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Query: UMLS:C0003873 (rheumatoid arthritis)
 53,068 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The purposes of this study were to describe the prevalence of fatigue, examine the association between fatigue and doctor visits, and identify correlates of fatigue in rheumatoid arthritis (RA). On average, a high degree of fatigue was reported to occur every day, to remain constant during the course of a week, and to most often affect walking and household chores. When controlling for disease severity and insurance coverage, respondents who reported more fatigue made more visits to the rheumatologist than those reporting less fatigue. A regression model with fatigue as the dependent variable revealed that the following variables explained a significant amount of variance: pain rating, functional status, sleep quality, female gender, comorbid conditions, and duration of disease.
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PMID:Correlates of fatigue in older adults with rheumatoid arthritis. 845 94

A 65-year-old woman was referred to our department because of general fatigue and anorexia for one month. The patient has received anti-rheumatoid therapy with aurothiomalate and bucillamine for the last two years for rheumatoid arthritis diagnosed 11 years earlier. Based on her systemic arthralgia, positive RA factor, and characteristic pleural effusion, the diagnosis of rheumatoid pleural effusion was made and prednisolone was administered. Two weeks later, the pleural effusion had improved. Rapid tapering of the drug over one month resulted in reappearance of pleural effusion. Slow tapering of prednisolone resulted in disappearance of the pleural effusion. One year after discharge, the patient was again referred to our department because of increased arthralgia. Pleural effusion reappeared after similar rapid tapering of the drug. These results suggest that induction of pleural effusion may occur in rheumatoid arthritis patients as a result of rapid tapering of steroids. Tapering of steroids in rheumatoid patients should be performed with care.
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PMID:[A case of rheumatoid arthritis accompanied by repeated pleural effusion associated with rapid tapering of steroid]. 851 3

The effectiveness of an exercise prescription and unsupervised home exercise programme was tested on 37 subjects with rheumatoid arthritis and 34 with systemic lupus erythematosus. Subjects were randomly assigned to control or stationary bicycling at home, using loaned bicycles. Exercise subjects (with bicycles) did better than controls, but not significantly, on all outcomed measures (exercise tolerance test, fatigue, depression and helplessness) at 3 months. Bicycles were reclaimed at 3 months and all subjects in both groups given instructions for home exercise. Exercise in the second 3 months was predicted primarily by baseline exercise habits and fatigue. It is concluded that although safe, unsupervised home exercise programmes may benefit few patients. Future research should address methods of stimulating and maintaining unsupervised exercise programmes in patients with systemic rheumatic disease.
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PMID:Effectiveness of minimally supervised home aerobic training in patients with systemic rheumatic disease. 854 9

Various diseases often occur after delivery but the systemic examinations have not been studied before. Thyroid dysfunction frequently (4.4%) occurs after delivery through an immune rebound mechanism. If postpartum women complain of the symptoms caused by thyrotoxicosis (palpitation, weight loss, increased sweating, finger tremor, fatigue) or hypothyroidism (edema, cold intolerance, hoarseness, sleepiness, fatigue), it is essential to examine thyroid hormones, thyroid stimulating hormone, anti-thyroid microsomal antibody (MCHA) and anti-TSH receptor antibody. To predict who will develop postpartum thyroid dysfunction, the measurement of MCHA during pregnancy is useful because 62% of the subjects with positive MCHA show thyroid dysfunction after delivery. The individuals at high risk of postpartum onset of Graves' thyrotoxicosis can be found early in their pregnancy by the detection of thyroid stimulating antibody (TSAb). Other autoimmune diseases, such as rheumatoid arthritis, systemic lupus erythematosus, autoimmune hypophysitis and so on, also could develop after delivery. These findings indicate that laboratory tests in the postpartum period are essential to diagnose postpartum onset of autoimmune diseases and the measurement of autoantibodies in early pregnancy is useful for prediction of their onset in the postpartum period.
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PMID:[Postgravid health care and laboratory tests]. 855 72

Rheumatoid arthritis is generally a progressive disease, with radiographic evidence of joint damage, declines in functional status, and premature mortality. In addition, the disease has severe long term economic consequences, including direct costs of medical care, indirect costs of work disability and interference with social roles, as well as the intangible costs of pain, fatigue, helplessness, loss of self-efficacy, and other psychological difficulties. The consequences of rheumatoid arthritis have often been underestimated by health professionals, reimbursement agencies, the general public, and even rheumatologists. Furthermore, the adverse effects of potential therapies have often been regarded as more severe than the 'adverse effects' of untreated disease. More than 50% of patients with rheumatoid arthritis who are younger than 65 years and who were working at onset of disease receive work disability payments, and 0.8% of the US population eligible to work are individuals who have symmetrical polyarthritis but who, unfortunately, are not working. The total earnings gap between individuals with symmetrical arthritis and those in the general population was $US8.9 billion for women and $US8.7 billion for men, for a total of $US17.6 billion (1986 US dollars). The projected costs of knee replacement in patients with rheumatoid arthritis in the US are between $US600 million and $US900 million annually. New approaches to therapy, which include earlier and more aggressive intervention, new drugs, and combinations of drugs, appear required to provide adequate control of inflammation, so that the long term damage of rheumatoid arthritis might be prevented and the considerable costs ameliorated. The possible adverse effects and costs of treatment must be balanced against the adverse effects and underestimated costs of rheumatoid arthritis.
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PMID:The underestimated long term medical and economic consequences of rheumatoid arthritis. 871 94

A multiplanar approach and a good tissue differentiation characterize magnetic resonance imaging which have a great role in exploring numerous musculo-skeletal lesions; review of main indications and limits. MRI is useful in diagnosing certain undisplaced fractures, fatigue and insufficiency fractures, and consequences. Fibrous cartilage and hyalin cartilage lesions, tears of tendons, ligaments and muscles are well appreciated. MRI is also very good for an early and correct diagnosis of avascular necrosis, spinal degenerative lesions, spinal consequences of rheumatoid arthritis and ankylosing spondylitis, and bone metastases. It is the technique of choice for local staging of bone and soft tissue sarcomas.
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PMID:[Magnetic resonance imaging of the locomotor apparatus]. 876 42

We report herein a case of amyloid goiter associated with rheumatoid arthritis in which hypothyroidism was observed. A 52-year-old housewife who had suffeed from rheumatoid arthritis for 15 years was referred to our hospital because of general fatigue. On admission, a large goiter was observed. Laboratory data showed primary hypothyroidism. Renal biopsy and gastric mucosa biopsy showed amyloid deposition of AA-type. Thyroid biopsy showed massive amyloid involvement. Although the findings of iodine-123 scintigraphy, technetium-99m pertechnetate scintigraphy, computed tomography and magnetic resonance image studies were similar to those for goiter associated with chronic thyroiditis, tallium-201 chloride scintigraphy gave a differing result, demonstrating absent uptake at 3 hours in this case. Replacement therapy with levothyroxine relieved the symptoms. This case was unusual in that amyloid goiter presented clinically as hypothyroidism. Absence of tallium-201 chloride uptake at 3 hours may be a diagnostic specificity for amyloid goiter in differentiating its hypothyroidism from that caused by chronic thyroiditis.
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PMID:Amyloid goiter: radiological study in a case presenting hypothyroidism. 882 Sep 91

In the second part of their article on the emerging field of neuroimmunology, the authors present an overview of the role of neuroimmune mechanisms in defence against infectious diseases and in immune disorders. During acute febrile illness, immune-derived cytokines initiate an acute phase response, which is characterized by fever, inactivity, fatigue, anorexia and catabolism. Profound neuroendocrine and metabolic changes take place: acute phase proteins are produced in the liver, bone marrow function and the metabolic activity of leukocytes are greatly increased, and specific immune reactivity is suppressed. Defects in regulatory processes, which are fundamental to immune disorders and inflammatory diseases, may lie in the immune system, the neuro endocrine system or both. Defects in the hypothalamus-pituitary-adrenal axis have been observed in autoimmune and rheumatic diseases, chronic inflammatory disease, chronic fatigue syndrome and fibromyalgia. Prolactin levels are often elevated in patients with systemic lupus erythematosus and other autoimmune diseases, whereas the bioactivity of prolactin is decreased in patients with rheumatoid arthritis. Levels of sex hormones and thyroid hormone are decreased during severe inflammatory disease. Defective neural regulation of inflammation likely plays a pathogenic role in allergy and asthma, in the symmetrical form of rheumatoid arthritis and in gastrointestinal inflammatory disease. A better understanding of neuroimmunoregulation holds the promise of new approaches to the treatment of immune and inflammatory diseases with the use of hormones, neurotransmitters, neuropeptides and drugs that modulate these newly recognized immune regulators.
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PMID:Neuroimmune mechanisms in health and disease: 2. Disease. 887 36

The objective of our study was to estimate the impact of early rheumatoid arthritis (RA) on psychological distress by comparing patients with RA and matched controls. A sample of 238 patients (age 20-70 years, mean age 52 yrs) with RA of 0 to 4 years duration (mean 2.2 yrs), was compared to 116 control persons matched to the patients with respect to sex, age, and geographic area. Data were collected through self-report questionnaires. Patients with RA rated their mental health significantly lower than the controls. Symptoms of anxiety and depression were significantly higher among arthritic patients. Twenty% of the patients had scores indicating possible psychiatric caseness compared to 6% of the controls. However, controlling for pain, disability, and fatigue, there was no significant difference in psychological distress between the patients and the controls. RA appears to have a strong impact on mental distress even early in the disease. The present study demonstrates that pain, disability, and fatigue are strongly related to the increased levels of psychological distress in RA.
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PMID:The impact of early rheumatoid arthritis on psychological distress. A comparison between 238 patients with RA and 116 matched controls. 899 72

Many studies have demonstrated that aerobic exercise training is beneficial to prevent physical deconditioning in persons with rheumatoid arthritis (RA) without inducing adverse effects on individual's joints and general health. After significant results in individuals with RA (Functional Class I and II), the present study was conducted to demonstrate the feasibility of a modified dance-based exercise program to improve the physical fitness and psychological state of persons with RA (Class III). Ten (10) female subjects (mean age, 54 +/- 10 years) participated in an eight-week exercise program (twice weekly). Health status, use of medication, joint pain and swelling, cardiorespiratory fitness, activity of daily living, and psychological state were assessed before and after the training program. A high level of participation has been maintained by the participants (mean = 14.8/16 sessions). Most of them were able to perform a maximal exercise test on treadmill and reached 90% of the predicted heart rate at maximal exercise. No significant gain in aerobic power was observed for the group as a whole, but four subjects showed improvements of between 10% and 20% of their cardiorespiratory fitness. Positive changes in depression, anxiety, fatigue, and tension were observed after the eight-week exercise program. No deleterious effect on the health status was observed. These findings provide some evidences as to the feasibility of submitting individuals with RA to a modified dance-exercise program. Further studies, however, are required to determine the long-term effect of weight-bearing exercise on the health status of individuals with RA.
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PMID:Dance-based exercise program in rheumatoid arthritis. Feasibility in individuals with American College of Rheumatology functional class III disease. 912 16


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