrosis factor receptor–associated periodic syndrome
Authors: Gattorno M. , Pelagatti M. A. , Meini A. , Obici L. , Barcellona R. , Federici S. , Buoncompagni A. , Plebani A. , Merlini G. , Martini A. 
Published: April 2008

AbstractObjectiveTo evaluate the efficacy and safety of treatment with the interleukin‐1 receptor antagonist anakinra in patients with tumor necrosis factor receptor–associated periodic syndrome (TRAPS) requiring high cumulative doses of steroids.MethodsFour children (mean age 9.1 years [range 4–13 years]) and 1 adult (age 33 years) with TRAPS were enrolled in the study. The 3 children with cysteine mutations (C52Y, C55Y, C43R) had prolonged and frequent attacks of fever. One child with the R92Q mutation and the adult patient with the C43R mutation displayed a more chronic disease course, with fluctuating, nearly continuous symptoms and persistent elevation of acute‐phase reactant levels (including serum amyloid A [SAA]). All patients were treated with anakinra (1.5 mg/kg/day).ResultsAll of the patients had a prompt response to anakinra, with disappearance of symptoms and normalization of acute‐phase reactant levels, including SAA. In all pediatric patients, anakinra was withdrawn after 15 days of treatment. After a few days (mean 5.6 days [range 3–8]) a disease relapse occurred, which dramatically responded to reintroduction of anakinra. During the following period of observation (mean 11.4 months [range 4–20 months]), the patients did not experience episodes of fever or other disease‐related clinical manifestations. Levels of acute‐phase reactants remained in the normal range. No major adverse reactions or severe infections were observed.ConclusionContinuous treatment with anakinra effectively controlled both the clinical and laboratory manifestations in patients with TRAPS and prevented disease relapses.
Nidogen‐1 and nidogen‐2 in healthy human cartilage and in late‐stage osteoarthritis cartilage
Authors: Kruegel Jenny , Sadowski Boguslawa , Miosge Nicolai 
Published: April 2008

AbstractObjectiveTo investigate the presence and function of nidogen‐1 and nidogen‐2 in healthy human cartilage and in late‐stage osteoarthritis (OA) cartilage.MethodsThe location and quantity of nidogen‐1 and nidogen‐2 protein and messenger RNA were determined in cartilage tissue obtained from healthy donors and from patients with late‐stage knee OA. Samples were analyzed by immunohistochemistry, in situ hybridization, and real‐time reverse transcription–polymerase chain reaction. Adhesion and inhibition assays, a pre‐embedding method, fluorescence‐activated cell sorting, and ultrastructural investigations with integrins were also carried out.ResultsDeveloping tissue from human embryos showed strong staining for both nidogens in condensed mesenchyme and in rib anlagen. Homogeneous staining for nidogen‐1 was observed in the extracellular matrix of healthy articular cartilage, whereas nidogen‐2 was localized pericellularly. In late‐stage OA cartilage, expression of nidogen‐1 was decreased pericellularly around diseased chondrocytes, whereas nidogen‐2 was increased. However, both nidogens had strongly increased levels around elongated chondrocytes, especially in areas of deep surface fissures. In vitro, both nidogens functioned as adhesion proteins for cells from the OA defect. In vivo, colocalizations with integrins αv and β1 as well as internalization of nidogens by chondrocytes in vitro were observed.ConclusionNidogens are involved in human limb development. They occur in healthy articular cartilage and show increased expression, primarily around elongated chondrocytes, in OA cartilage. Therefore, the activities of nidogens might be a sign of cartilage regeneration in late‐stage OA. Furthermore, the adhesive character of nidogens, specifically as adhesion proteins for chondrocytes from late‐stage OA, as well as the enhanced chondrocyte–nidogen interaction in OA indicate that both proteins play a key role in the pathogenesis of OA and either could be applied as a diagnostic marker.
Measuring health in patients with fibromyalgia: Content comparison of questionnaires based on the International Classification of Functioning, Disability and Health
Authors: Prodinger Birgit , Cieza Alarcos , Williams David A. , Mease Philip , Boonen Annelies , Kerschan‐Schindl Katharina , Fialka‐Moser Veronika , Smolen Josef , Stucki Gerold , Machold Klaus , Stamm Tanja 
Published: April 2008

AbstractObjectiveTo analyze the content of outcome measures commonly used to assess health in patients with fibromyalgia (FM) by linking the items of the instruments with the International Classification of Functioning, Disability and Health (ICF) in order to evaluate the adequacy of currently used measures.MethodsQuestionnaires used in FM were identified in a structured literature search. All concepts included in the items of the questionnaires were linked to ICF categories, according to previously published linking rules, by 2 independent health professionals. The percentages of linked ICF categories addressing the different ICF components were calculated.ResultsGeneric and symptom‐specific instruments were included. From the 296 items contained in all 16 instruments, 447 concepts were extracted and then linked to 52 ICF categories of the component body functions, 1 category of the component body structure, 40 categories of the component activities and participation, and 9 categories of the component environmental factors. More than half of the concepts identified were linked to body function, fewer were linked to activities and participation, and only concepts of 4 instruments were linked to the ICF component environmental factors.ConclusionMany concepts were linked to the categories in the ICF component body functions. While linking to the broad category, purportedly similar instruments often covered widely varying areas of function at more fine‐grained levels of detail. Some categories, such as environmental factors, were barely covered by any of the instruments and might constitute an important aspect of health deserving better coverage and future development.
Effects of glucocorticoids on weight change during the treatment of Wegener's granulomatosis
Authors: Wung Peter K. , Anderson Troy , Fontaine Kevin R. , Hoffman Gary S. , Specks Ulrich , Merkel Peter A. , Spiera Robert , Davis John C. , St.Clair E. William , McCune W. Joseph , Stone John H. 
Published: April 2008

AbstractObjectiveWeight gain is a side effect of glucocorticoid (GC) use, but the natural history and health implications of changes in weight that occur during the treatment of inflammatory disease are not understood.MethodsWe evaluated data from the Wegener's Granulomatosis Etanercept Trial. Patients were categorized according to clinical outcome at 1 year: remission (no disease flares), single flare, or multiple flares. Risk factors for gaining ≥10 kg were examined in multivariate models.ResultsWeights at baseline and 1 year were available for 157 (93%) of the 168 patients analyzed. During year 1, the mean cumulative prednisone dosage in the multiple flares subgroup was 7.9 gm, compared with 6.0 gm and 3.9 gm in the single flare and remission subgroups, respectively (P < 0.001). Patients in these subgroups gained an average of 2.6 kg, 4.1 kg, and 5.8 kg, respectively (P = 0.005). Weight gain did not correlate with cumulative GC dose (R = 0.10, P = 0.25). Thirty‐five patients (22.3%) gained and maintained ≥10 kg in the first year. New diagnosis of Wegener's granulomatosis at baseline was an independent predictor of gaining ≥10 kg at 1 year (odds ratio 19.7, 95% confidence interval 2.4–162.6, P = 0.006). Among the 78 patients in the remission subgroup, 40 sustained remissions through the 2‐year time point. For these 40 patients, the mean weight gained at year 1 did not regress by the end of year 2, despite the absence of continued GC use.ConclusionDisease control was associated with lower cumulative GC doses but greater weight gain. More than one‐fifth of patients gained >10 kg in the first year of treatment. The quantity of weight gained by patients during treatment has potential future health implications.
A primary care back pain screening tool: Identifying patient subgroups for initial treatment
Authors: Hill Jonathan C. , Dunn Kate M. , Lewis Martyn , Mullis Ricky , Main Chris J. , Foster Nadine E. , Hay Elaine M. 
Published: April 2008

AbstractObjectiveTo develop and validate a tool that screens for back pain prognostic indicators relevant to initial decision making in primary care.MethodsThe setting was UK primary care adults with nonspecific back pain. Constructs that were independent prognostic indicators for persistence were identified from secondary analysis of 2 existing cohorts and published literature. Receiver operating characteristic curve analysis identified single screening questions for relevant constructs. Psychometric properties of the tool, including concurrent and discriminant validity, internal consistency, and repeatability, were assessed within a new development sample (n = 131) and tool score cutoffs were established to enable allocation to 3 subgroups (low, medium, and high risk). Predictive and external validity were evaluated within an independent external sample (n = 500).ResultsThe tool included 9 items: referred leg pain, comorbid pain, disability (2 items), bothersomeness, catastrophizing, fear, anxiety, and depression. The latter 5 items were identified as a psychosocial subscale. The tool demonstrated good reliability and validity and was acceptable to patients and clinicians. Patients scoring 0–3 were classified as low risk, and those scoring 4 or 5 on a psychosocial subscale were classified as high risk. The remainder were classified as medium risk.ConclusionWe validated a brief screening tool, which is a promising instrument for identifying subgroups of patients to guide the provision of early secondary prevention in primary care. Further work will establish whether allocation to treatment subgroups using the tool, linked with targeting treatment appropriately, improves patient outcomes.