PubMed Health⌕ Search

Biomedical subjects

J J Rasker

Publications and source records attributed to J J Rasker.

At least 91 records · Page 5Linked to original sources
PubMed1988

The arthritis sufferer and the community: a comparison of arthritis sufferers in rural and urban areas.

One hundred and two rural patients and 100 urban patients with rheumatoid arthritis and osteoarthrosis and 203 age and sex matched controls were visited in their homes to evaluate their problems, needs, and expectations. Although one would expect disability to affect the mobility of a person, it was found that rural patients were more mobile than their urban counterparts despite the same degree of functional disability. They were more content with their lot, even though their circumstances were less favourable. Both groups of patients had little contact with their general practitioners, social workers, or district nurses, and lacked information about their disease and the availability of financial grants or home adaptations. The main problem for the individual patient was not pain, but the frustration of being unable to do things they used to do and of dependency on others.

Activities of Daily Living↗
PubMed1987

Frequency of infections among rheumatoid arthritis patients, before and after disease onset.

The self-reported frequency of genitourinary and bronchopulmonary infections in postmenopausal women with rheumatoid arthritis (RA) and in postmenopausal women with osteoarthritis and/or soft tissue rheumatism was compared. Neither before, nor after the onset of joint disease was a higher frequency reported by the RA patients. The previously established increased mortality from infectious disease among RA patients might be due to a more severe infectious disease course, leading to an increased case-fatality rate.

Aged↗
PubMed1987

The natural history of rheumatoid arthritis over 20 years. Clinical symptoms, radiological signs, treatment, mortality and prognostic significance of early features.

A 20 year follow up is reported on 100 patients with definite or classical rheumatoid arthritis when they were all initially seen within one year of the onset of arthritis. Forty-six patients have died and in 17 death was due to or related to RA. Mortality was greater in men than in women and in patients who had classical rather than definite RA at one year. Thirty of the surviving 54 patients have either no or only moderate restriction of physical activity. Those who had definite RA at one year are now better as regards functional capacity and joint score than those who had classical RA. In general the titre of the Rose test has tended to fall and those who have become seronegative have done better than those remaining seropositive.

Adolescent↗
PubMed1987

Gout in the elderly, a separate entity?

To evaluate whether the clinical pattern of gout differed between elderly women and men a retrospective study was performed in all women (22) and men (18) in our rheumatological clinics who developed gout after the age of 60. The diagnosis was made after a mean of 2.6 years of joint complaints in women and after 1.2 years in men. In about half the patients complaints started in more than one joint, often including the big toe. In five women, but none of the men, complaints started in the fingers. No correlation was found between gout and the presence of tophi or Heberden's nodes in the finger joints. The mean uric acid level was higher in women (0.61 mmol/l) than in men (0.53 mmol/l), and almost all the women (95%) used diuretics and only 56% of the men did so.

Age Factors↗
PubMed1986

Noncontraceptive hormones and rheumatoid arthritis in perimenopausal and postmenopausal women.

The use of noncontraceptive hormones before onset of joint disease was compared between 490 perimenopausal and postmenopausal women with rheumatoid arthritis and a control group of 659 women with soft-tissue rheumatologic disorders and/or osteoarthritis. Both groups were sampled randomly from the attendees of five rheumatologic clinics. A negative association was found between the onset of rheumatoid arthritis and the previous use of noncontraceptive hormones (odds ratio, 0.32; 95% confidence interval, 0.16 to 0.64). This association persisted on univariate and multivariate control of potentially confounding variables and on subgroup analysis. The protective effect of oral contraceptives on the development of rheumatoid arthritis was confirmed.

Arthritis, Rheumatoid↗
PubMed1986

Influence of weather on stiffness and force in patients with rheumatoid arthritis.

A simple instrument has been developed for quantitative measurement of stiffness (elasticity) and maximum force of the fingers and was tested in a series of 122 out-patients with RA and 101 healthy controls. Values measured for stiffness were higher in RA patients and were scattered more widely than in controls and the mean values for force in the RA patients were lower than in controls. RA patients with an elevated ESR have significantly less strength than those with low ESR. We evaluated the influence of the time of day and weather (humidity and air temperature on the wards and outside the hospital, barometer pressure) on stiffness and force. In 13 in-patients with definite or classical RA and 12 controls, measurements were performed in the morning and afternoons, over periods of 3 weeks. In RA patients, both stiffness and force increased with outside air humidity (p less than 0.05), confirming the clinical experience that stiffness increases in damp weather. In the controls, force decreased with a higher air humidity on the wards (p = 0.05) and increased with higher barometer pressure (p less than 0.05). In the controls joint stiffness was higher in the morning than in the afternoon (p less than 0.05). In the RA group, rather unexpectedly, the reverse was found (p = 0.06), possibly explained by the time of the day the investigation was done. Only in the controls was a significant increase in force noted during the 3 weeks of investigation (p less than 0.005). No correlation was seen between force and stiffness. No correlation was found between disease activity as expressed in ESR, Hb, Rose titre, ARA grading and stiffness or force.

Arthritis, Rheumatoid↗
PubMed1985

Synovectomy of the knee with 90Y.

In 33 patients with chronic arthritis of the knee, 48 knees were treated with an intra-articular injection of 5 mCi yttrium silicate (90Y). There were 27 patients with rheumatoid arthritis (RA) and 6 with osteoarthrosis (OA); the mean follow-up period was 33 months. At clinical investigation after 1 year, no signs of pain or swelling were found in 15 knees. In most cases, pain and swelling improved subjectively, with a mean duration of 11 months; in 20 knees, the improvement lasted more than 22 months. When radiographs showed severe destruction, 90Y treatment was unsuccessful, but an important new finding was that most patients with mild or moderate radiological abnormalities appeared to have a long-lasting improvement. The result did not correlate with erythrocyte sedimentation rate (ESR), haemoglobin or Rose titre at the time of injection or at follow up, suggesting that the result of the treatment is more dependent on local factors than on the disease activity. The results of 90Y treatment in 6 OA knees with persistent swelling were promising regarding swelling, even in patients with moderate radiological abnormalities. The main side-effect was a sometimes painful swelling of the knee, which was always successfully treated with an intraarticular corticosteroid injection. In 90Y-treated knees, the incidence of unstable joints was not significantly higher than in non-treated knees. In conclusion, 90Y synovectomy may be a successful treatment for patients older than 50 years with chronic arthritis of the knee due to RA and probably also OA, even when moderate radiological abnormalities are present.

Aged↗
PubMed1985

Salivary secretion and connective tissue disease in man.

Parotid and submandibular gland secretions collected from patients with rheumatoid arthritis or systemic sclerosis have been analysed and the results compared with those obtained from a matched group of healthy individuals. Flow rates were measured and the saliva samples assayed for amylase, kallikrein, protein, and salivary IgA concentration. The results showed that only patients with rheumatoid arthritis had a reduced salivary flow, especially parotid flow, with a significantly increased concentration of salivary IgA in both parotid and submandibular saliva. Patients with systemic sclerosis did not show significantly altered salivary flow rates, but there was a marked depletion of salivary IgA content in both parotid and submandibular saliva. Neither disease states appeared to alter the kallikrein or amylase content of saliva. The possible clinical value of these findings is discussed.

Adult↗
PubMed1984

The natural history of rheumatoid arthritis: a fifteen year follow-up study. The prognostic significance of features noted in the first year.

One hundred patients with definite or classical rheumatoid arthritis have been followed since the early months of their disease; after 15 years the 65 surviving patients were reviewed. Their functional capacity had fallen by comparison with reviews made 3 and 11 years after onset, but half were still unimpaired or only moderately so (grade 1 and 2). The number of affected joints had risen to an average of 8 joints in men and 13 in women, but the ESR and the titre of the Rose test were lower than in the first year. Haemoglobin levels had risen in men, but fallen in women. The first-year titre of the Rose test proved to be of great prognostic significance, regarding ARA grading and number of affected joints after 15 years, but it did not correlate with the functional capacity. However, the functional capacity at 3 years correlated significantly with its value at 11 and 15 years. Patients with rheumatoid nodules were significantly worse than the remainder in many respects. A positive Schirmer test, showing diminished tear secretion, did not relate to any of the clinical parameters. The medical and surgical treatment is briefly reviewed.

Activities of Daily Living↗
PubMed1984

The relationship between aurothioglucose- and D-penicillamine-induced proteinuria.

We studied patients with rheumatoid arthritis who have been treated with aurothioglucose (Au) and subsequently with D-penicillamine (DP), and who developed drug-induced proteinuria, over a 10-year period. Twelve patients developed Au-induced and 19 DP-induced proteinuria. Of the 12 patients with Au-induced proteinuria, only 2 (17%) developed DP-induced proteinuria, indicating a slightly increased risk as compared with the overall incidence (9.3%) of this reaction in 168 DP-treated patients. In addition, only a minority (2 out of 19, 10.6%) of patients with DP-induced proteinuria had previous Au-induced proteinuria. These data may indicate that different mechanisms are operative in Au and DP-induced proteinuria, as is also suggested by the finding that HLA-DR3 was present more frequently in the latter (50%) than in the former (21%). A history of previous Au-induced proteinuria is insufficient reason to deny these patients the benefits of subsequent treatment with DP.

Arthritis, Rheumatoid↗
PubMed1984

A combined immunohistological and histochemical analysis of lymphocyte and macrophage subpopulations in the rheumatoid nodule.

The histochemical demonstration of acid phosphatase (ACP) and adenosine triphosphatase (ATP) has been combined with standard immunofluorescence techniques, using a panel of monoclonal and conventional antibodies, to examine lymphocyte and macrophage subsets and their microanatomical relationships within the subcutaneous rheumatoid nodule (RN). This analysis reveals that the RN is composed largely of strongly HLA-DR+, ATP- macrophages which contain lysosomal enzymes (ACP) in large amounts. The lymphocytic infiltrate which is sparse and poorly organized is comprised almost entirely of thymus derived lymphocytes (T cells) with a normal proportion of helper/inducer (OKT4+) and suppressor/cytotoxic (OKT8+) cells. These observations are in contrast to the findings in the rheumatoid synovial membrane of a prevalence of interdigitating type, HLA-DR+ cells and the predominance of helper (OKT4+) type T cells.

Antibodies, Monoclonal↗
PubMed1983

Are rheumatoid nodules caused by vasculitis? A study of 13 early cases.

Rheumatoid nodules are especially found in patients with seropositive rheumatoid arthritis (RA). It is often suggested that the genesis of these lesions is due to a vasculitis in smaller capillary vessels or venules. To test this hypothesis we studied fresh nodules in 13 patients, all with classical or definite RA. In 7 cases a total of 8 nodules were removed within 10 days of origin and in 6 other cases between 2 and 8 weeks. In the former group immunofluorescence was found in 5 out of 8 cases, and in the latter group 3 out of 6 were positive. Immunoglobulin deposition together with complement was found only in cases of 10 days' duration or less. No correlation was found with the patient's age or disease duration, ESR, ANA positivity, Rose titre, haemoglobulin, or use of prednisolone. In 3 out of 7 nodules younger than 7 days no palisade layer was found, whereas in older nodules this layer was always present. Vasculitis was not more frequently present in the cases with younger nodules. Our study does not support the hypothesis that vasculitis is the primary cause of nodules.

Aged↗
PubMed1983

HLA-DR antigens and proteinuria induced by aurothioglucose and D-penicillamine in patients with rheumatoid arthritis.

By means of a case-control study we investigated the association between HLA phenotypes and the development of proteinuria after aurothioglucose or D-penicillamine treatment in patients with rheumatoid arthritis (RA). HLA-DR3 was markedly increased in 44 treatment cases compared with 66 RA controls (46 versus 18%, p = 0.002). HLA-DR3 positive patients were at greater risk during treatment with D-penicillamine (RR 10.1, p = 0.001) than gold treated cases (RR 1.7, p = 0.365). The associations between HLA-DR3 and nephrotic syndrome (RR = 6.3, p = 0.004) and early onset proteinuria (RR = 5.4, p less than 0.001) were stronger compared with uncomplicated proteinuria (RR = 3.1, p = 0.017) and late-onset proteinuria (RR = 1.6, p = 0.459), respectively. It appears that genetic factors in RA influence the development, the degree and the time of onset of drug induced proteinuria.

Arthritis, Rheumatoid↗
PubMed1982

Oral contraceptives and rheumatoid arthritis: further evidence for a preventive effect.

To investigate a reported negative association between the use of oral contraceptives (OC) and the development of rheumatoid arthritis, a case-control study was undertaken to compare the histories of OC use between 228 women with a diagnosis of probable or definite rheumatoid arthritis and 302 women with the diagnosis of soft-tissue rheumatism and/or osteoarthritis. The use of OCs before the onset of joint complaints was acknowledged by 31.1% of the rheumatoid arthritis patients and by 55.6% of the controls. After adjustment for possible confounding variables, the rate ratio for ever use became 0.42 (95% confidence interval 0.27--0.65), while it was 0.40 (0.22-0.72) for ex-users and 0.45 (0.28-0.75) for current users. These findings confirm the finding from the Royal College of General Practitioners Oral Contraceptive Study that the incidence rate of rheumatoid arthritis among OC users was halved.

Adult↗