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Biomedical subjects

K Kaarela

Publications and source records attributed to K Kaarela.

At least 91 records · Page 5Linked to original sources
PubMed1986

Incidence of hip involvement and need for total hip replacement in rheumatoid arthritis. An eight-year follow-up study.

In an 8-year follow-up of a prospective study of recent arthritis, 103 patients were found to have erosive and 97% seropositive rheumatoid arthritis. A 20% incidence of hip joint involvement was observed among them. Moderate radiological changes could be seen in 10%, severe destruction (Larsen 4 or 5) in 3%, and acetabular protrusion in 1% of the patients. It was estimated that the minimum annual need of total hip replacement in rheumatoid arthritis in Finland would be 470. This is about 100 per million in the overall population. At the end of the follow-up the Larsen X-ray index was highly significantly (p less than 0.001), ESR significantly (p less than 0.005), and CRP clearly (p less than 0.03) higher in the 13 patients with radiologically confirmed hip changes than in the 90 without them. Thus their hip destruction is attributable to a more severe disease condition and not to the glucocorticoids administered. Furthermore, HLA-B27 was positive in 69% of the above-mentioned 13 patients compared with 27% of the rest, and this difference (p less than 0.005) may also explain the poor prognosis for true rheumatoid arthritis patients.

Adolescent↗
PubMed1985

Prognostic factors and diagnostic criteria in early rheumatoid arthritis.

The purpose of the present undertaking was to investigate prognosis of patients with non-specific or rheumatoid arthritis and to study the value of different diagnostic criteria for rheumatoid arthritis (RA) at the beginning of the disease. During the years 1973-75, a total of 442 patients with recent (less than or equal to 6 months) arthritis were studied at the Rheumatism Foundation Hospital, Heinola, Finland. In 1982 the outcome of the 200 patients with the diagnosis of RA or non-specific arthritis was established. Their ages at the time of the first hospitalization were 16-77 years, mean 41. There were 63 men and 137 women. The follow-up period was 6-9 years, mean 7.6. The outcome was measured by joint score, function score, the sum of ESR and CRP, X-ray index, outcome index, which was composed of the preceding ones, ESR, and CRP. The outcome was poor in half of the patients. Ninety-eight signs and symptoms registered at the first hospitalization were compared with the seven facets of outcome using Pearson's correlation coefficient r. The significances of the correlation coefficients were tested by Student's t-test. From 10 to 39 variables correlated highly significantly (p less than 0.001) with the measures of outcome; however, most of the variables had only moderate correlations. At best 14 variables showed 0.40 less than r less than 0.58 when correlated with the outcome index. In conclusion, at the onset of an arthritic disease symmetrical polyarthritis in peripheral joints, serum rheumatoid factor, X-ray changes, morning stiffness, high ESR, and old age correlated best with a destructive joint disease. Plasma proteins as indices of non-specific inflammation mattered less. The relationships between 22 entry variables and the seven facets of prognosis were further evaluated by means of stepwise multiple regression analysis. The results were essentially the same as reached above. One or two variables, most often the number of diseased peripheral joints and serum Waaler-Rose test, always explained the variance better than the number of ARA criteria alone. To study the value of the diagnostic criteria, diagnosis of the patients was made in the following three ways: RA with five or more erosive joints (N = 78), RF-positive and erosive RA (N = 93), RF-positive and nonerosive or RF-negative and erosive RA (N = 125). The patients outside each of the diagnostic groups formed the corresponding control groups.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1984

Comparison of the analgesic effect of ten nonsteroidal anti-inflammatory drugs.

The analgesic effect of 10 anti-inflammatory drugs was compared using a single-blind method in 90 patients with rheumatoid arthritis. Each patient received two different drugs, for three days each and each drug was evaluated in 18 patients. After the trial, the patients considered which of the drugs they preferred. The greatest relief from pain was achieved by diclofenac, indomethacin, naproxen and tolfenamic acid, each of these being preferred by the majority of patients and being significantly (p less than 0.01) better than the least effective drugs ketoprofen and proquazone. Acetylsalicylic acid, azapropazone, carprofen and ibuprofen were considered intermediate in efficacy.

Adult↗
PubMed1983

Relationship between clinical synovitis and radiological destruction, in rheumatoid arthritis.

The clinical synovitis and radiological destruction of wrist and subtalar joints were followed over a 3-year period in 107 patients with rheumatoid arthritis of no longer than 6 months' duration. The joints were examined clinically and by X-ray on entry to study, at one year and at three years of study. The progress of joint destruction was highly significantly correlated with the frequency of clinical synovitis at the three examinations in both wrist and subtalar joints.

Arthritis, Rheumatoid↗
PubMed1983

Long-term prognosis of monoarthritis. A follow-up study.

During 1973-75, a total of 446 patients with recent arthritis were examined. The diagnosis in 32 cases was non-classified monoarthritis. After the 3-9 years' follow-up of these 32 patients, two seropositive, definite rheumatoid arthritis cases (6%), and one ankylosing spondylitis case were noted. In the remaining patients the diagnosis was still non-specific arthritis. Of the 31 patients tested, 39% were HLA-B27-positive. The difference between this and the HLA-B27-positivity in the normal Finnish population (14%) is statistically significant (p less than 0.005). At the end of the follow-up the good prognosis of monoarthritis was confirmed: only one erosion developed in one patient's hands or feet.

Adult↗
PubMed1983

Prognosis of inflammatory joint diseases. A three-year follow-up study.

The prognosis 3 years after the onset of the disease was studied in 107 patients with definite rheumatoid arthritis, 161 with probable RA or non-specific arthritis, 84 with either ankylosing spondylitis, Reiter's disease or reactive arthritis, 14 with psoriatic arthritis and 10 with a systemic connective tissue disease. Prognosis was measured by clinical involvement of joints, radiological erosions in joints, deterioration in joint function, ESR, and working ability. A total of 44% of all patients were symptomless after 3 years. The prognosis was best in patients with an "HLA B 27-associated" disease and non-specific arthritis, and worst in RA. Two patients died during the follow-up of systemic connective tissue disease and one committed suicide with an overdose of hydroxychloroquine. Two HLA B27-positive patients developed systemic amyloidosis.

Arthritis↗
PubMed1983

The value of the diagnostic criteria in rheumatoid arthritis.

The ARA and the New York diagnostic criteria for rheumatoid arthritis were studied in 411 patients with a recent inflammatory joint disease (100 with RA, 311 with other disease) in order to evaluate their value in distinguishing progressive rheumatoid arthritis from other joint diseases. Rheumatoid factor, symmetrical polyarthritis, morning stiffness, and X-ray changes were of the greatest value in diagnosing RA in the early stage of the disease. Other diagnostic criteria had either a poor specificity or sensitivity, and were thus of less importance as discriminators.

Arthritis, Rheumatoid↗
PubMed1982

Pharmacokinetics and tolerance of slow-release indomethacin tablets in rheumatoid arthritis.

The pharmacokinetics, efficacy and tolerance of a new formulation of slow-release indomethacin tablet were compared with those of a conventional indomethacin capsule in 30 patients with rheumatoid arthritis. The slow-release tablet was absorbed more slowly than the capsule (tmax 3.7 h and less than 2 h, respectively) and produced more even serum drug levels in 10 subjects. Side-effects, especially dizziness and diarrhoea, were less frequent after the slow-release tablet than during the capsule period.

Adult↗
PubMed1982

Xerostomia in Sjögren's syndrome treated with Sali-Synt. A double-blind cross-over trial.

In a double-blind cross-over trial, a new synthetic saliva Sali-Synt was compared with placebo for the treatment of xerostomia in Sjögren's syndrome. Sali-Synt may soothe the pain in the mouth and reduces sleep disturbances better than placebo, but no statistically significant differences were found. Seven patients of 12 preferred Sali-Synt to placebo in helping xerostomia.

Adult↗
PubMedDate not supplied

Conventional monotherapy compared to a "sawtooth" treatment strategy in the radiographic progression of rheumatoid arthritis over the first eight years.

OBJECTIVE: To describe the treatment with disease-modifying antirheumatic drugs (DMARDs) in two inception cohorts of rheumatoid arthritis (RA) patients and to compare their radiographic outcomes. METHODS: A recent onset RA cohort was collected in Heinola in 1973-1975, and another in Jyväskylä in 1983-1989. The cohorts were followed up prospectively and treated with available DMARDs. The radiographic outcomes of 103 and 85 seropositive cohort patients from Heinola and Jyväskylä respectively were assigned Larsen scores (0-100) for their wrist, hand and foot radiographs in years 0, 1, 3, and 8, and compared with each other. RESULTS: In this study it was seen that DMARD treatment for RA became more extensive over time. The earlier cohort patients were treated with gold sodium thiomalate, chloroquine and D-penicillamine, while 8 additional DMARDs and various DMARD combinations were used for the later cohort patients. At the 8 year visit, 23%, 33%, and 2% of the Heinola patients, and 6%, 45%, and 21% of the Jyväskylä patients respectively were being treated with chloroquine, other single DMARDs, or DMARD combinations. Destruction in the peripheral joints remained lower in the more extensively treated cohort; from 0 to 8 years the median Larsen score increased from 1 to 25.5 and from 0 to 12 (p = 0.001) for the Heinola and the Jyväskylä patients, respectively. CONCLUSION: Our result supports a role of DMARDs in preventing joint destruction in RA in the long-term.

Antirheumatic Agents↗