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Biomedical subjects

A Bjelle

Publications and source records attributed to A Bjelle.

At least 91 records · Page 5Linked to original sources
PubMed1984

Alpha-1-antitrypsin types and rheumatoid arthritis.

Frequencies of alpha-1-antitrypsin (Pi) phenotypes were studied in 100 female and 100 male Swedish patients with classical rheumatoid arthritis and compared with the population frequencies. A significant increase of rare Pi types (MS, MZ, MF and SZ) was found among the patients. However, the increase concerned mainly Z heterozygotes and was more strongly pronounced in male patients. The M-subtypes showed no association with rheumatoid arthritis. Previous investigations of Pi types in rheumatoid arthritis have shown somewhat variable results. The results so far indicate, however, that an association between the Z allele and rheumatoid arthritis is likely to exist, while the evidence for a relationship between rheumatoid arthritis and other Pi alleles is considerably weaker.

Adolescent↗
PubMed1984

Eosinophil cationic protein in inflammatory synovial effusions as evidence of eosinophil involvement.

Eosinophils are seldom noted in inflammatory synovial fluids but are reported to infiltrate the synovial tissue in inflammatory arthritides. To elucidate a possible role for eosinophils in inflammatory joint reactions the concentrations of eosinophil cationic protein (ECP)--a specific granule protein from eosinophils--were measured by radioimmunoassay in 90 synovial fluids from patients with various inflammatory arthritides (rheumatoid arthritis, reactive and crystal arthritides, Reiter's disease and psoriatic arthropathy). In the same specimens lactoferrin was measured as an indicator of neutrophil-involved inflammation. In comparison with the normal circulating levels of ECP and lactoferrin the measured synovial fluid concentrations of both proteins were considerably raised in all patient groups with inflammatory joint diseases in contrast to patients with non-inflammatory arthritides. There was a striking positive correlation between the ECP and lactoferrin synovial fluid concentrations. These data indicate that eosinophil activation is prominent in inflammatory joint reactions and is linked to the activation of neutrophils. The regulation of degranulation or secretion by eosinophils is unknown. Our in-vitro studies showed that peripheral blood isolated neutrophils as well as eosinophils degranulated when exposed to IgG complexes. However, eosinophil degranulation was modest compared with neutrophil degranulation. These data suggest that neutrophil phagocytosis of, for example, immune complexes may be one major mechanism in neutrophil degranulation but that other factors determine the appearance of eosinophil products in inflammatory synovial effusions. The possible modulatory or harmful role of eosinophils in inflammatory joint disease can at present only be speculated on.

Adolescent↗
PubMed1984

Rheumatic disorders in a health survey: how valid and reliable are the reports?

The validity and reliability of interview reports on rheumatic disorders in a Swedish nationwide health survey were studied. Two samples, including altogether 157 individuals, who had reported rheumatic disorders, were medically examined 6 to 24 months after the original interview. The reproducibility of the original interview was studied by the means of two re-interviews. The proportional distribution of rheumatic disorders according to diagnostic group was similar to that in the original interview, in the two re-interviews and at the medical examination. In a subject-to-subject comparison the overall agreement between the medical examination and the lay re-interview was 84% (kappa 0.35) regarding presence of rheumatic disorders, and 57% (kappa 0.41) regarding matching of rheumatic diagnostic groups. In the original interview and the lay re-interview the same individual rheumatic disorder was reported by 38% of the subjects; 58% agreed regarding rheumatic diagnostic groups. The interview reports on rheumatic disorders in the health survey can therefore be considered to have acceptable validity and reliability only with regard to the proportional distribution of groups of rheumatic disorders, based on aggregated data.

Adolescent↗
PubMed1984

Drug prescription patterns for rheumatic disorders in Sweden.

Drug prescription patterns, expressed in defined daily doses (DDD), were registered during the 1970s for disease modifying antirheumatic drugs (DMARD) and for nonsteroidal antiinflammatory drugs (NSAID). An increased prescription of DMARD was found at a national level (Sweden), starting with chloroquine, followed by penicillamine and finally by gold. This same tendency was seen at a county (Västerbotten) and a university hospital level (Umeå). Among NSAID for oral use, the prescription of indomethacin and phenylbutazone gradually decreased in Sweden. Naproxen and ibuprofen increased rapidly, surpassing the others from 1975. This increase was far less marked at the county level and at the rheumatology department of Umeå in which the overall prescription of NSAID for inpatients decreased during the 70s.

Administration, Oral↗
PubMed1984

HLA-B27 and involvement of sacroiliac joints in rheumatoid arthritis.

The frequency of radiographic signs of sacroiliac joint involvement (greater than or equal to 2 and greater than or equal to 3 according to the New York criteria) was significantly higher in 28 HLA-B27 positive patients with classical seropositive rheumatoid arthritis (RA), than in 28 B27 negative RA controls. The B27 positive RA patients had more subcutaneous nodules (p less than 0.01), worse functional class (p less than 0.05), and higher levels of erythrocyte sedimentation rate (ESR) (p less than 0.05) and haptoglobin (p less than 0.05). Sacroiliitis, independent of HLA-B27, was associated with higher levels of ESR (p less than 0.05), and with a higher frequency of positive ANA test (p less than 0.05). It is neither related to the functional class nor to the duration of the disease.

Adult↗
PubMed1983

Beta-thromboglobulin in inflammatory synovial fluid.

Activated platelets release substances which potentially can contribute to joint lesions in inflammatory arthritides. To elucidate a possible participation of platelets in inflammatory joint reactions, the concentrations of the platelet protein beta-thromboglobulin (beta-TG) were measured in 90 inflammatory synovial fluids. Seven percent of the patients with rheumatoid arthritis and none of the patients with other inflammatory joint diseases (e.g., Reiter's disease, reactive or crystal arthritides) had beta-TG concentrations in synovial fluid exceeding the upper normal range of plasma beta-TG. The absent or very modest signs of local platelet activation were contrasted by the pronounced neutrophilic and monocytic activation, as assessed by the measurements of some granule proteins: lactoferrin, myeloperoxidase, lysozyme, and ferritin. No correlation was found between these inflammatory cell markers and beta-TG. A positive correlation (p less than 0.001) was noted between beta-TG and beta 2-microglobulin, which appeared in particularly high amounts in rheumatoid arthritis. This correlation may reflect a disturbed permeability of synovial membrane for LMW proteins or a related activation of platelets and lymphocytes. The present results do not give any evidence of platelet activation playing a major role in proliferative or destructive processes in arthritis.

Adolescent↗
PubMed1983

Joint fluid leukocytosis of patient with rheumatoid arthritis Computer analysis of possible explanative factors.

The relationship between joint fluid leukocytosis and some clinical and laboratory parameters (disease duration, ESR, maximal titres of rheumatoid factor and of antinuclear factors, blood leukocytosis and sex) was studied in 27 consecutive patients with seropositive rheumatoid arthritis. The concentration of leukocytes was significantly higher in the synovial fluid than in peripheral blood. Variations of joint fluid leukocytosis could, however, not be explained by disease duration, actual ESR, maximal rheumatoid factor or antinuclear factor titres, concentration of blood leukocytes, or sex. It is suggested that a possible correlation between joint fluid leukocytosis and the listed parameters of rheumatoid arthritis may be too complex for analysis by a linear multiple regression model in samples of the present size.

Adult↗
PubMed1983

Total care for rheumatic disorders in an integrated health care system.

Utilization of care for rheumatic disorders (chapt XIII of ICD) was studied in an area of Sweden during 1978. In the total health care system, approximately 16 to 18% of the population with a rheumatic disorder were seen. The majority (12% of the population) of these patients were treated at the primary care centres. Only 1% were registered as in-patients, 1/4 of whom were admitted to the rheumatology department. Cases with back disorders constituted the largest diagnostic group of rheumatic disorders, both in primary care and in the departments of internal medicine, at the district level as well as in the regional hospital. The most important contribution of the rheumatology department was the care of a select group of patients--those with rheumatoid arthritis and systemic rheumatic diseases. However, primary care saw more patients also within the whole group of inflammatory rheumatic diseases. In the department of orthopaedic surgery, osteoarthritis was the major diagnosis among rheumatic disorders, totalling 38% of their rheumatic in-patients. Selection of patients for specialized care depended upon diagnosis, age, sex and distance to the hospital.

Adolescent↗
PubMed1983

Joint fluid leukocytosis of patients with rheumatoid arthritis evidence for neutrophil and monocyte chemotaxis in vivo.

The cell picture of the synovial fluid of fourteen patients with rheumatoid arthritis was studied in smears contrasted with the May-Grünwald-Giemsa stain. The cytology was dominated by neutrophils, many with signs of necrobiosis. The mononuclear cells displayed signs of proliferation and differentiation. Comparison with the immobile erythrocyte provided evidence that the accumulation of leukocytes in the synovial fluid of patients with rheumatoid arthritis was due to active leukocyte migration, presumably stimulated random movement and chemotaxis.

Arthritis, Rheumatoid↗
PubMed1983

Chloroquine in long-term treatment of rheumatoid arthritis.

The effect of long-term (18-70 months) chloroquine treatment 250 mg daily, in rheumatoid arthritis (RA) was studied in 20 patients. Sedimentation rates were significantly reduced, as compared to a reference group of 10 RA patients on no treatment of disease modifying anti-rheumatic drugs. Radiographical progression of the disease was low in the majority of chloroquine-treated patients but not significantly different from the finding in the patients of the reference group. Rapid radiographical progression during 2-3 years was, however, observed in 5 patients despite chloroquine treatment.

Adult↗
PubMed1983

Molecular weight distribution of hyaluronic acid of human synovial fluid in rheumatic diseases.

New methods to isolate and characterize the molecular weight distribution of hyaluronic acid have been applied to human synovial fluids from arthritic patients. Considerable variations in molecular weight distribution were found between the individual fluids. These methods facilitate a detailed characterization of hyaluronic acid--a prerequisite for understanding the role of hyaluronic acid for normal joint function and to evaluate the therapeutic use of local application in joint diseases.

Adult↗
PubMed1983

Musculo-skeletal symptoms in early sarcoidosis. Twenty-four newly diagnosed patients and a two-year follow-up.

Musculo-skeletal symptoms were screened in 24 consecutive patients with newly diagnosed sarcoidosis and followed up two years later. Ten patients had joint involvement. Symptoms were most frequently found in ankle joints, followed by hand and knee joints. Arthritis was found in seven (29%) patients, two of whom suffered from monoarthritis of foot and wrist joint, respectively. Three patients had tenosynovitis. Muscle symptoms such as myalgia were present in six patients. Open biopsy of the gastrocnemius muscle showed epithelioid cell granulomatosis in nine of 20 patients. Only three of these nine patients had symptoms of myalgia, although not in the biopsied muscle. At follow-up, musculo-skeletal symptoms were found in only three patients, all of whom initially had Löfgren's syndrome.

Adult↗
PubMed1982

Pyrophosphate arthropathy in two Swedish families.

A clinical and radiographic survey of 110 members of 2 families with hereditary pyrophosphate arthropathy was performed. The mode of inheritance was autosomal, dominant with a variable penetrance. Twenty-two percent of the family members had joint involvement related to pyrophosphate arthropathy, 47% of those over 50 years of age had experienced acute attacks of arthritis and/or had joint calcifications. The majority of individuals with both arthritis and joint calcifications suffered from chronic pain that resulted in early retirement. A high frequency of back pain was observed, but no ankylosis or deformity. Surgery was performed for parathyroid hyperplasia on the propositus in 1 family, and several members of her family suffered from symptoms that suggested a disturbance of calcium phosphate metabolism. There were several differences between our patients and 50 cases of sporadic pyrophosphate arthropathy from the same area of Sweden. Familial cases had an earlier onset, a greater number of involved joints, and peripheral joint involvement more often. Back pain was more frequent, and calcifications of intervertebral discs were found only in the hereditary cases.

Adult↗
PubMed1982

Hereditary pyrophosphate arthropathy (familial articular chondrocalcinosis) in Sweden.

Genealogical links between three Swedish families with hereditary pyrophosphate arthropathy were found in the 18th century, indicating a possible founder effect, similar to earlier findings in Slovakia, France and Chile. However, no connection between the Swedish and other European families with the disease has so far been found. In accordance with other reported familial aggregations of pyrophosphate arthropathy, the transmission of the disease in the Swedish families appeared to be autosomal dominant with incomplete penetrance and variable expressivity. Severe symptoms related to homozygotic cases reported in some other families were not found in Sweden.

Adult↗
PubMed1982

Crystal arthropathies in osteo-arthritis--clinical aspects and laboratory techniques for crystal identification.

Crystal arthropathies are frequent findings in patients with radiographical osteo-arthritis (OA). The associations between cartilage degeneration and crystal deposition of hydroxy-apatite or calcium pyrophosphate dihydrate are not yet understood. However, from the clinical point of view it is important to differentiate synovitis caused by micro-crystals from other symptoms in OA since symptomatic relief is readily obtained with the use of antiphlogistic drugs. Methods to screen synovial fluids for crystals should be introduced in routine clinical practice.

Aging↗