| 1. |
- Jönsson, B, et al.
(author)
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Cost-effectiveness of Fracture Prevention in Established Osteoporosis
- 1996
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In: Scandinavian Journal of Rheumatology. Supplement. - : Taylor & Francis. - 0301-3847 .- 1502-7740 .- 0300-9742 .- 1502-7732. ; 25:Suppl. 103, s. 30-38
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Journal article (peer-reviewed)abstract
- This study presents the results of a computer simulation model for calculating the cost-effectiveness and cost-utility of treating patients with established osteoporosis in order to reduce the risk of fractures. The results are based on Swedish data for risk of fracture and costs. The treatment intervention modelled is based on treatment of a 62-year-old woman with established osteoporosis. The cost per hip fracture avoided is 350,000 SEK, assuming a 50% reduction in the risk of fracture due to 5 years of treatment. A sensitivity analysis for changes in the cost and effectiveness of treatment, the risk of fracture and the discount rate is performed. The cost per life-year gained and the cost per quality-adjusted life-year (QALY) gained is presented to enable comparison of the cost-effectiveness of treating osteoporosis with that of other health care interventions. A comparison between treating the same woman for osteoporosis and mild hypertension shows a cost per life-year gained of 220,000 SEK and 128,000 SEK respectively. Cost per QALY gained is very similar for the two interventions: 105,000 SEK and 103,000 SEK respectively. This model provides a tool to enable clinicians, administrators and health policy makers to analyze and understand the economic aspects of a major health policy issue.
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| 2. |
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| 3. |
- Andersson-Gäre, Boel, et al.
(author)
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Serum concentration of hyaluronan, IgM and IgA rheumatoid factors in a population based study of juvenile chronic arthritis
- 1994
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In: Scandinavian Journal of Rheumatology. - 0300-9742 .- 1502-7732. ; 23:4, s. 183-90
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Journal article (peer-reviewed)abstract
- Increased serum levels of hyaluronan (HA) have been found in patients with liver diseases, psoriasis, malignancies as well as in rheumatoid arthritis and osteoarthritis. In the two latter groups serum HA levels may reflect the extent of synovial involvement and inflammation, rather than only unspecific information. This study was performed to elucidate the value of measuring HA in children with juvenile chronic arthritis (JCA) and to study its relation to class specific rheumatoid factors (IgM Rf and IgA Rf). HA was analysed in sera from 271 patients with JCA and 130 controls using a radiometric assay and IgM Rf and IgA Rf were analysed using an enzyme immunoassay. The results were analysed in relation to JCA subgroup, disease activity and functional outcome. In patients and controls higher levels of HA were found in young children than in older. Raised levels of HA and IgM Rf were mainly found in children with polyarticular disease. Impaired functional outcome was related to raised HA levels. No correlation was found between HA levels and IgM Rf or IgA Rf. Measurement of HA levels in JCA is of no diagnostic value because of low sensitivity. Quantification of HA may, however, have prognostic value in a subgroup of patients belonging to the polyarticular subgroup.
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| 4. |
- Andersson, H. Ingemar, 1950-, et al.
(author)
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Characteristics of subjects with chronic pain, in relation to local and widespread pain report : a prospective study of symptoms, clinical findings and blood tests in subgroups of a geographically defined population
- 1996
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In: Scandinavian Journal of Rheumatology. - 0300-9742 .- 1502-7732. ; 25:3, s. 146-154
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Journal article (peer-reviewed)abstract
- The relation between reported chronic pain and clinical findings was studied by comparing survey data six months before and eighteen months after a clinical examination. Studied individuals (n = 165) were randomly selected from subsamples of an initial survey (n = 1806) to a general population. Among individuals reporting chronic pain 85% were assessed to have chronic pain at the examination. Diagnoses were found in 22% of examined pain individuals. Myofascial pain syndrome and myalgia were the most common findings. Compared with located neck-shoulder pain, widespread pain had a greater impact on the individual, a worse prognosis regarding pain duration and working capacity, and revealed a raised serum urate level of unclear significance. Although no specific cause of pain is found in individuals with widespread pain it is important to identify and treat this group due to the great effects on functional capacity and the worse prognosis.
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| 8. |
- Danfors, Torsten, et al.
(author)
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Positron emission tomography with 11C-D-deprenyl in patients with rheumatoid arthritis. Evaluation of knee joint inflammation before and after intra-articular glucocorticoid treatment
- 1997
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In: Scandinavian Journal of Rheumatology. - 0300-9742 .- 1502-7732. ; 26:1, s. 43-48
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Journal article (peer-reviewed)abstract
- Seven patients with arthritic disease and with clinical signs of inflammation of the knee joint, were investigated with positron emission tomography (PET) after injection of [N-methyl-11C]-D-deprenyl. Two healthy volunteers were included as controls. In five patients the investigation was repeated after an intra-articular injection of glucocorticoids. All patients showed very high uptake of the tracer in the paraarticular structures of the joint. After treatment there was approximately a 50% reduction of the uptake in the treated knees, both in the high uptake regions and in the surrounding soft tissues. No change was observed in the non-treated knees. In the healthy volunteers, only soft tissue surrounding the joint showed an uptake of the tracer, but at a magnitude which was 6-8 times lower than the high uptake regions in the arthritis patients. Although the mechanisms for the high uptake of 11C-D-deprenyl in affected joints of patients with arthritis is not clear, the present work points to a potential of PET for the assessment of disease intensity and monitoring of treatment.
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| 9. |
- Eberhardt, Kerstin, et al.
(author)
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Early rheumatoid arthritis--some social, economical, and psychological aspects
- 1993
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In: Scandinavian Journal of Rheumatology. - : Informa UK Limited. - 1502-7732 .- 0300-9742. ; 22:3, s. 119-123
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Journal article (peer-reviewed)abstract
- Physical, psychological, and social features were assessed with standardized methods in 84 early RA patients followed prospectively for 2 years. During this time disease activity decreased, and disability evaluated by HAQ remained small. Psychological distress measured by SCL-90 (Symptom Check List) was in general not very pronounced and fairly stable over time. A high pain level at baseline provided a 4 times higher risk for a high level of psychological distress after 2 years. The prevalence of early retirement was 37% at the end of the study. Physical demanding work and a high initial HAQ score were the best predictors of work disability, increasing the risk of not working 10.7 and 5.5 times, respectively. At least 28% of patients had lower annual income compared to the year before disease onset. The ability to do shopping, home work, leisure time activities and social activities were negatively influenced by the disease in more than half of the patients. The social and economical consequences were thus considerable in the early stages of RA.
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| 10. |
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| 11. |
- Gunnarsson, I, et al.
(author)
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Olsalazine-induced lupus syndrome
- 1997
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In: Scandinavian journal of rheumatology. - : Informa UK Limited. - 0300-9742 .- 1502-7732. ; 26:1, s. 65-66
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Journal article (peer-reviewed)
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| 12. |
- Jónsson, Helgi, et al.
(author)
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Rheumathoid Arthritis in an Icelandic Textbook from 1782
- 1996
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In: Scandinavian Journal of Rheumatology. - : Informa UK Limited. - 0300-9742 .- 1502-7732. ; 25:3, s. 134-137
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Journal article (peer-reviewed)abstract
- In 1782, Jón Petursson, a district physician in Northern Iceland, published a textbook on arthritis and its remedies intended for common use. Working within a very simple diagnostic system, essentially comprising osteoarthritis (arthritis fixa) and inflammatory arthritis (arthritis vaga), he describes arthritis vaga as a common, chronic, symmetric, destructive, inflammatory polyarthritis, sometimes with systemic manifestations. It affected people of all ages with a peak incidence around forty, and had a female preponderance. The last observation is of particular interest as he knew he was contradicting all the available literature. Contemporary descriptions of Jon Petursson suggest that he may have had rheumatoid arthritis himself which would explain his excellent description of this disease.
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| 18. |
- Roos, Ewa M., et al.
(author)
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WOMAC osteoarthritis index
- 1999
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In: Scandinavian Journal of Rheumatology. - : Informa UK Limited. - 0300-9742 .- 1502-7732. ; 28:4, s. 210-215
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Journal article (peer-reviewed)abstract
- Objective: To validate the WOMAC Osteoarthritis Index for use in Sweden. Methods: Test-retest reliability, internal consistency, validity, and responsiveness was determined in 52 patients (mean age 48 (20-69)) with arthroscopically assessed cartilage damage of the tibio-femoral knee joint. Results: All WOMAC scales were internally consistent with Cronbach's alpha coefficients of 0.83, 0.87, and 0.96 pre-operatively. Test-retest reliability was satisfactory with intraclass correlation coefficients of 0.74, 0.58, and 0.92. As hypothesized worse post-operative but not preoperative outcomes were associated with radiographic OA. In comparison with the SF-36 the expected correlations were found when comparing items measuring similar and dissimilar constructs, supporting the concepts of convergent and divergent construct validity. Three months after arthroscopy significant mean improvement was seen in all WOMAC scales (p <0.0004). Conclusion: The Swedish version of WOMAC is a reliable, valid, and responsive instrument with metric properties in agreement with the original widely used version.
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| 19. |
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| 20. |
- Simonsson, M., et al.
(author)
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The prevalence of rheumatoid arthritis in Sweden
- 1999
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In: Scandinavian Journal of Rheumatology. - Abingdon : Taylor & Francis. - 0300-9742 .- 1502-7732. ; 28:6, s. 340-343
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Journal article (peer-reviewed)abstract
- The aim of this study was to ascertain the prevalence of rheumatoid arthritis (RA) in a Swedish general adult population. A questionnaire about chronic pain was mailed to a total of 3928 subjects who were chosen as a random sample of the population in two communities in the county of Halland. All persons answering affirmatively to questions intended to identify patients with RA were invited to a clinical examination. X-rays of hands and feet, and analyses of rheumatoid factor and C reactive protein were performed provided that the patients fulfilled two or more of the five clinical items of the 1987 ARA criteria. Furthermore, non-participants were searched for in a patient register and in medical records from the local rheumatology unit in an attempt to identify further cases. Using the modified 1987 ARA criteria for population studies the prevalence rate of RA was calculated to 0.51% (95%, CI = 0.31-0.79).
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| 21. |
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| 22. |
- Tarkowski, A., et al.
(author)
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Use of anti-thymocyte globulin in the management of refractory systemic autoimmune diseases
- 1993
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In: Scandinavian Journal of Rheumatology. - 0300-9742 .- 1502-7732. ; 22:6, s. 261-6
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Journal article (peer-reviewed)abstract
- The purpose of our pilot study was to evaluate the short-and long-term efficacy of T-lymphocyte depletion in the management of patients with refractory, systemic autoimmune diseases. Nine patients with severe, therapy-resistant autoimmune diseases were subjected to T-cell depletion procedure using polyclonal anti-T-cell antibodies combined with peroral administration of azathioprine and/or cyclosporine. The proband group consisted of 4 patients with systemic lupus erythematosus, 3 with progressive systemic sclerosis, and 2 with rheumatoid arthritis. Administration of polyclonal anti-T-cell antibodies was performed at a single occasion via a central venous catheter during 9-10 days. Immunological analyses of T-cell phenotypes and function and assessment of organ function (kidneys, lungs, bone-marrow) has been performed prospectively in all the patients studied. This treatment resulted in prompt and long-lasting (mean follow-up time: 25.6 months) improvement of autoimmune hemolytic anemia, glomerulonephritis, lung fibrosis, skin and joint involvements in the majority of cases. Adverse effects of this treatment included two episodes of infection (E. coli and Cytomegalovirus) and three cases of serum sickness, and were all easily managed. We suggest that this treatment modality adopted from transplant rejection therapy could be employed in cases of severe autoimmune diseases unresponsive to regular immunosuppressive treatment.
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| 23. |
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| 27. |
- Bergström, Ulf, et al.
(author)
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Lower disease activity and disability in Swedish patients with rheumatoid arthritis in 1995 compared with 1978
- 1999
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In: Scandinavian Journal of Rheumatology. - 1502-7732. ; 28, s. 160-165
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Journal article (peer-reviewed)abstract
- The aim of this study was to evaluate differences in disease activity, disability, and medical treatment in consecutive patients with rheumatoid arthritis seen at the outpatient clinics in Malmö, in 1978 (n=148) and 1995 (n=164). The groups were similar with regard to age, gender, disease duration, and the proportion having had hip or knee replacement surgery. The patients in 1995 had lower values for CRP (p<0.001), Ritchie Articular Index (mean values: 5.5 vs. 9.9, p<0.001), and Steinbrocker functional class index (mean values: 1.96 vs. 2.16, p<0.001) than the 1978 group. The 1995 patient group was also more extensively treated with DMARD:s (68 vs. 51%, p<0.01) and glucocorticosteroids (23 vs. 12%, p<0.02) and had historically been treated with almost twice as many DMARD:s (2.7 vs. 1.5, p<0.001). Similar findings regarding disease activity and disability were made when restricting the analysis to subgroups of patients that were seropositive or had a shorter disease duration (<5 yrs). The lower disease severity in the 1995 group may be secondary to a more active medical treatment, although other possibilities such as differences in selection and secular changes in disease severity unrelated to medication cannot be excluded.
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| 28. |
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| 29. |
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| 31. |
- GLANT, TT, et al.
(author)
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CARTILAGE - DISCUSSION
- 1995
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In: SCANDINAVIAN JOURNAL OF RHEUMATOLOGY. - 0300-9742. ; , s. 63-63
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Journal article (other academic/artistic)
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| 32. |
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| 33. |
- Mandl, Thomas, et al.
(author)
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Disturbances of autonomic nervous function in primary Sjogren's syndrome
- 1997
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In: Scandinavian Journal of Rheumatology. - 1502-7732. ; 26:5, s. 401-406
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Journal article (peer-reviewed)abstract
- Autonomic nervous function was evaluated by deep breathing [expiration/inspiration (E/I) ratio] and tilt table tests [acceleration (AI) and brake indices (BI)] in 19 patients with primary Sjogren's syndrome (pSS) and in 56 age matched controls. The E/I-ratio and systolic blood pressure (at rest, 1, and 8 min after tilt) were found to be significantly reduced (p < 0.001, p < 0.05, p < 0.01, p < 0.01 respectively) in patients with pSS whereas neither AI, BI nor diastolic blood pressure did differ significantly between patients and controls (NS). The van Bijsterveld's score correlated negatively with the AI (r = -0.77, p< 0.001) as well as the BI (r = -0.60, p < 0.01). No correlations were found between the 3 autonomic nerve function parameters (E/I-ratio, AI, BI) and unstimulated whole sialometry or salivary gland scintigraphy. We conclude that autonomic disturbances, mainly affecting the parasympathetic nerves are associated with pSS.
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| 34. |
- Persson, Lars-Olof, 1951, et al.
(author)
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Psychological factors in chronic rheumatic diseases--a review. The case of rheumatoid arthritis, current research and some problems.
- 1999
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In: Scandinavian journal of rheumatology. - 0300-9742. ; 28:3, s. 137-44
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Journal article (peer-reviewed)abstract
- An overview of studies relating psychological factors to perceived well-being among Rheumatoid Arthritis (RA) patients is presented. Most attention has been devoted to the perception of control, coping and the effects of cognitive distortions. The introduction of these constructs have advanced the understanding of psychological distress among RA patients, although they explain only a smaller part. One reason could be that they give an oversimplified picture of adjustment processes in chronic and disabling diseases. This may partly be because their development are based either on studies of depression in a psychiatric sense or on how healthy subjects manage stressful events in daily life. The results therefore have limited relevance for adjustment to a life-long, chronic illness like RA. Recent research has also suggested that personality dispositions, especially neuroticism, play a substantial role in all types of subjective experiences. Finally, some issues for future research are discussed.
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| 35. |
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