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Biomedical subjects

E Koó

Publications and source records attributed to E Koó.

At least 19 recordsLinked to original sources
PubMed2003

Measurement of disease activity in psoriatic arthritis. Extended report.

OBJECTIVE: To determine whether activity indices, generally accepted in rheumatoid arthritis (RA) are useful and valid to measure disease activity in psoriatic arthritis (PsA) patients with peripheral arthritis. METHODS: 38 PsA patients were studied before and after a one year DMARD treatment. Extended and reduced tender and swollen joint counts, Ritchie articular index, Health Assessment Questionnaire HAQ) score, erythrocyte sedimentation rate (ESR) morning stiffness, the patient's and the assessor's global assessment (PGA and AGA) were recorded. Disease activity scores, EULAR, ACR and Clegg improvement criteria were calculated. RESULTS: All indices correlated well before and after treatment with AGA (r > 0.337, p < 0.042), except morning stiffness and tender joint counts. After treatment, PGA correlated well only with the 68 and 28 tender joint counts, ESR and HAQ (r > 0.340, p < 0.05). The response to DMARD treatment was well characterized with the changes in the number of tender and swollen joint counts, and DAS4, DAS3, DAS28. The changes correlated with the PGA and AGA. The level of agreement between Clegg and the EULAR improvement criteria with both extended and reduced joint count was comparable (p < 0.01). CONCLUSION: The well-known activity indices generally accepted in RA, as tender and swollen joint count, DAS3, DAS4, DAS28, are useful and valid indices measuring arthritis activity in PsA with peripheral arthritis. The correlation between Clegg and EULAR improvement classification indices were similar. Both seemed to characterize changes authenticated during DMARD treatment.

Activities of Daily Living↗
PubMed2003

Termination of disease-modifying antirheumatic drugs in rheumatoid arthritis and in psoriatic arthritis. A comparative study of 270 cases.

102 rheumatoid arthritis (RA) and 104 psoriatic arthritis (PsA) patients' records were analysed according to a standardised protocol. Using Cox regression, life-table analysis and log rank test, the effectiveness and toxicity of, and duration of disease modifying antirheumatic drug (DMARD) treatment were compared in RA and PsA. RA patients were treated with gold sodium thiomalate (GST), methotrexate (MTX) and sulphasalazine (SSZ) for a median duration of 35, 72 and 12 months respectively, whereas PsA patients were treated for 12, 12 and 17 months. The differences for GST and MTX were statistically significant (p=0.0043 and 0.0447). Drug toxicity was more frequently seen among patients with PsA (p=0.0023). No difference in efficacy could be proved. Results suggest that there is a significant difference between RA and PsA patients in terms of toxicity of these agents. Therefore, separate treatment strategies are needed, and earlier results with RA may not be directly applicable to PsA.

Antirheumatic Agents↗
PubMed2003

Elevated levels of synovial fluid antibodies reactive with the small proteoglycans biglycan and decorin in patients with rheumatoid arthritis or other joint diseases.

OBJECTIVES: To determine whether patients with rheumatoid arthritis (RA) express humoral immunity to the small proteoglycans biglycan and decorin and to compare the response to that of patients suffering from other joint diseases. METHODS: Serum and synovial fluid IgG and IgM antibody levels were determined by enzyme-linked immunosorbent assay. Antibodies to biglycan and decorin as well as to other known and extensively investigated cartilage matrix components such as type II collagen, aggrecan and fibronectin were investigated. Patients suffering from RA, osteoarthritis (OA), psoriatic arthritis and other seronegative spondylarthropathies were included in the study. Correlation between antibody levels and clinical/laboratory parameters was determined. RESULTS: Patients with RA expressed an increased humoral immunity to biglycan, while patients with seronegative spondylarthropathies displayed elevated decorin-specific synovial antibody levels compared with OA patients. CONCLUSION: These results indicate a significantly higher immunity to small proteoglycans in RA and seronegative spondylarthropathies than in OA suggesting a possible involvement in the pathogenesis of inflammatory rheumatic diseases.

Adult↗
PubMed2000

[Various clinical patterns of relapsing polychondritis in six cases].

Relapsing polychondritis is a relatively rare disease characterized by episodic inflammation and progressive destruction of cartilage involving ears, nasal and laryngotracheal cartilage, cardiovascular system and the eyes. The increasing awareness of its clinically distinct has resulted in recognition of at least 550 reported cases. Six cases are reported to demonstrate the wide variety of clinical pattern. The most common features of the disease are auricular and nasal cartilage inflammation and nondeforming arthritis. Ocular symptoms and vasculitis is relatively rare. Two cases of relapsing polychondritis with laryngotracheobronchial manifestations illustrate the severe clinical features of the disease. Relapsing polychondritis may associate with diverse forms of connective tissue disease, such as rheumatoid arthritis. It seems interesting to note the onset in childhood. Treatment has been primarily symptomatic. In situations of mild symptoms, initial treatment is with nonsteroidal antiinflammatory drugs. For cases with serious manifestation, corticosteroids and immunosuppressants are indicated.

Adult↗
PubMed1995

[Diagnosis and differential diagnosis of psoriatic arthritis on basis of follow up of 215 cases].

The interval between the appearance of the symptoms of psoriasis and/or arthritis and the setting up the diagnosis of the psoriatic arthritis was studied in 215 patients suffering from definite psoriatic arthritis. About 2.3 years were over until the setting-up of the diagnosis in these 30 patients whose psoriasis and arthritis began simultaneously. The interval to set up the diagnosis of psoriatic arthritis was 5.4 years in average if the psoriasis itself was the first sign and it was 8.6 years in case the arthritis preceded psoriasis. The symptoms promoting to set up the right diagnosis were in order to frequency as follows: appearance of psoriasis, sausage digits, distal interphalangeal involvements, nail changes and transformation the monoarthritis into asymmetrical oligoarticular or polyarticular form. The difficulty of the differential diagnosis was studied. 15 different previous false diagnoses were enumerated the rate of which was the highest (67.3%) in the group starting with arthritis. The authors call the attention to the importance of looking for psoriatic skin and nail changes in every nonclassified arthritic patient in the interest of an early diagnosis and right therapy in course of the follow-up.

Adult↗
PubMed1991

[How to choose a basic drug for psoriatic arthritis?].

On the basis of an earlier retrospective study in 270 psoriatic arthritis (PA) patients and according to the data of the literature 1. aurotherapy for the patients having mild skin changes and active joint involvement (mainly polyarticular type), 2. sulfasalazine for the patients having moderate skin changes and moderate articular activity, 3. etretinate for the patients having widespread skin involvement and mild articular activity, 4. methotrexate for the patients having both severe skin and severe articular involvement were introduced by the authors. The experiences of prospective study of 52 patients treated with disease modifying antirheumatic drugs (DMARDs) during 3-6 months are reported (21: aurothiomalate, 13: sulfasalazine, 4: methotrexate, 14: etretinate). Morning stiffness (MS), visual analog scale (VAS), number of swollen joints (No), psoriasis area and severity index (PASI) and erythrocyte sedimentation rate (ESR) were monitored. The methotrexate proved to be the most effective in every parameters, except the ESR. Regarding PASI the etretinate was the second most effective. Among the monitored parameters ESR and VAS showed significant improvement at every drugs. Withdrawal was necessary in 7 cases during aurotherapy (7/21), in 4 cases during sulfasalazine (4/13), in 4 cases during etretinate (4/14), meanwhile there was not withdrawal during methotrexate therapy. Low frequency of skin exacerbation (4/52) doesn't contraindicate the introduction of these drugs. If the choice and monitoring of psoriatic arthritis patients is correct we can detect really good results with DMARDs in PA.

Arthritis, Psoriatic↗
PubMed1991

Juvenile psoriatic arthritis.

Among 664 juvenile chronic arthritis patients cared for in the Outpatient Clinic of the Pediatric Rheumatology Unit of the National Institute of Rheumatology and Physiotherapy 11 were found with juvenile psoriatic arthritis, and their data regarding skin, joint, ophthalmological, laboratory and radiological manifestations were analysed. These patients were categorised according to the four subgroups suggested by Truckenbrodt et al. Considering that the occurrence of the disease is rare, the small number of patients investigated in this study can provide additional data to the study of Truckenbrodt. The higher number of patients with JPA thus studied can give more information for a multicentric evaluation.

Adolescent↗
PubMed1990

[Gold salts in the treatment of psoriatic arthritis].

270 psoriatic arthritis patients were studied retrospectively. 65 patients of them were treated with aurothiomalate. The drug was effective in 62% of aurothiomalate treated patients, in 35% were registrated side effects. These data correspond to the experiences with gold salt treatment in rheumatoid arthritis. Exacerbation of skin manifestation, as a special side effect occurring in psoriatic arthritis patients treated with gold salts isn't a contraindication.

Adolescent↗
PubMed1984

Inhibition of the complement activation by an adrenal androgen, dehydroepiandrosterone.

The effect of dehydroepiandrosterone (DEA), an adrenal androgen successfully used for preventing attacks in hereditary angioneurotic edema (HANE) patients was studied on the activation of classical and alternative complement pathway. The steroid inhibited both the spontaneous and immune activation of the classical complement pathway (CP), the former effect, however, was found to be more marked than the latter one. DEA exerted its inhibiting effect most probably by interfering with the internal activation of C1. Because DEA rendered HANE patients symptom free but induced only a slight increase in their serum C1-INH level, our present findings suggest that inhibition of CP activation may have a significance in the therapeutic effect of DEA and possibly of other androgens as well.

Angioedema↗
PubMed1983

Effect of dehydroepiandrosterone on hereditary angioedema.

Hereditary angioneurotic edema (HAE) is a complement-related clinical disorder with a deficiency of the C1 esterase inhibitor protein. Eight patients with severe attacks of the disease were treated with the adrenal "androgen" dehydroepiandrosterone sulphate (DS). Steroid therapy for 3-28 months resulted in dramatic improvement in their clinical state and a moderate increase in the serum concentration of C1 inhibitor. There was a significant increase in the serum level of either unconjugated dehydroepiandrosterone (D) or of DS during treatment.

Adolescent↗
PubMed1983

Adrenocortical function in bronchial asthma.

Female patients with "intrinsic" bronchial asthma without corticosteroid therapy for at least 3 months revealed low blood concentration of total protein-unbound + protein-bound) and free (biologically active, protein-unbound) cortisol, dehydroepiandrosterone and dehydroepiandrosterone sulphate, as also a low urinary excretion of dehydroepiandrosterone metabolites. The results suggest that bronchial asthma is associated with hypoadrenia due to an impaired production not only of cortisol, but also of adrenocortical androgens resulting in an insufficient hormone supply of the target organs. These seem noteworthy, since recent observations showed relationships between the immune responsiveness and sex hormones.

Adolescent↗