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Search Results for : Arthritides
Merck Online Lab
Diagnosis Therapy Rehabilitation Imaging Clinical Laboratory
Chondrogenic differentiation of human subchondral progenitor cells is impaired by rheumatoid arthritis synovial fluid.
Author(s): Kr; üger, JP; Endres, M; Neumann, K; H; äupl, T; Erggelet, C; Kaps, C
Journal: J Orthop Res 2010 May 5; Vol. 28, Issue 6; Page(s) 819-27
[Medline ID - 20041492]

In microfracture, subchondral progenitors enter the cartilage defect and form cartilage repair tissue. We hypothesize that synovial fluid (SF) from rheumatoid arthritis (RA) donors affects chondrogenesis of human subchondral progenitors stimulated with transforming growth factor-beta3 (TGFB3), whereas SF from normal and osteoarthritis (OA) donors do not. Human progenitors from subchondral cortico-spongious bone (pool of n = 4) were cultured in micromasses under serum-free conditions and were stimulated with 10 ng/mL TGFB3 and with 5% SF from normal, OA, and RA donors (pool of n = 7, each). Histological staining of proteoglycan and immunostaining of type II collagen showed that progenitors stimulated with SF from RA donors show significantly reduced cartilage matrix formation compared to prog enitors treated with TGFB3 or with SF from normal and OA donors (n = 3, each). Gene expression analysis of typical chondrocyte marker genes and genes encoding matrix modifying enzymes showed that SF from OA and RA donors influence the onset of TGFB3-mediated chondrogenesis (pool of 20 micromasses), but had no effect on the gene expression profile after prolonged culture in micromasses. These results suggest that SF from RA patients may impair the chondrogenic development of mesenchymal progenitors in microfracture, whereas osteoarthritic SF may has no negative effect on the cartilage matrix formation.

Femoro-acetabular impingement: can indirect MR arthrography be considered a valid method to detect endoarticular damage? A preliminary study.
Author(s): Pozzi, G; Stradiotti, P; Parra, CG; Zagra, L; Sironi, S; Zerbi, A
Journal: Hip Int 2010 Apr 22; Vol. 19, Issue 4; Page(s) 386-91
[Medline ID - 20041388]

To assess the effectiveness of indirect Magnetic Resonance arthrography (i-MRa) in the detection of chondral and labral lesions related to femoro-acetabular impingement (FAI) a series of 21 hip joints in 17 patients with a clinical diagnosis of FAI were examined either with standard MR imaging, i-MRa and direct-MR arthrography (d-MRa). Sensitivity and accuracy of i-MRa in detecting chondral, labral and tardive lesions were calculated and compared with standard MR. The agreement in detecting endoarticular damage between i-MRa and d-MRa and the interobserver agreement was assessed by K statistic (p < 0.05). Finally the presence of trocanteric bursitis was evaluated. I-MRa showed higher values of both sensivity and accuracy than standard MR in detecting chondral damage, with an increase to 92% for the first item and 95% for the second. The same was noticed in labrum evaluation with an increase to 88% and 90% respectively. The level of agreement between i-MRa and d-MRa in detection of chondral lesions was excellent, substantial for the labral damage and absolute for early osteoarthritic changes. An excellent interobserver agreement resulted in detection of both chondral and labral damages with i-MRa. In 6 hips (28,5%) we also found the presence of peri-trochanteric soft tissue inflammation that indicated the possibility of extrarticular involvement in FAI. Indirect-MRa can be considered a valid method of assessing endoarticular damage related to FAI, in comparison to d-MRa. It should be performed instead of standard MR if d-MRa is not available.

Midterm results of cementless total hip replacement in rapidly destructive arthropathy and a review of the literature.
Author(s): Peters, KS; Doets, HC
Journal: Hip Int 2010 Apr 22; Vol. 19, Issue 4; Page(s) 352-8
[Medline ID - 20041382]

BACKGROUND AND PURPOSE: Rapidly destructive arthropathy (RDA) of the hip is a disease of unknown etiology characterized by a rapid destruction of the acetabular and femoral aspects of the hip joint. The purpose of this study was to assess the outcome of cementless total hip replacement in this category of patients. METHODS: A prospective study was performed of all cases of rapidly destructive arthropathy treated by cementless total hip replacement between 1998 and 2005. There were 6 female patients (8 hips) meeting the criteria of RDA. Median age at surgery was 74 years (range 64-83). Using the Paprosky classification of acetabular defects, five hips had a type 2B acetabular defect and three a type 3A acetabular defect. In all cases a cementless prosthesis was used. In two cases a shelf plasty of the acetabulum was added. Radiographic and clinical follow-up was performed up to 9 years postoperatively (mean follow-up 69 months, range 24-104 months). RESULTS: At radiographic follow-up, no signs of prosthetic loosening or migration were seen. Harris Hip Score improved from 25.8 (SD 7.3, range 11-34) preoperatively to 88.3 (SD 9.7, range 71-98) at latest follow-up. CONCLUSION: Cementless total hip replacement in patients with rapidly destructive arthropathy led to a good result in a series of eight cases at midterm follow-up.

Clinical outcome study and radiological findings of Zweymuller metal on metal total hip arthroplasty. a follow-up of 6 to 15 years.
Author(s): Paleochorlidis, IS; Badras, LS; Skretas, EF; Georgaklis, VA; Karachalios, TS; Malizos, KN
Journal: Hip Int 2010 Apr 22; Vol. 19, Issue 4; Page(s) 301-8
[Medline ID - 20041375]

We report the clinical and radiological outcome of 99 Zweymuller metal on metal total hip arthroplasties in 84 patients followed up prospectively for a mean period of 9.5 (range, 6-15) years. There were 29 (34.5%) male and 55 (65.5%) female patients with a mean age of 62.85 years (range, 50-70 years) at the time of surgery. All patients had osteoarthritis. One acetabular component and one stem were revised due to aseptic loosening. One femoral stem was revised due to a periprosthetic fracture. HHS score improved from a preoperative mean of 62.56 points (SD 8.87) to a final postoperative follow-up mean of 93.48 (SD 7.7). Cumulative success rate for both implants at 13 years, with aseptic loosening as the end point, was 97.05%, while for both implants at 13 years, with revision for any reason as the end point, it was 91.17%. Satisfactory results were observed with the use of this prosthesis.

Total shoulder arthroplasty in dislocation arthropathy.
Author(s): Lehmann, L; Magosch, P; Mauermann, E; Lichtenberg, S; Habermeyer, P
Journal: Int Orthop 2009 Dec 31
[Medline ID - 20041242]

Follow-up examinations of 45 patients who received shoulder arthroplasty for osteoarthritis following shoulder instability were conducted after 44 months. The goal of this study was to describe the clinical findings associated with advanced glenohumeral arthritis due to shoulder instability and instability repairs and to present the clinical results and complications of treating this with shoulder arthroplasty. The weighted average Constant score increased significantly from 49.4 to 81.3 points. There was no significant difference in the type of arthroplasty with 35 cases of total shoulder replacements and ten cases of hemiarthoplasty. The rate of complications was 40% (18/45 patients) with 20% (9/45 patients) requiring an operative revision. Patients with arthritis after instability repair showed great improvement in all qualities of the Constant score. Nonetheless, further analyses are required to determine why such a relatively young group of patients showed high complication rates.

Autoimmune disease classification by inverse association with SNP alleles.
Author(s): Sirota, M; Schaub, MA; Batzoglou, S; Robinson, WH; Butte, AJ
Journal: PLoS Genet 2010 Mar 23; Vol. 5, Issue 12; Page(s) e1000792
[Medline ID - 20041220]

With multiple genome-wide association studies (GWAS) performed across autoimmune diseases, there is a great opportunity to study the homogeneity of genetic architectures across autoimmune disease. Previous approaches have been limited in the scope of their analysis and have failed to properly incorporate the direction of allele-specific disease associations for SNPs. In this work, we refine the notion of a genetic variation profile for a given disease to capture strength of association with multiple SNPs in an allele-specific fashion. We apply this method to compare genetic variation profiles of six autoimmune diseases: multiple sclerosis (MS), ankylosing spondylitis (AS), autoimmune thyroid disease (ATD), rheumatoid arthritis (RA), Crohn's disease (CD), and type 1 diabetes (T1D), as well as five non-autoimmune diseases. We quantify pair-wise relationships between these diseases and find two broad clusters of autoimmune disease where SNPs that make an individual susceptible to one class of autoimmune disease also protect from diseases in the other autoimmune class. We find that RA and AS form one such class, and MS and ATD another. We identify specific SNPs and genes with opposite risk profiles for these two classes. We furthermore explore individual SNPs that play an important role in defining similarities and differences between disease pairs. We present a novel, systematic, cross-platform approach to identify allele-specific relationships between disease pairs based on genetic variation as well as the individual SNPs which drive the relationships. While recognizing similarities between diseases might lead to identifying novel treatment options, detecting differences between diseases previously thought to be similar may point to key novel disease-specific genes and pathways.

Cryoglobulin evaluation: best practice?
Author(s): Sargur, R; White, P; Egner, W
Journal: Ann Clin Biochem 2010 Mar 6; Vol. 47, Issue Pt 1; Page(s) 8-16
[Medline ID - 20040794]

Cryoglobulins are serum immunoglobulins that precipitate at temperatures below 37 degrees C and re-dissolve on warming. Cryoglobulinaemia leads to variable symptoms including characteristic purpura, ischaemia of extremities, renal failure, peripheral neuropathy, abdominal pain secondary to intestinal ischaemia and arthralgias. Cryoglobulin testing is underutilized in clinical practice. It has been neglected in clinical laboratories and by clinicians due to several factors, such as the length of time it takes for serum cryogl obulin analysis to be performed in the laboratory, the perceived difficulty in getting optimal sampling conditions and a failure to appreciate that even apparently low levels of cryoglobulin can be associated with severe symptoms in some patients. The most important variable confounding standardization of cryoglobulin testing is improper sample handling. A recent report critically appraising the current practice of cryoglobulin evaluation in 137 laboratories in Europe by United Kingdom National External Quality Assurance Scheme (UKNEQAS) illustrated the wide variability in practice. Although many clinical laboratories perform cryoglobulin evaluation, there are widespread differences in the methodology used and the care with which this is carried out and this leads to considerable intralaboratory and interlaboratory variability. The most common sources of error are false-negative results due to loss of cryoprecipitate during transport and storage. Better standardization is needed to avoid missed diagnoses and improve the comparability of results. Laboratories should ensure that sample temperature is maintained at 37 degrees C until the serum is separated. In this article, we briefly review the classification and clinical features of cryoglobulins and suggest best practice guidelines for laboratory detection and identification of cryoglobulins.

Inflammatory arthritis in a patient with primary biliary cirrhosis: B cell mediated synovitis.
Author(s): Smith, MD; Walker, JG; Ahern, MJ; Roberts-Thomson, PJ
Journal: J Rheumatol 2010 Apr 7; Vol. 37, Issue 1; Page(s) 212-4
[Medline ID - 20040650]

ABSTRACT NOT AVAILABLE

Abrupt development of sarcoidosis with a prodromal increase in plasma osteopontin in a patient with rheumatoid arthritis during treatment with etanercept.
Author(s): Takatori, S; Kamata, Y; Murosaki, T; Iwamoto, M; Minota, S
Journal: J Rheumatol 2010 Apr 7; Vol. 37, Issue 1; Page(s) 210-1
[Medline ID - 20040649]

ABSTRACT NOT AVAILABLE

Successful use of etanercept in acquired angioedema in a patient with psoriatic arthritis.
Author(s): Rottem, M; Mader, R
Journal: J Rheumatol 2010 Apr 7; Vol. 37, Issue 1; Page(s) 209
[Medline ID - 20040647]

ABSTRACT NOT AVAILABLE
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