Rheumatoid Arthritis: Prost A

Berthelot JM, Bataille R, Maugars Y, Prost A. · Rheumatology Department, Nantes Teaching Hospital, France. · Rev Rhum Engl Ed. · Pubmed #10526382 No free full text.

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Berthelot JM, Huguet D, Gouin F, Letenneur J, Bertrand-Vasseur A, Moreau A, Lemaitre R, Maugars Y, Prost A. · Rheumatology Department, Nantes Teaching Hospital, France. · Rev Rhum Engl Ed. · Pubmed #10418067 No free full text.

Abstract: We report a case of recurrent multiple bursitis (19 episodes at nine sites) requiring seven surgical procedures in a European women with a 38-year history of severe, nodular, destructive seropositive rheumatoid arthritis unresponsive to second-line drugs. The episodes of bursitis were not correlated with activity of the joint disease. Some cysts migrated over a considerable distance. At least two cysts contained chylous fluid. The histologic study of one cyst demonstrated a cholesterol crystal granuloma. Potential relationships linking cholesterol crystals, chylous cysts, and migrating multiple bursitis are discussed. The relevant literature is reviewed.

Berthelot JM, Saraux A, Maugars Y, Prost A, Le Goff P. · Rheumatology Department, Brest Teaching Hospital, France. · Rev Rhum Engl Ed. · Pubmed #10339779 No free full text.

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Laborie Y, Berthelot JM, Alliaume C, Baron J, Caumon JP, Desmas V, Rossard A, Maugars Y, Prost A. · Rheumatology Department, Hôtel-Dieu, CHU Nantes, France. · Joint Bone Spine. · Pubmed #12027310 No free full text.

Abstract: OBJECTIVE: To determine the very long-term clinical and functional outcomes in rheumatoid arthritis (RA) patients followed by office-based or hospital-based physicians. PATIENTS AND METHODS: A questionnaire including items on clinical outcomes (active disease, remission, burn-out) and the Health Assessment Questionnaire (HAQ) was mailed to 122 patients with RA of at least 15 years' duration; 61 were followed by office-based physicians and 61 by hospital-based physicians. In the 88 (72%) respondents, mean age was 63 +/- 13 years and mean disease duration was 20.1 +/- 8.7 years. RESULTS; None of the patients experienced burn-out of their disease, and only six (7%) met Pinals' remission criteria. However, 23 (26%) reported a current subjective remission with a mean duration of 8.5 +/- 5.9 months. Although the mean pain score in the 88 patients was 4.1 +/- 2.3, only 50 (56%) patients reported a physician visit during the last 6 months. HAQ scores varied widely, the mean being 1.11 +/- 0.84. Forty (46%) patients had a history of arthroplasty (knee or hip in 29 (33%)). Of the 34 nonrespondents, seven had died (at a mean age of 74 years), and in four of these seven the cause of death was infection or immobility-related complications; in the 27 survivors, disease activity was considered minimal by the physicians or patients, 11 (41%) patients believed they were in remission, and mean time since the last physician visit was 3.9 years. Conclusion. Although burn-out within 20 years of RA onset seems exceedingly rare, clinical activity is milder than in early RA; over one-fourth of our patients believed they were in remission and over one half had not seen a physician during the last 6 months. Functional outcomes varied widely across patients but were acceptable overall, a result that is partly ascribable to the favorable effects of surgery. No differences in functional outcomes were found between patients followed by office-based physicians and those followed by hospital-based physicians.

Berthelot JM, Saraux A, Maugars Y, Prost A, Le Goff P. · Department of Rheumatology, Hôtel-Dieu, CHU Nantes, 44093, Nantes-Cedex 01, France. · Semin Arthritis Rheum. · Pubmed #11303308 No free full text.

Abstract: OBJECTIVE: To compare the conclusions of studies addressing the outcome of early-arthritis cohorts. METHODS: The methodologies of previous reports on early-arthritis cohorts were examined, and their results and conclusions were compared. RESULTS: Thirty-four reports on 23 cohorts of early arthritis were found. The methodology was poor in most studies, with numerous inclusion and exclusion biases, frequently short follow-up periods, and a lack of precision about the rationale for diagnosis. However, similar conclusions were reached on several points: a large number of cases of early arthritis remained undifferentiated and/or resolved spontaneously, about 80% of cases initially classified as undifferentiated or rheumatoid arthritis retained this diagnosis during follow-up, and the incidence of psoriatic arthritis in most studies was similar (2% to 4%). Conversely, there were striking discrepancies among studies concerning the frequency of crystal arthropathies (0% to 18%), spondyloarthropathy (1% to 33%) and rheumatoid arthritis (15% to 47%). CONCLUSIONS: There appears to be a lack of agreement among researchers about the nosology and/or taxonomy of many cases of mild arthritis, despite the existence of classification criteria. RELEVANCE: Recognition of cultural bias in the diagnosis of early arthritis could be a prerequisite for the optimization of new sets of criteria for the diagnosis of early rheumatoid arthritis and spondyloarthropathy.

Glémarec J, Guillot P, Laborie Y, Berthelot JM, Prost A, Maugars Y. · Rheumatology Department, Hôtel-Dieu Teaching Hospital, Nantes, France. · Joint Bone Spine. · Pubmed #10773969 No free full text.

Abstract: OBJECTIVES: To evaluate the overall efficacy in various disorders of glucocorticoid injection into the lateral atlantoaxial joints, performed via the posterior route under fluoroscopic control. METHODS: Retrospective study of 26 patients including 16 (19 injections) with mechanical disorders and ten (16 injections) with inflammatory disorders. RESULTS: The response rate was 69.3%, the mean pain scale score decrease was 52.3 +/- 40.1%, and the mean duration of pain relief was 8.1 +/- 11.8 months. All three parameters were significantly (P < 0.005) better in the subgroup with inflammatory disorders than in the subgroup with mechanical disorders (response rate, 100% vs 50%; pain scale score decrease, 80 +/- 27% vs 34.2 +/- 40%, and pain relief duration, 16.9 +/- 14.9 months vs 24.5 months). A single patient developed a side effect (moderately severe hypertension). CONCLUSION: Glucocorticoid injection into the lateral atlantoaxial joints is a valid treatment alternative in patients who fail to respond to conventional noninvasive therapy.

Berthelot JM, Glemarec J, Maugars Y, Prost A. · No affiliation provided · Rheumatology (Oxford). · Pubmed #12048303 links to  free full text

This publication has no abstract.