OBJECTIVE: The incidence and clinical significance of anti-cyclic citrullinated peptide (CCP) antibodies in a cohort of Chinese patients with juvenile idiopathic arthritis (JIA) and adults with rheumatoid arthritis (RA) were studied. METHODS: Anti-CCP antibodies were determined by enzyme-linked immunosorbent assay (ELISA) in 59 patients with JIA, 129 adult RA patients, 48 children with diseases other than JIA, 68 adult patients with rheumatic diseases other than RA, and 60 normal adults. Associations between anti-CCP antibodies and clinical and laboratory parameters were determined by Fisher's exact test. RESULTS: Six of 59 (10.2%) patients with JIA and 71 of 129 (55%) patients with RA were positive for anti-CCP. Four of five RF-positive JIA patients and two of 54 RF-negative JIA patients were positive (p<0.001). One paediatric patient with allergy (0.9%) and two adult patients with rheumatic diseases other than RA (2.3%) were positive. All healthy controls were negative for anti-CCP. The specificity was 99.1% for JIA and 98.4% for RA. The sensitivity was 10.2% for JIA and 55% for RA. Positive predictive values were 85.7% for JIA and 97.3% for RA and negative predictive values were 66.9% for JIA and 68.5% for RA. CONCLUSION: The anti-CCP antibody assay is a valuable tool for the diagnosis of RA and a subset of JIA in Chinese patients. It could be a useful predictive test for joint erosion in JIA of the polyarticular RF-positive subset and may be influential in the choice of the best therapeutic strategy in patients with recent-onset arthritis.

Adolescent↗

PubMedDate not supplied

The feet in Apert's syndrome.

Apert's syndrome (acrocephalosyndactyly type 1) is characterised by anomalies of the cranium, hands, and feet. The cranial and hand anomalies have been investigated, and the management of these is well established. In contrast, the anomalies affecting the feet and their management has previously received little attention. Forty-three children with Apert's syndrome underwent investigation of the anomalies affecting their feet. This consisted of history, clinical examination, and where possible, radiographic examination to establish the anomalies present, how these altered during development, and their clinical significance. The conclusion of the study is that there are widespread anomalies of the feet, with defects including both predictable dysmorphic changes and progressive fusions of the skeletal components during skeletal maturity. These fusions and their effect on growth combine to produce increasing deformity during childhood. The clinical significance of the anomalies is that walking is often delayed, and the increasing deformity results in difficulty obtaining footwear. This is the most common reason for surgery to the feet being undertaken during childhood to improve the shape of the feet to facilitate the provision of footwear. The unexpectedly high incidence of surgery in this study suggests that the management of foot deformities may require surgery more frequently than current literature would suggest.

Acrocephalosyndactylia↗

PubMedDate not supplied

Bread-making as a source of vaginal infection with Saccharomyces cerevisiae. Report of a case in a woman and apparent transmission to her partner.

We report the case of a woman, who baked her own bread, acquiring a vulvovaginal infection caused by saccharomyces cerevisiae, a yeast used extensively in the baking and brewing industries. Her partner was also infected, and the infections proved difficult to eradicate. Oral and topical treatment with nystatin along with disinfection of both patients' underwear produced clinical and microbiologic cure.

Adult↗

PubMedDate not supplied

Ethanol metabolism in women taking oral contraceptives.

The relationship between oral contraceptives and ethanol metabolism in women was examined in a group of 40 female social drinkers between the ages of 21 and 30. Twenty women taking oral contraceptives and 20 women not taking oral contraceptives were given a moderate dose of ethanol (0.52 g/kg) during the menstrual, intermenstrual and premenstrual phases of the menstrual cycle. The group of women taking oral contraceptives demonstrated a significantly decreased ethanol elimination rate (105 mg/kg/hr) than the women not taking oral contraceptives (121 mg/kg/hr, p less than .005). Ethanol disappearance rate also was significantly decreased for women taking oral contraceptives (0.015%/hr) than women not taking them (0.019%/hr, p less than .001). These results were consistent across the three phases of the menstrual cycle and when body leanness was taken into consideration. The decreased rate of ethanol metabolism in women taking oral contraceptives is consistent with reports of other drugs having decreased metabolic rates in women taking birth control pills. These results suggest that women taking oral contraceptives should be cautioned concerning their possible interaction with ethanol, as well as other drugs.

Adult↗

PubMedDate not supplied

The determination of amines in the vaginal secretions of women in health and disease.

The presence of amines in vaginal fluid is thought to be an important contributory factor in the pathogenesis of bacterial vaginosis (BV). As part of on-going work investigating the aetiology of this infection, two separate studies were performed in which gas chromatography was used to measure and compare the amines present in the vaginal secretions of normal women, a group infected with BV and some having other sexually transmitted diseases. The amines studied were methylamine, isobutylamine, putrescine, cadaverine and phenylethylamine. The results of the studies were contrary to expectations, in that they showed an overall similarity in both normal women and in those with BV and other vaginal infections. These findings now bring in to question the validity of amines being a reliable focus, either in the diagnosis of BV, or in investigations into the aetiology of the disease.

Amines↗

PubMedDate not supplied

Amines in semen-free vaginal secretions.

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Amines↗

PubMedDate not supplied

Comparison of the influence of spermicidal and non-spermicidal contraception on bacterial vaginosis, candidal infection and inflammation of the vagina--a preliminary study.

This preliminary study compared the signs, symptoms and prevalence of bacterial vaginosis (BV) and candidal infections in women using spermicides, with those using other forms of contraception, to establish whether nonoxynol-9 had any therapeutic value against BV or gave rise to vaginal candidiasis and inflammation. Overall results showed that the prevalence of BV in non-spermicide users was 35/113 (31%) but was significantly less in spermicide users, 10/66 (15%), P < 0.05. Nonoxynol-9 was not associated with increased isolation of Candida albicans, which was found in 16/113 (14%) of non-spermicide users, and in 8/66 (12%) of those using spermicides, P > 0.1. Vaginal inflammation and discharge were significantly less in spermicide users, 19/66 (29%) than in the non-spermicide group, 50/113 (44%), P < 0.05. Nonoxynol-9 contraception was associated with a significantly reduced prevalence of BV, but not with increased candidiasis or vaginal inflammation.

Candidiasis, Vulvovaginal↗

PubMedDate not supplied

Quality of life after heart transplantation in patients assigned to double- or triple-drug therapy.

The purpose of this study was to compare the quality of life after heart transplantation for patients treated with cyclosporine and azathioprine (double therapy) versus cyclosporine, azathioprine, and corticosteroids (triple therapy). This study was based on a randomized, prospective trial and was focused on patients from ages 17 to 57 years at 1-year after transplantation. Patients who received double therapy showed advantages on 10 of 11 measures of quality of life. Significant differences were found on measures of anxiety, sexual activity, physical well-being, and financial well-being. Patients who received double-drug therapy reported a lower frequency and less distress from the side effects of immunosuppression; a higher proportion of double-drug therapy patients had returned to full-time employment. In addition double-therapy patients were better able to control body mass. These features may explain why double-drug therapy patients reported a higher quality of life, and in the long term, could be important from a cost benefit analysis.

Adaptation, Psychological↗

PubMedDate not supplied

Rehabilitation after heart transplantation: the Australian experience.

This study was designed to assess aspects of the quality of life and rehabilitation of heart transplant recipients who had transplantations at St. Vincent's Hospital, New South Wales, Australia, between February 1984 and March 1987. Factors determining return to full-time employment were delineated. A questionnaire was sent to 51 recipients. The response rate was 92%. The questionnaire measured employment status and satisfaction with family, social, marital, and sexual life. Financial status, exercise ability, and participation in daily activities were also assessed. Analysis showed that 53% of recipients had returned to either full-time or part-time employment, home duties, or full-time study. A further 28% were receiving a pension, 9% had chosen voluntary retirement, 6% were receiving unemployment benefits, and 4% were getting paid leave. Ability to exercise was improved for 77% of recipients and remained the same for another 14%. Financial status was unchanged for 45% and improved for 17%. Thirty-eight percent believed that they were worse off financially. Ratings of social, family, and marital life showed nearly complete or complete satisfaction in most cases. Satisfaction with sex life was less favorable. Comparison of the group who had returned to full-time employment with the group receiving a pension identified two variables of work status--length of time since transplantation and employment status before transplantation. There were also some differences between the two groups on quality of life ratings.

Adolescent↗

PubMedDate not supplied

Trimethylamine and the amine 'wiff' test not related in bacterial vaginosis.

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Amines↗