bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dendritic cell uptake of human apoptotic and necrotic neutrophils inhibits CD40, CD80, and CD86 expression and reduces allogeneic T cell responses: Relevance to systemic vasculitis
Authors: Clayton Abigail R. , Prue Rebecca L. , Harper Lorraine , Drayson Mark T. , Savage Caroline O. S. 
Published: August 2003

AbstractObjectiveThere is a breakdown of tolerance to neutrophil components during systemic vasculitis, which is marked by autoantibodies and T cells with specificity for proteinase 3 or myeloperoxidase, expressed on the surface of apoptotic neutrophils. This study was undertaken to investigate the effects of human apoptotic and necrotic neutrophils on human dendritic cell (DC) phenotype and ability to stimulate allogeneic T cell proliferation.MethodsDCs were generated from human peripheral blood mononuclear cells and allowed to interact with human apoptotic and necrotic neutrophils in the presence or absence of tumor necrosis factor α (TNFα). Effects on DC phenotype and ability to stimulate T cell proliferation were observed.ResultsImmature DCs engulfed apoptotic and necrotic neutrophils, resulting in up‐regulation of CD83 and class II major histocompatibility complex molecules, but down‐regulation of CD40, CD80, and CD86, and a decreased ability to stimulate T cell proliferation. When TNFα was added in combination with apoptotic neutrophils, the inhibitory effects were overcome to some extent.ConclusionOur results suggest that DC uptake of apoptotic or necrotic neutrophils alone does not shift the immune response from tolerance to autoimmunity in systemic vasculitis. However, cytokines found at sites of inflammation in vasculitis patients may act as maturation factors for DCs, and in combination with apoptotic neutrophils, may lead to an autoimmune phenotype.
Bisphosphonate resistance in Paget's disease of bone
Authors: Joshua Fred , Epstein Martin , Major Gabor 
Published: August 2003

AbstractObjectiveTo determine whether resistance to one bisphosphonate predicts resistance to another bisphosphonate.MethodsOne hundred patients with Paget's disease were treated with intravenous (IV) pamidronate. The initial dose was 120 mg, followed by further doses of 240 mg, until either biochemical remission was achieved or a total dose of 1 gm was given. Biochemical remission was defined as an alkaline phosphatase level within the reference range. Patients whose disease failed to respond to pamidronate were then treated with alendronate for 6 months. Patients whose disease failed to respond to alendronate were given either tiludronate for 3 months, or clodronate for 6 months.ResultsSixteen of the 100 patients treated with pamidronate failed to achieve a biochemical response despite a cumulative dose of 1 gm. Of the 16 nonresponders, 1 died of an unrelated cause, and the remaining 15 patients were treated with alendronate. In 2 of these patients, the treatment was changed to another bisphosphonate because of gastrointestinal intolerance to alendronate. Of the remaining 13 patients, 9 (69%) achieved full biochemical remission. In 4 other patients, both pamidronate and alendronate therapy were unsuccessful (1 patient responded to tiludronate, tiludronate therapy was unsuccessful in 1, clodronate was unsuccessful in 1, and 1 patient elected to receive no further treatment). Of the 2 patients who could not receive alendronate because of gastrointestinal intolerance, 1 achieved normalization with tiludronate, and a repeat course of pamidronate was unsuccessful in the other. In total, 73% of patients in whom initial treatment with IV pamidronate was unsuccessful responded to a change in bisphosphonate treatment.ConclusionFailure to achieve biochemical normalization is likely to be specific to the individual drug rather than indicative of bisphosphonate class resistance.
Treatment of rheumatoid arthritis with tumor necrosis factor inhibitors may predispose to significant increase in tuberculosis risk: A multicenter active‐surveillance report
Authors: Gómez‐Reino Juan J. , Carmona Loreto , Valverde Vicente Rodríguez , Mola Emilio Martín , Montero Maria Dolores 
Published: August 2003

AbstractObjectiveThe long‐term safety of therapeutic agents that neutralize tumor necrosis factor (TNF) is uncertain. Recent evidence based on spontaneous reporting shows an association with active tuberculosis (TB). We undertook this study to determine and describe the long‐term safety of 2 of these agents, infliximab and etanercept, in rheumatic diseases based on a national active‐surveillance system following the commercialization of the drugs.MethodsWe analyzed the safety data actively collected in the BIOBADASER (Base de Datos de Productos Biológicos de la Sociedad Española de Reumatología) database, which was launched in February 2000 by the Spanish Society of Rheumatology. For the estimation of TB risk, the annual incidence rate in patients treated with these agents was compared with the background rate and with the rate in a cohort of patients with rheumatoid arthritis (RA) assembled before the era of anti‐TNF treatment.ResultsSeventy‐one participating centers sent data on 1,578 treatments with infliximab (86%) or etanercept (14%) in 1,540 patients. Drug survival rates (reported as the cumulative percentage of patients still receiving medication) for infliximab and etanercept pooled together were 85% and 81% at 1 year and 2 years, respectively. Instances of discontinuation were essentially due to adverse events. Seventeen cases of TB were found in patients treated with infliximab. The estimated incidence of TB associated with infliximab in RA patients was 1,893 per 100,000 in the year 2000 and 1,113 per 100,000 in the year 2001. These findings represent a significant increased risk compared with background rates. In the first 5 months of 2002, after official guidelines were established for TB prevention in patients treated with biologics, only 1 new TB case was registered (in January).ConclusionTherapy with infliximab is associated with an increased risk of active TB. Proper measures are needed to prevent and manage this adverse event.
sE‐selectin for stratifying outcome in rheumatoid arthritis
Authors: Egerer Karl , Hertzer Julia , Feist Eugen , Albrecht Anja , Rudolph Paul Eberhard , Dörner Thomas , Burmester Gerd‐Rüdiger 
Published: August 2003

AbstractObjectivesTo determine the usefulness of sE‐selectin as a marker for early diagnosis and stratification of rheumatoid arthritis.MethodsWe investigated several markers of disease activity, including circulating adhesion molecules and other standard laboratory tests, in a 2–3 year followup analysis of patients with rheumatoid arthritis.ResultsThe mean ± SD levels of sE‐selectin (91.68 ± 31.8 ng/ml versus 49.83 ± 14.76 ng/ml) and rheumatoid factor (375.7 ± 394.4 U versus 44.66 ± 37.63 U) were strongly elevated in severe (n = 15) versus mild (n = 7) courses of disease. Statistical calculation of mean and standard deviation revealed that sE‐selectin represents a highly significant marker for the presence of persistent and aggressive disease over time, regardless of therapeutic intervention and observation time points (P = 0.0004). Notably, regression analysis identified constant values for all parameters analyzed and, therefore, a stable course of the disease could be predicted from the beginning.ConclusionsE‐selectin appears to be a powerful marker to predict the severity of rheumatoid arthritis.
Positive family history of psoriasis does not affect the clinical expression and course of juvenile idiopathic arthritis patients with oligoarthritis
Authors: Tsitsami Elena , Bozzola Elena , Magni‐Manzoni Silvia , Viola Stefania , Pistorio Angela , Ruperto Nicolino , Martini Alberto , Ravelli Angelo 
Published: August 2003

AbstractObjectiveIn the 1997 revision of the International League of Associations for Rheumatology (ILAR) criteria for juvenile idiopathic arthritis (JIA), a family history of psoriasis is an exclusion for the oligoarthritis category. We investigated whether psoriasis in a first or second degree relative influences the clinical expression and course of JIA patients with oligoarthritis.MethodsIn a cross‐sectional study, consecutive oligoarticular‐onset JIA patients were investigated. Clinical evaluations included confirmation of a family history of psoriasis and assessment of nail abnormalities, dactylitis, psoriatic rash, variables of JIA activity, and laboratory indicators of inflammation. Retrospective assessments included sex, onset age, disease duration, antinuclear antibodies, HLA–B27, uveitis, ocular complications, second‐line therapies, intraarticular corticosteroid injections, radiographic joint lesions, joint involvement over time, and laboratory investigations at disease presentation and first observation.ResultsA total of 185 patients were included. Thirty‐three had a positive family history of psoriasis (group 2) and 139 did not (group 1). Thirteen patients fulfilled the ILAR criteria for juvenile psoriatic arthritis (group 3). Patients in groups 1 and 2 were comparable for all parameters, except for a higher frequency of females in group 1 (P = 0.04). As compared with group 2, patients in group 3 were less frequently antinuclear antibody positive and had a more severe arthritis and a different distribution of joint involvement.ConclusionWe found close similarities in the clinical features and course among patients with oligoarthritis who had a positive family history for psoriasis and those who did not. These findings argue against the exclusion of the former patients from the oligoarthritis category of JIA.
Clinical and epidemiologic analysis of giant cell (temporal) arteritis from a nationwide survey in 1998 in Japan: The first government‐supported nationwide survey
Authors: Kobayashi Shigeto , Yano Tetsuro , Matsumoto Yoshifuji , Numano Fujio , Nakajima Nobuyuki , Yasuda Keishu , Yutani Chikao , Nakayama Toshiko , Tamakoshi Akiko , Kawamura Takashi , Ohno Yoshiyuki , Inaba Yutaka , Hashimoto Hiroshi 
Published: August 2003

AbstractObjectiveTo elucidate epidemiologic and clinical manifestations of Japanese patients with giant cell arteritis (GCA), the first nationwide survey for GCA was conducted in 1998 in Japan.MethodsThe first questionnaire on GCA for patients treated in 1997 was sent to 10,717 medical departments in Japan. A total of 177 patients were reported. Among the 177 patients, 66 GCA patients with detailed clinical and epidemiologic features on second survey were analyzed.ResultsPrevalence in patients 50 years of age and older in 1997 was 1.47 per 100,000 population in Japan. The average age at onset was 71.5 years old. The male:female ratio was 1:1.7. The association with permanent and complete visual loss (6.5%), jaw claudication (15.2%), and polymyalgia rheumatica (PMR) (30.3%) were low in frequency compared with those reported from other countries. All patients were treated with corticosteroids. Only 3 (4.5%) patients were reported as deceased due to other causes.ConclusionThe prevalence of GCA in Japan was revealed to be extremely low compared with other countries. Clinical findings of permanent and complete visual loss, jaw claudication, and PMR were infrequent among Japanese patients with GCA.
The relationship between self‐report and performance‐related measures: Questioning the content validity of timed tests
Authors: Stratford Paul W. , Kennedy Deborah , Pagura Sonia M. C. , Gollish Jeffrey D. 
Published: August 2003

AbstractObjectiveTo examine the determinants of the modest correlation between self‐report and performance‐related measures in patients with osteoarthritis of the hip or knee.MethodsMeasures included the Lower Extremity Functional Scale (LEFS), the self paced walk, timed up‐and‐go, and stair test. Each performance measure consisted of 3 domains: time, pain (visual analog scale), and exertion (Borg scale). Activity specificity was assessed by examining correlations between the LEFS with single activity and multiple activity time scores. Domain specificity was examined by comparing correlations between the LEFS and single and multiple domain scores. The impact of measurement error was considered.ResultsIncreasing the number of activity time scores had no effect. Forming a composite performance score based on time, pain, and exertion substantially increased the correlation from 0.44 (composite timed score) to 0.59 (pooled domain and activity score) (P = 0.009).ConclusionPerformance scores based on time alone appear to inadequately represent the breadth of health concepts associated with functional status.
Physical function and health‐related quality of life of Spanish patients with ankylosing spondylitis
Authors: Ariza‐Ariza Rafael , Hernández‐Cruz Blanca , Navarro‐Sarabia Federico 
Published: August 2003

AbstractObjectiveTo determine the physical function and the quality of life (QOL) of Spanish patients with ankylosing spondylitis (AS), and to study the reliability of the Spanish version of the Bath Ankylosing Spondylitis Functional Index (BASFI).MethodsClinimetric variables, including Spanish BASFI (test‐retest), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), QOL instruments (Short Form 36 [SF‐36] and European Quality of Life Questionnaire [EuroQol]), Bath Ankylosing Spondylitis Metrology Index (BASMI), and chest expansion, were assessed.ResultsA total of 92 patients were included: 69 males (75%), age (mean ± SD) 40.7 ± 9.1 years, and disease duration 11 ± 7.8 years. The scores (mean ± SD) were (from 0 the best to 10 the worst): BASFI 4.3 ± 2.4; BASDAI 4.5 ± 2.2; global SF‐36 5.5 ± 2.1; SF‐36 physical function 3.8 ± 2.5; SF‐36 physical scale 4.9 ± 2.7; SF‐36 mental scale 3.7 ± 2.7; SF‐36 physical role limitations 5.6 ± 4.4; SF‐36 general health 5.5 ± 2.1; SF‐36 pain 5.4 ±2.8; SF‐36 vitality 5.1 ± 2; EuroQoL rating scale 3.9±2.1; EuroQol health profile (from 0 the best to 2 the worst) 0.6 ± 0.4; and BASMI 4.7 ± 1.6. Significant association was found between BASFI and SF‐36 physical function domain (r = 0.75, R2 = 0.56, P < 0.0001). BASFI Cronbach's alpha was 0.92, Spearman's rho = 0.91, P < 0.0001.ConclusionsPhysical function and QOL are deteriorated in AS. The physical domain is more impaired than the mental one. The SF‐36 and the health profile of the EuroQol may be used as generic instruments to measure health‐related QOL. Spanish BASFI index is a reliable instrument.
Socioeconomic impact of osteoarthritis in Hong Kong: Utilization of health and social services, and direct and indirect costs
Authors: Woo Jean , Lau Edith , Lau Chak Sing , Lee Polly , Zhang James , Kwok Timothy , Chan Cynthia , Chiu P. , Chan Kai Ming , Chan A. , Lam D. 
Published: August 2003

AbstractObjectiveTo determine the direct and indirect cost of osteoarthritis (OA) according to disease severity, and to estimate the total cost of the disease in Hong Kong.MethodsThis study is a retrospective, cross‐sectional, nonrandom, cohort design, with subjects stratified according to disease severity based on functional limitation and the presence or absence of joint prosthesis. Subjects were recruited from primary care, geriatric medicine, rheumatology, and orthopedic clinics. There were 219 patients in the mild disease category, 290 patients in the severe category, and 65 patients with joint replacement. A questionnaire gathered information on demographic and socioeconomic characteristics, function limitation, use of health and social services, and effect on occupation and living arrangements over the previous 12 months. Costs were calculated as direct and indirect.ResultsLow education and socioeconomic class were associated with more severe disease. OA affected family or close relationships in 44%. The average cost incurred as a result of side effects of medication is similar to the average cost of medication itself. Excluding joint replacement, the direct costs ranged from Hong Kong (HK) dollar $11,690 to $40,180 per person per year and indirect costs, HK $3,300–$6,640. The direct costs are comparable to those reported in Western countries; however, the ratio of direct to indirect costs is much higher than 1, in contrast to the greater indirect versus direct costs reported in whites. The total cost expressed as a percentage of gross national product is also much lower in Hong Kong.ConclusionsThe socioeconomic impact of OA in the Hong Kong population is comparable to Western countries, but the economic burden is largely placed on the government, with patients having relatively low out‐of‐pocket expenditures.
Treatment of primary sjögren's syndrome with low‐dose human interferon alfa administered by the oromucosal route: Combined phase III results
Authors: Cummins Martin J. , Papas Athena , Kammer Gary M. , Fox Philip C. 
Published: August 2003

AbstractObjectiveThis study tested the safety and efficacy of human interferon (IFN) alfa for treatment of salivary hypofunction and dry mouth symptoms in primary Sjögren's syndrome patients.MethodsCombined results are reported from 2 phase III clinical trials in which a total of 497 subjects with primary Sjögren's syndrome received 150 international units of human IFN alfa or matching placebo 3 times per day for 24 weeks by the oromucosal route.ResultsSubjects given IFN alfa had a significantly (P = 0.01) greater mean increase in unstimulated whole saliva (UWS) flow, compared with subjects given placebo. In IFN alfa patients, increases in UWS correlated positively and significantly with improvements noted in 7 of 8 symptoms associated with oral and ocular dryness. The coprimary endpoints of stimulated whole saliva flow and oral dryness were not significantly improved in the IFN alfa group relative to placebo. No significant differences were found between the groups with respect to overall adverse event incidence or severity.ConclusionIFN alfa given at low dosage by the oromucosal route can significantly increase UWS flow in patients with primary Sjögren's syndrome, without causing significant adverse events.
Impact of socioeconomic status on the course of rheumatoid arthritis and on related use of health care services
Authors: Jacobi Catharina E. , Mol Geert D. , Boshuizen Hendriek C. , Rupp Ines , Dinant Huibert J. , Van den Bos Geertrudis A. M. 
Published: August 2003

AbstractObjectiveTo quantify the impact of socioeconomic status (SES) among patients with rheumatoid arthritis on 1) health outcomes and related health care utilization in relation to disease duration and 2) changes in health outcomes and related health care utilization over a 2‐year period.MethodsA questionnaire survey was conducted among 878 patients with rheumatoid arthritis (RA), varying in disease duration from 0 to more than 15 years. To determine the impact of SES on the health outcomes and health care use, patients were compared within and between 3 disease duration groups. Additionally, longitudinal changes in health outcomes and health care use were assessed with a followup questionnaire sent out 2 years later.ResultsPatients with low SES have worse disease activity, physical health, mental health, and quality of life than patients with high SES. These differences, however, decreased over time. Regarding health care use, we found that patients with low SES made considerably less use of allied health care than patients with high SES.ConclusionEfforts should be undertaken in health care to alleviate the health disadvantages of RA patients in lower socioeconomic groups. In particular, the access to allied health care could be improved.
Predicting the onset of forearm pain: A prospective study across 12 occupational groups
Authors: Nahit Elizabeth S. , Taylor Stewart , Hunt Isabelle M. , Silman Alan J. , Macfarlane Gary J. 
Published: August 2003

AbstractObjectiveTo determine, among workers free of forearm pain, the role of mechanical and psychosocial factors in predicting future onset.MethodsA prospective cohort study was conducted among 782 newly employed workers from 12 occupational groups. At baseline, a cohort of 782 workers free of forearm pain was identified and measurement was made about physical and psychosocial aspects of their job and working environment. Subjects were recontacted after 1 year to determine new onsets of forearm pain. A sample of those reporting new onset forearm pain underwent a structured examination of the upper limb.ResultsOne year after baseline, 666 (85%) subjects were followed up. The overall prevalence of new onset forearm pain was 8.3% (n = 55). The strongest mechanical risk factor was frequent repetitive movements of the arm or wrist (odds ratio [OR] 2.9, 95% confidence interval [95% CI] 1.6–5.2). The strongest psychosocial risk factors were work considered monotonous at least half of the time (OR 3.0, 95% CI 1.6–5.7) or work with little autonomy (OR 2.6, 95% CI 1.1–6.1). Three specific independent risk factors (monotonous work, repetitive wrist movement, working with hands above shoulder level) could distinguish groups of subjects at substantially different risks of onset.ConclusionsAlong with repetitive movements of the arms and wrists, mechanical postural factors and psychosocial factors also are important risk factors for onset of forearm pain. Our study emphasizes the multifactorial nature of risks for onset of forearm pain, and provides leads as to possible mechanisms for prevention.
Assessment of depression in rheumatoid arthritis: A modified version of the center for epidemiologic studies depression scale
Authors: Martens Matthew P. , Parker Jerry C. , Smarr Karen L. , Hewett James E. , Slaughter James R. , Walker Sara E. 
Published: August 2003

AbstractObjectiveThe Center for Epidemiologic Studies Depression Scale (CES‐D) is an instrument commonly used to assess depressive symptoms. Although the psychometric properties of the instrument are well established, the instrument's ability to identify confirmed cases of major depression has been unclear. The purpose of this study was to evaluate the ability of cutoff scores from both a full scale and a modified CES‐D to detect major depression in people with rheumatoid arthritis (RA).MethodData were analyzed from 457 persons with RA, including 91 who met criteria for major depression.ResultsResults indicated that, in general, a full scale cutoff score of 19 was the most efficient in identifying cases of major depression; the cutoff score of 19 outperformed a variety of other cutoff scores from the modified scale. Even the most efficient cutoff scores, however, demonstrated problems in accurately identifying people with depression.ConclusionThe CES‐D, while potentially useful as a screening tool, should not be used to identify cases of major depression.