Bibliography September2001
- BRUNNER HI, KIM KN, BALLINGER SH, BOWYER SL, GRIFFIN TA, HIGGINS GC, MIER R, PASSO MH, RENNEBOHM R, SCHIKLER K, LOVELL DJ: Current medication choices in Juvenile Rheumatoid Arthritis II - Update of a survey performed in 1993. Journal of Clinical Rheumatology 2001, 7:295-300.
Organism:Dr. H.I. Brunner, Children's Hosp. Med. Ctr.-PAV 2-129, William S. Rowe Div. of Rheumatology, 3333 Burnet Avenue, Cincinnati, OH 45229
Abstract: The documentation of treatments used for Juvenile Rheumatoid Arthritis (JRA) is important to allow for the evaluation of practice patterns for future outcome studies. A survey of nine pediatric rheumatologists was performed between September 1999 and February 2000. Each of the physicians prospectively recorded demographic and treatment information on consecutively sampled JRA patients (n=395). Pauciarticular onset JRA was present in 46%, polyarticular onset JRA in 35%, and systemic onset JRA in 19% of the children. Naproxen was the most frequently prescribed medication (55% of the patients), followed by methotrexate (MTX), which was used in 39% of the patients. Folic acid supplementation (1 mg/day) was provided to 69% of the patients treated with MTX. Etanercept was used in 11% of the children. Eleven percent of the patients received corticosteroids, and 13% of children on corticosteroids took calcium supplements. Uveitis was present in 8% and had a chronic course in 79% of those cases. Although systemic medications were used in 50% of the children with uveitis to control eye inflammation, severe damage to the eyes developed in 30% of them. Fourteen percent of the patients required gastroprotective medications. Compared with findings of a similar survey performed in 1993, there was no significant change in the frequency of use of naproxen, but nabumetone is now more often prescribed, and COX-2 inhibitors have been introduced in the therapy of JRA. Changes among second-line agents used for JRA have also occurred, although there was no change in the frequency of use of MTX or corticosteroids. JRA continues to be a treatment challenge for the practicing pediatric rheumatologist. Patients often show incomplete response to the currently available medications. Therefore, new therapeutic agents need to be evaluated for their use in JRA, and the treatment of JRA associated uveitis especially needs to be improved
Internet : brus9z@chmcc.org - BUCKWAY CK, ROSENFELD RG: Should we use growth hormone to treat genetic syndromes? Journal of Investigative Medicine 2000, 48:8A
Organism:Department of Pediatrics, Oregon Health Sciences University, Portland, OR USA - DE B, I, MEAZZA C, OLIVERI M, PIGNATTI P, VIVARELLI M, ALONZI T, FATTORI E, GARRONE S, BARRECA A, MARTINI A: Effect of IL-6 on IGF binding protein-3: A study in IL-6 transgenic mice and in patients with systemic juvenile idiopathic arthritis. Endocrinology 2001, 142:4818-4826.
Organism:Dr. A. Martini, Inst. Ric./Cura Ca. Sci. San Matteo, Universita degli Studi di Pavia, Piazzale Golgi 2, 27100 Pavia
Abstract: Stunted growth is a common complication of childhood diseases characterized by chronic inflammation or infections. We previously demonstrated that NSE/hIL-6 transgenic mice, overexpressing the inflammatory cytokine IL-6 since early phase of life, showed a marked growth defect associated with decreased IGF-I levels, suggesting that IL-6 is one of the factors involved in stunted growth complicating chronic inflammation in childhood. Here we show that NSE/hIL-6 mice have normal liver IGF-I production, decreased levels of IGF binding protein-3 (IGFBP-3) and increased serum IGFBP-3 proteolysis. Reduced IGFBP-3 levels results in a marked decrease in the circulating 150-kDa ternary complex, even in the presence of normally functional acid labile subunit. Pharmacokinetic studies showed that NSE/hIL-6 mice have accelerated IGF-I clearance. Patients with systemic juvenile idiopathic arthritis (s-JIA), a chronic inflammatory disease characterized by prominent IL-6 production and complicated by stunted growth associated with low IGF-I levels, have markedly decreased IGFBP-3 levels, increased serum IGFBP-3 proteolysis and normal acid labile subunit levels. Our data show that chronic overproduction of IL-6 causes decreased IGFBP-3 levels, resulting in a decreased association of IGF-I in the 150-kDa complex. Decreased levels of IGF-I appear to be secondary to increased clearance
Internet : amartini@smatteo.pv.it - DORIA AS, KISS MH, SALLUM AM, LOTITO AP, NAKA EN, CASTRO CC, CERRI GG: Correlation between osteochondral changes depicted by magnetic resonance imaging and disease progression. Rev.Hosp.Clin.Fac.Med.Sao Paulo 2001, 56:107-114.
Organism:Hospital das Clinicas, Faculty of Medicine, University of Sao Paulo
Abstract: PURPOSE: To determine the consequences of the chronic use of systemic corticosteroids in children with juvenile rheumatoid arthritis by means of evaluating osteochondral effects depicted by magnetic resonance imaging. PATIENTS AND METHODS: We reviewed clinical and magnetic resonance imaging findings in 69 children (72 knees) with juvenile rheumatoid arthritis. Two groups were studied. Group I: 34 (49.3%) children had previous or current use of systemic corticotherapy (22 girls; 12 boys; mean age: 11.3 years; mean disease duration: 5.9 years; mean corticotherapy duration: 2.9 years; mean cumulative dose of previous corticosteroids: 5000 mg); Group II: 35 (50.7%) children had no previous use of corticosteroids (27 girls; 8 boys; mean age: 11.7 years; mean disease duration: 5.3 years). The groups were compared statistically. RESULTS: In the group that had received corticotherapy (Group I), osteochondral abnormalities were significantly correlated to long-standing disease (>3.5 years; p<0.001). This correlation was not found in the group that had no previous history of corticotherapy (Group II). No correlations were established between median dose of corticosteroids and magnetic resonance imaging findings. CONCLUSION: It is important to further investigate the long-term intra-articular effects of systemic corticotherapy to ensure that the side effects of the aggressive therapy will not be more harmful for the joints than the symptoms suffered over the natural course of the disease
Internet : PM:11717717 - FURST DE, KEYSTONE EC, BREEDVELD FC, KALDEN JR, SMOLEN JS, ANTONI CE, BURMESTER GR, CROFFORD LJ, KAVANAUGH A: Updated consensus statement on tumour necrosis factor blocking agents for the treatment of rheumatoid arthritis and other rheumatic diseases (April 2001). Annals of the Rheumatic Diseases 2001, 60:iii2-iii5
Organism:Virginia Mason Research Centre, 1201 9th Avenue, Mailstop R1-RHE, Seattle, WA, 98101 USA - HAAPASAARI J, MAENPAA H, BELT EA: Stress fracture of the talar dome. Journal of developmental and behavioral.pediatrics 2001, 20:385-386.
Organism:Rheumatism Foundation Hospital, Heinola Finland - KOTANIEMI K, KAUTIAINEN H, KARMA A, AHO K: Occurrence of uveitis in recently diagnosed juvenile chronic arthritis : A prospective study. Ophthalmology 2001, 108:2071-2075.
Organism:Rheumatism Foundation Hospital, Heinola, Finland Department of Ophthalmology, Helsinki University Hospital, Helsinki, Finland National Public Health Institute, Helsinki, Finland
Abstract: OBJECTIVE: To examine the occurrence and characteristics of uveitis in patients with recently diagnosed juvenile chronic arthritis (JCA). DESIGN: A prospective observational case series. PARTICIPANTS/METHODS: The study covered the new cases detected with JCA (426 children), all of whom were referred to an ophthalmologic consultation during 1989 to 1996 at the Pediatric Department of the Rheumatism Foundation Hospital, Heinola, Finland. MAIN OUTCOME MEASURES: The children with JCA were followed by ophthalmologic and pediatric examinations two to four times a year. The type and course of arthritis and presentation and characteristics of uveitis were examined prospectively. RESULTS: Uveitis was detected in 104 of 426 children (24%). Two thirds of all patients and the same proportion of those with uveitis were girls. Proportionally, uveitis was found to be as common among children with oligoarthritis (27%) as among those with seronegative polyarthritis (25%). Antinuclear antibodies (ANA) were detected significantly more frequently in patients with uveitis (66%) than among those without uveitis (37%) (P < 0.001). The uveitis was asymptomatic in 99 cases; only 5 children had episodes of acute anterior symptomatic uveitis. Uveitis was found before or within 3 months from the onset of recent arthritis in 51 of 104 children (49%) and later on in 53 of 104 children (51%). The mean age at diagnosis of uveitis was 5.9 years (range, 1.1-17.7; median, 4.9 years). The mean period from the diagnosis of JCA to the diagnosis of uveitis was 1.1 years (range, -2.4-6.5; median, 0.3 years). The mean age at diagnosis of JCA was 4.8 years (range, 0.6-15; median, 3.2 years) among those with uveitis and 7.3 years (range, 0.9-16; median, 6.7 years) among those who did not have it (P < 0.001). Uveitis was ongoing in 63 children at the end of the follow-up period. The mean follow-up time was 4.5 years (range, 0-9.7) for all children and 5.6 years (range, 1.3-9.6) for those with uveitis. In most instances, the visual prognosis was good. In 25 of 104 patients (24%) one or more complications of uveitis were found, but in only three children did the visual acuity decrease to 20/60 or less, and none became blind. All the other patients had visual acuity >/= 20/40. CONCLUSIONS: In this patient group, uveitis in JCA frequently appeared very early after the onset of arthritis. The uveitis was significantly more common in patients with an early onset of arthritis combined with ANA positivity. The proportion of children with uveitis was as large in those with polyarthritis as in those with oligoarthritis, with no predilection to girls
Internet : PM:11713082 - KRUMREY-LANGKAMMERER M, HAFNER R: Evaluation of the ILAR criteria for juvenile idiopathic arthritis. J.Rheumatol. 2001, 28:2544-2547.
Organism:Pediatric Rheumatology Hospital Garmisch-Partenkirchen, Germany
Abstract: OBJECTIVE: A pediatric rheumatology committee of ILAR has proposed new classification criteria for chronic childhood arthritis. The umbrella term "juvenile idiopathic arthritis (JIA)" was chosen and the disease was subdivided into 7 categories. Evaluation for these criteria is under way. METHODS: We analyzed data of 200 consecutive children with rheumatic diseases. RESULTS: In total 172 patients fulfilled criteria for JIA. Twenty-seven of these (15.7%) had to be grouped into the category "other arthritis": 16 met criteria for 2 categories; the other 11 did not fit into any category. CONCLUSION: We suggest minor changes in the classification in order to classify 24 of these 27 patients into one of the specific categories without losing the claim for homogeneity in the different patient groups. Among the 44 patients with rheumatoid factor negative polyarthritis, 26 resembled oligoarthritis, with an extended oligoarticular joint pattern of 5 to 8 involved joints within the first 6 months. 18 had positive antinuclear antibodies, and 7 chronic uveitis. For these patients the introduction of a separate category "extended oligoarthritis at onset" should be considered to establish comparable patient groups
Internet : PM:11708431 - LAIHO K, KOTILAINEN P: Septic arthritis due to Prevotella bivia after intra-articular hip joint injection [1]. Joint Bone Spine 2001, 68:443-444.
Organism:K. Laiho, Rheumatism Foundation Hospital, 1812 Heinola - LAIHO K, KAUPPI M, SAVOLAINEN A, BELT EA: The cervical spine in mutilant juvenile chronic arthritis. Joint Bone Spine 2001, 68:425-429.
Organism:K. Laiho, Rheumatism Foundation Hospital, FIN-18120 Heinola
Abstract: Objective. To describe inflammatory cervical spine disorders in juvenile chronic arthritis (JCA) patients with arthritis mutilans (AM) hand deformity. Methods. The series consisted of 18 patients affected by AM hand deformity who fulfilled the European League of Associations for Rheumatology criteria for JCA. The patient records and the most recent cervical spine radiographs were evaluated for subluxations, atlantoaxial impaction (AAI) and apophyseal joint ankylosis. Results. Seventeen (94%) patients had subluxation, AAI or apophyseal joint ankylosis in the cervical spine. Apophyseal joint ankylosis was noted in 12 (67%) patients and AAI in 10 (56%). Anterior atlantoaxial subluxation was detected in five (28%) patients. Conclusion. Almost all of the JCA patients with AM hand deformity evinced some inflammatory changes in the cervical spine. Apophyseal joint ankylosis, AAI and multiplicity of changes in cervical spine may be considered characteristic in this subset of JCA patients. Patients with JCA and AM hand deformity tend to have severe changes also in the cervical spine. (c) 2001 Editions scientifiques et medicales Elsevier SAS
Internet : kari@laiho.as - MAENPAA H, SAVOLAINEN A, LEHTO MUK, BELT EA: Multiple stress fractures in a young girl with chronic idiopathic arthritis. Extended case report. Joint Bone Spine 2001, 68:438-442.
Organism:H. Maenpaa, Department of Orthopaedics, Rheumatism Foundation Hospital, FIN-18120 Heinola
Abstract: The occurrence of stress fractures in patients with long-standing rheumatoid arthritis (RA) is widely known. Osteoporosis, corticosteroid therapy, joint stiffness, contracture, angular deformity of the joint and failed joint reconstruction - all together or separately - predispose to bone loss and stress fractures. In the present report we describe the history of a girl with juvenile idiopathic arthritis (JIA) having multiple stress fractures. The relationship between corticosteroid therapy and immobilisation in the treatment of fractures is discussed. (c) 2001 Editions scientifiques et medicales Elsevier SAS
Internet : heikki.maenpaa@scanpoint.fi - MCGEER PL, MCGEER EG: Polymorphisms in inflammatory genes and the risk of Alzheimer disease. Arch.Neurol. 2001, 58:1790-1792.
Organism:Department of Psychiatry, University of British Columbia, Vancouver, Canada mcgeerpl@interchangeubcca
Abstract: The concept of inflammation as a major factor in Alzheimer disease (AD) has heretofore been based on postmortem findings of autodestructive changes associated with the lesions coupled with epidemiological evidence of a protective effect of anti-inflammatory agents. Now there is evidence that the risk of AD is substantially influenced by a total of 10 polymorphisms in the inflammatory agents interleukin 1alpha, interleukin 1beta, interleukin 6, tumor necrosis factor alpha, alpha(2)-macroglobulin, and alpha(1)-antichymotrypsin. The polymorphisms are all common ones in the general population, so there is a strong likelihood that any given individual will inherit 1 or more of the high-risk alleles. The overall chances of an individual developing AD might be profoundly affected by a "susceptibility profile" reflecting the combined influence of inheriting multiple high-risk alleles. Since some of the polymorphisms in question have already been linked to peripheral inflammatory disorders, such as juvenile rheumatoid arthritis, myasthenia gravis, and periodontitis, associations between AD and several chronic degenerative diseases may eventually be demonstrated. Such information could lead to strategies for therapeutic intervention in the early stages of such disorders
Internet : PM:11708985 - ROSENZWEIG SD, RUSSO RA, GALLEGO M, ZELAZKO M: Juvenile rheumatoid arthritis-like polyarthritis in Nijmegen breakage syndrome. J.Rheumatol. 2001, 28:2548-2550.
Organism:Servicio de Inmunologia, Hospital Nacional de Pediatria JP Garrahan, Buenos Aires, Argentina rosenzweig66@hotmailcom
Abstract: Nijmegen breakage syndrome (NBS) is a rare autosomal recessive disease (8q21) from the family of the genetically determined chromosomal instability syndromes. The disorder is characterized by microcephaly, growth retardation, immunodeficiency, and high incidence of cancer. Several noninflammatory anomalies of the musculoskeletal system have been described in patients with this syndrome. We describe an Argentinian girl with all the clinical, immunological, and cytogenic characteristics described for NBS plus a juvenile rheumatoid arthritis-like syndrome. To our knowledge this is the first report of a patient with the NBS who presented with a symmetric chronic polyarthritis resembling JRA
Internet : PM:11708432 - SICOTTE NL, VOSKUHL RR: Onset of multiple sclerosis associated with anti-TNF therapy. Neurology 2001, 57:1885-1888.
Organism:Division of Brain Mapping (Dr Sicotte), Department of Neurology (Drs Sicotte and Voskuhl), UCLA School of Medicine, Los Angeles, CA
Abstract: Therapies aimed at inhibiting tumor necrosis factor (TNF), a proinflammatory cytokine implicated in autoimmune disease are effective, especially for rheumatoid arthritis. We report a patient with new onset MS closely associated with the initiation of anti-TNF therapy for juvenile rheumatoid arthritis. It is possible that the inhibition of TNF triggered MS in this individual
Internet : PM:11723281 - STECHOVA K, VAVR c, REITZOVA H, CHUDOBA D, ZIMAK J, HROMADNIKOVA I: In vitro autoreactivity against skin in rheumatoid arthritis: Are peripheral blood mononuclear cells of patients with rheumatoid arthritis able to lyze autologous keratinocytes? Clinical and Experimental Medicine 2001, 1:71-74.
Organism:K. S(caron)techova, 2nd Department of Pediatrics, University Hospital Motol in Prague, V Uvalu 84, Prague 5 - Motol 15006
Abstract: An in vitro skin explant model was originally developed to predict the occurrence and severity of acute graft-versus-host disease in allogeneic hematopoietic stem cell transplants. In previous studies we reported that peripheral blood mononuclear cells of patients with rheumatoid arthritis were able to induce graft-versus-host-like histopathological changes when co-cultured in vitro with autologous skin explants. The aim of the present study was to verify if observed skin damage was really of autoimmune origin. Using a SUP51chromium release cytotoxic assay we found that peripheral blood mononuclear cells of patients lyzed autologous keratinocytes (n=5 patients with rheumatoid arthritis) but not autologous lymphoblasts (n=4 with rheumatoid arthritis, n=8 patients with juvenile idiopathic arthritis). No specific lysis of keratinocytes or lymphoblasts was observed in healthy controls (n=15). We hypothesize that autologous peripheral blood mononuclear cells might recognize similar autoantigen(s) expressed on epidermal cells, which gives rise to an autoimmune response in the synovium
Internet : katerina.stechova@lfmotol.cuni.cz - STEPHAN JL, KONE-PAUT I, GALAMBRUN C, MOUY R, BADER-MEUNIER B, PRIEUR AM: Reactive haemophagocytic syndrome in children with inflammatory disorders. A retrospective study of 24 patients. Rheumatology (Oxford) 2001, 40:1285-1292.
Organism:Unite d'Hematologie et d'Oncologie Pediatriques, Hotel Dieu, Clermont-Ferrand, Service de Pediatrie, Hopital Nord, Marseille, France
Abstract: BACKGROUND: The reactive haemophagocytic syndrome (RHS) is a little-known life-threatening complication of rheumatic diseases in children. It reflects the extreme vulnerability of these patients, especially those with systemic-onset juvenile chronic arthritis (JCA). This immunohaematological process may be triggered by events such as herpes virus infection and non-steroidal anti-inflammatory drug therapy. Treatment has not been standardized. METHODS: We characterized this unusual disorder and determined its incidence by carrying out a retrospective study of patients identified over a 10-yr period in French paediatric units. RESULTS: Twenty-four cases (nine males, 15 females) were studied. Eighteen had typical systemic-onset JCA, two had polyarthritis, two had lupus and two had unclassifiable disorders. Clinical features at diagnosis included high spiking fever (24 patients), enlargement of the liver and spleen (14), haemorrhagic diathesis (six), pulmonary involvement (12) and neurological abnormalities (coma or seizures) (12). RHS was the first manifestation of systemic disease in three cases. Admission to intensive care was required in ten cases. Hypofibrinogenaemia, elevated liver enzymes and hypertriglyceridaemia were found consistently. Phagocytic histiocytes were found in 14 of 17 bone marrow smears. RHS was presumed to have been precipitated by infection in 11 cases (four Epstein-Barr virus, three varicella-zoster virus, one parvovirus B19, one Coxsackie virus, one Salmonella, one Pneumocystis carinii) and by the introduction of medication in three cases (Salazopyrin plus methotrexate; morniflumate; aspirin). Macrophage activation was indicated by high levels of monokines in the serum of two patients. Twenty patients had only one episode, three had an early relapse and one patient had two relapses. The treatment regimen was tailored to each child as the clinical course was variable. There was no response to intravenous immunoglobulins, which were used in four cases. Intravenous steroids at doses ranging from conventional to pulse methylprednisolone induced remission in 15 of 21 episodes when used alone as the first-line treatment. Cyclosporin A was consistently and rapidly effective, both when used as second-line therapy in all seven of the episodes in which steroids failed and in all five patients who received it as their first-line treatment. This supports a central role of T lymphocytes in the haemophagocytic syndrome. Two patients died. One patient with lupus died of congestive fulminant heart failure after 4 days, despite treatment with intravenous steroids and immunoglobulins, and one patient with systemic-onset JCA died from multiorgan failure despite aggressive therapy with pulsed steroids and etoposide. CONCLUSIONS: RHS may be a more common complication of systemic disease in childhood than previously thought. This life-threatening complication should be diagnosed promptly, as it calls for the immediate withdrawal of potentially triggering medications, anti-infective therapy when relevant, and urgent immunosuppressive treatment, measures that are very often effective. Cyclosporin A may be the drug of choice
Internet : PM:11709613 - SULLIVAN KM, PARKMAN R, WALTERS MC: Bone Marrow Transplantation for Non-Malignant Disease. Hematology.(Am.Soc.Hematol.Educ.Program.) 2000, 319-338.
Abstract: This article reviews the experience in hematopoietic stem cell transplantation (HSCT) for non-malignant disease. HSCT has long been applied as treatment of life-threatening congenital immunodeficiency and metabolic diseases. In Section I, Dr. Parkman reviews that experience for severe combined immunodeficiency, Wiscott-Aldrich syndrome, hyper IGM syndrome, Chediak-Higashi disease and hereditary lymphohistiocytosis. The value of HSCT in genetic metabolic diseases such as osteopetrosis, osteogenesis imperfecta and the storage diseases are reviewed. In Section II, Dr. Walters reviews the experience over the last decade with allogeneic stem cell transplantation in patients with thalassemia major and sickle cell disease. In Section III, Dr. Sullivan reviews the more recent investigations using stem cell transplantation in patients with advanced autoimmune diseases such as systemic sclerosis, systemic lupus erythematosus, multiple sclerosis and juvenile rheumatoid arthritis. The pathogenesis and outcome with conventional care of these patients, the selection criteria and current results for HSCT, and the future directions in clinical research and patient care using this modality are addressed
Internet : PM:11701549 - TAKKEN T, VAN DER NJ, HELDERS &NA, &, PJM &NA, &: Methotrexate for treating juvenile idiopathic arthritis (Cochrane Review). Cochrane.Database.Syst.Rev. 2001, 4:CD003129
Organism:Department of Pediatric Physical Therapy, University Medical Center Utrecht, Room Kb 020560, POBox 85090, Utrecht, NETHERLANDS, 3508 AB ttakken@wkzazunl
Abstract: BACKGROUND: In both adult rheumatoid arthritis (RA) and juvenile arthritis, the focus has shifted from 'inflammation parameters' to more patient centered disability outcomes. In RA this resulted in the development of the Outcome Measures in Arthritis Clinical Trials (OMERACT), and in juvenile arthritis the Pediatric Rheumatology International Trials Organization (PRINTO) core set. This PRINTO-core set was established using a combination of statistical and consensus formation techniques. This core set contains a number of patient centered disability measures. This review systematically searched the available literature and reports the available evidence of efficacy of MTX, with special focus on patient centered disability measures in Juvenile Idiopathic Arthritis (JIA). OBJECTIVES: To perform a systematic review on the effects of MTX on functional ability, range of motion, quality of life, overall well-being and pain for patients with JIA. SEARCH STRATEGY: The Cochrane Controlled Trials Register (CCTR) and MEDLINE were searched up to March 2001, using the search strategy sensitive for randomised controlled trials, used by the Cochrane Collaboration. SELECTION CRITERIA: Randomized controlled trials and controlled clinical trials comparing MTX against placebo or standard care in patients with Juvenile Idiopathic Arthritis (JIA) were selected. DATA COLLECTION AND ANALYSIS: Two reviewers (TT, JN) determined the studies to be included in this review and extracted the data of patient centered disability measures. The data were pooled using standardized mean differences (SMD) for limited joint range score, number of joints with swelling. The number of joints with pain on motion were evaluated using weighted mean differences (WMD). Physicians global assessment, parents global assessment and withdrawals due to efficacy and side effects were evaluated with pooled odds ratios (OR). MAIN RESULTS: Only two studies with a total 165 JIA patients under 18 years of age were included in this review. For JIA patients, MTX therapy had small to moderate effects on patient centered disability outcomes. The effect on joint range of motion, number of joints with pain and swelling and physician's and parent's assessment of disease activity showed a relative percentage improvement from 3 to 23% greater with MTX than with placebo. REVIEWER'S CONCLUSIONS: Current evidence suggests that MTX does have minimal clinically significant effects (>20%) on patient centered disability measures in JIA patients
Internet : PM:11687174 - TENNANT A, KEARNS S, TURNER F, WYATT S, HAIGH R, CHAMBERLAIN MA: Measuring the function of children with juvenile arthritis. Rheumatology (Oxford) 2001, 40:1274-1278.
Organism:Rheumatology & Rehabilitation Research Unit, School of Medicine, The University of Leeds and United Leeds Teaching Hospitals, General Infirmary, Leeds, UK
Abstract: OBJECTIVE: Juvenile idiopathic arthritis (JIA) can affect a child's performance across a range of activities necessary to normal childhood development. Although there are now several available measures of disability in JIA, none have been validated for use with children in the UK. Consequently, a study was undertaken to compare and validate four such measures, together with a locally developed function test. METHODS: Fifty-three children between the ages of 5 and 16 yr were recruited into the study. The mean age was 10.4 yr and mean duration of disease 4 yr. Seventy per cent were female. RESULTS: Internal consistency was adequate in three of five measures. Four of five measures showed the expected associations between disease activity and function (P<0.05). The level of reliability was poor for tests that involved direct assessment by therapists. Most showed poor levels of unidimensionality. CONCLUSION: Until new measures become available, the CHAQ appears to be the current 'best buy' for measuring function in children with arthritis
Internet : PM:11709611 - TUERLINCK D, DUREZ P, NEVEN B, BODART E, DEVOGELAER JP, BOUTSEN Y: Suboptimal clinical response to anti-tumor necrosis factor alpha antibody therapy in a child with severe systemic juvenile rheumatoid arthritis. Journal of developmental and behavioral.pediatrics 2001, 20:398
Organism:Department of Pediatry, Cliniques Universitaires de Mont Godinne, Universite catholique de Louvain, B-1200, Bruxelles Belgium - WAHEED NK, MISEROCCHI E, FOSTER CS: Ocular concerns in juvenile rheumatoid arthritis. International Ophthalmology Clinics 2001, 41:223-234.
- WALTER B: Occupational therapy for chronic juvenile arthritis. Ergotherapie und Rehabilitation 2001, 40:5-14.
Organism:B. Walter, Ergother. St. J.-Stift Sendenhorst, Westlor 7, 48324 Sendenhorst
Abstract: The prognosis for rheumatoid diseases in children and young people can be positively influenced by early diagnosis and an effective combination of medicinal and non-medicinal treatment such as physical therapy and, in particular, occupational therapy. This should include providing any assistive equipment necessary at the onset of malalignments. As part of a comprehensive treatment plan, specific instruction for patient and parents must also be provided, as well as psycho-social care and integration in school and the working world. Between the occupational therapy treatment for children and young people and that offered to adults, there are key differences
Internet : bureck@st-josef-stift.de - WOUTERS C, BILLIAU AD, CORNILLIE F: Anti-TNF-alpha therapy for systemic juvenile idiopathic arthritis: First experience with long term treatment. Journal of developmental and behavioral.pediatrics 2001, 20:405
Organism:Pediatric Rheumatology, University of Leuven, Leuven Belgium