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Biomedical subjects

K Kaarela

Publications and source records attributed to K Kaarela.

At least 73 records · Page 4Linked to original sources
PubMed1993

Amyloidosis--incidence and early risk factors in patients with rheumatoid arthritis.

In a 15-year follow-up examination, reactive secondary amyloidosis (RSA) was found by subcutaneous fat biopsy in six out of 74 still living patients (8.1%) of an original population of 102 with erosive and seropositive rheumatoid arthritis (RA). Five of the 24 deceased patients had had RSA. Thus the 15-year incidence of RSA in RA was at least 10.9% (11/102). To study early prognostic aspects of RSA, comparison was made of 14 entry variables and the initial treatment in the RSA group (n = 11) and the control group (n = 81) respectively. At onset (< or = 6 months) of RA only serum orosomucoid, but after three years morning stiffness, ESR, serum CRP and orosomucoid were significantly worse in patients whom later developed RSA. Three out of 48 patients treated with gold sodium thiomalate and seven out of 30 treated with chloroquine developed RSA (p = 0.04). It is concluded that continuously active disease was the risk factor underlying RSA. The role of early chloroquine therapy is discussed.

Adult↗
PubMed1993

Predictive value of synovial fluid analysis in rheumatoid arthritis. A 7.5-year follow-up study.

OBJECTIVES: To evaluate the prognostic value of some synovial fluid variables in patients with rheumatoid arthritis. METHODS: Twenty-nine patients with erosive rheumatoid arthritis and hydropsy in a knee joint were followed for 7.5 years in a prospective study. At the start of the study the knee joints were aspirated and 15 synovial fluid variables were analyzed. The patients were divided into two groups according to whether or not there had been progress of radiologically detected destruction in the knee joints during the follow-up. RESULTS: Of the synovial fluid variables at the start, only C3 (p = 0.030) and acid phosphatase (p = 0.047) differed significantly between the groups, the former being lower and the latter higher in patients with deterioration of knee joints. CONCLUSIONS: These preliminary results may indicate that low synovial fluid C3 and high acid phosphatase predict poor prognosis in a joint affected by rheumatoid arthritis.

Acid Phosphatase↗
PubMed1993

How often is seropositive rheumatoid arthritis an erosive disease? A 17-year followup study.

OBJECTIVE: The frequency of erosiveness was studied in rheumatoid arthritis (RA) by longterm followup. METHODS: A community based cohort of 263 patients with recent onset (< or = 6 months) arthritis were followed in Heinola. At 8-year followup examination 113 cases were found to have rheumatoid factor positive (seropositive) nonspecific arthritis, and 15 were nonerosive in the radiographs. The 15 patients were reexamined in 1992 (17-year followup). RESULTS: Eleven of 15 were found to have erosive disease, and of these, 6 had putative psoriatic arthritis, 4 RA, and one monoarthritis of the knee. Of the remaining 4 seropositive nonerosive cases only one fulfilled the 1987 American College of Rheumatology (ARA) criteria for RA. CONCLUSION: In patients with seropositive RA with 4 1987 ARA criteria, 99% developed erosive disease.

Adolescent↗
PubMed1992

HLA typing and seropositivity in Finnish and in Polish patients with rheumatoid arthritis and amyloidosis.

We determined HLA-A, -B, -C and -DR antigens in 83 patients with rheumatoid arthritis (RA) and reactive secondary amyloidosis (RSA), 60 in Finland and 23 in Poland, and compared the results with control RA patients and blood donors. There were no significant differences in the frequencies of HLA between the RA patients with and those without RSA in either Finland or Poland, and no significant differences between the Finnish and Polish patients with RSA. All the RSA patients from Finland and 70% of the RSA patients from Poland were seropositive. In the development of RSA, the prolonged period of inflammatory stimuli may play a more important role than genetic factors.

Adolescent↗
PubMed1990

Seronegative rheumatoid arthritis: a clinical study with HLA typing.

We examined both clinically and by determining HLA-A, -B, -C and -DR antigens 50 patients thought to have seronegative erosive polyarticular rheumatoid arthritis (RA) in Finland and the USSR. All the patients fulfilled at least 4 of the 1987 ARA criteria for RA. According to HLA typing and clinical findings, of which a part was collected by followup, the patients fell into 5 groups: HLA-B27 related diseases, putative psoriatic arthritis, putative juvenile chronic polyarthritis, and seropositive and seronegative RA. Our results indicate that most of the patients with seronegative RA had some other disease. In the remaining cases the presence of rheumatoid factors had not been examined adequately, especially at the early phase of disease. The classification of erosive seronegative polyarticular patients is discussed.

Adolescent↗
PubMed1989

Hidden psoriatic arthritis in seronegative oligoarthritis: a 14-year follow-up study.

Out of a cohort of 64 patients with seronegative oligoarthritis (SO), 8 patients with HLA-B13, 5 with Bw16 and 3 with HLA-B17 were invited to participate in a 14-year check-up. Thirteen patients showed some features of psoriatic arthritis, including 5 with suspected skin or nail disease, 5 with a family history of psoriasis, 3 with DIP joint affliction, and 2 with aortic valve insufficiency. It is concluded that a quarter of the patients with SO may have hidden psoriatic arthritis.

Adolescent↗
PubMed1989

The effect of different indomethacin formulations in young and elderly patients: a comparative controlled clinical trial.

In a double-blind, crossover trial a controlled-release multiple-units indomethacin formulation (50 mg twice daily) was compared with conventional capsules (25 mg twice daily with 50 mg in the evening) in 12 young and 18 elderly in-patients with rheumatoid arthritis. Earlier findings that younger patients preferred a slow-release formulation and the elderly a standard formulation could not be confirmed. As a whole, the duration of morning stiffness was reduced more (p = 0.02) with the controlled-release formulation than with the conventional formulation. During the treatment period (7 days), 4 patients reported side-effects from the conventional capsules, 3 from the controlled-release formulation, and 6 from both treatments; 53% of the patients preferred the controlled-release formulation, while 20% preferred the conventional capsule (p = 0.046).

Adult↗
PubMed1989

Subjective disease experience in Sjögren's syndrome. A computerized discrimination analysis.

A study was made of the ability of a computerized discrimination analysis to distinguish between primary or secondary Sjögren's syndrome on the one hand and, on the other, various rheumatic diseases which may be, but in this study were not, complicated by Sjögren's syndrome. The analysis was based on a questionnaire including 76 two- or three-scale items. Among these 76 questions, five with a maximum potential for distinguishing between various subgroups were selected and obviously represent the questions for the physician to ask when taking the patient's history. As shown by classification matrix tables, computerized analysis of questionnaires might represent a useful way to assess the prevalence of clinical cases of Sjögren's syndrome and to aid health care administrators in assessing the extent of the Sjögren's syndrome problem. In contrast, manual analysis of patients' graded answers did not provide any simple or practicable method for the diagnostic work-up of cases. Therefore it seems that subjective symptoms should not be included in the diagnostic criteria for Sjögren's syndrome, which in clinical work should be based on objective evidence alone.

Arthritis, Rheumatoid↗
PubMed1989

Prognostic significance of synovial fluid analysis in rheumatoid arthritis.

Thirty patients with definite rheumatoid arthritis and hydropsy in a knee joint were followed for 42 months in a prospective study. The knee joints were initially aspirated and 15 synovial fluid variables investigated. The patients were split into two groups, those with and those without progress of radiologically detected destruction in the knee joints during the follow-up. Of the synovial fluid variables at the start synovial fluid proteins (P = 0.002) and acid phosphatase (P = 0.03) differed statistically significantly between the groups, both being higher in patients with worsening of knee joint. The results suggest that high synovial fluid proteins and acid phosphatase are predictors of poor prognosis in a joint affected by rheumatoid arthritis.

Adult↗
PubMed1988

Significance of rheumatoid factors in an eight-year longitudinal study on arthritis.

A community-based cohort comprising 150 patients with recent-onset seropositive arthritis or seronegative oligoarthritis or polyarthritis was monitored for 8 years. Of the different rheumatoid factor (RF) tests, the initial positivity in the most sensitive assays (latex slide test and IgM-RF by enzyme immunoassay) was the most reliable factor when distinguishing between the erosive and nonerosive cases. The individual RF isotypes fluctuated in four serial specimens, but each patient tended to preserve his or her reactivity pattern. Seroconversion from positive to negative within the 1st year of follow-up did not indicate a particularly good long-term prognosis.

Arthritis, Rheumatoid↗
PubMed1987

Work capacity of patients with inflammatory joint diseases. An eight-year follow-up study.

In a prospective study of recent arthritis, 103 patients had rheumatoid arthritis (RA), 63 seronegative oligoarthritis (SO), 67 reactive arthritis (REA), 20 ankylosing spondylitis (AS), and 13 psoriatic arthritis (PA). At the 8-year check-up, 36% of patients with RA were at work, compared with 69% in PA (p less than 0.002), and 85-90% in AS, SO, and REA (p less than 0.001). Correspondingly 43% of the RA patients were disabled by arthritis, compared with 23% in PA (NS), 15% in AS (p less than 0.005), none in SO, and 4% in REA (p less than 0.001). No significant differences in work capacity were noted between patients with PA, AS, SO or REA. In RA, the educational backgrounds of patients unable to work (44 patients) and able to work (37 patients) did not differ from each other or from the overall population of Finland, but a significantly (p less than 0.01) smaller number of patients with arduous work were able to continue at work. The mean age of 49 years for RA patients unable to work differed highly significantly (p less than 0.001) from the 35 years of RA patients at work. However, the weightiest cause of limited work capacity was severity of disease.

Adult↗
PubMed1986

Alpha 1-antitrypsin in acute anterior uveitis and rheumatic diseases.

To test the pathogenetic role of the phenotype MZ of alpha 1-antitrypsin/alpha 1-protease inhibitor (PI) in acute anterior uveitis (AAU) and in different rheumatic diseases we examined 360 unrelated patients including 93 with AAU alone, 24 patients with AAU and ankylosing spondylitis (AS), 21 patients with AAU and Reiter's disease (RD), 26 patients with AAU, AS, and RD 54 patients with AS alone, 16 patients with RD alone, 115 patients with rheumatoid arthritis (RA) alone, and 11 patients with psoriatic arthritis (PA) alone. Of the 164 AAU patients, 80 had a single attack, and 84 had repeated episodes. There were neither significant differences between different groups of the patients and 120 healthy controls nor between patients with AAU alone and patients with AAU and AS or RD in the frequencies of the PI phenotypes tested. The results indicate that the PI MZ type is not closely associated with AAU, AS, RD, RA and PA and that it does not play any role in determining whether AAU shows a pattern of a single attack or repeated episodes, and whether AAU occurs alone or together with AS or RD.

Acute Disease↗