The Experts below are selected from a list of 11613 Experts worldwide ranked by ideXlab platform
James J Nocton - One of the best experts on this subject based on the ideXlab platform.
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ophthalmologic examinations in children with Juvenile Rheumatoid Arthritis
Pediatrics, 2006Co-Authors: James Cassidy, Jane Kivlin, Carol Lindsley, James J NoctonAbstract:Unlike the joints, ocular involvement with Juvenile Rheumatoid Arthritis is most often asymptomatic; yet, the inflammation can cause serious morbidity with loss of vision. Scheduled slit-lamp examinations by an ophthalmologist at specific intervals can detect ocular disease early, and prompt treatment can prevent vision loss.
Thomas J. A. Lehman - One of the best experts on this subject based on the ideXlab platform.
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Update on the pathogenesis and treatment of systemic onset Juvenile Rheumatoid Arthritis.
Current Opinion in Rheumatology, 2005Co-Authors: Alexa Adams, Thomas J. A. LehmanAbstract:PURPOSE OF REVIEW Although systemic onset Juvenile Rheumatoid Arthritis accounts for only about 20% of most reported series, children with systemic onset Juvenile Rheumatoid Arthritis are often the most difficult to treat. Many children with persistent systemic onset Juvenile Rheumatoid Arthritis have marked physical and emotional disability as a result of both disease and treatment-related morbidities. This review highlights recent studies that better elucidate the etiopathogenesis of systemic onset Juvenile Rheumatoid Arthritis. New therapies derived from better understanding of cytokines, cytokine gene expression, and their complex interactions, which result in inflammation, are improving our ability to control active disease while reducing or reliance on corticosteroids. RECENT FINDINGS Recent advances in our understanding of the etiopathogenesis of systemic onset Juvenile Rheumatoid Arthritis have led to therapies that specifically target the cytokines found in abnormal quantities in children with active disease. Biologic agents that directly target interleukin-1a, interleukin-6, and tumor necrosis factor alpha are currently in use, and additional agents that modulate interleukin-18, myeloid-related proteins 8 and 14, natural killer cell function, and macrophage migration inhibitory factor production are under investigation. SUMMARY Anakinra, monoclonal antibody to interleukin-6 receptor, and thalidomide each have led to significant clinical improvement with fewer side effects than resulted when corticosteroids were the mainstay of therapy.
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Thalidomide therapy for recalcitrant systemic onset Juvenile Rheumatoid Arthritis.
The Journal of Pediatrics, 2002Co-Authors: Thomas J. A. Lehman, Kim H. Striegel, Karen OnelAbstract:Systemic onset Juvenile Rheumatoid Arthritis unresponsive to nonsteroidal anti-inflammatory drugs may be controlled with corticosteroids, but these drugs have significant side effects. We report 2 steroid-dependent children with systemic onset Juvenile Rheumatoid Arthritis who did not respond to multiple nonsteroidal anti-inflammatory drugs, methotrexate, azathioprine, cyclosporine, and etanercept. Both children had significant improvement with thalidomide therapy.
David L. Causey - One of the best experts on this subject based on the ideXlab platform.
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Psychological symptoms in chronic fatigue and Juvenile Rheumatoid Arthritis.
Pediatrics, 1999Co-Authors: Bryan D. Carter, William G. Kronenberger, Joseph F. Edwards, Gary S. Marshall, Kenneth N. Schikler, David L. CauseyAbstract:Objective. To determine if psychological morbidity in youth with chronic fatigue is caused by the stress of coping with a chronic illness. Study Design. Case–control study comparing pediatric patients with debilitating chronic fatigue and matched subjects with Juvenile Rheumatoid Arthritis, a chronic medical illness with similar functional sequelae. Setting. Pediatric Infectious Diseases Clinic and Juvenile Rheumatoid Arthritis Clinic of Kosair Children9s Hospital. Participants. Nineteen children and adolescents with debilitating chronic fatigue and 19 age- and sex-matched peers with Juvenile Rheumatoid Arthritis. Outcome. Structured Interview, Kaufman Brief Intelligence Test, Child Behavior Checklist, and Youth Self-Report. Results. Intellectual functioning on the Kaufman Brief Intelligence Test Composite was average (103, standard score) for both groups. Pediatric patients with chronic fatigue had higher levels of internalizing psychological distress than patients suffering from Juvenile Rheumatoid Arthritis, despite the fact that both groups had a similar pattern of decline in social and physical activities. Duration of illness did not explain the difference in psychological symptoms. Conclusions. Psychological factors may play a more active role in debilitating chronic fatigue in pediatric patients than can be explained by the stress of coping with a similar chronic, non–life-threatening illness.
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Psychological symptoms in chronic fatigue and Juvenile Rheumatoid Arthritis.
Pediatrics, 1999Co-Authors: Bryan D. Carter, William G. Kronenberger, Joseph F. Edwards, Gary S. Marshall, Kenneth N. Schikler, David L. CauseyAbstract:To determine if psychological morbidity in youth with chronic fatigue is caused by the stress of coping with a chronic illness. Case-control study comparing pediatric patients with debilitating chronic fatigue and matched subjects with Juvenile Rheumatoid Arthritis, a chronic medical illness with similar functional sequelae. Pediatric Infectious Diseases Clinic and Juvenile Rheumatoid Arthritis Clinic of Kosair Children's Hospital. Nineteen children and adolescents with debilitating chronic fatigue and 19 age- and sex-matched peers with Juvenile Rheumatoid Arthritis. Outcome. Structured Interview, Kaufman Brief Intelligence Test, Child Behavior Checklist, and Youth Self-Report. Intellectual functioning on the Kaufman Brief Intelligence Test Composite was average (103, standard score) for both groups. Pediatric patients with chronic fatigue had higher levels of internalizing psychological distress than patients suffering from Juvenile Rheumatoid Arthritis, despite the fact that both groups had a similar pattern of decline in social and physical activities. Duration of illness did not explain the difference in psychological symptoms. Psychological factors may play a more active role in debilitating chronic fatigue in pediatric patients than can be explained by the stress of coping with a similar chronic, non-life-threatening illness.
James Cassidy - One of the best experts on this subject based on the ideXlab platform.
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ophthalmologic examinations in children with Juvenile Rheumatoid Arthritis
Pediatrics, 2006Co-Authors: James Cassidy, Jane Kivlin, Carol Lindsley, James J NoctonAbstract:Unlike the joints, ocular involvement with Juvenile Rheumatoid Arthritis is most often asymptomatic; yet, the inflammation can cause serious morbidity with loss of vision. Scheduled slit-lamp examinations by an ophthalmologist at specific intervals can detect ocular disease early, and prompt treatment can prevent vision loss.
Stephen C Foster - One of the best experts on this subject based on the ideXlab platform.
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visual outcomes prognosticators in Juvenile Rheumatoid Arthritis associated uveitis
Ophthalmology, 1997Co-Authors: Reza Dana, Jesus Merayolloves, Debra A Schaumberg, Stephen C FosterAbstract:Abstract Purpose: The purpose of the study is to delineate the visual prognosticators in Juvenile Rheumatoid Arthritis-associated uveitis. Methods: The records of 43 patients with Juvenile Rheumatoid Arthritis-associated uveitis who were observed for at least 6 months were studied retrospectively. Bivariate and multivariate statistical models were applied to more than 40 parameters to determine the relative odds of visual rehabilitation among patients with each characteristic. Results: Thirty-seven (86%) patients were females and 6 (14%) males. The mean known age of uveitis onset was 13 years, with females having, on average, 4 years earlier onset of disease compared to males ( P = 0.04). Ninety-three percent had chronic, 5% had recurrent, and 2% had an acute monophasic disease course. Of the 76 affected eyes, 93% were nongranulomatous and 97% had iridocyclitis. The mean overall duration of uveitis was 146 months, with females suffering from a significantly longer duration of active disease than did males ( P P = 0.006), shorter duration of uveitis ( P = 0.007), older age at disease onset ( P = 0.02), and a shorter delay in presentation to a subspecialist ( P = 0.02) were associated significantly with visual acuity improvement. Visual acuity at presentation ( P = 0.001), use of systemic nonsteroidal anti-inflammatory drugs ( P = 0.01), older age at disease onset ( P = 0.02), absence of glaucomatous neuropathy ( P = 0.02), and male sex ( P = 0.03) were correlated strongly with a final visual acuity outcome of 20/40 or better. Conclusion: Juvenile Rheumatoid Arthritis-associated uveitis is a serious disease with a guarded visual prognosis. It is hoped that increased awareness of its prognosticators will lead to treatment and referral patterns that have the best chance of minimizing the likelihood of visual impairment in patients with Juvenile Rheumatoid Arthritis.
