A majority of Brazilian patients with rheumatoid arthritis HLA-DRB1 alleles carry both the HLA-DRB1 shared epitope and anti-citrunillated peptide antibodies

The objective of the present study was to evaluate the contribution of the shared epitope (SE), the rheumatoid arthritis (RA) protection model, and the occurrence of anti-cyclic citrullinated peptide (anti-CCP) antibodies in RA patients from a genetically diverse population. One hundred and forty Brazilian RA patients and 161 matched controls were typed for HLA-DRB1 alleles using amplified DNA hybridized with sequence-specific oligonucleotide probes or primers. Patients were stratified according to the presence or absence of SE (DRB1*0401, *0404, *0405, *0101, *1001, and *1402), of the DERAA alleles (DRB1*0103, *0402, *1102, *1103, *1301, *1302, and *1304), and X (all other alleles). Anti-CCP antibodies were measured by ELISA. The combined frequency of SE-positive alleles was significantly greater (76.4 vs 23.6%, P < 0.0001) than the controls. The SE/SE and SE/X genotypes were over-represented (P < 0.0001, OR = 6.02) and DERAA/X was under-represented in RA patients (P < 0.001, OR = 0.49), whereas the frequencies of the SE/DERAA, X/X and X/DERAA genotypes were not significantly different from controls. The frequency of anti-CCP antibodies was higher in SE-positive patients than in SE-negative patients (64.6 vs 44.7%, P = 0.03; OR = 2.25). Although the Brazilian population is highly miscegenated, the results of this study support the findings observed in most genetically homogeneous populations with RA; however, they are not mutually exclusive but rather complementary. The participation of DRB1-DERAA alleles in protection against RA was also observed (OR = 0.4; 95%CI = 0.23-0.68).CNPqFAEP

Postural Control Parameters In Elderly Female Fallers And Non-fallers Diagnosed Or Not With Knee Osteoarthritis

Objectives: To compare stabilometric parameters of elderly female fallers and non-fallers associated or not with knee osteoarthritis (OA). Methods: Fifty-six elderly female fallers and non-fallers diagnosed or not with unilateral or bilateral knee OA were divided into the following groups: FOA (n = 10), elderly female fallers with knee OA; FNOA (n = 11), elderly female fallers without knee OA; NFOA (n = 14), elderly female non-fallers with knee OA; and NFNOA (n = 21), elderly female non-fallers without knee OA. For analyzing semi-static balance on a force platform with the elderly females standing, the following parameters were assessed in four conditions: center of pressure (COP), anterior-posterior and mediolateral displacements (APD and MLD, respectively); and COP anterior-posterior and mediolateral displacement velocities (APV and MLV, respectively). The following conditions were assessed: 1) standing on a firm wooden surface with eyes open (WSEO); 2) standing on a firm wooden surface with eyes closed (WSEC); 3) standing on a foam surface with eyes open (FSEO); 4) standing on a foam surface with eyes closed (FSEC). Results: The elderly females with knee OA showed greater APD in all four conditions assessed (P 0.05). Conclusions: Knee OA per se increases APD of the COP, while the history of falls, regardless of the presence of knee OA, hinders postural control in the ML direction. © 2012 Elsevier Editora Ltda.524512517Owings, T.M., Grabiner, M.D., Variability of step kinematics in young and older adults (2004) Gait Posture, 20 (1), pp. 26-29Brunt, D., Santos, V., Kim, H.D., Light, K., Levy, C., Initiation of movement from quiet stance: comparison of gait and stepping in elderly subjects of different levels of functional ability (2005) Gait Posture, 21 (3), pp. 297-302Oliveira, A.S., Fisioterapia aplicada aos idosos portadores de doenças reumáticas (2004) Fisioterapia Geriátrica: A prática de assistência ao idoso, , In: Rebelatto JR, Morelli JGS (eds.), Barueri: ManoleHanks, J., Levine, D., Condições reumáticas (2001) Manual de Reabilitação Geriátrica, , In: Kauffman TL (ed.), São Paulo: Ganabara KooganLustri, W.R., Morelli, J.G.S., Aspectos Biológicos do Envelhecimento (2004) Fisioterapia Geriátrica: A prática de assistência ao idoso, , In: Rebelatto JR, Morelli JGS (eds.), Barueri: ManoleHassan, B.S., Mockett, S., Doherty, M., Static postural sway, proprioception, and maximal voluntary quadriceps contraction in patients with knee osteoarthritis and normal control subjects (2001) Ann Rheum Dis, 60 (6), pp. 612-618Rao, S.S., Prevention of falls in older patients (2005) Am Fam Physician, 72 (1), pp. 81-88Cress, M.E., Buchner, D.M., Questad, K.A., Esselman, P.C., deLateur, B.J., Schwartz, R.S., Continuous-scale physical functional performance in healthy older adults: a validation study (1996) Arch Phys Med Rehabil, 77 (12), pp. 1243-1250Pajala, S., Era, P., Koskenvuo, M., Kaprio, J., Törmäkangas, T., Rantanen, T., Force platform balance measures as predictors of indoor and outdoor falls in community-dwelling women aged 63-76 years (2008) J Gerontol A Biol Sci Med Sci, 63 (2), pp. 171-178Shumway-Cook, A., Woollacott, M.H., Controle Motor - Teoria e aplicações práticas (2003), 2.ed. São Paulo: ManolePerracini, M.R., Flo, C.M., Funcionalidade e envelhecimento (2009), Rio de Janeiro: Guanabara KooganLord, S., Clark, R.D., Webster, I.W., Postural stability and associated physiological factors in a population of aged persons (1991) J Gerontol, 46 (3), pp. M69-M76Thapa, P.B., Gideon, P., Brockman, K.G., Fought, R.L., Ray, W.A., Clinical and biomechanical measures of balance as fall predictors in ambulatory nursing home residents (1996) J Gerontol A Biol Sci Med Sci, 51 (5), pp. M239-M246Rubenstein, L.Z., Robbins, A.S., Schulman, B.L., Rosado, J., Osterweil, D., Josephson, K.R., Falls and instability in the elderly (1988) J Am Geriatr Soc, 36 (3), pp. 266-278Abrahamová, D., Hlavacka, F., Age-related changes of human balance during quiet stance. 2008. (2008) Physiol Res, 57 (6), pp. 957-964Era, P., Sainio, P., Koskinen, S., Haavisto, P., Vaara, M., Aromaa, A., Postural balance in random sample of 7,979 subjects aged 30 years and over (2006) Gerontology, 52 (4), pp. 204-213Du Pasquier, R.A., Blanc, Y., Sinnreich, M., Landis, T., Burkhard, P., Vingerhoets, F.J., The effect of aging on postural stability: a cross sectional and longitudinal study (2003) Neurophysiol Clin, 33 (5), pp. 213-218Piirtola, M., Era, P., Force platform measurements as predictors of falls among older people - a review (2006) Gerontology, 52 (1), pp. 1-16Hammerman, D., Clinical implications of osteoarthritis and ageing (1995) Ann Rheum Dis, 54 (2), pp. 82-85Horak, F.B., Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls? (2006) Age Ageing, 35 (2 SUPPL.), pp. ii7-ii11Fitzgerald, G.K., Piva, S.R., Irrgang, J.J., Bouzubar, F., Starz, T.W., Quadriceps activation failure as a moderator of the relationship between quadriceps strength and physical function in individuals with knee osteoarthritis (2004) Arthritis Rheum, 51 (1), pp. 40-48Perracini, M.R., Ramos, L.R., Fatores associados a quedas em uma coorte de idosos residentes na comunidade (2002) Rev Saúde Pública, 36 (6), pp. 709-716Wegener, L., Kisner, C., Nichols, D., Static and dynamic balance responses in persons with bilateral knee osteoarthritis (1997) J Orthop Sports Phys Ther, 25 (1), pp. 13-18Hassan, B.S., Doherty, S.A., Mockett, S., Doherty, M., Effect of pain reduction on postural sway, with knee osteoarthritis proprioception and quadriceps strength in subjects with knee osteoarthritis (2002) Ann Rheum Dis, 61 (5), pp. 422-428Maki, B.E., Holliday, P.J., Topper, A.K., A prospective study of postural balance and risk of falling in an ambulatory and independent elderly population (1994) J Gerontol, 49 (2), pp. M72-M84Swanenburg, J., de Bruin, E.D., Uebelhart, D., Mulder, T., Falls prediction in elderly people: a 1-year prospective study (2010) Gait Posture, 31 (3), pp. 317-321Sinaki, M., Brey, R.H., Hughes, C.A., Larson, D.R., Kaufman, K.R., Balance disorder and increased risk of falls in osteoporosis and kyphosis: significance of kyphotic posture and muscle strength (2005) Osteoporos Int, 16 (8), pp. 1004-1010Jeka, J., Kiemel, T., Creath, R., Horak, F., Peterka, R., Controlling human upright posture: velocity information is more accurate than position or acceleration (2004) J Neurophysiol, 92 (4), pp. 2368-237

Interleukin-18, interleukin-12B and interferon-\u3b3 gene polymorphisms in Brazilian patients with rheumatoid arthritis: A pilot study

Polymorphisms in interleukin (IL)-18, IL-12 and interferon (IFN)-\u3b3 genes are associated with different levels of cytokines expression and have been associated with rheumatoid arthritis (RA). IL-18 +105 A/C, IL-12B +1188 A/C and IFN-\u3b3 +874 T/A polymorphisms were analyzed by restriction fragment length polymorphism-polymerase chain reaction (PCR) and amplification refractory mutation system PCR from 90 RA patients and 186 healthy individuals. There were significant differences to IL-18 +105 A/C polymorphism between the RA and control groups (odds ratio\u2009=\u20093.77; P\u2009<\u20090.0001). Individual carriers of the variant allele C had a 3.77-fold increased risk of for RA (P\u2009=\u20090.0032). No association was observed for IL-12B and IFN-\u3b3 polymorphisms. Our finds suggest a possible role for IL-18 polymorphism in the RA susceptibility in studied population

The extrapituitary prolactin promoter polymorphism is associated with rheumatoid arthritis and anti-CCP antibodies in Mexican population

Background and objective: Women with multiple sclerosis (MS) who intend to get pregnant are often advised to discontinue disease modifying therapy (DMT) prior to conception. This recommendation is not based on medical evidence and may interfere with disease control by immunomodulatory drugs. The present study was designed to help discuss the effect of DMT for MS on pregnancy and on disease course. Patients and methods: Retrospective data from 152 pregnancies of 132 women with MS were collected by the physician in charge of the case. All data were entered into a specific file for qualitative and quantitative statistical analysis. Results: From the total group of patients, 89 pregnancies occurred without any exposure to MS drugs, while 61 pregnancies occurred with at least eight weeks of exposure to MS immunomodulatory drugs. The rate of obstetric and neonatal complications was similar in both groups, except for the newborn weight and height which was smaller for mothers receiving medications. Mothers' post-delivery relapse rate and EDSS scores in the follow-up period were significantly higher in the absence of treatment. Conclusion: It is possible that, with further such supportive data, international guidelines on MS treatment in young women who intend to get pregnant may need to be revised. " 2012 Elsevier B.V.",,,,,,"10.1016/j.clineuro.2012.04.024",,,"http://hdl.handle.net/20.500.12104/45105","http://www.scopus.com/inward/record.url?eid=2-s2.0-84872295057&partnerID=40&md5=c20df0b7feedea45f4a1222a90afb6b2",,,,,,"2",,"Clinical Neurology and Neurosurgery",,"15

The effects of long-term exposure to disease-modifying drugs during pregnancy in multiple sclerosis

Background and objective: Women with multiple sclerosis (MS) who intend to get pregnant are often advised to discontinue disease modifying therapy (DMT) prior to conception. This recommendation is not based on medical evidence and may interfere with disease control by immunomodulatory drugs. The present study was designed to help discuss the effect of DMT for MS on pregnancy and on disease course. Patients and methods: Retrospective data from 152 pregnancies of 132 women with MS were collected by the physician in charge of the case. All data were entered into a specific file for qualitative and quantitative statistical analysis. Results: From the total group of patients, 89 pregnancies occurred without any exposure to MS drugs, while 61 pregnancies occurred with at least eight weeks of exposure to MS immunomodulatory drugs. The rate of obstetric and neonatal complications was similar in both groups, except for the newborn weight and height which was smaller for mothers receiving medications. Mothers' post-delivery relapse rate and EDSS scores in the follow-up period were significantly higher in the absence of treatment. Conclusion: It is possible that, with further such supportive data, international guidelines on MS treatment in young women who intend to get pregnant may need to be revised. © 2012 Elsevier B.V