Objective: To assess driving problems experienced by patients with rheumatoid arthritis (RA) and to examine the relationship between functional status and driving difficulty.
Methods: Using the South Eastern Ontario Medical Organization (SEAMO) database, we identified 721 patients with RA from both urban and rural backgrounds. They completed a cross-sectional, self-administered mail survey that included the Health Assessment Questionnaire (HAQ-DI) and a co-morbidity questionnaire.
The in vitro mechanical properties of 14 wrist extensor tendons salvaged at surgery from patients with inflammatory (rheumatoid) arthritis and noninflammatory arthrosis were measured in uniaxial tension and compared. The rheumatoid tendons had higher extensibility at low stresses, lower stiffness in the linear portion of the stress-strain curve, greater rates of stress relaxation, and lower ultimate strengths than did the nonrheumatoid tendons. Differences in tangent modulus, stress remaining at 100 seconds, and ultimate tensile strength were significant at the 95% confidence level.
View Article and Find Full Text PDFClin Biomech (Bristol)
December 1996
OBJECTIVE: A study was undertaken to determine the experimental accuracy of a non-invasive optoelectonic 3-dimensional tracking system in assessing wrist joint motion. DESIGN: This was an in vivo experimental study involving volunteer subjects performing prescribed wrist motions. BACKGROUND: Current clinical practice does not include routine kinematic analysis for evaluating arthritic disease state, although motion disorders are common.
View Article and Find Full Text PDFWe describe a 38-year-old white woman with Down's syndrome with a history of chronic arthritis and hyperuricemia who presented with acute left knee pain, patellar tenderness and patello-femoral instability. Findings appeared due to a fracture of the lateral femoral condyle, which responded to conservative therapy with a spica cast. Patellofemoral instability in Down's syndrome can be associated with significant morbidity including femoral condyle fracture.
View Article and Find Full Text PDFObjective: To develop and validate revised criteria for global functional status in rheumatoid arthritis (RA).
Methods: Revised criteria were formulated and tested for criterion and discriminant validity in 325 patients with RA.
Results: The revised criteria developed are as follows: class I = able to perform usual activities of daily living (self-care, vocational, and avocational); class II = able to perform usual self-care and vocational activities, but limited in avocational activities; class III = able to perform usual self-care activities but limited in vocational and avocational activities; class IV = limited in ability to perform usual self-care, vocational, and avocational activities.
Osteoarthritis (OA), the commonest form of arthritis, is an important cause of chronic morbidity. Assessment of patients with OA can be improved by the recognition of several patterns with which this disorder can present. When these patterns are delineated by a careful history, physical examination, appropriate radiographs and laboratory tests, it often leads to a more precise diagnosis and ultimately better management of these patients.
View Article and Find Full Text PDFHypertriglyceridemia has been reported frequently in patients with hyperuricemia and gout. The current studies have evaluated this relationship. To examine whether hypertriglyceridemia leads to hyperuricemia, IV intralipid was given to three gouty patients.
View Article and Find Full Text PDFTwenty-six patients with rheumatoid arthritis (average age, 57 years; average duration of disease, 11 years) who were unresponsive to antiinflammatory and slow-acting antirheumatic drug therapy were entered into a controlled, double-blind, crossover study to assess the efficacy of plasmapheresis therapy. All patients received 10 true and 10 sham aphereses as outpatients and continued to take their usual drugs. Twenty patients completed the study, and six were withdrawn--three because of poor venous access.
View Article and Find Full Text PDFA 52-year-old Caucasian man with chronic neutropenia and recurrent infections was found to have an increased proportion of peripheral T lymphocytes having Fc receptors for IgG (T gamma ). Although levels of antibody-dependent cell-mediated cytotoxicity (ADCC) and "natural" killing (NK) by unfractionated lymphocytes were similar to those of a control donor, the frequency of KN cells was markedly increased. Removal of E rosette-forming cells eliminated both NK and ADCC by the patient's peripheral blood, in marked contrast to the enhanced cytotoxicity seen with control lymphocytes.
View Article and Find Full Text PDFJ Am Geriatr Soc
February 1982
The efficacy and the toxicity pattern of D-penicillamine were studied in patients with rheumatoid disease followed up between April 1975 and March 1979. The population of patients was divided into an elderly group (greater than or equal to 60 years old, mean = 65 years) and a younger group (less than 60 years old, mean = 41 years). Patients with classic or definite rheumatoid disease not responsive to nonsteroidal drugs were eligible.
View Article and Find Full Text PDFOne hundred and one patients with rheumatoid arthritis were followed prospectively to assess the efficacy and toxicity of therapy with D-penicillamine. After a mean total followup of 11.5 months (38 patients have completed 2 years of followup) there was a 70% overall improvement rate with 2 complete remissions.
View Article and Find Full Text PDFTwo patients with severe seropositive rheumatoid arthritis previously unresponsive to conventional therapy have been treated with leucapheresis. This technique involves continuous cell separation daily to remove primarily lymphocytes. Clinical improvement was recorded with the use of standard rheumatological measures of inflammation.
View Article and Find Full Text PDFEighty-three consecutive patients with rheumatoid factor-negative polyarthritis seen during a 1-year period were evaluated clinically, radiologically, and with the B27 test. Patients with definite spondylitis, juvenile chronic polyarthritis, a collagen disease, a known metabolic arthropathy, or primary generalized osteoarthritis were excluded. The patients could be classified into two groups independent of any knowledge of B27 testing.
View Article and Find Full Text PDFThis study compares the effect of azathioprine with those of gold and chloroquine in early (Class II) rheumatoid arthritis (RA). Thirty-three similar patients with classic or definite RA of less than 5 years duration were randomly entered, 11 into each drug group. Assessment of standard clinical and laboratory measures at 12 and 24 weeks showed significant improvement in all three groups.
View Article and Find Full Text PDFHip involvement in ankylosing spondylitis (AS) is a common and disabling problem. The clinical and x-ray records of 87 patients with definite AS (Rome criteria) were examined to define and characterize their hip disease. Clinical hip disease was present in 33 cases (38%), was usually bilateral (91%), and tended to begin early in the disease course; it was the cause of 50% of the Class III and IV disability in the entire study group.
View Article and Find Full Text PDFEleven patients with ankylosing spondylitis underwent reconstructive hip surgery (21 hips). In 10 of these hips multiple surgical procedures had been performed. The final procedure included total hip arthroplasties (16 hips), femoral cup arthroplasties (four hips) and an Austin-Moore prosthetic replacement (one hip).
View Article and Find Full Text PDFA clinical and radiographic study of 98 patients with definite ankylosing spondylitis (Rome criteria) was undertaken to evaluate differences in men and women with the disease. Clinical manifestations which were atypical in the 18 female patients when compared to those of the men included older age of disease onset, higher incidence of initial and subsequent peripheral joint disease, more common cervical spine symptomatology, and milder disease course. Radiographic differences in the women included a high incidence of cervical spine abnormalities, a combination of cervical spine and sacroiliac joint alterations with a normal intervening thoracic and lumbar segment, and frequent and severe osteitis pubis.
View Article and Find Full Text PDFThe mutation in a young gouty male with a partial deficiency of hypoxanthine-guanine phosphoribosyltransferase has been evaluated. The serum uric acid was 11.8 mg/100 ml, and the urinary uric acid excretion was 1,279 mg/24 h.
View Article and Find Full Text PDFJ Rheumatol
September 1975
A detailed roentgenographic and pathologic study of the sacro-iliac joint in a cadaver with renal osteodystrophy revealed subchondral abnormalities, particularly in the ilium, which consisted of resorption of bone, substitutive fibrosis, and thickening of remaining trabeculae. Overlying articular cartilage degeneration was also apparent. The "pseudo-widening" of the joint space noted in ante and post-mortem radiographs in this patient simulated the findings in early ankylosing spondylitis.
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