Arthritis and rheumatism
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Arthritis and rheumatism · Feb 2004
Interleukin-18 enhances monocyte tumor necrosis factor alpha and interleukin-1beta production induced by direct contact with T lymphocytes: implications in rheumatoid arthritis.
At sites of inflammation, T cells exert pathologic effects through direct contact with monocyte/macrophages, inducing massive up-regulation of interleukin-1 (IL-1) and tumor necrosis factor alpha (TNFalpha). We examined the regulatory effects of IL-18 on monocyte activation by direct contact with T lymphocytes in rheumatoid arthritis (RA). ⋯ IL-18 augments monocyte activation induced by contact with activated T cells in RA synovitis, which is dependent on activation of the NF-kappaB and PI 3-kinase pathways. IL-18 up-regulates the expression of the TNF receptors VCAM-1 and ICAM-1 on monocytes, which mediate the enhancing effects of IL-18 on T cell-monocyte contact.
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Arthritis and rheumatism · Dec 2003
ReviewAccess to pediatric rheumatology care in the United States.
To describe rheumatology providers, depict their availability, and determine the extent to which internist rheumatologists may expand access to care for children with rheumatic diseases. ⋯ Our analysis suggests that internist rheumatologists are more geographically diffuse than pediatric rheumatologists and act as substitutes for pediatric rheumatologists in those regions that lack such providers. Research is needed to understand the role of internist rheumatologists in caring for children with rheumatic diseases and the quality of the care that they provide to this population.
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Arthritis and rheumatism · Dec 2003
Physical functioning over three years in knee osteoarthritis: role of psychosocial, local mechanical, and neuromuscular factors.
To identify factors that predict a poor physical function outcome over 3 years in individuals with knee osteoarthritis (OA), in an effort to aid in the development of strategies to prevent such functional limitations and consequential disability. ⋯ Factors placing individuals with knee OA at greater risk of a poor function outcome by at least 1 of the 2 function measures included the local factors laxity and proprioceptive inaccuracy, as well as age, BMI, and knee pain intensity. Factors protecting against a poor function outcome included strength, the psychosocial factors mental health, self-efficacy, and social support, and the activity level measured by the amount of aerobic exercise per week. The identification of these factors provides possible targets for rehabilitative and self-management strategies to prevent disability.