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Hawley DP, Foster HE, Beresford MW, Ramanan A, Rapley T, McErlane F. 12. Prescribing Patterns in Juvenile Idiopathic Arthritis: A Survey of Current Practice in the United Kingdom. Rheumatology (Oxford) 2018. [DOI: 10.1093/rheumatology/kex390.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Long E, Foster HE, Hughes M, Wauchope E, McErlane F. 37. Time to Methotrexate or Etanercept Treatment in Children with Juvenile Idiopathic Arthritis: An Audit of Current Practice. Rheumatology (Oxford) 2017. [DOI: 10.1093/rheumatology/kex390.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hanson H, Hart R, Deehan D, Foster HE. THU0570 Employment Issues Among Young Adults with Juvenile Idiopathic Arthritis (JIA): Patient Perpectives and Current Clinical Practice. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2013-eular.1098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Hawley DP, Pain CE, Baildam EM, Foster HE. PReS-FINAL-2119: United Kingdom survey of current management of juvenile localised scleroderma. Pediatr Rheumatol Online J 2013. [PMCID: PMC4044558 DOI: 10.1186/1546-0096-11-s2-p131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Cornell P, Trehane A, Thompson P, Rahmeh F, Greenwood M, Baqai TJ, Cambridge S, Shaikh M, Rooney M, Donnelly S, Tahir H, Ryan S, Kamath S, Hassell A, McCuish WJ, Bearne L, Mackenzie-Green B, Price E, Williamson L, Collins D, Tang E, Hayes J, McLoughlin YM, Chamberlain V, Campbell S, Shah P, McKenna F, Cornell P, Westlake S, Thompson P, Richards S, Homer D, Gould E, Empson B, Kemp P, Richards AG, Walker J, Taylor S, Bari SF, Alachkar M, Rajak R, Lawson T, O'Sullivan M, Samant S, Butt S, Gadsby K, Flurey CA, Morris M, Hughes R, Pollock J, Richards P, Hewlett S, Edwards KR, Rowe I, Sanders T, Dunn K, Konstantinou K, Hay E, Jones LE, Adams J, White P, Donovan-Hall M, Hislop K, Barbosa Boucas S, Nichols VP, Williamson EM, Toye F, Lamb SE, Rodham K, Gavin J, Watts L, Coulson N, Diver C, Avis M, Gupta A, Ryan SJ, Stangroom S, Pearce JM, Byrne J, Manning VL, Hurley M, Scott DL, Choy E, Bearne L, Taylor J, Morris M, Dures E, Hewlett S, Wilson A, Adams J, Larkin L, Kennedy N, Gallagher S, Fraser AD, Shrestha P, Batley M, Koduri G, Scott DL, Flurey CA, Morris M, Hughes R, Pollock J, Richards P, Hewlett S, Kumar K, Raza K, Nightingale P, Horne R, Chapman S, Greenfield S, Gill P, Ferguson AM, Ibrahim F, Scott DL, Lempp H, Tierney M, Fraser A, Kennedy N, Barbosa Boucas S, Hislop K, Dziedzic K, Arden N, Burridge J, Hammond A, Stokes M, Lewis M, Gooberman-Hill R, Coales K, Adams J, Nutland H, Dean A, Laxminarayan R, Gates L, Bowen C, Arden N, Hermsen L, Terwee CB, Leone SS, vd Zwaard B, Smalbrugge M, Dekker J, vd Horst H, Wilkie R, Ferguson AM, Nicky Thomas V, Lempp H, Cope A, Scott DL, Simpson C, Weinman J, Agarwal S, Kirkham B, Patel A, Ibrahim F, Barn R, Brandon M, Rafferty D, Sturrock R, Turner D, Woodburn J, Rafferty D, Paul L, Marshall R, Gill J, McInnes I, Roderick Porter D, Woodburn J, Hennessy K, Woodburn J, Steultjens M, Siddle HJ, Hodgson RJ, Hensor EM, Grainger AJ, Redmond A, Wakefield RJ, Helliwell PS, Hammond A, Rayner J, Law RJ, Breslin A, Kraus A, Maddison P, Thom JM, Newcombe LW, Woodburn J, Porter D, Saunders S, McCarey D, Gupta M, Turner D, McGavin L, Freeburn R, Crilly A, Lockhart JC, Ferrell WR, Goodyear C, Ledingham J, Waterman T, Berkin L, Nicolaou M, Watson P, Lillicrap M, Birrell F, Mooney J, Merkel PA, Poland F, Spalding N, Grayson P, Leduc R, Shereff D, Richesson R, Watts RA, Roussou E, Thapper M, Bateman J, Allen M, Kidd J, Parsons N, Davies D, Watt KA, Scally MD, Bosworth A, Wilkinson K, Collins S, Jacklin CB, Ball SK, Grosart R, Marks J, Litwic AE, Sriranganathan MK, Mukherjee S, Khurshid MA, Matthews SM, Hall A, Sheeran T, Baskar S, Muether M, Mackenzie-Green B, Hetherington A, Wickrematilake G, Williamson L, Daniels LE, Gwynne CE, Khan A, Lawson T, Clunie G, Stephenson S, Gaffney K, Belsey J, Harvey NC, Clarke-Harris R, Murray R, Costello P, Garrett E, Holbrook J, Teh AL, Wong J, Dogra S, Barton S, Davies L, Inskip H, Hanson M, Gluckman P, Cooper C, Godfrey K, Lillycrop K, Anderton T, Clarke S, Rao Chaganti S, Viner N, Seymour R, Edwards MH, Parsons C, Ward K, Thompson J, Prentice A, Dennison E, Cooper C, Clark E, Cumming M, Morrison L, Gould VC, Tobias J, Holroyd CR, Winder N, Osmond C, Fall C, Barker D, Ring S, Lawlor D, Tobias J, Davey Smith G, Cooper C, Harvey NC, Toms TE, Afreedi S, Salt K, Roskell S, Passey K, Price T, Venkatachalam S, Sheeran T, Davies R, Southwood TR, Kearsley-Fleet L, Hyrich KL, Kingsbury D, Quartier P, Patel G, Arora V, Kupper H, Mozaffarian N, Kearsley-Fleet L, Baildam E, Beresford MW, Davies R, Foster HE, Mowbray K, Southwood TR, Thomson W, Hyrich KL, Saunders E, Baildam E, Chieng A, Davidson J, Foster H, Gardner-Medwin J, Wedderburn L, Thomson W, Hyrich K, McErlane F, Beresford M, Baildam E, Chieng SE, Davidson J, Foster HE, Gardner-Medwin J, Lunt M, Wedderburn L, Thomson W, Hyrich K, Rooney M, Finnegan S, Gibson DS, Borg FA, Bale PJ, Armon K, Cavelle A, Foster HE, McDonagh J, Bale PJ, Armon K, Wu Q, Pesenacker AM, Stansfield A, King D, Barge D, Abinun M, Foster HE, Wedderburn L, Stanley K, Morrissey D, Parsons S, Kuttikat A, Shenker N, Garrood T, Medley S, Ferguson AM, Keeling D, Duffort P, Irving K, Goulston L, Culliford D, Coakley P, Taylor P, Hart D, Spector T, Hakim A, Arden N, Mian A, Garrood T, Magan T, Chaudhary M, Lazic S, Sofat N, Thomas MJ, Moore A, Roddy E, Peat G, Rees F, Lanyon P, Jordan N, Chaib A, Sangle S, Tungekar F, Sabharwal T, Abbs I, Khamashta M, D'Cruz D, Dzifa Dey I, Isenberg DA, Chin CW, Cheung C, Ng M, Gao F, Qiong Huang F, Thao Le T, Yong Fong K, San Tan R, Yin Wong T, Julian T, Parker B, Al-Husain A, Yvonne Alexander M, Bruce I, Jordan N, Abbs I, D'cruz D, McDonald G, Miguel L, Hall C, Isenberg DA, Magee A, Butters T, Jury E, Yee CS, Toescu V, Hickman R, Leung MH, Situnayake D, Bowman S, Gordon C, Yee CS, Toescu V, Hickman R, Leung MH, Situnayake D, Bowman S, Gordon C, Lazarus MN, Isenberg DA, Ehrenstein M, Carter LM, Isenberg DA, Ehrenstein MR, Chanchlani N, Gayed M, Yee CS, Gordon C, Ball E, Rooney M, Bell A, Reynolds JA, Ray DW, O'Neill T, Alexander Y, Bruce I, Sutton EJ, Watson KD, Isenberg D, Rahman A, Gordon C, Yee CS, Lanyon P, Jayne D, Akil M, D'Cruz D, Khamashta M, Lutalo P, Erb N, Prabu A, Edwards CJ, Youssef H, McHugh N, Vital E, Amft N, Griffiths B, Teh LS, Zoma A, Bruce I, Durrani M, Jordan N, Sangle S, D'Cruz D, Pericleous C, Ruiz-Limon P, Romay-Penabad Z, Carrera-Marin A, Garza-Garcia A, Murfitt L, Driscoll PC, Giles IP, Ioannou Y, Rahman A, Pierangeli SS, Ripoll VM, Lambrianides A, Heywood WE, Ioannou J, Giles IP, Rahman A, Stevens C, Dures E, Morris M, Knowles S, Hewlett S, Marshall R, Reddy V, Croca S, Gerona D, De La Torre Ortega I, Isenberg DA, Leandro M, Cambridge G, Reddy V, Cambridge G, Isenberg DA, Glennie M, Cragg M, Leandro M, Croca SC, Isenberg DA, Giles I, Ioannou Y, Rahman A, Croca SC, Isenberg DA, Giles I, Ioannou Y, Rahman A, Artim Esen B, Pericleous C, MacKie I, Ioannou Y, Rahman A, Isenberg DA, Giles I, Skeoch S, Haque S, Pemberton P, Bruce I. BHPR: Audit and Clinical Evaluation * 103. Dental Health in Children and Young Adults with Inflammatory Arthritis: Access to Dental Care. Rheumatology (Oxford) 2013. [DOI: 10.1093/rheumatology/ket196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Lim D, Todd M, Kourtoglou N, Gerasimidis K, Gardner-Medwin J, Watson L, Tullus K, Pilkington C, Chesters C, Marks SD, Newland P, Jones C, Beresford MW, O'Neill P, Lee H, Tattersall R, McErlane F, Beresford M, Baildam E, Alice Chieng SE, Davidson J, Foster H, Gardner-Medwin J, Lunt M, Wedderburn LR, Thomson W, Hyrich KL, Kavirayani A, Thyagarajan MS, Ellis J, Helen Strike CNS, Ramanan AV, Coda A, Davidson J, Fowlie P, Walsh J, Carline T, Santos D, Brimlow KW, Rangaraj S, Grant C, Little J, Helen Strike CNS, Hinchcliffe A, Dick A, Ramanan A, Ekdawy D, Nagra G, Camina N, Edgerton J, Choi J, Lamb K, Hawley D, Rangaraj S, Cruikshank M, Sen E, Pain C, Leone V, Cruikshank M, Walsh J, Tattersall R, Hawley D, Dunkley L, Lee H, McMahon AM, Bale P, Armon K, Amin T, Wood M, Davies R, Southwood TR, Kearsley-Fleet L, Hyrich KL, Kearsley-Fleet L, Baildam E, Beresford M, Davies R, Foster HE, Mowbray K, Southwood TR, Thomson W, Hyrich KL, Agarwal M, Kavirayani A, Ramanan AV, Ellis J, Smith E, Gray W, Taylor-Robinson D, Foster HE, Beresford MW, Morgan T, Watson L, Beresford MW, Gohar F, Watson L, Beresford MW, Artim-Esen B, Radziszewska A, Pericleous C, Rahman A, Giles I, Ioannou Y, Jashek D, Mosley E, Rangaraj S, Moraitis E, Arnold K, Pilkington C, Russell NJ, Roderick M, Ramanan A, Roderick M, Russell N, Ramanan AV, Smith NSM, Wilson N, Gardner-Medwin J, Sen E, Chan M, Hardy E, Rapley T, Hensman P, Wraith JE, Foster H, Clarkson J, Gardner-Medwin J, Choudhery V, McVitty C, Davidson J, Hughes DH, Martin N, Warrier K, Sen E, Abinun M, Jandial S, O'Leary D, Staunton D, Lowry C, McSweeney N, Sen E, Abinun M, Friswell M, Foster H, Walsh A, Lowry C, Raja A. BSPAR ANNUAL CONFERENCE ABSTRACTS * Oral presentations * O1. The impact of modern management on outcomes of JIA compared with healthy controls. Rheumatology (Oxford) 2012. [DOI: 10.1093/rheumatology/ket116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lim D, Todd M, Kourtoglou N, Gerasimidis K, Gardner-Medwin J, Watson L, Tullus K, Pilkington C, Chesters C, Marks SD, Newland P, Jones C, Beresford MW, O'Neill P, Lee H, Tattersall R, McErlane F, Beresford M, Baildam E, Alice Chieng SE, Davidson J, Foster H, Gardner-Medwin J, Lunt M, Wedderburn LR, Thomson W, Hyrich KL, Kavirayani A, Thyagarajan MS, Ellis J, Helen Strike CNS, Ramanan AV, Coda A, Davidson J, Fowlie P, Walsh J, Carline T, Santos D, Brimlow KW, Rangaraj S, Grant C, Little J, Helen Strike CNS, Hinchcliffe A, Dick A, Ramanan A, Ekdawy D, Nagra G, Camina N, Edgerton J, Choi J, Lamb K, Hawley D, Rangaraj S, Cruikshank M, Sen E, Pain C, Leone V, Cruikshank M, Walsh J, Tattersall R, Hawley D, Dunkley L, Lee H, McMahon AM, Bale P, Armon K, Amin T, Wood M, Davies R, Southwood TR, Kearsley-Fleet L, Hyrich KL, Kearsley-Fleet L, Baildam E, Beresford M, Davies R, Foster HE, Mowbray K, Southwood TR, Thomson W, Hyrich KL, Agarwal M, Kavirayani A, Ramanan AV, Ellis J, Smith E, Gray W, Taylor-Robinson D, Foster HE, Beresford MW, Morgan T, Watson L, Beresford MW, Gohar F, Watson L, Beresford MW, Artim-Esen B, Radziszewska A, Pericleous C, Rahman A, Giles I, Ioannou Y, Jashek D, Mosley E, Rangaraj S, Moraitis E, Arnold K, Pilkington C, Russell NJ, Roderick M, Ramanan A, Roderick M, Russell N, Ramanan AV, Smith NSM, Wilson N, Gardner-Medwin J, Sen E, Chan M, Hardy E, Rapley T, Hensman P, Wraith JE, Foster H, Clarkson J, Gardner-Medwin J, Choudhery V, McVitty C, Davidson J, Hughes DH, Martin N, Warrier K, Sen E, Abinun M, Jandial S, O'Leary D, Staunton D, Lowry C, McSweeney N, Sen E, Abinun M, Friswell M, Foster H, Walsh A, Lowry C, Raja A. BSPAR ANNUAL CONFERENCE ABSTRACTS * Oral presentations * O1. The impact of modern management on outcomes of JIA compared with healthy controls. Rheumatology (Oxford) 2012. [DOI: 10.1093/rheumatology/kes277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Campbell R, Hofmann D, Hatch S, Gordon P, Lempp H, Das L, Blumbergs P, Limaye V, Vermaak E, McHugh N, Edwards MH, Jameson K, Sayer AA, Dennison E, Cooper C, Salvador FB, Huertas C, Isenberg D, Jackson EJ, Middleton A, Churchill D, Walker-Bone K, Worsley PR, Mottram S, Warner M, Morrissey D, Gadola S, Carr A, Cooper C, Stokes M, Srivastava RN, Sanghi D, Srivastava RN, Sanghi D, Elbaz A, Mor A, Segal G, Drexler M, Norman D, Peled E, Rozen N, Goryachev Y, Debbi EM, Haim A, Rozen N, Wolf A, Debi R, Mor A, Segal G, Debbi EM, Cohen MS, Igolnikov I, Bar Ziv Y, Benkovich V, Bernfeld B, Rozen N, Elbaz A, Collins J, Moots RJ, Clegg PD, Milner PI, Ejtehadi HD, Nelson PN, Wenham C, Balamoody S, Hodgson R, Conaghan P, Wilkie R, Blagojevic M, Jordan KP, Mcbeth J, Peffers MJ, Beynon RJ, Thornton DJ, Clegg PD, Chapman R, Chapman V, Walsh D, Kelly S, Hui M, Zhang W, Doherty S, Rees F, Muir K, Maciewicz R, Doherty M, Snelling S, Davidson RK, Swingler T, Price A, Clark I, Stockley E, Hathway G, Faas H, Auer D, Chapman V, Hirsch G, Hale E, Kitas G, Klocke R, Abraham A, Pearce MS, Mann KD, Francis RM, Birrell F, Tucker M, Mellon SJ, Jones L, Price AJ, Dieppe PA, Gill HS, Ashraf S, Chapman V, Walsh DA, McCollum D, McCabe C, Grieve S, Shipley J, Gorodkin R, Oldroyd AG, Evans B, Greenbank C, Bukhari M, Rajak R, Bennett C, Williams A, Martin JC, Abdulkader R, MacNicol C, Brixey K, Stephenson S, Clunie G, Andrews RN, Oldroyd AG, Evans B, Greenbank C, Bukhari M, Clark EM, Gould VC, Carter L, Morrison L, Tobias JH, Pye SR, Vanderschueren D, O'Neill TW, Lee DM, Jans I, Billen J, Gielen E, Laurent M, Claessens F, Adams JE, Ward KA, Bartfai G, Casanueva F, Finn JD, Forti G, Giwercman A, Han TS, Huhtaniemi I, Kula K, Lean ME, Pendleton N, Punab M, Wu FC, Boonen S, Mercieca C, Webb J, Shipley J, Bhalla A, Fairbanks S, Moss KE, Collins C, Sedgwick P, Clark EM, Gould VC, Morrison L, Tobias JH, Parker J, Greenbank C, Evans B, Oldroyd AG, Bukhari M, Harvey NC, Cole ZA, Crozier SR, Ntani G, Mahon PA, Robinson SM, Inskip HM, Godfrey KM, Dennison EM, Cooper C, Bridges M, Ruddick S, Holroyd CR, Mahon P, Crozier SR, Godfrey K, Inskip HM, Cooper C, Harvey NC, Bridges M, Ruddick S, McNeilly T, McNally C, Beringer T, Finch M, Coda A, Davidson J, Walsh J, Fowlie P, Carline T, Santos D, Patil P, Rawcliffe C, Olaleye A, Moore S, Fox A, Sen D, Ioannou Y, Nisar S, Rankin K, Birch M, Finnegan S, Rooney M, Gibson DS, Malviya A, Ferris CM, Rushton SP, Foster HE, Hanson H, Muthumayandi K, Deehan DJ, Birt L, Poland F, MacGregor A, Armon K, Pfeil M, McErlane F, Beresford MW, Baildam EM, Thomson W, Hyrich K, Chieng A, Davidson J, Foster HE, Gardner-Medwin J, Lunt M, Wedderburn L, Gibson DS, Finnegan S, Newell K, Evans A, Manning G, Scaife C, McAllister C, Pennington SR, Duncan M, Moore T, Rooney M, Pericleous C, Croca SC, Giles I, Alber K, Yong H, Isenberg D, Midgely A, Beresford MW, Rahman A, Ioannou Y, Rzewuska M, Mallen C, Strauss VY, Belcher J, Peat G, Byng-Maddick R, Wijendra M, Penn H, Roddy E, Muller S, Hayward R, Mallen C, Kamlow F, Pakozdi A, Jawad A, Green DJ, Muller S, Mallen C, Hider SL, Singh Bawa S, Bawa S, Turton A, Palmer M, Grieve S, Lewis J, Moss T, McCabe C, Goodchild CE, Tang N, Scott D, Salkovskis P, Selvan S, Williamson L, Selvan S, Williamson L, Thalayasingam N, Higgins M, Saravanan V, Rynne M, Hamilton JD, Heycock C, Kelly C, Norton S, Sacker A, Done J, Young A, Smolen JS, Fleischmann RM, Emery P, van Vollenhoven RF, Guerette B, Santra S, Kupper H, Redden L, Kavanaugh A, Keystone EC, van der Heijde D, Weinblatt ME, Mozaffarian N, Guerette B, Kupper H, Liu S, Kavanaugh A, Zhang N, Wilkinson S, Riaz M, Ostor AJ, Nisar MK, Burmester G, Mariette X, Navarro-Blasco F, Oezer U, Kary S, Unnebrink K, Kupper H, Jobanputra P, Maggs F, Deeming A, Carruthers D, Rankin E, Jordan A, Faizal A, Goddard C, Pugh M, Bowman S, Brailsford S, Nightingale P, Tugnet N, Cooper SC, Douglas KM, Edwin Lim CS, Bee Lian Low S, Joy C, Hill L, Davies P, Mukherjee S, Cornell P, Westlake SL, Richards S, Rahmeh F, Thompson PW, Breedveld F, Keystone E, van der Heijde D, Landewe R, Smolen JS, Guerette B, McIlraith M, Kupper H, Liu S, Kavanaugh A, Byng-Maddick R, Penn H, Abdulkader R, Dharmapalaiah C, Shand L, Rose G, Clunie G, Watts R, Eldashan A, Dasgupta B, Borg FA, Bell GM, Anderson AE, Harry RA, Stoop JN, Hilkens CM, Isaacs J, Dickinson A, McColl E, Banik S, Smith L, France J, Bawa S, Rutherford A, Scott Russell A, Smith J, Jassim I, Withrington R, Bacon P, De Lord D, McGregor L, Morrison I, Stirling A, Porter DR, Saunders SA, Else S, Semenova O, Thompson H, Ogunbambi O, Kallankara S, Baguley E, Patel Y, Alzabin S, Abraham S, Taher TE, Palfeeman A, Hull D, McNamee K, Jawad A, Pathan E, Kinderlerer A, Taylor P, Williams RO, Mageed RA, Iaremenko O, Mikitenko G, Ferrari M, Kamalati T, Pitzalis C, Tugnet N, Pearce F, Tosounidou S, Obrenovic K, Erb N, Packham J, Sandhu R, White C, Cardy CM, Justice E, Frank M, Li L, Lloyd M, Ahmed A, Readhead S, Ala A, Fittall M, Manson J, Ioannou Y, Sibilia J, Marc Flipo R, Combe B, Gaillez C, Le Bars M, Poncet C, Elegbe A, Westhovens R, Hassanzadeh R, Mangan C, France J, Bawa S, Weinblatt ME, Fleischmann R, van Vollenhoven R, Emery P, Huizinga TWJ, Goldermann R, Duncan B, Timoshanko J, Luijtens K, Davies O, Dougados M, Hewitt J, Owlia M, Dougados M, Gaillez C, Le Bars M, Poncet C, Elegbe A, Schiff M, Alten R, Kaine JL, Keystone E, Nash PT, Delaet I, Qi K, Genovese MC, Clark J, Kardash S, Wong E, Hull R, McCrae F, Shaban R, Thomas L, Young-Min S, Ledingham J, Genovese MC, Covarrubias Cobos A, Leon G, Mysler EF, Keiserman MW, Valente RM, Nash PT, Abraham Simon Campos J, Porawska W, Box JH, Legerton CW, Nasonov EL, Durez P, Pappu R, Delaet I, Teng J, Alten R, Edwards CJ, Arden N, Campbell J, van Staa T, Housden C, Sargeant I, Edwards CJ, Arden N, Campbell J, van Staa T, Housden C, Sargeant I, Choy E, McAuliffe S, Roberts K, Sargeant I, Emery P, Sarzi-Puttini P, Moots RJ, Andrianakos A, Sheeran TP, Choquette D, Finckh A, Desjuzeur ML, Gemmen EK, Mpofu C, Gottenberg JE, Bukhari M, Shah P, Kitas G, Cox M, Nye A, O'Brien A, Jones P, Sargeant I, Jones GT, Paudyal P, MacPherson H, Sim J, Doherty M, Ernst E, Fisken M, Lewith G, Tadman J, Macfarlane GJ, Mariette X, Bertin P, Arendt C, Terpstra I, VanLunen B, de Longueville M, Zhou H, Cai A, Lacy E, Kay J, Keystone E, Matteson E, Hu C, Hsia E, Doyle M, Rahman M, Shealy D, Scott DL, Ibrahim F, Abozaid H, Choy E, Hassell A, Plant M, Richards S, Walker D, Simpson G, Kowalczyk A, Prouse P, Brown A, George M, Kumar N, Mackay K, Marshall S, Nash PT, Ludivico CL, Delaet I, Qi K, Murthy B, Corbo M, Kaine JL, Emery P, Smolen JS, Samborski W, Berenbaum F, Davies O, Ambrugeat J, Bennett B, Burkhardt H, Prouse P, Brown A, George M, Kumar N, Mackay K, Marshall S, Bykerk V, Ostor AJ, Roman Ivorra J, Wollenhaupt J, Stancati A, Bernasconi C, Sibilia J, Scott DGI, Claydon P, Ellis C, Buchan S, Pope J, Fleischmann R, Dougados M, Bingham CO, Massarotti EM, Wollenhaupt J, Duncan B, Coteur G, Weinblatt M, Hull D, Ball C, Abraham S, Ainsworth T, Kermik J, Woodham J, Haq I, Quesada-Masachs E, Carolina Diaz A, Avila G, Acosta I, Sans X, Alegre C, Marsal S, McWilliams D, Kiely PD, Young A, Walsh DA, Fleischmann R, Bolce R, Wang J, Ingham M, Dehoratius R, Decktor D, Rao V, Pavlov A, Klearman M, Musselman D, Giles J, Bathon J, Sattar N, Lee J, Baxter D, McLaren JS, Gordon MM, Thant KZ, Williams EL, Earl S, White P, Williams J, Westlake SL, Ledingham J, Jan AK, Bhatti AI, Stafford C, Carolan M, Ramakrishnan SA. Muscle disorders * 111. The impact of fatigue in patients with idiopathic inflammatory myopathy: a mixed method study. Rheumatology (Oxford) 2012. [DOI: 10.1093/rheumatology/kes109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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FitzGerald MP, Payne CK, Lukacz ES, Yang CC, Peters KM, Chai TC, Nickel JC, Hanno PM, Kreder KJ, Burks DA, Mayer R, Kotarinos R, Fortman C, Allen TM, Fraser L, Mason-Cover M, Furey C, Odabachian L, Sanfield A, Chu J, Huestis K, Tata GE, Dugan N, Sheth H, Bewyer K, Anaeme A, Newton K, Featherstone W, Halle-Podell R, Cen L, Landis JR, Propert KJ, Foster HE, Kusek JW, Nyberg LM. Randomized multicenter clinical trial of myofascial physical therapy in women with interstitial cystitis/painful bladder syndrome and pelvic floor tenderness. J Urol 2012; 187:2113-8. [PMID: 22503015 DOI: 10.1016/j.juro.2012.01.123] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Indexed: 10/28/2022]
Abstract
PURPOSE We determined the efficacy and safety of pelvic floor myofascial physical therapy compared to global therapeutic massage in women with newly symptomatic interstitial cystitis/painful bladder syndrome. MATERIALS AND METHODS A randomized controlled trial of 10 scheduled treatments of myofascial physical therapy vs global therapeutic massage was performed at 11 clinical centers in North America. We recruited women with interstitial cystitis/painful bladder syndrome with demonstrable pelvic floor tenderness on physical examination and a limitation of no more than 3 years' symptom duration. The primary outcome was the proportion of responders defined as moderately improved or markedly improved in overall symptoms compared to baseline on a 7-point global response assessment scale. Secondary outcomes included ratings for pain, urgency and frequency, the O'Leary-Sant IC Symptom and Problem Index, and reports of adverse events. We compared response rates between treatment arms using the exact conditional version of the Mantel-Haenszel test to control for clustering by clinical center. For secondary efficacy outcomes cross-sectional descriptive statistics and changes from baseline were calculated. RESULTS A total of 81 women randomized to the 2 treatment groups had similar symptoms at baseline. The global response assessment response rate was 26% in the global therapeutic massage group and 59% in the myofascial physical therapy group (p=0.0012). Pain, urgency and frequency ratings, and O'Leary-Sant IC Symptom and Problem Index decreased in both groups during followup, and were not significantly different between the groups. Pain was the most common adverse event, occurring at similar rates in both groups. No serious adverse events were reported. CONCLUSIONS A significantly higher proportion of women with interstitial cystitis/painful bladder syndrome responded to treatment with myofascial physical therapy than to global therapeutic massage. Myofascial physical therapy may be a beneficial therapy in women with this syndrome.
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Affiliation(s)
- M P FitzGerald
- Loyola University Medical Center, Maywood, Illinois, USA.
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McErlane F, Beresford MW, Baildam EM, Thomson W, Hyrich K, Chieng A, Davidson J, Foster HE, Gardner-Medwin J, Lunt M, Wedderburn L, Nikiphorou E, Carpenter L, Kiely P, Walsh D, Dixey J, Young A, Kapoor SR, Filer A, Fitzpatrick M, Fisher BA, Taylor PC, Buckley C, McInnes I, Raza K, Young SP, Dougados M, Kissel K, Amital H, Conaghan P, Martin-Mola E, Nasonov E, Schett G, Troum O, Veldi T, Bernasconi C, Huizinga T, Durez P, Genovese MC, Richards HB, Supronik J, Dokoupilova E, Aelion JA, Lee SH, Codding CE, Kellner H, Ikawa T, Hugot S, Ligozio G, Mpofu S, Kavanaugh A, Emery P, Fleischmann R, Van Vollenhoven R, Pavelka K, Durez P, Guerette B, Santra S, Redden L, Kupper H, Smolen JS, Wilkie R, Tajar A, McBeth J, Hooper LS, Bowen CJ, Gates L, Culliford D, Edwards CJ, Arden NK, Adams J, Ryan S, Haywood H, Pain H, Siddle HJ, Redmond AC, Waxman R, Dagg AR, Alcacer-Pitarch B, Wilkins RA, Helliwell PS, Norton S, Kiely P, Walsh D, Williams R, Young A, Halls S, Law RJ, Jones J, Markland D, Maddison P, Thom J, Parker B, Urowitz MB, Gladman DD, Bruce I, Croca SC, Pericleous C, Yong H, Isenberg D, Giles I, Rahman A, Ioannou Y, Warrell CE, Dobarro D, Handler C, Denton CP, Schreiber BE, Coghlan JG, Betteridge ZE, Woodhead F, Bunn C, Denton CP, Abraham D, Desai S, du Bois R, Wells A, McHugh N, Abignano G, Aydin S, Castillo-Gallego C, Woods D, Meekings A, McGonagle D, Emery P, Del Galdo F, Vila J, Mitchell S, Bowman S, Price E, Pease CT, Emery P, Andrews J, Bombardieri M, Sutcliffe N, Pitzalis C, Lanyon P, Hunter J, Gupta M, McLaren J, Regan M, Cooper A, Giles I, Isenberg D, Vadivelu S, Coady D, Griffiths B, Lendrem D, Foggo H, Tarn J, Ng WF, Goodhead C, Shekar P, Kelly C, Francis G, Bailey AM, Thompson L, Hamilton J, Salisbury C, Foster NE, Bishop A, Coast J, Franchini A, Hall J, Hollinghurst S, Hopper C, Grove S, Kaur S, Montgomery A, Paskins Z, Sanders T, Croft PR, Hassell AB, Coxon DE, Frisher M, Jordan KP, Jinks C, Peat G, Monk HL, Muller S, Mallen C, Hider SL, Roddy E, Muller S, Hayward R, Mallen C. Oral abstracts 3: RA Treatment and outcomes * O13. Validation of jadas in all subtypes of juvenile idiopathic arthritis in a clinical setting. Rheumatology (Oxford) 2012. [DOI: 10.1093/rheumatology/kes119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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12
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Hawley DP, Baildam EM, Amin TS, Cruikshank MK, Davidson JE, Dixon J, Martin NS, Ohlsson V, Pilkington C, Rangaraj S, Riley P, Sundaramoorthy C, Walsh J, Foster HE. Access to care for children and young people diagnosed with localized scleroderma or juvenile SSc in the UK. Rheumatology (Oxford) 2012; 51:1235-9. [DOI: 10.1093/rheumatology/ker521] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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13
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Malviya A, Walker LC, Avery P, Osborne S, Weir DJ, Foster HE, Deehan DJ. The long-term outcome of hip replacement in adults with juvenile idiopathic arthritis. ACTA ACUST UNITED AC 2011; 93:443-8. [DOI: 10.1302/0301-620x.93b4.26078] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Juvenile idiopathic arthritis (JIA) is a chronic disease of childhood; it causes joint damage which may require surgical intervention, often in the young adult. The aim of this study was to describe the long-term outcome and survival of hip replacement in a group of adult patients with JIA and to determine predictors of survival for the prosthesis. In this retrospective comparative study patients were identified from the database of a regional specialist adult JIA clinic. This documented a series of 47 hip replacements performed in 25 adult patients with JIA. Surgery was performed at a mean age of 27 years (11 to 47), with a mean follow-up of 19 years (2 to 36). The mean Western Ontario and McMaster Universities osteoarthritis index questionnaire (WOMAC) score at the last follow-up was 53 (19 to 96) and the mean Health Assessment Questionnaire score was 2.25 (0 to 3). The mean pain component of the WOMAC score (60 (20 to 100)) was significantly higher than the mean functional component score (46 (0 to 97)) (p = 0.02). Kaplan-Meier survival analysis revealed a survival probability of 46.6% (95% confidence interval 37.5 to 55.7) at 19 years, with a trend towards enhanced survival with the use of a cemented acetabular component and a cementless femoral component. This was not, however, statistically significant (acetabular component, p = 0.76, femoral component, p = 0.45). Cox’s proportional hazards regression analysis showed an implant survival rate of 54.9% at 19 years at the mean of covariates. Survival of the prosthesis was significantly poorer (p = 0.001) in patients who had been taking long-term corticosteroids and significantly better (p = 0.02) in patients on methotrexate.
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Affiliation(s)
- A. Malviya
- Musculoskeletal Unit, Newcastle Hospitals NHS Trust, Freeman Hospital, High Heaton, Newcastle-upon-Tyne NE7 7DN, UK
| | - L. C. Walker
- University of Newcastle, Claremont Road, Newcastle-upon-Tyne NE1 7RU, UK
| | - P. Avery
- University of Newcastle, Claremont Road, Newcastle-upon-Tyne NE1 7RU, UK
| | - S. Osborne
- Musculoskeletal Unit, Newcastle Hospitals NHS Trust, Freeman Hospital, High Heaton, Newcastle-upon-Tyne NE7 7DN, UK
| | - D. J. Weir
- Musculoskeletal Unit, Newcastle Hospitals NHS Trust, Freeman Hospital, High Heaton, Newcastle-upon-Tyne NE7 7DN, UK
| | - H. E. Foster
- University of Newcastle, Claremont Road, Newcastle-upon-Tyne NE1 7RU, UK
| | - D. J. Deehan
- Musculoskeletal Unit, Newcastle Hospitals NHS Trust, Freeman Hospital, High Heaton, Newcastle-upon-Tyne NE7 7DN, UK
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Ball SV, Maxwell JL, Cruikshank MK, Douglas S, Price V, Davidson JE, Hanna L, Brown L, Watson L, Kelly J, Baildam EM, Cleary AG, McCann LM, Beresford MW, Hawley DP, Baildam EM, Amin TS, Cruikshank MK, Davidson J, Dixon J, Ennals G, Gulati R, Ohlsson V, Rangaraj S, Riley P, Sundaramoorthy C, Walsh J, Foster HE, Hendry GJ, Gardner-Medwin J, Turner DE, Woodburn J, Lorgelly PK, Hendry GJ, Steultjens MPM, Gardner-Medwin J, Woodburn J, Turner DE, Jandial S, Stewart J, Kay L, Foster HE, Leone V, McDonagh J, Pilkington C, Rangaraj S, Tizard EJ, Beresford MW, McErlane F, Kulkani P, Nicholl K, Foster HE, McErlane F, Foster HE, Symmons D, Hyrich K, Midgley A, Beresford MW, Pain CE, McCann LJ, Cleary AG, Beresford MW, Barnes N, Landes C, Baildam EM, Pain CE, Gargh K, McCann LJ, Rapley T, Heaven B, May C, Kay L, Foster H, Rapley T, Avery P, May C, Beresford M, Foster H, Rapley TR, May C, Foster HE, Sen ES, Mandal K, Hinchcliffe A, Dick AD, Ramanan AV, Thorbinson C, Midgley A, Beresford MW, Watson L, Midgley A, Hanna L, Jones C, Holt R, Pilkington C, Tullus K, Beresford MW, Wyllie R, Craig L. BSPAR ANNUAL CONFERENCE ABSTRACTS (presented in alphabetical order of first author). Rheumatology (Oxford) 2011. [DOI: 10.1093/rheumatology/keq394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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15
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Beresford MW, Cleary AG, Foster HE, Hutchinson E, Baildam EM, Davies K. Comment on: Developing standards of care for patients with juvenile idiopathic arthritis. Rheumatology (Oxford) 2010; 49:2227-9. [DOI: 10.1093/rheumatology/keq215] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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16
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Thapper M, Roussou E, Jandial S, Pearson J, Foster HE, Thompson B, Orr J, Platt P, Birrell F, Sritharan M, Croft A, Justice E, Carruthers D, Walker D, Robinson S, Jagatsinh Y, Adebajo A, Helliwell P, Rahman A, Shah P, Snowden N, Dexter H, Dornan T, Singh D, Meadows A, Frusher J, Sampson C, Sheehan NJ, Dahiya S, Croft AP, Sritharan M, Justice EA, Carruthers DM, Little J, Melath S, Procter S, Horne Z, Dahiya S, Lauder A, McCabe C, Rodham K. Education Research [291-300]: 291. Medical Students' Attitude Towards Rheumatology Training at Fy1 And Fy2 Level: Results from a National Survey. Rheumatology (Oxford) 2010. [DOI: 10.1093/rheumatology/keq732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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17
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Pascoli L, Napier NJ, Wray M, Mc Carron M, Mc Allister C, Rooney ME, Gibson DS, Pascoli L, McAlilister C, Scaife C, Dunn M, Pennington S, Rooney M, Pascoli L, Wright S, Mc Allister C, Rooney ME, Hinks A, Martin P, Flynn E, Eyre S, Packham J, Barton A, Worthington J, Thomson W, McErlane F, Kulkarni P, Nicholl K, Foster HE, Pain C, Baildam E, Foster H, Harrison M, Symmonds D, Hinks A, Martin P, Flynn E, Eyre S, Packham J, Barton A, Worthington J, Thomson W, Hinks A, Martin P, Flynn E, Eyre S, Packham J, Barton A, Worthington J, Thomson W. Paediatric and Adolescent Rheumatology [143-150]: 143. Knee Joint in JIA: A Prospective Evaluation of Clinical Examination, Ultrasound and Mri Assessment. A Newly Developed Knee MRI Scoring System in JIA. Rheumatology (Oxford) 2010. [DOI: 10.1093/rheumatology/keq724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Abstract
OBJECTIVE Thymic function declines exponentially with age. Impaired thymic function has been associated with autoimmune disease in adults but has never been formally assessed in childhood autoimmunity. Therefore, thymic function in children with the autoimmune disease juvenile idiopathic arthritis (JIA) was determined. METHODS Thymic function was measured in 70 children and young adults with JIA (age range 2.1-30.8 (median 10.4)) and 110 healthy age-matched controls using four independent assays. T cell receptor excision circles (WBLogTREC/ml) and the proportion of CD4(+) CD45RA(+)CD31(+) T cells (representing recent thymic emigrants; %RTEs) were quantified and intrathymic proliferation measured by calculating the alphaTREC/SigmabetaTREC ratio. Lastly, regulatory T cells (T(Reg)) of thymic origin (CD4(+)FOXP3(+)) were quantified in peripheral blood to assess the ability of the thymus in JIA to generate this T cell subset. RESULTS Thymic function was equivalent by all four parameters in JIA when compared with the control population. Furthermore, there was no consistent effect of JIA subtype on thymic function, although intrathymic proliferation was higher in the small rheumatoid factor (RF)(+) polyarticular group. There were no significant effects of disease-modifying antirheumatic drugs (DMARDs) or oral corticosteroids on thymic function, although those with the worst prognostic ILAR (International League of Associations for Rheumatology) subtypes were also those most likely to be on a DMARD. CONCLUSIONS It is demonstrated that children and young adults with JIA, unlike adults with autoimmune diseases, have thymic function that is comparable with that of healthy controls. The varied pathologies represented by the term "JIA" suggest this observation may not be disease specific and raises interesting questions about the aetiology of thymic impairment in adult autoimmunity.
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Affiliation(s)
- A R Lorenzi
- Institute of Cellular Medicine, Newcastle University, Newcastle-upon-Tyne, UK
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19
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Lorenzi AR, Foster HE, Isaacs JD. Thymic function and immune senescence in juvenile idiopathic arthritis: comment on the article by Prelog et al. Arthritis Rheum 2009; 60:310-312. [PMID: 19116926 DOI: 10.1002/art.24254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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20
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Foster HE, Eltringham MS, Kay LJ, Friswell M, Abinun M, Myers A. Delay in access to appropriate care for children presenting with musculoskeletal symptoms and ultimately diagnosed with juvenile idiopathic arthritis. ACTA ACUST UNITED AC 2007; 57:921-7. [PMID: 17665486 DOI: 10.1002/art.22882] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To document pathways of care, management, and interval from onset of symptoms to first pediatric rheumatology multidisciplinary team (PRhMDT) assessment for children with incident juvenile idiopathic arthritis (JIA). METHODS We conducted a retrospective observational study of children with incident JIA over a 3-year period. RESULTS The study included 152 patients with JIA (87 females). The median interval from symptom onset to first PRhMDT assessment was 20 weeks (range 0-416), with significant variation between JIA subtypes (P = 0.0097); children with extended oligoarticular JIA had the longest interval (median 60 weeks, range 12-320). Prior to pediatric rheumatology assessment, many children had referrals to multiple secondary care specialties and had been subjected to multiple and often invasive procedures including arthroscopy/synovial biopsy (18 [11.8%] of 152), but none were referred for ophthalmologic screening, physical therapy, or nursing input and a diagnosis of JIA was rarely made (98%). At first PRhMDT assessment, most patients had untreated active disease with active joint count >or=1 (135 [89%] of 152), restricted joint count >or=1 (135 [89%] of 152), and functional disability by Child Health Assessment Questionnaire score >0 (53 [68%] of 118); 1 child had undetected uveitis. Following PRhMDT assessment, interventions were invariably indicated, including joint injections (69 [45%] of 152), methotrexate (49 [32%] of 152), and physical therapy programs (all patients). CONCLUSION Delay in access to pediatric rheumatology assessment is common with complex pathways of referral. Many children were subjected to inappropriate invasive investigations and many had prolonged untreated active disease at the initial PRhMDT assessment. This delay is likely to affect long-term outcome and warrants further exploration.
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Affiliation(s)
- H E Foster
- Musculoskeletal Research Group, School Clinical Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
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21
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Foster HE, Kay LJ, Friswell M, Coady D, Myers A. Musculoskeletal screening examination (pGALS) for school-age children based on the adult GALS screen. ACTA ACUST UNITED AC 2006; 55:709-16. [PMID: 17013854 DOI: 10.1002/art.22230] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To develop and validate a musculoskeletal screening examination applicable to school-age children based on the adult Gait, Arms, Legs, Spine (GALS) screen. METHODS Adult GALS was tested in consecutive school-age children attending pediatric rheumatology clinics and was compared with an examination conducted, on the same day, by a pediatric rheumatologist who classified children as having abnormal or normal joints. Adult GALS was tested for validity compared with the pediatric rheumatologist's assessment and deficiencies in adult GALS were identified. Experts proposed amendments to adult GALS, achieving consensus by modified Delphi techniques. The resultant pediatric screening tool (pGALS) was tested (methodology identical to the testing of adult GALS) in an additional group of children. RESULTS Adult GALS was tested in 50 children (median age 11 years, range 4-16), of whom 37 (74%) had juvenile idiopathic arthritis. Adult GALS missed important abnormalities in 18% of children, mostly at the ankle, foot, and temporomandibular joints. The pGALS was tested in 65 children (median age 13 years, range 5-17 years) and demonstrated excellent sensitivity (97-100%) and specificity (98-100%) at all joints, with high acceptability scored by child and parent/guardian. The median time to perform pGALS was 2 minutes (range 1.5-3 minutes). CONCLUSION The pGALS musculoskeletal screening tool has excellent validity, is quick to perform, and is acceptable to school-age children and parents/guardians. We propose that pGALS be incorporated into undergraduate and postgraduate medical training to improve pediatric musculoskeletal clinical skills and facilitate diagnosis and referral to specialists.
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Affiliation(s)
- H E Foster
- The Medical School, University of Newcastle upon Tyne, Newcastle, UK.
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22
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Peake NJ, Khawaja K, Myers A, Nowell MA, Jones SA, Rowan AD, Cawston TE, Foster HE. Interleukin-6 signalling in juvenile idiopathic arthritis is limited by proteolytically cleaved soluble interleukin-6 receptor. Rheumatology (Oxford) 2006; 45:1485-9. [PMID: 16690760 DOI: 10.1093/rheumatology/kel154] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Interleukin-6 (IL-6) exerts multiple effects on chondrocytes and fibroblasts within the joint and is associated with disease activity in juvenile idiopathic arthritis (JIA). Although these cells express the ubiquitous signalling receptor for all IL-6-related cytokines, gp130, they do not express a cognate IL-6 receptor. Consequently, IL-6 responses within these cells occur via IL-6 trans-signalling relying on the presence of a soluble receptor (sIL-6R). Levels of sIL-6R in vivo are governed by either proteolytic cleavage (PC) of cognate receptor or by differential sIL-6R mRNA splicing (DS). The aim of this study was to evaluate the contribution of both isoforms to clinical parameters associated with IL-6 signalling in JIA. METHODS IL-6, sIL-6R and DS-sIL-6R were measured by ELISA in serum and synovial fluid (SF) samples from 86 JIA patients. These data were related to indicators of inflammation-erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) and compared between patients stratified by subtype, age and disease duration. RESULTS SF IL-6 significantly correlated with general indicators of activity (ESR and CRP) and SF PC-sIL-6R to a lesser degree with CRP. When the IL-6:sIL-6R ratio was calculated as an indicator of the potential for IL-6 signalling within the joint, 33% of SF samples showed a ratio >1 indicating saturation of sIL-6R by IL-6. Mean DS-sIL-6R levels were 0.71 ng/ml, whereas PC-sIL-6R levels constituted the majority of sIL-6R at 20.89 ng/ml. CONCLUSIONS IL-6 trans-signalling within the joints of JIA patients is predominantly governed by the presence of PC-sIL-6R, and the data provided suggest that synovial levels of IL-6 and sIL-6R would be sufficient to drive IL-6 responses in chondrocytes and synovial fibroblasts.
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Affiliation(s)
- N J Peake
- Musculoskeletal Research Group, Medical School Cookson Building, University of Newcastle-upon-Tyne, UK
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23
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Ferreira RA, Vastert SJ, Abinun M, Foster HE, Modesto C, Olivé T, Kuis W, Wulffraat NM. Hemophagocytosis during fludarabine-based SCT for systemic juvenile idiopathic arthritis. Bone Marrow Transplant 2006; 38:249-51. [PMID: 16770315 DOI: 10.1038/sj.bmt.1705415] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Waterhouse PJ, Thomason JM, Fitzgerald JF, Foster HE, Steen IN, Welbury RR. The dental attitudes, knowledge and health practices of patients with Juvenile Idiopathic Arthritis. Eur J Paediatr Dent 2005; 6:202-8. [PMID: 16426120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
AIM To investigate the dental attitudes, knowledge and dental health practices of children and adults with a previous diagnosis of Juvenile Idiopathic Arthritis (JIA). STUDY DESIGN A self-completion questionnaire. METHODS Ninety-one children and 82 adults with JIA were age and gender matched with 152 healthy controls. For those below the age of 16 years, the parents' attitude, knowledge and dental health practices were investigated by the questionnaire. The adult subjects and controls completed an identical questionnaire assessing their own attitude, knowledge and dental health practices. RESULTS Response rates of 84% and 75% were achieved for the subject and controls respectively. Both groups responded similarly to questions assessing perception of different medical conditions. The majority of respondents thought leukaemia was a very serious condition. Twenty-seven percent of subjects and 34% of controls felt dental decay was "slightly or not serious". Ninety percent of subjects and 93% of controls knew having sweet snacks during the day would harm teeth, but fewer were sure that eating sweet foods at mealtimes only would help reduce decay. The majority of respondents (63% and 56% respectively) did not know whether children should receive fluoride tablets but the majority of subjects in both groups had attended a dentist within the last year. STATISTICS Descriptive analyses and chi-squared analysis were undertaken. A p-value of < or =0.01 was taken as strong evidence of a difference between groups. CONCLUSION The perception of health and illness by both groups was appropriate. The questions investigating dental knowledge revealed understanding of the basic messages of prevention of dental disease, but finer detail appeared less well understood. Responses concerning dental health confirmed positive attitudes towards good dental health habits. The benefits of brushing with fluoride toothpaste were known, and the majority toothbrushed daily and received dental care within the previous year.
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Affiliation(s)
- P J Waterhouse
- School of Dental Sciences, University of Newcastle upon Tyne, Newcastle upon Tyne, UK.
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Peake NJ, Foster HE, Khawaja K, Cawston TE, Rowan AD. Assessment of the clinical significance of gelatinase activity in patients with juvenile idiopathic arthritis using quantitative protein substrate zymography. Ann Rheum Dis 2005; 65:501-7. [PMID: 16150790 PMCID: PMC1798108 DOI: 10.1136/ard.2005.039032] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To measure gelatinase activities in paired synovial fluid (SF) and serum of patients with juvenile idiopathic arthritis (JIA), and to assess how these activities relate to clinical and laboratory measures of disease activity. METHODS A quantitative protein substrate zymography method was adapted and validated for use with serum and SF. Bands of activity were measured by densitometry and correlated with standard laboratory indicators of inflammation: erythrocyte sedimentation rate and platelet count. RESULTS Gelatinase activity was found consistently in patients with JIA, with reproducible, quantified bands of activity corresponding to pro-matrix metalloproteinase-9 (pro-MMP-9), including the neutrophil associated lipocalin complex, and pro- and active forms of MMP-2. Both active MMP-2 and pro-MMP-9 were higher in JIA serum than in controls, though no differences were seen between patients grouped according to age, disease duration, or JIA subtype. However, SF MMP-9 correlated significantly with the laboratory indicators of inflammation, as did the relative level of active MMP-2. CONCLUSIONS Both MMP-2 and MMP-9 gelatinolytic activities are raised during active JIA and associated with inflammatory activity regardless of age and disease duration, supporting a role for MMPs in the breakdown of joint components from early in disease. These MMPs may be specific markers of active joint destruction linked to inflammatory JIA, MMP-9 as a product of infiltrating cells, and the activation of MMP-2 produced within the joint.
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Affiliation(s)
- N J Peake
- Musculoskeletal Research Group, School of Clinical Medical Sciences, Medical School Cookson Building, University of Newcastle upon Tyne, NE2 4HH, UK
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Peake NJ, Khawaja K, Myers A, Jones D, Cawston TE, Rowan AD, Foster HE. Levels of matrix metalloproteinase (MMP)-1 in paired sera and synovial fluids of juvenile idiopathic arthritis patients: relationship to inflammatory activity, MMP-3 and tissue inhibitor of metalloproteinases-1 in a longitudinal study. Rheumatology (Oxford) 2005; 44:1383-9. [PMID: 16049050 DOI: 10.1093/rheumatology/kei025] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To measure levels of the collagenases matrix metalloproteinase (MMP)-1 and -13 in the synovial fluid (SF) and serum of patients with juvenile idiopathic arthritis (JIA), and to correlate these measurements with inflammatory activity, levels of the collagenase activator MMP-3 and the tissue inhibitor of metalloproteinases-1 (TIMP-1). METHODS Levels of MMP-1, -3, -13 and TIMP-1 were measured in paired SF and serum from 82 JIA patients using enzyme-linked immunsorbent assay and compared between subtypes and patients of different ages and disease durations. These levels were also correlated to the active joint count (AJC) and standard measures of inflammatory activity and therapeutic response, including erythrocyte sedimentation rate (ESR) and platelet count (PLT). RESULTS MMP-1 was detected in JIA SF and correlated with PLT. MMP-3 levels were high in SF and detectable in serum where they correlated with PLT, ESR and AJC. MMP-13, however, was not detected in SF or serum. No differences were observed between patients grouped by subtype, age or disease duration. MMP-3 contributed the majority of total MMP in SF samples resulting in excess MMP levels over TIMP-1. CONCLUSIONS MMP-1 is up-regulated in SF concordant with inflammatory activity in JIA. This was true for patients in all JIA subtypes and age groups, suggesting that the capability for degradation of type II collagen is present in early disease, and throughout the disease course. MMP-3 may be important in the activation of collagenases and the saturation of exogenous inhibitors. Serum MMP-3 may therefore be a useful, measurable and specific marker of active disease in JIA.
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Affiliation(s)
- N J Peake
- Musculoskeletal Research Group, School of Clinical Medical Sciences, University of Newcastle-upon-Tyne, UK
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De Kleer IM, Brinkman DMC, Ferster A, Abinun M, Quartier P, Van Der Net J, Ten Cate R, Wedderburn LR, Horneff G, Oppermann J, Zintl F, Foster HE, Prieur AM, Fasth A, Van Rossum MAJ, Kuis W, Wulffraat NM. Autologous stem cell transplantation for refractory juvenile idiopathic arthritis: analysis of clinical effects, mortality, and transplant related morbidity. Ann Rheum Dis 2004; 63:1318-26. [PMID: 15361393 PMCID: PMC1754760 DOI: 10.1136/ard.2003.017798] [Citation(s) in RCA: 113] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To evaluate the safety and efficacy of autologous stem cell transplantation (ASCT) for refractory juvenile idiopathic arthritis (JIA). DESIGN Retrospective analysis of follow up data on 34 children with JIA who were treated with ASCT in nine different European transplant centres. Rheumatological evaluation employed a modified set of core criteria. Immunological reconstitution and infectious complications were monitored at three month intervals after transplantation. RESULTS Clinical follow up ranged from 12 to 60 months. Eighteen of the 34 patients (53%) with a follow up of 12 to 60 months achieved complete drug-free remission. Seven of these patients had previously failed treatment with anti-TNF. Six of the 34 patients (18%) showed a partial response (ranging from 30% to 70% improvement) and seven (21%) were resistant to ASCT. Infectious complications were common. There were three cases of transplant related mortality (9%) and two of disease related mortality (6%). CONCLUSIONS ASCT in severely ill patients with JIA induces a drug-free remission of the disease and a profound increase in general wellbeing in a substantial proportion of patients, but the procedure carries a significant mortality risk. The following adjustments are proposed for future protocols: (1) elimination of total body irradiation from the conditioning regimen; (2) prophylactic administration of antiviral drugs and intravenous immunoglobulins until there is a normal CD4+ T cell count.
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Affiliation(s)
- I M De Kleer
- Paediatric BMT unit, Suite KC 03.063, University Medical Centre Utrecht, PO box 85090, 3508 AB Utrecht, Netherlands
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Myers A, McDonagh JE, Gupta K, Hull R, Barker D, Kay LJ, Foster HE. More 'cries from the joints': assessment of the musculoskeletal system is poorly documented in routine paediatric clerking. Rheumatology (Oxford) 2004; 43:1045-9. [PMID: 15187245 DOI: 10.1093/rheumatology/keh245] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The aim of this study was to describe the assessment of the musculoskeletal (MSK) system in comparison with other systems in routine paediatric medical clerking. Furthermore, to survey trainee paediatricians (SPRs, specialist registrars) about their self-rated confidence in assessing the MSK system. METHODS Case notes of consecutive general paediatric medical patients admitted to three UK hospitals over a 4-week period were assessed using a standard pro forma. All patients had been assessed by a consultant paediatrician during their admission. A postal questionnaire was sent to all SPRs in training in each of the hospitals, regarding their confidence in assessing the MSK system compared with other systems and their exposure to MSK teaching. RESULTS Case notes of 257 patients [117 females, median age 3 yr (range 1-18 yr)] were reviewed. The most common reason for admission was acute infection, although the spectrum of other recorded diagnoses varied between hospitals. Thirteen children (5%) had an acute problem (e.g. infection) against a background of chronic disease. The case note documentation showed that cardiovascular (CVS), respiratory (RS) and gastrointestinal (GI) systems were assessed in the vast majority (>90%) of patients, irrespective of the underlying diagnosis. However, other systems were less well recorded; the trend being the same in each hospital and in descending order, the neurological system (38%), skin (32%), eyes (10%) and musculoskeletal system (4%). Only 2.7% (7/257) patients were documented to have been asked about MSK symptoms, and only 1.6% (4/257) had any documentation of joint examination--in all cases this was limited (e.g. range of movement of the knee only), and no patients had documentation of gait being examined, even in those children presenting with 'limp'. The response rate to the postal questionnaire was 60% (67/112). The self-rated confidence in MSK assessment was markedly low in comparison with other systems, even though 61/67 recalled some teaching of the MSK system as an undergraduate (61/67) or postgraduate (50/67). Of note none could recall teaching as an undergraduate in paediatric MSK assessment and where there had been postgraduate rheumatology MSK teaching this had been delivered by paediatric rheumatologists in many cases (34/50), reflecting the centres participating in the study. CONCLUSIONS In routine general paediatric medical in-patient clerking and throughout the admission, MSK assessment was rarely documented, and even where present was limited. This contrasts markedly with other systems which were examined in most children irrespective of the presenting complaint. Self-rated confidence in MSK assessment is low amongst SPRs compared with other systems, despite most recalling some teaching. This discrepancy between teaching and clinical practice needs to be addressed in undergraduate and postgraduate training.
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Affiliation(s)
- A Myers
- Department of Rheumatology, University of Newcastle upon Tyne, UK.
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Kay LJ, Baggott G, Coady DA, Foster HE. Musculoskeletal examination for children and adolescents: do standard textbooks contain enough information? Rheumatology (Oxford) 2004; 42:1423-5. [PMID: 14578443 DOI: 10.1093/rheumatology/keg357] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Welbury RR, Thomason JM, Fitzgerald JL, Steen IN, Marshall NJ, Foster HE. Increased prevalence of dental caries and poor oral hygiene in juvenile idiopathic arthritis. Rheumatology (Oxford) 2003; 42:1445-51. [PMID: 12810923 DOI: 10.1093/rheumatology/keg395] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Recent decades have seen a trend to treat juvenile idiopathic arthritis (JIA) with increasing immunosuppression to improve the long-term outcome. Poor oral hygiene and dental decay cause significant morbidity, and patients with chronic disease (who may be further immunocompromised by treatment) are at greater risk. This study investigated patients with JIA using standard measures of oral health. METHODS One hundred and forty-nine patients with JIA were included. The children were attending a regional paediatric rheumatology service and the adults were attending an adult rheumatology clinic. Random age- and sex-matched healthy controls were recruited from a dental teaching hospital. The structured dental examination included standard epidemiological indices of oral hygiene (gingival index, plaque index, oral cleanliness index) and dental decay [DMFT (decayed, missing or filled teeth) index]. RESULTS JIA patients, at all ages, had increased levels of dental decay and poor oral hygiene. This increased level of decay was statistically significant in the patients aged 0-11 yr. Significant levels of untreated caries and increased levels of missing teeth were found in JIA, suggesting that patients with JIA had less restorative dental treatment, with tooth extraction often the chosen option for the treatment of dental decay. CONCLUSIONS This is the largest study of oral health in JIA and is cross-sectional with non-diseased controls. It shows significantly increased levels of poor oral hygiene and dental decay in patients with JIA. The high levels of untreated dental decay suggest barriers to dental care. These results emphasize the role of regular dental care in the multidisciplinary management of JIA.
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Affiliation(s)
- R R Welbury
- Glasgow Dental Hospital and School, University of Glasgow and North Glasgow NHS Trust, UK.
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Affiliation(s)
- L R Wedderburn
- Rheumatology Unit, Institute of Child Health, UCL and Great Ormond Street Hospital NHS Trust, London, UK.
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Welbury RR, Thomason JM, Fitzgerald JL, Steen IN, Foster HE. Type and extent of enamel defects in juvenile idiopathic arthritis (JIA). Eur J Paediatr Dent 2002; 3:217-21. [PMID: 12870996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
AIM To establish whether there is an increased prevalence and extent of enamel defects associated with Juvenile Idiopathic Arthritis (JIA) in patients in the North of England. STUDY DESIGN clinical examination of subjects and age and sex matched controls. METHODS The labial surfaces of all erupted permanent teeth in subjects, as well as age and sex matched controls, were examined. They were classified for type and extent of defects according to the Modified DDE index. The records of 146 subjects and 142 controls were available for analysis. STATISTICS defects were expressed as the percentage of subjects or controls with or without any defects or specific types of defect. Fisher's exact test was used to compare the prevalence of disease in the two groups with significance being accepted at the 5% level. In addition, 95% confidence intervals for the relative risk of disease in the two groups were derived. RESULTS There was no significant difference between subjects and controls for the presence of any type of defect (p=0.48), demarcated opacities (p=0.39), diffuse opacities (p=0.71), or hypoplasias (p=0.19). There was no significant increase in severity of defects in subjects compared with controls. There was also no significant difference when comparing the group diagnosed before the age of 4 (0-3) and the group diagnosed after the age of 4 (>4) years. CONCLUSION There was no greater overall prevalence of enamel defects or specific type of defects and no greater extent of them in subjects with JIA compared with age and sex matched controls.
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Affiliation(s)
- R R Welbury
- Glasgow Dental Hospital and School, University of Glasgow and North Glasgow NHS Trust, Glasgow, UK
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Abstract
OBJECTIVES To investigate whether there are any differences in salivary flow rates and saliva composition that may contribute to the reported increase in caries prevalence in patients with juvenile idiopathic arthritis (JIA). DESIGN Randomized controlled trial. SETTING The sialochemistry of children with JIA has rarely been investigated. METHODS Unstimulated and stimulated whole saliva was collected from 17 randomly selected JIA patients and 17 age and sex matched controls. Both samples were analysed for salivary flow rate, pH, calcium and phosphate. RESULTS Unstimulated and stimulated JIA saliva flow rates, and the flow rate change from unstimulated to stimulated in JIA saliva were all significantly lower than the controls. There were no significant differences in the pH of unstimulated and stimulated JIA saliva compared with the controls, however, the change in pH (from unstimulated to stimulated) in the study group was significantly greater. The JIA patients had non-significantly lower levels of both calcium and phosphate ions in the unstimulated and stimulated samples. CONCLUSIONS This data would suggest that there is both a reduced resting salivary flow and a reduced response to stimulation in JIA patients, which may contribute to a previously reported higher caries prevalence.
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Ikeda K, Wada Y, Sanematsu H, Foster HE, Shin D, Weiss RM, Latifpour J. Regulatory effect of experimental diabetes on the expression of endothelin receptor subtypes and their gene transcripts in the rat adrenal gland. J Endocrinol 2001; 168:163-75. [PMID: 11139780 DOI: 10.1677/joe.0.1680163] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Endothelins (ETs) mediate paracrine control of vascular tone and secretion of steroids and catecholamines in the adrenal gland through two ET receptor subtypes, ETA and ETB. The differential distribution and function of these subtypes are responsible for the multiplicity of endothelin actions in this tissue. This study examines the regulatory effects of experimental diabetes on the gene expression, subtype specificity and localization of ET receptor subtypes, ET isopeptides, and endothelin-converting enzyme-1 (ECE-1) in the rat adrenal gland. The densities, pharmacological properties and distribution of ET receptor subtypes ETA and ETB in adrenal glands from streptozotocin-induced diabetic, insulin-treated diabetic and age-matched control rats were investigated, using radioligand receptor binding and autoradiographic techniques. The gene expression of ETA and ETB receptors ET-1, ET-3 and ECE-1 was evaluated using relative multiplex reverse transcription/PCR. The induction of diabetes caused a marked reduction in body weight but no significant change in adrenal gland size. The density of ET receptors was significantly increased in the diabetic rat adrenal gland, mainly because of an increase in the expression of ETB receptors. Insulin treatment normalized the diabetes-induced changes in the expression levels of ET receptor subtypes to control levels. The expression level of ET-1 mRNA was up-regulated, whereas ET-3 mRNA was down-regulated in the diabetic adrenal gland compared with the controls. The ECE-1 mRNA level in the adrenal gland was not altered by the induction of diabetes. Autoradiographic studies showed that ETA and ETB are the predominant receptor subtypes in the adrenal medulla and cortex respectively. These results suggest that ETA and ETB receptors are differentially distributed and regulated in the diabetic rat adrenal gland.
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Affiliation(s)
- K Ikeda
- Department of Urology, Kumamoto University School of Medicine, Kumamoto, Japan
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Brown TM, Korting GE, Smith SD, Wheeler MA, Weiss RM, Foster HE. RE: A RANDOMIZED DOUBLE-BLIND TRIAL OF ORAL L-ARGININE FOR TREATMENT OF INTERSTITIAL CYSTITIS. J Urol 2000. [DOI: 10.1097/00005392-200011000-00059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Olsson LE, Anderson KR, Foster HE. Small bowel perforation after extracorporeal shock wave lithotripsy. J Urol 2000; 164:775. [PMID: 10953147 DOI: 10.1097/00005392-200009010-00038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- L E Olsson
- Section of Urology, Department of Surgery, Yale University School of Medicine, New Haven, CT, USA
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Nishi K, Wada Y, Saito M, Foster HE, Weiss RM, Latifpour J. Properties of alpha-1-adrenergic receptors in the rat prostate: effect of experimental diabetes. Urol Int 2000; 61:147-53. [PMID: 9933834 DOI: 10.1159/000030311] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We studied the effects of 8 weeks of streptozotocin (STZ)-induced diabetes on the density and the pharmacological properties of alpha1-adrenoceptors in the rat prostate using receptor-binding experiments with [125I]iodo-2[beta-(4-hydroxyphenyl)-ethylaminomethyl]tetralone [125I]HEAT. Saturation experiments showed the presence of specific [125I]HEAT-binding sites in the control and diabetic rat prostate and that the induction of diabetes significantly decreased the density of [125I]HEAT-binding sites in the rat prostate. [125I]HEAT-binding sites in the prostate of both groups were inhibited by prazosin (nonselective), spiperone (alpha1B-selective), WB4101 and 5-methylurapidil (alpha1A-selective) and BMY7378 (alpha1D-selective) with the following rank order of Ki values: prazosin < WB4101 < 5-methylurapidil < spiperone < BMY7378, indicating a similar pharmacological profile of alpha1-adrenoceptor in the 2 groups. Comparing the Ki values of the rat prostate with those obtained from the rat submaxillary gland (alpha1A), rat spleen (alpha1B), rat vas deferens (alpha1A + alpha1B) and those reported for cloned alpha1D, indicates the predominance of the alpha1A + alpha1B or the alpha1A subtype in the rat prostate. The present study demonstrates that STZ-induced diabetes downregulates the expression of alpha1-adrenoceptor in the rat prostate, without significantly affecting the receptor subtype specificity.
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MESH Headings
- Adrenergic alpha-Antagonists/pharmacology
- Analysis of Variance
- Animals
- Binding Sites
- Culture Techniques
- Diabetes Mellitus, Experimental/chemically induced
- Diabetes Mellitus, Experimental/metabolism
- Disease Models, Animal
- Down-Regulation
- Linear Models
- Male
- Prostate/drug effects
- Prostate/metabolism
- Rats
- Rats, Sprague-Dawley
- Receptors, Adrenergic, alpha/classification
- Receptors, Adrenergic, alpha/drug effects
- Receptors, Adrenergic, alpha/metabolism
- Reference Values
- Spleen/metabolism
- Streptozocin
- Submandibular Gland/metabolism
- Vas Deferens/metabolism
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Affiliation(s)
- K Nishi
- Section of Urology, Yale University School of Medicine, New Haven, Conn. 06520, USA
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Saito M, Wada Y, Ikeda K, Wang Z, Foster HE, Smith SD, Weiss RM, Latifpour J. Expression of endothelin receptor subtypes and their messenger RNAs in diabetic rat prostate: effect of insulin treatment. Mol Cell Biochem 2000; 210:1-12. [PMID: 10976752 DOI: 10.1023/a:1007041909477] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Streptozotocin (STZ)-induced diabetes causes an upregulation in the expression of endothelin (ET) receptors in the rat prostate (Eur J Pharmacol 310:197, 1996). We examined the effects of insulin treatment, started 8 weeks after the induction of diabetes, on the expression and distribution of ET receptors and their respective mRNAs in the rat prostate. The densities, pharmacological properties and distribution of ET receptors in the rat prostate were examined using radioligand receptor binding and autoradiographic studies, and gene expression of ET receptors was evaluated utilizing the reverse transcription-polymerase chain reaction (RT-PCR). STZ-injected rats had smaller prostates and reduced serum testosterone levels than control and insulin treated diabetic animals. ET receptor density was shown to be significantly higher in the prostate from diabetic rats than those from either control or insulin treated diabetic animals. The pharmacological profile of prostatic ET receptors was similar in all groups (approximately 80% ET(A); 20% ET(B) subtype). ET receptors were predominantly localized to the prostatic stroma. Induction of diabetes increased the expression of mRNA levels of ET(A) and ET receptors, and insulin treatment reversed this upregulation to control levels. These results indicate that (1) ET receptor subtypes are expressed in the rat prostate as transcription and translation products; (2) insulin can normalize the diabetes-induced upregulation in the expression of ET receptors and their respective mRNAs; and (3) diabetes-induced regression of the prostate may involve an alteration in ET receptors.
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MESH Headings
- Animals
- Autoradiography
- Blood Glucose/analysis
- Body Weight
- Diabetes Mellitus, Experimental/drug therapy
- Diabetes Mellitus, Experimental/metabolism
- Endothelin Receptor Antagonists
- Endothelin-1/metabolism
- Insulin/administration & dosage
- Insulin/blood
- Insulin/pharmacology
- Iodine Radioisotopes
- Male
- Organ Size
- Prostate/drug effects
- Prostate/metabolism
- Protein Isoforms
- RNA, Messenger/genetics
- RNA, Messenger/metabolism
- Radioligand Assay
- Random Allocation
- Rats
- Rats, Sprague-Dawley
- Receptor, Endothelin A
- Receptor, Endothelin B
- Receptors, Endothelin/agonists
- Receptors, Endothelin/genetics
- Receptors, Endothelin/metabolism
- Reverse Transcriptase Polymerase Chain Reaction
- Testosterone/blood
- Up-Regulation
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Affiliation(s)
- M Saito
- Section of Urology, Yale University School of Medicine, New Haven, Connecticut 06520, USA
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Ikeda K, Wada Y, Foster HE, Wang Z, Weiss RM, Latifpour J. Experimental diabetes-induced regression of the rat prostate is associated with an increased expression of transforming growth factor-beta. J Urol 2000; 164:180-5. [PMID: 10840456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
PURPOSE Transforming growth factor-beta (TGF-beta), a potent inhibitor of cell growth, plays an important role in the androgen-dependent processes of the prostate through a complex network of growth factors. TGF-beta expression in the prostate is under negative regulatory control of androgen. As experimental diabetes causes a regression of the prostate and decrease in serum testosterone levels in rats, we examined TGF-beta alterations at the mRNA and protein levels in the diabetic rat prostate. MATERIALS AND METHODS The expression of TGF-beta1 and TGF-beta2 and their respective mRNAs in prostates from streptozotocin (STZ)-induced diabetic, insulin-treated diabetic and age-matched control rats were investigated, using relative multiplex RT-PCR, semi-quantitative Western blotting, and immunohistochemistry. RESULTS Induction of diabetes caused a significant reduction in prostatic weight and in serum testosterone levels in rats. Both mRNA and protein levels of TGF-beta1, and mRNA level of TGF-beta2 were up-regulated in the diabetic rat prostate. Insulin-treatment normalized changes observed in prostatic weight and serum testosterone levels, and reversed the alterations in the TGF-beta1 and TGF-beta2 expression at the gene transcript and protein levels to control levels. Immunohistochemical studies demonstrated that TGF-beta1 is localized to prostatic stromal cells, whereas TGF-beta2 is located in both epithelial and stromal cells. CONCLUSION These results suggest that TGF-beta1 and TGF-beta2 may be involved in the diabetes-induced regression of the prostate gland.
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Affiliation(s)
- K Ikeda
- Section of Urology, Yale University School of Medicine, New Haven, Connecticut, USA
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McDonagh JE, Foster HE, Hall MA, Chamberlain MA. Audit of rheumatology services for adolescents and young adults in the UK. British Paediatric Rheumatology Group. Rheumatology (Oxford) 2000; 39:596-602. [PMID: 10888703 DOI: 10.1093/rheumatology/39.6.596] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Juvenile idiopathic arthritis (JIA) is associated with significant morbidity in adulthood with at least one third of children continuing to have active inflammatory disease into their adult years and up to 60% of all patients continuing to have some limitation of their activities of daily living. A survey of service provision for these young people in the transition from paediatric to adult rheumatology care was therefore undertaken. METHODS A postal questionnaire was sent to all 92 members of the British Paediatric Rheumatology Group, representing 61 units providing a paediatric rheumatology service in the UK and Eire. RESULTS Fifty-five replies were received representing a 60% completion rate of doctors and 84% of units on the mailing list. The majority of respondents were adult rheumatologists (n = 36, 65%) with 42% of respondents based in teaching hospitals. A median of 24 patients (new and follow-up, range 1-225) were seen in a median of two paediatric rheumatology clinics (range 0-15) per month. Eighteen per cent of units had a dedicated adolescent clinic (n = 9) with a median of one clinic per month and a median number of new patients per month of two (range 0-24) and 10 review patients (4-32). All the adolescent clinics involved an adult rheumatologist with five having a paediatrician in clinic and four having access to a paediatrician. The majority of clinics involved a specialist registrar (n = 6), a nurse specialist (n = 6), an occupational therapist (n = 6) and a physiotherapist (n = 5). The majority of clinics had flexible entry and exit criteria. In seven clinics there was a standardized process of transfer, first discussed at a median age of 13 yr (range 12-16) but no unit provided literature or organized pre-visits for this process. A demand for patient information resources (e.g. disease and drug information, careers) specifically aimed at adolescents with rheumatic diseases was identified. Generic health issues were only addressed by two clinics. Obstacles to current service provision and ideas for future developments were identified. CONCLUSIONS This survey identifies a heterogeneity of provision of healthcare for adolescents with rheumatic disease and highlights the potential for further research and development.
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Affiliation(s)
- J E McDonagh
- Great Ormond Street NHS Trust, London, Birmingham, UK
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Abstract
OBJECTIVE To assess fibroblast growth factor-2 (FGF2/bFGF), which is important in the development and maintenance of the normal prostate and in the development of human benign prostatic hyperplasia (BPH) and prostatic carcinoma, in an animal model of experimentally induced diabetes. Materials and methods Using Western blotting and immunohistochemical analyses, the expression of FGF2 in prostates from several groups of rats was investigated. Rats had diabetes for 8 or 16 weeks (induced by intravenous injection with 65 mg/kg streptozotocin); rats were also treated with insulin (starting 8 weeks after the induction of diabetes, for 8 weeks), and two further groups acted as age-matched control rats. Immunohistochemical markers for smooth muscle (alpha-actin) and epithelium (cytokeratin) were used to distinguish different cell types in adjacent prostatic sections. RESULTS Diabetic rats had smaller prostates and lower serum testosterone levels than their controls; insulin treatment of diabetic rats increased prostatic size and testosterone levels. As shown by Western blotting, diabetes caused greater FGF2 expression than in controls, whereas reverse-transcriptase polymerase chain reaction studies showed similar levels of prostatic FGF-2 mRNA in all groups. Immuno-histochemical studies showed that FGF-2 was expressed in both stromal and epithelial components of the rat prostate. Furthermore, although the expression of FGF2 was higher in epithelial than stromal cells in control prostates, it was distributed uniformly in the diabetic prostate. CONCLUSION The differences in the level of expression and pattern of distribution of FGF2 suggests a potential role for FGF2 in the changes observed in prostatic growth in diabetic rats.
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Affiliation(s)
- Z Wang
- Section of Urology, Yale University School of Medicine, New Haven Connecticut 06520, USA
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43
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Abstract
Juvenile idiopathic arthritis (JIA) results in significant morbidity that includes an adverse impact on oral health that is generally not well recognized. This review describes current literature which demonstrates poor oral health in children with JIA. The impact of JIA on oral health is probably multifactorial and these factors are discussed. This review emphasizes the role of paediatric dentistry in the multidisciplinary management of JIA and highlights the need for further research.
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Affiliation(s)
- A G Walton
- Department of Child Dental Health, The Dental Hospital and School, Richardson Road, Newcastle upon Tyne, UK
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Abinun M, Foster HE, Ramesh V, Craft AW. Heterogeneity of juvenile dermatomyositis. Lancet 2000; 355:1186. [PMID: 10791405 DOI: 10.1016/s0140-6736(05)72266-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Cooperberg MR, Chambers SK, Rutherford TJ, Foster HE. Cystic pelvic pathology presenting as falsely elevated post-void residual urine measured by portable ultrasound bladder scanning: report of 3 cases and review of the literature. Urology 2000; 55:590. [PMID: 10754180 DOI: 10.1016/s0090-4295(99)00565-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Dedicated portable ultrasound devices generally offer a rapid, noninvasive, largely operator-independent means of assessing post-void residual urine (PVR) volume. In most published series, PVR measured by portable ultrasound correlates well with catheterized urine volume. We report 3 cases in which follow-up of falsely elevated PVR measurements on ultrasound resulted in comparatively low catheterized volumes. In all 3 cases, the elevated readings were due to cystic ovarian pathology, which was diagnosed by formal radiologic evaluation and ultimately confirmed operatively in 2 cases. Cystic pathology of the pelvis or lower abdomen may present as an elevated PVR on ultrasound and low urine volume on subsequent catheterization and should prompt further evaluation.
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Affiliation(s)
- M R Cooperberg
- Department of Surgery, Section of Urology, Yale University School of Medicine, New Haven, Connecticut 06520-8041, USA
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Saito M, Wada Y, Ikeda K, Wang Z, Smith SD, Foster HE, Nishi K, Weiss RM, Latifpour J. Gene expression, localization, and pharmacological characterization of endothelin receptors in diabetic rat bladder dome. Eur J Pharmacol 2000; 387:253-63. [PMID: 10650170 DOI: 10.1016/s0014-2999(99)00753-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
As there are significant amounts of functional endothelin receptors in the mammalian urinary tract, we examined the effect of experimental diabetes on the expression of endothelin receptors and their mRNAs in the rat bladder dome. The density of endothelin receptors in the rat bladder dome was higher (8 and 16 weeks following the onset of diabetes) than in age-matched controls. Insulin treatment, started 8 weeks after the induction of diabetes, partially reversed the endothelin receptor alterations. The pharmacological profile of the endothelin receptors in the bladder dome was similar in all groups and was consistent with the predominance of the endothelin ET(A) receptor subtype (ET(A):ET(B)=approximately 4:1). Autoradiographic studies demonstrated that the endothelin receptors were located in all tissue components of the bladder, including epithelial and muscular layers. Semiquantitative reverse transcription-polymerase chain reaction (RT-PCR) data indicated that diabetes increased the expression level of gene transcripts for both endothelin receptor subtypes and that insulin treatment reversed the mRNA upregulation.
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Affiliation(s)
- M Saito
- Section of Urology, Yale University School of Medicine, P.O. Box 208041, 333 Cedar Street, New Haven, CT 06520, USA
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Korting GE, Smith SD, Wheeler MA, Weiss RM, Foster HE. A randomized double-blind trial of oral L-arginine for treatment of interstitial cystitis. J Urol 1999; 161:558-65. [PMID: 9915448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
PURPOSE Nitric oxide synthase activity is decreased in the urine of patients with interstitial cystitis compared to the urine of controls. In a preliminary trial oral L-arginine, the substrate for nitric oxide synthase, increased urinary nitric oxide synthase activity and improved interstitial cystitis symptoms. This randomized, double-blind, placebo controlled study further investigates the efficacy of L-arginine treatment for interstitial cystitis. MATERIALS AND METHODS A total of 53 interstitial cystitis patients were assigned to receive daily 1,500 mg. L-arginine or placebo orally for 3 months. Interstitial cystitis symptoms were assessed by interviews at 2 weeks, and 1, 2 and 3 months. RESULTS The trial was completed by 21 of 27 patients in the L-arginine group and 25 of 26 in the placebo group. Using per protocol analysis 29% (6 of 21 patients) in the L-arginine group and 8% (2 of 25) in the placebo group were clinically improved by the end of the trial (p = 0.07). A Likert scale showed greater global improvement in the L-arginine group (48%, 10 of 21) compared to the placebo group (24%, 6 of 25) at 3 months (p = 0.05) with a decrease in pain intensity (p = 0.04), and tendency toward improvement in urgency (p = 0.06) and frequency of pain (p = 0.09). Using an intention to treat approach to analysis there were no differences between groups. CONCLUSIONS Oral L-arginine (1,500 mg. daily) may decrease pain and urgency in a subset of interstitial cystitis patients.
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Affiliation(s)
- G E Korting
- Department of Surgery, Yale University School of Medicine, New Haven, Connecticut 06520-8041, USA
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Abstract
A review of the literature relating to juvenile chronic arthritis (JCA) is presented. It includes a description of the disease itself and identifies our knowledge of the increased risk of dental disease associated with this condition. In addition the impact of JCA therapy on the dental management of the patient is discussed. The review highlights the need for further research into the effects of the disease on dental caries, periodontal disease and saliva.
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Affiliation(s)
- A G Walton
- Department of Child Dental Health, Newcastle upon Tyne, UK
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Abstract
In general, for movements to visual targets, response times increase with the number of possible response choices. However, this rule only seems to hold when an incompatibility exists between the stimulus and response, and is absent when stimulus and response are highly compatible (e.g., when reaching toward the location of the stimulus). Stimulus-response (S-R) compatibility can be manipulated either at the level of stimulus and response characteristics, or at the level of the mapping between elements of the stimulus and response sets. The current study was undertaken to determine the extent of the interaction between choice and each of these two levels of S-R compatibility. Subjects used a joystick to move a cursor in response to two, four or eight possible cues, with S-R compatibility manipulated along two dimensions (type of stimulus, and mapping between stimulus and response sets) in separate blocks of trials. Choice effects were absent when S-R relationships were highly compatible, moderate when incompatible in either of the two dimensions, and greatest when incompatible in both dimensions. These results indicate that choice affects response selection at each stage in the decoding of S-R relationships. Similar but smaller effects were seen for trials in which the stimulus was the same as that presented in the immediately preceding trial, suggesting that repeated stimulus-response transformations are faster and more efficient due to the priming effects of previous trials.
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Affiliation(s)
- P Dassonville
- Brain Sciences Center (11B), Minneapolis VA Medical Center, One Veterans Drive, Minneapolis, MN 55417, USA
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Nishi K, Latifpour J, Saito M, Foster HE, Yoshida M, Weiss RM. Characterization, localization and distribution of alpha1 adrenoceptor subtype in male rabbit urethra. J Urol 1998; 160:196-205. [PMID: 9628650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE The subtype specificity, localization and distribution of urethral alpha1-adrenoceptors were studied in the male rabbit urethra. MATERIALS AND METHODS The properties of the urethral alpha1-adrenoceptors were investigated using radioligand receptor binding and light microscopic autoradiography with [125I]iodo-2-[b-(4-hydroxyphenyl)-ethylaminomethyl]tetralone (HEAT), and immunohistochemistry with monoclonal anti-alpha smooth muscle actin and anti-alpha sarcomeric actin antibodies. RESULTS Saturation experiments with [125I]HEAT demonstrated the presence of significant amounts of a single high affinity binding site for alpha1 adrenoceptors in the male rabbit urethra. The pharmacological profile of the alpha1 adrenoceptors in rabbit urethra, determined by inhibition experiments with subtype selective alpha1 adrenoceptor antagonists, was characterized by the following rank order of potency of inhibition constants (Ki values): prazosin < or = WB 4101 < spiperone < 5-methylurapidil < BMY 7378. The pKi values for the rabbit urethra were correlated with the pKi values for rat spleen, submaxillary glands, and vas deferens and for those reported for cloned alpha1d receptors with correlation coefficients of 0.68, 0.929, 0.909, and 0.523, respectively. CONCLUSIONS The pharmacological characterization demonstrates the predominance of alpha1A or alpha1A + alpha1B adrenoceptor subtype(s) in male rabbit urethral smooth muscle. Furthermore, the autoradiographic and immunohistochemical studies show a heterogeneous distribution of alpha1 adrenoceptors along the longitudinal axis of the urethra, within the smooth muscle fibers, with the receptors being localized more densely in the proximal than in the distal urethra.
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Affiliation(s)
- K Nishi
- Section of Urology, Yale University School of Medicine, New Haven, Connecticut 06520-8041, USA
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