Greenhouse Gas Inventory Model for Biochar Additions to Soil

Stabilizing the global climate within safe bounds will require greenhouse gas (GHG) emissions to reach net zero within a few decades. Achieving this is expected to require removal of CO2 from the atmosphere to offset some hard-to-eliminate emissions. There is, therefore, a clear need for GHG accounting protocols that quantify the mitigation impact of CO2 removal practices, such as biochar sequestration, that have the potential to be deployed at scale. Here, we have developed a GHG accounting methodology for biochar application to mineral soils using simple parameterizations and readily accessible activity data that can be applied at a range of scales including farm, supply chain, national, or global. The method is grounded in a comprehensive analysis of current empirical data, making it a robust method that can be used for many applications including national inventories and voluntary and compliance carbon markets, among others. We show that the carbon content of biochar varies with feedstock and production conditions from as low as 7% (gasification of biosolids) to 79% (pyrolysis of wood at above 600 °C). Of this initial carbon, 63-82% will remain unmineralized in soil after 100 years at the global mean annual cropland-temperature of 14.9 °C. With this method, researchers and managers can address the long-term sequestration of C through biochar that is blended with soils through assessments such as GHG inventories and life cycle analyses.

Natural climate solutions for Canada

Alongside the steep reductions needed in fossil fuel emissions, natural climate solutions (NCS) represent readily deployable options that can contribute to Canada's goals for emission reductions. We estimate the mitigation potential of 24 NCS related to the protection, management, and restoration of natural systems that can also deliver numerous co-benefits, such as enhanced soil productivity, clean air and water, and biodiversity conservation. NCS can provide up to 78.2 (41.0 to 115.1) Tg CO₂e/year (95% CI) of mitigation annually in 2030 and 394.4 (173.2 to 612.4) Tg CO₂e cumulatively between 2021 and 2030, with 34% available at ≤CAD 50/Mg CO₂e. Avoided conversion of grassland, avoided peatland disturbance, cover crops, and improved forest management offer the largest mitigation opportunities. The mitigation identified here represents an important potential contribution to the Paris Agreement, such that NCS combined with existing mitigation plans could help Canada to meet or exceed its climate goals.

Influence of two management practices in the Canadian Prairies on radiative forcing

Surface albedo and soil carbon sequestration are influenced by agricultural management practices which impact the Earth's radiation budget and climate change. In this study we investigate the impact of reduced summer fallowing and reduced tillage in the Canadian Prairies on climate change by estimating the change in radiative forcing due to albedo and soil carbon sequestration. Seasonal variations of albedo, which are dependent on agricultural management practices and soil colour in three soil zones, were derived from 10-day composite 250-m Moderate Resolution Imaging Spectroradiometer (MODIS) data. Using this information, we found an overall increase of surface albedo due to the conversion from summer fallowing to continuous cropping and from conventional tillage (CT) to either no-tillage (NT) or reduced tillage (RT). The increase was dependent on soil brightness, type of vegetation and snow cover. Using data from the Census of Agriculture and taking into consideration both albedo and soil carbon changes, we estimated that from 1981 to 2016, the total radiative forcing for the cropland area in the Canadian Prairies was -405 μW m^-2 due to the conversion of CT to either NT or RT and about 70% was due to the change in albedo. During the same period, the total radiative forcing was -410 μW m^-2 due to a reduction in the area under summer fallow and about 62% was due to the change in albedo. The equivalent atmospheric CO₂ drawdown from these two management changes from albedo change was about 7.8 and 8.7 Tg CO₂ yr^-1, respectively. These results demonstrate that it is important to consider both the changes of soil carbon and surface albedo in evaluating climate change impacts due to agricultural management practices.

How early can the seeding dates of spring wheat be under current and future climate in Saskatchewan, Canada?

Background

Shorter growing season and water stress near wheat maturity are the main factors that presumably limit the yield potential of spring wheat due to late seeding in Saskatchewan, Canada. Advancing seeding dates can be a strategy to help producers mitigate the impact of climate change on spring wheat. It is unknown, however, how early farmers can seed while minimizing the risk of spring frost damage and the soil and machinery constraints.

Methodology/principal findings

This paper explores early seeding dates of spring wheat on the Canadian Prairies under current and projected future climate. To achieve this, (i) weather records from 1961 to 1990 were gathered at three sites with different soil and climate conditions in Saskatchewan, Canada; (ii) four climate databases that included a baseline (treated as historic weather climate during the period of 1961–1990) and three climate change scenarios (2040–2069) developed by the Canadian global climate model (GCM) with the forcing of three greenhouse gas (GHG) emission scenarios (A2, A1B and B1); (iii) seeding dates of spring wheat (Triticum aestivum L.) under baseline and projected future climate were predicted. Compared with the historical record of seeding dates, the predicted seeding dates were advanced under baseline climate for all sites using our seeding date model. Driven by the predicted temperature increase of the scenarios compared with baseline climate, all climate change scenarios projected significantly earlier seeding dates than those currently used. Compared to the baseline conditions, there is no reduction in grain yield because precipitation increases during sensitive growth stages of wheat, suggesting that there is potential to shift seeding to an earlier date. The average advancement of seeding dates varied among sites and chosen scenarios. The Swift Current (south-west) site has the highest potential for earlier seeding (7 to 11 days) whereas such advancement was small in the Melfort (north-east, 2 to 4 days) region.

Conclusions/significance

The extent of projected climate change in Saskatchewan indicates that growers in this region have the potential of earlier seeding. The results obtained in this study may be used for adaptation assessments of seeding dates under possible climate change to mitigate the impact of potential warming.

First Report of Damping-Off of Durum Wheat Caused by Arthrinium sacchari in the Semi-Arid Saskatchewan Fields

Durum wheat (Triticum durum Desf.) is an important crop in western Canada. In 2005, Arthrinium sacchari was frequently isolated from soil and durum wheat plants of the semi-arid fields of Swift Current, Saskatchewan, Canada (50°16'N, 107°44'W). The susceptibility of durum wheat to damping-off caused by this fungus was evaluated. To our knowledge, this is the first report of A. sacchari in North America (1) and the first mention of its association with durum wheat. DNA was extracted (MoBio Isolation Kit, Carlsbad, CA) from 2-week-old A. sacchari isolates (FBC.3, FBC.45, and FBC.143) grown on PDA. The internal transcribed spacer (ITS) of the rDNA was amplified from each isolate and sequenced (Plant Biotechnology Institute, Saskatoon, SK, Canada) and similarity analyses were performed using the BLAST search algorithm in GenBank. All three sequences (Accession Nos. EF076710, EF076711, and EF076712A) showed 99% similarity with A. sacchari (Accession No. AF393679). An in vitro assay was performed by placing 1-cm² agar plugs containing mycelia of A. sacchari (FBC.3, FBC.45, and FBC.143) onto surface-sterilized durum. Surface-sterilized seeds inoculated in the same way with Fusarium graminearum or F. avenaceum were used as negative controls, and noninoculated surface-sterilized seeds were used as a positive control. A second in vitro assay involved inoculating the same isolates onto seeds placed in sterilized sandy soil. In both assays, 10 seeds per petri plate and three plates per treatment were used and plates were incubated at 21°C for 1 week in darkness. All experiments were performed twice. On PDA, preemergence damping-off was found in 60% of A. sacchari FBC.3, 55% of A. sacchari FBC.45 and FBC.143, 50% of F. avenaceum, and 58% of F. graminearum inoculated seeds. In sterilized soil, the incidence of preemergence damping-off ranged from 43 to 30%. Subsequent incubation over a period of 3 weeks resulted in 100% postemergence damping-off in A. sacchari FBC.45 and FBC.3 as well as in both Fusarium spp. inoculated controls, 60% postemergence damping-off in A. sacchari FBC.143, and no damping-off in the noninoculated control. Arthrinium and Fusarium spp. were reisolated only from symptomatic plants, satisfying Koch's postulates. In conclusion, durum wheat is highly susceptible to damping-off caused by A. sacchari, showing characteristic dark brown or violet lesions in infected tissues. A. sacchari was previously reported to be present in South America and eastern Asia. In China, it is considered an important mycotoxigenic species (2). Thus, infection of durum wheat crops with A. sacchari could pose a significant threat to North American wheat production. References: (1) D. F. Farr et al. Fungal Databases. Systematic Botany and Mycology Laboratory. Online publication. ARS, USDA, 2006. (2) X. J. Liu et al. Acta Mycol. Sinica 7:221, 1988.

Glomerulonephritis in rheumatoid arthritis

We present data on 10 patients with RA who developed glomerulonephritis which was not related to gold or penicillamine therapy. Although two of these patients had received gold this had been discontinued 13 and 18 yr before the diagnosis of glomerulonephritis. Seven patients presented with nephrotic syndrome and three with proteinuria and microscopic haematuria. Renal histology showed a membranous nephropathy (five patients), mesangial IgA nephropathy (two patients), focal segmental necrotizing glomerulonephritis (two patients) and focal segmental glomerulosclerosis (one patient).

Disease-modifying antirheumatic drugs: gold, penicillamine, antimalarials, and sulfasalazine

In the assessment of the effects of disease-modifying antirheumatic drugs, three or four clinical measurements supported by the erythrocyte sedimentation rate, and sometimes radiographs, are generally agreed to be correct. Some advocate functional assessments also, or even alternatively. Several studies compared gold, penicillamine, antimalarials, and sulfasalazine either with each other or with placebo, and occasionally with methotrexate. No important differences between the general performance of the four drugs were found. More work was reported on sulfasalazine than on the other three drugs; the data support that it has a place in our armamentarium. Several important contributions concerned strategies of treatment. It is considered that disease-modifying antirheumatic drugs should be used earlier and more aggressively in rheumatoid arthritis. This aspect was perhaps the key note of the 1990 literature on this topic. As part of the new strategies, combination therapy is urged by some rheumatologists, whereas others urge caution on the grounds that we do not yet know enough about the effects of combinations, or by how much the risks of adverse effects are increased in combination.

Chain breaking antioxidant status in rheumatoid arthritis: clinical and laboratory correlates

The ability of fresh sera to resist attack by peroxyl radicals (TRAP) was found to be significantly lower in 20 patients with rheumatoid arthritis (RA) than in 20 healthy controls, consistent with the existence of a redox stress in RA imposed by inflammation. TRAP values in RA varied inversely with a combination of visual analogue pain scale, duration of early morning stiffness, grip strength, and articular index (reflecting inflammatory activity) using multiple linear regression analysis. The concentration of the antioxidant vitamin ascorbic acid was lower in RA plasma and the oxidation-reduction equilibrium of ascorbic acid was disturbed, giving further support to the existence of a redox stress. The major determinant of TRAP in vitro was found to be serum uric acid in RA and serum vitamin E in controls. Serum urate concentration in RA correlated inversely with oxidative changes in serum albumin and IgG. It is suggested that serum urate might have an antioxidant role under certain conditions by limiting free radical induced oxidative changes to protein during inflammation.

Clinical and laboratory effects of prolonged therapy with sulfasalazine, gold or penicillamine: the effects of disease duration on treatment response

Serial observations for up to 5 years of clinical score (a subjective global assessment), serum C-reactive protein (CRP) and the erythrocyte sedimentation rate (ESR) were analyzed in 3 groups of patients with active rheumatoid arthritis (RA) requiring treatment with a second line drug. The groups comprised 315 patients (243 women, 72 men) who had sulfasalazine (SAS); 203 patients (141 women, 62 men) who had sodium aurothiomalate (gold) and 163 patients (131 women, 32 men) who had penicillamine. The groups matched in most respects but the gold group had a smaller proportion of women, a shorter median disease duration and a higher median CRP than the remaining 2 groups. The penicillamine group contained a higher proportion of seropositive patients. In each group there were significant improvements in clinical score, CRP and ESR for all time points from 6 to 30 months; these improvements were maintained for longer (up to 60 months for SAS) in the SAS and gold groups but the differences between the drugs after 30 months were probably a consequence of falling number of patients, not differing drug potencies. The mean ESR and CRP levels fell to about 30 mm/h and 20-30 mg/l, respectively. Response was defined as (1) treatment duration greater than 6 months, (2) clinical score improvement greater than 4 by 6 months, (3) ESR fall to less than 30 mm/h by 6 months. By these criteria 142 of 681 patients (20.9%) responded; the response rates were SAS 20.3%, gold 24.1%, penicillamine 17.8%.(ABSTRACT TRUNCATED AT 250 WORDS)

Measurement of conjugated diene lipids by derivative spectroscopy in heptane extracts of plasma

A series of experiments are described which show that second derivative spectroscopy can be used to quantify conjugated lipid dienes as markers of lipid peroxidation in heptane extracts of plasma from patients with rheumatoid arthritis, osteoarthritis, and healthy controls. Results obtained by this method gave reasonable agreement with those derived from the measurement of simple absorbance in chloroform/methanol extracts. Two minima were observed in the derivative spectrum of plasma lipid extracts. These minima occurred at 233 and 241 nm and corresponded to absorbance maxima in the conventional UV spectrum. Using a combination of phospholipase hydrolysis, reverse phase high performance liquid chromatography (HPLC) and second derivative spectroscopy we confirmed that these two minima can be attributed to a single fatty acid (9 cis-, 11 trans-linoleic acid) shown previously to account for greater than 90% of diene conjugation in human plasma samples. When the biological isomer 9 cis-, 11 trans-linoleic acid was separated by reverse phase HPLC from the mixture of other plasma phospholipid-2-esterified fatty acids we observed a change in derivative spectroscopy minima from 233 and 241 nm to 228 and 237 nm. Minima at the latter two wavelengths were also seen with pure preparations of the Paint Research Isomer (9 trans-, 11 trans-linoleic acid) which eluted later than biological 9 cis-, 11 trans-linoleic acid using reverse phase HPLC, suggesting that the absorption spectra of these pure cis-, trans and trans, trans dienes are similar but can be altered by the presence of other fatty acids in the extract.

It is said that elevated erythrocyte sedimentation rate and the elevation of C-reactive protein (CRP) may be indicators of continuing joint destruction in rheumatoid arthritis. What then is the explanation for joint destruction in some patients in whom there is no such apparent elevation of either the sedimentation rate of CRP?

It is said that elevated erythrocyte sedimentation rate and the elevation of C-reactive protein (CRP) may be indicators of continuing joint destruction in rheumatoid arthritis. What then is the explanation for joint destruction in some patients in whom there is no such apparent elevation of either the sedimentation rate or CRP?

Effects of rifampicin with and without isoniazid in rheumatoid arthritis

A patient with rheumatoid arthritis (RA) experienced great improvement in her RA when given antituberculous treatment for pulmonary tuberculosis (TB). Two of the drugs used in TB, rifampicin and isoniazid, include immunomodulatory effects among their properties. To investigate whether these drugs have any effect in RA, we studied 20 patients who were given either rifampicin 600 mg daily (10 patients) or rifampicin 600 mg with isoniazid 300 mg daily (10 patients). Eighteen patients completed at least 3 months' treatment. Six of the 7 patients with early RA (less than 3 years) improved; their median erythrocyte sedimentation rate fell from 43.5-10 mm/h (p = 0.036) and median serum C-reactive protein from 40-0 mg/l (p = 0.036). Eleven patients with longer histories of RA did not improve. Our results suggest rifampicin with or without isoniazid may be effective in RA.

Rheumatoid arthritis and IgA nephropathy

We describe four patients with seropositive rheumatoid arthritis who developed proteinuria and microscopic haematuria. Renal biopsy demonstrated a mesangial proliferative glomerulonephritis with mesangial deposits of IgA. These data suggest a possible causal relationship between rheumatoid arthritis and IgA nephropathy.

Long-term treatment of rheumatoid arthritis with sulphasalazine, gold, or penicillamine: a comparison using life-table methods

Life-table analysis was applied to the records of 317 patients with rheumatoid arthritis (RA) treated with sulphasalazine (SAS), 201 treated with sodium aurothiomalate (gold), and 163 with penicillamine. They comprised all those treated in our department with these drugs between January 1973 and July 1984. Risks of treatment termination for all reasons were similar for each drug at five years (gold 92%, penicillamine 83%, SAS 81%). The risk of treatment termination due to inefficacy was less for gold (29.5%) than for penicillamine (38.1%) or sulphasalazine (41.2%). Adverse effects, however, led to withdrawal of gold in 57%, penicillamine in 41.2%, and SAS in 37%; the most effective drugs appeared most toxic. Serious adverse effects were much more common in association with gold (17.4%) and penicillamine (12.3%) than with SAS (1.6%). Sulphasalazine appears as well tolerated over long periods in RA as gold or penicillamine and is associated with fewer serious adverse effects; of these drugs, it might therefore be considered the agent of first choice.

Sulphasalazine for rheumatoid arthritis: toxicity in 774 patients monitored for one to 11 years

Sulphasalazine is being used increasingly to treat rheumatoid arthritis, though its long term safety profile has not been established in this condition. The incidence and nature of adverse effects occurring in 774 patients with rheumatoid arthritis treated with sulphasalazine for periods ranging from one to 11 years were therefore noted. Altogether 205 of the patients stopped treatment permanently due to an adverse effect. One hundred and fifty six (76%) of these events occurred within three months and few beyond the first year. Most events were trivial and were self limiting after withdrawal of the drug; of the potentially more serious adverse effects, 33 (66%) occurred within three months of treatment. None of the patients died or suffered lasting ill effects. It is concluded that adverse effects of treatment with sulphasalazine are generally seen within three months; though regular monitoring is desirable during that period, thereafter few worrying problems occur.

Non-steroidal anti-inflammatory drugs and renal failure

In 3 years seventeen patients presented to one unit with renal failure associated with the use of non-steroidal anti-inflammatory drugs (NSAID). Seven patients presented with acute renal failure, in four due to acute tubular necrosis and in three to acute interstitial nephritis; all recovered when NSAID treatment was stopped. Four patients presented with symptomless renal impairment discovered during routine follow-up in a rheumatology clinic; again all improved on withdrawal of NSAID. The remaining six patients presented with chronic renal failure, a disorder not previously associated with NSAID treatment. The pattern of renal disease associated with NSAID may be more extensive than has previously been recognised. A history of NSAID use should be sought in all patients presenting with unexplained renal failure.

The effect of antirheumatic drugs on circulating immune complexes in rheumatoid arthritis

The relationship between antirheumatic drug treatment and levels of circulating immune complexes (125I-C1q binding activity) has been investigated in a prospective two-year study of patients with rheumatoid arthritis using the erythrocyte sedimentation rate (ESR) and serum C-reactive protein concentration as indices of disease activity. Twenty-eight patients were treated with non-steroid anti-inflammatory drugs, 14 patients had 'second line' drugs and 13 patients were treated with adrenal corticosteroids. Serum 125I-C1q binding activity did not change during non-steroid anti-inflammatory drug treatment; however, immune complex levels did fall during treatment with new (ICI 55,897, sulphasalazine) and established (gold, penicillamine) second line drugs. Serum 125I-C1q binding activity reflected the response to treatment shown by serum C-reactive protein and ESR. Serum C-reactive protein concentration and ESR fell with all doses of adrenal corticosteroids. In contrast, immune complex levels did not fall when doses of adrenal corticosteroids were below 20 mg/day prednisolone. 125I-C1q binding activity fell during high dose adrenal corticosteroid therapy (greater than 40 mg/day prednisolone; 1 g methylprednisolone infusions). Serial measurements of 125I-C1q binding activity correspond to ESR and the serum C-reactive protein concentration in distinguishing between anti-inflammatory drugs, which provide symptomatic relief only, and second line drugs which may retard disease progression. The fall in circulating immune complex levels during 'high' dose corticosteroid treatment, but not during 'low' dose treatment, suggests that corticosteroids have a dose-dependent effect on the immune system in addition to their anti-inflammatory properties.

Serum amyloid A protein during the treatment of rheumatoid arthritis with second-line drugs

Serum amyloid A protein (SAA), serum C-reactive protein (CRP) and the ESR were measured in 19 patients with rheumatoid arthritis before treatment and during therapy with gold, penicillamine or sulphasalazine for a mean period of 14.8 months (range 6-23 months). All three measurements decreased significantly; however, only 7% of SAA values fell to within the normal range (18-44 mg/l), compared to 38% measurements of serum CRP (less than 10 mg/l) and 32% of the ESR (less than 25 mm/h). In 8 (42%) of the 19 patients, SAA remained high (greater than 400 mg/l) for 3 months or more whilst serum CRP was depressed below 20 mg/l; this discrepancy was not related to particular drugs. We conclude that during treatment of rheumatoid arthritis with gold, penicillamine or sulphasalazine, SAA concentrations can be high when serum CRP and ESR are suppressed. SAA may be a more sensitive index of disease activity.

Does sulphasalazine cause folate deficiency in rheumatoid arthritis?

Sulphasalazine impairs folic acid absorption and metabolism but rarely leads to folate deficiency in inflammatory bowel disease (IBD). In rheumatoid arthritis (RA), however, serum and red cell folate concentrations are often low and sulphasalazine might stress folate metabolism. In a prospective study, 2 g sulphasalazine was compared with 500 mg penicillamine daily in 30 patients over 24 weeks. Pre-treatment serum and red cell folate concentrations were low-normal. Improvements in disease activity and haemoglobin occurred in both treatment groups, but MCV increased only in patients taking sulphasalazine. Serum and red cell folate concentrations did not change in either group. Increased MCV with sulphasalazine might therefore reflect reticulocytosis secondary to drug-induced haemolysis. The mechanisms by which sulphasalazine antagonizes folate metabolism are dose-dependent and, consequently, higher doses might precipitate folate deficiency.

Rheumatoid arthritis: the effects of treatment with dapsone on hemoglobin

Hemoglobin concentration (Hb) was measured at 6 week intervals for up to a year in 84 patients with rheumatoid arthritis treated with dapsone. During the first 6 weeks, mean Hb decreased from 12.0 to 11.0 g/dl (p less than 0.001). Falls in Hb occurred in 81% of patients but exceeded 2 g/dl in only 10%. After more than 6 weeks of treatment mean Hb increased, though a few individuals became anemic during this period. Anemia led to discontinuation of dapsone in 5 (6%) patients. Men and patients receiving corticosteroids had higher pretreatment Hb values; after falls in mean Hb at 6 weeks, recovery was more rapid in these 2 subgroups. Changes in Hb produced by 100 mg and 150 mg dapsone daily were similar.

Outcome of attempts to treat rheumatoid arthritis with gold, penicillamine, sulphasalazine, or dapsone

The outcome of attempts to continue treatment indefinitely with either gold, penicillamine, sulphasalazine, or dapsone was studied in 240 patients with rheumatoid arthritis (RA). The usual reason for discontinuing treatment was the occurrence of an adverse effect. This led to 53% of patients stopping gold, 33% sulphasalazine, 32% penicillamine, and 17% dapsone. The next most frequent reason was that the drug was ineffective, leading to discontinuation in 37% of patients having dapsone, 24% sulphasalazine, 19% penicillamine, and 16% gold. Other reasons for stopping treatment were infrequent. The high discontinuation rate of these drugs over 2 years in part accounts for the conflict of opinion on whether they can alter the course of RA; their efficacy must to a large extent be governed by their acceptability.

Comparison between penicillamine and sulphasalazine in rheumatoid arthritis: Leeds-Birmingham trial

Sulphasalazine was first formulated by Svartz in the early 1940s, specifically for use as a remission inducing drug in rheumatoid arthritis. After the publication of an unfavourable trial, however, the drug was restricted to patients with ulcerative colitis. In the late 1970s sulphasalazine was re-examined in rheumatoid arthritis and favourable results reported in "open" trials. A double blind controlled trial was therefore conducted comparing enteric coated sulphasalazine and D-penicillamine in patients with active rheumatoid arthritis. A total of 63 patients were recruited in two centres; 31 were treated with sulphasalazine and 32 received penicillamine. After 16 weeks' treatment both drugs had produced significant improvements in clinical score, pain score measured on a visual analogue scale, grip strength, Ritchie articular index, erythrocyte sedimentation rate, and serum C reactive protein concentration. Nausea was the major side effect in the sulphasalazine treated group. No potentially dangerous effects of sulphasalazine were encountered in contrast with those seen in the penicillamine group. The results suggest that sulphasalazine is an effective and safe drug capable of producing remissions in active rheumatoid arthritis. They also lend confidence to the use of preliminary "open" trials as a means of screening for remission inducing drugs in rheumatoid arthritis.

A comparison between clinical and laboratory tests in rheumatoid arthritis

Five clinical measurements (clinical score, articular index, visual analogue pain score, visual analogue function score, grip strength) were compared with two laboratory tests (the erythrocyte sedimentation rate and serum C-reactive protein concentration) in 68 patients with rheumatoid arthritis (RA). Patients treated with nonsteroid anti-inflammatory drugs showed clinical deterioration when treatment was interrupted, followed by improvement on resumption; there was no change in the laboratory tests. Patients treated with remission-inducing drugs (RIDs) had improved clinical measurements and also reduced erythrocyte sedimentation rate and serum C-reactive protein levels. Treatment with RID's led to similar trends in both clinical and laboratory tests, but correlation coefficients between the tests at intervals rarely attained statistical significance. The different response times for each test and probably also errors inherent in clinical measurements introduced sufficient variability to account for the discrepancy. Of the clinical tests, 'clinical score' appeared the most satisfactory.

High-dose intravenous methylprednisolone in rheumatoid arthritis

Fourteen patients with severe rheumatoid arthritis (RA) were given 27 courses of methylprednisolone intravenously, each of 3 infusions of 1 g on alternate days. After 7 days there was marked improvement in clinical state and most laboratory tests; levels of ESR and 4 serum acute-phase proteins, C3, C, IgG, and IgA, fell significantly. Serum IgM and rheumatoid factor titre were unchanged. 125I C1q binding fell in all instances where it was initially raised. Clinical remission lasted a mean of 10 weeks. Serum C-reactive protein (CRP) fell to less than 30 mg/l after all courses except one within 7 days and rose above this figure after a mean of 7 weeks. The ESR fell below 30 mm/h within seven days in 17 courses and remained below this value for a mean of 7 weeks. Three patients had clinical remissions, with serum CRP less than 30 mg/l and ESR less than 30 mm/h, lasting more than 42 weeks.