Rheumatology Commons^™

Biomechanical Loading As A Driver Of Synovial Neovascularization And Microvascular Dysfunction In Knee Osteoarthritis, Mckenzie Carter

Electronic Thesis and Dissertation Repository

Synovial inflammation and biomechanical loading are independent risk factors for knee osteoarthritis (OA). However, the relationship between inflammatory and biomechanical factors, specifically if increased biomechanical loading causes synovial inflammation in OA (mechanoinflammation), is not well understood. The purpose of this thesis was to explore the associations of knee load during walking with features of synovial inflammation in knee OA. The knee adduction moment magnitude was associated with increased synovial vascularization and perivascular edema. Synovial fluid from OA patients with high knee adduction moments promoted endothelial cell migration in vitro. Late-stage knee OA synovial fluid caused endothelial monolayer hyperpermeability in …

The Natural History Of Modic Changes - A 5- And 15-Year Follow-Up Study, Parnian Saremi

Electronic Thesis and Dissertation Repository

Modic changes (MCs), defined as bone marrow lesions adjacent to the vertebral endplate seen on MRI, have been associated with back pain. There are different types of MCs, with different histopathological correlates. This community-based study sample comprised 110 men from the Twin Spine Study, with baseline, 5-year, and 15-year follow-up MRIs. Following training and reliability testing, 1320 endplates (T12-S1) were evaluated for MC presence, type, and dimensions at each time point. Results demonstrated that Type 2 Modic Changes (MC2) were the most common type, with approximately half located at the two lowest disc levels. However, Type 1 Modic Changes (MC1) …

Joint Protection Programs For People With Hand Arthritis, Pavlos Bobos

Electronic Thesis and Dissertation Repository

The fact that Joint Protection Programs (JPP) can reduce pain and improve function is based on small, but definitive Randomized Controlled Trials (RCTs), conducted in the 1980s. However, changes over time in the nature of hand use, the rapid expansion of technology, and improvements in our understanding of health literacy mean that these programs are now outdated. Further, problems with adherence to JPP are well documented. The purpose of this thesis was 1) to conduct a scoping review to map all the available evidence around joint protection programs in published and unpublished studies 2) to evaluate the effectiveness of joint …

Viral Etiology Of Rheumatoid Arthritis, Fatima Kudaeva

Electronic Thesis and Dissertation Repository

Viruses can trigger rheumatoid arthritis (RA) or inflammatory arthritis (IA). Our study provides insight into etiology of RA/IA. We analyzed the evidence relating to the risk of RA after viral infections; estimated the distribution of IA onsets over time; quantified the effect of influenza on the risk of IA.

Results of systematic review and meta-analysis showed that the risk of RA/IA is increased after parvovirus B19 and chikungunya virus. There seems to be a risk of RA after chronic hepatitis C (HCV), but whether it is a true RA or HCV-associated arthritis is not clear.

We estimated the distribution of …

Methotrexate And Cardiovascular Events, Alpesh Shah

Electronic Thesis and Dissertation Repository

We conducted a systematic review and meta-analysis to assess the association of MTX with cardiovascular morbidity, cardiovascular mortality and all-cause mortality in patients with autoimmune disease. Our primary outcome was incident cardiovascular events. After screening 13,479 citations, we identified a total of 30 eligible studies. We synthesized adjusted risk estimates using a random effects model. MTX was significantly associated with a 25% reduction in cardiovascular events (pooled RR: 0.75, 95% CI: 0.65, 0.86, I²: 11%), a 55% reduction in cardiovascular mortality (0.45, 95% CI: 0.26, 0.80, I²: 33%) and a 40% reduction in all-cause mortality (0.60, …