January 2007

Bibliography January 2007

ARTAC H, ALP H, KELES S, REISLI Iet TUNC R: Systemic onset juvenile rheumatoid arthritis presenting with absence of B lymphocytes, Rheumatol.Int., Vol. ., 2007
Organism:Departments of Pediatrics, Pediatric Immunology and Allergy Division, Selcuk University Meram Medical Faculty, Beysehir Yolu, 42080, Konya, Turkey, hasibeartac@yahoocom
Abstract:Juvenile rheumatoid arthritis (JRA) is a complex disease involving the interactions of several cell populations with different mediators. Herein, we report a five-year-old girl with systemic-onset JRA. At admission, peripheral blood flowcytometric analysis showed the percentages of CD19(+) and CD20(+) B cells were <1%. These values returned to normal on the tenth day of steroid treatment. This is the first report of JRA presented with absence of B lymphocytes in the literature and suggested that lymphocytes subset analysis could change with treatment in patients with JRA. Different clinical signs and symptoms reflecting aspects of JRA are critical for the etiology of the disease and to identify new strategies for treatment
BADDOURA R, HADDAD S, AWADA H, AL MASRI AF, MERHEB G, ATTOUI S, OKAIS J, MESSAYKE Jet GHANDOUR F: Severity of rheumatoid arthritis: the SEVERA study, Clin.Rheumatol., Vol. 25(5), 700-704., 2006
Organism:Rheumatology Department, Hotel-Dieu Hospital, St Joseph University, Beirut, Lebanon rbaddoura@usjedulbFAU - Baddoura, Rafic
Abstract:This study aims to assess the severity of rheumatoid arthritis (RA) in rheumatology practice in our population. All outpatients and inpatients with RA seen by registered rheumatologists over a 1-year period were included. Severity was measured using the Larsen score for hands and wrists and the Modified Health Assessment Questionnaire (M-HAQ). Two hundred ninety-eight RA cases were included. Mean age was 51.5 years. Among them, 261 (87.6%) were females. Disease duration was less than a year in 26 subjects (8.7%) and 10 years and above in 108 (36.2%) with a mean of 8.9. There were 220 (73.8%) subjects who had M-HAQ score <1. In 61 (20.5%) subjects, M-HAQ score was > or =1 and <2, and 17 (5.7%) had M- HAQ score > or =2. In relation with disease duration, M-HAQ starts with an average (SD) value of 0.7 (0.6) during the first year, decreases to 0.4 (0.4) at 5-year disease duration and increases after 10 years of disease progression to an average of 0.9 (0.8). Mean (SD) Larsen score was 51.9 (29.5) and median was 45. A total of 25% had a Larsen score > or =50% of maximum. Larsen score increased significantly (p<0.0001) with disease duration, starting at an average (SD) of 36.1 (14.9) during the first year, rising to 42.5 (15.8) around 5 years and reaching 73.9 (36.9) after 10 years. RA severity in our practice is comparable to that reported in Western populations in terms of radiological damage; however, functional status differs, possibly reflecting cultural differences
BEHRENS EM, BEUKELMAN Tet CRON RQ: Juvenile idiopathic arthritis classification criteria: loopholes and diagnosis software, J.Rheumatol., Vol. 34(1), 234-235., 2007
Organism:
BRIK R, GEPSTEIN V, SHAHAR E, GOLDSHER Det BERKOVITZ D: Tumor necrosis factor blockade in the management of children with orphan diseases, Clin.Rheumatol., Vol. ., 2007
Organism:Department of Pediatrics and Pediatric Rheumatology Service, Meyer Children's Hospital of Haifa, PO Box 9602, Technion, Haifa, 31096, Israel
Abstract:Tumor necrosis factor (TNF) blockade has been used successfully to treat a number of rheumatic disorders that have a substantial burden of illness. In children, the TNF antagonists are used mainly for the treatment of juvenile idiopathic arthritis (JIA). There are, however, a variety of rare systemic inflammatory diseases, in which TNF blockade appears promising. Preliminary data in adults suggest that several forms of vasculitis appear to be responsive to TNF antagonists-Behcet's disease, polyarteritis nodosa, Wegener granulomatosis, among others. Some of them respond better to infliximab, a chimeric monoclonal anti-TNF antibody, than to etanercept, a recombinant p75 TNF receptor. We describe our limited experience with infliximab in the treatment of three children with rare vasculitic conditions
BUC M, PARNICKA Z, ROVENSKY Jet KOS c: Juvenile idiopatic arthritis an overview of current status in immunopathogenesis, immunogenetic, and immunotherapy|, 2006
Organism:Juvenile arthritis is one of the most common inflammatory disorders of the childhood. It is not a unique form of the disease what results in variety of its terms. JIA is a genetically determined disease, there are more than 20 genes known to be involved in till now. HLA, MIF, CTLA4, PTNPN22, SLC11A1, IRF-1, IL-1alpha, IL-6, IL-18 serve as their representatives. Laboratory diagnosis of the blood reveals increased numbers of B cells, hypergamma-globulinemia as well as elevated levels of complement components. Rheumatoid factor, antinuclear antibodies (ANA), pANCA, and anticardiolipin antibodies are found in sera of some patients. CD4+ T cell play a principal role in the etiopathogenesis, however TCR gamma delta T cells are also detected in increased numbers both, in the blood and in the synovial fluid, respectively. Increased levels of TNF, TNF-receptors (p50, p75), IL-2 and IL-12p40 soluble receptors as well as chemokines, IL-8, MCP-2 and soluble CD23 are disclosed here at the investigation, too. Monoclonal antibodies anti-TNF and those against IL-6 receptors started to be applied as additional therapy to manage glucocorticoid-resistant forms of JIA
CAHILL AM, BASKIN KM, KAYE RD, ARABSHAHI B, CRON RQ, DEWITT EM, BILANIUK Let TOWBIN RB: CT-guided percutaneous steroid injection for management of inflammatory arthropathy of the temporomandibular joint in children, AJR Am.J.Roentgenol., Vol. 188(1), 182-186., 2007
Organism:Department of Radiology, University of Pennsylvania, Children's Hospital of Pennsylvania, Philadelphia, PA 19104, USAFAU - Cahill, Anne Marie
Abstract:OBJECTIVE: The purposes of this study were to retrospectively review an injection technique, to develop a grading system for evaluation of imaging findings, and to report preliminary outcome related to percutaneous CT-guided steroid injection into the temporomandibular joints of children with inflammatory arthropathy. CONCLUSION: CT-guided steroid injection into the temporomandibular joint of children with inflammatory arthropathy results in clinical and imaging improvement in a substantial proportion of children treated
FERREIRA RA, SILVA CHM, SILVA DAO, SOPELETE MC, KISS MHB, MINEO JRet FERRIANI VPL: Is measurement of IgM and IgA rheumatoid factors (RF) in juvenile rheumatoid arthritis clinically useful?|, 2007
Organism:The prevalence and clinical relevance of IgM and IgA RF detected by ELISA were studied in 91 patients with juvenile rheumatoid arthritis (JRA) and 45 healthy children. IgM and IgA RF were detected, respectively, in 33 and 44% of the patients, compared to 6.7 and 15.6% of the healthy children (p = 0.001 and 0.0006, respectively). The frequency of IgM RF was significantly higher in patients with polyarticular (52%) as compared to systemic onset JRA (21%; p = 0.04). Five out of ninety-one patients and none of the control group were IgM RF positive by the latex test. High levels of IgM RF were detected more frequently in patients with active disease (p = 0.01) and positi ve latex agglutination test (p < 0.001) and had a marginally significant association with severe radiological deformities (p = 0.05). The presence of IgA RF was associated with active disease in polyarticular onset JRA children (p = 0.04). In conclusion, high levels of IgM RF and the detection of IgA RF can be useful in assessing clinical activity in a subset of patients with JRA. (c) 2006 Springer-Verlag
FORREST CM, STONE TW, MACKAY GM, OXFORD L, STOY N, HARMAN Get DARLINGTON LG: Purine metabolism and clinical status of patients with rheumatoid arthritis treated with dipyridamole, Nucleosides Nucleotides Nucleic Acids., Vol. 25(9-11), 1287-1290., 2006
Organism:Institute of Biomedical and Life Sciences, University of Glasgow, Glasgow, UKFAU - Forrest, C M
Abstract:The anti-inflammatory activities of methotrexate and sulphasalazine may be mediated by increases in endogenous adenosine levels. Since the vascular protective drug dipyridamole inhibits the uptake and metabolism of adenosine we have now tested this compound in patients with rheumatoid arthritis to assess its effects on their symptoms. Forty patients (aged 18-75 years) received dipyridamole 400 mg/day or placebo. The levels of adenosine and its major metabolites were determined by high performance liquid chromatography (HPLC) in blood samples taken at baseline and at monthly intervals during treatment for 6 months. After three months of treatment there was a significant reduction in the modified Health Assessment Questionnaire (mHAQ) score, but these effects were not maintained, and dipyridamole did not modify disease severity scores or the levels of adenosine and its metabolites. We conclude that the symptoms of rheumatoid arthritis were not modified by treatment with dipyridamole
GORSKA A, URBAN M, PIETREWICZ Eet GORSKI S: Composition of linoleic and arachidonic acids in phosphatidylcholine of erythrocytes membrane and IL-6 and TNF-alpha in serum and C-reactive protein concentration in children with juvenile idiopathic arthritis|, 2006
Organism:The study objective was to determine the relationship, if any, between the levels of arachidonic and linoleic acids in erythrocyte membrane phosphatidylcholine (PCH), serum interleukin 6 (IL-6) and TNF alpha levels and C-reactive protein (CRP) in juvenile idiopathic arthritis (JIA). Materials and methods. The study involved 49 children with JIA, aged 3-18 years (mean 11.3+/-3.9), and 29 healthy subjects. The JIA children were divided into 2 groups: group 1-24 children (in exacerbation period) with mean CRP level of 15.6mg/L +/- 13.3 and group II - 25 children (in remission period - joint swelling-free) with CRP of 7.8mg/L +/- 5.8 on average. Lipids were extracted acc ording to a modified Folch's method. Fatty acids in erythrocyte membrane PCH were identified using gas chromatography (Hewlett-Packard 5890). The levels of IL-6 and TNFalpha were determined by ELISA, using Quantikine sets: R&D System (USA), while CRP was measured by nephelometric method on a BN II apparatus (Behring). Results. We found a significant decrease in the level of linoleic acid (p<0.05) and a statistically insignificant reduction in arachidonic acid in JIA patients as compared to the controls. The decrease in linoleic acid was more pronounced in the active phase of JIA (p<0.001. The higher serum CRP level was accompanied by a significantly elevated level of IL 6 (p<0.05). The concentration of TNFalpha was elevated, but the difference had no statistical significance. Conclusions. The levels of linoleic and arachidonic acids in erythrocyte PCH decreased and the concentrations of IL-6 and TNF-alpha increased in JIA children in the active phase of the disease. The differences intensified with a rise in CRP
GRAF C, CARDOSO G, SILVA MBet SKARE TL: Intra ocular pressure in chronic users of oral glucocorticoids for rheumatoid arthritis, Acta Reumatol.Port., Vol. 31(2), 151-5, 183., 2006
Organism:Ophthalmology Service, Hospital Universitario Evangelico de Curitiba BrasilFAU - Graf, Christie
Abstract:OBJECTIVE: To evaluate intra ocular pressure (IOP) among rheumatoid arthritis (RA) patients who are chronic oral glucocorticoid users in low to moderate doses. MATERIAL AND METHODS: We have studied 125 subjects: 72 glucocorticoid users and 53 controls. The glucocorticoid users were RA patients treated with 5 to 40 mg/day of prednisone or equivalent. Controls were patients with osteoarthritis or with soft tissue rheumatic syndromes who had never used glucocorticoid orally or locally. The IOP was measured three times with Perkins tonometer in both eyes and the mean value was compared between groups. For statistical analysis we used the mean value between the IOP of both eyes. RESULTS: Among RA glucocorticoid users the mean dose was 9.7 mg of prednisone daily during a mean period of 71.1 months. The IOP of glucocorticoid users was 5.8% higher than controls. This difference did not reach statistical significance. The rise in IOP was not affected by the duration of glucocorticoid treatment or by the dose. No RA patient using oral glucocorticoids was found to have abnormal IOP in this study. CONCLUSIONS: Low dose glucocorticoids causes a small (5.8%), non significant increase in intraocular pressure
GUTHRIE B, ROUSTER-STEVENS KAet REYNOLDS SL: Review of medications used in juvenile rheumatoid arthritis, Pediatr.Emerg.Care., Vol. 23(1), 38-46., 2007
Organism:Division of Pediatric Emergency Medicine, Children's Memorial Hospital, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA bguthrie@childrensmemorialorgFAU - Guthrie, Bridgette
Abstract:Juvenile rheumatoid arthritis is a chronic condition. The goal of therapy is to control pain, preserve joint range of motion and function, minimize systemic complications, and assist in normal growth and development. Recent advances in understanding the pathophysiology of arthritis have expanded the treatment of this chronic condition. Many medications including nonsteroidal anti-inflammatory agents, disease-modifying antirheumatic drugs, biologic agents, and cytotoxic agents are available for treating juvenile rheumatoid arthritis. Emergency medicine physicians should be familiar with the different classes and adverse effects of these drugs
HARRIS CL, RAISCH DW, ABHYANKAR U, MARFATIA S, CAMPBELL HMet SATHER MR: GI risk factors and use of GI protective agents among patients receiving nonsteroidal antiinflammatory drugs, Ann.Pharmacother., Vol. 40(11), 1924-1931., 2006
Organism:Pharmaceutical Management and Research, Veterans Affairs Cooperative Studies Program Clinical Research Pharmacy, Albuquerque, NM 87106-4180, USA crystalharris@cspresearchmedvagovFAU - Harris, Crystal L
Abstract:BACKGROUND: Patient characteristics increase the risk of gastrointestinal (GI) complications associated with nonsteroidal antiinflammatory drugs (NSAIDs). Patients at risk may not be prescribed protective therapies that might mitigate their risk of NSAID-associated GI complications. OBJECTIVE: To assess GI risk among Veterans Affairs (VA) patients on NSAID therapy, determine whether therapy conformed to VA guidelines for lessening the risk of GI complications, and identify patient risk factors associated with conformance. METHODS: Using databases from 3 VA medical centers, we retrospectively identified patients receiving NSAIDs and obtained data regarding age, history of GI bleed over 8 years, GI adverse effects associated with NSAIDs, diagnoses, and medication history over one year. We inferred health status from age-adjusted Charlson comorbidity index values. Each patient's risk of developing GI complications over one year was calculated using these data. Among patients at significant or substantial risk, we assessed conformance to VA guidelines. We used logistic regression to identify risk factors associated with conformance and determine adjusted ORs (AORs) with 95% CIs for each risk factor. RESULTS: There were 19 122 patients receiving NSAIDs. Of 4589 patients at significant risk and 1246 at substantial risk, 1161 (25.3%) and 356 (28.6%), respectively, were prescribed guideline-conformant therapy. Risk factors associated with conformance (p < or = 0.001) among patients at significant risk were rheumatoid arthritis (AOR 1.34; 95% CI 1.13 to 1.58) and GI adverse effects (AOR 1.53; 95% CI 1.42 to 1.64). For substantial risk patients, risk factors associated with conformance (p < or = 0.031) were rheumatoid arthritis (AOR 1.65; 95% CI 1.37 to 1.98), concomitant corticosteroids (AOR 1.21; 95% CI 1.02 to 1.43), GI hospitalization (AOR 2.01; 95% CI 1.57 to 2.59), and GI adverse effects (AOR 1.79; 95% CI 1.47 to 2.18). CONCLUSIONS: Many patients at risk for GI adverse events do not receive guideline-conformant therapy. Educational interventions to improve conformance could focus on specific risk factors for GI complications
IGLESIAS MJ, CUTTICA RJ, HERRERA CM, MICELOTTA M, PRINGE Aet BRUSCO MI: Design and validation of a new scale to assess the functional ability in children with juvenile idiopathic arthritis (JIA), Clin.Exp.Rheumatol., Vol. 24(6), 713-718., 2006
Organism:Kinesiology Unit, Dr Pedro de Elizalde Hospital (ex Casa Cuna), Buenos Aires, ArgentinaFAU - Iglesias, M J
Abstract:OBJECTIVE: The assessment of the functional ability is one of the items of the core set to define improvements in patients with JIA, CHAQ being the most used scale already validated in 32 countries. The aim of this study was to design and validate a new scale named CAPFUN (capacidad funcional = functional ability) to assess functional ability in children with JIA. METHODS: This scale includes 20 items, 8 of upper limbs, 8 of lower limbs, 3 combined, and 1 of cervical spine, developed in two steps according with OMERACT. Each item is scored: 0 when it is impossible to be performed, 1 when it is performed incompletely or with difficulties, and 2 when it is well performed. Seventy three patients with JIA according to ILAR criteria were assessed: 25 boys (34.2%) and 48 girls (65.8%) whose aver-age age was 12.8 years (95% CI 11.8 - 13.8) and the time from disease onset was 5.02 years (95% CI 3.9 - 6.1). For validation purposes, it was applied to 91 healthy children and adolescents. In every patient, correlation with active joints count and functional class according to Steinbrocker was assessed and with CHAQ in 31 patients in this series. RESULTS: The CAPFUN index obtained in all healthy children was 2. Patients' media CAPFUN index was 1.54 (95%CI 1.38 - 1.68). The CAPFUN index for Steinbrocker's class I was 1.84 +/- 1.8; for class II 1.60 +/- 1.5 and for class III 0.91 +/- 1 (F 24.1 p < 0.001). CAPFUN showed significant correlation with CHAQ (Spearman coefficient -0.79 p < 0.001), with active joints count (Spearman coefficient -0.72 p < 0.001) and with Steinbrocker functional classes (Spearman coefficient -0.69 p < 0.001). This scale showed a good internal reliability (alpha coefficient equal to 0.94), its construct validity is demonstrated by its good correlation with Steinbrocker's scale and with CHAQ. CONCLUSION: CAPFUN is a new instrument in order to assess functional ability in children with JIA. This scale showed a good internal reliability. Construct validity is demonstrated by its high correlation with Steinbrocker's scale and with CHAQ. This study demonstrates the usefulness of CAPFUN for the assessment of functional ability in children with JIA
JARVIS JN: Diagnostic and prognostic potential of gene microarrays in rheumatoid arthritis, Expert.Rev.Mol.Diagn., Vol. 5(5), 655-659., 2005
Organism:University of Oklahoma College of Medicine, Department of Pediatrics, Rheumatology Section, Oklahoma City, OK 73104, USA james-jarvis@ouhsceduFAU - Jarvis, James N
Abstract:Rheumatoid arthritis and juvenile rheumatoid arthritis are histopathologically similar diseases characterized by chronic inflammation of the synovium. The pathogenesis of these diseases is unknown, but the emergence of gene expression profiling provides considerable promise that some of the complex, interconnected immunopathologic events underlying these diseases will soon be better understood. This review will summarize the potential use of gene expression profiling as a diagnostic or prognostic modality, and the potential benefits or limits of such uses. It will conclude with a short discussion of the potential for using gene expression profiling to identify novel targets of therapy in rheumatoid arthritis and related diseases
JENNINGS F, TOFFOLO S, DE ASSIS MRet NATOUR J: Brazil Patient Knowledge Questionnaire (PKQ) and evaluation of disease-specific knowledge in patients with rheumatoid arthritis, Clin.Exp.Rheumatol., Vol. 24(5), 521-528., 2006
Organism:Division of Rheumatology, Federal University of Sao Paulo (UNIFESP), Sao Paulo, SP, BrazilFAU - Jennings, F
Abstract:OBJECTIVE: To create a Brazilian version of the Patient Knowledge Questionnaire--PKQ, an instrument for measuring the knowledge of patients with rheumatoid arthritis (RA) as regards their disease, and through the use of this instrument, also measure the knowledge of RA patients from reference hospitals in the city of Sao Paulo. METHODS: Two teachers of English translated the PKQ into Portuguese in order to obtain a single version, which was then translated back into English to evaluate its equivalence to the original version (back translation). The final version in Portuguese was applied to 20 patients with RA for adaptation to cultural issues, and questions not understood by 20% or more patients were subsequently modified. Inter- and intraobserver reliability and the constructive validity of the PKQ were tested. The questionnaire was then applied to 100 RA patients, selected in four outpatient clinics at reference hospitals in the city of Sao Paulo. RESULTS: Three of the PKQ questions were modified to adapt to cultural issues. Intraclass correlation coefficients used for the reliability and validity of the PKQ were between were between 0.62 and 0.94, therefore, statistically significant (p< 0.05). The mean PKQ score was 12.96 and the mean test application time was 10.3 minutes, for the 100 patients assessed. The lowest scores were observed in the domains of medications and joint protection/energy conservation. PKQ scores showed a positive correlation with the level of education (r=0.40) and a negative correlation with the patients' age (r= -0.32) and with HAQ (r= -0.28). CONCLUSION: The Brazilian version of the PKQ that was created and proved to be a reliable and valid instrument. Patients' knowledge of RA is poor, particularly in the domains regarding medications and joint protection/energy conservation
LEE YJ, KANG SW, PARK JJ, BAE YD, LEE EY, LEE EBet SONG YW: Interleukin-18 promoter polymorphisms in patients with Behcet's disease, Hum.Immunol., Vol. 67(10), 812-818., 2006
Organism:Department of Internal Medicine, Medical Research Center, Seoul National University College of Medicine, Seoul, KoreaFAU - Lee, Yun Jong
Abstract:Behcet's disease (BD) is an idiopathic systemic inflammatory disease and is considered to be a T helper 1 (Th1) type cytokine driven disorder. Moreover, levels of interleukin-18 (IL-18), a pivotal mediator of Th1 cytokine response, have been reported to be upregulated in BD. Therefore, we investigated the distribution of IL-18 promoter -607 C/A and -137 G/C polymorphisms in 103 BD patients (mean age 41.0 years; 48 male, 55 female) using allele-specific-polymerase chain reaction. As compared with healthy control subjects, BD patients had a significantly higher frequency of the -607 CC genotype (42.7% vs 23.3%, odds ratio [OR] = 2.455, 95% confidence interval [CI] = 1.350-4.461, p(c) = 0.021) and a higher frequency of the -607 C allele (60.7% vs 48.1%, OR = 1.668, 95% CI = 1.129-2.464, p = 0.0101). Haplotype analysis showed that BD patients had significantly less -607A/-137G haplotype (27.3% vs 44.2%, OR = 0.469, 95% CI = 0.268-0.820, p(c) = 0.032) and -607A/-137G haplotype homozygote (5.8% vs 20.4%, OR = 0.242, 95% CI = 0.096-0.612, p(c) = 0.014) than control subjects. In addition, the frequency of -607C/-137G haplotype homozygote was significantly higher in BD patients than control subjects (48.5% vs 20.4%, OR = 3.684, 95% CI = 1.997-6.791, p(c) = 0.0014). Although there were no associations between the polymorphisms and clinical manifestations or severity, patients with the -607 CC genotype or -607C/-137G haplotype homozygote showed significantly earlier symptom development (p = 0.034 by ANOVA; p = 0.009 by t-test, respectively) than those with other genotypes or diplotypes. These results suggest that the IL-18 promoter gene is a candidate susceptibility gene in BD patients
LEVALAMPI T, HONKANEN V, LAHDENNE P, NIEMINEN R, HAKALA M et MOILANEN E: Effects of infliximab on cytokines and soluble adhesion molecules in patient with juvenile idiopathic arthritis, 295, 02-07-2001
LOW JM, CHAUHAN AKet MOORE TL: Abnormal kappa :lambda light chain ratio in circulating immune complexes as a marker for B cell activity in juvenile idiopathic arthritis, Scand.J.Immunol., Vol. 65, 76-83., 2007
Organism:Room 213A Doisy Hall,1402 S Grand Blvd, St Louis, MO 63103 USA USA
Abstract:Patients with juvenile idiopathic arthritis (JIA) have been shown to have elevated levels of circulating immune complexes (CICs) which correlated with disease activity. Our aim was to assess B cell activity by measuring the amount of and the kappa:lambda chain immunoglobulin light (L) chain ratio in CICs from JIA patients and to determine potential evidence for either an antigen-driven response or B-cell receptor editing. We used an enzyme-linked immunosorbent assay to measure kappa and lambda chains present in the CICs from the sera of patients with JIA. Statistical analysis was performed using Pearson's correlation, one-way ANOVA and Bonferroni post hoc analysis. Sera from 44 JIA patients were examined for the concentration of L chains in CICs. Healthy controls had a kappa:lambda chain ratio of 1.2:1, whereas this ratio was reversed among JIA subgroups with RF-positive polyarthritis (1:1.2), RF-negative polyarthritis (1:1.3), oligoarthritis (1:2.3) and systemic-onset arthritis (1:2.5). In addition, overall lambda chain selection was not significantly associated with a particular immunoglobulin heavy (H) chain and occurred with all immunoglobulin isotypes. We showed preferential s election of lambda chains contributing to the formation of potentially pathogenic CICs from JIA patients, of all onset types compared to healthy controls, in an H chain-independent manner. The reversal of kappa:lambda chain ratio within the JIA CICs and association with all immunoglobulin isotypes demonstrated the potential for L chain editing. Furthermore, we conclude that a reversal of the normal kappa:lambda chain ratio in JIA CICs may be used as a marker for increased B-cell activity
MELCHING LI, FISHER WD, LEE ER, MORT JSet ROUGHLEY PJ: The cleavage of biglycan by aggrecanases, Osteoarthritis.Cartilage., Vol. 14(11), 1147-1154., 2006
Organism:Shriners Hospital for Children, McGill University, Montreal, Quebec, CanadaFAU - Melching, L I
Abstract:OBJECTIVE: Aggrecanase-1 [a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS)-4] and aggrecanase-2 (ADAMTS-5) have been named for their ability to degrade the proteoglycan aggrecan. While this may be the preferred substrate for these enzymes, they are also able to degrade other proteins. The aim of this work was to determine whether the aggrecanases could degrade biglycan and decorin. METHODS: Biglycan, decorin and aggrecan were purified from human and bovine cartilage and subjected to degradation by recombinant aggrecanase-1 or aggrecanase-2. In vitro degradation was assessed by sodium dodecyl sulfate/polyacrylamide gel electrophoresis (SDS/PAGE) and immunoblotting, and the cleavage site in biglycan was determined by N-terminal amino acid sequencing. SDS/PAGE and immunoblotting were also used to assess in situ degradation in both normal and arthritic human articular cartilage. RESULTS: Both aggrecanase-1 and aggrecanase-2 are able to cleave bovine and human biglycan at a site within their central leucine-rich repeat regions. Cleavage occurs at an asparagine-cysteine bond within the fifth leucine-rich repeat. In contrast, the closely related proteoglycan decorin is not a substrate for the aggrecanases. Analysis of human articular cartilage from osteoarthritic (OA) and rheumatoid arthritic (RA) joints showed that a biglycan degradation product of equivalent size is present in the extracellular matrix. No equivalent degradation product was, however, detectable in normal adult human articular cartilage. CONCLUSION: Biglycan, which is structurally unrelated to aggrecan, can act as a substrate for aggrecanase-1 and aggrecanase-2, and these proteinases may account for at least part of the biglycan degradation that is present in arthritic cartilage
MOR-VAKNIN N, PUNTURIERI A, SITWALA K, FAULKNER N, LEGENDRE M, KHODADOUST MS, KAPPES F, RUTH JH, KOCH A, GLASS D, PETRUZZELLI L, ADAMS BSet MARKOVITZ DM: The DEK nuclear autoantigen is a secreted chemotactic factor, Mol.Cell Biol., Vol. 26(24), 9484-9496., 2006
Organism:Department of Internal Medicine, Division of Infectious Diseases, University of Michigan Medical Center, Ann Arbor, MI 48109-0640, USAFAU - Mor-Vaknin, Nirit
Abstract:The nuclear DNA-binding protein DEK is an autoantigen that has been implicated in the regulation of transcription, chromatin architecture, and mRNA processing. We demonstrate here that DEK is actively secreted by macrophages and is also found in synovial fluid samples from patients with juvenile arthritis. Secretion of DEK is modulated by casein kinase 2, stimulated by interleukin-8, and inhibited by dexamethasone and cyclosporine A, consistent with a role as a proinflammatory molecule. DEK is secreted in both a free form and in exosomes, vesicular structures in which transcription-modulating factors such as DEK have not previously been found. Furthermore, DEK functions as a chemotactic factor, attracting neutrophils, CD8+ T lymphocytes, and natural killer cells. Therefore, the DEK autoantigen, previously described as a strictly nuclear protein, is secreted and can act as an extracellular chemoattractant, suggesting a direct role for DEK in inflammation
NISHIMOTO N: [IL-6 targetting therapy for inflammatory immune diseases], Nippon Naika Gakkai Zasshi., Vol. 95(9), 1795-1800., 2006
Organism:
POPKO J, MARCINIAK J, ZALEWSKA A, GORSKA A, ZWIERZ K, SIERAKOWSKI Set URBAN M: Activity of N-acetyl-beta-hexosaminidase and its isoenzymes in serum and synovial fluid from patients with different arthropathies, Clin.Exp.Rheumatol., Vol. 24(6), 690-693., 2006
Organism:Department of Pediatric Orthopedics and Traumatology, Rheumatology Medical University of Bialystok, Poland jpopko@ambeduplFAU - Popko, J
Abstract:OBJECTIVE:To evaluate the activity of N-acetyl-Beta-hexosaminidase (HEX) and its isoenzymes in the serum and synovial fluid of healthy volunteers and patients with an injury to the anterior cruciate ligament and/or meniscus (ACL) osteoarthritis (OA), juvenile idiopathic arthritis (JIA) and rheumatoid arthritis (RA).METHODS:The activity of HEX and its isoenzymes was determined according to Zwierz et al. method. Protein content was determined by the biuret method.RESULTS:The specific activity of HEX and its isoenzymes in the serum of patients with JIA showed a tendency to increase in comparison to the reference group. The specific activity of total HEX in the serum of RA patients was significantly increased in comparison to control. Our results show, that specific activity of HEX in synovial fluid, in the reference group 4.2 +/- 0.21 microkat/kg protein (0.25 unit/mg protein), is similar to activity in normal temporomandibular joint fluid (0.3 unit/mg protein). Therefore, we included this group in our research. In patients with OA and ACL injuries, HEX and its isoenzymes showed a tendency to increase in the specific activity in synovial fluid. The specific activity of HEX and its isoenzymes in the synovial fluid of patients with RA and JIA was significantly elevated in comparison to the control and the remaining groups.CONCLUSION:In the synovial fluid of patients with JIA and RA, the specific activity of HEX and its isoenzymes significantly increased in comparison to control and patients with diseases of a non-inflammatory etiology (OA and ACL). In the synovial fluid of control and diseased groups, HEX constituted a higher percent of total proteins than in serum
PRAKKEN Bet KUIS W: ARTHRITIS IN ADOLESCENTS AND CHILDREN (JUVENILE IDIOPATHIC ARTHRITIS). Edited by I. Szer, Y. Kimura, P. Malleson and T. Southwood, Rheumatology (Oxford)., Vol. ., 2007
Organism:
SAURENMANN RK, LEVIN AV, FELDMAN BM, ROSE JB, LAXER RM, SCHNEIDER Ret SILVERMAN ED: Prevalence, risk factors, and outcome of uveitis in juvenile idiopathic arthritis: A long-term followup study, Arthritis Rheum., Vol. 56(2), 647-657., 2007
Organism:University Children's Hospital, Zurich, Switzerland
Abstract:OBJECTIVE: To assess the prevalence, risk factors, and long-term outcome of uveitis in patients with juvenile idiopathic arthritis (JIA). METHODS: An inception cohort of all 1,081 patients diagnosed as having JIA at a single tertiary care center was established. A questionnaire and followup telephone calls were used to confirm the diagnosis of uveitis. Ophthalmologists' records of patients with uveitis were collected. Kaplan-Meier and Cox regression analyses were used to assess risk factors for developing uveitis and for complications of uveitis. RESULTS: After a mean followup time of 6.9 years, 142 of 1,081 patients (13.1%) had developed uveitis. Risk factors were young age at diagnosis, female sex, antinuclear antibody positivity, and the subtype of JIA. The relative contribution of these risk factors was different for the different subtypes of JIA. Until the end of the study, uveitis complications had developed in 53 of 142 patients with uveitis (37.3%; 4.9% of the total cohort). Only 16 of 175 involved eyes (9.1%) in 14 of 108 patients (13%; 1.3% of the total cohort) for whom ophthalmology reports were available had best corrected visual acuity less than 20/40 (mean followup time for uveitis of 6.3 years). Abnormal vision was associated with synechiae or cataract. CONCLUSION: Risk factors for developing uveitis were different among subtypes of JIA. The long-term outcome of JIA-associated uveitis in our cohort was excellent despite the high rate of complications
SCHAFER N, BLAUMEISER B, BECKER T, FREUDENBERG-HUA Y, HANNEKEN S, EIGELSHOVEN S, SCHMAEL C, LAMBERT J, DE WEERT J, KRUSE R, NOTHEN MMet BETZ RC: Investigation of the functional variant c.-169T > C of the Fc receptor-like 3 (FCRL3) gene in alopecia areata, Int.J.Immunogenet., Vol. 33(6), 393-395., 2006
Organism:Institute of Human Genetics, University of Bonn, Bonn, GermanyFAU - Schafer, N
Abstract:A functional variant in the Fc receptor-like 3 (FCRL3) gene has been implicated in susceptibility to autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus and autoimmune thyroid disease. Investigating a large case-control sample of patients with alopecia areata (AA), we found no evidence for the involvement of FCRL3 in susceptibility to AA
SCHMELING Het HORNEFF G: Tumour necrosis factor alpha promoter polymorphisms and etanercept therapy in juvenile idiopathic arthritis|, 2007
Organism:The objective of this study was to investigate the influence of TNF-alpha promoter alleles on clinical response to etanercept therapy in JIA. TNF-alpha promoter polymorphisms at positions -163, -238, -244, -308, -376 were determined in 137 JIA patients treated with etanercept for at least 3 months. A PCR fragment of about 500 bp of the TNF gene promoter was amplified. Polymorphisms were detected by a single sequencing procedure. Patients with the genotype -308GG achieved an ACR-JRA 30 response at month 6 more frequently than patients with the genotype -308GA or AA. This was already notable at month 3 of therapy. This difference in the total patient group is attributable to the JIA subgroup with rheumatoid factor negative polyarthritis. In this subgroup, patients with the -308GG genotype achieved an ACR-JRA 30 response more frequently than those with the -308GA or AA genotype (84 vs. 33% at months three, P < 0.01, 93 vs. 67% at months six, P < 0.05). There was no influence of the -238 TNF-alpha promoter alleles on clinical response. The rare alleles at position -376 or at positions -163 and -244 were too infrequent. There is an association between TNF gene promoter polymorphisms and response to etanercept in rheumatoid factor negative polyarticular JIA. (c) 2006 Springer-Verlag
SEEGER JD, WEST WA, FIFE D, NOEL GJ, JOHNSON LNet WALKER AM: Achilles tendon rupture and its association with fluoroquinolone antibiotics and other potential risk factors in a managed care population, Pharmacoepidemiol.Drug Saf., Vol. 15(11), 784-792., 2006
Organism:i3 Drug Safety, Auburndale, MA, USA jseeger@epidemiologycomFAU - Seeger, John D
Abstract:BACKGROUND: Case reports and observational studies have implicated fluoroquinolone antibiotic exposure as a risk factor for Achilles tendon rupture (ATR), an uncommon condition for which there are few formal studies. We sought to quantify the strength of association between exposure to fluoroquinolone antibiotics and the occurrence of ATR, accounting for other risk factors. METHODS: This was a case-control study nested within a health insurer cohort. Cases of ATR were identified and confirmed using patterns of health insurance claims that were validated through sampled medical record review. Information on risk factors, including fluoroquinolone exposure, came from health insurance claims. RESULTS: There were 947 cases of ATR and 18 940 controls. A dispensing of a fluoroquinolone antibiotic in the past 6 months was more common among ATR cases than controls, although not significantly so (odds ratio (OR) = 1.2; 95% confidence interval (CI) = 0.9-1.7), and exposure to a higher cumulative fluoroquinolone dose was more strongly associated (OR = 1.5, 95%CI = 1.0-2.3). Other risk factors for ATR were trauma (OR = 17.2, 95%CI = 14.0-20.2), male sex (OR = 3.0, 95%CI = 2.6-3.5), injected corticosteroid administration (OR = 2.2, 95%CI = 1.6-2.9), obesity (OR = 2.0, 95%CI = 1.2-3.1), rheumatoid arthritis (OR = 1.9, 95%CI = 1.0-3.7), skin or soft tissue infections (OR = 1.5, 95%CI = 0.9-2.3), oral corticosteroids (OR = 1.4, 95%CI = 1.0-1.8), and non-fluoroquinolone antibiotics (OR = 1.2, 95%CI = 1.1-1.5). CONCLUSIONS: The elevation in ATR risk associated with fluoroquinolones was similar in magnitude to that associated with oral corticosteroids or non-fluoroquinolone antibiotics. Trauma and male sex were more strongly associated with ATR, as were obesity and injected corticosteroids
SHIH M, HOOTMAN JM, STRINE TW, CHAPMAN DPet BRADY TJ: Serious psychological distress in U.S. adults with arthritis, J.Gen.Intern.Med., Vol. 21(11), 1160-1166., 2006
Organism:Office of Health Assessment and Epidemiology, Los Angeles County Department of Public Health, Los Angeles, CA 90012, USA mshih@ladhsorgFAU - Shih, Margaret
Abstract:BACKGROUND: Arthritis and mental health disorders are leading causes of disability commonly seen by health care providers. Several studies demonstrate a higher prevalence of anxiety and depression in persons with arthritis versus those without arthritis. OBJECTIVES: Determine the national prevalence of serious psychological distress (SPD) and frequent anxiety or depression (FAD) in adults with arthritis, and in adults with arthritis, identify risk factors associated with SPD. METHODS: Cross-sectional data from the 2002 National Health Interview Survey, an in-person household interview survey, were used to estimate the prevalence of SPD and FAD in adults with (n=6,829) and without (n=20,676) arthritis. In adults with arthritis, the association between SPD and sociodemographic, clinical, and functional factors was evaluated using multivariable logistic regression. RESULTS: The prevalence of SPD and FAD in adults with arthritis is significantly higher than in adults without arthritis (5.6% vs 1.8% and 26.2% vs 10.7%, P<.001, respectively). In adults with arthritis, SPD was significantly associated with younger age, lower socioeconomic status, divorce/separation, recurrent pain, physical inactivity, having functional or social limitations, and having comorbid medical conditions. Adults aged 18 to 44 years were 6.5 times more likely to report SPD than those 65 years or older, and adults with recurrent pain were 3 times more likely to report SPD than those without recurrent pain. CONCLUSIONS: Serious psychological distress and FAD affect persons with arthritis and should be addressed in their treatment. Younger adults with arthritis, and those with recurrent pain or either functional or social limitations, may be at higher risk for SPD
SOHN DI, LABORDE HA, BELLOTTI Met SEIJO L: Juvenile rheumatoid arthritis and bronchiolitis obliterans organized pneumonia|, 2007
Organism:Diverse pleuropulmonary manifestations, including pleural effusion, rheumatoid nodulosis, fibrosis, obliterans brochiolitis, bronchiectasias, vasculitis, drug-induced lung disease, and obliterans bronchiolitis with organized pneumonia, have been described in patients with rheumatoid arthritis (RA). Bronchiolitis obliterans organized pneumonia (BOOP) is an uncommon condition described in patients with RA but not in juvenile RA (JRA). We described a patient with JRA who developed a BOOP. (c) Clinical Rheumatology 2005
SONG A, CARTER KD, NERAD JA, BOLDT Cet FOLK J: Steroid-induced ptosis: case studies and histopathologic analysis, Eye., Vol. ., 2007
Organism:1University of Iowa Hospitals & Clinics, Department of Ophthalmology, Iowa City, IA, USA
Abstract:PurposeThe purpose of this study was to review patients who developed ptosis after subtenon's steroid injection and to study the mechanism of steroid-induced ptosis in an animal model.MethodsPart 1. Twenty-two patients with uveitis who had received posterior subtenon's triamcinolone acetonide injections were retrospectively reviewed. Demographics, type of uveitis, type and number of surgeries, pre and postoperative marginal reflex distance (MRD1), and clinical outcomes were evaluated. Part 2. Study of rabbit levator muscle and aponeurosis histopathology after subtenon's triamcinolone injection was performed.ResultsPart 1. The average age was 44.6 years (range: 14 - 85 years) with a mean follow-up of 14 months. The most common causes of uveitis included uveitis after cataract extraction (five), pars planitis (three), multifocal choroiditis (three), and juvenile rheumatoid arthritis (three). The average time to documented onset of ptosis was 13.9 months (range: 0-49 months). In patients who received only one steroid injection, the average time to ptosis recorded was 2.7 months (range: 0-6 months). Seventeen patients underwent ptosis repair. Part 2. No ptosis was noted in the experimental and control groups. Histopathologic analysis of levator tissues revealed no significant difference in atrophy or degree of inflammation between experimental and control groups.ConclusionsPtosis following subtenon's steroid injection ranged from mild to moderate and occurred a few months after steroid injection. Prior studies of muscles and periocular tissues exposed to corticosteroids demonstrated degenerative muscle changes; our studies revealed no histopathologic changes in the levator muscle or aponeurosis.Eye advance online publication 12 January 2007; doi:10.1038/sj.eye.6702667
STOECKMAN AK, BAECHLER EC, ORTMANN WA, BEHRENS TW, MICHET CJet PETERSON EJ: A distinct inflammatory gene expression profile in patients with psoriatic arthritis, Genes Immun., Vol. 7(7), 583-591., 2006
Organism:Department of Medicine, University of Minnesota Medical School, Center for Immunology, University of Minnesota, Minneapolis, MN 55455, USAFAU - Stoeckman, A K
Abstract:Psoriatic arthritis (PsA) is a systemic inflammatory condition featuring polyarthritis associated with psoriasis. Apart from clinical indicators, few biomarkers exist to aid in the diagnosis and management of PsA. We hypothesized that whole blood gene expression profiling would provide new diagnostic markers and/or insights into pathogenesis of the disease. We compared whole blood gene expression profiles in PsA patients and in age-matched controls. We identified 310 differentially expressed genes, the majority of which are upregulated in PsA patients. The PsA expression profile does not significantly overlap with profiles derived from patients with rheumatoid arthritis or systemic lupus erythematosus. Logistic regression identified two lymphocyte-specific genes (zinc-finger protein 395 and phosphoinositide-3-kinase 2B) that discriminate PsA patients from normal controls. In addition, a highly coregulated cluster of overexpressed genes implicated in protein kinase A regulation strongly correlates with erythrocyte sedimentation rate. Other clusters of coregulated, yet suppressed genes in PsA patient blood include molecules involved in T-cell signaling. Finally, differentially expressed genes in PsA fall into diverse functional categories, but many downregulated genes belong to a CD40 signaling pathway. Together, the data suggest that gene expression profiles of PsA patient blood contain candidate novel disease markers and clues to pathogenesis
SUN KH, LIN HY, CHEN LW, TAI HY, LIN ML, FENG CK, SUNG JS, LIU HFet LIU WT: Human foamy virus bel1 sequence in patients with autoimmune rheumatic diseases, Clin.Rheumatol., Vol. 25(5), 694-699., 2006
Organism:Institute of Biotechnology in Medicine, School of Medical Technology and Engineering, National Yang-Ming University, Taipei, Taiwan, Republic of China khsun@ymedutwFAU - Sun, Kuang-Hui
Abstract:Since the association between human foamy virus (HFV) with rheumatic autoimmune diseases remains controversial, this study was designed to determine the relationship between HFV and systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), or progressive systemic sclerosis (PSS). The bel1 and Pol sequences of HFV were measured by reverse transcriptase-polymerase chain reaction (RT-PCR) in plasma and by PCR in peripheral blood mononuclear cells (PBMC) from patients with SLE, RA, and PSS. Antibodies against Bel1 and Pol were assessed by enzyme-linked immunosorbent assay. Active HFV infections were detected by a Bel1-responsive indicator cell line. The bel1 sequence was detected in the plasma (SLE 59, RA 32, and PSS 63%) and PBMC (SLE 54, RA 71, and PSS 57%). However, active HFV infection existed only in patients with the bel1 sequence in both plasma and PBMC. In SLE patients, antibodies against Bel1 (7.1%) and Pol (4.5%) were also detected. The results suggest a possible association between HFV infection and these autoimmune rheumatic diseases
TAYEL MYet TAYEL KY: Prevalence of juvenile chronic arthritis in school children aged 10 to 15 years in Alexandria, J.Egypt.Public Health Assoc., Vol. 74(5-6), 529-546., 1999
Organism:Department of Internal Medicine, Faculty of Medicine, High Institute of Public health, Alexandria UniversityFAU - Tayel, M Y
Abstract:The study was conducted using a cross sectional design to determine the prevalence of Juvenile chronic arthritis (JCA) among 10 to 15 years old school children in Alexandria, and to develop (if possible) a tool for screening children for arthritis. The study included 1500 children selected by using a multistage stratified random sample of students enrolled in the primary and preparatory schools in Alexandria Governorate. The results of this study indicated that the prevalence of JCA was 3.3 per 1000. Also a simple tool, composed of some questions, could effectively identify children with JCA. However, clinical examination supported by a history from the child provides the best reliable means of diagnosis. The present study recommended the use of community rather than hospital based surveys for estimating the true prevalence of the disease
TILLING L, TOWNSEND Set DAVID J: Methotrexate and hepatic toxicity in rheumatoid arthritis and psoriatic arthritis, Clin.Drug Investig., Vol. 26(2), 55-62., 2006
Organism:Department of Rheumatology, Royal Berkshire and Battle Hospitals NHS Trust, Reading, UKFAU - Tilling, Lindsey
Abstract:BACKGROUND: We set out in this study to demonstrate the adverse effect profile of methotrexate when used in the treatment of rheumatoid arthritis (RA) and psoriatic arthritis (PsA) in a district general hospital population, and to investigate the effect of alcohol consumption in these patients. METHODS: A prospective evaluation of 550 RA patients and 69 PsA patients was undertaken, controlling for confounding factors. Systematically randomised patients were further analysed regarding alcohol consumption. A transaminase level of three times the upper limit of normal on two or more occasions was taken to indicate hepatic injury. RESULTS: Gastrointestinal disturbance was the predominant adverse effect in RA patients (9.8%); hepatic disturbance was the most frequent in PsA patients (14.5%). Both groups had hepatic enzyme elevation; PsA patients were at significantly greater risk of elevated transaminases than RA patients (14.5% vs 7.5%, respectively, chi2 = 4.017). Alcohol consumption did not correlate with hepatic injury (mean 5.15 vs 6.6 alcohol units/week consumed by RA and PsA patients, respectively). CONCLUSION: Our data show methotrexate-treated PsA patients have a higher incidence of hepatotoxicity compared with methotrexate-treated patients with RA. It is proposed that psoriatic patients may be inherently more susceptible to methotrexate hepatotoxicity than are rheumatoid patients
UBENAUF KM, KRUEGER M, HENNEKE Pet BERNER R: Lipopolysaccharide binding protein is a potential marker for invasive bacterial infections in children, Pediatr.Infect.Dis.J., Vol. 26(2), 159-162., 2007
Organism:From the Centre for Pediatrics and Adolescent Medicine, University Hospital of Freiburg, Freiburg, GermanyFAU - Ubenauf, Katja M
Abstract:BACKGROUND:: The aim of this study was to test the hypothesis that elevated lipopolysaccharide binding protein (LBP) serum concentration is a useful marker in the early diagnosis of invasive bacterial infection in children. We measured LBP in serum and cerebrospinal fluid (CSF) of children with proven invasive infection caused by Haemophilus influenzae, Streptococcus pneumoniae and Neisseria meningitidis. PATIENTS AND METHODS:: Samples were collected from 39 children (aged 2 months to 17 years) with bacterial sepsis (n = 19) or meningitis (n = 20). Bacterial infection was diagnosed when a blood or CSF culture was positive and clinical signs of invasive infection were present. The control group consisted of serum (n = 60) and CSF (n = 19) samples from children with neurologic disease, juvenile idiopathic arthritis or viral infection. In 10 patients with bacterial infection, follow-up samples (24 and 48 hours) were available. LBP values were measured by an immunochemiluminescence analyzer (IMMULITE; DPC Biermann, Bad Nauheim, Germany) and compared with tumor necrosis factor-alpha and interleukin-8 concentrations. RESULTS:: The median LBP serum concentrations in patients with bacterial infection were markedly elevated compared with the control groups (45.0 [33.1-55.2] versus 8.3 [6.8-10.1] mug/mL [median and 5-95% confidence interval]; P < 0.0001). Follow-up serum values of LBP were persistently elevated despite adequate antibiotic treatment, whereas tumor necrosis factor-alpha and interleukin-8 concentrations decreased. In contrast, LBP concentrations in the CSF were below the detection limit of 0.5 mug/mL in 67% of patients with bacterial meningitis (median <0.5 mug/mL), whereas tumor necrosis factor-alpha and interleukin-8 levels were highly elevated. CONCLUSION:: LBP serum concentration is elevated in serum of children with invasive bacterial infection and could be a promising diagnostic marker
WOLLMERSTEDT N, KIRSCHNER S, FALLER Het KONIG A: Reliability, validity and responsiveness of the German Short Musculoskeletal Function Assessment Questionnaire in patients undergoing surgical or conservative inpatient treatment, Qual.Life Res., Vol. 15(7), 1233-1241., 2006
Organism:Lehrstuhl fur Orthopadie, Universitat Wurzburg, Albert-Schweitzer-Str 14, Kelsterbach, Hessen 65451, Germany nicolewollmerstedt@t-onlinedeFAU - Wollmerstedt, Nicole
Abstract:OBJECTIVE: The patient-based evaluation of outcome is gaining increased importance. The aim of the study was to demonstrate the reliability, validity and responsiveness of the German version of the Short Musculoskeletal Function Assessment Questionnaire (SMFA-D) in patients undergoing surgical or conservative treatment. METHODS: Three hundred and thirty-two patients suffering from osteoarthritis of the hip or knee, rheumatoid arthritis or rotator cuff tear undergoing surgical or medical inpatient treatment were followed up for 12 month. Patients underwent both SMFA-D and other assessments and clinical as well as radiological examinations. Reliability, validity and responsiveness of the SMFA-D were evaluated. RESULTS: Values of the SMFA-D subscales, Function index (M 22-49, SD 12-20, range 0-96) and Bother index (M 29-52, SD 15-23, range 0-100), showed a normal distribution. Internal consistency (0.88-0.97) and retest reliability (0.71-0.96) coefficients were satisfactory to excellent. In most cases, the SMFA-D correlated significantly with function tests, physicians' function ratings, patients' pain ratings and other quality-of-life questionnaires in all patient subgroups. The results support both the construct and criterion validity of the measure. Different patient groups and subgroups could be discriminated with the SMFA-D scales. The standardized response means of SMFA-D subscales were in surgical patients better than in conservatively treated patients and comparable to those of the SF-36 Physical Component Summary scale. CONCLUSIONS: The German version of SMFA is a reliable, valid and responsive questionnaire in patients with osteoarthritis of the hip or knee, rheumatoid arthritis or rotator cuff tear undergoing surgical or medical inpatient treatment. Thus, the use of the SMFA-D in these patients can be recommended
WORETA F, THORNE JE, JABS DA, KEDHAR SRet DUNN JP: Risk Factors for Ocular Complications and Poor Visual Acuity at Presentation Among Patients With Uveitis Associated With Juvenile Idiopathic Arthritis, Am.J.Ophthalmol., Vol. %20;., 2006
Organism:Departments of Ophthalmology
Abstract:PURPOSE: To describe the frequencies of and risk factors for ocular complications and poor visual acuity at presentation in a cohort of patients with juvenile idiopathic arthritis (JIA)-associated uveitis. DESIGN: Cross-sectional study. METHODS: setting: Single-center, academic practice. study population: Seventy-five patients with JIA-associated uveitis were evaluated between July 1984 and August 2005. observation procedures: Data on patients diagnosed with JIA-associated uveitis were entered retrospectively into a database and analyzed. outcome measures: Visual acuity of 20/50 or worse or 20/200 or worse, and presence of ocular complications (including cataract, posterior synechiae, band keratopathy, elevated intraocular pressure, hypotony, macular edema, and epiretinal membrane) at presentation. RESULTS: At presentation, ocular complications were seen in 67% of eyes affected by JIA-associated uveitis. Presence of >/=1+ anterior chamber flare, a positive antinuclear antibody (ANA), and a shorter duration between the diagnosis of arthritis and uveitis were significantly associated with the presence of ocular complication. The frequencies of 20/50 or worse and of 20/200 or worse visual acuities at presentation in affected eyes were 36% and 24%, respectively. The presence of >/=1+ anterior chamber flare and a history of intraocular surgery before presentation were significantly associated with 20/50 or worse and 20/200 or worse vision. Presence of posterior synechiae also was associated with 20/200 or worse vision at presentation. The main causes of poor vision at presentation for affected eyes and better-seeing eyes were cataract, band keratopathy within the visual axis, and glaucoma. CONCLUSIONS: Ocular complications and poor vision at presentation were common in our patients with JIA-related uveitis
YAZICI AC, ASLAN G, BAZ K, IKIZOGLU G, API H, SERIN MS, TEZCAN S, EMEKDAS Get TASDELEN B: A high prevalence of parvovirus B19 DNA in patients with psoriasis, Arch.Dermatol.Res., Vol. 298(5), 231-235., 2006
Organism:Department of Dermatology, School of Medicine, Mersin University, 33079, Mersin, Turkey aycacordan@yahoocomFAU - Yazici, Ayca Cordan
Abstract:Psoriasis is a common inflammatory skin disease. Infectious models are considered to be of pathophysiological importance in psoriasis. The immunological profile of stable psoriasis plaques suggests that viral antigens may be important. Human parvovirus B19 (PVB19) is a single-stranded DNA virus that causes various clinical symptoms. Several case reports have suggested associations between PVB19 infection and various chronic autoimmune and dermatologic diseases. There has so far been no information regarding the role of PVB19 in psoriasis, except psoriatic arthritis. In this report, to investigate the role of PVB19 in psoriasis, we analyzed PVB19 DNA of peripheral blood from psoriatic patients (n = 47) in comparison with blood donors (n = 20). We also determined the presence of anti-PVB19 IgG and IgM antibodies by using enzyme-linked immunosorbent assay (ELISA). We found that the presence of PVB19 DNA in patients with psoriasis (38%) was significantly higher than in controls (0%, P < 0.01). Anti-PVB19 IgG antibodies were detected in 79% of the cases while only 6% had anti-PVB19 IgM antibodies. PVB19 DNA presence was associated with seropositivity for anti-PVB19 IgG (P < 0.05) but not with IgM antibodies, indicating subclinical activation of latent infection. No correlation was found between the presence of PVB19 DNA and a patient's age, sex, type of psoriasis, or psoriasis area and severity index. The data demonstrated a statistically significant association between psoriasis and PVB19. Therefore, we suggest that PVB19 infection may be of pathophysiological importance in psoriasis
ZONNEVELD-HUIJSSOON E, RONAGHY A, VAN ROSSUM MA, RIJKERS GT, VAN DER KLIS FR, SANDERS EA, VERMEER-DE BONDT PE, HOES AW, VAN DER NET JJ, ENGELS C, KUIS W, PRAKKEN BJ, VAN TOL MJet WULFFRAAT NM: Safety and efficacy of meningococcal c vaccination in juvenile idiopathic arthritis, Arthritis Rheum., Vol. 56(2), 639-646., 2007
Organism:Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
Abstract:OBJECTIVE: To determine whether vaccinations aggravate the course of autoimmune diseases such as juvenile idiopathic arthritis (JIA) and whether the immune response to vaccinations may be hampered by immunosuppressive therapy for the underlying disease. METHODS: In this multicenter cohort study, 234 patients with JIA (ages 1-19 years) were vaccinated with meningococcal serogroup C (MenC) conjugate to protect against serogroup C disease (caused by Neisseria meningitidis). Patients were followed up for disease activity for 1 year, from 6 months before until 6 months after vaccination. IgG antibody titers against MenC polysaccharide and the tetanus carrier protein were determined by enzyme-linked immunosorbent assay and toxin binding inhibition assay, respectively. A serum bactericidal assay was performed to determine the function of the anti-MenC antibodies. RESULTS: No change in values for any of the 6 components of the core set criteria for juvenile arthritis disease activity was seen after MenC vaccination. Moreover, no increase in the frequency of disease relapse was detected. Mean anti-MenC IgG concentrations in JIA patients rose significantly within 6-12 weeks after vaccination. Of 157 patients tested, 153 were able to mount anti-MenC IgG serum levels >2 mug/ml, including patients receiving highly immunosuppressive medication. The 4 patients with a lower anti-MenC antibody response displayed sufficient bactericidal activity despite receiving highly immunosuppressive medication. CONCLUSION: The MenC conjugate vaccine does not aggravate JIA disease activity or increase relapse frequency and results in adequate antibody levels, even in patients receiving highly immunosuppressive medication. Therefore, patients with JIA can be vaccinated safely and effectively with the MenC conjugate