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Biomedical subjects

A Calin

Publications and source records attributed to A Calin.

At least 19 recordsLinked to original sources
PubMed1992

Increasing age at presentation for patients with ankylosing spondylitis.

An analysis of the age at first presentation was undertaken in patients with ankylosing spondylitis and mechanical back pain seen at the London Hospital department of rheumatology between 1952 and 1983. There was a significant positive correlation with the calendar year of presentation in the patients with ankylosing spondylitis but a negative correlation in those with mechanical back pain. An increasing age at presentation in ankylosing spondylitis is likely to be due to an increasing age at disease onset--all anticipated biases would act in the opposite direction. This observation in a prospective study supports the findings of other studies using different epidemiological techniques.

Adult↗
PubMed1991

The European Spondylarthropathy Study Group preliminary criteria for the classification of spondylarthropathy.

Classification criteria for most of the disorders belonging to the spondylarthropathy group already exist. However, the spectrum of spondylarthropathy is wider than the sum of these disorders suggests. Seronegative oligoarthritis, dactylitis or polyarthritis of the lower extremities, heel pain due to enthesitis, and other undifferentiated cases of spondylarthropathy have been ignored in epidemiologic studies because of the inadequacy of existing criteria. In order to define classification criteria that also encompass patients with undifferentiated spondylarthropathy, we studied 403 patients with all forms of spondylarthropathy and 674 control patients with other rheumatic diseases. The diagnoses were based on the local clinical expert's opinion. The 403 patients included 168 with ankylosing spondylitis, 68 with psoriatic arthritis, 41 with reactive arthritis, 17 with inflammatory bowel disease and arthritis, and 109 with unclassified spondylarthropathy. Based on statistical analysis and clinical reasoning, we propose the following classification criteria for spondylarthropathy: inflammatory spinal pain or synovitis (asymmetric or predominantly in the lower limbs), together with at least 1 of the following: positive family history, psoriasis, inflammatory bowel disease, urethritis, or acute diarrhea, alternating buttock pain, enthesopathy, or sacroiliitis as determined from radiography of the pelvic region. These criteria resulted in a sensitivity of 87% and a specificity of 87%. The proposed classification criteria are easy to apply in clinical practice and performed well in all 7 participating centers. However, we regard them as preliminary until they have been further evaluated in other settings.

Europe↗
PubMed1991

Primary ankylosing spondylitis, psoriatic and enteropathic spondyloarthropathy: a controlled analysis.

Within our ankylosing spondylitis (AS) population (n = 1331), 85% (n = 1128) had primary AS (1 degree AS), 9% (n = 121) had psoriatic AS (PsAS) and 6% (n = 82) enteropathic AS (IBDAS). In an attempt to explore further the relationship between 1 degree AS and the secondary spondyloarthritides, we evaluated 121 consecutive patients with PsAS and 82 with IBDAS, as well as 202 controls with primary disease. The patients were matched for sex and age at review PsAS:48.1 (SD 11.3) years vs 1 degree AS:48.4 (SD 11.5), and IBDAS:46.0 (SD 12.7) vs 1 degree AS:45.9 (SD 12.7). The sex distribution for IBDAS (M:F, 1:1), was significantly less (p less than 0.001) than that for PsAS (M:F, 3.5:1) or 1 degree AS (M:F, 2.4:1). Overall, compared to 1 degree AS the PsAS and IBDAS tended to have greater disease severity as defined by e.g., (1) those taking non-steroidal antiinflammatory drugs, 86 vs 72% (p less than 0.01) and 71 vs 60% (p less than 0.05), respectively; (2) decreased spinal mobility (scale 0-8) 5.0 (SD 2.0) vs 4.4 (SD 2.3); p = 0.029 and 4.9 (SD 2.0) vs 3.9 (SD 2.4); p = 0.024, respectively; and (3) PsAS resulted in a higher AIMS pain score; 4.9 (SD 2.5) vs 4.0 (SD 2.4): p = 0.042. By contrast, peripheral joint involvement, number of total hip replacements and capacity for employment were similar in all 3 groups. In conclusion (1) among the AS population the prevalence of 1 degree AS, PsAS and IBDAS is 90, 6 and 4%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

New light on uveitis in ankylosing spondylitis.

Inflammatory eye disease is well recognized in ankylosing spondylitis (AS) but the relationship between the uveitis and the spondyloarthropathy is poorly defined. The following conclusions may be drawn from a study of 1331 consecutive patients with AS: the prevalence of uveitis was 40% (535 subjects), almost half of whom had greater than 5 attacks. Family studies of sib pairs, concordant for AS, showed that uveitis occurred randomly with a concordance for uveitis/no uveitis of only 43%. A comparison of patients with (n = 535) and without (n = 796) uveitis showed no important differences. Analysis of potential trigger factors among 72 patients with recurrent disease revealed no seasonal, infective or other correlation. The removal of an intrauterine device from a woman with severe intractable bilateral uveitis was associated with remission of the eye disease. In summary, although genetic background determines susceptibility to uveitis the pattern of the disease suggests the possibility of random environmental triggers unrelated to the course of the underlying rheumatological disorder.

Humans↗
PubMed1990

Serum keratan sulphate levels rise in rheumatoid arthritis patients, but fall in ankylosing spondylitis patients compared with normal controls.

Serum levels of keratan sulphate (KS) were found to be significantly elevated in patients with destructive and predominantly seronegative rheumatoid arthritis (RA) compared with a control population. Levels in RA did not correlate with clinical or laboratory indices of joint activity or damage. Conversely levels were depressed in ankylosing spondylitis (AS) compared with controls.

Arthritis, Rheumatoid↗
PubMed1990

Selective IgA deficiency and spondyloarthropathy: a distinct disease?

A woman with selective IgA deficiency and severe ankylosing spondylitis (AS), complicated by intractable peripheral arthritis, is described. Three previous cases of selective IgA deficiency and AS have been reported, all of whom had severe AS. It is suggested that selective IgA deficiency is a poor prognostic factor in AS and therefore warrants further investigation to determine the clinical course of such patients.

Adult↗
PubMed1990

Willingness to accept risk in the treatment of rheumatic disease.

STUDY OBJECTIVE: The aim was to assess patients willingness to accept mortal risk in the drug treatment of chronic rheumatic disease. DESIGN: A non-random sample of consecutive patients were interviewed with a standardised survey instrument. SETTING: The study took place in the Royal National Hospital for Rheumatic Diseases, Bath, UK. PATIENTS: 100 consecutive in- and out-patients aged 65 or less were interviewed, 50 with rheumatoid arthritis and 50 with ankylosing spondylitis. Mean age was 48 years with mean disease duration of 14 years. The rheumatoid arthritis group was mainly female (84%), v 26% in the ankylosing spondylitis group. MEASUREMENTS AND MAIN RESULTS: Risk preferences were elicited using the method of standard gamble in the context of a hypothetical new drug. Patients indicated the maximum percentage probability of mortality they regarded as acceptable to achieve four different levels of benefit: total cure (20.7%), relief of pain (16.9%), relief of stiffness (13.1%), return to normal functioning (14.5%). Rheumatoid arthritis patients displayed a higher (p less than 0.05) willingness to accept risk than ankylosing spondylitis patients for all gambles except relief of stiffness. Analysis of variance indicated that willingness to accept risk decreases with the duration of disease and increases with reductions in self assessed health status. CONCLUSIONS: Evaluative methods such as standard gamble can elicit useful risk-benefit preference data from patients to assist those who manage clinical risks.

Adult↗
PubMed1990

A prospective nationwide cross-sectional study of NSAID usage in 1331 patients with ankylosing spondylitis.

Drug studies in ankylosing spondylitis (AS) are usually short term, in highly selected patients at academic centers. We present data on 1331 UK patients with AS. Patients were reviewed prospectively in 1985 and 1987. Given the nationwide population base we avoided biases relating to local medical preferences or market forces. Eighty-six percent (n = 1149) were taking medication in 1985 and 78% (n = 1040) in 1987. The most common drug in 1985 was indomethacin (Indo) with 35%, followed by naproxen (N; 21%), piroxicam (P; 9%), diclofenac (D; 7%) and ibuprofen (6%; all others less than 5%). Two years later the figures were Indo 34%, N 19% and D 12%. At followup, survival rates (the number remaining taking each drug) were Indo 75%, N 63%, P 74% and D 67%. The 2 main reasons for stopping a drug were lack of efficacy (Indo 10%, N 25%, P 34%, D 32%) and toxicity (Indo 39%, N 30%, P 30%, D 40%). Sixty percent of patients taking Indo reported good or excellent pain relief, compared with 57% on N, 47% on P and 47% on D. Good or excellent stiffness relief was obtained in 55% of patients on Indo, 38% on N, 44% on P and 40% on D. At any one time over 75% of individuals with AS are receiving drug treatment. The most popular nonsteroidal antiinflammatory drug for AS in 1985 and 1987 was Indo, which scored highest in terms of efficacy, pain relief, stiffness relief and survival. The survival rate over 2 years ranged from 63% (N) to 75% (Indo).

Adult↗
PubMed1990

Is there sexual inequality in ankylosing spondylitis? A study of 498 women and 1202 men.

The responses of 1700 members (1202 men) of the National Ankylosing Spondylitis Society to a self-administered questionnaire were analyzed. The male:female ratios for primary ankylosing spondylitis, psoriatic spondylitis and spondylitis associated with inflammatory bowel disease were 2.4:1, 3.5:1 and 1:1, respectively. A positive family history was significantly less prevalent in men than women as were hand, elbow, shoulder and knee symptoms. In a parallel radiographic study, 100 men matched for age of onset and disease duration with 50 women demonstrated similar sacroiliac, cervical and hip disease but worse involvement of the lumbar spine.

Adult↗
PubMed1990

Postsalmonella reactive phenomena in 2 patients with ankylosing spondylitis: no modification of the underlying disease.

HLA-B27 related disease occurs in 2 main forms, ankylosing spondylitis (AS) or reactive arthropathy/Reiter's syndrome. These entities often "breed true" within families or distinct ethnic groups. Reactive arthropathy/Reiter's syndrome may be complicated by AS, but little is known about the impact on AS of a de novo reactive arthropathy occurring at a later date. We describe 2 patients with AS who developed postsalmonella reactive phenomena several years after the onset of their primary disease. In both patients the intestinal salmonella infection did not modify the course of the AS.

Adult↗