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Cervical spine subluxations common in patients with severe rheumatoid arthritis
Scientists from Finland found a high prevalence of cervical spine subluxations in 154 patients with rheumatoid arthritis waiting for orthopaedic surgery. There was no evidence, that characteristic symptoms like neck pain might be associated with the disorders, the authors report.
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Low level laser therapy decreases pain and morning stiffness
In patients with rheumatoid arthritis, low level laser therapy seems to be effective as a short-term treatment for relief of pain and morning stiffness, researchers from the Cochrane Collaboration reported in a recent review of controlled trials including all articles published up to June 2005.
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Cardiovascular risk factors in patients with rheumatoid arthritis
Carotid atherosclerosis in patients with rheumatoid arthritis is affected by both established cardiovascular risk factors and manifestations of disease inflammation, scientists from the University of Texas Health Science Center at San Antonio approved.
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Fatigue in patients with rheumatoid arthritis
Fatigue is an important, intrusive, and overwhelming problem in patients with rheumatoid arthritis, British scientists write in the October issue of Arthritis Care & Research. The team from the University of Bristol studied the patients' perceptions to explore the individual disease concepts. They found two types of fatigue: severe weariness and dramatic overwhelming fatigue.
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New hereditary chondropathy identified
Scientists have recently defined a clinical syndrome “characterized by marked cartilage friability and osteochondral debonding”, which is reported in the October issue of Arthritis & Rheumatism.
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Aerobic exercise decreases musculoskeletal pain in seniors
Musculoskeletal pain increases with age – but not in older adults who participate in regular vigorous exercise, including running. This is the result of a current survey by scientists from California. Thus morbidity associated with aging can be reduced by regular aerobic activity, the authors conclude.
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Mineral oils: Arthritogenic agents in humans?
Exposure to mineral oil is associated with an increased risk of developing rheumatoid arthritis, Swedish scientists found out in a case-control study. These findings are of high interest as the same mineral oils can induce an erosive and rheumatoid arthritis-like polyarthritis in rats.
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Smoking is risk factor for rheumatoid nodules
Patients with early sero-positive rheumatoid arthritis have a higher risk for rheumatoid nodules if smoking. This is the result of a current survey by Swedish researchers. However, tobacco use other than smoking was not associated with an increased risk of nodules.
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Outcome of patients with rheumatoid arthritis improved
In patients with rheumatoid arthritis the course of disease activity has become milder over the past twenty years, scientists from the Netherlands found out. They note, that this improving trend coincides with a more aggressive treatment strategy.
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Inhibition of NF-?B signaling pathway in mouse model
Interleukin-6 and tumor necrosis factor-alpha are important factors in the pathogenesis of rheumatoid arthritis, as these mediators promote chronic inflammation and joint damage. Nuclear factor-?B (NF-?B) is a transcriptional activator of genes for these cytokines. It also plays a key role in the regulation of osteoclast differentiation.
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Stress and rheumatoid arthritis
Acute exposure to mental stress increases levels of C reactive protein in patients with rheumatoid arthritis, researchers from the University of Birmingham (UK) report. They compared the effects of acute stress on inflammatory, haemostatic, rheological, and haemodynamic activity in 21 patients with rheumatoid arthritis and 10 patients with osteoarthritis. The scientists used osteoarthritis patients as controls, as both diseases have several symptoms in common, though osteoarthritis does not have "a significant systemic inflammatory component”.
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Rheumatoid arthritis and linked infections
Viral infections are frequently linked to arthritis. To assess the possible role of such infections with respect to the development of chronic rheumatic complications, Marjatta Leirisalo-Repo from the Helsinki University Central Hospital summarized the recent literature on the association of infection with early arthritis in a current publication.
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Some differences between women and men with rheumatoid arthritis
Female patients with early rheumatoid arthritis are referred later to a rheumatologist than men, scientists from Norway say. They analysed data of 44 patients, who met standard criteria for rheumatoid arthritis. Lag time between disease onset and the first encounter with a physician was recorded as the "patient’s delay". The time between this encounter and the referral to a rheumatologist was recorded as the "physician’s delay".
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Ear and central nervous system involvement in rheumatoid arthritis
Central nervous system involvement should be considered in patients with a history of rheumatoid arthritis even in the absence of systemic symptoms, experts from the Mayo Clinic in Rochester (Minnesota, USA) recommend. “Making the diagnosis may require meningeal and brain biopsy”, the scientists say.
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Osteoporosis in younger patients with rheumatoid arthritis
Scientists from Brazil found reduced lumbar spine bone mineral density in patients with rheumatoid arthritis of relatively short disease duration. “The identification of prognostic markers for bone loss in patients with rheumatoid arthritis should not only prompt early therapeutic intervention, but also facilitate early preventive measures”, the researchers from Porto Alegre note.
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Anti-CCP superior compared with rheumatoid factor?
Detection of antibodies to cyclic citrullinated peptides (anti-CCP) seems useful for the diagnosis of rheumatoid arthritis, researchers from Germany say. The scientists from the Münster University Hospital tested 700 consecutive serum samples from patients at an outpatient clinic for the presence of rheumatoid factor and anti-CCP.
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Rheumatology and diet
Are dietary factors important modifiers of the risk of rheumatoid arthritis? To answer this question, scientists from Denmark analysed data of 57.053 individuals who completed a detailed self-administered food frequency questionnaire. Using information of the Danish National Patient Registry, the researchers identified sixty-nine cohort members who developed rheumatoid arthritis during an average follow-up period of 5,3 years.
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Treatment of rheumatoid cachexia
The phrase 'rheumatoid cachexia' describes the loss of body cell mass that may occur among patients with rheumatoid arthritis. Specifically, rheumatoid cachexia is characterized by altered energy and protein metabolism and consequent muscle wasting. Scientists from the University of Wales-Bangor (UK) have examined two potential intervention strategies.
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Histopathology of rheumatoid arthritis-associated lung disease
In patients with rheumatoid arthritis-associated interstitial lung disease, the usual interstitial pneumonia pattern seems to be more prevalent than the non-specific interstitial pneumonia pattern. This is the result of a current survey by scientists from Korea, Japan and the United States. The researchers also found a strong correlation of histopathology with the smoking history of study participants.
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WLQ: New instrument to analyse work participation
Participation restrictions, in particular in work participation, is increasingly recognized as an important outcome of rheumatoid arthritis. It should be assessed in all outcome and intervention studies in arthritis patients, experts from the Netherlands demand in an editorial of “The Journal of Rheumatology”.
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Patients with extensive joint damage should abandon high-intensity exercises!
Rheumatoid arthritis patients with extensive damage in large joints should avoid to participate in high-intensity exercise programs, Dutch researchers recommend. “High-intensity weight-bearing exercises appear to accelerate joint damage progression in patients with pre-existing extensive damage”, Marten Munneke and his colleagues write in the current issue of “Arthritis Care and Research”.
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New insights on chronic pain
Addressing an individual's depression will not necessarily have an impact on the sensory dimension of pain, scientist from the United States and from Germany note in a current publication. Both, pain and depression, need to be treated when they occur together in the same patient, the researchers commend. Thus, prescribing an antidepressant medication that has no analgesic properties is not sufficient.
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New biomarker for treatment efficacy
Synovial sublining macrophages might be used as a biomarker for the evaluation of new anti-rheumatic drugs, a current study suggests. Paul Tak from the University of Amsterdam and his colleagues from Belgium, Scotland and Ireland assessed the association between changes in infiltration of CD68+ synovial sublining macrophages and clinical improvement after pharmaceutical treatment in 88 patients.
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Costs of rheumatoid arthritis
Direct costs of rheumatoid arthritis are three times higher for patients with long-standing disease compared to patients with early disease. This is the result of a Belgium survey. The higher costs were seen “especially for physiotherapy and need for devices and adaptations”, the authors note.
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Rheumatoid arthritis and pulmonary carcinoma
Does co-morbidity of rheumatoid arthritis alter the clinical manifestation of lung cancer? Scientists from Taiwan deny that. “Rheumatoid arthritis has no influence on lung cancer stage and does not shorten the survival of lung cancer patients”, the experts from the Taipei Veterans General Hospital write in a current publication.
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JPA: Stress and mood predictive of daily disease symptoms
Daily fluctuations in both stress and mood are important predictors of increased pain, stiffness and fatigue in children with juvenile poly-articular arthritis (JPA). This is the result of a current survey, published in “Arthritis & Rheumatism”.
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No correlation between weight loss and disease activity
Weight reduction strategies have little if any influence on rheumatoid arthritis inflammation, Scandinavian scientists say. “Perhaps this is not surprising with regards to what is already known from research on the metabolic syndrome and on atherosclerotic vascular disease, where isolated overweight is ranked as a less important factor of risk”, Lars Sköldstam from the County Hospital in Visby and his colleagues write in the “Nutrition Journal”, a peer reviewed online publication by BioMed Central.
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Current reviews on bee venom acupuncture and Ayurvedic medicines in patients with rheumatoid arthritis
Bee venom acupuncture, used in Eastern Asia since at least the second century, has shown significant anti-inflammatory and analgesic effects in a sufficient number of animal studies, scientists from the Seoul College of Korean Medicine at the Kyung Hee University (Seoul) found out.
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Tendency for symmetrization
Symmetry is considered an important criterion for the differentiation of rheumatoid arthritis from other forms of inflammatory polyarthritis. In a current survey, Swiss and Canadian scientists now tried to quantify asymmetry of radiological joint damage in rheumatoid arthritis. Result: Prevalence of asymmetry in joint damage is low, in fact. Furthermore, the researchers found a tendency for symmetrization over time, especially in seropositive patients.
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High need for information in patients with rheumatoid arthritis
Rheumatoid arthritis care is not consistent with modern treatment guidelines, researchers from the University of British Columbia found out. “Efforts to educate family physicians and consumers about the shift in rheumatoid arthritis treatment paradigms and to improve access to rheumatologists are needed”, the authors write in the April issue of “Arthritis Care & Research”.
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Step by step to more physical activity
Rheumatoid arthritis often confers disability and increased risk of coronary heart disease. As there is good evidence for the safety and benefit of moderately intensive exercise, patients should be recommended and supported in physical activity, Swedish researchers wrote in a review in 2004 (Lakartidningen 2004; 101: 3516-9).
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Distensibility of the abdominal aorta and myocardial microvascular disease in rheumatoid arthritis
Arterial stiffness is an important factor in cardiovascular co-morbidity in patients with rheumatoid arthritis, Swedish researchers suggest. “Rheumatoid arthritis is associated with decreased distensibility of the abdominal aorta in females, and such changes seem to correlate with disease severity”, Carl Turesson and his colleagues write in an article of Rheumatology, published online on March 22, 2005.
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Impact of temperament and pregnancy examined
Scientists have found relationships among the individual temperament disposition and the satisfaction with health status in patients suffering from rheumatoid arthritis. “Assessment of temperament can facilitate early identification of potential problems and is useful for selecting or designing tailored interventions”, the authors from the University of Minnesota and the Minnesota State University write in the March issue of Clinical Nurse Specialist.
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Disease activity: Most important mortality risk factor
Measures of disease activity are independent predictors of mortality in patients with rheumatoid arthritis, Swedish researchers say. “Improving these variables may also improve long-term outcome”, Christina Book and her colleagues hypothesize in the March issue of The Journal of Rheumatology.
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Silica exposure associated with increased risk of rheumatoid arthritis
Exposure to silica could be a risk factor for the development of rheumatoid arthritis, according to a current study from Sweden. Patrik Stolt and colleagues from the Karolinska Institute in Stockholm found an increased risk of rheumatoid arthritis in silica exposed men. “This association is not explained by smoking habits”, the authors write in the April issue of the Annals of Rheumatic Diseases.
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Patients with rheumatoid arthritis at high risk of peripheral vascular disease?
Incompressibility and obstruction of peripheral arteries are increased in rheumatoid arthritis, scientists from the University of Texas found out. This means, “that patients with rheumatoid arthritis are at high risk of experiencing peripheral vascular disease, a risk that has not been previously recognized", Inmaculada del Rincon noted. The results of his study showed evidence, that patients with advanced joint damages are on highest risk of arterial impairments.
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Larsen score decreases after stem cell transplantation
Progression of joint destruction in patients with severe rheumatoid arthritis can be reduced remarkably by an autologous stem cell transplantation (ASCT), Dutch researchers confirm. Several previous studies have shown beneficial effects for ASCT after high-dose chemotherapy in patients with refractory rheumatoid arthritis, but this is the first study to document the outcome radio-graphically, Robert Verburg writes in the current issue of “Arthritis & Rheumatism”. “The results of the present analysis demonstrate major beneficial effects of high-dose chemotherapy plus ASCT on the rate of joint destruction during the first two years of follow-up after treatment”, the scientist from the Leiden University Medical Center notes.
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Gene-transduced chondrocytes effective in animal experiment
Researchers from Japan have successfully transferred basic fibroblast growth factor gene into isolated rabbit chondrocytes. Transplantation of the autologous gene-transduced chondrocytes showed “a clear beneficial effect on the repair of rabbit articular cartilage defects”, Naoki Yokoo and his colleagues report in the January issue of “Arthritis and Rheumatism”.
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Anti-CCP antibodies and RF: Specificity of 100 percent
In patients with very early synovitis, the combination of antibodies to cyclic citrullinated peptide (anti-CCP antibodies) and rheumatoid factor (RF) show high specificity and positive predictive value, but low sensitivity for a diagnosis of rheumatoid arthritis. “This autoantibody combination can be used to identify patients with disease destined to develop rheumatoid arthritis who may be appropriate for very early intervention”, British researchers write in the current issue of the “Journal of Rheumatology”.
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90 percent of arthritis patients have ever used complementary and alternative medicine
Use of complementary therapies is common in patients with rheumatoid arthritis, researchers from the University of New Mexico Health Sciences Center in Albuquerque (USA) found out. “Health care providers should be aware of the high use of complementary and alternative medicine and incorporate questions about its use into routine assessments and treatment planning”, the authors write in “Preventing Chronic Disease”, a peer-reviewed electronic journal. They indicate, that conventional therapies alone are not meeting the needs of arthritis patients.
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Rheumatoid factor positive patients on highest risk of congestive heart failures
Patients with rheumatoid arthritis show nearly twice the risk of developing congestive heart failures compared to individuals without the chronic inflammatory disease. This is the result of a current population-based, retrospective study from the Mayo Clinic in Rochester, Minnesota (USA). “This excess risk is not explained by traditional cardiovascular risk factors or clinical ischemic heart disease”, the authors note in the February issue of “Arthritis & Research”.
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Foetal exposure to tobacco smoke: higher risk of polyarthropathies
Maternal smoking may increase the risk of rheumatoid arthritis and other inflammatory polyarthropathies in the unborn child, two scientists from Finland write. But this coherence seems to apply only to girls – in boys, maternal smoking does not affect the disease risk, Jouni Jaakkola and Mika Gissler found out. The reasons for this gender specificity are unclear.
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Rhythms in rheumatic symptoms
Maybe it is not only fundamental, what kind of pharmaceuticals are administered to patients with rheumatoid arthritis, but also, at what daytime, two Italian scientists assume in the current issue of “Rheumatic diseases clinics of North America”. The experts say, circadian rhythms of the inflammatory reaction of the disease suggest important implications.
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Influence of weather conditions on rheumatic diseases
Should pharmacological and non-pharmacological treatments for patients with rheumatic diseases be modulated depending on the predictable weather conditions? Spanish scientists say, “that in the future it may be possible”.
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Left ventricular dysfunction common in JRA patients
Despite an asymptomatic cardiac status, significant systolic and diastolic functional abnormalities exist in patients with juvenile rheumatoid arthritis (JRA), scientists from India found out.
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Focus on early rheumatoid arthritis
The term ‘early rheumatoid arthritis’ is not apposite, British experts affirm in the February issue of “Best Practice & Research Clinical Rheumatology”. William Dixon and Deborah Symmons say, that “patients either have established rheumatoid arthritis or an undifferentiated inflammatory arthritis”.
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Silver Ring Splints effective in patients with stable disease
Silver Ring Splints can improve sleight of hand in patients with rheumatoid finger joint deformities eligible for splinting, scientists from the Netherlands write in the December issue of “Arthritis Care & Research”. For a satisfactory outcome, “careful patient preassessment and optimal adjustment of Silver Ring Splints are essential”, Theo Zijlstra and his colleagues from the Medisch Spectrum Twente Hospital and University Twente in Enschede note.
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Direct access to hospital reviews could be advantageous
Patients with rheumatoid arthritis are generally managed by regular hospital reviews initiated by a physician. Often the patient is well at consultation but unable to access support rapidly when it is required. Thus most general practitioners estimate short specialist access as more important than regular reviews.
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High intake of red meat associated with increased risk of rheumatoid arthritis
People with a high level of red meat consumption and a low intake of vitamin C may have an increased risk of inflammatory arthritis, according to the results of a current study published in the December issue of Arthritis & Rheumatism. "Non-genetic factors, such as aspects of lifestyle, may explain 40% of the risk of rheumatoid arthritis", Dorothy Pattison from the University of Manchester and her colleagues explain.
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Bone mineral density and stress fractures
In patients with rheumatoid arthritis high radiological damage is associated with low bone mineral density (BMD) of the hip, scientists of the Netherlands say. This finding “suggests an association between the severity of rheumatoid arthritis and the risk of generalised bone loss”, the authors write in the current issue of “ Annals of the Rheumatic Diseases”.
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Rheumatoid arthritis of the cervical spine: early recognition is vital
Involvement of the cervical spine is common in rheumatoid patients – and delayed or missed recognition can result in death. On this account, scientists of the Rush Medical College in Chicago reviewed the English medical literature with focus on more recent studies on surgical treatment and clinical outcomes of lesions, present in the rheumatoid neck.
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Women with rheumatoid arthritis and low BMI have a high risk of cardiovascular death
A low body mass index (BMI) is associated with a significantly increased risk of cardiovascular death among patients with rheumatoid arthritis, researchers of the Mayo Clinic in Rochester discovered. Sherine Gabriel and her colleagues compared the effect of a low BMI on cardiovascular mortality in a population-based cohort of subjects with rheumatoid arthritis (diagnosed from 1955 through 1994) with that in a cohort of individuals without this disease from the same population.
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Does breastfeeding protect against rheumatoid arthritis?
Breastfeeding for more than 12 months is associated with a risk reduction of rheumatoid arthritis, scientists from the Harvard Medical School ( Boston ) report. “This apparent effect was dose dependent, with a significant trend toward lower risk with longer duration of breastfeeding”, Elizabeth Wood Karlson and her colleagues wrote in the November issue of Arthritis & Rheumatism.
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Work disability in rheumatoid arthritis
Work disability – a common outcome of rheumatoid arthritis – is a societal and individual problem, as patients lose status, income and social support. It occurs early in the course of disease, scientists from Canada say.
Arthritis Rheum (2004); 51(5): 843-52
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Diffuse pulmonary rheumatoid nodules
Dyspnoea in patients with rheumatoid arthritis can be due to pulmonary rheumatoid nodules, scientist from Japan report in a current publication. The authors from Nagoya University Graduate School of Medicine and Kamo Hospital in Toyota refer to the case of a patient with articular symptoms and seropositivity, who exhibited a rapid clinical course of dyspnoea.
Pathol Int (2004);54(10): 798-802
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Autologous stem cell transplantation in juvenile rheumatoid arthritis: high rate of remission but significant mortality risk
Autologous stem cell transplantation (ASCT) can induce remission of juvenile idiopathic arthritis and produce a profound increase in general wellbeing in a substantial proportion of patients, an international team of scientists stated in the October issue of Annals of Rheumatic Diseases. „But the procedure carries a significant mortality risk“, the investigators underline.
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SE gene and smoking independent risk factors
Smoking appears to significantly increase the risk of rheumatoid arthritis among men and women with a genetic predisposition for the disease. This is the result of a Swedish population-based case-control study.
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Ophthalmologic complications in patients with juvenile rheumatoid arthritis
Frequency of uveitis in patients with juvenile rheumatoid arthritis may be lower than expected, researchers from the George Washington University (Washington) and the Mayo Clinic in Rochester say.
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Concept of early rheumatoid arthritis well accepted
The concept of “early rheumatoid arthritis” says, that early and aggressive treatment can prevent damage and achieve sustained low disease activity or remission. Yet no diagnostic criteria are available, as the American College of Rheumatology (ACR) classification is derived from patients with established disease.
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Detection of small joint synovitis by ultrasonography – easy to learn?
Synovial activation in rheumatoid arthritis maintains the inflammation and leads to the destruction of the involved joints. Ultrasonography allows assessment of soft tissue structures and has become a valued tool for diagnosing small joint synovitis. Rheumatologists initially not experienced in this technique can do it accurately, French authors say.
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Increased mortality and rising number of deaths
Rheumatoid arthritis patients show increased mortality. They are at higher risk of dying of urogenital, gastrointestinal, respiratory and cardiovascular diseases or infections. This is the result of a current cross-sectional population-based study. The number of deaths from arthritis and other rheumatic conditions is rising in the USA, an additional survey says.
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“Need to assess different types of support”
Instrumental and emotional support affect critical outcomes Rheumatoid Arthritis patients, two scientists from San Francisco say. “Instrumental support is beneficial to the maintenance of valued activities, a critical factor in the psychological adjustment of individuals living with rheumatoid arthritis”, Alyson Neugebauer and Patricia Katz write in a current issue of Arthritis Care & Research. Emotional support shows a significant short-term influence on depressive symptoms.
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Quality of life in early Rheumatoid Arthritis
Health related quality of life (HRQOL) is significantly worse in rheumatoid arthritis patients as compared to patients with other arthritides very early in the disease. This is the result of a current survey published in The Journal of Rheumatology. Researchers from Finland found patients with rheumatoid arthritis being most severely affected concerning dexterity, household activities, activities of daily living and pain.
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Anti-CCP of high clinical relevance
Anti-CCP (cyclic citrullinated peptide antibodies) show high diagnostic value in patients with rheumatoid arthritis (RA). This is the result of different surveys published in the current issue of “ Annals of the Rheumatic Diseases”. “CCP proved to be a powerful diagnostic tool, especially in ambiguous cases or RF negative patients”, German researchers say.
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Case report: tortuous vertebral artery
An anomaly of the vertebral artery resulting from rheumatoid arthritis can cause cerebral and cerebellar infarction due to anterior cervical spinal fusion, three orthopedic surgeons from the Naval Hospital in Guam warn in a current case report. They refer to a 60-year-old patient with rheumatoid arthritis of the cervical spine, who sustained a vertebral artery injury during anterior corpectomy. Vascular anatomy was not examined before surgical decompression.
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High cardiovascular mortality rate in rheumatoid arthritis patients: an effect of dyslipidemia?
Patients with rheumatoid arthritis have an increased prevalence of coronary heart disease and high cardiovascular mortality rates. The causes of this coherency are still unclear. As dyslipidemia is a well known risk factor of atherosclerosis, scientists from Turkey compared lipid profiles in rheumatoid arthritis patients and controls in a current study.
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