Arthritis and rheumatism
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Arthritis and rheumatism · Aug 2004
Perceptions of, and willingness to consider, total joint arthroplasty in a population-based cohort of individuals with disabling hip and knee arthritis.
To examine perceptions of total joint arthroplasty (TJA) and how they relate to willingness to consider TJA. ⋯ Participants overestimated the pain and disability needed to warrant TJA. These misperceptions were strongly associated with unwillingness to consider TJA and should be addressed at a population level.
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Arthritis and rheumatism · Aug 2004
Shedding of mutant tumor necrosis factor receptor superfamily 1A associated with tumor necrosis factor receptor-associated periodic syndrome: differences between cell types.
To investigate the effect of mutations in tumor necrosis factor receptor superfamily 1A (TNFRSF1A) on the ability of the receptors to be cleaved from the cell surface upon stimulation. The mutations we studied are associated with clinically distinct forms of TNF receptor-associated periodic syndrome (TRAPS). We also investigated different cell types within the same form of TRAPS. ⋯ Differences in TNFRSF1A shedding are not purely a function of the TNFRSF1A structure, but are also influenced by other features of genetic makeup and/or cellular differentiation. It is unlikely that a defect in TNFRSF1A shedding per se can fully explain the clinical features that are common to TRAPS patients with different TNFRSF1A mutations.
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Arthritis and rheumatism · Aug 2004
Antiphospholipid syndrome nephropathy in patients with systemic lupus erythematosus and antiphospholipid antibodies: prevalence, clinical associations, and long-term outcome.
To evaluate the prevalence, clinical associations, and outcome of antiphospholipid syndrome (APS) nephropathy in patients with systemic lupus erythematosus (SLE) and antiphospholipid antibodies (aPL) and in SLE patients without aPL. ⋯ Among patients with SLE, APS nephropathy occurs almost exclusively in those with aPL, suggesting an important role of aPL in the pathogenesis of APS nephropathy. Patients with APS nephropathy develop hypertension, raised serum creatinine levels, and progression of histologic lesions, all of which are associated with a poor renal outcome. Manifestations of APS also tend to develop in these patients. APS nephropathy should be included in the APS classification criteria, and the use of appropriate anticoagulant therapy should be tested.
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Arthritis and rheumatism · Jul 2004
Randomized Controlled Trial Clinical TrialEtanercept in Sjögren's syndrome: a twelve-week randomized, double-blind, placebo-controlled pilot clinical trial.
To assess the safety and potential efficacy of etanercept in the treatment of Sjögren's syndrome (SS). ⋯ We found no evidence to suggest that treatment with etanercept at a dosage of 25 mg twice weekly for 12 weeks was clinically efficacious in SS. A larger trial will be necessary to definitively address the efficacy of etanercept in the treatment of SS.
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Arthritis and rheumatism · Jul 2004
Amplification of the synovial inflammatory response through activation of mitogen-activated protein kinases and nuclear factor kappaB using ligation of CD40 on CD14+ synovial cells from patients with rheumatoid arthritis.
To determine the signal transduction pathways in CD14+ synovial cells from patients with rheumatoid arthritis (RA) after CD40 ligation, and to examine their role in amplifying synovial inflammation in affected joints. ⋯ These data indicate that the CD40-CD154 interaction activates the ERK, p38, and NF-kappaB pathways in CD14+ synovial cells from RA patients to produce TNFalpha, IL-1alpha, and IL-1beta, which in turn amplifies inflammatory responses by stimulating FLS. Inhibition of the CD40-CD154 interaction or its signal transduction pathways would be a strong and efficient strategy for the management of synovial inflammation in RA.