Rheumatoid Arthritis: Morović-Vergles J

Babić-Naglić D, Laktasić N, Jajić Z, Anić B, Morović-Vergles J, Curković B, Anonymous00257. · Klinika za reumatske bolesti i rehabilitaciju Medicinskoga fakulteta Sveucilista u Zagrebu, KBC Zagreb, Kispatićeva 12, 10000 Zagreb. · Reumatizam. · Pubmed #18450273 No free full text.

Abstract: Spondyloarthritides (SpA) as a group are one of the most common rheumatic disorders with a predominant affection of the spine. Conventinal disease modifying antirheumatic drugs which are effective in rheumatoid arthritis have poor effect on spinal inflammation. Today there is confirmed efficacy ofbiologics in spondylitis. This therapy is expensive and potentially hazaradous. Croatian Society for Rheumatology set up recommendations for the use of TNF-alpha blockers in SpA. There are several important points to be considered before their use: diagnosis of Spa, duration and disease activity, previous therapy and it's efficacy, application and efficacy ofbiologics, contraindications and safety preacutions and finally a decision for continuous tretament with biologics.

Morović-Vergles J. · Zavod za klinicku imunologiju i reumatologiju, Klinika za unutarnje bolesti Klinicka bolnica "Dubrava", 10000 Zagreb. · Reumatizam. · Pubmed #19024280 No free full text.

Abstract: B cells play a critical role in the pathogenesis of rheumatoid arthritis. Recently, a number of biological agents that target B cells have been tested as therapies for these conditions. Of this group of agents, the first in clinical use has been rituximab, a chimeric monoclonal antibody that depletes B cells by binding to the CD20 cell-surface antigen. 25-40% of patients treated with a TNF inhibitor fail to achieve adequate response. A treatment response is inadequate if low disease activity or remission is not achieved. Treatment of patients with inadequate response to TNF inhibitors represents a challenge. What are the options? Switch to another anti-TNFalpha agent or initiate treatment with a biological agent with a different mechanism of action? In patients with persistent active disease despite anti-TNFalpha therapy, treatment with rituximab may be more effective than switching to another anti-TNFalpha.

Morović-Vergles J. · Zavod za klinicku imunologiju i reumatologiju, Klinika za unutarnje bolesti Klinicka bolnica "Dubrava", Avenija G. Suska 6, 10000 Zagreb. · Reumatizam. · Pubmed #19024275 No free full text.

Abstract: Rheumatoid arthritis (RA) is associated with an increased risk of cardiovascular disease. Traditional cardiovascular risk factors (including male sex, family history for cardiovascular disease, age, dyslipidaemia, arterial hypertension, diabetes mellitus, smoking and obesity) do not adequately account for the extent of cardiovascular disease in RA. The pathogenesis of accelerated atherosclerosis in RA is not celar. Increasing evidence suggests a key role of inflammation in the onset and progression of atherosclerosis. Endothelial dysfunction represents the earliest manifestation of atherosclerosis. Hypertension prevalence in patients with RA is higher than that in the general population, It is attributable risk to the development of future cardiovascular events. Despite its serious complications, control of hypertension is far from adequate in the general population and even more so in rheumatoid arthritis patients.

Curković B, Babić-Naglić D, Morović-Vergles J, Anić B, Grazio S. · Hrvatsko reumatolosko drustvo HLZ-a, Subićeva 9, 10000 Zagreb. · Reumatizam. · Pubmed #18450272 No free full text.

Abstract: Rheumatoid arthritis is a chronic, inflammatory disease with the prevalence about 1%. Rheumatoid arthritis is characterized with synovitis, erosive changes of the joints, pain and functional deficit. Etiology of the disease is unknown. In the pathogenesis of rheumatoid arthritis the key role have proinflammatory citokines, particularly, tumour necrosis factor (TNFalpha). TNFalpha blockers have documented, fast and continuous efficacy with generaly well accepted safety profile. Nowadays, TNFalpha antagonists are established drugs in early and late phase of rheumatoid arthritis. Prescription of TNFalpha antagonists is controlled, according local restrictions, regarding high costs of the therapy. On behalf of the Croatian Society for Rheumatology we propose recommendations for the TNFalpha antagonist therapy in rheumatoid arthritis.

Morović-Vergles J. · Zavod za klinicku imunologiju i reumatologiju, Klinika za unutarnje bolesti Klinicka bolnica "Dubrava", Av. G. Suska 6, 10000 Zagreb. · Reumatizam. · Pubmed #15554372 No free full text.

Abstract: Spondyloarthropathies constitute a cluster of interrelated and overlapping chronic inflammatory rheumatic diseases of unknown etiology that include ankylosing spondylitis, psoriatic arthritis, reactive arthritis, enteropathic arthritis and undifferentiated spondyloarthritis. These diseases are not associated with rheumatoid factor, they occur in genetically predisposed individuals and show a strong association with HLA-B27. The primary pathologic sites include the entheses, the sacroiliac joints and the axial skeleton with or without some nonarticular structures, such as the skin, eye, aortic valve, heart and kidney.

Morović-Vergles J. · Zavod za klinicku imunologiju i reumatologiju, Klinika za unutarnje bolesti Klinicka bolnica Dubrava, Av. G. Suska 6, 10000 Zagreb. · Reumatizam. · Pubmed #15098367 No free full text.

Abstract: Rheumatoid arthritis (RA) is a systemic inflammatory disease mainly characterized by synovitis and joint destruction. Etiology of RA is unknown. Although the impact of genetic factors is obvious, the genetic basis is not sufficient to explain the triggering of the immune insult. The dominant feature is inflammation, primary in synovium. The synovial membrane in RA becomes hyperplastic. There is an increased number of both type synoviocytes and is infiltrated with immune and inflammatory cells: particularly macrophages, B- and T-lymphocytes, plasma cells and dendritic cells. Increased levels of cytokines are present. Cytokines play a central role in the perpetuation of synovial inflammation. The persistence of the chronic inflammatory response in conjunction with ongoing joint destruction (is finding in many patients with RA despite the use of effective anti-inflammatory agents and disease-modifying drugs) probably appears as a direct result of the sustained recruitment, inappropriate retention and impaired apoptosis.

Morović-Vergles J, Galesić K, Seferović M, Skobić N. · Klinicku imunologiju i reumatologiju, Klinika za unutarnje bolesti, KB Dubrava, Zagreb. · Reumatizam. · Pubmed #12476751 No free full text.

Abstract: A 29-year old women with adult onset Still's disease (AOSD) was presented. On addmision to hospital the patient was febrile, with sore throat, arthralgia/arthritis and myalgia. The patient had lymphadenopathy on the neck, and laboratory findings showed leukocytosis with neutrophilia, accelarated erythrocyte sedimation rate (ESR), increased reactants of acute inflammation and normocytic anemia. During the diagnostic process, infectious, hematologic and neoplastic diseases were ruled out and the diagnosis of AOSD was made. The therapy with metilprednisolone 1 mg/kg of body weight was started. One month latter, the clinical status of the patient improved as well as laboratory findings. The dose of steroids was tappered to 16 mg per day. After 6 months of therapy, steroids were stopped and patient was followed further one year and she was free of symptoms of disease.

Curković B, Babić-Naglić D, Morović-Vergles J, Anić B, Grazio S. · Hrvatsko reumatolosko drustvo HLZ-a, Subićeva 9, 10000 Zagreb. · Reumatizam. · Pubmed #19024266 No free full text.

Abstract: Rheumatoid arthritis is a chronic, inflammatory disease with the prevalence about 1%. Rheumatoid arthritis is caracterized with synovitis, erosive changes of the joints, pain and functional deficit. Etiology is unknown. In the pathogenesis of rheumatoid arthritis the key role have proinflammatory citokines, particularly, tumour necrosis factor (TNFalpha). TNFalpha blockers have documented, fast and continuous efficacy with generally well accepted safety profile. Nowdays, TNFalpha antagonists are established drugs in early and late phase of rheumatoid arthritis. Prescription of TNFalpha antagonists is controlled, according local restrictions, regarding high costs of the therapy. On behalf of Croatian Society for Rheumatology we propose recommendations for the TNFalpha antagonist therapy in rheumatoid arthritis.

Morović-Vergles J, Martinović-Kaliterna D. · Zavod za klinicku imunologiju i reumatologiju, Klinika za unutarnje bolesti, Klinicka bolnica "Dubrava", Avenija G. Suska 6, 10000 Zagreb. · Reumatizam. · Pubmed #18351144 No free full text.

Abstract: Rheumatoid arthritis (RA) is a chronic, systemic disease. Female patients outnumber males in a ratio of 3:1. Cytokines and immune cells networks have been identified as important mediators in the pathogenesis and perpetuation of inflammation in RA. This information has been successfully used into the development of new and significantly more effective treatments, for example anticytokines agents. The goal in managing RA is to achieve remission. We report five patients with RA successfully treated with etanercept.

Vergles D, Culo IM, Durasević Z, Soldo-Juresa D, Galesić K, Morović-Vergles J. · Odjel za abdominalnu kirurgiju, Klinika za kirurgiju, Klinicka bolnica Dubrava, Avenija G. Suska 6, 10000 Zagreb. · Reumatizam. · Pubmed #17580546 No free full text.

Abstract: The presence of positive rheumatoid factor (RF) titer in a patient with rheumatoid arthritis (RA) is of clinical value because its presence tends to correlate with the development of extraarticular manifestations. There is a loose correlation with severity of disease and titer. Extraarticular manifestations includes vasculitis, pericarditis, subcutaneous nodules, pulmonary nodules or interstitial fibrosis, episcleritis and mononeuritis multiplex. The vasculitis is most frequently evidenced as skin infarctions/ulcerations and mononeuritis multiplex. We report a case of rheumatoid vasculitis in a 48 years old women with long history of RA, who developed vasculitis of distal arteries with gangrene of digits of upper and lower extremities.

Morović-Vergles J, Galesić K, Vergles D. · Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, Dubrava University Hospital, Zagreb, Croatia. · Ann Saudi Med. · Pubmed #17356312 No free full text.

This publication has no abstract.

Galesić K, Morović-Vergles J, Vergles D, Racić I, Horvatić I. · Odjel za nefrologiju, Zavod za klinicku imunologiju i reumatologiju, Klinika za unutarnje bolesti KB "Dubrava" * Av. G. Suska 6 * 10000 Zagreb. · Reumatizam. · Pubmed #15554367 No free full text.

Abstract: We report a case of hypokalaemic quadriparesis in 31-year old woman in whom the discovery of distal renal tubular acidosis led to the diagnosis of primary Sjögren's syndrome. Hypokalaemic paralysis as initial manifestation of primary Sjögren's syndrome is rare, but when it occurs it may precede symptoms of xerostomia and xerophthalmia. The diagnosis of primary Sjögren's syndrome should be considered in young women who present with progressive weakness, hypokalaemia and metabolic acidosis.

Morović-Vergles J. · Zavod za klinicku imunologiju i reumatologiju, Klinika za unutarnje bolesti Klinicka bolnica, Dubrava, Av. G. Suska 6, 10000 Zagreb. · Reumatizam. · Pubmed #15098376 No free full text.

Abstract: Cyclooxygenase-II (cox-II) selective inhibitors and other non-steroidal anti-inflammatory drugs (NSAIDs) are indicated for pain and stiffness in inflammatory rheumatoid arthritis. Rofecoxib have been shown to be associated with a reduced incidence of gastric erosions on endoscopy compared to standard NSAIDs in patients with arthritis. Many studies in acute pain management have been performed with rofecoxib. The dental pain model is a typical study design of severe acute pain. Onset of pain relief occurred within 45 minutes in single-dose studies of rofecoxib 50 mg in postoperative dental pain. Rofecoxib consistently demonstrated analgesic efficacy in a variety of moderate to severe pain models.