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Dissertations / Theses on the topic 'Rheumatoid arthritis Immunological aspects'
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Sverdrup, Berit. "Aspects of the role of mineral oil as immunological adjuvant in rheumatoid arthritis /." Stockholm, 2007. http://diss.kib.ki.se/2007/978-91-7357-112-8/.
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Effertz, Bernard Stephen. "The humoral immune response to streptococcal cell wall-induced arthritis in the rat." Diss., The University of Arizona, 1989. http://hdl.handle.net/10150/184877.
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I investigated the humoral immune response to streptococcal cell walls (SCW) in arthritis susceptible Lewis and resistant Fisher rats. All rats were given a single intraperitoneal injection of either SCW or saline (controls). Rats were sacrificed, three rats per time point, over an eleven week period and serum was collected for ELISA. SCW injected Lewis rats produced anti-SCW antibody, whereas control rats did not. Anti-SCW antibody was significantly elevated over controls between days 14-28 (post injection). Both saline and SCW injected Fisher rats produced anti-SCW antibody, but with different kinetics. Anti-SCW antibody increased by day 7 and remained elevated over controls till day 21, after which there was no difference. ELISA were designed to determine the SCW epitope(s) recognized by anti-SCW antibody. Formamide extracts of SCW, peptidoglycan and polysaccharide, were investigated along with the terminal epitope of polysaccharide, N-acetyl-D-glucosamine, and the peptidoglycan precursor peptide. The data revealed that anti-SCW antibody was directed against a combined SCW epitope, given the lack of significant binding to any of the SCW epitopes tested. Isotype analysis of anti-SCW antibody revealed that the Lewis response was composed primarily of IgG2a whereas the Fisher response was composed primarily of IgM. Binding of rat IgG isotypes to whole streptococcus, SCW, peptidoglycan, and polysaccharide was investigated, given the possibility of background binding by the streptococcal Fc-receptor. Streptococcal binding of rat IgG was specific for IgG2c and the polysaccharide portion of SCW was necessary for binding. Passive immunization of naive Lewis rats with antibody from rats with active arthritis was ineffective at transferring the disease. However, subcutaneous injection of affinity purified anti-SCW antibody or IgG into Lewis rats, followed twenty-four hours later by a single intraperitoneal injection of SCW, suppressed the acute phase and inhibited the chronic disease. IgM rheumatoid factor (RF) was present in the serum of both saline and SCW injected Lewis and Fisher rats. However, SCW injection only induced a significant increase in IgM RF (between days 3-7) in Lewis rats. Passive immunization of Fisher rats with affinity purified IgM RF (from Lewis serum), three days post SCW injection, was ineffective at inducing arthritis.
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Nordström, Dan C. E. "Cellular inflammation in arthritis a study of clinical, histological, and immunological aspects in rheumatoid and reactive arthritis /." Hki : Societas scientiarum Fennica, 1989. http://catalog.hathitrust.org/api/volumes/oclc/58508848.html.
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Lacey, Derek. "NFκB independent pathway activation of rheumatoid arthritis FLS by macrophage migration inhibitory factor (MIF)." Monash University, Faculty of Medicine, 2003. http://arrow.monash.edu.au/hdl/1959.1/9457.
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Penglis, Peter Savas. "The relationships between eicosanoid production and pro-inflammatory cytokines." Title page, contents and summary only, 2001. http://web4.library.adelaide.edu.au/theses/09PH/09php3985.pdf.
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Includes bibliographical references (leaves 182-240). Explores alternate strategies that may alter inflammatory cytokine production, particularly tumour necrosis factor đ [tumor necrosis factor-alpha], and therefore provide a possible treatment for rheumatoid arthritis.
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Duke, O. L. "Immunological observations in rheumatoid arthritis." Thesis, University of Cambridge, 1987. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.598674.
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Bedwell, A. E. "Immunological abnormalities of rheumatoid arthritis." Thesis, University of Bristol, 1986. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.372005.
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Pritchard, M. L. "Psychological aspects of rheumatoid arthritis." Thesis, University of Exeter, 1987. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.381050.
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Milicic, Anita. "Studies of the genetic and immunological basis of rheumatoid arthritis." Thesis, University of Oxford, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.275411.
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Brink, Mikael. "Presence of immunological markers preceding the onset of rheumatoid arthritis." Doctoral thesis, Umeå universitet, Reumatologi, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-102589.
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Rheumatoid arthritis (RA) is a chronic inflammatory disease with an unknown aetiology characterized by joint destruction. Both genetic and environmental factors contribute to the disease development with HLA-DRB1* alleles and smoking identified as most important. The disease is characterized by the presence of autoantibodies, originally by rheumatoid factor (RF) and more recently by anti citrullinated protein/peptide antibodies (ACPA) and antibodies against carbamylated peptides (CarP). These autoantibodies are present, not only after the onset of disease, but also prior to the onset of symptoms. The development of RA is a gradual process lasting several years before the onset of any joint symptom, but when and if there is a temporal difference in the development both between and within the different antibody systems is currently unknown. B-cells produce the antibodies, and a subset of B-cells, i.e., B-regulatory (Breg) cells, produces interleukin-10, and thus have the ability to down-regulate pro-inflammatory cytokines. Whether the Breg cells are involved in the pathogenesis of RA is, as yet, unknown. The aim of this thesis was to increase knowledge of the pathophysiological processes in the development of RA through identification of factors involved. The analyses involved detection of autoantibodies to post-translationally modified peptides/proteins in addition to RF isotypes, cell surface markers on immune cells in asymptomatic individuals, who have an increased risk of developing RA. In a co-analysis of the registers of patients with RA attending the Department of Rheumatology, with the registers from population based screening programmes within the Biobank of Northern Sweden, blood samples collected from individuals prior to the onset of symptoms were identified, as were those from population control subjects. A cohort of pre-symptomatic individuals also donated samples at the time of receiving a diagnosis of RA. First-degree relatives (FDR) of patients with RA were also identified and included for analyses. The levels of ten different ACPAs, i.e., (fibrinogen (Fib) α563-583(573), Fibα580-600(591), Fibβ62-81a(72), Fibβ62-81b(74), Fibβ36-52, a-enolase (CEP-1), triple helical collagen type II (citC1III), filaggrin (Fil307-324), vimentin (Vim) 2-17, and Vim60-75) were measured using the ImmunoCAP ISAC system (Phadia/ThermoFischer, Uppsala, Sweden) in blood samples from individuals before the onset of symptoms and when diagnosed with RA in comparison with those in population based controls. In a subset of samples, the levels of anti-CarP antibodies were measured using ELISA coated with anti-CarP-FCS, as well as analysis of RF of IgM, IgG and IgA isotype using the EliA assay (Phadia, Uppsala, Sweden). Breg cells were analysed both with and without stimulation ex vivo along with other cell types using flow cytometry in samples from patients with RA, their first degree relatives (FDR) and healthy controls. In paper I it was shown that levels of ACPA were initially restricted to a few antibodies but disseminated over time to involve additional different antibodies. The levels of antibodies to CEP-1, Fibß36-52, and filaggrin were significantly increased. In paper II, anti-CarP antibodies were positive in 5-13% of the individuals negative for the various ACPA studied. The presence of anti-CarP antibodies was significantly related to radiological destruction of joints at baseline, at follow-up after 24 months and to the radiological progress between baseline and 24months. In paper III, the relationships between the frequencies of RF isotypes, the ten different ACPA, anti-CCP2 and anti-CarP antibodies before the onset of any symptoms and the presence of certain combinations of antibodies were associated with a very high risk of developing RA. In paper IV Breg cells from patients with RA are functionally impaired and FDR showed a similar pattern by responding less to stimulation ex vivo than cells from healthy controls. In conclusion, individuals who subsequently develop RA have an increased number and amount of ACPAs, anti-CarP antibodies and RF of IgM, IgG and IgA isotype, several years before symptom onset. Most of the different antibodies analysed remain associated with disease development after adjustments for each separate antibody. In FDRs, Breg cells were functionally altered in that they produce less IL-10 and consequently contribute to a more inflammation-prone status, as in their relatives with RA. These findings contribute to information about the development of RA as well as a given individual’s risk(s) of developing RA and its progression.
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Salih, Abdelrazig Mustafa. "A clinical and immunological study of peripheral neuropathy in rheumatoid arthritis." Thesis, Keele University, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.318158.
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Meltzer, Janet R. "Psychological adjustment in juvenile rheumatoid arthritis /." The Ohio State University, 1987. http://rave.ohiolink.edu/etdc/view?acc_num=osu148758564557603.
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Bishop, Carole Marie. "Coping with pain in rheumatoid arthritis." Thesis, University of British Columbia, 1990. http://hdl.handle.net/2429/29207.
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This research investigated the role of coping strategies in reducing the pain experience of rheumatoid arthritis (RA) patients over a seven-day period. Sixty-three patients completed a twice-daily structured dairy consisting of an eight scale revision of the Ways of Coping (WOC), the depression subscale of the Affects Balance Scale (ABS), and a pain visual analogue scale (VAS). Multivariate analyses for repeated measures identified two coping strategies, Self-Care and Positive Reappraisal, as significantly effective in pain reduction. Self-Care includes behavioral attempts to manage the symptoms of RA. Positive Reappraisal involves cognitive efforts to redefine pain experience in positive terms. The other six coping strategies also demonstrated a trend to increased use on days when pain decreased. These data imply that intraindividual approaches in examining the coping/pain association have potential benefit for determining a causal relation between coping and pain.Medicine, Faculty of
Cellular and Physiological Sciences, Department of
Graduate
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Ljung, Lotta. "Aspects on inflammation and cardiovascular comorbidity in rheumatoid arthritis." Doctoral thesis, Umeå universitet, Reumatologi, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-57702.
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There is an increased risk for cardiovascular (CV) comorbidity among patients with rheumatoid arthritis (RA), with premature atherosclerosis, and a higher incidence of CV events, compared with the general population. Disease related factors add to the CV risk, and interact with the traditional CV risk factors. The underlying mechanism for this is not completely understood. In active RA there is a loss of muscle mass and an increase in body fat content. Production of cytokines, i.e., adipokines, in the adipose tissue could link the inflammation with the CV system. Control of the inflammation has been suggested to modify the CV risk in RA, and the recently introduced biological drugs, such as the tumor necrosis factor inhibitors (TNFi), have opened up new treatment opportunities. The aim of this thesis was to evaluate aspects of the interaction between inflammation and CV comorbidity in RA using biochemical and epidemiological methods. Methods In the first two studies, patients with established RA were examined for clinical disease activity, and blood samples were analysed for cytokines and adipokines using ELISAs and multiplex technology. In Study I (n RA=23) anthropometric measurements were assessed and in Study II (n RA=51) measurements of intima-media thickness (IMT), and endothelial function (FMD). From a subgroup of patients (Study II, n RA=13) samples of abdominal subcutaneous adipose tissue (SAT) were analysed for content of adipokines. In study III and IV associations between treatment with TNFi and acute coronary syndromes (ACS) were analysed using data from the Swedish Rheumatology Register; in Study III regarding early RA (n TNFi exposed=1,271, n bionaïve RA=4,729), and in Study IV comprising patients with RA of all stages (n TNFi exposed=7,213, n bionaïve RA=17,769) and with a matched general population comparator cohort (n=32,161). Associations between response to TNFi therapy and risk for ACS in the early RA cohort were evaluated in a nested case-control design (cases n=24, controls n=81). Results Serum levels of the cytokines/adipokines interleukin-1 receptor antagonist (IL-1Ra), IL-6, osteopontin, visfatin and TNF were increased in patients compared with controls (p≤0.001-0.036). The amount of TNF receptor II extracted from SAT was greater in patients (p=0.006). The serum (s-) levels of IL-1Ra correlated with s-leptin (r=0.71, p≤0.001) and s-haptoglobin in RA patients (r=0.56, p≤0.01). The result from a factor analysis indicated IL-1Ra to be associated with both adipose tissue and inflammation. Levels of s-visfatin (p=0.019) and s-IL-1Ra (p=0.023), respectively, were positively associated with IMT independently of inflammatory activity and CV risk factors. PAI-1 and MCP-1 extracted from SAT showed inverse associations with IMT. Patients with RA, whether exposed to TNFi or bio-naïve, had a doubled risk for ACS compared with the general population; HR 2.09 (95%CI 1.58-2.76) and 1.80 (1.49-2.17), respectively. No significant associations between risk for ACS and TNFi exposure were detected after adjustments; HR 0.80 (0.52-1.24) in early RA and HR 1.08 (0.82-1.41) in RA of any duration. Furthermore, no association between the risk for ACS and response to TNFi treatment in patients with early RA was observed, OR 1.5 (0.3-6.9). Conclusions The results indicate that cytokines/adipokines may have a role in the development of atherosclerosis in RA patients. A continuing increase in the risk of ACS in RA compared with the general population, despite modern therapeutic strategies, was noted. Neither exposure nor response to treatment with TNFi was associated with any modification of the risk for ACS.
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Innala, Lena. "Early rheumatoid arthritis aspects of severity and co-morbidity." Doctoral thesis, Umeå universitet, Reumatologi, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-88477.
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Background Rheumatoid arthritis (RA) is a systemic progressive destructive joint disease with an increased risk for co-morbidity and premature death if untreated. Cardiovascular disease (CVD) is the main cause of death but also other co-morbid conditions contribute to the patient’s shorter life expectancy. Inflammation is important for the development of CVD, but knowledge of its relationship with other co-morbidities is sparse. Early disease modifying anti rheumatic drugs (DMARDs) can suppress disease activity and improve the long-term outcome. The aim of this thesis was to evaluate prospectively aspects of disease activity and severity in a large cohort of patients with early RA. Predictive and prognostic markers, e.g., antibodies against citrullinated proteins/peptides (ACPAs), occurring in early disease and with implications for disease outcome and co-morbidity were evaluated. Methods Patients with early RA (i.e., symptomatic for ≤12 months) have, since December 1995, been consecutively included in a large survey of prospective and observational studies on the progression of RA and the development of co-omorbidity. Autoantibodies, inflammatory, genetic markers and radiographs have been analyzed. In paper I, 210 RA patients and 102 controls were followed regularly for two years. The predictive value of four different ACPAs in relation to disease activity and radiological progression was evaluated. In Paper II (n = 700) and in Papers III-IV (n =950), patients with early RA from the four northern-most counties of Sweden were followed regularly for 5 years. Data on risk factors and co-morbidity was collected, according to the study protocol, from clinical records and self-reported questionnaires from patients at inclusion into the study cohort and after five years. The predictive value of traditional and potential disease related risk factors for new cardiovascular events (CVE) was evaluated (II). In Paper III, the impact of age at the onset RA, stratified as being young onset RA (<58 years; YORA) and late onset RA (≥58 years; LORA) on disease activity, severity and chosen treatment, was evaluated. In Paper IV, the development of new co-morbidities after RA onset and their relation to inflammatory activity was assessed. Results The presence of anti-mutated citrullinated vimentin (MCV ) antibodies was associated with a more severe disease course, estimated by disease activity score, erythrocyte sedimentation rate (ESR) and swollen joint count after 24 months, compared with anti-CCP2, anti-CCP3, and anti CCP3.1 antibodies. In Paper II, the incidence of a new CVE during 5 years was explained by several of the traditional CV risk factors, and potentiated by a high disease activity. Treatment with DMARDs decreased the risk. In Paper III, LORA patients were associated with greater disease activity/severity at disease onset and over time compared with YORA who were more often ACPA positive. YORA patients were treated earlier with DMARDs, whilst LORA patients were more often treated with corticosteroids and less so with DMARDs early in the course of their disease. In Paper IV, 53%of patients already had one or more co-morbidities already at the onset of RA. After 5 years, 41% of the patients had developed at least one new co-morbidity. ESR at baseline and accumulated disease activity were associated with a new co-morbidity after five years. Conclusion Early RA patients sero-positive for anti- MCV antibodies appeared to have a higher disease activity over time. The occurrence of a new CVE in early RA patients was predicted by traditional risk factors for CVD which were potentiated by a high disease activity. Treatment with DMARDs decreased the risk. Patients with young onset of RA were associated with a higher frequency of ACPA. Late onset of RA was associated with higher disease activity/severity at inclusion and over time. However, LORA patients were more often treated with corticosteroids and less so with DMARDs early in the disease course. Development of a new co-morbidity during the five years following diagnosis was related to ESR.
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Nissinen, Riikka. "Immunological features of chronic active rheumatoid arthritis : chemokine receptor and cytokine profile in synovial fluid, peripheral blood and gut in patients with rheumatoid arthritis." Helsinki : University of Helsinki, 2003. http://ethesis.helsinki.fi/julkaisut/laa/kansa/vk/nissinen/.
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Chu, Sok-iam Peony. "The role of self-efficacy in rheumatoid arthritis patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1994. http://hub.hku.hk/bib/B29689156.
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Södergren, Anna. "Epidemiological and pathogenic aspects on cardiovascular disease in rheumatoid arthritis." Doctoral thesis, Umeå universitet, Reumatologi, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-1906.
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Rheumatoid arthritis (RA) is a chronic disabling disease that is associated with a shortened life span. Cardiovascular disease (CVD) contributes to this increased mortality, and also to a great extent to the co-morbidity observed in patients with RA. This thesis aimed to investigate these issues further. The incidence of, and prognosis after an acute myocardial infarction (AMI) /or stroke in a cohort of RA patients was compared with that in the general population within the northern Sweden MONICA register. The standard incidence ratio (SIR) for AMI was 2.9 and for stroke 2.7 in RA patients compared with the general population (p<0.05 for both). During the first 10 years following an event, RA patients had a higher overall case fatality (CF) compared with controls (HR for AMI=1.67, 95%CI [1.02, 2.71], HR for stroke=1.65, 95%CI [1.03, 2.66]). An elevated level of homocysteine is regarded to be a risk marker for CVD. The effects of treatment with B vitamins on the homocysteine level in patients with RA were studied in a consecutive cohort of patients with RA. Sixty-two patients with RA having a homocysteine level of 12 mol were randomized to receive either a placebo or a combination of the vitamins B6, B12 and folic acid. The patients were treated and evaluated in a double-blind manner over 12 months. The homocysteine level was found to be significantly decreased in the B-vitamin treated patients compared with the placebo group (p<0.0001). To evaluate the progression of sub-clinical atherosclerosis in patients with very early RA compared with controls, all patients from the three most northern counties of Sweden newly diagnosed with RA and aged ≤60 years were consecutively recruited. Age and sex matched controls from the general population were also included. Intima media thickness (IMT) of the common carotid artery and endothelium dependent flow mediated dilation (ED-FMD) of the brachial artery were measured using ultrasonography. After 18 months the same measurements were undertaken in a sub-group of the patients with early RA and the relevant controls. There were no differences between patients with early RA and controls in terms of IMT or ED-FMD at inclusion into the study. However, after 18 months there was a significant increase in the IMT among the patients with early RA (p<0.05); no such increase occurred in the control group. Biomarkers of endothelial activation that may reflect the early atherosclerosis that occurs in RA were also evaluated. At inclusion, both IMT and ED-FMD among the patients with early RA related significantly to several of the biomarkers of endothelial activation. Furthermore, markers of inflammation (e.g., DAS28) were significantly related to biomarkers of endothelial activation. In conclusion, RA patients had a higher incidence of CVD and a higher CF after a CV event. The increased homocysteine level among patients with RA was as easy to decrease as in the general population. At the time of diagnosis of RA there were no differences in atherosclerosis between patients and controls, however the patients with RA had a more rapid progression of atherosclerosis than the control subjects. Moreover, there were implications of endothelial activation already in patients with very early RA. Taken together, these results emphasize the necessity of optimizing the preventive, diagnostic and caring strategies for CVD in patients with RA.
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Reckner, Olsson Åsa. "Occupational and environmental aspects on the aetiology of rheumatoid arthritis /." Linköping : Univ, 2003. http://www.bibl.liu.se/liupubl/disp/disp2003/med807s.pdf.
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Humby, Frances Claire. "The clinical and immunological significance of ectopic lymphoneogenesis in the rheumatoid synovial membrane." Thesis, Queen Mary, University of London, 2010. http://qmro.qmul.ac.uk/xmlui/handle/123456789/28086.
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Despite the development of new biomarkers predicting prognosis in rheumatoid arthritis (RA) remains challenging and targeting of powerful biologics difficult. The presence of ectopic germinal centres (GC) within synovium has long been recognised (ectopic lymphoneogenesis [ELN]) and data have suggested that they manufacture antibody (Ab). High affinity class switched Ab production occurs through class switch recombination (CSR) and somatic hypermutation (SHM) both critically dependent on activation induced cytidine deaminase (AID). However, whether ectopic GCs express AID has not been known. Nonetheless data associating ELN with disease severity suggest a role for ELN in RA pathogenesis and as a potential biomarker. A classification system for RA synovium, based on the concept of ELN has been proposed as: (i) aggregate, (ii) aggregate GC+ and, (iii) an unorganised infiltrate. However whether these distinct pathotypes and/or degree of aggregation equate to disease severity is unclear. Thus my first aim was to develop and validate a pathological scoring system for rheumatoid synovium capable of quantifying the degree of ELN. My second aim was to investigate whether the presence and/or degree of ELN within the synovial membrane correlated with both clinical phenotype and predicted erosive damage. I demonstrate that the aggregational score developed is highly reliable and that ELN within synovial tissue associates with a higher level of synovial inflammation but is not predictive of damage. My third aim was to investigate whether GCs within RA synovium were functional. I provide evidence of functionality by demonstrating that ectopic GCs invariably express AID, are surrounded by anti-CCP+ plasma cells, support ongoing CSR and the manufacture of anti-CCP Abs. My final aim was to characterise a cohort of synovial B cells consistently found surrounding ectopic GCs. I identify a novel B cell subset within RA synovium, interfollicular large B cells, (5)(5)(5) and demonstrate that interfollicular large B cells in lymph node express a somatically mutated IgH.
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Gröndal, Lollo. "The rheumatoid forefoot : surgical treatment and epidemiological aspects /." Stockholm : Karolinska institutet, 2007. http://diss.kib.ki.se/2007/978-91-7357-054-1/.
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Chopra, M. S. "Some biochemical aspects of blood in rheumatoid arthritis and vascular diseases." Thesis, University of Strathclyde, 1987. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.381360.
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Ho, Chun-wai Tom. "Social support as a predictor of the psychological adjustment of patients with rheumatoid arthritis in Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1998. http://hub.hku.hk/bib/B29725355.
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Pokorny, Ljubica. "Genetic markers of rheumatoid arthritis in a Western Cape black and coloured population." Thesis, Cape Technikon, 1996. http://hdl.handle.net/20.500.11838/1475.
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Thesis (Masters Degree( Medical Technology) --Cape Technikon, Cape Town,1996Intensive investigations in many different populations over the last decade, have indicated a failure to understand the inheritance of rheumatoid arthritis (RA). It was hoped that genes within the class IT region of the major histocompatibility complex (MHq could shed some light on the inheritance of this autoimmune disease and which are now known without doubt, to confer susceptibility to the disease. Genetic studies of RA have concentrated primarily on its autoimmune nature and several investigations of MHC class IT molecules, have demonstrated an association between specific HIA alleles and susceptibility to RA, in particular the DRBI*04 and DRBI*01 alleles. - The HIA system is known to be associated with many diseases involving an immune aetiology. The structural features of specific DR and DQ genes give clues to the molecular mechanisms by which these alleles are associated with RA It has been found by many investigators that there is more than one susceptibility allele for RA at the DRBI locus. Questions arise whether the DRBI molecule itself directly contributes to the pathogenesis ofRA and why some DRBI genes carrying DRBI*04 alleles, are not associated withRA Animal studies have emphasised the critical importance of T-cells in the pathogenesis of RA Immune responsiveness is thought to be controlled by specific allelic variation by determining the ability of specific T-cell receptors (fCRs) to be triggered by recognition of class IT molecules during the induction of the immune response. In a disease such as RA, however, where multiple alleles are thought to confer risk, it is not yet known whether each of these alleles shares some common structural feature triggering a single T-cell pathway or whether each allele represents an alternative recognition site which triggers different T-cell clones, all of which lead to a similar clinical syndrome.
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Ernestam, Sofia. "Rheumatoid arthritis : pharmacological modulation of cytokines - aspects of clinical response and endocrine regulation /." Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-628-X/.
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Kastbom, Alf. "Autoantibodies and genetic variation in rheumatoid arthritis : aspects on susceptibility and disease course." Doctoral thesis, Linköping : Univ, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-8618.
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Law, Wai-han, and 羅慧嫺. "Molecular mechanisms of arsenic trioxide in an in vitro model of rheumatoid arthritis synoviocyte." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2008. http://hub.hku.hk/bib/B41508531.
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Cheng, Ping-yuen, and 鄭秉源. "Association between tea drinking and markers of rheumatoid arthritis: a cross sectional study of baseline datafrom the Guangzhou biobank cohort study." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B3972394X.
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Lee, Sui Hong Philip, and 李瑞康. "An exploratory study of the effectiveness of meditation on patients with rheumatoid arthritis." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1995. http://hub.hku.hk/bib/B31250075.
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Ångström, Lars. "Aerobic capacity in rheumatoid arthritis : aspects of associations with cardiovascular risk factors and disease activity." Licentiate thesis, Umeå universitet, Reumatologi, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-164592.
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Rheumatoid arthritis (RA) is a systemic and inflammatory disease that has been associated with an increased morbidity and mortality in cardiovascular disease (CVD). Low aerobic capacity is one of the strongest independent risk factors for CVD and all-cause mortality in the general population. In patients with longstanding RA, low aerobic capacity has been related with a worse cardiovascular profile and an increased risk of CVD mortality. As a consequence of this, low aerobic capacity might provide an additional risk factor for CVD in patients with RA. The aim of this thesis was to describe the associations between aerobic capacity and risk factors for CVD as well as disease activity in patients with early RA, and also the effects of intensive exercise therapy on traditional risk factors for CVD and disease activity in patients with longstanding RA. Paper I, a cross-sectional study including 67 patients with early RA, mean (SD) age 53.1 (14.4), assessments of aerobic capacity, CVD risk factors, disease activity and functional ability were taken. Data were analysed for the associations between aerobic capacity and CVD risk factors and disease activity. In paper II, an intervention study, including 13 patients with RA, median age (Q1-Q3) 57 (44-64) years, aerobic capacity, pulse wave analysis (PWA), CVD risk factors, and disease activity were analysed for changes after 10 weeks of intensive exercise therapy. Additional follow-up was made after 25 weeks. In paper I, the mean (SD) aerobic capacity was 31.6 (8.7) ml O2/kg/min. CVD risk factors and disease activity were all in favour of patients with higher aerobic capacity. In a multiple regression model, adjusted for age and sex, aerobic capacity was significantly associated with percent body fat (β=-0.502, 95%CI=-0.671;-0.333) and triglycerides (β=-2.365, 95%CI=-4.252;-0.479). In paper II, intensive exercise over ten weeks was shown to be a feasible method to significantly improve aerobic capacity (p=≤0.05), systolic blood pressure (p=≤0.01) and the number of tender joints (p=≤0.05). No detrimental effect on disease activity was recorded. This thesis adds further knowledge of aerobic capacity and its associations with CVD risk factors and disease activity in patients with RA. Also, intensive exercise therapy was a feasible intervention to improve CVD risk factors. To include assessment of aerobic capacity in regular clinical practice may improve patient management as well as patient outcome in patients with RA.Bakgrund: Reumatoid artrit (RA, ledgångsreumatism) är en kronisk inflammatorisk sjukdom som i första hand angriper leder, men kan även påverka inre organ. Typiska symptom är ledsvullnad, smärta, morgonstelhet och nedsatt funktion i lederna. Patienter med RA har visat sig ha en ökad risk att insjukna i och avlida i hjärt- och kärlsjukdom. I den allmänna befolkningen har låg syreupptagningsförmåga (kondition) visat sig vara en av de starkaste riskfaktorerna för att insjukna i eller att avlida i hjärt- och kärlsjukdom. Tidigare studier har visat att patienter med RA kan ha låg kondition vilket kan utgöra en riskfaktor för hjärt- och kärlsjukdom även vid RA. Syfte: Syftet med denna avhandling var att beskriva sambanden mellan kondition och riskfaktorer för hjärt- och kärlsjukdom och sjukdomsaktivitet. Ett annat syfte var att studera hur intensiv cykelträning påverkar kondition, traditionella riskfaktorer och sjukdomsaktivitet hos patienter med RA. Metod: Studie I är en tvärsnittsstudie, bestånde av 67 patienter med tidig RA, som hade en medelålder på 53 år. De undersöktes avseende; kondition, riskfaktorer för hjärt- och kärlsjukdom och sjukdomsaktivitet för att analysera samband mellan dessa. Studie II är en träningsstudie, bestående av 13 patienter med RA, med en medianålder på 57 år. Kondition, riskfaktorer för hjärt- och kärlsjukdom och sjukdomsaktivitet analyserades för att se förändringar efter tio veckors intensiv cykelträning samt vid en uppföljning efter 25 veckor. Resultat: I studie I visade den studerade gruppen ett konditionsmedelvärde på 31.6 mL. Sambandsanalyser visade att högre kondition var relaterad till lägre grad av riskfaktorer för hjärt- och kärlsjukdom, samt lägre 10 års risk för hjärt- och kärlsjukdom och sjukdomsaktivitet. I studie II fann vi att tio veckors intensiv cykelträning kan vara en användbar metod för att förbättra kondition, blodtryck och antalet ömma leder. Ingen ökad sjukdomsaktivitet noterades. Slutsatser: Dessa studier bidrar med kunskap om samband mellan kondition och riskfaktorer för hjärt- och kärlsjukdom samt sjukdomsaktiviteten hos patienter med RA. De visar också att intensiv cykelträning kan vara en effektiv metod att förbättra kondition och blodtryck hos patienter med RA.
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Björk, Mathilda. "Aspects of Disability in Rheumatoid Arthritis : a five-year follow-up in the Swedish TIRA project." Doctoral thesis, Linköpings universitet, Rehabiliteringsmedicin, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-11956.
Full textAbstract:
Rheumatoid arthritis (RA) is a progressive disease, often leading to disability. Because the disease course develops rapidly during the first years after diagnosis, more knowledge is needed about the early disease course to minimize later disability. This thesis describes the course of disability in early RA such as hand function, pain intensity, activity limitation and sick leave. In addition, this thesis compares disability between women and men and compares disability between RA patients and referents. This thesis is primarily based on data from the 320 patients that were included in the multi-centre project in Sweden called ‘Early interventions in rheumatoid arthritis’ (TIRA). A wide range of outcome variables was registered between 1996 and 2006 during regular follow-ups from time for diagnosis through the eight-year follow-up. Outcome regarding disease activity and disability of RA patients still remaining in TIRA at the three and five year follow-up respectively are used in this thesis. Data concerning sick leave were obtained for the patients during six years (1993-2001) – three years before and three years after diagnosis. Referents were included in two of the studies. Data regarding disability in referents were obtained according to hand function and activity limitation using the Health Assessment Questionnaire (HAQ). Data for sick leave were obtained for six years in referents, for the same period as the RA patients. For most variables, disability in RA was most pronounced at time of diagnosis but before intervention started. Disability was then reduced already at the 3-month follow-up and thereafter affected but stable during the following five years. The exception was participation, reflected by sick leave, a variable that was stable from inclusion to three years from diagnosis. Activity limitation, pain intensity and sick leave in RA that represents different aspects of disability were explained by other aspects of disability and contextual factors rather than by disease activity. RA affects women and men differently in some aspects. Women had more severe course of activity limitations than men according to HAQ. Men were more affected than women in range of motion, although the differences were small in a clinical perspective. However, pain intensity and frequency of sick leave did not differ between women and men. Patients with RA have pronounced disability in relation to referents although several variables improve soon after diagnosis. This discrepancy refers to hand function as well as activity limitations and sick leave. The frequency of sick leave increased during the year before diagnosis in relation to referents and was thereafter high compared to sick leave in referents.
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Eriksson, Catharina. "Immunological mechanisms in systemic autoimmunity : autoantibodies and chemokines in systemic lupus erythematosus and during treatment with TNF inhibitors in rheumatoid arthritis." Doctoral thesis, Umeå universitet, Klinisk immunologi, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-42954.
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Background. Rheumatoid Arthritis (RA) is an autoimmune inflammatory disease that, without powerful treatment, may lead to irreversible joint damage. During the past decade, anti-cytokine therapy has become available, e.g., infliximab, a chimeric antibody targeting the pro-inflammatory cytokine TNF that has a central role in the inflammatory process in RA patients. Systemic Lupus Erythematosus (SLE) is a systemic autoimmune disease that may affect all organs and is characterized by a massive antibody production. Chemokines, chemokine receptors and lipoprotein receptor-related protein 1(CD91) are regulators of inflammation in autoimmune diseases and T-cell migration. Objectives. The aim of this study was to get a deeper understanding how TNF blocking treatment influences inflammatory mechanisms and autoantibody formation in RA with special reference to similarities and differences with SLE. Methods. In patients with RA treated with anti-TNF, and in SLE patients (ACR criteria) clinical evaluation was performed and blood samples analyzed. Autoantibodies were analyzed using indirect immunofluorescence, ELISA and multiplex flow cytometry in samples from anti-TNF treated RA patients (n=59) followed longitudinally for 54 weeks, in pre-diseased samples from SLE patients (n=38) and matched population-based controls (n=152). T-cell expression of chemokine receptors and CD91 was analyzed by flow cytometry, whilst serum levels of chemokines were determined using ELISA in anti-TNF treated RA-patients (n=24) followed longitudinally (30 weeks), and cross-sectionally in SLE-patients (n=23). Expression of mRNA for chemokines was analyzed in T-cells from SLE-patients (n=10) using PCR. Results. After treatment with infliximab, RA patients produced ANA, anti-dsDNA and anti-nucleosome antibodies, but not anti-ENA antibodies. Although these antibodies are considered typical for SLE only one patient developed a transient lupus-syndrome. Antibodies against cell nuclear antigens, including ENA, were detected several years before the first clinical symptom of SLE; anti-SSA was the earliest detectable antibody. In RA-patients before infliximab treatment, the T-cell expression of several chemokine receptors was elevated compared with healthy controls. In contrast, only one soluble chemokine, IP-10 was elevated. After treatment the levels of soluble MIP-1β, MCP-1 and IP-10, and the T-cell expression of CCR2 were decreased. In SLE-patients MIP-1β, MCP-1, SDF-1, IP-10 and RANTES in blood were elevated, whilst expression of CXCR5 and CCR6 on T-cells was lower than in healthy controls. T-cell expression of CXCR2 and CCR1 was elevated in active disease (measured as SLEDAI index), whereas the CXCR5 and CCR2 expression was lower in inactive SLE. In SLE patients with nephritis IP-10 was lower and T-cell expression of CXCR3 and CCR3 elevated compared with patients without nephritis. The expression of CD91 was higher on T-cells from patients not responsive to infliximab treatment compared with responders. Conclusion. These findings indicate that anti-TNF (infliximab) treatment in RA-patients has a major impact on the production of autoantibodies and chemokines. The autoantibody profile in infliximab-treated patients was similar to that predating disease onset in SLE patients with the exception of anti-ENA being detectable in SLE, but the development of lupus-syndromes was rare. The expression of CD91 on T-cells may predict responsiveness to infliximab. The expression of chemokine receptors in SLE- patients seemed to be related to disease activity. Anti-nuclear antibodies were detectable years before clinical disease onset in patients who developed SLE suggesting a gradual pathogenic process.
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Lombard, Louise Ann. "Body composition of rheumatoid arthritis patients and their perceptions and practices regarding diet, nutritional supplements and other treatments." Thesis, Stellenbosch : Stellenbosch University, 2011. http://hdl.handle.net/10019.1/17941.
Full textAbstract:
Thesis (MNutr)--Stellenbosch University, 2011ENGLISH ABSTRACT: Introduction Rheumatoid Arthritis (RA) is a chronic, inflammatory, autoimmune disorder characterized by inflammation of the joints and surrounding tissue causing pain, swelling and stiffness. Studies suggest that aspects of the diet may alleviate symptoms and decrease the risk of complications. The scientific basis for a role of dietary therapy in RA has grown although there is still no consensus on the optimum diet. It has been shown that persons with RA tend to have a poor nutritional status; and rheumatoid cachexia, the loss of body cell mass, occurs in nearly two-thirds of all patients with RA. The study aimed to establish what RA patients are practicing and their perceptions regarding the effect of diet, nutritional supplements, medication and complementary and alternative medicines (CAM) and therapies on their symptoms as well as determining their body composition and the possible presence of rheumatoid cachexia. Methodology The study design was a cross-sectional study with an analytical component. The study population consisted of adult (18 years or older) RA patients in the Cape Metropole from the private and public sector. An interviewer-administered questionnaire was used followed by the measurement of weight, height, waist circumference and skinfold thickness. Information was also gathered from the medical records. Results The sample size comprised of 251 RA patients (n=201 public sector; n=50 private sector). The mean body mass index (BMI) was 30.3 kg/m2 for females and 26.6 kg/m2 for males. BMI was used to classify obesity (n=133; 45.9%), overweight (n=66; 26.8%), normal weight (n=63; 25.6%) and underweight (n=4; 1.6%). Waist circumference measurement classifications showed a substantially increased risk for metabolic complications in 51.8% of participants (n=127) and an increased risk in 21.2% of participants (n=52). Just over half of the participants (n=65; 55.6%) had an unhealthy high body fat percentage classification. Rheumatoid cachexia was seen in 10.3% participants (n=12). Low fat-free mass (Fat-free mass index <10th percentile) was seen in 21% participants (n=24) and obesity (Fat mass index >90th percentile) was seen in 27% of participants (n=31). Twenty nine percent of participants (n=73) believed that certain types of food could improve their symptoms of RA and 60% of participants (n=151) believed that certain foods worsened their symptoms. Sixty four percent of participants (n=161) thought that nutritional supplements or complementary and alternative medicines and therapies could improve their symptoms of RA and 98% (n=246) of participants used nutritional supplements. The most frequently used supplements included folic acid (n=218; 91.6%), calcium (n=182; 76.5%), vitamin D (n=185; 77.7%), omega-3 fatty acids (n=48; 64.9%) and multivitamin and mineral preparations (n=22; 29.7%). Conclusion The obesity and waist circumference figures were unacceptably elevated in this population and the body composition of these RA patients should be highlighted as a concern. The high prevalence of risk factors for cardiovascular disease (CVD) need to be urgently addressed since CVD is the leading cause of mortality in RA patients. This study highlights the important role of the intra-professional team, including the dietitian, in the management of RA patients.
AFRIKAANSE OPSOMMING: Inleiding Rumatoïede artritis (RA) is 'n chroniese, inflammatoriese, outo-immuun siekte wat gekenmerk word deur inflammasie van die gewrigte en omliggende weefsel en veroorsaak pyn, swelling en styfheid. Studies dui daarop dat aspekte van die dieet simptome kan verlig en die risiko van komplikasies kan verminder. Die wetenskaplike basis vir die rol van dieetterapie in RA het gegroei, hoewel daar nog geen konsensus aangaande die optimale dieet is nie. Dit is al bewys dat persone met RA geneig is om 'n swak voedingstatus te hê; en rumatoïede cachexia, die verlies van liggaam selmassa in byna twee-derdes van alle pasiënte met RA voorkom. Die doel van die studie was om te bepaal wat RA-pasiënte se praktyke en persepsies ten opsigte van die uitwerking van dieet, voedselaanvullings, medikasie en aanvullende of alternatiewe medisyne (CAM) en terapieë op hul simptome het, sowel as om hul liggaamsamestelling en die moontlike teenwoordigheid van rumatoïede cachexia te bepaal. Metodiek Die studie ontwerp was 'n dwarssnitstudie met 'n analitiese komponent. Die studiepopulasie het bestaan uit volwassene (18 jaar of ouer) RA pasiënte uit die privaat en openbare sektore in die Kaapse Metropool. Onderhoude was gevoer met behulp van vraelyste. Gewig, lengte, middelomtrek en velvoudikte was ook gemeet. Inligting was ook versamel uit mediese rekords. Resultate Die steekproefgrootte het uit 251 RA pasiënte (n=201 openbare sektor, n=50 privaat sektor) bestaan. Die gemiddelde liggaamsmassa-indeks (LMI) was 30.3 kg/m2 vir vroue en 26.6 kg/m2 vir mans. LMI was gebruik om vetsug te klassifiseer (n=133; 45.9%), asook oorgewig (n=66; 26.8%), normale gewig (n=63; 25.6%) en ondergewig (n=4; 1.6%). Klassifikasie van middelomtrek metings het 'n aansienlike verhoogde risiko vir metaboliese komplikasies in 51.8% van die deelnemers (n=127) en 'n verhoogde risiko in 21.2% van die deelnemers (n=52) getoon. Net meer as die helfte van die deelnemers (n=65; 55.6%) het 'n ongesonde hoë liggaamsvet persentasie klassifikasie getoon. Rumatoïede cachexia was by 10.3% van die deelnemers (n=12) gevind. Lae vetvrye massa (vetvrye massa indeks <10de persentiel) was by 21% deelnemers (n=24) en vetsug (vet massa indeks >90ste persentiel) in 27% van die deelnemers (n=31) teenwoordig. Nege-entwintig persent van die deelnemers (n=73) het geglo dat sekere voedselsoorte hul simptome van RA kon verbeter en 60% van die deelnemers (n=151) was van mening dat sekere kosse die simptome kon vererger. Vier-en-sestig persent van die deelnemers (n=161) het gedink dat voedingsaanvullings of aanvullende en alternatiewe medisyne en terapieë hulle simptome van RA kon verbeter en 98% (n=246) van die deelnemers het voedingsaanvullings gebruik. Die mees algemene gebruikte aanvullings was foliensuur (n=218; 91.6%), kalsium (n=182; 76.5%), vitamien D (n=185; 77.7%), omega-3 vetsure (n=48, 64,9%) en multi-vitamien en mineraal preparate (n=22; 29.7%). Gevolgtrekking Die vetsug en middelomtrek syfers was onaanvaarbaar verhoog in die studiepopulasie en die liggaamsamestelling van hierdie RA pasiënte is 'n bekommernis. Die hoë voorkoms van risikofaktore vir kardiovaskulêre siekte (KVS) moet dringend aangespreek word, aangesien die KVS die grootste oorsaak van sterfte in RA pasiënte is. Hierdie studie beklemtoon die belangrike rol van die intra-professionele span, met inbegrip van die dieetkundige, in die bestuur van RA pasiënte.
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Gerber, Roné. "Exploring the perceptions of women with rheumatoid arthritis of how their illness impacts their relationship with their intimate partner." Thesis, University of the Western Cape, 2006. http://hdl.handle.net/11394/2069.
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Magister Psychologiae - MPsychThis study explored women's perceptions of how their illness (Rheumatoid Arthritis- RA) affects their relationship with their intimate life partner. RA is a chronic, inflammatory, auto-immune illnes, which mainly affects the synovial membranes of multiple joints. This highly inflammatory poly-arthritis may lead to joint destruction, chronic pain, deformity and loss of functioning as unfortunate outcomes of the established illness. RA affects key life domains such as psychological well-being, social well-being, family and couple relationships, employment, loss of independence and restrictions in daily functioning.
South Africa
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Lin, Yan-kai, and 林欣佳. "Silencing of B cell activation factor gene and its implication in treating autoimmune arthritis." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2007. http://hub.hku.hk/bib/B45011370.
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Elramli, Amal. "Effectiveness of community based physical activity on step count and sedentary behaviour in people with rheumatoid arthritis within the first five years of diagnosis." Thesis, University of Glasgow, 2017. http://theses.gla.ac.uk/8491/.
Full textAbstract:
Background: Rheumatoid Arthritis (RA) is associated with increased risk of cardiovascular disease (CVD). Physical inactivity is a modifiable risk factors of CVD and frequently associated with impaired functional status and health related quality of life. Objectives: This single blind randomised controlled trial investigated the impact of a pedometer-supported walking and education programme (Walk for RA-WARA) on PA, sedentary time, PA self-efficacy, disease activity, functional capacity, quality of life and cardiovascular (CV) risk in people with RA. Methods: Seventy-six individuals, aged 56 (±15) years and within 5 years from RA diagnosis were randomly assigned to either the WARA intervention group (six weekly group education sessions and two booster sessions at 3 and 6 months) or the control group (single session). Demographic data were recorded and Body Mass Index (BMI), Waist-Hip ratio (WHR), Waist-Height ratio (WHtR), and blood pressure were measured. The primary outcomes were objectively measured PA profiles, daily step counts and time spent sedentary, using an activPALTM and self-reported using international physical activity questionnaire (IPAQ). Functional status was assessed with six-minute walk test (6MWT), health assessment questionnaire (HAQ), and hand grip strength. Rheumatoid arthritis quality of life (RAQoL) and PA Self-efficacy were evaluated. Blood samples were taken and the 10-year risk of CVD scores were calculated, using the Scottish Intercollegiate Guidelines Network (ASSIGN). Data were analysed descriptively and mixed generalised linear models (GLM) were used incorporating restricted maximum likelihood (REML) and post-hoc analyses. Interviews were undertaken with 10 people from the intervention and data were analysed thematically using the framework approach and NVivo 11 software. Results: The intervention group showed a significantly greater increase than the control group in steps/day at 3 months (by 3413 (1835-4990) steps/day, mean (95%CI)) (P < 0.001), and 6 months (3599 (2135-5062) steps/day) (P < 0.001) and a significant reduction in IPAQ weekday (P=0.014) and weekend sitting time (P=0.046). There were significant improvements in 6MWT (P < 0.001), PA self-efficacy (P=0.008), systolic blood pressure (P=0.002) and ASSIGN scores (P < 0.001) in the intervention group. Participants found education sessions, booster sessions, hand-outs, pedometer, PA diaries were important factors in increasing their step counts. In addition, they stated that WARA programme was enjoyable and helpful in terms of raising their knowledge regarding their condition. They also reported they felt much healthier and their mood had improved. Conclusions: The 6-month WARA intervention was effective in promoting PA, PA self-efficacy, physical function, and reducing the 10-year risk of CVD. The WARA programme may be a useful adjunct to current clinical practice in rheumatology.
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Cedergren, Jan. "Radical aspects on arthritis : the role of neutrophil generation of nitric oxide and superoxide in inflammatory conditions." Doctoral thesis, Linköping : Univ, 2007. http://www.bibl.liu.se/liupubl/disp/disp2007/med984s.pdf.
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Olive, Colleen. "Molecular characterisation of the T-cell receptors expressed in rheumatoid arthritis patients." Phd thesis, 1993. http://hdl.handle.net/1885/143110.
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Roberts-Thomson, Peter J. "Low molecular weight IgM in health and disease / by Peter John Roberts-Thomson." 1987. http://hdl.handle.net/2440/38410.
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x, 156 leaves :Title page, contents and abstract only. The complete thesis in print form is available from the University Library.
Thesis (M.D.)--University of Adelaide, Dept. of Medicine, 1988
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Roberts-Thomson, Peter J. "Low molecular weight IgM in health and disease / by Peter John Roberts-Thomson." Thesis, 1987. http://hdl.handle.net/2440/38410.
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Penglis, Peter Savas. "The relationships between eicosanoid production and pro-inflammatory cytokines." Thesis, 2001. http://hdl.handle.net/2440/111707.
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Explores alternate strategies that may alter inflammatory cytokine production, particularly tumour necrosis factor α [tumor necrosis factor-alpha], and therefore provide a possible treatment for rheumatoid arthritis.Thesis (Ph.D.) -- University of Adelaide, Dept. of Medicine, 2001
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Shirazi, Aida. "Nutrient intake of women with rheumatoid arthritis before and after receiving arthritis medication." Thesis, 1996. http://hdl.handle.net/1957/27438.
Full textAbstract:
We examined the nutrient intake of women with rheumatoid arthritis
(RA) before and after initiation of treatment with arthritis medication.
Results of past (before taking arthritis medication) and present diets of RA
subjects were compared to the past and present diets of the non-RA group.
Subjects with RA were 19 women with a mean age of 65 ± 9 years who were
diagnosed with RA and were receiving arthritis medication on a regular
basis. The non-RA subjects were 19 women with a mean age of 57 ± 3
years who were apparently healthy and were not taking any prescription
medication. Both groups were interviewed to determine past and present
dietary nutrient intake by using the Health Habits and History food
frequency questionnaire (FFQ) developed by the National Cancer Institute.
Nutrient intake determined from 3-day dietary records and present diet
FFQs were comparable.
Total energy and fat in the past diets of the RA group were
significantly higher (p<0.05) than the past diets of the non-RA group.
Within each group there were significant reductions (p<0.05) between the
past and present mean dietary intakes of total energy, fat and protein.
There were no significant differences between the past and present
micronutrient intakes between or within the two groups. However, the
micronutrient content of the present diets of the RA group was lower in
calcium, iron, thiamin and riboflavin than the non-RA group as measured
by the number of subjects who had <67% of the RDA. There was a
significant (p<0.05) decrease in the mean daily consumption of the meat,
poultry, fish, eggs and bean group in both non-RA and RA groups. There
was also a significant (p<0.05) decrease in the mean daily consumption of
the fat, oil and sweets group among the RA subjects.
RA subjects were taking an average of 3±1 arthritis medications.
There were no significant correlations between the number of medications
taken by the RA group and their dietary nutrient intake. However, the
significant (p<0.05) decline in total energy intake by the RA group could
possibly be due to medication side effects. Since present total energy
intake was lower in both groups, these results could reflect the general
decline in energy intake with advancing age.
There were significant (p<0.05) differences between the past and
present self-reported weights of the non-RA and RA groups showing a
general reduction in weight over time in both groups. Mean body mass
indexes (BMI) for RA subjects was higher than the non-RA subjects',
possibly reflecting the lower activity level of the RA group.Graduation date: 1996
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Hodkinson, Bridget Dale. "Many hands that don't work: aspects of early rheumatoid arthritis." Thesis, 2013. http://hdl.handle.net/10539/12658.
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Objective:
This study prospectively investigated disease activity, functional disability and health-related quality of life (HRQoL ) in South Africans with early RA, and sought predictors of clinical response at 12 months to traditional disease modifying anti-rheumatic drugs (DMARD) treatment. In addition, the relationships between disease activity, circulating cytokines, the presence of auto-antibodies, the shared epitope (SE), and rheumatoid nodules (RN) were explored.
Methods:
A cohort of 171 patients with early (≤ 2 years) RA who were DMARD-naïve at inception were prospectively assessed for response to DMARDs over a 12-month period using the simplified disease activity index (SDAI), the Health Assessment Questionnaire-disability index (HAQ-DI) and the Short Form-36 (SF-36). At inception, rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibodies (aCCP) were measured and genomic DNA was analysed using high-resolution PCR typing of the HLA-DR1 allele. Circulating cytokines and growth factors were measured using the Bio-Plex® suspension array system.
Results:
The 171 patients (140 females) at baseline had a mean age of 47 years, mean symptom duration of 12 months and had severe disease with a mean SDAI of 39, HAQ of 1.7, and globally low SF-36 scores. In the 134 patients seen at 12 months, despite significant improvements, only 28% achieved low disease activity, and 69% still had substantial functional disability (HAQ-DI >0.5), and 66% had suboptimal mental health (SF-36 mental composite score <66.6). Baseline predictors of poor outcomes included unemployment, low level of schooling, female sex, high HAQ-DI and pain scores, and a low haemoglobin level. The 6-months SDAI was better than the baseline SDAI in predicting the 12-month SDAI.
The sensitivity and specificity of the aCCP test was 83%, and 85%, and the best specificity seen when both RF and aCCP were positive (95%). SE alleles were found in 92% of patients, and were strongly associated with aCCP, with disease activity and with proinflammatory cytokines. Circulating cytokines in RA reflect a multifaceted increase in immune reactivity with strong correlations between these cytokines, and auto-antibodies, in particular in the subgroup of patients with high disease activity. Subcutaneous RN were seen in 23% of patients, and were associated with more severe joint disease, and significantly higher levels of Th1 and macrophage derived cytokines, with significantly higher vascular endothelial growth factor levels.
Conclusions:
In this, the first prospective study of RA in sub-Saharan Africa, patients had severe RA, with a high disease burden at baseline and a high proportion carrying the SE allele, aCCP and rheumatoid nodules, with a multifaceted increase in circulating pro-inflammatory cytokines and growth factors. A large proportion of early RA patients have ongoing disease activity, substantial functional disability and suboptimal mental health despite 12 months of DMARD therapy. These findings, together with the high number of patients lost to follow-up, underscore the need for better disease control including an aggressive tight control strategy, and biologic therapy, and for patient- centred rehabilitation programmes with close links to psycho-social services.
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"Genetic associations of rheumatoid arthritis in Chinese." Thesis, 2011. http://library.cuhk.edu.hk/record=b6075400.
Full textAbstract:
Li, Martin.Thesis (Ph.D.)--Chinese University of Hong Kong, 2011.
Includes bibliographical references (leaves 187-208).
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Abstract also in Chinese.
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Lewitton, Bertha. "Body image and anxiety as prognostic indicators in rheumatoid arthritis." Thesis, 2014. http://hdl.handle.net/10210/9902.
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M.A. (Clinical Psychology)Rheumatoid arthritis, lithe great crippler" 1 has now established itself firmly in the category 'psychosomatic disease' and a psychosomatic approach is used when considering the aetiology of the disease and often the therapy and prognosis of the patient as well. The rehabilitation of the afflicted patient is the central concern of medical and para-medical personnel engaged in rheumatology. The patient's motivation for rehabilitation is generally considered to be the single most important factor affecting the rehabilitation process. The task of assessing this motivation falls to the psychologist...
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Naidoo, Pamela. "The effects of coping, social support, attribution and cognitive illness representation on outcome measures of pain, disability and psychological well-being in rheumatoid arthritis patients." Thesis, 2002. http://hdl.handle.net/10413/3104.
Full textAbstract:
This study investigates the psychosocial aspects of rheumatoid arthritis (RA),a chronic debilitating disease. It explores the quality of life in a low socio-economic group of clinic-based adult RA patients. The aims of the study were as follows: (1) to assess the impact of both socio-demographic and psychosocial factors on RA health outcome, (2) to develop a multivariate, predictive model for RA, and (3) to assess the moderating role (or stress-reducing function) of psychosocial factors between the objective experience of RA and the subjective experience of RA. A sample of 186 RA patients with a mean age of 49.51 years and a mean duration of RA of 10.80 years were subjected to a series of selfadministering questionnaires to assess their subjective experience of the disease. Coping, social support, causal attribution, cognitive illness representation, pain and functional status were assessed. The objective experience of RA was based on those health status measures that included the following: firstly, ESR levels (a laboratory measure), and secondly, class (classified level of disability) and joint status (severity of joint inflammation) which were assessed and recorded by the rheumatologist. The data obtained were subjected to a systematic statistical analysis to assess the following: (1) the relationships between the socio-demographic factors, psychosocial factors and factors representing RA health outcome using correlational analysis (Pearson r), (2) the value of socio-demograhic and psychosocial factors in predicting subjective and objective RA health outcomes using step-wise hierarchical multivariate regression analysis, and (3) the moderating or stress-reducing effect of psychosocial factors between the objective and subjective health status measures using moderated regression analysis. Findings revealed that psychological factors, especially coping, were more significant predictors than socio demographic factors of RA health outcome (quality of life of RA individuals). Furthermore, the psychosocial factors coping, network social support, helplessness and causal attribution were found to play a moderating role in RA health outcome. The results of the study confirm both the health-sustaining and the stress-reducing function of psychological factors. Theoretically this study is located within the stress and coping paradigm of Lazarus and Folkman (1984).Thesis (Ph.D.)-University of Natal, Pietermaritzburg, 2002.
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Van, Heerden Carlette. "The effect of aquatic therapy for rheumatoid and osteo arthritic sufferers." Thesis, 2012. http://hdl.handle.net/10210/5718.
Full textAbstract:
M.A.As compared with psychoanalytic and other psychotherapies, behaviour therapy appears to have three distinct advantages. First of all, the treatment approach is precise. The target behaviours to be modified are specified, the methods to be used are clearly delineated, and the results can be readily evaluated (Marks, 1982). Second, the use of explicit learning principles is a sound basis for effective interventions as a result of their demonstrated scientific validity (Kazdin & Wilson, 1978). Third, the economy of time and costs is quite good. Not surprisingly, then, the overall outcomes achieved with behaviour therapy compare favourably with those of other approaches (Smith, Glass & Miller, 1980). Behaviour therapy usually achieves results in a short period of time because it is generally directed to specific symptoms, leading to faster relief of an individual's distress and to lower financial costs. In addition, more people can be treated by a given therapist.
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Gerber, Roné. "Exploring the perceptions of women with rheumatoid arthritis of how their illness impacts their relationship with their intimate partner." Thesis, 2006. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_1162_1189160666.
Full textAbstract:
This study explored women's perceptions of how their illness (Rheumatoid Arthritis- RA) affects their relationship with their intimate life partner. RA is a chronic, inflammatory, auto-immune illnes, which mainly affects the synovial membranes of multiple joints. This highly inflammatory poly-arthritis may lead to joint destruction, chronic pain, deformity and loss of functioning as unfortunate outcomes of the established illness. RA affects key life domains such as psychological well-being, social well-being, family and couple relationships, employment, loss of independence and restrictions in daily functioning.