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Biomedical subjects

A Bjelle

Publications and source records attributed to A Bjelle.

At least 19 recordsLinked to original sources

Effect of active hand exercise and wax bath treatment in rheumatoid arthritis patients.

The effect of active hand exercise and warm wax treatment was evaluated in 52 rheumatoid arthritis patients randomized into four groups: (1) both exercise and wax bath, (2) exercise only, (3) wax bath only, and (4) controls. Treatment was given three times a week for 4 weeks. Deficits in flexion and extension in digits II-V bilaterally, grip function, grip strength, pain, and stiffness were measured before and after the treatment period. The control group was measured at corresponding times. Wax bath treatment followed by active hand exercise resulted in significant improvements of range of motion (ROM) and grip function. Active hand exercise alone reduced stiffness and pain with nonresisted motion and increased ROM. Wax bath alone had no significant effect.

Adult

Prevalence of radiographic osteoarthritis in two elderly European populations.

Was compared the prevalence of radiographic osteoarthritis (ROA) in two elderly populations, one in Göteborg (Sweden) and one in Zoetermeer (The Netherlands). The comparison was preceded by an inter-observed analysis of 150 films, revealing lower percentage agreements and kappa values when analysing the films on a five-point scale compared to the analysis in a dichotomy of "abnormal" and "normal" films. An intra-observer analysis of 50 films revealed higher percentage agreement and kappa values of well over 0.75, suggesting that radiographs could be read by one observer when different populations are being compared. The prevalence of hand ROA was higher in the Göteborg population, while the prevalence of knee ROA showed no significant differences. No significant increase with age of the cohorts was found for hand ROA in either population and no increase with age for knee ROA was found in the Swedish population. In the Zoetermeer population, knee ROA increased with age in both sexes.

Age Factors

Radiographic osteoarthritis in the elderly. A cohort comparison and a longitudinal study of the "70-year old people in Göteborg".

The prevalence of radiographic osteoarthritis in hand and knee joints was studied in representative subsamples of the 75 and 79 year old population of Göteborg, Sweden. A comparison between two cohorts of 79-year-olds, revealed no significant difference between them. A longitudinal study within one of these cohorts including those aged between 75 and 79 showed a modest but not statistically significant progression of osteoarthritis in hand and knee joints. The results suggest a reduced progression of osteoarthritis after 75 years of age.

Aged

A longitudinal study of the occurrence of joint complaints in elderly people.

Joint complaints were studied in two cohorts longitudinally followed at 4-5 year intervals between the ages of 70 and 79, representative of the elderly population of Göteborg, Sweden. Joint complaints were reported by 30-43% of the women and by 15-25% of the men. A significant increase of joint complaints was found in both sexes between the ages of 70 and 75 but not thereafter. The knee joints were the most common site of complaints in both sexes. Complaints were not consistently reported by the probands at all examinations, however, and a 'disappearance' of complaints with age was found. Complaints on all three occasions were reported by 15% of the women and 3% of the men. An association was observed between repeatedly reported complaints and radiographic osteoarthritis as well as with self-reported rheumatoid arthritis.

Aged

Measuring the quality of life of women with rheumatoid arthritis or systemic lupus erythematosus: a Swedish version of the Quality of Life Scale (QOLS).

The Quality of Life Scale (QOLS) was translated into Swedish and reliability and validity was studied. The Swedish version (QOLS-S) was given to 100 women with rheumatoid arthritis or systemic lupus erythematosus along with the Arthritis Impact Measurement Scales and a visual analog pain scale. Disease activity was also measured using the Ritchie Articular Index and a patient version of the Systemic Lupus Activity Measure. Results indicated that the QOLS-S had high test-retest reliability (r = .84 for a 4-week interval) and internal consistency reliability (alpha = .82 at Time 1 and .88 at Time 2). An hypothesis that the QOLS-S would have low to moderate correlations with measures of health status and disease activity was supported. We conclude that the QOLS-S is a reliable and valid measure of quality of life in Swedish women with RA and SLE and that it provides a measure of quality of life that is distinct from health status and disease activity.

Adult

Outcome of parenteral gold therapy in RA patients: a comparison between two periods using life-table analysis.

Tolerance and outcome of parenteral gold therapy were compared using life-table analysis and ARA remission criteria between 151 rheumatoid arthritis (RA) patients treated in 1983 and in 210 patients treated in 1985. The total risk of termination of therapy was significantly higher in patients treated in 1983 than those treated in 1985. The most common causes were mucocutaneous reactions (41 and 25% in 1983 and 1985, respectively), unsatisfactory effect (15 and 25%) and practical problems (14 and 26%). The outcome regarding all ARA remission criteria except for fatigue (not systematically registered) was significantly more favourable in patients treated in 1985 than in those treated in 1983.

Adolescent

Functional status assessment.

Methodology of functional status assessment for musculoskeletal disorders has developed considerably in recent years. Reliability and sensitivity of measurements of physical functions are studied more systematically, and observer tests of activities of daily living functions have been developed with increased accuracy. A major area of interest, however, is reflected in studies of multidimensional assessments of functional limitations and the development of arthritis-specific questionnaires. The importance and difficulties of assessing function in clinical practice have been emphasized. Increasing interest among health planners and health economists in outcome measurements utilizing multidimensional functional assessments is evolving.

Activities of Daily Living

Rheumatic symptoms following an outbreak of campylobacter enteritis: a five year follow up.

Eighty six of 106 (81%) guests attending a party were followed up after an outbreak of Campylobacter jejuni enterocolitis. Acute diarrhoeal illness was reported in 35 subjects (33%), of whom seven showed acute rheumatic symptoms either alone or with other symptoms of infection with C jejuni. The antibody response to C jejuni corresponded well with the intensity of the disease. In the early phase of the gastrointestinal disease the patients with acute rheumatic symptoms displayed significantly higher IgM antibody levels in serum samples than the other patients in this study. Levels of antibodies to C jejuni were increased in serum samples from 31 patients (29%) without symptoms of infection with C jejuni. At a follow up after five and a half years, four of these patients suffered from chronic rheumatic disorders. One HLA-B27 positive woman developed reactive arthritis with a relapse seven years later. The remaining 20 subjects (19%) remained healthy and their antibody tests and stool cultures were negative for C jejuni. It is concluded that C jejuni enterocolitis is significantly associated with rheumatic symptoms in the early phase and may also cause chronic rheumatic disorders.

Acute Disease

Osteoarthritis in the elderly: clinical and radiological findings in 79 and 85 year olds.

The prevalence of joint complaints and clinical and radiological findings of osteoarthritis in wrist, hand, and knee joints was studied in representative population subsamples of 79 and 85 year olds. Joint complaints, clinical findings of osteoarthritis, and radiographic osteoarthritis were more common in women. Age related differences in the prevalence of osteoarthritis were not found. Although there was a correlation between clinical signs of osteoarthritis and radiographic osteoarthritis, clinical signs were often present without radiographic evidence and moderate and severe radiographic osteoarthritis was often present without clinical signs.

Aged

Swallowing problems in rheumatoid arthritis.

Twenty-nine female patients with definite or classical rheumatoid arthritis (RA) and 30 controls were investigated in order to evaluate oral symptoms, particularly xerostomia, and swallowing difficulties in RA by means of a questionnaire, physical examination, stimulated saliva secretion, labial salivary gland biopsy, esophageal manometry and laboratory blood tests. Xerostomia was reported by 6 patients (21%), compared with no-one in the control group. Four of these 6 patients had decreased stimulated saliva secretion, compared with 2 of the remaining 23 patients. Dysphagia was experienced by 8 patients (28%), compared with one control subject. Dysphagia was associated with disease severity. Esophageal manometry revealed a decrease of the amplitude of the peristaltic pressure complex in the proximal part of esophagus in the RA group, indicating dysfunction of the striated muscles. No correlation was found between dysphagia and esophageal manometry results.

Arthritis, Rheumatoid

Laryngeal involvement in rheumatoid arthritis.

Twenty-nine female patients with definite or classical rheumatoid arthritis (RA) and 30 controls were studied in order to assess the prevalence of laryngeal involvement in patients with RA and the occurrence of extrathoracic airway obstruction. Laryngeal involvement was assessed by physical examination including direct fiberoptic laryngoscopy, respiratory function tests and low-voltage radiography. Physical examination revealed laryngeal involvement in 17 RA patients (59%), extrathoracic airway obstruction was indicated by spirometry in 4 (14%) and radiography revealed pathological findings in 3 patients (10%). One or more signs of laryngeal involvement were found in 20 patients (69%). Symptoms of breathing difficulties were common (75%) among patients with laryngeal involvement. The erythrocyte sedimentation rate and class-specific rheumatoid factors were not correlated to laryngeal involvement.

Adult

Prediction of team care effects in outpatients with rheumatoid arthritis.

Predictive factors for the outcome of 1-year rheuma-team care were studied in 68 female rheumatoid arthritis (RA) outpatients (mean age 56 years, mean RA duration 15 years). Seventy-three background variables were analyzed in a 4-step statistical model including partial and multivariate correlations in order to disclose the best predictors of change scores of the outcome measures chosen. These concerned disease activity (C-reactive protein, Lansbury articular index), physical joint function (Keitel index), mood (Mood Adjective Check List, MACL), and overall health (Sickness Impact Profile). Between 14 and 47% of the variance of the 1-year outcome change scores was explained by combinations of 2 or 3 predictors out of 12 strong background variables. The lowest value of explained variance was noted for MACL, and the highest for C-reactive protein. Both clinical, social, and self-assessed health data were among the predictors. Our results can provide a guide in the selection of patients with RA for multidisciplinary team care, in the formulation of treatment goals, and the creation of cost-effectiveness schedules.

Adult

Factors associated with radiographic osteoarthritis: results from the population study 70-year-old people in Göteborg.

Selected factors potentially associated with radiographic osteoarthritis (OA) were studied in 2 subsamples of 79-year-olds, within the longitudinal prospective study 70-year-old People in Göteborg. A very significant (p less than 0.01 in men, p less than 0.001 in women) association was found between radiographic knee OA and body mass index (BMI), and a significant (p less than 0.05) association was also observed between radiographic hand OA and BMI in men. Smoking correlated negatively (p less than 0.01) to radiographic knee OA in both sexes, even after adjusting for BMI. Other factors, including diabetes, ischemic heart disease, hypertension, physical activity, education, vocational training, marital status, serum uric acid, triglycerides, cholesterol and blood glucose levels did not correlate to radiographic OA. Finally, no correlation was found between either decreased bone mineral content or the presence of previous fragility fractures.

Aged

Pain management.

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Humans

Purification and characterization of IgG immunoconglutinins from patients with systemic lupus erythematosus: implications for a regulatory function.

The levels of IgG immunoconglutinins in plasma from patients with rheumatoid arthritis, systemic lupus erythematosus and primary biliary cirrhosis were monitored by ELISA. High levels of IgG immunoconglutinins were found mainly in plasma from patients with systemic lupus erythematosus. These immunoconglutinins bound to microtitre plate-fixed C3, C3b and C3c but poorly to C3d. This binding was inhibited by particle-bound C3b and iC3b but not by the corresponding soluble fragments. Furthermore, Western blot analysis revealed no immunoconglutinin-binding to reduced C3 peptides and no binding was shown to soluble C3 alpha and beta chain by ELISA. IgG immunoconglutinins were purified from three plasma specimens by affinity chromatography on activated thiol sepharose ATS/C3 fragments. Two immunoconglutinin preparations that preferentially recognize ATS-C3b, inhibited C5-convertase function by 50-100% while one immunoconglutinin that recognized ATS-C3d,g had no effect. The two former immunoconglutinins also inhibited all three factor I cleavages in C3 alpha chain but the latter inhibited only the third cleavage. None of the immunoconglutinins affected the binding of complement-coated anti-BSA/BSA complexes to CR1 (CD35) on human erythrocytes, but the two immunoconglutinins that inhibited all factor I cleavages also inhibited the factor I-induced release of anti-BSA/BSA complexes from CR1. The results show that immunoconglutinins recognize specific epitopes on bound C3 fragments and that they are able to modulate C3-mediated functions.

Antibody Specificity

A comparison of overall health between patients with rheumatoid arthritis and a population with and without rheumatoid arthritis.

Women with rheumatoid arthritis (RA) at a rheumatology outpatient clinic (PAT) were compared with women with RA in representative samples of the Gothenburg population (POP), and with non-arthritic women in this population (REF). Clinical routine measures disclosed substantial dysfunction in both RA groups. Their physical, psychosocial, and overall function, assessed by means of the Sickness Impact Profile (SIP), was more impaired than that of the REF. The PAT had a higher disease activity and worse overall health status than the POP. In definite and classical RA, a poorer SIP physical and overall function was noted in the PAT than in the POP group, despite similar mean age and mean disease duration. Women with probable RA in the POP group had worse SIP dysfunction than the REF, particularly regarding ambulation and personal care. The SIP was sensitive to variations in disease activity and comprehensively disclosed dysfunction better than routine clinical measures.

Activities of Daily Living

Clinical assessment of rheumatic diseases using viscoelastic parameters for synovial fluid.

For the first time it is clearly exhibited that synovial fluid (SF) is thixotropic. Although no hysteresis loops were observed for SF, not even at high shear rates, thixotropy may be exhibited by measuring the rate of recovery after extensive shearing. The rebuilding of the structure in a small-amplitude oscillatory state following the high-shear-rate state reveals the thixotropic behaviour. Five different viscoelastic parameters for various synovial fluids (SF) were obtained using oscillatory rheometry. It was also shown that for SF in the low frequency range, corresponding to a knee joint almost at rest, the shear loss modulus G" is greater than the shear storage modulus G', since the system is allowed to dissipate energy at rest. However, with movement, G' increases and eventually becomes greater than G" at a characteristic frequency above which the system has insufficient time to dissipate energy and hence responds as an elastic body. This functional behaviour, characteristic for normal SF, broke down in the SF of rheumatoid arthritis. It was also absent in the SF of knee joints with meniscus lesions and ligament defects.

Elasticity