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)

Cells of the immune system synthesize prolactin and express mRNA and receptors for that hormone. Interleukin 1, interleukin 6, gamma interferon, tumor necrosis factor, platelet activator factor, and substance P participate in the release of prolactin. This hormone is involved in the pathogenesis of adjuvant arthritis and restores immunocompetence in experimental models. In vitro studies suggest that lymphocytes are an important target tissue for circulating prolactin. Prolactin antibodies inhibit lymphocyte proliferation. Prolactin is comitogenic with concanavalin A and induces interleukin 2 receptors on the surface of lymphocytes. Prolactin stimulates ornithine decarboxylase and activates protein kinase C, which are pivotal enzymes in the differentiation, proliferation, and function of lymphocytes. Cyclosporine A interferes with prolactin binding to its receptors on lymphocytes. Hyperprolactinemia has been found in patients with systemic lupus erythematosus. Fibromyalgia, rheumatoid arthritis, and low back pain patients present a hyperprolactinemic response to thyrotropin-releasing hormone. Experimental autoimmune uveitis, as well as patients with uveitis whether or not associated with spondyloarthropathies, and patients with psoriatic arthritis may respond to bromocriptine treatment. Suppression of circulating prolactin by bromocriptine appears to improve the immunosuppressive effect of cyclosporine A with significantly less toxicity. Prolactin may also be a new marker of rejection in heart-transplant patients. This body of evidence may have an impact in the study of rheumatic disorders, especially connective tissue diseases. A role for prolactin in autoimmune diseases remains to be demonstrated.
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PMID:Prolactin, immunoregulation, and autoimmune diseases. 206 74

Twenty patients, 10 males and 10 females, age range 32-76, mean age 57.80 years, with diagnoses of acute multiple joint disorders (9 cases), flare-ups of rheumatoid arthritis (4 cases), low back pain due to lumbosacral disc pathology (4 cases), osteoarthritis of large joints (3 cases), all with severe pain and corresponding functional limitation of the joints involved, were treated with a nabumetone preparation (1 g capsules; one capsule at night before going to bed) for 8-12 days. During treatment, symptoms subsided gradually with adequate recovery of joint function. Parameters concerning general tolerability did not reveal clinically relevant changes compared to baseline. Local tolerability was mostly satisfactory. Two patients complained of mild side effects (gastric pain and skin phenomena). Treatment was considered effective in 15 cases, scarsely effective in 4, and ineffective in one.
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PMID:[Treatment of acute rheumatic-articular diseases with nabumetone]. 214 18

In 900 randomly selected individuals, 50-70 years old, we examined the prevalence over the preceding 12-month period of rheumatic complaints of more than 6 weeks' duration. We found them to represent a major health problem, with an overall prevalence of 37.8%, the predominant diagnoses being subacromial shoulder pain (6.7%), neck pain (6.5%), low back pain (6.3%), osteo-arthrosis (8.5%), and arthralgia (4.9%). With a prevalence of 1.0%, primary fibromyalgia was as common as rheumatoid arthritis (0.7%) and other chronic arthritides (1.1%). The prevalences of the different diagnoses were higher among participants whose data were obtained from personal investigation by a physician than among non-participants where data were obtained by interview, letter, and scrutiny of case records. The odds ratio from incurring more than one rheumatic disease was higher for subacromial shoulder pain and lowest for arthralgia and osteo-arthrosis.
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PMID:The commonest rheumatic complaints of over six weeks' duration in a twelve-month period in a defined Swedish population. Prevalences and relationships. 261 26

The three Tokelau atolls are 8 degrees south of the equator. In 1966 the islands were involved in a severe hurricane which drew attention to overcrowding and led to resettlement of more than half the population in New Zealand. One thousand three hundred and eighty one migrants over 15 years old were examined in New Zealand in 1980 and 1981 for rheumatic complaints as part of a continuing assessment. Clinical criteria for osteoarthritis (COA), including crepitus in any joint and in the knee, showed an increase in prevalence with age and weight in both sexes. Partial correlation coefficient analysis showed an association of the number of affected joints or the severity of knee COA (COAK) with both age and weight. Stepwise regression showed that age was the best predictor of both COA and COAK scores. Weight had predictive value only for COAK and only in women. Using the tracking method, previous high and/or increasing weight was related to COAK observed at this assessment. Heberden nodes increased with age and were more prevalent in women but were not associated with weight. Low back, dorsal and neck pain showed no association with age or sex. Low back pain was associated with weight. Joint pain following injury occurred in 15.4% of men. Gout, more common in men, was the only frequent inflammatory arthritis found. Two definite cases of rheumatoid arthritis (RA) were identified and four had criteria 1 and 2 for the New York criteria.
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PMID:Rheumatic complaints in Tokelau. I. Migrants resident in New Zealand. The Tokelau Island migrant study. 295 65

The migration of 1381 Tokelauans 15 years and over to New Zealand leaving 811 in Tokelau, provided a unique opportunity to test centuries of speculation on the impact of environment on rheumatic disease. There was no change in all rheumatic complaints. The migrant men had more gout, joint pain following injury, and neck pain. The migrant women had more dorsal back pain. There was no change in the prevalence of clinically defined osteoarthritis (COA) despite positive associations with weight and higher weights in the migrants. Rheumatoid arthritis was infrequent in both populations. Low back pain was common but was not more common in migrants, though compensation payments are readily available in New Zealand and are not in the Islands.
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PMID:Rheumatic complaints in Tokelau. II. A comparison of migrants in New Zealand and non-migrants. The Tokelau Island migrant study. 295 66

An observation method for the assessment of pain behaviors in patients with rheumatoid arthritis (RA) has been developed. We investigated the extent to which the frequencies of pain behaviors differentiated patients with RA and patients with chronic low back pain from depressed and nondepressed, pain free, control subjects. The reliability of the pain behavior frequencies of patients with RA across 2 observation sessions also was determined. Total pain behavior scores clearly differentiated patients with RA and low back pain from depressed and nondepressed, pain free, control subjects. Pain behavior observed in patients with RA showed a high degree of stability over time. The results of our study suggest that the behavioral observation method will prove useful in the assessment of RA pain in clinical and research settings.
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PMID:The assessment of pain in rheumatoid arthritis: disease differentiation and temporal stability of a behavioral observation method. 295 73

The Osteoarthritis (OA) Criteria Subcommittee of the American Rheumatism Association set out to develop (a) a classification of OA that includes recognised subsets; and (b) subsets of OA identified by a combination of clinical and laboratory features. For the purposes of classification, OA should be specified if of unknown origin (idiopathic, primary) or if related to a known medical condition or event (secondary). Clinical criteria for classification of idiopathic OA of the knee were developed through a multicentre study group involving 130 patients with OA and 107 comparison patients. Comparison diagnoses included rheumatoid arthritis (RA) and other painful conditions of the knee exclusive of referred or para-articular pain. Variables from the history, physical examination, laboratory test results and radiographs were used to develop sets of criteria that serve different investigative purposes: clinical examination (sensitivity 89%; specificity 88%); clinical examination and laboratory tests (sensitivity 88%; specificity 93%); clinical examination, laboratory tests and radiographs (sensitivity 94%; specificity 88%). In contrast to prior classification criteria, the proposed criteria utilise decision trees or algorithms. Clinical criteria for classification of idiopathic OA of the hip are under development. Comparison groups are comprised of patients with other rheumatic diseases (e.g. RA), periarticular pain (e.g. trochanteric bursitis) and referred pain (e.g low back pain). From a method of opinion sampling, OA of the hip may be suggested by a combination of clinical criteria including the following: age greater than 40 years, weight-bearing pain, pain relieved by sitting, antalgic gait, decreased painful range of motion, a normal erythrocyte sedimentation rate (ESR) and a negative rheumatoid factor test.
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PMID:Criteria for the classification of osteoarthritis of the knee and hip. 331 7

The prevalence of articular chondrocalcinosis was studied in a group of 100 patients with seropositive rheumatoid arthritis (RA). Articular chondrocalcinosis was observed less frequently (3%) than in a control group (19%) of 221 age and sex matched patients with low back pain or extraarticular rheumatism. This difference is statistically significant (p less than 0.001). Articular chondrocalcinosis occurred in the older patients with RA, and was observed in those with the shortest duration of the disease.
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PMID:Articular chondrocalcinosis in seropositive rheumatoid arthritis. Comparison with a control group. 357 33

We surveyed general and family practitioners to evaluate their patterns of referring musculoskeletal disease patients to rheumatologists and orthopedists. Patients who had rheumatoid arthritis, systemic lupus erythematosus, and ankylosing spondylitis were most often referred to rheumatologists, whereas patients with osteoarthritis, persistent low back pain, and post-traumatic knee pain were most often referred to orthopedists. As conditions worsened in severity, referrals were more frequent. Patients with conditions that were difficult to diagnose, such as possible shoulder tendinitis that was unresponsive to initial nonsteroidal therapy, undiagnosed polyarthritis, and intermittent knee swelling with pain, were most often treated without referral and, when referred, were most often sent to orthopedists. Belief in the effectiveness of rheumatologists or orthopedists correlated strongly with reported referral behavior, yet most respondents considered themselves capable of managing the majority of patients with musculoskeletal diseases. Neither practice arrangement, board certification, nor educational background affected referral behavior. However, younger physicians were more likely (P = 0.002) to refer patients to rheumatologists. Multivariate analysis showed that the significant predictors of global referral behavior were belief in the effectiveness of subspecialists and a small number of musculoskeletal problems seen by the generalist. The predictors of referral to rheumatologists were belief in rheumatologist efficacy and young physician age.
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PMID:Referral of musculoskeletal disease patients by family and general practitioners. 405 27

As compared to control-groups of rheumatoid arthritis and chronic non-inflammatory low back pain, over a hundred polyclinical patients suffering from ankylosing spondylitis were assessed with respect to several personality characteristics by psychological testing and proved to be relatively sthenic and educated. In trying to explain these personality features some disease-related factors seem to be relevant in ankylosing spondylitis: a relatively mild course of disease, the relief of complaints by exercise and a long pre-diagnostic period.
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PMID:Sthenia, ambition and educational level in patients suffering from ankylosing spondylitis: a controlled study of personality features as compared to rheumatoid arthritis and unspecified low back pain. 623 84


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