Site: About Arthritis

Pain Scales Help Arthritis Patients Rate Their Level of Pain
Pain scales help arthritis patients rate their level of pain so it can be communicated to their doctor, other health professionals, or even family. It's a self-reported pain level so...

Low-Dose Aspirin and NSAIDs - A Safe Combination for Arthritis Patients?
Many patients are prescribed low-dose aspirin as a cardioprotective treatment but they are already taking an NSAID (nonsteroidal anti-inflammatory drug) to treat arthritis. Is it safe to take both? Is...

Self-attacking Immune Cells Turned Off in Healthy People; Turned On in Rheumatoid Arthritis
Rheumatoid arthritis and lupus are autoimmune diseases -- conditions associated with self-attacking immune cells. According to a report in the December 22, 2008 edition of Journal of Experimental Medicine, healthy...

12 Steps for Setting Goals When Challenged With Arthritis
Having arthritis is life-changing. Pain and limitation associated with arthritis impact all aspects of daily living. As abilities become less and inabilities become greater, the disease seems to be in...

Green Tea Helps Arthritis With Its Anti-inflammatory Properties
Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed for the treatment of rheumatoid arthritis and other types of arthritis. While NSAIDs are effective against inflammation, they also are associated with adverse...

Physical Disability Can Boost Marital Happiness
You may have done a double-take when you read that headline -- but yeah -- a new study claims that physical disability can impact marital happiness in a good way....

Small Therapeutic Ultrasound Device Helps Relieve Arthritis
Imagine a therapeutic ultrasound device that's so small it fits in the palm of your hand. According to Chronical Online, George K. Lewis -- a third year Ph.D. student in...

Gastrointestinal Bleeding Hospitalizations Have Dropped Among Arthritis Patients
New and improved treatments for arthritis, acid reflux disease, ulcers and other conditions have reduced the rate of hospitalizations for gastrointestinal bleeding by 14% from 1998 to 2006. Taking nonsteroidal...

The Palm Pistol Compensates for Arthritic Hands
The Palm Pistol is a single-shot handgun that was designed for people with medical conditions -- such as arthritis -- that can affect manual dexterity and hand strength. The...

Synvisc-One Recommended for FDA Approval
Synvisc-One, a single injection version of Genzyme's Synvisc, has been recommended for approval by the FDA Orthopaedic and Rehabilitation Devices Panel. The original formulation of Synvisc -- approved in the...

Site: MedicineNet Arthritis General

Calcium Channel Blockers
Title: Calcium Channel Blockers
Category: Medications
Created: 2/14/2002 6:38:00 AM
Last Editorial Review: 1/6/2009

Health Tip: Relief From Carpal Tunnel
Title: Health Tip: Relief From Carpal Tunnel
Category: Health News
Created: 1/3/2009 2:00:00 AM
Last Editorial Review: 1/5/2009

Study Links Osteoporosis Drugs to Jaw Trouble
Title: Study Links Osteoporosis Drugs to Jaw Trouble
Category: Health News
Created: 1/2/2009 2:00:00 AM
Last Editorial Review: 1/2/2009

Osteoporosis Drugs Work, but How?
Title: Osteoporosis Drugs Work, but How?
Category: Health News
Created: 1/2/2009
Last Editorial Review: 1/2/2009

Biorhythms
Title: Biorhythms
Category: Diseases and Conditions
Created: 9/30/1998
Last Editorial Review: 12/29/2008

Apheresis (Hemapheresis, Pheresis)
Title: Apheresis (Hemapheresis, Pheresis)
Category: Procedures and Tests
Created: 6/24/2001
Last Editorial Review: 12/29/2008

Exercise Shields Against Osteoporosis
Title: Exercise Shields Against Osteoporosis
Category: Health News
Created: 12/24/2008 2:00:00 AM
Last Editorial Review: 12/24/2008

tetracycline, Sumycin
Title: tetracycline, Sumycin
Category: Medications
Created: 3/26/1998 2:30:00 PM
Last Editorial Review: 12/19/2008

Health Tip: Managing Joint Pain
Title: Health Tip: Managing Joint Pain
Category: Health News
Created: 12/18/2008 2:00:00 AM
Last Editorial Review: 12/18/2008

naproxen, Anaprox, Naprelan, Naprosyn, Aleve
Title: naproxen, Anaprox, Naprelan, Naprosyn, Aleve
Category: Medications
Created: 12/31/1997
Last Editorial Review: 12/17/2008

Nonsteroidal Antiinflammatory Drugs (NSAIDs)
Title: Nonsteroidal Antiinflammatory Drugs (NSAIDs)
Category: Medications
Created: 6/3/1999 9:24:00 PM
Last Editorial Review: 12/17/2008

Children of Centenarians Face Lower Heart Risks
Title: Children of Centenarians Face Lower Heart Risks
Category: Health News
Created: 12/17/2008 2:00:00 AM
Last Editorial Review: 12/17/2008

Site: Arthritis Research & Therapy - Latest articles

MRI bone oedema scores are higher in the arthritis mutilans form of psoriatic arthritis and correlate with high radiographic scores for joint damage
IntroductionThe aim of this study was to investigate the magnetic resonance imaging (MRI) features of bone disease in the arthritis mutilans (AM) form of psoriatic arthritis (PsA) Methods: 28 patients with erosive psoriatic arthritis were enrolled (median disease duration 14 years). Using x-rays (hands and feet), 11 patients were classified as arthritis mutilans and 17 as non-arthritis mutilans by 2 observers. Magnetic resonance imaging scans (1.5T) of the dominant hand (wrist and fingers scanned separately) were obtained using standard contrast-enhanced T1 weighted and fat saturated T2 weighted sequences. Scans were scored separately by 2 readers for bone erosion, oedema and proliferation using a psoriatic arthritis magnetic resonance imaging scoring system. X-rays were scored for erosions and joint space narrowing. Results: 1013 bones were scored on MRI by both readers. Reliability for scoring erosions and bone oedema was high: intraclass correlation coefficients = 0.80 and 0.77 respectively, but only fair for bone proliferation (intraclass correlation coefficient = 0.42). MRI erosion scores were higher in arthritis mutilans patients (53.0 vs 15.0, p = 0.004) as were bone oedema and proliferation scores (14.7 vs 10.0, p = 0.056 and 3.6 vs 0.7, p = 0.003 respectively). MRI bone oedema scores correlated with MRI erosion scores and X-ray erosion and joint space narrowing scores (r= 0.65, p=0.0002 for all) but not DAS28CRP or pain scores. Conclusions: In this psoriatic arthritis patient group, MRI bone oedema, erosion and proliferation were all more severe in the arthritis mutilans-form. Bone oedema scores did not correlate with disease activity measures but were closely associated with X-ray joint damage scores. These results suggest that MRI bone oedema may be a pre-erosive feature and that bone damage may not be coupled with joint inflammation in psoriatic arthritis.

Interactions among type I and II interferon, tumor necrosis factor, and beta-estradiol in the regulation of immune response-related gene expressions in systemic lupus erythematosus
IntroductionSystemic lupus erythematosus (SLE) is a prototypical autoimmune disease characterized by various clinical manifestations. Several cytokines interact and play pathological roles in SLE, although the etiopathology is still obscure. Here, we investigated the network of immune response-related molecules expressed in the peripheral blood of SLE patients and the effects of cytokine interactions on the regulation of these molecules. Methods: Gene expression profiles of the peripheral blood from SLE patients and healthy women were analyzed using DNA microarray. Differentially expressed genes categorized into "Immune Response" were selected and analyzed using bioinformatics tools. Since interactions among tumor necrosis factor (TNF), interferon (IFN)-gamma, beta-estradiol (E2), and IFN-alpha may regulate the expression of interferon-inducible (IFI) genes, stimulating and co-stimulating experiments were carried out on peripheral blood mononuclear cells (PBMCs) followed by analysis using quantitative reverse transcription-polymerase chain reaction. Results: Thirty-eight down and sixty-eight up-regulated genes were identified in the functional category "Immune Response". Overexpressed IFI genes were confirmed in SLE patient peripheral bloods. Using network-based analysis on these genes, several networks including cytokines, such as TNF and IFN-gamma, and E2 were constructed. TNF-regulated genes were dominant in these networks, but in vitro TNF stimulation on PBMCs showed no differences in the above gene expressions between SLE and healthy individuals. Co-stimulating with IFN-alpha and one of TNF, IFN-gamma, or E2 revealed that TNF has repressive while IFN-gamma essentially has synergistic effects on IFI gene expressions in vitro. E2 showed variable effects on IFI gene expressions among three individuals. Conclusions: TNF may repress the abnormal regulation by IFN-alpha in SLE while IFN-gamma may have synergistic effect. Interactions between IFN-alpha and one of TNF, IFN-gamma, or E2 appear to be involved in the pathogenesis of SLE.

Monocytes are essential for inhibition of synovial T cell glucocorticoid mediated apoptosis in rheumatoid arthritis
IntroductionRheumatoid arthritis (RA) is characterized by synovial inflammation with local accumulation of mononuclear cells such as macrophages and lymphocytes. We previously demonstrated that intraarticular glucocorticoids decrease the synovial tissue (ST) T cell population, and therefore aimed to investigate if this is mediated through modulation of apoptosis. Methods: Apoptosis and cell phenotype were evaluated by immunohistochemistry and dual immunofluorescence in synovial biopsy sections from 12 RA patients before and after a mean of 11 days of an intraarticular triamcinolone knee injection. In vitro, RA synovial fluid (SF) derived T cells were evaluated for Annexin V expression by multi-color flow cytometry after 24 hours exposure to dexamethasone, methylprednisolone or triamcinolone. We also tested induction of apoptosis by dexamethasone on psoriatic arthritis SF derived T cells using the same method. Results: Intraarticular glucocorticoids reduced ST T cells but not macrophage number. ST apoptosis levels were unchanged following treatment, virtually absent from lymphoid aggregates and minimal in CD3+ cells both before and after treatment. RA SF T cells were resistant to glucocorticoid-induced apoptosis when cultured in the presence of monocytes, but rendered sensitive to all three tested compounds upon SF isolation. Furthermore, transwell coculture of monocytes and T cells demonstrated that soluble factor(s) and not cellular contact are essential for T cell resistance to glucocorticoid-mediated apoptosis. This feature is RA specific as far as dexamethasone-induced apoptosis in non-isolated SF T cells obtained from psoriatic arthritis patients. Conclusions: We demonstrate that monocytes rescue synovial T cells from glucocorticoid-induced apoptosis, a feature that is specific for RA. To overcome this we propose the use of monocyte-targeted therapies rather than T cell apoptosis inducing therapies.

Increased expression of lipocalin-type prostaglandin D2 synthase in osteoarthritic cartilage
No abstract available

Interferon-induced versus chemokine transcripts as lupus biomarkers
Compelling support for a central role for interferon-alpha in lupus pathogenesis has led to new focus on the role of innate immune system activation in the generation of pathogenic mediators. These insights have been extended in translational studies of patients with well characterized disease activity and clinical manifestations in order to identify informative molecular biomarkers. Chemokines are among the interferon-inducible genes, and new data support an association between expression of chemokines and both lupus disease activity and organ damage. Longitudinal studies that relate molecular biomarkers to disease activity will be needed to validate these promising data and establish a sensitive measure of change for interventional studies and patient care.

Lack of association between glucocorticoid use and presence of the metabolic syndrome in patients with rheumatoid arthritis: a cross sectional study
IntroductionRheumatoid arthritis (RA) associates with excessive cardiovascular morbidity and mortality, attributed to both traditional and novel cardiovascular risk factors. The metabolic syndrome, a cluster of classical cardiovascular (CV) risk factors including hypertension, obesity, glucose intolerance and dyslipidaemia, is highly prevalent in rheumatoid arthritis. Reports suggest that long-term glucocorticoid (GC) use may exacerbate individual cardiovascular risk factors, but there have been no studies in rheumatoid arthritis to assess whether it associates with the metabolic syndrome. We examined whether glucocorticoid exposure associates with the presence of metabolic syndrome in patients with rheumatoid arthritis. Methods: Rheumatoid arthritis patients (n=398) with detailed clinical and laboratory assessments were categorised into 3 groups according to glucocorticoid exposure: no/limited (<3 months) exposure (NE); low-dose (<7.5mg/day) long-term exposure (LE); and medium-dose ([greather than or equal to]7.5mg to 30mg/day) long-term exposure (ME). The metabolic syndrome was defined using the National Cholesterol Education programme (NCEP) guidelines. The association of glucocorticoid exposure with the metabolic syndrome was evaluated using binary logistic regression. Results: The metabolic syndrome was present in 40.1% of this population and its prevalence did not differ significantly between the glucocorticoid exposure groups (NE: 37.9% vs LE: 40.7% vs ME: 50%, p=0.241). Binary logistic regression did not demonstrate any increased odds for the metabolic syndrome when comparing ME to LE (OR=1.64 95%CI: 0.92 to 2.92, p=0.094), and remained non significant after adjusting for multiple potential confounders. Conclusions: Long-term glucocorticoid exposure does not appear to associate with a higher prevalence of the metabolic syndrome in patients with rheumatoid arthritis. The components of the metabolic syndrome may already be extensively modified by other processes in rheumatoid arthritis (including chronic inflammation and treatments other than glucocorticoids), leaving little scope for additive effects of glucocorticoids.

Incremental cost effectiveness of proton pump inhibitors for the prevention of non-steroidal anti-inflammatory drug ulcers: a pharmacoeconomic analysis linked to a case-control study
IntroductionWe estimated the cost-effectiveness of concomitant proton-pump inhibitors (PPIs) in relation to the occurrence of non-steroidal anti-inflammatory drug (NSAID) ulcer complications. Methods: This study was linked to a nested case-control study. Patients with NSAID ulcer complications were compared with matched controls. Only direct medical costs were reported. For the calculation of the incremental cost-effectiveness ratio we extrapolated the data to 1,000 patients using concomitant proton-pump inhibitors and 1,000 patients not using proton-pump inhibitors for one year. Sensitivity analysis was performed by 'worst case' and 'best case' scenarios in which the 95% CI of the odds ratio (OR) and the 95% CI of the cost estimate of a NSAID ulcer complication were varied. Costs of proton-pump inhibitors was varied separately. Results: 104 incident cases and 284 matched controls were identified from a cohort of 51.903 NSAID users with 10.402 NSAID exposition years. Use of proton-pump inhibitors was associated with an adjusted OR of 0.33 (95% CI 0.17 to 0.67; p=0.002) for NSAID ulcer complications. In the extrapolation the estimated number of NSAID ulcer complications was 13.8 for non-PPI users, and 3.6 for proton-pump inhibitors users. The incremental total costs were Euro 50.094 higher for concomitant proton-pump inhibitors use. The incremental cost-effectiveness ratio was Euro 4.907 per NSAID ulcer complication prevented when using the least costly proton-pump inhibitors. Conclusions: Concomitant use of proton-pump inhibitors for the prevention of NSAID ulcer complications costs Euro 4.907 per NSAID ulcer complication prevented when using the least costly proton-pump inhibitors. The price of proton-pump inhibitors highly influenced the robustness of the results.

More intrinsic parameters should be used in assessing degeneration of articular cartilage with quantitative ultrasound
During the last decade, the quantitative ultrasound technique has been widely employed as a versatile modality to investigate a thin but crucial tissue layer ? the articular cartilage. Previous studies provide information about the morphology and mechanical and acoustic properties of the tissue derived from ultrasound measurements and correlate them with cartilage degeneration. In a previous issue of Arthritis Research & Therapy, Kuroki and colleagues presented a study about the relationship between International Cartilage Repair Society grading and ultrasound echo magnitude, duration, and interval in human knee cartilage. We think indirect measurements of the intrinsic physical characteristics of cartilage, as reported in this study, should be interpreted more carefully as they can be affected by many experimental and physical factors. In this editorial, we offer our opinion that more intrinsic material parameters should be selected for the assessment of degeneration states of cartilage using quantitative ultrasound.

Antiphospholipid syndrome
Antiphospholipid syndrome is diagnosed when arterial or venous thrombosis or recurrent miscarriages occur in a person in whom laboratory tests for antiphospholipid antibodies (anticardiolipin antibodies and/or lupus anticoagulant and/or anti-beta 2-glycoprotein I) are positive. Despite the strong association between antiphospho-lipid antibodies and thrombosis, their pathogenic role in the development of thrombosis has not been fully elucidated. Novel mechanisms involving both the complement pathway and micro-particles have been described. The knowledge of these new pathogenic approaches might identify novel therapeutic targets and therefore may improve the management of these patients.

Vastus medialis cross-sectional area is positively associated with patella cartilage and bone volume in a pain-free, community based population
IntroductionAlthough vastus medialis and lateralis are important determinants of patellofemoral joint function, their relationship with patellofemoral joint structure is unknown. The aims of this study were to examine potential determinants of vastus medialis and lateralis cross-sectional area, and the relationship between the cross-sectional area and patella cartilage and bone volumes. Methods: 297 healthy adult subjects had magnetic resonance imaging (MRI) of their dominant knee. Vastus medialis and lateralis cross-sectional area was measured 37.5mm superior to the quadriceps tendon insertion at the proximal pole of the patella. Patella cartilage and bone volume were measured from these images. Demographic data and participation in vigorous physical activity was assessed by questionnaire. Results: The determinants of increased vastus medialis and lateralis cross-sectional area were older age (p less than or equal to 0.002), male gender (p < 0.001) and greater body mass index (BMI) (p less than or equal to 0.07). Participation in vigorous physical activity was positively associated with vastus medialis cross-sectional area (regression coefficient [beta] 90.0 95%confidence interval [CI] 38.2, 141.7)(p < 0.001) but not with vastus lateralis cross-sectional area (beta 10.1 95% CI -18.1, 38.3)(p = 0.48). The cross-sectional area of vastus medialis only was positively associated with patella cartilage (beta 0.6 95% CI 0.23, 0.94)(p = 0.001) and bone (beta 3.0 95% CI 1.40, 4.68)(p < 0.001) volume after adjustment for potential confounders. Conclusions: Our results in a pain-free, community based population suggest that increased cross-sectional area of vastus medialis, which is associated with participation in vigorous physical activity, and increased patella cartilage and bone volume, may benefit patellofemoral joint health and reduce the long-term risk of patellofemoral pathology.