J Rheumatol
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Comparative Study
Musculoskeletal pain and quality of life in patients with noninflammatory joint pain compared to rheumatoid arthritis: a population survey.
To establish the prevalence of different types of noninflammatory musculoskeletal pain in the general population, to determine the sociodemographic characteristics of persons reporting such pain, and to compare the epidemiological features in a population setting between different types of noninflammatory musculoskeletal pain and patients with confirmed rheumatoid arthritis (RA). ⋯ This population study supports the hypothesis of a continuum for most health related quality of life measures, starting with noninflammatory regional musculoskeletal pain and ending with multiple periarticular or inflammatory disease (widespread pain and RA). This study also shows that widespread pain and RA had similar health effect, except for levels of disability.
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To investigate the effect of the neuropeptide depleting agent capsaicin on neuropeptides in both synovial and nonsynovial articular tissues and on the relative degree of joint inflammation in established antigen induced arthritis (AIA). ⋯ These data indicate that SP and CGRP immunoreactivity is maintained in synovial and nonsynovial articular tissues of non-capsaicin treated knees during subacute joint inflammation. In the capsaicin treated AIA knees, however, there was partial neuropeptide depletion. Nerve fibers containing SP were more sensitive to the peptide depleting effects of capsaicin than were CGRP positive fibers. Depletion of SP and CGRP from some joint tissues did not correlate with a decrease in joint inflammation. Studies incorporating a broad range of dosages will be required to determine whether intraarticular treatment with capsaicin can effectively deplete neuropeptides and thereby ameliorate established inflammatory arthritis.
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To study at a molecular level the clonality of interleukin 2 (IL-2) expanded T cell lines derived from rheumatoid nodules. Such cell lines were reported in earlier studies with flow cytometry and antiidiotypic monoclonal antibodies (MAb) to be obligoclonal. ⋯ Molecular analysis of TCR rearrangements in IL-2 expanded T cell lines from rheumatoid nodules strongly suggests that in situ T cell activation is related to classical antigen induced immune activation.
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To determine the clinical importance of anticardiolipin (aCL), anti-beta(2)-glycoprotein I (a beta(2)-GPI), antiprothrombin (aPT), and lupus anticoagulant (LAC) antibodies in patients with systemic lupus erythematosis (SLE) with and without a history of thrombosis. ⋯ Only high levels of IgG aCL and presence of LAC and/or a beta(2)-GPI are relevant in defining a thrombotic subset of patients with SLE. Longitudinal prospective studies are needed to investigate the predictive value of the different antiphospholipid and protein cofactor antibodies.
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Randomized Controlled Trial Comparative Study Clinical Trial
Fibromyalgia--are there different mechanisms in the processing of pain? A double blind crossover comparison of analgesic drugs.
Pain was analyzed in patients with fibromyalgia (FM) in a randomized, double blind, crossover study using intravenous (i.v.) administration of different drugs. ⋯ FM diagnosed according to the American College of Rheumatology criteria seems to include patients with different pain processing mechanisms. A pharmacological pain analysis with subdivision into responders and nonresponders might be considered before instituting therapeutic interventions or research.