bluuebunny/crossref_metadata_2025_split huggingface dataset:
Persistence of borrelia burgdorferi in ligamentous tissue from a patient with chronic lyme borreliosis
Authors: Häupl Thomas , Hahn Gabriele , Rittig Michael , Krause Andreas , Schoerner Christoph , Schönherr Ulrich , Kalden Joachim R. , Burmester Gerd R. 
Published: February 2007

AbstractObjective. To document the persistence of Borrelia burgdorferi in ligamentous tissue samples obtained from a woman with chronic Lyme borreliosis.Methods. Spirochetes were isolated from samples of ligamentous tissue, and the spirochetes were characterized antigenetically and by molecular biology techniques. The ligamentous tissue was examined by electron microscopy. Humoral and cellular immune responses were analyzed.Results. Choroiditis was the first recognized manifestation of Lyme disease in this patient. Despite antibiotic therapy, there was progression to a chronic stage, with multisystem manifestations. The initially significant immune system activation was followed by a loss of the specific humoral immune response and a decrease in the cellular immune response to B burgdorferi over the course of the disease. “Trigger finger” developed, and a portion of the flexor retinaculum obtained at surgery was cultured. Viable spirochetes were identified. Ultramorphologically, the spirochetes were situated between collagen fibers and along fibroblasts, some of which were deeply invaginated by these organisms. The cultured bacteria were identified as B burgdorferi by reactions with specific immune sera and monoclonal antibodies, and by polymerase chain reaction amplification and Southern blot hybridization techniques.Conclusion. To our knowledge, this is the first report of the isolation of B burgdorferi from ligamentous tissue. This suggests that tendon tissues serve as a specific site of spirochete residence in human hosts.
Bronchiolitis obliterans organizing pneumonia associated with essential mixed cryoglobulinemia
Authors: Zackrison Leila H. , Katz Paul 
Published: February 2007

AbstractBronchiolitis obliterans organizing pneumonia (BOOP) is an uncommon and underrecognized pathologic finding observed in a variety of syndromes including connective tissue diseases. Although lung involvement in essential mixed cryoglobulinemia (EMC) has been reported, there are no previous reports of BOOP in EMC. We report herein a case of longstanding EMC associated with interstitial and cavitary lung disease histologically consistent with BOOP. A theory of a possible etiologic basis for the development of BOOP in patients with connective tissue diseases is discussed.
Bone mineral density and knee osteoarthritis in elderly men and women. the framingham study
Authors: Hannan Marian T. , Anderson Jennifer J. , Zhang Yuqing , Levy Daniel , Felson David T. 
Published: February 2007

AbstractObjective. To examine the possible inverse relationship between osteoporosis and osteoarthritis (OA) by evaluating the association between bone mineral density (BMD) and knee OA in the Framingham Study cohort.Methods. Of the 1,154 Framingham Study cohort subjects in whom BMD measurements were obtained at biennial examination 20, 932 (81%) had had knee OA assessed during the Framingham Knee OA Study 4 years earlier. BMD of the proximal femur and radius was measured by densitometry. Knee OA was assessed from a weight‐bearing anteroposterior radiograph and graded on a scale of 0 (no OA) to 4 (severe OA). Osteophytes and joint space narrowing were also evaluated separately. Linear regression was used to test the association of BMD with knee OA, with osteophytes, and with joint space narrowing, after adjustment for age, body mass index, and mean number of cigarettes smoked per day.Results. The subjects included 572 women and 360 men with an age range of 63–91 years (mean 71 years). Of these, 351 had no OA, 269 had grade 1 OA, 170 had grade 2 OA, 93 had grade 3 OA, and 49 had grade 4 OA. Mean femoral BMD at the 3 proximal femur sites was 5–9% higher in men and women with either grade 1, grade 2, or grade 3 knee OA, compared with those with no knee OA (P < 0.0001). Mean femoral BMD in those with grade 4 OA was not higher than in those with no OA. Radius BMD was not associated with knee OA in subjects of either sex. Women with osteophytes had higher BMD compared with women with no osteophytes. Mean BMD did not differ across levels of joint space narrowing.Conclusion. We conclude that, among women, femoral BMD is higher in those with osteophytosis of the knee, and BMD is not necessarily associated with joint space narrowing.
Treatment of rheumatoid arthritis with chimeric monoclonal antibodies to tumor necrosis factor α
Authors: Elliott Michael J. , Maini Ravinder N. , Feldmann Marc , Long‐Fox Alice , Charles Peter , Katsikis Peter , Brennan Fionula M. , Walker Jean , Bijl Hanny , Ghrayeb John , Woody James N. 
Published: February 2007

AbstractObjective. To evaluate the safety and efficacy of a chimeric monoclonal antibody to tumor necrosis factor α (TNFα) in the treatment of patients with rheumatoid arthritis (RA).Methods. Twenty patients with active RA were treated with 20 mg/kg of anti‐TNFα in an open phase I/II trial lasting 8 weeks.Results. The treatment was well tolerated, with no serious adverse events. Significant improvements were seen in the Ritchie Articular Index, which fell from a median of 28 at study entry to a median of 6 by week 6 (P < 0.001), the swollen joint count, which fell from 18 to 5 (P < 0.001) over the same period, and in the other major clinical assessments. Serum C‐reactive protein levels fell from a median of 39.5 mg/liter at study entry to 8 mg/liter at week 6 (P < 0.001), and significant decreases were also seen in serum amyloid A and interleukin‐6 levels.Conclusion. Treatment with anti‐TNFα was safe and well tolerated and resulted in significant clinical and laboratory improvements. These preliminary results support the hypothesis that TNFα is an important regulator in RA, and suggest that it may be a useful new therapeutic target in this disease.
The effect of long‐term methotrexate therapy on hepatic fibrosis in rheumatoid arthritis
Authors: Bjorkman David J. , Boschert Mark , Tolman Keith G. , Clegg Daniel O. , Ward John R. 
Published: February 2007

AbstractObjective. To evaluate the progression of hepatic fibrosis in patients with rheumatoid arthritis (RA) treated with methotrexate (MTX).Methods. Fifteen patients receiving MTX for RA were prospectively studied by electron microscopic analysis of biopsy specimens.Results. Five of the 15 patients had evidence of increased hepatic collagen after 2 years of MTX therapy.Conclusion. Hepatic fibrosis may progress in a subgroup of RA patients treated with MTX.
Inhibition of cartilage proteoglycan release by a specific inactivator of cathepsin b and an inhibitor of matrix metalloproteinases. evidence for two converging pathways of chondrocyte‐mediated proteoglycan degradation
Authors: Buttle David J. , Handley Christopher J. , Ilic Mirna Z. , Saklatvala Jeremy , Murata Mitsuo , Barrett Alan J. 
Published: February 2007

AbstractObjective. To investigate mechanisms of cartilage matrix destruction by a study of the effects of a specific inactivator of cathepsin B and an inhibitor of several matrix metalloproteinases (MMP) on cartilage proteoglycan release.Methods. Cartilage explants were treated with either recombinant human interleukin‐1α (rHuIL‐1α) or retinoic acid in the presence or absence of the inhibitors, and proteoglycan release was quantitated. Tests for nonspecific effects of the inhibitors included reversibility, rates of protein synthesis and glycolysis, and effects on other rHuIL‐1α–mediated events.Results. The cathepsin B inactivator inhibited rHuIL‐1α–stimulated proteoglycan release at nanomolar concentrations, but failed to significantly inhibit retinoic acid–stimulated proteoglycan release. An inhibitor of MMP was inhibitory to both rHuIL‐1α–stimulated release and retinoic acid–stimulated release.Conclusion. Cathepsin B is implicated in rHuIL‐1α–stimulated loss of cartilage proteoglycan. Its lack of involvement in retinoic acid–stimulated proteoglycan release suggests the existence of at least 2 pathways of cartilage proteoglycan breakdown, which may converge at the activation of a matrix prometalloproteinase.
Loss of trabecular bone mineral density in systemic lupus erythematosus
Authors: Kalla Asgar Ali , Fataar Abdul Basier , Jessop Susan Jane , Bewerunge Linda 
Published: February 2007

AbstractObjective. To evaluate trabecular bone mineral density (BMD) in young ambulatory female patients with systemic lupus erythematosus (SLE).Methods. Bone mineral density (gm/cm2) at the lumbar vertebrae (L1–L4) and at the left femur (neck, trochanter, intertrochanter, and Ward's triangle) was measured by dual x‐ray absorptiometry in 46 SLE patients (mean age 31 years, mean disease duration 76 months) and in 108 healthy female controls (mean age 32 years). Twenty‐two of the SLE patients were receiving corticosteroids (CS) at the time of the study.Results. Lumbar BMD in the SLE patients was less severely reduced than was BMD at the femoral sites, but the SLE group was closer to the lumbar fracture threshold of 0.812 gm/cm2 than was the control group (P = 0.0009). There were no significant differences between the SLE patients currently being treated with corticosteroids and those who were not (P > 0.3). BMD at Ward's triangle and at the femoral neck was not significantly reduced in the SLE patients. Total femoral BMD had a sensitivity of 76% and specificity of 62% in differentiating the SLE group from the controls. The positive predictive value was 61% and the negative predictive value was 89%. The prevalence of osteopenia in the SLE patients was 25%.Conclusion. SLE causes significant trabecular bone loss, which is not due to corticosteroid therapy.
Sjögren's syndrome presenting as hypokalemic periodic paralysis
Authors: Dowd James E. , Lipsky Peter E. 
Published: February 2007

AbstractWe describe a 21‐year‐old Hispanic woman who presented with hypokalemic paralysis as the initial manifestation of Sjögren's syndrome (SS). Our review of the English literature revealed 12 previously reported cases of SS and renal tubular acidosis (RTA). Paralysis often preceded the sicca complex in those patients. Renal function in the patients with hypokalemic paralysis was reduced compared with that in patients who had primary SS and RTA but no history of hypokalemic paralysis (P < 0.002). Hypokalemic periodic paralysis is a rare manifestation of SS. It is seen more often in patients with primary SS, may precede the classic sicca complex, and may serve as a clinical marker for more severe renal disease in patients who have primary SS and RTA.
Systemic lupus erythematosus in a rhesus macaque
Authors: Anderson Scott T. , Klein Edwin C. 
Published: February 2007

AbstractWe describe the clinical course and histopathologic findings in a rhesus macaque (Macaca mulatta) which developed a systemic inflammatory disorder resembling systemic lupus erythematosus (SLE). The manifestations of the SLE included antinuclear antibody, hemolytic anemia, membranoproliferative glomerulonephritis, and arthritis. To our knowledge, spontaneously occurring SLE has not previously been described in nonhuman primates.
Idiopathic inflammatory myopathy of the antisynthetase (jo‐1) type associated with noncaseating granulomas
Authors: Moder Kevin G. , Gaffey Thomas A. , Matteson Eric L. 
Published: February 2007

AbstractThe idiopathic inflammatory myopathies are a heterogeneous group of syndromes that share the finding of chronic muscle inflammation. Recently, serologic subtyping of autoantibodies found in patients with these syndromes has been used to identify distinct clinical entities. We describe a 36‐year‐old woman who, based on the findings of polymyositis documented by both electromyography and muscle biopsy, features of Raynaud's phenomenon, symmetric polyarthritis, “mechanic's hands,” and Jo‐1 antibody positivity, was considered to have the antisynthetase subset of idiopathic inflammatory myopathy. In addition, the patient had granulomatous synovitis, and noncaseating granulomas were found in a breast nodule. This is the first published report of granuloma formation in the antisynthetase syndrome.
Comparison of Amitriptyline, Cyclobenzaprine, and Placebo in the Treatment of Fibromyalgia
Authors: Carette Simon , Bell Mary J. , Reynolds W. John , Haraoui Boulos , Mccain Glenn A. , Bykerk Vivian P. , Edworthy Steven M. , Baron Murray , Koehler Barry E. , Fam Adel G. , Bellamy Nicholas , Guimont Chantal 
Published: February 2007

AbstractObjective. To compare the relative efficacy and tolerability of amitriptyline, cyclobenzaprine, and placebo in the treatment of fibromyalgia, and to identify predictors of response to amitriptyline and cyclobenzaprine.Methods, Two hundred eight patients who fulfilled the American College of Rheumatology criteria for the classification of fibromyalgia were entered into a 6‐month prospective, double‐blind, multicenter trial and were randomized to 1 of 3 treatment groups: amitriptyline, cyclobenzaprine, or placebo.Results. After 1 month, 21%, 12%, and 0% of the amitriptyline, cyclobenzaprine, and placebo patients, respectively, had significant clinical improvement (amitriptyline versus placebo P = 0.002, cyclobenzaprine versus placebo P = 0.02, amitriptyline versus cyclobenzaprine P not significant). These percentages increased to 36%, 33%, and 19%, respectively, at the 6‐month assessment (P not significant). The nature and frequency of side effects reported by patients treated with amitriptyline and those reported by patients treated with cyclobenzaprine were similar. A normal Minnesota Multiphasic Personality Inventory (MMPI) profile at baseline was predictive of clinical improvement at the 1‐month evaluation (odds ratio 3.3, 95% confidence interval 1.2—9.0). However, neither the MMPI profile nor any of the demographic, clinical, or functional parameters evaluated at baseline predicted long‐term response.Conclusion. Our data confirm the short‐term efficacy of amitriptyline and cyclobenzaprine in a small percentage of patients with fibromyalgia. Long‐term efficacy could not be demonstrated because of a higher‐than‐expected placebo response. Predictors of response to these drugs could not be determined.
Objective and Subjective Sleep Disturbances in Patients with Rheumatoid Arthritis
Authors: Hirsch Marco , Carlander Bertrand , Vergé Monick , Tafti Mehdi , Anaya Juan‐Manuel , Billiard Michel , Sany Jacques 
Published: February 2007

AbstractObjective. To assess objective and subjective evidence of sleep disturbances in patients with rheumatoid arthritis (RA) and to examine correlations between parameters of inflammatory activity and sleep pathology.Methods. Nineteen RA patients and 19 age‐matched healthy control subjects underwent all‐night polysomnography on 2 consecutive nights. RA patients were also evaluated for daytime sleepiness by mean sleep latency test and responded to a self‐report questionnaire on their first night.Results. Whereas normal sleep architecture is conserved in RA, we confirmed former findings of severe sleep fragmentation and an enhanced presence of primary sleep disorders. No correlation exists between RA activity and the sleep disorders. Subjective assessment was not consistent with the objective evidence of sleep disruption, unlike the findings in patients with fibrositis.Conclusion. Sleep is severly disturbed in patients with RA, regardless of the inflammatory disease activity. the specificity of the sleep disorders assessed needs confirmation, as does specific sleep therapy for these patients.
Interleukin‐2 Receptor Levels in the Sera of Rheumatoid Arthritis Patients Treated with Methotrexate
Authors: Polisson Richard P. , Dooley Mary Anne , Dawson Deborah V. , Pisetsky David S. 
Published: February 2007

AbstractObjective. To evaluate the association of the level of soluble serum interleukin‐2 receptor (sIL‐2R) with disease activity and response to therapy in patients with rheumatoid arthritis (RA).Methods. The sIL‐2R levels of 148 patients with refractory RA were determined by enzyme‐linked immunosorbent assay. This parameter was correlated with other clinical observations obtained during a prospective, randomized, placebo‐controlled trial of methotrexate, sponsored by the Cooperative Systematic Studies of Rheumatic Diseases consortium. Using statistical modeling, the usefulness of sIL‐2R as a measure of disease activity and a predictor of outcome was evaluated.Results. The mean sIL‐2R level in all RA patients was markedly elevated compared with that in normal control subjects, and decreased significantly during the trial. There was no correlation of the sIL‐2R level and the joint pain/tenderness count either at study entry or study end. There was a significant correlation of the sIL‐2R level and the erythrocyte sedimentation rate, both at study entry and study end. A multiple linear regression model showed that treatment with methotrexate, but not the sIL‐2R level or the change in sIL‐2R level, predicted a change in joint count. A stepwise multiple logistic regression model defined no significant predictive information for outcome for the level of sIL‐2R at study entry.Conclusion. After controlling for the simultaneous effects of other important clinical variables, the level of sIL‐2R does not appear to predict the response to methotrexate in patients with refractory RA. Further analysis of cohorts of patients with earlier RA needs to be performed.
Increased Antiretroviral Antibody Reactivity in Sera from a Defined Population of Patients with Systemic Lupus Erythematosus
Authors: Blomberg Jonas , Nived Ola , Pipkorn RüDiger , Bengtsson Anders , Erlinge David , Sturfelt Gunnar 
Published: February 2007

AbstractObjective. The implied role of retroviruses in the pathogenesis of murine systemic lupus erythematosus (SLE) led us to study antiretroviral antibodies in a population‐based SLE cohort.Methods. Immunoassays using whole virus and synthetic peptides were performed on sera from 72 patients with SLE and 88 control subjects.Results. Reactions with whole baboon endogenous virus occurred more frequently in patients with SLE, and correlated with the presence of anti‐RNP and anti‐Sm. Some retroviral env and gag peptides, several of which were similar to U1 small nuclear RNP, reacted more strongly in patients with SLE, and their presence was correlated with discoid rash, hematologic disorder, and other symptoms.Conclusion. These results provide circumstantial evidence for involvement of retroviruses in the pathogenesis of human SLE; further studies should be carried out using other techniques for measurement of retroviral expression.
Abnormalities of Renal Physiology in Systemic Sclerosis
Authors: Clements Philip J. , Lachenbruch Peter A. , Furst Daniel E. , Maxwell Morton , Danovitch Gabriel , Paulus Harold E. 
Published: February 2007

AbstractObjective. To evaluate the prognostic value of measurements of renal plasma flow and circulating vasoactive hormones in patients with systemic sclerosis (SSc).Methods. Renal plasma flow (para‐aminohippurate [PAH] clearance) and levels of selected circulating hormones (plasma renin activity [PRA] and serum aldosterone and catecholamines) were assessed in 57 SSc patients under the following conditions: at rest, in response to cold, while in upright position, and in response to sodium depletion. Survival was assessed 10.7 years after testing (20 patients had died).Results. Both unstimulated and stimulated PRA clearance rates were frequently elevated. Resting PAH clearances were usually abnormally low. PAH clearances and levels of aldosterone and catecholamines did not change during cold stimulation. Supine PRA levels following acute sodium depletion correlated with survival (P < 0.008).Conclusion. The frequent finding of elevated PRA and reduced PAH values reflects clinically the high frequency of renovascular disease noted histopathologically in SSc. Isolated decreases in PAH and elevations in PRA, however, did not predict renal crisis. Changes in PAH clearances were not demonstrable during cold stimulation. An abnormally high supine PRA after sodium depletion correlated with improved survival.
Clinical and Prognostic Associations Based on Serum Antinuclear Antibodies in Japanese Patients with Systemic Sclerosis
Authors: Kuwana Masataka , Kaburaki Junichi , Okano Yutaka , Tojo Takeshi , Homma Mitsuo 
Published: February 2007

AbstractObjective. To clarify the clinical features and prognosis of systemic sclerosis (SSc) based on serum antinuclear antibodies (ANA).Methods. We studied 275 consecutive Japanese patients newly diagnosed as having SSc, who were first evaluated during the period 1971—1990. Eight SSc–related ANA were identified using indirect immunofluorescence, double immunodiffusion, or immunoprecipitation assays. Clinical and prognostic features were retrospectively analyzed in patient groups, categorized by their serum ANA.Results. Cumulative survival rates at 10 years after diagnosis of SSc were 93% in patients with anticentromere antibodies (ACA), 72% in those with anti—U1 RNP, 66% in those with anti—DNA topoisomerase I (anti—topo I), and 30% in those with anti‐RNA polymerases I, II, and III (anti‐RNAP). Major organ involvement linked to cause of death included biliary cirrhosis in patients with ACA, isolated pulmonary arterial hypertension and cerebral hemorrhage in those with anti—U1 RNP, pulmonary interstitial fibrosis in those with anti—topo I, and cardiac and renal involvement in those with anti‐RNAP.Conclusion. Determinations of serum ANA in SSc patients are useful in predicting organ involvement and long‐term outcome.
Chronicity of The Eosinophilia—Myalgia Syndrome
Authors: Kaufman Lee D. 
Published: February 2007

AbstractObjective. To define the natural history and outcome of eosinophilia—myalgia syndrome (EMS) among a cohort of patients followed up at one center since the onset of their disease.Methods. Fifty‐seven patients with well‐characterized EMS were evaluated prospectively at a university hospital for 21—64 months (mean 36 months).Results. Eighty‐eight percent of the patients continue to have symptomatic disease with >3 clinical manifestations. Fatigue (91%), muscle cramping (75%), myalgia (70%), paresthesias with objectively demonstrated hypesthesias (62%), articular symptoms (54%), scleroderma‐like skin changes (44%), and proximal muscle weakness (40%) are the most common features of chronic EMS. New findings identified among this cohort include cognitive symptoms in 86% of the study group, tremor, and myoclonus.Conclusion. The recognition of new manifestations in EMS and ongoing clinical disease in 88% of patients highlights the chronic nature of this disorder. Continued prospective followup of a large patient base is warranted to further define the natural history of this newly recognized illness.