Rheumatoid arthritis and ankylosing spondylitis

Povidone-iodine is the cleansing agent most commonly used before accessing implanted venous devices. This agent has peak bacteriocidal action when allowed to air-dry for 20 min postscrub. However, the drying time increases the length of the procedure and the risk for accidental contamination of the site. In this study, the effectiveness of air drying versus blot drying povidone-iodine-prepared skin sites was compared by examining the number of bacterial colonies present on skin cultures obtained after each drying method. No significant differences in the number of bacterial colonies between the two drying methods were found.     

Rheumatoid arthritis and risk of cancer

In the current study we linked data from the Danish Hospital Discharge Register and the Danish Cancer Registry to estimate cancer occurrence among more than 20,000 patients hospitalized at least once with rheumatoid arthritis during 1977-1987. During a follow-up interval of up to 15 years, we found increased risks of non-Hodgkin's lymphoma, Hodgkin's disease and lung cancer, while the risk of colorectal cancer was decreased. These findings were all in agreement with the results of previous studies from two other Nordic countries, which were based on a similar type of data. We also found an excess of non-melanoma skin cancer and a deficit of female breast cancer, of which only the breast cancer observation had been seen in an earlier study.     

Rheumatoid arthritis in a patient with osteopoikilosis

57-years old woman with spotted bones was reported, with concomitant rheumatoid arthritis. It was great concern because of low incidence of osteopoikilia and diagnosis obstacles concerning coexistence of this two pathologies.     

Rheumatoid arthritis and the risk of malignancy

OBJECTIVE: To determine the relative risks of malignancy and of site-specific malignancies in patients with rheumatoid arthritis (RA). METHODS: In a prospective cohort study, 862 patients with RA (96% white) were enrolled from 1966 to 1974 and were followed up for up to 35 years (mean 17.4 years) at the University of Saskatchewan Rheumatic Disease Unit. All diagnoses of cancer were cross-referenced with the Provincial Cancer Registry. Expected cancer incidence rates were determined based on province of Saskatchewan population statistics matched to each study patient for age, sex, and calendar year. Standardized incidence ratios (SIRs) of the observed-to-expected cancer incidence and 95% confidence intervals (95% CI) were then calculated. RESULTS: A total of 136 cases of cancer were observed compared with 168 expected (SIR 0.80, P = 0.011 [95% CI 0.67-0.95]). The relative risk of colorectal malignancy was significantly reduced in the RA study population (SIR 0.52, P = 0.037 [95% CI 0.25-0.96]). A significant excess of leukemia was found (SIR 2.47, P = 0.026 [95% CI 1.12-4.69]), whereas the incidence rates for Hodgkin's disease and non-Hodgkin's lymphoma and all other site-specific malignancies were not found to be significantly different from general population rates. CONCLUSION: In our cohort of RA patients, colorectal cancer was detected in only half the expected number of patients. This risk reduction may be related to long-term nonsteroidal antiinflammatory drug (NSAID) use in RA, as has been suggested in several other studies of long-term NSAID use. An increased risk of leukemia was confirmed. This may be due to the persistent immune stimulation associated with RA itself, since other potential explanatory factors for increased leukemia were not apparent. Despite the excess of hemopoietic malignancy and despite treatment of RA with potentially oncogenic agents, the overall risk of malignancy was reduced in this RA cohort.     

Rheumatoid arthritis: current clinical and research directions

Conventional PCR-SSP, which is based on an agarose gel-based read-out, has the disadvantages of time-consuming post-PCR steps and low potential for automation. The aim of our study was to sort out these drawbacks by establishing a fluorescence-based PCR-SSP system for HLA-C. The assay relies on the sequence-specific identification of amplicons with individually labeled probes that are cleaved during successful PCR by the 5'-3' exonuclease activity of the Taq-DNA Polymerase. The oligonucleotides are labeled with a unique and spectrally resolvable fluorescent reporter dye at the 5' terminus (FAM or TET) and a common quencher dye at the 3' terminus (TAMRA). In case of amplification, the reporter escapes from the quenching control caused by the physical separation of the dyes, resulting in a significant increase of the reporter fluorescence. This allows simultaneous and differential detection of the specific HLA (FAM) and internal control (TET) product. The HLA-C fluorotyping information is based on the individual reporter fluorescence released by 18 PCR primer mixes. Using this method, we analyzed 145 samples previously typed with conventional PCR-SSP and found a concordance rate of 100%. Furthermore, fluorotyping revealed quantitative results that may indicate the presence of homozygosity by high signal intensities. This provided extra protection not to miss new alleles which are not amplified by the current primer mixes. These features as well as the capability of high sample throughput and the possibility of automation makes fluorotyping an attractive tool for PCR-based HLA typing.     

Rheumatoid arthritis. Designing and implementing a treatment plan

Treating rheumatoid arthritis can be very satisfying when patients participate fully in designing and implementing their therapeutic strategy. However, the strategy's success depends on early intervention and disease modification. Many patients do well when education, rest, diet, exercise, and drug therapy are incorporated into an individualized regimen.     

Rheumatoid arthritis improved by treatment with levamisole and L-histidine

A case of classical rheumatoid arthritis of 12 years' duration, was treated during an exacerbation with levamisole and remission was induced. The findings support the postulate that depressed cell-mediated immunity to an unknown antigen is the primary immunity defect in rheumatoid arthritis, and that the defence mechanism stimulant levamisole is an effective treatment, at least in some cases. The lack of toxicity of the drug is noted, but in this case the blood aspirin level rose while the patient was taking levamisole with an unaltered dose of aspirin. There was some depression of the neutrophil count after five months which responded to a reduced dosage.     

Rheumatoid arthritis treated with chlorambucil: a five-year follow-up

Tympanotomy and a transvestibular approach to the fundus of the internal auditory meatus is described. The surgical technique is modified from that proposed by Alvarez de Cozar and Antoli-Candela in 1970. The surgical anatomy of the operative sites is detailed. The surgical procedure is found indicated in patients in whom preservation of hearing is not considered and vestibular neurectomy required. The described technique provides a simple but efficient and safe alternative to the translabyrinthine approach to the internal auditory meatus for division of the vestibular and cochlear nerves.     

Rheumatoid arthritis and hydroxyapatite-coated hip prostheses: five-year results. International ABG Study Group

Medium- and long-term results from cemented total hip arthroplasty (THA) in patients with rheumatoid arthritis (RA) show a higher incidence of infection and aseptic loosening when compared to other diagnoses. Early results using uncemented prostheses are variable. Hydroxyapatite (HA) coatings are thought to improve early osseointegration in uncemented THA. In a prospective, international, multicenter clinical study, 32 RA patients who received 33 uncemented HA-coated prostheses were followed up for a minimum of 5 years. Medium-term clinical results are excellent. No infection or aseptic loosening has been recorded. Excellent osseointegration was observed radiographically. Bone remodeling was consistent with mainly proximal to midstem stress transfer. We conclude that uncemented, proximally HA-coated prostheses are a promising alternative to cemented prostheses for RA patients.     

Rheumatoid arthritis: Review of psychological factors related to etiology, effects, and treatment.

Provides a comprehensive review of the psychological literature related to the etiology, effects, and treatment of rheumatoid arthritis (RA), which is a chronic disease with no known cause or cure that typically follows an unpredictable course. A brief summary of the relevant medical aspects of RA is also included. The possible role of psychological variables in the onset of RA is discussed, with emphasis on the potential etiological role of stress. An examination of the multiple consequences of RA suggests that psychologists can play an important role in the development of standardized assessment techniques to measure the effects of RA. The increasing use of psychological treatment strategies to reduce the pain and disability associated with RA also reflects the growing collaboration between rheumatologists and psychologists. It is concluded that methodological problems apparent in the literature must be overcome for psychologists to contribute further to clinical research and practice in the rheumatic disease area. (5 p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)