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Biomedical subjects

H Isomäki

Publications and source records attributed to H Isomäki.

At least 91 records · Page 5Linked to original sources

Mortality from amyloidosis and renal diseases in patients with rheumatoid arthritis.

Patients with rheumatoid arthritis (RA), 500 men and 500 women, aged 40 years and over, together with a control population matched by age and sex, were observed over a 10 year period. The overall mortality was significantly higher in both men and women with rheumatoid arthritis than in the controls due to an excess mortality from infections and cardiovascular and renal diseases. During the follow up 31 patients with RA (12 male, 19 female) and one male control subject died from amyloidosis and 42 RA patients (19 male, 23 female) and one male control from renal diseases. The most important causes of renal deaths were chronic nephritis and renal infections.

Adult↗

Similar survival rates for rheumatoid and non-rheumatoid cancer patients.

The survival rate for cancer patients with rheumatoid arthritis was compared with that for non-rheumatoid cancer patients. This was accomplished by linking two nationwide Finnish data registers, the Social Insurance Institution's Population Register and the Finnish Cancer Registry. For 2012 of the 2062 rheumatoid patients with cancer diagnosed after the diagnosis of rheumatoid arthritis, the Cancer Registry was successfully searched for a non-rheumatoid of diagnosis of control patient who matched with respect to sex, age, year of diagnosis of cancer and location of the tumour (and also, for leukaemia, with respect to cell type). The 5-year relative survival rate for male rheumatoid patients was 21.2% and, for the control cancer patients, 25.4%. In females, the corresponding rates were 38.2% for the rheumatoid patients and 41.2% for the control patients (p less than 0.05). At some sites, particularly with leukaemia, the rates for the rheumatoid patients were lower than those for the control patients. The difference, however, only reached a 5% significance level for colorectal cancer in males. Rheumatoid arthritis and its treatment do not seem to have any appreciable effect on the survival of cancer patients.

Arthritis, Rheumatoid↗

Death certificate and mortality in rheumatoid arthritis.

Patients with rheumatoid arthritis (RA), 500 males and 500 females, aged 40 years and over, together with an age- and sex-matched control population, were observed over a 10-year period. Altogether 208 male and 148 female RA patients died during the follow-up period. RA was mentioned on the death certificates of 111 men (53%) and for 96 women (65%). Serious underreporting of RA was observed when the main cause of death was malignant neoplasms and diseases of the circulatory system. The results show that analysis of the causes of death can be highly biased if the RA diagnosis is based only on information on the death certificate.

Adult↗

Cancer mortality in patients with rheumatoid arthritis.

Patients with rheumatoid arthritis (RA), 500 males and 500 females, aged 40 years and over, together with an age and sex matched control population, were observed over a 10-year period. The overall mortality was significantly higher in both men and women with RA than in the controls. During the followup, 42 patients with RA (28 males, 14 females) and 58 control subjects (36 males, 22 females) died from malignant neoplasms, but this difference was not statistically significant. A significant excess of deaths from neoplasms of the hematopoietic system was observed in patients with RA. Subjects without RA had significantly higher mortality rate from cancer of gastrointestinal origin than patients with RA.

Adult↗

Ten year mortality and causes of death in patients with rheumatoid arthritis.

Five hundred men and 500 women, aged 40 or over, with rheumatoid arthritis, together with a control population matched for age and sex, were observed over 10 years. During that time 352 patients with rheumatoid arthritis (208 men, 144 women) and 221 controls (148 men, 73 women) died. The overall mortality was significantly higher (p less than 0.0001) in both men and women with rheumatoid arthritis than in the controls. Infections and cardiovascular and renal diseases (especially amyloidosis) appeared to be the main causes of death in rheumatoid arthritis.

Adult↗

Comparison of the effects of different anti-inflammatory drugs on synovial fluid prostanoid concentrations in patients with rheumatoid arthritis.

The effects of one-day treatment with nine nonsteroidal anti-inflammatory drugs and prednisolone on human synovial fluid concentrations of prostanoids were studied. The doses were calculated so as to be approximately equipotent according to clinical experience and the recommendations of the manufacturers. Most of the drugs used reduced clearly PGE2 and TxB2 levels in synovial fluid, but only a slight diminution in 6-keto-PGF1 alpha values was found. Carprofen, diclofenac, indomethacin, naproxen and tolfenamic acid reduced significantly the synovial fluid PGE2 concentrations. Diclofenac and indomethacin also reduced significantly the synovial TxB2 concentrations.

6-Ketoprostaglandin F1 alpha↗

Immunonephelometric quantitation of complement split product (C3d) plasma levels in rheumatic disease.

A simple method is described for routine quantitative determination of C3d by laser nephelometry after precipitation of intact C3 by polyethylene glycol. Plasmas from 292 patients with different types of rheumatic disease was tested. Elevated C3d levels were a far more common finding than low levels of complement components C3 or C4, but despite the increased sensitivity, the test only seemed diagnostically useful for systemic lupus erythematosus and MCTD. Though a better test than the quantitation of C3 and C4, the value of C3d determination in rheumatic disease seems to be limited.

Adult↗

When does the rheumatologist need surgical consultation?

The rheumatologist is in many ways dependent on the help of the surgeon, from the early diagnosis of arthritis to the treatment of old destruction. The longer the medical history of the condition, the more important its surgical treatment. Collaboration between rheumatologists and surgeons should be encouraged. It is generally best to have a rheumatologist in charge of the patient. The rheumatologist then consults a surgeon when necessary. Rheumatologists must be sufficiently well acquainted with the indications for and prospects of surgical treatment. Only then can they consult a surgeon at the right moment on the need for surgical treatment. Rheumatological treatment and consultation units should be built to allow for convenient regular orthopaedic consultation.

Arthritis↗

Linoleic acid treatment in inflammatory arthritis.

Ten patients with chronic rheumatic diseases were treated either with sunflower oil (linoleic acid 66%; n = 6) or with olive oil (linoleic acid 4%; n = 4) for 21 days. Sunflower oil but not olive oil increased the serum concentrations of linoleic acid in all fractions studied. In cholesteryl esters, both arachidonic acid and dihomo-gamma-linolenic acid concentrations were slightly diminished. The changes in all these fatty acids were already seen on the first days of treatment. Plasma arachidonic acid metabolites showed no uniform changes during the treatment. Excretions of the main metabolite of prostacyclin (6-keto-PGF1 alpha) and thromboxane B2 into urine were slightly increased in most patients on sunflower oil. No marked improvement was seen in the clinical or conventional laboratory parameters in either treatment.

Arachidonic Acids↗

Comparison of the analgesic effect of ten nonsteroidal anti-inflammatory drugs.

The analgesic effect of 10 anti-inflammatory drugs was compared using a single-blind method in 90 patients with rheumatoid arthritis. Each patient received two different drugs, for three days each and each drug was evaluated in 18 patients. After the trial, the patients considered which of the drugs they preferred. The greatest relief from pain was achieved by diclofenac, indomethacin, naproxen and tolfenamic acid, each of these being preferred by the majority of patients and being significantly (p less than 0.01) better than the least effective drugs ketoprofen and proquazone. Acetylsalicylic acid, azapropazone, carprofen and ibuprofen were considered intermediate in efficacy.

Adult↗

Xanthoma tendinosum in a normolipemic ectodermal dysplasia patient.

A female patient with congenital ectodermal dysplasia is described, who developed xanthoma tendinosum in her hands simulating rheumatoid arthritis. The serum lipids of this patient were normal. Both ectodermal dysplasia and xanthoma tendinosum in a normolipemic patient are rather uncommon and to our knowledge have not been previously reported in one and the same patient.

Adult↗

Predicting the outcome of rheumatoid arthritis. A Soviet-Finnish co-operative study.

The prognostically important signs and symptoms in the early stage of rheumatoid arthritis were studied in 136 patients selected and treated in Moscow and in 139 patients in Heinola, Finland. The follow-up time was 3 years. The outcome was poor in patients with early signs of radiological destruction in the joints, with rheumatoid factor in serum, with early functional disability or deficient flexion of the fingers, with multiple affliction of the finger, metatarsophalangeal or wrist joints, with marked morning stiffness, and with CRP in the serum. The age of the patients did not influence the outcome in Moscow, whereas in Heinola the mean age was higher in patients with a poor outcome. Despite the marked differences in the therapeutic methods and the outcome for patients, the prognostically important signs and symptoms were very similar in both centres.

Arthritis, Rheumatoid↗

Relationship between clinical synovitis and radiological destruction, in rheumatoid arthritis.

The clinical synovitis and radiological destruction of wrist and subtalar joints were followed over a 3-year period in 107 patients with rheumatoid arthritis of no longer than 6 months' duration. The joints were examined clinically and by X-ray on entry to study, at one year and at three years of study. The progress of joint destruction was highly significantly correlated with the frequency of clinical synovitis at the three examinations in both wrist and subtalar joints.

Arthritis, Rheumatoid↗

Prognostic value of the type of onset of rheumatoid arthritis.

The type of onset in 235 patients with rheumatoid arthritis (RA) was acute in 69, subacute in 55, and gradual in 111 patients. The radiological destruction of the hands and feet after 7 years from the beginning of the disease was the same in all patient groups. Thus the nature of the onset of RA seems not to have any significant influence on the outcome of the arthritis.

Acute Disease↗

Keratodermia blenorrhagica, arthritis, and polymyositis with cardiopulmonary complications.

A patient is described who had polymyositis with arthritis, keratodermia blenorrhagica, pulmonary fibrosis, and cardiac failure with a right bundle branch block. The cutaneous lesions on his palms and soles, considered to be specific for Reiter's syndrome, pointed to an overlapping of polymyositis with features of this syndrome. Findings typical of myositis were present. In addition a muscle biopsy showed sarcolemmal and endomysial deposits of IgG and IgM, and the serum level of IgM was elevated. Because skin lesions appeared at the height of symptoms in other organs, the possibility is raised that both might stem from a common immune process.

Arthritis↗

Prognosis of inflammatory joint diseases. A three-year follow-up study.

The prognosis 3 years after the onset of the disease was studied in 107 patients with definite rheumatoid arthritis, 161 with probable RA or non-specific arthritis, 84 with either ankylosing spondylitis, Reiter's disease or reactive arthritis, 14 with psoriatic arthritis and 10 with a systemic connective tissue disease. Prognosis was measured by clinical involvement of joints, radiological erosions in joints, deterioration in joint function, ESR, and working ability. A total of 44% of all patients were symptomless after 3 years. The prognosis was best in patients with an "HLA B 27-associated" disease and non-specific arthritis, and worst in RA. Two patients died during the follow-up of systemic connective tissue disease and one committed suicide with an overdose of hydroxychloroquine. Two HLA B27-positive patients developed systemic amyloidosis.

Arthritis↗