| 1. |
- Bertilsson, Lennart, et al.
(författare)
-
Disease course, outcome, and predictors of outcome in a population-based juvenile chronic arthritis cohort followed for 17 years
- 2013
-
Ingår i: Journal of Rheumatology. - : The Journal of Rheumatology. - 0315-162X .- 1499-2752. ; 40:5, s. 715-724
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate disease course, outcome, and predictors of outcome in an unselected population-based cohort of individuals diagnosed with juvenile chronic arthritis (JCA) followed for 17 years. METHODS: The cohort consisted of 132 incidence JCA cases identified 1984-1986 according to EULAR criteria. At 5-year followup, 129 individuals underwent joint assessment, laboratory measurements, radiographic examination, and medication and functional assessment. At 17-year followup, 86 were examined with joint assessment, laboratory measurements, medication assessment, Health Assessment Questionnaire (HAQ), Keitel functional test (KFT), and Medical Outcomes Study Short Form-36 (SF-36). RESULTS: At 17-year followup, 40% were in remission, 44% changed subgroups, median HAQ score was 0.0 (range 0.0-1.5), and median KFT was 100 (range 54-100). SF-36 scores were significantly lower compared to a reference group. Thirty-nine percent of those in remission at 5-year followup were not in remission at 17-year followup. In multivariate analyses of variables from the 17-year followup: remission was predicted by remission at 5-year followup (OR 4.8); HAQ > 0 by rheumatoid factor (RF)-positivity at 5-year followup (OR 3.6); KFT < 100 by nonremission (OR 11.3); and RF-positivity (OR 5.6) at 5-year followup; and the SF-36 physical component summary score above average of the reference group by remission at 5-year followup (OR 5.8). CONCLUSION: This longterm study of 86 individuals with JCA showed large variability of disease courses and of impaired health-related quality of life. Sixty percent were not in remission at 17-year followup. Longterm outcome was best predicted by and associated with characteristics at 5-year followup rather than those at onset.
|
|
| 2. |
- Boström, Elisabeth Almer, 1983, et al.
(författare)
-
Salivary resistin reflects local inflammation in Sjögrens syndrome
- 2008
-
Ingår i: Journal of Rheumatology. - 0315-162X .- 1499-2752. ; 35:10, s. 2005-2011
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To assess the role of resistin in primary Sjogren's syndrome (pSS) and its relation to local inflammation. METHODS: Blood and saliva were collected from 37 patients with pSS (duration of symptoms 12.6+/-1 yrs) and 32 healthy controls. Expression of resistin in salivary glands was visualized immunohistologically, and levels of resistin were detected by ELISA. Levels of resistin were evaluated at baseline and following oral dehydroepiandrosterone (DHEA) treatment (50 mg/day). The effect of DHEA treatment on the secretion of resistin was assessed in vitro in human leukocytes after challenge with insulin and lipopolysaccharide. RESULTS: Levels of resistin in saliva were significantly higher in patients with pSS than in controls, while circulating levels of resistin were similar in both groups. Resistin was expressed in the epithelial cells of striated ducts and in the lymphocytic foci. Resistin levels in saliva were related to the intensity of inflammation in the minor salivary glands of pSS patients. No changes of the levels of resistin in blood or saliva were observed during DHEA treatment. Exposure of naive leukocytes to DHEA in vitro induced significant expression of resistin compared to nonstimulated peripheral blood mononuclear cells (p=0.031). CONCLUSION: We showed that levels of resistin are upregulated locally in the salivary glands of patients with pSS; and that the levels of resistin correspond to the intensity of lymphocytic inflammation in patients with pSS. We suggest that resistin is expressed in the salivary glands of patients with pSS and may be a driving factor of local inflammation.
|
|
| 3. |
- Cvetkovic, Jasmina Trifunovic, et al.
(författare)
-
Susceptibility for and clinical manifestations of rheumatoid arthritis are associated with polymorphisms of the TNF-alpha, IL-1 beta, and IL-lRa genes
- 2002
-
Ingår i: Journal of Rheumatology. - 0315-162X .- 1499-2752. ; 29:2, s. 212-219
-
Tidskriftsartikel (refereegranskat)abstract
- Objective. To analyze the association of genetic polymorphisms of pro-inflammatory cytokines with rheumatoid arthritis (RA) in comparison with healthy controls from Northern Sweden and the potential contribution of these genetic variants for disease severity and development of cardiovascular complications. Methods. Polymerase chain reaction amplification was used for analysis of TaqI restriction fragment length polymorphism (RFLP) of interleukin-1 beta (IL-1beta), variable tandem repeat polymorphism of IL-1 receptor antagonist (IL-1Ra) gene and NcoI RFLP at position -308 of tumor necrosis factor-alpha (TNF-alpha) gene, One hundred and fifty-four patients with RA, 42 men and 112 women, were consecutively recruited into the study through the Department of Rheumatology. Results. The allele A1 of TNF-alpha was more common in the patient group (p < 0.01 OR = 1.62). Patients having the genotype A1A2 seemed to develop more severe disease compared with patients with A1A1 genotype: they were younger at disease onset (p < 0.05), had a higher accumulated disease activity (p < 0.05) and worse functional class (p < 0.05), Patients with genotype A2A2 of IL-1beta had higher accumulated disease activity score than patients with A1A1 and A1A2 (p < 0.05). The allelic combination A1 IL-1beta/A2 IL-1Ra was less prevalent in RA patients who developed cardiovascular complications (p < 0.005 OR = 0.20). Conclusions. The A1 allele of TNF-alpha associates with RA. Genotypes A1A2 of TNF-alpha and A2A2 of IL-1beta are associated with more severe disease. The allelic combination A1 IL-1beta/A2 IL-1Ra is less often present in RA patients who developed cardiovascular complications.
|
|
| 4. |
- Dahlqvist, Solbritt Rantapää, et al.
(författare)
-
HLA-B27 and involvement of sacroiliac joints in rheumatoid-arthritis
- 1984
-
Ingår i: Journal of Rheumatology. - 0315-162X .- 1499-2752. ; 11:1, s. 27-32
-
Tidskriftsartikel (refereegranskat)abstract
- The frequency of radiographic signs of sacroiliac joint involvement (greater than or equal to 2 and greater than or equal to 3 according to the New York criteria) was significantly higher in 28 HLA-B27 positive patients with classical seropositive rheumatoid arthritis (RA), than in 28 B27 negative RA controls. The B27 positive RA patients had more subcutaneous nodules (p less than 0.01), worse functional class (p less than 0.05), and higher levels of erythrocyte sedimentation rate (ESR) (p less than 0.05) and haptoglobin (p less than 0.05). Sacroiliitis, independent of HLA-B27, was associated with higher levels of ESR (p less than 0.05), and with a higher frequency of positive ANA test (p less than 0.05). It is neither related to the functional class nor to the duration of the disease
|
|
| 5. |
- Dahlqvist, Solbritt Rantapää, et al.
(författare)
-
HLA haplotypes in a family with ankylosing-spondylitis and rheumatoid-arthritis
- 1985
-
Ingår i: Journal of Rheumatology. - 0315-162X .- 1499-2752. ; 12:3, s. 518-522
-
Tidskriftsartikel (refereegranskat)abstract
- HLA haplotypes (including A, B, C and DR loci) were studied in a family with members who had both rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Sacroiliitis was found in 7 family members, one of whom had AS and 2 others erosive, seropositive RA. They carried the B27-DR4 haplotype, suggesting a possible dual genetic association of the same haplotype in both RA and AS. Three other different HLA-B27 containing haplotype were found, 2 of which could be associated with sacroiliitis/AS. Within this family sacroiliitis and/or AS rather seemed associated with the B27 antigen itself than with the same haplotype.
|
|
| 6. |
- Elert, J, et al.
(författare)
-
Muscle endurance, muscle tension and personality-traits in patients with muscle or joint pain - a pilot-study
- 1993
-
Ingår i: Journal of Rheumatology. - 0315-162X .- 1499-2752. ; 20, s. 1550-1556
-
Tidskriftsartikel (refereegranskat)abstract
- Objective. To investigate the relationships between personality traits, depressive symptomatology and continuous muscle tension. Methods. These were investigated by means of a visual analog scale and the presence of continuous muscle tension during repeated isokinetic shoulder flexions in patients with muscle or joint pain and controls. Results. A significantly higher level of muscle tension between contractions was found in the patient groups in painful muscles. The patients with primary fibromyalgia and trapezius myalgia differed in degree of depressive symptomatology compared to controls. Conclusion. Inhibition of aggression correlated significantly with the tension level between contractions during the isokinetic test indicating interaction between psychological and somatic factors.
|
|
| 7. |
- Eurenius, Eva, et al.
(författare)
-
Predicting physical activity and general health perception among patients with rheumatoid arthritis
- 2007
-
Ingår i: Journal of Rheumatology. - 0315-162X .- 1499-2752. ; 34:1, s. 10-15
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To describe changes over one year in physical activity, body functions, and disease activity in patients with rheumatoid arthritis (RA) and to identify predictors for physical activity and general health perception. METHODS: One hundred two patients with RA were recruited for the study (median age 57 yrs, range 19-84; median disease duration 15 mo, range 4-78; 76% women). Self-reported data on physical activity and health locus of control, tests of lower extremity function, grip force, joint range of motion, balance, and measures of disease activity, including pain, general health perception, Health Assessment Questionnaire (HAQ), and Disease Activity Score (DAS28), were collected on 2 occasions, one year apart. Each variable was dichotomized to fit logistic regression models, performed to identify which variables predicted physical activity and general health perception over one year. RESULTS: Physical activity was stable, while lower extremity function, grip force, and range of motion improved and DAS28 decreased significantly over one year. A high physical activity level at baseline was the only predictor of high physical activity (odds ratio 3.85, 95% confidence interval 1.67-9.09) one year later. Low pain (OR 8.47, 95% CI 2.97-24.39), high physical activity (OR 3.72, 95% CI 1.39-10.10), and good lower extremity function (OR 2.94, 95% CI 1.04-8.33) were identified as predictors of good general health perception. CONCLUSION: While pain is a well known predictor of general health perception, to our knowledge, this is the first study to identify predictive factors related to physical activity and lower extremity function as important for perceived health among patients with RA.
|
|
| 8. |
- Forsblad-d'Elia, Helena, et al.
(författare)
-
Biomechanical properties of common carotid arteries assessed by circumferential two-dimensional strain and β stiffness index in patients with ankylosing spondylitis
- 2021
-
Ingår i: Journal of Rheumatology. - : The Journal of Rheumatology. - 0315-162X .- 1499-2752. ; 48:3, s. 352-360
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Ankylosing spondylitis (AS) is associated with an elevated risk of cardiovascular disease (CVD) related to atherosclerosis, preceded by arterial stiffness. We aimed to examine common carotid artery (CCA) biomechanical properties using ultrasound to calculate β stiffness index (indicating arterial stiffness) and, a more recently developed technique, two-dimensional (2D) speckle tracking strain (indicating arterial motion and deformation, strain) to 1) compare with age- and sex-matched controls and to 2) analyze relationships between strain and stiffness with disease characteristics and traditional risk factors for CVD in AS patients.METHODS: In this cross-sectional study, a cohort of 149 patients with AS, mean age 55.3±11.2 years, 102(68.5%) men, 146 (98%) HLA-B27 positive, were examined. Bilateral CCAs were examined for circumferential 2D strain and β stiffness index. A subgroup of 46 patients were compared with 46 age- and sex-matched controls, both groups without hypertensive disease, diabetes, myocardial infarction or stroke.RESULTS: Mean bilateral circumferential 2D strain was lower in AS patients compared with controls, 7.9±2.6% vs 10.3±1.9%, p<0.001 whereas mean bilateral β stiffness index was higher, 13.1±1.6mmHg/mm vs 12.3±1.3mmHg/mm, p=0.018. In multivariable linear regression analyses strain was associated with age, erythrocyte sedimentation rate, history of anterior uveitis and treatment with csDMARD and/or bDMARD (R2 0.33), while stiffness was associated with age (R2 0.19).CONCLUSION: Both CCA circumferential 2D strain and β stiffness index differed between AS patients and controls. Strain was associated with AS-related factors and age while stiffness with age, suggesting that the obtained results reflect different pathogenic vascular processes.
|
|
| 9. |
- Forsblad d'Elia, Helena, 1961, et al.
(författare)
-
Influence of hormone replacement therapy on disease progression and bone mineral density in rheumatoid arthritis.
- 2003
-
Ingår i: The Journal of rheumatology. - 0315-162X .- 1499-2752. ; 30:7, s. 1456-63
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Hormone replacement therapy (HRT) is known to exert a positive effect in preventing bone loss and a beneficial effect on the disease activity in rheumatoid arthritis (RA). We evaluated the effects of HRT on bone mineral density (BMD) and on the course of established RA. METHODS: Eighty-eight postmenopausal women with RA were randomly allocated to receive HRT, vitamin D3, and calcium supplementation or vitamin D3 and calcium supplementation alone for 2 years. The effects of additional HRT on laboratory and clinical measures of disease activity, quality of life, and BMD and on radiographic joint damage were investigated. RESULTS: Treatment with HRT suppressed signs of inflammation as shown by reduction in erythrocyte sedimentation rate (ESR) (p = 0.025) and an elevation in hemoglobin concentration (p = 0.007), a better clinical outcome assessed by response on the Disease Activity Score 28 (DAS28) (p = 0.036), increased BMD in the forearm, proximal femur and spine (p < 0.01), and retarded (p = 0.026) progression of joint destruction among patients with radiological progressive disease. No significant effect on quality of life was seen. CONCLUSION: Two years of HRT in women with active RA had significant ameliorating effects on inflammation, DAS28 response, and BMD and was associated with slower progression of radiological joint destruction. The mechanisms by which HRT exerts its effects remain to be elucidated. We suggest HRT can be used in addition to conventional therapy in the management of postmenopausal patients with RA.
|
|
| 10. |
- Geijer, Mats, et al.
(författare)
-
The Swedish Early Psoriatic Arthritis Registry 5-year Followup : Substantial Radiographic Progression Mainly in Men with High Disease Activity and Development of Dactylitis
- 2015
-
Ingår i: Journal of Rheumatology. - : The Journal of Rheumatology. - 0315-162X .- 1499-2752. ; 42:11, s. 2110-2117
-
Tidskriftsartikel (refereegranskat)abstract
- Objective. To describe early radiographic findings in patients from the Swedish psoriatic arthritis (SwePsA) registry, progression of destruction, correlations with clinical disease variables, and predictors of destruction. Methods. Hand and foot radiographs were available for 72 of 197 SwePsA patients followed for 5 years. Clinical data were collected according to the SwePsA protocol. Results. Disease characteristics and clinical improvement were similar in men and women. Radiographic abnormalities were more pronounced in men. Total Wassenberg radiographic score at baseline was 0 in 45% of men and 51% of women. One man and one woman had a score >10. At 5 years, total score was 0 in 14% of men and 40% of women (p = 0.018); 17% of men and 7% of women had scores >10. Mean total scores for men and women had increased. Baseline erythrocyte sedimentation rate was associated with baseline total radiographic score. In men, swollen joint count was positively, and in women tender joint count negatively, correlated to total radiographic score. After 5 years, only male scores, mainly hand scores, significantly correlated with 28-joint Disease Activity Score and Disease Activity Index for Psoriatic Arthritis scores, swollen joint count, and dactylitis. Achieving remission or minimal disease activity after 5 years protected against structural damage, mainly in men. Conclusion. Radiographic progression in early PsA was generally slow but substantial. Male sex appears to be a risk factor for early radiographic damage while the presence of baseline radiographic damage and dactylitis developing during followup seem to predict further destruction. Hand and foot radiograph scoring cannot be substituted with clinical signs.
|
|
