Download the Free Unbound MEDLINE PubMed App to your smartphone or tablet.
Available for iPhone, iPad, iPod touch, and Android.
Arthritis, general [keywords]
- Factors associated with poor self-reported health status after aortic valve replacement with or without concomitant bypass surgery. [JOURNAL ARTICLE]
- Eur J Cardiothorac Surg 2014 Nov 19.
Improving patients' health status is a central goal for cardiac surgery. Knowledge remains sparse on how combined CABG or other factors influence long-term, self-reported health status after aortic valve replacement (AVR). The aims of this study were (i) to identify significant factors influencing self-reported health status of patients assessed up to 13 years after AVR; and (ii) to compare their health with the age- and gender-matched general population.A survey questionnaire was sent to 1191 patients who had undergone AVR with or without concomitant CABG between 2000 and 12. Physical and mental sum scores of Short Form 12 were used as dependent variables and 34 independent variables including the Minnesota living with Heart Failure Questionnaire (MLHFQ) were evaluated by hierarchical linear regression. A comparison was made with the Norwegian general population. Clinical data were obtained from the local cardiac surgery database.In all, 912 patients (77%) responded (mean age: 73 years; 63% men). Of these, 59% had an isolated AVR. The mean assessment interval since surgery was 6 years. Several factors significantly predicted worse physical health: low education level (b: -2.8, P = 0.005), higher preoperative EuroSCORE (b: -0.88, P = 0.007), high NYHA class (b: -4.5, P < 0.001), depression (b: -5.62, P = 0.012), worse MLHFQ physical scores (b: -0.70, P < 0.001), arthritis (b: -5.13, P = 0.003), osteoporosis (b: -6.96, P = 0.010) and cancer (b: -4.48, P = 0.047) accounting for 60% of the variation (P < 0.001). Living alone (b: -3.60, P < 0.001), anxiety (b: -12.99, P < 0.001), depression (b: -6.82, P < 0.001) and worse MLHFQ emotional score (b: -0.50, P < 0.001) predicted poor mental health status, and explained 58% of the variation among AVR patients (P < 0.001). Both genders had poorer physical and mental health than their age-matched general population peers, particularly those in older age groups.AVR patients, regardless of gender, had worse physical and mental health than the general population. Living alone, educational level, physical symptom status, anxiety and depression were the most important predictors of physical and mental health status after AVR. Implementing new screening protocols for psychosocial risk factors and individualized rehabilitation programmes may contribute to improved health in AVR patients.
- Rheumatoid arthritis patients with hip fracture: a nationwide study. [JOURNAL ARTICLE]
- Osteoporos Int 2014 Nov 20.
The study was to investigate the outcomes of rheumatoid arthritis (RA) patients with hip fractures with a large-scale, population-based, nationwide, case-cohort study using the Taiwan National Health Insurance database. The group has hip fractures at a younger age, higher complication, and mortality rate, which indicate that early intervention is necessary.This study seeks to evaluate the incidence, mortality, and complication rates in RA patients with hip fractures, using a nationwide database.Data were collected from the National Health Insurance Research Database of Taiwan. The study group included 117,129 patients with hip fractures diagnosed from January 2004 to December 2010. Matching based on the propensity of RA patients was used. In total, 1,088 hip fractures were reported among patients with RA. Patients with hip fractures were divided into two groups: those without RA (controls) and those with RA (RA group). The incidence of hip fracture and mortality and complication rates after the hip fracture were then compared between the two groups.RA patients had a significantly higher incidence of hip fracture (3,260/100,000 person-years) compared with the general population (72/100,000 person-years). Hip fractures occurred significantly earlier among RA patients (70.6 ± 5.3 years) compared with the control group (76.1 ± 6.2 years). Cumulative mortality rates at 6-month and 1-year follow-up were significantly higher among patients in the RA group (9.47 and 18.47 %) compared to the controls (8.47 and 13.62 %) and among RA patients without hip fractures (3.24 and 6.16 %). There was a significantly higher incidence of osteomyelitis after hip fracture among the RA group than among the body mass index-, comorbidity-, age-, and sex-matched patients in the control group.Compared to patients without RA, those with RA have a higher incidence of hip fractures at a relatively younger age and with higher complication and mortality rates. Steroid and disease-modifying anti-rheumatic drugs, the most common medicine in Taiwanese RA patients, might contribute to the high incidence of fracture and post-op infection. Appropriate early intervention to prevent hip fractures in RA patients is a critical issue in rheumatology care.
- Systematic and Open Identification of Researchers and Authors: Focus on Open Researcher and Contributor ID. [REVIEW]
- J Korean Med Sci 2014 Nov; 29(11):1453-1456.
Unique identifiers of researchers and authors can help all stakeholders of scientific communications improve their workflows. There have been several attempts to establish professional networks of scholars and list their scholarly achievements on digital platforms. Some of these platforms such as Google Scholar, Web of Knowledge and PubMed are searched to pick relevant peer reviewers, assess authors' publication history or choose suitable candidates for research and academic projects. However, each of these hubs has its specific applications, limiting the universal use for permanent tagging of researcher profiles. The Open Researcher and Contributor ID (ORCID) initiative, launched in 2012, is aimed at registering scholarly contributors and averting the persistent ambiguity of recorded author names. The ORCID registry is growing fast and integrating with other ID-generating platforms, thereby increasing the functionality of the integrated systems. ORCID identifiers are increasingly used for selecting peer reviewers and acknowledging various scholarly contributions (e.g., published articles, reviewer comments, conference presentations). The initiative offers unique opportunities for transparent disclosures of author contributions and competing interests and improving ethical standards of research, editing, and publishing.
- Predictive value of anti-citrullinated peptide antibodies: a real life experience. [JOURNAL ARTICLE]
- Immunol Res 2014 Nov 19.
Rheumatoid Arthritis (RA) is an autoimmune destructive joint disease, characterized by the presence of rheumatoid factor and anti-citrullinated peptide antibodies. Anti-citrullinated peptide antibodies were recently defined as RA criterion with sensitivity and specificity of 50-80 and 75-95 %, respectively. However, in the general population, the predictive value of anti-citrullinated peptide antibodies is yet to be determined. Herein, we aim to determine the predictive value of anti-citrullinated peptide antibodies in real life as well as clinical and serological factors related to this value. Retrospective cross-sectional study of consecutive samples evaluated for anti-citrullinated peptide antibodies in a referral autoimmune laboratory. Demographic and clinical parameters at the time the sample was drawn were collected. During November 2011 through December 2013, a total of 215 anti-citrullinated peptide antibody tests were performed in our laboratory. Data were available for 140 samples of which only 28 samples were positive for anti-citrullinated peptide antibodies. Of the 140 patients tested, 18 were diagnosed with RA, of which 12 were positive and 6 were negative for anti-citrullinated peptide antibody test. Thus, in this cohort, anti-citrullinated peptide antibodies were positive in 20 % of samples with a positive predictive value (PPV) of 43 % and a negative predictive value of 95 %. In real life, only 20 % of anti-citrullinated peptide antibody tests referred to a tertiary center where found to be positive. The negative predictive value of this test is very high and may support the common use of anti-citrullinated peptide antibody test as an exclusion criterion in the process of evaluating a patient with rheumatic disease.
- Increased nocturnal periodic limb movements in rheumatoid arthritis patients meeting questionnaire diagnostic criteria for restless legs syndrome. [JOURNAL ARTICLE]
- BMC Musculoskelet Disord 2014 Nov 18; 15(1):378.
Based on questionnaire criteria, the sensorimotor disorder restless legs syndrome (RLS) has been reported to have a higher prevalence in rheumatoid arthritis (RA) patients than in the general population. There has been some speculation that peripheral arthritic symptoms may allow false positive responses to questionnaire criteria. This study evaluates whether RA patients meeting RLS questionnaire criteria also have objective evidence of increased periodic limb movements (PLMs) characteristic of RLS.Participants were recruited from RA clinic. Questionnaire data collected at study entry included: pain scores, rheumatoid arthritis disease activity index, Epworth sleepiness scale, Pittsburgh sleep quality index and RLS diagnostic criteria. Each participant was provided a PAM-RL actigraphic monitor, which attached to the ankle. This device was worn for two consecutive nights then returned for data download. Laboratory data including hemoglobin, iron studies, renal function and C-reactive protein levels were collected.Of the 57 participants, 23 met RLS diagnostic criteria. Those who met RLS criteria demonstrated higher mean frequency of nocturnal PLMs (19.63/hour; SD:21.13) than those who did not meet RLS criteria (11.13/hour; SD:12.10; p = 0.033). There were no significant differences between groups in terms of patient characteristics, disease activity or duration measures. Patients meeting RLS criteria did have poorer sleep quality measures (p <0.001).RA patients who met RLS diagnostic criteria demonstrated higher frequencies of nocturnal PLMs than RA patients who did not meet criteria for RLS. This finding supports use of the RLS diagnostic criteria in helping to differentiate between RA arthritic symptoms and RLS.
- Increased prevalence of JC polyomavirus viruria was associated with arthritis/arthralgia in patients with systemic lupus erythematosus. [JOURNAL ARTICLE]
- Lupus 2014 Nov 17.
The objective of this paper is to investigate the prevalence of reactivation of the human polyomavirus John Cunningham virus (JCV) in patients with systemic lupus erythematosus (SLE) and its associated clinical manifestations.Sixty-one patients with SLE and 22 controls were enrolled. Urine JCV viral load was quantified by real-time polymerase chain reaction (PCR). Length variants of the VP1 gene were analyzed using capillary electrophoresis.The prevalence of JCV viruria (63.9% vs. 18.2%, p < 0.001) and urine JCV viral load (2.92 ± 2.76 vs. 0.81 ± 1.85 copies/ml by log10 scale, p < 0.001) were significantly higher in patients with SLE compared with controls. JCV viruria (+) SLE patients had a higher occurrence of arthritis/arthralgia compared with JCV viruria (-) SLE patients (64.1% vs. 22.7%, p = 0.003). In SLE patients, the urine JCV viral load was significantly associated with the occurrence of arthritis/arthralgia. SLE patients with urine JCV viral load >10,000 copies/ml exhibited a 12.75-fold (95% confidence interval 2.88-56.40) risk in clinical arthritis/arthralgia, 18.90-fold (95% confidence interval 2.10-170.39) risk in persistent arthritis, and significantly greater number of length variants in the VP1 gene of JCV compared with JCV viruria (-) SLE patients.Reactivation of JCV in the urinary tract of SLE patients was very common. Both JCV viruria and urine JCV viral load were associated with the occurrence of arthritis/arthralgia in patients with SLE. High urine JCV viral load also was associated with the genetic variant in the VP1 gene.
- Anti-cyclic citrullinated peptide antibodies in ulcerative colitis, and its relation with disease activity. [Journal Article]
- Med J Islam Repub Iran 2014.:76.
Ulcerative colitis an inflammatory bowel disease (IBD) and chronically idiopathic immune related that associates with extraintestinal manifestations such as arthritis. Despite of the highly specificity of anticyclic citrullinated peptide (CCP) antibodies for rheumatoid arthritis, their role in IBD remains unclear. There are only a few studies on the prevalence of anti-CCP antibodies in patients with IBD. This study aimed to assess the prevalence of anti- CCP antibodies in ulcerative colitis and to investigate possible associations with their clinical and laboratory characteristics Methods: In this cross-sectional study, 93 consecutive patients with ulcerative colitis referred to gastroenterology clinics in Razi referral hospital of Rasht, Iran, from September 2010 to September 2011. Rheumatologic examination, demographic data and clinical presentation of patients were recorded on specially prepared data sheets. Blood sample was collected for assessment of anti-CCP and other laboratory tests. Data were analyzed by the Chi square test, Fisher Exact test and student t test, using the SPSS 20 software for Windows, and P value less than 0.05 was considered significant.Of 93 patients, anti-CCP antibodies detected in 10.8% of cases (CI 95%: 4.5-17.1%). There were a significant relation between the prevalence of anti CCP positivity and aphthous ulcers and ocular manifestations whereas other parameters were not significantly related.Anti CCP may have a possible role in some ulcerative colitis manifestations but there was no association between the presence of these antibodies and activity or extension of inflammatory colitis. We suggest other studies especially molecular studies to investigate other aspects of these antibodies in IBD patients.
- Utility of arthroscopic guided synovial biopsy in understanding synovial tissue pathology in health and disease states. [Journal Article, Review]
- World J Orthop 2014 Nov 18; 5(5):566-73.
The synovium is the soft tissue lining diarthrodial joints, tendon sheaths and bursae and is composed of intimal and subintimal layers. The intimal layer is composed of type A cells (macrophages) and type B cells (fibroblasts); in health, the subintima has few inflammatory cells. The synovium performs several homeostatic functions and is the primary target in several inflammatory arthritides. Inflammatory states are characterised by thickening of the synovial lining, macrophage recruitment and fibroblast proliferation, and an influx of inflammatory cells including lymphocytes, monocytes and plasma cells. Of the various methods employed to perform synovial biopsies arthroscopic techniques are considered the "gold standard", and have an established safety record. Synovial biopsy has been of critical importance in understanding disease pathogenesis and has provided insight into mechanisms of action of targeted therapies by way of direct evidence about events in the synovial tissue in various arthritides. It has been very useful as a research tool for proof of concept studies to assess efficacy and mechanisms of new therapies, provide tissue for in vitro studies, proteomics and microarrays and allow evaluation for biomarkers that may help predict response to therapy and identify new targets for drug development. It also has diagnostic value in the evaluation of neoplastic or granulomatous disease or infection when synovial fluid analysis is non-contributory.
- Association of the PDE3A-SLCO1C1 locus with the response to anti-TNF agents in psoriasis. [JOURNAL ARTICLE]
- Pharmacogenomics J 2014 Nov 18.
Psoriasis is a prevalent autoimmune disease of the skin that causes significant psychological and physical disability. Tumor necrosis factor (TNF)-blocking agents have proven to be highly efficacious in the management of moderate-to-severe psoriasis. However, a significant percentage of patients do not respond to this treatment. Recently, variation at the PDE3A-SLCO1C1 (phosphodiesterase 3A-SoLute Carrier Organic anion transporter family member 1C1) locus has been robustly associated with anti-TNF response in rheumatoid arthritis. Using a cohort of 130 psoriasis patients treated with anti-TNF therapy, we sought to analyze the association of this locus with treatment response in psoriasis. We found a highly significant association between PDE3A-SLCO1C1 and the clinical response to TNF blockers (P=0.0031). Importantly, the allele that was previously associated with the lack of response to rheumatoid arthritis (G allele, single-nucleotide polymorphism rs3794271) was associated with a higher anti-TNF efficacy in psoriasis. The results of this study are an important step in the characterization of the pharmacogenetic profile associated with anti-TNF response in psoriasis.The Pharmacogenomics Journal advance online publication, 18 November 2014; doi:10.1038/tpj.2014.71.
- High-resolution imaging of bone and joint architecture in rheumatoid arthritis. [REVIEW]
- Br Med Bull 2014 Nov 17.
Rheumatoid arthritis (RA) is characterized by local and systemic bone loss caused by increased bone resorption. We describe the current utilization of high-resolution peripheral quantitative computed tomography (HR-pQCT) in the evaluation of bone and joint in RA.PubMed was searched for publications using keywords that included 'bone microarchitecture', 'high-resolution peripheral quantitative computed tomography' and 'rheumatoid arthritis'.HR-pQCT may simultaneously allow assessment of trabecular and cortical bone parameters and be a useful method for depicting bone erosions.HR-pQCT only assesses bone microarchitecture at the distal radius and tibia. Controversy exists regarding the optimal way to differentiate cortical and trabecular regions.Although HR-pQCT is currently a research tool, there is potential for its use in the clinical diagnosis and management in RA. Further research is required to evaluate the clinical relevance of imaging abnormalities identified in RA patients.