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Swollen joint

Merete L Hetland, Niels Steen Krogh, Kim Hørslev-Petersen, Berit Schiøttz-Christensen, Inge Juul Sørensen, Jensen Dorte Vendelbo
OBJECTIVES: Electronic platforms have been developed to help the clinician monitor disease activity in rheumatoid arthritis (RA) to support at treat-to-target strategy. We present an initiative to interactively improve disease control in patients with rheumatoid arthritis. METHODS: In patients who presented with one or more swollen joints AND moderate/high disease activity (i.e. either CDAI≥10.1 and/or DAS-28CRP>3.2, which is automatically calculated in the DANBIO registry), a red alert was shown, which activated a pop-up: "This patient has at least one swollen joint AND either CDAI≥ 10...
September 2016: Clinical and Experimental Rheumatology
Piet L C M van Riel, Lisanne Renskers
In rheumatoid arthritis (RA), disease activity cannot be measured in all individual patients according to a single variable. The Disease Activity Score (DAS) and the DAS28 have been developed to measure disease activity in RA both in daily clinical practice as well as in clinical trials on a group as well as individual level. The DAS/DAS28 is a continuous measure of RA disease activity that combines information from swollen joints, tender joints, acute phase response and general health. The DAS-based EULAR response criteria were primarily developed to be used in clinical trials...
September 2016: Clinical and Experimental Rheumatology
Zhaleh Shariati Sarabi, Mehran Ghazi Saeidi, Mandana Khodashahi, Ali Etemad Rezaie, Kamila Hashemzadeh, Rozita Khodashahi, Hossein Heidari
BACKGROUND: Rheumatoid arthritis (RA) is a chronic inflammatory joint disorder with unknown etiology. Atorvastatin is a lipid-lowering agent that affects the inflammatory processes. OBJECTIVE: This study aimed to determine the anti-inflammatory effects of atorvastatin on the Disease Activity Index and high-density lipoprotein (HDL) concentrations in RA patients. METHODS: This clinical trial was performed on 38 RA patients, who were referred to the Imam Reza and Ghaem Medical Centers of Mashhad, Iran between 2013 and 2014...
August 2016: Electronic Physician
Marlène Genty, Bernard Combe, Marie Kostine, Elodie Ardouin, Jacques Morel, Cédric Lukas
OBJECTIVES: To assess predictive factors of improvement in related fatigue in rheumatoid arthritis (RA) patients newly receiving biologic therapy, and specifically the influence of the improvement of the quality of sleep. METHODS: We conducted a multicentre prospective study in RA patients requiring initiation or change of biologic therapy. The improvement in fatigue, sleep disorders and depression was assessed respectively by the FACIT fatigue scale, Spiegel scale and Beck Depression Inventory at inclusion (M0) and 3 months (M3) after the beginning of treatment...
October 7, 2016: Clinical and Experimental Rheumatology
Suzanne Arends, Elisabeth Brouwer, Monique Efde, Eveline van der Veer, Hendrika Bootsma, Freke Wink, Anneke Spoorenberg
OBJECTIVES: Randomised controlled trials and open-label extension studies have demonstrated the clinical efficacy and safety of tumour necrosis factor-alpha (TNF-α) blocking therapy in pre-selected study patients with ankylosing spondylitis (AS). Our aim was to investigate the 7-year drug survival and clinical effectiveness of etanercept treatment in AS patients in daily clinical practice. METHODS: Consecutive AS patients from the prospective observational GLAS cohort who started etanercept because of active disease were included and evaluated over 7 years according to a fixed protocol...
October 7, 2016: Clinical and Experimental Rheumatology
Alexis Ogdie, William J Taylor, Tuhina Neogi, Jaap Fransen, Tim L Jansen, H Ralph Schumacher, Worawit Louthrenoo, Janitzia Vazquez-Mellado, Maxim Eliseev, Geraldine McCarthy, Lisa K Stamp, Fernando Perez-Ruiz, Francisca Sivera, Hang-Korng Ea, Martijn Gerritsen, Giovanni Cagnotto, Lorenzo Cavagna, Chingtsai Lin, Yin-Yi Chou, Anne-Kathrin Tausche, Manuella Lima Gomes Ochtrop, Matthijs Janssen, Jiunn-Horng Chen, Ole Slot, Juris Lazovskis, Douglas White, Marco A Cimmino, Till Uhlig, Nicola Dalbeth
OBJECTIVES: To examine the performance of ultrasound for the diagnosis of gout using presence of monosodium urate (MSU) crystals as the gold standard. METHODS: We analyzed data from the Study for Updated Gout Classification Criteria (SUGAR), a large, multi-center observational cross-sectional study of consecutive subjects with at least one swollen joint who conceivably may have gout. All subjects underwent arthrocentesis; cases were subjects with MSU crystal confirmation...
October 16, 2016: Arthritis & Rheumatology
Latika Gupta, Shruti Bhattacharya, Vikas Agarwal, Amita Aggarwal
Monocytes of patients with ankylosing spondylitis (AS) have toll-like receptor 4 (TLR4) overexpression on their monocytes. Myeloid-related protein (MRP) 8/14 protein complexes are calcium-binding proteins, which act as endogenous ligands to TLR4. Thus, we studied the levels of MRP8/14 in adult AS patients. MRP8/14 levels were assessed in 99 adult AS patients satisfying Assessments in Ankylosing Spondylitis International Society 2010 criteria and 71 healthy controls by ELISA. Patient disease parameters like patient and physician global assessment, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), swollen and tender joint count, entheseal count by Maastricht enthesitis index, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were also recorded...
October 13, 2016: Clinical Rheumatology
Anais Gardette, Sébastien Ottaviani, Jérémie Sellam, Francis Berenbaum, Frédéric Lioté, Bruno Fautrel, Elisabeth Palazzo, Alain Meyer, Jean Sibilia, Philippe Dieudé
BACKGROUND: Previous studies suggested that obesity could negatively affect the response to anti-tumor necrosis factor α (TNFα) agents in rheumatoid arthritis (RA). However, data are lacking on whether obesity affects the response to abatacept (ABA). We aimed to determine whether body mass index (BMI) affects the response to ABA in RA. PATIENTS AND METHODS: In this multicenter retrospective study, we included RA patients who received ABA. BMI was calculated at the initiation of treatment...
October 13, 2016: European Journal of Clinical Investigation
Takeshi Kuroda, Naohito Tanabe, Yukiko Nozawa, Hiroe Sato, Takeshi Nakatsue, Daisuke Kobayashi, Yoko Wada, Takako Saeki, Masaaki Nakano, Ichiei Narita
Objective Our objective was to examine the safety and effects of therapy with biologics on the prognosis of rheumatoid arthritis (RA) patients with reactive amyloid A (AA) amyloidosis on hemodialysis (HD). Methods Twenty-eight patients with an established diagnosis of reactive AA amyloidosis participated in the study. The survival was calculated from the date of HD initiation until the time of death, or up to end of June 2015 for the patients who were still alive. HD initiation was according to the program of HD initiation for systemic amyloidosis patients associated with RA...
2016: Internal Medicine
David Wasylynko
OBJECTIVE: To present a case of chronic elbow pain as a result of a hidden underlying osteochondral defect. CLINICAL FEATURES: A 17-year old baseball player presented with chronic lateral elbow pain. Examination revealed swelling of the elbow with signs of possible ligament, muscle, and tendon injury. DIAGNOSIS AND TREATMENT: Although there was apparent soft-tissue injury, the elbow swelling created immediate suspicion of a more serious underlying condition...
September 2016: Journal of the Canadian Chiropractic Association
Fatemeh Javadi, Arman Ahmadzadeh, Shahryar Eghtesadi, Naheed Aryaeian, Mozhdeh Zabihiyeganeh, Abbas Rahimi Foroushani, Shima Jazayeri
OBJECTIVE: Previous studies have shown that the bioflavonoid quercetin has anti-inflammatory and anti-nociceptive effects. We investigated the effect of quercetin supplementation on inflammation, disease severity, and clinical symptoms in women with rheumatoid arthritis (RA). METHODS: The present study was a randomized, double-blind, placebo-controlled clinical trial in which 50 women with RA were allocated into a quercetin (500 mg/day) or placebo group for 8 weeks...
October 6, 2016: Journal of the American College of Nutrition
Brigitte Michelsen, Eirik Klami Kristianslund, Hilde Berner Hammer, Karen Minde Fagerli, Elisabeth Lie, Ada Wierød, Synøve Kalstad, Erik Rødevand, Frode Krøll, Glenn Haugeberg, Tore K Kvien
OBJECTIVE: To investigate the predictive value of discordance between (1) tender and swollen joint count and (2) patient's and evaluator's global assessment on remission in patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA). METHODS: From the prospective, multicentre Norwegian-Disease-Modifying Antirheumatic Drug study, we included patients with RA and PsA starting first-time tumour necrosis factor inhibitors and DMARD-naïve patients starting methotrexate between 2000 and 2012...
October 4, 2016: Annals of the Rheumatic Diseases
Ahmad Rahal, Mahmoud Farhoud, Melissa Gaines
A 63-year-old woman with a history of hyperlipidemia presented to our hospital with a swollen right hand. The patient noted that she had closed her hand in a car door one week earlier, causing minor trauma to the right third metacarpophalangeal joint. Shortly after injuring her hand, she'd sought care at an outpatient facility, where she was given a diagnosis of cellulitis and a prescription for an oral antibiotic. The swelling, however, worsened, prompting her visit to our hospital.
August 2016: Journal of Family Practice
Aneela N Mian, Khaldoun Chaabo, Julekha Wajed, Sujith Subesinghe, Nicola J Gullick, Bruce Kirkham, Toby Garrood
BACKGROUND: In patients with rheumatoid arthritis (RA) clinical measures of disease activity may not reliably discriminate between patients with active inflammatory disease and those with concomitant fibromyalgia (FM). Recent work has shown RA patients with a 28 tender joint count (TJC) minus swollen joint count (SJC) of 7 or more (joint count criteria) are more likely to meet classification criteria for FM. This study aimed to determine whether RA patients meeting clinical criteria for FM had lower levels of joint inflammation as determined by ultrasound (US)...
September 23, 2016: BMC Musculoskeletal Disorders
Bengt Wahlin, Thomas Meedt, Fredrik Jonsson, Michael Y Henein, Solveig Wållberg-Jonsson
Objective. A long-term follow-up of patients with rheumatoid arthritis (RA) to evaluate factors related to coronary artery calcification (CAC). Methods. All 22 eligible patients (4 males/18 females, mean age 65 years, and RA-duration 30-36 years) from the original (baseline; n = 39) study of atherosclerosis were included. Inflammation, cardiovascular risk factors, and biomarkers were measured at baseline. At follow-up 13 years later, CAC was assessed by computed tomography (CT) and the grade of inflammation was measured...
2016: BioMed Research International
Carlos Omar López López, Everardo Fuentes Lugo, Everardo Alvarez-Hernández, Ingris Peláez-Ballestas, Rubén Burgos-Vargas, Janitzia Vázquez-Mellado
Epidemiologic data from recent decades show a significant increase in the prevalence and incidence of gout worldwide, in addition to changes in its clinical expression. Our objective was to compare the frequency of the severity of gout and disability in two patient groups at our clinic during different periods. We included and compared data of two groups: group A (1995-2000), patients from previous report, and group B (2010-2014), the baseline data of current patients participating in a cohort (GRESGO). This evaluation included data of socioeconomic and educational levels, demographics, associated diseases, previous treatment, clinical and biochemical data, and disability evaluated using the Health Assessment Questionnaire (HAQ)...
September 8, 2016: Clinical Rheumatology
Vibeke Strand, Mark Kosinski, Chieh-I Chen, George Joseph, Regina Rendas-Baum, Neil M H Graham, Hubert van Hoogstraten, Martha Bayliss, Chunpeng Fan, Tom Huizinga, Mark C Genovese
BACKGROUND: Sarilumab is a human monoclonal antibody directed against the alpha subunit of the interleukin-6 receptor complex. In the MOBILITY phase III randomized controlled trial (RCT), sarilumab + methotrexate (MTX) treatment resulted in clinical improvements at 24 weeks that were maintained at 52 weeks in adults with rheumatoid arthritis (RA), who have inadequate response to MTX (MTX-IR). These analyses indicate the effects of sarilumab + MTX versus placebo on patient-reported outcomes (PROs) in this RCT...
2016: Arthritis Research & Therapy
M Ghavipour, G Sotoudeh, E Tavakoli, K Mowla, J Hasanzadeh, Z Mazloom
BACKGROUND/OBJECTIVES: Since the main characteristics of Rheumatoid Arthritis (RA) are joint dysfunction caused by inflammation and serious pain, anti-inflammatory agents may alleviate the clinical symptoms in RA. Pomegranate juice is rich in polyphenolic compounds that possess antioxidant and anti-inflammatory activities. This study aimed to determine the beneficial effects of pomegranate extract (POMx) in RA patients. SUBJECTS/METHODS: A total of 55 RA patients were enrolled and randomly allocated to an intervention group (n=30) or a control group (n=25)...
August 31, 2016: European Journal of Clinical Nutrition
Muznay N Khawaja, Martin J Bergman, Jeffrey Yourish, Jinglan Pei, William Reiss, Edward Keystone
OBJECTIVE: The American College of Rheumatology/European League Against Rheumatism established definitions of remission for rheumatoid arthritis (RA) based on composite scores including tender and swollen joint counts (TJC/SJC), Patient Global visual analog scale (VAS) score, laboratory tests, and, in Simplified Disease Activity Index (SDAI), Physician Global score. Time constraints on a physician's schedule demand an easy yet accurate tool to measure disease activity. We assessed the predictability of Routine Assessment of Patient Index Data 3 (RAPID3) with/without a single swollen joint versus SDAI and/or Boolean remission criteria for functional and radiographic outcomes...
August 26, 2016: Arthritis Care & Research
Ellen Sauar Norli, Gina H Brinkmann, Tore K Kvien, Olav Bjørneboe, Anne J Haugen, Halvor Nygaard, Cathrine Thunem, Elisabeth Lie, Maria D Mjaavatten
OBJECTIVES: To study occurrence of and factors associated with self-limiting arthritis among patients fulfilling the 2010 ACR/EULAR classification criteria for rheumatoid arthritis (RA) (2010 RA criteria) in patients with ≤16 weeks׳ duration of joint swelling. METHODS: We applied the 2010 RA criteria in 1118 patients included in a 2-year longitudinal cohort. In all, 256 patients fulfilled the 2010 RA criteria at baseline; outcome was defined as either "self-limiting arthritis" (no DMARD use during follow-up, no swollen joints at last assessment, and no final clinical diagnosis of RA) or "persistent disease...
July 20, 2016: Seminars in Arthritis and Rheumatism
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