Psychological aspects of rheumatoid arthritis

1980 ◽  
Vol 10 (1) ◽  
pp. 159-163 ◽  
Author(s):  
B. M. Gardiner
Keyword(s):  
Rheumatoid Arthritis ◽  
Psychological Assessment ◽  
Psychological Factors ◽  
Prognostic Significance ◽  
Attitudes And Beliefs ◽  
Psychiatric Disturbance ◽  
Psychological Variables ◽  
Follow Up Care ◽  
The Relationship

SYNOPSISThis study had 3 aims: to determine whether rheumatoid arthritics had certain personality traits; to examine the relationship between psychological factors and the presence of rheumatoid factor in blood serum; and to explore the prognostic significance of psychological factors in the management of rheumatoid arthritis. Within a few days of discharge, 129 in-patient rheumatoid arthritics were clinically and psychologically assessed and allocated at random to 1 of 3 forms of follow-up care. The psychological assessment included measures of personality, non-psychotic psychiatric disturbance, and attitudes and beliefs. A year later all patients were reassessed. It was found that rheumatoid arthritics were more neurotic in personality, more likely to give socially desirable responses, and more prone to psychiatric disturbance, than the general population. Seropositive patients were less susceptible to psychiatric disturbance than seronegative patients. None of the psychological variables predicted disease activity, but those patients who rated themselves as ‘slow, dependent, and weak’ lost more time off work in the subsequent year.

Prognosis

2020 ◽  
pp. 241-247
Keyword(s):  
Coronary Artery Disease ◽  
Poor Prognosis ◽  
B Cell Lymphoma ◽  
Graves Disease ◽  
Papillary Thyroid ◽  
Myxedema Coma ◽  
Follow Up Care ◽  
Artery Disease ◽  
The Relationship

With early diagnosis, timely institution of L-T4 replacement therapy, regular patient follow-up care, and attention to other attendant complications, the prognosis in Hashimoto's thyroiditis (HT) is excellent with patients leading a normal life. Untreated myxedema coma has a poor prognosis and a high mortality rate, particularly in old age. Transient periods of thyrotoxicosis sometimes occur, and rarely full hyperthyroid Graves' disease with active ophthalmopathy. There is an increased prevalence of coronary artery disease in patients with untreated or undertreated HT. The relationship between papillary thyroid carcinoma (PTC) and HT has been controversial. Primary thyroid B-cell lymphoma affects less than one in a thousand persons, and it is more likely to affect those with long-standing autoimmune thyroiditis. Complications of over-replacement with L-T4 should be avoided. This chapter explores the prognosis of Hashimoto's disease.

The Relationship Between N-Terminal Pro-Brain Natriuretic Peptide Level and Myocardial Performance Index and Their Prognostic Importances in Patients With Acute Myocardial Infarction in Short Term Follow-up

2020 ◽  
Vol 1 (1) ◽  
pp. 12-17
Author(s):  
Mehmet Küçükosmanoğlu ◽  
Cihan Örem
Keyword(s):  
Heart Failure ◽  
Prognostic Significance ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ejection Time ◽  
Ventricular Ejection Fraction ◽  
Significant Difference ◽  
The Mean ◽  
The Relationship

Introduction: MPI is an echocardiographic parameter that exibit the left ventricular functions globally. NT-proBNP  is an important both diagnostic and prognostic factor in heart failure. In this study, we aimed to investigate the prognostic significance of serum NT-proBNP levels and MPI in patients with STEMI. Method: Totally 104 patients with a diagnosis of STEMI were included in the study. Patients followed for 30-days and questioned for presence of symptoms of heart failure (HF) and cardiac death. Patients were invited for outpatient control after 30-days and were divided into two groups: (HF (+) group) and (HF (-) group). Results: Totally 104 patients with STEMI were hospitalized in the coronary intensive care unit. Of those patients, 17 were female (16%), 87 were male (84%), and the mean age of the patients was 58.9±10.8 years. During the 30-day follow-up, 28 (27%) of 104 patients developed HF. The mean age, hypertension ratio and anterior STEMI rate were significantly higher in the HF (+) group compared to the HF (-) group. Ejection time (ET) and left ventricular ejection fraction (LVEF) were significantly lower and MPI was significantly higher in the HF (+) group. When the values on day first and  sixth were compared, NT-ProBNP levels were decreased in both groups. There was no significant difference between the two groups in terms of the change in MPI values on the first and sixth days. Multiple regression analysis showed that the presence of anterior MI, first day NT-proBNP level and LVEF were independently associated with development of HF and death. Conclusion: In our study, NT-proBNP levels were found to be positively associated with MPI in patients with acute STEMI. It was concluded that the level of NT-proBNP detected especially on the 1st day was more valuable than MPI in determining HF development and prognosis after STEMI.  

Prognostic Significance of Fragmented QRS in Patients with Hypertrophic Cardiomyopathy

Cardiology ◽  
2017 ◽  
Vol 138 (1) ◽  
pp. 26-33 ◽  
Author(s):  
Xili Lu ◽  
Wei Wang ◽  
Ling Zhu ◽  
Yilu Wang ◽  
Kai Sun ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Clinical Outcomes ◽  
Cox Regression ◽  
Prognostic Significance ◽  
Cox Regression Analysis ◽  
Fragmented Qrs ◽  
All Cause Mortality ◽  
The Relationship ◽  
Cvd Mortality

Objectives: The relationship between a fragmented QRS (fQRS) and clinical outcomes in patients with hypertrophic cardiomyopathy (HCM) remains unclear. This study aimed to investigate the prognostic significance of fQRS in patients with HCM. Methods: Between 2000 and 2012, 326 unrelated patients with HCM (72% male with a mean age of 52 years) were included and were divided into 2 groups: those with fQRS and those without fQRS. Results: A total of 105/326(32.2%) patients with HCM presented with fQRS at enrollment. During a follow-up of 5.3 ± 2.4 years, 33 patients died, 30 of cardiovascular disease (CVD). Cox regression analysis revealed that fQRS predicted a higher risk of all-cause mortality (adjusted hazard ratio [HR] 2.24; 95% confidence interval [CI] 1.08-4.64; p = 0.030) and CVD mortality (adjusted HR 2.68; 95% CI 1.22-5.91; p = 0.014). Our study also showed that fQRS increased the risk of heart failure-related death (adjusted HR 3.75; 95% CI 1.24-11.30; p = 0.019). Conclusions: Our results indicate that fQRS is associated with adverse clinical outcomes in patients with HCM.

scholarly journals Psychosocial, Socioeconomic, Behavioral, and Environmental Risk Factors for BMI and Overweight Among 9-to-11-Year Old Children

2009 ◽  
Vol 7 (SI) ◽  
pp. 99-118
Author(s):  
Angie J. Keihner ◽  
Patrick R. Mitchell ◽  
Carolyn Kitzmann ◽  
Sharon Sugerman ◽  
Susan Foerster
Keyword(s):  
Risk Factors ◽  
Parent Education ◽  
Low Cost ◽  
School Lunch ◽  
Attitudes And Beliefs ◽  
School Lunches ◽  
Point Increase ◽  
Z Scores ◽  
The Relationship

This study explored the risk factors for higher BMI and overweight in 9- to 11-year-old children using the 2007 California Children’s Healthy Eating and Exercise Practices Survey. A total of 741 children completed a two-day food and activity diary. Of these, 299 children participated in the follow-up telephone interview, reporting attitudes and beliefs. Linear regressions identified risk factors related to BMI z-scores; logistic regressions were used for binomial overweight status. Independent variables included children’s diet, activity, screen time, food modeling, family norms/rules, home environment, poverty, and parent education, adjusting for race/ethnicity. Parent education was the strongest risk factor with a clear gradient towards reduced risk as parent education improved. Children were .3 BMI z points lower and one-third less likely to be overweight as education level rose. Each serving of fried vegetables consumed was related to .3 point increase in BMI z. Children were 1.2-1.3 times more likely to be overweight with each increase in school lunch participation. Low-cost overweight prevention efforts targeting children with less parent education, school lunches, and consumption of fried vegetables may reduce BMI and help prevent childhood overweight. Additional investigation should determine the underlying factors contributing to the relationship between eating school lunch and overweight.

Antinuclear Antibodies and Lupus-like Manifestations in Rheumatoid Arthritis and Ankylosing Spondylitis Patients at 4 Months' Follow-up After Treatment with Infliximab and Etanercept

2020 ◽  
Vol 16 (1) ◽  
pp. 61-66 ◽  
Author(s):  
Mir Amir Aghdashi ◽  
Mohsen Khadir ◽  
Roshan Dinparasti-Saleh
Keyword(s):  
Rheumatoid Arthritis ◽  
Ankylosing Spondylitis ◽  
Treatment Regimen ◽  
Antinuclear Antibodies ◽  
Clinical Symptoms ◽  
Underlying Disease ◽  
Case Group ◽  
Tnf Α ◽  
The Relationship

Background: Up to 44% of patients treated with infliximab and 7% of patients treated with etanercept reported to have anti-drug antibodies within the first 6 months of treatment. Recently, anti-TNF-α therapies have been reported to be employed in the induction of the druginduced lupus erythematous. Objective: The aim of the present study was to investigate the relationship between anti-TNFα antibodies and various manifestations of lupus erythematous. Methods: We enrolled a total of 56 cases divided into 28 known cases of rheumatoid arthritis and 28 cases of ankylosing spondylitis patients and 56 controls. The case group was divided into 4 groups according to the underlying disease (RA or AS) and treatment regimen (infliximab or etanercept). ANA and anti-dsDNA levels and lupus criteria were assessed at the beginning of the study and 4 months after the initiation of anti-TNFα. Results: 36% and 21% of RA patients treated with infliximab, were ANA and anti-dsDNA positive after 4 months (P=0.003, P=0.025). 28% and 7% of RA patients treated with etanercept, were ANA and anti-dsDNA positive after 4 months (P=0.009, P=0.15). 21% and 7% of AS patients treated with infliximab, were ANA and anti-dsDNA positive, respectively (P=0.025, P=0.15). 14% and 7% of AS patients treated with etanercept, were ANA and anti-dsDNA positive, respectively (P=0.63, P=0.15). Three patients who were positive for auto-antibodies developed three criteria for SLE. Conclusions: Infliximab potentially may increase both ANA and anti-dsDNA levels in rheumatoid arthritis, but only ANA in ankylosing spondylitis patients. In general, clinicians should consider different clinical symptoms of ATIL, which may be present as a lupus-like syndrome similar to idiopathic SLE or classical DIL.

scholarly journals Relationship between periodontitis and rheumatoid arthritis and the effect of non-surgical periodontal treatment

2009 ◽  
Vol 20 (5) ◽  
pp. 355-364 ◽  
Author(s):  
Márcia de Noronha Pinho ◽  
Renê Donizeti Ribeiro Oliveira ◽  
Arthur Belém Novaes Jr. ◽  
Júlio César Voltarelli
Keyword(s):  
Rheumatoid Arthritis ◽  
Periodontal Treatment ◽  
Pocket Depth ◽  
Old Patients ◽  
Probing Pocket Depth ◽  
Sf 36 ◽  
Group 3 ◽  
The Relationship ◽  
Group 1

This study analyzed the association of periodontal disease (PD) and rheumatoid arthritis (RA). Seventy-five 35-60-year-old patients were assigned to 5 groups according to the presence (+) or not (-) of PD and RA and the treatment received (TR+) or not (TR-) for PD. Group 3 uses total prosthesis (TP). Clinical and laboratory evaluations were performed at baseline, 3 and 6 months of follow-up by probing pocket depth, bleeding on probing and plaque index for PD, HAQ, DAS28, SF-36 and laboratory: AAG, ESR, CRP for RA. Statistically significant differences for PD after 3 (p=0.0055) and after 6 months (p=0.0066) were obtained in Group 1 (RA+PD+TR+) and 2(RA+PD+TR-); significant reduction in the % of BOP after 6 months (p=0.0128) and significant reduction in the % of Pl after 3 (p=0.0128) and 6 months (p=0.0002) in Group 1. Statistically significant differences between Groups 1 and 3 (RA+TP) for DAS28 at baseline and after 3 months were observed, but not after 6 months. No other parameters for RA were significantly affected. The relationship between RA and PD disease activities is not clear, but the importance of periodontal treatment in the control of inflammation to avoid tooth extraction is evident.

The ACPA isotype profile reflects long-term radiographic progression in rheumatoid arthritis

2010 ◽  
Vol 69 (6) ◽  
pp. 1110-1116 ◽  
Author(s):  
Diane van der Woude ◽  
Silje W Syversen ◽  
Ellen I H van der Voort ◽  
Kirsten N Verpoort ◽  
Guro L Goll ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Progression ◽  
Enzyme Linked Immunosorbent Assay ◽  
Prognostic Information ◽  
Radiographic Damage ◽  
The Relationship ◽  
Acpa Status ◽  
Citrullinated Protein

BackgroundThe presence of anti-citrullinated protein antibodies (ACPA) is a powerful predictive factor for the development and progression of rheumatoid arthritis (RA). The ACPA response has been shown to consist of various isotypes, but the consequences of differences in isotype distribution have not been extensively investigated.ObjectiveTo investigate the relationship between ACPA isotypes, disease progression and radiological outcome.MethodsACPA isotypes were determined in sera of anti-cyclic citrullinated peptide 2-positive patients by enzyme-linked immunosorbent assay (ELISA). To investigate whether the ACPA response continues to evolve during disease development, the ACPA isotype profile during progression of undifferentiated arthritis (UA) to RA was studied. The association of disease progression with ACPA isotype use was assessed using long-term radiographic follow-up data from patients with RA in two independent cohorts.ResultsThe ACPA isotype distribution did not expand during disease progression from UA to RA, but was relatively stable over time. In both RA cohorts, the baseline ACPA isotype profile was a significant predictor of disease severity, with more isotypes indicating a higher risk of radiographic damage (odds ratio for every additional isotype: 1.4 (95% CI 1.1 to 1.9) p<0.001). ACPA isotypes supplied additional prognostic information to ACPA status alone, even after correction for other predictive factors.ConclusionsThe magnitude of the ACPA isotype profile at baseline reflects the risk of future radiographic damage. These results indicate that the presence and the constitution of the ACPA response are relevant to the disease course of RA.

STUDY ON PROGNOSIS OF SERUM ACID URIC IN ACUTE ISCHEMIC STROKE

2017 ◽  
pp. 119-123
Author(s):  
Dinh Toan Nguyen ◽  
Viet Hoan Tong
Keyword(s):  
Uric Acid ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Functional Dependence ◽  
Prognostic Significance ◽  
Current Evidence ◽  
Control Group ◽  
Hospital Arrival ◽  
The Relationship

Background: Current evidence shows that uric acid is a potent antioxidant whose serum concentration increases rapidly after acute ischemic stroke (AIS). Nevertheless, the relationship between serum uric acid (SUA) levels and AIS outcome remains debatable. We aimed to describe the prognostic significance of SUA in AIS. Methods: We studied 84 patients with AIS admitted to the cardiology, Hue Central Hospital from May, 2015 to October 2016. Acid uric concentration was measured at hospital arrival, day 3 and day 7. Correlated equation was constructed to analyze the association of SUA with functional outcome as assessed by the modified Rankin scale (mRS) at 30-day follow-up. Results: Mean SUA concentration at hospital arrival was (344.86±64.84 μmol/l), day 2 (323.76±57.47 μmol/l), day 3 (308.57±42.50 μmol/l) and higher than those of control group significantly (304.93±38.29 μmol/l). SUA was correlated positively with severity assessed by NIHSS and the functional dependence (mRS >2) at 30 days. Conclusions: Our findings support the hypothesis that SUA is more a marker of the magnitude of the cerebral infarction than an independent predictor of stroke outcome. Key words: acute ischemic stroke (AIS), uric acid, prognosis

scholarly journals Effect of Anti-TNF Antibodies on Clinical Response in Rheumatoid Arthritis Patients: A Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Chunxiao Wu ◽  
Shengxu Wang ◽  
Peifeng Xian ◽  
Lu Yang ◽  
Ying Chen ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Response ◽  
Immunosorbent Assay ◽  
Meta Analysis ◽  
Enzyme Linked Immunosorbent Assay ◽  
Tnf Inhibitor ◽  
Chip Technology ◽  
Assay Methods ◽  
The Relationship

Background. Antitumor necrosis factor (anti-TNF) drugs have been applied for rheumatoid arthritis (RA) treatment; however, patients having anti-drug antibodies (ADAbs) do not benefit from these drugs. The meta-analysis aims to comprehensively assess the relationship between ADAb positive (ADAb+) and anti-TNF response in RA patients.Methods. Observational studies comparing different clinical response between ADAb+ and ADAb negative groups were included. Odds ratio (OR) with its corresponding 95% confidence interval (CI) was used as effect size. Subgroup analyses stratified by TNF inhibitor types and assay methods for ADAb detection were performed.Results. Totally, 10 eligible studies containing 1806 subjects were included. ADAb+ was significantly associated with reduced anti-TNF response to RA at all the time points after follow-up (P<0.001). Subgroup analysis also supported this significant association (P<0.05), except for enzyme-linked immunosorbent assay (ELISA) group at 3 months, infliximab (INF) and enzyme-linked immunosorbent assay (ELISA) groups at 6 months, and Immunological Multi-Parameter Chip Technology (IMPACT) group at 12 months.Conclusion. ADAb+ was significantly associated with reduced clinical response in RA patients, and other alternatives should be considered in RA patients presenting ADAb+.

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