Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0003873 (rheumatoid arthritis)
 53,068 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Abdominal aortic aneurysm is a condition affecting nearly 4% of the elderly population. It has a potential for producing a wide range of symptoms, including abdominal pain and back pain. The latter is particularly difficult to interpret in patients with chronic rheumatological conditions, and delayed diagnosis may be associated with a poor outcome. We present a patient with rheumatoid arthritis and chronic low back pain, who developed bilateral leg weakness and hesitancy of micturition, due to an abdominal aortic aneurysm invading the spine.
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PMID:Direct erosion of lumbar spine by an abdominal aortic aneurysm, resulting in paraparesis: unusual presentation. Case report. 747 45

To determine the prevalence of rheumatic diseases in Chinese of Han nationality in the north and the south of China, samples of 4,192 adults in Beijing (north) and 5,057 in Shantou (south) area were studied. The same questionnaire was administered to each subject surveyed. Physical examinations were done in all who gave positive answers. For those who gave positive response to certain set of questions, blood antinuclear antibody and rheumatoid factor tests and radiographs of hand and/or sacroiliac joint were done. The prevalence of definite rheumatoid arthritis (RA) was 0.34% in the north (95% confidence interval 0.20-0.51) and 0.32% (0.95% CI 0.16-0.47) in the south and ankylosing spondilitis was noted in 0.26% of both samples (95% confidence interval in the north 0.11-0.42 and in the south 0.14-0.40). Only 3 cases of systemic lupus erythematosus in the north and one in the south were identified. General rheumatic pain was reported more frequently in the north. Lumbar problems were recorded on examinations 5 times more commonly in the north than in the south (men 25.0% vs 5.3%, women 38.0% vs 6.5%) and knee problems 10 times (men 24.0% vs 1.8%, women 36.0% vs 3.4%) more commonly in the north; the difference was greatest in the age of 55-64. A further study in the south is planned to assess the contribution of inter-observer error and/or difference in cultural response to the north/south difference observed in the prevalence of general rheumatic symptoms and back pain. A search for environmental risk factors such as climate, diet, degeneration or overuse would then be indicated to explain these differences.
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PMID:[Rheumatic diseases in China]. 779 61

The risk of renal papillary necrosis and renal dysfunction due to the chronic use of nonsteroidal anti-inflammatory drugs (NSAIDs) is unknown. In a prospective study of 259 heavy analgesic users seen in a general medical hospital over an 11-year-period beginning in January 1982, 69 new cases of analgesic nephropathy with renal papillary necrosis were confirmed by intravenous urogram (26.6%), ultrasonography (30.4%), and/or computed tomography (43%). Twenty-nine of these patients (42%) had consumed excessive quantities of NSAIDs alone; an additional nine patients (13%) had consumed NSAIDs predominantly in combinations with paracetamol, aspirin, phenacetin, caffeine, and/or traditional herbal medications. Of those patients who consumed NSAIDs alone, 17 had consumed only a single type of NSAID and the remaining 12 had consumed multiple types of NSAIDs. The amount of NSAIDs administered ranged from 1,000 to 26,600 capsules or tablets over a 2- to 25-year period. Renal impairment (serum creatinine, 126 to 778 mumol/L) was noted in 26 of these 38 patients (64.8%). The reasons given for consuming NSAIDs include gouty arthritis (18 patients), osteoarthritis (seven patients), rheumatoid arthritis (six patients), chronic headache (three patients), gouty arthritis plus chronic headache (three patients), and chronic backache (one patient). All patients were prescribed these drugs and were followed medically. The occurrence of analgesic nephropathy was predominantly in males (male to female ratio, 1.9:1). Most of the patients did not have the characteristic psychological profile attributed previously to analgesic abuse nephropathy. Associated addictive habits, such as the use of psychotropic drugs and sleeping tablets, purgative abuse, and alcoholism, were absent.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Chronic renal disease and papillary necrosis associated with the long-term use of nonsteroidal anti-inflammatory drugs as the sole or predominant analgesic. 802 20

Back pain and low back pain can be caused by extravertebral diseases, functional disorders or morphologic changes of the spine. Diagnosis of back pain is mainly done by clinical examination. The examination of segmental mobility is necessary to make the diagnosis of functional disorders. X-ray and laboratory are mainly used to exclude morphologic changes of the spine. Functional disorders are best treated by chirotherapy completed by rehabilitation of the active motion apparatus. The most important morphologic diseases of the spine causing back pains are deformities, especially lumbar scoliosis, infectious diseases as pyogenous or specific spondylitis, rheumatic diseases as rheumatoid arthritis, mostly at the occipitocervical region, and Bechterew's disease, furthermore instability caused by spondylolisthesis or iatrogenic low back pain as the failed-backsyndrome and tumors, which are in the majority metastases. The role of degenerative changes as a cause of back pain is difficult to estimate. The operative treatment of spinal instability, which has changed in the last years is described, as modern treatment facilities of lumbar disc herniation as chemonucleolysis or percutaneous nucleotomy.
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PMID:[The spine in adulthood]. 837 59

Thirty-five male patients, aged 34-79 yr, with definite rheumatoid arthritis (RA) were recruited from out-patient clinics and randomized to receive monthly injections of testosterone enanthate 250 mg or placebo as an adjunct therapy for 9 months. Endpoints included disease activity parameters and bone mineral density (BMD). At baseline, there were negative correlations between the ESR and serum testosterone (r = -0.42, P < 0.01) and BMD (hip, r = -0.65, P < 0.01). A total of 29.6% of all patients had at least one vertebral fracture, most having multiple fractures. Back pain, however, was not more prevalent in fracture patients (55% vs 50%). Disease activity was significantly higher in the fracture group (joint score P < 0.05, rheumatoid factor P < 0.01). Thirty patients completed the trial, 15 receiving testosterone and 15 receiving placebo. There were significant rises in serum testosterone, dihydrotestosterone and oestradiol in the treatment group. There was no significant effect of treatment on disease activity overall, five patients receiving testosterone underwent a "flare'. Differences in mean BMD following testosterone or placebo were non-significant (spine: +1.2% vs -1.1%; femur: -0.3% vs +0.3%). There was no suggestion of a positive effect of testosterone on disease activity in men with RA.
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PMID:A randomized trial of testosterone therapy in males with rheumatoid arthritis. 867 May 79

This prospective study was conducted to evaluate the short- and medium-term impact of the outpatient education sessions that have been available at the Cochin Teaching Hospital since 1992. Each patient was asked to complete a ten-item anonymous questionnaire at the beginning of the education session (evaluation 0), immediately after the session (evaluation 1), after six months (evaluation 2) and after 12 months (evaluation 3). Mean numbers of correct answers per patient were calculated. Eight education sessions were evaluated (osteoarthritis, osteoporosis, rheumatoid arthritis, back pain, conservative treatments, surgical treatments, low-calorie diets and high-calcium diets). One hundred twenty-four patients completed the first two questionnaires, 94 (75.80%) completed the six-month questionnaire and 75 (60.5%) completed the 12-month questionnaire. Mean numbers of correct answers were as follows: 5.7 before the session, 7.3 after the session (p = 0.0001), 7.2 after six months (p = 0.0001), and 7.9 after 12 months (p = 0.0001). These results demonstrate that the education sessions significantly improved patient knowledge in the short and medium term. Their impact on quality of life is being evaluated.
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PMID:Education for outpatients with rheumatic diseases. Evaluation of short-term and medium-term results. 889 59

Therapeutic trials in rheumatoid arthritis (RA), osteoarthritis, seronegative spondyloarthopathies, back pain, systemic lupus erythematosus, and systemic sclerosis are reviewed. For RA, minocycline has been proven effective in some subsets of RA, whereas tumor necrosis factor receptor IgG fusion protein appears quite effective for treating the symptoms of RA in a more resistant group. The latter trial illustrates the importance of tumor necrosis factor in RA. Also, the triple combination of hydroxychloroquine, sulfasalazine, and methotrexate is very effective even in resistant RA. In osteoarthritis, the effects of nonsteroidal anti-inflammatory drugs, intra-articular steroids, and biologics are reviewed, with generally nondifferentiable nonsteroidal anti-inflammatory drug effects and some short-term intra-articular effects of new biologics. Sulfasalazine is moderately effective for ankylosing spondylitis and psoriatic arthritis, although the large placebo response in the latter makes it more difficult to show responses. Trials in the treatment of back pain are beginning to be published, with a large cohort study over 1 year favoring surgery for early relief of pain in both sciatica and lumbar stenosis, but not showing a clear advantage in functional outcome at 1 year. Finally, early reports show the ability of dihydroepiandrosterone to decrease steroid use in systemic lupus erythematosus, whereas Relaxin appears to be effective in decreasing skin involvement in systemic sclerosis. These trials demonstrate in numerous ways the need to consider the elements of good trial design when testing therapeutic modalities in the rheumatic diseases. These key elements include 1) careful patient definition and selection; 2) removal of bias (requiring blinding, randomization, prospective studies, and often, placebo); 3) use of well-defined outcomes; and 4) careful analytic techniques.
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PMID:Update on clinical trials in the rheumatic diseases. 956 7

The majority of thymic lymphomas are either lymphoblastic lymphoma, large B cell lymphoma or Hodgkin's disease, and other types of non-Hodgkin lymphoma are rare. A case of low-grade B cell lymphoma of mucosa-associated lymphoid tissue (MALT) in the thymus is reported. A 55-year-old Japanese female with a history of rheumatoid arthritis (RA) complained of back pain. A mediastinal tumor was identified by computerized tomography and magnetic resonance imaging, and the thymus was resected through median sternotomy. The solid and nodular tumor had several small satellite extensions and was completely confined to within the thymus. Histologically, monotonous medium-sized centrocyte-like cells occupied the medulla of the thymus and infiltrated Hassall's corpuscles (lymphoepithelial lesions). Immunohistochemically, tumor cells were positive for CD20 and CD79a. IgA and kappa light chain restriction were also found in plasmacytoid cells in the tumor. Clonal rearrangement of the immunoglobulin heavy chain gene was demonstrated by polymerase chain reaction. This case was diagnosed as MALT-type low-grade B cell lymphoma in the thymus. This is the first report of low-grade B cell lymphoma in the thymus associated with RA. As autoimmune diseases are known to be associated with lymphoid neoplasms, it is suggested that the RA played an important role in the development of malignant lymphoma in this case.
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PMID:Low-grade B cell lymphoma of mucosa-associated lymphoid tissue in the thymus of a patient with rheumatoid arthritis. 958 69

The prevalence of rheumatic diseases in developing countries is largely unknown. Studies which allow comparison of data within the contrasting communities of the Third World and the developed world have the potential to provide insights into disease aetiologies. The current study compared the frequency of rheumatic symptoms (point prevalence) amongst 1997 adults distributed evenly between poor rural and poor urban communities and relatively affluent urban people. Comparisons were also made with similarly but previously derived prevalence rates of rheumatic symptoms and rheumatoid arthritis (RA) in south Pakistan and Pakistanis in England. A significantly higher prevalence of joint pain was seen in the north compared with the south. RA was more common in the north and similar to the frequency amongst Pakistanis resident in England. Ethnic and genetic susceptibility might have accounted for this. There was significantly more soft-tissue rheumatism and back pain in the northern rural population compared with those in the city. Fibromyalgia was almost completely absent from the urban affluent, but osteoarthritis of the knee was significantly more common in this community, perhaps due to relative obesity. RA was least in the urban poor, a phenomenon that might be attributable to earlier death of females or other undetermined factors.
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PMID:Prevalence of the major rheumatic disorders in the adult population of north Pakistan. 965 Oct 74

The education of rheumatic patients in Croatia has begun in 1975 by introducing the school of back pain. Soon after that has begun the education of children with scoliosis. The education of patients with rheumatoid arthritis and ankylosing spondylitis was establish in 1985. Along with the courses of patient's education, there were printed a publications dedicated to the same problem. At the beginning there was printed a textbook Rheumatic diseases with training for rheumatic patients (1978.) and then textbook Jogging (1982.) and Reta (1984.). During 1994, there were graduated a publications dedicated to the disease having the same name: Rheumatoid arthritis, Ankylosing spondylitis, Uric arthritis and Psoriatic arthritis, which were reprinted in enlarged form (1997). Protection of the joints in rheumatic disease (1998.) is a new textbook for patients about correctly usage of the joints. Textbook Prevention of back pain and neck pain (1998.) is dedicated to healthy people for the prevention of pain syndromes of vertebra. Thus, the education was introduced in almost all parts of rheumatology and in whole Republic of Croatia.
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PMID:[History of patient education in rheumatic diseases in Croatia]. 992 Oct 7


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