共查询到20条相似文献,搜索用时 15 毫秒
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To determine the natural history of cervical lesions in rheumatoid arthritis, 161 patients who had been followed for a minimum of 5 years were enrolled in this study. The average follow-up period was 10.2 years (range, 5 to 20 years). The severity of the rheumatoid arthritis was classified into three types based on the multiplicity of peripheral joint rheumatoid involvement: a least erosive subset, a more erosive subset, and a mutilating disease subset. Ninety-two patients (57%) had upper cervical involvement, which progressed in the order of anterior atlantoaxial subluxation, anterior atlantoaxial subluxation combined with vertical subluxation, and vertical subluxation alone. Subaxial subluxation was found in 18 patients (11%). In 17 of these 18 patients, upper cervical lesions were also noted. The incidence of cervical involvement in each disease subset was 39% in the least erosive group, 83% in the more erosive group, and 100% in the mutilating disease group. Fifty percent of the patients with cervical involvement had neck pain, and the remaining patients were asymptomatic. Neural involvement occurred in 10 patients. In 7 of these 10 patients, vertical subluxation of the atlas was responsible for the neural deficit. Six patients required surgical intervention because of progressive myelopathy. 相似文献
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Bethany J. Foster Ciaran M. Duffy Atul K. Sharma 《Pediatric nephrology (Berlin, Germany)》1998,12(2):113-116
Systemic-onset juvenile rheumatoid arthritis (JRA) is a complex disease which affects many organ systems. Associated renal
lesions are unusual, with the possible exception of amyloidosis. We describe a girl with systemic-onset JRA who developed
first membranous nephropathy and then, 3.5 years later, a severe crescentic glomerulonephritis. The membranous lesion followed
therapy with intravenous immune globulin, and the possibility that this intervention caused the renal disease must be considered.
It appears that both of these lesions should be added to the list of possible complications of systemic-onset JRA.
Received January 16, 1997; received in revised form July 29, 1997; accepted July 31, 1997 相似文献
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Ana Carolina Araruna Alves Paulo de Tarso Camillo de Carvalho Marcio Parente Murilo Xavier Lucio Frigo Flávio Aimbire Ernesto Cesar Pinto Leal Junior Regiane Albertini 《Lasers in medical science》2013,28(2):529-536
Rheumatoid arthritis (RA) is an autoimmune inflammatory disease of unknown etiology. Treatment of RA is very complex, and in the past years, some studies have investigated the use of low-level laser therapy (LLLT) in treatment of RA. However, it remains unknown if LLLT can modulate early and late stages of RA. With this perspective in mind, we evaluated histological aspects of LLLT effects in different RA progression stages in the knee. It was performed a collagen-induced RA model, and 20 male Wistar rats were divided into 4 experimental groups: a non-injured and non-treated control group, a RA non-treated group, a group treated with LLLT (780 nm, 22 mW, 0.10 W/cm2, spot area of 0.214 cm2, 7.7 J/cm2, 75 s, 1.65 J per point, continuous mode) from 12th hour after collagen-induced RA, and a group treated with LLLT from 7th day after RA induction with same LLLT parameters. LLLT treatments were performed once per day. All animals were sacrificed at the 14th day from RA induction and articular tissue was collected in order to perform histological analyses related to inflammatory process. We observed that LLLT both at early and late RA progression stages significantly improved mononuclear inflammatory cells, exudate protein, medullary hemorrhage, hyperemia, necrosis, distribution of fibrocartilage, and chondroblasts and osteoblasts compared to RA group (p?<?0.05). We can conclude that LLLT is able to modulate inflammatory response both in early as well as in late progression stages of RA. 相似文献
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There is an increasing number of rheumatoid patients who get septic arthritis. Chronic use of steroids is one of the important predisposing factors. The clinical picture of septic arthritis is different in immunocompromised patients like patients with rheumatoid arthritis. The diagnosis and management are discussed in this review article. 相似文献
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Lohse A Carbillet JP Onimus M Stevenel F Toussirot E Wendling D 《Joint, bone, spine : revue du rhumatisme》2003,70(1):67-70
The term "intraosseous synovial cyst" is used to designate both the epiphyseal cyst-like lesions seen in patients with rheumatoid arthritis (RA) and mucoid cysts, which occur in a different setting. We report the case of a patient in whom a 4-cm cyst-like lesion developed in the left tibia 18 years after onset of RA and 6 years after osmic acid synovectomy of the left knee. Positive contrast arthrography and magnetic resonance imaging visualized a communication between the lesion and the joint space. Preexisting bone and joint lesions and increased intraarticular pressure play a major role in the genesis of cyst-like lesions in RA. In our patient, the osmic acid synovectomy may have contributed to the development of the lesion. "Synovial cyst" is a misnomer for these giant lesions, which are geodes rather than cysts. Despite their low incidence, these lesions deserve attention because they raise diagnostic and therapeutic problems. 相似文献
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Kaito T Hosono N Ohshima S Ohwaki H Takenaka S Fujiwara H Makino T Yonenobu K 《Spine》2012,37(20):1742-1746
STUDY DESIGN.: A retrospective cohort analysis. OBJECTIVE.: To determine the effect of biological agents (BAs) on the development and progression of cervical spine lesions and identify predictors of lesion progression. SUMMARY OF BACKGROUND DATA.: The introduction of BAs has facilitated advances in the treatment of rheumatoid arthritis (RA). BAs reduce disease activity and limit structural joint damage. However, the effect of BAs on cervical spine lesions remains unclear. METHODS.: Thirty-eight subjects who received more than 2 years of continuous BA treatment were enrolled. The mean x-ray interval was 4.4 years. RA activity was evaluated by disease activity score (DAS)-C reactive protein (CRP) and matrix metalloproteinase (MMP)-3. Radiographical definitions of cervical lesions were atlanto-dental interval (ADI) more than 3 mm for atlanto-axial subluxation (AAS), Ranawat value less than 13 mm for vertical subluxation (VS), and anterior or posterior listhesis more than 2 mm for subaxial subluxation (SS). Definitions of radiographical progression were an increase of ADI more than 2 mm for AAS, a decrease of both Ranawat and Redlund-Johnell values more than 2 mm for VS, and an increase of listhesis more than 2 mm for SS. RESULTS.: RA activity responded dramatically to BA therapy (DAS-CRP from 4.3 to 2.3, P < 0.01; MMP-3 from 207.9 ng/mL to 105.6 ng/mL, P < 0.01). Baseline radiographical evaluation showed no pre-existing cervical spine lesions in 12 cases, AAS in 15 cases, and VS in 11 cases. Radiological progression was found in 1 (8%) patient in the no lesion group, 12 patients (80%) in the AAS group, and 9 patients (80%) in the VS group. The incidence of progression was significantly lower in the no lesion group compared with the other groups. Multivariate regression analysis showed that the presence of pre-existing cervical lesions was the single greatest predictor of progression. CONCLUSION.: BAs prevented the development of de novo cervical spine lesions in patients with RA, but failed to inhibit progression of pre-existing RA lesions. 相似文献
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Amplification of the nephrotoxic effect of cyclosporine by preexistent chronic histological lesions in the kidney 总被引:3,自引:0,他引:3
K M Leunissen F T Bosman F H Nieman G Kootstra M A Vromen T C Noordzij J P van Hooff 《Transplantation》1989,48(4):590-593
In contrast to its importance in improving renal graft survival, nephrotoxicity is the most serious side effect of cyclosporine. Dosage reductions of CsA mitigate its nephrotoxic effect. However, CsA nephrotoxicity is still a problem in clinical transplantation. In this study the relationships among preexistent chronic histological lesions, donor age, and renal function after transplantation in 100 CsA treated renal allograft patients are described. Multivariate data analysis revealed a significant statistical effect of the presence of preexistent chronic histological lesions on nonimmediate function (-.42, less than 0.0001) that was relatively twice as large as the effects of cold ischemia time (-.21, less than 0.05). Also in predicting creatinine clearance at 1 and 3 months, preexisting chronic histological lesions had the most important effect (-.39, less than 0.0001; -.57, less than 0.0001, respectively), whereas the presence or absence of rejection episodes was less predictive (.24, less than 0.001; .20, less than 0.01, respectively). Preexistent chronic histological lesions had also significant effects in predicting conversion to azathioprine and prednisolone, because of CsA nephrotoxicity (-.42; less than 0.0001). The degree of CsA nephrotoxicity therefore varies according to the presence of preexistent chronic histological lesions. Because of the increase of these lesions with age, one has to be aware of an exaggerated CsA toxicity, especially in the older donor age group and in older patients treated with CsA for various reasons. 相似文献
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类风湿关节炎是临床常见病、多发病,致残率高,常常合并骨质疏松,这严重影响临床疗效和疾病预后,现代医学临床治疗和选择的药物很多,但是胃肠道不良反应突出,而中医药的辨证施治和多靶点多途径整体治疗有其独特优势,特别是补肾通络法通过临床和实验验证,证实其疗效显著,值得推广和应用。 相似文献
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Naoki Shoda Atsushi Seichi Katsushi Takeshita Hirotaka Chikuda Takashi Ono Hiroyuki Oka Hiroshi Kawaguchi Kozo Nakamura 《European spine journal》2009,18(6):905-910
Since sleep apnea is a risk factor for high mortality of rheumatoid arthritis (RA) patients, this study examined the prevalence
in RA patients with occipitocervical lesions, and the associated radiographic features. Twenty-nine RA patients requiring
surgery for progressive myelopathy due to occipitocervical lesions (3 males, 26 females, average age 65 years) were preoperatively
evaluated. Twenty-three (79%) had sleep apnea defined as apnea–hypopnea index >5 events per hour measured by a portable monitoring
device, and all of them were classified as the obstructive type. Among gender, age, bone mass index (BMI), and radiographic
parameters related to occipitocervical lesions: atlantodental interval (ADI), cervical angles (O/C1, C1/2, and C2/6), and
cervical lengths (O–C2 and O–C6), the ADI and cervical lengths were shown to be significantly associated with the presence
of sleep apnea by parametric statistical analysis. Since there were positive correlations between the ADI and cervical lengths
by Pearson’s test, we performed a multivariate logistic regression analysis after adjustment for confounding factors and found
that small ADI was the principle parameter associated with sleep apnea. We therefore conclude that the prevalence of sleep
apnea is higher than that in a general RA population that was reported previously, and believe that occipitocervical lesions
are an independent risk factor for this condition. Small ADI and short neck, secondary to the vertical translocation by RA,
may cause obstructive sleep apnea, probably through mechanical or neurological collapse of the upper airway. 相似文献