Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:P01889 (ankylosing spondylitis)
 5,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A randomized study was performed on 24 patients with ankylosing spondylitis to compare the efficacy and tolerability of 20 mg tenoxicam daily with 50 mg diclofenac twice daily. There were 6 withdrawals from the group taking tenoxicam and 4 from the diclofenac group. Depression in 1 patient taking tenoxicam was the only significant adverse event. Both drugs were otherwise well tolerated. Tenoxicam and diclofenac were rated as good or excellent by 27% and 55% of patients, respectively. Global assessment, pain and duration of morning stiffness were improved with both drugs but this improvement was not statistically significant and there was no statistically significant difference between the two groups. This study confirms that tenoxicam is effective and well tolerated but larger numbers would be required to detect a small difference between groups.
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PMID:Tenoxicam compared with diclofenac in patients with ankylosing spondylitis. 217 70

Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) advocated for use in painful and inflammatory rheumatic and certain nonrheumatic conditions. It may be administered orally or rectally using a convenient once or twice daily regimen. Dosage adjustments are not usually required in the elderly or those with mild renal or hepatic impairment although it is probably prudent to start treatment at a low dosage and titrate upwards in such groups of patients. Numerous clinical trials have confirmed that the analgesic and anti-inflammatory efficacy of naproxen is equivalent to that of the many newer and established NSAIDs with which it has been compared. The drug is effective in many rheumatic diseases such as rheumatoid arthritis, osteoarthritis, ankylosing spondylitis and nonarticular rheumatism, in acute traumatic injury, and in the treatment of and prophylaxis against acute pain such as migraine, tension headache, postoperative pain, postpartum pain and pain associated with a variety of gynaecological procedures. Naproxen is also effective in treating the pain and associated symptoms of primary or secondary dysmenorrhoea, and decreases excessive blood loss in patients with menorrhagia. The adverse effect profile of naproxen is well established, particularly compared with that of many newer NSAIDs, and the drug is well tolerated. Thus, the efficacy and tolerability of naproxen have been clearly established over many years of clinical use, and it can therefore be considered as a first-line treatment for rheumatic diseases and various pain states.
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PMID:Naproxen. A reappraisal of its pharmacology, and therapeutic use in rheumatic diseases and pain states. 220 85

256 individuals with inflammatory rheumatic diseases and 117 individuals of two control groups returned their questionnaires in a survey of subjective symptoms of the masticatory system. Subjective symptoms of the temporomandibular joint (tmj) were reported by 41% of the patients with rheumatoid arthritis, 29% of the patients with psoriatic arthritis, 20% of the patients with ankylosing spondylitis and 23% of the patients with other rheumatic diseases (such as Reiter's syndrome). Statistically significant differences (p less than 0.05) regarding the occurrence of "difficulties in opening the mouth wide" and "crepitus from the tmj" were found between the various types of rheumatic arthritis. In 40 patients with rheumatic diseases and tmj-symptoms the tmj was examined clinically, by orthopantomography and lateral tomography. Radiographic abnormalities were found in 68% of the patients and classified by a new radiographic index, according to the index of Steinbrocker. There were no indications for a relationship between a loss of posterior support and extensive radiographic changes of the tmj. The most common objective symptoms were pain on chewing, crepitus in the tmj and tenderness to palpation of the masticatory muscles and neck.
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PMID:[Clinical study on rheumatoid arthritis of the TMJ]. 226 60

Neck disorders implicated as causes of headache fall into two groups: a) those in which the cervical lesions are unequivocally demonstrable, and in which treatment of those lesions helps the headache; these are widely accepted as causes of headache, and include: congenital and acquired craniovertebral junction disorders, rheumatoid arthritis and ankylosing spondylitis of the upper cervical spine, and dissection or trauma to the carotid or vertebral arteries; b) those in which the neck disorder is either banal or not objectively demonstrable, and which seldom improve following treatment of the neck; these are not widely accepted as causes of headache; they include whiplash syndrome, segmental hypomobility-hypermobility syndrome, the posterior cervical sympathetic syndrome, cervical migraine, third occipital nerve headache, and cervicogenic headache. Features of a headache suggesting its cervical origin are: 1) abrupt onset following sudden excessive movement of the head; 2) persistent unilateral suboccipital or occipital pain; 3) consistent reproduction by neck movements and by nothing else; 4) abnormal postures of head and neck; 5) significant painful limitation of movement of upper cervical spine; 6) abnormal mobility at craniovertebral junction; 7) C2 sensory abnormalities or lower medulla or upper cervical cord signs.
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PMID:[Headache of cervical origin]. 230 70

The literature reports that 70% of the cases of sinus tarsi syndrome are post-traumatic, following an inversion sprain, and that 30% result from inflammatory disorders, such as rheumatoid arthritis, ankylosing spondylitis, and gouty arthritis. However, in the case presented, talipes equinovarus deformity and sinus tarsi syndrome coexisted. One of the corrective goals in the management of the talipes equinovarus deformity is the realignment of the articulation between the medial plantarly deviated talar head and the anteromedial segment of the calcaneus. The calcaneus must be rotated from a plantarflexed position into a dorsiflexed position. The posterior tubercle will be moved down and in, with the anterior process moved up and out away from the talar head. By correcting the plantarflexed varus attitude of the calcaneus, it is put in a valgus position that often closes down the sinus tarsi upon weightbearing. This compression may result in pain over the lateral aspect of the midfoot with hindfoot instability, as seen in the case presented. As a result of the abnormal anatomical relationship of the talus and calcaneus, the patient developed severe pain in the sinus tarsi. Based on the medical history and present postoperative results, the authors find a long-term sequela of talipes equinovarus deformity to be sinus tarsi syndrome.
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PMID:Sinus tarsi syndrome in a patient with talipes equinovarus. 232 75

The cauda equina syndrome is an uncommon and poorly understood complication of ankylosing spondylitis. The clinical and radiologic findings in five patients with this syndrome are described. Typical findings include cutaneous sensory impairment of the lower limbs and perineum with sphincter disturbances. Motor impairment occurs less frequently, and associated pain is an inconstant feature. Enlargement of the caudal sac and dorsal arachnoid diverticula that erode the lamina and spinous processes are characteristic myelographic and computed tomographic findings. The pathogenesis of the cauda equina syndrome in ankylosing spondylitis remains unknown but may be due to demyelination, post-irradiation ischemia, or compression from spinal arachnoiditis.
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PMID:Cauda equina syndrome complicating ankylosing spondylitis. 232 76

Nerves of the synovial membrane and of the capsule of the hip have been studied with the usual techniques of optical neuropathology. We studied 52 hips from 46 patients: 13 hips of post-fracture states of the femoral neck, 13 hips of idiopathic osteonecrosis, 6 hips of rheumatoid arthritis, 6 hips of ankylosing spondylitis and 14 hips of osteoarthrosis. Small capsular and synovial nerves mainly located close to blood vessels are modified by the lesions of the surrounding tissue (inflammatory, vascular, traumatic and mechanical disturbances). The degree of involvement is related to the disease and its evolution. The peri- and endoneurium is thickened and demyelination is mostly observed. Nerve lesions begin focally and for some time are segmental. The final lesions correspond to a complete fibrous transformation of the nerve with loss of axons. We suggest a correlation between nerve lesions and the existence or absence of pain in the hip.
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PMID:Pathology of the capsular and synovial hip nerves in chronic hip diseases. 234

We reviewed the results of forty-two total hip replacements that had been done with the self-locking Autophor ceramic total hip prosthesis in thirty-four patients. The patients ranged in age from twenty-five to sixty-seven years (average, forty-eight years). The diagnoses were avascular necrosis (eight patients), degenerative arthritis (nineteen patients), ankylosing spondylitis (one patient), post-traumatic arthritis (two patients), and rheumatoid arthritis (four patients). Seven procedures were revisions: five, of a loose cemented total hip prosthesis and two, of a loose noncemented endoprosthesis. No revision was done for infection. The length of follow-up ranged from twenty-seven to sixty-six months (average, fifty-one months). The patients were evaluated by physical examination, serial radiographs, and questionnaires. The hips were rated with the modified Harris hip score. At the time of follow-up, eleven of the twenty-seven patients who had had a primary hip replacement complained of at least moderate pain that limited activities; however, only three patients had to have a revision. The femoral components had a notable tendency to subside more than five millimeters, and in fifteen hips there was radiographic evidence of progressive loosening. Our experience with the self-locking Autophor ceramic total hip prosthesis has been disappointing. We no longer use it.
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PMID:Unsatisfactory results with a ceramic total hip prosthesis. 187 79

The role played by simple analgesics in the treatment of ankylosing spondylitis (AS) is not clear. A questionnaire survey of AS patients and rheumatologists revealed that a majority (78%) of patients took NSAIDs and a substantial proportion (34%) took simple analgesics. A majority of rheumatologists (65%) considered simple analgesics worth prescribing for AS patients. Rheumatologists tended to prescribe NSAIDs more often initially than simple analgesics while the reverse was true for general practitioners. Over half the patients (57%) considered pain relief as their first priority for drug treatment. Other objectives such as prevention of deformities and relief of stiffness were less important. A sizeable proportion of patients (15%) bought over-the-counter drugs. Prescribing habits of doctors can be improved by listing over-the-counter drugs in the British National Formulary and Data Sheet Compendium.
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PMID:Use of simple analgesics in the treatment of ankylosing spondylitis. 243 89

A 41-year-old male with a 20-year history of classical ankylosing spondylitis, psoriasis and seropositive, nodular erosive rheumatoid arthritis presented with a 12-month history of thoracolumbar junction pain following minor trauma. A pseudoarthrosis was noted at the T11/12 level on plain radiographs and tomograms. A gallium scan showed no increased isotope uptake, and a computed tomogram (CT) revealed no evidence of a paraspinal collection. Conservative management including cast immobilisation and local radiotherapy was ineffective, and spinal fusion was required. A typical Andersson lesion was found at operation. The diagnostic and therapeutic problems of such discovertebral lesions are discussed.
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PMID:A destructive discovertebral lesion: septic discitis, ankylosing spondylitis, or rheumatoid arthritis? 252 9


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