Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0015672 (fatigue)
51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Forty patients with rheumatoid arthritis were randomly allocated to treatment with auranofin 3 mg b.d. or hydroxychloroquine 200 mg b.d. Twenty patients received each drug. Efficacy was analysed by comparing patients with available data at weeks 12, 24, 36 and 48 with baseline within each treatment group, and between treatment groups at each of these same time points. There were statistically significant improvements in all measured parameters of clinical efficacy among hydroxychloroquine treated patients, and in all efficacy parameters except one (time to onset of fatigue) in the auranofin treatment group. There were no significant differences between the treatment groups for any parameter of clinical efficacy. Of the laboratory parameters measured, only auranofin treatment produced statistically significant decreases in the concentration of IgA, IgG and IgM, with significant differences between treatments being detected in the case of IgA and IgG. Eight auranofin-treated and three hydroxychloroquine-treated patients were withdrawn because of adverse reactions before completing 48 weeks treatment. The commonest reason for stopping auranofin treatment was diarrhoea (5 cases). Three hydroxychloroquine-treated and two auranofin-treated patients were withdrawn from the study because of inefficacy of the trial drug. Auranofin had a more 'potent' biochemical profile than hydroxychloroquine, although more patients tolerated one year of treatment with the latter drug.
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PMID:A single-blind comparative study of auranofin and hydroxychloroquine in patients with rheumatoid arthritis. 643 15

Total lymphoid irradiation (TLI) was administered to 11 patients who had intractable rheumatoid arthritis that was unresponsive to conventional medical therapy, including aspirin, multiple nonsteroidal antiinflammatory drugs, gold salts, and D-penicillamine. Total lymphoid irradiation was given as an alternative to cytotoxic drugs such as azathioprine and cyclophosphamide. After radiotherapy, 9 of the 11 patients showed a marked improvement in clinical disease activity as measured by morning stiffness, joint tenderness, joint swelling, and overall functional abilities. The mean improvement of disease activity in all patients ranged from 40-70 percent and has persisted throughout a 13-28 month followup period. This improvement permitted the mean daily steroid dose to be reduced by 54%. Complications included severe fatigue and other constitutional symptoms during radiotherapy, development of Felty's syndrome in 1 patient, and an exacerbation of rheumatoid lung disease in another. After therapy, all patients exhibited a profound T lymphocytopenia, and a reversal in their T suppressor/cytotoxic cell to helper cell ratio. The proliferative responses of peripheral blood mononuclear cells to phytohemagglutinin, concanavalin A, and allogeneic leukocytes (mixed leukocyte reaction) were markedly reduced, as was in vitro immunoglobulin synthesis after stimulation with pokeweed mitogen. Alterations in T cell numbers and function persisted during the entire followup period, except that the mixed leukocyte reaction showed a tendency to return to normal values.
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PMID:Sustained improvement of intractable rheumatoid arthritis after total lymphoid irradiation. 688 88

A double-blind, cross-over trial compared the antiinflammatory and analgesic effects as well as tolerability of diclofenac sodium (Voltaren) and ibuprofen. Twenty-four outpatients with rheumatoid arthritis were included. A single-blind placebo period was inserted between the two active treatments. The daily dose of diclofenac sodium was 50 mg bid and that of ibuprofen 400 mg tid. The duration of each treatment period was 14 days. The efficacy was measured by the following criteria: Articular index (Lansbury), morning stiffness, fatigue, pain (measured on a visual analogue scale), consumption of rescue-analgesics, status of the arthritic condition, and patient preference. No significant differences were found between diclofenac sodium and ibuprofen, but regarding consumption of analgesic, global evaluation, rheumatic activity, and activity index, a slight trend towards a better effect of diclofenac sodium was found. The study had an adequate sensitivity as it could distinguish placebo from the active treatments for all parameters evaluated. No patient was withdrawn for unwanted effects. None of the laboratory data showed abnormalities of clinical relevance.
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PMID:Diclofenac sodium (Voltaren) and ibuprofen in rheumatoid arthritis. A randomized double-blind study. 700 69

The consequences of inflation and accelerating introduction of automation and microprocessors into industry are a shift from unskilled to skilled work, the lessening of opportunities for the unskilled worker, and growing unemployment. If disabled people are competing for employment they must take every opportunity to extend education and acquire skills. Juvenile chronic arthritis presents one set of problems in vocational rehabilitation at the beginning of a working career and adult rheumatoid arthritis another, commonly in those over 45 years old and previously established in work. The prevalence of severe disability in juvenile chronic arthritis is about 1 in 20 000 of the population, females are affected twice as often as males and 1 in 10 has defective vision or blindness due to chronic iridocyclitis. At school, besides education, there must be emphasis on encouraging independence, self-confidence, mobility and determination. A School Leavers' Conference early in the last year at school gives the adolescent the best chance of choosing a career. Rheumatoid arthritis is three times more common in women and increasingly, over the last 40 years, women are working besides home-making. Morning stiffness, fatigue, immobility and pain are the common symptoms of widespread involvement of joints and systemic disturbance. The principal determinant in the success of vocational rehabilitation is personality, and the social and environmental factors are more significant than the degree of disability. The Disablement Resettlement Officer can assure continuity of rehabilitation between the health and employment services: a favourable outcome is work, self-derived income independence and freedom of movement using whatever technical aids are required to achieve this.
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PMID:Rheumatoid arthritis: vocational rehabilitation. 718 85

A survey of 100 rheumatoid arthritis patients was conducted in order to gain insight into the problems that interfered with the patients' daily living patterns. Some of the more important problems investigated included stiffness, tiredness, functional hand problems, depression, inability to cope with daily activities and employment. Lack of understanding of the role of physiotherapy and occupational therapy has led to an underutilizaton of these services.
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PMID:Social and rehabilitational aspects of rheumatoid arthritis. 725 41

A study was conducted to develop criteria for clinical remission in rheumatoid arthritis (RA). Data were provided by 35 rheumatologists on 175 RA patients considered to be in complete remission (with or without antirheumatic therapy) and 169 RA patients in partial remission or with active disease. Six criteria yielded optimal discrimination: morning stiffness absent or not exceeding 15 minutes, no fatigue, no joint pain by history, no joint tenderness, no joint or tendon sheath swelling, and no elevation of erythrocyte sedimentation rate. In this study sample, the presence of five or more of these criteria in an individual patient yielded 72% sensitivity for clinical remission and 100% specificity in discriminating RA patients with active disease. In a population sample, it is estimated that the overall accuracy of these criteria would be more than 90% in RA patients.
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PMID:Preliminary criteria for clinical remission in rheumatoid arthritis. 730 32

Fatigue fracture of the pelvis in a 66-year-old woman with rheumatoid arthritis was recognized after bilateral total knee replacements. The fatigue fractures occurred sequentially and bilaterally in the superior and inferior pubic rami. Satisfactory recovery occurred in response to conservative treatment. The fracture of the right superior ramus failed to unite. Fatigue fracture should be suspected if there is pain in the pectineal region after knee arthroplasty.
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PMID:Fatigue fracture of the pelvis after total knee replacements: report of a case. 740 8

A 64 year-old woman with rheumatoid arthritis was admitted to our hospital because of general fatigue. She noticed polyarthralgia 8 months prior to the admission and diagnosis of rheumatoid arthritis was made. Administration of salazosulfapyridine (1.0 g/day) was started 6 months before the admission. Complete remission of rheumatoid arthritis was obtained in 2 months and blood cell counts showed normal values at that time. The results of laboratory tests included hemoglobin; 8.6 g/dl, white blood cell count; 1,900/mm3 with a differential of 19% neutrophils, 77% lymphocytes, and 4% monocytes; platelets were 21,000/mm3. A bone marrow aspiration and biopsy were performed. There were reduced numbers of myelocytes, erythroblasts, and megakaryocytes indicating aplastic anemia. Salazosulfapyridine was discontinued. Prednisolone, anabolic steroid and granulocyte-colony stimulating factor (G-CSF) were administrated. In spite of these therapy, recovery of peripheral blood cell counts have not been observed and supporting therapy including red cell and platelets transfusion have been continued. To our knowledge, this is the first case report which describes occurrence of aplastic anemia in patients with rheumatoid arthritis treated by salazosulfapyridine.
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PMID:[A case of rheumatoid arthritis complicated with salazosulfapyridine-induced aplastic anemia]. 755 32

This study compares functional changes to change in measures of disease activity following the introduction of slow-acting anti-rheumatic drugs (SAARD) in patients with active rheumatoid arthritis (RA). Clinical and laboratory variables were simultaneously monitored at 6-monthly intervals, over approximately 18 months. Function was measured by a performance testing, the Keitel function index (KFI), which was divided into sections representing small and large joints [hand (HFI); wrist (WFI) and limb function index (LFI)]. One-hundred-and-fifteen patients were studied, of whom 21 were male. The mean age of the subjects was 49 yr (S.D. +/- 12) and mean duration of disease 7 yr (S.D. +/- 7). The mean KFI at entry was 38 (S.D. +/- 18) while at the end of the study it was 31 (S.D. +/- 17) (P < 0.0001). The change in KFI following therapy correlated with the change in Ritchie articular index (RAI) (r = 0.4; P < 0.0001), early morning stiffness (EMS) (r = 0.3; P = 0.004), swollen joint count (JC) (r = 0.4; P = 0.0005), C-reactive protein (CRP) (r = 0.2; P < 0.05) and Lansbury systemic index (LSI) (r = 0.35; P = 0.002), but not with change in Westergren erythrocyte sedimentation rate (ESR) or change in time to onset of fatigue. Multiple regression analysis showed that 32% of the variation in KFI at the end of the study could be predicted by a combination of ESR, sulphasalazine therapy, RAI, disease duration and chloroquine treatment at onset (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Responsiveness of Keitel functional index compared with laboratory measures of disease activity in rheumatoid arthritis. 770 60

Three experimental questionnaires were compared with the Influence of Rheumatic Diseases on Health and Lifestyle (IRGL) questionnaire, a Dutch version of the Arthritis Impact Measurement Scales. Sixty-two patients with osteoarthritis (OA) and 35 patients with rheumatoid arthritis (RA), all of whom underwent hip arthroplasty, completed the study. Results showed that visual analogue scales for pain, stiffness, fatigue, and anxiety were strongly correlated with a number of the IRGL scales. Patient preference scales were sensitive to change and provided additional information on aspects of the patients' quality of life (QOL) that were felt to be important by the patients themselves. The questionnaire on performance in various roles in life was insensitive to change. In existing questionnaires, there is an attempt to represent the concept of QOL in terms of its most important aspects. Such realizations of the concept of QOL are not entirely suitable for application in clinical trials. The IRGL is overly complex, and its sometimes comprehensive scales do not deal with the possible effects of treatment. Neither of these properties is conducive to sensitivity to change. Visual analogue scales reduce the complexity. A simpler representation of QOL that can evaluate aspects relevant to treatment is recommended.
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PMID:Quality of life assessment: a comparison of four questionnaires: for measuring improvements after total hip replacement. 774 39


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