Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0152031 (swollen joints)
 535 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Already in the early phase of rheumatoid arthritis (RA) sick-leave (SL) frequently indicates a severe handicap with respect to work capacity. However, the significance of demographic, disease and work characteristics for SL are not known in early RA. Therefore, the indicators of SL (defied as the history of SL as certified by a physician) were sought in a cross-sectional multicenter study of early RA (< or = 1 year duration). One-hundred-and-thirty-four employed consecutive outpatients fulfilled > or = 4 of 7 ARA 1987 criteria of RA: 85 females (63%), age 50 years (median), disease duration 7 months (median). At the time of the examination 74 of the 134 patients (55%) were on SL because of RA (dependent dichotomous variable of the analyses). In order to identify the most important indicators of SL all variables with p < or = 0.10 in univariate analyses were entered into a multivariate logistic regression (stepwise forward analysis, p < or = 0.10). Parameters included in two different regression models (somatic variable and depression, job characteristics, respectively) were analyzed together in order to find the final model (p < or = 0.05). The following variables were included in the final logistic regression model of SL (p < or = 0.05): higher values of age, pain, and number of swollen joints, frequent overhead work, frequent pressure of time at work. Other indicators of SL in univariate analyses (p < or = 0.10) were not included in the model: male sex, low functional capacity, walking time, control over the pace and activities of work, occupational qualification, elevated ESR and depression. Significant indicators of SL are work conditions, disease activity, pain and age. Thus interventions focusing on the amelioration of the work capacity and thereby on the reduction of SL should concentrate on both the control of the disease and the improvement of the work conditions.
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PMID:[Indicators of work incapacity in the first year of chronic polyarthritis]. 896 82

Clinical measurement in rheumatoid arthritis (RA) has focused on articular problems. Although measures like the Health Assessment Questionnaire (HAQ) are widely used to determine functional impairment, there is a need to determine the overall effect of RA on general health status. We evaluated the relationship of a generic health status measure-the Nottingham Health Profile (NHP)-to the clinical, laboratory and radiological changes in the EULAR core data set for RA. Two hundred consecutive out-patients with RA were recruited. Their mean age was 58.9 yr and mean disease duration 11.3 yr. Patients completed the NHP and the following assessments were made: the EULAR Core Data Set, the duration of morning stiffness, the Disease Activity Score (DAS), rheumatoid factor (RF) levels, and Larsen's score for X-rays of hands and wrists. RA patients had higher scores on the NHP than both a random population sample and a second sample of patients with a variety of common diseases. NHP scores were not related to age or disease duration in RA. There was little relationship between perceived distress and the Larsen score, RF, ESR and C-reactive protein levels. Moderate associations were seen between NHP scores and disease activity measures, including the number of tender and swollen joints, pain and the duration of early morning stiffness, and also with a disability measure-the HAQ. NHP scores were highly related to disease activity measured by DAS. High DAS scores were associated with high scores in the energy level, pain and sleep sections of the NHP. The NHP gives relevant information about RA patients. They have high scores for pain, physical mobility and energy level sections, and also have high distress for sleep and emotional reactions.
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PMID:The Nottingham Health Profile as a measure of disease activity and outcome in rheumatoid arthritis. 911 79

Pentoxifylline (POF) has been shown to have anti-inflammatory and immunomodulatory effects. including suppression of TNF-alpha production by activated macrophages, Th-1 response of T cells, and fibroblasts' proliferation and metalloproteinase production. Pentoxifylline was also reported to possess therapeutic properties in 50% of severe refractory RA in an open study. We experienced a 64 year-old man with seronegative RA, stage 2, class 3. He showed 23 swollen joints, 32 painful joints, ADL score 37/40, and ESR 135 mm/h. All these parameters were dramatically improved 3 weeks after administration of POF 300 mg/d and prednisolone 5 mg/d. Discontinuation of POF resulted in rapid exacerbation of RA. POF was restarted and the patient showed complete recovery from arthritis with normalization of ESR within 3 months and was maintained a complete remission for another 1 year. This case further supports a potential antirheumatic effect of POF on some patients with RA.
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PMID:[Remission induction after pentoxifylline treatment in a patient with rheumatoid arthritis]. 949 69

Several kinds of disease modifying anti-rheumatic drugs (DMARDs) can be utilized for the treatment of patients with rheumatoid arthritis (RA) to expect the prevention of joint damage progression and the improvement of quality of life. However, the methodology for the use of DMARDs is still controversial. On the basis of our prospective study, earlier introduction of DMARDs can be more efficient for the suppression of active disease. Thus, for the patients with more than three swollen joints, high ESR and CRP, immediate prescription of DMARD is recommended. And if these situation will not change even 6 months after starting the therapy, we should make all possible efforts to lead patients into remission using DMARD or corticosteroids, which would prevent patients from disability of joint function and thus would improve the quality of life of patients with early RA.
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PMID:[Disease modifying anti-rheumatic drugs(DMARDs)]. 1007 20

Although peripheral and central nervous system involvement have been well recognized in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), autonomic nervous system (ANS) involvement has rarely been studied, and has shown conflicting results. We performed cardiovascular ANS assessment in 34 RA and 37 SLE patients, using standard cardiovascular reflex tests. The results in each patient were compared with age- and sex-matched healthy controls. Forty-seven percent of the RA patients and 19% of the SLE patients had symptoms suggesting ANS dysfunction. The heart rate variation in response to deep breathing was significantly decreased in both the RA and SLE patients (p = 0.001). This diminished heart rate response showed no correlation with the disease duration, the number of swollen joints, the Ritchie articular index, ESR, or rheumatoid factor in the RA group, or the disease duration, the SLEDAI score or ESR in the SLE group. The clinical significance of the diminished cardiovascular ANS response needs to be investigated.
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PMID:Cardiovascular autonomic nervous system dysfunction in patients with rheumatoid arthritis and systemic lupus erythematosus. 1020 61

The aim of this study was to determine the conditions under which a sufficient preoperative amount of autologous blood could be obtained with administration of rHuEPO (recombinant human erythropoietin) in anaemic patients with rheumatoid arthritis (RA). Thirty-one patients (29 female, two male) with RA who were unable to donate any autologous blood owing to a haemoglobin level of less than 11 g/dl were recruited for this study. Their mean age at the time of operation was 59.3 years. The study protocol for preoperative autologous blood donations started 2.7 weeks before surgery. All patients received 6000 IU rHuEPO intravenously three times a week, supplemented with 40 mg intravenous saccharated ferric oxide at each rHuEPO administration. The protocol also included the provision that 200 g of blood at the first and third donations and 400 g of blood at the second donation were collected. The patients who were able or unable to donate 800 g of blood by this protocol were regarded as having a good or poor response, respectively, to rHuEPO. Patients with a poor response to rHuEPO showed greater clinical symptoms (morning stiffness, the number of swollen joints, Ritchie index) and higher laboratory inflammation parameters (ESR, CRP, platelets, IL-6, TNFalpha, IL-1beta) than patients with a good response to rHuEPO. The poor-response group showed a significant decrease in the progression of inflammation compared with the good-response group. Before treatment with rHuEPO, anaemia in the poor-response group was the same as that in the good-response group, except for impairment of UIBC (unsaturated iron-binding capacity). The poor-response group had a higher blood loss than the good-response group. In conclusion, anaemic RA patients should be considered as candidates for aggressive blood conservation interventions that depend on erythropoietin-modulated erythropoiesis. However, it is important to determine this approach under good control of inflammation.
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PMID:Autologous blood transfusion with recombinant erythropoietin treatment in anaemic patients with rheumatoid arthritis. 1046 68

One of the lines of inquiry into rheumatoid arthritis (RA) is a quest for markers capable of prognosticating the course of the illness. It is only genetic factors, the presence of rheumatoid factor, and activity of the illness that are most significant prognostic criteria. Showing much promise among the current approaches is DAS (Disease Activity Score) which relies on four variables (Richey index, number of swollen joints, ESR, and health index). The baseline and cumulative DAS values over a certain period of time can be used as prognostic factors. It is these criteria that the European League Against the Rheumatic Diseases Committee on Standardization of Clinical and Therapeutic Investigations have given approval to. They have been termed EULAR criteria.
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PMID:[The current methods for predicting the course of rheumatoid arthritis]. 1047 26

We investigated the utility of combination therapy of actarit with gold agents in patients with active rheumatoid arthritis resistant to gold agents even after the administration of gold agents for longer than 24 weeks in principle. 1. In the final global improvement rate by the combination therapy of actarit with gold agents, the ratio of "improved" and/or better was 30.8% (12/39). 2. The clinical evaluation items which showed significant improvement were grip strength, ESR, number of painful joints, number of swollen joints, active joint count, duration of morning stiffness and Lansbury's activity index. 3. ADRs were observed in 6 patients per 75 patients (8.0%), but there was no serious ADR.
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PMID:[Effect of actarit combination therapy in patients with active rheumatoid arthritis resistant to gold agents]. 1150 13

Rheumatoid arthritis is severe destructive inflammatory joint disease which usually leads to invalidisation of patient in spite of current therapies. The aim of the trial was to assess the effect of Cyclosporin A (Sandimmun (SIM), Sandos Pharma) in prevention of disability, reduction of inflammatory disease activity, tolerability, safety and suitability for a long treatment in severe treatment refractory juvenile rheumatoid arthritis (JRA). Fifteen patients of 7-15 years old (12 girls and 3 boys), of whom 6 had systemic seronegative and 9 had poliarticular seropositive severe JRA with anatomical stage 2-4 and functional capacities 2-3, were treated with Cyclosporin A in open self-controlled trial of 6 months duration for 15 patients and of 12 months duration for 7, All of them received non-steroid anti-inflammatory drugs and were regularly intra-articularly injected with corticosteroids and 6-prednisolone at a mean dose of 8.0 mg/day. Cyclosporin A was administrated in a dose of 3.5-4.5 mg/kg/day. Efficacy control was carried out according to dynamics of clinical and laboratory criteria of the disease activity, functional capacities and radiographic data. The results of the trial have shown that Cyclosporin A therapy led to statistically significant improvement in almost all clinical outcome variables (the number of swollen joints, p < 0.01, the number of painful joints, p < 0.001; pain score, p < 0.01; duration of morning stiffness, p < 0.001; volume of proximal interphalangeal joints, p < 0.001) and several laboratory parameters (ESR, p < 0.001; IgG level, p < 0.05; 6 seropositive patients became seronegative). All the patients exhibited significant increase in functional abilities and stabilization of joint destruction process. Response was considered as very good in 70% of patients and good in 20%, Prednisolone dose and the number of corticosteroid injections were reduced (p < 0.05). Adverse effects of Cyclosporin A included hypertrichosis, gingivitis, increase in appetite and weight, transitory increase in creatinin serum level of 30% over baseline, relapse of bacterial viral infection. These patients required temporal withdrawal of Cyclosporin A. It is concluded that Cyclosporin A therapy is effective in severe JRA, is well tolerated by patients, is suitable for a long-term treatment and has probable disease modifying effect in JRA.
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PMID:Immunosuppressive Therapy with Cyclosporin A of Severe Treatment Refractory Juvenile Rheumatoid Arthritis. 1268 42

The Rheumatoid arthritis (RA) causes early retirement and great number of working day losses. According to our investigation, retirement of patient in our country comes even earlier then in other countries. Possible causes for that are limited possibilities of application of contemporary therapy, which result in severer clinical course of the diseases as well as of the different criteria of the physicians for evaluation of the working ability. The aim of this work was to propose the criteria, which would help physicians to evaluate temporary or permanent working ability. For the purpose of forming the proposal of criteria, functional tests, parameters from our own research as well as the suggestions of the top world's institutions OMERACT, EULAR) are used. In order to assess working ability one should need: pain assessment, Ritchie articular index, the number of painful and swollen joints, morning stiffness duration, index of joint motion, functional ability measured by HAQ, ESR, CRP, Disease Activity Score (DAS), and rtg of both hands. Decision of working ability should not be made based on the current status of some parameters; it should be made by the analysis of the disease's progression. If the index of joint motion, functional status and rtg changes are severer every year, the retirement should be considered. The appropriate evaluation of current activity and follow up of its progression with the usage of the proposed criteria should help primary care physicians to evaluate temporary and permanent working disability.
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PMID:[Criteria for work capacity evaluation in rheumatoid arthritis]. 1501 3


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