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Results for “ARTHRITIS, RHEUMATOID”

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At least 19 recordsLinked to original sources
PubMed2001

Development of an instrument to measure pain in rheumatoid arthritis: Rheumatoid Arthritis Pain Scale (RAPS).

OBJECTIVE: To develop a valid and reliable clinical instrument for measuring pain in adult patients with rheumatoid arthritis. The resulting Rheumatoid Arthritis Pain Scale (RAPS) is a quantitative, single-score, self-report 24-item instrument. METHODS: Psychometric evaluation of RAPS was conducted following estimation of content validity and a pilot study. The actual study used a convenience sample of 120 adults, 18 years of age or older, with pain of at least 3 months duration. The setting was a large rheumatology private practice in a metropolitan southwestern city. The gate control and affective motivational theories of pain served as a framework guiding the development of RAPS, which includes items suggestive of the multidimensional pain experience in rheumatoid arthritis. Four subscales, physiological, affective, sensory-discriminative, and cognitive, evaluated numerous pain factors. RESULTS: Findings indicate a high estimate for internal consistency for the total scale and a moderate to high estimate of internal consistency for projected subscales. Data were analyzed using Cronbach's coefficient alpha, Pearson product-moment correlation coefficients, and exploratory factor analysis. Using Cronbach's coefficient alpha, RAPS showed an internal consistency reliability coefficient of 0.92, a strong indicator of reliability. Reliability assessments for the 4 subscales also indicate reliability, with Cronbach's coefficients ranging from 0.65 to 0.86. Exploratory factor analysis yielded 3 factors with criteria for factor loadings > or = 0.4. CONCLUSION: The study's findings provided support for RAPS as a reliable and valid measurement of rheumatoid arthritis pain. Assessment of rheumatoid arthritis pain and its relationship to treatment outcomes could significantly impact the treatment interventions.

Adult↗
PubMed1995

The effect of age and renal function on the efficacy and toxicity of methotrexate in rheumatoid arthritis. Rheumatoid Arthritis Clinical Trial Archive Group.

OBJECTIVE: To evaluate whether age and renal impairment affect the rate of side effects or expected efficacy of methotrexate (MTX) in rheumatoid arthritis (RA). METHODS: Data was pooled from 11 MTX clinical trials containing 496 patients treated with MTX. We evaluated those patients less than 60 years old and those in 5-year groupings of age over age 60. Using serum creatinine, weight, and age, we calculated creatinine clearance and placed patients into quartiles based on their baseline creatinine clearance. To evaluate efficacy, we used changes in American College of Rheumatology core set efficacy measures available in these trials. To quantify side effects, we scored each side effect based on a modified Fries toxicity score and assigned each patient a score based on the worst side effect experienced during the trial. We also separately evaluated liver toxicities (twice normal elevation of AST or ALT), respiratory toxicity and severe toxicities. Intent-to-treat analyses were performed, adjusting for study of origin. Results were confirmed by placebo controlled trials, comparing MTX and placebo treated patients. RESULTS: Neither age nor renal impairment had any effect on the efficacy of MTX. Those in the oldest age groups (65-69 years, > or = 70 years) were not at higher risk of side effects from MTX. However, patients with renal impairment had a higher overall rate of toxicity and were at higher risk of severe and respiratory toxicities than those whose creatinine clearances were at least 99.8 ml/min (reference group). The odds of severe toxicity were increased roughly 4-fold in those with renal impairment. CONCLUSION: Among clinical trial patients, age does not affect MTX efficacy or the rate of side effects. Renal impairment, however, increases the risk of side effects.

Aged↗
PubMed1978

Nitroblue tetrazolium test in psoriatic arthritis, rheumatoid arthritis, and osteoarthrosis.

Nitroblue tetrazolium test scores were obtained in 43 patients with psoriatic arthritis, 32 patients with rheumatoid arthritis, and 16 patients with osteoarthrosis. The mean score in all groups was similar and was higher than previously reported in patients awaiting heart surgery or with noninfective dermatoses. The test is not thought to be helpful in differentiating psoriatic arthritis from rheumatoid arthritis, and its usefulness in the diagnosis of septic arthritis superimposed on other forms of arthropathy is limited.

Arthritis↗
PubMed1992

Plasma interleukin-6 and renin substrate in reactive arthritis, rheumatoid arthritis, and systemic lupus erythematosus.

In order to study the role of interleukin-6 (IL-6) in inflammatory disease we monitored plasma levels of IL-6 and acute phase proteins such as C-reactive protein (CRP) and renin substrate (RS) in patients with reactive arthritis (ReA), rheumatoid arthritis (RA), and systemic lupus erythematosus (SLE). Venous plasma samples were collected: (1) during the acute phase or exacerbation of the disease, and (2) several months latter during convalescence. Increased mean [95% confidence intervals (CI)] levels of plasma IL-6 were observed in patients with ReA both in the acute phase and later, 229 (177 to 280) ng/l and 197 (134 to 260) ng/l respectively (P less than 0.001 as compared to controls). The corresponding plasma IL-6 levels in RA patients were 283 (223 to 340) ng/l and 183 (151 to 226) ng/l, respectively (P less than 0.001 as compared to controls). Plasma IL-6 levels in SLE patients were not increased. Plasma RS levels were increased in all patient groups, but no significant correlation to IL-6 or CRP levels was observed, whereas plasma IL-6 and CRP levels showed a positive correlation in ReA and RA patients.

Acute-Phase Proteins↗
PubMed2000

Characterisation of autoantibodies to neutrophil granule constituents among patients with reactive arthritis, rheumatoid arthritis, and ulcerative colitis.

OBJECTIVE: To study the frequency and distribution of antineutrophil cytoplasmic autoantibodies (ANCA) among patients with reactive arthritis (ReA), rheumatoid arthritis (RA), and ulcerative colitis (UC) using different immunological methods. METHODS: Fifty serum samples from patients with reactive arthritis (26 with acute disease and 24 with chronic disease-that is disease of more than one year) were analysed for ANCA with indirect immunofluorescence, enzyme linked immunosorbent assay (ELISA) with six different neutrophil granule proteins as antigens, and immunoblotting on whole neutrophil extract and extracts of azurophil and specific granules. Thirty serum samples from patients with RA and UC served as controls in ELISA and indirect immunofluorescence. RESULTS: Sixteen per cent of patients with ReA were positive in immunofluorescence compared with 30% of patients with RA, and 70% of patients with UC. Thirty two per cent of patients with ReA were positive in ELISA. Antibodies directed against lactoferrin occurred in 20%, antibodies against bactericidal permeability increasing protein (BPI), elastase, cathepsin G, myeloperoxidase, and proteinase 3 were found in 8%, 2%, 2%, 8%, and 6%, respectively. Overall, 50% of RA sera and 53% of UC sera were positive in one or more ELISA assays, the corresponding figures for antibodies against individual antigens were for RA 7%, 3%, 0%, 13%, 47%, 17% and for UC 13%, 20%, 0%, 23%, 10%, and 17%. In immunoblotting, bands corresponding to lactoferrin and BPI were recognised in 44% and 22% of ReA sera. CONCLUSION: Antibodies against neutrophil granule antigens are often found in patients with ReA, primarily among those with chronic disease. The different methods detect various subsets of antibodies, with immunoblotting being the most and immunofluorescence the least sensitive.

Acute Disease↗
PubMed1989

Seronegative rheumatoid arthritis, rheumatoid factor cross reactive idiotype expression, and hidden rheumatoid factors.

The major rheumatoid factor cross reactive idiotype (RCRI), defined by prototypic monoclonal rheumatoid factors (RFs), is expressed as a dominant idiotype by pokeweed mitogen induced plasma cells obtained from seropositive (RF+) patients with rheumatoid arthritis (RA). Some patients who meet clinical diagnostic criteria for RA set by the American Rheumatism Association fail to express RFs at any time during their clinical course. To determine if seronegative (RF-) patients with RA, so designated by the latex fixation, Rose-Waaler classic binding assays, or a RF enzyme linked immunosorbent assay (ELISA), express the RCRI in the absence of detectable RFs we examined pokeweed mitogen plasma cells from these patients by indirect immunofluorescence. In addition, we used an inhibition ELISA to detect RCRI bearing molecules in the sera of RF- patients with RA. Five of 10 RF- patients with RA had a high prevalence of RCRI+ plasma cells (16-49% of total pokeweed mitogen plasma cells in culture). Six of 20 RF- patients with RA had high serum concentrations of molecules marked by the RCRI, equivalent to 21-110 micrograms/ml of RCRI+ reference monoclonal IgM RF. Four of five patients who expressed the RCRI in high prevalence in pokeweed mitogen plasma cells, also demonstrated high concentrations of RCRI in their sera detected by inhibition ELISA. There was significant concordance of RCRI expression determined by the two different assays. Four RF- patients with RA who expressed RCRI in their whole sera had hidden RFs detected in their 19S and, in one case, 7S serum fraction. Detection of RF related molecules in whole sera by the expression of RCRI in RF- patients with RA identifies a subgroup of RF- patients with RA who possess hidden RFs. Some RF- patients with RA can express the major RCRI in pokeweed mitogen plasma cells and in their sera and therefore are related to patients with prototypic Waldenstrom's macroglobulinaemia, who produce RCRI+ 19S IgM monoclonal RFs.

Adult↗
PubMed1972

Rheumatoid arthritis, rheumatoid factor, and tests for Australia or hepatitis-associated antigen.

False-positive results in tests for hepatitis-associated antigen using latex agglutination techniques may be due to rheumatoid factor in the serum. Possibly the use of IgM antibody in preparing the latex particles might diminish the occurrence of such reactions. No evidence was found for a relation between rheumatoid arthritis and a significant incidence of hepatitis-associated antigen detectable by countercurrent immunoelectro-osmophoresis.

Arthritis, Rheumatoid↗
PubMed1991

Changes of the lung in rheumatoid arthritis--rheumatoid pneumonia. A clinicopathological study.

The frequency and patho-histological characteristics of pulmonary changes were studied on the autopsy material of 100 patients with rheumatoid arthritis (RA). The formal pathogenesis and different stages of vasculitis, rheumatoid nodule, interstitial pneumonia, rheumatoid pleuritis, obliterative bronchiolitis, amyloidosis and the so-called rheumatoid pneumonia in the lungs is discussed. The rheumatoid pneumonia is a disseminating inflammatory lobular-sublobular process, not described previously. The frequency of rheumatoid pneumonia was 4%. The rheumatoid pneumonia is characterized by the necrotic vasculitis, fibrinoid necrosis or thrombovasculitis of the pulmonary and bronchial arterioles, and of small arteries. Because of the diminished blood supply distal to the vascular changes inflammatory foci may develop, more or less respecting the anatomic borders of pulmonary tissue. The lobular-sublobular inflammation is basically of non haemorrhagic character. Because of the recurrent nature of vasculitis, foci of inflammation in different stages can be observed in the lungs simultaneously side by side. Clinically the rheumatoid pneumonia was accompanied by severe RA, according to the frequency and severity of acute exacerbations. In all 4 cases of rheumatoid pneumonia the pulmonary process had been proven clinically and radiologically. Rheumatoid pneumonia occurred subsequent to recurrent arthritis following steroid withdrawal, and it was resistant to antibiotics.

Adult↗
PubMed1976

Noninfectious canine arthritis: rheumatoid arthritis.

Chronic unremitting, generally symmetric, erosive polyarthritis was studied in 8 dogs. The disease had clinical, serologic, radiographic, and pathologic changes similar to those of rheumatoid arthritis of man. The condition occurred mainly in smaller breeds of dogs, with time of onset from 8 months to 8 years of age, Characteristic radiographic changes were seen in the joints several weeks to several months after the appearance of the initial lameness. Synovial fluid contained an increased number of neutrophils, and synovial fluid and synovial tissues were sterile for anaerobic and aerobic bacteria, mycoplasma, chlamydia, and viruses. Corticosteroids were therapeutically ineffective in all of the cases; however, corticosteroids, cyclophosphamide, and azathioprine were effective when used in combination in several dogs.

Animals↗
PubMed2004

Quantification of radiological damage in inflammatory arthritis: rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis.

Quantification of radiological damage in inflammatory arthritis is important. It has proven its value in clinical trials, but its use in clinical practice is becoming more important as well. Scoring methods for rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis are available. These differ in the joints and features assessed. This results in differences in the scoring range, but also in the method of performance. The various methods for the three diseases are detailed in this chapter. Most information is available for rheumatoid and for this disease the relationship between radiological damage and long-term outcome is summarised.

Arthritis, Psoriatic↗