bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accumulation of advanced glycation end products as a molecular mechanism for aging as a risk factor in osteoarthritis
Authors: DeGroot Jeroen , Verzijl Nicole , Wenting‐Van Wijk Marion J. G. , Jacobs Kim M. G. , Van El Benno , Van Roermund Peter M. , Bank Ruud A. , Bijlsma Johannes W. J. , TeKoppele Johan M. , Lafeber Floris P. J. G. 
Published: April 2004

AbstractObjectiveOsteoarthritis (OA) is one of the most prevalent and disabling chronic conditions affecting the elderly. Its etiology is largely unknown, but age is the most prominent risk factor. The current study was designed to test whether accumulation of advanced glycation end products (AGEs), which are known to adversely affect cartilage turnover and mechanical properties, provides a molecular mechanism by which aging contributes to the development of OA.MethodsThe hypothesis that elevated AGE levels predispose to the development of OA was tested in the canine anterior cruciate ligament transection (ACLT) model of experimental OA. Cartilage AGE levels were enhanced in young dogs by intraarticular injections of ribose. This mimics the accumulation of AGEs without the interference of other age‐related changes. The severity of OA was then assessed 7 weeks after ACLT surgery in dogs with normal versus enhanced AGE levels.ResultsIntraarticular injections of ribose enhanced cartilage AGE levels ∼5‐fold, which is similar to the normal increase that is observed in old dogs. ACLT surgery resulted in more‐pronounced OA in dogs with enhanced AGE levels. This was observed as increased collagen damage and enhanced release of proteoglycans. The attempt to repair the matrix damage was impaired; proteoglycan synthesis and retention were decreased at enhanced AGE levels. Mankin grading of histology sections also revealed more‐severe OA in animals with enhanced AGE levels.ConclusionThese findings demonstrate increased severity of OA at higher cartilage AGE levels and provide the first in vivo experimental evidence for a molecular mechanism by which aging may predispose to the development of OA.
Low‐dose aspirin and prevention of cranial ischemic complications in giant cell arteritis
Authors: Nesher Gideon , Berkun Yaakov , Mates Michal , Baras Mario , Rubinow Alan , Sonnenblick Moshe 
Published: April 2004

AbstractObjectiveCranial ischemic complications such as cerebrovascular accidents (CVAs) and acute visual loss are among the leading causes of giant cell arteritis (GCA)–related morbidity. In this retrospective study, we evaluated the effect of treatment with low‐dose aspirin on the incidence of cranial ischemic complications in GCA.MethodsCharts of 175 consecutive patients in whom GCA was diagnosed between 1980 and 2000 were reviewed for medical data. Data for 166 patients who were followed up for at least 3 months were also available.ResultsAt the time of the diagnosis of GCA, 36 patients (21%) had already been receiving low‐dose aspirin (100 mg/day). In all cases, the indication for this treatment was ischemic heart disease. There were no significant differences between the aspirin‐treated and non–aspirin‐treated groups regarding the mean age of patients, the male‐to‐female ratio, duration of GCA‐related symptoms, rates of headaches, systemic symptoms, and jaw claudication, and the mean erythrocyte sedimentation rate, hemoglobin count, and platelet count. Cerebrovascular risk factors (hypertension, hyperlipidemia, or diabetes mellitus) were more common in the aspirin‐treated group (38.9% versus 20%;P= 0.03). Cranial ischemic complications were diagnosed in 43 patients at presentation: 30 patients had acute visual loss, 11 had CVAs, and 2 had both conditions simultaneously. Only 3 of the aspirin‐treated patients (8%) presented with cranial ischemic complications, compared with 40 (29%) of the non–aspirin‐treated patients (P= 0.01). Despite the use of steroid therapy, cranial ischemic complications developed in 14 of the 166 patients followed up for 3 months or longer. However, cranial ischemic complications developed in only 3% of the aspirin‐treated patients, compared with 13% of the patients treated with prednisone only (P= 0.02).ConclusionThese data suggest that low‐dose aspirin decreases the rate of visual loss and CVAs in patients with GCA.
Reappraisal of the epidemiology of giant cell arteritis in Olmsted County, Minnesota, over a fifty‐year period
Authors: Salvarani Carlo , Crowson Cynthia S. , O'Fallon W. Michael , Hunder Gene G. , Gabriel Sherine E. 
Published: April 2004

AbstractObjectiveTo investigate time trends in the incidence and survival of giant cell arteritis (GCA) over a 50‐year period in Olmsted County, Minnesota.MethodsUsing the unified record system at the Mayo Clinic, we identified all incident cases of GCA first diagnosed between 1950 and 1999. Incidence rates were estimated and adjusted to the 1980 United States white population for age and sex. The annual incidence rates were graphically illustrated using a 3‐year centered moving average. Survival rates were computed and compared with the expected rates in the population.ResultsThere were 173 incident cases of GCA during the 50‐year study period. Of these, 79% were women and the mean age at diagnosis was 74.8 years. The overall age‐ and sex‐adjusted incidence per 100,000 persons 50 years of age or older was 18.8 (95% confidence interval [95% CI] 15.9–21.6). Incidence was higher in women (24.4; 95% CI 20.3–28.6) than in men (10.3; 95% CI 6.9–13.6). Incidence rates increased significantly over the study period (P = 0.017); in particular, a progressive increase was observed from 1950 to 1979; subsequently, no substantial increases in incidence rates were observed. A cyclic pattern of annual incidence rates was apparent, with evidence of 6 peak periods. Survival among individuals with GCA was not significantly different from that expected in the population (P = 0.80).ConclusionsThe incidence of GCA increased over the first 3 decades of the study, then remained stable over the last 20 years. The previously observed cyclic pattern of annual incidence rates was still apparent over a 50‐year period. Overall survival in GCA was similar to that in the population.
The safety and efficacy of leflunomide in combination with infliximab in rheumatoid arthritis
Authors: Hansen K. E. , Cush J. , Singhal A. , A. Cooley D. , Cohen S. , Patel S. R. , Genovese M. , Sundaramurthy S. , Schiff M. 
Published: April 2004

AbstractObjectiveTo report the safety and efficacy of leflunomide (LEF) in combination with infliximab (INF) for the treatment of rheumatoid arthritis.MethodsIn an open, multicenter, retrospective study, data were collected on the safety and efficacy of LEF and INF.ResultsEighty‐eight patients received the combination of LEF and INF for an average of 6.6 months and a total exposure of 581 patient‐months. The mean duration of LEF was 17 ± 9 months (range 3–32 months; median 18.5 months) with an average of 4.8 INF infusions per patient. In all but 3 subjects, LEF was used initially and INF was added later. Infusion reactions occurred in 3 patients (0.7% of all infusions). A total of 34% of subjects experienced adverse events and in 6 (6.8% of the group) these were deemed serious. Ten infections occurred when patients were taking the combination; 9 patients recovered fully and 1 died of bacterial pneumonia. A lifetime smoker developed lung cancer and another patient was found to have colon cancer.ConclusionsThe adverse events noted within the combination therapy group were in keeping with the known risks of each drug when used individually. Limited data were available on efficacy, but a general improvement in disease control was noted with the combination of drugs, which for most patients involved the addition of INF to previous use of LEF.
The influence of peripheral arthritis on disease activity in ankylosing spondylitis patients as measured with the Bath Ankylosing Spondylitis Disease Activity Index
Authors: Heuft‐Dorenbosch Liesbeth , Van Tubergen Astrid , Spoorenberg Anneke , Landewé Robert , Dougados Maxime , Mielants Herman , Van Der Tempel Hille , Van Der Heijde Désirée 
Published: April 2004

AbstractObjectivesTo assess the differences in disease activity as measured by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) between patients with and without peripheral arthritis/enthesitis. To investigate whether scores on the BASDAI change by omitting the 2 questions on peripheral disease.MethodsDisease activity was assessed on a 10‐cm visual analog scale and by BASDAI. Alternative BASDAIs were constructed by omitting the peripheral joints question and/or the enthesitis question. Correlations between the alternative BASDAIs and other measures of disease activity were calculated. Generalized estimating equations (GEE) were used to assess whether having peripheral arthritis influenced BASDAI and alternative BASDAI scores, and to assess whether peripheral arthritis influenced the score of the individual questions of the BASDAI.ResultsAt baseline, the BASDAI was calculated in 214 patients. In patients with peripheral arthritis (n = 56), the mean (SD) BASDAI score was 4.4 (2.3) as compared with 3.1 (1.9) (P < 0.0001) in the patients without peripheral arthritis (n = 158). The relationship between arthritis and the BASDAI score appeared to be truly longitudinal (GEE regression coefficient β = 0.64; 95% confidence interval 0.28–1.00). Peripheral arthritis was significantly longitudinally associated with all separate item scores of the BASDAI. Omitting the peripheral joints and/or enthesitis question from the BASDAI questionnaire only partially explained the difference in BASDAI score between the 2 groups.ConclusionDisease activity measured by the BASDAI is higher in patients with concomitant peripheral disease compared with patients with disease restricted to the axial skeleton. The increased BASDAI score in patients with peripheral arthritis is partially explained by increased overall disease activity as well as by a disproportionate contribution of the peripheral joints question to the overall score.
Positive classic antineutrophil cytoplasmic antibody (C‐ANCA) titer at switch to azathioprine therapy associated with relapse in proteinase 3–related vasculitis
Authors: Slot Marjan C. , Tervaert Jan Willem Cohen , Boomsma Maarten M. , Stegeman Coen A. 
Published: April 2004

AbstractObjectiveTo analyze disease‐free survival in patients with antineutrophil cytoplasmic antibody (ANCA)–associated small‐vessel vasculitis (AAV) treated with cyclophosphamide only or switched to azathioprine after 3 months of full remission while taking cyclophosphamide.MethodsWe analyzed disease‐free survival in all consecutive patients diagnosed with AAV between 1990 and 2000 at our center. Patients were treated with cyclophosphamide only (1990–1996) or switched to azathioprine after 3 months of remission while taking cyclophosphamide (1997–2000). All patients received at least 12 months of followup.ResultsOf the total 128 patients, 53 (41%) relapsed. Forty‐four of the 128 patients (34%) had been switched to azathioprine therapy. Disease‐free survival at 2 and 4 years was 76% and 65% in the cyclophosphamide group compared with 76% and 51% in the azathioprine group. In patients with proteinase 3 (PR3) classic ANCA (C‐ANCA)–associated vasculitis who were switched to azathioprine (n = 33), a positive C‐ANCA titer at the moment of treatment switch (n = 13) was significantly associated with relapse (RR 2.6, 95% confidence interval 1.1–8.0; P = 0.04). In patients with a negative ANCA titer at the time of switch to azathioprine, disease‐free survival at 2 and 4 years was 80% and 62%, which was identical to that for patients treated with cyclophosphamide only. In patients who were ANCA‐positive at the time of treatment switch, disease‐free survival at 2 and 4 years was only 58% and 17%.ConclusionSwitching cyclophosphamide to azathioprine after induction of remission in patients with PR3‐ANCA‐associated vasculitis who are still ANCA‐positive at the time of treatment switch is associated with a high risk of relapse.
Prognosis and quality of life in patients with acute low back pain: Insights from a comprehensive inception cohort study
Authors: Coste Joël , Lefrançois Gérard , Guillemin Francis , Pouchot Jacques ,   For the French Study Group for Quality of Life in Rheumatology
Published: April 2004

AbstractObjectiveTo investigate the respective contribution of various biologic and psychosocial factors, especially initial health‐related quality of life (HRQOL), in the natural history of acute low back pain (LBP) and to evaluate the impact of this condition on HRQOL.MethodsFor 3 months, we assessed 113 patients consulting for nonspecific acute LBP of <72 hours duration at inclusion and treated with acetaminophen. Endpoints included pain, disability assessed by the Roland Disability Questionnaire, and HRQOL assessed by the Short Form 36 health survey (SF‐36).ResultsSeventy‐three percent of patients recovered within 2 weeks and 5% of patients developed chronic LBP. Prior low back surgery, higher initial disability questionnaire score, lower SF‐36 score, and temporary compensation status were independently associated with delayed recovery. The impact of the acute LBP episode on HRQOL was brief and moderate, except for patients with comorbidity, psychiatric disorders, those of foreign origin, unemployed, or with job dissatisfaction. The impact of compensation status, sick leave, and bed rest was more profound and lasting.ConclusionsThis study highlights the large contribution of work‐related factors, but also initial HRQOL, to the prognosis of LBP. It also suggests that LBP impairs HRQOL mainly through compensation and inappropriate medical care, and that, in turn, impaired HRQOL favors the condition becoming chronic. These findings have implications for future research into the management of LBP.
Structural, psychological, and genetic influences on low back and neck pain: A study of adult female twins
Authors: MacGregor Alexander J. , Andrew Toby , Sambrook Philip N. , Spector Tim D. 
Published: April 2004

AbstractObjectiveTo assess genetic and environmental influences on low back and neck pain in a classic twin design and to examine the extent to which these are explained by structural changes seen on magnetic resonance imaging (MRI) and psychological and lifestyle variables.MethodsThe subjects comprised 1,064 unselected women (181 monozygotic [MZ] and 351 dizygotic [DZ] twin pairs) recruited from a national registry of twin volunteers. Outcome measures included lifetime history of low back and neck pain (using a range of increasingly stringent definitions), MRI scores of disc degeneration in the lumbar and cervical spine, psychological distress as assessed by the General Health Questionnaire (GHQ), and lifestyle variables assessed by questionnaire.ResultsFor all definitions of pain, there was a consistent excess concordance in MZ when compared with DZ twins, equating to a heritability for low back pain in the range of 52–68% and for neck pain in the range of 35–58%. The strongest associations were between low back pain and MRI change (odds ratio [OR] 3.6, 95% confidence interval [95% CI] 1.8–7.3]) and between neck pain and response on the GHQ (OR 3.3, 95% CI 2.1–5.0). These associations were mediated genetically.ConclusionsGenetic factors have an important influence on back and neck pain reporting in women. These factors include the genetic determinants of structural disc degeneration and an individual's inherited tendency toward psychological distress. MRI changes are the strongest predictor of low back pain.
Factor V Leiden and prothrombin gene G20210A mutations in Italian patients with Behçet's disease and deep vein thrombosis
Authors: Silingardi Mauro , Salvarani Carlo , Boiardi Luigi , Accardo Pietro , Iorio Alfonso , Olivieri Ignazio , Cantini Fabrizio , Salvi Fabrizio , Corte Renato La , Triolo Giovanni , Ciccia Francesco , Ghirarduzzi Angelo , Filippini Davide , Paolazzi Giuseppe , Iori Ido 
Published: April 2004

AbstractObjectiveTo evaluate the frequency and type of vascular lesions and to study the association of factor V gene G1691A (Leiden) and prothrombin gene G20210A polymorphisms with venous thrombosis in Italian patients with Behçet's disease (BD).MethodsIncluded were 118 consecutive Italian BD patients followed over a 3‐year period (1997–1999) who satisfied the International Study Group criteria for BD. The control group consisted of 132 healthy Italian blood donors. All BD patients and controls were genotyped by polymerase chain reaction and allele‐specific restriction enzyme techniques for factor V Leiden and prothrombin gene G20210A polymorphisms.ResultsVascular lesions were observed in 37 (31.4%) patients. The 2 most common lesions were subcutaneous thrombophlebitis (10.2%) and deep vein thrombosis (DVT) of the legs (22.8%). No significant demographic and clinical differences between patients with and without DVT were present. The distribution of allele and genotype frequencies of prothrombin gene G20210A and factor V Leiden polymorphisms did not differ significantly between BD patients and healthy controls. The frequencies of carriage rates of prothrombin gene G20210A and factor V Leiden polymorphisms in BD patients with and without DVT were similar. However, the frequency of 20210A allele was significantly higher in BD patients with ocular disease than in those without, particularly in the patients with posterior uveitis/retinal vasculitis.ConclusionsThe frequency and types of vascular lesions in Italian BD patients were similar to those reported in studies from other countries. No association between factor V Leiden mutation and G20210A mutation in the 3′‐untranslated region of the prothrombin gene with DVT was found. However, a prothrombin gene G20210A mutation may influence the development and severity of ocular involvement in BD.
“The rheumatologist can see you now”: Successful implementation of an advanced access model in a rheumatology practice
Authors: Newman Eric D. , Harrington Thomas M. , Olenginski Thomas P. , Perruquet James L. , McKinley Karen 
Published: April 2004

AbstractObjectiveTo provide rheumatologic care to patients in a timely and patient‐centered manner.MethodsWe developed and implemented processes to measure and help eliminate backlog, created access time for same‐day patients, and retooled the appointments process to be more efficient and patient focused. In addition, we developed a protocol to be used by our primary care colleagues to care for osteoarthritis of the knee in a standardized manner.ResultsThe third available rheumatology appointment fell from about 60 days to <2 days. Cancellations fell from 40% to <20%. Patient satisfaction measures (composite score, physician score, and accessibility score) improved significantly. The number of new patients seen for knee osteoarthritis decreased by 6.7%, whereas the number of new rheumatoid arthritis referrals increased by 50.4%. Financial performance improved as well.ConclusionsThis advanced access model in a busy academic rheumatology practice demonstrated considerable improvement in access, patient satisfaction, and finances. Using a team approach, we are now able to give the patient the rheumatologic care they want and need at a time they want and need it.
Mycophenolate mofetil for remission maintenance in the treatment of Wegener's granulomatosis
Authors: Langford Carol A. , Talar‐Williams Cheryl , Sneller Michael C. 
Published: April 2004

AbstractObjectiveTo examine the safety of mycophenolate mofetil (MMF) for remission maintenance in patients with Wegener's granulomatosis (WG) who had been treated with daily cyclophosphamide (CYC) and glucocorticoids to induce remission.MethodsFourteen patients were treated for active WG using a standardized regimen of CYC and glucocorticoids for induction of remission and MMF for remission maintenance. Outcome was assessed using predetermined definitions based on clinical characteristics and pathologic, laboratory, and radiographic findings.ResultsRemission occurred in all 14 patients (100%) at a median time of 3 months. The median time to discontinuation of glucocorticoids was 8 months. No patients died during protocol treatment and 6 patients (43%) relapsed at a median of 10 months after achieving remission. MMF was well tolerated and no patients had to be withdrawn as a result of medication toxicity.ConclusionThe use of CYC and glucocorticoids for induction of remission and MMF for remission maintenance was well tolerated, but disease relapses were observed.
History of affective disorder and the experience of fatigue in rheumatoid arthritis
Authors: Jump Rebecca L. , Fifield Judith , Tennen Howard , Reisine Susan , Giuliano Anthony J. 
Published: April 2004

AbstractObjectiveTo evaluate how a prior affective disorder (major depression or generalized anxiety disorder) affects current fatigue among individuals with rheumatoid arthritis (RA). To determine whether that relationship is mediated by self‐efficacy expectations.MethodsForty‐eight RA patients with a prior affective disorder and 74 without a history of affective disorder completed a mailed questionnaire that included the Multidimensional Assessment of Fatigue and indicators of neuroticism and self efficacy.ResultsRA patients with a history of affective disorder reported higher levels of fatigue than those with no previous affective disturbance. Controlling for neuroticism and self efficacy, affective disorder history continued to predict current fatigue. Mediational analyses revealed both direct and indirect effects (via self efficacy) of history of affective disorder on the experience of fatigue in RA.ConclusionHistory of affective disorder independently predicts higher levels of fatigue in RA patients, and self efficacy plays a mediating role in this relationship.
Use of mainstream nonpharmacologic treatment by patients with arthritis
Authors: Li Linda C. , Maetzel Andreas , Pencharz James N. , Maguire Lyn , Bombardier Claire ,   The Community Hypertension and Arthritis Project (CHAP) Team
Published: April 2004

AbstractObjectiveTo examine the use of nonpharmacologic treatment by patients with osteoarthritis (OA) and rheumatoid arthritis (RA).MethodsPatients were recruited from physicians' offices in Ontario, Canada. All participants completed questionnaires that asked about their health status, use of medications and nonpharmacologic treatments, and use of health care resources.ResultsA total of 326 patients with OA and 253 patients with RA completed the survey on the use of nonpharmacologic treatment. Only 73% of patients with OA had been told to use nonpharmacologic modalities, but 98.8% had tried at least 1 type of treatment. About 97% of those with RA had been told to use and had tried at least 1 type of treatment. Most patients continued to use a treatment once they had tried it.ConclusionThe use of nonpharmacologic modalities is common among patients with arthritis. It is important that clinicians address with their patients the appropriate use of and barriers to continuing these treatments.